Designing an App to Promote Physical Exercise in Sedentary People Using a Day-to-Day Algorithm to Ensure a Healthy Self-Programmed Exercise Training.

Heart rate variability (HRV) has allowed the implementation of a methodology for daily decision making called day-to-day training, which allows data to be recorded by anyone with a smartphone. The purpose of the present work was to evaluate the validity and reliability of HRV measurements with a new mobile app (Selftraining UMH) in two resting conditions. Twenty healthy people (10 male and 10 female) were measured at rest in supine and seated positions with an electrocardiogram and an application for smartphones at the same time (Selftraining UMH) using recordings obtained through an already validated chest-worn heart rate monitor (Polar H10). The Selftraining UMH app showed no significant differences compared to an electrocardiogram, neither in supine nor in sitting position (p > 0.05) and they presented almost perfect correlation levels (r ≥ 0.99). Furthermore, no significant differences were found between ultra-short (1-min) and short (5-min) length measurements. The intraclass correlation coefficient showed excellent reliability (>0.90) and the standard error of measurement remained below 5%. The Selftraining UMH smartphone app connected via Bluetooth to the Polar H10 chest strap can be used to register daily HRV recordings in healthy sedentary people.

Physical Performance Differences Between Spanish Selected and Nonselected Para-Footballers With Cerebral Palsy for the National Team.

In regular football, the players' selection process involves an objective assessment based on their anthropometric and physical performance. However, available literature focused on players' selection process in cerebral palsy (CP) football is scarce. PURPOSE: To describe the anthropometrical and physical performance profiles of the International Spanish CP footballers and to compare them with the remaining CP football players from the national competition. METHOD: A total of 75 CP football players from the Spanish CP Football National Competition (classified into the 3 existing classes: football class [FT] 1 = 38; FT2 = 29; FT3 = 8) participated in the study. Participants were divided into 2 groups: selected players (n = 15) and nonselected players (n = 60) for the national team. Anthropometrical data and physical performance (countermovement jump, 20-m sprint, modified agility T-test [MAT], and dribbling test) were collected. RESULTS: There were significant differences in the 20-m sprint, MAT, and dribbling for the total sample and in MAT and dribbling for FT2 and FT3 classes between selected players and nonselected players (P < .05), but there were no differences for FT1. The MAT and dribbling showed a positive correlation and a high percentage of player selection prediction. CONCLUSION: Change-of-direction ability (ie, MAT) and dribbling skills are important when performing the selection process, as they allow the evaluation of important aspects of the game, but they may also provide the technical staff with an idea of the functionality and the physical performance of the players in each sport class.

Using Decision Trees to Support Classifiers' Decision-Making about Activity Limitation of Cerebral Palsy Footballers.

This study aimed (1) to determine the appropriateness of using decision trees as a classification tool for determining the allocation of sport classes of para-footballers with "moderate vs. mild" cerebral palsy (CP) profiles of spastic diplegia/hemiplegia and ataxia/athetosis based on observational outcomes by international classifiers, and (2) to identify what key observational features were relevant to discriminating among different impairment levels. A sample of 16 experienced international classifiers from five world regions participated in this study, observing activity limitation of a final sample of 21 international CP footballers when performing 16 gross-motor and sports-specific tests for balance (n = 3), coordination (n = 5), running, accelerations and decelerations (n = 3), jumping (n = 4), and change of direction ability (n = 1). For the overall sample (336 observations), the model included eight decision nodes and 24 branches with 17 leaves, including side-step, side-stepping, and triple hop as the tests with the best sensitivity (precision = 67.0%). For those with spastic diplegia (64 observations: Two nodes, six branches with five leaves), the range of motion in the side-step test and the balance in the tandem walk tests correctly classified 89.1% of the observations. In those with athetosis and ataxia (96 observations), the model included five nodes, 15 branches, and 11 leaves (176 observations, precision = 86.5%). For those with spastic hemiplegia, a model containing two nodes, six branches, and five leaves had 90.9% accuracy, including observational features of balance in the side-step test and symmetry in the side-stepping test. The observational tool used in this study, based on the impact of specific impairment measurements of hypertonia, athetosis, and ataxia, can be used to determine which assessments are more appropriate for discriminating between functional profiles in para-footballers with CP.

