Changes In Physical Fitness Research Articles

Changes in Physical Fitness during COVID-19 Pandemic Lockdown among Adolescents: A Longitudinal Study.

The negative impact of COVID-19 on physical activity has been improved, while the research on changes in physical fitness that may be caused by physical inactivity is still scarce. This study aims to explore the impact of the COVID-19 pandemic lockdown on physical fitness, and the impact of initial physical fitness indicators on their changes during the lockdown in adolescents. A longitudinal study including 265 adolescents aged 14.1 ± 0.4 years old was conducted in China. Physical fitness measurement at baseline and follow-up were respectively measured before (November 2019) and after the lockdown (July 2020). Several physical fitness indicators including aerobic fitness (i.e., 800-m or 1000-m run) and explosive force (i.e., 50-m sprint) deteriorated during the lockdown. Whereas the performances of vital capacity, flexibility (i.e., sit and reach), and muscular strength (i.e., pull-ups) were significantly improved during the lockdown. Furthermore, the reduction in physical fitness for adolescents with higher physical fitness before the lockdown was greater than that for others. These findings may contribute to the development of targeted intervention strategies for physical fitness promotion during the lockdown caused by the public health emergency.

Can Primary School Mathematics Performance Be Predicted by Longitudinal Changes in Physical Fitness and Activity Indicators?

ObjectiveTo determine to what extent physical fitness indicators and/or moderate to vigorous physical activity (MVPA) may account for final mathematics academic performance (APmath) awarded at the end of primary school.MethodsSchool-aged youth were sampled in a repeated-measures, longitudinal design in Grade 6 (∼11 years), and again in Grade 9 (∼14 years). The youth (N = 231, 111 girls) completed a fitness test battery consisting of: flamingo balance test, standing long jump, backward obstacle course, plate tapping, sit ups, sit and reach, handgrip, and 20-m shuttle run. APmath scores were obtained for all children at the end of Grade 5, end of Grade 8, and end of Grade 9 (their final year of primary school). In a sub-sample of Grade 6 youth (N = 50, 29 girls), MVPA was measured objectively via SenseWear Pro Armbands (MVPAOB) for seven consecutive days, with measurements repeated in Grade 9.ResultsMath scores decreased from Grade 6 to 9 for both boys and girls (95%CI: −0.89 to −0.53, p < 0.001). MVPAOB was reduced by ∼45.7 min (−33%) from Grade 6 to 9 (p < 0.01). Significant main and interaction effects are noted for each fitness indicator (p < 0.05). A backward stepwise multiple regression analysis determined significant shared variance in final APmath grade to the change scores from Grade 6 to Grade 9 in: ΔAPmath, Δbackward obstacle course, Δsit and reach, and Δsit-ups [R2 = 0.494, F(4,180) = 43.67, p < 0.0001]. A second regression was performed only for the youth who completed MVPAOB measurements. In this sub-sample, MVPAOB did not significantly contribute to the model.ConclusionLongitudinal changes in youth fitness and their delta change in APmath score accounted for 49.4% of the variance in the final math grade awarded at the end of Grade 9. Aerobic power, upper body strength, and muscular endurance share more common variance to final math grade in boys, whereas whole-body coordination was the more relevant index in girls; this finding suggests that future research exploring the relationship of AP and PF should not be limited to cardiorespiratory fitness, instead encompassing muscular and neuro-muscular components of PF.

Changes in Active Behaviours, Physical Activity, Sedentary Time, and Physical Fitness in Chilean Parents during the COVID-19 Pandemic: A Retrospective Study.

