Dose-Response Relationship Between Exercise Duration and Enhanced Function and Cognition in Acutely Hospitalized Older Adults: A Secondary Analysis of a Randomized Clinical Trial.

Background and Objectives: Exercise may reverse functional decline in hospitalized older adults, but the optimal duration is unclear. This study examined the potential relationship between in-hospital multicomponent exercise program duration and changes in physical function, cognition, and muscle function to maximize exercise-related health benefits in acutely hospitalized older patients. Research Design and Methods: This secondary analysis of a multicenter randomized controlled trial examined the relationship between the duration of an in-hospital multicomponent exercise program and changes in physical function, cognition, and muscle strength in 570 acutely hospitalized older adults. Participants completed 3, 4, or 5-7 consecutive days of exercise based on the progression of their acute medical illness. The acute clinical condition of the older patients was similar across the study groups (i.e., 3/4/5-7 days) at admission. Outcomes included the Short Physical Performance Battery (SPPB) for functional capacity, Gait Velocity Test for gait speed, handgrip for muscle strength, and cognitive tests. Results: Of the 570 patients included in the analysis, 298 were women (52.3%), and the mean (SD) age was 87.3 (4.8) years. Exercise groups increased SPPB scores compared with controls, with gains of 1.09 points after three days, 1.97 points after four days, and 2.02 points after 5-7 days (p < .001). The 4-day program showed the most significant benefit for functional capacity. Gait velocity increased by 0.11 m/s after 4 and 5-7 days (p = .032). Similar dose-response relationships were seen for handgrip strength and cognition, with 5-7 days showing more significant gains than three days (p < .05). Discussion and Implications: Multicomponent exercise programs enhance physical and cognitive function in hospitalized older adults, regardless of exercise dosage. A 4-day program significantly boosts functional capacity, although 5-7 days improves handgrip strength and cognition, highlighting the importance of exercise dosage in countering functional decline. Implementing evidence-based inpatient exercise prescriptions can help reverse muscle weakness and improve cognitive and physical function.Clinical Trial Registration: NCT04600453.

Effects of short-term multicomponent exercise intervention on muscle power in hospitalized older patients: A secondary analysis of a randomized clinical trial.

BACKGROUND: Bed rest during hospitalization can negatively impact functional independence and clinical status of older individuals. Strategies focused on maintaining and improving muscle function may help reverse these losses. This study investigated the effects of a short-term multicomponent exercise intervention on maximal strength and muscle power in hospitalized older patients. METHODS: This secondary analysis of a randomized clinical trial was conducted in an acute care unit in a tertiary public hospital. Ninety (39 women) older patients (mean age 87.7 ± 4.8 years) undergoing acute-care hospitalization [median (IQR) duration 8 (1.75) and 8 (3) days for intervention and control groups, respectively]) were randomly assigned to an exercise intervention group (n = 44) or a control group (n = 46). The control group received standard care hospital including physical rehabilitation as needed. The multicomponent exercise intervention was performed for 3 consecutive days during the hospitalization, consisting of individualized power training, balance, and walking exercises. Outcomes assessed at baseline and discharge were maximal strength through 1 repetition maximum test (1RM) in the leg press and bench press exercises, and muscle power output at different loads (≤30% of 1RM and between 45% and 55% of 1RM) in the leg press exercise. Mean peak power during 10 repetitions was assessed at loads between 45% and 55% of 1RM. RESULTS: At discharge, intervention group increased 19.2 kg (Mean Δ% = 40.4%) in leg press 1RM [95% confidence interval (CI): 12.1, 26.2 kg; P < 0.001] and 2.9 kg (Mean Δ% = 19.7%) in bench press 1RM (95% CI: 0.6, 5.2 kg; P < 0.001). The intervention group also increased peak power by 18.8 W (Mean Δ% = 69.2%) (95% CI: 8.4, 29.1 W; P < 0.001) and mean propulsive power by 9.3 (Mean Δ% = 26.8%) W (95% CI: 2.5, 16.1 W; P = 0.002) at loads ≤30% of 1RM. The intervention group also increased peak power by 39.1 W (Mean Δ% = 60.0%) (95% CI: 19.2, 59.0 W; P < 0.001) and mean propulsive power by 22.9 W (Mean Δ% = 64.1%) (95% CI: 11.7, 34.1 W; P < 0.001) at loads between 45% and 55% of 1RM. Mean peak power during the 10 repetitions improved by 20.8 W (Mean Δ% = 36.4%) (95% CI: 3.0, 38.6 W; P = 0.011). No significant changes were observed in the control group for any endpoint. CONCLUSIONS: An individualized multicomponent exercise program including progressive power training performed over 3 days markedly improved muscle strength and power in acutely hospitalized older patients.

