Four-year longitudinal associations of physical activity, waist circumference, and blood pressure in UK adolescents.

BACKGROUND: This study assessed the specific influence of physical activity (PA) and waist circumference (WC) on the 4-year growth trajectory of blood pressure in UK high-school students. METHODS: Four-year longitudinal monitoring of 1501 adolescents was conducted as part of the EoEHHS. Measurements were taken in Grades (G)7, 9, and 11. RESULTS: Systolic (SBP) and diastolic blood pressure (DBP) increased over the 4-year period (SBP G7 114.6 ± 8.9 mmHg, G9 118.1 ± 9.7 mmHg, G11 122.8 ± 7.8 mmHg; DBP G7 66.7 ± 6.6 mmHg, G9 68.0 ± 6.4 mmHg, G11 70.0 ± 5.2 mmHg). Baseline WC predicted baseline and growth in SBP, but the strongest contribution to SBP came from changes in WC (ß = 0.084, p = 0.002). Baseline PAQ-A score (ß = -0.822, p = 0.020) and changes in PAQ-A score (ß = -0.650, p = 0.019) were associated with smaller increases in DBP over the 4-year measurement period. CONCLUSIONS: Baseline and change in WC predicted the growth trajectory of SBP, while baseline and change in PA predicted the growth trajectory of DBP. PA and WC have a prognostic value in predicting changes in blood pressure in adolescents. Increasing PA during adolescence could slow the rise in DBP over time. This is meaningful for future hypertension and CVD risk reduction into adulthood. IMPACT: Hypertension in adolescents is a growing health problem that is often overlooked. Baseline and changes in waist circumference over a 4-year period predicted development of systolic blood pressure, while baseline and changes in physical activity predicted development of diastolic blood pressure. Physical activity and waist circumference have a prognostic value in predicting changes in blood pressure in adolescents and could be valuable in planning programmes to prevent hypertension in similar communities and reduce the risk of future adult hypertension.

European fitness landscape for children and adolescents: updated reference values, fitness maps and country rankings based on nearly 8 million test results from 34 countries gathered by the FitBack network.

OBJECTIVES: (1) To develop reference values for health-related fitness in European children and adolescents aged 6-18 years that are the foundation for the web-based, open-access and multilanguage fitness platform (FitBack); (2) to provide comparisons across European countries. METHODS: This study builds on a previous large fitness reference study in European youth by (1) widening the age demographic, (2) identifying the most recent and representative country-level data and (3) including national data from existing fitness surveillance and monitoring systems. We used the Assessing Levels of PHysical Activity and fitness at population level (ALPHA) test battery as it comprises tests with the highest test-retest reliability, criterion/construct validity and health-related predictive validity: the 20 m shuttle run (cardiorespiratory fitness); handgrip strength and standing long jump (muscular strength); and body height, body mass, body mass index and waist circumference (anthropometry). Percentile values were obtained using the generalised additive models for location, scale and shape method. RESULTS: A total of 7 966 693 test results from 34 countries (106 datasets) were used to develop sex-specific and age-specific percentile values. In addition, country-level rankings based on mean percentiles are provided for each fitness test, as well as an overall fitness ranking. Finally, an interactive fitness platform, including individual and group reporting and European fitness maps, is provided and freely available online (www.fitbackeurope.eu). CONCLUSION: This study discusses the major implications of fitness assessment in youth from health, educational and sport perspectives, and how the FitBack reference values and interactive web-based platform contribute to it. Fitness testing can be conducted in school and/or sport settings, and the interpreted results be integrated in the healthcare systems across Europe.

How effective are external cues and analogies in enhancing sprint and jump performance in academy soccer players?

This study investigated the effect of external (EC) and internal coaching cues (IC), analogies with a directional component (ADC) on sprint (20 m) and vertical jump performance in academy soccer players (n = 20). A repeated-measures analysis, with post-hoc comparisons, was used to identify any differences between these cues and a neutral (control) cue. Significant differences were found for both sprint (p < 0.001) and jump (p = 0.022) comparisons among cue types. In post-hoc analyses for the 20 m sprint, significant differences were observed between the EC and the IC, favouring the EC (p < 0.01, ES = 1.27 [CI: 0.24, 2.30]), and "away" ADC and the IC, favouring the "away" ADC (p < 0.01, ES = 1.21 [CI: 0.19, 2.22]). No other cues showed significant differences. For vertical jump, there was just one significant difference between comparisons, that being for the "away" ADC vs. the neutral cue, favouring the latter (p = 0.023, ES = 0.4 [CI: -0.04 to 0.84]). It appears that ECs and ADCs are most effective when coaching sprinting performance in academy soccer players. However, simply encouraging maximal effort from a youth athlete also appears to be a reasonable cueing strategy to drive performance in youth athletes.

