Assessing physical activity in people with mental illness: 23-country reliability and validity of the simple physical activity questionnaire (SIMPAQ).

BACKGROUND: Physical inactivity is a key contributor to the global burden of disease and disproportionately impacts the wellbeing of people experiencing mental illness. Increases in physical activity are associated with improvements in symptoms of mental illness and reduction in cardiometabolic risk. Reliable and valid clinical tools that assess physical activity would improve evaluation of intervention studies that aim to increase physical activity and reduce sedentary behaviour in people living with mental illness. METHODS: The five-item Simple Physical Activity Questionnaire (SIMPAQ) was developed by a multidisciplinary, international working group as a clinical tool to assess physical activity and sedentary behaviour in people living with mental illness. Patients with a DSM or ICD mental illness diagnoses were recruited and completed the SIMPAQ on two occasions, one week apart. Participants wore an Actigraph accelerometer and completed brief cognitive and clinical assessments. RESULTS: Evidence of SIMPAQ validity was assessed against accelerometer-derived measures of physical activity. Data were obtained from 1010 participants. The SIMPAQ had good test-retest reliability. Correlations for moderate-vigorous physical activity was comparable to studies conducted in general population samples. Evidence of validity for the sedentary behaviour item was poor. An alternative method to calculate sedentary behaviour had stronger evidence of validity. This alternative method is recommended for use in future studies employing the SIMPAQ. CONCLUSIONS: The SIMPAQ is a brief measure of physical activity and sedentary behaviour that can be reliably and validly administered by health professionals.

Ideal cardiovascular health and its association with sedentary behaviour and fitness in psychiatric patients. The PsychiActive project.

BACKGROUND AND AIMS: Ideal cardiovascular health (CVH) was defined as meeting ideal levels of 4 health behaviours (smoking, body mass index, physical activity, and diet) and 3 biological factors (blood pressure, total cholesterol, and glucose) and is inversely related to cardiovascular disease and mortality. However, the prevalence of ideal CVH in patients with severe mental illness and the possible independent associations of sedentary behaviour and fitness with CVH score are unexplored. METHODS AND RESULTS: This study included 142 (34 women) outpatients with severe mental illness (primarily schizophrenia, n = 92). CVH was evaluated according to the American Heart Association guidelines. Sedentary behaviour, cardiorespiratory fitness, and muscular strength were measured by an activity-monitor, the 6-min walk test, and handgrip dynamometry. Cardiorespiratory fitness and strength values were combined in a composite fitness score. The prevalence of ideal CVH was: non-smoking (47.9%), body mass index (16.9), physical activity (83.1%), diet (10.4%), blood pressure (40.4%), total cholesterol (62.9%), and plasma glucose (66.7%). Low levels of sedentary behaviour and high cardiorespiratory, strength, and composite fitness score were associated with meeting the ideal threshold in most CVH metrics and having higher global CVH score; however, only cardiorespiratory and composite fitness score remained significantly related to global CVH score independent of sedentary behaviour and multiple confounders. CONCLUSIONS: Patients with severe mental illness generally have low prevalence of ideal CVH metrics, especially diet and body mass index. Additionally, our findings suggest the need or considering cardiorespiratory fitness, regardless of sedentary behaviour, to promote ideal CVH in this population.

Non-osteogenic muscle hypertrophy in children with McArdle disease.

INTRODUCTION: McArdle disease is an inborn disorder of muscle glycogen metabolism that produces exercise intolerance, and has been recently associated with low values ​​of lean mass (LM) and bone mineral content (BMC) and density (BMD) in affected adults. Here we aimed to study whether this bone health problem begins in childhood. METHODS: Forty children and adolescents were evaluated: 10 McArdle disease and 30 control children (mean age of both groups, 13 ± 2y). Body composition was evaluated by dual-energy X-ray absorptiometry and creatine kinase (CK) levels were determined in the patients as an estimate of muscle damage. RESULTS: Legs bone mass was significantly lower in patients than in controls (-36% for BMC and -22% for BMD). Moreover, patients had significantly higher LM values in the legs than controls, whereas no difference was found for fat mass. CK levels were positively associated with LM in McArdle patients. A correlation was found between LM and BMD variables in the control group but not in McArdle patients. CONCLUSION: We have identified a 'non-osteogenic muscle hypertrophy' in children with McArdle disease. This phenomenon warrants special attention since low osteogenesis at an early age predicts a high risk for osteoporosis later in life.

