Active breaks: a strategy to counteract sedentary behaviors for Health Promoting Schools. A discussion on their implementation in Italy.

Abstract: School Active Breaks are short bouts of physical activity (5-15 minutes) conducted by appropriately trained teachers and delivered during or between curricular lessons. They are a good strategy to counteract sedentary behaviors, and a growing body of evidence shows that they can represent also a tool to promote and improve health, school wellbeing and academic achievements. On 19 February 2022, the Working Group on Movement Sciences for Health of the Italian Society of Hygiene, Preventive Medicine and Public Health organized an Awareness Day on the effectiveness, usefulness and feasibility of School Active Breaks, opened to teachers, educators, school leaders, pediatricians, personnel from Departments of Prevention and Public Health and Health Policy-makers. During the event, the testimonies about the experiences already carried out in Italy showed that School Active Breaks are an effective intervention that each school can easily include in its educational offer and apply in any context.

Effect of whole body vibration frequency on neuromuscular activity in ACL-deficient and healthy males.

Whole-body vibration (WBV) has been shown to enhance muscle activity via reflex pathways, thus having the potential to contrast muscle weakness in individuals with rupture of the anterior cruciate ligament (ACL). The present study aimed to compare the magnitude of neuromuscular activation during WBV over a frequency spectrum from 20 to 45 Hz between ACL-deficient and healthy individuals. Fifteen males aged 28±4 with ACL rupture and 15 age-matched healthy males were recruited. Root mean square (RMS) of the surface electromyogram from the vastus lateralis in both limbs was computed during WBV in a static half-squat position at 20, 25, 30, 35, 40 and 45 Hz, and normalized to the RMS while maintaining the half-squat position without vibration. The RMS of the vastus lateralis in the ACL-deficient limb was significantly greater than in the contralateral limb at 25, 30, 35 and 40 Hz (P<0.05) and in both limbs of the healthy participants (dominant limb at 25, 30, 35, 40 and 45 Hz, P<0.05; non dominant limb at 20, 25, 30, 35, 40 and 45 Hz, P<0.05). The greater neuromuscular activity in the injured limb compared to the uninjured limb of the ACL-deficient patients and to both limbs of the healthy participants during WBV might be due to either augmented excitatory or reduced inhibitory neural inflow to motoneurons of the vastus lateralis through the reflex pathways activated by vibratory stimuli. The study provides optimal WBV frequencies which might be used as reference values for ACL-deficient patients.

Improving neuromuscular performance in young basketball players: plyometric vs. technique training.

AIM: The aim of this study was to compare the effects of plyometric training versus basketball technique training on improving neuro-muscular performance. METHODS: Thirty-six (age 14.9±0.9 years, body height 164.0±7.6 cm, body weight 54.0±8.7 kg, BMI 20.1±2.4 kg·m-2) basketball players girls were randomly allocated to 2 groups: Basketball Plyometric Training (BPT, N.=18) and Basketball Technique Training (BTT, N.=18). The players were tested by two specific tests: counter movement jump (CMJ) and squat jump (SJ) before and after 6 training weeks. RESULTS: The jump height, as dependent variable, showed a different trend as an effect of the different training protocols, in contrast with the current knowledge. Manova did not show significant interactions between the two groups for the height of jumps, while significant differences were found for interaction time × training (P<0.05) and for main effect × time (P<0.001). After training, the BPT group increased significantly CMJ performance by 11.3% (P<0.05), whereas the BTT group increased by 4.6%. Likewise, the BPT group demonstrated a significant greater improvement of jump height than BTT group (an increase of 15.4% vs. 7.5%, P<0.01; respectively). CONCLUSION: These results suggest that both training protocols proposed in this study improved vertical jump performance. However, a combination of the two protocols, plyometric training and sport-specific-exercises, could be useful to optimize performance by an easy transition from controlled a-specific to sport-specific performance requirements. In conclusion, BPT is a safe and effective method of achieving a favourable neuro-muscular performance than BTT in female basketball players.

Acute effect of different stretching methods on flexibility and jumping performance in competitive artistic gymnasts.

AIM: The purpose of this study was to investigate the acute effects of 3 different warm up methods of stretching (static, proprioceptive neuromuscular facilitation, and stretching exercises on a Vibration platform) on flexibility and legs power-jumping performance in competitive artistic gymnasts. METHODS: Eighteen competitive artistic gymnasts were recruited to participate in this study. Subjects were exposed to each of 3 experimental stretching conditions: static stretching (SS), proprioceptive neuromuscular facilitation stretching (PNF), and stretching exercises on a Vibration platform (S+V). Flexibility assessed with sit and reach test (S & R) and jumping performance with squat jump (SJ) and counter movement jump (CMJ) and were measured before, immediately after and 15 min after the interventions. RESULTS: Significant differences were observed for flexibility after all stretching conditions for S+V (+1.1%), SS (+5.7%) and PNF (+6.8%) (P=0.000), which remained higher 15 min after interventions (S+V (1.1%), SS (5.3%) and PNF (5.5%), respectively (P=0.000). CONCLUSION: PNF stretching increased flexibility in competitive gymnasts, while S+V maintained jumping performance when both methods were used as part of a warm-up procedure.

