Association of the Mediterranean diet with arterial stiffness, inflammation, and medication use in women with systemic lupus erythematosus: an exploratory study.

BACKGROUND: Patients with systemic lupus erythematosus (SLE) face increased cardiovascular risk not completely explained by traditional cardiovascular risk factors. Arterial stiffness, inflammation or disease-related therapies may be contributors to augmented cardiovascular risk, whereas healthy dietary habits could help in their management. OBJECTIVE: The aim of the present study was to analyze the association of the adherence to the Mediterranean Diet with arterial stiffness, inflammation, and disease-related medication in women with SLE. METHODS: A total of 76 women with SLE were included in this cross-sectional exploratory study. The adherence to the Mediterranean Diet was assessed using the Mediterranean Diet Score. Arterial stiffness was measured through pulse wave velocity (PWV). Inflammatory profile was evaluated through high-sensitivity C-reactive protein (hsCRP). The use (yes / no) and doses (mg /day and cumulative dose in last 3 years) of corticosteroids and immunosuppressants were also registered. RESULTS: No association of the overall adherence to the Mediterranean Diet with PWV, hsCRP or medication use was found (all P>0.05). Lower intake of full dairy products was related to greater odds of corticosteroids use (odds=1.72; P=0.004), and both higher current (ß =0.29; P= 0.024) and cumulative (ß =0.21; P=0.040) doses. Lower intake of red wine was associated with lower odds of immunosuppressants use (odds=0.63; P=0.008). CONCLUSIONS: No association of the adherence to the Mediterranean Diet with arterial stiffness, inflammation or disease-related medication was observed in women with SLE with mild disease activity. However, higher dairy products and lower red wine consumption were related to lower use of disease-related medication. Future studies intervention studies are needed to better understand how nutritional education promoting Mediterranean Diet food groups can complement conventional SLE treatments.

Evaluation of the effects of a gamified, fully immersive and stroke-specific virtual reality intervention for improving disability and quality of life in patients with stroke in the subacute phase: study protocol of the RESET randomised trial.

Stroke is the leading cause of disability and the second cause of death worldwide. The increasing burden of stroke underscores the importance of optimising rehabilitation protocols. Virtual reality (VR) can improve poststroke prognosis. A VR software combining gamification, full immersion and stroke specificity (ie, the Development and validation of a novel viRtual rEality software for improving diSability and quality of lifE in patients with sTroke (RESET) software) might substantially improve disability and quality of life (QoL). However, this technology is still very scarce. The RESET trial aims to assess the effects of an early 10-week gamified, fully immersive and stroke-specific VR intervention (ie, starting at week 3 poststroke) on disability and QoL in people with stroke in the subacute phase. People with ischaemic or haemorrhagic stroke (n=94) aged ≥ 18 years will be randomised to receive (1) usual care (UC), (2) commercial VR or (3) gamified, fully immersive and stroke-specific VR (RESET). The three groups will receive UC (ie, three sessions/week of 90 min of standard rehabilitation). The VR groups will additionally receive three VR sessions of 20 min per week. The outcome measures will be assessed at baseline (week 2 from stroke occurrence), week 13 (approximately 90 days from the event) and week 26 (approximately 6 months from the event). The primary outcome is disability measured with the Barthel Index. Secondary outcomes include QoL, upper-extremity and lower-extremity motor function, gross manual dexterity, handgrip strength and cognitive function. This study will unravel the effects of a gamified, fully immersive and stroke-specific VR software on disability and QoL in patients with stroke in the early subacute phase.Trial registration number: NCT06132399.

Optimizing resistance training intensity in supportive care for survivors of breast cancer: velocity-based approach in the row exercise.

PURPOSE: Resistance training mitigates side effects during and after cancer treatment. To provide a new approach for precisely and safely assessing and prescribing the intensity of resistance training in supportive cancer care, the purpose of this study was to evaluate the load-velocity relationship during the row exercise in women survivors of breast cancer. METHODS: Twenty women survivors of breast cancer who had undergone surgery and had completed core breast cancer treatment within the previous 10 years completed an incremental loading test until the one repetition maximum (1RM) in the row exercise. The velocity was measured during the concentric phase of each repetition with a linear velocity transducer, and their relationship with the relative load was analyzed by linear and polynomial regression models. RESULTS: A strong relationship was observed between movement velocity and relative load for all measured velocity variables using linear and polynomial regression models (R2 > 0.90; SEE < 6.00%1RM). The mean velocity and mean propulsive velocity of 1RM was 0.40 ± 0.03 m·s-1, whereas the peak velocity at 1RM was 0.64 ± 0.07 m·s1. CONCLUSION: In women survivors of breast cancer, monitoring movement velocity during the row exercise can facilitate precise assessment and prescription of resistance training intensity in supportive cancer care.

