Physical Performance Research Articles

Effect of Blood Flow Restriction on Gait and Mobility in Older Adults: A Systematic Review and Meta-Analysis.

Older adults demonstrate gait impairments that increase their risk for falls. These age-related mobility impairments are in part due to declines in muscle mass and strength. High-intensity exercise can improve muscle strength and mobility but may not be tolerable for older adults due to musculoskeletal injury and pain. Blood flow restriction (BFR) with lower-intensity exercise offers a strategy that may be more tolerable for older adults, but whether BFR improves gait and mobility in older adults is unclear. The purpose of this systematic review and meta-analysis was to determine the effect of BFR on gait and mobility in healthy older adults. PubMed, Embase, Cochrane Library, and CINAHL were systematically searched for articles utilizing BFR in older adults. Articles were included if adults were over 60 years, did not have chronic health conditions, had undergone randomized controlled trials, and presented objectively measured gait outcomes. The search identified 1501 studies, of which 9 were included in the systematic review and 8 studies in the meta-analysis. Outcome measures included the Timed Up and Go (TUG), 6-Minute Walk Test (6MWT), 400 m walk test, Short Physical Performance Battery (SPPB), and 10 m walk test. Meta-analyses found improvements in the TUG (mean difference (MD) = -0.71; 95% CI = -1.05, -0.37; p < 0.001) and SPPB (MD = -0.94; 95% CI = -1.48, -0.39; p < 0.001) in BFR compared to no BFR. There were no differences in gait speed (MD = 0.59; 95% CI = -0.22, 1.41; p = 0.16). BFR may be effective for gait and mobility tasks over shorter distances. Clinicians may consider incorporating BFR to improve mobility and gait function in older adults.

The Relation between Parameters of Physical Performance and Depression in Consecutive Hospitalized Geriatric Patients with Heart Failure.

In the geriatric population, the risk of cardiometabolic diseases is strongly influenced by comorbidities. The aim of the study was to estimate the prevalence of depression among hospitalized patients with heart failure (HF) and to assess the relation between physical performance and depression in this population. We included consecutive hospitalized patients with HF aged >65 years. The depression symptoms were evaluated using the Geriatric Depression Scale (GDS), the physical performance was assessed using the grip strength measurements, the Back Scratch Test, the Timed Up and Go Test (TUGT), the Five Times Sit to Stand Test (5 × SST), and the 6 min walk test. We included 206 patients (134 females and 72 males, median age 82 years (77-86) years). Altogether, 33% of participants had signs of depression. The association was found between depression severity and economic status (p = 0.001), stressful events (p = 0.005), self-reported general health status (p = 0.001), and heart failure severity assessed by the New York Heart Association class (NYHA), p = 0.003. The Back Scratch Test, the TUGT, and the 5xSST were associated with depression severity in a univariable regression analysis (β coefficient 0.04 [95% CI 0.00-0.08], 0.20 [95% CI 0.12-0.27], 0.18 [95% CI 0.07-0.27], respectively); however, when adjusted for co-factors, the TUGT and the 5xSST (0.17 [95% CI 0.08-0.26] and 0.14 [95% CI 0.02-0.26], respectively) were significantly related to the GDS score. Grip strength and the 6 min walk test were not related to the GDS score in the univariable nor multivariable analysis. These findings were confirmed in the logistic analyses. Our study indicated a high incidence of depression among elderly hospitalized patients with heart failure. Depression severity in older patients with HF is related to physical performance decline as assessed by the Timed Up and Go Test and the Five Times Sit to Stand Test. Grip strength and the 6 min walk test are not related to the GDS score in this population.

Less Total-Body Fat and Lower-Extremity Fat Are Associated with More High-Intensity Running during Games in Female University Soccer Players

This study examined the relationship between body composition and on-field, in-game physical performance in female collegiate soccer players. Body composition, including total mass, fat mass, and lean tissue mass for the lower extremities and total body, was measured in 10 starting players using dual energy x-ray absorptiometry (DXA). On-field, in-game physical performance was tracked via a global positioning system (GPS) over 14 regular-season games, measuring total distance and distance covered in six speed zones. Players covered 4544.7 ± 495.2 m in the first half of the game and significantly less distance in the second half (3356.5 ± 1211.7 m, p = 0.004). A repeated measures ANOVA revealed decreased distances in jogging, low-, and moderate-intensity running during the second half compared to the first half of the game (p &lt; 0.001). Lower total-body fat mass, total-body fat percentage, and lower-extremities fat mass were correlated with greater distances at moderate- and high-intensity running during the second half and entire game (r values from −0.644 to −0.745, p &lt; 0.01 to 0.04). These findings suggest that body composition can influence the distance covered at moderate- and high-intensity running speed during competitive games. Training strategies aimed at reducing fat mass and incorporating high-intensity training may benefit female soccer players and enhance team success.

