Can Dance Improve Turning in People With Parkinson's Disease?

Objective: To investigate the effects of a dance intervention on selected functional parameters during the 180° turning phase of the Timed Up & Go (TUG) test in people with Parkinson's Disease (PwPD). Methods: Fifteen adults clinically diagnosed with idiopathic PD were allocated into dance intervention (DIG; n = 7 ; age 73 ± 2 years) and control (CG; n = 8; age 64 ± 5 years) groups. The dance intervention lasted for 3 months (1 hour, twice a week). At baseline, all participants completed the Unified PD Rating Scale-part III, the International Physical Activity Questionnaire-short form, and the Hoehn & Yahr scale. Pre- and post-intervention, the primary outcomes were measured (number of steps and time to complete the 180° turning phase of the TUG test) at 2 speeds (comfortable walking and as quickly and safely speed) while using the Xsens® 3D motion suit. The secondary outcome (girdle dissociation) was assessed by calculating the difference between pelvis and affected shoulder orientation in the transverse plane (dissociation angles) at each data point during the TUG test's 180° turning phase. Results: At participant's comfortable walking speed, the functionality during the 180° turning remained unaffected following the dance intervention. However, at participant's fast speed, the dance intervention group significantly reduced the number of steps with a large effect size, and the total time taken to complete the 180° turning with a medium effect size. Post-intervention, most participants in the dance intervention group reduced the affected shoulder and pelvic girdle dissociation and turned more "en bloc." Conclusion: Dance can improve selected functional parameters during the 180° turning at fast speed in PwPD. The current results should be considered in rehabilitation programs.

Postural adjustments and perceptual responses of Nordic running: concurrent effects of poles and irregular terrain.

PURPOSE: In the natural environment, humans must continuously negotiate irregular and unpredictable terrain. Recently, the poles have been extensively used during trial running events. However, we know little about how humans adjust posture and bilateral coordination to use poles in irregular terrain. Here, we compared kinematics, bilateral coordination and perceptual responses between regular (compact dust) and irregular terrain (medium-length grass) during running at preferred speed with and without poles. METHODS: In this transversal observational study, thirteen young healthy adults (8 men; mean ± SD; age 29.1 ± 8.0 years, body mass 76.8 ± 11.4 kg; height 1.75 ± 0.08 m) were evaluated during running at a self-selected comfortable speed with and without poles on regular and irregular terrains. RESULTS: Our results show that, despite more flexed pattern on lower-limb joints at irregular terrain, the usage of poles was not enough to re-stabilize the bilateral coordination. Also, the perceived exertion was impaired adding poles to running, probably due to more complex movement pattern using poles in comparison to free running, and the invariance in the bilateral coordination. CONCLUSION: Besides the invariability of usage poles on bilateral coordination and lower-limb kinematics, the runners seem to prioritize postural stability over lower limb stiffness when running in medium-length grass given the larger range of ankle and knee motion observed in irregular terrain. Further investigations at rougher/hilly terrains will likely provide additional insights into the neuromotor control strategies used to maintain the stability and on perceptual responses using poles during running.

The effects of Brazilian dance, deep-water exercise and nordic walking, pre- and post-12 weeks, on functional-motor and non-motor symptoms in trained PwPD.

BACKGROUND: Motor and non-motor symptoms affect functional autonomy, mobility and daily life activities in People with Parkinson's Disease (PwPD). Brazilian Dance (BD), Deep-water exercise (DWE), and Nordic Walking (NW) are well-accepted, low-cost, and safe non-pharmacological strategies for untrained PwPD. However, no previous studies have investigated and compared the effects of these interventions on trained PwPD. OBJECTIVE: To describe and compare the effects of BD, DWE and NW, pre- and post-12 weeks, on functional-motor and non-motor symptoms in trained PwPD. METHODS: Eighty-three trained PwPD were randomly assigned into three groups: BD (n = 31), DWE (n = 21) and NW (n = 31), that participated in one of the interventions for 12 weeks. We applied Timed up and go at two speeds (self-selected and fast); 6-min and 10-meter walk test; Sit-to-Stand and handgrip test; Unified Parkinson Disease Rating Scale - III; Falls Efficacy Scale; Montreal Cognitive Assessment questionnaire; and Parkinson's Disease Questionnaire-39. The main (group and time) and interaction effects were analyzed using GEE analysis (p<0.05). RESULTS: Statistical differences were found between groups in the handgrip test (p<0.01), the time (p = 0.04), and interaction group*time (p< 0.01) in the Sit-to-stand test. While BD improved the Sit-to-stand test performance (ES=1.00; large effect size), DWE and NW remained unchanged (ES=0.16 and ES=0.14; low effect size). CONCLUSION: BD, DWE, and NW maintained most of the functional-motor and non-motor symptoms in trained PwPD. BD was shown to be more effective at improving strength in the lower limbs, when compared to NW and DWE.

