Acute neuromuscular and perceptual responses to blood flow restriction exercise in adults with severe haemophilia: A pilot study.

INTRODUCTION: No previous studies have implemented a standard blood flow restriction (BFR) training session in people with severe haemophilia (PwH), where this type of training has been contraindicated. AIMS: The purpose of this study was to evaluate the tolerability, adverse events, and neuromuscular and perceptual responses to an acute session of low load (LL) knee extensions with BFR in PwH under prophylaxis. METHODS: Eight PwH performed one LL-BFR session with 40% arterial occlusion pressure (AOP). Perceptual responses and adverse effects were assessed, together with high-density surface electromyography of vastus medialis (VM) and lateralis (VL). RESULTS: Significant normalized root mean square differences were found within each set, but not between sets. Spatial distribution (centroid displacement (p > .05), modified entropy (VM, set two, cycles three and five, p = .032) and coefficient of variation (VM, set two, cycles four and five lower than cycle three (p = .049; p = .036)) showed changes within each set. Median frequency showed a slight increase during cycle four of set four (p = .030). Rate of perceived exertion slightly increased with each set while tolerability slightly decreased in the last set and fear of training with BFR generally decreased after the session. CONCLUSIONS: In PwH, a LL-BFR session at 40% AOP is safe and feasible. Our results suggest that potential muscle impairments may blunt neuromuscular adaptations induced by BFR.

Multimodal sensorimotor assessment of hand and forearm asymmetries: a reliability and correlational study.

Background: Effective rehabilitation of upper limb musculoskeletal disorders requires multimodal assessment to guide clinicians' decision-making. Furthermore, a comprehensive assessment must include reliable tests. Nevertheless, the interrelationship among various upper limb tests remains unclear. This study aimed to evaluate the reliability of easily applicable upper extremity assessments, including absolute values and asymmetries of muscle mechanical properties, pressure pain threshold, active range of motion, maximal isometric strength, and manual dexterity. A secondary aim was to explore correlations between different assessment procedures to determine their interrelationship. Methods: Thirty healthy subjects participated in two experimental sessions with 1 week between sessions. Measurements involved using a digital myotonometer, algometer, inclinometer, dynamometer, and the Nine-Hole Peg test. Intraclass correlation coefficients, standard error of the mean, and minimum detectable change were calculated as reliability indicators. Pearson's correlation was used to assess the interrelationship between tests. Results: For the absolute values of the dominant and nondominant sides, reliability was 'good' to 'excellent' for muscle mechanical properties, pressure pain thresholds, active range of motion, maximal isometric strength, and manual dexterity. Similarly, the reliability for asymmetries ranged from 'moderate' to 'excellent' across the same parameters. Faster performance in the second session was consistently found for the Nine-Hole Peg test. No systematic inter-session errors were identified for the values of the asymmetries. No significant correlations were found between tests, indicating test independence. Conclusion: These findings indicate that the sensorimotor battery of tests is reliable, while monitoring asymmetry changes may offer a more conservative approach to effectively tracking recovery of upper extremity injuries.

Identification of physically demanding work tasks among cleaners: field study using electromyography.

While chronic forearm pain is a common and debilitating condition among cleaners, the most physically demanding tasks remain unidentified. The present field study examines forearm muscle activity during 9 common cleaning tasks in a real working environment. Seven healthy cleaners participated in this study (age: 35.17 ± 9.62 yr; height: 168.17 ± 8.06 cm; weight: 77.14 ± 13.78 kg; experience: 5.60 ± 3.29 yr). Surface wireless electromyography (EMG) was recorded from 2 muscles on both sides of the upper limb, flexor carpi ulnaris (FCU), and extensor carpi radialis (ECR), and normalized to maximal voluntary isometric contractions (MVIC). Top-3 demanding high-force tasks (90th percentile EMG) were the rough floor, dirty rough floor, and office floor mopping for the FCU, and mopping high walls, ceiling mopping, and baize cleaning for the ECR. Top-3 static work tasks (10th percentile EMG) were mopping low walls, ceiling mopping, and dirty rough floors mopping for the FCU and mopping of high walls, low walls, and ceiling for the ECR. The study identified the forearm muscles' most physically demanding work tasks during cleaning tasks. The development of better working tools is recommended to avoid high-force overload as well as prolonged static overload of these muscles in cleaners.