12583 Nutrient Intake And Physical Performance In Patients With Acromegaly

Abstract Disclosure: N.N. Hupalowski: None. C.P. Rocha: None. S.Z. Fidalski: None. C.L. Boguszewski: Consulting Fee; Self; Recordati. Research Investigator; Self; Crinetics. Speaker; Self; Ipsen, Novo Nordisk. V.Z. Borba: None. Acromegaly is a chronic disease characterized by increased levels of growth hormone (GH) and insulin-like growth factor 1 (IGF-1). These patients exhibit increased skeletal muscle mass but poorer performance in functional physical assessments. Certain nutrients are important for both muscle mass and strength, as well as for maintaining an anti-inflammatory state in the body. Objective: To assess the correlation between nutrient intake and physical performance in patients with acromegaly. Patients and Methods: An observational, cross-sectional study of patients with acromegaly matched 1:1 by sex and age with a control group. Patients underwent analysis of dietary patterns using the validated Food Frequency Questionnaire (FFQ), and physical performance and strength were measured using Hand Grip Strength (HGS), 5 Times Seat to Stand Test (STST), Time Up and Go (TUG), and Short Physical Performance Battery (SPPB) tests. Results: It was evaluated 47 patients (54.1% women; mean age 56.3 ± 11.6 years), which were compared with 36 controls (53.9% women; mean age 56.7 ± 13.4). There was no difference between groups in HGS evaluation. The performance of patients with acromegaly were poorer in the STST, SPPB and TUG. Better performance was associated with selenium (p=0.045), vitamin E (p=0.034), flavonol (p=0.02) and vitamin A (0.024) intake. Conclusion: Physical performance is compromised in patients with acromegaly, especially in lower limbs, and it was associated with lower consumption of selenium, vitamin E, flavonol and vitamin A. Presentation: 6/2/2024

7785 Muscle Strength and Physical Performance Are Closely Related to Muscle Quality Regardless of Muscle Mass or Diabetes Status

Abstract Disclosure: J. Seo: None. I. Jung: None. S. Park: None. D. Lee: None. J. Yu: None. H. Cho: None. K. Kim: None. E. Song: None. K. Kim: None. N. Kim: None. H. Yoo: None. S. Kim: None. K. Choi: None. N. Kim: None. C. Shin: None. Weakness or slowness is essential to define sarcopenia rather than less muscle mass. Myosteatosis is associated with low muscle strength and poor physical performance, and ectopic fat deposition is a characteristic of diabetes (DM). We investigated the association between muscle strength/physical performance and myosteatosis by considering DM status and muscle mass in community-dwelling older adults. A total of 982 subjects (447 men and 535 women) aged 54-83 years in 8th examination of the Korean Genome and Epidemiology Study Ansan cohort participated in this study. Handgrip strength (HSG), 4-m walking velocity (VEL) and 30-Seconds Sit-to-Stand Test (STST) were checked, appendicular skeletal muscle mass (ASM) and total muscle mass (TMM) by DXA were measured. In midthigh CT image, total muscle area (TMA) was measured and categorized into 3 components using Hounsfield Unit (HU): normal-attenuation muscle area (NAMA, 35-100HU), low-attenuation muscle area (LAMA, 0-34HU), and inter/intramuscular adipose tissue (IMAT) area. As muscle quality indices, the NAMA index, LAMA index, and IMAT index were defined by dividing each parameter by TMA. DM was diagnosed by fasting glucose ≥126 mg/dL, 2hr-OGTT glucose ≥200 mg/dL, HbA1c ≥6.5% or anti-diabetic medication. Subjects with DM (38% of total subjects) had higher age and body mass index (BMI) compared to non-DM subjects. Prevalence of low muscle mass (M:&amp;lt;7.0kg/m2, F:&amp;lt;5.4kg/m2 of ASM/height2) was not statistically different by the presence of DM (DM vs non-DM, 11.7% vs 9.7% in men, 3.6% vs 7.6% in women). However, prevalence of low HGS (M:&amp;lt;28kg, F:&amp;lt;18kg) and slow VEL (&amp;lt;1.0m/sec) was higher in DM subjects than non-DM subjects (DM vs non-DM, low HSG: 18.3% vs 5.6% in men, 28.0% vs 17.3% in women, slow VEL: 40.6% vs 30.7% in men, 61.7% vs 46.2% in women). After adjusting for age and BMI, men with DM had lower muscle mass (ASM, ASM/height2,), TMA and NAMA index but higher LAMA index and IMAT index compared to men without DM. Also, men with DM had lower HGS (p=0.001) and poor STST (p=0.008) than men without DM. In women, muscle mass and muscle quality indices were not significantly different with or without DM, but women with DM had worse STST than women without DM (p=0.013). Age and sex adjusted HSG, but not VEL and STST, was positively associated with muscle mass (ASM, ASM/height2, ASM/BMI, and TMM). Age and sex adjusted HSG, VEL, and STST were positively associated with NAMA index and negatively associated with LAMA index and IMAT index regardless of DM. Linear regression analysis revealed that both ASM and NAMA (or LAMA) indices were independent association factors for HGS. Subjects with DM showed a more pronounced decrease in physical performance and muscle strength than a decrease in muscle mass. In this population-based cohort, less myosteatosis was associated with greater muscle strength and better physical performance, regardless of muscle mass or DM status. Presentation: 6/2/2024

8068 Beneficial Effects of a Personalized Exercise Program for Patients with Cushing's Disease and Acromegaly After Biochemical Control

