Submaximal Test Research Articles

The Effect of Exercise Training as Adjuvant Treatment on Functional Capacity in Congenital Heart Disease with Negative Vaso Reactivity Test Pulmonary Hypertension Patient at Saiful Anwar Hospital Malang

Background: Pulmonary hypertension associated with congenital heart disease (CHD) is an important subgroup that accounts for approximately 11% of all patients with PAH. Physical limitations are one of the main symptoms of hemodynamic changes in patients with PH. Objective: This study aimed to evaluate the effect of physical exercise therapy for 12 weeks as an additional therapy with PDE-5 inhibitors on the functional capacity of patients with Congenital Heart Disease accompanied by Pulmonary Artery Hypertension (CHD – PH). Method: This research was an analytic experimental study with a prospective cohort research method. This study used data sources obtained from medical records to adjust subjects based on inclusion and exclusion criteria, initial cardiac training test examination data was carried out at IPJT in patients selected as subjects. The patient's clinical outcomes were followed in the next 12 weeks. Result: This research was conducted on 16 samples divided into two groups, namely the control and study groups. The evaluation after 12 weeks found that there was an increase in mileage as measured through the 6MWT submaximal test and a better duration of physical activity in the study group tested through the Endurance Shuttle Walk Test (ESWT). This is consistent with the effect of physical exercise, which suppresses systemic inflammation and causes vasodilation, thereby increasing oxygen delivery to the tissues. This causes more optimal aerobic metabolism and reduces lactate production. So that the patient did not quickly feel tired during activities. However, there was no significant increase in the Incremental Shuttle Walk Test. This could be due to the relatively short training duration of 12 weeks. Conclusion: A positive correlation exists between physical exercise and increased functional capacity of patients with CHD who were evaluated using 6MWT and ESWT.

Association Between Cardiorespiratory Fitness and Cancer Incidence and Cancer-Specific Mortality of Colon, Lung, and Prostate Cancer Among Swedish Men

Cardiorespiratory fitness (CRF) levels appear to be an important risk factor for cancer incidence and death. To examine CRF and prostate, colon, and lung cancer incidence and mortality in Swedish men, and to assess whether age moderated any associations between CRF and cancer. A prospective cohort study was conducted in a population of men who completed an occupational health profile assessment between October 1982 and December 2019 in Sweden. Data analysis was performed from June 22, 2022, to May 11, 2023. Cardiorespiratory fitness was assessed as maximal oxygen consumption, estimated using a submaximal cycle ergometer test. Data on prostate, colon, and lung cancer incidence and mortality were derived from national registers. Hazard ratios (HRs) and 95% CIs were calculated using Cox proportional hazards regression. Data on 177 709 men (age range, 18-75 years; mean [SD] age, 42 [11] years; mean [SD] body mass index, 26 [3.8]) were analyzed. During a mean (SD) follow-up time of 9.6 (5.5) years, a total of 499 incident cases of colon, 283 of lung, and 1918 of prostate cancer occurred, as well as 152 deaths due to colon cancer, 207 due to lung cancer, and 141 deaths due to prostate cancer. Higher levels of CRF (maximal oxygen consumption as milliliters per minute per kilogram) were associated with a significantly lower risk of colon (HR, 0.98, 95% CI, 0.96-0.98) and lung cancer (HR, 0.98; 95% CI, 0.96-0.99) incidence, and a higher risk of prostate cancer incidence (HR, 1.01; 95% CI, 1.00-1.01). Higher CRF was associated with a lower risk of death due to colon (HR, 0.98; 95% CI, 0.96-1.00), lung (HR, 0.97; 95% CI, 0.95-0.99), and prostate (HR, 0.95; 95% CI, 0.93-0.97) cancer. After stratification into 4 groups and in fully adjusted models, the associations remained for moderate (>35-45 mL/min/kg), 0.72 (0.53-0.96) and high (>45 mL/min/kg), 0.63 (0.41-0.98) levels of CRF, compared with very low (<25 mL/min/kg) CRF for colon cancer incidence. For prostate cancer mortality, associations remained for low (HR, 0.67; 95% CI, 0.45-1.00), moderate (HR, 0.57; 95% CI, 0.34-0.97), and high (HR, 0.29; 95% CI, 0.10-0.86) CRF. For lung cancer mortality, only high CRF (HR, 0.41; 95% CI, 0.17-0.99) was significant. Age modified the associations for lung (HR, 0.99; 95% CI, 0.99-0.99) and prostate (HR, 1.00; 95% CI, 1.00-1.00; P < .001) cancer incidence, and for death due to lung cancer (HR, 0.99; 95% CI, 0.99-0.99; P = .04). In this cohort of Swedish men, moderate and high CRF were associated with a lower risk of colon cancer. Low, moderate, and high CRF were associated with lower risk of death due to prostate cancer, while only high CRF was associated with lower risk of death due to lung cancer. If evidence for causality is established, interventions to improve CRF in individuals with low CRF should be prioritized.