Influence of brick laying height on biomechanical load in masons: Cross-sectional field study with technical measurements.

BACKGROUND: Work-related musculoskeletal disorders (WMSDs) located in the low back and neck/shoulder regions are major concerns for both workers, workplaces, and society. Masons are prone to WMSD, because their work is characterized by repetitive work and high physical workload. However, the knowledge on the physical workload during bricklaying is primarily based on subjective measurements. OBJECTIVE: This cross-sectional field study with technical measurements aimed to quantify physical workload in terms of muscular activity and degree of forward bending during bricklaying at different working heights among masons, i.e., knee, hip, shoulder, and above shoulder height. METHODS: Twelve male (36.1±16.1 years) experienced masons participated in a cross-sectional field study with technical measurements. Surface electromyography from erector spinae longissimus and upper trapezius muscles and an inertial measurement unit-sensor placed on the upper back were used to assess the physical workload (level of muscle activation and degree of forward bending) different bricklaying heights. Manual video analysis was used to determine duration of work tasks, frequency, type, and working height. The working heights were categorized as 'knee', 'hip', 'shoulder', and 'above shoulder'. The 95 percentiles of the normalized Root Mean Square (RMSn) values were extracted assess from erector spinae and trapezius recordings to assess strenuous level muscle of muscle activation. RESULTS: The RMSn of dominant erector spinae muscle increased from hip- to shoulder height (from 26.6 to 29.6, P <  0.0001), but not from hip to above shoulder height and decreased from hip to knee height (from 26.6 to 18.9, P <  0.0001). For the dominant trapezius muscle, the RMSn increased from hip- to shoulder- and above shoulder height (from 13.9 to 19.7 and 24.0, respectively, P <  0.0001) but decreased from hip- to knee height (from 13.9 to 11.5, P <  0.0001). Compared to hip height (27.9°), an increased forward bending was detected during bricklaying at knee height (34.5°, P <  0.0001) and a decreased degree of forward bending at shoulder- and above shoulder height (17.6° and 12.5°, P <  0.0001, respectively). CONCLUSION: Based on technical measurements, bricklaying at hip height showed the best compromise between muscular load and degree of forward bending. This study contributes to the development of the work environment for masons and can help guide preventive initiatives to reduce physical workload.

Longitudinal Associations between 24-h Movement Behaviors and Cardiometabolic Biomarkers: A Natural Experiment over Retirement.

INTRODUCTION: Physical activity, sedentary behavior, and sleep, that is, 24-h movement behaviors, often change in the transition from work to retirement, which may affect cardiometabolic health. This study investigates the longitudinal associations between changes in 24-h movement behaviors and cardiometabolic biomarkers during the retirement transition. METHODS: Retiring public sector workers ( n = 212; mean (SD) age, 63.5 (1.1) yr) from the Finnish Retirement and Aging study used a thigh-worn Axivity accelerometer and filled out a diary to obtain data on daily time spent in sedentary behavior (SED), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA), and sleep before and after retirement (1 yr in-between). Cardiometabolic biomarkers, including LDL-cholesterol, HDL-cholesterol, total/HDL-cholesterol ratio, triglycerides, C-reactive protein, fasting glucose, and insulin, were measured. Associations between changes in 24-h movement behaviors and cardiometabolic biomarkers were analyzed using compositional robust regression and isotemporal substitution analysis. RESULTS: Increasing LPA in relation to remaining behaviors was associated with an increase in HDL-cholesterol and decrease in total/HDL-cholesterol ratio ( P < 0.05 for both). For instance, reallocation of 30 min from sleep/SED to LPA was associated with an increase in HDL-cholesterol by 0.02 mmol·L -1 . Moreover, increasing MVPA in relation to remaining behaviors was associated with a decrease in triglycerides ( P = 0.02). Reallocation of 30 min from SED/sleep to MVPA was associated with 0.07-0.08 mmol·L -1 decrease in triglycerides. Findings related to LDL-cholesterol, C-reactive protein, fasting glucose, and insulin were less conclusive. CONCLUSIONS: During the transition from work to retirement, increasing physical activity at the expense of passive behaviors was associated with a better lipid profile. Our findings suggest that life transitions like retirement could be utilized more as an optimal time window for promoting physical activity and health.