Effects of eccentric-emphasized leg curl intervention on muscle strength imbalance markers in professional soccer players during pre-season.

BACKGROUND: The effects of strength training on muscle strength imbalance are unclear in professional soccer players. As a result, this study examined the effects of an 8-week strength training program comprising eccentric-emphasized prone leg curl adjusted according to the individual strength imbalance status. METHODS: Ten professional soccer players (26.0 ± 3.6 yrs) participated in the study. Players who had a ≥ 10% contralateral imbalance in knee flexors eccentric peak torque (n = 6) performed two additional repetitions per set in the low-strength limb (high-volume, HV) compared to the high-strength limb (low-volume, LV). Isokinetic concentric knee extension and concentric and eccentric knee flexion peak torque (PT) and derived contralateral imbalances and conventional and functional hamstring-to-quadriceps ratios (H:Q) were assessed at baseline and after 8 weeks. Differences at baseline were assessed using paired-sample T-tests, and a two-way (limb x time) repeated measures analysis of covariance (ANCOVA) for changes over time. RESULTS: A significant improvement in the eccentric knee flexion PT was observed in both limbs after 8 weeks (P < 0.05), with greater effects observed in the HV limb (25.0 N m, 95% CI: 15.1-34.9 N m). Significant decreases were also observed in the contralateral imbalances from concentric knee extension and flexion and eccentric knee flexion PT (P < 0.05). Differences were not observed in concentric knee extension and flexion PT (P > 0.05). CONCLUSIONS: A short-term eccentric-emphasized leg curl intervention adjusted by the initial knee flexors eccentric strength was an efficient method to improve knee flexors strength imbalance in professional soccer players.

Effects of a Short-Term Detraining Period on the Strength Deficit and Functional Performance of Highly Trained Soccer Players.

ABSTRACT: Loturco, I, Grazioli, R, Veeck, F, Nakamura, FY, Inácio, M, Schons, P, Preissler, A, Pinto, RS, Pereira, LA, McGuigan, MR, and Cadore, EL. Effects of a short-term detraining period on the strength deficit and functional performance of highly trained soccer players. J Strength Cond Res 37(10): 2058-2063, 2023-The aim of this study was to examine the effects of a 4-week detraining period on the neuromuscular performance of highly trained soccer players. Pre and post detraining, 18 adult soccer players (age: 27 ± 4.9 years; height: 180.2 ± 7.1 cm; body mass [BM]: 78.9 ± 7.6 kg) performed vertical jumps, 20-m linear sprints, curve sprint and change of direction speed tests, and a progressive loading test in the half-squat exercise with loads corresponding to 50, 100, and 150% of the players' BM to assess the peak-force (PF), mean power (MP), and strength-deficit (SDef). Pre and post differences in the variables of interest were analyzed using paired t -tests and effect sizes (ES). No significant changes were detected for vertical jumping height and sprint times. Higher PF at 50 and 100% BM and lower SDef were shown when comparing pre- and postassessments (ES = 0.66, 0.68, 0.55; p = 0.018, 0.016, and 0.046, respectively). The MP at 50 and 100% BM increased significantly after the detraining phase (ES = 0.56, 0.82; p = 0.049 and 0.007, respectively). The results indicate that these athletes were able to maintain and achieve satisfactory levels of performance after a short period of training cessation. Interestingly, some strength- and power-derived parameters improved significantly after short-term detraining, which may have important implications for training programs aimed at maximizing speed and power performance. It is recommended that coaches test their players not only at the beginning but also at the end of the season, to better evaluate variations in performance and thus create more efficient and tailored training strategies.

