Cardiovascular and metabolic health effects of team handball training in overweight women: Impact of prior experience.

PURPOSE: We tested the hypothesis that participation in small-sided team handball training could provide beneficial effects on cardiovascular and metabolic parameters in overweight premenopausal women with special focus on the importance of prior team handball experience. METHODS: A 16-week RCT training intervention was conducted in overweight premenopausal women randomized into three groups: a team handball training group without prior experience (UN; n = 13), a team handball group with prior experience (EXP; n = 10), and an inactive control group (CON; n = 9). Both UN and EXP completed 1.6 ± 0.3 training sessions per week with average heart rates of 84 ± 5 and 85 ± 9% of maximal heart rate, respectively. Cardiovascular and metabolic parameters were assessed before and after the intervention. RESULTS: Compared to CON, UN had significant increases in VO2max  (7 ± 4%) and intermittent endurance performance (26 ± 14%) as well as reduced total fat mass (4 ± 6%), total fat percentage (4 ± 5%), and android fat mass (7 ± 12%), respectively (all P < .05). Compared to UN and CON, EXP displayed increased left ventricular mass and left ventricular mass index (both P < .05) after the training period. There were no significant changes between any of the groups in muscle mass, blood lipids, resting heart rate, and blood pressure (all P > .05). CONCLUSION: Small-sided team handball training in overweight premenopausal women resulted in improvement of VO2max and body composition for participants with minimal team handball experience, indicating that prior team handball experience is not a prerequisite for improving physiological parameters of importance for health. Furthermore, EXP displayed cardiac adaptations, including increased left ventricular mass and left ventricular mass index.

Correction to: Cardiovascular, muscular, and skeletal adaptations to recreational team handball training: a randomized controlled trial with young adult untrained men.

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Cardiovascular, muscular, and skeletal adaptations to recreational team handball training: a randomized controlled trial with young adult untrained men.

PURPOSE: The prevalence of lifestyle diseases has escalated, and effective exercise training programmes are warranted. This study tested the hypothesis that regular participation in small-sided team handball training could provide beneficial health effects on cardiovascular, skeletal, and muscular parameters in young adult untrained men. METHOD: Twenty-six untrained 20-30-year-old men were randomly allocated to either a team handball training group (HG; n = 14), which completed 1.9 ± 0.3 training sessions per week over 12 weeks, or an inactive control group (CG; n = 12). Physiological training adaptations were assessed pre- and post interventions by DXA scans, blood samples, muscle biopsies, and physical tests. RESULTS: The average heart rate during training was equivalent to 84 ± 4% of maximal heart rate. Compared to CG, HG displayed significant increases in VO2max (11 ± 6%), proximal femur bone mineral density (2 ± 1%), whole-body bone mineral content (2 ± 1%), intermittent endurance performance (32 ± 16%), incremental treadmill test performance (16 ± 7%) and muscle citrate synthase activity (22 ± 28%) as well as decreases in total fat mass (7 ± 7%) and total fat percentage (6 ± 7%) (all p < 0.05). There were no significant changes in muscle mass, blood pressure, resting heart rate, muscle hydroxyl-acyl-dehydrogenase activity, or blood lipids (all p > 0.05). CONCLUSION: Participation in regular recreational team handball training was associated with positive cardiovascular, skeletal, and muscular adaptations, including increased maximal oxygen uptake, increased muscle enzymatic activity, and improved bone mineralization as well as lower fat percentage. These findings suggest that recreational team handball training may be an effective health-promoting activity for young adult men.

Football training in men with prostate cancer undergoing androgen deprivation therapy: activity profile and short-term skeletal and postural balance adaptations.

PURPOSE: To investigate the activity profile of football training and its short-term effects on bone mass, bone turnover markers (BTMs) and postural balance in men with prostate cancer (PCa) undergoing androgen deprivation therapy (ADT). METHODS: This was a randomised 12-week study in which men with PCa undergoing ADT were assigned to a football intervention group [FTG, n = 29, 67 ± 7 (±SD) years] training 2‒3 times per week for 45‒60 min or to a control group (n = 28, 66 ± 5 years). The activity profile was measured using a 5-Hz GPS. The outcomes were total body and leg bone mineral content (BMC) and density, BTMs and postural balance. RESULTS: In the last part of the 12 weeks, FTG performed 194 ± 41 accelerations and 296 ± 65 decelerations at >0.6 m/s/s and covered a distance of 905 ± 297 m at speeds >6 km/h and 2646 ± 705 m per training session. Analysis of baseline-to-12-week change scores showed between-group differences in favour of FTG in total body BMC [26.4 g, 95 % confidence interval (CI): 5.8-46.9 g, p = 0.013], leg BMC (13.8 g, 95 % CI: 7.0‒20.5 g, p < 0.001) and markers of bone formation: P1NP (36.6 µg/L, 95 % CI: 10.4‒62.8 µg/L, p = 0.008) and osteocalcin (8.6 µg/L, 95 % CI: 3.3‒13.8 µg/L, p < 0.01). The number of decelerations correlated to the increase in leg BMC (r = 0.65, p = 0.012). No between-group differences were observed for the remaining outcomes. CONCLUSION: Football training involves numerous runs, accelerations and decelerations, which may be linked to marked increases in bone formation markers and preserved bone mass in middle-aged and elderly men with PCa undergoing ADT. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01711892.

