Mechanical properties, collagen and glycosaminoglycan content of equine superficial digital flexor tendons are not affected by training.

Physical activity can activate extracellular matrix (ECM) protein synthesis and influence the size and mechanical properties of tendon. In this study, we aimed to investigate whether different training histories of horses would influence the synthesis of collagen and other matrix proteins and alter the mechanical properties of tendon. Samples from superficial digital flexor tendon (SDFT) from horses that were either (a) currently race trained (n = 5), (b) previously race trained (n = 5) or (c) untrained (n = 4) were analysed for matrix protein abundance (mass spectrometry), collagen and glycosaminoglycan (GAG) content, ECM gene expression and mechanical properties. It was found that ECM synthesis by tendon fibroblasts in vitro varied depending upon the previous training history. In contrast, fascicle morphology, collagen and GAG content, mechanical properties and ECM gene expression of the tendon did not reveal any significant differences between groups. In conclusion, although we could not identify any direct impact of the physical training history on the mechanical properties or major ECM components of the tendon, it is evident that horse tendon cells are responsive to loading in vivo, and the training background may lead to a modification in the composition of newly synthesised matrix.

Enhancing endurance performance with combined imagined and actual physical practice.

PURPOSE: The perception of effort exerts influence in determining task failure during endurance performance. Training interventions blending physical and cognitive tasks yielded promising results in enhancing performance. Motor imagery can decrease the perception of effort. Whether combining motor imagery and physical training improves endurance remains to be understood, and this was the aim of this study. METHODS: Participants (24 ± 3 year) were assigned to a motor imagery (n = 16) or a control (n = 17) group. Both groups engaged in physical exercises targeting the knee extensors (i.e., wall squat, 12 training sessions, 14-days), with participants from the motor imagery group also performing motor imagery. Each participant visited the laboratory Pre and Post-training, during which we assessed endurance performance through a sustained submaximal isometric knee extension contraction until task failure, at either 20% or 40% of the maximal voluntary contraction peak torque. Perceptions of effort and muscle pain were measured during the exercise. RESULTS: We reported no changes in endurance performance for the control group. Endurance performance in the motor imagery group exhibited significant improvements when the intensity of the sustained isometric exercise closely matched that used in training. These enhancements were less pronounced when considering the higher exercise intensity. No reduction in perception of effort was observed in both groups. There was a noticeable decrease in muscle pain perception within the motor imagery group Post training. CONCLUSION: Combining motor imagery and physical training may offer a promising avenue for enhancing endurance performance and managing pain in various contexts.

Prediction and mediation analysis for treatment responses to combined cognitive and physical training for older adults.

Diminished cognitive and physical functions negatively affect the daily functions of individuals. Although combined cognitive and physical training prevents instrumental activities of daily living (IADL) disability in older adults, no predictive model or mediation analysis of IADL after combined training exists. This study aims to employ prediction and mediation analysis to identify the predictors of IADL performance and to elucidate the mediators of the association between baseline global cognition and subsequent IADL performance following combined cognitive and physical training. This study involved 177 participants aged 60 years and older who underwent combined training. Cognitive function was measured with the Montreal Cognitive Assessment (MoCA), Digit Symbol Substitution Test (DSST), Color Trails Test, Word List, and a dual task; physical function with the Timed Up and Go (TUG) test; daily function with the Lawton IADL Scale. We conducted regression analyses to identify the predictors of IADL performance, and mediation analysis to examine whether DSST and TUG mediate the relationship between MoCA and IADL. The pre-intervention DSST and TUG were significant independent predictors of post-intervention IADL. The association between the pre-intervention MoCA and post-intervention IADL was mediated by pre-intervention DSST and TUG. This study highlighted the importance of measuring and improving processing speed and functional mobility before and during interventions to enhance IADL outcomes.Trial registration: NCT03619577, 23/07/2018; NCT04689776, 29/12/2020.

Combined physical training protects the left ventricle from structural and functional damages in experimental pulmonary arterial hypertension.

