Injury Risk Analysis among Judo Athletes with Intellectual Disabilities.

The main aim of this study was to evaluate injury prevalence, incidence rate, and burden in judo athletes with intellectual disabilities (ID) who participate in international competitions. This retrospective cross-sectional study analyzed data from the past year for 182 judo athletes with ID. Data was collected using a self-reported questionnaire, adapted from previous research, that included questions about injuries impacting training or competition, injury type, mechanism, severity, diagnosis, and location on the body. The injury prevalence among judo athletes with ID occurred most often during training (68.2%) and primarily affected the lower extremities (35%). Age group and injury prevalence were significantly related (χ2=7.91; P=0.04), while gender, weight, and ability level were not. Results were closer to those previously reported for conventional judo, which is likely due to the lower practice intensity among judo athletes with ID. Injury prevalence was lower than in prior studies, but the incidence rates aligned when considering training time in judo athletes with ID. Injury burden analysis revealed that females had a lower burden than males, while older athletes experienced a higher burden than younger athletes. Most injuries occur during training, which is likely attributable to safety-focused competition rules.

Aerobic exercise training reduces deep-frying oil-induced apoptosis of hippocampal tissue by reducing oxidative stress in male rats.

Deep-frying oil (DFO) contains high amounts of free radicals, and consuming foods prepared with this method causes damage to nervous tissue due to oxidative stress (OS). Since moderate-intensity aerobic exercise training (AT) reduces OS, the current search investigated the effects of AT on OS, apoptosis, and neurogenesis markers in the hippocampal tissue of DFO-fed rats. Eighteen Wistar male rats (200-280 gr) were randomly allocated to a control group fed with normal food (Con-ND), a control group receiving DFO (Con-DFO), and a group receiving DFO-aerobic exercise (EX-DFO) (n = 6 in each). DFO was gavaged for four weeks, five days a week, with a dose of 2 ml. AT included running on a treadmill for four weeks and five sessions per week (40 min per session). The expression of genes B-cell lymphoma 2 (BCL-2), Protein X associated with Bcl-2 (BAX), Caspase-3 (Casp-3), and Caspase-9 (Casp-9) was measured by PCR method. The ELISA method was used to calculate levels of Superoxide dismutase (SOD) and Catalase (CAT) activity, malondialdehyde (MDA), and Brain-Derived Neurotrophic Factor (BDNF). Also, the expression of the proteins Cannabinoid receptor type 1(CB1), Cannabinoid receptor type2 (CB2), Glial fibrillary acidic protein (GFAP), Neuronal nuclei (NeuN), and DNA fragmentation was evaluated by Immunohistochemical and TUNEL staining. DFO feeding led to a significant increase in apoptotic markers, such as BAX, Casp-3, and Casp-9 gene expression, and DNA fragmentation (p ≤ 0.05) while decreasing BDNF concentration SOD activity (p ≤ 0.05). AT significantly reduced the BAX, Casp-3, Casp-9, MDA, CB1, GFAP, and DNA fragmentation (p ≤ 0.05). In conclusion, AT can reduce the harmful effects of feeding with DFO on the hippocampal tissue.

Effects of Socioeconomic Environment on Physical Activity Levels and Sleep Quality in Basque Schoolchildren.

The socioeconomic and built environment of an area are interrelated with health data and have a direct influence on children's development. There are facilitators and barriers for schools to promote physical activity depending on the socioeconomic status of the school. The aim of this study was to analyse the relationship between physical activity and sleep and the socioeconomic level of children in the Basque Country. The sample consisted of 1139 schoolchildren between the ages of six and seventeen (566 boys and 573 girls) from 75 schools (43 public and 32 private). Differences between groups were compared using the Mann-Whitney U test (two samples), Kruskal-Wallis one-factor ANOVA (k samples), and Spearman's Rho correlation. There are sex differences in light (200.8 ± 62.5 vs. 215.9 ± 54.7) and moderate (69.0 ± 34.3 vs. 79.9 ± 32.1) physical activity in favour of the female group of higher socioeconomic status compared to male group of higher socioeconomic status. In the case of vigorous physical activity, the female group performed less than the male group across all socioeconomic statuses, which was statistically significant in the groups of high socioeconomic status (11.6 ± 9.3 vs. 6.9 ± 5.7) in group 2 and medium socioeconomic status (11.1 ± 9.3 vs. 7.7 ± 6.1) in group 3. There is an inverse relationship between sedentary behaviour and BMI, total bed time, total sleep time, and night-time awakenings. There is also an inverse relationship between all levels of physical activity performed with respect to BMI and total sleep efficiency. These data point towards notable inequalities in physical activity and daily sleep in Basque schoolchildren, which in turn may be marginalised in our current school system due to the effects of the socioeconomic environment.

