Physical Fitness Research Articles

The effect of special exercises using some auxiliary tools to develop some bio-kinetic abilities and the accuracy of the crushing and snatch forehand strikes among badminton players

The best means and ways to develop an athlete's physical and skill capabilities, and among these means is the use of training aids that help develop some bio-kinetic abilities, and prepared exercises have had an important role in improving athletic performance in badminton, where the player must possess physical fitness, explosive power, and strength. Characterized by speed as well as accuracy, awareness, and focus while playing on the court, the badminton player must be physically fit through a continuous movement of small and large muscles to achieve good performance, which requires special physical abilities and skills, and the most important of these bio-kinetic abilities are agility, coordination, and measuring the coordination between the eye and the arm. These abilities are needed by the badminton player while playing on the court. The study aimed to prepare special exercises using some auxiliary tools to develop some bio-kinetic abilities and the accuracy of the crushing and lightning forehand strikes among badminton players, in addition to identifying the effect of special exercises using some auxiliary tools on For badminton players, the researcher adopted the experimental method, and the sample number was (10) players from the badminton training center in the Armenian club, aged (17-19). They were distributed into two experimental and control groups, and they were chosen randomly because the research objectives require the use of athletes proficient in the game's technical performance. The researcher applied her main experiment using special exercises with some auxiliary tools, with (4) training units per week for (8) weeks. The results of the study showed that there was a positive effect on the results of bio-kinetic abilities between the two groups and in favor of the experimental group. It was shown in the kinetic response speed test for the first experimental group 7.423, agility 3.012, and compatibility 3.123, and for the second experimental group in the kinetic response speed test 3.208, agility 6.861, and compatibility 6.907. As for the skill tests for the first experimental group, The front smash hit was 7,234 and the diagonal front snap shot was 28.00. It was shown in the skill tests for the second experimental group that the front smash hit was 3,372 and the diagonal front snap shot was 3,400, which included exercises. The researcher recommends adopting the results of this study and disseminating them, and emphasizing equipping the stadiums with modern training methods, due to the results they achieve. Positive physical development serves one of the goals of sustainable development: good health and good education.

Physical fitness in youth: a systematic review of changes during and after the COVID-19 pandemic

Abstract Background Restrictions during the COVID-19 pandemic induced changes in the fitness behavior of children and adolescents, which may be associated with long-term public health challenges. This systematic review analyses how physical fitness has changed during the pandemic and to what extent the changes remain in the aftermath of the pandemic. Methods We conducted a systematic search in seven databases with a peer-reviewed search string for studies until Dec 2023. Our inclusion criteria encompassed studies with children and adolescents ≤19 years living in the WHO European Region and in which validated measurements were used (single measurements or test batteries). Eligibility screening, data extraction and risk of bias assessment (using ROBINS-E instrument) were all carried out independently by two reviewers. We published an a priori protocol in a peer-review journal and conducted reporting in accordance with the PRISMA 2020 statement. Trial registration: PROSPERO: CRD42023395871. Results Our search retrieved 28 studies from 15 WHO European Region countries with an age range from 5 to 19 years. Physical fitness was reported in 21 validated single measurements (e.g. 20 m shuttle run, handgrip strength, standing long jump) and 9 validated test batteries (e.g. Alpha-Fitness Battery, German Motor Test, International Physical Performance Test Profile). The preliminary analyses pointed to a sharp decline in youth physical fitness during the COVID-19 pandemic. After restrictions were eased, physical fitness improved, but remained under pre-pandemic levels, particularly in boys. Conclusions The findings indicate a potential suboptimal behavioral adaptation of children and adolescents after the COVID-19 pandemic. Medium and long-term programs to change passive behavior and improve physical fitness are urgently needed. In addition to individual prevention programs, stronger consideration should also be given to schools and sport clubs regarding activities promoting physical fitness. Key messages • Physical fitness in children and adolescents remains below pre-pandemic levels after restrictions removal. • Initiating immediate public health action to increase physical fitness is urgently needed.

Low physical fitness indicates future injury, mental health, menstrual cycle disruptions and burnout in female emergency service personnel and healthcare providers

Musculoskeletal injury (MSKi), depression, anxiety and burnout place a considerable burden on emergency services personnel and healthcare providers (HCP). Physical fitness is related to both mental and physical health in these populations but females in these are hugely underrepresented in this literature. As female representation in first-responder and HCP roles increases, the need for female specific research is needed. This study examines physical fitness as a short-term indicator of future reproductive health, MSKi, and mental health for females employed as first-responders or HCP. Thirteen first-responders and 29 HCP completed an initial health and demographics questionnaire, a comprehensive physical assessment (e.g., bone mineral density, muscular strength, muscular endurance, muscular power, flexibility, and aerobic capacity), and a health questionnaire 6-7 months after the physical testing. We found that i) bone mineral density, relative upper body strength, and lowerbody power were related to sustaining future MSKi, ii) better lower body endurance and flexibility was related to future menstrual cycle disruptions, and iii) low bone mineral density was related future self-reported burnout and Patient Health Questionnaire score >10. Physical fitness characteristics can be helpful indicators of future MSKi risk, menstrual cycle disruptions, and mental health status in females employed in arduous occupations.

