High-intensity Physical Activity Research Articles

Optimised return to play: high treatment success rate in core muscle injury with surgical release of the anterior tendon of the rectus abdominis muscle and proximal tenotomy of the adductor longus muscle

ObjectivesCore muscle injury is a debilitating condition that causes chronic groin pain in athletes, particularly common in soccer players. The condition is characterised by pain in the inguinal region and can lead to a significant number of absences from high-intensity physical activity. It is caused by repetitive overload without proper counterbalance from the abdominal muscles, hip flexors, and adductors in susceptible athletes. Surgical indications for core muscle injury consider cases where non-surgical treatments have not provided sufficient relief. The aim of this study was to assess the results of surgical intervention for core muscle injury using the technique employed by the Sports Medicine Group of (Institute of Orthopedics and Traumatology of Hospital das Clínicas – Universidade de São Paulo). The procedure involves releasing the anterior portion of the tendon of the rectus abdominis muscle near the pubic symphysis, along with proximal tenotomy of the adductor longus muscle tendon. MethodsThis study utilised a consecutive historical cohort analysis of the medical records of 45 male athletes, of which, 75.6% were professional soccer players, who underwent surgical treatment between January 1, 2002, and December 31, 2021. The participants included active athletes aged between 18 and 40 years, with a mean age of 23.9 years, and were diagnosed with myotendinous core muscle injury. These athletes experienced pain in the pubic symphysis and adductor tendon region and had previously undergone medical treatment and physical therapy for a duration of three to six months without significant improvement. ResultsThe average time for athletes to return to sport after surgery was 135 days, with a majority of participants being soccer and futsal players. The surgical intervention yielded promising results, with a positive correlation between unilateral injuries and the time taken to return to sport. The complication rate was low, at 6.7%. Notably, the rate of symptom resolution was high, at 93.3%. Furthermore, the analysis indicated that the player's position on the field significantly influenced the discharge period, suggesting that the game position plays a role in the recovery process. ConclusionThe combined surgical procedure involving the release of the rectus abdominis tendon and adductor longus muscle tenotomy demonstrates favourable outcomes for athletes with core muscle injury. This study provides strong support for the effectiveness of this surgical approach in managing the condition and offers a potential path to recovery and return to sports activities. Level of evidence4. Study designCross-sectional study.

Moving beyond moderate-to-vigorous physical activity: the role of light physical activity during adolescence.

Regular physical activity is an important component of a healthy lifestyle for young people. However, an estimated 80% of adolescents globally are insufficiently active. Traditionally, health benefits were attributed only to physical activity of at least moderate intensity, and recommendations focused on achieving a threshold of moderate-to-vigorous physical activity, without consideration of other aspects of movement within the 24 h cycle. Recently, the overall daily balance of active and sedentary behaviours has gained recognition as an important determinant of health. However, the relationship between light intensity physical activity and health has not been fully explored. In this perspective paper, we discuss key challenges in defining, measuring and analysing light physical activity which have hindered the advancement of knowledge in this area. Next, we suggest three ways in which light physical activity may enhance adolescent wellbeing: firstly, by replacing sedentary behaviours to increase daily movement; secondly, by supporting the accumulation of higher intensities of physical activity; and thirdly, by providing positive experiences to facilitate lifelong engagement with physical activity. In highlighting the importance of light physical activity during adolescence, we aim to encourage critical reflection and the exploration of new approaches towards physical activity within public health and beyond.

THE ACID-BASE CHANGES IN HIGHLY QUALIFIED ORIENTER SPORTSMEN UNDER THE INFLUENCE OF GLUCOSE ELECTROLYTE DRINK WITH THE PLANT EXTRACTS ADDITION

