Enhancing Behavioural Changes: A Narrative Review on the Effectiveness of a Multifactorial APP-Based Intervention Integrating Physical Activity.

The rapid evolution of technologies is a key innovation in the organisation and management of physical activities (PA) and sports. The increase in benefits and opportunities related to the adoption of technologies for both the promotion of a healthy lifestyle and the management of chronic diseases is evident. In the field of telehealth, these devices provide personalised recommendations, workout monitoring and injury prevention. The study aimed to provide an overview of the landscape of technology application to PA organised to promote active lifestyles and improve chronic disease management. This review identified specific areas of focus for the selection of articles: the utilisation of mobile APPs and technological devices for enhancing weight loss, improving cardiovascular health, managing diabetes and cancer and preventing osteoporosis and cognitive decline. A multifactorial intervention delivered via mobile APPs, which integrates PA while managing diet or promoting social interaction, is unquestionably more effective than a singular intervention. The main finding related to promoting PA and a healthy lifestyle through app usage is associated with "behaviour change techniques". Even when individuals stop using the APP, they often maintain the structured or suggested lifestyle habits initially provided by the APP. Various concerns regarding the excessive use of APPs need to be addressed.

Long-Term Physical Activity Effectively Reduces the Consumption of Antihypertensive Drugs: A Randomized Controlled Trial.

BACKGROUND: Although physical activity (PA) has been shown to enhance hypertension control, the impact of exercise on the potential decrease of the use of antihypertensive medications remains inadequately researched. AIM: The aim was to assess the impact of a two-year PA on the medication requirements of individuals with hypertension. METHODS: A clinical trial was conducted, involving 130 participants with essential hypertension who took at least one antihypertensive medication. Participants were randomly assigned to either a control group (CG n = 65) or an experimental group (EG n = 65) that underwent a 24-month supervised PA program based on a combination of aerobic and resistance training. The antihypertensive drug load for each participant was determined by adding the ratios of the prescribed daily dose (PDD) to the defined daily dose (DDD) for all antihypertensive medications taken by the participants. The outcome measures were evaluated at 0, 6, 12, 18, and 24 months. RESULTS: A total of 76 participants completed the 24-month assessment, and RM-ANOVA revealed a significantly lower antihypertensive drug load in the EG compared to the CG at 18 (p < 0.017) and 24 months (p < 0.003). CONCLUSION: A long-term PA program can decrease the antihypertensive drug load in older adults with essential hypertension. The trend of improvement regarding the EG drug load intake and the trend of CG drug load increase, although not significant over time, results in a significant difference between the groups at 18 months and an even greater difference at 24 months. This trend certifies the protective value of PA against the aging process and its related health risk factors.

A Systematic Review of Flywheel Training Effectiveness and Application on Sport Specific Performances.

The objective of this systematic review was to examine the effectiveness of flywheel training, which allows for the replication of specific sports movements, overloading both the concentric and eccentric phases. Inclusion criteria were injury prevention outcomes; ability in terms of strength, power, sprinting, jumping and change of direction; competitive athletes; and RCTs. Exclusion criteria were a lack of a control group and lack of baseline and/or follow-up data. The databases used were Web of Science, Scopus, PubMed, Cochrane Library, and Sage. The revised Cochrane risk-of-bias tool was used to assess the quality of the selected RCTs. The Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence was used. A PICOS (participants, intervention, comparators, study outcomes, and study design) approach was used to evaluate eligibility. A total of 21 RCTs with 8 to 54 participants in each study analyzed flywheel technology and its application in nine sports. The results showed that flywheel training is a good strategy to improve sports performance, providing variation in training methodologies and athletes' adherence. Further studies are needed to define guidelines on training modality, weekly frequency, volume, and inertia load. Only a few studies have applied the flywheel device directly to overload specific multidirectional movements at different joint angles. This method is not exempt from criticalities, such as the cost and the ability to carry out only individual training.

Acute Effects of Combining Whole-Body Electromyostimulation with Resistance Training in Active Women.

