Endurance Research Articles

A Discussion on Adding Personalized Strength Training to College Students' Physical Health in Physical Education Courses

This paper provides an in-depth discussion of the effects of incorporating standardised individualised strength training in the college physical education curriculum on the physiological health of college students. With the popularisation of higher education and the intensification of employment competition, the physical and mental health of college students has attracted much attention. As a key part of the physical education curriculum, its reform and innovation are particularly important. Standardised personalised strength training effectively improves the muscular strength and endurance of college students and strengthens their physical fitness through the development of targeted training plans and the full consideration of students' individual differences. This kind of training not only promotes the improvement of cardiorespiratory function of college students and reduces the risk of cardiovascular disease, but also regulates their psychological state and enhances their overall sense of well-being through exercise. In addition, personalised strength training also cultivated students' teamwork and self-challenge spirit, laying a solid foundation for their all-round development. Therefore, the incorporation of standardised personalised strength training in the college physical education curriculum has a positive impact on the physiological health of college students and is worthy of further promotion and application.

Association of lifelong exercise characteristics with aortic pathology in patients with Marfan syndrome

Abstract Background Marfan syndrome (MFS) is a genetic connective tissue disease with an increased risk for aortic root dilatation and aortic dissection. Current guidelines, based on expert consensus, recommend exercise restrictions due to concerns that exercise-induced hemodynamic stress may accelerate aortopathy. Studies examining exercise characteristics and their association with aortopathy in MFS patients are lacking. Purpose To assess the association of lifelong exercise characteristics (volume, intensity and type) with the presence of aortic dilatation in MFS patients. Methods An international multi-centre study was conducted in MFS adults. Patients were classified as sedentary (<500 metabolic equivalent of task minutes per week [MET-min/wk]), active (500-1000 MET-min/wk), or highly active (≥1000 MET-min/wk) based on lifelong exercise volumes assessed by a validated questionnaire. Patient’s dominant exercise intensity was classified as moderate (3-6 MET) or vigorous (≥6 MET), and sport type as skill, power, mixed, or endurance. Echocardiography was used to assess diameters at the sinuses of Valsalva (SoV) and ascending aorta (AA), and Campens Z-scores were calculated. Aortic dilatation was evaluated as a diameter ≥40, ≥45 mm, a Z-score ≥2 or ≥3 respectively. Results 315 patients (36[27-49] years, 53% male) were included of which 104 were sedentary, 77 active and 134 highly active (Fig. 1). 42 patients did not perform sport-related exercise, whereas 147 and 121 patients predominantly participated in moderate or vigorous intensity sports. Patients performing sports were allocated to the skill (n=13), power (n=27), mixed (n=158), endurance (n=66) or non-dominant (n=9) exercise type group. Mean SoV and AA diameters were 42.9±7.7 mm and 33.9±7.3 mm. SoV or AA diameters of ≥40 mm were present in 200 (64%) and 41 (13%) patients, whereas 223 (71%) and 81 (26%) patients had a Z-score ≥2 for the SoV or AA. Exercise volume was not associated with SoV dilatation (Fig. 2). Moderate and vigorous intensity sports were associated with a lower prevalence of SoV Z-score ≥3. Power sport was associated with a lower prevalence of all definitions of SoV dilatation, whereas mixed and endurance sports were associated with a lower prevalence of SoV Z-score ≥3. No associations were found with AA dilatation. Of the 17 (5%) patients who suffered from an aortic dissection, 1 case occurred during walking (type A dissection) whereas all other cases were not exercise-related. Conclusions Lifelong exercise volumes were not associated with aortic dilatation in MFS patients. Power sports and vigorous intensity exercise were inversely related to SoV dilatation. Further investigation is warranted to clarify whether this association reflects that patients engaging in these activities have a less severe cardiovascular phenotype, or that they are protected from exercise-related aortic complications, and if patients may miss health benefits due to too exercise restrictions.

The impact of exercise training in Fontan procedure patients: a systematic review and meta-analysis

