High-intensity Functional Exercise Research Articles

Enjoyment and Affective Responses to Moderate and High-Intensity Exercise: A Randomized Controlled Trial in Individuals with Subsyndromal PTSD.

This crossover randomized controlled trial examined the acute psychological effects of a bout of moderate-intensity continuous aerobic exercise (MICE) and a bout of high-intensity functional exercise (HIFE), relative to a no-exercise sedentary control (SED), in participants (N = 21; 15 f; 24.7 ± 9.3 years) with subsyndromal post-traumatic stress disorder (PTSD). Affective state (Energy, Tiredness, Tension, Calmness) was assessed before (Pre), immediately after (Post 0), 20-min after (Post 20), and 40-min after (Post 40) each condition. Affective valence was assessed during each condition, and exercise enjoyment was assessed at Post 0. Enjoyment was significantly greater following HIFE and MICE relative to SED. Energy was significantly increased Post 0 HIFE and MICE but decreased Post 0 SED. Tension was reduced following all conditions and was significantly lower at Post 40 relative to Pre for HIFE, MICE, and SED. Tiredness was significantly reduced at Post 40 relative to Pre following MICE only, while Calmness was significantly lower at Post 40 relative to Pre following MICE and SED. Overall, both exercise conditions were enjoyed to a greater extent than the control, but MICE may provide greater psychological benefits with respect to Calmness and Tiredness. This study is among the first to assess acute changes in affective states relative to various exercise modes in individuals living with subsyndromal PTSD.

DOES EXERCISE PRESERVE FAT FREE MASS DURING A VERY LOW ENERGY DIET IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA?

INTRODUCTION AND AIMS Obesity is a major comorbidity of Obstructive Sleep Apnea (OSA), contributing to 58% of moderate to severe cases in adults. Very low energy diets (VLED) are effective for rapidly reducing weight however are associated with a greater fat free mass reduction compared to other energy restricted diets. Exercise may protect against this and has been shown to improve apnoea hypopnea index (AHI) independently of weight loss. We aimed to assess the feasibility and tolerability of rapid weight loss induced by VLED with or without high-intensity functional exercise in overweight and obese men with OSA. METHODS This two-arm open-label pilot randomised trial included 20 participants with a BMI of ≥27kg/m2 and moderate to severe OSA. Patients were randomised to VLED-only (VO) or VLED plus exercise (VEX) for 12-weeks. Both groups followed a VLED providing <800kcal/day for 8 weeks, followed by a 4-week refeeding period. The VEX group also participated in supervised high-intensity functional exercise training consisting of resistance and aerobic training of up to 5 days per week. RESULTS A total weight loss of -14.5kg [95%CI -17.5 to -11.5] and -9.3kg FM [95%CI -11.0 to -7.6] was achieved (measured by DEXA). Fat-free mass (FFM) reduction occurred (-3.9kg [95%CI -5.5 to -2.3]), with a trend towards preservation in the VEX group. The VO group reduced AHI by 42.9%, moving from severe to moderate OSA. The VEX group’s AHI change (-32.6%) approached but did not reach the moderate category post-intervention. CONCLUSION The VLED, with or without exercise, proved feasible and well-tolerated and demonstrated positive outcomes in body composition and AHI. The VEX group suggested a potential trend in preserving FFM compared to the VO group. These results are promising, indicating the need for a larger, definitive trial to confirm these findings and explore the impact of exercise on FFM preservation in this population.