Impact of COVID-19 lockdown on physical activity, insomnia, and loneliness among Spanish women and men.

During COVID-19 pandemic, quality of living was impacted by social isolation, loneliness, and altered sleep habits. The aims of this study were (1) to examine the relationship between physical activity (PA) levels with insomnia and loneliness among adults during Spain's first COVID-19 wave of lockdown and its impact on women and (2) to examine the digital technologic resources used to support both PA and other recreational activities in women. A cross-sectional design was used. An anonymous 15-min online survey was conducted in Spain to adults (≥ 18 years old) during the first COVID-19 lockdown, a 40-day period. A snowball distribution method was employed using personal email and social networks (Facebook, Whatsapp, Linkedin, Twitter). Variables studied included: socio-demographic items, insomnia, loneliness, PA, and digital technologic resources. A total of 996 adults (females = 663, 66.6%) completed the survey. Higher education levels were associated with greater PA levels (p-value < 0.001). Women presented with higher insomnia risk than men with low PA levels (OR = 1.9, CI = 1.25; 2.95). Living with family members or other individuals was related to lower insomnia risk. A strong correlation between medium-high PA levels was found with greater digital technology resources (DTS) than individuals with low PA levels. Females used significantly more DTS than males (p-value < 0.001). No significant associations between DTS were found with age or academic education level. PA levels, sex, and loneliness were related to insomnia risk. A strong correlation between PA and DTS use was observed. Participants with medium-high PA levels and females use them more than those with low PA levels and males. We recommend promoting the PA through digital technologies for women. This recommendation would also improve sleep disorders in women who present higher insomnia risks than men.

Physical Activity Levels and Sleep in Schoolchildren (6-17) with and without School Sport.

There is strong evidence to support the association between daily physical activity and sleep parameters in children and adolescents. Physical activity and outdoor play are favourably associated with most sleep outcomes in school children. The aim is to find out the levels of physical activity and the quality of sleep in Basque schoolchildren aged between six and seventeen and to analyse the possible differences between those who carry out some kind of physical sports activity and those who do not. The sample consisted of 1082 schoolchildren (50.1% male and 49.9% female). Differences between groups were compared using the Mann-Whitney U test (2 samples) and Kruskal-Wallis one-factor ANOVA (k samples). A total of 723 (66.94%) of the participants said they practiced some physical sports activity. The accelerometers obtained significant differences in all levels of physical activity, as well as in sleep efficiency, with higher levels of physical activity (sedentary p = 0.001; light p = 0.017; moderate p = 0.009; vigorous p = 0.001 and moderate-to-vigorous physical activity p = 0.002) and better sleep efficiency (p = 0.002) in those schoolchildren who perform some type of physical sports activity. A significant difference in time spent in sedentary activities was also observed between primary and secondary school pupils of both sexes and regardless of the degree of physical sports activity completion.

Effects of a Long-Term Adapted Judo Program on the Health-Related Physical Fitness of Children with ASD.

