THE IMPACT OF TOTAL PHYSICAL ACTIVITY ON MICROVASCULAR COMPLICATIONS IN TYPE 1 DIABETES MELLITUS PATIENTS.

The incidence of diabetes is increasing worldwide, emphasizing an emerging need for blood glucose control optimization to prevent the development of chronic complications and improve the quality of life. This retrospective cohort study aimed to investigate the effects of total physical activity on microvascular diabetic complication development in patients with type 1 diabetes mellitus (T1DM). The study included 71 T1DM patients, average age 41 years and HbA1c 7.78%. Most patients (82.1%) reported having hypoglycemia, while the minority of patients developed microvascular complications, mostly nonproliferative retinopathy (17.7%). All subjects included in the study were moderately or vigorously physically active. No association was observed between total physical activity and regulation of glycemia, hypoglycemic incidents, or development of microvascular complications. Until sufficient data from prospective studies become available, our data support the findings of no negative effect of higher intensity physical activity on the development of microvascular complications in T1DM patients.

Prehabilitation of overweight and obese patients with dysglycemia awaiting bariatric surgery: Predicting the success of obesity treatment.

Bariatric surgery offers the best health results in overweight and obese patients but is not a risk and/or complication-free treatment. In cases with additional hyperglycemia, the burden of surgery can be even higher and alter both short-term and long-term outcomes. Although bariatric surgery offers glycemic improvements and in the case of early onset diabetes disease remission, weight loss results are lower than for obese patients without diabetes. Different multimodal programs, usually including interventions related to patients' performance, nutritional and psychological status as well as currently available pharmacotherapy before the surgery itself might considerably improve the immediate and late postoperative course. However, there are still no clear guidelines addressing the prehabilitation of obese patients with dysglycemia undergoing bariatric surgery and therefore no unique protocols to improve patients' health. In this minireview, we summarize the current knowledge on prehabilitation before bariatric surgery procedures in patients with obesity and dysglycemia.

The Influence of Protective Headgear on the Visual Field of Recreational-Level Skiers.

The benefit of protective headgear for recreational skiers is an ongoing debate in the snow sports industry, and there are a lot of opposing opinions. Due to the dynamic conditions in which winter sports are performed, athletes demand rapid and constant processing of visual information. A sufficient level of anticipation helps athletes to properly position themselves to reduce the forces transferred to the head or even move to avoid a collision. To objectively identify the impact of protective headgear on the visual field when skiing, it is necessary to conduct suitable measurements. The sample consisted of 43 recreational-level skiers (27 M, 16 F; age 31.6 ± 8.23 years). A predefined testing protocol on an ortoreter was used to assess the visual field for three conditions of wearing protective headgear. Differences in perceived visual stimuli between the three conditions were evaluated by repeated measures analysis of variance (ANOVA). Based on the observed results, it can be concluded that the combination of wearing a ski helmet and ski goggles significantly negatively influences visual performance in a way that the visual field is narrowed, for both helmet users and non-users, only when comparing the tested conditions. When comparing helmet users and non-users, there are no differences in the amount of visual impairment; therefore, the habit of wearing a helmet does not influence the ability of perceiving visual stimuli.

Inline Skating as an Additional Activity for Alpine Skiing: The Role of the Outside Leg in Short Turn Performance.

The complexity of skiing movements urges recreational alpine skiers and competitors to undertake many specific skill trainings not only during the season but also during the off-season using alternative sports. In AS, the role of the outside leg is crucial for successful turn performance. By measuring kinematic and kinetic parameters, we could define whether there is an objective similarity of the role and the movements of the outside leg while performing a turn in AS to those in the most used additional activity, IS. The sample consisted of ten female alpine ski instructors (age 31.6 ± 8.23, height 170.66 ± 7.32 cm, weight 60.16 ± 7.58 kg). Overall, 280 turns were analyzed (140 for AS and 140 for IS). For the purposes of this study, the variable sample consisted of 14 variables in total. For the detection of differences between short turn performance in AS and IS, MANOVA was used. The main findings of our study are defined similarities in pressure distribution during IS and AS and noticeable differences in the kinematic parameters of the outside leg between the mentioned activities. Based on the gathered results, recreational alpine skiers should be aware that IS cannot be used for the purpose of AS adoption, but rather as a dry-land additional activity for AS preparation.

NAFLD and Physical Exercise: Ready, Steady, Go!

Along with the increase in obesity and type 2 diabetes, the non-alcoholic fatty liver disease (NAFLD) incidence is escalating, thus becoming a leading cause of liver cirrhosis and a significant burden of liver-related outcomes. Since there is no pharmacotherapy available to address the NAFLD, the most effective solutions seem to be lifestyle changes centered on physical activity. Exercise could mediate its beneficial effects directly on the liver and indirectly via extrahepatic pathways, forming a dose-response relationship with NAFLD in terms of prevalence and disease severity. Health-enhancing physical activity (HEPA) levels are mainly needed to exert beneficial effects in obese subjects, while even a small amount of exercise can be beneficial for lean individuals to prevent NAFLD. This mini-review addresses three major points regarding physical activity and NAFLD: prevention, treatment, and extrahepatic benefits, offering recommendations on type and intensity of exercise in liver disease.

