Validity of the Physical Activity Questionnaires IPAQ-SF and GPAQ for Cancer Survivors: Insights from a Spanish Cohort.

Regular physical activity (PA) decreases mortality risk in survivors of breast and colorectal cancer. Such impacts of exercise have prompted initiatives designed both to promote and adequately monitor PA in cancer survivors. This study examines the validity of 2 widely used self-report methods for PA determination, the International Physical Activity Questionnaire short version (IPAQ-SF) and Global Physical Activity Questionnaire (GPAQ). Both instruments were compared with the triaxial accelerometry (Actigraph) method as an objective reference standard. Study participants were 204 cancer survivors (both sexes, aged 18-79 years). Compared with accelerometry, both questionnaires significantly overestimated PA levels (across all intensities) and underestimated physical inactivity levels. No differences were detected between the 2 questionnaires except for a shorter inactivity time estimated by GPAQ (p=0.001). The Bland and Altman method confirmed that both questionnaires overestimated all PA levels. Receiver operating characteristic (ROC) analysis classified IPAQ and GPAQ as fair and poor predictors, respectively, of the proportions of survivors fulfilling international PA recommendations (≥150 min·week-1 of moderate-vigorous PA). IPAQ-SF showed a higher sensitivity but lower specificity than GPAQ. Our data do not support the use of IPAQ-SF or GPAQ to determine PA or inactivity levels in cancer survivors.

Response rate to the treatment of Waldenström macroglobulinemia: A meta-analysis of the results of clinical trials.

Waldenström macroglobulinemia (WM) is a malignant lymphoproliferative disorder characterized by the presence of a high level of serum monoclonal IgM and a lymphoplasmacytic infiltrate in the bone marrow. This meta-analysis sought to assess the effectiveness of the different treatments for WM tested in published trials using the response rate (RR) as the main outcome measure. Forty-six articles (1409 patients) identified were entered in a variable effects model meta-analysis of proportions (rates and sample sizes). A greater response to treatment was produced in patients treated with a combination of 2+ drugs (RR=73%; 95%CI: 62, 83; p<0.01) than in those receiving monotherapy with rituximab (RR=44%; 95%CI: 34, 55; p<0.01) or a purine analogue [61% (95%CI: 43, 78; p<0.01) for cladribine and 53% (95%CI: 34, 72; p<0.01) for fludarabine]. The combination rituximab+cladribine emerged as particularly effective (RR=87%; 95%CI: 78, 94; p<0.01), slightly more effective than rituximab+bortezomib/dexamethasone (RR=84%; 95%CI: 79, 88; p<0.01) and rituximab+cyclophosphamide/dexamethasone [RR=81% (95%CI: 72, 88; p<0.01)]. Our results are in overall agreement with treatment recommendations from the seventh International Workshops on WM. Our findings are limited by the fact that we could not analyze progression-free survival (PFS). More phase II/III trials are needed to corroborate promising recent findings with bendamustine and carfilzomib and further research are needed to standardize recommendations based on maximum treatment efficacy combined with lowest toxicity, differentiation between first vs second line treatment, or long-term follow up after treatment.

Attenuation of the influence of cardiolocomotor coupling in heart rate variability interpretation during exercise test.

During exercise test, cardiolocomotor coupling related components appear in heart rate variability (HRV), blurring its interpretation as autonomic nervous system (ANS) marker. These cardiolocomotor coupling related components are centered at the pedalling and running stride frequency, as well as at their aliases, and may overlap with the low frequency (LF) and high frequency (HF) components of HRV. In this work cardiolocomotor-related HRV components are studied during maximal exercise test on treadmill and cycle ergometer. Power in the bands related to cardiolocomotor coupling increases with exercise intensity in cycle ergometer but not in treadmill exercise test, where it displays higher values for all exercise intensities. A method is proposed to reduce the effect of this coupling in the interpretation of HRV. Evolution of the power in the low frequency (LF) and high frequency (HF) bands are studied after the proposed reduction of cardiolocomotor coupling, showing more significant changes with exercise intensity than before the method is applied.