Speed-Related Abilities Are Similarly Improved After Sled Training Under Different Magnitudes of Velocity Loss in Highly Trained Soccer Players.

PURPOSE: We examined the effects of two 8-week resisted-sprint training programs under different magnitudes of velocity loss (VL) on the speed-related performance of highly trained soccer players. METHODS: Twenty-one soccer players (age: 25.9 [5.4] y) were randomly assigned to 1 of 2 groups: (1) the "moderate-load group," players who trained with sled loads that induced 15%VL relative to unloaded sprint velocity (n = 11); and (2) the "heavy-load group," players who trained with sled loads that induced 40% VL relative to unloaded sprint velocity (n = 10). Linear sprint (10 m), curve sprint, change-of-direction speed, resisted-sprint performance at 15% VL and 40% VL, and vertical jumping ability were tested pretraining and posttraining. A 2-way repeated-measures analysis of variance was used to test for differences between groups. In addition, percentage changes were calculated for speed-related abilities and compared with their respective coefficients of variation to determine whether individual changes in performance were greater than the test variance (ie, "true change"). RESULTS: A main effect of time was detected for 10-m sprint, curve sprint, change-of-direction speed, and 15% VL and 40% VL resisted-sprint times, with significant decreases in sprint times (P = .003, P = .004, P = .05, P = .036, and P = .019, respectively). Jump variables did not change significantly over time. There were no group-by-time interactions for any tested variable (P > .05), but the "true change" analysis revealed meaningful individual changes in both groups. CONCLUSIONS: Both moderate- and heavy-sled loading conditions may optimize the development of speed-related abilities in highly trained soccer players. Nevertheless, resisted-sprint training responses may differ meaningfully when assessed on an individual basis.

Interrelationships Between Multiple Speed Tests in Youth Soccer: Are Players Equally Efficient at Performing Different Sprint and Change of Direction Tasks?

ABSTRACT: Freitas, TT, Pereira, LA, Alcaraz, PE, Cadore, EL, Grazioli, R, Azevedo, PHSM, Jeffreys, I, and Loturco, I. Interrelationships between multiple speed tests in youth soccer: Are players equally efficient at performing different sprint and COD tasks? J Strength Cond Res 37(4): 848-853, 2023-We investigated the relationships between linear and multidirectional sprint tests in elite young soccer players, using different speed measurements and their associated deficits. Twenty-three under-17 and 17 under-16 soccer players performed, on the same day, 17-m linear sprint (with 10-m split times), curve sprints for "good" and "weak" sides (CSGS and CSWS, respectively), and zigzag and 505 change of direction (COD) tests. The Pearson's product moment test was used to determine the relationships among the tested variables. Significance level was set at p < 0.05. Large and very large significant correlations were observed between CSGS and CSWS and 10-m ( r = 0.73 and r = 0.53, respectively; p < 0.0001) and 17-m sprint velocity ( r = 0.84 and r = 0.74, respectively; p < 0.0001). Moderate and significant associations were identified between zigzag and 17-m sprint performances ( r = 0.40; p = 0.02). No significant relationships were found between 505 performance and 17-m sprint velocity and between the different COD tasks ( p > 0.05). Significant correlations were observed between sprint performance at 10- and 17-m and both CS and COD deficits ( r values ranging from 0.37 to 0.54; p < 0.05). In general, higher linear sprinting velocities were associated with superior performances in smoother multidirectional tasks (i.e., CS and zigzag tests) but not in more aggressive COD maneuvers (i.e., 505). Faster athletes in linear actions presented greater CS and COD deficits. No associations were detected between the different COD measurements, supporting the notion that the technical and mechanical demands of COD actions are angle and velocity dependent. From a practical perspective, comprehensive speed testing batteries (i.e., incorporating linear sprints, CS, and different COD assessments) should be administered to young soccer players, to better understand their ability to change direction and sprint over multiple trajectories.

A descriptive ranking of blood pressure and physical fitness of Latin-American ethnic schoolchildren.

