Barriers to and facilitators of physical activity in adults living with and beyond cancer, with special emphasis on head and neck cancer: a systematic review of qualitative and mixed methods studies.

PURPOSE: Physical activity can improve health outcomes for cancer patients; however, only 30% of patients are physically active. This review explored barriers to and facilitators of physical activity promotion and participation in patients living with and beyond cancer. Secondary aims were to (1) explore similarities and differences in barriers and facilitators experienced in head and neck cancer versus other cancers, and (2) identify how many studies considered the influence of socioeconomic characteristics on physical activity behaviour. METHODS: CINAHL Plus, MEDLINE, PsycINFO, Scopus and Cochrane (CDSR) were searched for qualitative and mixed methods evidence. Quality assessment was conducted using the Mixed Methods Appraisal Tool and a Critical Appraisal Skills Programme Tool. Thematic synthesis and frequency of reporting were conducted, and results were structured using the Capability-Opportunity-Motivation-Behaviour model and Theoretical Domains Framework. RESULTS: Thirty qualitative and six mixed methods studies were included. Socioeconomic characteristics were not frequently assessed across the included studies. Barriers included side effects and comorbidities (physical capability; skills) and lack of knowledge (psychological capability; knowledge). Having a dry mouth or throat and choking concerns were reported in head and neck cancer, but not across other cancers. Facilitators included improving education (psychological capability; knowledge) on the benefits and safety of physical activity. CONCLUSION: Educating patients and healthcare professionals on the benefits and safety of physical activity may facilitate promotion, uptakeand adherence. Head and neck cancer patients experienced barriers not cited across other cancers, and research exploring physical activity promotion in this patient group is required to improve physical activity engagement.

Mixed circuit training acutely reduces arterial stiffness in patients with chronic stroke: a crossover randomized controlled trial.

PURPOSE: Investigate whether a single bout of mixed circuit training (MCT) can elicit changes in arterial stiffness in patients with chronic stroke. Second, to assess the between-day reproducibility of post-MCT arterial stiffness measurements. METHODS: Seven participants (58 ± 12 years) performed a non-exercise control session (CTL) and two bouts of MCT on separate days in a randomized counterbalanced order. The MCT involved 3 sets of 15 repetition maximum for 10 exercises, with each set separated by 45-s of walking. Brachial-radial pulse wave velocity (br-PWV), radial artery compliance (AC) and reflection index (RI1,2) were assessed 10 min before and 60 min after CTL and MCT. Ambulatory arterial stiffness index (AASI) was calculated from 24-h recovery ambulatory blood pressure monitoring. RESULTS: Compared to CTL, after 60 min of recovery from the 1st and 2nd bouts of MCT, lower values were observed for br-PWV (mean diff = - 3.9 and - 3.7 m/s, respectively, P < 0.01; ICC2,1 = 0.75) and RI1,2 (mean diff = - 16.1 and - 16.0%, respectively, P < 0.05; ICC2,1 = 0.83) concomitant with higher AC (mean diff = 1.2 and 1.0 × 10-6 cm5/dyna, respectively, P < 0.01; ICC2,1 = 0.40). The 24-h AASI was reduced after bouts of MCT vs. CTL (1st and 2nd bouts of MCT vs. CTL: mean diff = - 0.32 and - 0.29 units, respectively, P < 0.001; ICC2,1 = 0.64). CONCLUSION: A single bout of MCT reduces arterial stiffness during laboratory (60 min) and ambulatory (24 h) recovery phases in patients with chronic stroke with moderate-to-high reproducibility. TRIAL REGISTRATION: Ensaiosclinicos.gov.br identifier RBR-5dn5zd.

Postexercise hypotension and related hemodynamic responses to cycling under heat stress in untrained men with elevated blood pressure.

