***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : The influences of exercising on cytokine response , fatigue and cardiorespiratory values are important aspects of rehabilitation in persons with multiple sclerosis ( PwMS ) .  Exercise performed within these programs is often practised in water but the effects of immersion on PwMS have not been systematic ally investigated . Objective : The objective of this study is to determine differences in cytokine and neurotrophin concentrations , fatigue and cardiorespiratory values in response to 3 week endurance training conducted on a cycle ergometer or an aquatic bike . Methods : A r and omized controlled clinical trial was conducted in 60 MS patients ( Exp and ed Disability Status Scale range 1.0–6.5 ) .  Resting serum levels of brain-derived neurotrophic factor ( BDNF ) , nerve growth factor ( NGF ) , Interleukin-6 , soluble receptor of IL-6 and tumor necrosis factor alpha , and concentrations in response to cardiopulmonary exercise test ( CPET ) , fatigue and cardiorespiratory values were determined at entry and discharge . Subjects performed daily 30 minute training at 60 % of VO2max . Results : Cytokines and neurotrophins showed no significant differences between groups over the training intervention . Within the water group BDNF resting and post-CPET concentrations ( p<0.05 ) showed a significant increase and NGF tended to increase after the training intervention . Short-term effects on BDNF ( CEPT ) tended to increase at the start and significantly thereafter ( p<0.05 ) . No changes occurred in the l and group . Other cytokines and fatigue scores remained unchanged over the training period . Cardiorespiratory values improved significantly over time within both groups . Conclusion : This study indicates that aquatic training activates BDNF regulation and can be an effective training method during rehabilitation in PwMS We examined the acute effect of cold-water temperature on post-exercise energy intake ( EI ) for 1 h. In a r and omized , crossover design , 11 men ( 25.6 + /- 5 y ) exercised for 45 min on a submersed cycle ergometer at 60 + /- 2 % VO2max in 33 degrees C ( neutral ) and 20 degrees ( cold ) water temperatures , and also rested for 45 min ( control ) .  Energy expenditure ( EE ) was determined using indirect calorimetry before , during , and after each condition . Following exercise or rest , subjects had free access to a st and ard assortment of food items of known caloric value . EE was similar for the cold and neutral water conditions , averaging 505 + /- 22 ( + /- st and ard deviation ) and 517 + /- 42 kcal , respectively ( P = NS ) . EI after the cold condition averaged 877 + /- 457 kcal , 44 % and 41 % higher ( P < 0.05 ) than for the neutral and resting conditions , respectively . Cold-water temperature thus stimulated post-exercise EI . Water temperature warrants consideration in aquatic programs design ed for weight loss The influences of exercise on cytokine response , health-related quality of life ( HR-QoL ) , and fatigue are important aspects of MS rehabilitation . Physical exercises performed within these programs are often practice d in water , but the effects of immersion have not been investigated . To investigate the influences of short-term immune responses and cardiorespiratory fitness on HR-QoL and fatigue during 3 weeks endurance training conducted on a cycle-ergometer or an aquatic-bike . R and omized controlled clinical trial in 60 MS patients .  