Design of a randomised controlled trial of adapted physical activity during adjuvant treatment for localised breast cancer: the PASAPAS feasibility study.

INTRODUCTION: After a diagnosis of localised breast cancer, overweight, obesity and weight gain are negatively associated with prognosis. In contrast, maintaining an optimal weight through a balanced diet combined with regular physical activity appears to be effective protective behaviour against comorbidity or mortality after a breast cancer diagnosis. The primary aim of the Programme pour une Alimentation Saine et une Activité Physique Adaptée pour les patientes atteintes d'un cancer du Sein (PASAPAS) randomised controlled trial is to evaluate the feasibility of implementing an intervention of adapted physical activity (APA) for 6 months concomitant with the prescription of a first line of adjuvant chemotherapy. Secondary aims include assessing the acceptability of the intervention, compliance to the programme, process implementation, patients' satisfaction, evolution of biological parameters and the medicoeconomic impact of the intervention. METHODS AND ANALYSIS: The study population consists of 60 women eligible for adjuvant chemotherapy after a diagnosis of localised invasive breast cancer. They will be recruited during a 2-year inclusion period and randomly allocated between an APA intervention arm and a control arm following a 2:1 ratio. All participants should benefit from personalised dietetic counselling and patients allocated to the intervention arm will be offered an APA programme of two to three weekly sessions of Nordic walking and aerobic fitness. During the 6-month intervention and 6-month follow-up, four assessments will be performed including blood draw, anthropometrics and body composition measurements, and questionnaires about physical activity level, diet, lifestyle factors, psychological criteria, satisfaction with the intervention and medical data. ETHICS AND DISSEMINATION: The study was approved by the French Ethics Committee (Comité de Protection des Personnes Sud-Est IV) and the national agencies for biomedical studies and for privacy. All participants will give written informed consent. The study findings will be disseminated through the scientific public and serve as a foundation for future randomised controlled trials of efficacy.

Rowing performance and estimated training load.

We related the rowing performance and the associated physiological parameters to the training load as estimated by a questionnaire addressing the mean habitual weekly energy expenditure (MHWEE) of twenty-one international and national level oarsmen. The questionnaire also addressed the energy expenditure during training (EET) sessions classified as low- (EE1), moderate- (EE2), and high-intensity (EE3). To evaluate the physiological capability of the oarsmen, they performed incremental exercise to determine their maximal oxygen uptake (V.O(2max)) and the V.O(2) relative to V.O(2max) corresponding to the 4 mmol.l(-1) blood lactate concentration (V.O(2)4 %). The mean work rate sustained during a 2000-m all-out event on a rowing ergometer was considered as the rowing performance. On average, the rowers spent 16.4 +/- 1.0 h.wk(-1) in training with 56 +/- 3 % of the time spent on the water. EET represented 43.5 +/- 1.7 % of MHWEE. Rowing performance and V.O(2max) were both related to MHWEE and EET. Also, rowing performance was related to EE1, EE2, and EE3. In contrast, V.O(2)4 % was not related to the estimated energy expenditures. These results suggest that rowing performance and V.O(2max) are related to training load while V.O(2)4 % was not in the present group of highly trained oarsmen.

[Relation between physical activity, muscle function and IGF-1, testosterone and DHEAS concentrations in the elderly]. / Relations entre l'activité physique, la fonction musculaire et les concentrations en IGF-1, testostérone et DHEAS lors de l'avancée en âge.