Physical fitness is one of the most important physical and mental health aspects for children with Autism Spectrum Disorder (ASD). This study aimed to test the effects of a long-term adapted judo program on the health-related physical fitness of children with ASD. The participants were recruited from various associations of families and schools for children with special needs. Twenty-one children were assigned to an experimental group and nineteen to a control group. The experimental group participated in a six-month adapted judo program consisting of 90 min of practice each week. Health-related physical fitness was measured using the indicators obtained from the ALPHA-fitness battery, the estimated VO2max and the waist/height ratio0.5. Changes within and between groups were analyzed using linear mixed models for repeated measures designs and test-retest reliability of tests requiring a maximum score using the Intraclass Correlation Coefficient (ICC). A judo program tailored for children with ASD can improve the cardio-metabolic health and cardiorespiratory fitness of its participants. The problems involved with administering physical aptitude tests that involve maximum effort or performance in children with ASD cast serious doubts on the reproducibility of their results.

Aerobic Capacity in Adults with Congenital Heart Disease: More than VO2peak, a Follow-Up Study.

To control the development of people with congenital heart disease (CHD), it is important to follow their aerobic capacity (AC), especially when they exercise. This research aimed to study the progress of AC during a follow-up of adults with CHD. This is a longitudinal study which involved 127 adults with a mean age of 33.8 (11.1) years (57.5% female; 75 moderate CHD and 52 complex CHD) who had undergone two cardiopulmonary exercise tests (CEPT) in at least one year between the first and the second test. The AC and exercise performance (EP) (duration of exercise time, velocity and percentage of grade) were assessed using a ramp protocol over a treadmill. In a mean of 4.5 (2.0) years of follow-up, there was a significant decrease in AC. The VO2peak at baseline was 27.8 (27.7) mL/kg/min (82.9% (20.3%) predicted) versus 26.6 (7.8) mL/kg/min (79.3% (20.8%) predicted) at the end of follow-up. This decline was independent of the body weight increase. There was no significant difference in HRpeak and EP among periods. These results suggest a sign of favorable evolution of adults with CHD. More research is needed to study different factors that could contribute to AC reduction.

Self-management strategies and multicomponent training to mitigate the effects of the interruption of physical exercise programmes in the pandemic context on functionality, sedentary behaviour, physical capacity, mental health, body composition and quality of life in older adults: a blinded randomized controlled study protocol.

BACKGROUND: Considering the confinement recommended by the World Health Organization due to the pandemic caused by COVID-19, many community physical exercise programmes for older adults have had their activities cancelled. In this context, proposing strategies to recover the possible adverse effects of the confinement period is pertinent. The use of self-management strategies associated with regular physical activity reduces sedentary behaviour and improves physical capacity in older adults. Thus, the purpose of this study was to describe a multicomponent training programme combined with a self-management strategy protocol to mitigate the effects of interruptions in physical exercise programmes on functionality, physical capacity, mental health, body composition and quality of life in older adults. METHODS: This will be a blinded, randomized and controlled clinical trial performed in São Carlos, SP, Brazil. Eighty older adults will be divided into two groups: multicomponent training (Multi) and multicomponent training + self-management strategies (Multi+SM). The intervention will be performed over 16 weeks on three alternate days of every week, with 50-min sessions. The assessment of physical capacity will be performed before the interruption of physical exercise programmes (T0: initial assessment, March 2020), preintervention (T1: immediately after the return of the exercise programme) and postintervention (T2). The assessments of physical activity level, quality of life, mental health, functionality and body composition will be performed at T1 and T2. DISCUSSION: The results from this MC+SM protocol will allow us to contribute clinical support to evaluate the variables analysed and to guide future public health policies with the aim of minimizing the possible deleterious effects arising from the physical exercise interruption periods caused by epidemics and pandemics. TRIAL REGISTRATION: RBR-10zs97gk . Prospectively registered in Brazilian Registry of Clinical Trials (ReBEC) on 17 June 2021. Registry name: Use of self-management strategies combined with multicomponent training to mitigate the effects of social distancing due to COVID-19 on capacity, physical capacity, mental health and quality of life in older adults - A blind, randomized and controlled clinical trial.

Hemodynamic and cardiorespiratory responses to submaximal and maximal exercise in adults with Down syndrome.