Cardiorespiratory fitness and cardiovascular risk among in-patients with depression compared to healthy controls.

Compared to the general population, individuals with depression have an increased risk for cardiovascular diseases. Nevertheless, little is known so far whether cardiorespiratory fitness (CRF) moderates this relationship. Therefore, we examined whether common physiological cardiovascular risk factors differ between patients with depression and healthy (non-depressed) controls, whether patients and controls differ in CRF, and whether higher CRF is associated with a lower cardiovascular risk in both patients and healthy controls. Additionally, we examined whether within the patient sample, cardiovascular risk factors differ between patients with mild, moderate and severe depression, and whether the relationship between symptom severity and cardiovascular risk is moderated by patients' CRF levels. Data from a multi-centric, two-arm randomized controlled trial (RCT) was analyzed, including 210 patients (F32, single episode: n = 72, F33, recurrent major depression: n = 135, F31-II, bipolar type II: n = 3) and 125 healthy controls. Waist circumference, body mass index, body fat, blood pressure, cholesterol levels, triglycerides, and blood glucose were considered as cardiovascular risk markers. CRF was assessed with a submaximal ergometer test. Differences between groups were examined via χ2-tests and (multivariate) analyses of covariance. Compared to healthy controls, patients with depression had a higher cardiovascular risk as evident from about half of the examined indicators. In the total sample, participants with good CRF had more favourable scores across nearly all risk markers than counterparts with poor CRF. For most variables, no interaction occurred between group and fitness, indicating that in patients and controls, similar differences existed between participants with poor and good CRF. Few differences in risk markers were found between patients with mild, moderate and severe depression, and no interaction occurred between depression severity and CRF. Patients with depression and healthy controls differ in several cardiovascular risk markers, putting patients at increased risk for CVDs. In contrast, people with good CRF show more favourable cardiovascular risk scores, a relationship which was observed in both healthy controls and patients with depression. Physical health of psychiatric patients should receive the clinical attention that it deserves. Lifestyle interventions targeting healthy diet and/or physical activity are recommended as a physically active and healthy lifestyle contributes equally to patients' mental well-being and cardiovascular health.

Physical Activity, Exercise Capacity and Sedentary Behavior in People with Alpha-1 Antitrypsin Deficiency: A Scoping Review.

Alpha-1 antitrypsin deficiency (AATD) isa hereditary disorder and a genetic risk factor for chronic obstructive pulmonary disease (COPD). Physical activity (PA) is important for the prevention and treatment of chronic disease. Little is known about PA in people with AATD. Therefore, we aimed to map the research undertaken to improve and/or measure PA, sedentary behaviour (SB) or exercise in people with AATD. Searches were conducted in CINAHL, Medline, EMBASE and clinical trial databases for studies published in 2021. Databases were searched for keywords (physical activity, AATD, exercise, sedentary behavior) as well as synonyms of these terms, which were connected using Boolean operators. The search yielded 360 records; 37 records were included for review. All included studies (n = 37) assessed exercise capacity; 22 studies reported the use of the six-minute walk test, the incremental shuttle walk test and cardiopulmonary exercise testing were reported in three studies each. Other objective measures of exercise capacity included a submaximal treadmill test, the Naughton protocol treadmill test, cycle ergometer maximal test, endurance shuttle walk test, constant cycle work rate test, a peak work rate test and the number of flights of stairs a participant was able to walk without stopping. A number of participant self-reported measures of exercise capacity were noted. Only one study aimed to analyze the effects of an intensive fitness intervention on daily PA. One further study reported on an exercise intervention and objectively measured PA at baseline. No studies measured SB. The assessment of PA and use of PA as an intervention in AATD is limited, and research into SB absent. Future research should measure PA and SB levels in people with AATD and explore interventions to enhance PA in this susceptible population.

Body Composition Is Related to Maximal Effort Treadmill Test Time in Firefighters.