Abstract Background Patients undergoing the Fontan procedure experience long-term complications related to decreased exercise capacity. Exercise training(ET) has emerged as a non-pharmacological solution for increasing cardiorespiratory fitness. However, the effect and safety of exercise training in patients following the Fontan procedure are still unclear. Objectives We aimed to perform a meta-analysis comparing ET versus no exercise intervention for patients following Fontan operation in efficacy and safety outcomes. Methods We systematically searched PubMed, Embase, and Cochrane databases on November 23, 2023, for randomized controlled trials (RCTs) comparing ET, including aerobic, endurance, or inspiratory muscle training, versus no exercise intervention in patients following Fontan operation. We computed mean differences (MD) with a 95% confidence interval (CI) for continuous endpoints. The primary endpoint was (1) peak O2 consumption. Our study also included the secondary endpoints of: (2) maximum workload; (3) peak heart rate(HR); and (4) peak saturation of O2. We performed a subgroup analysis between different exercise therapies. Results This meta-analysis included five RCTs and 154 patients. Follow-up ranged from 3 to 6 months. Regarding ET, two studies used aerobics, one used endurance, and three used inspiratory muscle therapy as exercise therapy for patients with Fontan operations. Our findings on the maximum workload endpoint were more significant for exercise therapy (MD 20.98W; 95% CI 5.32 to 36.65; p<0.01; Fig. 1A) compared to no intervention group. However, there was no significant difference in peak oxygen (MD 2.03 ml/kg/min; 95% CI -0.29 to 4.35; p=0.095; Fig. 1B), peak HR (MD 1.10 bpm; 95% CI -4.07 to 6.27; p=0.68); and peak saturation of O2 (MD 0.39%; 95% CI -1.93 to 2.72; p=0.74). A subgroup analysis between different ET types (aerobic vs. endurance vs. inspiratory muscle training) showed no significant subgroup interaction(p=0.91; Fig. 1B). Conclusion In this meta-analysis, ET is associated with a slight increase in maximum workload in patients following the Fontan procedure. Further multicenter RCTs are warranted to assess the efficacy of comparing different types of ET and their impact on peak oxygen consumption.

Systematic review and meta-analysis on the effects of physical activity-based interventions on frailty status and clinical outcomes in adults with long-term cardiac conditions

Abstract Introduction Frailty is common in patients with long-term cardiac conditions and is associated with poor clinical outcomes, but limited treatment options are available. Previous studies investigating interventions for frailty have shown positive results with physical activity interventions, however, these studies were largely based on general elderly populations. Aim To assess the impact of physical activity-based interventions on frailty and clinical outcomes in frail patients with long-term cardiac conditions. Methods A systematic review and meta-analysis was conducted based on the PRISMA guideline, using Medline, Embase, CENTRAL, PEDro, CINAHL electronic databases for articles published between 2000 and 2023. Studies which recruited adults >18 years with long-term cardiac conditions (including angina, acute coronary syndrome (ACS), valve disease, heart failure (HF), atrial fibrillation, cardiac surgery and congenital heart disease) who underwent physical activity-based interventions were included. The primary outcome was change in frailty (measured using a validated tool) post intervention. We also assessed the effect of interventions on mortality and hospitalisation. Results We screened 2697 records and reviewed 91 full-text articles; 12 studies (14 articles) were included, involving 1394 patients. Median age of participants ranged from 64 to 82 years. Five studies recruited participants with HF, 3 evaluated participants post transaortic valve implantation, 3 recruited cardiac surgical patients and 1 study evaluated participants post ACS. Physical activity-based interventions were multi-domain, including a mixture of aerobic, strength, balance, endurance and respiratory muscle training; the majority (N=10) had individualised exercise prescription. Meta-analysis of 8 randomised controlled trials (RCTs) showed statistically significant improvement in frailty associated with physical activity-based interventions compared to controls [pooled standardised mean difference (95% CI) = -0.34 (-0.59 to -0.08), p = 0.01, I2 = 48%]. Seven RCTs evaluated change in frailty by short physical performance battery (SPPB). Meta-analysis of these studies showed a statistically significant improvement in SPPB associated with physical activity-based interventions compared to controls [pooled mean difference (95% CI) = 0.83 (0.31-1.34), p = 0.002, I2 = 49%]. (Figure) The magnitude of improvement in SPPB exceeded the minimally clinically significant improvement of 0.5. Three studies evaluated the effect of physical activity-based intervention on clinical outcomes, all of which showed neutral effect on mortality and hospitalisation. Conclusion Physical activity-based interventions in patients with frailty and long-term cardiac conditions were associated with significant improvement in frailty status, with neutral effect on mortality and hospitalisation. Figure: Meta-analysis of 7 RCTs assessing effect of physical activity-based interventions on SPPB

Discipline-specific adaptation patterns in respiratory and lower limb musculotendinous structures: cyclists vs. basketball players.