BACKGROUND: Under the adverse remodeling of the right ventricle and interventricular septum in pulmonary arterial hypertension (PAH) the left ventricle (LV) dynamics is impaired. Despite the benefits of combined aerobic and resistance physical trainings to individuals with PAH, its impact on the LV is not fully understood. OBJECTIVE: To test whether moderate-intensity combined physical training performed during the development of PAH induced by MCT in rats is beneficial to the LV's structure and function. METHODS: Male Wistar rats were divided into two groups: Sedentary Hypertensive Survival (SHS, n = 7); and Exercise Hypertensive Survival (EHS, n = 7) to test survival. To investigate the effects of combined physical training, another group of rats were divided into three groups: Sedentary Control (SC, n = 7); Sedentary Hypertensive (SH, n = 7); and Exercise Hypertensive (EH, n = 7). PAH was induced through an intraperitoneal injection of MCT (60 mg/kg). Echocardiographic evaluations were conducted on the 22nd day after MCT administration. Animals in the EHS and EH groups participated in a combined physical training program, alternating aerobic (treadmill running: 50 min, 60% maximum running speed) and resistance (ladder climbing: 15 climbs with 1 min interval, 60% maximum carrying load) exercises, one session/day, 5 days/week for approximately 4 weeks. RESULTS: The physical training increased survival and tolerance to aerobic (i.e., maximum running speed) and resistance (i.e., maximum carrying load) exertions and prevented reductions in ejection fraction and fractional shortening. In addition, the physical training mitigated oxidative stress (i.e., CAT, SOD and MDA) and inhibited adverse LV remodeling (i.e., Collagen, extracellular matrix, and cell dimensions). Moreover, the physical training preserved the amplitude and velocity of contraction and hindered the reductions in the amplitude and velocity of the intracellular Ca2+ transient in LV single myocytes. CONCLUSION: Moderate-intensity combined physical training performed during the development of MCT-induced PAH in rats protects their LV from damages to its structure and function and hence increases their tolerance to physical exertion and prolongs their survival.

Effects of physical training on depression and related quality of life in pre-frail and frail older adults: a systematic review and meta-analysis.

OBJECTIVES: To investigate the effects of physical training on depression and related quality of life in pre-frail and frail individuals. DESIGN: A systematic review and meta-analysis. PARTICIPANTS: Pre-frail and frail older adults. METHODS: Five electronic databases, including PubMed, Cochrane, Medline, CINAHL, and Wiley were searched through December 2023. Randomized controlled trials (RCT) comparing physical training with usual care, health education, or light-intensity exercise were included. Outcomes included depression and depression-related quality of life. The quality of the included studies was assessed using Physiotherapy Evidence Database (PEDro) score, and the Cochrane Risk of Bias Tool was used to assess the risk of bias. Meta-analysis was performed using the RevMan5.4. The certainty of the evidence was evaluated by The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. RESULTS: Ten articles with 589 participants met the inclusion criteria and were included. The pooled analysis indicated that depression (SMD = -0.55, 95%CI = -0.92, -0.17, p = 0.004) and mental health status in life (SMD = 1.05, 95%CI = 0.59, 1.50, p < 0.00001) improved significantly in the experimental group. The results of subgroup analysis revealed that the beneficial effects of physical training were significant only in frail older adults but not in pre-frail older adults. CONCLUSION: This meta-analysis showed that the positive effects of physical training on depression and related quality of life were evident for people with frailty. However, no positive results were observed in pre-frail older adults, indicating the need for further investigation in this subgroup.

Physical Activity and Self-Determination towards Exercise among Esports Athletes.