BACKGROUND: There is a general lack of information about how insufficient physical activity impacts blood pressure and physical fitness in Latin-American ethnic minorities. AIMS: To describe the interactions between insufficient physical activity, blood pressure, and physical fitness outcomes in Latin-American schoolchildren of different ethnicity. METHODS: This was a prospective, international, multi-center, and cross-sectional study of three Latin-American countries involving schoolchildren from seven ethnic groups of Colombia (Tikuna, Nasa, Embera), Brazil (African, Mulato), and Chile (Mapuche), and also European schoolchildren from Brazil and Chile. Data were categorized based on whether participants were physically active (PA) or insufficient physical activity (iPA) using the WHO physical activity recommendations. The main outcomes were systolic (SBP), diastolic (DBP), and mean arterial (MAP) blood pressure, and scores for physical and cardiorespiratory fitness (CRF, by estimated V˙O2max), handgrip muscle strength (HGS), and standing long jump (SLJ). Secondary outcomes were anthropometric measures (weight, height, body mass index [BMI], waist circumference [WC], waist-to-height ratio), and body fat percentage (BF%, limited data by country). Primary and secondary outcomes were ranked. RESULTS: For both PA and iPA categories, significant interactions between ethnic groups were found concerning SBP/DBP (F(37.7), ES 0.08; F(51.5), ES 0.08), V˙O2max (F(37.7), ES 0.08; F(51.5), ES 0.08), HGS (F(33.8), ES 0.07; F(5.03), ES 0.04), and SLJ (F(64.3), ES 0.14; F(64.3), 0.14). In the iPA category, Mapuche schoolchildren were classified 1st (119.5; 81.5) with highest SBP/DBP and highest MAP (94.6 mmHg); Embera schoolchildren were classified 1st with lowest V˙O2max (33.7 mL/kg/min); and European schoolchildren were classified 1st (19.9 kg) with lowest HGS and SLJ (121.4 m) physical fitness. CONCLUSIONS: Under conditions of insufficient physical activity conditions, Mapuche schoolchildren had the most detrimental blood pressure, whereas Embera, Tikuna, and European schoolchildren had the lowest levels of physical fitness. These results serve to highlight the need for the early and appropriate promotion of physical activity based on ethnic differences in Latin-American schools.

Effects of Moderate-to-Heavy Sled Training Using Different Magnitudes of Velocity Loss in Professional Soccer Players.

ABSTRACT: Grazioli, R, Loturco, I, Lopez, P, Setuain, I, Goulart, J, Veeck, F, Inácio, M, Izquierdo, M, Pinto, RS, and Cadore, EL. Effects of moderate-to-heavy sled training using different magnitudes of velocity loss in professional soccer players. J Strength Cond Res 37(3): 629-635, 2023-This study investigated the effects of a 11-week moderate-to-heavy sled training intervention with different magnitudes of velocity loss on sprint and jump performance, mechanical muscle function, and body composition in professional soccer players. Seventeen players (age 25.8 ± 4.3 years; height 180.0 ± 8.6 cm; mass 77.7 ± 9.7 kg) were randomly allocated into 2 groups, based on different magnitudes of velocity loss: 10% of velocity decrease (G10, n = 8) and 20% of velocity decrease (G20, n = 9). The velocity-based sled training consisted of 20-m resisted sprints with a progressive loading increase from 45 to 65% of body-mass throughout the intervention. Pre-intervention and postintervention sprint and jump performance, hamstring and quadriceps peak torque and isometric rate of torque development, and lower-limb lean mass measured by dual X-ray absorptiometry were assessed and compared. Two-way repeated measures analysis of variance revealed a significant time-effect for decreases in 10- and 20-m sprint times ( p = 0.018 and p = 0.033, respectively), but without a time-group interaction. The G10 showed greater beneficial effects than G20 for both 10-m (-5.5 ± 3.3%, magnitude-based inference [MBI]: possibly vs. -1.7 ± 5.9%, MBI: possibly trivial) and 20-m (-2.5 ± 2.1%, MBI: possibly vs. -1.4 ± 3.7%, MBI: likely trivial) sprint times. Moreover, there was a significant time effect for countermovement jump height and quadriceps isometric peak torque, which decreased significantly after training ( p = 0.019 and p = 0.010, respectively), with no within-group effect of time vs. group interaction for these respective outcomes. The novel velocity-based sled model proposed here, especially under lower magnitudes of velocity loss, was able to significantly improve linear sprint performance in professional soccer players.

