Intensity Physical Activity Research Articles

Changes in physical activity and all-cause mortality among individuals with dementia: a cohort study using the National Health Insurance Service Database in Korea

ObjectiveTo examine associations between the amount and changes in regular physical activity (PA) before and after diagnosis of dementia and all-cause mortality risk, and whether these associations differ by PA...

Physical activity and exercise intensity terminology: a joint American College of Sports Medicine (ACSM) expert statement and exercise and sport science Australia (ESSA) consensus statement

Physical activity and exercise intensity terminology: a joint American College of Sports Medicine (ACSM) expert statement and exercise and sport science Australia (ESSA) consensus statement

Association of Objectively Measured Sedentary Behavior With Arterial Stiffness: Findings From the Nijmegen Exercise Study.

Sedentary behavior (SB) may affect arterial stiffness, preceding the development of cardiovascular disease. We investigated the association of objectively measured SB with arterial stiffness. We also investigated factors that affected this association. We recruited adult volunteers and measured SB with thigh-worn accelerometery for 24 hrs/day for eight consecutive days. Central (carotid-femoral pulse wave velocity, cfPWV, gold standard) and local carotid arterial stiffness (stiffness index Beta and pressure-strain elasticity EP) were measured with ultrasound. Linear regression was used and adjusted for demographics, cardiometabolic factors, and moderate-to-vigorous physical activity (MVPA) volume. Effect modification was studied with interaction terms. Participants (N = 664, 64 (standard deviation: 11, range: 23-89) years, 397 (59.8%) male) demonstrated 9.1 (1.6) hrs/day of SB, and arterial stiffness was 8.6 (3.0) m/s for cfPWV, 6.4 (2.9) for Beta, and 87 (43) kPa for EP. SB was not associated with cfPWV (β = 0.04 95% CI (-0.11, 0.18), p = 0.60). The association of SB with local arterial stiffness was modified by systolic blood pressure (SBP) and MVPA volume. Stratified analyses revealed positive associations of SB with Beta (β = 0.29 (0.05, 0.53), p = 0.016) and EP (β = 4.83 (1.39, 8.27), p = 0.006) in participants with SBP > 134 mmHg or > 103 min/day of MVPA (β = 0.23 (0.03, 0.42), p = 0.024 and β = 3.55 (0.82, 6.29), p = 0.011, respectively). We found no association of objectively measured SB with central arterial stiffness. However, SB was positively associated with local carotid stiffness in participants with higher SBP or MVPA levels. In certain subgroups, SB may affect carotid arterial stiffening, reinforcing the relation between SB and cardiovascular disease.

Causal mediation analysis of factors influencing physical activity and community access among people with mild to moderate Parkinson's disease

ObjectiveTo examine how known causal factors (exercise self-efficacy, balance, walking capacity) affect outcomes (moderate intensity physical activity, community access) in people with Parkinson's disease (PD): through a direct pathway, indirectly through potential mediators (non-motor impairments), or through combined direct and mediated paths. DesignCausal mediation analyses using baseline and three-month data from pooled treatment groups in a randomized controlled trial. SettingData were collected at two university clinical research centers. ParticipantsOne hundred thirty-eight people with PD. InterventionsHome and community-based walking and strength exercise program. Main Outcome Measure(s)Exposures were exercise self-efficacy, walking ability, and balance. Potential mediators included pain, fatigue, mood (anxiety, depression, affect, apathy), stigma, and cognition (executive function and cognitive flexibility). Outcomes were physical activity and community access behaviour at three-month follow-up. Separate models were developed for each causal factor-mediator-outcome combination. To minimise bias, all models were adjusted for known confounders (comorbidities, freezing of gait, severity of motor impairments, and/or age) and baseline values of the outcomes. ResultsSelf-efficacy of walking duration had a causal relationship with moderate intensity physical activity through direct and combined paths (p<.001). Walking capacity had a causal relationship with community access through direct (p=.03-.04) and combined (p=.02-.03) paths. Balance did not affect community access (p>.05). There were no significant mediation effects through indirect pathways for either outcome. ConclusionsThe effect of known causal factors on physical activity and community access was not mediated by non-motor impairments. Walking self-efficacy and walking capacity remain the primary intervention targets for improving physical activity and community access, respectively, in people with PD.

