Background: Although complex in nature, the pathophysiology of depression involves reduced or impaired neuroplastic capabilities. Restoring or enhancing neuroplasticity may serve as a treatment target for developing therapies for depression. Aerobic exercise (AEx) has antidepressant benefits and may enhance neuroplasticity in depression although the latter has yet to be substantiated. Therefore, we sought to examine the acute effect of AEx on neuroplasticity in depression. Methods: Sixteen individuals with (DEP; 13 female; age = 28.5 +/- 7.3; Montgomery- Asberg Depression Rating Scale [MADRS] = 21.3 +/- 5.2) and without depression (HC; 13 female; age 27.2 +/- 7.5; MADRS = 0.8 +/- 1.2) completed three experimental visits consisting of 15 min of low intensity AEx (LO) at 35% heart rate reserve (HRR), high intensity AEx (HI) at 70% HRR, or sitting (CON). Following AEx, excitatory paired associative stimulation (PAS 25ms ) was employed to probe neuroplasticity. Motor evoked potentials (MEP) were assessed via transcranial magnetic stimulation before and after PAS 25ms to indicate acute changes in neuroplasticity. Results: PAS 25ms primed with HI AEx led to significant increases in MEP amplitude compared to LO and CON. HI AEx elicited enhanced PAS 25ms -induced neuroplasticity for up to 1-h post -PAS. There were no significant between -group differences. Conclusion: HI AEx enhances PAS measured neuroplasticity in individuals with and without depression. HI AEx may have a potent influence on the brain and serve as an effective primer, or adjunct, to therapies that seek to harness neuroplasticity.

PURPOSE:Stroke is a leading cause of long-term disability in the US, yet a feasible assessment measure with predictive value for components of the International Classification of Functioning, Disability, and Health (ICF) Core Set for Stroke is lacking. The purpose of the present study was to explore the predictive value of potential assessment measures on factors within each ICF component in stroke survivors. MATERIALS AND METHODS:Demographic, anthropometric, blood-based biomarker, physical functioning, and Global Physical Activity Questionnaire data were collected on stroke survivors in the 2011-2018 NHANES cycles. Potential predictors (handgrip strength relative to weight, age, sex, race, education level, marital status, poverty ratio, stroke chronicity) of physical function, activities of daily living (ADLs), participation in social activities, metabolic syndrome, and meeting physical activity recommendations were evaluated using weighted linear and ordinal logistic regression. RESULTS:Relative handgrip strength was a significant predictor of physical function, difficulty participating in ADLs and social activities, and odds of meeting physical activity recommendations. As relative handgrip strength increased, these factors improved among stroke survivors. CONCLUSIONS:To decrease disability rates and optimize function among stroke survivors, the use of assessment measures like relative handgrip strength that may predict multiple ICF components is warranted.

BACKGROUND:Maximizing independence and function post-stroke are two common therapy goals. Rate of torque development in lower-extremity muscles was recently reported to be associated with walking speed; however, trainability and subsequent effect on gait is unknown. This study aimed to determine effect of power training on paretic and non-paretic limb torque parameters, spatiotemporal gait parameters, and walking speed in chronic stroke survivors. METHODS:Individuals with chronic stroke (n = 22; 7 females; 62.7 ± 8.8 yrs) completed 24 progressive power-training sessions over 8 weeks with pre and post assessments. Knee extensor strength was assessed via dynamometry with torque parameters measured from maximal voluntary isometric contractions. Gait speed and spatiotemporal gait parameters were assessed via an instrumented gait mat, and a 6-min walk test was performed. FINDINGS:Rate of torque development at 200 ms and peak torque improved 58.6% and 14.1%, respectively, in the quadricep of the paretic limb (p < 0.05); conversely the non-paretic limb was unchanged. On average, self-selected walking speed, fastest-comfortable walking speed, and 6-min walk test improved 21.7%, 21.1%, and 19.5%, respectively (all p < 0.05). Change in torque development at 100 ms in the quadricep of the non-paretic limb was positively associated with improvements in self-selected and fastest-comfortable walking speeds (both r = 0.70, p < 0.05) and 6-min walk (r = 0.78, p < 0.001). INTERPRETATIONS:These findings suggest power training may be an effective intervention for improving torque development in the quadricep of the paretic limb in individuals with chronic stroke. Further research to explore utility and mechanistic aspects of force development for gait function in chronic stroke survivors is warranted.