Effects of recreational soccer in men with prostate cancer undergoing androgen deprivation therapy: study protocol for the 'FC Prostate' randomized controlled trial.

BACKGROUND: Androgen deprivation therapy (ADT) is a cornerstone in the treatment of advanced prostate cancer. Adverse musculoskeletal and cardiovascular effects of ADT are widely reported and investigations into the potential of exercise to ameliorate the effects of treatment are warranted. The 'Football Club (FC) Prostate' study is a randomized trial comparing the effects of soccer training with standard treatment approaches on body composition, cardiovascular function, physical function parameters, glucose tolerance, bone health, and patient-reported outcomes in men undergoing ADT for prostate cancer. METHODS/DESIGN: Using a single-center randomized controlled design, 80 men with histologically confirmed locally advanced or disseminated prostate cancer undergoing ADT for 6 months or more at The Copenhagen University Hospital will be enrolled on this trial. After baseline assessments eligible participants will be randomly assigned to a soccer training group or a control group receiving usual care. The soccer intervention will consist of 12 weeks of training 2-3 times/week for 45-60 min after which the assessment protocol will be repeated. Soccer training will then continue bi-weekly for an additional 20 weeks at the end of which all measures will be repeated to allow for additional analyses of long-term effects. The primary endpoint is changes in lean body mass from baseline to 12 weeks assessed by dual X-ray absorptiometry scan. Secondary endpoints include changes of cardiovascular, metabolic, and physical function parameters, as well as markers of bone metabolism and patient-reported outcomes. DISCUSSION: The FC Prostate trial will assess the safety and efficacy of a novel soccer-training approach to cancer rehabilitation on a number of clinically important health outcomes in men with advanced prostate cancer during ADT. The results may pave the way for innovative, community-based interventions in the approach to treating prostate cancer. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01711892.

Cardiovascular effects of 3 months of football training in overweight children examined by comprehensive echocardiography: a pilot study.

We examined effects of a 3-month football training programme in overweight children using comprehensive echocardiography and peripheral arterial tonometry. Twenty preadolescent overweight children (17 boys, 3 girls aged 8-12 yrs; body mass index [BMI] ≥ 85(th) percentile) participated in a structured 3-month football training programme, consisting of 4 weekly 60-90 min sessions with mean heart rate (HR) > 80% of HRmax (football group, FG). A parallel control group (CG) included 11 children (7 boys, 4 girls) of equivalent age from an obesity clinic. After 3 months, systolic blood pressure was unchanged in FG, but had increased in CG (112 [s 6] vs. 122 [10] mmHg, P = 0.02). FG demonstrated increased left ventricular (LV) posterior wall diameter (0.60 [0.07] vs. 0.68 [0.10] cm, P < 0.001) and an improved right ventricular systolic function determined by tricuspid annular plane systolic excursion (TAPSE, 2.01 [0.29] vs. 2.27 [0.28] cm, P = 0.003). Measures of LV systolic function showed only discrete alterations and two-dimensional (2D) global strain was not changed. After 3 months, global isovolumetric relaxation time (IVRTglobal) had increased in FG (64.0 [7.5] vs. 73.9 [9.4] ms, P < 0.001) while other examined LV diastolic function variables were not altered. No echocardiographic changes were observed in CG. Between-group differences in pre-post delta values were observed for systolic blood pressure, TAPSE, and IVRTglobal (P = 0.02-0.03). We conclude that short-term football training may have positive structural and functional effects on the cardiovascular system in overweight preadolescent children.

Short-term street soccer improves fitness and cardiovascular health status of homeless men.