Longitudinal Changes in Adolescents’ Sedentary, Light, Moderate and Vigorous Physical Activity Levels

Background and purpose: In recent years, sedentary behaviour (SB) has become a significant risk factor for health, alongside the decline of physical activity (PA) in the population. This study explored adolescents’ PA and SB using a longitudinal design, from the age of 13 to 15, to elucidate any changes and when they potentially occur. Method: The data material from the accelerometer measurements was analysed using the program SPSS, version 28. Repeated measures ANOVA (and follow-up test with Bonferroni corrections) were used to assess changes in the four activity levels during the three years. Independent t-tests were used to examine gender differences in each year and at each activity level and to determine differences in activity level between participants with valid data for all three years and those with valid data only at 13 and/or 14 years of age. Results: Statistical analyses of the accelerometer measurements revealed a significant increase in time in the lowest activity level and a decrease in light, moderate and vigorous intensity PA levels during the three years. These changes were larger from 13 to 14, than from 14 to 15, years of age. However, no significant interaction was found between time and gender. Analyses also showed a significantly higher time spent in SB and lower time spent in moderate activity among girls compared to boys at 13, but not at the age of 14 and 15. Conclusions: The findings, which indicate a reduction in PA and increased sedentary time with increasing age, are discussed, which we argue are important to increase and solidify involvement in PA among adolescents. Emphasized here is the importance of communicating the diverse possibilities of movement and challenging understandings of what PA can be for youth.

Socio-Economic Determinants of the Physical Activity Intensity in Russia

The study examines the socioeconomic, demographic and health determinants of physical activity intensity in Russia. Using RLMS-HSE (the Russia Longitudinal Monitoring Survey – Higher School of Economics) data for 2021 and indicators of six levels of physical activity intensity, the authors built ordered probit models and calculated average marginal effects for a set of covariates. The independent variables were selected based on the SLOTH microeconomic model describing individual preferences towards physical activity.The ordered probit regression provided empirical support for Meltzer and Jena's theoretical framework, stating that as income increases, with the pronounced substitution effect, the time spent on physical activity decreases, and the intensity of physical activity rises. In our study, the thesis about an increase in intensity with rising income was confirmed for a subsample of men but not women. For women, the intensity was determined by factors such as multiple morbidity and residing outside of Moscow or Saint Petersburg, which were not significant in the regressions for men.The study resulted in several important conclusions. The intensity analysis showed that physician recommendations regarding the type of physical activity should consider patients' workload. For individuals with a busy schedule, recommended types of exercise that require a long time (for example, walking) are not suitable. At the same time, intense workouts (such as tennis or gym classes) can be built into the schedule. There is a need to develop sports infrastructure at workplaces, allowing individuals to allocate time for classes without bearing additional time and monetary costs associated with travel to the location of workouts. As income increases, exercising near the workplace allows an individual to increase the intensity of physical activity without incurring additional time costs

A profile approach to physical activity levels: what’s intensity got to do with reasons and motives for exercise?

BackgroundDespite the well-known benefits of physical activity (PA), non-communicable disease and premature mortality rates among adults continue to rise. The relationship between adults’ goals and exercise-specific motivation on the type of PA intensity one engages remains unclear. The purpose of this study was to identify physical activity (PA) profiles based on frequency and intensity (i.e., levels of PA) in an adult sample. A secondary purpose was to examine how the PA profiles differ on the reasons people have for exercising and behavioral regulation.MethodsA Cross-sectional survey was conducted with 1,169 (46.8 ± 16.7 years) participants solicited from a hospital-affiliated wellness center, social media promotions, and a research volunteer registry. The International PA Questionnaire (IPAQ) was used to determine frequency, intensity, and time spent engaging in PA. Additionally, the Reasons to Exercise (REX-2) scale, the Behavioral Regulation in Exercise Questionnaire-3 (BREQ-3), and demographics were assessed. K-cluster analyses were performed to identify profiles based on PA levels using the IPAQ guidelines. Multivariate analysis of variance (MANOVA) was used to assess profile differences.ResultsFive distinct PA clusters were derived, and defined as: a Low, Walking, Moderate Intensity, High Intensity, and Sitting cluster (p < .001). These clusters differed significantly (p < .001) from each other with respect to motivation, the reasons adults have for exercise, and PA levels.ConclusionThe results from this study support the important role of psychological factors such as motivation and reasons for exercise on behavioral outcomes (i.e., physical activity). For future research investigating adults PA- related behaviors, whether it be on adults starting a new exercise program or for PA maintenance, it may be beneficial to develop programs that encourage participants to reflect on the reasons they identify as important for exercising, and how such reasons contribute to their overall PA engagement behaviors.

