[Reference values for SPPB in people over 60 years of age in the Basque Country]. / Valores de referencia del SPPB en personas mayores de 60 años en el País Vasco.

PURPOSE: To provide reference values of Short Physical Performance Battery (SPPB) in adults and older adults in the Basque Country by identifying cut-off points for measuring fragility and comparing the values with other populations in Spain. LOCATION: Bilbao capital, Basque Country (Spain). PARTICIPANTS: 1923 people over 60 years old included in the Health Program for the Elderly of the City of Bilbao participated in the study. The PA program was delivered twice a week for a minimum of 12 weeks, with 50-minute sessions. MAIN MEASUREMENTS: Participants were evaluated with the SPPB, which assesses balance (PE), gait speed test (PM) and chair stand test (PS). Based on the results obtained from all tests, the functionality of the participants was identified as: severe (0-4 points), moderate (4-6 points), mild (7-9 points) and minimal (10-12 points) limitation. RESULTS: Mean age was 77.9 (5.6) years, 87.9% were women and 12.1% were men. The SPPB showed significant differences in age (p = 0.000) and gender (p = 0.005). In addition, a comparison was made with a similar population: 70-75 years = 0.6 (Cohen's d), 76-79 years = 0.98 (Cohen's d), and >80 years = 0.98 (Cohen's d). CONCLUSIONS: The present study indicates normative values for SPPB. People's functionality decreases, as they get older. Despite the current findings available to health professionals for more effective detection of fragility, many of them have not yet been translated into clinical practice.

Using trunk posture to monitor heat strain at work.

This study aimed to determine if trunk posture during walking is related to increases in rectal temperature (Tre). 24 males treadmill walked in one of four conditions (1): 30 min at 3.0 mph and 0% grade, 20 °C and 50% relative humidity (RH), wearing healthcare worker (HCW) PPE; (2): 30 min at 3.0 mph and 0% grade, 27.5 °C and 60% RH, HCW PPE; (3): 30 min at 3.0 mph and 0% grade, 32.5 °C and 70% RH, HCW PPE; and (4): 40 min at 40% VO2max, 30 °C and 70% RH, wearing firefighter PPE. Trunk posture (Zephyr BioHarness 3) and Tre were measured continuously. Tre was positively related to trunk posture, controlling for covariates (B = 3.49, p < .001). BMI and age moderated this relationship (Tre×age, B = 0.76, p < .001; Tre*BMI, B = -1.85, p < .001). Trunk posture measurement may be useful in monitoring fall potential and magnitude of heat stress of workers in hot environments. Practitioner Summary: Occupational hyperthermia increases worker risk for heat illness and injury but is difficult to monitor in the field. This investigation shows that trunk posture is independently and positively related to core temperature. Non-invasive measurement or visual inspection of trunk posture could provide novel insight on individual heat strain level.

Umbilical temperature correlation with core and skin temperatures at rest, in the heat and during physical activity.

PURPOSE: to determine the correlation of umbilical temperatures (Tumb) with simultaneously recorded chest wall temperature (Tchest) and rectal temperature (Trectal) in adults during rest, heat exposure and exercise. METHODS: A total of 28 healthy men, wearing different types of clothing (athletic garb, a spandex full body heating garment, firefighter bunker gear) had average and peak umbilical, chest wall and rectal temperature measurements taken during sedentary temperature stabilisation stages, heat exposure periods and active exercise phases. RESULTS: Curvilinear relationships were noted between Tchest and Tumb compared with Trectal and their association became noticeably positive and linear at approximately 35.5 °C. Polynomial regression analysis of Trectal with linear and quadratic forms of Tchest and Tumb indicated an overall R2 of 0.657 and 0.767, respectively. Bivariate analysis of a restricted data set (where Tchest and Tumb ≥35.5°), indicated that Tumb was significantly associated with Trectal (raverage = 0.710, p <0.001; rpeak = 0.841, p <0.001) and Tchest was also significantly associated with Trectal, but less so (raverage = 0.570, p <0.001; rpeak = 0.699, p <0.001). CONCLUSIONS: the umbilicus offers a non-invasive, peripheral site for measurement of temperature that more closely correlated with body core temperature than Tchest when core temperature was ≥35.5 °C.

