BACKGROUND: First-Episode Psychosis (FEP) is a devastating mental health condition that commonly emerges during early adulthood, and is characterised by a disconnect in perceptions of reality. Current evidence suggests that inflammation and perturbed immune responses are involved in the pathology of FEP and may be associated specifically with negative symptoms. Exercise training is a potent anti-inflammatory stimulus that can reduce persistent inflammation, and can improve mood profiles in general populations. Therefore, exercise may represent a novel adjunct therapy for FEP. The aim of this study was to assess the effect of exercise on biomarkers of inflammation, negative symptoms of psychosis, and physiological health markers in FEP.
METHODS: Seventeen young males (26.67 ± 6.64 years) were recruited from Birmingham Early Intervention in Psychosis Services and randomised to a 6-week exercise programme consisting of two-to-three sessions per week that targeted 60-70 % heart-rate max (HRMax), or a treatment as usual (TAU) condition. Immune T-helper (Th-) cell phenotypes and cytokines, symptom severity, functional wellbeing, and cognition were assessed before and after 6-weeks of regular exercise.
RESULTS: Participants in the exercise group (n = 10) achieved 81.11 % attendance to the intervention, with an average exercise intensity of 67.54 % ± 7.75 % HRMax. This led to favourable changes in immune cell phenotypes, and a significant reduction in the Th1:Th2 ratio (-3.86 %) compared to the TAU group (p = 0.014). After the exercise intervention, there was also a significant reduction in plasma IL-6 concentration (-22.17 %) when compared to the TAU group (p = 0.006). IL-8, and IL-10 did not show statistically significant differences between the groups after exercise. Symptomatically, there was a significant reduction in negative symptoms after exercise (-13.54 %, Positive and Negative Syndrome Scale, (PANSS) Negative) when compared to the TAU group (p = 0.008). There were no significant change in positive or general symptoms, functional outcomes, or cognition (all p > 0.05).
CONCLUSIONS: Regular moderate-to-vigorous physical activity is feasible and attainable in clinical populations. Exercise represents a physiological tool that is capable of causing significant inflammatory biomarker change and concomitant symptom improvements in FEP cohorts, and may be useful for treatment of symptom profiles that are not targeted by currently prescribed antipsychotic medication.

There have been few investigations into the effectiveness of thoracic spine exercises for improving thoracic range of motion (ROM) in any plane. This study assessed the effectiveness of two thoracic spine exercises: one in the quadruped position and one in the thoracic standing position. We determined how these exercises affect thoracic spine mobility ROM over a 2-week intervention period. Thirty-nine healthy participants were enrolled and assigned to a Quadruped Thoracic Rotation group (n=17 participants: 9 females and 8 males) or Flamenco Thoracic Spine Rotation group (n=22: 14 females and 8 males). All participants were administered a KOJI AWARENESSTM screening test, and the initial thoracic spine ROM before intervention exercise was measured in a laboratory setting. Quadruped Thoracic Rotation was performed as the quadruped exercise and Flamenco Thoracic Spine Rotation as the standing exercise. The KOJI AWARENESSTM thoracic spine test and ROM were evaluated on the day after the first exercise session and again after the program. Despite their different approaches to thoracic mobility, the quadruped exercise and standing exercise achieved equivalent improvement in thoracic ROM after 2 weeks. Practitioners have a range of exercise options for enhancing thoracic mobility based on their environmental or task-specific needs.

Objectives: The objective of the study was to carry out an analysis of the methodological quality of clinical trials (effects of exercise on frailty in older people) based on ACSM recommendations. Methods: The search scope included PubMed, Embase, Web of Science, Cochrane, and literature that cannot be retrieved from the database. The topic was the impact of exercise on frailty in elderly people. Changes in five outcome measures (FP, BI, SPPB, GS, and BMI) were assessed using mean differences (MD) and 95% confidence intervals (95% CI). A random effects model (RE) was used to conduct a meta-analysis and compare the results between subgroups. Results: The intervention effects of exercise on the five outcome indicators of frailty in elderly people were all significant (p < 0.05). The effect of a high-consistency subgroup on outcome indicators FP and GS was more significant than that of the low- or uncertain-consistency subgroup (MD: -1.09 < -0.11, MD: 2.39 >1.1). There was no significant difference in the intervention effect as reflected in the outcome measures SPPB and BMI in the high-consistency subgroup (p = 0.07, p = 0.34). There was no significant difference in the impact of the intervention on the outcome measure BI between the two subgroups (p = 0.06, p = 0.14). Conclusions: Exercise prescriptions with high consistency with ACSM recommendations may be more effective in both FP and GS interventions than those with uncertain or low consistency. However, it is essential to note that the data derived from the meta-analysis is still subject to the small number of studies, the unknown degree of consistency of participants in individual studies, and the different mix of cases in the studies.