Strength training elicits benefits both in performance and on a psychological level in women, such as increased muscle strength and improved self-esteem. Whole-body electromyostimulation (WB-EMS) could be a training strategy for enhancing muscular strength. The aim of this study was to assess the acute effects of a single session of WB-EMS superimposed over classic resistance training on isometric strength, endurance strength and flexibility. Furthermore, the safety of the protocol was assessed by monitoring the levels of creatine kinase (CK) 48 h after the training protocol was completed. Sixteen active women (aged 22.06 ± 1.88) were randomly assigned to an experimental group (EG) (n = 8) and a control group (CG) (n = 8). The EG performed four sets of 12 repetitions of three strength exercises with superimposed WB-EMS, while the CG performed the same protocol without WB-EMS. RM-ANOVA showed a significant time*group interaction on posterior kinetic chain extensors' mean and peak strength in the EG (F(1,14) = 10.036; p = 0.007; and F(1,14) = 20.719; p < 0.001; respectively). A significant time*group interaction was found in the sit and reach test for the EG (F(1,14) = 10.362; p = 0.006). Finally, ANOVA performed on the CK levels showed no significant difference between the groups (F(1,14) = 0.715; p = 0.412). WB-EMS training led to an immediate improvement in strength performance and flexibility, and this protocol was shown to be safe in terms of CK levels, 48 h after completing the training protocol.

Psychological Wellbeing and Perceived Fatigue in Competitive Athletes after SARS-CoV-2 Infection 2 Years after Pandemic Start: Practical Indications.

The COVID-19 pandemic deeply affected sports and athletes, influencing performance and psychological wellbeing. In order to provide useful guidelines for coaches, a web-based survey was conducted. Three web-based questionnaires were administered during the last phase of the Omicron wave to a total of 204 Italian athletes (age 24.96 ± 9.82): an informative questionnaire to collect sociodemographic data and infection symptoms information, the Fatigue Severity Scale (FSS) and the General Health Questionnaire-12 (GHQ-12). No differences between infection sequels of different variant typologies were found over the long term after the infection. The most frequently declared symptoms included cough (50%), muscular skeletal impairments (48%) fatigue (43%) and fever (43%). Results showed that female athletes have a higher risk of developing post-COVID-19 symptoms, GHQ-12 worse results (p = 0.005) and greater fatigue (p = 0.0002) than males. No significant difference in infection incidence between high- and low-level athletes was found. Endurance athletes showed greater perceived fatigue than anaerobic sports athletes (p = 0.045). Conclusions: These results suggested the need for specific approaches and continuous updating to differentiate training programs for different athletes during the return to play. Medical controls and daily monitoring of athletes of all levels after the infection could be advisable.

Impact of Active Breaks in the Classroom on Mathematical Performance and Attention in Elementary School Children.

BACKGROUND: The increasing need to face the problem of sedentarism, especially in the COVID-19 era, induced teachers and researchers to find new intervention methodologies in school context. Active breaks (ABs) include brief periods of physical activity as a part of the curriculum. This study aimed to investigate the AB acute responses on attentive skills and mathematical performance and attention in a primary school. METHODS: A total of 141 children (aged 9.61 ± 0.82), divided into six classes, participated in this study. Each class was randomly assigned to three groups on the basis of the type of protocol performed during the three ABs scheduled in a school day: fitness (FIT), creativity (CREAT), and control group (CON). At baseline and at the end of interventions, all participants underwent the Stroop Color and Word test (SCWT) and the math test (MATH) to assess the level of attention and mathematical performance, respectively. The degree of enjoyment was evaluated through the modified Physical Activity Enjoyment Scale. RESULTS: The factorial ANOVA showed significant differences between the FIT and CON in MATH test (p = 0.023) and SCWT (p = 0.034). CREAT and FIT groups showed higher degree of enjoyment than the CON (both ps < 0.001). CONCLUSIONS: This study showed a positive acute impact of AB interventions. FIT positively influenced attentive and math performances more than the CREAT, probably due to the correct work/rest ratio and executive rhythm that allowed children to reach a good level of exertion. This report showed that ABs can be a useful and productive activity to be performed between curricular lessons.

Stress Impact of COVID-19 Sports Restrictions on Disabled Athletes.