PGC-related gene variants and elite endurance athletic status in a Chinese cohort: a functional study.

This study aims to examine the association between proliferator-activated receptor γ (PGC)-gene family-related single nucleotide polymorphisms (SNPs) and elite endurance runners' status in a Chinese cohort, and to gain insights into the functionality of a subset of SNPs. Genotype distributions of 133 SNPs in PPARGC1A, PPARGC1B, PPRC1, TFAM, TFB1M, TFB2M, NRF1, GABPA, GABPB1, ERRα, and SIRT1 genes were compared between 235 elite Chinese (Han) endurance runners (127 women) and 504 healthy non-athletic controls (237 women). Luciferase gene reporter activity was determined in 20 SNPs. After adjusting for multiple comparisons (in which threshold P-value was set at 0.00041), no significant differences were found in allele/genotype frequencies between athletes and controls (when both sexes were analyzed either together or separately). The lowest P-value was found in PPARGC1A rs4697425 (P = 0.001 for the comparison of allele frequencies between elite female endurance runners and their gender-matched controls). However, no association (all P > 0.05) was observed for this SNP in a replication cohort from Poland (194 endurance athletes and 190 controls). Using functional genomics tool, the following SNPs were found to have functional significance: PPARGC1A rs6821591, rs12650562, rs12374310, rs4697425, rs13113110, and rs4452416; PPARGC1B rs251466 and rs17110586; and PPRC1 rs17114388 (all P < 0.001). This study found no significant association between PGC-related SNPs and elite endurance athlete status in the Chinese population, despite some SNPs showing potential functional significance and the strong biological rationale to hypothesize that this gene pathway is a candidate to influence endurance exercise capacity.

Effects of allopurinol on exercise-induced muscle damage: new therapeutic approaches?

Intensive muscular activity can trigger oxidative stress, and free radicals may hence be generated by working skeletal muscle. The role of the enzyme xanthine oxidase as a generating source of free radicals is well documented and therefore is involved in the skeletal muscle damage as well as in the potential transient cardiovascular damage induced by high-intensity physical exercise. Allopurinol is a purine hypoxanthine-based structural analog and a well-known inhibitor of xanthine oxidase. The administration of the xanthine oxidase inhibitor allopurinol may hence be regarded as promising, safe, and an economic strategy to decrease transient skeletal muscle damage (as well as heart damage, when occurring) in top-level athletes when administered before a competition or a particularly high-intensity training session. Although continuous administration of allopurinol in high-level athletes is not recommended due to its possible role in hampering training-induced adaptations, the drug might be useful in non-athletes. Exertional rhabdomyolysis is the most common form of rhabdomyolysis and affects individuals participating in a type of intense exercise to which they are not accustomed. This condition can cause exercise-related myoglobinuria, thus increasing the risk of acute renal failure and is also associated with sickle cell trait. In this manuscript, we have reviewed the recent evidence about the effects of allopurinol on exercise-induced muscle damage. More research is needed to determine whether allopurinol may be useful for preventing not only exertional rhabdomyolysis and acute renal damage but also skeletal muscle wasting in critical illness as well as in immobilized, bedridden, sarcopenic or cachectic patients.

Influence of sex and level on marathon pacing strategy. Insights from the New York City race.

Different pacing profiles have been identified in the literature for endurance sporting events: the 'positive', 'negative', 'even', 'parabolic shaped' and 'variable pacing'. Most studies have focused on competitive or elite athletes (including winners) without considering more recreational runners, for many of whom the primary goal is simply to finish the event. The major city marathons provide a large heterogeneous sample to compare the pacing profiles of competitive vs. recreational runners, and thus to understand pacing more broadly. A total of 190,228 New York finishers' (69,316 women) marathon times (from 2006 to 2011) were assessed. Although all runners developed a positive pace profile, a lower variability of speed through the race was found in the top runners (coefficient of variation (CV) for speed during 5-km splits: 7.8% (men) and 6.6% (women)) compared with the less successful runners (CV ranging from 8.3 to 14.4%). Both men and women try to maintain an even pace profile along the marathon course, partly by avoiding an excessively fast start that might result in a pronounced decrease in the speed in the second half of the race.