Strategies to reduce the spread of coronavirus disease 2019 (COVID-19) have caused different behavioural modifications in all populations. Therefore, this study aimed to determine changes in active commuting, moderate-to-vigorous physical activity (MVPA), physical fitness, and sedentary time during the COVID-19 pandemic in Chilean parents. Eighty-six fathers (41.30 ± 6.82 years) and 294 mothers (40.68 ± 6.92 years) of children from different schools from Valparaíso, Chile, participated. Inclusion criteria were adults with schoolchildren who were resident in Chile during the research period. Convenience sampling was used as a non-probabilistic sampling technique. Respondents completed a self-reported online survey about active commuting, MVPA, self-perceived physical fitness, and sedentary time July–September 2020 during the first pandemic period. Comparisons between before and during the pandemic were performed using t-tests and covariance analysis (ANCOVA), establishing a significance level at p < 0.05. Most participants stayed at home during the pandemic, whereas active and passive commuting significantly decreased in both fathers and mothers (p < 0.001). MVPA and physical fitness scores reduced considerably (p < 0.05), while sedentary time significantly increased (p < 0.05), independent of the sex of parents and children’s school type. Differences by age groups and the number of children were more heterogeneous, as younger parents showed a larger decrease in MVPA (p < 0.05) and physical fitness score (p < 0.05). Additionally, parents with one child showed a larger decrease in sedentary time (p < 0.05) than those with two or more children. The COVID-19 pandemic significantly affected healthy behaviours. Hence, health policies should promote more strategies to mitigate the long-term health effects of the pandemic on Chilean parents.

Variations of the Locomotor Profile, Sprinting, Change-of-Direction, and Jumping Performances in Youth Soccer Players: Interactions between Playing Positions and Age-Groups.

The purpose of this study was two-fold: (i) analyze the variations of locomotor profile, sprinting, change-of-direction (COD) and jumping performances between different youth age-groups; and (ii) test the interaction effect of athletic performance with playing positions. A cross-sectional study design was followed. A total of 124 youth soccer players from five age-groups were analyzed once in a time. Players were classified based on their typical playing position. The following measures were obtained: (i) body composition (fat mass); (ii) jump height (measured in the countermovement jump; CMJ); (iii) sprinting time at 5-, 10-, 15-, 20-, 25- and 30-m; (iv) maximal sprint speed (measured in the best split time; MSS); (v) COD asymmetry index percentage); (vi) final velocity at 30-15 Intermittent Fitness Test (VIFT); and (vii) anaerobic speed reserve (ASR = MSS − VIFT). A two-way ANOVA was used for establishing the interactions between age-groups and playing positions. Significant differences were found between age-groups in CMJ (p < 0.001), 5-m (p < 0.001), 10-m (p < 0.001), 15-m (p < 0.001), 20-m (p < 0.001), 25-m (p < 0.001), 30-m (p < 0.001), VIFT (p < 0.001), ASR (p = 0.003), MSS (p < 0.001), COD (p < 0.001). Regarding variations between playing positions no significant differences were found. In conclusion, it was found that the main factor influencing changes in physical fitness was the age group while playing positions had no influence on the variations in the assessed parameters. In particular, as older the age group, as better was in jumping, sprinting, COD, and locomotor profile.

Effects of tabata training on health-related fitness components among secondary school students

Physical education curricula in Polish schools should include more tasks to increase physical activity. The Tabata Training Program can help regulate body weight and induce changes in body fat and physical fitness. This study aimed to determine the effects of a 10-week PE curriculum supplemented by a Tabata Training Program on health-related fitness in 16-year-old secondary school students. The study examined 187 students (66 boys and 121 girls) assigned to either a Tabata Training Program intervention or control group. The intervention lasted 14 minutes during one physical education lesson per week. Pre- and post-intervention, anthropometric measurements were taken, and each participant performed physical fitness tests to evaluate muscular strength, flexibility, speed/agility, and cardiovascular efficiency. Boys of the intervention group significantly reduced body fat (by 1.77%, p&amp;lt;.05) and increased cardiovascular efficiency (the physical efficiency index was higher by 3.61 points, p&amp;lt;.05). Girls increased cardiovascular efficiency only (the physical efficiency index increased by 5 points, p&amp;lt;.001). However, slight changes in motor parameters were observed in all the participants. The Tabata Training Program demonstrated partial effectiveness but should be individualized and sex differences should be considered.

Characteristics of Physical Fitness and Age-Related Changes in People over 60 Years of Age

Characteristics of Physical Fitness and Age-Related Changes in People over 60 Years of Age

A Randomized Controlled Trial Protocol for Using an Accelerometer-Smartphone Application Intervention to Increase Physical Activity and Improve Health among Employees in a Military Workplace.