Abstract Disclosure: E. Valassi: None. L. Martel-Duguech: None. H. Bascuñana: None. V. Priego-Corredor: None. J. Viñals-Ribé: None. O. González-Viñuela: None. T. Caparrós-Pons: None. S.M. Webb: None. Background: Patients with Cushing’s disease (CD) in remission and controlled acromegaly (ACRO) present with residual metabolic derangements, muscle dysfunction, and poor quality of life (QoL). Although exercise is known to exert positive effects on psychophysical health in several conditions, evidence demonstrating its potential benefits in pituitary diseases is scanty. Main hypothesis: A personalized program of combined (aerobic and resistance training) exercise lasting 12 weeks improves cardiometabolic parameters, body composition, physical performance and QoL in patients with CD in remission and controlled ACRO. Methodology: Ten female patients with CD in remission [mean (±SD) age, 59±4 years, mean (±SD) BMI, 35±2 Kg/m2, median (IQR) duration of remission, 5(4) years] and 10 male patients with controlled ACRO [mean (±SD) age, 53±9 years, mean (±SD) BMI, 27±4 Kg/m2, median (IQR) duration of control, 6(3) years] underwent a 12-week, structured, personalized program of combined aerobic and resistance exercise, under the supervision of professional trainers. We evaluated the following parameters at baseline and within 72 hours after the completion of the exercise program: blood pressure (BP), BMI, waist and neck circumferences; physical performance (gait speed, hand grip strength, 30-Second Chair Stand; Timed “Up and Go”); lumbar and femoral bone mineral density (BMD) and body composition, using dual x-ray absorptiometry (DXA); muscle thickness (cm) at the middle and distal third of rectus femoris (RF) and vastus intermedius (VI) on both sides, using muscle ultrasound scans in the transverse plane (Philips Affiniti 70; The Netherlands); quality of life (QoL), using the questionnaires CushingQoL in CD patients and AcroQoL in ACRO patients. Major results: After completion of the exercise program, CD patients had lower diastolic BP and waist circumference as compared with baseline (p&amp;lt;0.05). Physical performance globally improved (p&amp;lt;0.01 for all function tests). Femoral BMD was higher, percentage of lean mass increased while trunk fat decreased (p&amp;lt;0.01). RF and VI muscle thickness was greater at both the middle and distal third on the right side (p&amp;lt;0.01), and at the distal third on the left as compared with baseline (p&amp;lt;0.05). ACRO patients had a lower systolic BP as compared with baseline. Gait speed and hand grip strength increased while performance on the 30-Second Chair Stand improved (p&amp;lt;0.05). Muscle thickness at the middle third of the right RF was greater as compared with baseline (p&amp;lt;0.05). QoL was unchanged in both CS and ACRO patients at the end of the program. Conclusions: A customized exercise program promotes beneficial cardiometabolic and muscle changes in patients with CD and ACRO and, therefore, should be offered in a specialized pituitary clinic, within an integrated multidisciplinary team approach. Study financed by ISCIII research project number FIS PI21/01223 Presentation: 6/1/2024

8553 GDF-15 Levels In Patients With Prostate Cancer On Androgen Deprivation Therapy

Abstract Disclosure: S.D. Jaramillo-Quiroz: Other; Self; VAPSHCS: Director Fund Research Fellowship/UW Abrass Family Fellowship Fund. CDMRP (PC170059).. L. Caeiro: None. L.J. Anderson: None. J.M. Garcia: None. Growth Differentiation Factor 15 (GDF-15) is a stress-induced cytokine known to induce anorexia and cachexia and a biomarker of biological aging, mitochondrial dysfunction, and worse hand grip strength and poor survival in different settings. Also, GDF-15 has pleiotropic functions at all stages of tumorigenicity and is suggested as a marker to differentiate BPH from PCa. Androgen Deprivation Therapy (ADT) is the standard treatment for advanced prostate cancer (PCa), but it also decreases muscle mass and function and Quality of life (QOL). The role and effects of GDF-15 in prostate cancer patients undergoing ADT are not well characterized and was explored in this longitudinal, 6-month, observational study that recruited men with (PCa) starting ADT (n=60, mean age 69). Body composition [dual energy X-ray absorptiometry (DEXA), body weight history], physical performance [handgrip strength (HGS), 6-minute walk test (6MWT), energy expenditure (indirect calorimetry and actigraphy)], were assessed before, at 3 and 6 months after starting ADT. QoL was assessed by the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30). GDF-15 was measured by ELISA. Mean differences performed with standard error of the mean, repeated measures ANOVA and Tukey’s Post Hoc test. Correlations were assessed by Spearman’s. After 6 months of ADT, fat mass was increased (mean difference: 1.14 ±0.38, p=0.0029), and lean muscle mass (mean difference: -1.214 ± 0.38, p=0.005), appendicular lean mass (ALM, mean difference: -0.879 ± 0.19, p=&amp;lt;0.0001). HGS (mean difference: -2.927 ± 0.59, p=&amp;lt;0.0001), and VO2 max decreased (mean difference -3.31 ± 0.83, p=0.0007). Baseline GDF-15 (mean 1456.59 ± 1022.80) was correlated with the changes in weight (r: -0.38, p=0.01), BMI (r: -0.33, p=0.01), ALM (r: -0.29, p=0.04), and fatigue (r: -0.38, p=0.004). As shown, baseline GDF-15 was inversely correlated with changes in weight, appendicular lean mass, and fatigue in subjects undergoing ADT, highlighting the possibility of its role as a biomarker and therapeutic target of body composition and patient-reported outcomes in this setting. Presentation: 6/1/2024

Relationship between Body Mass Index, Dynamic Balance, and Core Muscle Endurance in Firefighter Candidates: A Cross-Sectional Study