OBJECTIVE: Lower amounts of circulating anabolic hormones are thought to accelerate the age related decline in muscle mass and function. Replacement therapies are promising interventions but there are problems with these therapies. Thus alternative strategies should be developed. The age related changes in hormonal status may be probably influenced by exercise. The purpose of this study was: a) to confirm with other methods, more adapted for elderly people, the results of a previous study that has shown relationship between physical activity (PA) and quadriceps muscle function with dehydroepiandrosterone sulphate (DHEAS), insulin like growth factor-1 (IGF-1). Quadriceps muscle power (Pmax) is measured in this new work with a recently developed leg extensor machine and, b) to complete the results of the first study examining simultaneously the relationship between PA, Pmax and cardiorespiratory fitness (VO2max) with DHEAS, IGF-1 and testosterone in a group of healthy elderly people. METHODS: Fifty independent, community dwelling elderly subjects (25 mens and 25 womens) aged from 66 to 84 volunteered to participate in the study. PA was evaluated by the questionnaire and expressed using two activity indices: mean habitual daily energy expenditure (MHDEE) and the daily energy expenditure corresponding to leisure time sports activities (Sports Activity). Pmax and optimal shortening velocity (vopt) were measured on a Ergopower dynamometer. The Pmax was expressed relative to body mass, Pmax/kg (W kg-1), and relative to the mass of the two quadriceps muscles, Pmax/Quadr (W.kgQuadr-1). VO2max has been measured during a maximal treadmill exercise. RESULTS: In women, IGF-1 correlated significantly with MHDEE (r = 0.54, P = 0.004), Pmax/kg (r = 0.54, P = 0.004) and Pmax/Quadr (r = 0.46, P = 0.02), whereas DHEAS with MHDEE (r = 0.54, P = 0.004), Sports Activity (r = 0.65, P < 0.001), VO2max (r = 0.46, P = 0.02), Pmax/kg (r = 0.46, P = 0.02) and Pmax/Quadr (r = 0.55, P = 0.004). No such correlation was found in men. CONCLUSION: These findings confirm that in healthy elderly women physical activity, cardiorespiratory fitness and quadriceps muscle function are similarly related to levels of circulating DHEAS and IGF-1 suggesting a favourable influence of exercise on anabolic hormonal production in the elderly.

Lack of correlation between 6-month fluctuations in habitual physical activity and testosterone. Concentrations in elderly subjects.

BACKGROUND: To examine the influence of long-term modifications in habitual physical activity (PA) on resting total testosterone (TT) concentrations in a group of healthy elderly subjects. EXPERIMENTAL DESIGN: 6-month prospective study. SETTING: University research departments of exercise physiology and geriatric medicine. PARTICIPANTS: thirty-one independent, community dwelling elderly subjects (16 men and 15 women) aged > 65 who volunteered to participate. INTERVENTIONS: correlational study. MEASURES: PA was evaluated by a questionnaire QAPSE (Questionnaire d Activité Physique Saint-Etienne) and expressed by two activity indices: mean habitual daily energy expenditure (MHDEE) and daily energy expenditure corresponding to leisure time sports activities (Sports activity index). RESULTS: Changes in resting TT concentrations were not related to changes in MHDEE (r = -0.28; p = 0.30 and r = -0.001; p=0.99) and Sports activity (r = -0.30; p = 0.26 and r = -0.05; p = 0.85) in men and women, respectively. Similarly, relative (%) changes in TT were not related to relative changes in MHDEE (r = -0.16; p=0.55 and r = 0.17; p=0.55) and Sports activity (r = -0.11; p=0.68 and r = 0.02; p = 0.92). CONCLUSIONS: The levels of habitual PA undertaken by an average senior do not appear to affect TT levels in healthy active elderly men and women.

Quadriceps muscle function in relation to habitual physical activity and VO2max in men and women aged more than 65 years.

The relationship of quadriceps maximal muscle power (Pmax), corresponding optimal shortening velocity (v(opt)), and relative fatigability (Pmax%D) to maximal oxygen uptake (VO2max) and habitual physical activity (PA) was examined in healthy community-dwelling subjects (29 women and 25 men) aged more than 65 years old. PA was evaluated by a questionnaire and expressed using two activity indices: mean habitual daily energy expenditure (MHDEE) and the daily energy expenditure corresponding to leisure time sports activities (Sports Activity). In women, Pmax correlated positively with VO2max (r = .56) and with Sports Activity (rho = .41). Both Sports Activity and Pmax were significant independent predictors of VO2max and accounted for 62% of variance in VO2max. In men, v(opt) was significantly negatively related to MHDEE (r = -.59) and to Sports Activity (rho = -.40). Neither in women nor in men was Pmax%D correlated with VO2max or PA indices. The different relationship of Pmax and v(opt) with VO2max and PA indices suggests that habitual PA may be sufficient in active older women, but not in men, to positively influence quadriceps muscle function. These gender differences may suggest different approaches in exercise programming for elderly women and men.

