Cardiorespiratory Fitness Levels Research Articles

Physiological Fitness in People with Advanced Multiple Sclerosis

IntroductionPhysiological fitness, encompassing cardiorespiratory fitness (CRF) and body composition, are important markers of overall health, functional capacity, and quality of life in general and clinical populations. Characterizing fitness is important for the development of tailored interventions and strategies to optimize well-being across the spectrum of disability in multiple sclerosis (MS). While existing research has explored fitness in people with mild-to-moderate disability, there is a scarcity of data in people with advanced MS (Expanded Disability Severity Scale, EDSS≥7.0). ObjectiveTo characterize CRF and body composition and their associations with fatigue, quality of life, and function in individuals with advanced MS. MethodsParticipants (n=18, mean age=60.7 years-old, median EDSS=7.5) underwent a cardiopulmonary exercise test and dual-energy X-ray absorptiometry scanning. Main outcomes included peak volume of oxygen uptake (V̇O2peak) and whole and regional body fat, lean mass, bone mineral content, and bone density. Symptoms of fatigue (Modified Fatigue Impact Scale, MFIS), quality of life (29-item MS Impact Scale, MSIS-29), and daily function (Late-Life Function and Disability Instrument, LLFDI) were collected. ResultsParticipants exhibited notably low CRF levels (V̇O2peak=9.8 mL/min/kg) and poor body composition (lower lean mass, bone mineral content and density) compared to previous studies in the general population and in individuals with MS with lower disability. V̇O2peak was most consistently associated with function in daily life (LLFDI scores, rs≥0.637, p≤0.004). ConclusionThese findings reinforce the potential importance of physiological fitness to preserve function in people with advanced MS.

Improving exercise cardiac reserve assessment using a novel cardiopulmonary and echocardiography testing protocol (CPET-ESE) based on individualised exercise intensity domains

Abstract Background Functional exercise stress echocardiography (ESE) is used to quantify changes in cardiac reserve and can improve early cardiac dysfunction diagnosis and follow-up.[1.2] Current ESE protocols do not account for individual variations in fitness and heart rate response, leading to difficulties in defining normal reference values.[2,3] Physiologically defined exercise intensity domains could be implemented as part of combined cardiopulmonary and ESE testing (CPET-ESE) to address this problem. Purpose We propose that using exercise intensity domains as part of CPET-ESE will result in cardiac reserve values not influenced by individual cardiorespiratory fitness or physical activity (PA) levels. We also hypothesise by matching work-rates and heart rates (HR), respectively, cardiac reserve will be higher in those exercising at the higher exercise intensity domain. Methods A total of 45 healthy adults (mean age 43.8 ± 14.2, range 18-65 y) underwent a CPET followed by a CPET-ESE consisting of two 6-minute stages: 1. Moderate intensity (MOD) at 90% of the work-rate at the gas exchange threshold (GET) and 2. High intensity (HIGH) at 40% of the difference between GET and peak. Global left ventricular and right ventricular free wall (LV and RV) longitudinal strain (Sl), RV fractional area change (RV-FAC), peak LV and RV TDI derived systolic (S’) and diastolic velocities (E’) were measured at each step, including rest. HIGH steps were matched 1-to-n with MOD steps from other participants based on work-rate and HR, respectively. Questionnaire derived PA was classified as low, moderate, and high active. Cardiorespiratory fitness was measured as peak oxygen uptake relative to body mass (mL·kg-1·min-1). Results After adjusting for age and sex, neither higher PA nor peak VO2 were associated with higher cardiac function parameters at either intensity (Table 1). Higher peak VO2 was associated with higher work-rate for HIGH only, while higher PA was associated with lower HR for MOD only (interaction term p<0.05). When paired by matching HR and work-rate, respectively, HIGH was associated with higher cardiac function parameters compared to MOD (all except for LV-S’ and RV-FAC when HR matched, Table 2), despite those matched from HIGH being older, less physically active and having lower peak VO2 (p<0.05 for all). Conclusions Current ESE protocols, which define submaximal exercise intensity using arbitrary work-rate or HR targets,[3] do not account for the complex differences in exercise response between healthy individuals. Cardiac function augmentation during exercise is likely a response to VO2 kinetics and this is not accurately described by either HR or work-rate alone. We derived normal reference values for cardiac reserve from implementing physiologically defined exercise intensity domains within the combined CPET-ESE testing frameworks. These values could be more appropriately used when comparing diverse clinical populations using CPET-ESE.