BackgroundPost-stroke depression (PSD) occurs in approximately one-third of chronic stroke survivors. Although pharmacotherapy reduces depressive symptoms, side effects are common and stroke survivors have increased likelihood of multimorbidity and subsequent polypharmacy. Thus, alternative non-pharmacological treatments are needed. Combining two non-pharmacological anti-depressant treatments, aerobic exercise (AEx) and repetitive transcranial magnetic stimulation (rTMS), has been demonstrated to be feasible and well-tolerated in chronic stroke survivors.ObjectivesThe purpose of this trial was to determine the feasibility of conducting a multi-arm combinatorial trial of rTMS and AEx and to provide an estimate of effect size of rTMS+AEx on PSD symptoms.MethodsTwenty-four participants were allocated to one of four treatment arms AEx, rTMS, rTMS+AEx, or non-depressed Control receiving AEx. All participants received a total of 24 treatment sessions. Participant adherence was the primary outcome measure for feasibility and within group effect sizes in Patient Health Questionnaire-9 (PHQ-9) score was the primary outcome for preliminary efficacy.ResultsMean adherence rates to the exercise intervention for AEx, rTMS+AEx, and Control subjects were 83%, 98%, and 95%, respectively. Mean adherence rates for rTMS and rTMS+AEx subjects were 97% and 99%, respectively. The rTMS and rTMS+AEx treatment groups demonstrated clinically significant reductions of 10.5 and 6.2 points in PHQ-9 scores, respectively.ConclusionPerforming a multi-arm combinatorial trial examining the effect of rTMS+AEx on PSD appears feasible. All treatment arms demonstrated strong adherence to their respective interventions and were well received. rTMS and the combination of AEx with rTMS may be alternative treatments for PSD.

Objectives: To (1) examine the feasibility of combining lower extremity aerobic exercise (AEx) with a virtual reality (VR) upper extremity (UE) rehabilitation intervention and (2) provide an estimate of effect size for the combined intervention on UE function, aerobic capacity, and health-related quality of life.Design: Single-group feasibility trial.Setting: Research laboratory.Participants: Community-dwelling individuals with mild to moderate impairment of the UE at least 6 months post stroke (N=10; male, n=6; female n=4; mean age, 54 years).Intervention: All participants received 18 sessions over a nominal 2-3 sessions per week schedule of a combined AEx and VR-UE rehabilitation intervention. During each session, participants completed 15 minutes of lower extremity AEx followed by playing a VR-UE rehabilitation game for approximately 20 minutes.Main Outcome Measures: Feasibility was evaluated by metrics of adherence, retention, treatment acceptability, data completeness, and adverse events. UE function, aerobic capacity (peak oxygen consumption [Vo(2)peak]), and quality of life were assessed with the Fugl-Meyer Assessment of Upper Extremity (FMA-UE), expired gas exchange analysis, and Stroke Impact Scale (SIS), respectively.Results: Adherence was 100%, and there were no withdrawals or losses to follow-up to report. Participants completed the intervention in 49 +/- 14 days. Cohen's dz effect size calculations indicated the intervention elicited medium effects on FMA-UE (dz=0.50) and SIS memory domain (dz=0.46) and large effects on absolute Vo(2)peak (dz=1.46), relative Vo(2)peak (dz=1.21), SIS strength (dz=1.18), and SIS overall recovery domains (dz=0.81).Conclusions: Combining lower extremity AEx and VR-UE rehabilitation appears feasible in the clinical research setting. Fifteen minutes of lower extremity AEx performed at vigorous intensity appears to elicit clinically meaningful benefits in chronic stroke. Further examination of the combination of lower extremity AEx and VR-UE rehabilitation and its effects on physical function and quality of life is warranted.

