Adjunctive hiking bouts during 8 weeks regular sailing training improves cardiorespiratory and muscular responses during hiking emulation in highly trained sailors.

To investigate the effects of 8-week hiking bench training on cardiorespiratory and muscular responses of highly trained sailors during hiking emulation. Twenty-four sailors were assigned into two groups: the hiking bench training group (HTG, n = 12) and the control group (CG, n = 12). Both groups maintained their regular training with the HTG performed two additional hiking bench training sessions per week for 8 weeks, while the CG performed an equivalent duration of on-water sailing training. Physiological responses were assessed by performing four successive 3-min hiking bouts on a sailing emulation ergometer before and after the 8-week training period. Comparing the pretest, both groups exhibited a significant decrease (p < 0.05) in the percentage of maximal oxygen uptake (%VO2max) and maximal heart rate (%HRmax); the HTG experienced a greater decrease in %VO2max in bouts 2 and 3. The root mean square (RMS) of rectus femoris (RF), vastus lateralis (VL), rectus abdominis (RA), and external oblique decreased significantly (p < 0.05), whereas the mean power frequency (MPF) of RF, VL, and RA exhibited an increasing trend. The RMS of RF and RA in HTG were lower than those in CG in the initial three bouts; VL and EA in HTG were lower than those in CG in bouts 1 and 2 (p < 0.05). The MPF of RA in HTG was significantly increased in bouts 2, 3, and 4 (p < 0.05). Eight-week hiking bench training could improve hiking economy and the activation of lower limb and trunk muscles delaying the onset of fatigue in sailors.

Stigma and the use of umbrellas, hiking poles and walking sticks to aid walking in Hong Kong.

Background: The use of walking aids is widely acknowledged as one of the most relied-on forms of assistive technology. Using stick-shaped devices, such as a cane, is often the entrance for many people to the world of assistive technologies, often accompanied by the negative stigma associated with ageing and disability. Objectives: This study investigated the perception of disability and needs of the Hong Kong population using walking aids, aiming to inform device design and service provision. Methods: We observed 391 individuals using cane-like devices in their natural environment and conducted semi-structured interviews with 28 participants to understand stigma, barriers to acquisition, training, and design requirements. Results: Half of the interviewees (50%, n = 14) did not feel disabled when using a walking stick, while 39% felt slightly disabled. 56% of the observed sample used non-medical-looking aids like hiking poles or umbrellas. Most interviewees (79%) purchased off-the-shelf devices, but less than half received seller support in choosing appropriate aids. Conclusion: The feelings associated with using walking sticks and similar devices are mostly positive. There is a preference in Hong Kong for using devices without a medical appearance to aid walking, such as umbrellas and hiking poles. There is a need to raise awareness of the risks of using umbrellas to aid walking and empower the user to make informed decisions when purchasing walking aid devices. In addition, there is a need to support the supply chain of walking aids, including umbrellas and hiking poles, to provide more information on device use, misuse, training, and maintenance.

How traditional Norwegian outdoor activities are changing; a 10-year follow up in relation to sociodemographic factors.

Introduction: The study aims to evaluate the relationship between sociodemographic factors and changes in Norwegian outdoor activities between 2008 and 2018. Traditional outdoor activities, such as family trips in nature, the gathering of mushrooms and wild berries, and growing one's own plants to eat, are believed to have a positive impact on physical activity levels and health in general. Method: This study includes repeated cross-sectional surveys conducted in 38 randomly selected schools across two Norwegian counties. In 2008, 1,012 parents of 6th and 7th grade students from 27 schools completed a questionnaire. In 2018, 609 new parents from 25 schools participated. Variables were dichotomized. Descriptive analyses between groups were conducted using chi-square statistics. Binary logistic regression analyses were performed with the three outdoor activities as dependent variables, including year only (model 1), and then also gender, age (continuous), education (own and partners), and household income as independent variables (model 2). Results: Participation in weekly family trips in nature increased from 22% to 28% (p = 0.002), the OR for year 2018 vs. year 2008 was 1.51. Adjusted for sociodemographic factors, the OR remained stable and significant. Education was the only significant sociodemographic factor (OR = 1.60), indicating the odds of those with a higher education to be 60% higher to engage in weekly family trips in nature. Gathering of wild mushrooms and plants remained stable with time. Being female (OR = 1.44), age (OR = 1.049) and education (OR = 1.49) was related to gathering. An increase in growing plants to eat was observed with an increase from 42% to 51% (p < 0.001), OR = 1.33. However, it did not remain significant in model 2. Education was, in general, positively related to growing food (OR = 1.35). Conclusion: We observed a positive increase in family trips in nature over the period from 2008 to 2018. Furthermore, elder parents seem to be more involved in the long-rooted traditional Norwegian grow- and gather culture, and a social gradient is apparent as those with higher education do participate more often in traditional outdoor activities.

