The role of supervision and motivation during exercise on physical and mental health in older adults: a study protocol for a randomized controlled trial (PRO-Training project).

BACKGROUND: Although supervised exercise is frequently recommended for older adults, its superiority over unsupervised exercise remains uncertain. Furthermore, whether motivational techniques could help to enhance the effectiveness of the latter remains to be elucidated. The present randomized controlled trial aims to determine the role of supervision and motivational strategies on the safety, adherence, efficacy, and cost-effectiveness of different exercise programs for improving physical and mental health in older adults. METHODS: Participants (n = 120, aged 60-75 years) will be randomly allocated into five groups: 1-Control (CON), 2-Supervised exercise without motivational intervention (SUP), 3- Supervised exercise with motivational intervention (SUP +), 4- Unsupervised exercise without motivational intervention (UNSUP) and 5- Unsupervised exercise with motivational intervention (UNSUP +). Over 24 weeks, all exercise groups will participate in a multicomponent exercise program three times/week (performed in group classes at a center for SUP and SUP + , or home without supervision but with the help of a mobile app for UNSUP and UNSUP +), while the CON group will maintain their usual lifestyle. The motivational intervention (for SUP + and UNSUP + groups) will be based on the self-determination theory, including strategies such as phone calls, interactive workshops, motivational messages, informative infographics and videos. Primary outcomes will include safety, adherence, costs, and lower-body muscular function using a leg press machine. Secondary outcomes will include upper-body muscular function, physical and cardiorespiratory function, blood pressure and heart rate, body composition, health-related quality of life, cognitive performance, anxiety, depression, physical activity levels, sleep and sedentarism, biochemical markers, motivators and barriers to exercise. Assessments will be conducted at baseline, mid-intervention (i.e., week 13), at the end of the intervention (i.e., week 25), and 24 weeks later (i.e., week 49). DISCUSSION: The findings of this trial might provide valuable insights into the role of supervision and motivational strategies on the effectiveness of exercise programs for older adults. Additionally, the study could contribute to developing cost-effective interventions, supporting the design of future public policies for healthy aging. TRIAL REGISTRATION: NCT05619250. Registered 16 November 2022.

Clustering Health Behaviors in Mexican Adolescents: The HELENA-MEX Study.

Purpose: The prevalence of excess weight within the adolescent population is rapidly increasing in Mexico, especially in areas with lower socioeconomic status. The present study aimed to identify lifestyle clustered patterns in adolescents and analyze the associations among these clusters and body composition. Method: A final sample of n=259 participants (13 to 17 years old, 58.7% girls), residents in rural and urban areas, were included. Hierarchical and k-means clusters analyses included moderate to vigorous physical activity (MVPA), cardiorespiratory fitness (CRF), handgrip strength, screen time, sleep time, and diet. The associations between cluster membership and body composition were analyzed through general linear models (ANCOVA), including sex, age, place of residence, and socioeconomic status as covariates. Results: Three different clusters were identified: Cluster 1, [Unhealthy] (low values in all lifestyle patterns), Cluster 2, [Low Physical Fitness] (low values in CRF and handgrip strength) and Cluster 3, [High Physical Activity and CRF] (highest values in CRF, handgrip strength and MVPA). Clusters 2 and 3 showed high values in screen time and industrialized food consumption. There were no differences in sleep between the 3 Clusters. ANCOVA analysis revealed that participants belonging to Cluster 3 showed significantly lower adiposity and a higher Fat Free Mass compared with the other two clusters (p < 0.05). Conclusion: Our findings suggest that a lifestyle characterized by high levels of physical activity and physical fitness and low consumption of industrialized food may be protective against the problem of obesity, which could be helpful to develop interventions to reduce excess weight in Mexican adolescents.

Pelvic Floor Muscle Training Interventions in Female Athletes: A Systematic Review and Meta-analysis.