Actigraph GT3X: validation and determination of physical activity intensity cut points.

The aims of this study were: to compare energy expenditure (EE) estimated from the existing GT3X accelerometer equations and EE measured with indirect calorimetry; to define new equations for EE estimation with the GT3X in youth, adults and older people; and to define GT3X vector magnitude (VM) cut points allowing to classify PA intensity in the aforementioned age-groups. The study comprised 31 youth, 31 adults and 35 older people. Participants wore the GT3X (setup: 1-s epoch) over their right hip during 6 conditions of 10-min duration each: resting, treadmill walking/running at 3, 5, 7, and 9 km · h⁻¹, and repeated sit-stands (30 times · min⁻¹). The GT3X proved to be a good tool to predict EE in youth and adults (able to discriminate between the aforementioned conditions), but not in the elderly. We defined the following equations: for all age-groups combined, EE (METs)=2.7406+0.00056 · VM activity counts (counts · min⁻¹)-0.008542 · age (years)-0.01380 · body mass (kg); for youth, METs=1.546618+0.000658 · VM activity counts (counts · min⁻¹); for adults, METs=2.8323+0.00054 · VM activity counts (counts · min⁻¹)-0.059123 · body mass (kg)+1.4410 · gender (women=1, men=2); and for the elderly, METs=2.5878+0.00047 · VM activity counts (counts · min⁻¹)-0.6453 · gender (women=1, men=2). Activity counts derived from the VM yielded a more accurate EE estimation than those derived from the Y-axis. The GT3X represents a step forward in triaxial technology estimating EE. However, age-specific equations must be used to ensure the correct use of this device.

Intermonitor variability of GT3X accelerometer.

The main purpose of this study was to assess the inter-monitor reliability of the tri-axial GT3X Actigraph accelerometer over a range of physical activities (PA). This device collects motion data on each of the vertical (Y), horizontal right-left (X), and horizontal front-back (Z) axes and also calculates the vector summed value √X(2)+Y(2)+Z(2) known as 'vector magnitude' (VM). 8 GT3X accelerometers were worn at the same time by the same participant. Accelerometers were placed back-to-front, all facing forward and in sets of 4 securely taped together, attached to a belt and allocating each block above either left or right hip at waist level. Inter-monitor reliability was assessed during 6 conditions: rest, walking (4 and 6 km·h(-1)), running (8 and 10 km·h(-1)) and repeated sit-to-stand (40 times·min(-1)). The intra-class correlation coefficients were high for X, Y and Z axes (i.e., all ≥ 0.925) and for VM (≥ 0.946). In conclusion, we found good inter-instrument reliability of the GT3X accelerometer across all planes, yet our results also suggest that the X and Z axes do not provide further benefits over the 'traditional' Y-axis to assess the movement in typical PA.

Effects of 7-weeks competitive training period on physiological and mental condition of top level judoists.

AIM: We examined hormonal and haematological parameters and the profile of mood states (POMS) in top level judoists undertaking a 7-week competitive training period in a real contest. METHODS: Participants were 10 top level judoists belonging to the Spanish National Team. Training load was calculated by multiplying the training session intensity by the duration of the training session. The judoists competed in two official events on weeks 3 and 6 of the study. RESULTS: Urinary catecholamines increased at the end of the competitive period. Serum cortisol increased during the weeks in which judoists competed, confirming the existence of and anticipatory cortisol response to exercise; although we failed to find serum testosterone increases. Because of leukocyte values did not change, except monocytes, we speculate that the intensity of training was not sufficiently high to evoke injury to muscle tissue. Anger, tension, and fatigue increased according with training load, suggesting that the training exercise led participants into a negative psychological state. CONCLUSION: Findings indicate that during competitive periods, judoists suffer hormonal and mood changes according to training load and competitive events. Results support the usefulness of monitoring biological and psychological markers during season in order to adjust training loads and periods of recovery.