Optimizing exercise prescription during breast cancer rehabilitation in women: Analysis of the load-velocity relationship in the box squat exercise.

The aims of this study were to assess (i) the load-velocity relationship during the box squat exercise in women survivors of breast cancer, (ii) which velocity variable (mean velocity [MV], mean propulsive velocity [MPV], or peak velocity [PV]) shows stronger relationship with the relative load (%1RM), and (iii) which regression model (linear [LA] or polynomic [PA]) provides a greater fit for predicting the velocities associated with each %1RM. Nineteen women survivors of breast cancer (age: 53.2 ± 6.9 years, weight: 70.9 ± 13.1 kg, and height: 163.5 ± 7.4 cm) completed an incremental load test up to one-repetition maximum in the box squat exercise. The MV, MPV, and the PV were measured during the concentric phase of each repetition with a linear velocity transducer. These measurements were analyzed by regression models using LA and PA. Strong correlations of MV with %1RM (R2 = 0.903/0.904; the standard error of the estimate (SEE) = 0.05 m.s-1 by LA/PA) and MPV (R2 = 0.900; SEE = 0.06 m.s-1 by LA and PA) were observed. In contrast, PV showed a weaker association with %1RM (R2 = 0.704; SEE = 0.15 m.s-1 by LA and PA). The MV and MPV of 1RM was 0.22 ± 0.04 m·s-1, whereas the PV at 1RM was 0.63 ± 0.18 m.s-1. These findings suggest that the use of MV to prescribe relative loads during resistance training, as well as LA and PA regression models, accurately predicted velocities for each %1RM. Assessing and prescribing resistance exercises during breast cancer rehabilitation can be facilitated through the monitoring of movement velocity.

Associations of physical activity, sedentary time, and fitness with cardiovascular risk and atherosclerosis over 3 years in women with systemic lupus erythematosus.

INTRODUCTION: Cardiovascular (CV) diseases are among the main causes of death in systemic lupus erythematosus (SLE). Physical activity (PA) and fitness are potential protective factors against the progression of CV risk factors and atherosclerosis. AIM: To analyze trends over time in PA, sedentary time (ST) and physical fitness and their associations of with traditional and novel markers of CV risk and subclinical atherosclerosis in women with SLE over a 3-year follow-up period. METHODS: In this exploratory study, 77 White Hispanic women with SLE (43.3±13.8 years) with mild disease activity were followed after 3 years (n=44). HDL and LDL cholesterol (blood samples), BMI and muscle mass (stadiometer and bioimpedance device), blood pressure (BP), pulse wave velocity (PWV, Mobil-O-Graph® monitor), carotid plaques and intima-media thickness (General Electric Medical Systems, LOGQ-6 model) were assessed. PA and ST were measured using triaxial accelerometers. Physical fitness was assessed with the back-scratch, handgrip strength, 30-s chair stand, and 6-min walk, tests. RESULTS: After 3 years, LDL-c (estimated mean change [est]=13.77mg/dL) and PWV (0.13m/s) increased while diastolic BP (-2.80mmHG) decreased (all, p<0.05). In mixed models, 6-min walk test was positively associated with HDL-c (est=0.07); back scratch (est=0.33) and chair-stand (est=1.19) tests were positively associated with systolic BP (all, p<0.05). No other trends or associations over time were identified (all, p>0.05). CONCLUSIONS: PA, ST, fitness, and most studied CV risk factors remained stable over time, with only marginal changes in LDL-c, PWV, and diastolic BP. Overall, PA and ST were not longitudinally associated with CV risk factors and subclinical atherosclerosis and contradictory weak associations were found for physical fitness.