Power Training Prescription in Older Individuals: Is It Safe and Effective to Promote Neuromuscular Functional Improvements?

Muscle power has been reported to be critical in counteracting age-related declines in functional performance. Muscle power output in functional performance exercises can be greatly improved in a short period of time (i.e., ≤ 12 weeks) using specific exercise interventions such as power training (i.e., exercises attempting to move loads ranging from 20 to 70% of 1-repetition maximum as fast as possible during the concentric muscle action, followed by a controlled, slower eccentric muscle action). Despite the widespread evidence on the effectiveness of power training in older adults (~ 300 scientific articles published on this topic in the past 10 years), some scientists do not recommend the use of explosive-type muscular contractions during resistance training (i.e., power training) for the older population; indeed, some international guidelines do not mention this type of exercise for older people. The reasons underlying this absence of mention and recommendation for the use of power training as a fundamental exercise strategy for older people are still not well known. Therefore, we attempted to point out the main issues about safety, feasibility, and effectiveness of muscle power training to promote neuromuscular functional improvements in older people.

Interindividual variability of adaptations following either traditional strength or power training combined to endurance training in older men: A secondary analysis of a randomized clinical trial.

This study aimed to investigate the interindividual responses following two different concurrent training (CT) regimens in neuromuscular, cardiorespiratory and functional outcomes of older men. Thirty-five older men (65.8 ± 3.9 years) were randomly allocated into one of two CT groups: power training (PT) + high-intensity interval training (HIIT) (n = 17); or traditional strength training (TST) + HIIT (n = 18). Maximal dynamic strength (one-repetition maximum, 1RM), rate of force development at 100 milliseconds (RDF100), countermovement jump power (CMJ), quadriceps femoris muscle thickness (QF MT), functional tests (sit-to-stand, timed-up-and-go, and stair climbing), and peak oxygen consumption (VO2peak) were assessed pre-, post-8 and post-16 weeks of training. The Chi-squared test was used for assessing differences in the prevalence of responders (Rs), non-responders (NRs), and adverse responders (ARs). Similar prevalence of individual responses (Rs, NRs and ARs) between groups were observed after intervention in almost all outcomes: 1RM; power at CMJ; QF MT, and functional tests (P > 0.05). However, a significant difference in the distribution of Rs, NRs and ARs between groups was observed in the RFD100 after 16 weeks (p = 0.003), with PT + HIIT group presenting high prevalence of Rs than TST + HIIT (100 % vs. 50 %). The inclusion of explosive-type of contractions in a concurrent training regime induces greater responsiveness in the RFD100 in older men, while no differences compared to traditional strength training are observed in maximal strength, muscle size, VO2peak, and functional performance.

Low handgrip strength is associated with higher cancer prevalence in frail nonagenarians and centenarians.

It is known that muscle strength is associated with adverse health outcomes associated with cancer-related symptoms. The purpose of this study was to investigate the association between handgrip strength and cancer in frail oldest old. In this prospective cohort study, 81 nonagenarians and centenarians were included [mean age (SD): 94.2 (3.8) years]. Data related to prevalent cancer were self-reported and global strength was assessed by handgrip strength. Logistic regressions were calculated for age- and sex-specific tertiles of relative grip strength, with participants in the highest tertile considered as the reference group. The χ2 test was used to assess differences in tertile categories of normalized handgrip strength between groups (i.e., cancer diagnoses or not). Significant differences were obtained for normalized handgrip strength tertile categories between groups: older adults without a diagnosis of cancer had higher handgrip strength values than peers with cancer (p = 0.039). Of those with cancer, 50% were classified in tertile 1, 36% in tertile 2 and 14% in tertile 3. Considering those without a diagnosis of cancer, 27% were in tertile 1, 32% in tertile 2 and 41% in tertile 3. Low handgrip strength is associated with higher cancer prevalence in frail nonagenarians and centenarians.