Accelerometer-measured physical activity pattern in older patients with frailty and heart failure

Abstract Background Physical activity (PA) assessed by accelerometers represents a novel method to understand the PA profile of older patients with heart failure (HF). We hypothesized that PA level and pattern vary in HF patients across the spectrum of frailty status. Aim To report the duration, intensity and volume of PA in older patients with HF according to frailty status. Methods We recruited 150 HF patients≥65 years from a hospital-based HF clinic between March and October 2023. Frailty was assessed using the Short Physical Performance Battery (SPPB); patients with SPPB 10-12, 7-9, 4-6 and ≤3 was classified as robust, mildly, moderately and severely frail respectively. To evaluate PA profile, all patients wore a wrist accelerometer on their non-dominant hand for 7 days (24 hours/ day). PA parameters including average acceleration over 24 hours (proxy of volume of activity); time spent in inactive, light, moderate and vigorous intensity activities; intensity gradient (more negative gradient equates to poorer intensity profile) and time of most active continuous bouts of PA, were compared amongst frailty groups. Results 146 participants with good quality accelerometer data were included in the analysis; median age 80 (range 65-94 years), 65% male. Thirty-eight percent had heart failure with reduced ejection fraction (HFrEF); 21% had NYHA class III/IV symptoms; median NT-proBNP was 2040 ng/L (IQR = 1110 - 4930). Frail patients were more likely to be older with more comorbidities; they also had more severe HF symptoms and higher NT-proBNP. Frail patients had lower volume of PA compared to robust patients, evidenced by lower average acceleration (milligravity-mg) over 24 hours [20.4 (robust); 16.0 (mildly frail); 13.5 (moderately frail); 13.2 (severely frail), p&amp;lt;0.001]. PA intensity profile was poorer in frail patients compared to robust patients [median intensity gradient: -2.72 (robust); -2.92 (mildly frail); -3.00 (moderately frail); -3.07 (severely frail), p&amp;lt;0.001]. (Table 1) Frail patients spent more time inactive compared to robust patients [median time spent inactive (minutes): 654 (robust); 689 (mildly frail); 780 (moderately frail); 720 (severely frail), p&amp;lt;0.001]. The median time (minutes) spent in light [225 (robust); 190 (mildly frail); 164 (moderately frail); 159 (severely frail)] and moderate to vigorous activity [62 (robust), 23 (mildly frail), 15 (moderately frail) and 13 (severely frail), p&amp;lt;0.001] were significantly shorter in frail compared to robust patients. (Figure 1) The most active continuous bout of PA of patients across the frailty spectrum appeared to between 10 AM to 2 PM. Conclusion The duration, volume and intensity of PA was generally low in older patients with HF. Worse frailty status was associated with longer duration of physical inactivity, shorter duration of light, moderate or vigorous activity, poorer PA intensity profile and lower volume of PA.