Introduction: The genetic disorder causing Down syndrome (DS) affects the cardiorespiratory and hemodynamic parameters. When exercising, sufficient blood flow is necessary for active muscles. Cardiac output (Q) must be proportional to the peripheral requirements. In case the stroke volume (SV) is lower, the heart rate (HR) will increase further in order to maintain an adequate blood flow in the active territories (HR compensatory response). People with DS have a lower HR response to maximal exercise. Nevertheless, the response of the hemodynamic and cardiorespiratory parameters during the submaximal phases of maximal exercise was not well studied. Objective: to evaluate cardiorespiratory and hemodynamic parameters 1) during submaximal and 2) maximal metabolic treadmill test in individuals with and without DS. Methods: fifteen adults with DS (age = 27.33 ± 4.98 years old; n = 12 males/3 females) and 15 adults without disabilities, matched by age and sex, participated in this cross-sectional study. Peak and submaximal cardiorespiratory and hemodynamic parameters were measured during a treadmill test. Linear mixed-effects models were used to analyse interactions between the variables. Post-hoc analyses were employed to assess within and between-group differences. Results: The DS group showed lower peak values for ventilation (VE), respiratory exchange ratio (RER), tidal volume (VT), ventilatory equivalent for O2 (VEqO2), end-tidal partial pressure for O2 (PETO2), O2 uptake (VO2) and CO2 production (all p < 0 .050), Q, SV, systolic and diastolic blood pressure (SBP, DBP), and HR (all p < 0 .050). There were group-by-time interactions (all p < 0 .050) for all ventilatory submaximal values. Significant group and time differences were observed for VE; RER; respiratory rate (RR); VEqO2; PETO2; VO2, and VT (all p < 0 .050). There were also group-by-time interactions (all p < 0 .050) and group and time differences for SBP, mean arterial blood pressure (MAP) and HR (all p < 0.010). Conclusion: During submaximal exercise, we verified a compensatory response of HR, and greater VE and VO2 in the individuals with DS. In addition, we were able to observe that the DS group had a reduced SBP and MAP response to submaximal exercise. On the other hand, we found that adults with DS have lower peak hemodynamic and cardiorespiratory values, and a lower cardiac reserve. Further research is warranted to investigate the effects of these results on the general health of adults with DS and the impact of long-term exercise programs on these parameters.

Serious Games for Executive Functions Training for Adults with Intellectual Disability: Overview.

(1) Background: Throughout the history of medical and psychology practice, specialists have worked to improve the quality of treatment and rehabilitation, which has led to the emergence of concepts such as serious games. These tools focus on different areas of intervention procedures, one of which is to help people with intellectual disability (ID). Individuals with ID have problems with executive functions (EFs), which are related to adaptive functioning. Recent studies showed that serious games positively impact cognitive, social, and communication skills in people with ID. The purpose of this study is to analyze the solutions that have been found in EF training for adults with ID in recent years, evaluating them with a number of key parameters and identifying the features and possible problems in the further development of our system. (2) Methods: A review was conducted starting with 573 articles in English related to serious games and selected from studies that had been published since 2015. Finally, 10 were examined in detail as they focused on EFs in adults with ID. They were searched in seven major databases ("Association for Computing Machinery" (ACM), IEEE Xplore database, DBLP computer science bibliography, Google Scholar, PubMed, SCOPUS, and PsycInfo). (3) Results: It was determined that the most frequent EFs referred to in the studies analyzed were planning and decision-making, followed by working memory and social cognition, behavioral regulation, flexibility, and inhibition capacity. The basic approach to the creation of support systems was also analyzed in terms of technical and program execution. The trend results' analysis evidenced improvements in EFs, even though they were not significant. This comprehensive technique enabled the identification of the main features and aspects to be taken into account for further development of our system.

The association between social capital indicators and psychological distress in Catalan adolescents.