Obese individuals do not underreport dietary intake to a greater extent than nonobese individuals when data are allometrically-scaled.

OBJECTIVE: The aim of this study was to assess the extent of misreporting in obese and nonobese adults on an absolute, ratio-scaled, and allometrically-scaled basis. METHOD: Self-reported daily energy intake (EI) was compared with total energy expenditure (TEE) in 221 adults (106 male, 115 female; age 53 ± 17 years, stature 1.68 ± 0.09 m, mass 79.8 ± 17.2 kg) who participated in a doubly-labeled water (DLW) subsection of 2013-2015 National Diet and Nutrition Survey. Data were log transformed and expressed as absolute values, according to simple ratio-standards (per kg body mass) and adjusted for body mass allometrically. Absolute and ratio-scaled misreporting were examined using full-factorial General Linear Models with repeated measures of the natural logarithms of TEE or EI as the within-subjects factor. The natural logarithm of body mass was included as a covariate in the allometric method. The categorical variables of gender, age, obesity, and physical activity level (PAL) were the between-factor variables. RESULTS: On an absolute-basis, self-reported EI (2759 ± 590 kcal·d-1 ) was significantly lower than TEE measured by DLW (2759 ± 590 kcal·d-1 : F1,205  = 598.81, p < .001, ηp 2 =0.75). We identified significantly greater underreporting in individuals with an obese BMI (F1,205  = 29.01, p <.001, ηp 2 =0.12), in more active individuals (PAL > 1.75; F1,205  = 34.15, p <.001, ηp 2 =0.14) and in younger individuals (≤55 years; F1,205  = 14.82, p < .001, ηp 2 =0.07), which are all categories with higher energy needs. Ratio-scaling data reduced the effect sizes. Allometric-scaling removed the effect of body mass (F1,205 =0.02, p = 0.887, ηp 2 =0.00). CONCLUSION: In weight-stable adults, obese individuals do not underreport dietary intake to a greater extent than nonobese individuals. These results contradict previous research demonstrating that obesity is associated with a greater degree of underreporting.

Fitness Changes in Adolescent Girls Following In-School Combined Aerobic and Resistance Exercise: Interaction With Birthweight.

PURPOSE: To assess the efficacy of a supervised in-school combined resistance and aerobic training program in adolescent girls and investigate whether responses differ according to birthweight. METHODS: Participants (girls aged 13-17 y) were randomized either to an intervention replacing physical education (PE) classes with 2 × 60-minute training sessions per week (n = 58) or to a control group that continued to attend 2 × 60 minutes per week of curriculum PE (n = 41). We measured muscular fitness (handgrip, standing long jump, and sit-ups), cardiorespiratory fitness (20-m shuttle run), skinfolds, and lean body mass preintervention and postintervention and determined effect size (Hedge's g) differences between changes in these measures. We also compared changes within lower (<3000 g) and normal birthweight intervention and PE control subgroups. RESULTS: The intervention group showed greater improvements in all the fitness measures and lean body mass (g = 0.22-0.48) and lower skinfold increases (g = 0.41) than PE controls. Within the intervention group, improvements in all fitness measures were larger in lower birthweight (g = 0.53-0.94) than in normal birthweight girls (g = 0.02-0.39). CONCLUSION: Replacing curriculum PE with supervised training improved muscular and cardiorespiratory fitness and body composition outcomes in adolescent females. Our findings suggest an enhanced adaptive response to training in participants with lower birthweight which warrants further investigation.

A randomised controlled trial of 1- versus 2-day per week formats of Nordic hamstring training on explosive athletic tasks in prepubertal soccer players.