Skeletal and respiratory muscle weakness contributes to decreased exercise capacity in hypertrophic cardiomyopathy

Abstract Background and Aims Although decreased exercise capacity (due to dyspnea or angina-like symptoms) constitutes the fundamental characteristics of hypertrophic cardiomyopathy (HCM), the pathophysiology of these symptoms remains only partly understood. We investigated clinical and functional determinants of decreased exercise capacity in a broad range of HCM patients irrespective of primary disease aetiology (either genetic disorder or e.g. infiltrative phenocopies in the course of cardiac amyloidosis), overt heart failure (HF) and the presence of haemodynamically significant left ventricular outflow tract obstruction (LVOTO). Further, we deterimined the contribution of skeletal and respiratory muscle weakness to decresed exercise capacity. Methods We analyzed clinical data and functional assessments (skeletal and respiratory muscle strength, physical fitness) in relation to symptomatology and sub-maximal exercise capacity in 82 clinically stable patients with HCM (females: 32 %; age: 62±16 years; left ventricular ejection fraction [LVEF] 59±7%; intraventricular septum wall thickness [IVS] 19±4 mm; median plasma N-terminal pro-B-type natriuretic peptide [NT-proBNP]: 818 pg/mL [lower and upper quartile: 208-1917]; New York Heart Association [NYHA] class 0/I/II/III: 38/18/33/11 % [0 indicates no HF]; significant LVOTO: 29%). Results HCM patients with more severe symptomatology (NYHA class II-III vs 0-I) were older, had more frequently significant LVOTO and greater comorbidity burden, and had higher NT-proBNP and worse estimated renal function (all p≤0.03). Gender distribution, percentage of beta-blocker therapy and implanted device, body mass index, major echocardiography parameters (including LVEF, left ventricular end-diastolic diameter and IVS), high-sensitive (hs) cardiac troponin type I and hs-C-reactive protein were comparable in these 2 groups of subjects (all p>0.05). In multivariable linear regression models more advanced age, higher circulating natriuretic peptides (NT-proBNP) and previous coronary revascularization were independent predictors of more advanced NYHA class (standardized β-coefficient=0.30, p<0.01; β=0.27, p<0.01; and β=0.22, p<0.05; respectively). Similarly, more advanced age, female sex and higher NT-proBNP were independent correlates of shorter distance in 6-minute walking test (6MWT) (β=-0.46, p<0.001; β=-0.26, p<0.001; and β=-0.36, p<0.001; respectively). All analyzed muscle parameters (including respiratory muscle strength parameters) and objective measures of physical fitness (Functional Fitness Test for older adults) remained independently associated with 6MWT distance (all p<0.001) when adjusted for aforementioned clinical and laboratory correlates of 6MWT. Conclusions Muscle weakness and low physical fitness are related to decreased exercise capacity in HCM and may be potential therapeutic targets to alleviate disease symptoms also in non-obstructive HCM phenotype.

Evidence of association between gender and physical fitness in physically active people in Colombia

Abstract Background Physical Condition (PC) is an important health marker (Colley, 2019), as a predictor of morbidity and mortality from cardiovascular diseases, among other causes (Cruz, 2018). Aim To perform association tests between gender (G) and CP in physically active people in Colombia. This study is observational cross-sectional, 1,503 people participated, 1,019 Women (W) (68.6%) and 485 Men (M) (31.4%) in Colombia, mean age 52±16.2 in W and 42±17.8 in M. Data were analyzed with Rstudio v2022.12.0. The statistical protocol was: 1- Empirical distribution. 2- Normality tests with Kolmogorov-Smirnov. 3- Tests of independence with Chi-square (χ²). The mean (X¯), percentage (%) and standard deviation (±) were taken into account. PC was measured in body composition variables; Body Mass Index (BMI), Body Adiposity Index (BAI) and Abdominal Circumference (AC), Grip Strength (GS) and Maximal Oxygen Consumption (Vo2max). Results In W, 38.3% (27.2±1.37) were overweight (Ow) and 19.1% (33.0±2.83) obese (Ob), 69.6% (90.9±8.14) cardiovascular risk (CVR) for AC and 50.4% (32±4.73) risk for BAI. Regarding GS 43.4% (15.8±6.38) is weak and 54.6% (27.7±4.98) Vo2max is low. In M 35.6% (26.9±1.48) presented Ow and 10.6% (32.7±2.39) in Ob, 39.7% (98.4±6.8) with Rcv by AC and 24.3% (29.7±3.45) at risk by BAI. As for GS 41.5% (27.1±6.39) are weak and 32.3% (33.3±6.33) under Vo2max. According to independence tests with χ² there is association between the G and BMI (χ²=1452.1, df = 1427, p-value=0. 315), G and AC (χ²=394.9, df = 382, p-value=0. 313), G and Vo2max (χ²=155.5, df = 6, p-value<2. 2e-16), G and BAI (χ²=2970.3, df = 1502, p-value<2.2e-16), G and GS (χ²=6015.5, df = 1502, p-value<2.2e-16). This project has been approved by the bioethics committee. Conclusions Test of independence with (χ²), being a non-homogeneous sample, there is a strong association between G and PC with BMI, BAI, AC, GS and Vo2max, each variable depending on the others, evidencing higher Rcv in women with respect to men. Key messages • Several studies consider Physical Condition (PC) is an important health marker (Colley, 2019), as a predictor of morbidity and mortality of cardiovascular disease, among other causes (Cruz, 2018). • There is a strong association between G and the levels of BMI, BAI, AC, SG and Vo2max variables, each variable depending on the others, showing a higher Rcv in women compared to men.