PURPOSE: To investigate the effect of heat stress on postexercise hypotension. METHODS: Seven untrained men, aged 21-33 years, performed two cycling bouts at 60% of oxygen uptake reserve expending 300 kcal in environmental temperatures of 21 °C (TEMP) and 35 °C (HOT) in a randomized, counter-balanced order. Physiological responses were monitored for 10-min before and 60-min after each exercise bout, and after a non-exercise control session (CON). Blood pressure (BP) also was measured during the subsequent 21-h recovery period. RESULTS: Compared to CON, systolic, and diastolic BPs were significantly reduced in HOT (Δ = - 8.3 ± 1.6 and - 9.7 ± 1.4 mmHg, P < 0.01) and TEMP (Δ = - 4.9 ± 2.1 and - 4.5 ± 0.9 mmHg, P < 0.05) during the first 60 min of postexercise recovery. Compared to TEMP, rectal temperature was 0.6 °C higher (P = 0.001), mean skin temperature was 1.8 °C higher (P = 0.013), and plasma volume (PV) was 2.6 percentage points lower (P = 0.005) in HOT. During the subsequent 21-h recovery period systolic BP was 4.2 mmHg lower in HOT compared to CON (P = 0.016) and 2.5 mmHg lower in HOT compared to TEMP (P = 0.039). CONCLUSION: Exercise in the heat increases the hypotensive effects of exercise for at least 22 h in untrained men with elevated blood pressure. Our findings indicate that augmented core and skin temperatures and decreased PV are the main hemodynamic mechanisms underlying a reduction in BP after exercise performed under heat stress.

Relationship Between Percentages of Heart Rate Reserve and Oxygen Uptake Reserve During Cycling and Running: A Validation Study.

Guimarães, GC, Farinatti, PTV, Midgley, AW, Vasconcellos, F, Vigário, P, and Cunha, FA. Relationship between percentages of heart rate reserve and oxygen uptake reserve during cycling and running: a validation study. J Strength Cond Res 33(7): 1954-1962, 2019-This study investigated the relationship between percentages of heart rate reserve (%HRR) and oxygen uptake reserve (%VO2R) during a cardiopulmonary exercise test (CPET) and discrete bouts of isocaloric cycling and treadmill running. Thirty men visited the laboratory 3 times for anthropometrical and resting VO2 assessments, and perform cycling and running CPETs. Ten men visited the laboratory twice more to investigate the validity of the %HRR-%VO2R relationships during isocaloric bouts of cycling and running at 75% VO2R with energy expenditures of 400 kcals. The %HRR was significantly higher than the %VO2R during both CPETs at all exercise intensities (p < 0.001). During isocaloric exercise bouts, mean %HRR-%VO2R differences of 6.5% and 7.0% were observed for cycling and running, respectively (p = 0.007-p < 0.001). The %HRR and %VO2R increased over time (p < 0.001), the rate of which was influenced by exercise modality (p < 0.001). On average, heart rate was 5 (p = 0.007) and 8 (p < 0.001) b·min higher than predicted from the second energy expenditure quartile for cycling and running, respectively; however, observed VO2 was lower than predicted during all quartiles for cycling, and the first quartile for running. Consequently, time to achieve the target energy expenditure was greater than predicted (p < 0.01). In conclusion, the %HRR-%VO2R relationship observed during CPET data did not accurately transpose to prolonged isocaloric bouts of cycling and running. In addition, power outputs and speeds defined by the American College of Sports Medicine equations for cycling and running, respectively, overestimated VO2 and energy expenditure.

Exercise program design considerations for head and neck cancer survivors.