Firefighting tasks may require near maximal levels of cardiorespiratory fitness. Previous research has indicated that body fat percentage (BF%) and aerobic capacity (VO2peak) are related to the performance of firefighting tasks. Since a standard submaximal treadmill test for firefighters is terminated at 85% of maximal heart rate (MHR), key performance information relating to maximal cardiorespiratory effort may not be measured in a submaximal test. The purpose of this study was to examine the relationships between body composition and time spent running at intensities greater that 85% MHR. Height, weight, body mass index (BMI; kg/m2), BF%, MHR (bpm), VO2peak (mL/kg/min), predicted VO2peak (P-VO2peak; mL/kg/min), submaximal treadmill test time (WFIsub Test Time; min), and maximal treadmill test time (WFImax Test Time; min) were collected in fifteen active-duty firefighters. The results indicated that significant relationships (p < 0.05) existed between BF% and VO2peak, BF% and WFImax Test Time, BF% and Tdiff, and VO2peak and WFImax Test Time. P-VO2peak was not significantly different than VO2peak, and the WFImax Test Time was significantly longer than the WFIsub Test Time. These results indicate that a submaximal treadmill test may reasonably predict VO2peak, but key information about physiological work at intensities greater than 85% MHR may be missed when using submaximal effort tests.

Exercise systolic blood pressure indexed to work rate predicts future risk of incident stroke

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): 1) The CircM network, Linköping University 2) The Swedish Stroke Association. Background Hypertension is a major risk factor for stroke. Exaggerated peak systolic blood pressure (SBP) during exercise is associated with increased risk of hypertension in normotensive subjects, whereas low, rather than high, peak exercise SBP predicts cardiovascular and all-cause mortality. Purpose We aimed to study the risk of incident fatal and non-fatal stroke in relation to absolute and work rate indexed exercise SBP, in patients referred for exercise testing. Methods We cross-linked clinical data from 14,428 bicycle ergometer exercise tests with data from the National Patient Registry and the Registry of Prescribed Medications up until December 2019. Subjects with a history of cerebrovascular disease were excluded, as well as subjects with submaximal tests, a drop in SBP during exercise, or with missing SBP data at the end of exercise. Baseline comorbidity was defined as diagnosis of, or treatment for, hypertension, diabetes, hyperlipidemia, and coronary artery disease (CAD). Work rate indexed SBP response (SBP/Watt-slope) was calculated as the increase in SBP during exercise divided by the increase in work rate. We applied Cox regression to calculate hazard ratios (HR) with 95% confidence intervals (95% CI) for the risk of incident stroke in association to peak SBP and the SBP/Watt-slope. We used absolute values as well the upper limit of normal (≥2 Z scores) of a recently published reference population, with reference equation including age, sex, SBP at rest, Wmax (for SBP peak only) and height (for SBP/W-slope only). Analyses were adjusted for age, sex, and baseline comorbidity. Results In total, 7,946 subjects (54% male, age 55±13 years) were included, with baseline comorbidity of hypertension (28%), diabetes (7%), hyperlipidemia (16%), and CAD (13%). During a median follow-up of 8.4 years (inter quartile range 5.8-11.5), 3.1% developed ischemic (2.2%) or hemorrhagic (1.0%) stroke. There were positive associations to future stroke with absolute peak exercise SBP (HR: 1.08 [1.03 – 1.13] per 10 mmHg increase) and with SBP/Watt-slope (HR: 1.09 [1.05 – 1.14] per 1 mmHg/10 Watt increase), but not after adjustment for sex, age and baseline comorbidity. However, having a SBP/Watt-slope ≥2 Z scores was associated with an increased risk for stroke (HR: 1.56 [1.08 – 2.25)] after adjustment for baseline comorbidity, whereas an adjusted SBP peak ≥2 Z scores was not (HR: 0.62 [0.32 – 1.21]). Conclusion A workload-indexed SBP response (SBP/Watt-slope) above the upper limit of normal may help to identify subjects with no history of cerebrovascular disease at risk of future stroke. In contrast, the absolute exercise SBP response to exercise does not add substantial information to the risk estimation above age, sex, and baseline comorbidity.