In real conditions of high-intensity training and competitive load of athletes, the most important for sports success is the preservation of energy metabolism indicators, and, in particular, the acid-base balance in the range of homeostatic normal values. One of the possible ways to maintain the acid-base balance of an athlete is the use of homeostatic electrolyte drinks, which can have a fairly rapid effect. In this regard, for our work we have identified the following goal of the study: to analyze the possibility of using the functional drink "Aluston" (FDA) produced by JSC "Alushta Essential Oil Plant" to maintain the acid-base balance of athletes and a possible increase in performance, training duration, resistance of athletes to long-term physical activity of high intensity.
 Methods: Stepwise loading protocol was used on a Kettler bicycle ergometer (Hmbq, Germany). Capillary blood sampling from athletes was carried out at rest before the start of the load and immediately after it was completed using an Epoc capillary (Epocal Inc., Canada). Biochemical parameters of blood like pH, concentration of CO2 and O2, [Na+], [К+], [Сa2+], [Cl–], [HCO3–], Lactate, Glucose, Crea, Hct, Hb, BE(ecf), BE(b ) were recorded by the Epocreader and Epochost analyzers (Epocal Inc., Canada). It was shown that FDA contributes to the stabilization of anion gaps, reduces the severity of the shift of the standard (BE-ecf) and true (BE-b) excess bases into the negative range, which can be regarded as a more pronounced preservation of the “strength” of blood buffer systems, and contributed to a decrease in tension in the pair acidosis-alkalosis. In addition, FDA supplementation likely shifts the phase of creatine fermentation to later loading stages.
 The last experimental fact requires further research, and also, modification changes in the composition, concentration ratio of active components in the “Aluston” drink remain relevant.

Health behaviors and cancer screening in family caregivers vs. general population

Abstract Purpose This study aimed to compare health behaviors and healthcare utilization between family caregivers of advanced cancer patient and general population. Methods Data of 158 family caregivers were obtained from one oncologic clinic and from 3,775 Korean adults aged 40 years or older who participated in the Eighth Korea National Health and Nutrition Examination Survey. Propensity-score matching was employed to match family caregivers with general population (1:1). We assessed health behaviors and healthcare visit, cancer screening, and influenza vaccination among two groups. Further, we performed subgroup analysis to explore factors associated with health behaviors and healthcare utilization of family caregivers. Results After propensity-score matching, the proportion of individuals performing moderate to high-intensity physical activity (MVPA) of 500 METs or more was higher in the caregiver group (p = 0.004). Also, the proportion of cancer screenings over a two-year period was significantly lower in the family caregiver group compared to the non-caregiver group (62.1% versus 73.1%, p = 0.045). In subgroup analysis, family caregivers with higher HADS depression scores were less likely to engage in MVPA, while those with higher HADS anxiety scores showed a significant decrease in healthcare visits. Family caregivers who received social care/economic support had an increased aOR in healthcare visits for own health (aOR 0.18 95% CI 0.04-0.91). Moreover, caregivers who had high competency and rewards were more likely to engage in MVPA. Conclusions The caregiver's has vulnerable aspects of and healthcare utilization, affected by their depression or anxiety. Social care/economic support was associated with improved health behavior and utilization of caregivers. Further studies for multi-dimensional support for caregivers’ health is needed. Key messages • Family caregivers, especially those with higher levels of depression or anxiety, face challenges in terms of their health and healthcare utilization. • Social care/economic support is crucial in improving their health behaviors and healthcare access.

The Impact of Physical Activity on Depressive Symptoms among Urban and Rural Older Adults: Empirical Study Based on the 2018 CHARLS Database.

Using data from the China Health and Retirement Longitudinal Study 2018, we employed the propensity score matching method to examine the effect of physical activity on depressive symptoms among older adults across rural and urban areas. The study sample consisted of 5055 participants, with urban and rural populations representing 31.3% and 68.7%, respectively. This study found that rural older adult individuals exhibited a greater incidence of depressive symptoms and lower physical activity levels when compared to their urban counterparts. Engagement in high-intensity physical activity was identified as an effective method for mitigating depressive symptoms among older adults. However, the moderating effects of physical activity were only observed among urban older adult individuals. Our findings revealed a cross-sectional correlation between physical activity and depressive symptoms among older adult Chinese individuals, and this link differed between urban and rural areas. Although high-intensity physical activity has a positive effect on depressive symptoms among older adults, physical activity interventions should sufficiently consider the variations in older adults' living conditions and environments due to urban-rural differences so that interventions can be customized to improve the mental health of older adults.