CONTEXT: Athletes are almost 3 times more at risk of experiencing urinary incontinence (UI) than sedentary women, with prevalence rates varying from 10.9% in low-impact sports such as cycling to 80% when engaging in high-impact sports such as trampoline gymnastics. To treat UI, pelvic floor muscle (PFM) training (PFMT) is recommended as a first line of treatment. OBJECTIVE: The aim of the present study was to perform a meta-analysis of the available literature on the efficacy of PFMT interventions in young, nulliparous female athletes. DATA SOURCES: A literature research was conducted using PubMed, Sport Discus, and Web of Science. STUDY SELECTION: The inclusion criteria were studies with PFMT intervention in female athletes or recreationally active women. Interventions could be carried out for treatment or prevention of pelvic floor dysfunctions. STUDY DESIGN: Systematic review with meta-analysis. LEVEL OF EVIDENCE: Level 5. DATA EXTRACTION: A descriptive analysis of the articles included in the systematic review was carried out. Meta-analyses could be performed on 6 of the included articles, evaluating the maximal voluntary contraction (MVC) of the PFMs, the amount of urinary leakage (AUL), and the vaginal resting pressure (VRP). Random-effects model and standardized mean differences (SMD) ± 95% CI were reported. RESULTS: The meta-analysis showed that PFMT produced a significant increase in MVC (SMD, 0.60; 95% CI, 0.11 to 1.08; P = 0.02) and a significant reduction of AUL (SMD, -1.13; 95% CI, -1.84 to -0.41; P < 0.01) in female athletes. No effects were shown in VRP (SMD, -0.05; 95% CI, -1.27 to 1.17; P = 0.93). CONCLUSION: PFMT is shown to be effective in increasing PFM strength and reducing urine leakage in female athletes, being a powerful tool to prevent and treat pelvic floor dysfunction in this population.

Residual effects of 12 weeks of power-oriented resistance training plus high-intensity interval training on muscle dysfunction, systemic oxidative damage, and antioxidant capacity after 10 months of training cessation in older people with COPD.

OBJECTIVE: This study aimed to assess the residual effects of a 12-week concurrent training program (power training + high-intensity interval training) in older adults with chronic obstructive pulmonary disease (COPD). METHODS: A total of 21 older adults with COPD [intervention (INT), n = 8; control (CON), n = 13; 76.9 ± 6.8 years] were assessed at baseline and 10 months after the completion of the intervention by the short physical performance battery (SPPB), health-related quality of life (EQ-5D-5L), vastus lateralis muscle thickness (MT), peak pulmonary oxygen uptake (peak VO2 ) and peak work rate (Wpeak ), early and late isometric rate of force development (RFD), leg and chest press maximum muscle power (LPmax and CPmax ), and systemic oxidative damage and antioxidant capacity. RESULTS: Compared to baseline, after 10 months of detraining, the INT group presented increased SPPB (∆ = 1.0 point), health-related quality of life (∆ = 0.07 points), early RFD (∆ = 834 N∙s-1 ), LPmax (∆ = 62.2 W), and CPmax (∆ = 16.0 W) (all p < 0.05). In addition, a positive effect was noted in INT compared to CON regarding MT and Wpeak (both p < 0.05). No between-group differences were reported in peak VO2 , late RFD, systemic oxidative damage, and antioxidant capacity from baseline to 10 months after the completion of the intervention (all p > 0.05). CONCLUSIONS: Twelve weeks of concurrent training were enough to ensure improved physical function, health-related quality of life, early RFD and maximum muscle power and to preserve MT and Wpeak but not peak VO2 , late RFD, systemic oxidative damage and antioxidant capacity in the subsequent 10 months of detraining in older adults with COPD.

Influence of sex hormones status and type of training on regional bone mineral density in exercising females.