Salud cardiovascular en España basada en el Life's Essential 8 y su asociación con mortalidad general y cardiovascular: la cohorte ENRICA / Cardiovascular health in Spain based on the Life's Essential 8 and its association with all-cause and cardiovascular mortality: the ENRICA cohort

Introducción y objetivos: La American Heart Association ha desarrollado el índice Life's Essential 8 (LE8) para promover la prevención de la enfermedad cardiovascular (ECV). Este estudio examinó la distribución del LE8 en la población adulta española y su asociación con la mortalidad general y por ECV.MétodosSe analizaron datos de 11.616 personas de edad≥ años (el 50,5% mujeres) del estudio ENRICA, reclutadas en 2008-2010 y seguidas hasta 2020-2022. El LE8 incluye 8 parámetros (dieta, actividad física, exposición a la nicotina, sueño, índice de masa corporal, lípidos y glucosa en sangre y presión arterial) y se puntúa de 0 a 100. La asociación entre LE8 y mortalidad se resumió mediante hazardratio obtenidas de modelos de Cox.ResultadosEl 13,2% de los participantes (del 6,1 al 16,9% según la comunidad autónoma) mostraron mala salud cardiovascular (LE8≤49). Tras una mediana de 12,9 años de seguimiento, ocurrieron 908 muertes totales y, durante una mediana de 11,8 años de seguimiento, 207 muertes por ECV. Tras ajustar por los principales factores de confusión y comparados con el cuartil más bajo (menos saludable) de LE8, los HR (IC 95%) de mortalidad general en el segundo, el tercer y el cuarto cuartil fueron, respectivamente, 0,68 (0,56-0,83), 0,63 (0,51-0,78) y 0,53 (0,39-0,72). Los resultados correspondientes a la mortalidad cardiovascular, considerando riesgos competitivos de muerte, fueron 0,62 (0,39-0,97), 0,55 (0,32-0,93) y 0,38 (0,16-0,89).ConclusionesUna proporción sustancial de los españoles mostraron mala salud cardiovascular. Una mayor puntación de LE8, desde el segundo cuartil, se asocia con menores mortalidad general y cardiovascular. (AU)

Introduction and objectives: The American Heart Association has recently developed the Life's Essential 8 (LE8) score to encourage prevention of cardiovascular disease (CVD). This study assessed the distribution of LE8 in the Spanish adult population and its association with all-cause and CVD death.MethodsWe used data from 11 616 individuals aged 18 years and older (50.5% women) from the ENRICA study, recruited between 2008 and 2010 and followed up until 2020 to 2022. The LE8 score includes 8 metrics (diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids and glucose, and blood pressure) and ranges from 0 to 100. The association of LE8 score with mortality was summarized with hazard ratios (HR), obtained from Cox regression.ResultsIn total, 13.2% of participants (range, 6.1%-16.9% across regions) had low cardiovascular health (LE8≤49). During a median follow-up of 12.9 years, 908 total deaths occurred, and, during a median follow-up of 11.8 years, 207 CVD deaths were ascertained. After adjustment for the main potential confounders and compared with being in the least healthy (lowest) quartile of LE8, the HR (95%CI) of all-cause mortality for the second, third and fourth quartiles were 0.68 (0.56-0.83), 0.63 (0.51-0.78), and 0.53 (0.39-0.72), respectively. The corresponding figures for CVD mortality, after accounting for competing mortality risks, were 0.62 (0.39-0.97), 0.55 (0.32-0.93), and 0.38 (0.16-0.89).ConclusionsA substantial proportion of the Spanish population showed low cardiovascular health. A higher LE8 score, starting from the second quartile, was associated with lower all-cause and CVD mortality. (AU)

Exercise interventions following bariatric surgery are poorly reported: A systematic review and a call for action.

OBJECTIVES: This study assessed the transparency and replicability of exercise-based interventions following bariatric surgery by evaluating the content reporting of exercise-based clinical trials. DESIGN: The study design of the present article is a systematic review. DATA SOURCES: PubMed, Scopus, Web of Sciences, PsycINFO, and Cochrane were searched from their inception to May 2023. ELIGIBILITY CRITERIA: Eligible studies were clinical trials including exercise interventions in participants following bariatric surgery. There were 28 unique exercise interventions. Two independent reviewers applied the exercise prescription components of Frequency, Intensity, Time, and Type (FITT; four items) and the Consensus on Exercise Reporting Template (CERT; 19 items). Exercise interventions were organized into four major exercise components: aerobic training, resistance training, concurrent training, and "others." RESULTS: The FITT assessment revealed that 53% of the trials did not report the training intensity, whereas 25% did not indicate the duration of the major exercise component within the training session. The mean CERT score was 5 out of a possible score of 19. No studies reached CERT score >10, while 13 out of the total 19 CERT items were not adequately reported by ≥75% of the studies. CONCLUSION: This study highlights that the exercise interventions following bariatric surgery are poorly reported, non-transparent, and generally not replicable. This precludes understanding the dose-response association of exercise and health-related effects and requires action to improve this scientific field.