Development and psychometric evaluation of a health questionnaire on back care knowledge in daily life physical activities for adolescent students.

PURPOSE: The most relevant musculoskeletal problems are related with back health. Study instruments have been designed for adult patient population but not for school-aged children. The aim of this study was to develop and evaluate the psychometric properties of a questionnaire to assess adolescents' level of back care knowledge in daily life physical activities. METHODS: Participants were 171 adolescents from secondary schools. The questionnaire was made up of 24 questions. A Delphi method was used for test validation. Cronbach's alpha, test-retest, Wilcoxon signed-rank and Bland-Altman graph were used to evaluate the instrument reliability. RESULTS: Cronbach's alpha (α = 0.82) showed a strong internal consistency. Test-retest was excellent for total score (0.76) and moderate to excellent (0.54-0.76) for seven score conceptual categories with good results of standard error of the mean and minimal detectable change. No differences were found between test 1 and test 2 except for the standing posture scores. CONCLUSION: The questionnaire showed acceptable psychometric values. Results showed that this questionnaire is a good instrument to assess adolescent's back care knowledge.

Match-play activity profile in professional soccer players during official games and the relationship between external and internal load.

AIM: The aim was to quantify for the first time the physical and physiological profile of professional soccer players in official games using GPS and heart rate (HR) response. METHODS: Thirty professional soccer players were investigated during a half in competitive club level matches (N.=348) using GPS devices. RESULTS: The relative total distance was 118.9±10.7 m∙min(-1) and player's Work-To-Rest Ratio was 2.1:1. Defenders covered the lowest total distance, while Second-Strikers (2(nd)S) and Wide-Midfielders (W-MD) traveled the greatest total distance. Defenders presented the lowest Work-To-Rest Ratio values. Playing position also impacted on all sprinting performance results, except in average sprint distance and time of sprint. The number of sprints and repeated-sprint sequences recorded by the W-MD and Strikers (S) were significantly greater than any other group. The average HR recorded was 87.1%HRmax and the relationship between the external and internal load value (Effindex) was 1.4 with significant differences in both between playing positions. W-MD recorded a significantly smaller average HR than any other group and Centre-Backs showed a significantly smaller Effindex value than any other group. Conversely, W-MD showed a significantly greater Effindex value than any other group, except the 2(nd)S. CONCLUSION: This study has verified a number of statistically significant differences between the different playing positions. Coaches should be focused on the specific physical and physiological requirements of the playing positions to optimize the training prescription in soccer. The relationships between external and internal load measures among position-specific indicates that players with less overall running performance during match-play were the worst in Effindex.

The validity of incremental exercise testing in discriminating of physiological profiles in elite runners.

The goal of this study was to determine whether traditional ergoespirometric incremental exercise testing carried out to the point of exhaustion could be useful in distinguishing the physiological profiles of elite runners that compete in races that lasted about 8 minutes versus those that lasted about 2 hours. Ten male marathon runners (performance time: 2:12:04, coefficient of variation (CV) = 2.33%) and 8 male 3000 m steeplechase runners (performance time: 8:37.83, CV = 2.12%) performed an incremental test on the treadmill (starting speed 10 km·h-1; increments, 2 km·h-1; increment duration, 3 min to exhaustion). Heart rate (HR), VO2, and lactate concentrations were measured at the end of each exercise level. At maximal effort, there were no differences between the groups regarding VO2max and maximal HR; however, the workload time, vVO2max and peak treadmill velocity were significantly higher in the 3000 m steeplechase group (p<0.05). At submaximal effort, there were no significant differences between groups for VO2 (ml·kg-1·min-1), HR, or lactate. Our results show that this type of testing was not sufficient for discriminating the physiological profiles of elite runners who competed in middle-distance versus long-distance events (e.g. in the marathon and the 3000 m steeplechase).