The primary objective of this study was to examine the influence of hormonal ovarian profile and training characteristics on spine, pelvis, and total body bone mineral density (BMD) in a group of well-trained females. Forty-two eumenorrheic females, twenty-eight monophasic oral contraceptive (OC) users and thirteen postmenopausal females participated in this study. Body composition was measured by total body dual-energy X-ray absorptiometry (DXA) to determine BMD of the areas of interest. Endurance-trained premenopausal females showed lower spine BMD compared to resistance-trained premenopausal females (1.03 ± 0.1 vs. 1.09 ± 0.09 g/cm2; p = 0.025). Postmenopausal females reported lower BMD level in comparison to eumenorrheic females in pelvis (1.079 ± 0.082 vs 1.19 ± 0.115 g/cm2; p = 0.005), spine (0.969 ± 0.097 vs 1.069 ± 0.109 g/cm2; p = 0.012) and total (1.122 ± 0.08 vs 1.193 ± 0.077 g/cm2; p = 0.018) and OC users whose duration of OC use was less than 5 years (OC < 5) in pelvis (1.235 ± 0.068 g/cm2; p < 0.001) and spine (1.062 ± 0.069 g/cm2; p = 0.018). In addition, lower BMD values were found in OC users who had been using OC for more than 5 years (OC ≥ 5) than eumenorrheic females in pelvis (1.078 ± 0.086 g/cm2; p = 0.029) and spine (0.966 ± 0.08 g/cm2; p = 0.05). Likewise, OC ≥ 5 showed lower values than and OC < 5 in pelvis (p = 0.004) and spine (p = 0.047). We observed a lower spine BMD value in premenopausal endurance-trained females compared to premenopausal resistance-trained females. Moreover, this research observed that prolonged use of OCs may reduce bone mass acquisition in the spine and pelvis, even in well-trained females. Finally, postmenopausal showed lower BMD despite being exercising women.Trial registration: ClinicalTrials.gov identifier: NCT04458662.Highlights Ovarian hormonal profile should be considered when assessing BMD in female athletes.The duration of oral contraceptive use influences spine and pelvis regional BMD in exercising females.Postmenopausal women show lower BMD when compared to premenopausal females despite being exercising females.

Effects of Different Rapid Weight Loss Strategies and Percentages on Performance-Related Parameters in Combat Sports: An Updated Systematic Review.

Most combat sports (CS) are structured in weight categories, and it is very common to carry out body weight adjustment strategies in order to compete in lower weight categories. For this reason, different rapid weight loss (RWL) strategies are usually performed to pass the pre-competition weigh-in test, and then a replenishment of fluids and carbohydrate-rich foods is conducted in an attempt to recover the weight and avoid a performance loss. In this context, no clear references have been found on whether these types of strategies have negative effects, impairing the athlete's combat and/or physical performance. For this reason, the aim of this study was to review the scientific literature on the effect of rapid weight reduction strategies on the performance of CS athletes. A literature search was performed through four different databases (PubMed, SPORTDiscus, Web of Science and ScienceDirect). Four inclusion criteria were established as follows: (1) the subjects had to be competitors in the CS and carry out RWL strategies; (2) at least two measurement points, that is, normal conditions and dehydration condition; (3) measurements in a real competition or simulating the same conditions; (4) original research articles written in English or Spanish and available in full text. Finally, a total of 16 articles were finally included in this research. All subjects (n = 184) were athletes from combat disciplines, with a minimum of 3-4 years of practice, as well as with certain experience in RWL. Six of the studies reported that an RWL strategy of around 5% of body weight loss did not affect performance parameters. However, the other ten studies with RWL between 3 and 6% or even higher reported negative effects or impairments on different parameters related to performance and/or athlete's psychophysiology, such as perceived fatigue, mood states, strength and power production, as well as changes in hormonal, blood and urine parameters, body composition, or the kinematics of the technical gesture. Although there is still no clear answer to the issue approached in this research, in general terms, it seems that in order to guarantee an acceptable athletic performance of the competitor, the weight loss should not exceed 3% to ≤5% of body weight together with ≥24 h for adequate (or at least partial) recovery and rehydration processes. In addition, it is highly recommended to lose weight progressively over several weeks, especially focusing on competitions lasting several days, as well as multiple rounds or qualifying stages.

Effect of Kegel Exercises on Lower Urinary Tract Symptoms in Young Gymnasts: A Prospective Cohort Study.