Benefits of a light- intensity bout of exercise on attentional networks functioning

The effects of physical exercise on attentional performance have received considerable interest in recent years. Most of previous studies that assessed the effect of an acute bout of exercise on attentional performance have generally been approached by analysing single attentional functions in isolation, thus ignoring the functioning of other attentional functions, which characterizes the real perception-action environmental conditions. Here, we investigated the effect of two different intensities (light vs. vigorous) of acute exercise on attentional performance by using the ANTI-Vea, a behavioral task that simultaneously measures three attentional functions (phasic alertness, orienting, and cognitive control) and the executive and arousal components of vigilance. 30 young (age = 20.93; SD = 1.51 years) physically active participants (21 men and 9 women) completed three experimental sessions: the first one to assess their physical fitness and baseline performance in the ANTI-Vea, and the other two sessions (in counterbalanced order) to assess changes in attentional and vigilance performance after an acute bout of light- intensity vs. vigorous- intensity physical exercise. Beneficial effects on some accuracy scores (i.e., overall higher accuracy in the attentional sub-task and fewer false alarms in the executive vigilance sub-task) were observed in the light- intensity exercise condition compared to baseline and vigorous- intensity. Additionally, the RT score of phasic alertness was increased after the light- intensity exercise in comparison with baseline. The present findings suggest that a bout of acute exercise at light- intensity might induce some short-term beneficial effects on some aspects of attention and vigilance.

Feasibiliy, safety and patient perceptions of an exercise-based cardiac telerehabilitation programme

Abstract Background Despite proven benefits of exercise-based cardiac rehabilitation (EBCR), few patients with myocardial infarction (MI) complete these programs and there is a need to develop more flexible and evidence-based options. Purpose The aim of this study was to evaluate feasibility, safety, and patient perceptions of remotely delivered EBCR. Methods This study was conducted at 23 cardiac rehabilitation centres during the Covid-19 pandemic (March 2020-September 2022), when access to centre-based EBCR was restricted. A total of 231 patients with MI <80 years were included 2-4 weeks after discharge to participate in a remote EBCR programme 2 times/week for 3-4 months. Exercise was delivered through a real-time group-based video meeting, connecting the physiotherapist to patients exercising at home. Safety monitoring in terms of adverse events (AE) and serious adverse events (SAE) were recorded. Outcomes were assessed before and after remote EBCR completion and comprised tests of physical fitness and questionnaires: self-reported physical activity and exercise (Haskell questionnaire), physical capacity (VAS), kinesiophobia (TSK-Heart), health-related quality of life (EQ5D-VAS), self-efficacy for exercise, and patient acceptance of the program. Results Patients performed in median 19 (Q1 9 - Q3 23) remote EBCR sessions. A total of 16 AEs were registered during exercise (e.g chest pain, syncope, dizziness, musculoskeletal symptoms) which were all resolved. Two SAEs that required hospitalization were reported (chest pain, in-stent restenosis), both unrelated to exercise. At end of remote EBCR, significant improvements in physical fitness, self-reported exercise and physical capacity, kinesiophobia, and health-related quality of life were observed (Table 1). Delta values were similar to previous centre-based EBCR studies. Patients agreed that remote EBCR improved health care access (83%), was easy to use (94%), and 95% found exercise performance and interaction acceptable. Conclusions This study supports that remote EBCR is feasible and safe with a high patient acceptance post-MI. The clinical effectiveness needs to be confirmed in a randomized controlled design.

Research on the relationship between physical literacy and demographic variables and interpersonal support for physical exercise among adolescents in China.