High physical activity relates to higher risk of incident carotid plaque components

Abstract Background The rupture of carotid atherosclerotic plaque, primarily driven by plaque components, is among the leading causes of ischemic stroke. Although physical activity (PA) stands as a major modifiable target for prevention of atherosclerotic diseases, recent studies suggested a potential adverse impact of high-volume PA on atherosclerotic plaque burden in athletes. Data remains scarce from the community-dwelling population regarding to the impact of PA on the longitudinal change of carotid plaque components. Objectives To assess the association between PA and the incidence of carotid plaque components and explore whether the association of PA with stroke and all-cause mortality differs by the presence of plaque components. Methods Between 2007 and 2012, in a community- dwelling cohort in Netherlands, 1327 stroke-free persons (mean ± standard deviation age 72 ± 9 years, 45% women) with carotid atherosclerosis (carotid intima-media thickness &amp;gt; 2.5 mm) were invited for magnetic resonance imaging (MRI) to assess carotid plaque components. From these, 696 persons (1267 carotid arteries) underwent a follow-up MRI between 2014 and 2017 (median between-scan interval 6 years). Carotid plaque components included calcification, intraplaque hemorrhage (IPH), and lipid-rich necrotic core (LRNC). The volume of moderate, vigorous and total PA (unit: metabolic equivalent task hour, MET-h) was assessed using LASA Physical Activity Questionnaires around the time of the first MRI scan. Participants were followed for the occurrence of stroke or all-cause mortality until December 31, 2019. Generalized estimation equation and Cox regression models were used in the analyses, with adjustments for plaque size and other cardiovascular risk factors. Results Compared to lowest quintile PA group, participants in the highest quintile total PA group had a higher risk of new onset of plaque components, odds ratio (95%CI) 2.69 (1.21; 5.94) for calcification, 1.35 (0.82; 2.24) for LRNC and 1.93 (1.12; 3.34) for IPH (Figure 1). Similar associations were observed for vigorous PA but not for moderate PA. Over a median follow-up of 9.5 years, 118 persons suffered a stroke and 298 died. As shown in table 1, baseline IPH, rather than LRNC or calcification, modulated the associations of PA with stroke and all-cause mortality (P-interaction &amp;lt;0.05): higher total PA was associated with a lower risk of stroke among IPH-free persons, with the hazard ratio (95% CI) of 0.929 (0.867; 0.996) per 10 MET-h/week increase; no associations between PA and stroke were found among those with IPH. Similar associations were found between vigorous PA and all-cause mortality. Conclusions Among the middle-aged and elderly with subclinical atherosclerosis, high level PA, especially high vigorous PA, may lead to an unstable carotid plaque. The beneficial effect of PA on stroke and all-cause mortality is only among persons with a stable carotid plaque profile, especially without IPH.

Physical activity and sedentarism among non-binary gender identified university students

Abstract Background Physical inactivity (PA) and sedentary behavior (SB) are modifiable risk factors for non-communicable diseases (NCDs). Data indicates that non-binary gender identified people find it difficult to perform PA, this is a disadvantage for them to reach their full health potential. Methods Students were selected by convenience sampling to complete a survey between October-November 2023. A validated PA questionnaire was included. PA and SB were classified into 4 levels: Active but sedentary, extremely sedentary, physically active and discreetly active. Data were analyzed using Statistical Package for the Social Sciences (SPSS). Results Out of 32 students did not identified themselves as binary gender. In our sample, 28,1% (vs 12.9% binary students) don’t do PA. Of those doing PA, 52,2% don’t meet World Health Organization recommendations. Among those who perform PA, there no difference in the amount of minutes/week of moderate or intense physical activity performed. Regarding SB, 93,8% spend &amp;gt;6 hours/day in SB (vs 84.7% binary students, mean 7,82 vs 8,75, Sg. 0,032). When grouped into PA/SB categories 65,6% (vs 40,5%) were extremely sedentary in contrast to 1,4% physically active (vs 8.8%). Conclusions In Spain, 1 in 4 young people does not identify with the male/female categories. In our sample, physical inactivity and sedentarism are higher among those who do not identify as male/female. Once they commit to physical activity, there is no difference in the time spent between those who meet the WHO recommendations. More research is needed to understand the reasons for these differences and ensure barrier-free access to healthy lifestyle habits on campus. Key messages • Non-binary gender identified students are less physically active and more sedentary than their peers. • Once they commit to physical activity recommendations, there are no differences among their performance.