Association of objectively measured lifting load with low-back pain, stress, and fatigue: A prospective cohort study.

OBJECTIVES: Limited knowledge exists about the association of lifting loads on a daily basis with physical and mental symptoms among warehouse workers. This study investigated associations between objectively measured lifting load and low-back pain (LBP), mental stress, and bodily fatigue after work and the following morning. METHODS: Warehouse workers (N=85) from the retail industry replied to daily questionnaires before and after work for 21 days about LBP intensity, mental stress, and bodily fatigue (outcome, all scales 0-10). We assessed lifting exposure using company records from the warehouse logistic systems on total lifting load (kg) per workday. Associations between variables were tested using linear mixed models with repeated measures controlling for relevant confounders. RESULTS: Mean daily lifting load was 1667.2 kg (range: 0-9998.4 kg). Compared to lifting 0-499 kg during a workday, lifting 500-1999 kg was associated with 0.59 points [95% confidence interval (CI) 0.10-1.08] elevated LBP intensity after work, while lifting ≥5000 showed a higher LBP intensity of 1.26 points (95% CI 0.48-2.03). LBP intensity remained elevated the following morning. Lifting ≥5000 kg was associated with higher mental stress after work of 0.74 points (95% CI 0.10-1.37), while no association was observed for bodily fatigue. CONCLUSIONS: Higher daily lifting loads were associated with higher LBP intensity after work and the following morning. These findings suggest that warehouses should consider the daily lifting loads when organizing warehouse work to prevent development of LBP, eg, using company records to provide a more equal distribution of daily lifting loads between workers.

Effects of consecutive workdays and days off on low back pain, fatigue and stress: prospective cohort study among warehouse and construction workers.

OBJECTIVES: Limited knowledge exists about day-to-day changes in physical and mental symptoms in warehouse and construction workers. This study investigated the associations between consecutive workdays and days off with low back pain (LBP) intensity, bodily fatigue and mental stress. METHODS: Participants (n=224) received daily questions for 21 days about LBP, fatigue, stress (outcome, 0-10 scales), and workdays and days off (exposure). We tested associations between 1-3 workdays (n=148) and 1-2 days off (n=158) with LBP intensity, bodily fatigue and mental stress after work and the following morning using linear mixed models with repeated measures controlling for relevant confounders. RESULTS: Consecutive workdays led to progressively increased LBP intensity, with three workdays increasing LBP intensity by 1.76 (95% CI 1.48 to 2.03) points. Bodily fatigue and mental stress increased after one workday (2.06 (95% CI 1.80 to 2.32) and 0.97 (95% CI 0.77 to 1.17) points, respectively) and remained stable for three workdays. After 1 day off, bodily fatigue and mental stress decreased -1.82 (95% CI -2.03 to -1.61) and -0.88 (95% CI -1.05 to -0.71) points, respectively, without decreasing further. In contrast, LBP intensity decreased progressively -1.09 (95% CI -1.27 to -0.91) and -1.45 (95% CI -1.67 to -1.24) points after 1 and 2 days off, respectively. CONCLUSIONS: Workdays and days off affected the outcome variables differently. LBP intensity progressively increased with consecutive workdays, while workers needed 2 days off to recover. This study provides valuable knowledge about how to organise the workweek to prevent LBP, fatigue and stress, potentially reducing labour market withdrawal.

Acts of offensive behaviour and risk of disability pension in Danish female eldercare workers: prospective cohort with 11-year register follow-up.