Static Balance in Hereditary Spastic Paraplegias: a Cross-sectional Study.

Motor and somatosensory pathway dysfunction due to degeneration of long tracts in hereditary spastic paraplegias (HSP) indicates that postural abnormalities may be a relevant disease feature. However, balance assessments have been underutilized to study these conditions. How does the static balance of individuals with HSP with eyes open and closed differ from healthy controls, and how does it relate to disease severity? This cross-sectional case-control study assessed the static balance of 17 subjects with genetically confirmed HSP and 17 healthy individuals, evaluating the center of pressure (COP) variables captured by a force platform. The root-mean-square of velocities and mean of displacements amplitudes in mediolateral and anteroposterior axes were correlated with disease severity. All COP parameters' performances were significantly impaired in HSP subjects compared to controls (p < 0.001 for all comparisons). COP with eyes open and closed differed for all variables within the HSP group, whereas in the control group, differences were observed only for anteroposterior velocity and amplitude. Spastic Paraplegia Rating Scale presented moderate direct correlations with the most COP variables (Rho = - 0.520 to - 0.736). HSP individuals presented significant postural instability with eyes open and to a greater extent with eyes closed, corroborating the clinical findings of somatosensorial and proprioceptive pathways dysfunction. The degrees of proprioceptive and motor impairments are mutually correlated, suggesting that similar pathophysiological mechanisms operate for the degeneration of these long tracts. COP parameters can be seen as disease severity biomarkers of HSP, and they should be assessed in future clinical trials.

Long-term progression of clinician-reported and gait performance outcomes in hereditary spastic paraplegias.

Introduction: Hereditary spastic paraplegias (HSPs) are a heterogeneous group of neurodegenerative diseases in which little is known about the most appropriate clinical outcome assessments (COAs) to capture disease progression. The objective of this study was to prospectively determine disease progression after 4.5 years of follow-up with different clinician-reported (ClinRO) and gait performance outcomes (PerFOs). Methods: Twenty-six HSP patients (15 SPG4, 5 SPG7, 4 SPG5, 2 SPG3A) participated in this single-center cohort study in which the ClinRO: Spastic Paraplegia Rating Scale; and the PerFOs: 10-meters walking test and timed-up and go (TUG), at self-selected and maximal walking speeds; Locomotor Rehabilitation Index; and 6-min walking test were performed at baseline and after 1.5 (18 patients) and 4.5 (13 patients) years. Results: In the 3-year interval between the second and third assessments, significant progressions were only found in PerFOs, while in the overall 4.5 years of follow-up, both PerFOs and ClinROs presented significant progressions. The progression slopes of COAs modeled according to the disease duration allowed the estimation of the annual progression of the outcomes and sample size estimations for future clinical trials of interventions with different effect sizes. TUG at maximal walking speed was the only COA capable of differentiating subjects with a worse compared to a stable/better impression of change and would require the smallest sample size if chosen as the primary endpoint of a clinical trial. Discussion: These findings indicate that both performance and clinician-reported outcomes can capture long-term progression of HSPs, with some PerFOs presenting greater sensitivity to change. The presented data are paramount for planning future disease-modifying and symptomatic therapy trials for this currently untreatable group of diseases.

Pendular mechanism determinants and elastic energy usage during walking of obese and non-obese children.