This study aimed at assessing how chronic exposure to specific exercise training (high-intensity intervals vs. endurance), comparing experienced basketball-players (BP, N.=16), cyclists (CY, N.=16), and non-specifically trained individuals (CN, N.=16), influences the structural and functional characteristics of both lower limb and respiratory musculotendinous structures. Vastus lateralis, gastrocnemius lateralis, and medialis, diaphragm muscles, as well as patellar tendon and Achilles tendon, were assessed using B-mode ultrasonography. Maximal voluntary isometric and passive torque measurements were conducted in the knee-extensors and plantar-flexors. Additionally, a subset of participants (N.=10 for each group) underwent a fatigue-inducing exercise-till-exhaustion protocol, and the strength of lower limb and respiratory muscles was evaluated immediately before and after the trial. Athletes had bigger and stronger musculotendinous structures and greater endurance to fatigue than CN (P<0.05). BP had bigger plantar-flexors and diaphragm, greater fascicles length, more explosive plantar-flexors and respiratory muscles and bigger tendons than CY (P<0.05). On the other hand, CY showed greater muscle pennation angle and greater endurance to fatigue for both, lower limb, and respiratory muscles (P<0.05). The present study emphasizes that chronic and specific exercise training leads to distinctive adaptations, not only in lower limb musculotendinous structures but also in other components such as respiratory muscles.

Reliability of a standardized protocol of the Single Leg Heel Rise Test

The single leg heel rise (SLHR) test is a widely used method for assessing calf muscle-tendon unit (MTU) endurance in various fields, including medicine, sports, and dance. The objectives of this study were to examine the reliability of a standardized SLHR test protocol with a heel rise measurement device and to investigate the relationship between SLHR repetitions, SLHR total work, and both maximal voluntary isometric contraction (MVIC) and reactive strength index (RSI) outcomes of the plantar flexors. 21 sport students (8 females, 13 males) were assessed for SLHR outcomes (number of repetitions, height of heel rises, total positive work performed) in two data collection sessions, as well as unilateral lower extremity MVIC and RSI. Test-retest reliability showed excellent reliability and low variability for the number of repetitions (Intraclass correlation coefficient (ICC)=0.91, 95% CI: 0.73 to 0.97; coefficient of variability (CV): 8.1- 8.7%), height of the heel rises (ICC=0.92, 95% CI: 0.81 to 0.97; CV: 4.6 - 5.2%) and total positive work performed (ICC=0.96, 95% CI: 0.87 to 0.99; CV: 6.8 - 9.8%) in both feet. No significant correlation was identified between SLHR repetitions, MVIC, and reactive strength outcome measures. A moderate correlation was observed between the total work performed in the SLHR and RSI outcomes that could potentially be explained by the body weight (BW) of the participants. The SLHR test provides reliable measures for lower leg muscular endurance, yet it does not predict plantar flexor maximal strength or reactive strength. In future studies, we advise employing this standardized protocol for screenings of athletes and dancers.

Physical activity habits among members of the Athens Medical Society in Greece

Abstract Introduction Benefits of regular physical activity and exercise are well documented. Healthcare workers play a crucial role in counseling and appropriately referring their patients to adopt physical activity. However, doctors’ exercise habits range between different medical specialties and health service infrastructure. Purpose In this study, we assess physicians’ exercise performance according to the recommendations of 2020 ESC Guidelines. Methods The population of this cross-sectional study comprised 742 physicians of the Athens Medical Society (AMS), Greece. The study instrument was a self-administered questionnaire mailed in October 2023 to investigate physicians’ exercise habits, baseline characteristics of population, specialty, and health service infrastructure [Greek National Healthcare System (GNHS) or Private Practice (PP)]. European Society of Cardiology (ESC) Guidelines recommend at least 150 min/week of moderate-intensity exercise in all healthy adults. Subjects were divided in two groups according to their compliance to ESC Guidelines: 1. Moderate-intensity endurance exercise training per week ≥ 150 min (Group A); 2. Moderate-intensity endurance exercise training per week &amp;lt;150 min (Group B). Results The recommended exercise training per week goal is achieved by the majority of AMS members (53.4%) with an estimated mean exercise endurance training time of 240 ± 285 minutes. Between Group A and Group B there was no difference in age (50±12years vs. 50±13years, p=0.73), whereas there was significant difference in male sex prevalence (58% vs. 43%, p &amp;lt;0.001), in Body Mass Index (24.7 ± 3.8 kg/m2 vs. 26.2 ± 4.7 kg/m2, p &amp;lt;0.001), in Smoking habits (17.4% vs. 23.5%, p=0.04), in diabetes mellitus incidence (6.6% vs. 11.8%, p= 0.01) and in the use of activity monitoring wearables (45.2% vs. 29.8%, p&amp;lt;0.001). Interestingly, there was significant difference between GNHS and PP doctors representation in Group A and B with more doctors in the PP categorized in the Group A (p=0.008) (Figure 1). Importantly, logistic regression analysis revealed that even after adjustment for the aforementioned confounders there was significant under-representation of the GNHS in the Group A or otherwise doctors in the GNHS have 33% decrease odds of achieving the recommended exercise training per week (Odds Ratio: 0.676, 95%CI 0.484, 0.943, p=0.02) (Table 1). Conclusion A significant proportion of the AMS members follows the recommended ESC guidelines for minimum exercise training per week. Several factors affect their adherence to exercise time recommendation. Interestingly, AMS doctors working on the GNHS independently of other factors are less adherent to exercise recommendations. These findings emphasize the need to strengthen prevention strategies to AMS.