Achieving theorical cardiorespiratory fitness is associated with high-volumen training in a phase II cardiac rehabilitation program

Abstract Background and Puropose Cardiac Rehabilitation (CR) is an interdisciplinary therapeutic program with demonstrated success rates in reducing cardiovascular outcomes. To obtain these benefits, it is important to achieve a level of cardiorespiratory fitness (CRFIt) that should be close to the ideal according to age and gender (theorical). The best way to measure it, is through VO2p, or with its surrogate value in METs-load. In our Phase II CR program, both aerobic and strength training is supervised 3 times per week, but emphasis is placed on weekly aerobic training volume (TVol) for a sufficient dose, in order to guarantee outcomes. Our hypothesis is that with adequate TVol, CRFit will be achieved at ideal levels (theorical). The aim of the study is to evaluate the safety and achievement in CRFit measured by METs-load in patients with heart disease during a high-volume Phase II CR program. Methods Quasi-experimental study of a comprehensive Phase II CR program in which patients were evaluated by initial and final exercise testing. Depending on the result, they were assigned for 4-6 weeks (4 to those patients with >5METs and 6 to those with <5METs) to 3 weekly concurrent training sessions (30 mins of aerobic at 70-85% of their heart rate reserve plus strength training), in addition to the corresponding educational, nutritional and psychological intervention. TVol was calculated by METs/week (METs-minute obtained by ergo or treadmill multiplied by 90 minutes). Progressions were made to achieve a weekly program average TVol>500 METs/week according to guidelines recomendations. An adverse event was defined as malignant ventricular arrhythmias, cardiorespiratory arrest, or death. Results A population of 522 patients was analyzed, 72% men, average age of 58.8 years (+-0.59), with coronary ischemic disease, heart failure and cardiomyopathies as the most common heart diseases. Regarding the average theorical METs (8.23, +-0.6), our patients achieved final average METs of 10.2 (+-0.26) and 90.02% (+-0.53) of attendace (Figure 1). The average of TVol were 637.4 (+-37.35) METs/week. The differential between the initial and final METs (Delta1) was correlated by Spearman with the differential between the final METs and its theorical (Delta2) and a significant moderate correlation was found (r=0.32 Spearman, p <0.001). TVol and Delta2 shows a strong and significant correlation (r=0.72 Spearman, p<0.001) (Figure 2). No adverse events were reported in any of the training sessions. Conclusion The Phase II CR program with concurrent training only 3 times per week but with TVol>600 METs/week is safe and guarantees a CRFit above the ideal level (theorical). We recommend to measure and fullfill training volume as a strategy to achieve promising results in exercise tolerance and functional capacity in patients with heart disease.

Selected somatic parameters and body composition as predictors of cardiorespiratory fitness among Polish adolescents aged 11–14

The aim of the study was to verify whether selected somatic parameters and components of body composition were significant predictors of cardiorespiratory fitness (CRF) among a potentially healthy Polish population of adolescents aged 11–14 years. The cross-sectional study was conducted on a group of 375 subjects (164 girls, and 211 boys). A 20 m shuttle run test (20 m SRT) was used to assess CRF. The total number of rounds was taken into account. Basic somatic parameters were measured: body mass (BM), body height (BH), waist circumference (WC), hip circumference (HC), body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR), and body composition components: body fat percentage (FM%), fat mass (FM kg), total body water (TBW), fat-free mass (FFM). Statistical analyses included basic statistical measures (mean and standard deviation) and Spearman rank correlation coefficient. Multiple linear regression analysis was performed to detect significant predictors of CRF. In each proposed model, the dependent variable was the number of rounds, and the independent variables were selected somatic parameters and components of body composition. More than half (65%) of the subjects had an average or lower level of CRF, and 35% of the population presented a good or above good level of CRF. The study showed a statistically significant negative correlation between BM, FM%, FM kg, HC, WC, BMI, WHR, WHtR and the number of laps in the total sample. The strongest correlation in the group of girls was noted for age (r = 0.34) and in the group of boys for FM% (r = -0.52\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$-0.52$$\\end{document}). Each regression model presented proved to be statistically significant, and the significant predictors of CRF in the group of girls were age (R2\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$R^2$$\\end{document} = 16%) and FM% (R2\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$R^2$$\\end{document} = 6%). In the group of boys, the significant predictors of CRF were WHtR (R2\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$R^2$$\\end{document} = 8%) and age (R2\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$R^2$$\\end{document} = 2%). Estimating body fat distribution is useful in assessing cardiorespiratory fitness, and this in turn indicates its usefulness in preventive screening of school-aged adolescents.