The mechanical and metabolic responses of walking by obese children are not yet well understood. The objectives of this study were (1) to compare the pendular mechanism (recovery, phase shift by α and ß values, and ratio between forward and vertical mechanical work), the maximum possible elastic energy usage and the bilateral coordination during walking between non-obese and obese children, and (2) to verify if the bilateral coordination could contribute to understanding the pendular mechanism and elastic energy usage in these populations. Nine obese (six female, 8.7 ± 0.5 years, 1.38 ± 0.04 m, 44.4 ± 6.3 kg and 24.1 ± 3.50 kg/m2 ) and eight non-obese (four female, 7.4 ± 0.5 years, 1.31 ± 0.08 m, 26.6 ± 2.1 kg and 16.4 ± 1.40 kg/m2 ) children were analysed during walking on a treadmill at five speeds: 1, 2, 3, 4 and 5 km/h. The results indicated that although the mechanical energy response of the centre of mass during walking is similar between obese and non-obese children, the obese children showed a lower pendulum-like mechanism and greater elastic energy usage during level walking. Therefore, obese children seem to use more elastic energy during walking compared to non-obese children, which may be related to their apparent higher positive work production during the double support phase. Finally, bilateral coordination presented high values at slow speeds in both groups and requires further attention due to its association with falls. NEW FINDINGS: What is the central question of this study? Are there any differences of the pendular and elastic mechanisms and bilateral coordination during walking between non-obese and obese children? What is the main finding and its importance? To our knowledge, this study is the first to analyse the mechanical energy usage and the bilateral coordination of obese and non-obese children during walking. Obese children had a lower pendular recovery mechanism and used more elastic energy compared to non-obese children. The bilateral coordination was higher at slow speeds in both groups and requires further attention due to its association with falls.

Energetic responses of head-out water immersion at different temperatures during post-exercise recovery and its consequence on anaerobic mechanical power.

PURPOSE: While exercise recovery may be beneficial from a physiological point of view, it may be detrimental to subsequent anaerobic performance. To investigate the energetic responses of water immersion at different temperatures during post-exercise recovery and its consequences on subsequent anaerobic performance, a randomized and controlled crossover experimental design was performed with 21 trained cyclists. METHOD: Participants were assigned to receive three passive recovery strategies during 10 min after a Wingate Anaerobic Test (WAnT): control (CON: non-immersed condition), cold water immersion (CWI: 20 â„ƒ), and hot water immersion (HWI: 40 â„ƒ). Blood lactate, cardiorespiratory, and mechanical outcomes were measured during the WAnT and its recovery. Time constant (τ), asymptotic value, and area under the curve (AUC) were quantified for each physiologic parameter during recovery. After that, a second WAnT test and 10-min recovery were realized in the same session. RESULTS: Regardless the water immersion temperature, water immersion increased [Formula: see text] (+ 18%), asymptote ([Formula: see text]+ 16%, [Formula: see text] + 13%, [Formula: see text] + 17%, HR + 16%) and AUC ([Formula: see text]+ 27%, [Formula: see text] + 18%, [Formula: see text] + 20%, HR + 25%), while decreased [Formula: see text] (- 33%). There was no influence of water immersion on blood lactate parameters. HWI improved the mean power output during the second WAnT (2.2%), while the CWI decreased 2.4% (P < 0.01). CONCLUSION: Independent of temperature, water immersion enhanced aerobic energy recovery without modifying blood lactate recovery. However, subsequent anaerobic performance was increased only during HWI and decreased during CWI. Despite higher than in other studies, 20 °C effectively triggered physiological and performance responses. Water immersion-induced physiological changes did not predict subsequent anaerobic performance.

Tensiomyography: from muscle assessment to talent identification tool.