This study examined the effect of 12 weeks of small-sided street soccer (2.2 ± 0.7 sessions/week) and fitness center training (0.5 ± 0.2 sessions/week) on physical fitness and cardiovascular health profile for homeless men. Exercise capacity, maximal oxygen uptake (VO(2max)), body composition (DXA scans), blood pressure (BP), and blood lipid profile were determined before and after the intervention period for 22 soccer-group subjects (SG) and 10 waiting list controls (CO). In addition, time-motion analyses, HR measurements, and pedometer recordings were performed during street soccer training and daily-life activities. During a 60 min 4 versus 4 street soccer session 182 ± 62 intense running bouts were performed; mean HR was 82 ± 4% HR(max) and HR was >90% HR(max) for 21 ± 12% (±SD) of total time. On a day without training the participants performed 10,733 ± 4,341 steps and HR was >80% HR(max) for 2.4 ± 4.3 min. In SG, VO(2max) was elevated (p < 0.05) from 36.7 ± 7.6 to 40.6 ± 8.6 ml/min/kg after 12 weeks and incremental cycle test performance was improved (p < 0.05) by 81 s (95% CI: 47-128 s). After 12 weeks, fat percentage (19.4 ± 8.5 to 17.5 ± 8.6%) and LDL cholesterol (3.2 ± 1.1 to 2.8 ± 0.8 mmol L(-1)) were lowered (p < 0.05) in SG. The observed changes in SG were different (p < 0.05) from CO and no intra-group changes occurred for CO (p > 0.05). BP was unaltered after 12 weeks (p > 0.05), but diastolic BP was lowered for all SG subjects with pre-values >75 mmHg (83 ± 6 to 76 ± 6 mmHg, n = 8, p < 0.05). In conclusion, the exercise intensity is high during street soccer and regular street soccer training can be used as an effective activity to promote physical fitness and cardiovascular health status for homeless men.

Reduced telomere shortening in lifelong trained male football players compared to age-matched inactive controls.

AIMS: Current evidence points to cellular anti-ageing effects of regular endurance training which may differ from other sport modalities. Effects of football training on markers of cell senescence have not been tested. METHODS: One hundred and forty healthy, non-smoking men participated in the study, including young elite football players aged 18-30 years (YF, n = 35, 21.6 ±â€¯0.5 yrs), elderly football players aged 65-80 years (EF, n = 35, 71.9 ±â€¯0.5 yrs), untrained young controls (YC, n = 35, 24.3 ±â€¯0.6 yrs) and elderly controls (EC, n = 35, 70.1 ±â€¯0.7 yrs). Besides body composition (DXA scan), resting heart rate (RHR), blood pressure (BP) and selected fasting blood variables, mononuclear cells (MNC) were isolated. MNC telomere length was determined by flow-fluorescence in-situ hybridization (FISH) and polymerase chain reaction (PCR). Telomerase activity was quantified using telomerase repeat amplification protocol (TRAP) assay. mRNA expression of anti- and pro-senescent factors was measured with real-time PCR. RESULTS: EF showed 2.5% higher (p = 0.047) granulocyte telomere length and 1.3% higher (p = 0.009) lymphocyte telomere length compared to EC. EF had 37% lower (p = 0.025) mRNA expression of the pro-senescent factor p16 compared to EC. No significant between-group differences (p > 0.050) were observed in telomerase activity or anti-senescent factors (TRF2, Ku70 and POT1a) for EF vs EC. YF had higher telomerase activity (4.2-fold, p = 0.001), telomere repeat binding factor (TRF) 2 mRNA expression (3.2-fold, p = 0.003), Ku70 mRNA expression (2.3-fold, p < 0.001) and POT1a mRNA expression (2.2-fold, p = 0.002) compared to YC, but there was no significant between-group difference in telomere length. CONCLUSION: This study is the first cross-sectional, controlled trial showing effects of lifelong football participation on telomere shortening and senescence markers in circulating cells, suggesting that football induces cellular anti-senescence mechanisms implying positive long-term cardiovascular health effects.

Effects of small-sided recreational team handball training on mechanical muscle function, body composition and bone mineralization in untrained young adults-A randomized controlled trial.