The present study aimed to establish exercise preferences, barriers, and perceived benefits among head and neck cancer survivors, as well as their level of interest in participating in an exercise program. Patients treated for primary squamous cell carcinoma of the head and neck between 2010 and 2014 were identified from the hospital database and sent a postal questionnaire pack to establish exercise preferences, barriers, perceived benefits, current physical activity levels, and quality of life. A postal reminder was sent to non-responders 4 weeks later. The survey comprised 1021 eligible patients of which 437 (43%) responded [74% male, median (interquartile range) age, 66 (60-73) years]. Of the respondents, 30% said 'Yes' they would be interested in participating in an exercise program and 34% said 'Maybe'. The most common exercise preferences were a frequency of three times per week, moderate-intensity, and 15-29 min per bout. The most popular exercise types were walking (68%), flexibility exercises (35%), water activites/swimming (33%), cycling (31%), and weight machines (19%). Home (55%), outdoors (46%) and health club/gym (33%) were the most common preferred choices for where to regularly exercise. Percieved exercise benefits relating to improved physical attributes were commonly cited, whereas potential social and work-related benefits were less well-acknowledged. The most commonly cited exercise barriers were dry mouth or throat (40%), fatigue (37%), shortness of breath (30%), muscle weakness (28%) difficulty swallowing (25%), and shoulder weakness and pain (24%). The present findings inform the design of exercise programs for head and neck cancer survivors.

Continuous and Accumulated Bouts of Cycling Matched by Intensity and Energy Expenditure Elicit Similar Acute Blood Pressure Reductions in Prehypertensive Men.

Fonseca, GF, Farinatti, PTV, Midgley, AW, Ferreira, A, de Paula, T, Monteiro, WD, and Cunha, FA. Continuous and accumulated bouts of cycling matched by intensity and energy expenditure elicit similar acute blood pressure reductions in prehypertensive men. J Strength Cond Res 32(3): 857-866, 2018-This study investigated differences in postexercise hypotension (PEH) after continuous vs. accumulated isocaloric bouts of cycling. Ten prehypertensive men, aged 23-34 years, performed 2 bouts of cycling at 75% oxygen uptake reserve, with total energy expenditures of 400 kcal per bout. One exercise bout was performed continuously (CONTIN) and the other as 2 smaller bouts each expending 200 kcal (INTER1 and INTER2). Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and cardiac autonomic control were monitored in a supine position for 10 minutes before and 60 minutes after each exercise bout, and during a control session. Compared with control, blood pressure was significantly reduced after CONTIN (SBP: [INCREMENT] - 3.4 mm Hg, p < 0.001; MAP: [INCREMENT] - 2.5 mm Hg, p = 0.001), INTER1 (SBP: [INCREMENT] - 2.2 mm Hg, p = 0.045), and INTER2 (SBP: [INCREMENT] - 4.4 mm Hg, p < 0.001; DBP: [INCREMENT] - 2.7 mm Hg, p = 0.045; MAP: [INCREMENT] - 3.3 mm Hg, p = 0.001). The PEH was similar in CONTIN and INTER2, whereas INTER2 elicited greater PEH than INTER1 (SBP and MAP: [INCREMENT] - 2.0 and [INCREMENT] - 1.8 mm Hg, respectively, p ≤ 0.05). Increases in sympathovagal balance from baseline were inversely related to changes in SBP and DBP after CONTIN and INTER2 (r = -0.64 to -0.71; p = 0.021-0.047). These findings indicate that similar amounts of PEH are observed when exercise is performed as a single 400-kcal exercise bout or 2 × 200-kcal bouts and that the exercise recovery pattern of cardiac autonomic activity may be important in eliciting PEH.

Standardized MET Value Underestimates the Energy Cost of Treadmill Running in Men.

The main purpose of the present study was to compare the reference metabolic equivalent (MET) value and observed resting oxygen uptake (VO2) for defining cardiorespiratory fitness (VO2max) and characterizing the energy cost of treadmill running. A heterogeneous cohort of 114 healthy men volunteered to participate. In Part 1 of the study, 114 men [mean±SD, age: 24±5 years; height: 177.1±7.9 cm; body mass: 75.0±10.0 kg] visited the laboratory twice for assessment of resting and maximal VO2 values to compare the reference MET value vs. observed resting VO2 and to investigate the association between resting VO2 and VO2max. In Part 2, 14 of the 114 men visited the laboratory once more to perform a 30-min bout of running at 8.0 km∙h-1/8.3 METs. The mean observed resting VO2 of 3.26 mL·kg-1·min-1 was lower than the reference MET value of 3.5 mL·kg-1·min-1 (P<0.001). Resting and maximal VO2 values relative to total body mass and fat-free mass were positively correlated (R=0.71 and 0.60, respectively; P<0.001). The maximal MET and energy cost of treadmill running were consequently underestimated when calculated using the reference MET value only for those with low VO2max (P=0.005 to P<0.001). In conclusion, the reference MET value considerably overestimated observed resting VO2 in men with low VO2max, resulting in underestimations of the maximal MET, exercise intensity prescription, and the energy cost of running.