Biological and psychological monitoring of training status during an entire season in top kayakers.

AIM: The aim of this study was to analyze changes in selected biological and psychological variables in a group of top level kayakers along a 42-week training season. METHODS: Eight top junior sprint kayakers (age=16.8±2.1) (5 men and 3 women) with international competitive experience participated in the research. During the 42-wk season the subjects were tested in three occasions: (T1) in the second week of the general training period, (T2) at the beginning of the specific training period, (T3) at the beginning of the competitive training period. Firstly, subjects were asked to complete the Recovery-Stress Questionnaire for Athletes (RESTQ-Sport) and the Profile of Mood States (POMS) questionnaires, and Borg´s rate of perceived exertion scale (RPE). Immediately after, blood samples were collected and white blood cells, creatine kinase (CK), C-reactive protein (CRP), myeloperoxidase protein levels (MPO) and glutathione status were determined. ANOVA with repeated measures was used to determine the differences between tests. RESULTS: From the hematological and biochemical measures only total leukocytes changed significantly, increasing at T3 when compared to T1. There were no differences along the entire season in both RESTQ-Sport and POMS scores or indices. Concerning performance, the group improved their maximal strength (+17.4% in bench-press 1RM) and their specific-distance time (+9.8%). The main finding of the present study was that training was well-balanced between stress and recovery because while specific performance increased, signs of overtraining were not found. CONCLUSION: Training monitoring in athletes should be performed in a multilevel approach using measurements of performance as well as biological or psychological parameters.

Effects of different vibration exercises on bench press.

This study was undertaken to analyze the effects of different vibration recovery strategies via feet or hands on the number of repetitions performed and on mean velocity, peak velocity and blood lactate concentration during consecutive bench-press sets. 9 elite judo athletes performed 3 sets of bench press at 60% of one-repetition maximum (1RM), leading to failure and allowing a 180 s rest period between sets. During the rest period, 1 of the 3 following procedures was performed: 150 s rest plus 30 s push-up vibration exercise (Push-up), 150 s rest plus 30 s squat vibration exercise (Squat) or 180 s only rest (Passive). Statistical analysis revealed that the Squat condition resulted in a significant increase in the number of repetitions achieved, in comparison with all other rest strategies. However, kinematic parameters and blood lactate concentration were not affected by vibration. These data suggest that a vibration stimulus applied to the feet, between sets, can result in positive improvements in upper body resistance exercise performance. Although the mechanisms are not fully understood, this positive effect of vibration could be due to an increased motor cortex excitability and voluntary drive.

Physical activity and energy expenditure measurements using accelerometers in older adults.

The purpose of this review is to address methodological issues related to accelerometer-based assessments of physical activity (PA) in older individuals. Special interest is also put on recently updated technology. No definitive evidence exists currently to indicate which are the more valid and reliable accelerometer models for use with older people. When it comes to selecting an accelerometer, issues of affordability, product reliability, monitor size, technical support, and comparability with other studies may be equally as important as the relative validity and reliability of an instrument. The accelerometer should be attached as close as possible to the body's center of mass, and in the case of elders using walking aids, it should be placed on the same body side. Variability due to positioning can be reduced with careful training and supervision. Typically, the sampling period is between 3 and 7 days and it is not yet clear if variability exists between weekdays and weekend in the elderly. It is possible that aging effects on physical and cognitive health may limit the ability of an older adult to be compliant with an accelerometer protocol; in this line many methods have been suggested for increasing compliance to protocols for research studies. Accelerometers can provide reliable information on mobility and objective measurement of PA. These activity monitors have significant advantages when compared with other quantitative methods for measurement of energy expenditure. Accelerometers are currently used mainly in a research setting; however, with recent advances, incorporation into clinical and fitness practice is possible and increasing.