Comparison of estimated core body temperature measured with the BioHarness and rectal temperature under several heat stress conditions.

Monitoring and measuring core body temperature is important to prevent or minimize physiological strain and cognitive dysfunction for workers such as first responders (e.g., firefighters) and military personnel. The purpose of this study is to compare estimated core body temperature (Tco-est), determined by heart rate (HR) data from a wearable chest strap physiology monitor, to standard rectal thermometry (Tre) under different conditions. Tco-est and Tre measurements were obtained in thermoneutral and heat stress conditions (high temperature and relative humidity) during four different experiments including treadmill exercise, cycling exercise, passive heat stress, and treadmill exercise while wearing personal protective equipment (PPE). Overall, the mean Tco-est did not differ significantly from Tre across the four conditions. During exercise at low-moderate work rates under heat stress conditions, Tco-est was consistently higher than Tre at all-time points. Tco-est underestimated temperature compared to Tre at rest in heat stress conditions and at a low work rate under heat stress while wearing PPE. The mean differences between the two measurements ranged from -0.1 ± 0.4 to 0.3 ± 0.4°C and Tco-est correlated well with HR (r = 0.795 - 0.849) and mean body temperature (r = 0.637 - 0.861). These results indicate that, the comparison of Tco-est to Tre may result in over- or underestimation which could possibly lead to heat-related illness during monitoring in certain conditions. Modifications to the current algorithm should be considered to address such issues.

Evaluation of protective ensemble thermal characteristics through sweating hot plate, sweating thermal manikin, and human tests.

The purpose of this study was to evaluate the predictive capability of fabric Total Heat Loss (THL) values on thermal stress that Personal Protective Equipment (PPE) ensemble wearers may encounter while performing work. A series of three tests, consisting of the Sweating Hot Plate (SHP) test on two sample fabrics and the Sweating Thermal Manikin (STM) and human performance tests on two single-layer encapsulating ensembles (fabric/ensemble A = low THL and B = high THL), was conducted to compare THL values between SHP and STM methods along with human thermophysiological responses to wearing the ensembles. In human testing, ten male subjects performed a treadmill exercise at 4.8 km and 3% incline for 60 min in two environmental conditions (mild = 22°C, 50% relative humidity (RH) and hot/humid = 35°C, 65% RH). The thermal and evaporative resistances were significantly higher on a fabric level as measured in the SHP test than on the ensemble level as measured in the STM test. Consequently the THL values were also significantly different for both fabric types (SHP vs. STM: 191.3 vs. 81.5 W/m(2) in fabric/ensemble A, and 909.3 vs. 149.9 W/m(2) in fabric/ensemble B (p < 0.001). Body temperature and heart rate response between ensembles A and B were consistently different in both environmental conditions (p < 0.001), which is attributed to significantly higher sweat evaporation in ensemble B than in A (p < 0.05), despite a greater sweat production in ensemble A (p < 0.001) in both environmental conditions. Further, elevation of microclimate temperature (p < 0.001) and humidity (p < 0.01) was significantly greater in ensemble A than in B. It was concluded that: (1) SHP test determined THL values are significantly different from the actual THL potential of the PPE ensemble tested on STM, (2) physiological benefits from wearing a more breathable PPE ensemble may not be feasible with incremental THL values (SHP test) less than approximately 150-200 W·m(2), and (3) the effects of thermal environments on a level of heat stress in PPE ensemble wearers are greater than ensemble thermal characteristics.

Development of Continuous Assessment of Muscle Quality and Frailty in Older Patients Using Multiparametric Combinations of Ultrasound and Blood Biomarkers: Protocol for the ECOFRAIL Study.