HR-QoL , fatigue , cardiorespiratory fitness , and short-term immune changes ( serum concentrations in response to cardiopulmonary exercise test ) of brain-derived neurotrophic factor ( BDNF ) , nerve growth factor ( NGF ) , interleukin-6 , and the soluble receptor of IL-6 ( sIL-6R ) were determined at the beginning and end of 3 weeks of training intervention . Subjects performed daily 30 min training at 60 % of their VO2peak . SF-36 total ( p = 0.031 ) , physical ( p = 0.004 ) , and mental health ( p = 0.057 ) scores show time effects within both groups . Between-group effects were shown for FSMC total ( p = 0.040 ) and motor function score ( p = 0.041 ) . MFIS physical fatigue showed time effects ( p = 0.008 ) for both groups . Linear regression models showed relationships between short-term immune responses and cardiorespiratory fitness with HR-QoL and fatigue after the intervention . This study indicates beneficial effects of endurance training independent of the training setting . Short-term immune adaptations and cardiorespiratory fitness have the potential to influence HR-QoL and fatigue in persons with MS . The specific immune responses of immersion to exercise need further clarification AIM Among the fitness activities , cycling in water immersion performed with water stationary bikes ( WSB ) has become very popular . However , there is a lack of information concerning their physiological dem and . The aim of the present study was to assess the cardiovascular responses to four WSBs . METHODS Twenty-two healthy participants underwent a grade d exercise test on a cycle ergometer . Sixteen of them , 8 males ( age 31.5 + or - 8.2 years ) and 8 females ( age 31.9 + or - 5.8 years ) with the same level of peak oxygen consumption ( VO(2peak ) ) were chosen and su bmi tted , in r and om order , to four incremental testing sessions performed with four different models of WSB , one with no resistance ( WSB1 ) , two with resistance added to the bottom bracket axle ( WSB2 and WSB3 ) , one with resistance added to the pedals ( WSB4 ) . The VO(2peak ) and heart rate peak ( HR(peak ) ) were measured in all five conditions . RESULTS Since no significant main effect for gender was detected , the data were grouped and analyzed all together . No significant differences were found in VO(2peak ) and HR(peak ) within the five testing conditions , whilst time to exhaustion ( P<0.01 ) and pedaling frequency ( RPM ) at volitional exhaustion ( P<0.01 ) were both significantly different across the four WSBs . When pedaling at 70 RPM , the oxygen consumption and heart rate response ( as % of VO(2peak ) and HR(peak ) ) were approximately 45 % and 60 % for WSB1 , 60 % and 70 % for WSB3 , 90 % and 90 % for WSB2 and WSB4 , respectively . CONCLUSIONS The present results provide useful information for instructors and practitioners because they demonstrate that different models of WSBs could elicit very different cardiovascular responses Seven women at 25 weeks ' gestation  exercised on l and and in the water at 70 % maximum oxygen capacity ( VO2max ) on a bicycle ergometer . Women had significantly lower heart rates and lower systolic blood pressures during immersion exercise . Women had a mean diuresis of 207 ml ( 6.5 ml/min ) during water exercise compared with 98 ml . ( 2.4 ml/min ) during l and exercise .  Fetal heart rates showed a tendency toward being higher after l and exercise compared with water exercise . Six of seven fetuses displayed tachycardia after l and exercise compared to one of seven after water exercise . Exercise on l and and during immersion at 70 % VO2max was well tolerated . However , exercise during immersion offers several physiologic advantages during pregnancy Abstract Wahl , P , Sanno , M , Ellenberg , K , Frick , H , Böhm , E , Haiduck , B , Goldmann , J-P , Achtzehn , S , Brüggemann , G-P , Mester , J , and Bloch , W. Aqua cycling does not affect recovery of performance , damage markers , and sensation of pain . J Strength Cond Res 31(1 ) : 162–170 , 2017—To examine the effects of aqua cycling ( AC ) vs. passive recovery ( P ) on performance , markers of muscle damage , delayed onset of muscle soreness ( DOMS ) , and the persons perceived physical state ( PEPS ) after 300 countermovement jumps ( CMJs ) . Twenty male participants completed 300 CMJs . Afterward , they were r and omly assigned to either the P group or the AC group , the latter performing 30 minutes of AC . Before , directly after the 300 CMJs , after the recovery session , and up to 72 hours post , performance of leg extensor muscles , damage markers , the PEPS , and DOMS