OBJECTIVES: To investigate whether acts of offensive behaviour (threats, violence, workplace bullying and sexual harassment) in the workplace and type of perpetrator (internal or external to the workplace) of the offensive behaviours predicted risk of disability pension in Danish eldercare workers. METHODS: We merged survey responses from 8731 female eldercare workers with a national register on social transfer payments (Danish Register for Evaluation of Marginalisation (DREAM)), including all types of disability benefits. Using Cox proportional hazards models, we investigated the prospective association between self-reported exposures at baseline and the risk of receiving disability pension (any type of disability benefit payment) during 11 years of follow-up, while adjusting for potential confounders. RESULTS: Self-reported exposure to threats (hazard ratio (HR) 1.14; 95% confidence interval (CI) 1.00-1.32), violence (HR 1.16; 95% CI 1.00-1.35) and bullying (HR 1.44; 95% CI 1.22-1.71) predicted increased risk of disability pension during follow-up, when adjusted for age and educational attainment. When further adjusted for psychosocial working conditions only bullying remained a statistically significant (HR 1.39; 95% CI 1.16-1.67) predictor of disability pension. The results indicated no elevated risk for participants reporting sexual harassment. Moreover, we observed stronger associations between self-reported exposure to threats, violence and workplace bullying and risk of disability pension when the perpetrator was internal to the workplace (i.e. colleagues, managers and/or subordinates), than when the perpetrator was reported to be external to the workplace (i.e. service users, and/or relatives of service users). CONCLUSIONS: Results indicate that prevention of work-related exposure to threats, violence and workplace bullying may contribute to reduce involuntary early retirement in female eldercare workers.

Exploring exposure to multiple psychosocial work factors: prospective associations with depression and sickness absence.

BACKGROUND: Most studies on the psychosocial working environment have focused on evaluating the isolated effect of individual psychosocial work factors or looked at effects through a lens of theories such as job strain or effort-reward imbalance. However, to fathom the intricate nature of workers' experience of occupational strain, there is a need to investigate the combined and cumulative effects of multiple exposures to psychosocial work factors on workers' health. METHODS: In this prospective cohort study, we created an additive index (range 0-4) on number of baseline exposures to quantitative demands, emotional demands, role conflicts, and workplace bullying. Via logistic regression and Cox regression, we estimated the association between the additive index of psychosocial work factors and depressive disorder and long-term sickness absence (LTSA). We assessed the onset of depressive disorder using the Major Depression Inventory at 6-month follow-up and the onset of LTSA using a national register during 12-month follow-up. RESULTS: For onset of depressive disorder, high exposure to any one [odds ratio (OR) 2.98], two (OR 3.14), three (OR 6.44) and all four (OR 9.62) adverse psychosocial work factors predicted a statistically significant increased risk. For onset of LTSA, high exposure to any one [hazard ratio (HR) 1.13], two (HR 1.67), three (HR 2.31) and all four (HR 4.04) psychosocial work factors predicted an increased risk. The two latter associations were statistically significant. Trend tests indicated an exposure-response relationship for both outcomes. CONCLUSIONS: Workers reporting exposure to multiple adverse psychosocial work factors had a higher risk of developing depressive disorder and LTSA.

Handgrip strength and work limitations: A prospective cohort study of 70,820 adults aged 50 and older.

The purpose of the study was to investigate the association between handgrip strength and the incidence of work limitations in European adults aged 50 and older. We conducted a prospective cohort study among adults aged 50 and older from 27 European countries and Israel. Data were collected from the Survey of Health, Ageing and Retirement in Europe (SHARE) waves 1, 2, 4, 5, 6, and 7. Handgrip strength was measured using a hand dynamometer (Smedley, S Dynamometer, TTM) and participants replied to questions about work limitations. Cox regression was conducted for statistical analyses. A total of 70,820 older adults (mean age 61 ± 7.7 years; 54.3 % women) were followed during a mean of 3.8 ± 2.9 years. The fully adjusted model showed that participants with low handgrip strength (<16 kg in women and <27 kg in men) had a significantly higher risk of work limitations compared with participants with normal values of handgrip strength (hazard ratio: 1.36; 95 % confidence interval: 1.28-1.44). Kaplan-Meier trajectories revealed that the survival probability to experience work limitations in the normal handgrip category was 20 % lower than in the low handgrip category in most of the follow-up period. We identified low level of handgrip strength as a risk factor for work limitations in adults aged 50 years or older. This could be used as an accessible measure to screen workers at risk of developing work limitations.