Don't go chasing waterfalls: the phenology of Amblyomma americanum and increased collection of medically relevant ticks further away from hiking trails in the Piedmont of North Carolina, USA.

Hiking is a popular recreational activity in North Carolina that may expose people to ticks and tick-borne pathogens. However, there is a lack of knowledge on how ticks are distributed on and near trails. Our study tested the hypothesis that ticks are more likely to be encountered when moving further away from trails by measuring differences in relative abundance at various distances. We tested 4 distances (middle of trail, edge of trail, 5 m, 20 m), as well as an on-trail and off-trail grouping. We collected significantly more ticks and ticks were more likely to be collected at our 20 m and 5 m sampling distances rather than directly on or adjacent to trails, and significantly more were collected during off-trail collections than on-trails. When looking only at Amblyomma americanum, post hoc comparisons revealed that significantly more juvenile stages were collected at 5 m and 20 m distances, but not for adults. Our monthly sampling also allowed us to describe the phenology of A. americanum in North Carolina, which is consistent with the phenology of this species in the southeastern United States with adults peaking May-Jun, nymphs Jun-Jul, and larvae in Jul-Aug. These results generally demonstrate the importance of utilizing established trails when hiking to decrease tick-borne disease risk and should be communicated to the public as a recommendation for reducing tick-encounter risk.

Sex-specific analysis of hiking accidents in the Austrian Alps: a follow-up from 2015 to 2021.

Background: Hiking is one of the most popular leisure sport activities practiced in the Alps during the summer season, but bears the risk of mountain emergencies, accidents, and fatalities. This paper provides an updated analysis of hiking accidents for the years 2015 to 2021 in the Austrian Alps, thereby outlining fatal and non-fatal accident characteristics. Methods: For this retrospective analysis, mountain hiking accidents documented by the Austrian Alpine Police during a 7-year period were screened for potential exclusion criteria. The final sample size consisted of 7368 accidents and 7552 victims. The outcome measures were mainly specified by sex, age, injury degree, injury location, pathophysiological characteristics, and cause of injury. Results: The overall annual number of accidents showed a continuous increase from 428 in 2015 to 544 in 2021. In total, 7.1% of the total victims died during the 7-year period, with male hikers being significantly more affected than female hikers (m: 80.8%, f: 19.2%; p ≤ 0.001). The sex specific distribution for non-fatal hiking accidents was 55.9% in women and 44.1% in men. Male victims showed significantly more frequent cardiovascular events (m: 78.5%, f: 21.5%), multiple injuries (m: 60.2%, f: 39.8%), and wounds/blood loss (m: 57.4%, f: 42.6%) than female victims, whereas women showed more fractures (m: 31.5%, f: 68.5%) than men (p ≤ 0.001). Additionally, men were more likely to injure their abdomen/chest (3.7%), head (14.1%), and multiple body parts (26.5%), whereas women were more likely to injure their ankle or foot (42.3%). Finally, men were more likely to have an accident during the ascent (24.1%), whereas women during the descent (69.0%) (p ≤ 0.001). Conclusion: This paper provides the latest data and a deeper insight into sex-specific characteristics of mountain hiking accidents in the Austrian Alps.

Mapping Risk Judgment and Risk Taking in Mountain Hiking: An Information Integration Approach.