Device-measured vigorous intermittent lifestyle physical activity (VILPA) and major adverse cardiovascular events: evidence of sex differences.

Vigorous intermittent lifestyle physical activity (VILPA) refers to brief bouts of intense physical activity embedded into daily life. To examine sex differences in the dose-response association of VILPA with major adverse cardiovascular events (MACE) and its subtypes. Using multivariable-adjusted cubic splines, we examined the associations of daily VILPA duration with overall MACE and its subtypes (incident myocardial infarction, heart failure and stroke) among non-exercisers (individuals self-reporting no leisure-time exercise and no more than one recreational walk per week) in the UK Biobank. We also undertook analogous analyses for vigorous physical activity among exercisers (individuals self-reporting participation in leisure-time exercise and/or recreational walking more than once a week). Among 13 018 women and 9350 men, there were 331 and 488 all MACE, respectively, over a 7.9-year follow-up. In women, daily VILPA duration exhibited a near-linear dose-response association with all MACE, myocardial infarction and heart failure. In men, dose-reponse curves were less clear with less evidence of statistical signifigance. Compared with women with no VILPA, women's median daily VILPA duration of 3.4 min was associated with hazard ratios (HRs; 95% confidence intervals) of 0.55 (0.41 to 0.75) for all MACE and 0.33 (0.18 to 0.59) for heart failure. Women's minimum doses of 1.2-1.6 min of VILPA per day were associated with HRs of 0.70 (0.58 to 0.86) for all MACE, 0.67 (0.50 to 0.91) for myocardial infarction, and 0.60 (0.45 to 0.81) for heart failure. The equivalent analyses in UK Biobank's accelerometry sub-study exercisers suggested no appreciable sex differences in dose-response. Among non-exercising women, small amounts of VILPA were associated with a substantially lower risk of all MACE, myocardial infarction and heart failure. VILPA may be a promising physical activity target for cardiovascular disease prevention, particularly in women unable or not willing to engage in formal exercise.

Assessment of controlled assistance from e-bikes as a mitigation strategy for individual PM exposure

Abstract Background While promoting active mobility and outdoor activities can benefit health (HLT), it also increases Exposure (EXP) to air pollutants, such as particulate matter (PM), due to the increased ventilation rate (VR) under physical activity. Traditional assessments of individual (IND) PM EXP involve costly equipment inaccessible to the public, but real-time low-cost sensors (LCS) are now emerging. This study presents a proof of concept to demonstrate the use of LCS for examining the real-time IND respiratory dose deposited (RDD) to PM cycling across the Brescia province. Methods An e-bike was ridden 33 times between 2022 and 2023 wearing a LCS for PM concentration [PM] linked to a GPS. Respiratory dose deposited(RDD) was calculated for six different locations within each route based on experimental PM and various VR. Results The LCS allows for the study of the spatial and temporal variability of [PM], revealing a significant difference (p &amp;lt; 0.01) according to the heating system operation and no significant difference (p &amp;gt; 0.05) depending on the location. RDD increases with [PM] and VR. Real-time and integrated RDD is calculated for routes with high (&amp;gt; 50 µg/m3), medium (25 µg/m3), and low (&amp;lt;10 µg/m3) [PM2.5]. The e-bike assistance is activated when the WHO interim target 4 of [PM] is reached to reduce VR, which corresponds to a shift to a lower physical activity intensity. The RDD calculated using the e-bike assistance over the path reduces RDD by about 23% and 11% over the high and medium [PM], while it never activates for the low [PM]. Conclusions This study demonstrates that the use of LCS allows the estimation of IND RDD, and the implementation of mitigation strategies based on controlled assistance from e-bikes would enable the reduction of PM individual EXP. Key messages • The integration of HLT data from wearable and air quality LCS enables the promotion of active mobility and outdoor activities controlling the EXP to air pollutants. • Establishing generalized guidelines based on this mitigation strategies for individual exposure reduction may also inform policy recommendations for promoting active and green mobility.

