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After 30 minutes of vigorous intensity exercise, skeletal muscle lactate content was 44% lower, and pyruvate dehydrogenase activity was 38% greater signaling better maintenance of the acetyl-CoA/CoA ratio, and therefore less lactate accumulation and decreased reliance on anaerobic metabolism (31)

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Participants were excluded from the study if they met any of the following criteria: (1) severe cognitive impairment, (2) insufficient English, (3) seizures, (4) skeletal abnormalities, e.g