Risk analysis is essential for promoting hiking-based tourism. Our objective in the present study was to map 395 mountain hikers' positions on risk judgment and risk taking, according to how they integrated three antecedent factors of confidence (environment, team, and self). For integrating information, people can develop an additive rule whereby they apply the same weight to all information or use interaction rules (i.e., conjunctive or disjunctive), to give different weights to information. In the questionnaire our participants completed, there were eight scenarios that combined the three confidence antecedent factors as information cues. We applied cluster analysis, repeated-measures analyses of variance, chi-square tests, and bivariate correlation analyses to the questionnaire results to identify three participant risk positions. In the first risk position (cluster 1), participants used a disjunctive integration rule for both risk judgment and risk taking. In the second risk position (Clusters 2 and 4), they used an additive integration rule for risk judgment while they used a disjunctive integration rule for risk taking. In the third risk position (cluster 3), they used an additive integration rule for both risk judgment and risk taking. In each risk position, confidence in the three antecedent factors (environment, team, and self) negatively affected risk judgment and positively affected risk taking. We found the compositions of the clusters to be related to the participants' sex, and we discuss various advantages of applying information integration for mountain hiking practitioners and promoters.

Musculoskeletal injuries during trail sports: Sex- and age-specific analyses over 20 years from a national injury database.

INTRODUCTION: Musculoskeletal (MSK) injuries in US trail sports are understudied as trail sport popularity grows. This study describes MSK injury patterns among hikers, trail runners, and mountain bikers from 2002 through 2021 and investigates MSK injury trends acquired during mountain sports. METHODS: The National Electronic Injury Surveillance System (NEISS) was used to identify US emergency department (ED) patients from 2002-2021 (inclusive) who endured MSK injuries during hiking, trail running, or mountain biking. Injury rates and national estimates were calculated across demographics. RESULTS: 9835 injuries were included (48.4% male, 51.6% female). Injuries increased over time, with 1213 from 2002-2005 versus 2417 from 2018-2021. No sex differences existed before 2010, after which female injury rates exceeded those of males. The following findings were statistically significant, with P<0.05: females endured more fractures and strains/sprains; males endured more lacerations; concussions and head injuries were higher among those <18 y; dislocations and strains/sprains were higher for 18 to 65 y; fractures were higher for >65 y; <18 y had high mountain-biking and low running rates; 18 to 65 y had high running rates; and >65 y had low biking and running rates. Although all diagnoses increased in number over time, no significant differences existed in the proportion of any given diagnosis relative to total injuries. CONCLUSIONS: MSK injuries during trail sports have increased since 2002. Males endured more injuries until 2009, after which females endured more. Significant sex and age differences were found regarding injury diagnosis and body parts. Further studies are needed to confirm these trends and their causes.

Physiological adaptations of active postmenopausal women and matched men to the multi-day Sardinia Selvaggio Blu wild trek: a gender-comparative pilot study.

PURPOSE: To evaluate the effects of wild trekking by examining, in postmenopausal women, the physiological adaptations to an intensive 5-day wild trek and comparing their responses to those displayed by a group of men of comparable age, training status and mountaineering skills. METHODS: Six healthy, active postmenopausal women in their sixth decade of life participated in the study. Six men of comparable age and training status were also enrolled for gender-based comparisons. The participants traversed the Selvaggio Blu wild trek (Sardinia, Italy) completing a total of 56 km, for an overall height differential of 14,301 m. During all 5-day trek, subjects were supervised by two alpine guides. Changes in body composition, cardiorespiratory fitness, and metabolic patterns of energy expenditure were evaluated before and after the intervention. RESULTS: Total energy expenditure during the trek was significantly higher (p = 0.03) in women (12.88 ± 3.37 kcal/h/kg) than men (9.27 ± 0.89 kcal/h/kg). Extracellular (ECW) and intracellular water (ICW) increased significantly following the trek only in women (ECW: - 3.8%; p = 0.01; ICW: + 3.4%; p = 0.01). The same applied to fat-free mass (+ 5.6%; p = 0.006), fat mass (- 20.4%; p = 0.006), skeletal muscle mass (+ 9.5%; p = 0.007), and appendicular muscle mass (+ 7.3%; p = 0.002). Peak VO2/kg (+ 9.4%; p = 0.05) and fat oxidation (at 80 W: + 26.96%; p = 0.04; at 100 W: + 40.95%; p = 0.02; at 120 W: + 83.02%; p = 0.01) were found increased only in women, although no concurrent changes in partial pressure of end-tidal CO2 (PETCO2) was observed. CONCLUSIONS: In postmenopausal women, a 5-day, intensive and physically/technically demanding outdoor trekking activity led to significant and potentially relevant changes in body composition, energy balance and metabolism that are generally attained following quite longer periods of training.

Low Energy Intake Leads to Body Composition and Performance Decrements in a Highly-Trained, Female Athlete: The WANDER (Woman's Activity and Nutrition during an Extensive Hiking Route) Case Study.