Physical activity is beneficial for improving health and reducing sick leave absences. This article describes a protocol for an intervention using an interactive accelerometer smartphone application, telephone counselling, and physical activity recordings to increase the physical activity of workers in the military and improve their health. Under the protocol, employees from six military brigades in Finland will be randomly assigned to intervention and control groups. The intervention group’s participants will use accelerometers to measure their daily physical activities and their quality of sleep for six months. They will receive feedback based on these measurements via a smartphone application. The intervention group’s participants will be encouraged to exercise for two hours per week during working hours, and to participate in telephone counselling. The control group’s participants will continue with their normal exercise routines, without the accelerometer or feedback. The participants of both groups will be measured at the baseline, after the intervention period, and six months after the end of the intervention. The measurements will include accelerometer recordings, biochemical laboratory tests, body composition measurements, physical fitness tests, and questionnaires on sociodemographic factors, physical activities, and health. The primary outcomes will indicate changes in physical activity, physical fitness, and sick leave absences. The findings will help to develop a straightforward and cost-effective model for supporting the health and working capabilities of employees in the military and other workplaces.

Changes in Physical Fitness of Older People During the COVID-19 Pandemic in Germany: Objective Training Data

The purpose of this study was to analyze objective training data on changes in leg muscle training before and after the COVID-19 lockdown during spring 2020 in Germany. Overall, the training data of 4435 individuals in the age group (AG) 45-64 years (55±5 years, 66% ♀) and of 2853 in the AG 65-95 years (72±6 years, 54% ♀) were exported from chip-controlled exercise circuits. Training weight and number of repetitions performed on the leg extensor were used to calculate a leg score (LS), considering the last three training sessions before the lockdown (baseline) and the first ten individual sessions as well as the averaged sessions for August, September and October after individual training resumption. Based on the baseline LS, three training intensity groups (TG_low, medium, high) were defined, and analyzed for differences (ANOVA). The LS in TG_low remained stable after the lockdown, but increased compared to baseline in both AGs after the first ten sessions (p<0.05). In TG_medium, LS was reduced at the first post training session (p<0.05) and returned to baseline levels at training session eight in the younger and session two in the older adults. In both AGs, LS was reduced in the TG_high (p<0.001), and did not reach baseline levels by October. Hence, the LS of TG_high was identified as being particularly affected by the training interruption, irrespective of age. More individually tailored training recommendations should be made for these individuals to be able to regain their initial training levels and avoid long-term adverse health effects.

The Study of Muscle, Mobility, and Aging (SOMMA): An Overview

SOMMA is an NIA-funded cohort study to identify biological determinants of mobility and fitness. The overall aim of SOMMA is to use biopsies, novel biomarkers, advanced imaging, and intensive physical and cognitive assessments to elucidate the biological processes that contribute to changes in mobility and physical fitness with aging. SOMMA will recruit 875 people age 70+ (of whom about 200 have been enrolled.) We take biopsies of the vastus lateralis muscle to quantify mitochondrial content and function of the electron transport chain. We use 31PMR spectroscopy to quantify mitochondrial capacity to generate ATP in quadriceps muscle (ATPmax). We will quantify other biological properties in biopsies including denervation, autophagy and accumulated biochemical damage and use gene expression to discover pathways that contribute to mobility and fitness. SOMMA uses MR for quadriceps volume and D3Cr dilution for total skeletal muscle mass, cardiopulmonary exercise testing to measure fitness (VO2 peak). We are also making many other intensive assessments of physical and cognitive function. Mobility endpoints include baseline and three year change in 400 m and 4 meter gait speed and fitness. SOMMA is building a large biobank of muscle, adipose blood, and urine specimens that will be available for ancillary studies. In this Symposium, we will present results from analyses of associations between muscle mitochondrial function and strength, muscle mass, cognitive performance, gait speed, and fitness. The symposium will also preview opportunities for collaborations and ancillary studies with SOMMA.

Changes in Physical Fitness, Dietary Habits and Family Habits for Spanish Children during SARS-CoV-2 Lockdown.

Background: habits related to diet and physical activity in children were modified due to the lockdown that Spain had between March and June 2019 because of the health crisis caused by the appearance of SARS-CoV-2. The aim of the study was to know the impact that the lockdown had on physical fitness values in children aged 11–12. Methods: the study consisted of 50 Spanish children aged 11–12 (M = 11.40; SD = 0.50), 33 (66%) boys and 17 (34%) girls. Data collection was performed using the Alpha-Fitness Battery, a validated instrument to assess dietary intake, habits and practices, and an ad hoc survey to collect sociodemographic data and other information relevant to the study. Results: there were significant differences (p < 0.05) in the results of fitness variables measured in the standing long jump, agility speed and aerobic capacity, as well as in the results of maximal oxygen uptake (VO2 max) between, before and after lockdown in both boys and girls. No significant differences were found in measurements of right and left hand grip (p > 0.05). Conclusions: there is evidence of a significant impact of SARS-CoV-2 lockdown on physical fitness values in boys and girls aged 11–12.

