Reduction in insulin degludec dosing for multiple exercise sessions improves time spent in euglycaemia in people with type 1 diabetes: A randomized crossover trial.

AIMS: To compare the time spent in specified glycaemic ranges in people with type 1 diabetes (T1D) during 5 consecutive days of moderate-intensity exercise while on either 100% or 75% of their usual insulin degludec (IDeg) dose. MATERIALS AND METHODS: Nine participants with T1D (four women, mean age 32.1 ± 9.0 years, body mass index 25.5 ± 3.8 kg/m2 , glycated haemoglobin 55 ± 7 mmol/mol (7.2% ± 0.6%) on IDeg were enrolled in the trial. Three days before the first exercise period, participants were randomized to either 100% or 75% of their usual IDeg dose. Participants exercised on a cycle ergometer for 55 minutes at a moderate intensity for 5 consecutive days. After a 4-week wash-out period, participants performed the last exercise period for 5 consecutive days with the alternate IDeg dose. Time spent in specified glycaemic ranges, area under the curve and numbers of hypoglycaemic events were compared for the 5 days on each treatment allocation using a paired Students' t test, Wilcoxon matched-pairs signed-rank test and two-way ANOVA. RESULTS: Time spent in euglycaemia over 5 days was greater for the 75% IDeg dose versus the 100% IDeg dose (4008 ± 938 minutes vs. 3566 ± 856 minutes; P = 0.04). Numbers of hypoglycaemic events (P = 0.91) and time spent in hypoglycaemia (P = 0.07) or hyperglycaemia (P = 0.38) was similar for both dosing schemes. CONCLUSIONS: A 25% reduction in usual IDeg dose around regular exercise led to more time spent in euglycaemia, with small effects on time spent in hypo- and hyperglycaemia.

Holistic physical exercise training improves physical literacy among physically inactive adults: a pilot intervention study.

BACKGROUND: Physical literacy (PL), given as a multidimensional construct, is considered a person's capacity and commitment to a physically active lifestyle. We investigated the effect of a holistic physical exercise training on PL among physically inactive adults. METHODS: A non-randomised controlled study was conducted. Thirty-one physically inactive adults in the intervention group (IG; 81% females, 44 ± 16 years) participated in a holistic physical exercise training intervention once weekly for 15 weeks. A matched, non-exercising control group (CG) consisted of 30 physically inactive adults (80% female, 45 ± 11 years). PL, compliance and sociodemographic parameters were measured. PL was evaluated by a questionnaire, covering five domains: physical activity behaviour, attitude towards a physically active lifestyle, exercise motivation, knowledge and self-confidence/self-efficacy. Data were analysed using ANCOVA models, adjusted for age, gender and BMI at baseline. RESULTS: At post-training intervention, the IG showed significant improvements in PL (p = 0.001) and in the domains physical activity behaviour (p = 0.02) and exercise self-confidence/self-efficacy (p = 0.001), with no changes overserved for the CG regarding PL and those domains. No intervention effect were found for the other three domains, i.e. attitude, knowledge and motivation. Additionally, for the IG baseline BMI was identified to be positively correlated with physical exercise-induced improvements in PL (ß = 0.51, p = 0.01). CONCLUSIONS: The results from this study are very useful for further public health activities, which aim at helping physically inactive adults to adopt a physically active lifestyle as well as for the development of further PL intervention strategies. This pilot-study was a first attempt to measure PL in inactive adults. Yet, a validated measurement tool is still not available. Further research is necessary to determine the psychometric properties for this PL questionnaire. TRIAL REGISTRATION: German Clinical Trials Register (DRKS), DRKS00013991 , date of registration: 09.02.2018, retrospectively registered.

Health Impact Assessment (HIA) of a Daily Physical Activity Unit in Schools: Focus on Children and Adolescents in Austria Up to the 8th Grade.