Exercise tolerance during VO2max testing is a multifactorial psychobiological phenomenon.

Fifty-nine men completed a VO2max test and a questionnaire to establish reasons for test termination, perceived exercise reserve (difference between actual test duration and the duration the individual perceived could have been achieved if continued until physical limitation), and perception of verbal encouragement. Participants gave between 1 and 11 factors as reasons for test termination, including leg fatigue, various perceptions of physical discomfort, safety concerns, and achievement of spontaneously set goals. The two most common main reasons were leg fatigue and breathing discomfort, which were predicted by pre-to-post test changes in pulmonary function (p = 0.038) and explosive leg strength (p = 0.042; R2 = 0.40). Median (interquartile range) perceived exercise reserve, was 45 (50) s. Two-thirds of participants viewed verbal encouragement positively, whereas one-third had a neutral or negative perception. This study highlights the complexity of exercise tolerance during VO2max testing and more research should explore these novel findings.

Effective microorganism - X attenuates circulating superoxide dismutase following an acute bout of intermittent running in hot, humid conditions.

This study determined the effectiveness of antioxidant supplementation on high-intensity exercise-heat stress. Six males completed a high-intensity running protocol twice in temperate conditions (TEMP; 20.4°C), and twice in hot conditions (HOT; 34.7°C). Trials were completed following7 days supplementation with 70 ml·day(-1) effective microorganism-X (EM-X; TEMPEMX or HOTEMX) or placebo (TEMPPLA or HOTPLA). Plasma extracellular Hsp72 (eHsp72) and superoxide dismutase (SOD) were measured by ELISA. eHsp72 and SOD increased pre-post exercise (p < 0.001), with greater eHsp72 (p < 0.001) increases observed in HOT (+1.5 ng·ml(-1)) compared to TEMP (+0.8 ng·ml(-1)). EM-X did not influence eHsp72 (p > 0.05). Greater (p < 0.001) SOD increases were observed in HOT (+0.22 U·ml(-1)) versus TEMP (+0.10 U·ml(-1)) with SOD reduced in HOTEMX versus HOTPLA (p = 0.001). Physiological and perceptual responses were all greater (p < 0.001) in HOT versus TEMP conditions, with no difference followed EM-X (p > 0.05). EM-X supplementation attenuated the SOD increases following HOT, potentiating its application as an ergogenic aid to ameliorate oxidative stress.

Apolipoprotein E ε4 allele modulates the immediate impact of acute exercise on prefrontal function.

The difference between Apolipoprotein E ε4 carriers and non-carriers in response to single exercise sessions was tested. Stroop and Posner tasks were administered to young untrained women immediately after walking sessions or moderately heavy exercise. Exercise had a significantly more profound impact on the Stroop effect than on the Posner effect, suggesting selective involvement of prefrontal function. A significant genotype-by-exercise interaction indicated differences in response to exercise between ε4 carriers and non-carriers. Carriers showed facilitation triggered by exercise. The transient executive down-regulation was construed as due to exercise-dependent hypofrontality. The facilitation observed in carriers was interpreted as better management of prefrontal metabolic resources, and explained within the antagonistic pleiotropy hypothesis framework. The findings have implications for the interpretation of differences between ε4 carriers and non-carriers in the benefits triggered by long-term exercise that might depend, at least partially, on mechanisms of metabolic response to physical activity.

Ramp-incremented and RPE-clamped test protocols elicit similar VO2max values in trained cyclists.