A SCOPING REVIEW FOR PERSON-FOCUSED FALL PREVENTIVE INTERVENTIONS IN LONG-TERM CARE FACILITIES

Abstract Falls are a significant concern in long-term care facilities (LTCFs) as fall-related injuries (FRI) can result in functional impairment, disability, and death. Older adults living in LTCFs are at greater risk for falls than those in the community. Using scoping review methodology, we aimed to synthesize evidence examining intervention effects of person-focused interventions for risk assessment and prevention in LTCFs to identify evidence-based practices. Databases searched included Medline, CINAHL, and EMBASE to identify original research from 2017 to April 2022 in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guideline. Following the removal of duplicates, 888 articles were identified for possible review, following title and abstract screening 84 studies underwent full-text review against inclusion/exclusion criteria, with 30 studies remaining for analysis. We conducted a narrative synthesis to summarize the included studies. Evidence-based interventions for fall prevention identified include (1) exercise programs (e.g., high-intensity functional exercise, aerobic exercise, short stick exercises, etc.); (2) balance training programs (e.g., Wii Fit); (3) multifaceted, nurse-led education; and (4) others (e.g., whole body vibration, and lavender olfactory stimulation). Outcomes of included studies included the number of falls, fall rate, risk of falls, and fear of falls before and after interventions. Overall, most studies reported significant effects of person-focused interventions in LTCFs. Available evidence supports that well-designed person-focused interventions can reduce falls and fear of falls for individuals in LTCFs.

Translating scientific recommendations into reality: a feasibility study using group-based high-intensity functional exercise training in adolescents with cerebral palsy

Purpose To examine the feasibility and effects of a functional high-intensity exercise intervention performed in a group-setting on functionality, cardiovascular health and physical performance in adolescents with cerebral palsy (CP). Methods Ten adolescents with a diagnosis of CP (2 females; 16.6 ± 3.4 years; GMFCS: I-II) participated in a 12-week training intervention, containing progressive resistance training using free weights and high-intensity workouts twice a week. The six-minute walking test, arterial stiffness and physical performance (strength and power tests) were measured before and after the intervention. Results No adverse events were reported. We measured small increases in the six-minute walking test (Δ = 28.8 m, 95% CI [-1.78;52.7]; g = 0.34 [-0.04;0.72]) and a small reduction in arterial stiffness (Δ = −4.65% [-10.90;1.25]; g = −0.46 [-1.36;0.21]). All measures of physical performance increased (0.24 ≤ g ≤ 0.88). Conclusion Functional training with free weights in high-functioning adolescents with CP is safe and effective in increasing parameters of physical performance and cardiovascular health. Positively influenced indicators of everyday independence (i.e. strength parameters) showed a transfer into movements of daily life. Concerns about adverse events through high-intensity training in adolescents with CP appear unjustified when training is performed progressively, following basic training principles.

The Physiological Responses Of Volume-Matched High-Intensity Functional Exercise Protocols With Varied Time Domains.

The Physiological Responses Of Volume-Matched High-Intensity Functional Exercise Protocols With Varied Time Domains.

Dual-Task Training Effects on Mobility of Older Adults Residents of Porto Alegre: Pilot Study

Introduction: Balance deficit during gait is a factor that affects older people’s mobility. It’s related to an increased risk of falls, hospitalization, and mortality. Regular physical activity is an easy and low-cost strategy to improve older adults’s functional mobility. Dual-task training is also suggested to improve balance and has been highlighted in the new World Guidelines for Falls Prevention and Management for Older Adults. Objective: This study aimed to evaluate the effects of dual-task training on functional mobility of community-dwelling older adults. Methodology: Volunteers over 60 years old were submitted to a 24-weeks exercise routine associated with dual-task challenges. On the first 12 weeks of muscular training, based on The High Intensity Functional Exercise (HIFE) Program was applied. On the following 12 weeks, cognitive challenges and dual-task exercises were added to the exercise protocol. Functional mobility was evaluated by different gait strategies (Figure 8 Walking Test, Tandem Gait Test, 10 Meter Walk Test), in admission, after 12 weeks, and at the end of 24 weeks intervention protocol. Results: Seven participants achieved the preestablished protocol length. The mean values showed that the time of execution has diminished in Tandem Gait Test and Figure 8 Walking Test, when comparing the first and the last evaluations. Conclusion: The results of the study indicate that possible dual-task exercise is an effective way to improve older adults’s gait.

High-Intensity Functional Training: Perceived Functional and Psychosocial Health-Related Outcomes from Current Participants with Mobility-Related Disabilities.