Clinical overlap between healthy athletes and athletes with arrhythmogenic right ventricular cardiomyopathy

Abstract Introduction The extensive physiological cardiac remodelling that results from the haemodynamic stress of endurance exercise shares many features with the pathological manifestations of arrhythmogenic right ventricular cardiomyopathy (ARVC), giving rise to a significant diagnostic challenge for clinicians. Contemporary discriminators of disease have been derived from comparisons between healthy athletes and non-athletic ARVC patients. Differentiation between healthy and diseased athletes may be more difficult. Purpose To assess published clinical differentiators of physiological remodelling from ARVC in a cohort of endurance athletes. Methods This project utilises data from the Pro@heart consortium comprising elite endurance athletes that have received comprehensive cardiac phenotyping using cardiac magnetic resonance imaging, echocardiography, resting and ambulatory electrocardiography and cardiopulmonary exercise testing. Measures of cardiac structure and function with potential to differentiate health and disease were assessed in healthy endurance athletes without symptoms or suspicion of ARVC, endurance athletes diagnosed with ARVC (meeting ARVC task force criteria) and athletes with suspected sub-clinical ARVC (complex ventricular arrhythmias and ≥1 task force criteria). One way ANOVA assessed differences in continuous variables, while Chi Square with pair wise Z test and Bonferroni p value correction were used to test for differences in nominal data. Results Athletes with ARVC and athletes with suspected ARVC displayed more clinical indicators of ARVC compared to healthy athletes (table 1). While a greater proportion of athletes with ARVC and suspected ARVC met ≥1 and ≥3 indicators of pathology compared to healthy athletes, it was relatively common for healthy athletes to meet ≥1 criteria (53%) and ≥3 criteria (14%) (table 2). Comparison of mean values showed right ventricular ejection fraction (RVEF) and right ventricular fractional area change (RV FAC) were lower in athletes with or suspected to have ARVC compared to healthy athletes, however no significant differences in burden of ventricular premature beats (VPB) were noted (table 1). A high burden of VPBs, evidence of ventricular arrhythmia, evidence of late gadolinium enhancement (LGE), a low RVEF, and a reduced RV FAC were more prevalent in athletes with ARVC compared to healthy athletes (table 2). However, there was clinically relevant overlap in all measures between healthy and diseased athletes (table 2). Right ventricular to left ventricular volume ratio was a particularly poor discriminator of pathology (table 1 &amp; 2). Conclusion Electrophysiological, structural and functional abnormalities are not uncommon in healthy athletes resulting in significant overlap with athletic ARVC patients. Future research is required to identify better clinical discriminators of disease, and to assess the clinical significance of abnormal measures in ostensibly healthy athletes

Association between wearable activity trackers usage and levels of physical activity among Athens Medical Society members

Abstract Introduction Wearable Activity Trackers (WAT) provide real-time feedback on activity levels and play a pivotal role in fostering an active lifestyle. Moreover, WAT can encourage doctors’ awareness to be more conscious of their daily physical activity whose exercise habits range between different medical specialties. Purpose The aim of this study is to evaluate the influence of WAT usage on physicians’ exercise habits according to the recommendations of ESC Guidelines. Methods This cross-sectional study comprised 742 physicians of the Athens Medical Society (AMS), Greece. The study instrument was a self-administered questionnaire mailed in October 2023 to evaluate physicians’ usage of WAT, baseline characteristics of population, specialty, and physical exercise habits. European Society of Cardiology (ESC) Guidelines recommend at least 150 min/week of moderate-intensity exercise in all healthy adults. Subjects were divided in two groups according to their usage of WAT or not in their everyday life: 1. Daily usage of WAT (Group A); 2. No regular or even on usage of WAT (Group B). Results A considerably high proportion of the total population use WAT daily (38%). Between Group A and Group B there was no difference in age (49±12 years vs. 51±13 years, p=0.07), male sex prevalence (55% vs. 49%, p=0.08) and BMI (25.7± 4.6 kg/m2 vs. 25.2± 4.1 kg/m2, p=0.11). Interestingly, there was statistically significant difference in mean exercise endurance training time between Group A and Group B (301±304 min. vs. 209±268 min., p&amp;lt;0.001) (Figure 1) and in the proportion of the doctors who follow the ESC Recommendations (63.5% vs. 47.2%, p&amp;lt;0.001). Furthermore, most of the physicians who use WAT have awareness for ESC Guidelines (59% vs. 47%, p&amp;lt;0.001), and most of them apply diet to lose weight (36% vs. 29%, p=0.04). Finally, WAT were mostly used by 4 main specialties: Cardiology (47%), Endocrinology (44%), Surgery (35%) and Internal Medicine (25%), with cardiologists reporting the higher use (p=0.045). Conclusion This study underscores the widespread adoption of WAT among physicians, highlighting their potential to positively influence exercise habits and adherence to ESC Guidelines. Physicians using WAT demonstrated increased exercise endurance training time, greater awareness of ESC Guidelines, and a higher propensity to implement weight loss diets compared to non-users. Additionally, variations in WAT usage and awareness of ESC Guidelines across medical specialties emphasize the need for targeted interventions to promote physical activity and enhance overall health among healthcare professionals.

