Inflammatory Cytokines Response to Isometric Handgrip Exercise and the Effects of Duration and Intensity of the Isometric Effort in Prehypertensive Subjects

BACKGROUND Chronic low grade systemic inflammation has been identified as a major risk factor for chronic diseases. The potential for physical exercise to induce anti-inflammatory effect is now increasingly being explored but there is paucity of data regarding the effects isometric exercise on inflammatory cytokines. The objective of this study was to investigate the responses of selected inflammatory cytokines to isometric handgrip exercise and identify possible effects of intensity and duration of the isometric effort on these variables. CASE PRESENTATION: A total of one hundred and ninety two (N=192) sedentary pre-hypertensive subjects, aged between 30-50years were recruited into the study and randomly distributed into three groups of 64 subjects each. The subjects performed a 24 consecutive day’s isometric hand grip exercise at 30% Maximum Voluntary Contraction. At the end of the 24 days, the group one (GP1) discontinued with the exercise protocol while the group two (GP2) continued the exercise protocol for another 24 consecutive days and the group three (GP3) continued with the exercise protocol for another 24 consecutive days but at 50%MVC. The parameters used to assess for the inflammatory cytokine variables included interleukin 10, interleukin 6 and tumor necrotic factor. At the end of the study, there was an increase in the resting values of interleukin 10 across the three groups while the resting values of interleukin 6 and tumor necrotic factor reduced significantly across groups. CONCLUSIONS: The reductions noted in the pro-inflammatory cytokines and increase in the anti-inflammatory cytokines could have a positive impact in the management of chronic diseases. It was also found that increase in intensity and/or duration produced more proportionate effect.

Penerapan Isometric Handgrip Exercisedan Slow Deep Breathing Exercise Untuk Menurunkan Tekanan Darah

Hypertension is an increase in blood pressure with systolic above 140 mmHg and diastolic above 90 mmHg. One of the non-pharmacological methods to lower blood pressure is to do isometric handgrip exercise and slow deep breathing exercise. The purpose of this case study is to evaluate blood pressure by implementing isometric handgrip exercise and slow deep breathing exercise toward hypertensive patients within five day of training (twice per day). There were two hipertensive patients involvid in this study. The results of this case study showed that the blood pressure of both patients dropped to normal. The firt patients blood pressure dropped to normal from 160/100 mmHg to 130/80 mmHg after the intervention. Similarly, the second patients blood pressure reduced from 170/100 mmHg to 120/80 mmHg. This study conclusion that the isometric handgrip exercise and slow deep breathing exercise can lower blood pressure.Keywords: Hypertension; Isometric Handgrip; Slow Deep Breathing AbstrakHipertensi adalah peningkatan tekanan darah dengan sistolik diatas 140 mmHg dan diastolik diatas 90 mmHg.salah satu tindakan nonfarmakologi yang dapat menurunkan tekanan darah adalah dengan melakukan latihan isometric handgrip exercise dan slow deep breathing exercise. Tujuan dilakukannya penerapan studi kasus ini adalah untuk menurunkan tekanan darah dengan menggunakan latihan isometric handgrip exercise dan slow deep breathing exercise pada keluarga dengan hipertensi. Metode yang digunakan adalah dengan penerapan latihan isometric handgrip exercise dan slow deep breathing exercise. Hasil dari studi kasus ini menunjukkan adanya penurunan tekanan darah pada klien I dan II yang disertai dengan penurunan rasa nyeri, klien I dengan tekanan darah 160/100 mmHg turun menjadi 130/80 mmHg dan klien II dengan tekanan darah 170/100 mmHg turun menjadi 120/80 mmHg. Kesimpulan dari penerapan isometric handgrip exercise dan slow deep breathing exercise adalah bahwa penerapan latihan isometric handgrip exercise dan slow deep breathing exercise dapat menurunkan tekanan darah selama 5 hari latihan dengan 2 kali pertemuan setiap harinya.Kata kunci: Hipertensi; Isometric Handgrip; Slow Deep Breathing

The effect of extracellular hyperosmolality on sweat rate during metaboreflex activation in passively heated young men