The Impact of Interactive Video Games Training on the Quality of Life of Children Treated for Leukemia

Objectives: The study aimed to assess the impact of interactive video games (IVGs) as a form of physical activity (PA) on the quality of life. Methods: The study used a quality-of-life questionnaire (KIDSCREEN-10) and the HBSC questionnaire. In order to determine individual IVGs training parameters, an initial assessment of cardiorespiratory fitness level was performed, using the Cardio Pulmonary Exercise Test—Godfrey’s progressive protocol. Children in the intervention group participated in 12 interval training sessions using IVGs (Microsoft’s Xbox 360 S console with Kinect,). Results: The study included 21 patients (7–13 years old; 12 boys and 9 girls) treated for acute lymphoblastic leukemia (n = 13) and acute myeloid leukemia (n = 8). Before the IVGs, all children had insufficient PA levels (90% of children in the intervention group and 90.91% of children in the control group did not engage in any PA during the last 7 days). After the intervention, 80% of the children in the IVGs group undertook PA lasting at least 60 min a day, three times a week. They exhibited better well-being, a subjective feeling of improved physical fitness (p < 0.0001), a greater subjective sense of strength and energy (p < 0.0001), and less feeling of sadness (p = 0.0016) than the children from the control group (p = 0.0205). Conclusions: The results of our study confirmed that an attractive form of virtual game or sport is willingly undertaken by children undergoing cancer treatment, and has significant benefits in improving the quality-of-life parameters. There is a clear need to create specific recommendations and rehabilitation models for children with cancer.

Physiological influences on neurovascular coupling: A systematic review of multimodal imaging approaches and recommendations for future study designs.

In this review, we have amalgamated the literature, taking a multimodal neuroimaging approach to quantify the relationship between neuronal firing and haemodynamics during a task paradigm (i.e., neurovascular coupling response), while considering confounding physiological influences. Original research articles that used concurrent neuronal and haemodynamic quantification in humans (n ≥ 10) during a task paradigm were included from PubMed, Scopus, Web of Science, EMBASE and PsychINFO. Articles published before 31 July 2023 were considered for eligibility. Rapid screening was completed by the first author. Two authors completed the title/abstract and full-text screening. Article quality was assessed using a modified version of the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. A total of 364 articles were included following title/abstract and full-text screening. The most common combination was EEG/functional MRI (68.7%), with cognitive (48.1%) and visual (27.5%) tasks being the most common. The majority of studies displayed an absence/minimal control of blood pressure, arterial gas concentrations and/or heart rate (92.9%), and only 1.3% monitored these factors. A minority of studies restricted or collected data pertaining to caffeine (7.4%), exercise (0.8%), food (0.5%), nicotine (2.7%), the menstrual cycle (0.3%) or cardiorespiratory fitness levels (0.5%). The cerebrovasculature is sensitive to numerous factors; thus, to understand the neurovascular coupling response fully, better control for confounding physiological influences of blood pressure and respiratory metrics is imperative during study-design formulation. Moreover, further work should continue to examine sex-based differences, the influence of sex steroid hormone concentrations and cardiorespiratory fitness.

Swim, Strength, or Combined Programs: Effect on Health-Related Physical Fitness in Adolescents With Down Syndrome.