Modifications of 24-h movement behaviors to prevent obesity in retirement: a natural experiment using compositional data analysis.

BACKGROUND: Retirement often leads to a more passive lifestyle and may therefore lead to weight gain. This study aims to investigate longitudinal associations between changes in 24-h movement behaviors and BMI and waist circumference in relation to the transition from work to retirement. METHODS: The study population included 213 retiring public sector workers (mean age 63.5 years, standard deviation 1.1) from the Finnish Retirement and Aging study. Before and after retirement participants wore an Axivity accelerometer on their thigh and filled in a daily log for at least four days to measure daily time spent sleeping, in sedentary behavior (SED), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA). Also, their body mass index (BMI) and waist circumference were measured repeatedly. Compositional linear regression analysis and isotemporal substitution analysis were used to study associations between one-year changes in 24-h movement behaviors and concurrent changes in BMI and waist circumference. RESULTS: An increase in MVPA in relation to sleep, SED and LPA was associated with a decreasing BMI (ß = -0.60, p = 0.04) and waist circumference (ß = -2.14, p = 0.05) over one year from before retirement to after retirement. In contrast, increasing sleep in relation to SED, LPA and MVPA was associated with an increasing BMI (ß = 1.34, p = 0.02). Reallocating 60 min from MVPA to SED or sleep was estimated to increase BMI by on average 0.8-0.9 kg/m2 and waist circumference by 3.0 cm during one year. CONCLUSIONS: During the transition from work to retirement, increasing MVPA was associated with a slight decrease in BMI and waist circumference, whereas increasing sleep was associated with an increasing BMI. Common life transitions, like retirement, should be considered when giving recommendations and guidance for physical activity and sleep.

Expected reasons for leaving the labour market and loss of paid employment among older workers: prospective cohort study.

BACKGROUND: Surveying expected reasons for retirement may be a useful strategy to maintain labor market affiliation. The aim was to investigate the prospective association between self-reported expected reasons for leaving the labour market and subsequent loss of paid employment before the state pension age among older workers. METHODS: The prospective risk of loss of paid employment before the official state pension age was estimated from expected reasons for leaving the labour market among 10,320 currently employed older workers (50-63 years) from the SeniorWorkingLife study. In 2018, participants replied to 15 randomly ordered questions about expected reasons for leaving the labour market and were in 2020 followed in a national register containing information on labour market participation. RESULTS: Loss of paid employment before state pension age was predicted by expected reasons related to 'Health, work demands and occupational well-being': 'Poor physical health' (RR 1.47, 95% CI 1.45-1.49), 'Poor mental health' (RR 1.36, 95% CI 1.32-1.40), 'Not being capable of doing the job' (RR 1.20, 95% CI 1.18-1.22), and 'Not thriving at the workplace' (RR 1.14, 95% CI 1.11-1.17). Expected reasons related to the possibility of receiving voluntary early retirement benefits also increased this risk. Expected reasons related to 'Leisure' ('Wish for more self-determination'; 'Wish for more time for hobbies'), 'Economy' ('Economic considerations'; 'Possibility of receiving pension'), and 'Norms' ('Retirement norms'; 'To make space for younger employees') decreased the risk of loss of paid employment before state pension age. Age-stratified analyses revealed that expected reasons related to the domain of 'Health, work demands and occupational well-being' predicted risk of loss of paid employment to a greater extent among workers aged 50-55 compared to those aged 56-63. CONCLUSIONS: Expected reasons for leaving the labour market predicted actual labour market participation among older workers in Denmark. Expected reasons related to poor physical and mental health, and not being capable of doing the job seem to be stronger PUSH-factors among workers aged 50-55 compared to those aged 56-63. Preventing early labour market detachment should take the worker's expected reasons for leaving into account.