Sustained inflammation and high cortisol reactivity following an coronary event

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Heart and lung foundation Sweden. Background Over the last decades, significant improvements have been made in medical and lifestyle managements of patients with coronary artery disease (CAD). Nonetheless, "residual inflammatory risk" for recurrent cardiovascular events is high in this patient group and remains a diagnostic and therapeutic challenge. Activation of the NLRP3 inflammasome, involving release of interleukin (IL)-1β and IL-18 followed by their downstream target IL-6, is considered a major component of the inflammatory process in atherosclerosis. One major immunomodulator is the hypothalamic–pituitary–adrenal (HPA) axis. Interestingly, there is increasing evidence that cortisol exerts proinflammatory effects through the induction of NLRP3 expression. Purpose We investigated whether sustained inflammation was associated with altered HPA stress reactivity in patients with CAD. From 4 weeks up to 6 months after a coronary event, we measured systemic inflammation, with focus on inflammasome-related cytokines, and HPA axis hormones (ACTH and cortisol) before and after acute physical stress. Method We included 81 patients (mean age 62 years, 77 % males) and 30 controls (mean age 69 years, 67 % males). Patients underwent a standardized submaximal exercise stress test at 4 weeks (visit A) and 3-6 months after the coronary event (visit B) while controls performed one test only. Free cortisol was measured in saliva before, directly and 30 min after exercise. IL-18, IL-Ra (as a surrogate for IL-1 β), IL-6, ACTH and total cortisol were measured in plasma before and 30 min after exercise. Results At visit A, plasma levels of CRP (baseline only) and IL-6 did not differ between patients and controls while IL-18 and IL-1Ra were significantly higher in patients both before and after exercise, 500 (391-632) vs 386 (295-493), p=0.002; and 179 (141-267) vs 147 (117- 182), p=0.005, respectively(table 1). At visit B, CRP decreased while IL-18 and IL-1Ra levels remained at higher levels than controls. At both visits, patients showed a heightened cortisol reactivity (i.e. significant increase directly after exercise) while this did not occur in controls (Figure 1). At visit B, the relative increase in cortisol directly after exercise was even higher than at visit A (p=0.024). At both visits, ACTH decreased significantly after exercise in patients (p&amp;lt;0.01), probably due to negative feedback, while no change in ACTH was observed in controls. Conclusion Sustained elevations in IL-18 and IL-1Ra in CAD patients following a coronary event may indicate enhanced activity of NLRP3 inflammasome. Furthermore, patients exhibited a heightened cortisol stress reactivity, a phenomenon which has been associated with atherosclerosis progression and sedentary lifestyle in the population. It may be speculated that HPA axis alteration is directly associated with NLRP3 inflammasome activation in CAD, thus opening doors to new insights in prevention. However, this remains to be further investigated.

One size does not fit all - translating absolute accelerometry to relative individual physical activity intensity for health

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): The main funding body of The Swedish CArdioPulmonary bioImage Study (SCAPIS) is theSwedish Heart-Lung Foundation. The study is also funded by the Knut and Alice Wallenberg Foundation, the Swedish Research Council and VINNOVA (Sweden’s Innovation agency) the University of Gothenburg and Sahlgrenska University Hospital, Karolinska Institutet and Stockholm county council, Linköping University and University Hospital, Lund University and Skåne University Hospital, Umeå University and University Hospital, Uppsala University and University Hospital. Introduction Physical activity intensity can be expressed in either absolute (e.g. brisk walking or metabolic equivalents) or relative terms (e.g. proportion of maximal oxygen consumption or perceived exertion) (1). Although intervention studies typically use relative intensity for exercise prescription, large scale observational studies measuring physical activity with accelerometers always use absolute intensity. The association between relative physical activity intensity and cardiometabolic risk factors has not been studied using accelerometry previously. Purpose To compare absolute and relative measures of physical activity intensity in terms of physical activity level and associations with cardiovascular risk factors among individuals with different fitness level. Methods A subsample of the Swedish CArdioPulmonary bioImage Study (SCAPIS), in total 4234 men and women aged 50-64, was analysed (2). Physical activity was measured by accelerometers and the raw data processed with the 10 Hz frequency extended method (FEM) to get a more accurate measure of physical activity intensity compared to previous methods (3). Maximal oxygen consumption (fitness) was estimated by a submaximal ergometer test. Waist to hip ratio, systolic blood pressure, glycated haemoglobin (HBA1c) and high-density lipoprotein to total cholesterol ratio were combined into a composite cardiometabolic risk factor score. Partial least squares regression was used to investigate the associations of absolute and relative physical activity intensity with fitness as well as the composite score. The sample was divided into tertiles of fitness for stratified analyses. Results Overall, there was an association between physical activity at absolute moderate intensity and above, and the health outcomes. Yet, the main associations were found in the absolute moderate intensity range for the low fitness group and in the absolute vigorous intensity range for the high fitness group. When considering relative intensity however, all the main associations started in the upper part of the moderate intensity range and peaked in the vigorous intensity range (Figure 1). In addition, when comparing absolute and relative cut-offs for moderate intensity, absolute moderate intensity was too low for 95% of individuals in the sample (Figure 2). When using absolute intensity, 99% of individuals reached the general guidelines of 150 minutes of moderate-to-vigorous physical activity per week, while only 21% reached the guidelines based on relative intensity. Conclusions Health benefits of absolute intensity are misleading for most individuals in this sample and absolute measures of physical activity overestimate time spent at moderate intensity and above. Relative intensity should be used when interpreting accelerometer measured physical activity and when communicating health promoting physical activity.