BACKGROUND: Frailty resulting from the loss of muscle quality can potentially be delayed through early detection and physical exercise interventions. There is a demand for cost-effective tools for the objective evaluation of muscle quality, in both cross-sectional and longitudinal assessments. Literature suggests that quantitative analysis of ultrasound data captures morphometric, compositional, and microstructural muscle properties, while biological assays derived from blood samples are associated with functional information. OBJECTIVE: This study aims to assess multiparametric combinations of ultrasound and blood-based biomarkers to offer a cross-sectional evaluation of the patient frailty phenotype and to track changes in muscle quality associated with supervised exercise programs. METHODS: This prospective observational multicenter study will include patients aged 70 years and older who are capable of providing informed consent. We aim to recruit 100 patients from hospital environments and 100 from primary care facilities. Each patient will undergo at least two examinations (baseline and follow-up), totaling a minimum of 400 examinations. In hospital environments, 50 patients will be measured before/after a 16-week individualized and supervised exercise program, while another 50 patients will be followed up after the same period without intervention. Primary care patients will undergo a 1-year follow-up evaluation. The primary objective is to compare cross-sectional evaluations of physical performance, functional capacity, body composition, and derived scales of sarcopenia and frailty with biomarker combinations obtained from muscle ultrasound and blood-based assays. We will analyze ultrasound raw data obtained with a point-of-care device, along with a set of biomarkers previously associated with frailty, using quantitative real-time polymerase chain reaction and enzyme-linked immunosorbent assay. Additionally, we will examine the sensitivity of these biomarkers to detect short-term muscle quality changes and functional improvement after a supervised exercise intervention compared with usual care. RESULTS: At the time of manuscript submission, the enrollment of volunteers is ongoing. Recruitment started on March 1, 2022, and ends on June 30, 2024. CONCLUSIONS: The outlined study protocol will integrate portable technologies, using quantitative muscle ultrasound and blood biomarkers, to facilitate an objective cross-sectional assessment of muscle quality in both hospital and primary care settings. The primary objective is to generate data that can be used to explore associations between biomarker combinations and the cross-sectional clinical assessment of frailty and sarcopenia. Additionally, the study aims to investigate musculoskeletal changes following multicomponent physical exercise programs. TRIAL REGISTRATION: ClinicalTrials.gov NCT05294757; https://clinicaltrials.gov/ct2/show/NCT05294757. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/50325.

Physiological and mental health changes in cancer patients during the COVID-19 state of emergency.

Backgrounds: Due to the COVID-19 pandemic that we are currently facing, many governments across the world have declared a state of emergency and even confinements. This stressful situation, in addition to prolonged stays at home, may imply a radical change in lifestyle behavior and physical activity (PA). The aim of this study is to evaluate the physiological and psychological effects in cancer patients who changed their PA habits during the COVID-19 state of emergency in Spain. Methods: Thirty-three participants were evaluated pre- and post-state of emergency. A series of questionnaires was used to assess cancer-specific quality of life. Results: The most relevant results revealed significantly lower walking time (p < 0.001) and sitting time (p = 0.014). Upper and lower body strength also decreased significantly (p = 0.009 and 0.012, respectively) and oxygen consumption (VO2 peak) (p = 0.023). None of the parameters analysed showed significant differences for psychological aspects (QLQ-C-30 and SF-36) and body composition. Conclusion: Lower physical activity leads to negative physiological adaptation, particularly affecting cardiovascular and strength levels. While it is important to maintain the general population's amount and intensity of exercise, this particularly vulnerable group's physical capacity is vital to their health and well-being.

Association between PhA and Physical Performance Variables in Cancer Patients.

Maintaining the physical performance of cancer patients is increasingly considered due to the growing number of cancer patients and the aggressiveness of the treatments. For this reason, bioimpedance is now being used to record patients' body composition by obtaining the phase angle (PhA). Although there is a direct relationship between PhA, age, sex and disease prognosis, it has not been measured as an analysis of physical performance in oncology patients and is a valid tool in the follow-up of cancer patients. For this purpose, 311 patients were evaluated, and both bioelectrical impedance analysis (BIA) and physical performance measurements were performed. The modification of the results concerning PhA was found to be highly relational, as a variation in one of the variables affected the other. It was concluded that each degree increase in PhA modified -22.57 s [-27.58; -17.53] in 400-m walking test (400 mWT); 13.25 kg [10.13; 16.35] in upper-body strength (UBS); 6.3 [4.95; 7.65] in lower-body strength (LBS); 1.55 mL/kg/min [0.98; 2.12] in VO2peak; 6.53 Watts [3.83; 9.20] in ventilatory threshold 1 (VT1); 10.36 Watts [7.02; 13.64] in ventilatory threshold 2 (VT2). It was also noted that age was a factor that affected the relationship between PhA and 400 mWT; the older the age, the higher the relationship. PhA data has been shown to be highly correlated with physical performance. This is of great importance in clinical practice because a cancer patient's physical performance levels can be assessed during treatment.