Introduction: Tensiomyography (TMG) is a non-invasive and cost-effective tool that is gaining popularity in fields such as sports science, physical therapy, and medicine. In this narrative review, we examine the different applications of TMG and its strengths and limitations, including its use as a tool for sport talent identification and development. Methods: In the course of crafting this narrative review, an exhaustive literature search was carried out. Our exploration spanned several renowned scientific databases, such as PubMed, Scopus, Web of Science, and ResearchGate. The materials we sourced for our review included a broad spectrum of both experimental and non-experimental articles, all focusing on TMG. The experimental articles featured varied research designs including randomized controlled trials, quasi-experiments, as well as pre-post studies. As for the non-experimental articles, they encompassed a mix of case-control, cross-sectional, and cohort studies. Importantly, all articles included in our review were written in English and had been published in peer-reviewed journals. The assortment of studies considered provided a holistic view of the existing body of knowledge on TMG, and formed the basis of our comprehensive narrative review. Results: A total of 34 studies were included in the review, organized into three sections: 1) assessing muscle contractile properties of young athletes, 2) using TMG in the talent identification and development process and 3) Future research and perspectives. According to data presented here, the most consistent TMG parameters for determining muscle contractile properties are radial muscle belly displacement, contraction time, and delay time. Biopsy findings from the vastus lateralis (VL) confirmed TMG as a valid tool for estimating the ratio of myosin heavy chain (%MHC-I). Conclusion: TMGs ability to estimate the ratio of %MHC-I has the potential to aid in the selection of athletes with the muscle characteristics best suited for a particular sport, eliminating the need for more invasive procedures. However, more research is warranted to fully understand TMG's potential and its reliability when used with young athletes. Importantly, the use of TMG technology in this process can positively impact health status, reducing the frequency and severity of injuries and the duration of recovery, and subsequently can reduce drop out rates among youth athletes. Future studies should look at twin youth athletes, as a model capable of discriminating between the influence of hereditary factors vs. environmental factors, in therms of muscle contractility and TMG's potential for instance.

Determinants of Dual-task Gait Speed in Older Adults with and without Parkinson's Disease.

Mobility difficulties for people with Parkinson's disease (PwPD) are more pronounced when they perform a simultaneous cognitive task while walking. Although it is known that neurodegeneration results in widespread motor and brain impairments, few studies have comprehensively examined possible physical and mental determinants of dual task walking in PwPD. In this cross-sectional study, we aimed to investigate if and how muscle strength (sit-to-stand 30-sec test), cognition (mini-mental state examination) and functionality (timed up and go test) affect walking performance (10-meter walking test) with and without arithmetic dual task from older adults with and without Parkinson's disease. Walking speed was reduced by 16% and 11% with arithmetic dual task for PwPD (from 1.07±0.28 to 0.91±0.29 m.s-1, p<0.001) and older adults (from 1.32±0.28 to 1.16±0.26 m.s-1, p=0.002) compared to essential walking. The cognitive state was similar among the groups, but it was only associated with the dual-task walking speed in PwPD. In PwPD, lower limb strength was the better predictor of speed, whereas mobility was more related to it in older adults. Therefore, future exercise interventions aiming to improve walking in PwPD should consider these findings to maximize their effectiveness.

Energy cost differences between marathon runners and soccer players: Constant versus shuttle running.

Purpose: In the last decades, the energy cost assessment provided new insight on shuttle or constant running as training modalities. No study, though, quantified the benefit of constant/shuttle running in soccer-players and runners. Therefore, the aim of this study was to clarify if marathon runners and soccer players present specific energy cost values related to their training experience performing constant and shuttle running. Methods: To this aim, eight runners (age 34 ± 7.30y; training experience 5.70 ± 0.84y) and eight soccer-players (age 18.38 ± 0.52y; training experience 5.75 ± 1.84y) were assessed randomly for 6' on shuttle-running or constant-running with 3 days of recovery in-between. For each condition, the blood lactate (BL) and the energy cost of constant (Cr) and shuttle running (CSh) was determined. To assess differences for metabolic demand in terms of Cr, CSh and BL over the two running conditions on the two groups a MANOVA was used. Results: V·O2max were 67.9 ± 4.5 and 56.8 ± 4.3 ml·min-1 kg-1 (p = 0.0002) for marathon runners and soccer players, respectively. On constant running, the runners had a lower Cr compared to soccer players (3.86 ± 0.16 J kg-1m-1 vs. 4.19 ± 0.26 J kg-1 m-1; F = 9.759, respectively; p = 0.007). On shuttle running, runners had a higher CSh compared to soccer players (8.66 ± 0.60 J kg-1 m-1 vs. 7.86 ± 0.51 J kg-1 m-1; F = 8.282, respectively; with p = 0.012). BL on constant running was lower in runners compared to soccer players (1.06 ± 0.07 mmol L-1 vs. 1.56 ± 0.42 mmol L-1, respectively; with p = 0.005). Conversely, BL on shuttle running was higher in runners compared to soccer players 7.99 ± 1.49 mmol L-1 vs. 6.04 ± 1.69 mmol L-1, respectively; with p = 0.028). Conclusion: The energy cost optimization on constant or shuttle running is strictly related to the sport practiced.