People with mobility-related disabilities (MRDs) experience many personal and environmental barriers to engagement in community-based exercise programs. We explored the experiences of adults with MRD who currently participate in high-intensity functional training (HIFT), an inclusive and accessible community-based exercise program. Thirty-eight participants completed online surveys with open-ended questions, with ten individuals also participating in semi-structured interviews via telephone with project PI. Surveys and interviews were designed to examine changes to perceived health, and the elements of HIFT that promote sustained participation. Thematic analysis revealed themes related to health changes following HIFT participation including improved physical, functional, and psychosocial health outcomes. Other themes emerged within the HIFT environment that promoted adherence for participants such as accessible spaces and equipment, and inclusive HIFT sessions and competitions. Additional themes included participants' advice for the disability and healthcare communities. The resulting themes are informed by the World Health Organization's International Classification of Functioning, Disability, and Health. The findings provide initial data on the potential effects of HIFT on multiple dimensions of health outcomes and contribute to the growing literature on community-based programs that are adaptable and inclusive for people with MRD.

High-Intensity Functional Training For Children With Autism Improves Social Skills, ASD Symptoms And Physical Performance

PURPOSE: This study assessed the feasibility and effectiveness of a 10-wk high intensity exercise program offered after-school for children with autism spectrum disorder (ASD) without intellectual disability. METHODS: Children with ASD (n = 11, M age: 9.53 ± 2.1 yr) engaged in a 1 hr after-school high intensity functional training exercise session, 2 d/wk for 10 wks that targeted social skills, ASD symptoms, and physical performance. Each group exercise session included an instruction period, warm-up, high intensity workout, related game, and cool-down. Social skill and symptom outcome measures included the Adapted Skillstreaming Checklist (ASC) and Social Responsiveness Scale 2nd Edition, School Age Form (SRS-2). Physical performance data (i.e., strength, flexibility, PACER aerobic fitness, power) were also collected. Paired t-tests were used to assess pre to post program performance differences. Participant and parent/guardian satisfaction surveys (7-point Likert scale) were administered following completion of the program. RESULTS: Feasibility and safety were supported in high levels of fidelity (96%), participant and parental satisfaction (4.66, 6.53 out of 7, respectively), and attendance (90% of all sessions), and there were no adverse events or injuries. Pre-post comparisons indicated significant improvements and large effects in social skills (ASC = 87.5 to 118.73; d = 1.95) and ASD symptoms (SRS-2 = 83.6 to 71.36; d = .98) and medium-to-large effects on tests of physical performance (PACER [6.9 to 9.9 laps; d = .86], 60 sec max sit-ups [13.3 to 23.5 reps, d = .58], 60 sec max body weight squats [19.5 to 29.6; d = .61]). CONCLUSION: This after-school high intensity exercise program for children with ASD without intellectual disability was feasible (high fidelity, satisfaction) and improved social functioning, ASD symptoms and physical performance.

High-intensity functional exercise does not cause persistent elevations in augmentation index in young men and women.

Elevations in central augmentation index (AIx) are predictive of cardiovascular disease. The objective of this study was to examine AIx immediately and 24 h following an acute bout of high-intensity functional training (HIFT) in apparently healthy young adults. A second aim compared the exercise-induced AIx recovery response between men and women. Thirty-two recreationally active younger adults (n=16 men) were tested. Baseline central hemodynamic measures were assessed, followed by a single bout of bodyweight HIFT. The HIFT included 4 rounds of burpees, jump squats, split squats, and walking lunges. Assessments were repeated 5, 10, 15, and 24 h post-exercise. AIx was normalized to a heart rate of 75bpm (AIx75). There was a significant main effect of time on AIx75 across all groups (P<0.001) with AIx75 increasing at all acute time points compared with baseline and returning to resting values 24 h post-exercise. When examining sex differences after covarying for height and body fat percentage, the authors found no time × sex interaction (P=0.62), or main effect for sex (P=0.41), but the significant main effect of time remained (P<0.001). The AIx75 response to HIFT follows a similar recovery pattern as previously studied modes of exercise with no residual effects 24h later and no differences between men and women indicating no persistent cardiovascular strain in younger adults participating in this mode of exercise.

The Effects of High-Intensity Functional Training on Cognition in Older Adults with Cognitive Impairment: A Systematic Review.