Changes in Children's Physical Fitness during Corona-Related Restrictions in Spring/Summer 2020

Due to the increasing spread of the coronavirus (SARS-CoV-2) and the accompanying containment measures, physical activity opportunities for children in the context of school and sport clubs were severely restricted in the spring/summer of 2020. The present study focuses on changes in children's physical fitness during this period. We conducted an almost full census of 131 primary school children in the 2nd grade in Bad Dürkheim, assessing their physical fitness immediately before the school closures on 16 March 2020 and after the end of the summer holidays (end of August) in Rhine-land-Palatinate, Germany. The standardised German motor skills test with nationally representative, gender- and age-specific reference values was used. For evaluation, we used repeated measures analysis of variance to detect significant changes in physical fitness within the observation period. We took into account changes to be expected due to pandemics containment measures, and found a significant increase in physical fitness and BMI for the total sample during the observation period. Only in the dimensions of speed and endurance did the children show less development than would have been expected for their age. The proportion of overweight children increased from 17.7 to 23.8%. The results show that the frequently formulated fear that the Corona-related restrictions in spring/summer 2020 could have negative effects on children's physical development is not completely justified. However, in the view of the authors, the developments in BMI and endurance diagnosed in the short observation period should definitely be understood as a warning signal in the case of further restricted physical activity offers due to school closures, suspended sport clubs and especially wintry weather conditions.

HealthyLIFE, a Combined Lifestyle Intervention for Overweight and Obese Adults: A Descriptive Case Series Study.

(1) Background: The aim of this study is to investigate changes over time in participants of healthyLIFE, a Combined Lifestyle Intervention (CLI) based on the Coaching on Lifestyle (CooL) intervention. This study focuses on changes in behavior, physical fitness, motivation and Positive Health eight months after the start of the intervention. (2) Methods: In total, 602 Dutch adults, meeting the CLI inclusion criteria, were included from January 2018 until October 2020 in this descriptive case series study. We collected a broad set of data regarding weight/BMI, physical fitness, motivation, self-efficacy, social influence, personal barriers and needs towards food and physical activity and perceived personal health by means of the six dimensions of Positive Health. (3) Results: Eight months after baseline, positive effects of the intervention were found on most outcome measures. We found an increase in all measured aspects of physical fitness (stamina, flexibility, mobility, hand grip strength and BMI). Dietary changes were limited during the healthyLIFE intervention, except for fruit consumption (increase with an effect size of 0.42). The largest effect sizes were found for the dimensions of Positive Health ranging from 0.41 to 0.68. (4) Conclusion: The healthyLIFE intervention is successful in improving participants’ BMI, physical fitness, and perceived physical, mental and social health. A broad health perspective, beyond physical measurements, is recommended when studying effects of the CLI.

The effect of exercise training interventions in adult kidney transplant recipients: a systematic review and meta-analysis of randomised control trials

Background Kidney transplant recipients (KTRs) are characterised by adverse changes in physical fitness and body composition. Post-transplant management involves being physically active, although evidence for the effect of exercise is limited. Objective To assess the effects of exercise training interventions in KTRs. Methods NCBI PubMed (MEDLINE) and CENTRAL (EMBASE, WHO ICTRP) databases were searched up to March 2021 to identify eligible randomized controlled trials (RCTs) that studied exercise training in adult KTRs. Outcomes included exercise capacity, strength, blood pressure, body composition, heart rate, markers of dyslipidaemia and renal function, and health-related quality of life (QoL). Results Sixteen RCTs, containing 827 KTRs, were included. The median intervention length was 14-weeks with participants exercising between 2–7x/week. Most studies used a mixture of aerobic and resistance exercise. Significant improvements were observed in cardiorespiratory function (VO2peak) (3.21 ml/kg/min, p = 0.003), 6MWT (76.3 meters, p = 0.009), physical function (STS-60, 4.8 repetitions, p = 0.04), and high-density lipoprotein (HDL) (0.13 mg/dL, p = 0.03). A moderate increase in maximum heart rate was seen (p = 0.06). A moderate reduction in creatinine was also observed (0.14 mg/dl, p = 0.05). Isolated studies reported improvements in strength, bone health, lean mass, and QoL. Overall, studies had high risk of bias suggestive of publication bias. Conclusions Exercise training may confer several benefits in adult KTRs, particularly by increasing cardiorespiratory function and exercise capacity, strength, HDL levels, maximum heart rate, and improving QoL. Additional long-term large sampled RCTs, incorporating complex interventions requiring both exercise and dietary behaviour change, are needed to fully understand the effects of exercise in KTRs.