According to the WHO, globally, one in seven adolescents experiences a mental disorder, being in a detrimental situation toward educational achievement, social cohesion, future health and life chances. Calls to identify risk and resilience factors to develop effective preventive actions have been made. Following a systemic approach, we conducted a cross-sectional study on the relationship between social capital and psychological distress in a sample of Catalan adolescents in Barcelona, taking into account a range of other relevant aspects at different levels influencing mental health, including gender, age, migrant status, family background, lifestyle factors, body mass index, and self-rated health. Data were collected through validated questionnaires in December 2016 from 646 of 14- to 18-year-old adolescents from three public and private high schools in Barcelona (Spain). Data analysis included descriptive analysis, a correlational study and logistic regression to obtain the odds ratio for social capital indicators to be associated with psychological distress. Our results suggest that reporting higher levels of family support and higher levels of teacher-student trust reduce the likelihood of suffering psychological distress. Higher levels of neighborhood informal control were associated with mental health, but a possible detrimental effect cannot be ruled out. Being a girl, reporting low self-rated health or higher media use was also associated with higher likelihood of psychological distress. Current results may encourage interventions that focus on social capital as a means to reduce psychological distress and foster well-being in youth.

Adherence to eHealth-Delivered Exercise in Adults with no Specific Health Conditions: A Scoping Review on a Conceptual Challenge.

Adherence has emerged as a focal point and critical determinant of success for physical activity interventions. The term is used for both traditional and digital interventions, and for prescribed and nonprescribed activities. Many other terms for adherence are being used interchangeably, as there is no consensus on its precise conceptualization. This scoping review aimed to advance the definition of adherence to eHealth programs, specifically for the adult population with no specific health conditions. A total of 2983 papers, published between 1 January 2016 and 13 March 2022, were retrieved from different databases (including grey literature). Of those, 13 studies met the eligibility criteria and were included for review. The selected studies used a wide array of technologies and consisted mainly of exercise interventions. Most of the reviewed publications contemplated exercise adherence as a percentage of expected dose. Most (8 out of 13) studies neither assessed nor specified an expected use of the involved technology. Results suggest a need for homogeneity in the conceptualization of adherence to physical activity and exercise, including those interventions delivered digitally.

Effects of exercise on fitness in adults with intellectual disability: a protocol of an overview of systematic reviews.

INTRODUCTION: Adults with intellectual disability (ID) have lower physical fitness levels than their peers without disabilities, representing a risk to their health since physical activity and cardiorespiratory fitness are directly related to better health and quality of life. Therefore, it is essential to determine the effects that exercise can have on them, as adults with ID present high comorbidities and lower life expectancy, altogether with lower rates of physical activity. The current overview of systematic reviews aims to provide an outline of the exercise benefits in health-related and skill-related fitness in adults with ID. METHODS AND ANALYSIS: Research will be conducted in PubMed, CENTRAL, EMBASE, PEDro, SPORTDiscus and CINAHL. The search terms will be categorised through population (eg, adult, ID); intervention (eg, exercise, physical activity) and outcomes (eg, cardiorespiratory fitness, body composition, muscular strength, muscular endurance, flexibility, balance, power, speed, agility, coordination, mobility and reaction time). Each database will be searched from their earliest available record up to 30 September 2021.Inclusion criteria will be: systematic reviews including at least one RCT that compare exercise interventions with a control group or another type of intervention; measure of fitness using objectives methods; inclusion of adults with ID (≥18 years old), and published in any language, with at least their abstract in English, Spanish, French and/or Portuguese. ETHICS AND DISSEMINATION: To our knowledge, our overview will be the first of its kind to address the topic in people with ID. The results could be used to determine which fitness components can be improved by exercise and to provide a valuable tool to develop comprehensive exercise programmes specific to people with ID. Ethical approval is not required. The knowledge generated will be disseminated electronically and in print and presented at conferences. PROSPERO REGISTRATION NUMBER: CRD42021237580.

Level of Physical Activity, Sedentary Behavior, and Sleep in the Child and Adolescent Population in the Autonomous Community of the Basque Country (6-17 Years Old): Protocol for the Mugikertu Study.