This randomised controlled trial examined the effect of volume-equated programmes of Nordic hamstring exercise (NHE) training, executed at frequencies of 1- or 2-days per week, on explosive athletic tasks (30 m sprint, 15 m manoeuvrability and standing long jump [SLJ]) in male youth soccer players (mean age: 10.3 ± 0.5 years). Players were divided into an experimental group (n = 31) which was further subdivided into 1-day (n = 16) and 2-days (n = 15) per week training conditions, and a control group (n = 14). There were significant group-by-time interactions for 30-m sprint (p < 0.001, d = 0.6), SLJ (p = 0.001, d = 1.27) and 15 m manoeuvrability (p < 0.001, d = 0.61). The experimental group demonstrated small to moderate effect sizes in 30-m sprint (d = 0.42, p = 0.077), SLJ (d = 0.97, p < 0.001) and 15 m manoeuvrability (d = 0.61, p < 0.001). The control group showed small significant performance decrements or no change in these variables. There were no significant differences between the 1-day and 2-day training groups. In two of the three tests (30 m sprint, SLJ) the 2-day group demonstrated larger effect sizes. The NHE enhances explosive athletic task performance in prepubertal youth soccer players and there may be only small advantages to spreading training over two days instead of one.

The associations between physical activity intensity, cardiorespiratory fitness, and non-alcoholic fatty liver disease.

BACKGROUND AND AIM: High levels of physical activity and cardiorespiratory fitness may protect against non-alcoholic fatty liver disease. We investigated whether different physical activity intensities and cardiorespiratory fitness were independent predictors of non-alcoholic fatty liver disease. METHODS: We included healthy adults with no prior diagnosis of liver dysfunction. Non-alcoholic fatty liver disease prevalence was estimated based on fatty liver index scores. We created tertiles of self-reported low, moderate, and vigorous physical activity. Participants completed an incremental treadmill test to estimate cardiorespiratory fitness, and data were subsequently separated into quintile groups (Q1 [least fit] through Q5 [most fit]). RESULTS: Non-alcoholic fatty liver disease prevalence in our sample of 7111 adults was 28.3% in male adults and 6.5% in female adults. Logistic regression showed the relative odds of non-alcoholic fatty liver disease were 42% lower if > 60 min/week of vigorous physical activity was maintained (odds ratio [OR] = 0.58, confidence interval [CI]: 0.49-0.68). There was a negative dose-response association between cardiorespiratory fitness and non-alcoholic fatty liver disease between Q1 and Q4. Compared with Q1, odds were 39% (OR = 0.61, CI: 0.51-0.73) lower in Q2, through to 51% lower in Q5 (OR = 0.49, CI: 0.41-0.60). Moderate physical activity did not reduce the odds of non-alcoholic liver disease. CONCLUSIONS: We found the lowest prevalence of non-alcoholic fatty liver disease in adults achieving > 60 min/week of vigorous physical activity. However, a stronger dose-response relationship existed between cardiorespiratory fitness and non-alcoholic fatty liver disease. Improving cardiorespiratory fitness as a potential therapeutic target for treatment and prevention of non-alcoholic fatty liver disease warrants further investigation.

The dose-response association between V̇O2peak and self-reported physical activity in children.

BACKGROUND: Previous research into the association between aerobic fitness and physical activity in children is equivocal. However, previous research has always assumed that such an association was linear. This study sought to characterize the dose-response association between physical activity and aerobic fitness and to assess whether this association is linear or curvilinear and varies by sex, age and weight status. METHODS: Physical activity (assess using the Physical Activity Questionnaire), aerobic fitness (20 m shuttle-run), BMI, screen-time and socio-demographic data were collected at ages 12, 14 and 16 years in (n = 1422) volunteers from 9 English schools. Multilevel-regression modelling was used to analyse the longitudinal data. RESULTS: The analysis identified a significant inverted "u-shaped" association between VO2max and PAQ. This relationship remained having controlling for the influences of sex, age and weight status. Daily screen time >4 hours and deprivation were also associated with being less fit (P < 0.01). CONCLUSIONS: This longitudinal study suggests that the dose-response relationship between PA and aerobic fitness in children is curvilinear. The health benefits of PA are greater in less active children and that sedentary and less active children should be encouraged to engage in PA rather than more active children to increase existing levels of PA.

Variable long-term developmental trajectories of short sprint speed and jumping height in English Premier League academy soccer players: An applied case study.