Fear of hypoglycemia, a game changer during physical activity in type 1 diabetes mellitus patients.

Hypoglycemia limits optimal glycemic management of patients with type 1 diabetes mellitus (T1DM). Fear of hypoglycemia (FoH) is a significant psychosocial consequence that negatively impacts the willingness of T1DM patients to engage in and profit from the health benefits of regular physical activity (e.g., cardiometabolic health, improved body composition, cardiovascular fitness, quality of life). Technological advances, improved insulin regimens, and a better understanding of the physiology of various types of exercise could help ameliorate FoH. This narrative review summarizes the available literature on FoH in children and adults and tools to avoid it.

What Are Kinematic and Kinetic Differences between Short and Parallel Turn in Alpine Skiing?

There are numerous programs worldwide adapted for alpine ski beginners and they all share the same primary goal-inclusion of skiing beginners in alpine ski schools. The final elements of ski school taught in the parallel skiing technique are parallel turn and short turn. Synchronized analysis of kinetic and kinematic parameters of the parallel turn (PT) and short turn (ST) was conducted to determine the main biomechanical differences from a standpoint of foot pressure and lower limb angles. Both elements were performed by nine male ski instructors (age 33.4 ± 8.62, height 179.52 ± 5.98 cm, weight 78.6 ± 8.88 kg). Kinetic and kinematic analysis was conducted on 180 turns, 90 for each element. Differences in kinetic and kinematic parameters between parallel and short turns were tested by a paired t-test. The main findings of our study are determined differences in the ratio of pressure distribution on the inside and the outside foot and differences in kinematic parameters of the outside leg between elements. The mentioned analysis can provide an objective insight into the complexity of each element and provide guidelines for teaching process of those elements. This study determined the reasons for higher complexity of ST compared to PT based on the objective evaluation of biomechanical factors.

What is the gut feeling telling us about physical activity in colorectal carcinogenesis?

In the last decades, more efforts are focused on the prevention and treatment of malignant diseases, given the increase in all cancers incidence A lifestyle change, including healthy eating habits and regular physical activity, has significantly impacted colorectal cancer prevention. The effect of dose-dependent physical activity on mortality and recurrence rates of colorectal carcinoma has been unequivocally demonstrated in observational studies. However, clear recommendations are not available on the frequency, duration, and intensity of exercise in patients with colorectal cancer due to the lack of evidence in randomized clinical trials. Regarding pathophysiological mechanisms, the most plausible explanation appears to be the influence of physical activity on reducing chronic inflammation and insulin resistance with a consequent positive effect on insulin growth factor 1 signaling pathways.

Sport Courage, Worry and Fear in Relation to Success of Alpine Ski Learning.

(1) Background: Individuals' psychological traits can influence not just success in sport but also the ability to learn new motor skills. We investigated whether sport courage, worry and fear differ between alpine ski-naive and basic level skiers and how they affect ski learning. (2): A total of 337 students (249 ski-naive and 88 basic level) participated in research consisting of a four-part questionnaire and structured skiing program. (3) Results: For beginners, lower fear (r = -0.30, p < 0.01) and higher Self-efficiency (r = 0.28, p < 0.05) and mastery (r = 0.20, p < 0.01) were associated with better performance; reducing fear and increasing self-efficiency and worry increased performance. Experienced skiers were better in determination, mastery, and self-efficiency (all p < 0.05). In case of lower score in worry (r = -0.28, p < 0.01) and higher in self-efficiency (r = 0.22, p < 0.05) performance was better. Males scored higher in sport courage scale-31 (all p < 0.05). In particular, self-efficiency was associated with better (r = 0.39, p < 0.01), and higher fear with poorer performance (r = -0.33, p < 0.01). Moreover, self-efficiency was a predictor of ski success (p < 0.001). On the other hand, females like ski beginners scored higher in fear (p < 0.001). In females, determination, mastery and self-efficiency had a positive correlation with skiing (r = 0.21, p < 0.05, r = 0.28, p < 0.01, and r = 0.33, p < 0.01, respectively), while association between Fear and skiing (r = -0.46, p < 0.01) was negative, and fear (p < 0.001) was inversely related to success. (4): Conclusions: Psychological factors and gender differences need to be considered during learning phases of alpine skiing. There is a positive association between self-efficiency and performance of male ski beginners, and negative association between fear and achieved results in basic alpine ski school in case of female ski beginners.

Are We Compensating for the Lack of Physical Activity in Our Diabetic Patients with Treatment Intensification?