PURPOSE: The present study compared the efficacy of ramp incremented and ratings of perceived exertion (RPE)-clamped test protocols for eliciting maximal oxygen uptake (VO2max). METHODS: Sixteen trained cyclists (age 34 ± 7 years) performed a ramp-incremented protocol and an RPE-clamped protocol 1 week apart in a randomized, counterbalanced order. The RPE-clamped protocol consisted of five, 2-min stages where subjects self-selected work rate and pedal cadence to maintain the prescribed RPE. After completing both test protocols subjects were asked which they preferred. RESULTS: The mean ± SD test time of 568 ± 72 s in the ramp protocol was not significantly different to the 600 ± 0 s in the RPE-clamped protocol (mean difference = 32 s; p = 0.09), or was the VO2max of 3.86 ± 0.73 L min(-1) in the ramp protocol significantly different to the 3.87 ± 0.72 L min(-1) in the RPE-clamped protocol (mean difference = 0.002 L min(-1); p = 0.97). Furthermore, no significant differences were observed for peak power output (p = 0.21), maximal minute ventilation (p = 0.97), maximal respiratory exchange ratio (p = 0.09), maximal heart rate (p = 0.51), and post-test blood lactate concentration (p = 0.58). The VO2max attained in the preferred protocol was significantly higher than the non-preferred protocol (mean difference = 0.14 L min(-1); p = 0.03). CONCLUSION: The RPE-clamped test protocol was as effective as the ramp-incremented protocol for eliciting VO2max and could be considered as a valid alternative protocol, particularly where a fixed test duration is desirable.

Exploring athletic identity in elite-level English youth football: a cross-sectional approach.

This study is the first empirical investigation that has explored levels of athletic identity in elite-level English professional football. The importance of understanding athletes' psychological well-being within professional sport has been well documented. This is especially important within the professional football industry, given the high attrition rate (Anderson, G., & Miller, R. M. (2011). The academy system in English professional football: Business value or following the herd? University of Liverpool, Management School Research Paper Series. Retrieved from http://www.liv.ac.uk/managementschool/research/working%20papers/wp201143.pdf ) and distinct occupational practices (Roderick, M. (2006). The work of professional football. A labour of love? London: Routledge). A total of 168 elite youth footballers from the English professional football leagues completed the Athletic Identity Measurement Scale (AIMS). Multilevel modelling was used to examine the effect of playing level, living arrangements and year of apprentice on the total AIMS score and its subscales (i.e., social identity, exclusivity and negative affectivity). Football club explained 30% of the variance in exclusivity among players (P = .022). Mean social identity was significantly higher for those players in the first year of their apprenticeship compared to the second year (P = .025). All other effects were not statistically significant (P > .05). The novel and unique findings have practical implications in the design and implementation of career support strategies with respect to social identity. This may facilitate the maintenance of motivation over a 2-year apprenticeship and positively impact on performance levels within the professional football environment.

The reliability and validity of a soccer-specific nonmotorised treadmill simulation (intermittent soccer performance test).

This study investigated the reliability and validity of a novel nonmotorised treadmill (NMT)-based soccer simulation using a novel activity category called a "variable run" to quantify fatigue during high-speed running. Twelve male University soccer players completed 3 familiarization sessions and 1 peak speed assessment before completing the intermittent soccer performance test (iSPT) twice. The 2 iSPTs were separated by 6-10 days. The total distance, sprint distance, and high-speed running distance (HSD) were 8,968 ± 430 m, 980 ± 75 m and 2,122 ± 140 m, respectively. No significant difference (p > 0.05) was found between repeated trials of the iSPT for all physiological and performance variables. Reliability measures between iSPT1 and iSPT2 showed good agreement (coefficient of variation: <4.6%; intraclass correlation coefficient: >0.80). Furthermore, the variable run phase showed HSD significantly decreased (p ≤ 0.05) in the last 15 minutes (89 ± 6 m) compared with the first 15 minutes (85 ± 7 m), quantifying decrements in high-speed exercise compared with the previous literature. This study validates the iSPT as a NMT-based soccer simulation compared with the previous match-play data and is a reliable tool for assessing and monitoring physiological and performance variables in soccer players. The iSPT could be used in a number of ways including player rehabilitation, understanding the efficacy of nutritional interventions, and also the quantification of environmentally mediated decrements on soccer-specific performance.