Prolonged physical inactivity in young adults may lead to deficiencies in musculoskeletal fitness, and thus a need exists to develop physical activity and exercise programmes that are effective of increasing musculoskeletal fitness. The aim of this study, therefore, was to investigate the effects of small-sided team handball training on lower limb muscle strength, postural balance and body composition in young adults. Twenty-six men and twenty-eight women were stratified for peak oxygen uptake (VO2peak) and body fat percentage and randomly allocated to either 12 wks of small-sided recreational team handball training (THG: 14 men and 14 women, age 24.1±2.6 yrs (mean±SD), VO2peak 39.8±5.9 ml/kg/min and body fat percentage 32.7±8.7%) or serving as non-exercising controls (CON: 12 men and 14 women, age 24.8±3.1 yrs, VO2peak 39.7±5.0 ml/kg/min, body fat percentage 31.7±9.7%). THG trained on average 1.8 times/week for 12 wks. At 0 and 12 wks, lower limb muscle strength, rate of force development (RFD), vertical jump height and power, postural balance, body composition and muscle biopsies were assessed. No training effects were observed for maximal isokinetic or isometric knee extensor strength, maximal vertical jump height or take-off power, fibre type distribution or capillarization. Late phase (RFD) increased (+7.4%, p<0.05) and postural sway excursion length was improved after training (-9%, p<0.05) in THG with no difference from CON (p>0.05). Further, THG demonstrated a decrease in body fat percentage (-3.7%) accompanied by increases in whole-body fat free mass (FFM) (+2.2%), leg FFM (+2.5%), total bone mineral content (BMC) (+1.1%), leg BMC (+1.2%), total hip bone mineral density (+1.6%) and hip T-score (+50%) which differed from CON (all p<0.05). In conclusion, recreational small-sided team handball training appears to effectively improve rapid force capacity, postural balance, lean and fat body mass and bone health in previously untrained young adults. The study was registered at ClinicalTrials.gov (NCT04247724). ClinicalTrials.gov ID number: NCT04247724.

Bone mineral density in lifelong trained male football players compared with young and elderly untrained men.

PURPOSE: The purpose of the present controlled cross-sectional study was to investigate proximal femur and whole-body bone mineral density (BMD), as well as bone turnover profile, in lifelong trained elderly male football players and young elite football players compared with untrained age-matched men. METHODS: One hundred and forty healthy, non-smoking men participated in the study, including lifelong trained football players (FTE, n = 35) aged 65-80 years, elite football players (FTY, n = 35) aged 18-30 years, as well as untrained age-matched elderly (UE, n = 35) and young (UY, n = 35) men. All participants underwent a regional dual-energy X-ray Absorptiometry (DXA) scan of the proximal femur and a whole-body DXA scan to determine BMD. From a resting blood sample, the bone turnover markers (BTMs) osteocalcin, carboxy-terminal type-1 collagen crosslinks (CTX-1), procollagen type-1 amino-terminal propeptide (P1NP), and sclerostin were measured. RESULTS: FTE had 7.3%-12.9% higher (p < 0.05) BMD of the femoral neck, wards, shaft, and total proximal femur in both legs compared to UE, and 9.3%-9.7% higher (p < 0.05) BMD in femoral trochanter in both legs compared to UY. FTY had 24.3%-37.4% higher (p < 0.001) BMD in all femoral regions and total proximal femur in both legs compared to UY. The whole-body DXA scan confirmed these results, with FTE showing similar whole-body BMD and 7.9% higher (p < 0.05) leg BMD compared to UY, and with FTY having 9.6% higher (p < 0.001) whole-body BMD and 18.2% higher (p < 0.001) leg BMD compared to UY. The plasma concentration of osteocalcin, CTX-1, and P1NP were 29%, 53%, and 52% higher (p < 0.01), respectively, in FTY compared to UY. CONCLUSION: BMD of the proximal femur and whole-body BMD are markedly higher in lifelong trained male football players aged 65-80 years and young elite football players aged 18-30 years compared to age-matched untrained men. Elderly football players even show higher BMD in femoral trochanter and leg BMD than untrained young despite an age difference of 47 years.

Fitness and health benefits of team handball training for young untrained women-A cross-disciplinary RCT on physiological adaptations and motivational aspects.

PURPOSE: The present study evaluated the effects of regular participation in small-sided team handball training on body composition, osteogenic response, physical performance, and cardiovascular risk factors, as well as well-being and motivation, in young untrained women. METHODS: Twenty-eight untrained 20- to 30-year-old women were randomized to a handball training group (HG; n = 14, height 170 ± 5 cm, weight 73 ± 11 kg, VO2peak 37.7 ± 4.1 mL/min/kg) that trained 1.7 ± 0.3 times per week over 12 weeks (70 min 4 v 4 handball sessions) or an inactive control group (CG; n = 14, 169 ± 5 cm, 71 ± 12 kg, 38.1 ± 3.7 mL/min/kg). Physiological and psychological and motivational training adaptations were assessed pre- and post-intervention by dual-energy X-ray Absorptiometry (DXA) scans, blood sampling, physical tests, and questionnaires. RESULTS: The average heart rate (HR) over all training sessions was equal to 85% ± 6% HRmax. Between-group intervention effects were observed in favor of HG for muscle mass (2.1%, p = 0.024), proximal femur bone mineral density (0.8%, p = 0.041), Yo-Yo IE1 intermittent endurance test level 1 (IE1) performance (35%, p < 0.001), and incremental treadmill test performance (11.5%, p = 0.003), but not total fat mass (p = 0.176), mean arterial blood pressure (p = 0.328), resting HR (p = 0.219), or blood lipids (p = 0.298-0.854). In CG, no changes were observed in any of the measured physiological variables after the training period. Compared to CG, HG had an increase in intrinsic motivation (p < 0.001) and in the well-being subscale "energy" (p = 0.010). CONCLUSION: Participation in regular recreational team handball training organized as small-sided games has marked beneficial effects on physical performance, musculoskeletal fitness, well-being, and motivation in untrained young women.