Physical activity and energy expenditure measurements using accelerometers in older adults / Utilización de los acelerómetros para la medida de la actividad física y el gasto energético en personas mayores

The purpose of this review is to address methodological issues related to accelerometer-based assessments of physical activity (PA) in older individuals. Special interest is also put on recently updated technology. No definitive evidence exists currently to indicate which are the more valid and reliable accelerometer models for use with older people. When it comes to selecting an accelerometer, issues of affordability, product reliability, monitor size, technical support, and comparability with other studies may be equally as important as the relative validity and reliability of an instrument. The accelerometer should be attached as close as possible to the body's center of mass, and in the case of elders using walking aids, it should be placed on the same body side. Variability due to positioning can be reduced with careful training and supervision. Typically, the sampling period is between 3 and 7 days and it is not yet clear if variability exists between weekdays and weekend in the elderly. It is possible that aging effects on physical and cognitive health may limit the ability of an older adult to be compliant with an accelerometer protocol; in this line many methods have been suggested for increasing compliance to protocols for research studies. Accelerometers can provide reliable information on mobility and objective measurement of PA. These activity monitors have significant advantages when compared with other quantitative methods for measurement of energy expenditure. Accelerometers are currently used mainly in a research setting; however, with recent advances, incorporation into clinical and fitness practice is possible and increasing (AU)

El objetivo de esta revisión se centra en cuestiones metodológicas relacionadas con la medición de la actividad física mediante acelerómetros en personas mayores. Se pone un especial énfasis en la tecnología más reciente. Actualmente no existen pruebas definitivas que indiquen que un modelo es más válido y fiable que otro para su utilización con los ancianos. Al seleccionar un acelerómetro, la comodidad, la fiabilidad del producto, el tamaño, el apoyo técnico y la comparación con otros estudios pueden ser tan importantes como la validez y la fiabilidad del instrumento. Los acelerómetros deben colocarse lo más cerca posible del centro de masas del cuerpo y en el caso de que los ancianos utilicen ayudas técnicas para caminar se deben situar en el mismo lado del cuerpo. La variabilidad debida a la colocación puede reducirse con un cuidadoso entrenamiento y supervisión. Normalmente el periodo de registro es entre 3 y 7 días y todavía no está claro si existe suficiente variabilidad entre días de la semana y de fin de semana en ancianos. Es posible que los efectos del envejecimiento sobre la salud física y cognitiva puedan limitar la capacidad de un anciano de adaptarse al protocolo de utilización de un acelerómetro; en esta línea se han sugerido métodos para incrementar el cumplimiento de los protocolos en estudios de investigación. Los acelerómetros pueden aportar información fiable sobre la movilidad y medidas objetivas de actividad física. Estos monitores presentan ventajas significativas cuando se comparan con otros métodos cuantitativos utilizados en la actualidad para la medida de la actividad física habitual. Actualmente los acelerómetros se utilizan principalmente en investigación; sin embargo, con la incorporación de avances recientes, su empleo es posible y se está incrementando en clínica y para la mejora de la forma física (AU)

Whole-body vibration training increases muscle strength and mass in older women: a randomized-controlled trial.

To determine whether 10 weeks of whole-body vibration (WBV) training has a significant effect on strength, muscle mass, muscle power, and mobility in older women, 26 subjects were randomly assigned to a WBV training group (n=13; mean age 79 years) and a control (CON) group (n=13; mean age 76 years). Maximal voluntary isometric contraction (MVIC) increased 38.8% in the WBV group, without changes in the CON group. Electromyographic activity of the vastus medialis (VM), the vastus lateralis, and the biceps femoris (BF) did not change in either group. Thigh muscle cross-sectional area increased significantly after training in VM (8.7%) and BF (15.5%). Muscle power at 20%, 40%, and 60% MVIC decreased from pre-test to post-test in the CON group; however, WBV training prevented the decrease in the WBV group. Consequently, mobility, measured by the Timed Up and Go test, increased significantly after training (9.0%) only in the WBV group. Ten weeks of lower limb WBV training in older women produces a significant increase in muscle strength induced by thigh muscle hypertrophy, with no change in muscle power. The adaptations to WBV found in the present study may be of use in counteracting the loss of muscle strength and mobility associated with age-induced sarcopenia.