Heart rate-based indices to detect parasympathetic hyperactivity in functionally overreached athletes. A meta-analysis.

Investigations into the sensitivity of heart rate-(HR) derived indices for tracking parasympathetic nervous system (PNS) changes in functionally overreached (F-OR) endurance-trained athletes have produced equivocal findings. Lack of clarity may be a result of methodological inconsistencies. Therefore, the aims of this systematic review and meta-analysis were (a) to determine the sensitivity of resting and post-exercise vagal-related HR variability (HRV) and HR recovery (HRR) indices to detect PNS modulation in F-OR and non-overreached (non-OR) athletes, and (b) to investigate the influence of methodological factors on the sensitivity of HR-based indices to detect PNS hyperactivity in F-OR athletes. We searched CENTRAL, Scopus, PubMed, Embase, and Web of Science up to May 2020 for the following terms: male and female endurance-trained athletes, controlled and uncontrolled studies that carried out an overload training period, and PNS modulation measured in resting and post-exercise, pre- and post-overload training period. A random-effects model of standardized mean difference (SMD) was estimated for each outcome measure based on the training-induced fatigue status (F-OR vs non-OR athletes), and the influence of methodological issues to detect PNS hyperactivity in F-OR was assessed by subgroup analyses. Pooled analysis showed that resting vagal-related HRV indices did not detect PNS hyperactivity in F-OR athletes (SMD+ = -0.01; 95% confidence interval [CI] = -0.51, 0.50), and no statistical difference (P = .600) was found with non-OR athletes (SMD+ = 0.15; 95% CI = -0.14, 0.45). However, subgroup analysis based on HRV parameter showed a moderate statistical increase in weekly averaged HRV in F-OR athletes (SMD+ = 0.81; 95% CI = 0.35, 1.26), while isolated HRV values did not reach statistical significance (SMD+ = -0.45; 95% CI = -0.96, 0.06). We observed a moderate and statistically significant increase in HRR indices among F-OR athletes (SMD+ = 0.65; 95% CI = 0.44, 0.87), no changes for non-OR athletes (SMD+ = 0.10; 95% CI = -0.15, 0.34), and statistically significant differences between F-OR and non-OR athletes (P < .001). Insufficient data prevented meta-analysis for post-exercise vagal-related HRV indices. Our findings show that when methodological factors are considered, HR-based indices are sensitive to increased PNS modulation in F-OR.

Anthropometrical Features of Para-Footballers According to Their Cerebral Palsy Profiles and Compared to Controls.

Cerebral palsy (CP) football is a team para-sport practiced by para-athletes with eligible impairments of hypertonia, athetosis, and ataxia. This study aimed: (1) to describe the anthropometrical and body composition profiles of international CP para-footballers with different CP profiles (i.e., spastic diplegia, athetosis/ataxia, spastic hemiplegia, and minimum impairment); (2) to analyze the differences between both affected/nondominant and nonaffected/dominant sides; and (3) to compare the sample of international-level CP para-footballers (n = 141) with a sample of highly trained able-bodied footballers (n = 39). Anthropometric measures included four breadths, nine girths, and six skinfolds, while body composition was measured through fat mass (including Carter's, Faulkner's, and Withers' equations), muscle mass (Lee's equation), and bone mass (Rocha's and Martin's equations). This study found differences between the able-bodied footballers and the following impairment profiles: spastic diplegia (skinfolds); ataxia/athetosis (corrected calf of the nondominant side, and calf skinfolds for both sides); and spastic hemiplegia (all measurements excepting femur breadth, and thigh and ankle girths). No differences were found between para-athletes with minimum impairment and the able-bodied footballers. This study demonstrates that football players with or without physical impairments of hypertonia athetosis or ataxia may be considered homogeneous in shape when dominant size is compared. Besides, the study provides reference scores on anthropometric measures and body composition of international-level CP para-footballers that can help sports coaches and physical trainers to monitor physical fitness of their para-athletes.

Calorie Restriction Improves Physical Performance and Modulates the Antioxidant and Inflammatory Responses to Acute Exercise.