In recent decades, the concept of "Physical Literacy" has emerged as a significant breakthrough in enhancing the physical health of children and adolescents. This concept has become the guiding principle and future direction for physical education reform in Western countries. As China's economic and social development enters a new phase, the negative impact of insufficient physical activity on adolescent health remains a significant challenge to the strategies of "Healthy China" and "A Leading Sports Nation." The unique value of physical literacy, which emphasizes the importance of regular physical activity, aligns perfectly with the developmental needs of the nation, the era, and individuals. Given the crucial role of interpersonal support in the development of adolescents' physical literacy, this study employs questionnaire surveys and statistical analysis to investigate the current state of physical literacy among Chinese adolescents. It explores the predictive relationship between parental support, teacher support, and peer support on physical literacy, aiming to provide guidance for the future development of adolescents' physical literacy. The research findings indicate significant differences in the five dimensions of physical literacy (attitude, sports knowledge, emotion, athletic ability, and physical fitness) among adolescents of different grades and residence type. Additionally, there are notable gender differences in the dimensions of sports knowledge, emotion, and athletic ability. The interaction effect of gender and grade is particularly evident in the emotional and physical fitness dimensions. There is a significant correlation between interpersonal support and all dimensions of physical literacy. After controlling for variables such as gender, grade, and family background, interpersonal support for adolescent physical exercise was found to have a significant impact on all dimensions of physical literacy. Among the forms of support, peer support was identified as a more powerful predictor of physical literacy compared to parental and teacher support.

Symptoms and atrial fibrillation burden measured by an insertable cardiac monitor in endurance athletes

Abstract Background Atrial fibrillation (AF) is the most common cardiac arrhythmia in athletes, but knowledge regarding AF burden, symptoms and quality of life (QoL) in endurance athletes with AF is limited. Purpose To study AF burden by continuous monitoring using insertable cardiac monitor (ICM), AF symptoms and QoL in endurance athletes with paroxysmal AF. Methods In endurance athletes diagnosed with paroxysmal AF who reported ≥2 episodes of AF, of which ≥1 during the past six months, we continuously monitored AF using ICM. Episodes recognized as AF by ICM were validated by a cardiologist. We defined AF burden as the cumulative duration of AF episodes lasting ≥30 secs divided by the total duration of monitoring. AF symptoms were assessed using the 21-item Atrial Fibrillation Effect on QualiTy-of-Life Questionnaire (AFEQT). AFEQT produces a summary score and three subscale scores (symptoms, daily activities, treatment concerns), ranging from 0 (complete AF-related disability) to 100 (no AF-related disability). We defined any score <80 as clinically relevant AF symptoms. We classified athletes according to the modified European Heart Rhythm Association (mEHRA) classification. Sport participation was obtained by questionnaires. Height and weight were measured and physical fitness was examined during cardiopulmonary exercise testing. Results A total of 38 athletes (3 female, 8%) were included. Table 1 shows their characteristics. Eight of the athletes (21%) had recurrent AF after previous AF ablation therapy. ICM recordings were available in 30 athletes who were monitored for an average of 53±21 days (mean±SD). Eighteen athletes (60%) had ≥1 AF episode, the median number of AF episodes was 2 (interquartile range 8.75), and the mean AF burden was 1.4±2.5%. The mean AFEQT summary score was 84±12 and 11 athletes (29%) had an AFEQT summary score <80. The mean AFEQT symptom subscale score was 78±18). While 21 athletes (55%) had a symptom subscale score <80, indicating clinically relevant symptomatic AF, 9 (24%) scored <60, indicating more severely symptomatic AF. Figure 1 shows ICM-detected AF burden across categories of mEHRA classes and categories of the AFEQT summary score. The AF burden corresponded to both AFEQT scores and mEHRA categories, with a higher AF burden associated with more symptomatic AF (Figure 1). AF burden was numerically lower in athletes with recurrent AF after previous AF ablation therapy, compared to athletes previously not treated with AF ablation (0.6% vs. 1.7%, p= 0.66), but previously ablated athletes were more symptomatic (AFEQT symptom subscale score 68 vs. 80, p= 0.04). Conclusions Despite a relatively low AF burden during continuous monitoring with ICM, a majority of the athletes had clinically relevant symptomatic AF. Athletes with recurrent AF after previous ablation therapy had a numerically lower AF burden, but were more symptomatic compared to athletes with paroxysmal AF not previously treated with AF ablation.

Association between fitness levels and physical activity in apparently healthy Colombian men