Growth and maturation affect long term physical performance, making the appraisal of athletic ability difficult. We sought to longitudinally track youth soccer players to assess the developmental trajectory of athletic performance over a 6-year period in an English Premier League academy. Age-specific z-scores were calculated for sprint and jump performance from a sample of male youth soccer players (n = 140). A case study approach was used to analyse the longitudinal curves of the six players with the longest tenure. The trajectories of the sprint times of players 1 and 3 were characterised by a marked difference in respective performance levels up until peak height velocity (PHV) when player 1 achieved a substantial increase in sprint speed and player 3 experienced a large decrease. Player 5 was consistently a better performer than player 2 until PHV when the sprint and jump performance of the former markedly decreased and he was overtaken by the latter. Fluctuations in players' physical performance can occur quickly and in drastic fashion. Coaches must be aware that suppressed, or inflated, performance could be temporary and selection and deselection decisions should not be made based on information gathered over a short time period.

Socio-demographic differences in Colombian children's muscular fitness: Does scaling for differences in body size present a challenge to conventional thinking?

OBJECTIVES: In low- to middle-income countries, children from less-deprived areas (from families of higher socio-economic status [SES]) have superior muscular fitness than those from low-SES groups. They are also taller and heavier, factors associated with muscular fitness. The purpose of this study was to identify any socio-demographic differences in Colombian children's muscular fitness and examine how these conclusions can be modified by scaling for differences in body size. METHODS: A total of 38,098 youths (46% girls), ninth grade students (aged 14-15 years), participated in a study of cross-sectional design. We recorded SES and family incomes, stature, and mass. Standing broad jump and handgrip strength were used to assess muscular fitness. A multiplicative allometric model was adopted to adjust for body-size differences. RESULTS: Children from the mid- to high-SES groups jumped significantly higher than children from the lowest SES group, although no SES group difference in grip strength was observed. After adjusting for body size, children from higher SES and with higher family incomes had significantly lower handgrip strength, and their superior jump height performances remained but were greatly reduced. Only children from the highest SES now jumped significantly higher that the lowest SES group. CONCLUSIONS: The superior jump performance and no difference in handgrip strength of Colombian children from higher SES may simply reflect their superior physiques. When body size is accounted for, these differences are reduced or even reversed, suggesting that children from higher SES groups should not be complacent regarding their apparent superior muscular fitness.

Cardiorespiratory fitness and activity explains the obesity-deprivation relationship in children.

This study examined the association between obesity and deprivation in English children and whether cardiorespiratory fitness or physical activity (PA) can explain this association. Obesity was assessed using IOTF criteria in 8,398 10-16 year olds. Social deprivation was measured using the Index of Multiple Deprivation (IMD) (subdivided into 3 groups; high, mid and low deprivation). Obesity was analysed using binary logistic regression with stature, age and sex incorporated as confounding variables. Children's fitness levels were assessed using predicted VO2 max (20-metre shuttle run test) and PA was estimated using the PA Questionnaire for Adolescents or Children (PAQ). A strong association was found between obesity and deprivation. When fitness and PA were added to the logistic regression models, increasing levels in both were found to reduce the odds of obesity, although it was only by including fitness into the model that the association between obesity and deprivation disappeared. Including estimated PA into the model was found to be curvilinear. Initial increases in PA increase the odds of obesity. Only by increasing PA to exceed the 71st percentile (PAQ = 3.22) did the odds of being obese start to decline. In order to reduce deprivation inequalities in children's weight-status, health practitioners should focus on increasing cardiorespiratory fitness via physical activity levels in areas of greater deprivation.

Maturation-Related Differences in Adaptations to Resistance Training in Young Male Swimmers.