IMPORTANCE: Lower urinary tract symptoms (LUTS) have been shown to exist in young athletes. The use of pelvic floor muscle training as a preventive strategy at an early age may be useful to avoid possible pelvic floor dysfunction in the future. OBJECTIVES: The aim of the study was to describe LUTS in underaged gymnasts. We also aimed to evaluate the effects of a 12-week Kegel exercise intervention for LUTS and urinary incontinence (UI) and their relationship to bother. STUDY DESIGN: A quasi-experimental (nonrandomized, noncontrolled) pre-post study was conducted. Nineteen gymnasts with a mean age of 13.21 ± 1.84 were selected from a gymnastics club in Madrid, Spain. Outcomes of LUTS and quality of life were measured using the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms validated questionnaire at baseline and at the end of the 12-week intervention. RESULTS: The participants presented with certain LUTS such as urgency UI (57.7%) or stress UI (47.4%), which negatively affect their daily lives by feeling annoyed in various aspects (when practicing gymnastics, getting up during the night to urinate or feeling bladder pain among others). No significant differences in LUTS and quality of life variables were observed after the exercise intervention ( P > 0.05). CONCLUSIONS: A high prevalence of LUTS was observed in a sample of underaged high-level gymnasts. The 12-week Kegel exercise intervention did not significantly reduce the presence of pelvic floor problems and even intensified some of them, probably because of an increased awareness. Pelvic floor muscle training as a preventive strategy at an early age seems to be necessary to avoid possible pelvic floor dysfunction in the future.

Circulating sestrins and force velocity profiling in older adults with type 2 diabetes.

Type 2 diabetes mellitus (T2DM) in old age affects the musculoskeletal system causing loss of muscle mass, strength, and physical function. Stress-inducible proteins named sestrins are potential novel biomarkers of muscle function due to their ability to suppress oxidative stress and prevent muscle degeneration. Our aim was to determine the association between different force-velocity (F-V) profiles with body composition, physical performance, and glucose control in older adults with T2DM. We also intended to determine the potential utility of sestrin 1 (Sesn1) and 2 (Sesn2) as biomarkers of physical functionality. Fifty-nine participants (69-79 years) were classified in 3 groups according to their F-V profile based on the leg press exercise: nondeficit (NDEF = 40.7%), force deficit (FDEF = 28.8%), and velocity deficit (VDEF = 30.5%). Both VDEF and FDEF groups showed lower muscle power than NDEF (Cohen's d 0.87 and 0.75 for effect size, respectively). Serum Sesn2 levels, maximal dynamic strength, arms and legs fat-free mass were reduced in FDEF compared to the NDEF group (p < 0.05), whereas glycated haemoglobin (HbA1c) and fasting glucose levels were similar among groups. ROC analysis revealed the distinction between the NDEF and FDEF group based on Sesn2 concentrations (<0.72 ng/mL), suggesting their potential use as functional biomarkers for early intervention through exercise. Older adults with T2DM show different F-V profiles, related to low levels of Sesn2, impaired body composition and physical performance, and may be taken into consideration to target exercise training in this specific population.Highlights The influence of different F-V deficit profiles on body composition, physical function and circulating sestrins in older adults with type 2 diabetes were studied.Both force and velocity deficits negatively affected muscle power.Force deficits are associated to low circulating sestrin 2 levels and regional fat-free mass.Basal serum sestrin 2 levels are potential biomarkers to characterise F-V profiles.

Effects of 10-Week Online Moderate- to High-Intensity Interval Training on Body Composition, and Aerobic and Anaerobic Performance during the COVID-19 Lockdown.