Comparative efficacy of exercise, diet and/or pharmacological interventions on BMI, ovulation, and hormonal profile in reproductive-aged women with overweight or obesity: a systematic review and network meta-analysis.

BACKGROUND: The increasing prevalence of obesity worldwide poses a significant threat to reproductive function owing, in part, to hormonal disturbances caused by negative feedback between excess adiposity and the hypothalamic-pituitary-ovarian axis. Consequently, finding the most appropriate strategies to lose weight and improve ovulation in women with overweight or obesity is a clinically relevant matter that needs to be investigated. A comprehensive comparison of the independent and combined efficacy of lifestyle and/or pharmacological interventions on BMI, ovulation, and hormonal profile in women with overweight or obesity at risk of anovulatory infertility would facilitate improving fertility strategies in this population. OBJECTIVE AND RATIONALE: This study aimed to evaluate the comparative efficacy of exercise, diet, and pharmacological interventions on BMI, ovulation, and hormonal profile in reproductive-aged women with overweight or obesity. SEARCH METHODS: A systematic review was performed by searching PubMed, Scopus, Web of Science, PsycINFO, and Cochrane Library up to 14 December 2023, for randomized controlled trials assessing the effects of exercise, diet and/or pharmacological interventions (i.e. weight-lowering drugs or ovulation inducers) on BMI, ovulation, and/or hormonal profile in reproductive-aged women with overweight or obesity. We performed frequentist random-effect network meta-analyses and rated the certainty of the evidence. The primary outcomes were BMI and ovulation rate, and the secondary outcomes were serum reproductive hormone levels (gonadotrophins, androgens, or oestrogens). We performed sensitivity analyses, including the studies that only involved women with PCOS. OUTCOMES: Among 1190 records screened, 148 full texts were assessed for eligibility resulting in 95 trials (9910 women), of which 53% presented a high or unclear risk of bias. The network meta-analyses revealed that, compared to control: diet combined with weight-lowering drugs (mean difference (MD) -2.61 kg/m2; 95% CI -3.04 to -2.19; τ2 = 0.22) and adding exercise (MD -2.35 kg/m2; 95% CI -2.81 to -1.89; τ2 = 0.22) led to the greatest decrease in BMI; exercise combined with diet and ovulation inducers (risk ratio (RR) 7.15; 95% CI 1.94-26.40; τ2 = 0.07) and exercise combined with diet and weight-lowering drugs (RR 4.80; 95% CI 1.67-13.84; τ2 = 0.07) produced the highest increase in ovulation rate; and exercise combined with diet and weight-lowering drugs was the most effective strategy in reducing testosterone levels (standardized mean difference (SMD) -2.91; 95% CI -4.07 to -1.74; τ2 = 2.25), the third most effective strategy in increasing sex hormone-binding globulin levels (SMD 2.37; 95% CI 0.99-3.76; τ2 = 2.48), and it was coupled with being ranked first in terms of free androgen index reduction (SMD -1.59; 95% CI -3.18 to 0.01; τ2 = 1.91). The surface under the cumulative ranking curve scores suggested that: diet combined with weight-lowering drugs is the strategy most likely (94%) to produce the highest BMI reduction; and exercise combined with diet and ovulation inducers is the strategy most likely (89%) to produce the highest ovulation rate improvement. The sensitivity analyses, which exclusively included studies involving women diagnosed with PCOS, were consistent with the results presented above. WIDER IMPLICATIONS: Overall, the findings of this network meta-analysis indicate that the combination of exercise, diet, and pharmacological interventions is effective for weight loss, improving ovulation, and normalizing the androgen levels of women with overweight or obesity. Although higher quality studies are needed, these results support that the optimal treatment strategy for women with overweight or obesity wishing to conceive must consider exercise, diet, and pharmacological interventions during the shared decision-making process.

Recommendations for physical activity and exercise in persons living with Systemic Lupus Erythematosus (SLE): consensus by an international task force.