Leg extensor power and dehydroepiandrosterone sulfate, insulin-like growth factor-I and testosterone in healthy active elderly people.

We examined the association between quadriceps muscle function and serum levels of dehydroepiandrosterone sulphate (DHEAS), insulin-like growth factor I (IGF-I) and testosterone in a group of healthy elderly people. Fifty-three independent, community-dwelling elderly subjects (26 men and 27 women) aged from 66 to 84 years volunteered to participate in the study. Physical activity (PA) was evaluated by a questionnaire. Quadriceps maximal muscle power (Wmax) and optimal shortening velocity (v(opt)) were measured on a friction-loaded non-isokinetic cycle ergometer. The Wmax is expressed in relation to body mass (W(max/kg), W x kg(-1)), and in relation to the mass of the two quadriceps muscles (W(max/Quadr), W x kg(Quadr(-1))). In women, when adjusted for age, anthropometric measurements and PA indices, IGF-I correlated significantly with W(max/kg) (partial correlation: r = 0.59; P = 0.001), W(max/Quadr) (r = 0.58; P = 0.002) and v(opt) (r = 0.53; P = 0.004), whereas DHEAS was correlated significantly with W(max/kg) (r = 0.54; P = 0.003) and W(max/Quadr) (r = 0.58; P = 0.002). No such correlation was found in men. These findings indicate that in healthy elderly women lower values for quadriceps muscle Wmax and v(opt) are related, independently of age, anthropometric measurements and PA indices, to lower circulating levels of DHEAS and IGF-I.

Physical activity, aerobic capacity and selected markers of oxidative stress and the anti-oxidant defence system in healthy active elderly men.

The relationship of oxidative stress and the anti-oxidant defence system to maximal oxygen consumption (VO2max) and habitual physical activity was assessed in 26 elderly men (71.0 +/- 4.2 years) and compared to that of 12 young men (22.1 +/- 5.1 years). Physical activity was assessed by a questionnaire. Malondialdehyde (MDA), plasma total anti-oxidant status (TAS), the levels of red blood cell (RBC) superoxide dismutase (SOD) and glutathione peroxidase (GPX), as well as serum GPX activities were determined under resting conditions. The older and young men had similar TAS and RBC SOD, while MDA, RBC GPX and plasma GPX were higher, and RBC SOD/GPX ratio was significantly lower in the older men. Neither MDA nor anti-oxidants were associated with any of the physical activity/aerobic capacity measures in the elderly men. We conclude that in healthy elderly men with a good nutritional status, indicators of the anti-oxidant defence system are not lower in comparison with young men. Increased RBC and plasma GPX coupled with a high level of lipid peroxidation marker may indicate an adaptation of anti-oxidant defences to sustained oxidative stress. Furthermore, the results of the present study suggest that the level of habitual physical activity and aerobic capacity have no major influence on the resting balance between radical generation and blood anti-oxidant potential in healthy older men.

The symptomatology of upper respiratory tract infections and exercise in elderly people.

PURPOSE: To analyze, both by a retrospective and prospective study design, the relationship of maximal oxygen consumption (VO2max) and physical activity (PA) to upper respiratory tract infections (URTI) symptomatology in elderly subjects. METHODS: 61 (33 men and 28 women) healthy and weight-stable active elderly volunteers aged 66-84 yr participated in the study. PA was evaluated by a questionnaire QAPSE (Questionnaire d'Activite Physique Saint-Etienne) and expressed by two QAPSE activity indices: MHDEE (mean habitual daily energy expenditure) and sports activity (daily energy expenditure corresponding to leisure time sports activities). Log books for daily recording of URTI symptomatology were used in prospective design. RESULTS: In a 1-yr retrospective study a significant correlation was found between number of weeks with URTI per year and Sports activity index (r = -0.27, P = 0.037). In a prospective 12-month follow-up, the number of episodes per year and number of days with URTI per year were significantly negatively associated with sports activity index (r = -0.29, P = 0.022 and r = -0.26, P = 0.041, respectively). CONCLUSIONS: In healthy active elderly subjects the symptomatology of URTI over long periods of time is inversly related to energy expenditure utilized during moderately intensive physical exercise.