The adolescent population with Down syndrome (DS) appears to show higher levels of body fat and lower levels of cardiorespiratory fitness or muscle strength than their peers without disabilities. There is a need to create physical activity programs to improve these data. The aim of this research was to determine the effects of a 16-week swimming program, strength program, and combined program (swimming and strength training) on body composition and health-related physical fitness on adolescents with DS and to assess whether there are differences in the results of the different training programs. Forty-five adolescents (17 female and 28 male; average age 15.5 [1.53] years) with DS were recruited and randomized to three groups (swim [n = 15], strength [n = 15], and combined [n = 15]). Results showed that the swim group had significant improvements in all health-related physical fitness variables and there was an improvement in some body-composition variables (p < .05). The strength and combined groups obtained minor improvements in the variables analyzed. In summary, a 16-week swim program consisting of three sessions of 60min is able to improve levels of body composition and health-related physical fitness in adolescents with DS. The swim training program seems to be more effective in improving body composition and health-related physical fitness than the strength or combined program. These findings could be useful in different special-education centers due to the predisposition shown by the population with DS to this sportmodality.

Sport participation, weight status, and physical fitness in French adolescents.

The primary objective of this study was to investigate the associations between sport participation and weight status with physical fitness among French adolescents. The secondary aim was to establish sex- and age-specific physical fitness percentiles for French adolescents. The sample comprised 8084 adolescents (4126 boys, 3958 girls), aged 10-14years. Participants were tested on cardiorespiratory fitness and muscular strength using the following tests: 20-m shuttle run test and handgrip strength test. A questionnaire on organized sport participation was completed. Physical fitness levels were better in boys (P < 0.005). Handgrip strength increased with age whereas 20-m shuttle run performance decreased with age. Overweight and obese adolescents had significantly lower cardiorespiratory fitness levels than their normal-weight peers (P < 0.005), whereas normal-weight adolescents had lower cardiorespiratory fitness than thin adolescents (P < 0.005). Sport participation was higher for boys (57.2% boys vs. 52.8% girls) (P < 0.001). Adolescents who participated in at least one organized sport (either through a club or at school) were fitter than those who did not participate in organized sports (P < 0.005). Adolescents who engaged in organized sports were more active and physically fit than those who did not participate. The fitness benefits of club sports are greater than those provided by school-based sports, highlighting the potential of sports clubs as a key setting for promoting health. What is Known: • Physical fitness is a strong marker of health in children and adolescents. • The last French Report Card highlighted the lack of fitness data and the need for nationwide programs, while showing a significant decline in cardiorespiratory fitness among youth in recent decades.. What is New: • This study reveals that adolescents participating in organized sports have better physical fitness compared to their peers who do not, emphasizing the potential advantages of club sports over school-based activities. • We highlight the need for targeted strategies, particularly for overweight or obese adolescents and girls, to increase participation in organized sports and enhance health outcomes. • The study emphasizes the need to develop policies that improve access to organized sports clubs and expand physical education in schools, aiming to improve CRF in adolescents.

Effectiveness of cardiac rehabilitation in cancer survivors: A meta-analysis of randomized controlled trials

PurposeThis meta-analysis aimed to evaluate available data regarding the potential benefits of cardiac rehabilitation (CR) in cancer survivors. MethodsRelevant studies published from inception to April 2024 were retrieved from PubMed, Embase, Web of Science, CENTRAL, CINAHL, PsycINFO, Scopus, CNKI, WanFang, VIP, and CBM databases. Seven randomized controlled trials (RCTs) involving 526 cancer survivors were included in this meta-analysis. ResultsCR increased muscle strength (standardized mean difference (SMD) = 0.39, 95% confidence interval (CI): 0.06 to 0.72, P = 0.020), quality of life (QoL) (SMD = 0.61, 95% CI: 0.40 to 0.82, P < 0.001), and led to a decrease in Body Mass Index (BMI) (mean difference (MD) = −1.11, 95% CI: −2.02 to −0.19, P = 0.020), total cholesterol (TC) (MD = −0.41, 95% CI: −0.69 to −0.14, P = 0.003), triglyceride (TG) (MD = −0.33, 95% CI: −0.63 to −0.03, P = 0.030) and low-density lipoprotein (LDL) (MD = −0.34, 95% CI: −0.57 to −0.12, P = 0.003). The meta-analysis revealed that CR had no statistically significant impact on cardiorespiratory fitness (CRF) and high-density lipoprotein (HDL) levels. ConclusionsCR may represent an effective strategy to evaluate cancer survivors because it improves muscle strength and QoL and reduces BMI, TC, TG and LDL levels. Further RCTs with strict study designs and larger sample sizes are required to determine the effects of CR on cancer survivors.