Association of objectively assessed physical activity with total and central body fat in Spanish adolescents; the HELENA Study.

OBJECTIVES: To examine the association of objectively assessed physical activity (PA) with markers of total and central body fat in adolescents, and to determine whether meeting the current PA recommendations (> or = 60 min day(-1) of at least moderate intensity PA) is associated with reduced levels of total and central body fat. SUBJECTS/METHODS: A total of 365 Spanish adolescents aged 12.5-17.5 years participated in this cross-sectional study. PA was assessed by accelerometry and expressed as average PA (counts per minute), and min day(-1) of light, moderate, moderate to vigorous (MVPA) and vigorous PA. MVPA was dichotomized into < 60 min day(-1) and > or = 60. Total body fat was measured by DXA, BodPod and the sum of six skinfolds. Central body fat was measured by DXA at three regions (R1, R2 and R3), and waist circumference. RESULTS: All markers of central body fat were negatively associated with vigorous PA (P < 0.01) after controlling for sex, age and pubertal status. Abdominal adiposity measured at R1, R2 and R3 was also negatively associated with MVPA (P < or = 0.001), and with average PA (P < 0.01). All markers of total body fat were negatively associated with vigorous PA (P < 0.01), MVPA (P < 0.01) and average PA (P < 0.05). Adolescents engaged on at least 60 min day(-1) MVPA presented lower levels of total (P < 0.05) and central body fat (P < or = 0.01). CONCLUSIONS: The results suggest that vigorous PA may have a greater effect on preventing obesity in adolescents than does PA of lower intensity, whereas both average PA and at least moderate PA may have an impact on total and central body fat in youth.

Basic physiological measures determine fitness and are associated with running performance in elite young male and female Ethiopian runners.

AIM: The aim of this study was to determine if possible, with the resources available in Ethiopia, to make significant associations between racing performance and laboratory physiological test results in elite young African runners. METHODS: Twenty-four young Ethiopian runners (12 males and 12 females) attended the physiology laboratory of the Addis Ababa University, where skin fold thickness, basic resting pulmonary function and heart rate (HR) during an incremental treadmill exercise test were recorded a week before or a week after two official 800 and 1500 meter races. Performance was rated according to the scoring procedures of the International Association of Athletics Federations (IAAF): male runners (1041, CV=4.1%), female (1051, CV=2.8%). RESULTS: The sum of four skin folds was significantly correlated with male (r=-0.80, P<0.01) and female IAAF score (r= -0.78, P<0.01). IAAF score was also related to forced vital capacity (male: r=0.70, P<0.05; female: r=0.85, P<0.01) and forced expiratory volume in 1 s (male: r=0.63, P<0.05; female: r=0.80, P<0.01). For both sexes, HR at a fixed submaximal exercise workload was significantly associated with IAAF score. In both male and female runners, the more significant association was observed for a treadmill slope of 7.5% (r=-0.93, P<0.01; r= -0.95, P<0.01, respectively). CONCLUSIONS: These results show that basic physiological measures are useful in measuring fitness and in predicting middle-distance running performance in a homogeneous group of elite young male and female Ethiopian runners.

An analysis of resistance training based on the maintenance of mechanical power.

Resistance training techniques, that increase the global power output of an exercise, exercise set and continuous sets, can optimize neuromuscular adaptation and dynamic athletic performance. An observation that is apparent during traditional resistance training is the slowing of movement velocity as fatigue increases. To perform at maximum velocity, only repetitions that permit maintenance of the maximum power output are essential for increasing the global power output. This article reviews the available research which examines the pattern of velocity decrease with different load intensities. In addition, an analysis is performed of the possible advantages of resistance training based on the maintenance of the mechanical power versus traditional resistance training. Furthermore, a variety of fact-finding lines are proposed with the objective of answering the numerous open questions related to resistance training based on the maintenance of mechanical power.

Exercise in warm water decreases pain and improves cognitive function in middle-aged women with fibromyalgia.