A systematic study on the elevated risk of ankylosing spondylitis in adolescents engaged in intense physical exercise

This study investigates the link between intense physical activity during adolescence and the onset of ankylosing spondylitis (AS), particularly in individuals having the human leukocyte antigen (HLA)-B27 antigen, a known genetic marker for AS. The systematic literature review included studies published between 2014 and 2024. . Keywords and search terms included combinations of "ankylosing spondylitis," "HLA-B27," "adolescence," "intense physical exercise," and "genetic predisposition. Inclusion criteria focused on studies involving adolescents aged 15-24 years with genetic predispositions such as HLA-B27. Exclusion criteria included studies with unrelated outcomes such as individuals not within the target adolescent age range, non-peer-reviewed articles, and those with insufficient data on the target population. Findings revealed that adolescents with the HLA-B27 antigen who engaged in heavy weight exercise were at a heightened threat of developing AS. The mechanical stress from intense physical activity potentially triggered or exacerbated inflammation at entheses in genetically predisposed individuals. However, the onset of AS was not universally observed in all HLA-B27 positive individuals who participated in strenuous exercise, suggesting other genetic and environmental factors’ involvement. The study suggests that strenuous exercise during adolescence may act as a significant contributing factor to the onset of AS in individuals having a genetic predisposition such as HLA-B27. While not all individuals having HLA-B27 develop AS, genetic and environmental factors’ combination, including intense physical activity, may accelerate disease progression.

Effectiveness of Cross Friction Massage, Manual Therapy, Gastro Soleus Complex Stretch on Foot for Heel Pain in Menopause Women

Plantar fasciitis is a common musculoskeletal problem and is a frequent source of heel discomfort. Plantar fasciitis is a widespread ailment, but its exact mechanism and aetiology are yet unknown. Most people agree that it is related to recurrent micro-trauma. However, because of the hormonal changes that follow menopause, it is more common in postmenopausal women. Because estrogen maintains the suppleness and length of the plantar fascia, the decrease in oestrogen levels is important. The inferior heel area, especially in the vicinity of the medial plantar process, as well as the medial, lateral, and lower posterior parts of the calcaneus are frequently affected by heel pain. Weight-bearing activities are usually when the patient experiences the most severe pain, and the majority of the time, a shift in the quantity or intensity of physical activity occurs before the patient experiences symptoms. This study aims to show the effectiveness of three treatment protocols for plantar fasciitis: foot and ankle manipulation combined with cross-friction massage and gastrocsoleus complex stretching.

Physical activity levels and musculoskeletal disease risk in adults aged 45 and above: a cross-sectional study

BackgroundMusculoskeletal disease (MSD) is a major cause of disability among older adults, and understanding the role of physical activity (PA) in preventing these conditions is crucial. This study aimed to explore the association between PA levels and MSD risk among adults aged 45 and above, clarify the dose‒response relationship, and provide tailored guidelines.MethodsUsing data from the China Health and Retirement Longitudinal Study (CHARLS), a cross-sectional analysis was conducted on 15,909 adults aged 45 and over. The study population was divided into MSD (n = 7014) and nMSD (n = 8895) groups based on musculoskeletal health status. PA levels were assessed using the International Physical Activity Questionnaire and categorized into low intensity physical activity (LIPA), moderate vigorous physical activity (MVPA), and vigorous physical activity (VPA). Multivariable logistic regression models and restricted cubic spline regression were used to examine the relationship between PA levels and MSD risk in middle-aged and older adults. Sensitivity analyses and stratified analyses were also performed.ResultsThe main outcome measures were musculoskeletal diseases prevalence and PA levels. MVPA and VPA reduced MSD risk by 19% [OR = 0.81, 95% CI (0.72, 0.90), P < 0.001] and 12% [OR = 0.88, 95% CI (0.79, 0.98), P < 0.05], respectively. What’s more, after adjusting for confounding factors, VPA increased risk by 32% [OR = 1.32, 95% CI (1.04, 1.66), P < 0.05]. The relationship was nonlinear, showing a U-shaped pattern with age and hypertension status as significant moderators. The optimal PA energy expenditure was identified as approximately 1500 metabolic equivalents of tasks (METs) per week for adults aged 45–74, 1400 METs per week for those aged 75 and above, and 1600 METs per week for hypertensive adults aged 45 and older.ConclusionsFor adults aged 45 years and older, VPA significantly increases the risk of MSD. Adults aged 45 years and older should adjust their weekly METs based on their age. Additionally, those with hypertension should moderately increase their weekly METs to promote optimal musculoskeletal health.

