The Impact of Personalized versus Standardized Cardiorespiratory and Muscular Training on Health-Related Outcomes and Rate of Responders.

Recent research has shown more favorable training adaptations for inactive adults when cardiorespiratory fitness (CRF) exercise is prescribed with the use of ventilatory thresholds compared to percentages of heart rate reserve (HRR). However, there is limited research on changes in health-related outcomes with the use of these CRF methods in combination with muscular fitness exercises. The objective of this study was to compare the effectiveness of two training programs for improving CRF, muscular fitness, and cardiometabolic risk factors. Inactive men and women (n=109, aged 49.3±15.5 years) were randomized to a non-exercise control group or one of two exercise training groups. The exercise training groups consisted of 13 weeks of structured exercise with progression using either CRF exercise prescribed with the use of ventilatory thresholds and functional training for muscular fitness (THRESH group) or HRR and traditional muscular fitness training (STND group). After the 13-week protocol, there were significant differences in body weight, body composition, systolic blood pressure, high-density lipoprotein cholesterol (HDL-c), VO2max, 5-repetition maximum (RM) bench press, and 5-RM leg press for both treatment groups compared to the control group after controlling for baseline values. However, the THRESH group had significantly more desirable outcomes for VO2max, 5-RM bench press, 5-RM leg press, body composition, and HDL-c when compared to both the STND and control group. Additionally, the proportion of individuals estimated as likely to respond above 3.5 mL·kg-1·min-1 in VO2max (i.e., the minimal clinically important difference) was 76.4%, 20.8%, and 0.13% for the THRESH, STND, and control groups, respectively. While both exercise programs elicited favorable health-related adaptations after 13 weeks, these results suggest that a personalized program with exercise prescribed based on ventilatory threshold and with the use of functional muscular fitness training may yield greater training adaptations.

Patterns and correlates of sedentary behavior among university students.

Objective: To characterize the context, patterns, and correlates of sedentary behavior (SB) in university students. Participants: A total of 95 adults (41% men) enrolled in 34 different undergraduate majors. Methods: SB was assessed by questionnaire and accelerometer. Results: Objective SB and moderate-to-vigorous physical activity (MVPA) accounted for 8.4 ± 1.5 and 1.2 ± 0.5 h·day-1, respectively. Most SB was spent in occupational, leisure, and screen time behaviors, and was accumulated in short bouts of 10 min or longer. Women were more sedentary than men (522.0 ± 80.3 vs. 486.1 ± 91.3 min·day-1, p = 0.03) and engaged in more prolonged bouts of SB. Correlates of SB included female sex, smoking, light activity, MVPA, and markers of obesity, with higher levels of light activity and current smoking the strongest and most consistent correlates of reduced SB. Conclusions: University students engage in high amounts of SB and accumulate most of their SB in short bouts, with differences in patterns of SB between men and women.

Evaluation of an opioid and addiction treatment tele-education program for healthcare providers in a rural and frontier state.

OBJECTIVE: To develop and evaluate a relevant and readily accessible post-professional opioid use disorder (OUD) education program for a rural and frontier state. DESIGN: Observational study. SETTING/PARTICIPANTS: Healthcare providers enrolled in Extension for Community Healthcare Outcomes (ECHO) Idaho Opioid, a tele-mentoring education program. MAIN OUTCOME MEASURE: Participant-level demographics of those that attended the ECHO Idaho Opioid program and post-session and program evaluation -surveys. RESULTS: A total of 273 individuals attended at least one ECHO Idaho Opioid session (per session average = 22.8); 183 post-session evaluations (per session average = 6.3) and 42 program evaluations were completed. The program was well received by providers in a rural and frontier state and may be a viable option to enhance patient care for OUD patients in these communities. CONCLUSION: The Project ECHO model is successful at reaching providers across diverse geographic regions, overcoming barriers associated with attending advanced trainings or developing peer networks to improve patient care. The model can be used to develop educational content and delivery that participants believe is satisfactory, valuable, and applicable to their profession and practice.

Disablement in the Physically Active Scale Short Form-8: psychometric evaluation.