The effect of different environmental conditions on the decision-making performance of soccer goal line officials.

Goal line officials (GLO) are exposed to extreme environmental conditions when employed to officiate in professional European soccer cup competitions. The present study aimed to investigate the effect of such environments on GLO decision-making ability. Thirteen male participants were exposed to three conditions: cold (-5°C, 50% relative humidity (RH)); temperate (18°C, 50% RH); and hot (30°C, 50% RH) for 90 min per condition, with a 15 min half-time break after 45 min. Decision-making ability was assessed throughout the 90 min exposure. Core and skin temperatures were recorded throughout. Decision making was improved during exposure to the temperate condition when compared with the cold (mean difference = 12.5%; 95% CI = 1.1%, 23.9%; P = 0.031). Regression analysis indicated that as skin temperature increases so does decision-making ability. Exposure to cold conditions diminished the decision-making ability of GLO.

Confirming the attainment of maximal oxygen uptake within special and clinical groups: A systematic review and meta-analysis of cardiopulmonary exercise test and verification phase protocols.

BACKGROUND AND AIM: A plateau in oxygen uptake ([Formula: see text]) during an incremental cardiopulmonary exercise test (CPET) to volitional exhaustion appears less likely to occur in special and clinical populations. Secondary maximal oxygen uptake ([Formula: see text]) criteria have been shown to commonly underestimate the actual [Formula: see text]. The verification phase protocol might determine the occurrence of 'true' [Formula: see text] in these populations. The primary aim of the current study was to systematically review and provide a meta-analysis on the suitability of the verification phase for confirming 'true' [Formula: see text] in special and clinical groups. Secondary aims were to explore the applicability of the verification phase according to specific participant characteristics and investigate which test protocols and procedures minimise the differences between the highest [Formula: see text] values attained in the CPET and verification phase. METHODS: Electronic databases (PubMed, Web of Science, SPORTDiscus, Scopus, and EMBASE) were searched using specific search strategies and relevant data were extracted from primary studies. Studies meeting inclusion criteria were systematically reviewed. Meta-analysis techniques were applied to quantify weighted mean differences (standard deviations) in peak [Formula: see text] from a CPET and a verification phase within study groups using random-effects models. Subgroup analyses investigated the differences in [Formula: see text] according to individual characteristics and test protocols. The methodological quality of the included primary studies was assessed using a modified Downs and Black checklist to obtain a level of evidence. Participant-level [Formula: see text] data were analysed according to the threshold criteria reported by the studies or the inherent measurement error of the metabolic analysers and displayed as Bland-Altman plots. RESULTS: Forty-three studies were included in the systematic review, whilst 30 presented quantitative information for meta-analysis. Within the 30 studies, the highest mean [Formula: see text] values attained in the CPET and verification phase protocols were similar (mean difference = -0.00 [95% confidence intervals, CI = -0.03 to 0.03] L·min-1, p = 0.87; level of evidence, LoE: strong). The specific clinical groups with sufficient primary studies to be meta-analysed showed a similar [Formula: see text] between the CPET and verification phase (p > 0.05, LoE: limited to strong). Across all 30 studies, [Formula: see text] was not affected by differences in test protocols (p > 0.05; LoE: moderate to strong). Only 23 (53.5%) of the 43 reviewed studies reported how many participants achieved a lower, equal, or higher [Formula: see text] value in the verification phase versus the CPET or reported or supplied participant-level [Formula: see text] data for this information to be obtained. The percentage of participants that achieved a lower, equal, or higher [Formula: see text] value in the verification phase was highly variable across studies (e.g. the percentage that achieved a higher [Formula: see text] in the verification phase ranged from 0% to 88.9%). CONCLUSION: Group-level verification phase data appear useful for confirming a specific CPET protocol likely elicited [Formula: see text], or a reproducible [Formula: see text], for a given special or clinical group. Participant-level data might be useful for confirming whether specific participants have likely elicited [Formula: see text], or a reproducible [Formula: see text], however, more research reporting participant-level data is required before evidence-based guidelines can be given. TRIAL REGISTRATION: PROSPERO (CRD42021247658) https://www.crd.york.ac.uk/prospero.