Relationship of physical activity and fitness to lipid and lipoprotein (a) in elderly subjects.

PURPOSE: To determine, both by a cross-sectional and longitudinal study design, the relationship of maximal oxygen consumption (VO2max) and physical activity (PA) to blood lipids and lipoprotein(a) [Lp(a)] in a population of healthy and weight-stable elderly volunteers aged 66-84 yr. METHODS: In a cross-sectional study in 52 subjects (23 men and 29 women), all independent variables (age, anthropometric, VO2max, and PA indices) were used in a multiple stepwise regression analysis to select variables influencing lipid and lipoprotein parameters. In a prospective nonintervention study, 38 subjects (17 men and 21 women) were reexamined after 6 months. RESULTS: In a cross-sectional study, sports activity index contributed significantly to total cholesterol (TC), low density lipoprotein (LDL) cholesterol (LDL-C), TC/high density lipoprotein (HDL) cholesterol (HDL-C) ratio, and LDL-C/HDL-C ratio variance in men, whereas VO2max accounted for 23% variance of apolipoprotein A-I in women. In a prospective study, there was no indication that any measured variable was correlated with absolute or relative changes in PA indices in the total group or when analyzed by gender. CONCLUSIONS: These data confirm that favorable relationship between PA/fitness and blood lipid profile is visible in elderly people but spontaneous changes in habitual PA are not a sufficient stimulus to alter serum lipid and lipoprotein levels in this population. Furthermore, there is no direct association between Lp(a) levels and PA, fitness, or body composition in the elderly men and women.

Influence of acute and chronic exercise on insulin-like growth factor-I in healthy active elderly men and women.

We examined the influence of physical activity (PA) and acute resistance exercise on insulin-like growth factor I (IGF-I) in 39 healthy, independent, community-dwelling elderly volunteers (14 men and 25 women) aged from 66 to 84. In a longitudinal non-interventional study, we compared the fluctuations in IGF-I levels and changes in habitual PA over a 6-month period. PA was evaluated by a questionnaire QAPSE (Questionnaire d'Activité Physique Saint-Etienne), and expressed by two activity indices: mean habitual daily energy expenditure (MHDEE), and daily energy expenditure corresponding to leisure time sports activities (sports activity index). In an experimental design we compared IGF-I levels before, at 1 and 15 minutes after short quadriceps muscle exertion (10 consecutive repetitions) carried out with optimal muscle power development. Changes in IGF-I levels over a 6-month period were positively related to changes in MHDEE (r = 0.41; p<0.01), and sports activity (r = 0.40; p<0.02). When analyzed by gender, these correlations were still statistically significant in women (r = 0.39; p = 0.05 and r = 0.41; p<0.05), but not in men (r = 0.36; p = 0.21 and r = 0.20; p = 0.50). No changes (p = 0.17) were observed in serum IGF-I concentrations after the acute exercise protocol. These findings indicate that IGF-I levels are positively related to fluctuations in habitual PA, at least in women. Further research is needed to establish the best intensity and duration of exercise training to induce these changes.

Physical activity, fitness and integrated antioxidant system in healthy active elderly women.

We have related the oxidative stress and antioxidant defence system to maximal oxygen consumption (VO2max) and physical activity in elderly women. Twenty-nine community dwelling, healthy, active women aged 66-82 years participated in this study. Physical activity was measured by a questionnaire and expressed using two physical activity indices: mean habitual daily energy expenditure (MHDEE) and daily energy expenditure corresponding to leisure time sports activities (Sports activity index). Malondialdehyde (MDA), plasma total antioxidant status (TAS), the red blood cell (RBC) superoxide dismutase (SOD) and glutathione peroxidase (GPX) as well as serum GPX activities were determined under resting conditions. MDA was correlated positively with VO2max (r = 0.42), while RBC GPX was significantly negatively associated with VO2max (r =-0.39), MHDEE (r=-0.38) and sports activity index (rho=-0.36). Our data suggest that in healthy active older women the relationship between physical activity/fitness and antioxidant defence system may be complex, and that for some parameters an unfavourable influence of strenuous exercise may exist. The findings of this cross-sectional design need to be supported in further prospective studies before the associations are accepted as real.