OBJECTIVE: This case study's purpose was to quantify energy intake vs energy expenditure during a thru-hiker's trek and assess its relationship to performance and health. METHODS: A highly trained, female thru-hiker (Age (yrs): 62, Ht (cm): 157, Wt (kg): 53.5, BMI (kg/m2): 21.7, %BF: 26.0) embarked on a 4-month journey through the Pacific Crest Trail, USA. The athlete's body composition and 3-day diet record were assessed before (PRE) and after the hike (POST). During the hike, she tracked her diet and performance daily and completed a wellness survey each time she reached a town-check point. Data were analyzed for descriptive (weekly averages, means ± SD) and frequency statistics. RESULTS: She spent 10 wk (∼70 days) on the trail and hiked 1,506.35 km (26.1 ± 3.2 km/day) with an estimated energy expenditure of ∼2334 ± 351 kcal/day. During the hike, she under consumed calories (1285.3 ± 103 kcal) and dietary carbohydrate (169.5 ± 19.5g), fat (49.7 ± 5.8g), protein (41.9 ± 4.8g; 0.8 g/kg), fiber (11.8 ± 2.1g) and sodium (1642.4 ± 298.6 mg) when compared to ultra-endurance nutrition recommendations. She was unable to complete the trail due to fatigue and anthropometric changes. By POST, she had decreased total mass (PRE: 53.5 kg vs POST: 48.4 kg), BMI (PRE 21.6 vs POST: 19.5), fat-free mass (PRE: 39.6 vs POST: 38.8), and body fat (PRE: 26% vs POST: 19.6%) when compared to PRE. CONCLUSION: Trail-related challenges combined with high energy expenditures led to low nutrient intake which contributed to trail-ending injuries and performance decrements. Research aimed at addressing the barriers associated with thru-hike fueling is needed to identify nutritional opportunities to support hikers' performance and reduce injury risks.

Abnormal gait pattern in downhill hiking is related to muscular deficits of the knee flexors and extensors in active patients with total knee arthroplasty.

BACKGROUND: To assess the in-field walking mechanics during downhill hiking of patients with total knee arthroplasty five to 14 months after surgery and an age-matched healthy control group and relate them to the knee flexor and extensor muscle strength. METHODS: Participants walked on a predetermined hiking trail at a self-selected, comfortable pace wearing an inertial sensor system for recording the whole-body 3D kinematics. Sagittal plane hip, knee, and ankle joint angles were evaluated over the gait cycle at level walking and two different negative slopes. The concentric and eccentric lower extremity muscle strength of the knee flexors and extensors isokinetically at 50 and 120°/s were measured. FINDINGS: Less knee flexion angles during stance have been measured in patients in the operated limb compared to healthy controls in all conditions (level walking, moderate downhill, steep downhill). The differences increased with steepness. Muscle strength was lower in patients for both muscle groups and all measured conditions. The functional hamstrings to quadriceps ratio at 120°/sec correlated with knee angle during level and downhill walking at the moderate slope in patients, showing higher ratios with lower peak knee flexion angles. INTERPRETATION: The study shows that even if rehabilitation has been completed successfully and complication-free, five to 14 months after surgery, the muscular condition was still insufficient to display a normal gait pattern during downhill hiking. The muscle balance between quadriceps and hamstring muscles seems related to the persistence of a stiff knee gait pattern after knee arthroplasty. LoE: III.

Unraveling the unparalleled benefits of orienteering versus hiking on gait performance and cognition: A randomized clinical trial.