Association between Phase Angle and Subjective Perceptions of Health Variables in Cancer Patients.

The phase angle, an increasingly studied healthcare tool, was studied to explore its relationship with psychological factors in cancer patients. The aim of this study was to investigate the relationship between the phase angle (PhA), obtained by the bioimpedance analysis of body composition, and psychological factors measured by questionnaire in cancer patients. The study included 311 patients who underwent bioimpedance testing to determine their PhA value; their psychological profiles were assessed using SF-36, FACIT, QLQ-C30, and GHQ-12 questionnaires. Mixed linear regression models were used to analyze the relationship between PhA and the psychological tests. The results showed a statistical correlation between PhA and the GHQ-12, FACIT, and SF-36 questionnaires, with higher PhA values associated with better results on the questionnaires. In the QLQ-C30 questionnaire, a correlation was observed between PhA and the functioning scales (p < 0.001), except for emotional and cognitive functioning (p = 0.148 and p = 0.544, respectively), but not in most of the symptom scales. The PhA is a useful tool for assessing the subjective health perception of cancer patients, especially with regard to psychological factors. While there is a statistically significant correlation, further research is required before confidently applying it in clinical practice. The current predictive value of this predictor for certain psychological aspects is limited, underscoring the need for additional research.

Physical Activity Levels and Sleep in Schoolchildren (6-17) with and without School Sport.

There is strong evidence to support the association between daily physical activity and sleep parameters in children and adolescents. Physical activity and outdoor play are favourably associated with most sleep outcomes in school children. The aim is to find out the levels of physical activity and the quality of sleep in Basque schoolchildren aged between six and seventeen and to analyse the possible differences between those who carry out some kind of physical sports activity and those who do not. The sample consisted of 1082 schoolchildren (50.1% male and 49.9% female). Differences between groups were compared using the Mann-Whitney U test (2 samples) and Kruskal-Wallis one-factor ANOVA (k samples). A total of 723 (66.94%) of the participants said they practiced some physical sports activity. The accelerometers obtained significant differences in all levels of physical activity, as well as in sleep efficiency, with higher levels of physical activity (sedentary p = 0.001; light p = 0.017; moderate p = 0.009; vigorous p = 0.001 and moderate-to-vigorous physical activity p = 0.002) and better sleep efficiency (p = 0.002) in those schoolchildren who perform some type of physical sports activity. A significant difference in time spent in sedentary activities was also observed between primary and secondary school pupils of both sexes and regardless of the degree of physical sports activity completion.

Effects of Socioeconomic Environment on Physical Activity Levels and Sleep Quality in Basque Schoolchildren.

The socioeconomic and built environment of an area are interrelated with health data and have a direct influence on children's development. There are facilitators and barriers for schools to promote physical activity depending on the socioeconomic status of the school. The aim of this study was to analyse the relationship between physical activity and sleep and the socioeconomic level of children in the Basque Country. The sample consisted of 1139 schoolchildren between the ages of six and seventeen (566 boys and 573 girls) from 75 schools (43 public and 32 private). Differences between groups were compared using the Mann-Whitney U test (two samples), Kruskal-Wallis one-factor ANOVA (k samples), and Spearman's Rho correlation. There are sex differences in light (200.8 ± 62.5 vs. 215.9 ± 54.7) and moderate (69.0 ± 34.3 vs. 79.9 ± 32.1) physical activity in favour of the female group of higher socioeconomic status compared to male group of higher socioeconomic status. In the case of vigorous physical activity, the female group performed less than the male group across all socioeconomic statuses, which was statistically significant in the groups of high socioeconomic status (11.6 ± 9.3 vs. 6.9 ± 5.7) in group 2 and medium socioeconomic status (11.1 ± 9.3 vs. 7.7 ± 6.1) in group 3. There is an inverse relationship between sedentary behaviour and BMI, total bed time, total sleep time, and night-time awakenings. There is also an inverse relationship between all levels of physical activity performed with respect to BMI and total sleep efficiency. These data point towards notable inequalities in physical activity and daily sleep in Basque schoolchildren, which in turn may be marginalised in our current school system due to the effects of the socioeconomic environment.

Protective facemask impact on human thermoregulation: an overview.