Safety, feasibility, and neuromuscular activity of acute low-load resistance exercise with or without blood flow restriction in patients with severe hemophilia.

OBJECTIVE: To compare the safety, feasibility, and neuromuscular activity of acute low-load resistance exercise with/without blood flow restriction (BFR) in people with severe hemophilia (PwH). METHODS: Eight PwH under prophylaxis (5 with resistance training experience) performed 6 randomly ordered conditions of 3 intensity-matched knee extensions: no external load and no BFR, no external load and light BFR (20% of arterial occlusion pressure [AOP]), no external load and moderate BFR (40% AOP), external low load and no BFR, external low load with light BFR, and external low load with moderate BFR. Rated perceived exertion, pain, exercise tolerability, and adverse effects were assessed. Normalized root-mean-square (nRMS), nRMS spatial distribution, and muscle fiber-conduction velocity (MFCV) were determined using high-density surface electromyography for the vastus medialis and lateralis. RESULTS: Exercises were tolerated, without pain increases or adverse events. Externally resisted conditions with/without BFR provided greater nRMS than nonexternally resisted conditions (p < 0.05). Spatial distribution and MFCV did not vary between conditions. CONCLUSIONS: In these patients, knee extensions with low external resistance and BFR at 20% or 40% AOP appear safe, feasible and do not cause acute/delayed pain. However, BFR during three consecutive repetitions does not increase nRMS nor changes nRMS spatial distribution or MFCV.

Effectiveness of progressive moderate-vigorous intensity elastic resistance training on quality of life and perceived functional abilities in people with hemophilia: Secondary analysis of a randomized controlled trial.

INTRODUCTION AND AIM: Strength exercise training is advised for people with hemophilia (PWH); however, few studies have been published and have methodological limitations. The purpose of this study was to evaluate the effectiveness of progressive elastic resistance training on quality of life and perceived functional abilities in PWH. METHODS: Participants were randomly allocated to the intervention (n = 10) or control (n = 10) group. The intervention group performed progressive moderate-vigorous elastic resistance training (2 days/week, a total of 8 weeks), focusing on the muscles of the knee, elbow, and ankle joints. The control group continued its usual daily activities for 8 weeks. Quality of life (A36 Hemofilia-QoL®) and perceived functional abilities (Haemophilia Activities List) were assessed at baseline and an 8-week follow-up. RESULTS: The intervention group improved the quality-of-life dimension of joint damage perception in comparison to the control group (p = .015, large effect size). Regarding perceived functional abilities, the intervention group improved lying, sitting, kneeling, and standing (p = .006, small effect size), and complex lower extremities activities (i.e., walking short and long-distance, and up-down stairs) (p = .006, small effect size) compared to the control group. No other significant differences were observed. CONCLUSIONS: Eight weeks of progressive moderate-vigorous elastic resistance training in PWH improve the quality-of-life dimension of joint damage perception and perceived functional abilities (lying/sitting/kneeling/standing, and complex lower extremities activities). Our results suggest a limited effect of the program on the other items of quality of life measured by the questionnaire as emotional functioning, mental health, and social relationships. Importantly, no serious adverse effects occurred.

The association of the localized pain sensitivity in the residual limb and prosthesis use in male veterans with transtibial amputation.