Effects of two types of distractions on ratings of perceived exertion and affective response during acute high-intensity cycling exercise for fair cardiorespiratory fitness level in men

Effects of two types of distractions on ratings of perceived exertion and affective response during acute high-intensity cycling exercise for fair cardiorespiratory fitness level in men

Association Between Cardiorespiratory Fitness and Trend of Age-Related Rise in Arterial Stiffness in Individuals With and Without Hypertension or Diabetes

Abstract BACKGROUND This study aimed to investigate whether higher cardiorespiratory fitness (CRF) can modify the trend of age-related rise in arterial stiffness in individuals with and without hypertension (HTN) or diabetes. METHODS The study included 4,935 participants who underwent maximal cardiopulmonary exercise testing with respiratory gas analysis in a health screening program. CRF was directly measured using peak oxygen uptake during the cardiopulmonary exercise test, while arterial stiffness was evaluated using brachial–ankle pulse wave velocity (baPWV). RESULTS Participants with high CRF levels had significantly lower baPWV compared with those with low CRF levels, regardless of HTN or diabetes status (P &amp;lt; 0.05). The trend of baPWV increased with age, but the rate of age-related increase in baPWV was lower in individuals with moderate-to-high CRF levels compared with those with low CRF levels, regardless of HTN or diabetes status. Joint association analysis indicated that the trend of age-related increase in baPWV was the lowest in fit individuals without HTN or diabetes compared with unfit individuals with HTN or diabetes (P &amp;lt; 0.01). However, the trend of age-related increase in baPWV was not attenuated in fit with HTN or diabetes compared with unfit with HTN or diabetes. CONCLUSIONS These findings suggest that higher CRF levels may mitigate the trend of age-related rise in arterial stiffness in individuals with and without HTN or diabetes. However, this attenuating trend appears more pronounced in individuals without HTN or diabetes.

Estimated cardiorespiratory fitness level and utilization of antidepressants among older adults before and after the COVID-19 lockdown: Findings from the HUNT4 Trondheim 70+ study

BackgroundCardiorespiratory fitness (CRF) refers to the capacity of the cardiovascular and respiratory system to process oxygen. CRF is associated with depressive symptoms and findings suggest that CRF decreased significantly in older adults during the COVID-19 pandemic. However, purchase of prescribed antidepressants before and after the pandemic lockdown by CRF level in older adults has not yet been described. MethodsThis longitudinal study included 1221 community-dwelling older adults ≥70 years old participating in the Norwegian HUNT4 Trondheim 70+ study (2018–2019). Data on estimated CRF (eCRF) were linked to the Norwegian Prescribed Drug Registry and utilized defined daily doses (DDDs) of antidepressants from January 2019 throughout December 2021. Paired t-tests were performed to assess changes in DDDs before and after the Norwegian COVID-19 lockdown in March 2020. ResultsParticipants had a mean (M) and standard deviation (SD) age of 76.5 (5.2) years, 53.6% were women. In the total sample, the results showed a significant rise in purchase of antidepressants from before (M = 1.25, SD = 7.17) compared to after the lockdown (M = 1.52, SD = 7.86); t (1220) = −2.47, p = 0.014). The number of participants purchasing antidepressants also increased in the total sample and within each of the eCRF groups. In the different eCRF groups, only individuals in the highest eCRF tertile showed a significant higher purchase of antidepressants after the lockdown (M = 1.44, SD = 6.65); t (413) = −2.63, p = 0.009) compared to the year before (M = 0.99, SD = 5.21). ConclusionsCompared to before the COVID-19 pandemic lockdown, the utilization of antidepressants increased in community-dwelling older adults, with the steepest increase observed among those with the highest eCRF levels.