BACKGROUND: Esports is competitive video gaming, performed within teams or individually, across multiple genres. Players are required to be sedentary for extended periods and require a high-level of cognitive skills for successful competitive performance. There are conflicting findings within the physical activity research in the esports industry. The aim of this research is to explore self-reported physical activity through accelerometer-assessed physical activity, to gain a better insight into the physical activity behaviours of international e'athletes. METHOD: Participants (n = 796) across multiple popular esports games, holding any in-game rank, competing at any level, were recruited. The survey consisted of demographic details, esports experience, the International Physical Activity Questionnaire-Long Form (IPAQ-LF), and Behavioural Regulations towards Exercise Questionnaire (BREQ-3). Within a convenience sample, local intervarsity e'athletes (n = 18) were recruited to wear a wrist-worn accelerometer to measure physical activity for 7-days and then complete the survey. Results from the accelerometers were compared to the survey results to explore physical activity reporting within this population. RESULTS: When comparing IPAQ-LF to accelerometer data, players significantly over-report moderate-to-vigorous physical activity and weekly MET-min- 1 (p = .018, r = .63 and p ≤ .001, r = .92). The BREQ-3 showed that e'athletes categorised as high physical activity displayed significantly higher levels of intrinsic motivation, when compared to players categorised as low and moderate physical activity. CONCLUSIONS: E'athletes significantly over report physical activity time when measured through the IPAQ-LF, suggesting previous surveys may overestimate physical activity and further research is needed. Given the exponential growth of the industry and the level of physical inactivity, esports may contribute to global physical inactivity levels.

Effects of anodic transcranial direct current stimulation combined with physical training on the performance of elite swimmers.

Objective: Anodal transcranial direct current stimulation (a-tDCS) has been used to improve athletic performance in various populations; however, its role in improving performance in elite athletes is unclear. This study aimed to investigate the effects of a-tDCS on athletic performance in elite athletes. Methods: We used a single-blind, randomized controlled experimental design and recruited 24 national-level freestyle swimmers from China. All athletes were randomly divided into two groups; the experimental group underwent a-tDCS (current 2 mA for 20 min) combined with physical training, and the control group underwent a-tDCS sham stimulation combined with physical training. The physical training program was identical in the experimental and control groups. The intervention period was 6 weeks, with five weekly sessions of 110 min each, consisting of 20 min of a-tDCS and 90 min of physical training. Base strength, explosive strength, aerobic endurance, and anaerobic endurance were measured in the athletes before and after the intervention. Results: The results were as follows. 1) Basic strength: There was a significant improvement in 5RM pull-ups in the experimental and control groups before and after the intervention (p < 0.05). 2) Explosive strength: There was a significant improvement in vertical jump and swimming start distance into the water in the experimental and control groups before and after the intervention (p < 0.05). 3) Aerobic endurance: There was no significant improvement in the experimental and control groups before and after the intervention. 4) Anaerobic endurance: There was a significant improvement in 400 m running performance in the experimental and control groups before and after the intervention (p < 0.05). Conclusion: Compared to physical training alone, a-tDCS combined with physical training can better improve the athletic performance of high-level swimmers, especially in basic strength, explosive strength, and aerobic endurance.

Integrated aerobic exercise with LDE-docetaxel treatment: a novel approach to combat prostate cancer progression.

The variability in response to conventional prostate cancer (PC) therapies, coupled with the emergent issue of drug resistance, underscores the critical need for innovative treatment strategies. Aerobic physical exercise reduced incidence of several cancers, but the mechanism underlying these effects associated the nanoemulsion not fully understood. The application of a lipid nanoemulsion (LDE) delivery system for docetaxel (DTX), showing marked enhancement in therapeutic efficacy when combined with aerobic physical exercise. This novel intervention potentiates the antitumor activity of LDE-delivered DTX by augmenting nanoparticle internalization and inducing cell cycle arrest. Our findings reveal that this synergistic treatment not only significantly reduces prostate weight and mitigates adenocarcinoma proliferation but also attenuates anti-apoptotic BCL-2 protein expression. Concurrently, it elevates pro-apoptotic proteins and diminishes inflammatory markers. Metabolic profiling of the combined therapy group disclosed additional benefits, such as reduced lipid and plasma glucose levels. Collectively, our data illuminate the profound impact of integrating LDE-mediated DTX delivery with structured physical exercise, which together spearhead a dual-front assault on PC. This multimodal approach heralds a new paradigm in PC management, accentuating the promise of combined pharmacological and non-pharmacological interventions to elevate tumor suppressor protein activity and refine patient outcomes.