Using Ankle Weights as an Effective Way to Increase the Intensity of Physical Activity While Playing Immersive Virtual Reality Games on an Omnidirectional Treadmill

Active virtual reality games (AVRGs) have become more and more popular. As the intensity of this form of physical activity (PA) may be insufficient to achieve health-related benefits, it is worth looking for solutions that increase the intensity of PA. The main aim of the study was to evaluate the effect of leg loading in the form of ankle weights (AWs) on the PA intensity of young adults playing AVRGs using an omnidirectional treadmill. The enjoyment of the game and users’ perceptions of the usefulness of this type of exercise were also evaluated. The study involved 26 university students. Each participant played an AVRG game on an omnidirectional treadmill twice, without and with ankle weights (2 kg per leg). The intensity of PA was evaluated using a heart rate monitor. The attractiveness of the game was assessed using the Physical Activity Enjoyment Scale (PACES). The study found that the percentage of maximum heart rate in participants playing AVRGs without ankle weights was significantly lower than that observed when playing with the weights. In both cases, PA intensity was high. A survey showed that the weights attached to the ankles did not affect the perceptions of the enjoyment of the game. The use of ankle weights appears to be an effective and simple way to increase the intensity of physical exercise during AVRGs based on locomotor movements performed with the lower limbs, especially since, according to study participants, such a procedure does not negatively affect the enjoyment of the game. Due to the high intensity of PA while playing VR games using an omnidirectional treadmill, it can be assumed that regular use of this solution is likely to provide health benefits.

Physical activity levels before and after the COVID-19 restrictions among Danish adolescents: a retrospective cohort study.

It has been suggested that the COVID-19 restrictions may have negatively impacted physical activity (PA) levels, especially among adolescents, who often use organised sports to support their intrinsic motivation for staying active. This study aimed to investigate whether adolescents were less physically active after the COVID-19 restrictions compared with before and examine whether participation in organised sports has changed since the COVID-19 restrictions. This was a retrospective cohort study of Danish adolescents aged 15 to 19 years. Data was collected using a questionnaire in SurveyXact. The primary variable of interest was moderate or high-intensity PA frequency before and after COVID-19 restrictions (from March 11, 2020, to September 10, 2021). Secondary variables of interest included whether the PA was self-organised (e.g. running, hiking, going to a gym or cycling) or part of an organised sport delivered by a club or other association, before versus after the restrictions. A total of 324 participants responded to the questionnaire. The relative risk of not performing PA at least twice per week after COVID-19 restrictions compared with before was significantly larger (1.44; 95%CI: 1.19 to 1.85, p = 0.005). Before the lockdowns, 190 (59%) were engaged in organised sports compared with 152 (47%) after the restrictions (relative risk: 1.51, 95%CI: 1.19 to 1.92, p < 0.001). Compared with activity levels before the pandemic, adolescents became significantly less physically active following the COVID-19 restrictions, beyond what is typically observed during adolescence. These results emphasise a need for strategies to increase PA levels among adolescents to minimise the long-term negative effects of physical inactivity during adolescence.

Development and validation of a clinical model to predict preconception risk of gestational diabetes mellitus in nulliparous women: A retrospective cohort study.