Osteochondral Autograft Transplantation for Symptomatic Full-thickness Patellar Cartilage Defects in Adolescents.

This study aimed to review the clinical, radiographic, and magnetic resonance imaging (MRI) outcomes of osteochondral autograft transplantation applied to patellar cartilage lesions of patients under 18 years of age. Data from nine consecutive patients were retrospectively analyzed for indications, preoperative complications, and clinical-radiographic outcomes. Patients were clinically evaluated using the Pedi-IKDC and Lysholm scores. In addition, return to sports and knee pain were assessed. MRI evaluation included an analysis of osteochondral graft integration using the magnetic resonance observation of cartilage repair tissue 2.0 score and radiographic classification of osteoarthritis using the Kellgren-Lawrence system. Nine patients (9 knees, 6 males) with a mean age of 14 years (SD: 1.7, range; 11 to 17y) were analyzed. Lesions were located on the medial facet (N=5), lateral facet (N=3), and central ridge of the patella (N=1). One or 2 cylindrical osteochondral grafts were transplanted, with a median diameter of 9mm (range: 8 to 10mm). The average lesion size was 102.9mm2. At a mean follow-up of 45.1 months (range: 23 to 117mo), the mean Pedi-IKDC score was 89.2 (SD: 9.8), and the Lysholm score was 94.4 (SD: 4.8). Patients returned to sports in an average of 7.3 months (SD: 2, range: 6 to 12mo). MRI of 8 patients showed osteochondral graft integration with a mean magnetic resonance observation of cartilage repair tissue 2.0 score of 86.9 (SD: 7, range: 80 to 100). Six knees showed Kellgren-Lawrence grade 0 joint space on radiographs, and 3 showed grade 1. Eight patients were asymptomatic at the last follow-up, and 1 reported occasional mild pain with intense physical activity. One patient developed arthrofibrosis, requiring arthroscopic lysis of adhesions and manipulation. Osteochondral autograft transplantation is a safe and effective technique for treating symptomatic patellar full-thickness chondral lesions in adolescents. Long-term follow-up studies will determine whether the affected area maintains structural and functional integrity over time. Level IV-therapeutic study.

Running for two (or three!): The journey of an ultramarathoner across two pregnancies.

There is a lack of evidence regarding the safety of long-duration and vigorous intensity physical activity during pregnancy, such as that required during an ultramarathon. This case study is the first to examine the training, performance, health, and delivery outcomes for an ultramarathoner across two successive pregnancies (one twin and one singleton) that were delivered when the athlete was 41 and 43 years, respectively.. During her twin pregnancy, she ran an average of 91.72 ± 23.17 kilometers across 9.06 ± 2.38 hours per week. Both twins were normal for gestational age and delivered at 37 weeks. Twin B experienced mild hypoxic-ischemic encephalopathy, but made a full recovery following treatment. Twin pregnancy increases risk of this complication and there is no evidence to suggest that it is associated with vigorous intensity endurance activity. During her singleton pregnancy, the participant's distance and pace increased, running on average 157.80 ± 14.69 kilometers across 14.08 ± 1.60 hours per week. She also competed in 5 races including 3 ultramarathons and ranked well, with no adverse events during or following each of the races. She delivered prematurely (36 weeks and 6 days), but her baby was normal for gestational age.

The Relationship between Sleep and Physical Activity by Age, Race, and Gender.