Moran, J, Sandercock, GRH, Ramírez-Campillo, R, Wooller, J-J, Logothetis, S, Schoenmakers, PPJM, and Parry, DA. Maturation-related differences in adaptations to resistance training in young male swimmers. J Strength Cond Res 32(1): 139-149, 2018-This study examined the effects of resistance training on muscular strength and jump performances in young male swimmers. It was hypothesized that adaptations would be of a lower magnitude in less mature (prepeak height velocity [PHV]) than in more mature (post-PHV) subjects. Fourteen pre-PHV (-1.8 ± 1.0 years) and 8 post-PHV (1.6 ± 0.5 years) swimmers undertook a 30 minutes, twice-weekly resistance training program for 8 weeks. They were compared with matched control groups (pre-PHV: -2.0 ± 1.1, n = 15; post-PHV: 1.2 ± 1.0, n = 7). The effects on lower-body isometric strength (LBS), measured with midthigh pull, and vertical jump (VJ) height in the post-PHV group were large (effect size: 1.3 [0.4 to 2.2]) and small (0.4 [-0.4 to 1.2]), respectively. Effects on LBS and VJ height in the pre-PHV group were moderate (0.8 [0.1 to 1.4]) and trivial (0.2 [-0.5 to 0.8]), respectively. Estimates in the post-PHV control group (LBS: 0.7 [-0.2 to 1.6]; VJ: 0.2 [-0.7 to 1.0]) and the pre-PHV control group (LBS: 0.1 [-0.5 to 0.7]; VJ: -0.3 [-0.9 to 0.3]) may indicate the extent to which maturation could contribute to the performance changes seen in the respective training groups. Lower-body isometric strength and VJ are trainable, but to different magnitudes, in pre- and post-PHV swimmers. After appropriate foundational training to establish technical competency, twice-weekly resistance training sessions of 30 minutes duration, comprising 3 sets of 4 exercises can be effective in pre- and post-PHV youth.

The Relationship between Socioeconomic Status, Family Income, and Measures of Muscular and Cardiorespiratory Fitness in Colombian Schoolchildren.

OBJECTIVE: To determine the associations between socioeconomic status (SES) and physical fitness in a sample of Colombian youth. STUDY DESIGN: Prueba SER is cross-sectional survey of schoolchildren in Bogota, Colombia. Mass, stature, muscular fitness (standing long-jump, handgrip), and cardiorespiratory fitness (20-m shuttle run) were measured in 52?187 schoolchildren 14-16 years of age. Area-level SES was categorized from 1 (very low) to 4 (high) and parent-reported family income was categorized as low, middle, or high. RESULTS: Converting measures into z scores showed stature, muscular, and cardiorespiratory fitness were significantly (z?=?0.3-0.7) below European values. Children in the mid- and high SES groups jumped significantly further than groups with very low SES. Differences were independent of sex but became nonsignificant when adjusted for anthropometric differences. Participants in the mid-SES and high-SES groups had better handgrip scores when adjusted for body dimension. There were, however, no significant between-group differences in cardiorespiratory fitness, which was strongly clustered by school and significantly greater in students from private schools. CONCLUSIONS: Area-level SES is associated with measures of muscular fitness in Colombian schoolchildren. These associations were largely explained by the large differences in body dimensions observed between SES groups. When area-level SES is considered, there was no evidence that family income influenced fitness. The clustering of outcomes reaffirms the potential importance of schools and area-level factors in promoting fitness through opportunities for physical activity. Interventions implemented in schools, can improve academic attainment; a factor likely to be important in promoting the social mobility of children from poorer families.

Scaling children's waist circumference for differences in body size.

OBJECTIVES: Both waist circumference (WC) and body size (height) increase with age throughout childhood. Hence, there is a need to scale WC in children to detect differences in adiposity status (eg, between populations and different age groups), independent of body size/height. METHODS: Using two culturally different samples, 1 English (10-15.9 years n = 9471) and 2 Colombian (14-15 years, n = 37,948), for WC to be independent of height (HT), a body shape index was obtained using the allometric power law WC = a.HTb . The model was linearized using log-transformation, and multiple regression/ANCOVA to estimate the height exponents for WC controlling for age, sex, and any other categorical/population differences. RESULTS: In both samples, the power-law height exponent varied systematically with age. In younger children (age 10-11 years), the exponent was approximately unity, suggesting that pre-pubertal children might be geometrically similar. In older children, the height exponent declined monotonically to 0.5 (ie, HT0.5 ) in 15+ year-olds, similar to the exponent observed in adults. UK children's height-adjusted WC revealed a "u" shaped curve with age that appeared to reach a minimum at peak-height velocity, different for boys and girls. Comparing the WC of two populations (UK versus Colombian 14-15-year-old children) identified that the gap in WC between the countries narrowed considerably after scaling for height. CONCLUSIONS: Scaling children's WC for differences in height using allometric modeling reveals new insights into the growth and development of children's WC, findings that might well have been be overlooked if body size/height had been ignored.