Visceral adiposity: A major mediator of the relationship between epicardial adiposity and cardiorespiratory fitness in adults

Background and aimsEpicardial adiposity has been positively associated with visceral adipose tissue (VAT). Few studies have examined the association between cardiorespiratory fitness (CRF) and epicardial adiposity. Furthermore, whether this relationship was independent of VAT remains unexplored. Our purpose was to investigate the contribution of VAT in the relationships between CRF, physical activity (PA) and epicardial adipose tissue (EAT) in asymptomatic women and men. Methods and resultsWe examined the associations between EAT and VAT measured by magnetic resonance imaging, CRF measured by cardiopulmonary exercise testing, and PA assessed using pedometers and a 3-day PA journal in 239 apparently healthy adults (43 % women). Participants were compared according to EAT tertiles and CRF level in both sexes. Participants with the highest EAT level presented more VAT (p < 0.001), lower CRF (p < 0.01), and a more deteriorated cardiometabolic health score (p < 0.01) than those with the lowest EAT level. CRF was negatively associated with EAT in both sexes (p < 0.01). No significant relationship was found with PA (p = NS). Stepwise multivariable regression analyses showed that VAT explained most of the variance in EAT in women and men. Mediation analyses confirmed that VAT was a mediator of the association between CRF and EAT in both sexes. ConclusionIn women and men, VAT appears as a major mediator of the association between CRF and EAT thereby suggesting that managing VAT by improving CRF could help in the prevention of cardiometabolic disorders related to excess EAT.

Cardiorespiratory Fitness Assessment for Exercise Research in Mild Cognitive Impairment Due to Alzheimer's Disease.

To analyze cardiorespiratory fitness (CRF) levels using the gold-standard, laboratory-based cardiopulmonary exercise test (CPET) in community-dwelling older adults (N = 145) with amnestic mild cognitive impairment (aMCI), specifically CPET feasibility, CRF prediction, and CRF status in comparison to published sedentary, cognitively normal, age- and sex-adjusted normative data. Peak oxygen consumption (VO2Peak [mL/kg/min]) was assessed by CPET, which was categorized as submaximal, near-maximal, or maximal tests. VO2Max predicted was compared to VO2Max measured to assess its utility. Data were analyzed with t tests. Participants' mean age was 73.77 years (SD = 5.74 years), with 51.7% males, 91.7% Caucasian, 68.3% married, and 16.9 years (SD = 2.88 years) of education. Mean VO2Peak measured was 17.07 (SD = 4.92) for the total sample (18.29 [SD = 4.64] for males, 15.78 [SD = 4.91] for females). Sixteen (11.03%) CPETs were submaximal, 53 (36.55%) were near-maximal, and 76 (52.41%) were maximal. Mean VO2Max predicted was 28.59 (SD = 21.94) for the total sample (29.36 [SD = 22.3] for males, 27.76 [SD = 21.68] for females) and was significantly higher than VO2Max measured (p < 0.0001). Among participants with maximal CPETs, VO2Peak measured was significantly lower than sedentary normative data (p < 0.0001). CPET was feasible for older adults with aMCI. VO2Max predicted overly inflates CRF estimates. Low levels of CRF in older adults with aMCI suggest aerobic exercise as an important intervention. [Journal of Gerontological Nursing, 50(9), 31-36.].

212 Multi-trajectory analysis of changes in physical activity, BMI and cardiorespiratory fitness in adolescence

Abstract Purpose Over the past four decades, the worldwide prevalence of obesity has nearly tripled, with childhood obesity being now more common than ever. Furthermore, children and adolescents with overweight or obesity are at a higher risk of retaining this condition into adulthood (Lobstein et al., 2015). Previous studies have shown that larger increase in body mass index (BMI) during adolescence is associated with less improvements in cardiorespiratory fitness (CRF) and steeper decline in moderate to vigorous physical activity (MVPA) (Kolunsarka et al., 2021). However, the trajectories of these three variables during adolescence are diverse. Therefore, this study aimed to identify and investigate adolescents with similar concurrent changes in MVPA, CRF and BMI throughout adolescence. Methods In this four-year longitudinal study (2017-2021), device-measured MVPA, BMI and CRF data were collected annually from 1157 participants (Mage = 11.37 ± 0.37). A multivariate trajectory analysis was used to identify adolescents who share similar BMI, MVPA and CRF trajectories over four years. Results Three distinct groups were identified and labelled according to BMI trajectories. The ‘persistently normal’ group (86%) exhibited the highest baseline levels of CRF and MVPA, with significant increases in CRF and a concurrent decrease in MVPA. Conversely, the ‘improving from high’ group (5%) demonstrated a significant increase in CRF and a non-significant (p = 0.07) increase in MVPA. In contrast, the ‘progressing to very high’ group (9%) showed no significant changes in either MVPA or CRF. Conclusion These findings underscore the critical importance of early identification and targeted interventions to mitigate the risk of accelerated weight gain, insufficient physical activity and declining fitness during adolescence. Funding Source This study was funded by the Strategic Research Council within the Academy of Finland within the project SchoolWell, and the Finnish Ministry of Education and Culture.