The association of localized pain sensitivity in the residual limb and prosthesis use has clinical implications, however, rarely been assessed. This study aimed to investigate pain sensitivity and explore its range, variability, and association with prosthesis use alongside other demographic and clinical characteristics of veterans with transtibial amputation. Pain sensitivity was determined as pressure pain threshold (PPT) and pressure tolerance (PT) in 19 male veterans with a mean age of 49.5 years using pressure algometry at 12 anatomical locations on the residual limb. A comparison of pain sensitivity at each location, and among anatomical locations and participants was explored using independent t-test, analysis of variance, and Kruskal-Wallis tests, respectively. Pain sensitivity range (PSR), the difference between PT and PPT, was significantly different (p < 0.05) at mid-patellar tendon, medial tibial flare, and the distal end of the tibia. The lowest PPT and PT (20.5 and 33 Ncm-2, p = 0.13) were recorded at the distal end of the residual limb, and the highest PPT and PT (73.4 and 94.3 Ncm-2, p = 0.03) were recorded at the mid-patellar tendon. Pain sensitivity was significantly different among anatomical locations and participants. The correlation tests (Pearson and partial eta squared) showed non-significant associations of pain sensitivity with participants' demographic and clinical characteristics except for daily prosthesis use. The mid-patellar tendon, medial tibial flare, and distal end of the tibia revealed the lowest pain hypersensitivity due to higher PSR. Longer daily prosthesis use was associated with increased pain sensitivity.

Handgrip strength in older adults with chronic diseases from 27 European countries and Israel.

BACKGROUND/OBJECTIVES: Understanding the association of deconditioned strength with the most prevalent chronic diseases in older adults and inferring possible interventional strategies is of utmost importance. We aimed to investigate the association between handgrip strength and chronic diseases in a large representative European population of adults over the age of 50 years. SUBJECTS/METHODS: Individuals aged 50 or older residing in 27 European countries and Israel participated in this cross-sectional study. Data on prior or current chronic disease and handgrip strength were retrieved from the 7th wave of Survey of Health, Ageing and Retirement in Europe (SHARE). We tested associations using binary logistic regression adjusted for potential confounders. RESULTS: Based on data from 73,463 participants, the examined diseases showed a negative association with handgrip strength in the fully adjusted model. Participants from the highest tertile of handgrip strength had particularly lower odds for Parkinson ((Adjusted odds ratio (AOR) = 0.42 [95% Confidence Interval = 0.32-0.56])), stroke (AOR = 0.51 [95% Confidence Interval = 0.44-0.59], and emotional disorders ((Adjusted odds ratio (AOR) = 0.51 [95% Confidence Interval = 0.45-0.58])) compared with participants with the lowest level of handgrip strength in the fully adjusted model. CONCLUSIONS: There is a negative association between handgrip strength and a wide range of chronic diseases. Evaluating handgrip strength in this population may provide a valuable clinical measure and a simple preventive strategy in relation to these diseases. The present findings support the use of resistance training for the prevention of specific chronic conditions, particularly Parkinson, stroke and emotional disorders.

Occupational physical activity trends from 1987 to 2017: A nationally representative sample of 160,509 Spanish adults.

The aim of the study was to estimate temporal and updated trends of occupational physical activity (OPA) among Spanish adult population during the period between 1987 and 2017. We used all available rounds of the Spanish National Health Survey (160,509 adults, mean age 44.6 years [SD 16.6], 50.3% women) and multivariate regressions to determine temporal trends of high OPA from 1987 to 2017 in the general working population of Spain. The highest OPA prevalence was observed for participants aged 31-49 years in the 2003 survey. The prevalence of high OPA was generally low, but increased slightly over time in the 18-30, 50-64, and 65-75 years old (p < 0.001 for trend). In contrast, a general reduction in OPA was observed in the 16-17 years old (p < 0.001 for trend). Men consistently showed higher OPA prevalence than women. This study reports an increase in OPA prevalence in Spain from 1987 to 2017, which is low and significant in most socio-demographic groups, but small in absolute terms. The youngest group had a marked decreased in OPA prevalence over the course of the study. Men consistently showed higher OPA prevalence than women, but differences have become smaller in recent years. Our results may assist in the establishment of interventional strategies and future policies among specific subgroups.HighlightsThere is an increase in OPA prevalence in Spain from 1987 to 2017.The youngest group had a marked decreased in OPA prevalence over the course of the study.Men consistently showed higher OPA prevalence than women, but differences have become smaller in recent years.Frequent national surveillance of OPA to monitor long-term development of the working environment should be mandatory.