BACKGROUND: Patient-centered care and evidence-based practice (EBP) are core competencies for health care professionals. The importance of EBP has led to an increase in research involving clinical outcomes; current recommendations emphasize collecting patient focused measures, thus increasing the need for psychometrically sound patient reported outcome measures (PROMs) of health. Disablement has been identified as a valuable multi-dimensional construct for patient care. The Disablement in the Physically Active Scale Short Form-8 (DPA SF-8) has been proposed as a tool to be used in the physically active population that assesses a physical summary component of health and a quality of life component however, further analysis is necessary to ensure the instrument is psychometrically sound. METHODS: Confirmatory factor analyses (CFAs) were conducted on the DPA SF-8 at each time point to ensure factor structure. Reliability of the scale and internal consistency of the subscales were assessed, and a minimal detectable change (MDC) calculated. Additionally, a minimal clinically important difference (MCID) was also established, and invariance testing across three time points and groups was conducted. RESULTS: The CFAs at all three visits exceeded recommended model fit indices. The interclass correlation coefficient value (.924) calculated indicated excellent scale reliability and Cronbach's alpha for subscales PHY and QOL were within recommend values. The MDC value calculated was 5.83 and the MCID for persistent injuries were 2 points and for acute injuries, 3 points. The DPA SF-8 was invariant across time and across subgroups. CONCLUSIONS: The DPA SF-8 met CFA recommendations and criteria for multi-group and longitudinal invariance testing, which indicates the scale may be used to assess for differences between the groups or across time. Our overall analysis indicates the DPA SF-8 is a valid, reliable, and responsive instrument to assess patient improvement in the physically active population.

Associations of leisure screen time with cardiometabolic biomarkers in college-aged adults.

We examined whether screen time was associated with cardiometabolic disease (CMD) risk factors in young adults. Ninety-five adults (19.9 ± 11.4 years) self-reported medical and health behavior history, screen time (television viewing, video games and computer games), and dietary intake. Waist circumference, blood pressure, fasting glucose and lipid levels, cardiorespiratory fitness (VO2peak), and body composition were measured. Total sedentary behavior and moderate-to-vigorous physical activity (MVPA) were measured by accelerometer. On average, leisure screen time (2.0 ± 1.6 h day-1) accounted for 24% of total sedentary time (8.4 ± 1.5 h day-1). After adjustment for demographics, smoking, sleep duration, total energy intake, total sedentary time and MVPA, a 1-standard deviation increase in leisure screen time was associated with a 26% higher BMI, 29% higher waist circumference, 25% higher fat mass, 23% higher triglyceride, and 24% lower VO2peak (p < 0.05). Our findings suggest that screen time may contribute to the risk of obesity and CMD in young adults.

Skeletal muscle area and density are associated with lipid and lipoprotein cholesterol levels: The Multi-Ethnic Study of Atherosclerosis.

BACKGROUND: Loss of muscle mass with age may be a key player in metabolic dysregulation. We examined the associations between abdominal muscle area and density with lipids and lipoproteins. METHODS: One thousand eight hundred and sixty eight adults completed health history and physical activity questionnaires, provided venous blood samples for lipids and inflammatory biomarkers, and underwent computed tomography to quantify body composition. Associations between muscle area and density with multiple lipid measures were assessed with multivariable linear and logistic regression. RESULTS: The mean age and body mass index of participants was 65 years and 28 kg/m2, respectively, and 50% were female. After adjustment for demographics, cardiovascular disease risk factors, lipid-lowering medications, physical activity, sedentary behavior, inflammatory biomarkers, and central obesity, a 1-standard deviation increase in total abdominal, stability, and locomotor muscle areas was associated with a 13%, 11%, and 8% lower high-density lipoprotein cholesterol level, respectively (P < .05). With similar adjustment, a 1-standard deviation increase in total abdominal and stability muscle area was associated with a 13% and 12% lower total cholesterol level, respectively (P < .01). Compared to the lowest quartiles of total, stability, and locomotor muscle area, those in the higher quartiles of muscle area had over a 40% reduction in the odds of triglyceride levels greater than 150 mg/dL (P < .05). Total abdominal muscle density was positively associated with total cholesterol (P < .05) but was not associated with the other lipid outcomes. CONCLUSION: Maintaining adequate skeletal muscle mass with age may decrease specific lipid levels related to hyperlipidemia and development of cardiometabolic disease.

Eight Weeks of Strength and Power Training Improves Club Head Speed in Collegiate Golfers.

