Volume 3, Issue 1

Objectives The incidence of ischemic stroke continues to rise globally, however, regular physical activity before stroke onset significantly lowers its occurrence. Here, we evaluated whether low-intensity exercise preconditioning can improve neurological outcome, cerebral micro-angiogenesis, and neuronal injury in mice subjected to ischemic stroke. Methods 12-week-old C57BL/6J male mice were assigned to three groups: Sham group, transient middle cerebral artery occlusion (tMCAO group), and exercise preconditioning and tMCAO (Ex+tMCAO group). Ex+tMCAO group were underwent 4 weeks of low-intensity treadmill preconditioning for 5 days a week for 4 weeks (running speed, 10  m/min; running duration, 1 h/day) before ischemic stroke surgery. Behavioral tests were assessed 24 h after ischemic stroke to verify the effects of exercise preconditioning on acute recovery following ischemic stroke. Various techniques were used to evaluate ischemic infarct size and explore pathological changes in tissue morphology after ischemic stroke. In addition, to detect whether exercise preconditioning influenced levels of inflammatory cytokines, real-time PCR was performed on the infarcted brain tissues. Results Low-intensity exercise preconditioning significantly reduced infarct size, increased cerebral microvascular density, and ameliorated neuronal apoptosis induced by tMCAO. Moreover, the apoptosis evoked by tMCAO was reversed by exercise preconditioning, which also down-regulated the inflammatory cytokines IL-6, CCL11, CCL2, CXCL1, and Fosl1. Conclusions Low-intensity treadmill exercise preconditioning mitigates ischemic stroke injury in mice.

Objectives This randomized controlled pilot study aimed to investigate the therapeutic effects of Baduanjin exercise – a traditional Chinese mind-body practice integrating gentle movements, diaphragmatic breathing, and mindfulness – on alleviating aromatase inhibitor-induced menopausal symptoms, reducing cancer-related fatigue, and modulating systemic inflammatory markers (IL-6, IL-1β, TNF-α) in breast cancer patients. Methods 70 patients undergoing aromatase inhibitor therapy were recruited from Guangdong General Hospital and randomly assigned to either a Baduanjin exercise group (n=35) or a usual-care control group (n=35). The Baduanjin exercise group completed a supervised 12-week Baduanjin exercise regimen (three sessions weekly, 90 min/session), while controls maintained habitual activity. Menopausal symptoms were assessed using the Kupperman Index, fatigue severity via the Piper Fatigue Scale, and serum inflammatory markers (IL-6, IL-1β, TNF-α) through enzyme-linked immunosorbent assays at baseline and post-intervention. Results 39 participants (55.7 %) completed the trial (intervention: n=24; control: n=15). The Baduanjin exercise group demonstrated significant reductions in arthralgia severity (p<0.05) and fatigue subdomains (affective: p<0.05; cognitive/mood: p<0.05) compared to controls. Notably, IL-6 levels increased significantly in the Baduanjin exercise group vs. the control group (p<0.05), while IL-1β and TNF-α showed no intergroup differences. Conclusions Baduanjin exercise may ameliorate aromatase inhibitor-induced menopausal symptoms and fatigue in breast cancer patients, with distinct modulations in inflammatory biomarkers. Its low-intensity, culturally tailored design supports feasibility as an adjunctive therapy, warranting further investigation into IL-6-mediated mechanisms.

Objectives To evaluate the effect of moderate-to-high-intensity aerobic exercise performed the day before chemotherapy session on cancer-related fatigue (CRF) and to compare active vs. sedentary behaviors over the subsequent 5 days. Methods Twelve metastatic cancer patients (45–65 years old) were recruited in a crossover study including three experimental conditions performed the day before chemotherapy: 1) Control (REST), 2) moderate continuous exercise (MOD), and 3) high-intensity interval exercise (HIIE). CRF and other symptoms were assessed using visual analog scales. Sedentary and active behaviors, including light (LPA) and moderate-vigorous physical activity (MVPA), were estimated using an accelerometer. All measures were collected over the 5 days following chemotherapy treatment. Results Mixed-effect linear models showed CRF fluctuated throughout the day. A significant time effect on CRF was found on Day 1 (p<0.02), Day 3 (p=0.04), and Day 4 (p=0.05), with a trend on Day 2 (0.06<p<0.09). The HIIE condition lessened perceived fatigue 5 days after the chemotherapy session (p=0.05). No effect of time, condition, or interaction on sedentary behaviors (p>0.20), LPA or MVPA was observed. Global ANOVA tests confirmed these patterns, with significant time effects on CRF (η 2 up to 0.56) and no global effect on sedentary behavior or physical activity. Conclusions Moderate to vigorous aerobic exercise the day before chemotherapy may help mitigate CRF without exacerbating it in the following days. These findings support our hypothesis that pre-chemotherapy exercise can better prepare the body for treatment, potentially boosting energy levels and reducing sedentary time by increasing LPA activity.