How long does it take to achieve steady state for an accurate assessment of resting VO2 in healthy men?

The time necessary to obtain a steady state for an accurate and reliable assessment of resting [Formula: see text] remains unclear and was the purpose of this study. Thirty healthy men, aged 17-28 years, visited the laboratory twice for the assessment of resting [Formula: see text], which was assessed as follows: (a) 24 h abstention from physical exercise, alcohol, soft drinks and caffeine, (b) fasting for at least 8 h, (c) an acclimation period of 10 min, and (d) 60 min assessment in a supine position. Resting [Formula: see text] significantly changed during the 60 min (F = 37.4, P < 0.001), exhibiting a monoexponential decrease before reaching an asymptote. Post hoc pairwise comparisons showed that significant differences existed between consecutive means until the 30 min time point, after which there were no significant differences. The [Formula: see text] response across trials exhibited high test-retest reliability, with within-subject coefficients of variations at each time point ranging from 2.8 to 7.0 % and intraclass correlation coefficients ranging from 0.90 to 0.99. The reliability was higher from the 25 min time point onwards. Based on these findings, the following recommendations are made to promote accurate assessment of resting [Formula: see text]: (a) initiate the resting [Formula: see text] measurement with 10 min of acclimation to the assessment apparatus, (b) determine resting [Formula: see text] for a minimum of 30 min, until an apparent [Formula: see text] steady state has been achieved; and (c) determine resting [Formula: see text] for a further 5 min, with the average of this last 5 min of data being regarding as the resting [Formula: see text].

Warm-up strategies of professional soccer players: practitioners' perspectives.

Recent research has challenged the typical pre-match and half-time (HT) interval warm-up (WU) routines currently used by professional soccer players. This study surveyed 2010/11 season WU strategies and their underpinning scientific reasoning and situational factors via an internet-based questionnaire, which was distributed to English Premier League and Championship practitioners, of which 43% responded. The pre-match WU duration was 30.8 (8.2) min, ranging between 15-45 min, and 89% of practitioners administered a WU of ≥ 25 min. Respondents also reported a 12.4 (3.8) min period between the end of the WU and match kick-off. Eighty-nine per cent recognised the physiological benefits of re-WUs during this "down-time" period, with 63% instructing players to engage in such activity. During HT, 58% instructed players to re-WU either on the pitch or within stadia facilities, but "unwillingness of the coach/manager" (42%) and a "lack of time" (63%) were major constraints. Practitioners reported that 2.6 (1.6) min might be available for HT re-WUs. Factors such as match regulations, league policy, and stadia facilities were not generally considered as major barriers to the delivery of WUand re-WU strategies. We suggest that researchers consider the time-demands and barriers faced by practitioners whendeveloping experimental designs to examine WU regimens.

Appetite and energy intake following a bout of circuit resistance training in chronic hemiparetic stroke patients: a preliminary randomized controlled trial.

PURPOSE: The main aim of this study was to investigate the effects of circuit resistance training (CRT) on post-exercise appetite and energy intake in chronic hemiparetic stroke patients. A secondary aim was to evaluate the reproducibility of these effects. METHODS: Seven participants met the eligibility criteria and, in a randomized order, participated in a non-exercise control session (CTL) and two bouts of CRT. The CRT involved 10 exercises with 3 sets of 15-repetition maximum per exercise, performed using a vertical loading approach, with each set interspersed with 45s of walking. Expired gases were carried out   to calculate the net energy cost of the exercise and the relative energy intake post-CTL/CRT. Hunger, fullness, desire to eat, and energy intake were assessed at baseline and for 12 h after CTL and CRT. RESULTS: Compared to CTL, hunger, desire to eat (P < .001), and relative energy intake (P < .05) were significantly lower after CRT, whereas the perception of fullness was significantly higher (P < .001). Significant differences between CTL and CRT were observed only for the first 9 h of the post-exercise period for hunger, fullness, and desire to eat (P < .05). No significant differences in appetite or relative energy intake were observed between the two bouts of CRT. CONCLUSIONS: A bout of CRT elicited decreased post-exercise appetite and relative energy intake in chronic hemiparetic stroke patients. Decreased appetite perceptions lasted for around 9 h and were reproducible.