Date Presented 04/02/2022 Stroke often leaves survivors with lasting upper extremity (UE) motor impairments. To influence recovery, the brain must be plastic, or moldable, to allow change, and rehabilitation must be individualized and progressive to encourage change. Aerobic exercise can affect neuroplasticity, allowing subsequent UE intervention to have greater effects. Priming UE rehabilitation methods with aerobic exercise may result in improved upper extremity function and greater overall recovery. Primary Author and Speaker: Emerson Hart Contributing Authors: Michelle L. Woodbury, Ewan Williams, Chris M. Gregory, Ryan Ross

Globally, depression is a leading cause of disability and has remained so for decades. Antidepressant medications have suboptimal outcomes and are too frequently associated with side effects, highlighting the need for alternative treatment options. Although primarily known for its robust physical health benefits, exercise is increasingly recognized for its mental health and antidepressant benefits. Empirical evidence indicates that exercise is effective in treating individuals with depression; however, the mechanisms by which exercise exerts anti-depressant effects are not fully understood. Acute bouts of exercise have been shown to transiently modulate circulating levels of serotonin and norepinephrine, brain-derived neurotrophic factor, and a variety of immuno-inflammatory mechanisms in clinical cohorts with depression. However, exercise training has not been demonstrated to consistently modulate such mechanisms, and evidence linking these putative mechanisms and reductions in depression is lacking. The complexity of the biological underpinnings of depression coupled with the intricate molecular cascade induced by exercise are significant obstacles in the attempt to disentangle exercise’s effects on depression. Notwithstanding our limited understanding of these effects, clinical evidence uniformly argues for the use of exercise to treat depression. Regrettably, exercise remains underutilized despite being an accessible, low-cost alternative/adjunctive intervention that can simultaneously reduce depression and improve overall health. To address the gaps in our understanding of the clinical and molecular effects of exercise on depression, we propose a model that leverages systems biology and multidisciplinary team science with a large-scale public health investment. Until the science matches the scale of complexity and burden posed by depression, our ability to advance knowledge and treatment will continue to be plagued by fragmented, irreproducible mechanistic findings and no guidelines for standards of care.

While 2.5D and 3D solutions continue to drive advancements in the electronics packaging industry, challenges persist with their reliability and qualification. In this paper, we introduce a new technique that may prove valuable for nondestructive, in-situ measurements of package and die warpage. This system allows for the powerful visualization tools of Computed Tomography to be applied to samples at elevated and cryogenic temperatures over a broad temperature range (+125C to -257C).

Aerobic exercise (AEx) exerts antidepressant effects, although the neurobiological mechanisms underlying such effects are not well understood. Reduced brain-derived neurotrophic factor (BDNF) and elevated cortisol have been implicated in the pathophysiology of depression and appear to normalize with antidepressant treatment. Thus, BDNF and cortisol may serve as biological targets for developing AEx as an antidepressant treatment. PURPOSE:This study examined the effects of AEx, of different intensities, on serum BDNF and cortisol in individuals with and without depression. METHODS:Thirteen participants with depression (10 females; age = 27.2 ± 6.9 yr; Montgomery-Äsberg Depression Rating Scale = 21.7 ± 4.7) and 13 control participants (10 females; age 27.2 ± 7.2 yr; Montgomery-Äsberg Depression Rating Scale = 0.5 ± 0.9) participated. Experimental visits consisted of 15 min of low-intensity cycling (LO) at 35% heart rate reserve, high-intensity cycling (HI) at 70% heart rate reserve, or sitting (CON). During each visit, blood samples were obtained at baseline, immediately postexercise (IP), and then every 15 min postexercise for 1 h (15P, 30P, 45P, and 60P). Group, condition, and time differences in BDNF and cortisol were assessed. RESULTS:There were no group differences in cortisol and BDNF. Secondary analysis revealed that BDNF increased in an intensity-dependent nature at IP, and cortisol was significantly elevated at 15P after HI. Changes in BDNF and cortisol showed significant linear relationships with changes in HR. CONCLUSION:HI AEx can elicit acute, transient increases in BDNF and cortisol in young, healthy, and physically active, nondepressed and mild to moderately depressed individuals. This work suggests that AEx has potential to significantly affect the central nervous system function, and the magnitude of such effect may be directly driven by exercise intensity.

Characterization of Computed Tomography X-Ray ionizing dose will be presented along with a methodology to protect space bound flight hardware from exceeding total ionizing dose (TID) budget prior to mission completion.