Effects of endurance exercise under hypoxic conditions on the gastric emptying rate and intestinal cell damage.

The present study examined the effects of gastric emptying rate and intestinal cell damage following a single session of endurance exercise under "hypoxic" or "normoxic" conditions at the same relative intensity. Eleven healthy males performed two trials on different days, consisting of a 60min run on a treadmill at 70% maximal running velocity (vMax) while inspiring hypoxic (FiO2: 14.5%; HYP) or normoxic air (FiO2: 20.9%; NOR). The average running velocity was 11.4 ± 0.7km/h in NOR and 10.8 ± 0.5km/h in HYP, respectively. Venous blood samples were collected to evaluate plasma intestinal fatty acid binding protein (I-FABP) as an indicator of exercise-induced intestinal cell damage. The gastric emptying rate was determined by the 13C-sodium acetate breath test. Running velocities at 70% vMax and arterial oxygen saturation were significantly lower under HYP than NOR (p < 0.001). Peak heart rate and rating of perceived exertion during exercise did not differ significantly between the trials. Maximum 13C excretion time (an indication of the gastric emptying rate) was significantly delayed in the HYP (NOR: 38.5 ± 5.0min, HYP: 45.5 ± 9.6min; p = 0.010). Furthermore, the score of nausea increased slightly, but increased significantly after exercise only in the HYP (p = 0.04). However, exercise-induced changes in plasma I-FABP, adrenaline, and noradrenaline concentrations did not differ significantly between the two trials. These results suggest that endurance exercise under hypoxic conditions impairs digestive function in the stomach compared to exercise under normoxic conditions performed at the same relative intensity.

The Synergistic Effect of Intradialytic Concurrent Training and Melatonin Supplementation on Oxidative Stress and Inflammation in Hemodialysis Patients: A Double-Blind Randomized Controlled Trial

Background: This study aimed to investigate the effects of intradialytic concurrent (resistance–endurance) training combined with melatonin (MEL) supplementation on oxidative stress, inflammation, and cellular damage in hemodialysis (HD) patients. Methods: Thirty-two HD patients were randomly assigned to three groups: Exercise (EX)-MEL, EX-Placebo (PLA), and Control (C)-PLA. Participants in the EX-MEL and EX-PLA groups underwent 12 weeks of concurrent training. Before nocturnal sleep, they ingested either 3 mg of MEL (EX-MEL) or a placebo (EX-PLA and C-PLA). Blood samples were collected at baseline and after 12 weeks of intervention to assess lipid peroxidation [malondialdehyde (MDA)], antioxidant biomarkers [ferric-reducing antioxidant power (FRAP), reduced glutathione (GSH), total thiol (THIOL)], total bilirubin (TBIL), uric acid (UA), biomarkers of muscle and liver damage [aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), creatine kinase (CK), lactate dehydrogenase (LDH), and Gamma-glutamyltransferase (Gamma-GT)], and inflammation [C-reactive protein (CRP)]. Results: EX-MEL demonstrated a decrease in MDA (p &lt; 0.05) and CRP (p &lt; 0.05), and an increase in FRAP (p &lt; 0.05) pre- and post-training. Both EX-MEL and EX-PLA showed an increase in GSH (p &lt; 0.001, and p &lt; 0.05, respectively) and THIOL (p &lt; 0.01, and p &lt; 0.05, respectively) pre- and post-training. No significant changes were observed in TBIL, UA, ASAT, ALAT, CK, LDH, or Gamma-GT pre- and post-training across all groups. Conclusion: Concurrent training combined with MEL supplementation enhances oxidant–antioxidant balance and reduces inflammation in HD patients more effectively than intradialytic concurrent training alone.

Low energy availability surrogates are associated with Relative Energy Deficiency in Sport outcomes in male athletes

ObjectivesTo determine the association between surrogates of low energy availability (EA) and proposed health and performance outcomes of Relative Energy Deficiency in Sport (REDs) in a clinical sample of adolescent...

The Effect of Pre-Exercise Caffeine and Glucose Ingestion on Endurance Capacity in Hypoxia: A Double-Blind Crossover Trial.