Impact of exercise intervention-based changes on physical function biomarkers in older adults after hospital discharge: A systematic review with meta-analysis of randomized clinical trials.

BACKGROUND: This systematic review with meta-analysis aimed to compare the changes caused by exercise intervention with those provoked by usual care on physical function biomarkers in older adults immediately after hospital discharge. METHODS: Two independent authors performed a systematic search (PubMed, Scopus, Web of Science, and SciELO) of studies published from database inception until August 2021. Randomized clinical trials investigating the effects of an exercise intervention compared to usual care were included. The Cochrane Collaboration assessment tool was used to analyze the risk of bias. The comparisons included handgrip strength, the short physical performance battery scale, six-minute walking test, and 10-m gait speed. RESULTS: Overall, the exercise intervention led to significantly greater changes compared to usual care in physical function biomarkers [standard mean difference = 0.89, 95% CI = 0.39, 1.42; P = 0.001]. However, considering the very few studies investigating each variable separately, our sub-analysis did not reveal a significant effect of the exercise intervention on handgrip strength, the short physical performance battery, six minutes walking test, and 10-m gait speed. CONCLUSIONS: This systematic review with meta-analysis of randomized clinical trials suggests that exercise intervention induce greater physical function biomarker alterations in older adults after hospitalization than usual care including physical activity guidance. Future trials comparing the effects of these intervention groups on physical function biomarkers in this population are needed to confirm our results.

Dance as an Intervention to Reduce Fall Risk in Older Adults: A Systematic Review With a Meta-Analysis.

The purpose of this study was to summarize the evidence from randomized clinical trials on the effects of dance on fall risk in older adults through a systematic review with meta-analysis. Fall risk was assessed through timed up and go, Berg Balance Scale, or one-leg stand tests. Data are presented as mean differences for timed up and go test and standardized mean differences for Berg Balance Scale and one-leg stand tests between treatments with 95% confidence intervals, and calculations were performed using random effects models. Significance was accepted when p < .05. A significant difference was found between dance interventions and the control groups in the general analysis of fall risk assessed by timed up and go (mean differences: -1.446 s; 95% confidence interval [-1.586, -1.306]; p < .001) and Berg Balance Scale and one-leg stand tests (standardized mean differences: 0.737; 95% confidence interval [0.508, 0.966]; p < .001) in favor of the intervention group. Different dance interventions decreased the fall risk in older practitioners.

Jump performance and mechanics after a regular training bout in elite volleyball players.

BACKGROUND: Volleyball is a complex intermittent sport characterized by short explosive technical movements, many of which involve vertical jumping. The assessment of mechanical jumping variables in relation to both injury prevention and performance enhancement through the use of wearable technologies is becoming a new training tool among professional volleyball players. METHODS: The present study aimed to assess the vertical jumping mechanics before and after a controlled load (volume and intensity) of a routine volleyball training session among male professional players. Twelve male elite professional volleyball players (23.7±4.9 years, 198.1±6.2 cm, 92.2±10.3 kg) of national and international level belonging to the same Brazilian first league team were recruited. Biomechanical analysis of vertical unilateral countermovement jump (CMJ) and bilateral CMJ tests were performed before and after a routine training session of these players at their usual training court. An inertial orientation sensor placed at the third lumbar vertebra was employed for biomechanical data collection. RESULTS: In relation to the unilateral CMJ, a 10% decrease (P=0.02) in the vertical ground reaction force after training compared to pretraining values was observed. However, no significant differences were observed in the remaining outcomes. Regarding the bilateral CMJ, no significant differences were observed in all assessed outcomes. CONCLUSIONS: Our findings showed no evidence of fatigue after a controlled regular in season volleyball training session in professional players. In addition, this volleyball training session induced a significant reduction in the vertical ground reaction force during unilateral CMJ in volleyball players.

Predicting Cardiorespiratory Fitness in Female Soccer Players: The Basque Female Football Cohort Study.