Safety and feasibility of cardiopulmonary exercise testing in head and neck cancer survivors.

PURPOSE: Assess safety and feasibility of the cardiopulmonary exercise test (CPET) for evaluating head and neck cancer (HaNC) survivors. Also compare their cardiorespiratory fitness to age and sex-matched norms and establish current physical activity levels. METHODS: Fifty HaNC survivors [29 male; mean (SD) age, 62 (8) years], who had completed treatment up to 1 year previously, were recruited. Participants performed a CPET on a cycle ergometer to symptom-limited tolerance. Participants completed a questionnaire to report contributory factors they perceived as influencing test termination. Physical activity levels were determined using a self-reported physical activity questionnaire. RESULTS: Three participants did not complete the CPET because (1) poor fitting mouthpiece and naso-oral mask due to facial disfiguration from surgery; (2) knee pain elicited by cycling; and (3) early CPET termination due to electrocardiogram artefacts. Participants reached a mean peak oxygen uptake that was 34% lower than predicted and the mean (SD) CPET duration of 7:52 (2:29) min:s was significantly lower than the target test duration of 10 min (p < 0.001). Leg muscle aches and/or breathing discomfort were major contributory factors influencing test termination for 78% of participants, compared to 13% for dry mouth/throat and/or drainage in the mouth/throat. No major adverse events occurred. Participants were categorised as 26% active, 8% moderately active, and 66% insufficiently active. CONCLUSION: These preliminary data suggest the CPET appears safe and feasible for most HaNC survivors when strict exclusion criteria are applied; however, low levels of cardiorespiratory fitness should be considered when calculating an appropriate ramp rate.

Can mixed circuit training elicit the recommended exercise intensity and energy expenditure in people after stroke?

PURPOSE: To investigate whether mixed circuit training (MCT) elicits the recommended exercise intensity and energy expenditure in people after stroke, and to establish the between-day reproducibility for the percentages of heart rate reserve (%HRR), oxygen uptake reserve (%VO2R), and energy expenditure elicited during two bouts of MCT. METHODS: Seven people aged 58 (12) yr, who previously had a stroke, performed a cardiopulmonary exercise test, a non-exercise control session, and two bouts of MCT. The MCT included 3 circuits of 10 resistance exercises at 15-repetition maximum intensity, with each set of resistance exercise interspersed with 45-s of walking. Expired gases were collected during the MCT and control session and for 40 min afterward. Control session was necessary to calculate the net energy expenditure associated with each bout of MCT. RESULTS: Mean %VO2R (1st MCT: 51.1%, P = .037; 2nd MCT: 54.0%, P = .009) and %HRR (1st MCT: 66.4%, P = .007; 2nd MCT: 67.9%, P = .010) exceeded the recommended minimum intensity of 40%. Both %VO2R (P = .586 and 0.987, respectively) and %HRR (P = .681 and 0.237, respectively) during the 1st and 2nd bouts of MCT were not significantly different to their corresponding gas exchange threshold values derived from cardiopulmonary exercise testing. Mean net total energy expenditure significantly exceeded the minimum recommend energy expenditure in the 1st (P = .048) and 2nd (P = .023) bouts of MCT. Between-day reproducibility for %HRR, %VO2R, and energy expenditure was excellent (ICC: 0.92-0.97). CONCLUSIONS: MCT elicited physiological strain recommended for improving health-related fitness in people after stroke and these responses demonstrated excellent between-day reproducibility.