The impact of caffeine and glucose supplementation in a hypoxic environment on endurance exercise performance remains inconclusive. The current study examined the effect of pre-exercise carbohydrate and caffeine supplementation on endurance exercise performance in an acute hypoxic environment. Eight healthy active young males participated in this double-blind, within-subjects crossover study. Participants ingested the test drink 60 min before exercising at 50% Wmax for 90 min on a cycle ergometer (fatiguing preload); there followed an endurance performance test at 85% Wmax until exhaustion in a hypoxic chamber (~15%O2). Participants completed four experimental trials in a randomized order: caffeine (6 mg·kg-1; Caff), glucose (1 g·kg-1; CHO), caffeine (6 mg·kg-1) + glucose (1 g·kg-1; Caff-CHO), and taste- and color-matched placebo with no caffeine or CHO (PLA). Blood samples were collected during fasting, pre-exercise, every 30 min throughout the exercise, and immediately after exhaustion. The caffeine and glucose trials significantly enhanced endurance capacity in hypoxic conditions by Caff, 44% (68.8-31.5%, 95% confidence interval), CHO, 31% (44.7-15.6%), and Caff-CHO, 46% (79.1-13.2%). Plasma-free fatty-acid and glycerol concentrations were higher in Caff and PLA than in CHO and Caff-CHO (p < 0.05). The estimated rate of fat oxidation was higher in Caff and PLA than in CHO and Caff-CHO (p < 0.05). There were no significant differences in ratings of perceived exertion between trials. In conclusion, the ingestion of caffeine, glucose, or caffeine + glucose one hour before exercising in hypoxic conditions significantly improved 85% Wmax endurance performance after prolonged exercise.

High-intensity interval swimming improves cardiovascular endurance, while aquatic resistance training enhances muscular strength in older adults

The aim of this study was to examine the effects of free swimming (FS), aquatic resistance training (ART), and their combination (FS&ART) on the body composition, blood pressure, and physical fitness of older adults. The study employed a randomized controlled design, comparing three experimental groups with a control group. Eighty volunteers aged between sixty and seventy years (age: 66.2 ± 2.3 years; body mass index: 25.8 ± 4.3 kg/m²) participated in the 16-week intervention, consisting of two weekly sessions. Assessments were conducted at baseline and post-intervention, including anthropometric measurements, blood pressure readings, and the Senior Fitness Test. Significant differences were found between groups in post-intervention considering the chair stand test (p = 0.017; ES = 0.125), arm curl test (p = 0.029; ES = 0.111), 8-foot up and go test (p = 0.042; ES = 0.102), and walk test − 6 min (p = 0.005; ES = 0.156). Specifically, both ART (+ 20.1%; p < 0.05) and FS&ART (+ 19.5%; p < 0.05) showed significantly greater improvements in the chair stand test compared to the control group. Similarly, ART (+ 23.1%; p < 0.05) and FS&ART (+ 18.7%; p < 0.05) performed better than the control group. FS&ART also exhibited a significant improvement over the control group in the 8-foot up-and-go test (+ 14.6%; p < 0.05). In the 6-minute walk test, FS (+ 19.4%; p < 0.05) and FS&ART (+ 15.9%; p < 0.05) both significantly outperformed the control group. This study found that FS improves cardiovascular endurance, while ART enhances muscular strength and endurance in older adults, with combined benefits for agility, suggesting integration of combined modalities into community wellness initiatives for enhanced physical fitness and health outcomes.

Are caffeine effects equivalent between different modes of administration: the acute effects of 3 mg.kg-1 caffeine on the muscular strength and power of male university Rugby Union players.