PURPOSE: To develop gender-specific operational equations for prediction of cardiorespiratory fitness in female footballers. METHOD: Forty-eight semiprofessional female footballers performed an intermittent progressive maximal running test for determination of fixed blood lactate concentration (FBLC) thresholds. Relationships between FBLC thresholds and the physiological responses to submaximal running were examined. Developed equations (n = 48) were compared with equations previously obtained in another investigation performed in males (n = 100). RESULTS: Submaximal velocity associated with 90% maximal heart rate was related to FBLC thresholds (r = .76 to .79; P < .001). Predictive power (R2 = .82 to .94) of a single blood lactate concentration (BLC) sample measured at 10 or 11.5 km·h-1 was very high. A single BLC sample taken after a 5-minute running bout at 8.5 km·h-1 was related to FBLC thresholds (r = -.71; P < .001). No difference (P = .15) in the regression lines predicting FBLC thresholds from velocity associated with 90% maximal heart rate was observed between the female and male cohorts. However, regressions estimating FBLC thresholds by a single BLC sample were different (P = .002). CONCLUSIONS: Velocity associated with 90% maximal heart rate was robustly related to FBLC thresholds and might serve for mass field testing independently of sex. BLC equations accurately predicted FBLC thresholds. However, these equations are gender-specific. This is the first study reporting operational equations to estimate the FBLC thresholds in female footballers. The use of these equations reduces the burden associated with cardiorespiratory testing. Further cross-validation studies are warranted to validate the proposed equations and establish them for mass field testing.

Effects of multicomponent exercise training on the intrinsic capacity in frail older adults: review of clinical trials

Abstract Aim: To review the effects of multicomponent exercise training on the domains of the intrinsic capacity of physically frail older adults: locomotion, vitality, cognition, psychological outcomes, and sensory function. Methods: The search for the studies was carried out in the MEDLINE, Cochrane CENTRAL, and PEDro databases, along with manual search, delimiting the period of publication as the last 10 years. The initial search identified 338 studies and 18 among them were analyzed qualitatively. Results: From the analysis of the included studies, great variability was evidenced between the intervention protocols, as well as between the results. As for the effectiveness of multicomponent exercise training, it has been shown to induce a positive effect on most of the analyzed outcomes. Conclusion: In summary, the present review suggests that multicomponent physical training can be effective to improve aspects of locomotion, cognition, and psychological aspects in frail older populations. Nevertheless, more studies are needed to specify the time needed to achieve such adaptations, the magnitude of these adaptations, and the design of the most appropriate training program for each outcome related to intrinsic capabilities.

Two-Year Follow-up of a Multimodal Intervention on Functional Capacity and Muscle Power in Frail Patients With Type 2 Diabetes.

OBJECTIVES: To analyze the effects of a program composed of resistance training and nutritional interventions on functional capacity, maximal strength, and power output after 2 years of follow-up, including 2 periods of 16 weeks of intervention followed by several weeks of intervention cessation in frail patients with type 2 diabetes. DESIGN: MIDPOW is a substudy of a multicenter, multimodal intervention composed of resistance training combined with a structured diabetes and nutritional education program in frail and prefrail older people with type 2 diabetes (MID-Frail). SETTING AND PARTICIPANTS: This study recruited 52 participants (mean age: 79 ± 5.6, 63% women), with type 2 diabetes mellitus, frail or prefrail using Fried's frailty phenotype. METHODS: Primary outcomes of this substudy were Short Physical Performance Battery (SPPB) and maximal power output at 30% and 80% of 1RM. RESULTS: Each set of 16 weeks of intervention resulted in significant improvements in SPPB performance by a mean of 36.1% at week 18 (P < .001) and 10.2% at week 68 (P < .05). Maximal power output improvements at 30% and 80% of the 1RM ranged from 45.2% to 57.2% at week 18 (P < .01-.001); and no significant changes were observed after the second period of intervention. After 2 years of follow-up, the SPPB and maximal power values observed remained significantly higher than the baseline. CONCLUSIONS AND IMPLICATIONS: Resistance training combined with nutritional program improved SPPB, maximal strength, and power output in older frail patients with diabetes. These improvements were maintained above the basal levels after several weeks of intervention cessation during a 2-year follow-up.