ABSTRACT
Depression is common in attention-deficit/hyperactivity disorder (ADHD), but preventive behavioural interventions are lacking. This randomised controlled, pilot phase-IIa trial aimed to study a physical exercise intervention (EI) and bright light therapy (BLT)-both implemented and monitored in an individual, naturalistic setting via a mobile health (m-health) system-for feasibility of trial design and interventions, and to estimate their effects on depressive symptoms in young people with ADHD. Two hundred seven participants aged 14-45 years were randomised to 10-week add-on intervention of either BLT (10,000 lx; daily 30-min sessions) (n = 70), EI (aerobic and muscle-strengthening activities 3 days/ week) (n = 69), or treatment-as-usual (TAU) (n = 68), of whom 165 (80%) were retained (BLT: n = 54; EI: n = 52; TAU: n = 59). Intervention adherence (i.e. ≥ 80% completed sessions) was very low for both BLT (n = 13, 22%) and EI (n = 4, 7%). Usability of the m-health system to conduct interventions was limited as indicated by objective and subjective data. Safety was high and comparable between groups. Changes in depressive symptoms (assessed via observer-blind ratings, Inventory of Depressive Symptomatology) between baseline and end of intervention were small (BLT: -0.124 [95% CI: -2.219, 1.971], EI: -2.646 [95% CI: -4.777, -0.515], TAU: -1.428 [95% CI: -3.381, 0.526]) with no group differences [F(2,153) = 1.45, p = 0.2384]. These findings suggest that the m-health approach did not achieve feasibility of EI and BLT in young people with ADHD. Prior to designing efficacy studies, strategies how to achieve high intervention adherence should be specifically investigated in this patient group. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03371810, 13 December 2017.
ABSTRACT
During the COVID-19 pandemic, entire populations were instructed to live in home-confinement to prevent the expansion of the disease. Spain was one of the countries with the strictest conditions, as outdoor physical activity was banned for nearly two months. This study aimed to analyse the changes in physical activity and sedentary behaviours in Spanish university students before and during the confinement by COVID-19 with special focus on gender. We also analysed enjoyment, the tools used and motivation and impediments for doing physical activity. An online questionnaire, which included the International Physical Activity Questionnaire Short Form and certain "ad hoc" questions, was designed. Students were recruited by distributing an invitation through the administrative channels of 16 universities and a total of 13,754 valid surveys were collected. Overall, university students reduced moderate (-29.5%) and vigorous (-18.3%) physical activity during the confinement and increased sedentary time (+52.7%). However, they spent more time on high intensity interval training (HIIT) (+18.2%) and mind-body activities (e.g., yoga) (+80.0%). Adaptation to the confinement, in terms of physical activity, was handled better by women than by men. These results will help design strategies for each gender to promote physical activity and reduce sedentary behaviour during confinement periods.
Subject(s)
COVID-19/epidemiology , Exercise , Pandemics , Sedentary Behavior , Adolescent , Adult , Female , High-Intensity Interval Training , Humans , Male , Sex Factors , Spain/epidemiology , Students , Surveys and Questionnaires , Universities , Yoga , Young AdultABSTRACT
A few studies have recently reported that higher cardiorespiratory fitness is associated with higher volumes of subcortical brain structures in children. It is, however, unknown how different fitness measures relate to shapes of subcortical brain nuclei. We aimed to examine the association of the main health-related physical fitness components with shapes of subcortical brain structures in a sample of forty-four Spanish children aged 9·7 (sd 0·2) years from the NUtraceuticals for a HEALthier life project. Cardiorespiratory fitness, muscular strength and speed agility were assessed using valid and reliable tests (ALPHA-fitness test battery). Shape of the subcortical brain structures was assessed by MRI, and its relationship with fitness was examined after controlling for a set of potential confounders using a partial correlation permutation approach. Our results showed that all physical fitness components studied were significantly related to the shapes of subcortical brain nuclei. These associations were both positive and negative, indicating that a higher level of fitness in childhood is related to both expansions and contractions in certain regions of the accumbens, amygdala, caudate, hippocampus, pallidum, putamen and thalamus. Cardiorespiratory fitness was mainly associated with expansions, whereas handgrip was mostly associated with contractions in the structures studied. Future randomised-controlled trials will confirm or contrast our findings, demonstrating whether changes in fitness modify the shapes of brain structures and the extent to which those changes influence cognitive function.