Nutritional status and physical fitness of elderly sportsmen.

The nutritional status of elderly sportsmen has not been reported on, neither has the nutritional balance nor the precise relationship between nutritional status and physical fitness been detailed for this population. Thus, group of 18 sportsmen [age 63 (SD 4.5) years] was monitored by weighing their food during a 6-day period. Macro nutrient, mineral and vitamin content was derived from tables. Daily energy expenditure (DEE) and sport activity (DSA) were quantified over a 7-day period using a questionnaire. Physical fitness was assessed by maximal oxygen uptake (VO2max) measurements. The DEE was 11429 (SD 1890) kJ x day(-1). The DSA corresponded to 38% of DEE and VO2max to 35.9 (SD 6.1) ml x min(-1) x kg(-1). When compared with French recommended dietary allowances (RDA) intakes were higher for energy (+ 24%), macro nutrients, and most minerals and vitamins. Despite high energy intakes, some subjects had mineral and vitamin deficits. Energy intakes were significantly related to intakes of magnesium, phosphorus, iron, vitamins B2, B6, C and to VO2max, but not to age. Stepwise regressions indicated that vitamin C intake was the only determinant to have a relationship with VO2max. Thus, most elderly sportsmen had higher nutritional status than RDA, although some had mineral and vitamin deficits. It is therefore suggested that elderly sportsmen should be encouraged to consume food with higher mineral and vitamin contents.

Peak anaerobic power in elderly men.

The relationship of maximal anaerobic power (Pmax) of the quadriceps muscle and corresponding optimal shortening velocity (vopt) with age, habitual physical activity (PA) and maximal oxygen consumption (VO2max) were assessed in 37 healthy older [71.1 (SD 3.8) years] men and compared to those of 16 young [22.7 (SD 3.4) years] men. The PA was evaluated using a questionnaire. The Pmax and vopt were measured on a friction loaded non-isokinetic cycle ergometer. The Pmax was expressed relative to body mass - Pmax x kg(-1), and relative to the mass of the two quadriceps muscles - Pmax x kgquad(-1). The decline of Pmax x kg(-1) from youth to advanced age (8.3% per decade) was greater than the decrease in quadriceps muscle mass (3.8% per decade), in Pmax x kgquad(-1) (5.9% per decade) and in vopt (4.3% per decade). In the older men, a negative relationship of Pmax x kg(-1) (r = -0.33) and Pmax x kgquad(-1) (r = -0.44) with age was found. Ergometer measurements were not correlated with PA activity indices or VO2max, while VO2max was positively associated with PA. In a multiple stepwise regression analysis age was the only variable that contributed significantly to Pmax x kg(-1) and Pmax x kgquad(-1) variances. Our findings indicated that in these healthy elderly men, unlike the fall in VO2max, habitual PA did not attenuate the decline in Pmax of the quadriceps muscle with age. This finding was different from a previously described relationship in older women and would suggest sex differences in determining Pmax in healthy older subjects.

Physical activity and dehydroepiandrosterone sulphate, insulin-like growth factor I and testosterone in healthy active elderly people.