Despite the rapidly emerging evidence on the contributions of physical activity to improving cancer-related health outcomes, adherence to physical activity among young adults with lymphoma remains suboptimal. Guided by self-determination theory (SDT), the Lymfit intervention (a 12-week individualized exercise program with bi-weekly kinesiologist support and an activity tracker) aimed to foster autonomous motivation toward physical activity. This pilot randomized controlled trial aimed to evaluate the feasibility, acceptability, and preliminary effects of Lymfit. Young adults (N = 26; mean age of 32.1 years) with lymphoma who were newly diagnosed and those up to six months after completing treatment were recruited and randomly assigned one-to-one to either the intervention group (n = 13) or a wait-list control group (n = 13). All a priori feasibility benchmarks were met, confirming the feasibility of the study in terms of recruitment uptake, retention, questionnaire completion, intervention fidelity, missing data, Fitbit wear adherence, and control group design. The intervention acceptability assessment showed high ratings, with eight out of ten items receiving >80% high ratings. At post-intervention, an analysis of covariance models showed a clinically significant increase in self-reported physical activity levels, psychological need satisfaction, and exercise motivation in the intervention group compared to controls. Lymfit also led to meaningful changes in six quality-of-life domains in the intervention group, including anxiety, depression, fatigue, sleep disturbance, social roles and activities, and pain interference. The findings support Lymfit as a promising means to meet psychological needs and increase the autonomous motivation for physical activity in this group. A fully powered efficacy trial is warranted to assess the validity of these findings.

BACKGROUND: Persons with Parkinson\'s disease (PwPD) suffer from motor and non-motor symptoms which significantly affect their quality of life (QoL), and the QoL of their care partners (CP). Tandem cycling reduces PwPD motor symptoms; however, no studies have examined other benefits or included PwPD CP. We conducted an 8-week community virtual reality (VR) tandem cycling intervention to assess the feasibility and efficacy for PwPD and their CP (i.e., PD dyads). We hypothesized that dyadic tandem cycling would improve (1) PwPD motor and non-motor symptoms and (2) dimensions of PD dyads\' QoL and physiologic health.
METHODS: Ten PD dyads were recruited to complete 8 weeks of progressive intensity, bi-weekly tandem cycling. At pre- and post-testing, PwPD were assessed using the Movement Disorder Society-Unified Parkinson\'s Disease Rating Scale-III (MDS-UPDRS-III), functional gait assessment (FGA), and 10-m gait speed test. PD dyads also completed emotional and cognitive status questionnaires [e.g., Geriatric Depression Scale-Short Form (GDS-SF)], and wore BodyGuard 2 heart rate (HR) monitors for 48 h to assess surrogate measures of heart rate variability. Statistical analyses were conducted using Student\'s t tests with significance set at p ≤ 0.05.
RESULTS: Eight PD dyads and one PwPD completed the intervention. Retention of PwPD (90%) and CP (80%) was adequate, and PD dyad adherence ranged from 91.67 to 97.91%. PwPD demonstrated significant clinical improvements in MDS-UPDRS-III scores (- 7.38, p < 0.01), FGA scores (+ 3.50, p < 0.01), and 10-m gait speed times (+ 0.27 m/s, p < 0.01), in addition to significant self-reported improvements in mobility (- 13.61, p = 0.02), fatigue (- 5.99, p = 0.02), and social participation (+ 4.69, p < 0.01). CP depressive symptoms significantly decreased (- 0.88, p = 0.02), and PD dyads shared a significant increase in root mean square of the successive differences (RMSSD; p = 0.04).
CONCLUSIONS: Our pilot study demonstrated feasibility and multiple areas of efficacy supporting further investigation of community VR tandem cycling as a therapeutic intervention for PD dyads.