The present study aimed to investigate the effects of a 10-week online high-intensity interval training (HIIT) program on body composition and aerobic and aerobic performance in physically sedentary women. A parallel, two-group, longitudinal (pre, post) design was used with physical tests performed before (preintervention) and after (postintervention) the 10-week intervention period. A total of forty-eight healthy and physically sedentary women (defined as an individual who lacks regular exercise or a structured fitness routine) were recruited to participate in this study. The participants were distributed in two groups: the experimental group (EG) with 24 women (mean ± SD: age 21.21 ± 2.15 years; weight: 61.16 ± 8.94 kg; height: 163.96 ± 4.87 cm; body mass index (BMI): 22.69 ± 2.49 kg/m2) and the control group (CG) with another 24 women (mean ± SD: age 20.50 ± 1.29 years; weight: 62.0 ± 6.65 kg; height: 163.92 ± 4.89 cm; body mass index: 23.04 ± 1.74 kg/m2). The EG performed an online HIIT program for 10 weeks, while the CG continued with their daily life routines. The repeated measures ANCOVA indicated a significant effect in the within-group analysis for weight (p = 0.001; d = -0.96) and for BMI (p = 0.001; d = 0.24), with a significant decrease in the experimental group (EG). The control group (CG) did not show any significant decrease in either body weight or BMI. Regarding the maximal oxygen uptake (VO2 max) values, the EG exhibited a significant improvement (p = 0.001; d = -1.07), whereas the CG did not demonstrate a significant improvement (p = 0.08; d = -0.37). The EG's power output (W) (p = 0.001; d = -0.50) and power output standardized by body weight (W/kg) (p = 0.001; d = -0.96) were significantly improved. The CG did not show a significant improvement in either power output (W/kg) or power output. Lastly, the within-group analysis with load revealed that the EG significantly improved (p = 0.001; d = -0.50), while CG did not show a significant improvement in load (p = 0.10.; d = -0.10). The present study showed that 10 weeks of HIIT in an online environment during the COVID-19 lockdown significantly improved maximum oxygen consumption and caused weight loss and a significant decrease in body mass index in physically sedentary women. These results suggest that HIIT may be used as a time-efficient strategy to improve body composition and cardio-respiratory fitness in sedentary women.

Body Dissatisfaction and Its Association with Health-Related Factors in Rural and Urban Mexican Adolescents from the State of Jalisco.

BACKGROUND: To better understand Mexican adolescent's body self-perception, this study aimed to analyze their body dissatisfaction (BD) levels according to sex and place of residence. We also aimed to explore differences in body composition (BC), physical fitness (PF), and physical activity (PA) between satisfied and dissatisfied adolescents and to find the associations between BD and these parameters. METHODS: Cross-sectional, observational study carried out in Jalisco (Mexico) in which 451 adolescents (43.68% males, 43.90% rural) aged 13-17 years were evaluated. BD and self-perceived PF and PA were assessed with validated questionnaires, while objectively measured PF (strength, explosive strength, speed-agility, and cardiovascular fitness) was assessed using field tests. To evaluate BC, anthropometric measures and bioelectric impedance analysis were carried out. Regression analysis was used to ascertain the associations between health-related factors and body dissatisfaction. RESULTS: Girls obtained higher scores on the BD questionnaire than boys (11.12 ± 3.13 vs. 10.33 ± 2.73; p < 0.05), whereas no geographical differences between rural and urban adolescents were found. BD was positively associated with higher fat mass (ß = 0.15; p < 0.001), and negatively associated with muscle mass and PF (ß = -0.24 and ß = -0.23; p < 0.001). However, PA was not associated with any of the measured parameters. CONCLUSIONS: selected parameters of BC, PF, and sex have an impact on the Mexican adolescent's body satisfaction levels and should be considered when designing future health policies.

Effects of myofascial release or self-myofascial release and control position exercises on lower back pain in idiopathic scoliosis: A systematic review.

BACKGROUND: Idiopathic scoliosis is associated, among others, to muscular imbalance, functional limitations, and the most prevalent, back pain. The treatments usually applied are exercise, bracing or surgery. The objective of corrective exercise is to reduce symptoms and improve functional capacity and quality of life. Myofascial release (MFR) or Self-Myofascial release (SMFR) are manual techniques, intended to restore optimal muscle and fascia length, decrease pain, and improve function. PURPOSE: to analyze the effects of MFR and postural control programs in lower back pain and scoliosis curves. METHODS: A systematic literature review was conducted in high quality databases to identify the existing evidence of the effects of MFR and postural control on reducing back pain and scoliosis curves. RESULTS: Seventeen studies met inclusion criteria. 533 subjects and 94 MFR/SMFR applied interventions lasting one to 24 weeks/sessions were identified. Ten studies used MFR, six SMFR and one mixes techniques. Seven MFR and five SMFR studies shown positive result. One study using MFR and one using SMFR applied also postural control exercises. MFR was useful to reduce back pain in all studies included that aimed in that matter. In addition, 12 studies reported improvements in flexibility and/or stiffness reduction, and two studies observed improvements in postural control and balance. CONCLUSIONS: The combination of MFR and postural control programs might be suitable for reducing scoliosis and back pain. However, due to the reduced number of studies and the relatively small sample sizes used, results may be carefully interpreted, and more studies are needed.