Metaboreflex activation augments sweating during mild-to-moderate hyperthermia in euhydrated (isosmotic isovolemic) individuals. Recent work indicates that extracellular hyperosmolality may augment metaboreflex-mediated elevations in sympathetic nervous activity. Our primary objective was therefore to test the hypothesis that extracellular hyperosmolality would exacerbate metaboreflex-mediated increases in sweat rate. On two separate occasions, 12 young men (mean (SD): 25 (5) years) received a 90-min intravenous infusion of either 0.9% saline (isosmotic condition, ISO) or 3.0% saline (hyperosmotic condition, HYP), resulting in a post-infusion serum osmolality of 290 (3) and 301 (7) mOsm/kg, respectively. A whole-body water perfusion suit was then used to increase esophageal temperature by 0.8°C above resting. Participants then performed a metaboreflex activation protocol consisting of 90 s isometric handgrip exercise (40% of their pre-determined maximum voluntary contraction), followed by 150 s of brachial occlusion (trapping produced metabolites within the limb). Metaboreflex-induced sweating was quantified as the change in global sweat rate (from pre-isometric handgrip exercise to brachial occlusion), estimated as the surface area-weighted average of local sweat rate on the abdomen, axilla, chest, bicep, quadriceps, and calf, measured using ventilated capsules (3.8 cm2). We also explored whether this response differed between body regions. The change in global sweat rate due to metaboreflex activation was significantly greater in HYP compared to ISO (0.03 mg/min/cm2 [95% confidence interval: 0.00, 0.06]; p=0.047), but was not modulated by body region (site*condition interaction: p=0.679). These findings indicate that extracellular hyperosmolality augments metaboreflex-induced increases in global sweat rate, with no evidence for region-specific differences.

An open-source application for the standardized burst identification from the integrated muscle sympathetic neurogram.

Muscle sympathetic nerve activity (MSNA) can be acquired from humans using the technique of microneurography. The resulting integrated neurogram displays pulse-synchronous bursts of sympathetic activity which undergoes processing for standard MSNA metrics including burst frequency, height, area, incidence, total activity and latency. The procedure for detecting bursts of MSNA and calculating burst metrics is tedious and differs widely amongst laboratories world-wide. We sought to develop an open-source, cross-platform web application that provides a standardized approach for burst identification and a tool to increase research reproducibility for those measuring MSNA. We compared the performance of this web application against a manual scoring approach under conditions of rest, chemoreflex activation (N = 9, 20 min isocapnic hypoxia), and metaboreflex activation (N = 13, 2 min isometric handgrip exercise and 4 min post exercise circulatory occlusion). The intraclass correlation coefficient (ICC) indicated good to strong agreement between scoring approaches for burst frequency (ICC = 0.92 - 0.99), incidence (ICC = 0.94 - 0.99), height (ICC = 0.76 - 0.88), total activity (ICC = 0.85 - 0.99), and latency (ICC = 0.97 - 0.99). Agreement with burst area was poor to moderate (ICC = 0.04 - 0.67) but changes in burst area were similar with chemoreflex and metaboreflex activation. Scoring using the web application was highly efficient and provided data visualization tools which expedited data processing and the analysis of MSNA. We recommend the open-source web application be adopted by the community for the analysis of MSNA.

Systematic Review: Isometric Handgrip Exercise In Elderly With Hypertension

Tujuan systematic review ini untuk mengetahui pengaruh isometric handgrip exercise (IHE) pada lanjuat usia yang mengalami hipertensi agar dapat diaplikasikan sebagai evidence-based practice (EBP) pada lansia dengan hipertensi di Panti Wredha Muhammadiyah Rancabolang, Kota Bandung. Metode penelitian menggunakan Critical Appraisal Skills Programme (CASP) Systematic Review yang terdiri dari 11 daftar pertanyaan. Pembuatan rumusan pertanyaan klinis menggunakan format PICOT. Hasil systematic review diperoleh sebanyak 4 bukti penelitian, dengan 2 bukti memiliki level of evidence 2 karena menggunakan desain studi randomized controlled trial (RCT). 2 bukti lainnya memiliki level of evidence 3 karena menggunakan desain studi quasi experiment. IHE dapat dilakukan secara rutin oleh lansia dengan hipertensi di Panti ini. Hal tersebut dilakukan sebagai upaya untuk mengendalikan hipertensi dan diperlukan jadwal bersama agar semua lansia dapat teratur melakukan IHE ini. Keuntungan melakukan IHE dalam waktu yang pendek secara kontinyu selama 2 menit dapat menyebabkan tekanan darah dan denyut jantung mencapai nilai yang stabil, tidak berisiko terjadi cedera, dan teknik yang dilakukan cukup mudah. IHE dapat dilakukan di mana saja, dan hanya memerlukan alat sederhana seperti menggunakan alat berbentuk bola dengan konsistensi kenyal agar bisa ditekan-tekan oleh lansia dengan hipertensi. Bahkan dapat dilakukan tanpa alat sehingga memudahkan penderita hipertensi untuk melakukan IHE tersebut.