Relationships of Changes in Physical Activity and Sedentary Behavior With Changes in Physical Fitness and Cardiometabolic Risk Profile in Individuals With Type 2 Diabetes: The Italian Diabetes and Exercise Study 2 (IDES_2).

In the Italian Diabetes and Exercise Study_2 (IDES_2), behavioral counseling promoted a sustained increase in physical activity (PA) volume (+3.3 MET h ⋅ week-1), moderate- to vigorous-intensity PA (MVPA) (+6.4 min ⋅ day-1), and light-intensity PA (LPA) (+0.8 h ⋅ day-1) and decrease in sedentary time (SED-time) (-0.8 h ⋅ day-1). Here, we investigated the relationships of changes in PA/SED-time with changes in physical fitness and cardiometabolic risk profile in individuals with type 2 diabetes. In this 3-year randomized clinical trial, 300 physically inactive and sedentary patients were randomized 1:1 to receive 1-month theoretical and practical counseling once a year or standard care. Changes in physical fitness and cardiovascular risk factors/scores according to quartiles of accelerometer-measured changes in PA/SED-time were assessed, together with univariate and multivariable associations between these parameters, in the whole cohort and by study arm. Physical fitness increased and HbA1c and coronary heart disease 10-year risk scores decreased with quartiles of MVPA and SED-time change. In quartile IV of MVPA increase and SED-time decrease, cardiorespiratory fitness increased by 5.23 and 4.49 mL ⋅ min-1 ⋅ kg-1 and HbA1c decreased by 0.73 and 0.85%, respectively. Univariate correlations confirmed these relationships, and mean changes in both MPVA and SED-time predicted changes in physical fitness and cardiovascular risk factors/scores independently of one another and of other confounders. Similar findings were observed with LPA and PA volume and in each group separately. Even modest increments in MVPA may have a clinically meaningful impact, and reallocating SED-time to LPA may also contribute to improved outcomes, possibly by increasing total energy expenditure.

Physical Fitness Changes of Primary School Students: A Socio-Economic Evaluation

Bu araştırma ilkokul öğrencilerinde sosyo-ekonomik faktörlerin fiziksel uygunluk parametrelerine etkisinin incelenmesi amacı ile yapılmıştır. Özel bir ilkokulda öğrenim gören 44 kız öğrenci ve 39 erkek öğrenci olmak üzere toplam 83 öğrenci araştırmaya gönüllü olarak katılmıştır. Öğrencilerin fiziksel uygunluk düzeylerini değerlendirmek için Eurofit Test Bataryası kullanılmıştır. Eurofit test bataryası kapsamında; öğrencilerin vücut ağırlığı ve boy uzunluğu değerleri ölçülmüştür. Motorik performansların belirlenmesinde ise, flamingo denge, diske dokunma, otur-uzan, durarak uzun atlama, mekik, bükülü kol asılma ve 5x10 metre mekik testleri kullanılmıştır. Demografik özelliklerin belirlenmesinde araştırmacılar tarafından hazırlanan kişisel bilgi formu kullanılmıştır. Verilerin normal dağılıp dağılmadığı basıklık ve çarpıklık değerleri ile kontrol edilmiştir. İstatistiksel analiz boyutunda; betimsel analiz (ortalama, standart sapma, medyan, min-maks değer, oran, frekans) ve tek yönlü varyans analizi (ANOVA) kullanılmıştır. Ayrıca, Scheffe post hoc analizlerinden yararlanılmıştır. Araştırmalardan elde edilen bulgularda; anne eğitim düzeyinin öğrencinin fiziksel uygunluk düzeylerini etkilemediği tespit edilmiştir (p&gt;0.05). Baba eğitim düzeyinin sadece flamingo denge testi puanlarında anlamlı bir fark oluşturduğu belirlenmiştir (p