Aerobic exercise (AEx) is the most commonly studied mode of exercise for the treatment of depression [ [1] Cooney G.M. Dwan K. Greig C.A. Lawlor D.A. Rimer J. Waugh F.R. et al. Exercise for depression. Cochrane Database Syst Rev. 2013; 9 (CD004366) Crossref Scopus (567) Google Scholar ]. AEx has been implemented as a standalone approach as well as an adjunctive treatment concomitant with pharmacologic and psychotherapeutic treatments [ 2 Dunn A.L. Trivedi M.H. Kampert J.B. Clark C.G. Chambliss H.O. Exercise treatment for depression: efficacy and dose response. Am J Prev Med. 2005; 28: 1-8 Abstract Full Text Full Text PDF PubMed Scopus (933) Google Scholar , 3 Mura G. Moro M.F. Patten S.B. Carta M.G. Exercise as an add-on strategy for the treatment of major depressive disorder: a systematic review. CNS Spectr. 2014; 19: 496-508 Crossref PubMed Scopus (76) Google Scholar , 4 Jacquart S.D. Marshak H.H. Dos Santos H. Luu S.M. Berk L.S. McMahon P.T. et al. The effects of simultaneous exercise and psychotherapy on depressive symptoms in inpatient, psychiatric older adults. Adv Mind Body Med. 2014; 28: 8-17 PubMed Google Scholar , 5 Danielsson L. Papoulias I. Petersson E.L. Carlsson J. Waern M. Exercise or basic body awareness therapy as add-on treatment for major depression: a controlled study. J Affect Disord. 2014; 168: 98-106 Crossref PubMed Scopus (64) Google Scholar ]. AEx is effective in reducing depressive symptoms whether employed singularly or with other anti-depressant treatments. The safety and efficacy of repetitive transcranial magnetic stimulation (rTMS) for treatment of depression is also well documented [ 6 George MS, Lisanby SH, Avery D, McDonald WM, Durkalski V, Pavlicova M, et al. Daily left prefrontal transcranial magnetic stimulation therapy for major depressive disorder: a sham-controlled randomized trial. Arch Gen Psychiatry; 67(5):507–516. Google Scholar , 7 O'Reardon J.P. Solvason H.B. Janicak P.G. Sampson S. Isenberg K.E. Nahas Z. et al. Efficacy and safety of transcranial magnetic stimulation in the acute treatment of major depression: a multisite randomized controlled trial. Biol Psychiatry. 2007; 62: 1208-1216 Abstract Full Text Full Text PDF PubMed Scopus (1167) Google Scholar ]. Given the benefits of both AEx and rTMS individually, it seems plausible that combining these treatments may augment positive plasticity and therapeutic responsiveness. Prior to determining effectiveness, our goal in the present study was to provide preliminary evidence of feasibility and tolerability for combining AEx (stationary cycling) and rTMS into one simultaneous treatment for individuals with depression (Fig. 1).

Depression affects millions of Americans and is a leading contributor to disability and mortality in the United States. Evidence indicates that neuroplasticity is impaired in those with depression and successful treatment for depression appears to reestablish neuroplastic potential. Aerobic exercise (AE) has well-established antidepressant effects and has been shown to modulate neuroplasticity in non-depressed subjects. To date, the acute influence of exercise intensity on indices of neuroplastic adaptation have yet to be described. PURPOSE: To examine the efficacy of acute AE as a neuro-modulatory intervention in non-depressed control subjects. METHODS: Thirteen non-depressed subjects (8 female; 34.5 ± 8.7 years old) completed three experimental sessions that included assessment of corticospinal excitability (CE), AE (15 minutes) and paired associative stimulation (PAS) to determine neuroplastic potential. CE was assessed via transcranial magnetic stimulation and surface electromyography of the abductor pollicis brevis muscle before and after exercise, and for one hour after PAS. AE was performed on a stationary cycle ergometer at low intensity (LO), 35% heart rate reserve (HRR); high intensity (HI), 70% HRR; or a non-exercise control condition (CON). The primary outcome was change in peak-to-peak motor evoked potential amplitude relative to baseline assessment. RESULTS: Mean post-exercise CE across all time points was increased 26.2% in the LO condition, and 2.9% in the CON condition while the HI condition reduced CE 6.3%. Immediately following exercise, the LO condition produced a rapid 27.1% increase in CE while the HI condition produced a rapid 16.3% decrease in CE. Both the LO and HI conditions demonstrated a homeostatic response immediately post-PAS with a 15.0% reduction and 27.8% increase in CE, respectively. CONCLUSION: Lower exercise intensity appears to have a greater influence on increasing CE. Interestingly, the rapid effects of exercise appeared to be reversed by PAS suggesting the presence of homeostatic metaplasticity during these conditions. Modulation of CE via exercise in depression has yet to be established but may underlie the anti-depressant effects of AE. Work examining the influence of AE on CE in depression is currently in progress.