Subject(s)
Brain/anatomy & histology , Physical Fitness/physiology , Cardiorespiratory Fitness , Cerebrum/anatomy & histology , Child , Dietary Supplements , Female , Hand Strength , Humans , Magnetic Resonance Imaging , Male , SpainABSTRACT
BACKGROUND: The risk for major depression and obesity is increased in adolescents and adults with attention-deficit / hyperactivity disorder (ADHD) and adolescent ADHD predicts adult depression and obesity. Non-pharmacological interventions to treat and prevent these co-morbidities are urgently needed. Bright light therapy (BLT) improves day-night rhythm and is an emerging therapy for major depression. Exercise intervention (EI) reduces obesity and improves depressive symptoms. To date, no randomized controlled trial (RCT) has been performed to establish feasibility and efficacy of these interventions targeting the prevention of co-morbid depression and obesity in ADHD. We hypothesize that the two manualized interventions in combination with mobile health-based monitoring and reinforcement will result in less depressive symptoms and obesity compared to treatment as usual in adolescents and young adults with ADHD. METHODS: This trial is a prospective, pilot phase-IIa, parallel-group RCT with three arms (two add-on treatment groups [BLT, EI] and one treatment as usual [TAU] control group). The primary outcome variable is change in the Inventory of Depressive Symptomatology total score (observer-blinded assessment) between baseline and ten weeks of intervention. This variable is analyzed with a mixed model for repeated measures approach investigating the treatment effect with respect to all three groups. A total of 330 participants with ADHD, aged 14 - < 30 years, will be screened at the four study centers. To establish effect sizes, the sample size was planned at the liberal significance level of α = 0.10 (two-sided) and the power of 1-ß = 80% in order to find medium effects. Secondary outcomes measures including change in obesity, ADHD symptoms, general psychopathology, health-related quality of life, neurocognitive function, chronotype, and physical fitness are explored after the end of the intervention and at the 12-week follow-up. DISCUSSION: This is the first pilot RCT on the use of BLT and EI in combination with mobile health-based monitoring and reinforcement targeting the prevention of co-morbid depression and obesity in adolescents and young adults with ADHD. If at least medium effects can be established with regard to the prevention of depressive symptoms and obesity, a larger scale confirmatory phase-III trial may be warranted. TRIAL REGISTRATION: German Clinical Trials Register, DRKS00011666. Registered on 9 February 2017. ClinicalTrials.gov, NCT03371810. Registered on 13 December 2017.
Subject(s)
Affect , Attention Deficit Disorder with Hyperactivity/complications , Attention Deficit Disorder with Hyperactivity/therapy , Depression/prevention & control , Exercise Therapy/methods , Exercise , Pediatric Obesity/prevention & control , Phototherapy/methods , Telemedicine/methods , Adolescent , Adult , Age Factors , Attention Deficit Disorder with Hyperactivity/physiopathology , Attention Deficit Disorder with Hyperactivity/psychology , Clinical Trials, Phase II as Topic , Comorbidity , Depression/etiology , Depression/psychology , Europe , Exercise Therapy/adverse effects , Female , Humans , Male , Multicenter Studies as Topic , Pediatric Obesity/etiology , Pediatric Obesity/physiopathology , Phototherapy/adverse effects , Pilot Projects , Prospective Studies , Randomized Controlled Trials as Topic , Risk Factors , Time Factors , Treatment Outcome , Young AdultABSTRACT
INTRODUCTION: although ï¢-hydroxy-ï¢-methylbutyrate (HMB) is generally marketed as a supplement for increasing muscle mass and strength, it is still not fully understood how and in which particular sports and conditions HMB can be more effective. AIMS: the primary purpose of this review is to update and summarize the current knowledge about the usefulness of HMB and to organize this information by different sports with specific reference to sports with high wear and tear phenomena as soccer, rugby or football. METHODS: a search was performed in PubMed database. This review presents the results about HMB use in sport. RESULTS: the articles identified in this review support the notion that HMB could help to attenuate tissue catabolism and initiate muscle anabolism particularly in untrained individuals exposed to strenuous exercise or when trained individual are exposed to periods of high physical stress. HMB could therefore be applied in some specific periods of athlete's season where there are high-intensity training periods, high density of competitions and little recovery time between them, starting recovery phases from an injury period and/or any other different situation where performance or recovery could be affected by a great catabolic environment. CONCLUSION: this update contributes to clarify and define possible mechanisms and/or effectiveness of HMB supplementation related to endurance sports (i.e. cycling and athletics), strength-power sports (i.e. resistance training, football, rugby, soccer, judo, waterpolo and rowing) and recreational activities.