Normative Data for Musculoskeletal Fitness in 13,217 Children and Adolescents: The Croatian Fitness (CROFIT) Study

ABSTRACT Purpose: The main purpose of the study was to establish normative data for health-related musculoskeletal fitness. Method: We recruited 13,217 children and adolescents aged 11–18 years (6,181 boys and 7,036 girls; 57% of girls). To evaluate musculoskeletal fitness, the following field tests were applied: standing broad jump (cm), sprint 20 m (sec), medicine-ball throw (dm), sit-ups in one minute (#), sit-ups in one minute (short, #), and squats in one minute (#). Curves for the 10th, 20th, 30th, 40th, 50th (median), 60th, 70th, 80th, and 90th percentiles were calculated using the Lambda (L), Mu (M), and Sigma (S) method. The LMS method assumes that the data can be normalized by using a power transformation and removing the skewness. Results: Median scores for standing broad jump, sprint 20 m, medicine-ball throw, sit-ups in one minute, sit-ups in one minute (short) and squats in one minute were 185.00 cm, 3.66 sec, 80.00 dm, 46.00 x, 56.00 x and 49 x in boys and 160.00 cm, 4.01 sec, 60.00 dm, 40.00 x, 49.00 and 43 x in girls. Effect sizes (ES) showed that boys performed better in all physical fitness tests (ES = 0.50–1.05), compared to girls. In general, age-related physical fitness changes showed the plateau between ages 15 and 16 in boys, while in girls, the plateau was reached at the age of 14. Conclusions: This study shows standards for musculoskeletal tests in youth.

Influence of 2D:4D ratio on fitness parameters and accumulated training load in elite youth soccer players

BackgroundDigit ratio (2D:4D) characterized by the length of the second digit (2D) divided by the length of the fourth digit (4D), is a powerful marker of athletic performance. Some studies showed a negative correlation between 2D:4D ratio and sports performances.ObjectivesThe purpose of the present study was three-fold: (1) to analyze the influence of anthropometric and 2D:4D ratio on variations of accumulated training load (ATL) and fitness parameters: maximal oxygen uptake (V̇O2max), countermovement jump (CMJ), isometric muscular strength of the knee extensor for hamstring (ISH) and flexor for quadriceps (ISQ) muscles; along three stages of evaluation of soccer players based on playing positions; (2) to analyze the correlations between 2D:4D ratio and aforementioned parameters; and (3) to investigate if variance in fitness levels and ATL can explain the 2D:4D ratio.MethodsTwenty-four elite players under 17 years were daily monitored for their rating perceived exertion and ATL across 24 weeks over the season. Soccer players have also measured in three stages for anthropometric traits and fitness parameters.ResultsSignificant differences were observed between playing positions for body mass, goalkeepers had higher body mass compared to centre-midfielder and winger players. Moreover, there were significant differences in ATL between early-season to mid-season in goalkeepers (P = 0.032). The 2D:4D ratio (left and right) shown largely and negatively association with muscular strength (ISQ: r = − 0.80; r = − 0.78, P ≤ 0.001, ISH: r = − 0.63; r = − 0.62, P = 0.001, respectively) and VO2max changes (r = − 0.55, P = 0.005; r = − 0.50, P = 0.013, respectively); lastly, both 2D:4D ratio significantly predicted changes in muscular strength and VO2max in young soccer players.ConclusionsGoalkeepers tended to have higher body mass compared to centre-midfielder and winger players; and 2D:4D ratio revealed a mighty predictor of physical fitness changes in soccer players. Evidence should be helpful to professionals to highlight the usefulness of the 2D:4D into the identification of talent, but also to optimize young players' performance.

Physical fitness changes induced by thermal aquatic standardized exercise in chronic venous disease patients.