There is growing interest in the potential of alternative modes of caffeine administration for enhancing sports performance. Given that alternative modes may evoke improved physical performance via distinct mechanisms, effects may not be comparable and studies directly comparing the erogenicity of alternative modes of caffeine administration are lacking. To address this knowledge gap, the present study evaluated the effect of 3 mg·kg-1 caffeine delivered in anhydrous form via capsule ingestion, chewing gum or mouth rinsing on measures of muscular strength, power, and strength endurance in male Rugby Union players. Twenty-seven participants completed the study (Mean ± SD: Age 20 ± 2 yrs; daily caffeine consumption 188 ± 88 mg). Following assessments and reassessment of chest press (CP), shoulder press (SP), Deadlift (DL), and Squat (SQ) 1-repetition maximum (1RM) and familiarization to the experimental procedures, participants completed six experimental trials where they were administered 3 mg.kg-1 caffeine (Caff) or placebo (Plac) capsule(CAP), chewing gum(GUM) or mouth rinse(RINSE) in a randomized, double-blind and counterbalanced fashion prior to force platform assessment of countermovement jump, drop jump and isometric mid-thigh pull performance. Strength endurance was measured across two sets of CP, SP, DL, and SQ at 70% 1RM until failure. Pre-exercise perceptions of motivation and arousal were also determined. Caffeine increased perceived readiness to invest mental effort (p = .038; ηp2=.156), countermovement jump height (p = .035; ηp2=.160) and SQ repetitions until failure in the first set (p < .001; d = .481), but there was no effect of delivery mode (p > .687; ηp2<.015). Readiness to invest physical effort, felt arousal, drop jump height, countermovement jump, drop jump and isometric mid-thigh pull ground reaction force-time characteristics and repetitions until failure in CP, SP and DL were not affected by caffeine administration or mode of caffeine delivery (p > .0.052; ηp2< .136). 3 mg.kg-1 caffeine administered via capsule, gum or mouth rinse had limited effects on muscular strength, power, and strength endurance. Small effects of caffeine on CMJ height could not be explained by changes in specific ground reaction force-time characteristics and were not transferable to DJ performance, and effects specific to the SQ RTP exercise underpin the complexity in understanding effects of caffeine on muscular function. Novel modes of caffeine administration proposed to evoke benefits via distinct mechanisms did not offer unique effects, and the small number of effects demonstrated may have little translation to a single performance trial when data examining direct comparison of each caffeine vehicle compared against a mode matched placebo is considered.

Task-Based Eating and Drinking Interventions in Animal Models: A Narrative Review of Functional Improvements and Neuromuscular Adaptations in Age-Related Dysphagia.

Age-related dysphagia involves sarcopenia and nervous system changes affecting ingestion. The ACT-ING program, a novel task-based occupational therapy intervention, has been developed to improve strength, endurance, and ingestive skills using real-world eating and drinking tasks for older adults with age-related dysphagia. This narrative review evaluates the outcomes and neuromuscular adaptations of task-based eating and drinking interventions in aging animal models to inform potential refinements of the ACT-ING program and interpret results from an ongoing proof-of-concept study. Publications were obtained from PubMed, SCOPUS, CINAHL, and EMBASE, and selected following the PRISMA guideline. Thirteen randomized trials investigated a task-based fluid-licking intervention in rats, combining strength, endurance, and skill training. Results suggested benefits in improving muscle strength, endurance, and swallowing skills in terms of quantity and speed. Although neuromuscular adaptations were less conclusive, the intervention appeared to induce cortical plasticity and increase fatigue-resistant muscle fibers in the involved muscles. While these findings are promising, methodological concerns and potential biases were identified. Therefore, further research is necessary to refine the ACT-ING program, including both clinical studies in humans and preclinical studies in aging animal models that clearly define interventions targeting all aspects of ingestion-related skills within a motor learning and strength training framework.

The mediating role of kinesiophobia in pain intensity, physical function, and physical activity level in inflammatory arthritis.

Pain is the main symptom of inflammatory arthritis and it can impair physical functional performance and physical activity level. Some individuals can develop kinesiophobia and experience a vicious circle of worsening health. This study aimed to investigate the association between pain and physical functional performance/physical activity and determine whether kinesiophobia mediates this association. This was a cross-sectional study with individuals diagnosed with inflammatory arthritis (rheumatoid arthritis or spondyloarthritis) treated at a Rheumatology Outpatient Clinic. We assessed pain (Visual Analogue Scale), physical activity (International Physical Activity Questionnaire - long form), kinesiophobia (Tampa Scale for Kinesiophobia), and physical functional performance (Handgrip Strength Dynamometry, 30-second Sit-to-Stand test, Static Muscular Endurance test, and Timed Up and Go test). The mediating effect of kinesiophobia on the relationship between pain intensity and physical functional performance/physical activity was analyzed, and the significance of the mediating effect (kinesiophobia) was tested through a bootstrap approach. Thirty-three individuals with inflammatory arthritis (mean age: 48 ± 12 years) participated in the study. Kinesiophobia mediates the relationship between pain intensity and physical functional performance analyzed by the 30-second Sit-to-Stand test [indirect effect (IE)overall = -0.343, bootstrap 95% confidence interval (CI): -0.698 to -0.002] and by knee flexion at 90º of the dominant limb (IEoverall = -1.55, bootstrap 95% CI: -3.43 to -0.237). In conclusion, pain intensity can affect physical functional performance through kinesiophobia in individuals with inflammatory arthritis.

The use of dance to improve the health and wellbeing of older adults: A global scoping review of research trials.