Physical training mitigates alveolar bone and blood enzymatic antioxidants defense impairment induced by binge ethanol consumption in rats.

We aimed to investigate the effectiveness of physical training as a protective strategy to mitigate alveolar bone damage and blood antioxidant defense caused by ethanol (EtOH) consumption in a binge-drinking pattern. Male Wistar rats aged approximately 90 days were divided into four groups: control, training, EtOH, and training + EtOH. The physical training protocol was conducted on a treadmill for four consecutive weeks, while the animals in the EtOH group were administered EtOH via orogastric gavage for three consecutive days each week, following the binge drink pattern. After the training period, blood and mandibles were collected for plasma oxidative biochemistry analysis, and the alveolar bone was subjected to physicochemical composition analysis, tissue evaluation, and microtomography evaluation. Our results showed that EtOH induced oxidative stress and physical exercise promoted the recovery of antioxidant action. Physical training minimized the damage to the mineral/matrix composition of the alveolar bone due to EtOH consumption and increased the density of osteocytes in the trained group treated with EtOH than in those exposed only to EtOH. Furthermore, physical training reduced damage to the alveolar bone caused by EtOH consumption. Our findings suggest that physical training can serve as an effective strategy to reduce systemic enzymatic oxidative response damage and alleviate alveolar bone damage resulting from alcohol consumption. Further investigations are warranted to elucidate the underlying mechanisms and explore, in addition to physical training, the potential effects of other activities with varying intensities on managing alcohol-induced bone damage.

Lower-body muscular power predicts performance on urban combat simulation.

BACKGROUND: Military operations in urban environments requires faster movements and therefore may place greater demands on soldier strength and anaerobic ability. OBJECTIVE: The aim was to study how physical fitness and body composition are associated with occupational test for urban combat soldiers before and after a 5-day military field exercise (MFE). METHODS: Twenty-six conscripts (age = 20±1 yrs.) volunteered, of which thirteen completed the study. Occupational performance was determined by using the newly developed Urban Combat Simulation test (UCS); which included 50-m sprinting, moving a truck tire (56 kg) 2 meters with a sledgehammer, a 12-m kettlebell carry (2×20 kg) up the stairs with a 3-m ascent, 4-time sandbag lifts (20 kg) with obstacle crossing, and a 20-m mannequin (85 kg) drag. Aerobic and muscle fitness, as well as anaerobic capacity were measured, and, body composition was assessed with multifrequency bioimpedance analysis. RESULTS: The UCS performance correlated significantly with standing long jump performance, as well as lower and upper body maximal strength before (r = -0.56 to -0.66) and after (r = -0.59 to -0.68) MFE, and, with body mass and FFM before (r = -0.81 to -0.83) and after (r = -0.86 to -0.91) MFE. In the regression analyses, fat free mass (R2 = 0.50, p = 0.01) and counter movement jump in combat load (R2 = 0.46, p = 0.009) most strongly explained the UCS performance. CONCLUSION: This study demonstrated that muscle mass and lower body explosive force production together with maximal strength are key fitness components related to typical urban combat soldiers' military tasks. Physical training developing these components are recommended.

Impact of the COVID-19 pandemic on training and technology use among Chilean amateur athletes.