Introducción: aunque el ï¢-hidroxi-ï¢-metilbutirato (HMB) se ha empleado generalmente como suplemento para aumentar la masa muscular y la fuerza, es necesario un mejor entendimiento de su función y averiguar en qué deportes es más efectivo. Objetivos: el objetivo principal de esta revisión es actualizar y resumir el conocimiento existente en torno a la utilización del HMB para clasificarla en función de cada modalidad deportiva, con especial mención a aquellas actividades con un alto grado de destrucción muscular, como pueden ser el fútbol, el rugby o el fútbol americano. Métodos: se utilizó la base de datos PubMed para la búsqueda de artículos. Esta revisión presenta los resultados sobre la utilización de HMB clasificados por deportes. Resultados: la mayoría de los artículos seleccionados sugieren que cuando una persona entrenada o no entrenada se somete a un ejercicio intenso o diferente al habitual, el HMB puede atenuar el catabolismo muscular producido e iniciar los procesos anabólicos necesarios para recuperar lo antes posible. De esta forma, el HMB podría aplicarse en algunos momentos concretos de la temporada deportiva en los que hubiera períodos con entrenamientos de alta intensidad, o durante un periodo con alta densidad competitiva y con poca recuperación entre competiciones, o bien durante las primeras fases de la readaptación física después de una lesión y/o durante cualquier otra situación en la que el rendimiento o la recuperación se pueden ver afectados por un entorno altamente catabólico. Conclusión: esta revisión pretende aclarar y definir los posibles mecanismos por los que la suplementación con HMB puede ser efectiva en deportes de resistencia (ciclismo y carreras de fondo), en deportes de fuerza-potencia (fútbol, yudo, waterpolo, remo, fútbol americano y musculación) y en actividades deportivas recreacionales.
Subject(s)
Dietary Supplements , Sports , Valerates , Athletic Performance , Energy Metabolism , Humans , Muscle Strength/drug effects , Physical Endurance/drug effects , Signal Transduction , Valerates/administration & dosage , Valerates/metabolism , Valerates/pharmacologyABSTRACT
La capacidad cardiorrespiratoria es un potente indicador de salud presente y futura en niños y adolescentes, sin embargo se desconoce si también lo es para niños de edad reescolar, de 3 a 5 años. En el presente estudio, describimos la adaptación a preescolares del test original de 20m de ida y vuelta, su viabilidad y asimilación en niños de 3 a 5 años, así como su maximalidad y fiabilidad. Un total de 130 alumnos (4,91 ± 0,89 años; 77 niños), realizaron el test dos veces, con dos semanas de separación. La adaptación del test consistió principalmente en reducir la velocidad inicial de 8,5 km/h a 6,5 km/h. El test fue viable y tuvo una buena asimilación tanto en niños como en niñas y en los tres grupos de edad, 3, 4 y 5 años. La frecuencia cardíaca máxima (FCmáx) alcanzada para la muestra completa fue de 199,4 ± 12,5 latidos/minuto, equivalente a un 97% de la FCmáx teórica estimada, y sin diferencias significativas por sexo o edad. La diferencia de medias test-retest (error sistemático) en el número de vueltas alcanzado fue de 2 vueltas, sin diferencias por sexo o edad. No hubo evidencia de heterocedasticidad. Nuestros resultados sugieren que el test es máximo y fiable en este grupo de edad. Futuros estudios de intervención o longitudinales que utilicen este test deberían tener en cuenta que cambios en el rendimiento en el test de 2 vueltas podrían deberse a la propia variabilidad de la medida, mientras que cambios de mayor magnitud podrían ser atribuibles a la intervención o cambios asociados a la edad (AU)
Cardiorespiratory fitness is a strong indicator of present and future health in children and adolescents, however it is unknown whether it is for pre-schoolers, from 3 to 5 years. In the present study, we described the adaptation of the original 20m shuttle run test, it feasibility and acceptance in children from 3 to 5 years and its maximality and reliability. A total of 130 students (4.91 ± 0.89 years; 77 boys) performed the test twice, two weeks apart. The test adaptation consisted mainly in reducing the initial speed of 8.5 km/h to 6.5 km/h. The test was feasible and was well accepted in both boys and girls and the three age groups, 3, 4 and 5 years. The maximum heart rate (MHR) achieved for the entire sample was 199.4 ± 12.5 beats/min, equivalent to 97% of the estimated theoretical MHR, and no significant differences by gender or age. Mean test-retest difference (systematic error) in the number of laps achieved was 2 laps, with no significant differences between sex or age. There was no evidence of heteroscedasticity. Our results suggest the test is maximum and reliable in this age group. Future longitudinal or intervention studies using this test should take into account that changes in the test performance of 2 laps may be due to the variability of the measure, while wider changes would be attributable to the intervention or changes associated with age (AU)