OBJECTIVE: This international task force aimed to provide healthcare professionals and persons living with systemic lupus erythematosus (SLE) with consensus-based recommendations for physical activity and exercise in SLE. METHODS: Based on evidence from a systematic literature review and expert opinion, 3 overarching principles and 15 recommendations were agreed on by Delphi consensus. RESULTS: The overarching principles highlight the importance of shared decision-making and the need to explain the benefits of physical activity to persons living with SLE and other healthcare providers. The 15 specific recommendations state that physical activity is generally recommended for all people with SLE, but in some instances, a medical evaluation may be needed to rule out contraindications. Pertaining to outdoor activity, photoprotection is necessary. Both aerobic and resistance training programmes are recommended, with a gradual increase in frequency and intensity, which should be adapted for each individual, and ideally supervised by qualified professionals. CONCLUSION: In summary, the consensus reached by the international task force provides a valuable framework for the integration of physical activity and exercise into the management of SLE, offering a tailored evidence-based and eminence-based approach to enhance the well-being of individuals living with this challenging autoimmune condition.

Does a Resistance Training Program Affect Between-arms Volume Difference and Shoulder-arm Disabilities in Female Breast Cancer Survivors? The Role of Surgery Type and Treatments. Secondary Outcomes of the EFICAN Trial.

OBJECTIVE: The aims were (i) to assess the effects of a 12-week resistance training program on between-arms volume difference and shoulder-arm disabilities in breast cancer survivors and (ii) to evaluate whether the main risk factors for developing cancer-related lymphedema and shoulder-arm disabilities were associated with the effects of the training program. DESIGN: Randomized controlled trial. SETTING: University facilities. PARTICIPANTS: 60 female breast cancer survivors participated. ELIGIBILITY CRITERIA: to be a breast cancer survivor, and to have completed surgery, chemotherapy, and/or radiotherapy up to 10 years before recruitment. EXCLUSION CRITERIA: metastatic breast cancer, a breast reconstruction intervention planned within 6 months, any absolute contraindication for exercise, to perform more than 300 minutes/week of structured exercise. INTERVENTIONS: Participants were randomized to an exercise group (12-week resistance training program) or a control group. MAIN OUTCOME MEASURES: Between-arms volume difference, shoulder-arm disabilities, and upper-limb muscular strength were evaluated at baseline and at week 12. Treatment-related information was registered from medical history. RESULTS: No between-group differences were observed on between-arms volume difference (1.207; 95% CI -0.964, 3.377; P=.270) or shoulder-arm disabilities (2.070; 95% CI -4.362, 8.501; P=.521) after the training program. Likewise, there was no association of surgery type, presence of lymph node resection, chemotherapy, radiotherapy, and hormone therapy with the changes in between-arms volume and perceived shoulder-arm disabilities after the intervention. However, a higher increase in upper limb muscular strength was associated with a reduced shoulder-arm disabilities (-0.429; P=.020) in the exercise group. CONCLUSIONS: The findings suggest that resistance training does not affect between-arms volume difference and shoulder-arm disabilities in female breast cancer survivors. The main risk factors for developing lymphedema were not associated with the effects of the intervention, although a higher increase in upper-limb muscular strength was associated with reduced shoulder-arm disabilities.

Assessing the Maximal Mechanical Capacities Through the Load-Velocity Relationship in Elite Versus Junior Male Volleyball Players.

BACKGROUND: Physical testing is crucial for athlete monitoring, talent identification, optimizing training, and tailoring programs to enhance game-performance in elite competitions. HYPOTHESIS: Load-velocity (L-V) relationship variables discriminate between elite and junior volleyball players, correlate with volleyball-specific performance, and are generalizable across lower- and upper-body exercises. STUDY DESIGN: Cross-sectional study. LEVEL OF EVIDENCE: Level 3. METHODS: A total of 9 elite and 11 junior volleyball players were assessed for the L-V relationship (load-axis intercept [L0], velocity-axis intercept [v0], and area under the L-V relationship line [Aline]) during the countermovement jump (CMJ) and bench press throw (BPT) exercises. Block and spike jump height, as well as standing and jumping spike speed were assessed 24 hours later. RESULTS: Elite players presented greater magnitude in the L-V variables (P ≤ 0.03; effect size [ES] ≥ 1.06) and higher volleyball-specific performance (P ≤ 0.03; ES ≥ 1.09) than juniors (except for CMJ v0 and Aline). The L-V relationship variables were significantly associated with the block and spike jump height and jumping spike speed only in elite players (r ≥ 0.703 and P ≤ 0.04 in 11 out of 18 correlations). No significant associations were observed between CMJ and BPT for any L-V relationship variable (r ≤ 581; P ≥ 0.08, except for Aline in junior players). CONCLUSION: The L-V relationship is a practical procedure to assess volleyball players' maximal mechanical capacities, which are associated with volleyball-specific performance in elite players. However, these data should not be used interchangeably between playing standards or exercises. CLINICAL RELEVANCE: This information might help strength and conditioning coaches to prescribe more effective training programs that focus on developing the specific physical capacities necessary for players to potentially advance to elite status.