Abstract Physical condition (PC) such as strength and endurance favor functional independence and disease prevention (Melo, 2014). Objective: To characterize the levels of Physical Activity (PA) and CP in apparently healthy men who practice PA in different settings in Bogotá-Colombia. This study is observational cross-sectional, 485 Men (M) participated, mean age 42±17.8 years. To measure the levels PA the IPAQ (International Physical Activity Questionnaires) was applied. The Confidence Interval (CI) and Standard Error (SE) were taken into account. For PA levels, data were analyzed with Rstudio v2022.12.0, with empirical distribution tests, Kolmogorov-Smirnov normality and independence with Chi-Square (χ²), in addition, mean (X¯), percentage (%) and standard deviation (±). 90.6% of the H met the overall PA recommendations (Leisure Time+Active Transportation) with 95% CI (88.0-93.0) and SE (0.012). The PC variables such as; Body Mass Index (BMI), Body Adiposity Index (BAI), Abdominal Circumference (AC), Grip Strength (GS) and Maximal Oxygen Consumption (Vo2max). The results showed that 35.6% (26.9±1.48) of H were Overweight (Ow) and 10.6% (32.7±2.39) were Obese (Ob), 39.7% (98.4±6.8) with Cardiovascular Risk (Rcv) by AC and 24.3% (29.7±3.45) with risk by BAI. As for GS 41.5% (27.1±6.39) is weak and 32.3% (33.3±6.3) is low Vo2max. According to independence tests with χ² there is association between the G and BMI (χ²=1452.1, df = 1427, p-value=0. 315), G and AC (χ²=394.9, df = 382, p-value=0. 313), G and Vo2max (χ²=155.5, df = 6, p-value<2.2e-16), G and BAI (χ²=2970.3, df = 1502, p-value<2.2e-16), G and GS (χ²=6015.5, df = 1502, p-value<2.2e-16). This project was approved by the bioethics committee. Conclusions 149 men corresponding to 30.7% of the sample present an increased possibility of Rcv, despite compliance with global PA recommendations. It is recommended that PA programs reinforce the improvement and promotion of PC to prevent possible Rcv. Key messages • The capacities that define physical fitness (FC) such as strength and endurance favor functional independence and disease prevention (Melo, 2014). • Apparently healthy men in Colombia present a higher possibility of Cardiovascular Risk due to low levels of physical fitness, despite compliance with global BP recommendations.

Predicting physical fitness levels from resting ECG data: a machine learning approach in cardiovascular assessment

Abstract Background Exercise Stress Testing (EST), an inexpensive noninvasive modality, is widely used for preliminary cardiovascular evaluation and ongoing monitoring of cardiac patients. The MET (Metabolic Equivalent of Task) score from EST, indicating physical fitness, is associated with overall mortality risk and is extremely helpful for preoperative evaluation. Artificial Intelligence (AI) advances, particularly Deep Learning (DL) for resting ECG analysis, have significantly improved cardiac diagnostic accuracy. Objectives This study explores AI's ability to predict MET scores from resting ECGs, aiming to streamline fitness assessments and detect early changes in fitness levels. Methods The current analysis encompasses 45,518 consecutive EST evaluations from 31,532 individual patients from 2017 to 2023. MET scores were automatically computed using an established formula, while interpretations by certified cardiologists provided a benchmark for the AI model. Poor fitness was defined as being within the lowest quartile of MET scores, adjusted for sex and age. A deep learning framework was developed to process a 10-second snippet of resting phase ECG in raw waveform, predicting the likelihood of diminished fitness and thus acting as a binary classifier. The efficacy of this Poor Fitness AI model (PF-AI model) was assessed through metrics such as the area under the receiver operating characteristic curve (AUROC), along with sensitivity, specificity, and accuracy rates. Results The average age of the study group was 55±10 years, predominantly male (68.8%, n = 31,337). Among them, 1,152 were identified as having poor fitness. Applying the model to the entire cohort through 5-fold cross-validation yielded a sensitivity of 78%, a specificity of 81%, and an AUROC of 0.87 in predicting poor fitness. Conclusions Leveraging merely 10 seconds of resting ECG data, the PF-AI model proves to be a robust tool in predicting poor fitness levels, comparable to the outcomes of comprehensive stress testing.

Loneliness and the prevalence of injuries, falls and fractures in older people

Abstract The feeling of being alone (loneliness) experienced by older people contributes to deterioration of health, reduced physical and mental fitness, or inability to continue life roles. Loneliness may lead to behaviors that increase the risk of accidents, falls, and fractures, which are particularly dangerous in old age. The aim of this study was to assess the relationship between loneliness and the prevalence of injuries, falls, and fractures in older people. The studied group consisted of 464 people (48% men), aged 62-86 years (mean: 71.6, SD: 6.3), who participated in the Polish part of the HAPIEE Study (Health Alcohol and Psychosocial Factors in Eastern Europe); random subsample examined in 2019-2020. Trained nurses interviewed respondents in their homes. The 3-item UCLA scale (range 3-9, cut-off point≥6) was used to assess loneliness. Data on injuries or accidents in previous 10 years, falls in previous 12 months, history of wrist, hip fracture or undergoing joint surgery/alloplastic was recorded. Multivariable logistic regression analysis was used. There were 460 participants included in the analysis. In 34 participants (7.3%) UCLA score was ≥6. In the previous 10 years, 95 respondents (20.5%) reported an injury or accident, 77 (16.6%) fell in previous 12 months. There were 6 (1.3%) respondents with history of hip fracture, 48 (10.3%) with history of wrist fracture, and 35 (7.5%) with history of joint surgery/alloplastic. No statistically significant relationship between loneliness and the prevalence of injuries, falls and fractures in older residents was found neither in the crude models nor after adjustment for covariates (age, sex, BMI, marital status, having offspring). Loneliness did not predict injuries, falls, and fractures in older urban residents. It seems that perception of being alone is weaker determinant of health as a measure not fully reflecting objective social isolation, which may actually have a greater impact on falls and injuries. Key messages • 1/5 of older people have experienced any injury or accident and 17% reported to have fallen in the previous year. • Loneliness did not predict injuries, falls, and fractures in older urban residents.

