Agility training to integratively promote neuromuscular, cardiorespiratory and cognitive function in healthy older adults: a one-year randomized-controlled trial.

BACKGROUND: Exercise training recommendations for seniors include the targeted training of strength, balance, endurance and flexibility domains. Agility training (AT) is conceptualized as a multi-component and time-efficient training framework for older adults to improve physical, functional and cognitive health domains that are relevant for maintaining activities of daily living. The aim of this one-year trial was to comparatively evaluate the effects of agility training on physical and cognitive function. METHODS: Seventy-nine healthy older adults (AT: 61.5% female, 70.8 ± 4.8 years, 27.7 ± 4.2 kg/m2; CG: 60.5% female, 69.6 ± 4.7 years, 27.5 ± 4.4 kg/m2) took part in this one-year randomized controlled intervention and were either assigned to the agility training group (AT) with two weekly 60 min AT sessions or to the control group (CG), receiving no treatment. Participants were assessed pre, intermediate and post intervention for strength and power, balance, gait speed under multi-task conditions, aerobic capacity as well as cognitive performance. Linear mixed effects models were used to analyze the effect of treatment over time. RESULTS: Fifty-four participants (AG: 25, CG: 29) were analyzed, most drop-outs attributed to COVID-19 (17/30 dropouts). Adherence was good (75%) of 90 offered sessions. Notable effects in favor of AT were found for gait parameters in single (d = 0.355, Δ = 4.3%), dual (d = 0.375, Δ = 6.1%) and triple (d = 0.376, Δ = 6.4%) task conditions, counter movement jump performance (strength and power) (d = 0.203, Δ = 6.9%), static one leg balance (d = 0.256, Δ = 12.33%) and n-back reaction time (cognitive performance) (d = 0.204, Δ = 3.8%). No effects were found for the remaining outcomes (d < 0.175). CONCLUSION: AT might serve as an integrative training approach for older adults particularly improving gait and lower limb power parameters. It seems suitable to improve a broad range of seniors' health domains and should replace isolated training of these domains. However, individual variation and progression of exercises should be considered when programming agility training providing adequate challenges throughout a long-term intervention for all participants. TRIAL REGISTRATION: DRKS, DRKS00017469 . Registered 19 June 2019-Retrospectively registered.

Validation of a smart shirt for heart rate variability measurements at rest and during exercise.

Heart rate variability (HRV) monitoring is a promising option to estimate the autonomic nervous system regulation responding to exercise. Textiles with embedded sensors recording heartbeat intervals are a simple tool for data collection. The so-called smart shirts offer comfort for daily use and are managed easily. Their measurement accuracy for HRV calculation at rest is promising, but remains questionable during exercise. Therefore, the present study validated the Ambiotex smart shirt using HRV indices (root mean square of successive differences, rel. HF power [high-frequency power percentage of total power] and rel. LF [low-frequency power percentage of total power] power) during exercise. Eighty-three healthy participants (31 ± 6 years; 39 females, 44 males) completed an incremental exercise test on a bicycle ergometer wearing the smart shirt and an electrocardiogram simultaneously. We compared HRV indices of segments at rest (5 min), at warm-up (3 min) and twice at the exercise test (each 5 min). At rest and at warm-up, we observed excellent linear relationship (r > 0.96; R2 ​​​​​ > 0.94), excellent relative reliability (intraclass correlation coefficient ≥ 0.98; α ≥ 0.98) and acceptable agreement (bias < 10%). During the exercise test, measurement accuracy declined with increasing intensity but remained high (>0.8), although results for partial HRV indices were insufficient. In addition, percentage bias was unacceptable during an exercise test. However, the findings support the validity of the smart shirt for measuring HRV, especially at rest and at warm-up. We suggest using the smart shirt for monitoring HRV indices on a daily basis, but caution should be taken in the interpretation of HRV indices obtained during moderate to vigorous exercise intensities.

Cross-cultural adaptation and validation of the Kerlan-Jobe orthopedic clinic shoulder and elbow score for German-speaking overhead athletes.

BACKGROUND: The Kerlan-Jobe Orthopedic Clinic Shoulder and Elbow Score (KJOC) originally developed in English, assesses the functional status of the shoulder and elbow in overhead athletes. To date, no German version of the questionnaire exists. OBJECTIVE: The aim of the study was to translate and to culturally adapt the KJOC into German (KJOC-G) and to test its psychometric properties. METHODS: The first part of the study consisted of a translation and cross-cultural adaptation process which was performed in six stages according to international recommendations: Initial translations, synthesis, back translations, expert committee review, pretesting of the prefinal version, and final adaptations. Secondly, reliability, validity, and feasibility of the KJOC-G were assessed in German overhead athletes. RESULTS: The translation and adaptation process led to minor alterations due to cultural differences while maintaining the general structure and content of the original score. A total of 152 overhead athletes (age 25.0 ± 6.6 years; 87 men/65 women) were included in the main analyses. The internal consistency (Cronbach's alpha = 0.93) and test-retest reliability (ICC2.1 = 0.94) of the overall questionnaire were excellent. Moderate correlations with the German version of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire (r = -0.51, p < .05) as well as the DASH-sports module (r = -0.54, p < .05) suggest moderate construct validity. Known-group method analysis showed the ability of the KJOC-G to discriminate between actively playing symptomatic (score: 71.2 ± 16.0) and asymptomatic (score: 93.1 ± 8.7) athletes. CONCLUSION: The KJOC-G score is valid, reliable, and suitable for assessing the functional shoulder and elbow status in German-speaking overhead athletes.