Associations between cardiorespiratory fitness and cardiometabolic risk factors in children and adolescents with obesity

It is unclear if associations between cardiorespiratory fitness (CRF) and cardiometabolic risk factors are independent of degree of obesity, in children with obesity. The aim of this cross-sectional study on 151 children (36.4% girls), 9–17 years, from a Swedish obesity clinic, was to investigate associations between CRF and cardiometabolic risk factors, adjusted for body mass index standard deviation score (BMI SDS), in children with obesity. CRF was objectively assessed with the Åstrand-Rhyming submaximal cycle ergometer test, and blood samples (n = 96) and blood pressure (BP) (n = 84) according to clinical routine. Obesity specific reference values for CRF were used to create CRF levels. CRF was inversely associated with high-sensitivity C-reactive protein (hs-CRP), independent of BMI SDS, age, sex, and height. The inverse associations between CRF and diastolic BP did not remain significant when adjusted for BMI SDS. CRF and high-density lipoprotein cholesterol became inversely associated when adjusted for BMI SDS. Independent of degree of obesity, lower CRF is associated with higher levels of hs-CRP, as a biomarker of inflammation, in children with obesity and regular assessment of CRF should be encouraged. Future research in children with obesity should investigate if low-grade inflammation decreases when CRF is improved.

Energy expenditure and intensity of ritual jumping-dancing in male Maasai.

Traditional jumping-dance rituals performed by Maasai men involve prolonged physical exertion that may contribute significantly to overall physical activity level. We aimed to objectively quantify the metabolic intensity of jumping-dance activity and assess associations with habitual physical activity and cardiorespiratory fitness (CRF). Twenty Maasai men (18-37 years) from rural Tanzania volunteered to participate in the study. Habitual physical activity was monitored using combined heart rate (HR) and movement sensing over 3 days, and jumping-dance engagement was self-reported. A 1-h jumping-dance session resembling a traditional ritual was organized, during which participants' vertical acceleration and HR were monitored. An incremental, submaximal 8-min step test was performed to calibrate HR to physical activity energy expenditure (PAEE) and assess CRF. Mean (range) habitual PAEE was 60 (37-116) kJ day-1 kg-1 , and CRF was 43 (32-54) mL O2 min-1 kg-1 . The jumping-dance activity was performed at an absolute HR of 122 (83-169) beats·min-1 , and PAEE of 283 (84-484) J min-1 kg-1 or 42 (18-75)% when expressed relative to CRF. The total PAEE for the session was 17 (range 5-29) kJ kg-1 , ~28% of the daily total. Self-reported engagement in habitual jumping-dance frequency was 3.8 (1-7) sessions/week, with a total duration of 2.1 (0.5-6.0) h/session. Intensity during traditional jumping-dance activity was moderate, but on average sevenfold higher than habitual physical activity. These rituals are common, and can make a substantial contribution to overall physical activity in Maasai men, and thus be promoted as a culture-specific activity to increase energy expenditure and maintain good health in this population.

Comparison of six-minute walk test and incremental shuttle walk test in interstitial lung disease

BACKGROUND: This study aimed to compare six-minute walk test (6-MWT) and incremental shuttle walk test (ISWT) in evaluating the exercise capacity and physiological responses of stable patients with interstitial lung disease (ILD).METHODS: Thirty patients diagnosed with ILD who were stable during the study period were included in the study. Demographic characteristics of the patients, lung function tests and carbon monoxide diffusion capacities were recorded. 6-MWT and ISWT were applied to the patients on different days, and physiological responses were evaluated.RESULTS: The mean age of the patients was 52.4±14 years, and 17 (56.7%) were men. The mean distances covered in the 1st hour and 2nd hour of 6-MWT were 418.2±137.4 m and 443.4±143.4 m, respectively, and the difference was statistically significant (P<0.001). ISWT mean distance was 266.3±148.3 m. The difference between oxygen saturations measured before and after 6-MWT and ISWT (∆SaO2) was statistically significant (-7, -4) (P<0.001). Both 6-MWT and ISWT showed that there was a significant decrease in the exercise capacity of the patients with ILD, and there was a strong correlation between the walking distances measured in both tests (r=0.719, P<0.001). 6-MWT and ISWT walking distances showed the highest correlation with the maximum carbon monoxide diffusion capacity (DLCO) (%) (r=0.596, P<0.001 vs. r=0.666, P<0.001).CONCLUSIONS: 6-MWT and ISWT can be used to determine the exercise capacity in patients with ILD, and both tests show a strong correlation with DLCO, a parameter that has an important role in diagnosis, follow-up, treatment, and prognosis in this patient group. ISWT is a standardized test in which the maximal capacity is evaluated, it has a strong correlation with maximal and submaximal tests, and the peak oxygen consumption (V02 peak) calculated in this test shows a correlation with DLCO. Hence, ISWT is one step ahead in the follow-up of patients with ILD, monitoring treatment response, predicting survival and evaluating candidates for pulmonary rehabilitation program.