(1) Background: High-Intensity Functional Training (HIFT) is a new exercise modality that emphasizes multi-joint functional movements adaptable to any fitness level and promotes greater muscle recruitment. Previous studies have evaluated the positive effects of HIFT on mental and cognitive health but have not evaluated it in older people. This study aims to conduct a systematic review of randomized controlled trials assessing the effects of HIFT on general cognition in older adults with cognitive impairment. (2) Methods: Following the PRISMA 2020 guideline, articles that did a high-intensity functional physical exercise intervention on cognitive performance in older adults with mild to moderate cognitive impairment (MMSE > 10) or dementia, aged 55 years or older, published between 2011 and 2021 in five different electronic databases: PubMed, Web of Science, Scopus, CINAHL, and Cochrane plus were included. (3) Results: 7 articles were included, all having general cognition as their primary outcome. All assessed general cognition using the Mini-Mental State Examination, the ADAS-Cog, or both. All studies had at least one HIFT experimental group with a frequency of 2 sessions per week and a variable duration between protocols of 12, 13, 16, and 26 weeks. Two articles showed that a progressive HIFT program improves general cognition, four articles showed no significant changes within or between groups and one article concluded that a HIFT intervention does not slow cognitive decline. (4) Conclusions: Evidence exists of the benefits of HIFT on general cognition in older adults with cognitive impairment, assessed using the MMSE, the ADAS-cog, or both. Two articles that showed improvement in cognitive function used progressive HIFT with 80% RM at 6, 12, and 1 weeks; however, in the other articles, due to the heterogeneity of intervention protocols, measurement time points, and control group activities, mixed results were evidenced

Effect of Adding Motorized Cycle Ergometer Over Exercise Training on Balance in Older Adults with Dementia: A Randomized Controlled Trial

ABSTRACT Background Falls secondary to balance disturbances have been considered as a burden on health systems in people with dementia aged above 65. Exercise has been increasingly recommended to address such problem and the main challenges being the commitment and supervision of training. The study’s aim was to investigate the effect of adding motorized cycle ergometer (MCE) on high intensity functional exercise (HIFE) training on balance and cognition in older adults with dementia. Methods Sixty participants over the age of 65 were randomly allocated into 3 groups, Mo, Ex, and MoEx undergoing, respectively, 50 minutes MCE, HIFE, or combination of both. Sessions were done 3 times per week for 12 weeks. Outcome measures taken before and after study period were Berg Balance Scale (BBS), timed up and go test (TUG), and Mini Mental State Exam (MMSE). Results All groups showed significant improvement in BBS scores but not on TUG or MMSE scores. Between group analysis showed no privilege of any used training methods over the other for all measures taken. Conclusions Training with HIFE, MCE, or combination of both is effective in improving balance but not cognition. However, MCE can be an alternative to supervised exercise training in addressing balance.

The Effects of Verbal Encouragement and Compliments on Physical Performance and Psychophysiological Responses During the Repeated Change of Direction Sprint Test.

The general and sports psychology research is limited regarding the difference between the effects of verbal encouragement (VE) or compliment methods during high-intensity functional exercise testing. The purpose of this study was to explore the effects of VE and compliments on the performance of the repeated change-of-direction (RCOD) sprint test. A total of 36 male students in secondary school participated voluntarily in the study. They were divided equally into three homogeneous groups [VE group, compliment group (CG), and control group) and performed a standardized one repetition RCOD. The RCOD (6 × 20 m with 25-s active recovery) test consisted of a 100°change in the direction at every 4 m. Outcomes included performance indices (fast time, average time, and total time), rating of perceived exertion (RPE), and feeling scale scores. VE and the compliment increased the performance indices and RPE compared with the control group. In conclusion, VE during the exercise testing would be more beneficial for optimal performance and RPE compared with the compliment and control groups. However, the moods, during RCOD, reproduce more positively during compliment conditions than the VE and control groups.