OBJECTIVE: to examine the association of physical activity and cardio-respiratory fitness with dehydroepiandrosterone sulphate (DHEAS), insulin-like growth factor I (IGF-I) and testosterone in healthy elderly people. DESIGN: cross-sectional study. SETTING: university research department and department of geriatric medicine. PARTICIPANTS: 60 independent, community-dwelling elderly subjects (26 men and 34 women) aged 66-84 who volunteered to participate. MEASUREMENTS: physical activity was evaluated by the Questionnaire d'Activité Physique Saint-Etienne and expressed by three indices: mean habitual daily energy expenditure (MHDEE), daily energy expenditure (DEE) [comprising activities with intensities corresponding to at least three metabolic equivalents (MET; 3.5 ml.kg1 x min1 of oxygen consumption)] and sport activity. Cardio-respiratory fitness was expressed by maximal oxygen consumption (VO2max). RESULTS: In women, DHEAS correlated with VO2max (partial correlation: r=0.33; P=0.05), MHDEE (r=0.50; P=0.002), DEE > 3 METs (r=0.49; P=0.003) and sport activity (r=0.35; P=0.04) whereas IGF-I correlated with MHDEE (r=0.48; P=0.004). DHEAS was correlated with IGF-I (r=0.43; P < 0.02) and with testosterone (r=0.41; P < 0.02). No such correlation was found in men. CONCLUSION: lower habitual physical activity is related to lower levels of circulating DHEAS and IGF-I independently of age and anthropometric measures. Lower maximal aerobic capacity is associated with lower DHEAS concentrations, in healthy elderly women.

Habitual physical activity and peak anaerobic power in elderly women.

The aim of this study was to investigate the relationship between maximal anaerobic power (Pmax) and corresponding optimal velocity (Vopt) and habitual physical activity (PA) on the one hand and with maximal oxygen consumption (VO2max) on the other hand, in elderly women. Twenty-nine community dwelling, healthy women aged 66-82 years participated in the study. PA was evaluated using the Questionnaire d'Activite Physique Saint-Etienne (QAPSE) and expressed using two QAPSE activity indices: mean habitual daily energy expenditure (MHDEE) and daily energy expenditure corresponding to leisure time sports activities (sports activity). The subjects' Pmax and Vopt were measured while they cycled on a friction-loaded non-isokinetic cycle ergometer. Pmax was expressed relative to body mass [Pmax/kg(W.kg-1)], and relative to the mass of two quadriceps muscles [Pmax/Quadr(W.kg-1Quadr)]. A negative relationship between Pmax/kg (Spearman's r = -0.56; P < 0.01), Pmax/Quadr (r = -0.53; P < 0.01) and Vopt (r = -0.45; P < 0.05) and age was found. Pmax/kg was positively associated with MHDEE (r = 0.51; P < 0.01) and sports activity (r = 0.58; P < 0.01), as were Pmax/Quadr and Vopt (r = 0.55; P < 0.01 and r = 0.54; P < 0.01, respectively). Pmax/kg, Pmax/Quadr and Vopt correlated positively with VO2max. The positive relationship between ergometer measurements and PA indices was similar to that between VO2max and PA. Pmax/kg was, moreover, closely related to Vopt (r = 0.77; P < 0.001). When a multiple stepwise regression analysis was used to select the variables influencing ergometer measurements, MHDEE contributed significantly to Pmax/kg variance, whereas sports activity contributed to Pmax/Quadr and Vopt variances. In conclusion, the data from this cross-sectional study suggest that in healthy elderly women habitual PA, and especially leisure time PA, alleviates the decline of the Pmax of the quadriceps muscles.

Validation of a physical activity questionnaire in the elderly.

The purpose of this study was to validate a physical activity (PA) questionnaire, Questionnaire d'Activité Physique Saint-Etienne (QAPSE), in an homogenous population of elderly subjects and to estimate its potential for application in routine PA assessments in that age group. A group of 65 (31 men and 34 women) community dwelling, healthy people aged 65-84 years volunteered to participate in a validation substudy comparing maximal oxygen uptake (VO2 max) and anthropometric data. VO2 max correlated positively with mean habitual daily energy expenditure (MHDEE) (r = 0.56, P < 0.0001), greater than 3MET (metabolic equivalent) daily energy expenditure (DEE) activity (r = 0.371, P = 0.002), leisure activity (r = 0.368, P = 0.003), sports activity (r = 0.461, P < 0.0001), basic daily activity (r = 0.325, P = 0.008) and moving DEE activity (r = 0.273, P = 0.028) in both sexes, with MHDEE (r = 0.366, P = 0.043) and moving DEE activity (r = 0.388, P = 0.031) in the men and with MHDEE (r = 0.624; P < .0001), greater than 3MET DEE activity (r = 0.513, P = 0.002), leisure activity (r = 0.388, P = 0.024) and sports activity (r = 0.683, P < 0.001) in the women. The MHDEE was positively correlated with body mass (r = 0.464) and with fat free mass (r = 0.639) and negatively correlated with percentage body fat (r = -0.501). In a reproducibility sub-study (n = 44) a paired Student's t-test, based on mean differences between the two administrations of the questionnaire did not reach statistical significance for any of the QAPSE activity scores studied. Test-retest correlation coefficients ranged from 0.648 for moving score to 0.967 for MHDEE with correlation coefficient P values being less than 0.001 for all of the QAPSE activity scores. We concluded that QAPSE demonstrated excellent repeatability and good validity in relation to physical fitness and anthropometric data in the population of these healthy elderly volunteers.