Comparison of the neuromuscular response to three different Turkish, semi-professional football training sessions typically used within the tactical periodization training model

This study examined the neuromuscular responses to three typical football (soccer) training sessions and the reliability of peak speed (PS) measured during a submaximal running test (SRT) for identifying neuromuscular fatigue (NMF) status. Jump height (CMJH) and peak velocity (CMJPV) were collected from a CMJ test, while peak speed (PS) was collected during an SRT before and after each training session. Large effect size (ES) decreases were observed in each variable post-training (ES; − 1.42 to − 2.32). Significant differences (> 0.001) were detected between each football session's external load variables. Coefficients of variations were small (< 10%) with moderate (CMJPV; 0.53, PS; 0.44) and strong (CMJH; 0.72) intraclass correlation coefficients between pre-test measures. The demands of each football session aligned with the principles of tactical periodization and were sufficient to produce the fatigue necessary to elicit physiological adaptations. PS was also shown to be a viable measure of monitoring NMF status.

Comparison of physical activity and sports engagement between children with ADHD undergoing pharmacotherapy and healthy peers

Abstract: Background: Children with Attention Deficit Hyperactivity Disorder (ADHD) often face problems in the engagement and adherence of health-promoting behaviors, such as physical activity and sports. Stimulant treatment is effective for managing core symptoms, but it remains unclear if this type of treatment also normalizes the engagement in health-promoting behavior. In this case-control study, we aim to compare physical activity and sports participation between children with ADHD and healthy peers. Motor skills and aerobic fitness are investigated as potential mediators of differences between groups. Methods: Children with ADHD were matched to healthy peers based on sex, age, and socioeconomic status. Participants ( N=120; age: 10.8±1.4) reported their physical activity and sports participation using a 7-day recall protocol. Their engagement in activities at moderate and vigorous intensity as well as participation in individual and team sports was derived from the protocol. Participants further completed the Movement Assessment Battery for Children-2 (MABC-2) and a submaximal test on a cycling ergometer (PWC170). Results: Children with ADHD showed lower vigorous physical activity and participation in individual sports than healthy peers. They also achieved lower scores on the MABC-2 and the PWC170. Based on path-analyses, low PWC170 partially mediated the ADHD-related fewer engagement in vigorous physical activity and individual sports. Conclusion: Children with ADHD undergoing stimulant treatment show less participation in vigorous physical activity and individual sports than healthy peers. Poor aerobic fitness partly contributes to the relation between ADHD and low physical activity.

Modified Isoinertial-Based Ruffier Test in Healthy Individuals: A Feasibility Study

Cardiorespiratory fitness is an essential indicator in sports science and sports medicine that can be assessed with several tests. The Ruffier test is a submaximal test valid to estimate maximum oxygen uptake; it consists of 30 squats in 45 s, which may be challenging for inexperienced individuals. This study aims to verify the feasibility of a modified inertial-based version of the Ruffier test to assess cardiorespiratory fitness with 10 squats in 15 s. Both classic and isoinertial Ruffier tests were administered to thirty-five healthy young adults (20 men and 15 women), age 22.06 ± 2.13 years, BMI 23.87 ± 2.74. The two one-sided test confirmed the comparability of the isoinertial Ruffier test with its classic version within equivalence bounds of ±3.726. Furthermore, gender, age, body weight, the difference between peak heart rate after isoinertial squatting and resting heart rate, and the isoinertial Ruffier index are the coefficients of our best VO2max prediction model with an adjusted R2 of 0.937, sensitivity of 0.89, and specificity of 0.81. The study evidenced the feasibility of the isoinertial Ruffier test to measure cardiorespiratory fitness through a quick, safe, and short squat test easy to perform in fitness centers and primary care clinics.