Heart rate response and fitness effects of various types of physical education for 8- to 9-year-old schoolchildren.

The present study investigated the heart rate (HR) response to various types of physical education (PE) activities for 8- to 9-year-olds (five school classes, n = 93) and the fitness effects of a short-term PE training programme (three of the five classes, n = 59) with high compared to low-to-moderate aerobic intensity. HR was recorded during small-sided indoor soccer (SO), basketball (BB), unihockey (UH), circuit training (CT), walking (W) and Nintendo Wii Boxing (NWB) and Nintendo Wii Tennis (NWT). Maximal HR (HRmax) and physical fitness was determined by the Yo-Yo Intermittent Recovery Level 1 Children's test (YYIR1C) test. Following cluster randomisation, three classes were tested before and after 6 wks with 2 × 30 min/wk SO and UH lessons [high-intensity (HI), 2 classes, n = 39] or low-to-moderate intensity PE lessons (CON, 1 class, n = 20). Average HR in SO (76 ± 1% HRmax), BA (77 ± 1% HRmax) and UH (74 ± 1% HRmax) was higher (P < 0.05) than in CT (62 ± 1% HRmax), W (57 ± 1% HRmax), NWB (65 ± 2% HRmax) and NWT (57 ± 1% HRmax). Time with HR > 80% and 90% HRmax, respectively, was higher (P < 0.05) in SO (42 ± 4 and 12 ± 2%), BB (41 ± 5 and 13 ± 3%) and UH (34 ± 3 and 9 ± 2%) than in CT, W and NW (0-5%), with time >80% HRmax being higher (P < 0.05) in SO than UH. After 6 wk, YYIR1C performance was increased (P < 0.05) by 22% in HI (673 ± 57 to 821 ± 71 m), but unaltered in CON (674 ± 88 to 568 ± 81 m). HR 2 min into YYIR1C was lowered (P < 0.05) in HI after 6 wks (92.4 ± 0.8 to 89.1 ± 0.9% HRmax), but not in CON. In conclusion, ball games elicited high aerobic loading for young schoolchildren and a short-term, low-volume ball game PE-intervention improved physical fitness. Traditional PE sessions had no effects on intermittent exercise performance.

High-intensity training versus traditional exercise interventions for promoting health.

PURPOSE: The purpose of this study was to determine the effectiveness of brief intense interval training as exercise intervention for promoting health and to evaluate potential benefits about common interventions, that is, prolonged exercise and strength training. METHODS: Thirty-six untrained men were divided into groups that completed 12 wk of intense interval running (INT; total training time 40 min wk(-1)), prolonged running (approximately 150 min wk(-1)), and strength training (approximately 150 min wk(-1)) or continued their habitual lifestyle without participation in physical training. RESULTS: The improvement in cardiorespiratory fitness was superior in the INT (14% +/- 2% increase in V˙O2max) compared with the other two exercise interventions (7% +/- 2% and 3% +/- 2% increases). The blood glucose concentration 2 h after oral ingestion of 75 g of glucose was lowered to a similar extent after training in the INT (from 6.1 +/- 0.6 to 5.1 +/- 0.4 mM, P < 0.05) and the prolonged running group (from 5.6 +/- 1.5 to 4.9 +/- 1.1 mM, P < 0.05). In contrast, INT was less efficient than prolonged running for lowering the subjects' resting HR, fat percentage, and reducing the ratio between total and HDL plasma cholesterol. Furthermore, total bone mass and lean body mass remained unchanged in the INT group, whereas both these parameters were increased by the strength-training intervention. CONCLUSIONS: INT for 12 wk is an effective training stimulus for improvement of cardiorespiratory fitness and glucose tolerance, but in relation to the treatment of hyperlipidemia and obesity, it is less effective than prolonged training. Furthermore and in contrast to strength training, 12 wk of INT had no impact on muscle mass or indices of skeletal health.