Objective and importance: Residual effects of stroke include well-documented functional limitations and high prevalence of depression. Repetitive transcranial magnetic stimulation (rTMS) and aerobic exercise (AEx) are established techniques that improve depressive symptoms, but a combination of the two has yet to be reported. The purpose of this case series is to examine the safety, feasibility, and impact of combined rTMS and AEx on post-stroke depression and functional mobility. Clinical presentation: Three participants with a history of stroke and at least mild depressive symptoms (Patient Health Questionare-9 >= 5). Intervention: Both rTMS and AEx were completed 3 times/week for 8-weeks. rTMS was applied to the left dorsolateral prefrontal cortex, 5000 pulses/session at 10Hz, at an intensity of 120% of resting motor threshold. AEx consisted of 40min of treadmill walking at 50-70% of heart rate reserve. Results: Depressive symptoms improved in all three participants, with all demonstrating response (>= 50% improvement in symptoms) and likely remission. All participants improved their Six Minute Walk Test distance and Participants 1 and 2 also improved Berg Balance Scale scores. Participants 1 and 3 improved overground walking speeds. No serious adverse events occurred with the application of rTMS or AEx and the participants' subjective reports indicated positive responses. Adherence rate for both rTMS and AEx was 98%. Conclusion: Combined treatment of rTMS and AEx appears safe, feasible, and tolerable in individuals with a history of stroke and at least mild depressive symptoms. All participants had good compliance and demonstrated improvements in both depressive symptoms and walking capacity.

Abstract This paper presents the failure analysis on a 1.5m flex harness for a space flight instrument that exhibited two failure modes: global isolation resistances between all adjacent traces measured tens of milliohm and lower resistance on the order of 1 kiloohm was observed on several pins. It shows a novel method using a temperature controlled air stream while monitoring isolation resistance to identify a general area of interest of a low isolation resistance failure. The paper explains how isolation resistance measurements were taken and details the steps taken in both destructive and non-destructive analyses. In theory, infrared hotspot could have been completed along the length of the flex harness to locate the failure site. However, with a field of view of approximately 5 x 5 cm, this technique would have been time prohibitive.

The transfer of training effects of multiple-joint isokinetic resistance training to dynamic exercise performance remain poorly understood. Thus, the purpose of the present study was to investigate the magnitude of isokinetic and dynamic one repetition-maximum (1RM) strength and local muscular endurance increases after 6 weeks of multiple-joint isokinetic resistance training. Seventeen women were randomly assigned to either an isokinetic resistance training group (IRT) or a non-exercising control group (CTL). The IRT group underwent 6 weeks of training (2 days per week) consisting of 5 sets of 6-10 repetitions at 75-85% of subjects' peak strength for the isokinetic chest press and seated row exercises at an average linear velocity of 0.15 m s(-1) [3-sec concentric (CON) and 3-sec eccentric (ECC) phases]. Peak CON and ECC force during the chest press and row, 1RM bench press and bent-over row, and maximum number of modified push-ups were assessed pre and post training. A 2 x 2 analysis of variance with repeated measures and Tukey's post hoc tests were used for data analysis. The results showed that 1RM bench press (from 38.6 ± 6.7 to 43.0 ± 5.9 kg), 1RM bent-over row (from 40.4 ± 7.7 to 45.5 ± 7.5 kg), and the maximal number of modified push-ups (from 39.5 ± 13.6 to 55.3 ± 13.1 repetitions) increased significantly only in the IRT group. Peak isokinetic CON and ECC force in the chest press and row significantly increased in the IRT group. No differences were shown in the CTL group for any measure. These data indicate 6 weeks of multiple-joint isokinetic resistance training increases dynamic muscle strength and local muscular endurance performance in addition to specific isokinetic strength gains in women. Key pointsMultiple-joint isokinetic resistance training increases dynamic maximal muscular strength, local muscular endurance, and maximal isokinetic strength in women.Multiple-joint isokinetic resistance training increased 1RM strength in the bench press (by 10.2%), bent-over barbell row (by 11.2%), and maximal modified push-up performance (by 28.6%) indicating a carryover of training effects to dynamic exercise performance.The carryover effects may be attractive to strength training and conditioning professionals seeking to include alternative modalities such as multiple-joint isokinetic dynamometers to resistance training programs.