Agility Training to Integratively Promote Neuromuscular, Cognitive, Cardiovascular and Psychosocial Function in Healthy Older Adults: A Study Protocol of a One-Year Randomized-Controlled Trial.

Exercise training effectively mitigates aging-induced health and fitness impairments. Traditional training recommendations for the elderly focus separately on relevant physiological fitness domains, such as balance, flexibility, strength and endurance. Thus, a more holistic and functional training framework is needed. The proposed agility training concept integratively tackles spatial orientation, stop and go, balance and strength. The presented protocol aims at introducing a two-armed, one-year randomized controlled trial, evaluating the effects of this concept on neuromuscular, cardiovascular, cognitive and psychosocial health outcomes in healthy older adults. Eighty-five participants were enrolled in this ongoing trial. Seventy-nine participants completed baseline testing and were block-randomized to the agility training group or the inactive control group. All participants undergo pre- and post-testing with interim assessment after six months. The intervention group currently receives supervised, group-based agility training twice a week over one year, with progressively demanding perceptual, cognitive and physical exercises. Knee extension strength, reactive balance, dual task gait speed and the Agility Challenge for the Elderly (ACE) serve as primary endpoints and neuromuscular, cognitive, cardiovascular, and psychosocial meassures serve as surrogate secondary outcomes. Our protocol promotes a comprehensive exercise training concept for older adults, that might facilitate stakeholders in health and exercise to stimulate relevant health outcomes without relying on excessively time-consuming physical activity recommendations.

[Neuronal Blood Pressure Regulation]. / Neuronale Kontrolle des Blutdrucks.

Neuronal blood pressure control is mediated by the autonomic nervous system. In this article, physiological and pathophysiological mechanisms will be recapitulated. Blood pressure regulation aims at maintaining adequate cardiac output and a sufficient perfusion pressure for the organs. In glaucoma, ocular perfusion pressure is defined as the difference between systemic blood pressure and intraocular pressure and is crucial for the supply of the optic nerve. Patients who suffer from normal-tension glaucoma and low blood pressure are at risk of glaucoma progression. In primary open-angle glaucoma, blood pressure is also of importance. A 24-h ambulatory blood pressure monitoring with particular attention to the nocturnal dipping is recommended for all glaucoma patients. Internal medicine specialists and ophthalmologists should be aware of the mutual influence of the two diseases and take this it into account for the choice of an individual therapeutic strategy and target level.

Enhanced 400-m sprint performance in moderately trained participants by a 4-day alkalizing diet: a counterbalanced, randomized controlled trial.

BACKGROUND: Sodium bicarbonate (NaHCO3) is an alkalizing agent and its ingestion is used to improve anaerobic performance. However, the influence of alkalizing nutrients on anaerobic exercise performance remains unclear. Therefore, the present study investigated the influence of an alkalizing versus acidizing diet on 400-m sprint performance, blood lactate, blood gas parameters, and urinary pH in moderately trained adults. METHODS: In a randomized crossover design, eleven recreationally active participants (8 men, 3 women) aged 26.0 ± 1.7 years performed one trial under each individual's unmodified diet and subsequently two trials following either 4 days of an alkalizing (BASE) or acidizing (ACID) diet. Trials consisted of 400-m runs at intervals of 1 week on a tartan track in a randomized order. RESULTS: We found a significantly lower 400-m performance time for the BASE trial (65.8 ± 7.2 s) compared with the ACID trial (67.3 ± 7.1 s; p = 0.026). In addition, responses were significantly higher following the BASE diet for blood lactate (BASE: 16.3 ± 2.7; ACID: 14.4 ± 2.1 mmol/L; p = 0.32) and urinary pH (BASE: 7.0 ± 0.7; ACID: 5.5 ± 0.7; p = 0.001). CONCLUSIONS: We conclude that a short-term alkalizing diet may improve 400-m performance time in moderately trained participants. Additionally, we found higher blood lactate concentrations under the alkalizing diet, suggesting an enhanced blood or muscle buffer capacity. Thus, an alkalizing diet may be an easy and natural way to enhance 400-m sprint performance for athletes without the necessity of taking artificial dietary supplements.