Estimating the one-repetition maximum on the leg-press exercise in female breast cancer survivors.

We examined the accuracy of twelve different velocity-based methods for predicting the bilateral leg-press exercise one-repetition maximum (1RM) in breast cancer survivors. Twenty-one female breast cancer survivors (age 50.2 ± 10.8 years) performed an incremental loading test up to the 1RM. Individual load-velocity relationships were modeled by linear and quadratic polynomial regression models considering the mean velocity (MV) and peak velocity (PV) values recorded at five incremental loads (~45-55-65-75-85% of 1RM) (multiple-point methods) and by a linear regression model considering only the two distant loads (~45-85% of 1RM) (two-point method). The 1RM was always estimated through these load-velocity relationships as the load associated with a general (MV: 0.24 m/s; PV: 0.60 m/s) and an individual (MV and PV of the 1RM trial) minimal velocity threshold (MVT). Compared to the actual 1RM, the 1RMs estimated by all linear regression models showed trivial differences (Hedge's g ranged from 0.08 to 0.17), very large to nearly perfect correlations (r ranged from 0.87 to 0.95), and no heteroscedasticity of the errors (coefficient of determination (r2) < 0.10 obtained from the relationship of the raw differences between the actual and predicted 1RMs with their average value). Given the acceptable and comparable accuracy for all 1RM linear prediction methods, the two-point method and a general MVT could be recommended to simplify the testing procedure of the bilateral leg-press 1RM in breast cancer survivors.

Cardiovascular health in Spain based on the Life's Essential 8 and its association with all-cause and cardiovascular mortality: the ENRICA cohort.

INTRODUCTION AND OBJECTIVES: The American Heart Association has recently developed the Life's Essential 8 (LE8) score to encourage prevention of cardiovascular disease (CVD). This study assessed the distribution of LE8 in the Spanish adult population and its association with all-cause and CVD death. METHODS: We used data from 11 616 individuals aged 18 years and older (50.5% women) from the ENRICA study, recruited between 2008 and 2010 and followed up until 2020 to 2022. The LE8 score includes 8 metrics (diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids and glucose, and blood pressure) and ranges from 0 to 100. The association of LE8 score with mortality was summarized with hazard ratios (HR), obtained from Cox regression. RESULTS: In total, 13.2% of participants (range, 6.1%-16.9% across regions) had low cardiovascular health (LE8 ≤ 49). During a median follow-up of 12.9 years, 908 total deaths occurred, and, during a median follow-up of 11.8 years, 207 CVD deaths were ascertained. After adjustment for the main potential confounders and compared with being in the least healthy (lowest) quartile of LE8, the HR (95%CI) of all-cause mortality for the second, third and fourth quartiles were 0.68 (0.56-0.83), 0.63 (0.51-0.78), and 0.53 (0.39-0.72), respectively. The corresponding figures for CVD mortality, after accounting for competing mortality risks, were 0.62 (0.39-0.97), 0.55 (0.32-0.93), and 0.38 (0.16-0.89). CONCLUSIONS: A substantial proportion of the Spanish population showed low cardiovascular health. A higher LE8 score, starting from the second quartile, was associated with lower all-cause and CVD mortality.

No Changes in Body Composition and Adherence to the Mediterranean Diet after a 12-Week Aerobic Training Intervention in Women with Systemic Lupus Erythematosus: The EJERCITA-LES Study.

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease linked to high cardiovascular risk. To reach an adequate body composition status while maintaining proper dietary habits are effective strategies for reducing cardiovascular risk, both being potentially modified through exercise. This study aimed to evaluate the effects of a 12-week aerobic training intervention on anthropometry, body composition and adherence to the Mediterranean diet in women with SLE. A total of 58 women with SLE were assigned to either an exercise group (EG; n = 26) or a comparison group (CG; n = 32) in this non-randomized controlled trial. The EG comprised 12 weeks of aerobic exercise (two sessions/week) between 40-75% of the individual's heart rate reserve (calculated as maximum heart rate - resting heart rate) and the CG received usual care. At baseline and after the intervention, the anthropometry (i.e., weight, waist circumference, waist-to-hip ratio, and body mass index) and body composition (i.e., fat mass and lean mass) were assessed using a stadiometer, an anthropometric tape, and a bioimpedance device, respectively. Dietary habits were assessed with the Mediterranean Diet score. There were no between-group differences in neither anthropometric nor body composition parameters (all p > 0.05). Similarly, no between-group differences were obtained in the adherence to the Mediterranean diet after the exercise intervention (all p > 0.05). Contrary to the initial hypothesis, these results suggest that the 12-week aerobic training intervention performed in this study did not improve anthropometry, body composition or adherence to the Mediterranean diet in women with SLE.