Early identification of metabolic syndrome risk: A review of reviews and proposal for defining pre-metabolic syndrome status.

AIMS: a) To analyze the relationship of known and emerging biomarkers/indicators for early risk identification of cardiometabolic health risk; b) to identify early risk markers to be used in both clinical and nonclinical settings; and c) to propose a definition of early risk identification in terms of pre-metabolic syndrome (PreMetSyn). DATA SYNTHESIS: Pubmed/Medline, Web of Science, Embase, and Cochrane were searched for Systematic Reviews and Meta-analysis. Selected studies were evaluated, and relevant data were extracted and synthesized. CONCLUSIONS: Serum uric acid is a good predictive biomarker of metabolic syndrome (MetSyn) and has been associated with non-alcoholic liver fat disease (NAFLD) and type 2 diabetes. NAFLD emerges as an early risk indicator of PreMetSyn by itself. Muscle strength should also be included as an early risk marker of cardiometabolic health. High serum triglycerides and waist circumference confirm their predictive value regarding MetSyn. Indicators related to an inflammatory/pro-inflammatory status usually linked to MetSyn showed limited evidence as robust biomarkers for PreMetSyn. Authors suggest defining PreMetSyn related to cardiometabolic risk. It is also necessary to determine how close people are to the cut-off point of MetSyn components, including emerging indicators proposed by our review. Some biomarkers could be used as indicators of PreMetSyn, before any of the MetSyn components appear, allowing early health interventions to prevent its development. Defining a PreMetSyn status might consider both emerging indicators and those variables already included in the definition of MetSyn. New indicators should be considered to create a new risk score specifically meant for PreMetSyn.

Analysis of Effectiveness of a Supplement Combining Harpagophytum procumbens, Zingiber officinale and Bixa orellana in Healthy Recreational Runners with Self-Reported Knee Pain: A Pilot, Randomized, Triple-Blind, Placebo-Controlled Trial.

Recreational running (RR) is becoming a popular way to increase physical activity for improving health, together with a higher incidence of knee injuries. The aim was to analyze the effect of a four-week supplementation with a mixture of Harpagophytum procumbens, Zingiber officinale and Bixa orellana on males, middle-aged, RR with an undiagnosed knee discomfort. A randomized triple-blind placebo-control trial was conducted among male RR aged 40-60 years suffering from self-declared knee discomfort after training. Participants were assigned to supplementation (2 g/day in 6 doses; n = 13; intervention group (IG)) or matched placebo (n = 15; control group (CG)) for 4 weeks. At pre- and post-intervention, assessment of routine blood biomarkers, body composition, running biomechanics and body temperature was performed using standardized procedures. Machine learning (ML) techniques were used to classify whether subjects belonged to IG or CG. ML model was able to correctly classify individuals as IG or CG with a median accuracy of 0.857. Leg fat mass decreased significantly (p = 0.037) and a deeper reduction in knee thermograms was observed in IG (p < 0.05). Safety evaluation revealed no significant differences in the rest of parameters studied. Subjects belonging to IG or CG are clearly differentiated, pointing into an effect of the supplement of ameliorating inflammation.

Impact of the Home Confinement Related to COVID-19 on the Device-Assessed Physical Activity and Sedentary Patterns of Spanish Older Adults.