were measured . Jumping height during 300 CMJs significantly decreased in both groups ( AC : 13.4 % and P : 14.6 % ) . Maximal isometric strength ( AC : 21 % and P : 22 % ) and dynamic fatigue test ( AC : 35 % and P : 39 % ) of leg extensor muscles showed significant decreases in both groups . Myoglobin , creatine kinase , and lactate dehydrogenase significantly increased over time in both groups . Each of the 4 dimensions of the PEPS and DOMS showed significant changes over time . However , no significant differences between both groups were found for any of the parameters . Coaches and athletes should be aware that vertical jumping – induced fatigue decreases the ability to generate maximal isometric and submaximal dynamic force for more than 3 days after training . A single 30-minute session of AC was not able to attenuate the effects on muscular performance , markers of muscle damage , DOMS , or the PEPS compared with passive rest We aim ed to compare blood pressure ( BP ) responses following moderate-intensity continuous exercise ( MICE ) , high-intensity interval exercise ( HIIE ) in dry l and or HIIE in immersed condition , using 24-hour ambulatory BP monitoring . Forty-two individuals ( 65 ± 7 years , 52 % men ) with a baseline BP ≥ 130/85 mm Hg ( systolic/diastolic blood pressures [ SBP/DBP ] ) were r and omly assigned to perform one of the three following exercises on a stationary cycle : MICE ( 24 minutes at 50 % peak power output ) or HIIE in dry l and ( two sets of 10 minutes with phases of 15 seconds 100 % peak power output interspersed by 15 seconds of passive recovery ) or HIIE in up-to-the-chest immersed condition . While MICE modified none of the 24-hour average hemodynamic variables  , dryl and HIIE  induced a 24-hour BP decrease ( SBP : -3.6 ± 5.7/DBP : -2.8 ± 3.0 mm Hg , P < .05 ) and , to a much greater extent , immersed HIIE ( SBP : -6.8 ± 9.5/DBP : -3.0 ± 4.5 mm Hg , P < .05 ) . The one condition that modified 24-hour pulse-wave velocity was immersed HIIE ( -0.21 ± 0.30 m/s , P < .05 ) Abstract Pinto , SS , Brasil , RM , Alberton , CL , Ferreira , HK , Bagatini , NC , Calatayud , J , and Colado , JC . Noninvasive determination of anaerobic threshold based on the heart rate deflection point in water cycling . J Strength Cond Res 30(2 ) : 518–524 , 2016—This study compared heart rate ( HR ) , oxygen uptake ( V[Combining Dot Above]O2 ) , percentage of maximal HR ( % HRmax ) , percentage of maximal V[Combining Dot Above]O2 , and cadence ( Cad ) related to the anaerobic threshold ( AT ) during a water cycling maximal test between heart rate deflection point ( HRDP ) and ventilatory ( VT ) methods . In addition , the correlations between both methods were assessed for all variables . The test was performed by 27 men in a cycle ergometer in an aquatic environment . The protocol started at a Cad of 100 b·min−1 for 3 minutes with subsequent increments of 15 b·min−1 every 2 minutes until exhaustion . A paired two-tailed Student 's t-test was used to compare the variables between the HRDP and VT methods . The Pearson product-moment correlation test was used to correlate the same variables determined by the 2 methods . There was no difference in HR ( 166 ± 13 vs. 166 ± 13 b·min−1 ) , V[Combining Dot Above]O2 ( 38.56 ± 6.26 vs. 39.18 ± 6.13 ml·kg−1·min−1 ) , % HRmax ( 89.24 ± 3.84 vs. 89.52 ± 4.29 % ) , V[Combining Dot Above]O2max ( 70.44 ± 7.99 vs. 71.64 ± 8.32 % ) , and Cad ( 174 ± 14 b·min−1 vs. 171 ± 8 b·min−1 ) related to AT between the HRDP and VT methods . Moreover , significant relationships were found between the methods to determine the AT for all variables analyzed ( r = 0.57–0.97 ) . The estimation of the HRDP may be a noninvasive and easy method to determine the AT , which could be used to adapt individualized training intensities to practitioners during water cycling classes 
    Output:
    
Cardiovascular parameters were investigated by many of the studies with the results suggesting that the cardiac dem and of aquatic cycling seems similar to l and -based cycling .