P085 Body composition effects of High Intensity Functional Exercise training during rapid weight loss in obese patients with obstructive sleep apnoea: A pilot randomised controlled trial

Abstract Introduction While Very Low Energy Diets (VLEDs) have been proven to reduce weight in patients with obstructive sleep apnoea (OSA) and co-morbid obesity, they can also result in excessive loss of muscle mass which adversely impacts health. Concurrent exercise training is considered an effective method of preventing muscle mass loss. Methods This prospective randomised controlled trial will recruit 30 overweight and obese men with untreated moderate-to-severe OSA to undergo a 12-week VLED with or without high-intensity functional exercise (HIFE) training. HIFE will be delivered through a commercially available supervised exercise program and incorporates interval training with a combination of progressively graded aerobic and anaerobic exercise. The primary outcome measures are changes in body composition, assessed by dual x-ray absorptiometry (DEXA), and OSA severity (measured by apnoea hypopnea index). Secondary outcomes include glucose tolerance, ventilatory response, and peak oxygen uptake. Data will be analysed on an intention-to-treat basis. Paired T-tests will be used to test the treatment effect of exercise compared to control. Confidence intervals will be used to analyse change in muscle mass and other secondary outcomes. Results Only one participant has completed the protocol to date. No results are available at this time. Discussion The results of this pilot study will look to confirm whether HIFE can protect against muscle mass loss, and additively benefit OSA severity during VLED, compared to VLED alone. It will also inform estimation of feasibility for a larger definitive study.

Working it out: acute exercise to combat anxiety and depressive symptoms in individuals living with subsyndromal post-traumatic stress disorder

ABSTRACT Exercise has significantly reduced symptoms of mental health disorders, but often overlooked is post-traumatic stress disorder (PTSD). Purpose Examine the effects of moderate-intensity continuous aerobic exercise (MICE) and high-intensity functional exercise (HIFE), relative to an inactive control (SED), in participants with subsyndromal PTSD (sub-PTSD). Methods: Participants [N = 24, 9 males; age (M ± SD) = 25.9 ± 9.2 yrs] with sub-PTSD completed a VO2max test on day 1. Participants then completed 35-min MICE, HIFE, and SED conditions on days 2-4. Exercise conditions included a 5-min warm-up and cool-down, with 25-min exercise between 65–70 percent VO2max for MICE and an average of 80.36 ± 6.95 percent VO2max for HIFE. Anxiety and depression symptoms were assessed before (Pre), immediately (Post0), 20-min (Post20) and 40-minutes after (Post40) each condition. Results Anxiety Post40 was significantly less than Pre for HIFE [d = 1.05], MICE [d = 0.78], and SED [d = 0.53]. Depression Post40 was significantly less than Pre for HIFE [d = 0.76], MICE [d = 0.84], and SED [d = 0.32]. Conclusion Exercise significantly reduced anxiety and depression to a greater extent than SED. This study provides evidence for exercise-induced short-term improvements in comorbid psychological conditions associated with sub-PTSD. Implications for individuals experiencing clinical levels of PTSD could be vast and warrant further investigation.

Fitness Changes Among Military Personnel Enrolled In A 6-month High Intensity Functional Training Exercise Trial

PURPOSE: Improving and sustaining high fitness is important for United States (US) military personnel. Current Army Physical Readiness Training (APRT) has been criticized for subpar fitness preparation; concurrently significant grass roots participation in high intensity functional training (HIFT) programs has occurred. Neither has been tested in a randomized clinical trial (RCT) among military personnel, which was the purpose of this study. METHODS: Data are from protocol adherent participants (N = 59) of a 5-year cluster-RCT among active duty US military personnel. Participants were randomized in small groups to 6-months of training in APRT (n = 26; 38.5% women, 85% Officers, age 33.3 ± 5.3 yrs) or HIFT (n = 33; 21.2% women, 73% Officers, age 34.2 ± 6.6 yrs) 5 days/wk for approximately 60 minute sessions. APRT used the reset phase and the HIFT program was also ramped to increase in exercise complexity and intensity over time. At baseline and 6-months, participants completed fitness tests including the Army Physical Fitness Test (i.e., 2 min of push-ups, 2 min of sit-ups, 2 mile run), 1 rep max (1RM) deadlift, max reps pull-ups, horizontal jump, and timed dummy drag (165-lb). Within-groups analyses were conducted by sex using a single group t-test comparing change scores to no effect. A mixed effect model was conducted for between-group fitness changes. RESULTS: Within-group changes were statistically significant in APRT men for pull-ups (1.9 ± 2.4 reps; t = 2.99, p = .01), 1RM deadlift (23.3 ± 19.9 lbs; t = 4.55, p < .001), and dummy drag (-1.3 ± 2.0 sec, t = -2.6, p = .02); APRT women for sit-ups (7.4 ± 9.8 reps; t = 2.83, p = .04); HIFT men for pull-ups (2.1 ± 1.8 reps; t = 5.85, p < .001), 1RM deadlift (27.2 ± 32.6 lbs; t = 4.17, p < .001), dummy drag (-1.0 ± 2.0 sec; t = -2.49, p = .02), and horizontal jump (13.0 ± 12.1 cm; t = 5.38, p = .001); and HIFT women for 1RM deadlift (20.7 ± 13.7 lbs; t = 4.01, p = .007). No significant between-group differences were found (all p > .05). CONCLUSIONS: Results indicate both exercise programs increased fitness (i.e., upper body muscular endurance, abdominal endurance, and lower body strength and power). Men had more fitness gains, with no differences by treatment group. Despite unique participant challenges of time-consuming War College academics, a concurrent focus on exercise training produced fitness benefits.