Our aim was to characterize the effects of calorie restriction on the anthropometric characteristics and physical performance of sportsmen and to evaluate the effects of calorie restriction and acute exercise on mitochondria energetics, oxidative stress, and inflammation. Twenty volunteer taekwondo practitioners undertook a calorie restriction of 30-40% on three alternate days a week for one month. Eleven volunteer sportsmen participated as controls. Both groups performed an energy efficiency test to evaluate physical performance, and samples were taken before and after exercise. The total weight of participants significantly decreased (5.9%) after calorie restriction, while the efficiency of work and the contributions of fat to obtain energy were enhanced by calorie restriction. No significant differences induced by acute exercise were observed in individual non-esterified fatty acid percentage or oxidative stress markers. Calorie restriction downregulated the basal gene expression of nitric oxide synthase, antioxidant enzymes, mitochondrial uncoupling proteins, and repairing stress proteins, but it enhanced the expression of sirtuins in peripheral blood mononuclear cells. In conclusion, one month of calorie restriction decreases body weight and increases physical performance, enhancing energy efficiency, moderating the antioxidant and inflammatory basal gene expression, and influencing its response to acute exercise.

An Observational Tool to Assess Activity Limitation in Ambulatory People with Cerebral Palsy When Performing Motor Skills.

Ratios of physical activity and sports participation in people with cerebral palsy (CP) are still low compared with people without a disability. For an adequate and useful practice, physical activity professionals should understand how different types of CP profiles constrain the performance of motor skills that are required during sports practice. This study aims to develop an observation-based assessment tool to evaluate activity limitations in individuals with a moderate level of CP when performing skills requiring jumping, sprinting, change of direction, coordination, and balance. Nineteen observers with different backgrounds from five world regions were recruited for this study, with accredited experience classifying/observing para-athletes with CP. All observers watched videos of 20 international para-athletes with different CP profiles (bilateral spasticity, athetosis/ataxia, unilateral spasticity; all Gross Motor Function Classification System level I) performing 16 motor tasks, and their observations were recorded throughout an ad-hoc data collection instrument. A total of 6080 units of qualitative information were recorded for data analysis. An observation-based tool with qualitative descriptors is derived from data analyses, describing how coordination and balance affected mainly in those with dyskinesia/ataxia, range of movement in those with diplegia, and asymmetries in those with hemiplegia. This tool would help sports practitioners and physical educators to better understand how different CP profiles constrain the performance of motor skills.

Inter-Rater Reliability, Concurrent Validity and Sensitivity of Current Methods to Assess Trunk Function in Boccia Player with Cerebral Palsy.

Trunk function is a core factor to allocate Boccia players with cerebral palsy in BC1 and BC2 sport classes, according to the Boccia International Sports Federation (BISFed). However, the appropriateness of the current test to assess trunk function has never been studied to determine its reliability, validity and sensitivity to discriminate between different levels of impairment. Thirty-six players (BC1 = 13 and BC2 = 23) took part in this study. Trunk control was assessed through the BISFed trunk function scale (TFS) and a posturographic test battery consisting of two static and three dynamic tasks. The inter-rater reliability for the BISFed TFS was set at 94.44% of agreement. Moderate-to-high correlations were obtained between posturographic tasks (0.39 < r < 0.96; p < 0.05-0.01), while the BISFed TFS only correlated with two of the dynamic tasks and the overall dynamic score (-0.38 < r < -0.51; p < 0.05). The BISFed TFS was not able to discriminate between sport classes, whereas the static posturographic task did so (p = 0.004). Even though the current BISFed TFS presented good inter-rater reliability, it does not seem to have enough sensitivity to discriminate between BC1 and BC2. Although the static posturographic tasks were able to discriminate between sports classes, it seems necessary to develop new field tests assessing participants' trunk stabilization abilities.

Evaluation of the bilateral function in para-athletes with spastic hemiplegia: A model-based clustering approach.