Objectives This study explored the perceived barriers and enablers to participation in Immersion Therapy, a novel water-based intervention for people living with disability. Methods A mixed-methods design was used, comprising a custom survey with Likert-scale responses and optional comment sections, followed by semi-structured interviews. The survey was distributed to current and past Immersion Therapy participants recruited through purposive sampling in Adelaide, South Australia, between June and August 2024. Interviews were completed 2–6 weeks after the survey. Quantitative data were summarized descriptively, and qualitative insights were analyzed using reflexive thematic analysis. Although full data saturation was not achieved, consistent themes were identified across data sources. Results 16 participants completed the survey, and seven completed interviews. Key barriers included travel distance, changeroom accessibility, and anxiety around participation. Some were impairment-specific (e.g., temperature regulation, confidence in unfamiliar environments). Enablers included strong staff support, perceived safety, clear communication, and enjoyment. Participants often described a sense of empowerment and freedom of movement in water not achievable on land. Conclusions Barriers and enablers to participation in Immersion Therapy at the single center studied reflect the complex interplay of environmental, psychological, and individual factors. The findings highlight the importance of inclusive facility design, participant-centered communication, and program flexibility. Given the modest sample size and single-site design, the findings should be interpreted as exploratory. Addressing these modifiable barriers may support improved accessibility to therapeutic exercise services for people living with disability.

Clinical exercise professionals (CEPs) play a key role in supporting people with mental and physical health challenges. Yet access to services is inequitable, especially for ‘hard to reach’ or underserved populations such as people who have experienced trauma and social disadvantage, who could benefit most from exercise support. Through a socio-ecological lens, we discuss how limited referral pathways, variable workforce preparedness, and a lack of exercise integration within safe, equity-oriented systems of care contribute to underutilisation of CEPs. To deliver equitable care, we discuss strengthening workforce capacity through cultural responsiveness and trauma- and violence-informed care training. Partnerships and models of collaborative, community-based services are presented. We call to action various stakeholders to support activation of the CEP workforce to create appropriate physical activity opportunities for underserved populations.

Cardiac rehabilitation (CR), a multi-modal program centered around supervised exercise, is considered the standard of care for secondary cardiovascular disease (CVD) prevention. The primary goals of CR are managing CVD risk factors and improving patient quality of life through exercise, diet, and risk factor management. While exercise is considered the cornerstone program component, concurrent consumption of diets that provide adequate fruits, vegetables, whole grains, healthy fats, and lean protein, with a reduced intake of ultra-processed foods, saturated fats, added sugar, and sodium, are a key recommendation for secondary CVD risk reduction and risk factor management. Considerable evidence supports the role of Mediterranean Diet (MedDiet), Dietary Approaches to Stop Hypertension (DASH), and plant-based diets for primary and secondary CVD prevention. Yet, these dietary patterns have limited patient adherence and are subject to limited availability of registered dietitian in CR programs. To-date, research on the efficacy of dietary patterns within CR settings (i.e., concurrent to exercise and other risk factor management strategies) is limited, with only 11 randomized controlled trials conducted between 2000 and 2020. This review provides an overview of the current heart-healthy dietary recommendations and their efficacy for secondary CVD prevention. Novel dietary patterns with promising cardioprotective effects, such as time-restricted eating (TRE), are described as possible alternative dietary patterns. Limitations inherent to both current and novel dietary patterns are outlined. Future research directions aimed at enhancing the utility of dietary strategies to enhance the benefits of CR are suggested.