Investigation of Effectiveness of High-Intensity Functional Exercise On Older Adults: A Systematic Review

Aim: The aim of this systematic review was to investigate the effectiveness of HIFE on physiologic and psychological functions in older adults aged ≥65 years. Methods: This systematic review was designed according to the PEDro scale. PubMed, Web of Science and Scopus databases were used for the systematic searching. Total 1340 studies were identified. The full texts of these studies were examined in respect of the study inclusion and exclusion criteria, and finally 9 studies met the criteria and were included for evaluation. Results: Physical functions and psychosocial functions were evaluated via questionnaires and tests. According to results of the included studies HIFE was effective in respect of the evaluated parameters. Conclusions: As a result of this systematic review HIFE is effective on physical functions and hemodynamic responses but the effect on psychosocial functions are controversially, at the same time there were no reports of negative effects.

Mobility-A Bridge to Sense of Coherence in Everyday Life: Older Patients' Experiences of Participation in an Exercise Program During the First 3 Weeks After Hip Fracture Surgery.

Our aim with this article was to explore the experiences of older people who participated in the evidence-based High-Intensity Functional Exercise (HIFE) Program during the first 3 weeks of rehabilitation after hip fracture surgery. Nineteen older people participated in the study. Data were analyzed using systematic text condensation. One overarching theme “Exercise is the key for regaining mobility and a sense of coherence (SOC) in everyday life” emerged from the analysis in addition to these five themes: (a) understanding the existential importance of mobility; (b) maintaining a positive self-image by regaining mobility; (c) regaining one’s old life and independence in everyday living; (d) maintaining interpersonal relationships through mobility; and (e) creating positive emotions by being able to move. The findings highlight the importance of exercise as a strategy for regaining mobility, illustrated by the essential role it played in the participants’ lives after suffering a hip fracture.

Exercise effects on backward walking speed in people with dementia: A randomized controlled trial

BackgroundMultidirectional walking, including backward walking, is integral to daily activities, and seems particularly challenging in older age, and in people with pathology affecting postural control such as dementia. Research QuestionDoes exercise influence backward walking speed in people with dementia, when tested using habitual walking aids and without, and do effects differ according to walking aid use? MethodsThis study included 141 women and 45 men (mean age 85 years) with dementia from the Umeå Dementia and Exercise (UMDEX), a cluster-randomized controlled trial study set in 16 nursing homes in Umeå, Sweden. Participants were randomized to a High-Intensity Functional Exercise (HIFE) program targeting lower limb strength-, balance and mobility exercise or to a seated attention control activity. Blinded assessors measured 2.4-meter usual backward walking speed, at baseline, 4 - (intervention completion) and 7-month follow-up; tested 1) with habitual walking aids allowed, and 2) without walking aids. ResultsLinear mixed models showed no between-group effect in either backward walking speed test at 4 or 7 months; test 1) 0.005 m/s, P = .788 and –0.006 m/s, P = .754 and test 2) 0.030 m/s, P = .231 and 0.015 m/s, P = .569, respectively. In interaction analyses, exercise effects differed significantly between participants who habitually walked unaided compared with those that used a walking aid at 7 months (0.094 m/s, P = .027). SignificanceIn this study of older people with dementia living in nursing homes, the effects of exercise had no overall effects on backwards walking speed. Nevertheless, some benefit was indicated in participants who habitually walked unaided, which is promising and merits further investigation in future studies.