The Relationship of Cardiorespiratory Fitness, Physical Activity, and Coronary Artery Calcification to Cardiovascular Disease Events in CARDIA Participants.

Moderate-to-vigorous-intensity physical activity (MVPA), cardiorespiratory fitness (CRF), and coronary artery calcification (CAC) are associated with cardiovascular disease (CVD) risk. While a U-shaped relationship between CRF or MVPA and CAC has been reported, the presence of CAC among highly fit individuals might be benign. We examined interactive associations of CRF or MVPA and CAC with outcomes and evaluated the relationship of CRF and MVPA to CAC incidence. CARDIA participants with CAC assessed in 2005-06 were included (n=3,141, mean age 45). MVPA was assessed by self-report and accelerometer. CRF was estimated with a maximal graded exercise test. Adjudicated CVD events and mortality data were obtained through 2019. CAC was reassessed in 2010-11. Cox models were constructed to assess hazard ratios (HRs) for CVD, coronary heart disease (CHD), and mortality in groups defined by CAC presence/absence and lower/higher CRF or MVPA levels. Logistic models were constructed to assess associations with CAC incidence. Adjustment was made for sociodemographic and CVD risk factors. Relative to participants with no CAC and higher CRF, the adjusted HRs for CVD were 4.68 for CAC and higher CRF, 2.22 for no CAC and lower CRF, and 3.72 for CAC and lower CRF. For CHD, the respective HRs were 9.98, 2.28, and 5.52. For mortality, the HRs were 1.15, 1.58, and 3.14, respectively. Similar findings were observed when MVPA, measured either by self-report or accelerometer, was substituted for CRF. A robust inverse association of CRF and accelerometer-derived MVPA with CAC incidence was partly accounted for by adjusting for CVD risk factors. In middle-aged adults, CRF and MVPA demonstrated an inverse association with CAC incidence but did not mitigate the increased cardiovascular risk associated with CAC, indicating that CAC is not benign in individuals with higher CRF or MVPA levels.

Post-COVID-19 Pandemic Effect on University Students’ Fitness Level

Background and Study Purpose: Through the present paper, we aimed to determine to what extent physical capacity was affected by the restrictions during the pandemic. This confirmatory study hypothesises that university students’ fitness level and effort capacity decreased after the pandemic compared to the results obtained before sanitary restrictions. Material and Methods: Fifty female students at the economic faculties, part of two groups of 25 each, in the age range between 19 and 21, passed six physical tests. The applied physical tests targeted strength (sit-ups and squads in 30 s), power (standing long jump), flexibility (sit and reach), coordination (Matorin test), and cardio-respiratory fitness level (Ruffier test). Results: All test results, except one, demonstrate a statistically significant difference, confirming the hypothesis that the two samples differ in strength, power, flexibility, coordination, and cardio-respiratory fitness. By calculating Cohen d effect size, the standardized mean difference of the pandemic effect demonstrates how substantially different are the two samples. Conclusions: This study compares objective results of standardised fitness tests in two successive samples of young women that can contribute to a better understanding of the long-term impact of the pandemic breakdown on the fitness level. The physical abilities decrease between 10 and 28 per cent, with the most worrying level recorded at flexibility and abdominal strength tests. Remedial measures are needed to reverse the physical potential decrease of young adults after the sanitary crisis. A diminished physical potential of the future educated workforce would have lasting effects on their physical and mental health with higher healthcare expenditure and economic consequences due to a resilience and productivity decrease.