The main objective of this study was to device-assess the levels of physical activity and sedentary behaviour patterns of older adults during the situation prior to the COVID-19 pandemic, home confinement, and phase-0 of the deescalation. We also aimed to analyse the effectiveness of an unsupervised home-based exercise routine to counteract the potential increase in sedentary behaviour during the periods within the pandemic. A total of 18 noninstitutionalized older adults(78.4 ± 6.0 y.), members of the Spanish cohort of the EXERNET-Elder 3.0 project, participated in the study. They were recommended to perform an exercise prescription based on resistance, balance, and aerobic exercises during the pandemic. Wrist triaxial accelerometers (ActiGraph GT9X) were used to assess the percentage of sedentary time, physical activity, sedentary bouts and breaks of sedentary time. An ANOVA for repeated measures was performed to analyse the differences between the three different periods. During home quarantine, older adults spent more time in sedentary behaviours (71.6 ± 5.3%) in comparison with either the situation prior to the pandemic (65.5 ± 6.7%) or the ending of isolation (67.7 ± 7.1%) (all p < 0.05). Moreover, participants performed less bouts of physical activity and with a shorter duration during home quarantine (both p < 0.05). Additionally, no differences in the physical activity behaviours were found between the situation prior to the pandemic and the phase-0 of deescalation. According to our results, the home confinement could negatively affect health due to increased sedentary lifestyle and the reduction of physical activity. Therefore, our unsupervised exercise program does not seem to be a completely effective strategy at least in this period.

Effects of Power Training on Physical Activity, Sitting Time, Disability, and Quality of Life in Older Patients With Type 2 Diabetes During the COVID-19 Confinement.

BACKGROUND: To evaluate the effectiveness of a multicomponent supervised and unsupervised training program focused on muscle power to counteract the potential changes in sedentary behavior, disability, physical activity (PA), and health-related quality of life (HRQoL) caused by the COVID-19 pandemic domiciliary confinement in prefrail older adults with type 2 diabetes mellitus. METHODS: Thirty-five older adults with type 2 diabetes mellitus were assigned to 2 groups according to their frailty status: exercise training group (prefrail or frail; n = 21; 74.7 [4.5] y; 33.3% male) and control group (robust; n = 14; 73.1 [3.9] y; 42.9% male). The exercise training group followed a multicomponent training program focusing on muscle power: supervised (5 wk) and unsupervised (6 wk). The primary outcomes, including PA and sitting time, perceived disability, and HRQoL, were assessed at the baseline and after 11 weeks. RESULTS: At the end of confinement, there were significant decreases in PA in both groups (P < .05). Thus, sitting time increased more in the control group than in the exercise training group (P < .05). The HRQoL measures remained unchanged. CONCLUSIONS: Muscle power training before and during mandatory COVID-19 self-isolation in type 2 diabetes mellitus older adults (1) attenuates the COVID-19 domiciliary confinement-related increase in sitting time and (2) slightly decreases the self-reported levels of disability and maintains HRQoL.

Multicomponent Home-Based Training Program for Chronic Kidney Disease Patients during Movement Restriction.

Both intradialytic and out-of-clinic exercise programs (EP) have been proven to be a safe and effective way to increase fitness levels in end-stage chronic kidney disease (CKD) patients. The actual COVID-19 pandemic situation has forced the suspension of EP offered in hemodialysis centers in many countries; as well as all activities considered as "non-essential" (i.e., sport facilities and fitness centers). Therefore, there is a high risk that movement restrictions would promote physical inactivity and its associated diseases in CKD patients; especially those undergoing domiciliary confinement situations. Given the importance for CKD patients' overall health to maintain exercise levels and reach physical activity recommendations, the aim of this Protocol was to design a personalized, well-structured, multicomponent physical EP that CKD patients can safely follow at home. We also aimed to provide an initial fitness evaluation tool that allows patients to adapt the EP to their fitness level. Current general exercise recommendations for people living with chronic conditions have been analyzed to develop the present home-based EP proposal.

Comparative Analysis of the Effects of Daily Eating Habits and Physical Activity on Anthropometric Parameters in Elementary School Children in Latvia: Pach Study.