METHODS: Physical activities and sports in nature offer opportunities for leisure, health, and well-being. A randomized clinical trial (RCT) compared the effects of training, dualtask orienteering and single-task hiking in independent older adults (n = 90) allocated into three groups: orienteering group (OG), hiking group (HG) and control group (CG). Timed Up and Go (TUG) tests, including a dual-task (TUG-DT), and cognitive tests were administered. Differences were analyzed by Generalized Estimating Equations (GEE) and the effect size (ES) was calculated. Unpaired and paired tests were used for the evaluation of basic differences and after 24 weeks of intervention. RESULTS: This RCT highlights the interaction effects between groups and time. Only the OG in TUGDT reduced by 6 s, with change of 42% (ES=0.77). Likewise, Dual TUG + cognitive stops (TUG-DT+ CS) and Dual TUG + cognitive stops + cognitive errors (TUG-DT + CS + CE), reduced 7 (ES=0.85) and 8 (ES=0.90) seconds (<0.001). The task cost improved by 75% for OG and 24% for HG (p = 0.001), with an ES of 0.56 for OG. For cognition, there was a 49.2% increase (ES=2.00) for OG and 16.5% for HG in executive functions and visuospatial skills, a 31.4% increase (ES=1.64) for OG and 14.7% for HG in processing speed, and a 39.8% increase (ES=1.62) for OG and 6.5% for HG in memory. All interactions were <0.001. CONCLUSION: The orienteering demonstrated that has potential benefits in effectively improving gait performance and preventing cognitive decline in older adults. Brazilian Registry of Clinical Trials (ReBEC): RBR-99jmmpf.

Habitat visibility affects the behavioral response of a large herbivore to human disturbance in forest landscapes.

Wildlife can perceive humans as predators and human disturbance, whether lethal (e.g., hunting) or non-lethal (e.g., hiking, biking, and skiing), triggers antipredator behavior among prey. Visibility is the property that relates habitat structure to accessibility of visual information that allows animals to detect predators and evaluate predation risk. Thus, the visibility of a habitat (hereafter referred to as habitat visibility) for prey species alters the perceived risk of predation and therefore has a strong influence on their antipredator behavior. Yet, knowledge of how habitat visibility affects the response of animals to different types of human disturbance is limited, partly, because it is challenging to measure habitat visibility for animals at a fine spatial scale over a landscape, particularly in highly heterogeneous landscapes (e.g., forests). In this study, we employed a newly described approach that combines terrestrial and airborne LiDAR to contiguously measure fine-scale habitat visibility in a forested landscape. We applied the LiDAR-derived habitat visibility to examine how habitat visibility in forests affects the summer space use of 20 GPS-collared female red deer (Cervus elaphus) modeled with integrated step-selection functions in the Bavarian Forest National Park, Germany when exposed to various types of human disturbance including recreational activities, forest roads, hiking trails, and hunting. We found that red deer in our study area avoided areas with higher all types of human disturbance, especially during daylight hours. Furthermore, habitat visibility significantly modified the use of space by red deer in response to human recreational activities, forest roads, and hiking trails, but not to the hunting area. Red deer tended to tolerate a higher intensity of human recreational activities and to use areas closer to forest roads or hiking trails when they have lower habitat visibility (i.e., more cover). Our findings highlight the importance of considering visual perception when studying the response of wild animals to human disturbance. We emphasize the potential to mitigate negative consequences of human disturbance on wildlife, through measures such as maintaining vegetative buffers around recreational infrastructure (e.g., roads and skiing tracks) in order to reduce habitat visibility around areas frequented by humans.

Trucks versus treks: The relative influence of motorized versus nonmotorized recreation on a mammal community.

Outdoor recreation is increasing rapidly on public lands, with potential consequences for wildlife communities. Recreation can induce shifts in wildlife activity and habitat use, but responses vary widely even within the same species, suggesting mitigating factors that remain poorly understood. Both the type of recreation-motorized or nonmotorized-and the distance of wildlife from human disturbance may be important in developing a general understanding of recreation impacts on wildlife and making more informed management decisions. We conducted a camera-trapping survey in the Colville National Forest (CNF) of northeastern Washington in the summers of 2019 and 2020. We collected ~11,000 trap nights of spatially extensive data on nine mid-large mammalian species, simultaneously recording the presence and activity patterns of motorized (primarily vehicles on roads) and nonmotorized (primarily hikers on trails) recreation and wildlife both along trails and roads and off trails and off roads (away from most recreation). We used diel overlap analysis, time lag analysis, and single-season single-species occupancy modeling to examine the impact of recreation on the focal species. Species temporally avoided recreationists either by shifting to more nocturnal hours or delaying return to recently used recreation sites. Most species also responded spatially by altering the use or the intensity of use of camera sites due to recreation, although both positive and negative associations with recreation were documented. Species responded to nonmotorized recreation (e.g., hikers on trails) more often than motorized recreation (e.g., vehicles on roads). Most effects of recreation extended off the trail or road, although in three instances the spatiotemporal response of species to recreation along trails/roads disappeared a short distance away from those features. Our work suggests that a better understanding of landscape-scale impacts of recreation, including fitness consequences, will require additional work to disentangle the effects of different types of recreation and estimate the effective distance at which wildlife responds. Moreover, these results suggest that quiet, nonconsumptive recreation may warrant increased attention from land managers given its potential to influence the spatiotemporal ecology of numerous species.