BACKGROUND: Physical inactivity and sedentary behavior are increasingly common problems in the general population, which can lead to overweight, obesity, diabetes, cardiovascular disease, and decreased motor and cognitive capacity among children and adolescents. Establishing healthy habits in childhood on the basis of the World Health Organization's 2020 Physical Activity Guidelines is essential for proper physical, motor, and cognitive development. OBJECTIVE: The primary aim of this study is to describe the level of physical activity (PA), sedentary behavior, and sleep of the child and adolescent population from 6 to 17 years of age in the Basque Autonomous Community (BAC). Our secondary aim is to establish a starting point for future research and intervention protocols to improve the existing reality. METHODS: This cross-sectional study aims to recruit 1111 children and adolescents, aged 6 to 17 years from the BAC in a representative random sample. Participants will wear the ActiGraph WGT3X-BT triaxial accelerometer for 7 consecutive days in their nondominant wrist, and fill out a habit diary log of PA, mobility, and sleep routine. PA intensities, sedentary behavior, and sleep parameters (total bedtime, total sleep time, and sleep efficiency) will be calculated from raw accelerometer data using SPSS (IBM Corp). Participants will be randomly selected. RESULTS: The results of this study intend to demonstrate significant differences in PA levels in different age and gender groups since the volume of school PA in the BAC decreases as the age of the schoolchildren increases. The total study sample includes 1111 participants. In April 2021, up to 50% of the sample size was reached, which is expected to increase to 100% by April 2022. This sample will allow us to analyze, discuss, compare, and assess the reality of the school population, in a sensitive period of adherence to behavior patterns, using data from the geographical and administrative area of the BAC. This study will provide a realistic insight into PA levels among children and adolescents in the BAC. It will also offer scientific contributions on the positive relationship between PA levels and sleep quality in this population. CONCLUSIONS: This study might highlight the need for the promotion of cross-sectional policies so that children and adolescents may increase their levels of PA, thus improving both the school environment and positive healthy behavior. TRIAL REGISTRATION: ISRCTN Registry ISRCTN65573865; https://www.isrctn.com/ISRCTN65573865. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/31325.

Association of Self-Reported and Device-Measured Sedentary Behaviour and Physical Activity with Health-Related Quality of Life among European Older Adults.

Human movement behaviours such as physical activity (PA) and sedentary behaviour (SB) during waking time have a significant impact on health-related quality of life (HRQoL) in older adults. In this study, we aimed to analyse the association between self-reported and device-measured SB and PA with HRQoL in a cohort of community-dwelling older adults from four European countries. A subsample of 1193 participants from the SITLESS trial (61% women and 75.1 ± 6.2 years old) were included in the analysis. The association between self-reported and objective measures of SB and PA with HRQoL were quantified using Spearman's Rho coefficients. The strength of the associations between self-reported and device-measured PA and SB with self-rated HRQoL (mental composite score, MCS; physical composite score, PCS) were assessed through multivariate multiple regression analysis. Self-reported and device-measured PA and SB levels showed significant but poor associations with PCS (p < 0.05). The association with MCS was only significant but poor with self-reported light PA (LPA) and moderate-to-vigorous PA (MVPA). In conclusion, the findings of this study suggest that both self-reported and device-measured PA of all intensities were positively and significantly associated, while SB was negatively and significantly associated with the PCS of the SF-12.

Cardiac Autonomic Modulation Response Before, During, and After Submaximal Exercise in Older Adults With Intellectual Disability.

The analysis of the heart rate variability (HRV) consists of changes in the time intervals between consecutive R waves. It provides information on the autonomic nervous system regulation and it is a predictor of adverse cardiovascular events. Several studies analyzed this parameter in youth and adults with Intellectual Disability (ID). Nevertheless, there is a lack of information regarding the HRV before, during, and after exercise in older adults with ID. Therefore, we aimed to describe and compare the cardiac autonomic modulation before, during, and after the six-minute walk test (6MWT) in older adults with and without ID. Twenty-four volunteers with ID and 24 without ID (non-ID) participated in this study. HRV was assessed by R-R intervals at rest, during and after the 6MWT. At rest and recovery periods, the participants remained sited. The symbolic analysis was used to evaluate non-linear HRV components. The recovery HR kinetics was assessed by the mean response time, which is equivalent to time constant (τ)+time delay (TD). Between groups differences in HRV variables were not significant. During the recovery period, HR kinetics time variables showed significant better results in non-ID participants (TD: 6±5s vs. 15±11s; τ: 19±10s vs. 35±17s; and MRT: 25±9s vs. 50±11s, all p<0.050). In conclusion, our results suggest that the HRV in older adults with and without ID is similar during rest, exercise, and recovery. Recovery HR kinetics after the 6MWT was slower in older adults with ID. The reason for these results may be a reduced post-exercise vagal rebound in older adults with ID.