To develop and validate a model to predict the preconception risk of gestational diabetes mellitus (GDM) in nulliparous women. This was a retrospective cohort study. A total of 1565 women in early pregnancy who underwent preconception health examinations in the Women and Children's Hospital of Chongqing Medical University between January 2020 and June 2021 were invited to participate in a questionnaire survey. Logistic regression analysis was performed to determine the preconception risk factors for GDM. These factors were used to construct a model to predict GDM risk in nulliparous women. Then, the model was used to assess the preconception risk of GDM in 1060 nulliparous women. Independent preconception risk factors for GDM included the following: age 35 years or greater, diastolic blood pressure 80 mm Hg or greater, fasting plasma glucose 5.1 mmol/L or greater, body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) 24 or greater, weight gain 10 kg or greater in the year before pregnancy, age of menarche 15 years or greater, three or more previous pregnancies, daily staple food intake 300 g or greater, fondness for sweets, and family history of diabetes. BMI less than 18.5, daily physical activity duration 1 h or greater, and high-intensity physical activity were protective factors. These factors were used to construct a model to predict GDM risk in nulliparous women, and the incidence of GDM significantly increased as the risk score increased. The area under the curve of the prediction model was 0.82 (95% confidence interval 0.80-0.85). The preconception GDM risk prediction model demonstrated good predictive efficacy and can be used to identify populations at high risk of GDM before pregnancy, which provides the possibility for preconception intervention.

Association Between Depressed Mood Changes and Physical Activity Among Adolescents Post COVID-19 Pandemic.

Following the coronavirus disease 2019 (COVID-19) pandemic, adolescents have experienced decreased physical activity and a decline in mental health. This study analyzed the association between changes in depressed mood after the COVID-19 pandemic and physical activity among adolescents. The analysis was based on the results of the 17th Youth Health Behavior Online Survey conducted in 2021, which included 54848 middle and high school students in South Korea. Information on physical activity included low-intensity physical activity lasting >60 min/day, high-intensity physical activity, and strength training exercises. A logistic regression analysis was performed to evaluate the association between physical activity and changes in depression after the COVID-19 pandemic. After adjusting for sociodemographic characteristics and previous depression, adolescents who performed strength training exercises more than once per week had a 0.95-fold lower risk (odds ratio [OR]=0.948, 95% confidence interval [CI]=0.905-0.994, p= 0.027) of increasing depression after the COVID-19 pandemic, while the risk of decreasing depression increased by 1.22-fold (OR=1.215, 95% CI=1.131-1.305, p<0.001). The results were not significant for low-intensity physical activity for >60 min/day and high-intensity physical activity. Strength-training exercises are significantly associated with the prevention of depression among adolescents following the COVID-19 pandemic.

Metabolic cost and mechanical work of walking in a virtual reality emulator.

The purpose of this study was to investigate the metabolic cost (C), mechanical work, and kinematics of walking on a multidirectional treadmill designed for locomotion in virtual reality. Ten participants (5 females, body mass 67.2 ± 8.1kg, height 1.71 ± 0.07m, age 23.6 ± 1.9years, mean ± SD) walked on a Virtuix Omni multidirectional treadmill at four imposed stride frequencies: 0.70, 0.85, 1.00, and 1.15Hz. A portable metabolic system measured oxygen uptake, enabling calculation of C and the metabolic equivalent of task (MET). Gait kinematics and external, internal, and total mechanical work (WTOT) were calculated by an optoelectronic system. Efficiency was calculated either as WTOT/C or by summing WTOT to the work against sliding frictions. Results were compared with normal walking, running, and skipping. C was higher for walking on the multidirectional treadmill than for normal walking, running, and skipping, and decreased with speed (best-fit equation: C = 20.2-27.5·speed + 15.8·speed2); the average MET was 4.6 ± 1.4. Mechanical work was higher at lower speeds, but similar to that of normal walking at higher speeds, with lower pendular energy recovery and efficiency; differences in efficiency were explained by the additional work against sliding frictions. At paired speeds, participants showed a more forward-leaned trunk and higher ankle dorsiflexion, stride frequency, and duty factor than normal walking. Walking on a multidirectional treadmill requires a higher metabolic cost and different mechanical work and kinematics than normal walking. This raises questions on its use for gait rehabilitation but highlights its potential for high-intensity exercise and physical activity promotion.