OBJECTIVES: Spastic hemiplegia is one of the most common forms of cerebral palsy, in which one side of the body is affected to a greater extent than the other one. Hemiplegia severity (i.e. moderate vs mild forms) is currently used in some Para sports for classification purposes. This study evaluates the sensitivity of several tests of stability (e.g. one-legged stance test), dynamic balance (side-step test), coordination (rapid heel-toe placements), range of movement (backward stepping lunge), and lower limb power (the triple hop distance and the isometric peak force of the knee extensors) to discriminate between the impaired and unimpaired lower extremities' function in para-athletes with spastic hemiplegia. METHODS: A sample of 87 international para-athletes with cerebral palsy took part in the study, and their bilateral performance was measured for the abovementioned tests. The tests' sensitivity to discriminate between impaired vs unimpaired legs was assessed using Boruta's method. RESULTS: The triple hop distance, the magnitude of the mean velocity in the one-legged stance test and the time to perform the rapid heel-toe placement test are the most sensitive variables when performing random forest classifiers. In addition, the study confirms two optimal clusters by Gaussian finite mixture models to represent the athletes' performance. CONCLUSIONS: Reference scores for the clusters are provided, demonstrating that coordination, balance, and power of the lower limbs are relevant variables for classifying para-athletes with spastic hemiplegia.

Training Prescription Guided by Heart Rate Variability Vs. Block Periodization in Well-Trained Cyclists.

Javaloyes, A, Sarabia, JM, Lamberts, RP, Plews, D, and Moya-Ramon, M. Training prescription guided by heart rate variability vs. block periodization in well-trained cyclists. J Strength Cond Res 34(6): 1511-1518, 2020-Predefined training programs are common place when prescribing training. Within predefined training, block periodization (BP) has emerged as a popular methodology because of its benefits. Heart rate variability (HRV) has been proposed as an effective tool for prescribing training. The aim of this study is to examine the effect of HRV-guided training against BP in road cycling. Twenty well-trained cyclists participated in this study. After a preliminary baseline period to establish their resting HRV, cyclists were divided into 2 groups: an HRV-guided group and a BP group, and they completed 8 training weeks. Cyclists completed 3 evaluations weeks, before and after each period. During the evaluation weeks, cyclists performed: (a) a graded exercise test to assess V[Combining Dot Above]O2max, peak power output (PPO), and ventilatory thresholds with their corresponding power output (VT1, VT2, WVT1, and WVT2, respectively) and (b) a 40-minute simulated time-trial (40 TT). The HRV-guided group improved V[Combining Dot Above]O2max (p = 0.03), PPO (p = 0.01), WVT2 (p = 0.02), WVT1 (p = 0.01), and 40 TT (p = 0.04). The BP group improved WVT2 (p = 0.02). Between-group fitness and performance were similar after the study. The HRV-guided training could lead to a better timing in training prescription than BP in road cycling.

Change of Direction Ability Performance in Cerebral Palsy Football Players According to Functional Profiles.

The aims of the present study were to evaluate the validity and reliability of the two different change of direction ability (CODA) tests in elite football players with cerebral palsy (CP) and to analyse the differences in performance of this ability between current functional classes (FT) and controls. The sample consisted of 96 international cerebral palsy football players (FPCP) and 37 football players. Participants were divided into four different groups according to the International Federation of Cerebral Palsy Football (IFCPF) classes and a control group (CG): FT5 (n = 8); FT6 (n = 12); FT7 (n = 62); FT8 (n = 14); and CG (n = 37). The reproducibility of Modified Agility Test (MAT) and Illinois Agility Test (IAT) (ICC = 0.82-0.95, SEM = 2.5-5.8%) showed excellent to good values. In two CODA tests, CG performed faster scores compared with FPCP classes (p < 0.01, d = 1.76-3.26). In IAT, FT8 class comparisons regarding the other classes were: FT5 (p = 0.047, d = 1.05), FT6 (p = 0.055, d = 1.19), and FT7 (p = 0.396, d = 0.56). With regard to MAT, FT8 class was also compared with FT5 (p = 0.006, d = 1.30), FT6 (p = 0.061, d = 0.93), and FT7 (p = 0.033, d = 1.01). No significant differences have been found between FT5, FT6, and FT7 classes. According to these results, IAT and MAT could be useful and reliable and valid tests to analyse CODA in FPCP. Each test (IAT and MAT) could be applied considering the cut point that classifiers need to make a decision about the FT8 class and the other FT classes (FT5, FT6, and FT7).