The stress impact of COVID-19 restrictions has put the adapted sports community at an unprecedented level of emergency. The self-report Event Scale-Revised (IES-R) questionnaire was administered to assess the level of psychological distress and emotive reactions such as intrusion (INT), avoidance (AV) and hyperarousal (HYP) following training and competitions suspension within a sample of Italian disabled athletes. A total of 146 self-selected volunteers were included in this study: 73 disabled athletes (aged 42.11 ± 13.70) and 73 athletes (aged 40.23 ± 13.73) who served as the control group. Only 8.22% of the disabled participants vs. 30.14% of athletes were affected by subjective distress. MANOVA showed significant differences in IES-R subjective distress for age, where the emerging adults had a higher level of stress than adults (p = 0.031), and for the type of sport, where the individual sports group showed higher scores than the team sports group (p = 0.049). Regarding the IES-R subscales, significant differences were found in INT and AV for age, where the emerging adults showed higher scores than adults (p = 0.018 and p = 0.046, respectively). Significant differences were found in HYP for type of sport, where the individual sports group showed higher scores than the team sports group (p = 0.014). The results confirmed a lower distress level of disabled athletes to adverse events than that expressed by athletes. Both sports engagement and the experience of living with impairment, overcoming structural barriers, could act as a buffer effect against stress due to COVID-19 restrictions.

Exploring the Enjoyment of the Intergenerational Physical Activity.

Intergenerational physical activity could be a pleasant method to prevent elderly sedentary behaviors. The aim of this study is to provide a basis to develop an intergenerational physical activity between preschool children and elderly people. An assessing enjoyment three questionnaire survey was administered to 140 participants (aged 67.8 ± 9.1): the global physical activity questionnaire (GPAQ) assessing the sedentariness degree; the physical activity enjoyment scale (PACES-Q) assessing enjoyment for the physical activity usually practiced; the physical activity enjoyment scale (PACES-INT) assessing the enjoyment for a hypothetical intergenerational program. Successively, the sample was divided into subgroups based on age, gender, marital status, education, employment, sports background, sedentariness level and residential location. Four multichoice questions, aiming to have guidelines in organizing an intergenerational program, were used. A total of 44.3% of the sample found the physical activity practiced pleasant, whereas 81.5% enjoyed the intergenerational program (only 7.1% expressed a negative judgment). A separated one-way ANOVA showed significant differences in PACES-INT for gender, (p = 0.009), residential location, (p < 0.001) and employment (p = 0.004). About 80% of the sample would adhere to the intergenerational programs, despite the fatigue fear and logistic or family relationship problems.

A national COVID-19 quarantine survey and its impact on the Italian sports community: Implications and recommendations.

The outbreak of the 2019 coronavirus disease (COVID-19) created an international public health emergency, challenging the psychological resilience of the general population. Regarding this matter, a web-based survey was performed. Data were collected from the following 1,668 self-selected volunteers: 800 athletes (28.30 ± 10.93 years old); 558 coaches (36.91 ± 11.93 years old); and 310 sports managers (42.07 ± 13.38 years old). To assess the level of psychological stress, an Impact of the Event Scale-Revised (IES-R) questionnaire was used. The results indicated that 34.4% of the participants who were interviewed were affected by subjective distress while 26.4% rated their psychological impact from the sports activity interruption as severe. Separated one-way analysis of variance (ANOVA) tests showed significant differences in the IES-R total score (TS), indicating that the level of stress in terms of gender revealed that women were more stressed than men (p = 0.000), for "sports roles" in which the manager and coaches were more stressed than the athletes (p < 0.05), and "type of sport" in which fitness and individual athletes were more stressed than team athletes (p < 0.01). The middle-level athletes showed significantly more hyperarousal levels than high-level athletes (p = 0.012). The results of this survey may raise awareness of this problem and help athletic associations to have appropriate guidelines in order to better sustain their memberships and organize an optimal resumption of their sports activities. Along these lines, social interactions, which are typical of team sports, are crucial to warrant resilience and psychological health. The athletes by managing independently the new rules and measures, thanks to a clear communication, could improve their adaptive stress reaction.

Psychological Impact of the Quarantine-Induced Stress during the Coronavirus (COVID-19) Outbreak among Italian Athletes.