This study aimed to examine the effects of Body Mass Index (BMI) on dynamic balance and core muscle endurance in firefighter candidates. In physically demanding professions, such as firefighting, understanding the impact of BMI on physical performance metrics is crucial for both occupational safety and effectiveness. The study was conducted with 89 firefighter candidates, with a gender distribution of 23.6% female (n=21, age 19.86±1.86 years, height 1.64±0.05 m, weight 59.47±7.26 kg) and 76.4% male (n=68, age 19.82±1.25 years, height 1.78±0.04 m, weight 74.36±12.09 kg). Within the scope of the research, the results of the BMI, balance, and core muscle endurance tests were evaluated. BMI was calculated based on measurements of participant height and weight. Dynamic balance performance was assessed using the Y-Balance Test, while core muscle endurance was measured using the plank test. The performances of the participants in both tests were recorded and subjected to statistical analysis. Pearson correlation analysis and multiple regression models were used to examine the relationships among BMI, dynamic balance, and core muscle endurance. The findings indicated that an increase in BMI has adverse effects on balance and core muscle endurance performance. Specifically, firefighter candidates with higher BMI values exhibited shorter plank durations (females: r=-0.63; p=0.002, males: r=-0.566; p

6612 Both Overt And Mild Hypercortisolism Accelerate Biological Aging

Abstract Disclosure: K. Yu: None. J. Saini: None. J.N. Farr: None. F. Vanessa: None. S. Khosla: None. I. Bancos: Advisory Board Member; Self; AstraZeneca, Adrenas, Neurocrine, Spruce, Recordati, Xeris, Novo Nordisk, HRA Pharmaceuticals, Sparrow, Diurnal, Corcept. Research Investigator; Self; HRA Pharmaceuticals, Recordati. Importance: Patients with both mild autonomous cortisol secretion (MACS) and overt Cushing syndrome (CS) demonstrated high prevalence of aging-related morbidity and an increased mortality. Objective: To determine whether p16INK4a in T cell, a cell cycle enzyme that associated with chronological aging and cell senescence, is associated with hypercortisolism and hypercortisolism-related comorbidities. Design, Setting, and Participants: In this single-center cross-sectional study, we prospectively recruited consecutive patients with hypercortisolism between July 1, 2020 and August 24 2022. Patients were included if they were diagnosed with Cushing syndrome (CS) or mild autonomous cortisol secretion (MACS). Age- (± 2 years) and sex-matched referent subjects without known adrenal disorders were included if abdominal imaging was available. Participants on exogenous glucocorticoids within 3 months prior were excluded. Exposure: Presence of hypercortisolism (MACS and CS). Main Outcomes and Measures: Primary outcomes included p16INK4a, advanced glycation end products (AGE) reader result, Frailty Index score, frailty (defined as frailty index&amp;gt;0.31), and physical performances in patients and matched referents at index date. Secondary outcomes included correlation between biological age markers, hormonal workup and the risk of comorbidities. p16INK4a expression analysis was adjusted for age, sex, smoking, and alcohol use for all analyses except for associations with CVD and frailty. Results: Of 85 patients (87% women, mean age 53 years), 51 (60%) had MACS (34 had matched referents), 34 (40%) had overt CS (16 had matched referents). Patients with CS demonstrated a median 1.9-fold higher p16INK4a expression (P&amp;lt;.001), and patients with MACS showed a median of 1.70-fold p16INK4a expression (P=.013), when compared to referent subjects. Age- and sex-adjusted p16INK4a expression was associated with frailty index score (r=0.23, P=.035), time-up-and-go test (r=0.28, P=.048), gait speed (r=-0.36, P=.035), but not with AGE reader result, 6-minute walk test, or hand grip measurement. The p16INK4a expression was associated with history of cardiovascular disease (age-adjusted odds ratio (aOR)=3.70, 95% confidence interval (CI), 1.20-11.43) and frailty (aOR=2.27, 95%CI, 1.04-4.98). Conclusion and relevance: We demonstrated evidence of cell senescence in both patients with CS and patients with MACS. Further studies need to determine the impact of surgical, cortisol-lowering, and senolytic medical therapies in MACS on cell senescence and associated aging-related comorbidities. Presentation: 6/1/2024

7945 Modelling the Factors Associated With Sexual and Mood Symptoms Within the First Year of Anabolic-Androgenic Steroid Cessation in Men