Growing incidence of obesity and related diseases in children poses new challenges and calls for a review of lifestyle habits. This study aimed to assess daily eating habits (EH) and physical activity (PA) levels and identify their association with obesity in 8-10-year-old children. Children's EH and time spent in moderate-to-vigorous physical intensity (MVPA) was estimated from questionnaires (N = 1788). Weight, height, and waist circumference (WC) were collected, and body mass index (BMI) calculated. Girls consumed more fruits and vegetables, drank more water, and ate smaller portions of carbohydrate and protein rich foods but spent less time in MVPA compared to boys (p < 0.05). Obese children skipped breakfast more often and consumed less fruits and vegetables. Children who chose to eat in front of the screen had higher WC (62.88 ± 8.70 vs 60.59 ± 7.40 cm, p < 0.001) and higher BMI, and chose smaller vegetable portions and more calorie dense snacks (p < 0.001). 15.4% of pupils covered weekly MVPA recommendations with structured PA on weekdays. Increasing MVPA was related to a smaller number of unhealthy EH (p < 0.001). In conclusion, EH and PA levels differ between sexes and obese children have unhealthier EH. Higher levels of MVPA are related to healthier food choices, while pupils having meals in front of the screen have unhealthier EH and anthropometric measures. The majority of pupils did not reach the WHO recommendations of MVPA through structured PA on weekdays. Association between factors (EH and time spent in PA) and BMI was not found in this study.

Health-Related Factors in Rural and Urban Mexican Adolescents from the State of Jalisco: The HELENA-MEX Study.

Mexico shows a high prevalence of obesity in children and adolescents. Geographical location and cultural environment could play a role in the promotion of healthy lifestyles in terms of physical activity (PA), sedentary behavior (SB) and nutrition. The purpose of this study was to assess rural and urban differences in body composition (BC), physical fitness (PF), PA and nutritional status of adolescents from the state of Jalisco (Mexico). The study involved 469 students aged 13-17 years (55.0% girls) from eight high schools. BC was analyzed by bioimpedance and PF by standardized field tests. Objective measurements of PA and SB were taken in a subsample (n = 240). Energy intake (EI) was calculated from two 24h recalls. Rural residents presented a higher prevalence of overweight, waist circumference, trunk fat mass, regional fat free mass and muscle handgrip strength (all p < 0.05, η2p < 0.06). Cardiorespiratory fitness was similar among participants, whereas urban adolescents showed higher muscle power, speed-agility and flexibility scores (all p < 0.05, η2p < 0.07). Overall lifestyle behavior in urban adolescents was more sedentary (p < 0.05, η2p = 0.11). EI was similar in both locations. In conclusion, rural Mexican adolescents presented a generally lower sedentary behavior and a lower fitness and fatness profile than their urban peers.

Effects of concurrent exercise training on muscle dysfunction and systemic oxidative stress in older people with COPD.

Oxidative stress is associated with disease severity and limb muscle dysfunction in COPD. Our main goal was to assess the effects of exercise training on systemic oxidative stress and limb muscle dysfunction in older people with COPD. Twenty-nine outpatients with COPD (66-90 years) were randomly assigned to a 12-week exercise training (ET; high-intensity interval training (HIIT) plus power training) or a control (CT; usual care) group. We evaluated mid-thigh muscle cross-sectional area (CSA; computed tomography); vastus lateralis (VL) muscle thickness, pennation angle, and fascicle length (ultrasonography); peak VO2 uptake (VO2peak ) and work rate (Wpeak ) (incremental cardiopulmonary exercise test); rate of force development (RFD); maximal muscle power (Pmax ; force-velocity testing); systemic oxidative stress (plasma protein carbonylation); and physical performance and quality of life. ET subjects experienced changes in mid-thigh muscle CSA (+4%), VL muscle thickness (+11%) and pennation angle (+19%), VO2peak (+14%), Wpeak (+37%), RFD (+32% to 65%), Pmax (+38% to 51%), sit-to-stand time (-24%), and self-reported health status (+20%) (all P < 0.05). No changes were noted in the CT group (P > 0.05). Protein carbonylation decreased among ET subjects (-27%; P < 0.05), but not in the CT group (P > 0.05). Changes in protein carbonylation were associated with changes in muscle size and pennation angle (r = -0.44 to -0.57), exercise capacity (r = -0.46), muscle strength (r = -0.45), and sit-to-stand performance (r = 0.60) (all P < 0.05). The combination of HIIT and power training improved systemic oxidative stress and limb muscle dysfunction in older people with COPD. Changes in oxidative stress were associated with exercise-induced structural and functional adaptations.