Employee perception of managers' attitudes towards older workers is associated with risk of loss of paid work before state pension age: prospective cohort study with register follow-up.

It is increasingly urgent to retain older workers in the workforce. In the present study, we analysed the prospective associations between employees' perceptions of their managers' attitudes towards older workers, and of having experienced age discrimination in the labour market with the risk of loss of paid work before the state pension age. Questionnaire data from 10,320 currently employed workers aged 50 + on perceptions of managers' attitudes towards older workers and perceived age discrimination were collected at baseline in the SeniorWorkingLife study. Data on labour market affiliation were obtained from national registers at baseline and two-year follow-up. Results show that the perception of negative attitudes was prospectively associated with an increased risk of loss of paid work for three of the five negative attitudes "older workers create conflicts, their qualifications are outdated, and they cannot keep up with the pace and development". Perception of positive attitudes was prospectively associated with a reduced risk of loss of paid work. The perception of age discrimination was prospectively associated with an increased risk of loss of paid work. The results strengthen existing evidence on associations between ageism and labour market attachment, by applying a longitudinal design and including actual change in labour market participation. However, some negative attitudes may be more detrimental to the older workers' labour market participation. Employees' positive perceptions of managers' attitudes reduced the risk. Good relations between employees and managers appear to be important for retaining older workers in the labour market.

Neuromuscular and acute symptoms responses to progressive elastic resistance exercise in patients with chronic obstructive pulmonary disease: Cross-sectional study.

Background: Quadriceps muscle training is a key part in the rehabilitation of chronic obstructive pulmonary disease (COPD) patients. However, exercise intensity prescription and progression with the typically used elastic bands is challenging. We aimed to evaluate neuromuscular, acute symptoms and cardiorespiratory responses (heart rate and dyspnea) during progressive elastic resistance exercise in patients with COPD. Methods: Fourteen patients diagnosed with moderate-very severe COPD performed knee extensions at different elastic resistance levels (i.e., colors). The neuromuscular activity was recorded using surface electromyography for the rectus femoris, vastus lateralis and vastus medialis, together with rate of perceived exertion, perceived quadriceps fatigue, dyspnea, oxygen saturation and heart rate. Results: For the vastus lateralis and rectus femoris, increase of muscle activity was evident from a two-level increment when using the red color. For the vastus medialis, there were no muscle activity progressions. Dyspnea, quadriceps fatigue and especially rate of perceived exertion increased in a dose-response fashion and were correlated with the resistance level and muscle activity at the three muscles. Conclusion: Heavy elastic resistance exercise is feasible in COPD patients without excessive dyspnea and a stable cardiorespiratory response. In general, at least two elastic resistance increments are needed to enhance muscle activity for the vastus lateralis and rectus femoris, while there is no increase for the vastus medialis. These results may help to individualize exercise dosing during elastic resistance training in patients with COPD.

Physical and Quality of Life Changes in Elderly Patients after Laparoscopic Surgery for Colorectal Cancer-A Prospective Cohort Study.

Background-The incidence of colorectal cancer is increasing among elderly people, where postoperative complications are frequent. Methods-We evaluated postoperative physical and quality of life changes in elderly patients undergoing laparoscopic surgery for colorectal cancer. A prospective cohort study was performed in 31 colorectal cancer patients ≥60 years who were scheduled for laparoscopic surgery due to colorectal cancer. Outcomes were measured one month preoperative (T1), three days postoperative (T2) and one month postoperative (T3). Results-The largest early postoperative (from T1 to T2) declines were observed for isometric knee extension strength (33.1%), 30 s Chair Stand Test (27.9%) and handgrip strength (16.9%). Significant reductions in quality of life measured with the QLQ-C30 summary score and the EQ 5D index score were found between T1-T3 and T1-T2, respectively. Conclusions-A decline in isometric knee extension strength, 30 s Chair Stand Test, handgrip strength and quality of life is evident in elderly patients in the days following laparoscopic surgery for colorectal cancer. Preoperative values are recovered one month after surgery for all the outcomes, except for isometric knee extension, which should receive especial attention.