Subject(s)
Humans , Male , Female , Child, Preschool , Respiration/genetics , Breathing Exercises/instrumentation , Breathing Exercises/methods , Overweight/classification , Overweight/complications , Breathing Exercises/classification , Breathing Exercises , Overweight/metabolism , Overweight/prevention & controlABSTRACT
BACKGROUND: The al-Andalus physical activity intervention study is a randomised control trial to investigate the effectiveness of a land- and water-based exercise intervention for reducing the overall impact of fibromyalgia (primary outcome), and for improving tenderness and pain-related measures, body composition, functional capacity, physical activity and sedentary behaviour, fatigue, sleep quality, health-related quality of life, and cognitive function (secondary outcomes) in women with fibromyalgia. METHODS/DESIGN: One hundred eighty women with fibromyalgia (age range: 35-65 years) will be recruited from local associations of fibromyalgia patients in Andalucía (Southern Spain). Patients will be randomly assigned to a usual care (control) group (n = 60), a water-based exercise intervention group (n = 60) or a land-based exercise intervention group (n = 60). Participants in the usual care group will receive general physical activity guidelines and participants allocated in the intervention groups will attend three non-consecutive training sessions (60 min each) per week during 24 weeks. Both exercise interventions will consist of aerobic, muscular strength and flexibility exercises. We will also study the effect of a detraining period (i.e., 12 weeks with no exercise intervention) on the studied variables. DISCUSSION: Our study attempts to reduce the impact of fibromyalgia and improve patients' health status by implementing two types of exercise interventions. Results from this study will help to assess the efficacy of exercise interventions for the treatment of fibromyalgia. If the interventions would be effective, this study will provide low-cost and feasible alternatives for health professionals in the management of fibromyalgia. Results from the al-Andalus physical activity intervention will help to better understand the potential of regular physical activity for improving the well-being of women with fibromyalgia. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT01490281.
Subject(s)
Exercise Therapy/methods , Fibromyalgia/therapy , Immersion , Research Design , Water , Adult , Aged , Cognition , Female , Fibromyalgia/diagnosis , Fibromyalgia/physiopathology , Fibromyalgia/psychology , Health Status , Health Status Indicators , Humans , Middle Aged , Pain Measurement , Quality of Life , Recovery of Function , Spain , Surveys and Questionnaires , Swimming Pools , Time Factors , Treatment OutcomeABSTRACT
OBJECTIVE: To evaluate and compare the effectiveness of a 16-week multidisciplinary (exercise plus psychological therapy) and biodanza intervention in women with fibromyalgia. PATIENTS AND METHODS: Thirty-eight women with fibromyalgia were distributed to a 16-week multidisciplinary (3-times/week) intervention (n=21) or Biodanza (1-time/week) intervention (n=17). We assessed tender point, body composition, physical fitness and psychological outcomes (Fibromyalgia Impact Questionnaire, the Short-Form Health Survey 36 questionnaire (SF-36), the Hospital Anxiety and Depression Scale, Vanderbilt Pain Management Inventory (VPMI), Rosenberg Self-Esteem Scale and General Self-Efficacy Scale). RESULTS: We observed a significant group*time interaction effect for the scales of SF-36 physical role (P=0.038) and social functioning (P=0.030) and for the passive coping scale in VPMI (P=0.043). Post hoc analysis revealed a significant improvement on social functioning (P=0.030) in the multidisciplinary group whereas it did not change in the Biodanza group. Post hoc analysis revealed a reduction in the use of passive coping (positive) (P less than 0.001) in the multidisciplinary group. There was no significant interaction or time effect in body composition and physical fitness. CONCLUSIONS: 16 weeks of multidisciplinary intervention induced greater benefits than a Biodanza intervention for social functioning and the use of passive coping strategies in women with fibromyalgia.