The use of protective facemasks (PFMs) negatively impacts respiratory and dermal mechanisms of human thermoregulation through impairment of convection, evaporation, and radiation processes. The relatively minor reported increases in core temperature directly attributable to the wearing of PFMs suggest that associated perceptions of increased body temperature may have a significant psychological component or that regional or global brain temperature changes are involved. Modifications in PFM structure, components, and materials might allow for improved heat dissipation and enhanced compliance with use.

Physiological stress in flat and uphill walking with different backpack loads in professional mountain rescue crews.

This study aimed to determine the interactive physiological effect of backpack load carriage and slope during walking in professional mountain rescuers. Sixteen mountain rescuers walked on a treadmill at 3.6 km/h for 5 min in each combination of three slopes (1%, 10%, 20%) and five backpack loads (0%, 10%, 20%, 30%, and 40% body weight). Relative heart rate (%HRmax), relative oxygen consumption (%VO2max), and rating of perceived exertion (RPE, Borg 1-10 scale) were compared across conditions using two-way ANOVA. Significant differences in %VO2max, %HRmax, and RPE across slopes and loads were found where burden increased directly with slope and load (main effect of slope, p < 0.001 for all; main effect of load, p < 0.001 for all). Additionally, significant slope by load interactions were found for all parameters, indicating an additive effect (p < 0.001 for all). Mountain rescuers should consider the physiological interaction between slope and load when determining safe occupational walking capacity.

Effects of a Physical Exercise Intervention on Pain in Workplaces: A Case Study.

Interventions that promote physical activity and healthy habits in workplaces have proven to be effective in reducing risk factors associated with numerous pathologies. This study examines the effects of an individualized physical exercise program that lasts five minutes for 30 working days on the perceived pain of workers, as well as analyzing adherence to it within workplaces. Data were collected through a visual analog scale of 1-10 of the perception of pain by anatomical areas, and, thus, we could observe variations in the perceived pain of workers through a program of five individualized exercises for one minute each based on the analysis of the worker and the job position. Significant differences were observed in three of the four centers analyzed (1: p = 0.006; 2: p = 0.009; 3: p = 0.000; 4: p = 0.791). A five-minute exercise program in the work environment appears to be an effective tool in terms of time and an improvement in workers' perception of pain.

Level of Physical Activity, Sedentary Behavior, and Sleep in the Child and Adolescent Population in the Autonomous Community of the Basque Country (6-17 Years Old): Protocol for the Mugikertu Study.

BACKGROUND: Physical inactivity and sedentary behavior are increasingly common problems in the general population, which can lead to overweight, obesity, diabetes, cardiovascular disease, and decreased motor and cognitive capacity among children and adolescents. Establishing healthy habits in childhood on the basis of the World Health Organization's 2020 Physical Activity Guidelines is essential for proper physical, motor, and cognitive development. OBJECTIVE: The primary aim of this study is to describe the level of physical activity (PA), sedentary behavior, and sleep of the child and adolescent population from 6 to 17 years of age in the Basque Autonomous Community (BAC). Our secondary aim is to establish a starting point for future research and intervention protocols to improve the existing reality. METHODS: This cross-sectional study aims to recruit 1111 children and adolescents, aged 6 to 17 years from the BAC in a representative random sample. Participants will wear the ActiGraph WGT3X-BT triaxial accelerometer for 7 consecutive days in their nondominant wrist, and fill out a habit diary log of PA, mobility, and sleep routine. PA intensities, sedentary behavior, and sleep parameters (total bedtime, total sleep time, and sleep efficiency) will be calculated from raw accelerometer data using SPSS (IBM Corp). Participants will be randomly selected. RESULTS: The results of this study intend to demonstrate significant differences in PA levels in different age and gender groups since the volume of school PA in the BAC decreases as the age of the schoolchildren increases. The total study sample includes 1111 participants. In April 2021, up to 50% of the sample size was reached, which is expected to increase to 100% by April 2022. This sample will allow us to analyze, discuss, compare, and assess the reality of the school population, in a sensitive period of adherence to behavior patterns, using data from the geographical and administrative area of the BAC. This study will provide a realistic insight into PA levels among children and adolescents in the BAC. It will also offer scientific contributions on the positive relationship between PA levels and sleep quality in this population. CONCLUSIONS: This study might highlight the need for the promotion of cross-sectional policies so that children and adolescents may increase their levels of PA, thus improving both the school environment and positive healthy behavior. TRIAL REGISTRATION: ISRCTN Registry ISRCTN65573865; https://www.isrctn.com/ISRCTN65573865. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/31325.