Chronic Pubalgia in a Young Adult Managed by Iliohypogastric and Ilioinguinal Nerve Blocks

Chronic pubic pain is a commonly occurring problem in young males who are engaged in high-intensity physical activities such as sportsmen and army recruits among others. We would like to discuss a similar case of pubalgia which occurred in a 20-year-old male who is an avid athlete. The patient had reported multiple times to the hospital and was admitted and evaluated thoroughly. He was kept on nonsteroidal anti-inflammatory drugs and pregabalin for about a month. Despite this aggressive pain management, the patient continued to have continuous pain in his left groin. Due to his pain and inability to perform physically, the patient went into depression. After a thorough clinical evaluation, we offered the patient an ultrasound-guided iliohypogastric and ilioinguinal nerve block which resulted in the complete disappearance of his symptoms within a week, and he was able to return back to his regular training.

Winter recreational activities of male students staying at dormitory and their attitudes towards sports

Background: This study aims to analyze the winter recreational activities of male university students, their attitudes towards sports, and their physical activity states. Methods: The population of this cross-sectional study consists of the students staying in a male dormitory. Data were collected through a personal evaluation form and a scale of attitude towards sports. Results: Average sports attitude of students is 82.92. Playing okey game, playing football, spending time in the cafeteria and studying in the library are recreational activities that students frequently prefer in winter. There is a statistically significant difference between hobbies of students, playing football, spending time in the cafeteria and library activities and sports attitudes (p&lt;0.05). The odds of doing moderate and high aerobic physical activity for those who spend time in cafes are 2 times higher than those who do not, 2.8 times higher for those who go to fitness compared to those who do not, and 3.9 times higher for those with an income of 1000-1500 TL (Turkish Lira) compared to those with 1500 TL and more. Conclusions: The sports attitudes of those who have winter hobbies, play football, and have recreational activities in the library and cafeteria are high. Although fitness recreational activity does not make a significant difference in sports attitudes, it comes to the fore in the weekly recommended moderate and high-intensity aerobic physical activity behaviors. While recreational football made a difference in sports attitudes, it did not make this difference in the recommended physical activity behavior. Students often prefer to play okey, which takes place indoors outside the campus in the winter. For a healthy life, it is necessary to concentrate on recreational activities that will increase the sports attitude and physical activity behavior of the students on the university campus or student dormitory.

Prevalence of falls, injury from falls and associations with chronic diseases among community-dwelling older adults in Guangzhou, China: a cross-sectional study.

As a developing country with the largest older adult population in the world, strengthening the research on falls among the older adults is undoubtedly an urgent item in China. This study aimed to explore the prevalence and risk factors associated with falls and injury from falls among community-dwelling older adults in Guangzhou, China, particularly focusing on their associations with chronic diseases. A total of 1,629 participants aged 65 years and above were selected from 11 counties in Guangzhou by the multi-stage stratified random sampling method in 2021. Socio-demographic characteristics, health and lifestyle factors, the status of falls, and injury from falls were measured by structured questionnaires through face-to-face interviews. Chi-square tests and logistic regression analysis were used to identify factors associated with falls and injury from falls. Chord diagrams were used to explore their associations with chronic diseases. A total of 251 participants (15.41%, 95% CI: 13.98%-17.25%) reported falls, and 162 participants (9.46%, 95% CI:7.72%-11.55%) indicated an injury from falls. Logistic regression analysis showed the results as follows: female patients (adjusted OR = 1.721, 95% CI: 1.681-1.761) aged ≥80 years (1.910, 1.847-1.975), unemployed (1.226, 1.171-1.284), uninsured (1.555, 1.448-1.671), average monthly household income of 2,001-4,000 CNY (1.878, 1.827-1.930), number of services provided by the community health center ≥13 times per year (1.428, 1.383-1.475), illness within 2 weeks (1.633, 1.595-1.672), high-intensity physical activity (2.254, 2.191-2.32), sedentary (1.094, 1.070-1.117), and number of chronic disease illnesses ≥3 (1.930, 1.870-1.993). Meanwhile, those risk factors were also associated with injury from falls. The older adults with medium-intensity physical activity were at lower risk (0.721, 0.705-0.737) of falls and higher risk (1.086, 1.057-1.117) of being injured from falls. Chord diagrams showed the correlations between chronic diseases and falls and injury from falls among community-dwelling older adults in Guangzhou, China. The high prevalence of falls is found among community-dwelling older adults in Guangzhou, China, which is related to multiple factors such as demographic variables, lifestyle, and health status, especially for chronic diseases. Therefore, targeted interventions should be developed and implemented urgently.