OBJECTIVES: To compare the cognitive function performance in patients with fibromyalgia (FM) with respect healthy controls and to evaluate the short-term efficacy of exercise therapy in a warm, chest-high pool on pain and cognitive function in women with FM. METHODS: Sixty middle-aged women with FM were randomly assigned to either an exercise training group (n = 35) to perform 3 sessions per week of aquatic training (32 degrees C) including mobility, aerobic, strengthening, and relaxation exercises for 16 weeks, or a control group (n = 25). Twenty-five healthy women matched for age, weight, body mass index, and educational and physical activity levels were recruited. Pain was assessed in patients using a syringe calibrated like a pressure dolorimeter, and a visual analog scale. The severity of FM was evaluated using the Fibromyalgia Impact Questionnaire. Cognitive function was measured in healthy individuals and patients using several standardized neuropsychological tests. All patients were measured at baseline and post-treatment. RESULTS: At baseline, the healthy group evidenced cognitive performance that was significantly superior to the group of patients with FM in all of the neuropsychological tests. The exercise group significantly improved their pain threshold, tender point count, self-reported pain, severity of FM, and cognitive function, while in the control group the differences were not significant. CONCLUSION: An exercise therapy three times per week for 16 weeks in a warm-water pool is an adequate treatment to decrease the pain and severity of FM well as to improve cognitive function in previously unfit women with FM and heightened painful symptomatology.

Physiological measures associated with marathon running performance in high-level male and female homogeneous groups.

The study tested the hypothesis that physiological measurements can predict marathon running performance in a top-level homogeneous group of males and females. Ten male, performance: 2:12:04, coefficient of variation (CV)=2.33%, and 8 female marathon runners, performance: 2:34:53, CV=4.54%, performed an increment test on the treadmill (starting speed, 8 km.h-1; increments, 2 km.h-1; increment duration, 3 min to exhaustion). The heart rate (HR), VO2 and the lactate concentrations were measured at the end of each exercise level. During the recovery time, HR and lactate were measured. Furthermore, echocardiographic, anthropometric and haematologic measurements were made. The results of a stepwise multiple regression analysis using marathon time as the dependent variable yielded R2=0.983 for the male group and R2=0.984 for the female group. The model for the male group used the independent variables lactate value at 10 km.h-1, left ventricular telediastolic diameter (LVD) and lactate value at 22 km.h-1. The model for the female group used the independent variables subscapular skinfold, serum ferritin and sum of six skinfolds. Our study demonstrates that in males and females, physiological parameters can explain the variance in marathon time among elite homogeneous groups.

The changes in running performance and maximal oxygen uptake after long-term training in elite athletes.

AIM: The relationship between VO2max (mL x kg(-1) x min(-1)) and running performance has been assessed in cross-sectional studies. Follow-up studies of the long-term effects of running training on the changes in performance and VO2max have not been undertaken. METHODS: Twenty-five male endurance-trained (MET) and 8 female endurance-trained (FET) athletes were tracked over 4 years. In each event the athletes were divided into Class A, including half the number of athletes with the best performances, and Class B. VO2max, examined at the end of the competitive season, and the best performance was chosen each year. RESULTS: After 3 years of training, in MET and FET athletes the performance improved by 1.77% and 0.69% (P<0.01 and P=0.579), respectively. In Class A runners, training resulted in non-significant increase in performance (-0.04%) (P=0.982) and in Class B runners, performance increased by 3.16% (P=0.001). In all groups VO(2max) remained essentially unchanged. Longitudinal changes in the VO2max were not related with the changes in running performance in any group. CONCLUSIONS: This study show than in older runners with more years of training, heavy training does not produce improvements in running performance neither changes in the VO2max. It is possible that these elite athletes have reached the plateau in their performance; although unlikely, some improvement in training techniques may happen and break the present limit. In younger runners with less years of training, heavy training produce improvements in running performance without changes in the VO2max. These athletes that had not attained his biological limits at the beginning of study improved the performance in competition and it is quite probable that this improvement be due to training. The changes in performance were not related to changes in VO2max. Consequently, another physiological or psychological variables must be studied by longitudinal form to explain the variability of performance in competition.