HEMODYNAMIC RESPONSE IN ATHLETES WITH DIFFERENT PHYSICAL PERFORMANCE WHEN PERFORMING SUBMAXIMAL TEST PWC170

One of the main task of the current medico-biological control is aimed at the timely identification of the dysfunctionality of training overloads, a comprehensive assessment of the athlete's condition, and to establish a feedback, since most of the signs of inconsistency between the load and recovery are subjective by their nature, and may be masked by the problems of the psychological sphere or have general, non-specific manifestations. To find the symptoms during a single examination is far from being sufficient, an important component for a successful diagnosis is the observation of the stability and dynamics in symptoms. The purpose of the study is to investigate the response of cardiovascular system indicators in track and field athletes with different physical performance when performing the PWC170 submaximal test. 71 athletes, divided into two groups, were included in the study. The main group consisted of 30 people whose heart rate and blood pressure response were found as unsatisfactory when performing the standard Letunov test for professional athletes (hereinafter referred to as standard physical exercise). The comparison group included 41 people who demonstrated a satisfactory response. There were 34 women out of all participants, 15 individuals were in the main group and 19 individuals were in the comparison group. The average age of the examinees was 22.49 years, no significant differences in age were found between the two groups. Examinations were carried out in the Centre of Sports Medicine, Sumy State University. Among the athletes, a predominantly hypertensive type of reaction to the exercise test is observed, and the recovery of post-exercise parameters occurs slowly during the second half of the observation time that may evidence the predominance of the activity of the sympathetic tone of the autonomic nervous system. In our opinion, the practical significance of the diagnostic methods, which should be used for assessing the health of athletes, is determined, first of all, by their application in dynamics, in accordance with the changing conditions of the training schedule. Under such conditions, it seems reasonable to select simple and objective methods of testing the response to physical exertion in professional athletes that enables to evaluate their reaction to the load and hemodynamic parameters during and after the exertion of various nature.

The Efficacy of Chlorella Supplementation on Multiple Indices of Cycling Performance

This study investigated the effects of chlorella supplementation on submaximal endurance, time trial performance, lactate threshold, and power indices during a repeated sprint performance test by fourteen male trained cyclists. Participants ingested 6 g/day of chlorella or placebo for 21-days in a double-blinded randomized counter-balanced cross-over design, with a fourteen-day washout period between trials. Each completed a 2-day testing period comprising a 1-hour submaximal endurance test at 55% external power output max and a 16.1 km time trial (Day-1), followed by a lactate threshold (Dmax) and repeated sprint performance tests (3 X 20 s sprints interspersed by 4-mins) (Day-2). Heart rate (b.min−1), RER, V̇O2 (ml·kg−1·min−1), lactate and glucose (mmol/L), time (secs), power output (W/kg), and hemoglobin (g/L) were compared across conditions. Following chlorella supplementation (chlorella vs. placebo for each measurement) average lactate and heart rate were significantly lower (p < 0.05) during submaximal endurance tests (1.68 ± 0.50 mmol/L vs. 1.91 ± 0.65 mmol/L & 138 ± 11b.min−1 vs. 144 ± 10b.min−1), average power and peak power (W/kg) were significantly higher during repeated sprint bouts (9.5 ± 0.7 W/kg vs. 9.0 ± 0.7 W/kg & 12.0 ± 1.2 W/kg vs. 11.4 ± 1.4 W/kg), hemoglobin significantly increased (149.1 ± 10.3 g/L) in comparison to placebo (143.4 ± 8.7 g/L) (p = 0.05). No differences existed between conditions for all oxygen consumption values, 16.1 km time trial measures and lactate threshold tests (p > 0.05). In conclusion, chlorella may pose as an additional supplement for cyclists to consider, particularly for those cyclists who want to improve their sprinting.

Body composition and physical fitness in adults born small for gestational age at term: a prospective cohort study

There is lack of research on body composition and physical fitness in individuals born small for gestational age (SGA) at term entering mid-adulthood. We aimed to investigate these outcomes in adults born SGA at term. This population-based cohort study included 46 adults born SGA with birth weight < 10th percentile at term (gestational age ≥ 37 weeks) (22 women, 24 men) and 61 adults born at term with birth weight ≥ 10th percentile (35 women, 26 men) at 32 years. Body composition was examined anthropometrically and by 8-polar bioelectrical impedance analysis (Seca® mBCA 515). Fitness was measured by maximal isometric grip strength by a Jamar hand dynamometer, 40-s modified push-up test and 4-min submaximal step test. Participants born SGA were shorter than controls, but other anthropometric measures did not differ between the groups. Men born SGA had 4.8 kg lower grip strength in both dominant (95% CI 0.6 to 9.0) and non-dominant (95% CI 0.4 to 9.2) hand compared with controls. Grip strength differences were partly mediated by height. In conclusion, body composition and physical fitness were similar in adults born SGA and non-SGA at term. Our finding of reduced grip strength in men born SGA may warrant further investigation.

Replacing sedentary time with physical activity and sleep: Associations with cardiometabolic health markers in adults.