OBJECTIVE: This study aimed to assess the impact of moderate resistance training on intermuscular adipose tissue (IMAT) in elderly patients with type 2 diabetes and the independent effect of IMAT reduction on metabolic outcomes.
METHODS: In this randomized controlled trial, 85 patients with type 2 diabetes were assigned to either the resistance training group (42 participants) or the control group (43 participants) for a 6-month intervention. The primary outcome was changes in IMAT measured by computed tomography scan and magnetic resonance imaging using the interactive decomposition of water and fat with echo asymmetry and least squares qualification sequence. Secondary outcomes included changes in metabolic parameters.
RESULTS: Thirty-seven participants in each group completed the study. The IMAT area (measured by a computed tomography scan) in the resistance group decreased from 5.176 ± 1.249 cm2 to 4.660 ± 1.147 cm2, which is a change of -0.512 ± 0.115 cm2, representing a 9.89% decrease from the least-squares adjusted mean at baseline, which was significantly different from that of the control group (a change of 0.587 ± 0.115 cm2, a 10.34% increase). The normal attenuation muscle area (representing normal muscle density) in the resistance group increased from 82.113 ± 8.776 cm2 to 83.054 ± 8.761 cm2, a change of 1.049 ± 0.416 cm2, a 1.3% increase, which was significantly different from that of the control group (a change of -1.113 ± 0.416 cm2, a 1.41% decrease). Homeostasis model assessment 2 of beta cell function (HOMA2-β; increased from 52.291 ± 24.765 to 56.368 ± 21.630, a change of 4.135 ± 1.910, a 7.91% increase from baseline) and ratio of insulin increase to blood glucose increase at 30 min after the oral glucose tolerance test (∆I30/∆G30; increased from 4.616 ± 1.653 to 5.302 ± 2.264, a change of 0.715 ± 0.262, a 15.49% increase) in the resistance group were significantly improved compared with those in the control group, which had a change of -3.457 ± 1.910, a 6.05% decrease in HOMA2-β, and a change of -0.195 ± 0.262, a 3.87% decrease in ∆I30/∆G30, respectively. Adjusting for sex, age, diabetes duration, baseline IMAT, and the dependent variable at baseline, linear regression showed that the change in IMAT area was not related to the change in HOMA2 insulin resistance (β = -0.178, p = .402) or the change in HOMA2-β (β = -1.891, p = .197), but was significantly related to the changes in ∆I30/∆G30 (β = -0.439, p = .047), 2-h postprandial glucose (β = 1.321, p = .026), diastolic blood pressure (β = 2.425, p = .018), normal attenuation muscle area (β = -0.907, p = .019) and 10-year risk of atherosclerotic cardiovascular disease (β = 0.976, p = .002).
CONCLUSIONS: Low-level, moderate resistance training reduces IMAT content. Even a small reduction in IMAT may be related to a decrease in risk factors for atherosclerotic cardiovascular disease, but this small reduction may not be sufficient to reduce insulin resistance.

BACKGROUND: The purpose of this study was to investigate the effectiveness of a corrective exercise program on workers\' productivity with Upper Crossed Syndrome (UCS).
METHODS: We used Randomized Controlled Trial (RCT) with parallel groups, double-blind, randomized. The participants were workers recruited at a company of Markazi Province that 23 persons in test group and 25 in control group participated. Before and after the intervention, work productivity and activity impairment was measured by the WPAI-GH questionnaire. In addition, angles of FH and RS were measured by Goniometer, and kyphosis angle was measured by a flexible ruler. The exercise program consisted of stretching, strengthening, and stabilization exercises, conducted three times a week for eight weeks. The primary outcome was work productivity and activity impairment, and the secondary outcomes were FH, RS, and KY. All primary and secondary outcomes were measured before the interventions, one week after intervention.
RESULTS: Results revealed significant differences for KY (MD = 3.84, 95% CI: 0.75,6.94, p = 0.017), RS (MD = -1.83, 95% CI: -2.88, -0.88, p = 0.001), and FH (MD = 3.01, 95% CI: 1.98,4.04, p = 0.001) before and after the intervention. In addition, within-group differences showed a significant difference in work time missed (MD = -2.60, CI: -4.84, -0.37, p = 0.003**), and overall work productivity loss (MD = -2.02, CI: -3.78, -0.26, p = 0.013**) in exercise group. However, there were no significant effects on impairment at work and activity.
CONCLUSIONS: Since significant differences were detected in a selective exercise program on productivity, a continuous exercise program for more than 8-week could be effective in managing productivity and increasing practical working hours.