Abstract Disclosure: B. Grant: None. J. Kean: None. N.L. de Silva: None. O. Quinton: None. P. Bassett: None. J. McVeigh: None. A. Lingford-Hughes: None. S. Minhas: None. S. Bhasin: None. W.S. Dhillo: None. C.N. Jayasena: None. Context: Anabolic-androgenic steroids (AAS) are misused by millions of men worldwide to boost muscle size and physical performance. Recent studies have quantified the recovery of cardiovascular markers and testicular function following AAS cessation. Qualitative studies demonstrate that low mood, anxiety, suicidal ideation, and sexual dysfunction are also common following AAS cessation. However, no previous study has focused on quantifying symptoms within the first year of AAS cessation, nor investigated independently associated factors for these symptoms. Methods: Cross-sectional, observational study of 165 men in 3 groups; non-AAS (n=43); current-AAS (n=76); past-AAS ≤1 year (n=46). All participants completed questions on substance misuse, Beck Depression Inventory-II (BDI-II), International Index Erectile Function-15 (IIEF-15), General Anxiety Disorder (GAD-7), Quality-of-life (SF-36), and underwent fasting, morning blood sampling with urine toxicology. Results: As expected, current-AAS had lower gonadotropins and elevated serum total testosterone compared with past-AAS and non-AAS. Sexual function measured using IIEF-15 was impaired in men stopping AAS &amp;lt;1year (past-AAS) compared with current AAS users: (1) total: 69.0 [95% CI 64.0, 71.0], current-AAS; 61.0 [95% CI 56.0, 66.0], past-AAS; p=0.077; (2) erectile function: 30.0 [95% CI 29.0, 30.0], current-AAS; 28 [95% CI 21.0, 29.0], past-AAS; p=0.015; (3) sexual desire: 9.0 [95% CI 8.0, 10.0], current-AAS; 6.0 [95% CI 5.0, 8.0], past-AAS; p&amp;lt;0.0001; (4) overall satisfaction: 10.0 [95% CI 8.0, 10.0], current-AAS; 7.0 [95% CI 7.0, 8.0], past-AAS; p=0.002. Multivariable analysis suggested that psychiatric comorbidity (coefficient -6.5 [95% CI -13.0, -1.3] p=0.03) and AAS cessation (coefficient -10.8 [95% CI -5.6, -17.2]; p&amp;lt;0.001) were associated with lower total IIEF-15 scores.Depression scoring was worse in the past-AAS group compared with non-AAS: BDI-II 4.0 [95% CI 2.0, 7.0], non-AAS; 7.0 [95% CI 4.0, 16.0], past-AAS; p=0.0448. Multivariable analysis suggested that psychiatric comorbidity (OR 2.39 [95% CI 1.60, 3.57]; p&amp;lt;0.001) and lower serum total testosterone (OR 0.85 [95% CI 0.88, 0.94]; p=0.002) were associated with higher BDI-II scores.Energy and fatigue measured using SF-36 was lower in the past-AAS group compared with non-AAS: 70 [95% CI 65, 75], non-AAS; 60 [95% CI 50, 65], past-AAS; p=0.0498. No significant differences in anxiety scoring were detected. Discussion: We report the first, detailed quantification and modelling of symptoms in men currently misusing and stopped AAS within the previous year. These data reveal potentially treatable factors to improve symptoms of AAS cessation if proven within interventional studies. Presentation: 6/2/2024

Longitudinal comparison of the relationship of energy intake with body composition and physical performance in elite female basketball and volleyball players

Abstract Purpose To maximise sporting success, disciplines such as basketball and volleyball need to improve their methods of analysing the sporting performance and fitness of their athletes. Although energy intake quantities have been established at a theoretical level for women to perform at a sporting level, it has been found that these energy intake levels are not met or followed and that, despite this, the performance of female players is not diminished. Thus, the purpose of this research study was to describe and compare the anthropometric characteristics of these two disciplines and to identify the differences in actual and theoretical energy intake, as well as to observe physical performance in both disciplines. Methods Anthropometric data, continuous quantitative data, training time and characteristics, and energy intake data were collected. Performance tests included upper and lower body strength, speed, agility, and endurance tests. Dietary monitoring showed lower intakes of total energy, carbohydrate and protein than theoretically recommended. However, the athletes experienced overall improvements in performance and body composition. Results The mean total energy intake was 20.2 ± 4.3 kcal·kg−1·day−1. The minimum individual mean intake was 9.8 kcal·kg−1·day−1 and the maximum was 25.95 kcal·kg−1·day−1. Carbohydrates accounted for 54.3% ± 8.8% of the energy intake; 20.3% ± 6.5% from fats; 25.4% ± 5.7% from proteins. Conclusions Current data suggest that, although a cause-effect relationship between dietary intake and BC performance cannot be determined, elite athletes in these sports disciplines may experience beneficial outcomes despite having lower total energy, CHO, protein, and fat intakes than previously recommended in the literature.

8731 Glucose homeostasis remains normal across a range of adiposity in fit men and women

Abstract Disclosure: A.W. Potter: None. G.C. Chin: None. J.I. Jacques: None. L.J. Nindl: None. D.P. Looney: None. W.J. Tharion: None. C.L. Chapman: None. E.N. Halford: None. K.E. Friedl: None. Introduction. Glucose dysregulation is a major obesity-related comorbidity, affecting mental and physical performance. Glycated hemoglobin (HbA1c) is a validated and stable biomarker representing glucose regulation over 2-3 months. Nearly half of American adults (41%) have elevated HbA1c concentrations representing prediabetes (≥5.7%). In a large cross-sectional sampling of the American population, HbA1c becomes elevated in 33% of individuals at &amp;gt;24% body fat (BF) (men) and &amp;gt;38%BF (women). However, daily physical activity is an important moderator of metabolic health and adiposity - the “fit fat” concept. We evaluated this effect in physically active men and women. Methods. Body composition and metabolic health data were obtained from 36,392 adults (18,130 men and 18,262 women) in the National Health and Nutrition Examination Survey (NHANES) from 1999-2018, for comparison of %BF and HbA1c relationships. Body composition and HbA1c data were obtained from 220 healthy and physically fit active-duty military men and women (188 men, mean ± SD (range): age 25.7 ± 5.9 (18-53) years; height 176.3 ± 7.7 (154.0-201.1) cm; body mass 85.3 ± 11.9 (55.7-134.7) kg, maximal oxygen uptake (VO2max) 49.1 ± 11.9 (33.8-62.5) ml/kg/min; 32 women, age 26.5 ± 7.0 (19-45) years; height 161.4 ± 5.9 (147.1-172.8) cm; body mass 63.9 ± 8.3 (46.7-86.6) kg, VO2max 42.5 ± 8.3 (29.1-52.6) ml/kg/min). Body composition was measured using DXA (iDXA, General Electric Healthcare, Madison, WI) and HbA1c was measured from capillary blood samples using a validated point-of-care analyzer (DCA Vantage Analyzer, Siemens Medical Solutions USA, Inc, Malvern, PA). Results. HbA1c remained within the normal range (&amp;lt;5.7%) for 98% (216/220) of a relatively wide range of %BF in a group of men (9-36%) and women (21-46%) who engaged in daily physical activity. This sample included 64 men (34%) and 4 women (12.5%) that exceeded the 24 and 38%BF thresholds where clinically high HbA1c concentrations have been observed in the civilian population. From this subset, none of the assessed women had HbA1c ≥5.7%. Three men had HbA1c 5.7-5.8% and also high measured physical fitness (VO2max, 50.1-62.5 ml/kg/min) and low %BF (15-17%); while one had lower physical fitness (VO2max 43.87 ml/kg/min) and higher body fat (26%) (HbA1c 6%). Conclusion. Glucose homeostasis remains within normal values across a range of adiposity in fit men and women. These data support the importance of daily physical activity in mitigating elevations in HbA1c, even in individuals with increased relative body fat. Physical activity appears to have a protective effect for metabolism. Presentation: 6/3/2024