Prescribing statin therapy in physically (in)active individuals vs prescribing physical activity in statin-treated patients: A four-scenario practical approach.

Statins are among the most commonly prescribed medications worldwide. Statin-associated muscle symptoms (SAMS) represent a frequent statin-related adverse effect associated with statin discontinuation and increased cardiovascular disease (CVD) events. Emerging evidence indicate that the majority of SAMS might not be actually caused by statins, and the nocebo/drucebo effect (i.e. adverse effects caused by negative expectations) might also explain SAMS. Physical activity (PA) is a cornerstone in the management of CVD risk. However, evidence of increased creatine-kinase levels in statin-treated athletes exposed to a marathon has been generalized, at least to some extent, to the general population and other types of PA. This generalization is likely inappropriate and might induce fear around PA in statin users. In addition, the guidelines for lipid management focus on aerobic PA while the potential of reducing sedentary behavior and undertaking resistance training have been overlooked. The aim of this report is to provide a novel proposal for the concurrent prescription of statin therapy and PA addressing the most common and clinically relevant scenarios by simultaneously considering the different stages of statin therapy and the history of PA. These scenarios include i) statin therapy initiation in physically inactive patients, ii) PA/exercise initiation in statin-treated patients, iii) statin therapy initiation in physically active patients, and iv) statin therapy in athletes and very active individuals performing SAMS-risky activities.

Effectiveness of Land- and Water-based Exercise on Fatigue and Sleep Quality in Women With Fibromyalgia: The al-Ándalus Quasi-Experimental Study.

OBJECTIVE: To assess the effectiveness of 24 weeks of land- and water-based exercise on fatigue and sleep quality in women with fibromyalgia, and the persistence of changes 12 weeks after exercise cessation. DESIGN: Quasi-experimental study. SETTING: University facilities and fibromyalgia associations. PARTICIPANTS: Women with fibromyalgia (N=250; 50.8±7.6 years old). INTERVENTIONS: Participants were assigned to land-based exercise (n=83), water-based exercise (n=85), or no exercise control (n=82) groups. The intervention groups engaged in a similar multicomponent exercise program for 24 weeks. MAIN OUTCOME MEASURES: The Multidimensional Fatigue Inventory and Pittsburgh Sleep Quality Index were used. RESULTS: Intention-to-treat analyses revealed that, compared with the control group, at week 24: (i) the land-based exercise group improved physical fatigue (mean difference -0.9 units; 95% confidence interval -1.7 to -0.1; Cohen's d=0.4) and (ii) the water-based exercise group improved general fatigue (-0.8; -1.4 to -0.1, d=0.4), and global sleep quality (-1.6; -2.7 to -0.6, d=0.6). Additionally, compared with the land-based exercise group, the water-based exercise group improved global sleep quality (-1.2; -2.2 to -0.1, d=0.4). Changes were generally not sustained at week 36. CONCLUSION: Land-based multicomponent exercise improved physical fatigue, whereas water-based exercise improved general fatigue and sleep quality. The magnitude of the changes was small-to-medium, and no benefits were maintained after exercise cessation.

Acute Mechanical and Skin Temperature Responses to Different Interrepetition Rest Intervals During Full-Squat Exercise.

PURPOSE: This study aimed to (1) evaluate the acute effects of different interrepetition rest full-squat protocols on countermovement jump (CMJ) height, velocity loss (VL), and skin temperature (Tsk) and (2) determine whether the VL, the changes in Tsk, or the individual strength level is associated with the change in CMJ height. METHODS: Sixteen resistance-trained men randomly performed 3 squat protocols at maximal intended velocity with 60% of the 1-repetition maximum (sets × repetitions [interrepetition rest]): traditional (2 × 6 [0 s]), cluster 2 (2 × 6 [30 s every 2 repetitions]), and cluster 1 (1 × 12; [36 s every repetition]), plus a control session. CMJ height was assessed before and 2, 4, and 8 minutes after the protocols. RESULTS: There was a significant main effect of protocol for the VL (F = 20.54, P < .001) and loss in mean power (F = 12.85, P < .001; traditional > cluster 2 > cluster 1). However, we found a comparable reduction of CMJ height after 8 minutes: traditional (-3.4% [4.2%]), cluster 2 (-5.3% [4.9%]), cluster 1 (-5.4% [2.9%]), and control (-4.2% [3.6%]). Overall, mean Tsk acutely decreased after all the protocols. Higher individual strength level (but not VL or the changes in Tsk) was associated with lower CMJ-height loss (P < .05). CONCLUSIONS: Although different interrepetition rest full-squat protocols may alter the loss in velocity and power, they result in a similar decrease in Tsk and CMJ height, which could be more influenced by individual strength level than VL or changes in Tsk.