Maturation-Related Effect of Low-Dose Plyometric Training on Performance in Youth Hockey Players.

PURPOSE: The purpose of this intervention study was to investigate if a low-dose of plyometric training (PT) could improve sprint and jump performance in groups of different maturity status. METHOD: Male youth field hockey players were divided into Pre-PHV (from -1 to -1.9 from PHV; Experimental: n = 9; Control = 12) and Mid-PHV (0 to +0.9 from PHV; Experimental: n = 8; Control = 9) groups. Participants in the experimental groups completed 60 foot contacts, twice-weekly for 6 weeks. RESULTS: PT exerted a positive effect (effect size: 0.4 [-0.4-1.2]) on 10 m sprint time in the experimental Mid-PHV group but this was less pronounced in the Pre-PHV group (0.1 [-0.6-0.9]). Sprint time over 30 m (Mid-PHV: 0.1 [-0.8-0.9]; Pre-PHV: 0.1 [-0.7-0.9]) and CMJ (Mid-PHV: 0.1 [-0.8-0.9]; Pre-PHV: 0.0 [-0.7-0.8]) was maintained across both experimental groups. Conversely, the control groups showed decreased performance in most tests at follow up. Between-group analysis showed positive effect sizes across all performance tests in the Mid-PHV group, contrasting with all negative effect sizes in the Pre-PHV group. CONCLUSION: These results indicate that more mature hockey players may benefit to a greater extent than less mature hockey players from a low-dose PT stimulus. Sixty foot contacts, twice per week, seems effective in improving short sprint performance in Mid-PHV hockey players.

Reference values for the incremental shuttle walk test in patients with cardiovascular disease entering exercise-based cardiac rehabilitation.

The incremental shuttle walk test (ISWT) is used to assess functional capacity of patients entering cardiac rehabilitation. Factors such as age and sex account for a proportion of the variance in test performance in healthy individuals but there are no reference values for patients with cardiovascular disease. The aim of this study was to produce reference values for the ISWT. Participants were n = 548 patients referred to outpatient cardiac rehabilitation who underwent a clinical examination and performed the ISWT. We used regression to identify predictors of performance and produced centile values using the generalised additive model for location, scale and shape model. Men walked significantly further than women (395 ± 165 vs. 269 ± 118 m; t = 9.5, P < 0.001) so data were analysed separately by sex. Age (years) was the strongest predictor of performance in men (ß = -5.9; 95% CI: -7.1 to -4.6 m) and women (ß = -4.8; 95% CI: -6.3 to 3.3). Centile curves demonstrated a broadly linear decrease in expected ISWT values in males (25-85 years) and a more curvilinear trend in females. Patients entering cardiac rehabilitation present with highly heterogeneous ISWT values. Much of the variance in performance can be explained by patients' age and sex. Comparing absolute values with age-and sex-specific reference values may aid interpretation of ISWT performance during initial patient assessment at entry to cardiac rehabilitation.

A meta-analysis of maturation-related variation in adolescent boy athletes' adaptations to short-term resistance training.

This meta-analysis investigated the maturation-related pattern of adaptations to resistance training in boy athletes. We included studies examining the effects of 4-16-week resistance training programmes in healthy boy athletes aged 10-18 years. Pooled estimates of effect size for change in strength across all studies (n = 19) were calculated using the inverse-variance random effects model for meta-analyses. Estimates were also calculated for groups based on likely biological maturity status ("before", "during" and "after" peak height velocity). Using the standardised mean difference, resistance training increased strength across all groups (effect size = 0.98, [CI: 0.70-1.27]). Strength gains were larger during (1.11 [0.67-1.54]) and after (1.01 [0.56-1.46]) peak height velocity than before (0.5 [-0.06-1.07]). Adaptations to resistance training are greater in adolescent boys during or after peak height velocity. These findings should help coaches to optimise the timing of training programmes that are designed to improve strength in boy athletes.

Age-Related Variation in Male Youth Athletes' Countermovement Jump After Plyometric Training: A Meta-Analysis of Controlled Trials.