Effects of liquid cooling garments on recovery and performance time in individuals performing strenuous work wearing a firefighter ensemble.

This study investigated the effects of body cooling using liquid cooling garments (LCG) on performance time (PT) and recovery in individuals wearing a fully equipped prototype firefighter ensemble (PFE) incorporating a self-contained breathing apparatus (SCBA). Six healthy male participants (three firefighters and three non-firefighters) completed six experimental sessions in an environmental chamber (35°C, 50% relative humidity), consisting of three stages of 15 min exercise at 75% VO2max, and 10 min rest following each exercise stage. During each session, one of the following six conditions was administered in a randomized order: control (no cooling, CON); air ventilation of exhaust SCBA gases rerouted into the PFE (AV); top cooling garment (TCG); TCG combined with AV (TCG+AV); a shortened whole body cooling garment (SCG), and SCG combined with AV (SCG+AV). Results showed that total PT completed was longer under SCG and SCG+AV compared with CON, AV, TCG, and TCG+AV (p<0.01). Magnitude of core temperature (Tc) elevation was significantly decreased when SCG was utilized (p<0.01), and heart rate recovery rate (10 min) was enhanced under SCG, SCG+AV, TCG, and TCG+AV compared with CON (p<0.05). Estimated Esw rate (kg·h(-1)) was the greatest in CON, 1.62 (0.37), and the least in SCG+AV 0.98 (0.44): (descending order: CON>AV>TCG=TCG+AV>SCG>SCG+AV) without a statistical difference between the conditions (p<0.05). Results of the present study suggest that the application of LCG underneath the PFE significantly improves the recovery during a short period of rest and prolongs performance time in subsequent bouts of exercise. LCG also appears to be an effective method for body cooling that promotes heat dissipation during uncompensable heat stress.

Physiological responses to wearing a prototype firefighter ensemble compared with a standard ensemble.

This study investigated the physiological responses to wearing a standard firefighter ensemble (SE) and a prototype ensemble (PE) modified from the SE that contained additional features, such as magnetic ring enclosures at the glove-sleeve interface, integrated boot-pant interface, integrated hood-SCBA facepiece interface, and a novel hose arrangement that rerouted self-contained breathing apparatus (SCBA) exhaust gases back into the upper portion of the jacket. Although the features of the PE increased the level of encapsulation of the wearer that could lead to increased physiological stress compared with the SE, it was hypothesized that the rerouted exhaust gases provided by the PE hose assembly would (1) provide convective cooling to the upper torso, (2) reduce the thermal stress experienced by the wearer, and (3) reduce the overall physiological stress imposed by the PE such that it would be either less or not significantly different from the SE. Ten subjects (seven male, three female) performed treadmill exercise in an environmental chamber (22°C, 50% RH) at 50% [image omitted]O(2max) while wearing either the SE with an SCBA or the PE with an SCBA either with or without the hose attached (designated PEWH and PENH, respectively). Heart rate (HR), rectal and intestinal temperatures (T(re), T(in)), sweat loss, and endurance time were measured. All subjects completed at least 20 min of treadmill exercise during the testing. At the end of exercise, there was no difference in T(re) (p = 0.45) or T(in) (p = 0.42), HR, or total sweat loss between the SE and either PEWH or PENH (p = 0.59). However, T(sk) was greater in PEWH and PENH compared with SE (p < 0.05). Total endurance time in SE was greater than in either PEWH or PENH (p < 0.05). Thus, it was concluded that the rerouting of exhaust gases to the jacket did not provide significant convective cooling or reduce thermal stress compared with the SE under the mild conditions selected, and the data did not support the hypotheses of the present study.

Field evaluation of a new prototype self-contained breathing apparatus.