Effects of aging on arm coordination at different walking speeds.

BACKGROUND: Previous work has shown that the mean continuous relative phase and coordination variability of lower limbs are modified in older adults when walking. RESEARCH QUESTION: Here, we propose to understand the extent to which such control mechanisms for upper limbs are present during gait. Specifically, we seek to understand if aging and gait speed constraints influence the interjoint control of upper limbs during walking. METHODS: This observational study evaluated thirty-three participants, divided into older (n = 20, age 66.4 ± 4.3 years; mass: 77.2 ± 14.2 kg; height: 165 ± 9.20 cm) and young adults (n = 13, age 29.5 ± 4.7 years; mass 75.5 ± 9.6 kg; height: 172 ± 6.24 cm) were asked to walk at 0.28, 0.83, 1.38 m.s-1 on a level treadmill while their segmental movements were simultaneously registered with 3D motion capture system. We calculated the mean continuous relative phase and coordination variability (continuous relative phase variability) in elbow-shoulder and shoulder-hip pairs, and a generalized estimating equation was used to test the main and interaction effects of age and speed. RESULTS: Older adults had a reduced continuous relative phase (more in-phase coordination) of upper limbs at whole stance for elbow-shoulder, at loading response for shoulder-hip, at mid-stance and terminal stance for elbow-shoulder and shoulder-hip in comparison to young adults at different speeds (p < 0.05). The coordination variability of upper limbs was greater (higher continuous relative phase variability) in older than young adults at 0.28 and 1.38 m.s-1. SIGNIFICANCE: These findings substantiate the altered motor control role of upper limbs in gait aging, suggesting that lower self-selected speed may be related to the reduced ability to control arm movement during the intermediate phases of gait.

Quantifying physiological and biomechanical responses of shallow water walking: a systematic review and meta-analysis.

Detecting the physiological and biomechanical alterations in shallow water walking (SWW) due to water depth and speed is important for health professionals to perform accurate exercise prescription. This systematic review with meta-analysis aimed to investigate the acute physiological and biomechanical responses of SWW at different immersion depths in comparison to dry land walking. The main result (initial search: 1960 studies; systematic review: 42 studies; meta-analysis: 22 studies) indicated that metabolic power was higher in the immersion depth levels of xiphoid process (standardized mean differences (SMD) = 0.90; 95% confidence intervals (CI): 0.26 to 1.54) and waist (SMD = 3.35; 95% CI: -0.18 to 6.87) in comparison to dry land. SWW at xiphoid and waist depths seems to be an adequate exercise if the objective is to increase the energy expenditure and cardiovascular demand while the lower limb impact forces are reduced in comparison to dry land walking. PROSPERO registration: CRD42018113040.

Effects of Mental Fatigue on Reaction Time in Sportsmen.

AIM: Mental fatigue (MF) has been defined as a psychobiological state commonly caused by prolonged periods of demanding cognitive activity. However, the differences between women and men in their reaction times (RTs) to visual stimuli due to mental fatigue remain largely unknown. We compare the differences in RT and heart rate after an acute intervention of mental fatigue between male and female athletes. MATERIALS AND METHODS: For this aim, 64 participants (age 31.7 ± 6.2 y) performed a routine of 15 min of the Stroop test (PsyTool), with 600 tasks and five different colors. Their heart rate (HR) was registered before, during, and one, three, and five minutes after the Stroop test. Meanwhile, the RT was evaluated before and after the Stroop test. A general linear mixed model (GLMM) and a Bonferroni post hoc test were used to compare the HR between the conditions and an ANOVA two-way analysis was used to compare the values pre-/post-Stroop test. (α = 0.05). RESULTS: The GLMM for HR showed an effect on the time (p < 0.001) and the time × group interaction (p = 0.004). The RT was significantly increased pre- to post-Stroop test (p < 0.05); however, there was no difference between the pre- and post-HR measurements (p = 1.000) and the measurements one (p = 0.559), three (p = 1.000) and five (p = 1.000) min after the Stroop test. CONCLUSION: The present findings suggest that the parasympathetic branch of the autonomous nervous system which functions as a relaxation system tends to be activated under increasing mental fatigue, with a decreased performance (RT) similarly in men and women. Therefore, athletes could use MF induced during training to improve the time delay related to motor tasks.