Introduction: The COVID-19 pandemic was a health problem which affected the entire world. Sports were strongly affected, especially outdoors. The purpose of this study was to evaluate the impact of COVID-19 pandemic on training and technology use among Chilean amateur athletes. Method: An observational descriptive cross-sectional study, carried out during the 2021-2. Nonprobabilistic convenience sample of people over 18 years. Data were obtained via online survey and analyzed with Stata 16.0 statistical program for runners, triathletes, cyclists. Results: The sample was 179 athletes, average age was 42.5 years ±10.2; males were 58.6%. 22.65% of the sample were triathletes, 58% runners, and 18.2% cyclists. Training habits were measured during Pre-Pandemic (PP), Pandemic With Quarantine (PWQ), and Pandemic Without Quarantine (PWOQ). In total sample, a decrease was observed in variables of average training frequency of 1.28 sessions per week (p = 0.001; d = 0.648); weekly average training time of 189.63 min (p = 0.005; d = 0.293); days per week with high and medium intensity training of 0.95 (p = 0.001; d = 0.833) and 0.37 (p = 0.001; d = 0.327) respectively; and days per week with cardio training of 1.01 (p = 0.001; d = 0.678), comparing the PP and PWQ periods. When comparing PWQ and PWOQ, an increase was observed in the same variables mentioned above of 1,57 sessions per week (p = 0.001; d = 0.513); 162.68 min per week (p = 0.020; d = -0.245); days per week with high of 0.82 (p = 0.001; d = -0.714) and medium intensity training of 0.46 (p = 0.001; d = -0.412); days per week with cardio training of 1.14 (p = 0.001; d = -0.730); and included strength training of 0.42 (p = 0.012; d = -0.312). For technology incorporation, over 78% (p = 0.023) claimed to used devices to measure training, with the watch being the preferred device in over 72% (p = 0.002) during the three timeframes. Highlighted the rise in use of training software during and after the lockdown period of more than 23% (p < 0.001). Discussion: All variables related with training habits decreased comparing PP and PWQ and all variables rose between PWQ and PWOQ; however, comparing PP and PWOQ, there are small differences, which do not always favor the PWOQ, reflecting how athletes have not yet been able to recover their training rhythms. Finally, we should note that the use of technology increased, in all periods.

Beyond change scores: Employing an improved statistical approach to analyze the impact of entry fitness on physical performance during British Army basic training in men and women.

The aim was to use a robust statistical approach to examine whether physical fitness at entry influences performance changes between men and women undertaking British Army basic training (BT). Performance of 2 km run, seated medicine ball throw (MBT) and isometric mid-thigh pull (MTP) were assessed at entry and completion of Standard Entry (SE), Junior Entry-Short (JE-Short), and Junior Entry-Long (JE-Long) training for 2350 (272 women) recruits. Performance change was analyzed with entry performance as a covariate (ANCOVA), with an additional interaction term allowing different slopes for courses and genders (p < 0.05). Overall, BT courses saw average improvements in 2 km run performance (SE: -6.8% [-0.62 min], JE-Short: -4.6% [-0.43 min], JE-Long: -7.7% [-0.70 min]; all p < 0.001) and MBT (1.0-8.8% [0.04-0.34 m]; all p < 0.05) and MTP (4.5-26.9% [6.5-28.8 kg]; all p < 0.001). Regression models indicate an expected form of "regression to the mean" whereby test performance change was negatively associated with entry fitness in each course (those with low baseline fitness exhibit larger training improvements; all interaction effects: p < 0.001, η p 2 $$ {\eta}_{\mathrm{p}}^2 $$ > 0.006), particularly for women. However, when matched for entry fitness, men displayed considerable improvements in all tests, relative to women. Training courses were effective in developing recruit physical fitness, whereby the level of improvement is, in large part, dependent on entry fitness. Factors including age, physical maturity, course length, and physical training, could also contribute to the variability in training response between genders and should be considered when analyzing and/or developing physical fitness in these cohorts for future success of military job-task performance.

Physical exercise is essential for increasing ventricular contractility in hypertensive rats treated with losartan.