Prediction of central Augmentation Index in healthy adults.

Central Augmentation Index (AIx) is a surrogate marker of large artery stiffness that may provide valuable insight to cardiovascular health. The aim of this study was to evaluate the relationship between AIx and components of physical fitness. One hundred eighty-five healthy men and women (aged 20-79 years) underwent non-invasive assessment of arterial wave reflection to determine AIx, which was corrected to a heart rate of 75 beats per minute (AI×75). Body composition was evaluated using dual energy X-ray absorptiometry (DXA) and aerobic capacity (VO<inf>2max</inf>) was derived from expired gas analysis during a symptom limited exercise test on a treadmill. A multiple linear regression revealed age and VO<inf>2max</inf> as significant predictors of AI×75 [AI×75=32.055 + (0.252×age) - (0.722×VO<inf>2max</inf>)]. Upon removal of VO<inf>2max</inf> from regression analysis, resting heart rate (RHR) and % body fat (BF%) were revealed to be significant predictors of AI×75: AI×75=-61.316 + (0.481×age) + (0.565×BF%) + (0.56×RHR). Our findings demonstrate that central Augmentation Index can be reliably predicted in healthy adults who undergo a maximal exercise or body composition assessment. These prediction equations may be applied in non-medical settings to assist in creating comprehensive health and fitness profiles for healthy clientele.

Effect of incremental exercise training interventions in a Cardiac Rehabilitation Program following myocardial infarction

Abstract Background Exercise-based cardiac rehabilitation is recommended after myocardial infarction (MI) to improve prognosis, quality of life and control of cardiovascular risk factors. However, the specific impact of different exercise training interventions remains incompletely understood. Purpose To study the health outcomes of three incremental exercise training interventions during a Cardiac Rehabilitation Program (CRP) following MI. Methods We implemented a post-MI Phase 2 CRP in 2022. After initial exercise testing, a 3-month, individualized aerobic and strength ambulatory training program was provided by Cardiologists and Physical Medicine and Rehabilitation physicians (Group 1, n=58). Additionally, a subset of patients received one session of supervised teaching of aerobic and strength training by physiotherapists (Group 2, n=19), and another subset received 8-20 sessions of in-hospital supervised training (Group 3, n=13). Exercise testing was repeated at the end of Phase 2 and peak oxygen consumption (peak VO2) was measured. We analysed quality of life (SF-36), depression (PHQ2), anxiety (GAD2), adherence to Mediterranean diet (PREDIMED) and pharmacological treatment (Morisky-Green), and weekly physical activity (IPAQ). Health outcomes were compared at the beginning and after Phase 2 CRP. Results The cohort comprised 90 patients who completed Phase 2 CRP (mean age 61.2±10.8 years, 84.4% male and 47.8% smokers). Reductions in systolic blood pressure (-10.3±13.8mmHg), LDL cholesterol (-60.7±35.4mg/dL), weight (-2.8±6.6kg, -3±7.8%) and body mass index (-1±2.2) were attained (p&amp;lt;0.05). Smoking abstinence was accomplished in 88.4% of smokers and most patients achieved an LDL&amp;lt;55mg/dL (81.1%). Improvements in quality of life (SF-36 +10.4±19.4 points, p&amp;lt;0.001) and anxiety and depression symptoms (PHQ2 -0.5±1.6 points and GAD2 -0.6±1.6 points, p&amp;lt;0.01) were noted. An increase in peak VO2 (+5.12±5.44ml/kg/min, +23.5±27.4% from baseline, p&amp;lt;0.001) and predicted functional capacity (+13.4±23.8%, p&amp;lt;0.001) was achieved. Patients increased their reported weekly physical activity by 2520.3±2935.4 METS/week (+132% from baseline, p&amp;lt;0.001) and most of them were adherent to Mediterranean diet (91.1%) and pharmacological treatment (95.6%). Patients achieved similar health outcomes regardless of their exercise training group, except for patients in Group 3, who experienced a more pronounced improvement in peak VO2 (+8.1±6.4ml/kg/min, +37.8±34.7% from baseline; p&amp;lt;0.05) and a trend towards higher increase in predicted functional capacity (+21.7±19.2%, p&amp;lt;0.25) and greater weight loss (-5.5±9.4kg, -5.9±9.6%; p&amp;lt;0.2). Conclusions Supervised in-hospital training during a Phase 2 CRP provides superior physical fitness improvements and more pronounced weight loss in MI patients. However, a Phase 2 CRP based on ambulatory training provides similar benefits regarding other health outcomes, such as control of cardiovascular risk factors and quality of life amelioration.Exercise training interventions in a CRP