Lifestyle physical activity and rapid-rate non-sustained ventricular tachycardia in arrhythmogenic cardiomyopathy.

OBJECTIVE: To investigate the association of accelerometer-measured lifestyle physical activity with rapid-rate non-sustained ventricular tachycardias (RR-NSVTs) in patients with arrhythmogenic cardiomyopathy (AC). METHODS: This multicentre, observational study enrolled 72 patients with AC, including right, left and biventricular forms of the disease, with underlying desmosomal and non-desmosomal mutations. Lifestyle physical activity, objectively monitored with accelerometers (ie, movement sensors) and RR-NSVT, identified as >188 bpm and >18 beats from a textile Holter ECG for 30 days. RESULTS: Sixty-three patients with AC (38±17.6 years, 57% men) were included. A total of 17 patients experienced ≥1 RR-NSVTs, and a total of 35 events were recorded. The odds of occurrence of ≥1 RR-NSVT during the recording did not increase as a function of either total physical activity (OR 0.95, 95% CI (CI95%) 0.68 to 1.30 for 60 min increase) or moderate-to-vigorous activities (OR 0.89, CI95% 0.71 to 1.08 for 5 min increase). Participants presenting RR-NSVTs during the recording (n=17) did not present greater odds of RR-NSVT in the days with more time either in total physical activity (OR 1.05, CI95% 0.84 to 1.29 for additional 60 min) or moderate-to-vigorous activities (OR 1.05, CI95% 0.97 to 1.12 for additional 5 min). Physical activity levels were neither different between the patients with and without RR-NSVTs during the recording period nor in the days of occurrence of RR-NSVT compared with the rest of the days. Finally, 4 of the 35 RR-NSVTs recorded in the 30 days occurred during physical activity (3 during moderate-to-vigorous intensity and 1 during light-intensity activities). CONCLUSIONS: These findings suggest that lifestyle physical activity is not associated with RR-NSVTs in patients with AC.

Novel Curvilinear Sprint Test in Basketball: Reliability and Comparison With Linear Sprint.

ABSTRACT: Baena-Raya, A, Díez-Fernández, DM, López-Sagarra, A, Martínez-Rubio, C, Soriano-Maldonado, A, and Rodríguez-Pérez, MA. Novel curvilinear sprint test in basketball: reliability and comparison with linear sprint. J Strength Cond Res 37(9): e535-e540, 2023-This study (a) evaluated the reliability of a curvilinear sprint (CS) test to assess kinetic and kinematic outcomes in basketball players, (b) compared the kinetic and kinematic outcomes derived from curvilinear vs. linear sprints (LS), and (c) examined the association of both the CS and LS with change of direction (COD) performance. Thirty young basketball players (17 men and 13 women) competing at the national level (i.e., Spanish Basketball National League) performed a novel CS test around the 3-point line (the 3-point line CS test) to the right and left sides. The maximum and average values of acceleration (ACC), velocity (VEL), and centripetal force (CentF) were measured using Local Positioning System technology (WIMU PRO, Realtrack Systems S.L., Almería, Spain). All outcomes showed a high relative (intraclass correlations coefficient ≥ 0.90) and absolute (coefficient of variation [CV] < 5%) reliability, except the maximal CentF to the right (CV = 5.41%) and left sides (CV = 7.72%). Linear sprints displayed higher ACC and VEL outputs compared with the 3-point line CS test (all p < 0.001). Both sprinting tests were very large to nearly perfect associated with COD performance (LS r range from -0.71 to -0.86; CS r range from -0.68 to -0.94; p < 0.001), and the curvilinear ACC max was the kinematic outcome most strongly associated with COD performance ( r range from -0.73 to -0.94). In conclusion, the 3-point line CS test is reliable to measure CS performance in basketball and presents different kinetic and kinematic features than LS.