The treatment of hypertensive patients with losartan is very common. Despite the reduction in blood pressure, its effects on cardiac contractility and sympathetic autonomic drive are still controversial. In turn, aerobic physical training (APT) also presents an important therapeutic option, providing significant improvements in cardiovascular autonomic control, however little is known about its effects on cardiac contractility, especially when associated with losartan. Therefore, we investigated in spontaneously hypertensive rats (SHR) the effects of losartan and APT on cardiac hemodynamics and functionality, with emphasis on autonomic tonic balance and cardiac contractility. Sixty-four SHR (18 weeks old) were divided into four groups (N = 16): vehicle; vehicle submitted to APT through swimming for 12 weeks; treated with losartan (5 mg·kg-1·d-1) for 12 weeks; and treated with losartan associated with APT. The groups were submitted to cardiac morphological and functional analysis by echocardiography; double blockade of cardiac autonomic receptors with atropine and propranolol; and coronary bed reactivity and left ventricular contractility analyses by the Langendorff technique. APT improved functional parameters and autonomic balance by reducing sympathetic drive and/or increasing vagal drive. In contrast, it promoted a concentric remodeling of the left ventricle (LV). Treatment with losartan reduced sympathetic autonomic drive and cardiac morphological parameters, but there were no significant gains in cardiac functionality and contractility. When combined, the concentric remodeling of the LV to APT was abolished and gains in cardiac functionality and contractility were observed. Our findings suggest that the effects of losartan and APT are complementary and should be applied together in the treatment of hypertension. In spontaneously hypertensive rats, the combination of aerobic physical training with losartan treatment was crucial to greater blood pressure reductions and an increase in left ventricular contractility. Furthermore, losartan treatment prevented the concentric left ventricular remodeling caused by aerobic physical training.

Physical training improves inhibitory control in children aged 7-12 years: An fNIRS study.

Physical exercise plays a crucial role in the development of cognition and brain functions in children. Inhibitory control is an advanced cognition that affects children's life and learning. In the current study, the relationship between physical training and inhibitory control was explored. In total, 80 children were randomly but equally assigned to the experimental and control groups. The experimental group underwent physical training (volleyball) for 60 min, thrice a week for 12 weeks. In contrast, the control group did not undergo any training and continued with their daily routines. The flanker task and functional near-infrared spectroscopy (fNIRS) were employed to investigate the effects of 12-week physical training on inhibitory control and changes in the oxy-Hb concentration in the prefrontal cortex (PFC) during the task. The behavioral results revealed that the experimental group performed better on the flanker task (e.g., shorter response time [F(1,74) = 18.420, p < 0.001, ηp2 = 0.199] and higher accuracy [F(1,74) = 15.00, p < 0.001, ηp2 = 0.169] than the control group. The oxy-Hb concentration in the right dorsolateral PFC (R-DLPFC) was higher and the activation level of this region was higher during the flanker task [F(1,74) = 6.216, p < 0.05, ηp2 = 0.077]. Moreover, the McNemar test revealed improved cognitive performance in response time or accuracy and R-DLPFC activation induced by physical exercise coincided significantly (χ2 = 5.49, p < 0.05; χ2 = 6.081, p < 0.05). These findings suggest that the R-DLPFC is likely the neural substrate for improved cognitive performance elicited by 12-week physical training.

Effects of a home care community-dwelling intervention on cognition, mental health, loneliness and quality of life in elder people: The VERA study.

BACKGROUND: New technologies can provide practical solutions that respond to the needs of the elderly, improving their quality of life and well-being. The aim of this research was to validate a multimodal approach based on a video call system, by comparing the scores of different clinically validated tests at baseline and at the end of the intervention. METHODS: A longitudinal study was conducted with 7 healthy participants aged 61 to 92 years over a 6-month period. To measure the effectiveness of the intervention, five variables were assessed: cognitive impairment, quality of life, general health, perceived loneliness, and depression. The following inventories were used as instruments to measure the aforementioned variables at baseline, mid intervention and after intervention: MEC-35 scale, Fototest, FUMAT scale, WHOQOL-BREF scale, Yesavage Geriatric Depression Scale, the Spanish adaptation of the Hamilton Scale, the revised ESTE scale and the Goldberg's GHQ28 Mental Health scale. RESULT: The obtained results confirmed our hypothesis and the participants showed significant improvements after intervention in all the assessed domains except the cognitive domain, as expected. Results in FUMAT, WHOQOL-BREF, Yesavage Geriatric Depression, revised ESTE and the Goldberg's GHQ28 Mental Health scales were statistically significant (p < 0.05) and the effect sizes were large after intervention compare to baseline. CONCLUSIONS: We have shown that the intervention has been effective in providing the participants with psychological and social benefits in the variables of quality of life, general health, perceived loneliness and depression. The high clinical relevance achieved from the results obtained makes the system a very suitable tool to promote the independence and well-being of people who receive community-dwelling home care.