The Impact of Organized Exercise and Non-organized Leisured Time Activity on Serum Pentraxin3 and C-reactive Protein Levels, Lipid Profile and Physical Fitness in Diabetic Children

Background: Microvascular changes and precursors of atherosclerosis are frequently observed in young patients with early-onset type 1 diabetes (T1DM). Due to their known beneficial effects, physical activity is strongly recommended for its management. Objectives: This study aimed to investigate the effects of eight weeks of organized exercise (OE) and non-organized leisure time activity (NOLTA) on determinants of cardiovascular disease and physical fitness in children with type 1 diabetes. Methods: In this quasi-experimental study, 20 children with T1DM were randomly divided into two groups of 10: OE (n = 10, mean age = 12.60 ± 1.34 years) and NOLTA (n = 10, mean age = 12.40 ± 0.84 years). Subjects in both groups participated in their respective activities 3 days per week. Blood samples and physiological measurements were taken 48 hours before and after the 8-week training period. Results: High-density lipoprotein (HDL) levels and physical fitness factors increased significantly in both exercise groups. Fasting blood glucose, C-reactive protein, and the cholesterol/HDL ratio were also significantly reduced in both groups. Waist circumference, glycosylated hemoglobin, and the LDL/HDL ratio were significantly reduced only in the OE group. However, the decrease in the acute phase protein pentraxin 3 was minimal and statistically insignificant. Conclusions: In children and adolescents with T1DM, regular exercise—due to its anti-inflammatory effects and its ability to improve cardiorespiratory fitness, lipid profile, and blood glucose levels—may help reduce the severity and likelihood of cardiovascular disease in adulthood.

Exercise and Schizophrenia.

Schizophrenia is a complex mental disorder that affects millions of people worldwide and has a profound impact on various aspects of life, including physical activity. The relationship between schizophrenia and physical activity is an area of growing interest in medical and health research from a physical, mental, and psychosocial health perspective. Physical activity and structured exercise have been identified as promising interventions to improve physical and psychological health outcomes of people living with schizophrenia. This chapter provides a brief overview that explores various aspects of the relationship between physical activity, exercise, and schizophrenia. The impact of schizophrenia on human movement is discussed, along with an overview of physical activity and cardiorespiratory fitness levels in adults with schizophrenia. Additionally, the influence of exercise interventions on physical and psychological outcomes will be discussed, along with current physical activity recommendations for those living with schizophrenia.

The Interplay of Type 2 Diabetes Status, Cardiorespiratory Fitness Level, and Sudden Cardiac Death: A Prospective Cohort Study

BackgroundTo evaluate the individual and joint effects of type 2 diabetes (T2D) status and cardiorespiratory fitness (CRF) level with sudden cardiac death (SCD) risk. MethodsPrevalent T2D was defined based on guideline recommendations, and CRF level was assessed using a respiratory gas-exchange analyzer during exercise testing at baseline, in 2308 men aged 42-61 years. T2D status was classified as either “Yes” or “No,” and CRF level was classified as low, medium, or high. Cox regression analysis was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for SCD. ResultsA total of 264 SCDs occurred during a median follow-up of 28.1 years. Comparing Yes vs No history of T2D, the multivariable-adjusted HR (95% CI) for SCD was 1.79 (1.19-2.72). Comparing low vs high CRF levels, the corresponding adjusted HR (95% CI) for SCD was 1.77 (1.21-2.58). The HRs persisted when T2D status was further adjusted for CRF level, and vice versa. Compared with No-T2D & medium-high CRF level, men with No-T2D & low CRF and those with Yes-T2D & low CRF had an increased SCD risk: (HR = 1.87, 95% CI, 1.38-2.55) and (HR = 3.34, 95% CI, 2.00-5.57), respectively. No significant association occurred between men with Yes-T2D & medium-high CRF and SCD risk (HR = 1.46, 95% CI, 0.46-4.65). Modest evidence indicated the presence of additive and multiplicative interactions between T2D status and CRF level, in relation to SCD. ConclusionsAn interplay exists between T2D status, CRF level, and SCD risk in middle-aged and older men. Higher CRF levels may mitigate the increased SCD risk observed in men with T2D.