High-intensity functional exercise in older adults with dementia: A systematic review and meta-analysis

Objective: This study aimed to investigate the efficacy of high-intensity functional exercise among older adults with dementia. Methods: In this systematic review and meta-analysis of randomized controlled trials, we collected articles published before August 2020 from PubMed, Embase, and the Cochrane Library to evaluate the effect of high-intensity functional exercise on older adults with dementia. Primary outcomes included improvements in balance function and gait performance (speed, cadence, and stride length). The secondary outcomes included lower limb strength, activities of daily living, psychiatric well-being, depression, and cognition. Furthermore, we performed subgroup analysis with two high-intensity functional exercise programs: the Umeå program and Hauer’s program. Results: We identified 15 articles describing six trials including older adults with dementia undergoing high-intensity functional exercise or control activity. The meta-analysis indicated that high-intensity functional exercise, both in Hauer’s program and in the Umeå program, significantly improved balance function (pooled standardized mean difference 0.57, 95% confidence interval 0.31–0.83). Hauer’s program significantly improved gait speed, cadence, stride length, and lower limb strength. Beneficial effects on speed, cadence, and lower limb strength were retained for several months. The Umeå program facilitated activities of daily living and psychiatric well-being, with effects on activities of daily living lasting several months. In the only eligible trial, no effects on cognition were observed. Adverse effects of high-intensity functional exercise were minimal to none. Conclusions: High-intensity functional exercise is generally safe and is recommended for older individuals with mild or moderate dementia to provide benefits in motor performance and daily functioning.

Examination Of Low Energy Availability And Sleep In High-intensity Functional Exercise Program Athletes

Low energy availability (LEA) affects the body’s physiological systems, which can negatively affect an athlete’s performance and recovery. Athletes that participate in high-intensity functional exercise may not have adequate dietary intake to match energy needs or obtain optimal amount of sleep to recover fully. PURPOSE: To examine the low energy availability (LEA) and sleep among male and female recreational athletes who engage in high-intensity functional exercise programs. METHODS: Thirty adults (age: 31.2 ± 8.1; males: n = 12, 176.9 ± 6.2 cm, 89.5 ± 15.1 kg; females: 164.7 ± 7.1 cm, 69.9 ± 11.1 kg) participated in a larger cross-sectional study. Participants completed a demographic survey, Pittsburgh Sleep Quality Scale, a 7-day online dietary and exercise log. Participants were measured for height, weight, DXA scan (BMD), and RMR through indirect calorimetry (MedGem). ANOVAs examined differences between gender and energy needs, and Chi-squared analysis examined differences between gender and risk for LEA and Poor Sleep. RESULTS: Significant differences were found between gender and RMR (males: 2296.7±400.3 kg; females: 1761.7±341.6 kg; P=0.001), EI (males: 2027.5±694.5 kg; females: 1568.9±461.1 kg; P=0.038) and EEE (males: 357.8±60.3 kg; females: 279.3±44.4 kg; P≤0.01). No significant differences were found between gender and LEA (males: 24.8.7±12.2 kg; females: 25.0±8.9 kg). Overall risk for LEA was 66.7% (n = 20); however independently LEA was 50% (n=6) for males and 77.8% (n=14) for females. Overall, 63.3% (n=19) recreational athletes report poor sleep. No significant differences were found across gender and poor sleep, independently poor sleep for males was 50% (n=6) and females 72.2% (n=13). No significant differences were found between gender, poor sleep, and LEA. Of those at risk for LEA (n=20), 60% (n=12) also had reported poor sleep. CONCLUSIONS: Recreational athletes were at risk for both LEA and poor sleep, with a majority at risk for both. A combination of LEA and poor sleep can lead to poor performance and recovery from high-intensity exercises. Therefore, education to recreational athletes on the importance of dietary intake to match energy needs and encouragement for positive sleeping habits is imperative to optimize physiological recovery.