Real-time athletes status feedback and guidance based on smart wearable devices

Physical training for basketball players is important for improving the overall economic level of athletes. Smart wearable devices can enable coaches and athletes to plan and adjust training more scientifically and accurately by monitoring and recording athletes' physiological data and sports performance in real time. In this study, two sports physiological indexes, heart rate and blood oxygen saturation, were monitored and recorded by Xiaomi sports band 7 for basketball players, and a comparative study was conducted on the physical training process of adolescent female basketball players. The experiment proves that the real-time heart rate and blood oxygen saturation parameters provided by Xiaomi sports band 7 can reflect the athlete's body's adaptation to the training content in real time, and the coaches can better grasp the athlete's physical fitness level and improve the training effect by adjusting the training intensity (AU)

Efficacy of supervised exercise on sleep of women who survived breast cancer: a systematic review with meta-analysis.

PURPOSE: To analyze the efficacy of supervised exercise (SE) compared with control protocols on sleep parameters of women who survived breast cancer. METHODS: This systematic review with meta-analysis searched studies using the following electronic databases: PubMed, Scopus, Physiotherapy Evidence Database (PEDro), Cochrane Library, and EMBASE. The PEDro scale assessed the bias risk, and the study protocol was registered in the PROSPERO (no. CRD42023420894). RESULTS: Of 3,566 identified studies, 13 randomized clinical trials involving 847 women diagnosed with breast cancer were included. Interventions consisted of SE in an outpatient setting (62%) or combined protocols with supervised and home exercises. Most interventions (85%) used multicomponent protocols with aerobic and resistance exercises. Usual care and health education were the most reported controls. SE decreased the sleep disturbance score (- 31.61 [95% confidence interval = - 39.40 to - 23.83]) of the European Organisation for Research and Treatment of Cancer quality of life questionnaire and daytime dysfunction score (- 0.41 [95% confidence interval = - 0.73 to - 0.09]) of the Pittsburgh Sleep Quality Index (PSQI). Also, SE presented a tendency to improve the self-reported sleep quality score of the PSQI (p = 0.06). CONCLUSION: SE increased the subjective sleep quality and immobility time and decreased sleep disturbance and daytime dysfunction symptoms in women who survived breast cancer. Most SE protocols were multicomponent, with aerobic and resistance exercises ranging from moderate to high intensity. IMPLICATIONS FOR CANCER SURVIVORS: Supervised exercise may improve sleep quality and reduce symptoms of sleep disorders, contributing to survival outcomes.

Multimodal home-based rehabilitation intervention after discharge from inpatient geriatric rehabilitation (GeRas): study protocol for a multicenter randomized controlled trial.

BACKGROUND: Geriatric rehabilitation aims to maintain the functional reserves of older adults in order to optimize social participation and prevent disability. After discharge from inpatient geriatric rehabilitation, patients are at high risk for decreased physical capacity, increased vulnerability, and limitations in mobility. As a result, ageing in place becomes uncertain for a plethora of patients after discharge from geriatric rehabilitation and effective strategies to prevent physical decline are required. Collaboration between different health-care providers is essential to improve continuity of care after discharge from inpatient geriatric rehabilitation. The aim of this study is to evaluate the effectiveness of a multi-professional home-based intervention program (GeRas) to improve functional capacity and social participation in older persons after discharge from inpatient geriatric rehabilitation. METHODS: The study is a multicenter, three-arm, randomized controlled trial with a three-month intervention period. Two hundred and seventy community-dwelling older people receiving inpatient geriatric rehabilitation will be randomized with a 1:1:1 ratio to one of the parallel intervention groups (conventional IG or tablet IG) or the control group (CG). The participants of both IGs will receive a home-based physical exercise program supervised by physical therapists, a nutritional recommendation by a physician, and social counseling by social workers of the health insurance company. The collaboration between the health-care providers and management of participants will be realized within a cloud environment based on a telemedicine platform and supported by multi-professional case conferences. The CG will receive usual care, two short handouts on general health-related topics, and facultative lifestyle counseling with general recommendations for a healthy diet and active ageing. The primary outcomes will be the physical capacity measured by the Short Physical Performance Battery and social participation assessed by the modified Reintegration to Normal Living Index, three months after discharge. DISCUSSION: The GeRas program is designed to improve the collaboration between health-care providers in the transition from inpatient geriatric rehabilitation to outpatient settings. Compared to usual care, it is expected to improve physical capacity and participation in geriatric patients after discharge from inpatient geriatric rehabilitation. TRIAL REGISTRATION: German Clinical Trials Register (DRKS00029559). Registered on October 05, 2022.