Patellar Tendon Structural Adaptations Occur during Pre-Season and First Competitive Cycle in Male Professional Handball Players.

BACKGROUND: While there is evidence that tendon adapts to training load, structural alterations in the patellar tendon in response to training loads are still unclear. The aim of this study is to identify changes in patellar tendon structure throughout pre-season and after finalizing the first competitive cycle. METHODS: Nineteen professional handball players participated in the aforesaid cross-sectional study, in which patellar tendon scan and counter movement jump (CMJ) performance were conducted. Measurements were taken on the first and last day of pre-season training, and at the end of the first competitive cycle. RESULTS: The results revealed that variation on the tendon structure occurred, mainly at the end of pre-season training; for injured tendons this occurred at the proximal (Right p = 0.02), distal (Right p = 0.01), and (Left p = 0.02) tendon, while changes in healthy tendons occurred at the mid (Left p = 0.01) and distal tendon (Right p = 0.01). At the end of the first competitive cycle, changes were observed in the distal injured tendon (p = 0.02). CONCLUSION: Patellar tendon shows greater structural change after completing pre-season training than at the end of the first competitive cycle, from which it may be inferred that gradual loading during pre-season training allows the tendon to adapt and potentially decrease the onset of patellar tendinopathy.

Executive Functioning in Adults with Down Syndrome: Machine-Learning-Based Prediction of Inhibitory Capacity.

The study of executive function decline in adults with Down syndrome (DS) is important, because it supports independent functioning in real-world settings. Inhibitory control is posited to be essential for self-regulation and adaptation to daily life activities. However, cognitive domains that most predict the capacity for inhibition in adults with DS have not been identified. The aim of this study was to identify cognitive domains that predict the capacity for inhibition, using novel data-driven techniques in a sample of adults with DS (n = 188; 49.47% men; 33.6 ± 8.8 years old), with low and moderate levels of intellectual disability. Neuropsychological tests, including assessment of memory, attention, language, executive functions, and praxis, were submitted to Random Forest, support vector machine, and logistic regression algorithms for the purpose of predicting inhibition capacity, assessed with the Cats-and-Dogs test. Convergent results from the three algorithms show that the best predictors for inhibition capacity were constructive praxis, verbal memory, immediate memory, planning, and written verbal comprehension. These results suggest the minimum set of neuropsychological assessments and potential intervention targets for individuals with DS and ID, which may optimize potential for independent living.

Valores de referencia del SPPB en personas mayores de 60 años en el País Vasco / Reference values for SPPB in people over 60 years of age in the Basque Country

Objetivo: Proporcionar valores de referencia del Short Physical Performance Battery (SPPB) en adultos y adultos mayores en el País Vasco, identificando puntos de corte para medir la fragilidad y comparar los valores con otras poblaciones de España. Emplazamiento: Bilbao capital, País Vasco (España). Participantes: 1.923 personas mayores de 60 años incluidos en el Programa de Salud para Personas Mayores del Ayuntamiento de Bilbao participaron en el estudio. El programa de actividad física (AF) se impartió dos veces por semana durante un mínimo de 12 semanas, con sesiones de 50 minutos. Mediciones principales: Se evaluó a los participantes con la prueba SPPB que evalúa: equilibrio (PE), velocidad de la marcha en 4 m (PM) y la fuerza a través de la prueba de levantarse y sentarse de la silla (PS). Según el resultado obtenido de todas las pruebas, se identificó la funcionalidad de las personas en: limitación grave (cero a cuatro puntos), moderada (cuatro a seis puntos), leve (siete a nueve puntos) y mínima (10 a 12 puntos). Resultados: Edad media 77,9 (5,6) años, siendo el 87,9% mujeres y el 12,1% hombres. La batería SPPB mostro diferencias significativas en la edad (p = 0,000) y género (p = 0,005) Además, se realizó una comparación con una población similar: 70 a 75 años = 0,6 (d de Cohen), 76 a 79 años = 0,98 (d de Cohen) y >80 años = 0,98 (d de Cohen). Conclusiones: El presente estudio señala los valores normativos para SPPB. La funcionalidad de las personas disminuye a medida que avanza la edad. A pesar de los hallazgos actuales que los profesionales de la salud disponen para una detección más eficaz de la fragilidad, muchos de ellos aún no se han traducido a la práctica clínica.(AU)