This study aimed to examine the associations of sedentary time, and substituting sedentary time with physical activity and sleep, with cardiometabolic health markers while accounting for a full 24 h of movement and non-movement behaviors, cardiorespiratory fitness (CRF), and other potential confounders. The participants were 4585 members of the Northern Finland Birth Cohort 1966, who wore a hip-worn accelerometer at the age of 46 years for 14 consecutive days. Time spent in sedentary behaviors, light-intensity physical activity (LPA), and moderate-to-vigorous-intensity physical activity (MVPA) were determined from the accelerometer and combined with self-reported sleep duration to obtain the 24-h time use. CRF was estimated from the peak heart rate in a submaximal step test. An isotemporal substitution paradigm was used to examine how sedentary time and substituting sedentary time with an equal amount of LPA, MVPA, or sleep were associated with adiposity markers, blood lipid levels, and fasting glucose and insulin. Sedentary time was independently and adversely associated with the markers of cardiometabolic health, even after adjustment for CRF, but not in partition models including LPA, MVPA, sleep, and CRF. Substituting 60, 45, 30, and 15 min/day of sedentary time with LPA or MVPA was associated with 0.2%-13.7% favorable differences in the cardiometabolic health markers after accounting for LPA, MVPA, sleep, CRF, and other confounders. After adjustment for movement and non-movement behaviors within the 24-h cycle, reallocating additional time to both LPA and MVPA was beneficially associated with markers of cardiometabolic health in middle-aged adults regardless of their CRF level.

Affective Response to Exercise and Affective Judgments as Predictors of Physical Activity Intention and Behavior among New Mothers in their first 6-Months Postpartum.

Understanding the predictors of moderate to vigorous physical activity (MVPA) during early postpartum is important to improve promotion efforts. Affect-related constructs are key predictors of MVPA but have limited research in mothers during the postpartum period. To examine two affect-related constructs (affective response to exercise and affective judgments) as predictors of MVPA intention and behavior across three months, among a sample of new mothers. Participants were 105 mothers (M age = 30.64 years; SD = 3.93) who completed measures during postpartum at 2-months post-birth of their first child. The affective response to exercise (assessed at baseline [2-months postpartum] during a submaximal treadmill test), affective judgments and intention (baseline, 6-weeks after baseline), and MVPA (baseline, 6- and 12-weeks after baseline) were assessed via self-report. Path analysis, using ordinary least squares regression, showed that the affective response during exercise was a significant predictor of intention (baseline, 6-weeks), as well as change in intention from baseline to 6-weeks. By contrast, affective judgments predicted intention at 6-weeks, but not at baseline or in the change model. Past MVPA did not moderate these findings, although the affective response during exercise also had a significant indirect effect on MVPA through intention at 6-weeks and 12-weeks. Interventions targeting women's affective response during exercise may be important during postpartum, perhaps through self-paced physical activity guidance. Affective judgments may not be predictive of MVPA, in part due to unanticipated changes during early postpartum leading to inaccurate expectations of the physical activity experience.

Efficacy of aerobic exercise on aerobic capacity in slowly progressive neuromuscular diseases: A systematic review and meta-analysis.

Aerobic exercise aims to improve aerobic capacity. To summarize the evidence on the efficacy of aerobic exercise on aerobic capacity in slowly progressive neuromuscular diseases (NMDs). We searched the electronic databases MEDLINE, EMBASE, SPORTDiscus and Web of Science Conference Proceedings Index for articles published up to June 17, 2021, selecting randomized controlled trials that included adults with slowly progressive NMDs and compared aerobic exercise to no aerobic exercise. The primary outcome was peak oxygen uptake (VO2peak) directly post-intervention. Secondary outcomes included other peak test parameters, submaximal test parameters, long-term outcomes ≥8 weeks post-intervention, adherence and adverse events. Meta-analyses were performed for the primary outcome and for secondary outcomes when reported in more than 2 studies. Risk of bias was assessed with the Cochrane Risk of Bias tool and quality of evidence according to GRADE. Nine studies were included (195 participants with 8 different NMDs). Eight studies were rated at high risk of bias and 1 study was rated at some concerns. Duration of exercise programs ranged from 6 to 26 weeks, with 3 weekly training sessions of 20 to 40min, based on maximal capacity. Meta-analyses revealed short-term moderate beneficial effects of aerobic exercise on VO2peak (standardized mean difference [SMD] 0.55, 95% CI 0.23; 0.86) and peak workload (SMD 0.61, 95% CI 0.24; 0.99). Long-term effects were not assessed. Most training sessions (83-97%) were completed, but time spent in target intensity zones was not reported. Included studies lacked detailed adverse event reporting. There is low-quality evidence that aerobic exercise is safe and leads to moderate improvement of aerobic capacity directly post-intervention in slowly progressive NMDs, but the long-term efficacy remains unclear. Detailed information about the time spent in target intensity zones and adverse events is lacking. CRD42020200083.