Relationship between mean habitual daily energy expenditure and maximal oxygen uptake.

A population of 120 healthy voluntary subjects of both genders aged 16-88 was studied using the QAPSE (Saint-Etienne Physical Activity Questionnaire) with the purpose of investigating the factors influencing the relation between MHDEE (mean habitual daily energy expenditure) and VO2max (maximal oxygen uptake) to elucidate the factors accounting for individual variation. The mean of MHDEE obtained was 12,181.9 +/- 4041.9 kJ.d-1. The mean VO2max obtained was 39.9 +/- 13.8 ml.kg-1.min-1. A strong relationship between MHDEE and VO2max (r = 0.916; N = 120; P < 0.0001) was found. Further, MHDEE seemed to be the greater determinant in the variation of VO2max (89.35%). Other variables were found to be involved in the relation between MHDEE and VO2max for a smaller, but still substantial part: age (6.92%), PAST (exathletes who had considerably reduced or stopped their training) (2.45%), body mass (0.85%), and gender (0.43%). Two variables regarding maximal intensity of activity were not included in the multiple-linear regression analysis. These results suggested that the most important factor in the variation of VO2max is the total quantity of energy expenditure and not only the maximal intensity that could reach the subject.

A new tool for evaluating energy expenditure: the "QAPSE" development and validation.

The objective of this study was to design and validate a working tool for the objective evaluation of daily energy expenditure (DEE) by means of a simple, noninvasive method: the QAPSE (Saint-Etienne Physical Activity Questionnaire), a questionnaire about physical activity (PA) over a period of 7 d (168 h). This eight-page questionnaire is designed to provide a complete picture of the subject's habitual PA without any restriction concerning the activities investigated, nor any specialization in relation to health components. It investigates the five areas of PA during daily life: work or way of keeping occupied, leisure activity (sports and nonsports activities), housework, basic everyday activity, moving about from place to place. Assessment of physical activity was conducted in 115 healthy volunteer subjects of both sexes aged 20-88. The values of mean habitual daily energy expenditure (MHDEE) obtained varied between 6,510 and 24,331 kJ.d-1. The MHDEE were in agreement with the data reported in the literature for various groups differing in respect to level of activity, sex, and age. The study demonstrated the reproducibility of the QAPSE (r = 0.997; N = 20; P < 0.0001). Its validity was tested in a comparative study between MHDEE and caloric intake (r = 0.576; N = 20; P < 0.01).

A comparative study of the muscle strength and mass of the arm flexors and extensors in paraplegic and in non paraplegic basketball players.

OBJECTIVES: to study the changes in the strength of the elbow flexors and extensors in paraplegic subjects, and the agonist/antagonist mass and strength ratio in paraplegic wheelchair users. METHOD: 10 paraplegic wheelchair basketball players were compared with 10 healthy basketball players. The 20 subjects underwent a clinical and dynamometric isokinetic assessment, and a CT scan measurement of the muscle cross-sectional surface area of the flexor and extensor muscles of the elbows. RESULTS: there was an increase in muscle strength in paraplegic subjects. There was no significant difference in the agonist/antagonist ratio between the dominant and non dominant upper limb in paraplegics whereas such a difference was found in healthy subjects. The muscle mass was increased in the paraplegics, but a correlation between muscle mass and strength was only found in the healthy subjects.