7945 Modelling the Factors Associated With Sexual and Mood Symptoms Within the First Year of Anabolic-Androgenic Steroid Cessation in Men

Abstract Disclosure: B. Grant: None. J. Kean: None. N.L. de Silva: None. O. Quinton: None. P. Bassett: None. J. McVeigh: None. A. Lingford-Hughes: None. S. Minhas: None. S. Bhasin: None. W.S. Dhillo: None. C.N. Jayasena: None. Context: Anabolic-androgenic steroids (AAS) are misused by millions of men worldwide to boost muscle size and physical performance. Recent studies have quantified the recovery of cardiovascular markers and testicular function following AAS cessation. Qualitative studies demonstrate that low mood, anxiety, suicidal ideation, and sexual dysfunction are also common following AAS cessation. However, no previous study has focused on quantifying symptoms within the first year of AAS cessation, nor investigated independently associated factors for these symptoms. Methods: Cross-sectional, observational study of 165 men in 3 groups; non-AAS (n=43); current-AAS (n=76); past-AAS ≤1 year (n=46). All participants completed questions on substance misuse, Beck Depression Inventory-II (BDI-II), International Index Erectile Function-15 (IIEF-15), General Anxiety Disorder (GAD-7), Quality-of-life (SF-36), and underwent fasting, morning blood sampling with urine toxicology. Results: As expected, current-AAS had lower gonadotropins and elevated serum total testosterone compared with past-AAS and non-AAS. Sexual function measured using IIEF-15 was impaired in men stopping AAS &amp;lt;1year (past-AAS) compared with current AAS users: (1) total: 69.0 [95% CI 64.0, 71.0], current-AAS; 61.0 [95% CI 56.0, 66.0], past-AAS; p=0.077; (2) erectile function: 30.0 [95% CI 29.0, 30.0], current-AAS; 28 [95% CI 21.0, 29.0], past-AAS; p=0.015; (3) sexual desire: 9.0 [95% CI 8.0, 10.0], current-AAS; 6.0 [95% CI 5.0, 8.0], past-AAS; p&amp;lt;0.0001; (4) overall satisfaction: 10.0 [95% CI 8.0, 10.0], current-AAS; 7.0 [95% CI 7.0, 8.0], past-AAS; p=0.002. Multivariable analysis suggested that psychiatric comorbidity (coefficient -6.5 [95% CI -13.0, -1.3] p=0.03) and AAS cessation (coefficient -10.8 [95% CI -5.6, -17.2]; p&amp;lt;0.001) were associated with lower total IIEF-15 scores.Depression scoring was worse in the past-AAS group compared with non-AAS: BDI-II 4.0 [95% CI 2.0, 7.0], non-AAS; 7.0 [95% CI 4.0, 16.0], past-AAS; p=0.0448. Multivariable analysis suggested that psychiatric comorbidity (OR 2.39 [95% CI 1.60, 3.57]; p&amp;lt;0.001) and lower serum total testosterone (OR 0.85 [95% CI 0.88, 0.94]; p=0.002) were associated with higher BDI-II scores. Energy and fatigue measured using SF-36 was lower in the past-AAS group compared with non-AAS: 70 [95% CI 65, 75], non-AAS; 60 [95% CI 50, 65], past-AAS; p=0.0498. No significant differences in anxiety scoring were detected. Discussion: We report the first, detailed quantification and modelling of symptoms in men currently misusing and stopped AAS within the previous year. These data reveal potentially treatable factors to improve symptoms of AAS cessation if proven within interventional studies. Presentation: 6/2/2024

Textile-based 3D printing and traditional Chinese geometric patterns for fashion textile development

Here, textile-based 3D printing technology is combined with traditional Chinese patterns to create new effects. Traditional Chinese patterns are the main carrier of cultural heritage and have been widely applied as creative design elements to develop unique fashion and textile products. Two geometric patterns inspired by traditional Chinese patterns are developed through the direct deposition of polylactic acid onto polyester fabric. Then the physical and mechanical performances of the printed patterns are examined under a microscope, along with tensile, tear, and joint motion tests. After that, two garment prototypes are created to explore the design aesthetics of the 3D printed geometric patterns. This research work reports on a comprehensive and practical design process for the creation of 3D printed fashion textiles. The work is expected to provide insights for designers and researchers when reviving traditional elements through modern technology. More applications can be explored based on the results reported in this paper.