O.4.5-11 The association between health literacy and objectively measured physical activity in Norwegian young adult students

Abstract Background Insufficient physical activity (PA) is a significant public health challenge, with a drastic decline in activity levels observed in young adulthood likely contributing to increases in cardiometabolic risk factors with age. Recent research suggests that health literacy (HL) may be an important modifiable factor associated with reduced physical activity levels and poor health outcomes in elderly and disease-prone populations. However, limited research has focused on young adulthood when the drastic decline in PA is observed. Moreover, most previous studies have only assessed self-reported PA, which has limited accuracy. Therefore, the purpose of this study was to assess the relationship between HL and objectively measured PA levels in healthy young adults. Method 28 young adult (18-25 years) college students participated in the study (men: n = 7, women: n = 21). PA was measured objectively and subjectively using an accelerometer (Actigraph GT3X+) and the IPAQ questionnaire, respectively. The HLS19 instrument was used to assess HL, which was developed within “HLS19 – the International Health Literacy Population Survey 2019-2021” of M-POHL. Participants were categorized as having low or high health literacy based on the classification defined in the Norwegian HLS-19 report (2021). Additionally, each response was assigned a value (1-4) to calculate a summative health literacy point score, with a higher summative value indicating greater health literacy. Results In our cohort, 60% (n = 17) of the participants were categorized as having low and 39% (n = 11) as having high health literacy. There was no group difference in objective and subjective PA levels between those with low and high HL (all comparisons: p &amp;gt; 0.05). However, we observed a significant positive correlation between health literacy (point score) and objectively measured moderate to high-intensity PA (r = 0.52, p = 0.002). Likewise, there was a significant correlation between health literacy (point score) and self-reported total PA (r = 0.34, p = 0.03). Conclusion This is the first study to show a positive relationship between HL and PA in healthy young adult students, highlighting the potential role of HL in modulating PA in this population. Thus, further research is needed to determine whether targeting HL could effectively increase PA levels in young adults.

Association between work-related physical activity and depressive symptoms in Korean workers: data from the Korea national health and nutrition examination survey 2014, 2016, 2018, and 2020

BackgroundThe workplace experiences of employees can impact their mental health. Depressive symptoms, which are experienced by workers, are a mental health issue that deserves attention. Several studies have evaluated physical activity to prevent possible depression in workers in a work environment, however, research on physical activity and depression symptoms directly related to work is still insufficient. Therefore, we aimed to identify the relationship between work-related physical activity and depression among South Korean workers.MethodsWe used data from the Korean National Health and Nutrition Examination Survey conducted in 2014, 2016, 2018, and 2020, which included 31,051 participants. We excluded, participants aged < 15 years (n = 4,663), unemployed and economically inactive persons (n = 9,793), those who did not engage in work-related physical activities (n = 1,513) and leisure physical activities (n = 1,558), or those with missing data (n = 450). Therefore, the study included 13,074 participants. Work-related activity was measured by self-reporting, while depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9). Multiple logistic regression analysis was performed to investigate the association between work-related physical symptoms and depressive symptoms among workers.ResultsIndividuals who engaged in work-related physical activity had higher PHQ-9 scores than those who did not (male: odds ratio [OR]: 1.71, 95% confidence interval [CI]: 1.16–2.52; female: OR: 2.33, 95% CI: 1.66–3.29). High-intensity work-related physical activity significantly increased depressive symptoms (male: OR: 2.15, 95% CI: 1.04–4.43; female: OR: 2.90, 95% CI: 1.46–5.96). When classified according to the severity of depressive symptom, the OR of depressive symptoms of workers engaged in both leisure and work-related physical activities tended to be lower than that of those engaged only in work-related physical activities.ConclusionKorean workers who engaged in work-related physical activities exhibited more depressive symptoms. Therefore, our findings suggest that balancing work-related and leisure physical activities can help Korean workers prevent development of depressive symptoms.