BACKGROUND: We studied the association between leisure time physical activity (LTPA) and glycemic control, body mass index (BMI), and hypoglycemic incidents in type 1 (T1DM) and type 2 diabetes patients (T2DM). METHODS: This is a cross-sectional study of 198 diabetic patients (60 with type 1 diabetes, 138 with type 2 diabetes). LTPA was assessed by a validated 12-month questionnaire. Patients were grouped as sedentary and moderately to vigorously active. Outcome measures were Hemoglobin A1c (HbA1c), BMI, and hypoglycemic episodes. RESULTS: LTPA effect on the HbA1c reduction was present in diabetes type 1 patients. Patients who were involved in the moderate to vigorous-intensity physical activity had a greater decrease in the HbA1c (p = 0.048) than patients with low physical activity (p = 0.085). Level of LTPA was neither associated with increased number of hypoglycemic episodes, nor BMI. After an average of 4 years of diabetes, the number of patients requiring more than one antidiabetic agent increased, although the observed difference did not correlate with LTPA level. CONCLUSIONS: LTPA has an influence on the regulation of diabetes type 1, and intensification of medical treatment is compensating for the lack of lifestyle change-especially in type 2 diabetics.

Reliability and Validity of the Inline Skating Skill Test.

This study aimed to examine the reliability and validity of the inline skating skill test. Based on previous skating experience forty-two skaters (26 female and 16 male) were randomized into two groups (competitive level vs. recreational level). They performed the test four times, with a recovery time of 45 minutes between sessions. Prior to testing, the participants rated their skating skill using a scale from 1 to 10. The protocol included performance time measurement through a course, combining different skating techniques. Trivial changes in performance time between the repeated sessions were determined in both competitive females/males and recreational females/males (-1.7% [95% CI: -5.8-2.6%] - 2.2% [95% CI: 0.0-4.5%]). In all four subgroups, the skill test had a low mean within-individual variation (1.6% [95% CI: 1.2-2.4%] - 2.7% [95% CI: 2.1-4.0%]) and high mean inter-session correlation (ICC = 0.97 [95% CI: 0.92-0.99] - 0.99 [95% CI: 0.98-1.00]). The comparison of detected typical errors and smallest worthwhile changes (calculated as standard deviations × 0.2) revealed that the skill test was able to track changes in skaters' performances. Competitive-level skaters needed shorter time (24.4-26.4%, all p < 0.01) to complete the test in comparison to recreational-level skaters. Moreover, moderate correlation (ρ = 0.80-0.82; all p < 0.01) was observed between the participant's self-rating and achieved performance times. In conclusion, the proposed test is a reliable and valid method to evaluate inline skating skills in amateur competitive and recreational level skaters. Further studies are needed to evaluate the reproducibility of this skill test in different populations including elite inline skaters.

Success in Adopting Technique of Alpine Skiing with Respect to Motor Abilities of the Children Aged 7-8 Years.

The aim of this research was to determine relations between estimated motor abilities and efficiency of alpine ski learning in children ski beginners. It included 54 children between 7 and 8 years of age (average 7.44 ± 0.52 years). Children were tested for balance, agility, strength, coordination and frequency of movement on ten motor ability tests. After motor abilities were assessed, participants learned alpine skiing during six-day alpine ski school and upon completion of ski school program, were tested on three elements of alpine ski technique (stopping in a snow-plough, uphill turn and turns around the posted marks) by three independent judges. According to achieved level of ski knowledge, they were allocated to three groups differing by the level of success; less successful (N = 18; 26-44 points), moderately successful (N = 11; 45-48 points) and successful (N = 25; 49-55 points). Significant differences in success of adopting basic ski technique were noticed with respect to the results achieved in the task polygon backwards (F = 6.162, p = 0.004), foot tapping (F = 6.337, p = 0.003) and crossed arm sit-ups (F = 3.099, p = 0.053). The participants who successfully adopted the basic ski technique also achieved good results in tests: polygon backwards, foot tapping, crossed arm sit-ups, side steps, balancing on left leg perpendicular on balance board, vertical jump and medium results in tests 20m dash and balancing on right leg perpendicular on balance board. Our results suggest that successful participants have better developed coordination, frequency of movement, strength and agility.

The influence of ski helmets on sound perception and sound localisation on the ski slope.

OBJECTIVES: The aim of the study was to investigate whether a ski helmet interferes with the sound localization and the time of sound perception in the frontal plane. MATERIAL AND METHODS: Twenty-three participants (age 30.7±10.2) were tested on the slope in 2 conditions, with and without wearing the ski helmet, by 6 different spatially distributed sound stimuli per each condition. Each of the subjects had to react when hearing the sound as soon as possible and to signalize the correct side of the sound arrival. RESULTS: The results showed a significant difference in the ability to localize the specific ski sounds; 72.5±15.6% of correct answers without a helmet vs. 61.3±16.2% with a helmet (p < 0.01). However, the performance on this test did not depend on whether they were used to wearing a helmet (p = 0.89). In identifying the timing, at which the sound was firstly perceived, the results were also in favor of the subjects not wearing a helmet. The subjects reported hearing the ski sound clues at 73.4±5.56 m without a helmet vs. 60.29±6.34 m with a helmet (p < 0.001). In that case the results did depend on previously used helmets (p < 0.05), meaning that that regular usage of helmets might help to diminish the attenuation of the sound identification that occurs because of the helmets. CONCLUSIONS: Ski helmets might limit the ability of a skier to localize the direction of the sounds of danger and might interfere with the moment, in which the sound is firstly heard.