Associations between Borg's rating of perceived exertion and changes in urinary organic acid metabolites after outdoor weight-bearing hiking.

BACKGROUND: Developing methods to monitor exercise load and evaluate body fatigue and muscle injury over time in hiking training remains a key problem to be solved. A widely used psycho-physical tool to assess the subjective perception of effort during exercise is Borg's rating of perceived exertion (BRPE) scale. Data on the relationships and validity of the BRPE compared to objectively assessed metabolic criteria are still lacking, especially urinary organic acid concentrations. AIM: To verify whether the BRPE scale could be used in the prescription of outdoor hiking with weight-bearing and reveal the relationship between the BRPE scale and urinary physiological measures. METHODS: Eighty-nine healthy men (average age: 22 years) were enrolled in a 40 km (6 h) hiking training exercise with a 20 kg load. After training, the BRPE scale (6-20) was completed. All participants were divided into three groups according to the rating of the BRPE scale. Urine samples were collected before and after training. Urinary myoglobin levels were measured immediately using the fluorescent immunoassay method. The remaining urine was subpacked and frozen for the subsequent detection of urinary organic acids using gas chromatography and mass spectrometry. RESULTS: The contents of organic acids and myoglobin in urine were significantly increased after participants hiked 40 km (6 h) with a 20 kg load. Only orthogonal partial least-squares discrimination analysis performed well in separating the group with a BRPE score of 6-12 from the group with a BRPE score of 13-20. Significant differences in the urine levels of several organic acids were observed between the two groups, and the heatmap also presented different metabolic profiles based on BRPE. According to the standard of a variable importance in the projection > 1, fold change > 1.5 and P < 0.05, 19 different metabolites of urinary organic acids were screened and enriched in pathways mainly including the citrate cycle (tricarboxylic acid cycle) and alanine, aspartate and glucose metabolism. CONCLUSION: The BRPE scale identified significantly different urinary organic acid profiles between the higher and lower BRPE value groups, and, thus, could be used to monitor body fatigue in individuals participating in long-distance outdoor hiking with weight bearing.

Identification of Risk Areas for Gloydius Snakebites in South Korea.

Snakebites can pose a significant threat to human health as the destruction of natural habitats and increased human intrusion into ecosystems result in more frequent encounters with snakes. Mitigation measures for snakebites are particularly crucial for hiking trails where transportation of snakebite victims to medical facilities is challenging due to limited emergency resources and difficult access. This study employed a random forest-based species distribution model approach to investigate the potential habitats of Gloydius spp., specifically Gloydius saxatilis, Gloydius brevicaudus, and Gloydius ussuriensis, in South Korea and to assess the snakebite risk in national parks. Potential habitats of Gloydius spp. were identified and visualized by overlaying binary maps derived from species distribution models (SDMs) of each Gloydius spp. that corresponded to high-risk snakebite areas. In addition, hiking trails with high snakebite risk in the national parks were identified after demonstrating the statistical correlation between the potential habitat distribution of Gloydius spp. and the actual snakebite incidents in major regions of South Korea. The primary environmental variables determining Gloydius spp. habitat were the topographic position index, slope, and the annual average of the maximum and minimum temperatures. The potential habitat of G. saxatilis generally appeared in high-altitude mountainous areas, mostly in the eastern part of the study area. Favorable habitats for G. brevicaudus and G. ussuriensis were predominantly located in mountainous areas throughout the study area, with the exception of some high-altitude mountainous terrain in the east. The number of snakebite incidents per 10,000 people was significantly correlated with the area ratio of Gloydius spp. potential habitat (Spearman's rho = 0.638, p < 0.01). The proportion of snakebite risk areas among national parks in South Korea ranged from 18% to 57%. This study can support practical solutions to prevent injuries and fatalities among hikers due to snakebites by identifying areas with a high risk of snakebite accidents at the hiking-trail level.

Influence of blistering lesions on foot functionality in hikers.