Effects of Dietary Nitrate Supplementation on Physical Performance and Muscle Strength in Older People—A Systematic Review

ABSTRACTBackgroundSarcopenia, the loss of muscle strength and mass with age, is a major cause of morbidity for older people. Dietary nitrate supplementation has been proposed as an intervention to improve skeletal muscle function via action as nitric oxide (NO) donors. However, the effect of nitrate supplementation on physical performance and muscle strength in older people is unclear. We aimed to systematically review evidence on whether dietary nitrate supplementation improves markers of muscle strength, muscle mass and physical performance in older people.MethodsWe conducted a systematic review of randomised controlled trials according to a prespecified protocol by two reviewers. We included interventional studies using dietary nitrate supplementation, mean participant age of &gt;60 years, with or without muscle weakness. Outcomes of interest were physical performance, muscle strength and muscle mass. Risk of bias was assessed using a modified version of the Cochrane Risk of Bias tool. Results were grouped by intervention and outcome measures and were described by narrative synthesis.ResultsTwenty‐eight studies were included, with a size range of 8–72 participants. Intervention duration ranged from a single dose to 12 weeks. Seven studies were in healthy older people. Most studies had a high or unclear risk of bias; three had a low risk of bias. One‐hundred‐two outcomes were reported; 67 were related to physical performance, and 35 were related to muscle strength. No included study measured muscle mass. Thirty‐three outcomes showed significant improvement, two showed significant worsening and 67 showed no statistically significant difference. Meta‐analysis was not possible due to data heterogeneity. Subgroup analyses for different doses of nitrate (above or below 10 mmol nitrate per day), duration of treatment or specific commonly measured outcomes did not indicate any subgroup more likely to show positive results. The proportion of positive outcomes was similar in studies using beetroot extract, nitrate alone or exercise as a co‐intervention.ConclusionsCurrent evidence is insufficient to decide if dietary nitrate supplementation improves skeletal muscle function in older people. Future studies should be longer, larger and target older people with sarcopenia or frailty.

Changes in biopsychosocial factors based on transportation independence among older adults: A one-year study post-COVID-19 movement restrictions

IntroductionThe global COVID-19 pandemic prompted widespread lockdown measures, impacting transportation systems and specifically affecting the mobility of older adults, which could result in changes to their biophysical, psychological and social health, or better known as biopsychosocial health. However, limited information exists regarding the alterations in the biopsychosocial aspects of older adults during and after the COVID-19 movement restrictions, as well as their association. The objective of this study is to investigate the biopsychosocial dynamics associated with navigating transportation during and after the recovery phase of COVID-19 pandemic. Additionally, it aims to determine the association between transportation independence status and various biopsychosocial factors. MethodsA sub-sample of 100 individuals aged 60 years and above (mean age ± SD: 68.4 ± 5.3), from earlier cross-sectional study were recruited in a one year follow up study. Face-to-face interviews were conducted by the same researcher from baseline to obtain older adults’ sociodemographic health status, anthropometric measurements, functional status, depressive symptoms, nutritional status, cognitive status, visual assessment, physical activity and physical performance and transportation independence. Bivariate logistic regression was performed to examine the association. ResultsWhile there were no significant changes in transportation independence among older adults during and after the COVID-19 movement restriction, there were noticeable increases in outdoor mobility and certain changes in biopsychosocial factors. Results revealed higher fat mass (Adj OR = 1.20, 95% CI: 1.03–1.41, p < 0.05), poorer performance in Timed up and Go (TUG) (Adj OR = 1.40, 95% CI: 1.03–1.88, p < 0.05) test, poorer Hand Grip Strength (HGS) (Adj OR = .85, 95% CI: .74–.98, p < 0.05) and changes in Instrumental Activities of Daily Living (IADL) (p < 0.05) are associated with restricted transportation in older adults. ConclusionThe findings of this study highlight the importance of biopsychosocial health factors, such as body composition, physical performance, and function, which may be influenced by transportation independence among older adults.

Facilitators and barriers of long-term exercise adherence in healthcare workers formerly suffering from post-COVID-19 syndrome : Aqualitative 1-year follow-up and quantitative pilot study of the COFIT trial.

Early exercise intervention studies showed promising positive effects of physical exercising on post-COVID-19symptoms; however, little is known about long-term training adherence and what influences it. Semi-structured interviews were conducted with 17participants of the 8‑week original exercise intervention study. Facilitators and barriers were identified via thematic analysis and compared between those participants who continued their regular exercise behavior (continuous exercise group, CEG, n = 7) and those who stopped exercising (discontinuous exercise group, DEG, n = 10). Physical performance parameters and questionnaires regarding psychological health dimensions and work ability were assessed analogously to the original study. Qualitative analysis showed that two of the top three facilitators, (improving physical and mental health, sport has high priority) were the same in both groups. The respective third of the top three facilitators was (re)build physical and cognitive performance in the CEG and training in the group in the DEG. The top three barriers (exhaustion, sport has little priority, procrastination) were not only the same in both groups but also in the same order. The strongest post-COVID-19 associated facilitator for long-term exercise adherence is when the need for further reconditioning is felt. The strongest post-COVID-19 associated barrier is exhaustion. Availability of exercising in agroup is akey factor in increasing long-term exercise adherence.