Cuantificación de la actividad física en personas mayores / Assessment of physical activity in older adults

Los beneficios de la actividad física en la salud y la calidad de vida de las personas mayores son bien conocidos; sin embargo, la exactitud en la medición de la actividad física todavía es problemática. Hay varios métodos para cuantificar la actividad física y se debe seleccionar uno u otro en función del objetivo y de las características del estudio. Este artículo se centra en el análisis de 3 métodos: agua doblemente marcada, cuestionarios y detectores de movimiento. El método de agua doblemente marcada es el más exacto y es considerado de referencia. Debido a su alto coste todavía hay pocos estudios que utilicen este método en personas mayores. El cuestionario de actividad física es el método más simple y barato, aunque la mayoría ha sido desarrollado en poblaciones jóvenes y adultas. De ahí la necesidad de un cuestionario especialmente diseñado para personas mayores, como es el caso del Physical Activity Scale for the Elderly, el Yale Physical Activity Survey o el CHAMPS Physical Activity Questionnaire. Los detectores de movimiento también se han utilizado para medir la actividad física en personas mayores. En futuros estudios se debe determinar si dichos detectores son útiles para medir la actividad física de baja intensidad en personas mayores

The benefits of physical activity on health and quality of life in older people are well established but accurate measurement of physical activity remains problematic. There are several methods for assessing physical activity and each researcher should select a method according to the purpose and the characteristics of the study. The present article analyses three methods: doubly labelled water, questionnaires and motion sensors. Doubly labelled water is the most accurate method and is considered the gold standard. Because it is expensive, few studies have used this method in older people. A physical activity questionnaire is the simplest and least expensive method but most questionnaires have been validated in young people and adults. Therefore, a questionnaire specifically designed for older people, such as the Physical Activity Scale for the Elderly, the YALE Physical Activity Survey or the CHAMPS Physical Activity Questionnaire, is required. Motion sensors have also been used for physical activity assessment in older people. Future studies should determine whether these devices are useful for assessing low-intensity physical activity in older people

Anaerobic energy provision does not limit Wingate exercise performance in endurance-trained cyclists.

The aim of this study was to evaluate the effects of severe acute hypoxia on exercise performance and metabolism during 30-s Wingate tests. Five endurance- (E) and five sprint- (S) trained track cyclists from the Spanish National Team performed 30-s Wingate tests in normoxia and hypoxia (inspired O(2) fraction = 0.10). Oxygen deficit was estimated from submaximal cycling economy tests by use of a nonlinear model. E cyclists showed higher maximal O(2) uptake than S (72 +/- 1 and 62 +/- 2 ml x kg(-1) x min(-1), P < 0.05). S cyclists achieved higher peak and mean power output, and 33% larger oxygen deficit than E (P < 0.05). During the Wingate test in normoxia, S relied more on anaerobic energy sources than E (P < 0.05); however, S showed a larger fatigue index in both conditions (P < 0.05). Compared with normoxia, hypoxia lowered O(2) uptake by 16% in E and S (P < 0.05). Peak power output, fatigue index, and exercise femoral vein blood lactate concentration were not altered by hypoxia in any group. Endurance cyclists, unlike S, maintained their mean power output in hypoxia by increasing their anaerobic energy production, as shown by 7% greater oxygen deficit and 11% higher postexercise lactate concentration. In conclusion, performance during 30-s Wingate tests in severe acute hypoxia is maintained or barely reduced owing to the enhancement of the anaerobic energy release. The effect of severe acute hypoxia on supramaximal exercise performance depends on training background.