BACKGROUND: Friction blisters are formed by abrasion from frictional forces on the upper layer of the epidermis and can make physical activity an uncomfortable experience. To our knowledge, no previous studies have considered how these injuries affect the functionality of the foot. For this reason, the main aim of this study was to evaluate foot function in hikers, with or without blisters. MATERIAL AND METHODS: This case-control study examined 298 hikers who walked the Camino de Santiago long-distance trail (in northern Spain); 207 had one or more blistering foot lesions and 91 had no blisters. Sociodemographic and clinical variables were collected, and the number of blisters and their locations on the foot were recorded. All participants self-completed the Foot Function Index (FFI) questionnaire, in their native language. RESULTS: Pain and disability were significantly greater among the hikers with blisters (pain p=<0.001; disability p = 0.015). However, there were no significant differences in the limitation of physical activity between those with blisters (case group) and the control group (p = 0.144). Neither was there any correlation between the number of blisters and pain, disability or limitation of activity. However, the location of the lesion did influence foot functionality. Blisters on the metatarsal heads were more limiting and caused greater pain (right foot p = 0.009; left foot p = 0.017), greater disability (right foot p = 0.005; left foot p = 0.005), greater limitation of activity (on right foot p = 0.012) and more loss of foot functionality (right foot p = 0.002; left foot p = 0.007). CONCLUSION: The hikers with blisters experienced reduced foot functionality in terms of pain and disability. The number of blisters was not related to foot functionality. Blisters located on the metatarsal heads caused the greatest increase in pain, disability and limitation of activity.

From Zero to Hero: Type 2 Diabetes Mellitus Patients Hike on the Way of St. James-A Feasibility Study with Analyses of Patients' Quality of Life, Diabetes Distress and Glucose Profile.

This study investigates the feasibility of an accompanied 5-day hiking tour (Way of St. James) for type 2 diabetes mellitus (T2DM) patients and its impact on their quality of life/well-being, diabetes distress and glucose profile. Twenty-three T2DM patients (with and without insulin therapy) participated in the study. The 120 km pilgrimage (from Ferrol to Santiago de Compostela, Spain) was accompanied by three physicians, two diabetes counselors and one sports scientist. Quality of life/well-being was assessed by the World Health Organization's (WHO)-5 questionnaire, and diabetes distress was evaluated based on the Problem Areas in Diabetes (PAID) scale. The glucose levels of six insulin-treated patients were measured using continuous glucose monitoring (CGM) devices, considering that insulin-treated patients can be at increased risk of exercise-induced hypoglycemia. A significant improvement in quality of life/well-being was reported (p < 0.001), while diabetes distress did not change significantly (p = 0.203). Only two of the six insulin-treated patients showed moderate hypoglycemic episodes between 0.97% and 5.21% time below range per day, with glucose levels between 53−70 mg/dL. Hiking tours such as the one organized for this study can improve quality of life/well-being without increasing diabetes distress and are considered relatively safe for T2DM patients, even for those being treated with insulin.

Long-Term Effects of Mountain Hiking vs. Forest Therapy on Physical and Mental Health of Couples: A Randomized Controlled Trial.

BACKGROUND: Lifelong physical activity is related to longer health span, which is reflected at an individual level, and is of substantial socioeconomic relevance. Sedentary lifestyles, on the other hand, pose an increasingly major public health problem. In addition, the COVID-19 pandemic had a negative impact on activity levels and well-being. Previous research indicates that contact with nature might improve exercise levels as well as well-being. METHODS: This randomized, controlled clinical trial (ANKER-study) investigated the effects of two types of nature-based therapies (forest therapy and mountain hiking) in couples (FTG: n = 23; HG: n = 22;) with a sedentary or inactive lifestyle on health-related quality of life, relationship quality and other psychological and physiological parameters. RESULTS: The results of this study displayed that healthy and highly functioning women and men with sedentary lifestyles mentally benefit from contact with nature (quality of life, satisfaction with life, mood, internal and external health-related control beliefs). The gender-specific effect on women is most visible in the physiological outcomes (hemopoietic system, aerobic capacity, skeletal muscle mass and hydration) of mountain hiking. Men and women showed small improvements in blood pressure as a result of the interventions. CONCLUSIONS: The ANKER-study provides a method for valid comparison of forest therapy interventions for the first time. Regarding the COVID-19 pandemic, the nature-based intervention presented could offer a multimodal contribution to maintaining a more active lifestyle, further contact with nature that affects peoples physical as well as mental health, and an improvement in social interaction.