Oranchuk, DJ, Mannerberg, JM, Robinson, TL, and Nelson, MC. Eight weeks of strength and power training improves club head speed in collegiate golfers. J Strength Cond Res 34(8): 2205-2213, 2020-Club head speed (CHS) is a major determinant of drive distance, a key component of golf performance. The purpose of this study was to determine the indirect effects of an 8-week strength and power program on CHS. Twelve (6 men, 6 women) NCAA Division II golfers (20.3 ± 1.5 years) randomly assigned to an intervention or control group underwent either a periodized strength and power program consisting of high-load barbell movements or a bodyweight and rotational movement focused resistance training program. Outcomes were CHS, countermovement jump (CMJ) height, and 1RM back squat (BS), power clean (PC), and deadlift (DL). Dependent t-tests were used to assess differences in outcome variables pre-to-post for each group, independent t-tests were used to assess differences between groups, and Pearson correlations were used to assess associations between CHS and outcome variables. On average, the intervention group experienced improvements in all outcome variables except peak CHS (p = 0.60); the control group displayed no changes in any outcome variable except a decrease in average CHS (p = 0.028). Compared with the control group, the intervention group experienced greater improvements in average CHS, BS, PC, and average and peak CMJ height (p ≤ 0.05). Additionally, CHS had large associations with PC (r = 0.70, p = 0.012), BS (r = 0.64, p = 0.025), DL (r = 0.54, p = 0.068) and CMJ (r = 0.73, p = 0.007). These results suggest that improving muscular strength and power by increasing PC, BS, and CMJ is associated with increased CHS in collegiate golfers. Integrating a high-load, barbell-focused strength and power program may be beneficial for improving CHS and indirectly, golf performance.

Comparison of Self-Reported and Objectively Measured Sedentary Behavior and Physical Activity in Undergraduate Students.

OBJECTIVE: To investigate differences between estimates of sedentary behavior and physical activity (PA) from the International Physical Activity Questionnaire (IPAQ) and accelerometry in undergraduate students. PARTICIPANTS: 91 students participated in the study. METHODS: Sedentary behavior and PA were objectively measured by an accelerometer for 7 days and then self-reported with the IPAQ. Partial correlations were used to assess associations among PA variables and participant characteristics between the methods. Agreement was assessed via the Bland-Altman method. RESULTS: Correlation coefficients between self-reported and objectively measured PA ranged from 0.21 to 0.38 (p≤0.05 for all). A higher proportion of students were classified as meeting PA guidelines via self-report compared to objective measurements. Bland-Altman plots revealed acceptable agreement between methods, however, bias was evident for all PA intensities. Sex and lean body mass impacted these differences. CONCLUSIONS: Researchers should exercise caution when interpreting PA assessed via the IPAQ in undergraduate students.

The Effectiveness of Standing on a Balance Board for Increasing Energy Expenditure.

PURPOSE: This study aimed to investigate differences in energy expenditure (EE), heart rate (HR), productivity, fatigue, and pain while performing desk work while sitting (SIT), standing (STAND), and standing on a balance board (BOARD). METHODS: Thirty healthy adults (60% female, age = 39.7 ± 11.8 yr, body mass index = 26.7 ± 5.0 kg·m) employed in sedentary-based jobs volunteered for this randomized crossover trial. Participants performed typing work in three different positions: SIT, STAND, and BOARD, each condition lasting 30 min. Oxygen consumption (V˙O2) was measured via indirect calorimetry, and EE was calculated using respiratory quotient and corresponding caloric equivalent values. Productivity was quantified by measuring words typed per minute, accuracy, and typing mistakes. Overall feelings of fatigue and pain were self-reported three times during each position using validated 10-cm visual analog scales. Repeated-measures ANOVA was used to assess differences in outcome variables across conditions. RESULTS: V˙O2 was significantly different among all conditions regardless of current standing desk use (SIT = 3.35 ± 0.53, STAND = 3.77 ± 0.48, BOARD = 3.92 ± 0.54 mL·kg·min, P < 0.001). EE (kcal·min) also differed (P < 0.001) among SIT (1.27 ± 0.22), STAND (1.42 ± 0.26), and BOARD (1.48 ± 0.29). Compared with sitting (67 ± 9 bpm), HR was higher in STAND (76 ± 11 bpm) and BOARD (76 ± 11 bpm, P < 0.001). Measures of productivity were not different across conditions (P > 0.05). Fatigue progressively increased over each 30-min condition, whereas pain in SIT and BOARD increased from minute 10 to minute 20 and then leveled off between minutes 20 and 30. For STAND, pain continued to increase over time. CONCLUSION: Compared with sitting, a balance board may be effective for increasing EE without interfering with productivity in an occupational setting.