The 2019 Coronavirus (COVID-19) outbreak caused home confinement, as well as training and sport competitions withdrawals. The prolonged inactivity impact, and lack of in-person interactions among teammates-coaches, could negatively affect athletes. Total of 1508 self-selected Italian athletes, 338 children (aged 10.52 ± 1.31), 499 adolescents (aged 14.17 ± 1.13), and 671 adults (aged 27.59 ± 10.73), completed the Impact of Event Scale (IES-8, IES-15, and IES-R, respectively). Differences by gender, type of sport (individual vs. team), and competitive level (elite vs. amateur) were examined. One-way ANOVAs showed, in adults, significant differences between genders for perceived stress impact total score (TS; p = 0.017) and avoidance behavior, with higher scores in women (p = 0.045). Between individual and team sport, significant differences were found in TS (p = 0.038) and hyperarousal (p = 0.030), with higher results in individual. Adult elite athletes showed significantly higher scores in hyperarousal (p = 0.020) than amateurs. Significant differences were found between gender in adolescents for avoidance (p = 0.011), and between competitive levels in children, for intrusion (p = 0.020). These evidences may raise awareness on distress effects of COVID-19 lockdown among athletes and suggested applying specific well-being protocols during the activity resumption, considering gender, type of sport, and competitive level.

Effects of Accentuated Eccentric Training vs Plyometric Training on Performance of Young Elite Fencers.

The aim of the study was to evaluate the effects of 6-weeks accentuated eccentric training, using a rotary inertial device, on range of motion, assessed with Inter Malleolar Distance test, anthropometry, lower limb explosive and reactive strength, assessed with Squat Jump, Countermovement Jump and 7-Repeated Hop tests, in young elite fencers. Moreover, the effects on hamstring eccentric strength and two technical fencing movements, lunge and advance-advance lunge, were evaluated with motion analysis. The second aim was to evaluate the duration of the accentuated eccentric training residual effects, 6 weeks after the end of the training. Fifty-four male fencers were randomly assigned either to the Inertial Group (IG; n = 26; aged 17.3 ± 1.9 years) such as experimental group, or to the Plyometric Group (PG; n = 28; aged 17.6 ± 2.7 years) such as control group. IG carried out four exercises using the rotary inertial device attached to their waist by a rope. PG carried out several plyometric exercises at the same time in which the IG performed the accentuated eccentric training. MANOVA showed significant improvements in the vertical jumps height post training, with no differences between IG and PG. Significant improvements for technical movements, lunge distance (p = 0.006) and advance-advance lunge distance (p = 0.00005), were found within-group and between-groups (p = 0.00001), with higher improvements in IG than in PG. The univariate analysis showed a significant improvement in lower limb range of motion with higher increase in IG than in PG. The main findings were the significant improvement in lunge and advance-advance lunge distance, maintaining with the same execution time. These results suggested that it is important to apply accentuated eccentric load on specific sport movements.

Does Warm-up Type Matter? A Comparison between Traditional and Functional Inertial Warm-up in Young Soccer Players.

Functional inertial training, a popular high-intensity training mode, provides high neuromuscular activation, developing proprioception, postural control, power, and sprint time. Aim of the study was to assess the acute effects of two types of warm-up (WU), inertial warm-up (IWU) vs. traditional warm-up (TWU), on explosive and reactive strength, sprint, and Change of Directions (COD) in young soccer players. In a randomized cross-over design study, twelve soccer players (aged 13.3 ± 0.7) performed 16 min of IWU and 16 min of TWU. IWU and TWU were spaced two weeks apart. Pre and post intervention tests, aimed at assessing explosive and reactive strength, sprint, and COD ability included: Squat Jump test (SJ), Countermovement Jump test (CMJ), Drop Jump test (DJ), Seven Repetition Hopping test (7R-HOP), 40 m-sprint test (40 m), and Illinois Agility Test (IAT). RM-ANOVA, used to compare differences between IWU and TWU effects (the level of significance set at ρ ≤ 0.05), showed enhanced performance after the IWU compared to the TWU. In addition, the effects of the IWU on performance lasted longer after the IWU than after the TWU. For IAT, the enhanced effects of IWU on performance lasted up to ten minutes after the administration of the IWU. Our results suggest that IWU affects functional changes displaying earlier adaptation in explosive and reactive strength with longer lasting effects compared to TWU and it could be recommended in young soccer athletes as a WU procedure.