Lack of physical activity represents a risk factor for both cardiovascular and chronic venous diseases (CVD), nevertheless a specific exercise protocol for CVD patient is still missing. This investigation was aimed to assess the impact of a standardized exercise protocol in a thermal water environment on physical fitness and quality-of-life (QoL) in CVD patients. Sixteen (16) CVD patients performed 5 standardized exercise sessions in a thermal water pool. Before starting the exercise protocol, the cohort filled International Physical Activity Questionnaire (IPAQ) to determine their physical activity level. At baseline and at the end of the exercise program, leg volume, QoL, musculoskeletal and cardiovascular physical fitness were assessed by means of water plethysmography, validated questionnaire and functional test, blood pressure and heart rate at rest were also reported. All the patients were categorized as physically inactive: average activity time 235.6 (155.2) MET-minutes per week. At the end of the study, a significant leg volume reduction was found (-16%; p < .002). Significant improvement in lower limb strength (p < .0001), endurance (p < .006), rapidity and balance (p < .05) together with decrease in resting heart rate (-1.8%, p < .0001) and systolic blood pressure (-1.1%, p < .04) were reported, significant improvement in bodily pain (p < .0005) and social function (p < .002) QoL items were observed. The proposed exercise protocol in thermal aquatic environment demonstrated to be an effective treatment modality improving both cardiovascular and musculoskeletal outcomes and QoL in sedentary CVD patients. Aquatic environment investigations require proper analysis of the various factors involved, in a standardized and reproducible way. The herein report can be a reference for further studies on different health related conditions.

Changes in Physical Fitness and Body Composition Associated with Physical Exercise in Patients with Myasthenia Gravis: A Longitudinal Prospective Study.

There is a lack of guidelines for physical exercise in patients with myasthenia gravis (MG). A few pilot studies have shown that exercise can be safely applied to patients with MG. However, how physical exercise affects body composition, disease function, and disease severity remains unknown. In this prospective study, we enrolled 34 patients with MG with stable condition and evaluated the disease severity, physical fitness parameters, and body composition (measured using whole-body dual-energy X-ray absorptiometry (DXA)), before and after conducting a 24-week physical exercise regimen of aerobic and resistance strength training. The outcomes were measured by DXA, quantitative MG (QMG) score, quality of life score, handgrip strength and walking speed. During the training regimen, participants were free to decide how many exercise sessions per week and regularly reported their weekly exercise time. The physical exercise program was well tolerated by the participants, the parameters of the QMG score and handgrip strength improved, and participants’ body composition did not change significantly. The high exercise group experienced greater deterioration in muscle mass in the arms, but exhibited a greater improvement in forced vital capacity, walking speed, and symptom severity. The group with low QMG scores improved more in terms of physical fitness, including walking speed. These findings indicate that physical exercise is well tolerated by patients with MG, and is accompanied by improved muscular and physical functions. We propose that physical exercise is safe, effective, and appropriate for patients with well-regulated MG.

Physical Fitness and Skeletal Muscle Mass During Neoadjuvant Chemoradiotherapy in Patients with Locally Advanced Rectal Cancer: An Observational Study

Background: Patients with locally advanced rectal cancer are often considered for neoadjuvant chemoradiotherapy before resection. This presurgical treatment can have negative effects on physical fitness, muscle mass, and treatment compliance, which can negatively influence clinical outcomes. Objective: The aim of this study was to evaluate physical fitness and skeletal muscle mass before and after neoadjuvant chemoradiotherapy in single subjects with locally advanced rectal cancer. Design: An observational longitudinal study of single subjects. Methods: Routine care data were retrospectively analyzed. Data consisted of tumor characteristics, clinical data (eg, side effects and toxicity of the neoadjuvant chemoradiotherapy, loss of body mass), data on performance-based physical fitness, and computed tomography–derived skeletal muscle mass. An independent-samples t test or its nonparametric equivalent was performed on outcome measures to test for significant differences between T 0 and T 1. For comparing several subgroups in this cohort, the Mann-Whitney U test was performed and correlations were studied using the Pearson or Spearman correlation coefficient, as appropriate. Results: Data from 25 single subjects were available. Aerobic capacity (n = 25, P = .033) and skeletal muscle mass (n = 16, P = .005) were significantly reduced after neoadjuvant chemoradiotherapy. Although not statistically significant, a large number of patients demonstrated a decrease in muscle strength and functional mobility after completing neoadjuvant chemoradiotherapy. In 14 patients (56%), adverse events, dose-limiting toxicity, or early termination of treatment occurred. Conclusions: Aerobic capacity and skeletal muscle mass decreased following neoadjuvant chemoradiotherapy, with large interindividual differences concerning the changes in physical fitness and muscle mass. This between-subject variability indicates the importance of a personalized treatment approach.