The purpose of this study was to quantify and compare the acute metabolic responses to resistance exercise protocols comprising free-weight, body-weight, and battling rope (BR) exercises. Ten resistance-trained men (age = 20.6 +/- 1.3 years) performed 13 resistance exercise protocols on separate days in random order consisting of only one exercise per session. For free-weight exercise protocols, subjects performed 3 sets of up to 10 repetitions with 75% of their 1 repetition maximum. For the push-up (PU) and push-up on a BOSU ball protocols, subjects performed 3 sets of 20 repetitions. For the burpee and PU with lateral crawl protocols, subjects performed 3 sets of 10 repetitions. For the plank and BR circuit protocols, subjects performed 3 sets of 30-second bouts. A standard 2-minute rest interval (RI) was used in between all sets for each exercise. Data were averaged for the entire protocol including work and RIs. Mean oxygen consumption was significantly greatest during the BR (24.6 +/- 2.6 ml.kg(-1).min(-1)) and burpee (22.9 +/- 2.1 ml.kg(-1).min(-1)) protocols. For the free-weight exercises, highest mean values were seen in the squat (19.6 +/- 1.8 ml.kg(-1).min(-1)), deadlift (18.9 +/- 3.0 ml.kg(-1).min(-1)), and lunge (17.3 +/- 2.6 ml.kg(-1).min(-1)). No differences were observed between PUs performed on the floor vs. on a BOSU ball. However, adding a lateral crawl to the PU significantly increased mean oxygen consumption (19.5 +/- 2.9 ml.kg(-1).min(-1)). The lowest mean value was seen during the plank exercise (7.9 +/- 0.7 ml.kg(-1).min(-1)). These data indicate performance of exercises with BRs and a body-weight burpee exercise elicit relatively higher acute metabolic demands than traditional resistance exercises performed with moderately heavy loading.

Ratamess, NA, Rosenberg, JG, Kang, J, Sundberg, S, Izer, KA, Levowsky, J, Rzeszutko, C, Ross, RE, and Faigenbaum, AD. Acute oxygen uptake and resistance exercise performance using different rest interval lengths: The influence of maximal aerobic capacity and exercise sequence. J Strength Cond Res 28(7): 1875-1888, 2014-The purpose of this study was to examine the relationship between VO(2)max and acute resistance exercise performance and the acute metabolic effects of exercise sequencing. Seventeen resistance-trained men were tested for VO(2)max and 1 repetition maximum (1RM) strength. Subjects were randomly assigned to either a group that performed the squat first in sequence followed by the bench press (S; n = 8) or a group that performed the bench press first followed by the squat (BP; n = 9). Each group performed 3 protocols (using 1-, 2-, or 3-minute rest intervals [RIs] between sets in random order) consisting of 5 sets of each exercise with 75% of their 1RM for up to 10 repetitions while oxygen consumption was measured. Total repetitions completed were highest with 3-minute RI and lowest with 1-minute RI. Mean VO2 was significantly highest with 1-minute RI and lowest using 3-minute RI. Analysis of each exercise revealed a tendency (p = 0.07) for mean bench press VO2 to be higher when it was performed after the squat using 1-and 2-minute RIs. VO(2)max was significantly negatively correlated to 1RM bench press and squat (r = -0.79 and -0.60, respectively) and was significantly correlated to squat repetitions (r = 0.43-0.57) but did not correlate to bench press performance. It seems that VO(2)max is related to lower-body resistance exercise performance when short RIs are used, and the metabolic response to the bench press is augmented when it follows the squat in sequence using short RIs.