Cardiometabolic diseases remain the leading cause of death in the United States. Lifestyle factors contribute the majority of risk for these diseases. Although diet and exercise have been the primary focus of research on modifiable behaviors to target for interventions to prevent cardiometabolic disease, recent evidence suggests that sleep also plays an important role. Indeed, the updated American Heart Association campaign includes sleep as one of its "Essential Eight". This review details the reciprocally reinforcing positive relationship between sleep and daytime physical activity behaviors and explores how this relationship differs based on age, gender and race. For example, interventions to improve moderate intensity physical activity may be particularly beneficial to women, older adults, and Black Americans, who are at increased risk for sleep disturbances. Communicating to Americans the importance of managing their time to meet current physical activity and sleep recommendations is a challenge given that there are so many competing behaviors consuming large amounts of time (e.g., social media, gaming), but is critical given the importance of these behaviors for cardiometabolic health.

Physical activity interventions to prevent and manage type 2 diabetes in Aboriginal and Torres Strait Islander people: a systematic review.

To review evidence regarding the impact of physical activity interventions for preventing and managing type 2 diabetes in Aboriginal and Torres Strait Islander Australians. We searched for published reports of physical activity interventions for preventing and managing type 2 diabetes in Indigenous adults (18 years or older). There were no exclusion criteria regarding study type or duration, frequency, length, or intensity of physical activity, except that short term interventions were excluded. We assessed the quality of each study using the Joanna Briggs Institute (JBI) critical appraisal tools and the ethical and methodological quality of studies from an Indigenous Australian perspective with the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange (CREATE) Critical Appraisal Tool. MEDLINE; Scopus, Embase (Elsevier); Cumulative Index to Nursing and Allied Health Literature (CINAHL), Sports Discus, PsycINFO (EBSCO); Informit Complete; ProQuest Dissertations and Theses, and ProQuest Health and Medicine; each from their inception to 30 October 2022. The database searches identified 703 potentially relevant records; after removing duplicates and initial screening, the full text of 27 articles was assessed for eligibility. Nine studies met our inclusion criteria: two randomised controlled trials, five cohort studies, one quasi-experimental study, and one repeated cross-sectional study. Eight studies were rated as being of low or medium quality (median JBI score, 54%; interquartile range [IQR], 36-64%); seven studies were rated as being of low to medium ethical and methodological quality from the Indigenous perspective (median CREATE score, 50%; IQR, 36-64%). Six studies reported changes in glycated haemoglobin (HbA1c) levels, of which two (both cohort studies) reported significantly lower mean HbA1c levels after the intervention, but only one publication provided detailed results. No randomised controlled trials that investigated the effect of a combination of physical activity and dietary change for Indigenous Australians diagnosed with type 2 diabetes were identified. Differences in study design, outcome variables, and the small number of studies precluded meta-analysis. Quality research into the impact of physical activity interventions on type 2 diabetes in Indigenous people is sparse. To improve research translation, studies that involve Indigenous community members at all levels of the research process are needed. PROSPERO CRD42021247496 (prospective).

Evidence of the Long-Term Protective Effect of Moderate-Intensity Physical Activity on Cognitive Function in Middle-Aged and Elderly Individuals: A Predictive Analysis of Longitudinal Studies.

To investigate the effects of different intensities of physical activity (PA) on cognitive function in middle-aged and elderly individuals, and to predict future trends in cognitive ability using longitudinal data to assess the long-term role of PA in cognitive preservation. Data from the China Health and Retirement Longitudinal Study (CHARLS) were utilized. Mixed-effects models were employed to analyze the impacts of low-intensity PA (LPA), moderate-intensity PA (MPA), and vigorous-intensity PA (VPA) on overall cognition, episodic memory, and mental intactness. Random forest and XGBoost machine learning methods were employed to further validate the effects of PA. ARIMA models predicted future cognitive trends under the influence of PA. MPA demonstrated significant advantages in preserving cognitive function, particularly in overall cognition and episodic memory. While LPA had some protective effects, they were less significant than those of MPA, and VPA did not show advantages. Machine learning methods confirmed these findings. ARIMA model predictions indicated that the protective effects of MPA on cognitive function are likely to persist in the future. Moderate-intensity physical activity is associated with the preservation of cognitive ability in middle-aged and elderly individuals and may continue to provide this benefit in the future; however, further in-depth research is needed for confirmation.