Physical fitness assessment in multiple sclerosis patients: a controlled study.

There is growing evidence to show the effectiveness of physical exercise for multiple sclerosis (MS) patients. Aim of this study was to evaluate aerobic capacity, strength, balance, and the rate of perceived exertion (RPE) after exercise, in ambulatory patients with mild MS and matched control healthy participants. Seventeen MS patients aged 48.09 ± 10.0 years, with mild MS disability (Expanded Disability Status Scale: EDSS 1.5 to 4.5) and 10 healthy sedentary age matched (41.9 ± 11.2 years) subjects volunteered for the study. MS patients underwent medical examination with resting electrocardiogram, arterial blood pressure, EDSS, and Modified Fatigue Impact Scale-MFIS. Both groups also underwent physical assessment with the Berg Balance Scale(,) test (Berg), Six Minutes Walking Test (6MWT), maximal isometric voluntary contraction (MIVC) of forearm, lower limb, shoulder strength test, and the Borg 10-point scale test. The one-way ANOVA showed significant differences for MFIS (F1.19=9.420; p<0.01), Berg (F1.19=13.125; p<0.01), handgrip MIVC (F1.19=4.567; p<0.05), lower limbs MIVC (F1.19=7.429; p<0.01), and 6MWT (F1.19=28.061; p<0.01) between groups. EDSS, Berg test and Borg scores explained 80% of 6MWT variation. Mild grade EDSS patients exhibited impaired balance, muscle strength, and low self pace-6MWT scores, whereas RPE response after the exercise was similar to that of sedentary individuals. Both groups showed similar global physiological adjustments to exercise.

Neck balance system in the treatment of chronic mechanical neck pain: a prospective randomized controlled study.

BACKGROUND: Chronic mechanical neck pain (MNP) is a very common condition, that may occur in general population. There is a lack of evidence for most therapies except for exercise therapy with combining methods, whose effectiveness is still moderate. AIM: The aim of this study was to determine the effect of a novel neck balance system-Dal Monte 2(NBS-DM2) incorporated into a special cap on pain in sufferers of MNP after treatment and at three months follow-up. DESIGN: Prospective randomized controlled trial. SETTING: Outpatient clinic of the University of Rome "Foro Italico". POPULATION: Forty-five volunteers of both sexes affected by grade II MNP were enrolled. METHODS: NBS-DM2/RW (regular weight), NBS-DM2/NW (negligible weight) and Pulsed Electromagnetic Fields (PEMF) have been used for 8 weeks. Neck Disability Index (NDI), Neck Pain and Disability Scale (NDPS) questionnaires and Visual Analogic Scale (VAS) score were evaluated before, after the treatment period and 3 months after the end of treatment. RESULTS: NBS-DM2/RW compared with NBS-DM2/NW and PEMF group performed better in the reduction of the three measures at the end and at short term run (p ≤ 0.05). CONCLUSION AND CLINICAL REHABILITATION IMPACT: When applied to grade II MNP patients, NBS-DM2/RW leads to pain relief and reduction of disability. These effects persist over a short term follow-up period. PEMF therapy was found to have no significant effect on reduction of pain and disability in this study.

Psychological well-being and social participation assessment in visually impaired subjects playing Torball: a controlled study.

The aim of this study was to evaluate the differences in psychological well-being, symptomatic psychological disorders and social participation, between blind Torball players and non-players. Thirty blind male participants were recruited, 17 Torball players (aged 36.27±3.46) and 13 non-players (aged 34.80±2.53), and evaluated for social participation level, psychological well-being and symptomatic psychological disorders, using three validated self-report questionnaires: Participation Scale (PS), Psychological Well-Being Scale (PWBS) and Symptom Checklist 90 R (SCL-90-R) respectively. ANOVA showed significant overall differences between the two groups. The social restriction score in the non-player group was significantly higher (p<0.01) than the player group. The Torball player group showed significant better scores than non-player group in 5 of the 6 dimensions of the PWB Scale (p<0.01) and in 8 of the 10 dimensions of the SCL-90-R (7 dimensions p<0.01; 1 dimension p<0.05) and in the three global scores of the SCL-90-R (p<0.01). The results of this study showed a relationship between psychological well-being and social skills of visually impaired people and their Torball practice.