Subject(s)
Fibromyalgia/therapy , Combined Modality Therapy , Dance Therapy , Exercise Therapy , Female , Fibromyalgia/psychology , Humans , Middle Aged , Pain Management/methods , PsychotherapyABSTRACT
The study aimed to determine the effects of a 4-month Tai Chi intervention on tenderness, functional capacity, symptomatology, and quality of life in men with fibromyalgia. The effect of a 3-month detraining period was also analyzed. Six men with fibromyalgia (age 52.3 ± 9.3 years) followed a 4-month Tai Chi intervention. The outcome variables were tenderness, functional capacity (30-second chair stand, handgrip strength, chair sit and reach, back scratch, blind flamingo, 8 feet up and go, and 6-minute walk tests), and self-administered questionnaires. A significant improvement (p = .028) after the intervention period for the chair sit and reach test was found, such improvement was maintained after the detraining phase. Tenderness, symptomatology, and quality of life did not significantly change after the intervention period or the detraining phase. In summary, a 4-month Tai Chi intervention improved lower body flexibility in men with fibromyalgia. This improvement persisted after the detraining period.
Subject(s)
Exercise Therapy/methods , Fibromyalgia/psychology , Fibromyalgia/therapy , Quality of Life/psychology , Tai Ji , Activities of Daily Living , Arthralgia/pathology , Arthralgia/psychology , Arthralgia/therapy , Depression , Exercise Test , Fibromyalgia/pathology , Health Status Indicators , Humans , Male , Men's Health , Middle Aged , Pain Measurement , Self Report , Spain , Statistics as Topic , Surveys and Questionnaires , Time Factors , Treatment OutcomeABSTRACT
OBJECTIVE: The objective of this study was to determine the effects of a 3-month Biodanza intervention in women with fibromyalgia (FM). DESIGN: This was a controlled trial. SETTING/LOCATION: The study was conducted at a university research laboratory and social center. SUBJECTS: The study comprised 59 women with FM recruited from a local association of patients with FM. Participants were allocated to the Biodanza intervention group (n = 27) or usual-care group (n = 32). INTERVENTION: The Biodanza intervention was carried out once a week for 3 months. OUTCOME MEASURES: The outcome measures included the following: Pain threshold, body composition (body-mass index and estimated body fat percentage), physical fitness (30-second chair stand, handgrip strength, chair sit and reach, back scratch, blind flamingo, 8 feet up and go, and 6-minute walk test) and psychologic outcomes (Fibromyalgia Impact Questionnaire [FIQ], Short-Form Health Survey 36, Vanderbilt Pain Management Inventory, Hospital Anxiety and Depression Scale, General Self-Efficacy Scale, and Rosenberg Self-Esteem Scale). RESULTS: We observed a significant interaction effect (group*time) for pain threshold of several tender points (left [L] and right [R] side of the anterior cervical and supraspinatus, trapezius L and lateral epicondyle R, algometer score, tender points count), body fat percentage, and FIQ total score. In the intervention group, post hoc analysis revealed a significant improvement in pain threshold of the anterior cervical R and L and supraspinatus R and L tender points (all p < 0.05), algometer score (p = 0.008), tender point count (p = 0.002), body fat percentage (p = 0.001), and FIQ total score (p = 0.003). CONCLUSIONS: A 3-month (one session per week) Biodanza intervention shows improvements on pain, body composition, and FM impact in female patients.