Comparing Physical Activity and Quality of Life of Caregivers of Children With Physical Disabilities and Typically Developing Children.

There are conflicting reports of the level of physical activity (PA) and its relationship to quality of life (QoL) among caregivers of children with physical disabilities (CwPD). In this cross-sectional study, we aimed to compare the PA levels and QoL of two groups of caregivers - a CwPD group and caregivers of typically developing children (CwTD). We included 32 family caregivers in the CwPD group (22 women, 10 men; M age = 42.1, SD = 6.2years) and 32 caregivers in the CwTD group (24 women, 8 men; M age = 42.3, SD = 6.1years). We assessed PA with the International Physical Activity Scale-Short Form (IPAQ-SF) and self-reported activity diaries, and we assessed QoL with the Short-Form 36 (SF-36) questionnaire. Although the IPAQ scores and sitting times of caregivers in these two groups were not statistically different (p > .05), many parameters of self-reported activity diary data and total energy expenditure were significantly higher in the CwPD than the CwTD group (p < .05, effect size = .53-1.10). The CwPD group reported a lower QoL according to the SF-36 and its sub-scores (p < .05, effect size = .54-.77), and higher PA levels than those in the CwTD group. In the CwPD group, moderate, vigorous, and total PA scores were mildly to moderately associated with the total Qol score, and many of its subscores (r = .36 to .60, p < .05). The lower quality of life observed in CwPD, despite high-intensity physical activity levels, suggested that investigators and care providers should consider QoL in the CwPD group to be multifactorial and that here is a need for caregiver interventions to enhance QoL in this underserved population.

Therapeutic potential in rheumatic diseases of extracellular vesicles derived from mesenchymal stromal cells.

The incidence of rheumatic diseases such as rheumatoid arthritis and osteoarthritis and injuries to articular cartilage that lead to osteochondral defects is predicted to rise as a result of population ageing and the increase in high-intensity physical activities among young and middle-aged people. Current treatments focus on the management of pain and joint functionality to improve the patient's quality of life, but curative strategies are greatly desired. In the past two decades, the therapeutic value of mesenchymal stromal cells (MSCs) has been evaluated because of their regenerative potential, which is mainly attributed to the secretion of paracrine factors. Many of these factors are enclosed in extracellular vesicles (EVs) that reproduce the main functions of parental cells. MSC-derived EVs have anti-inflammatory, anti-apoptotic as well as pro-regenerative activities. Research on EVs has gained considerable attention as they are a potential cell-free therapy with lower immunogenicity and easier management than whole cells. MSC-derived EVs can rescue the pathogenetic phenotypes of chondrocytes and exert a protective effect in animal models of rheumatic disease. To facilitate the therapeutic use of EVs, appropriate cell sources for the production of EVs with the desired biological effects in each disease should be identified. Production and isolation of EVs should be optimized, and pre-isolation and post-isolation modifications should be considered to maximize the disease-modifying potential of the EVs.

Habitual physical activity modulates cardiometabolic health in long-term testicular cancer survivors