Physical activity has a variety of health benefits for young people. The World Health Organization (WHO) recommends that children and adolescents aged 5-17 years should be physically active for at least 60 min a day. This Health Impact Assessment (HIA) examined the potential impact of a daily physical activity unit in Austrian schools, with a focus on children and adolescents up to eighth grade. The HIA methodology systematically followed several stages: screening and scoping, appraisal, and formulation of recommendations. A literature review, an online survey (n = 712), focus group discussions (n = 4), and appraisal workshops (n = 2) have been carried out. The analyzed results indicate a primarily positive impact on the individual health of children and adolescents, on social and community-related networks, on living and working conditions, and on the system level. Recommendations for the implementation include ensuring equal opportunities and support for disadvantaged children and schools. Furthermore, the comprehensible selection of pilot regions and the nationwide resource planning should be considered. Additional important factors include the education and further training of pedagogical staff and coaches, and the availability of sufficient infrastructure. In the long term, the fixed integration of five additional teaching units of physical activity per week, and an increased focus on the elementary/nursery school sector were identified as significant.

Mixed Reality Prototype of Multimodal Screening for Early Detection of Cognitive Impairments in Older Adults: Protocol Development and Usability Study.

BACKGROUND: The early diagnosis of cognitive impairments is an important step in the adequate management of dementia. The project "Smart Cognition & Behaviour Screening powered by Augmented Reality" (SCOBES-AR) aims to develop a multimodal screening tool (MST) for the early detection of cognitive impairments using augmented and virtual reality. The first project phase selected validated assessments for combination with the MST and tested it in 300 healthy older adults. OBJECTIVE: This study established a protocol for the implementation and usability of a mixed reality (MR)-enhanced multidisciplinary screening tool for the early detection of cognitive impairments in older adults. The developed MST will be partially enhanced by MR, which is a combination of augmented reality (AR) and virtual reality (VR). This MR-enhanced prototype of the screening tool (MR-MST) will be tested and compared to the previously developed MST. The usability of the prototype will also be examined. METHODS: This single-center observational crossover design study screens 100 healthy participants (aged 60-75 years) for cognitive decline using a specially developed MST (assessment of cognitive functions, olfactory sensitivity, nutritional preferences, gait parameters, reaction times, and activities of daily living) and an MR-enhanced MST in which the assessments of cognitive functions, reaction time, activities of daily living, and gait will be performed using tailor-made software and AR and VR hardware. The results of the MR-enhanced MST will be compared to those without MR. The usability of the developed MR-enhanced MST will be tested on 10 investigators and 10 test participants using observed summative evaluation and the codiscovery method, and on 2 usability experts using the codiscovery and cognitive walkthrough methods. RESULTS: This study was funded by the Austrian Research Promotion Agency (grant 866873) and received approval from the ethics committee of the Medical University of Graz. The MR-MST and the experimental protocol for this study were developed. All participants gave written informed consent. As of July 15, 2022, a total of 70 participants have been screened. Data analysis and dissemination are scheduled for completion by September 2023. CONCLUSIONS: The development and testing of the MR-MST is an important step toward the establishment of the best practice procedure for the implementation of AR and VR in the screening of cognitive declines in older adults. It will help improve our knowledge of the usability and applicability of the developed prototype and promote further advancement in AR and VR technologies to be used in therapeutic settings. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/39513.

Primary Care and Physical Literacy: A Non-Randomized Controlled Pilot Study to Combat the High Prevalence of Physically Inactive Adults in Austria.

The multidimensional concept of physical literacy is fundamental for lifelong physical activity engagement. However, physical literacy-based interventions are in their infancy, especially among adults. Therefore, the purpose of this pilot study was to assess the association of a physical literacy-based intervention with changes in self-reported physical literacy among inactive adults. A non-randomized controlled study (2 × 2 design) was conducted, comparing pre- vs. postintervention. Twenty-eight inactive healthy participants in the intervention group (89% female, 53 ± 10 years) entered a physical literacy-based intervention once weekly for 14 weeks. The non-treated control group consisted of 22 inactive adults (96% female, 50 ± 11 years). Physical literacy was evaluated with a questionnaire encompassing five domains: physical activity behavior, attitude/understanding, motivation, knowledge, and self-efficacy/confidence. ANOVA models were applied to evaluate changes by time and condition. Following the intervention, significant improvements were seen for overall physical literacy and in four out of five physical literacy domains, including physical activity behavior, attitude/understanding, knowledge, and self-efficacy/confidence (all p < 0.01, Cohen's d = 0.38-0.83). No changes by time x condition were found for motivation. The physical literacy-based intervention applied in this study may be a promising approach to help inactive adults to adopt an active lifestyle.