A Miscibility Study of p(MMA-co-HEMA)-Based Polymer Blends by Thermal Analysis and Solid-State NMR Relaxometry.

Ternary amorphous solid dispersions (ASDs) consist of a multicomponent carrier with the aim of improving physical stability or dissolution performance. A polymer blend as a carrier that combines a water-insoluble and a water-soluble polymer may delay the drug release rate, minimizing the risk of precipitation from the supersaturated state. Different microstructures of the ternary ASD may result in different drug release performances; hence, understanding the phase morphology of the polymer blend is crucial prior to drug incorporation. The objective of this study is to investigate the miscibility of the water-insoluble p(MMA-co-HEMA) and water-soluble polymers such as HPC, HPMC, HPMC-AS, and Soluplus. To prepare the polymer blends, p(MMA-co-HEMA) was spray dried in 80/20 and 90/10 (w/w) ratios with one of the water-soluble polymers. Thermal analysis (mDSC and DMA) and solid-state (ss)NMR relaxometry were applied to study the miscibility of these blends. No conclusions regarding miscibility could be drawn from the Tg measurements by thermal analysis. However, phase-separation could be demonstrated in all blends by ssNMR relaxometry. Moreover, by measuring both the T1ρH and T1H relaxation times, domain sizes between 5 and 50 nm could be estimated. This work shows the importance of using complementary analytical techniques to investigate polymer miscibility.

Ability of Heart Rate Recovery and Gait Kinetics in a Single Wearable to Predict Frailty: Quasiexperimental Pilot Study.

Aging is a risk factor for falls, frailty, and disability. The utility of wearables to screen for physical performance and frailty at the population level is an emerging research area. To date, there is a limited number of devices that can measure frailty and physical performance simultaneously. The aim of this study is to evaluate the accuracy and validity of a continuous digital monitoring wearable device incorporating gait mechanics and heart rate recovery measurements for detecting frailty, poor physical performance, and falls risk in older adults at risk of falls. This is a substudy of 156 community-dwelling older adults ≥60 years old with falls or near falls in the past 12 months who were recruited for a fall prevention intervention study. Of the original participants, 22 participants agreed to wear wearables on their ankles. An interview questionnaire involving demographics, cognition, frailty (FRAIL), and physical function questions as well as the Falls Risk for Older People in the Community (FROP-Com) was administered. Physical performance comprised gait speed, timed up and go (TUG), and the Short Physical Performance Battery (SPPB) test. A gait analyzer was used to measure gait mechanics and steps (FRAIL-functional: fatigue, resistance, and aerobic), and a heart rate analyzer was used to measure heart rate recovery (FRAIL-nonfunctional: weight loss and chronic illness). The participants' mean age was 74.6 years. Of the 22 participants, 9 (41%) were robust, 10 (46%) were prefrail, and 3 (14%) were frail. In addition, 8 of 22 (36%) had at least one fall in the past year. Participants had a mean gait speed of 0.8 m/s, a mean SPPB score of 8.9, and mean TUG time of 13.8 seconds. The sensitivity, specificity, and area under the curve (AUC) for the gait analyzer against the functional domains were 1.00, 0.84, and 0.92, respectively, for SPPB (balance and gait); 0.38, 0.89, and 0.64, respectively, for FRAIL-functional; 0.45, 0.91, and 0.68, respectively, for FROP-Com; 0.60, 1.00, and 0.80, respectively, for gait speed; and 1.00, 0.94, and 0.97, respectively, for TUG. The heart rate analyzer demonstrated superior validity for the nonfunctional components of frailty, with a sensitivity of 1.00, specificity of 0.73, and AUC of 0.83. Agreement between the gait and heart rate analyzers and the functional components of the FRAIL scale, gait speed, and FROP-Com was significant. In addition, there was significant agreement between the heart rate analyzer and the nonfunctional components of the FRAIL scale. The gait and heart rate analyzers could be used in a screening test for frailty and falls in community-dwelling older adults but require further improvement and validation at the population level.

Perceived Health Status Predicts Resilience after Hip Fracture in Older People.

Background and Objectives: Perceived health status (PHS) is associated with various health outcomes in older adults, but its relationship with resilience in the context of events with a major impact on functional status (FS), such as hip fracture, has not been explored. Our objective was to evaluate whether older adults who report good PHS before a hip fracture have a higher probability of returning to their baseline physical performance (PP) and personal independence. Materials and Methods: We analyzed data from waves 1 and 2 of the Survey of Health, Ageing and Retirement in Europe (SHARE) study, enrolling patients ≥ 65 years who experienced a hip fracture between these two waves. As study outcomes, we analyzed changes in PP and functional abilities (FAs). Results: We included 149 participants with a mean age of 75.7 years (SD: 6.5); women comprised 66%. The incidence of loss of PP was 51.7% among participants with good PHS and 59.6% among those with poor PHS. FA worsened in 40% of participants with good PHS and 58.4% in those with poor PHS. Relative risk (RR) for loss of FA in people with good PHS was 0.68 (95% CI: 0.48-0.98), which did not change after an adjustment for age, gender, baseline FA, depression, number of comorbidities, education, income, and social support, despite it not reaching statistical significance. After adjustment, the risk of worsening PP in participants with good PHS was reduced by 34% (95% CI: 0.41-1.06). Conclusions: A simple question on PHS may predict the resilience of older adults after an acute stressor. A systematic evaluation of PHS can help identify patients with a higher probability of regaining function after a hip fracture and thus provide useful information for resource allocation.