Is menstrual delay a serious problem for elite rhythmic gymnasts?

AIM: The aim of this study was to identify the influence of training workloads and dietary habits on the menstrual status of elite rhythmic gymnasts. In many sports disciplines, it has long been assumed that menstrual disorders among elite female athletes are related to intense physical effort and insufficient energy intake. Potential consequences of this condition include reduced fertility and decreased bone density. METHODS: Eighty-one female gymnasts (age 15.9±3.1) completed two self-administered questionnaires: the Menstrual History Questionnaire (MHQ), and the Semiquantitative Food Frequency Questionnaire (FFQ). Eighty female athletes (age 16.3±3.7), who participated in basketball, volleyball, tae kwon do and fitness activity served as a control group. Physical characteristics, menstrual cycles, training workloads and dietary habits were compared and the relationship between physical training and menstrual cycle characteristics was assessed for the two groups. RESULTS: Fifty percent of the gymnasts declared themselves amenorrheic. Age was significantly and positively correlated (P<0.01) with menarche and menstrual irregularities, and negatively correlated with amenorrhea. The percentage of variance for age at menarche, explained by training hours/week and body mass, was 43%, (P<0.01). CONCLUSION: The present study, which examined and compared different age groups of gymnasts, showed that young rhythmic gymnasts who trained intensively, had a delayed onset of menarche of more than two years, thus favouring secondary amenorrhea. Nonetheless, almost all athletes, even though with significant delay, reached cycle regularity, thus minimizing the effect of menstrual disorders on fertility and bone density.

Prevalence of low back pain in former rhythmic gymnasts.

AIM: It is still debated as to whether rhythmic gymnastics is a discipline at risk of low back pain, because the concern for the extreme and repetitive hyperextension of the column may be counteracted by protective factors which are distinctive of rhythmic gymnasts, namely: leanness, lumbar flexibility and muscle strength. This study aimed to assess the prevalence of low back pain in a cohort of former elite-level rhythmic gymnasts of the Rhythmic Gymnastics National Team. METHODS: The Study Group included 60 adult females who were former rhythmic gymnasts of the Italian National Team. The Control Group included 60 adult females comparable for age, who were never involved in high level sport competitions. A standardized questionnaire was used to evaluate low back-pain symptoms. RESULTS: Low back pain complaints were reported by 22 former rhythmic gymnasts and by 28 controls (36.6% vs. 46.6%, p: n.s.); in the ex-gymnasts the age of onset of pain was earlier than in controls. The former rhythmic gymnasts complaining low back pain reported a higher prevalence of symptoms also during the time of competitions, and retired earlier than those without pain. CONCLUSIONS: Former elite rhythmic gymnasts reported a prevalence of low back-pain similar to sex and age matched general population. However, the rhythmic gymnasts who complained back pain during the sport activity are at risk of an early onset of symptoms after the retire from competitions. This study suggests that rhythmic gymnastics is not associated with increased risk of low back pain in the adult age.

Leaping ability and body composition in rhythmic gymnasts for talent identification.

AIM: Aim of this study was to investigate leaping ability and morphological characteristics in rhythmic gymnastics, in order to verify which parameters are useful indicators for the talent identification. METHODS: Twenty-five national gymnasts of international level (age 14.7+/-2.2 years) underwent three testing sessions: anthropometric measurements, vertical jumps (counter movement jump and hopping test), and three technical split leaps with stretched legs (SL), with ring (RG) and with back bend of the trunk (BBT). RESULTS: Elite had significantly different values (P < 0.05) of stature (1.65+/-0.03 vs 1.55+/-0.09 m), thigh length (0.42+/-0.03 vs 0.39+/-0.02 m) and FFM(42.42+/-2.81 vs 35.84+/-5.66 kg) compared to sub-elite. The height of hopping test was significantly higher in elite than sub-elite gymnasts (0.34+/-0.05 vs 0.27+/-0.04 m; P < 0.05), but no significant differences in counter movement jump between two groups were found. Ground contact time of hopping test was significantly correlated (P < 0.01) with SL (r = 0.613), RG (r = 0.632), and BBT (r = 0.542) values. By multiple regression analysis, among anthropometric and vertical jump variables, the hopping ground contact time was the strongest predictor of ground contact time of the three technical leaps (SL, RG, BBT) accounting for 26-37% of variance. CONCLUSION: Some anthropometric measurements are good indicators for the better performance in rhythmic gymnastics. Level of muscle compliance (stiffness) evaluated by hopping test is a good parameter for athletes selection and for monitoring leaps training.