Long-term effects of physical training on cardiopulmonary exercise parameters in young patients with congenital heart diseases.

INTRODUCTION: Physical activity is recognised as an important intervention in patients with CHD. However, more data on the actual magnitude of physical training impact on functional capacity in this group of patients are still warranted. We aim to assess effort tolerance in a contemporary cohort of patients with congenital heart disease, regularly following a training programme, in comparison with a matched control group. METHODS: Patients with CHD followed at the sports medicine department, who had undergone cardiopulmonary exercise test between 2011 and 2019, were included. Variables recorded were maximum workload, absolute and indexed maximum oxygen consumption, maximum heart rate, absolute and indexed maximum O2 pulse, ventilatory equivalent of CO2 and oxygen consumption/Work. Trend of cardiopulmonary parameters was analysed over time. Maximal workload, maximum oxygen consumption and ventilatory equivalent of CO2 were compared with a control group of patients with a more sedentary lifestyle, matched for diagnosis, gender, age, and body mass index. RESULTS: Among one hundred and eleven patients, 73 males (66%) were analysed. Median age was 14 (12-17) years. Twenty-nine patients (27%) were practising sports at competitive level. Maximum oxygen consumption and oxygen consumption % of maximum predicted were not significantly different at follow-up as compared with baseline. Follow-up of maximum oxygen consumption was 38.2 ± 9 ml/kg/min versus 38.6 ± 9.2 ml/kg/min (p = NS) and follow-up of %oxygen consumption was 88 ± 20 versus 87 ± 15 (p = NS). Ventilatory equivalent of CO2 significantly improved in the last test as compared with the baseline: 30 ± 4 versus 33 ± 5 (p = 0.002). As compared with the control group, trained patients displayed a significantly higher maximum workload and oxygen consumption, while ventilatory equivalent of CO2 was not significantly different. CONCLUSIONS: In our cohort, patients following a regular training programme displayed a significantly higher functional capacity as compared with not trained control group, irrespective of NYHA class. Objective functional capacity was stable over a median follow-up of 3 years.

The Impact of Multimorbidity Patterns on Changes in Physical Activity and Physical Capacity Among Older Adults Participating in a Year-Long Exercise Intervention.

This study investigated the impact of multimorbidity patterns on physical activity and capacity outcomes over the course of a year-long exercise intervention, and on physical activity 1 year later. Participants were 314 physically inactive community-dwelling men and women aged 70-85 years, with no contraindications for exercise at baseline. Physical activity was self-reported. Physical capacity measurements included five-time chair-stand time, 6-minute walking distance, and maximal isometric knee-extension strength. The intervention included supervised and home-based strength, balance, and walking exercises. Multimorbidity patterns comprised physician-diagnosed chronic disease conditions as a predictor cluster and body mass index as a measure of obesity. Multimorbidity patterns explained 0%-12% of baseline variance and 0%-3% of the change in outcomes. The magnitude and direction of the impact of unique conditions varied by outcome, time point, and sex. Multimorbid older adults with no contraindications for exercise may benefit from multimodal physical training.