PurposesPhysical activity (PA) may mitigate late cardiometabolic toxicity of cisplatin-based chemotherapy in testicular germ cell tumor (TGCT) long-term survivors. In this cross-sectional study, we evaluated the effects of habitual PA on metabolic syndrome (MetS) prevalence, and on the markers of cardiometabolic health and chronic inflammation in a population of long-term TGCT survivors.MethodsMetS prevalence was evaluated, and habitual PA was assessed using Baecke’s habitual PA questionnaire in TGCT survivors (n=195, age=41.1±8.1years, 11.7±5.2years post-therapy) and healthy male controls (n=41, age=38.2±8.8years). Participants were stratified into low- and high-PA groups based on median values. Differences were examined between low- and high-PA groups (in the entire sample, TGCT survivor sub-samples differing in disease stage, and healthy controls), and between TGCT survivors and controls. Next, TGCT survivors were stratified into age- and BMI-matched sub-groups based on post-treatment time (5–15/15/30years) and number of chemotherapy cycles (≤3/>3), allowing us to detect age- and BMI-independent effects of habitual PA on cardiometabolic health in the given TGCT survivor sub-populations. A correlation matrix of habitual PA and sport activity with cardiometabolic and pro-inflammatory markers was generated.ResultsTGCT survivors had higher MetS prevalence than controls. Patients with high habitual PA had lower waist circumference and Systemic Inflammation Index. Habitual PA scores correlated positively with HDL-cholesterol and negatively with waist circumference and atherogenic risk. Furthermore, cardiometabolic benefits of habitual PA were more pronounced in patients with disease stages 1 and 2. Effects of habitual PA on patients sub-populations stratified by chemotherapy dose and post-treatment time clearly showed that higher levels of habitual PA were associated with lower numbers of MetS components, except for patients who received more than 3 chemotherapy cycles and were examined more than15 years post-therapy.ConclusionsHigher levels of habitual PA effectively mitigated cardiometabolic toxicity in TGCT survivors. Patients with higher cumulative doses of chemotherapy may need structured exercise interventions involving higher-intensity physical activity to achieve significant improvements in cardiometabolic health.

Association of formaldehyde concentration with depression risk in US adults: a population-based epidemiology study.

The association of formaldehyde exposure with depression remains unknown. We used the data fromNational Health and Nutrition Examination Survey (NHANES) 2015-2016to evaluate the association between formaldehyde exposure and depression. Multivariable logistic regressions and restricted cubic spline (RCS) were implemented to examine the association between formaldehyde exposure and depression. A total of 1336 participants were included in the analysis, of which 110 (8.23%) participants were depressed. After adjusting for confounders, a significant association between formaldehyde exposure and depression (OR = 1.01, 95% CI: 1.00-1.02, P = 0.043) was observed. The RCS plot showed a positive association in a linear manner (PNonlinear = 0.109), and the risk began to rise rapidly with concentrations above 129.37nmol/g HB. The positive association remained in participants with high-intensity physical activity (OR = 1.08, 95% CI: 1.02-1.13, P = 0.003), but not in participants with other physical activities. Moreover, we constructed a novel nomogram to easily estimate the individual-specific probabilities of depression. In conclusion, formaldehyde exposure was associated with an elevated risk of depression, and the effect exhibited differences in participants with different levels of physical activity.

Mental health, eating habits and physical activity levels of elite Iranian athletes during the COVID-19 pandemic.

The COVID-19 pandemic has changed life styles of millions of people worldwide. This study investigated changes in the health, physical activity levels and eating habits of elite athletes during the COVID-19 pandemic lockdown in Iran. 383 (248 female and 135 male) elite athletes (168.82 ± 0.07 cm; 63.92 ± 7.42 kg; the body mass index (BMI): 22.3 ± 0.78 kg/m2) participated in this study. The International Physical Activity Questionnaire (IPAQ), Depression Anxiety Stress Scales (DASS-21) and the Impact of Event Scale-Revised (IES-R) study tools were used to measure levels of physical activity and mental health status, respectively. The Emotional Eater Questionnaire (EEQ) was used to assess food consumption related to emotion. Pearson and Spearman correlation analysis test were used in data analysis. Levels of depression and stress were mild and moderate, while levels of anxiety were severe and very severe in most elite athletes. There were levels of low emotional eating by elite athletes during the COVID-19 pandemic. Physical activity levels were negatively correlated with psychological mood measures (p≤0.05), while there were positive correlations between emotional eating behaviours and psychological mood measures (moderate correlation; p≤0.01) and light physical activity levels (weak correlation; p≤0.05). This study provides the first preliminary evidence showing that the COVID-19 lockdown conditions negatively influenced the eating habits and levels of physical activity and mental health in elite athletes. Regular high intensity physical activity as health strategy in elite athletes and the general population remains a strategy to improve overall health during the COVID-19 pandemic. Additionally, these findings suggest the need to devise strategies to improve the life styles of elite athletes during pandemics such as the Covid-19 pandemic.