Dance is a promising health resource for older adults, but empirical evidence remains inconsistent. The lack of synthesised evidence regarding program design, dose, and delivery limits understanding of factors influencing participation and health outcomes. This scoping review aimed to map the scope, range, and effectiveness of dance programs for older people, and identify gaps and opportunities for future research and practice. Searches across five databases (September 2023) identified 148 studies evaluating 116 dance programs (≥4 weeks) for older adults (≥55 years, N = 8060), Dance interventions delivered to clinical groups were excluded. Intervention design and delivery were charted against the TIDieR reporting checklist. Program outcomes including adherence, safety, and positive tests were charted into established taxonomies. Demographic information, program details, and implementation were often insufficiently reported. Participant groups differed by age range, with underserved communities underrepresented. Programs varied extensively in key factors including dose, prospective 'active ingredients', delivery approach, facilitator expertise, and class size. While dance was physically safe, adherence rates in older adults are comparable to other community exercise programs. Less than 40% of health assessments showed positive change, with more consistent benefits to physical endurance, strength, and function, moderate impacts on psychosocial health, and limited benefits to cognitive and brain health, and falls and falls risk. Dance is a meaningful, safe, adaptable, and low-cost health resource for older adults. Key opportunities for advancing research include improved access for underserved groups, program suitability assessments, strategies to support adherence and engagement including theory-informed approaches, and incorporation of participant and practitioner insights. Identification of key 'active ingredients' and dance program factors may improve understanding of causal pathways and mechanisms to optimise engagement and health impacts. Stronger reporting practices will facilitate comparisons across studies and more robust evidence synthesis. This review provides a critical knowledge foundation to guide future approaches in dance for health and offers reporting recommendations.

Cardiac electrical and functional activity following an outdoor cold-water swimming event

AimsParticipation in outdoor cold-water swimming (OCWS) events combines endurance exercise and cold exposure. Concerns have emerged about the potential risk of acute adverse cardiac events during OCWS, particularly during endurance events. We analysed the effect of prolonged OCWS on cardiac function in trained athletes. MethodsThe swimming event consisted of laps over a 1000-m course, for up to 6 h, in water at 15 °C. Twenty participants (11 males, 47.3 ± 8.6 years old) were included. Core temperature (Tcore) was monitored using an ingestible temperature sensor during and up to 1 h after the swim. Body composition, blood pressure, electrocardiogram (ECG), and transthoracic echocardiography were assessed 1 day before the event and within the first hour upon completion of the swim. ResultsMean body mass index was 27.1 ± 5.1 kg/m2 and fat mass was 25.2 ± 9.1 %. Mean duration of swimming was 214 ± 115 min. Minimum Tcore was 35.6 ± 1.3 °C. A significant lengthening of the QT interval corrected (QTc) for heart rate was observed post-exercise (437.7 ± 27.7 vs. 457.2 ± 35.9 ms, p = 0.012), with 5 participants exhibiting post-exercise QTc >500ms. OCWS did not alter the biventricular systolic function and left ventricular relaxation. No correlation was observed between ΔQTc and ΔTcore. ConclusionOCWS seemed to acutely delay post-exercise cardiac repolarization without alteration of cardiac function in a healthy trained population. Additional investigations would be warranted to explore the clinical implications of QT lengthening and its relationship with autonomic nervous system regulation during OCWS.

The effect of ischemic preconditioning on physical fitness and performance: a meta-analysis in healthy adults.

This meta-analysis aims to assess the impact of ischemic preconditioning (IPC) on physical fitness and performance, with a focus on its specific role in aerobic endurance, anaerobic endurance, explosive power and strength. Systematic searches were conducted across multiple databases (CNKI, CBM, Cochrane Library, Web of Science, PubMed, and Embase) up to September 6, 2023. We included studies that employed randomized controlled trial methods and sham ischemic preconditioning as the placebo group, and two reviewers independently screened literature and extracted data, using Review Manager 5.3 for analysis. This meta-analysis comprises 27 articles with 405 individuals, selected according to specified criteria. IPC significantly increased the blood lactate concentration after anaerobic speed endurance exercise (MD = 0.74, P = 0.03), the blood lactate concentration after incremental exercise (MD = 0.49, P = 0.04), the blood lactate concentration after muscular endurance exercise (MD = 0.68, P = 0.02), and the one-repetition maximum (MD = 1.38, P = 0.00001). Furthermore, it also significantly shortened completion time of the exercises primarily powered by glycolysis (MD = - 0.49, P = 0.01) and completion time of the exercises primarily powered by aerobic system (MD = - 7.27, P = 0.05), while marginally prolonging time to exhaustion (MD = 22.68, P = 0.08). However, IPC had no significant effect on maximum oxygen uptake, blood lactate concentration in fixed-load aerobic endurance exercise, peak power, or peak aerobic power, nor on completion time of the exercises primarily powered by phosphagen system. IPC could serve as a method to enhance physical performance, particularly for exercises primarily powered by aerobic system and glycolysis. Future research might explore how various cycles, locations, and widths of IPC affect the physical performance of participants with different activity levels.