Surfing a culturally-relevant physical activity: a new wave for health promotion

Abstract Background Surfing originated with Native Hawaiians prior to Western contact. It has since gained worldwide popularity, with an estimated 50 million surfers globally, and recently became an official Olympic sport. Associations have been reported between surfing and mental and physical health outcomes, greater community cohesion, and stronger intra-family relationships. Despite this evidence, surfing is deeply understudied in the context of health promotion. Purpose Surfing was analyzed from a mixed methods perspective to explore factors associated with lifetime participation and current engagement, including gender, race/ethnicity, chronic disease, social context, meaning, and average time of participation. Methods Hawai’i adult residents (n = 1066) completed an online or phone questionnaire. Modified Poisson regression models were fit for lifetime engagement and having a self-reported chronic disease, adjusting for primary race/ethnicity, age, gender, and education. Results Over their lifetime, 42% of respondents (50% men and 37% women) had participated in surfing. Engagement was highest during youth and young adulthood, and decreased with age, yet trends varied notably by race/ethnicity, gender, and generation. Lifetime surfing engagement was significantly related to lower likelihood of diabetes (aPR:0.72; 95%CI:0.56-0.92;p=0.009). Individuals who regularly participated in surfing typically did so with friends (78%) or family (61%); average surfing session duration was 209 minutes. Qualitative results revealed the relevance of surfing across levels of influence for health and wellbeing from physical fitness to community, culture, history and spirituality. Conclusions This work provides insights on the health promotion opportunities of surfing across the life-course and populations, including disease prevention and management. This study has implications for planning and policy locally and globally to achieve optimal community and planetary health. Key messages • Surfing is not only a sport for elite athletes, but also an activity that can support community and individual health and wellbeing in many populations over the lifespan. • Promotion of surfing and public ocean access can support multidimensional influences for wellbeing and should be a focus of cross sector collaborations for optimal community and planetary health.

Personalized cardiac rehabilitation in older geriatric patients: an analysis of age, heart failure subtypes, and physical metrics

Abstract Background While cardiac rehabilitation (CR) is recognized for enhancing physical fitness, psychological well-being, and overall quality of life in cardiac patients, its universal application often overlooks the heterogeneity within the geriatric population. This study delves into the effectiveness of CR among older geriatric patients, aiming to uncover the disparities in response across various demographics, heart failure subtypes, and angina classifications, thereby underscoring the imperative for personalized CR programs. Methods We retrospectively analyzed 438 CR participants from December 2020 to December 2023, stratifying them by age (median: 65.14 years, IQR: 57.23-72.64), sex (23.74% female), heart failure subtype, and CCS angina class to identify distinct response patterns to CR. The analysis included a comprehensive assessment of physical metrics pre- and post-12-week CR program following cardiac surgeries, transcatheter procedures, coronary events, and/or interventions. We employed the Wilcoxon Rank Sum test for statistical analysis, focusing on identifying non-responders and quantifying effect sizes (r) to determine the magnitude of change across various physical metrics. Results Notable improvements were observed in metabolic equivalents (METs) (+1.82), oxygen uptake (VO2 peak) (+6.36 mL/kg/min), Duke Activity Status Index (DASI) score (+14.79), moderate to vigorous physical activity (MVPA) (+131.28 minutes/week), sitting time (-1.21 hours/day), total activity (+145.65 minutes/week) and sit-to-stand repetitions (+2.65). The greatest effect sizes were observed in DASI score (r=0.750) and sit-to-stand (r=SIS) repetitions (r=0.610), consistent across demographics, heart failure, and CCS categories. Other metrics noted variable changes, with handgrip strength showing no consistent trend. Sensitivity analyses revealed that older geriatric patients (≥ 80 years) with HFpEF experienced significant improvements in DASI score (r=0.638), MVPA (r=0.636), and SIS (r=0.504), while those with HFrEF and HFmrEF showed no significant improvements in any physical metrics. CCS angina classification, common comorbidities, and initial referral events did not significantly influence outcomes. Conclusion This study reaffirms the efficacy of CR but crucially identifies the gaps in its universal application, particularly among older geriatric patients with diverse heart failure subtypes. Our analysis advocates for developing personalized CR programs tailored to patients' individual profiles to enhance effectiveness of rehabilitation. By addressing these specific needs, we can ensure more inclusive and optimized patient care, ultimately supporting the expansion of CR indications to foster a more holistic approach to cardiac health in the geriatric population.