5-Hydroxymethylfurfural and Alpha-Ketoglutaric Acid as an Ergogenic Aid During Intensified Soccer Training: A Placebo Controlled Randomized Study.

Intensified training may lead to fatigue or even a state of overreaching with temporary reductions in performance. Any aid helping to prevent these consequences and to better tolerate such a training regime would be of great importance. 5-hydroxymethylfurfural (5-HMF) and α-ketoglutaric acid (α-KG) supplementation has been suggested to support favorable training outcomes but its effectiveness to facilitate adaptations during an intensified training period has never been investigated. During an in-season competition break (2 weeks), seventeen young outfield soccer players (age:14.7 ± 0.4 yr) performed a 9-day lasting shock microcyle including 5-7 repeated sprint exercise sessions in addition to the regular training (∼6 sessions/wk) and match (1-2 matches/wk) schedule. Before the training period a treadmill test to exhaustion, a YOYO intermittent recovery level 2 (YYIR2) and a repeated sprint ability (RSA) test were performed. The treadmill test was repeated 3 days after the shock microcycle whereas the YYIR2 and the RSA test on day 10 after the training. Magnitude based inference analysis showed likely positive effects of the 5-HMF/α-KG compared to the control group for changes in the maximal running velocity (+0.3 ± 0.7 vs. -0.3 ± 0.8 km/h) and running velocity at lactate turn-point 1 (+0.2 ± 0.4 vs. -0.2 ± 0.6) and lactate turn-point 2 (+0.4 ± 0.4 vs. -0.2 ± 0.6 km/h, for the 5-HMF/α-KG and placebo group, respectively). Training improved YYIR2 performance (+180 ± 67 vs. +200 ± 168m) and RSA (mean time: -0.1 ± 0.1 vs. -0.1 ± 0.1s, for the 5-HMF/α-KG and placebo group, respectively) in both groups and to the same extent. In conclusion, an in-season shock microcyle including repeated sprint training improves YYIR2 performance and RSA in youth soccer players. Supplementation with 5-HMF/α-KG did not modify training adaptations but led to likely positive exercise performance responses shortly after the intensified training regime.

Acute physiological response to aerobic short-interval training in trained runners.

PURPOSE: To analyze the acute physiological response to aerobic short-interval training (AESIT) at various high-intensity running speeds. A minor anaerobic glycolytic energy supply was aimed to mimic the characteristics of slow continuous runs. METHODS: Eight trained male runners (maximal oxygen uptake [VO(2max)] 55.5 ± 3.3 mL · kg(-1) · min(-1)) performed an incremental treadmill exercise test (increments: 0.75 km · h(-1)· min(-1)). Two lactate turn points (LTP1, LTP2) were determined. Subsequently, 3 randomly assigned AESIT sessions with high-intensity running-speed intervals were performed at speeds close to the speed (v) at VO(2max) (vVO(2max)) to create mean intensities of 50%, 55%, and 60% of vLTP1. AESIT sessions lasted 30 min and consisted of 10-s work phases, alternated by 20-s passive recovery phases. RESULTS: To produce mean velocities of 50%, 55%, and 60% of vLTP1, running speeds were calculated as 18.6 ± 0.7 km/h (93.4% vVO(2max)), 20.2 ± 0.6 km/h (101.9% vVO(2max)), and 22.3 ± 0.7 km/h (111.0% vVO(2max)), which gave a mean blood lactate concentration (La) of 1.09 ± 0.31 mmol/L, 1.57 ± 0.52 mmol/L, and 2.09 ± 0.99 mmol/L, respectively. La at 50% of vLTP1 was not significantly different from La at vLTP1 (P = .8894). Mean VO(2) was found at 54.0%, 58.5%, and 64.0% of VO(2max), while at the end of the sessions VO(2) rose to 71.1%, 80.4%, and 85.6% of VO(2max), respectively. CONCLUSION: The results showed that AESIT with 10-s work phases alternating with 20 s of passive rest and a running speed close to vVO(2max) gave a systemic aerobic metabolic profile similar to slow continuous runs.