Firefighters are required to use a self-contained breathing apparatus (SCBA) for respiratory protection when engaged in a variety of firefighting duties. While the SCBA provides crucial respiratory support and protection, it is also cumbersome and heavy, thus adding to the physical work performed by the firefighter. The purpose of the present study was to evaluate and compare the low profile SCBA prototype to a standard SCBA, as assessed by the objective and subjective measures of mobility and comfort, time of donning/doffing, as well as by acquiring user feedback on SCBA design features during field activities. The results of the present study indicated that the prototype SCBA was rated as a significant improvement over the standard SCBA in the areas of range of motion (ROM), mobility, comfort, induction of fatigue, interaction with protective clothing, and operability when worn over a standard firefighter ensemble, while performing a series of International Association of Fire Fighters Fire Ground Survival Program training exercises. STATEMENT OF RELEVANCE: A prototype SCBA was evaluated and compared with a standard SCBA, focusing on the objective and subjective measures of mobility and comfort during field activities. Feedback from end users was collected during the evaluation. The findings of the present study can be used for improving the system design and overall performance of new prototype SCBAs.

Subjective perceptions and ergonomics evaluation of a liquid cooled garment worn under protective ensemble during an intermittent treadmill exercise.

While a personal protective equipment (PPE) ensemble effectively provides workers with protection from occupational hazards, working in a vapour-resistant ensemble increases the risk of heat illness/injuries and physiological burdens. The purpose of this study was to investigate the effect of body cooling via a liquid-cooled garment (LCG) underneath a PPE ensemble on perceived thermal strain, physiological responses and ergonomics during an intermittent treadmill exercise in warm environmental conditions. The results of the present study indicated that the concomitant wearing of LCG underneath the PPE ensemble significantly reduced subjective perception of heat and alleviated overall increase in body temperature and heart rate while no impact of wearing LCG on ergonomic features was found. The extension of the present findings to practical applications in occupational settings requires further research on a LCG system design and performance evaluations while the LCG is incorporated within the PPE ensemble. STATEMENT OF RELEVANCE: Implementation of a LCG underneath PPE for body cooling was investigated, focusing on its impact on individuals' perceived thermal strain, physiological responses and ergonomics. The findings of the present study indicated that body cooling via a wearable LCG underneath PPE significantly alleviated both perceived thermal and physiological strain in uncompensable heat stress condition.

Implementing Exercise in Standard Cancer Care (Bizi Orain Hybrid Exercise Program): Protocol for a Randomized Controlled Trial.

BACKGROUND: Despite the established benefits of regular exercise for patients with cancer to counteract the deleterious effects of the disease itself and treatment-related adverse effects, most of them do not engage in sufficient levels of physical activity and there is a paucity of data on the integration of efficacious exercise programs that are accessible and generalizable to a large proportion of patients with cancer into routine cancer care. OBJECTIVE: We intend to examine the effects attributable to the implementation of a community-based exercise program on cardiorespiratory functional capacity and quality of life for patients with cancer. METHODS: This will be a hybrid study. In the first experimental phase, patients diagnosed with any type of cancer will be randomized into two parallel groups. One group immediately performs Bizi Orain, a 3-month supervised exercise program (3 times a week), in addition to behavioral counseling in a primary health care setting; the other is a reference group that starts the exercise program 3 months later (delayed treatment). In the second observational phase, the entire cohort of participants will be followed-up for 5 years. Any person diagnosed with cancer in the previous 2 years is eligible for the program. The program evaluation involves the uptake, safety, adherence, and effectiveness assessed after completion of the program and with follow-ups at 3, 6, 12, 24, 36, 48, and 60 months. The primary outcomes of the experimental study, to be compared between groups, are improved physical function and quality of life, whereas overall survival is the main objective of the prospective study. To analyze the association between changes in physical activity levels and overall survival, longitudinal mixed-effects models will be used for repeated follow-up measures. RESULTS: A total of 265 patients have been enrolled into the study since January 2019, with 42 patients from the hematology service and 223 from the oncology service. CONCLUSIONS: Bizi Orain is the first population-based exercise program in Spain that will offer more insight into the implementation of feasible, generalizable, and sustainable supportive care services involving structured exercise to extend survival of patients with cancer, improve their physical function and quality of life, and reverse the adverse effects of their disease and related treatments, thereby reducing the clinical burden. TRIAL REGISTRATION: ClinicalTrials.gov NCT03819595; http://clinicaltrials.gov/ct2/show/NCT03819595. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/24835.