Wearable Devices for Training and Patient Monitoring: A Comprehensive Review

Introduction:Wearable technologies and remote patient monitoring (RPM) are transforming sports and healthcare by enabling continuous and real-time monitoring of various health parameters. These innovations hold significant potential for improving training outcomes in physical rehabilitation and fitness programs, managing chronic diseases, and enhancing patient engagement. Aim of the Study:This review aims to summarize and highlight the most relevant findings on the current status, clinical applications, challenges, and prospects of wearable health-related sensing technologies in the context of training and chronic disease management. Material and Methods:A review of scientific publications from 2018 to 2024 was conducted using PubMed and Google Scholar databases. Keywords such as "wearable," "remote patient monitoring," "sensors," "training," and "chronic disease management" were used. Conclusions:Wearable devices are gaining popularity among the entire population, not only among individuals with chronic health conditions. The use of wearable technologies has shown promise in improving training and health outcomes by providing continuous monitoring, personalized care, and enhanced training programs. However, challenges such as data accuracy, privacy concerns, and integration with healthcare systems must be addressed and present opportunities for future advancements.

Analysis of changes in lower limb joints of athletes during the movement of wild horses’ mane parting based on biomechanics

In the era of fitness, more and more young people are familiar with Taijiquan, a kind of physical fitness exercise. By conducting biomechanical analyses of the movements of Taijiquan, it is possible to exercise the body better. Numerous techniques in Taijiquan make it difficult to study each individually. Therefore, this paper studied the movement of “wild horses’ mane parting” in terms of biomechanics by analyzing the joint angle, stiffness, and impulse during this movement. Twenty male athletes were selected as subjects and divided into a professional group and a beginner group according to their training periods. High-speed cameras were used to shoot the “wild horses’ mane parting” movement. The angles of lower limb joints in these athletes were measured to calculate joint impulse and stiffness. The results showed that, compared with the professional group, there were significant differences in the adduction and abduction angle and the internal and external rotation angle between the beginner group and the professional group in the single-leg support movement stage (P&lt; 0.05). There were also significant differences in joint impulse and stiffness (P&lt; 0.05). Compared with beginners, long-term professional practitioners can make their movements more standardized. By comparing movements and data analysis, beginners can make their movements more standardized when practicing Taijiquan and avoid the risk of sports injury. The novelty of this article lies in the use of high-speed cameras to capture athletes’ movements, enabling accurate analyses of their joints and providing effective references for precise training.

Early resilience and epigenetic ageing: Results from the prospective Young Finns Study with a 31-year follow-up.

Evidence is accumulating on the connection of early adversities and harsh family environment with epigenetic ageing. We investigated whether early psychosocial resilience is associated with epigenetic ageing in adulthood. We used the population-based Young Finns data (n = 1593). Early psychosocial resilience was assessed in 1980-1989 across five broad domains: (1) index of psychological strength (self-esteem at home/in general/at school, perceived possibilities to influence at home, internal life control), (2) index of social satisfaction (perceived support from family/friends and life satisfaction), (3) index of leisure time activities (hobbies and physical fitness), (4) index of responsible health behaviors (infrequent smoking or alcohol consumption), and (5) index of school career (school grades and adaptation). Epigenetic ages were calculated for blood samples from 2011, and the analyses were performed with variables describing age deviation (AgeDevHannum, AgeDevHorvath, AgeDevPheno, AgeDevGrim) and DunedinPACE. Covariates included early family environment, polygenic risk scores for schizophrenia and major depression, adulthood education, and adulthood health behaviors. All of the early resilience indexes were associated with lower levels of epigenetic ageing in adulthood, most consistently with AgeDevGrim and DunedinPACE. The associations of psychological strength and social satisfaction, in particular, seemed to be non-linear. In a smaller subsample (n = 289), high early resilience was related to lower AgeDevGrim over a 25-year follow-up in those who had high "baseline" levels of AgeDevGrim. In conclusion, early resilience seems to associate with lower level of epigenetic ageing in adulthood. Our results tentatively suggest that early resilience may increase "equality in epigenetic ageing" in a general population.

Time junior middle school students invested to sports and their cognitive skill development: a time economics perspective

Great importance is attached to physical exercise and students’ cognitive development, yet the precise mechanism linking the time duration of physical activities or sports with adolescents’ cognitive development remains inconclusive. Based on the two-wave panel data of China Education Panel Survey (CEPS), this paper empirically examines the impact of daily physical exercise duration on junior middle school students’ cognitive abilities, by using the two-way fixed-effect estimation. The findings reveal a nonlinear relationship, specifically an inverted “U”-shaped pattern, between daily time length of physical activities or sports and students’ cognitive performance. The cognitive benefits of time investment in physical activities or sports reach the peak at approximately 0.829 h (equivalent to 50 min) per day among the teenagers in China. Furthermore, the daily time allocated to physical activities or sports affects students’ cognitive performance differentially, students attending rural schools were rewarded more progressively, students of poorer physical fitness and those in good shape did not show discernible between-group differences. This study shades light on educational governance and time management, urging school administrators, parents and students to optimize the efficiency and utility of time resource invested in sports activities.