Purpose: To provide reference values of Short Physical Performance Battery (SPPB) in adults and older adults in the Basque Country by identifying cut-off points for measuring fragility and comparing the values with other populations in Spain. Location: Bilbao capital, Basque Country (Spain). Participants: 1923 people over 60 years old included in the Health Program for the Elderly of the City of Bilbao participated in the study. The PA program was delivered twice a week for a minimum of 12 weeks, with 50-minute sessions. Main measurements: Participants were evaluated with the SPPB, which assesses balance (PE), gait speed test (PM) and chair stand test (PS). Based on the results obtained from all tests, the functionality of the participants was identified as: severe (0–4 points), moderate (4–6 points), mild (7–9 points) and minimal (10–12 points) limitation. Results: Mean age was 77.9 (5.6) years, 87.9% were women and 12.1% were men. The SPPB showed significant differences in age (p = 0.000) and gender (p = 0.005). In addition, a comparison was made with a similar population: 70–75 years = 0.6 (Cohen's d), 76–79 years = 0.98 (Cohen's d), and >80 years = 0.98 (Cohen's d). Conclusions: The present study indicates normative values for SPPB. People's functionality decreases, as they get older. Despite the current findings available to health professionals for more effective detection of fragility, many of them have not yet been translated into clinical practice.(AU)

Cardiorespiratory Coordination During Exercise in Adults With Down Syndrome.

Introduction: Down syndrome (DS) is a chromosomal disorder affecting simultaneously cardiovascular and respiratory systems. There is no research studying the coupling between these systems during cardiorespiratory exercise testing in a population with DS. Cardiorespiratory coordination (CRC), evaluated through principal component analysis (PCA), measures the covariation of cardiorespiratory variables during exercise. Objective: To investigate and compare CRC in adults with and without DS during maximal cardiorespiratory exercise testing. Methods: Fifteen adults with DS and 15 adults without disabilities performed a maximal cardiorespiratory exercise test on a treadmill. First, the slope, and afterward the velocity was increased regularly until participants reached exhaustion. The time series of six selected cardiorespiratory variables [ventilation per minute, an expired fraction of O2, the expired fraction of CO2, heart rate, systolic blood pressure (SBP), and diastolic blood pressure (DBP)] were extracted for the analysis. The number of principal components (PCs), the first PC eigenvalues (PC1), and the information entropy were computed for each group (non-DS and DS) and compared using a t-test or a Mann-Whitney U test. Results: Two PCs in the non-DS group and three PCs in the DS group captured the variance of the studied cardiorespiratory variables. The formation of an additional PC in the DS group was the result of the shift of SBP and DBP from the PC1 cluster of variables. Eigenvalues of PC1 were higher in the non-DS (U = 30; p = 0.02; d = 1.47) than in the DS group, and the entropy measure was higher in the DS compared with the non-DS group (U = 37.5; p = 0.008; d = 0.70). Conclusion: Adults with Down syndrome showed higher CRC dimensionality and a higher entropy measure than participants without disabilities. Both findings point toward a lower efficiency of the cardiorespiratory function during exercise in participants with DS. CRC appears as an alternative measure to investigate the cardiorespiratory function and its response to exercise in the DS population.