Moran, J, Sandercock, GRH, Ramírez-Campillo, R, Meylan, CMP, Collison, J, and Parry, DA. Age-related variation in male youth athletes' countermovement jump after plyometric training: A meta-analysis of controlled trials. J Strength Cond Res 31(2): 552-565, 2017-Recent debate on the trainability of youths has focused on the existence of periods of accelerated adaptation to training. Accordingly, the purpose of this meta-analysis was to identify the age- and maturation-related pattern of adaptive responses to plyometric training in youth athletes. Thirty effect sizes were calculated from the data of 21 sources with studies qualifying based on the following criteria: (a) healthy male athletes who were engaged in organized sport; (b) groups of participants with a mean age between 10 and 18 years; and (c) plyometric-training intervention duration between 4 and 16 weeks. Standardized mean differences showed plyometric training to be moderately effective in increasing countermovement jump (CMJ) height (Effect size = 0.73 95% confidence interval: 0.47-0.99) across PRE-, MID-, and POST-peak height velocity groups. Adaptive responses were of greater magnitude between the mean ages of 10 and 12.99 years (PRE) (ES = 0.91 95% confidence interval: 0.47-1.36) and 16 and 18 years (POST) (ES = 1.02 [0.52-1.53]). The magnitude of adaptation to plyometric training between the mean ages of 13 and 15.99 years (MID) was lower (ES = 0.47 [0.16-0.77]), despite greater training exposure. Power performance as measured by CMJ may be mediated by biological maturation. Coaches could manipulate training volume and modality during periods of lowered response to maximize performance.

The Cardiac Rehabilitation Inventory: A New Method of Tailoring Patient Support.

BACKGROUND: Uptake and adherence to cardiac rehabilitation (CR) are low, and a contributing factor to this may be the practical difficulties of providing a tailored CR environment suited to individual preferences and needs. OBJECTIVE: The aim of this study was to develop and test a short questionnaire that CR practitioners can use to understand individual patient need and tailor support accordingly. METHODS: A conceptual framework of engagement in CR was derived from a comprehensive literature review and the content analysis of semistructured interviews with 15 CR patients. The conceptual framework was used to construct the first version of the Cardiac Rehabilitation Inventory (CRI), which comprised 42 items. Responses on the CRI were measured using a 5-point Likert scale. The CRI was administered to 380 phase III and IV CR patients, and factor analysis (FA) was used to identify salient CR engagement factors. RESULTS: The simplest structure found using FA was three 6-item subscales that all had good levels of internal consistency (Cronbach's α) and were labeled (a) outcome anxiety, α = .726; (2) process anxiety, α = .724; and (3) autonomy, α = .653. The 3-factor CRI model was verified using confirmatory FA (CMin/df = 3.2, root-mean-square error of approximation = 0.073). Attenders were found to have higher levels of outcome anxiety than nonattenders (P < .001), and precontemplator nonattenders were found to have lower autonomy compared with attenders (P < .001). Standard multiple regression analysis indicated outcome anxiety was a strong predictor of CR intentions (r = 0.716), followed by autonomy (r = 0.110) and process anxiety (r = 0.031). CONCLUSIONS: The CRI is a reliable method of measuring CR outcome anxiety, process anxiety, and autonomy. These CRI measurements provide rehabilitation practitioners with valuable information that can help provide individual tailored support.

Modelling the association between weight status and social deprivation in English school children: Can physical activity and fitness affect the relationship?

BACKGROUND: The association between being overweight/obese and deprivation is a serious concern in English schoolchildren. AIM: To model this association incorporating known confounders and to discover whether physical fitness and physical activity may reduce or eliminate this association. SUBJECTS AND METHODS: Cross-sectional data were collected between 2007-2009, from 8053 10-16 year old children from the East-of-England Healthy Heart Study. Weight status was assessed using waist circumference (cm) and body mass (kg). Deprivation was measured using the Index of Multiple Deprivation (IMD). Confounding variables used in the proportional, allometric models were hip circumference, stature, age and sex. Children's fitness levels were assessed using predicted VO2 max (20-metre shuttle-run test) and physical activity was estimated using the Physical Activity Questionnaire for Adolescents or Children. RESULTS: A strong association was found between both waist circumference and body mass and the IMD. These associations persisted after controlling for all confounding variables. When the children's physical activity and fitness levels were added to the models, the association was either greatly reduced or, in the case of body mass, absent. CONCLUSIONS: To reduce deprivation inequalities in children's weight-status, health practitioners should focus on increasing physical fitness via physical activity in areas of greater deprivation.