BACKGROUND: Maternal obesity (MO) has been shown to adversely affect metabolic, oxidative, reproductive, and cognitive function in offspring. However, it is unclear whether lifestyle modification can ameliorate the metabolic and organ dysfunction programmed by MO and prevent the effects of metabolic syndrome in adulthood. This study aimed to evaluate whether moderate voluntary exercise in the offspring of rats born to obese mothers can ameliorate the adverse effects of MO programming on metabolism and liver function in mid-adulthood.
METHODS: Offspring of control (CF1) and MOF1 mothers were fed with a control diet from weaning. Adult males and females participated in 15 min exercise sessions five days/week. Metabolic parameters were analyzed before and after the exercise intervention. Liver oxidative stress biomarkers and antioxidant enzymes were analyzed before and after the intervention.
RESULTS: Males showed that CF1ex ran more than MOF1ex and increased the distance covered. In contrast, females in both groups ran similar distances and remained constant but ran more distance than males. At PND 300 and 450, male and female MOF1 had higher leptin, triglycerides, insulin, and HOMA-IR levels than CF1. However, male MOF1ex had lower triglycerides, insulin, and HOMA-IR levels than MOF1. Improvements in liver fat and antioxidant enzymes were observed in CF1ex and MOF1ex males and females compared to their respective CF1 and MOF1 groups.
CONCLUSIONS: These findings suggest that moderate voluntary exercise, even when started in mid-adulthood, can improve metabolic outcomes and delay accelerated metabolic aging in MO-programmed rats in a sex-dependent manner.

OBJECTIVE: This study aims to investigate the impact of four exercise modes (aerobic exercise, resistance exercise, aerobic combined with resistance multimodal exercise, and stretching) on the physical performance of cancer patients.
METHODS: Randomized controlled trials (RCTs) were exclusively collected from PubMed, EMBASE, Web of Science, and The Cochrane Library, with a search deadline of April 30, 2023. Different exercise interventions on the physical performance of cancer patients were studied, and the Cochrane risk of bias assessment tool was employed to evaluate the quality of the included literature. Data analysis was conducted using STATA 15.1 software.
RESULTS: This study included ten randomized controlled trials with a combined sample size of 503 participants. Network meta-analysis results revealed that aerobic combined with resistance multimodal exercise could reduce fat mass in cancer patients (SUCRA: 92.3%). Resistance exercise could improve lean mass in cancer patients (SUCRA: 95.7%). Furthermore, resistance exercise could enhance leg extension functionality in cancer patients with sarcopenia (SUCRA: 83.0%).
CONCLUSIONS: This study suggests that resistance exercise may be more beneficial for cancer-related sarcopenia.In clinical practice, exercise interventions should be tailored to the individual patients\' circumstances.
BACKGROUND: This review was registered on INPLASY2023110025; DOI number is https://doi.org/10.37766/inplasy2023.11.0025 .

OBJECTIVE: To investigate the effect of Self-designed Metabolic Equivalent Exercises (SMEE) on cancer-related fatigue in patients with gastric cancer.
METHODS: 130 patients with gastric cancer admitted to Department of Oncology of a tertiary hospital in Shanghai were enrolled and assessed for eligibility. After excluding 1 patient who declined to participate, 129 eligible patients were randomly assigned into SMEE (n = 65) and control (n = 64) groups. The Revised Piper Fatigue Scale (RPFS) and EORTC QLQ-C30 Quality of Life Scale were used to measure cancer-caused fatigue and quality of life, respectively, in both groups at the first admission and after 3 months.
RESULTS: After excluding patients who did not receive allocated intervention due to medical (n = 3) and personal (n = 2) reasons, those who were lost to follow-up (n = 3), and those who had discontinued intervention (n = 2), 119 patients (64 in the SMEE group and 55 in the control group) were included for analysis. There were no statistically significant differences in the RPFS or QLQ-C30 score between the two groups at baseline. After 3 months, the total RPFS score of the SMEE group was significantly lower than that of the control group (2.86 ± 1.75 vs. 4.65 ± 1.29, p = 0.009), with significant improvements in affective meaning (0.83 ± 0.92 vs. 1.13 ± 0.77, p = 0.044) and sensory (0.70 ± 0.71 vs. 1.00 ± 0.54, p < 0.001) subscales; in the SMEE group, QLQ-C30 scores in somatic (2.00 ± 0.27 vs. 1.31 ± 0.26, p < 0.001), emotional (2.67 ± 0.58 vs. 2.07 ± 0.48, p < 0.001), and social (3.23 ± 0.58 vs. 1.64 ± 0.51, p < 0.001) functioning were significantly higher than those in the control group, with significant improvements in fatigue (p < 0.001), nausea/vomiting (p = 0.014), shortness of breath (p < 0.001), constipation (p < 0.001), and diarrhea (p = 0.001) dimensions.
CONCLUSIONS: The self-programmed metabolic equivalent manipulation as an exercise intervention could effectively reduce the degree of cancer-caused fatigue and improve quality of life in patients with gastric cancer.