Relationship between knee extensor and flexor muscle strength and age in professional volleyball players.

We aimed to analyse the relationship of peak torque (PT) of the knee extensors (Ext) and flexors (Fle) with age, and the relationship between conventional ratio and age progression in volleyball players. A total of 41 elite male volleyball players (age: 25.0 ± 6.1 years, body mass: 93.0 ± 9.8 kg, height: 198.0 ± 6.8 cm) were evaluated in a isokinetic dynamometer at speeds of 60, 180 and 300 deg/s, and at dominant (D) and non-dominant (ND) legs. In general, the knee flexor and extensor muscles varied greatly among the athletes (from 81 to 156 N.m for flexors; from 116 to 250 N.m for extensors at 300 deg/s and at dominant side). The mass-specific PT of knee extensors showed strong and negative correlation with ageing at 60 and 180 deg/s (r = -0.52-0.62, p < 0.01). The conventional ratio showed regular and positive relationship at all evaluated velocities (60°.s-1, r = 0.453, p < 0.01; 180°.s-1, r = 0.498, p < 0.01; 300°.s-1, r = 0.316, p = 0.04). The results demonstrated that volleyball players are susceptible to age-related effects on muscular performance during their career; this finding illustrates the importance of adopting training strategies to improve the production of strength in the lower limbs, which is essential for vertical jumps.

Bilateral coordination of gait at self-selected and fast speed in patients with multiple sclerosis: a case-control study.

BACKGROUND: Multiple sclerosis (MS) is characterized by progressive demyelinating deterioration of nervous tissues in the brain and cord, leading to a disruption in the ability of parts of the nervous system to transmit signals. Although dorsal column pathways are compromised in neuropathological studies, gait control assessments, especially on speed effects, have been understudied in MS. OBJECTIVE: This study aimed to compare bilateral coordination of gait in subjects with MS at self-selected and fast speed and to relate these findings to disease severity (Expanded Disability Status Scale (EDSS)) and age. METHODS: An age-matched and sex-matched case-control study was performed to assess the bilateral coordination of gait of 26 MS subjects by evaluating the gait spatiotemporal parameters captured by an inertial measurement unit sensor. The bilateral variability, accuracy, and overall coordination (the sum of variability and accuracy) were assessed at a self-selected and fast speed, and correlated with disease severity and age. RESULTS: All gait control parameters improved at the fast speed compared to the self-selected walking speed (p<0.05 for all comparisons). The bilateral coordination of gait was moderately related to disease severity and age (p<0.05), and the gait spatiotemporal parameters were related to disease severity (p<0.001, from R=0.66 to R=0.70). CONCLUSION: Patients with MS showed significant impairment in the bilateral coordination of gait at self-selected compared to fast speed. Functional mobility tests and locomotor interventions should be cautious when analyzed at different paces. Interventions aiming to increase speed can be a proper and safe strategy in locomotor studies.

Acute Effects of Caffeine on Overall Performance in Basketball Players-A Systematic Review.

Caffeine supplementation has become increasingly popular among athletes. The benefits of caffeine include delaying the negative effects of fatigue, maintaining a high level of physical and mental performance, and improving certain abilities necessary for sport success. Given the complex nature of basketball, caffeine could be a legal, ergogenic stimulant substance, which will positively affect overall basketball performance. The purpose of this systematic review was to summarize evidence for the effect of acute caffeine ingestion on variables related to the basketball performance. Web of Science, PubMed, Scopus and ProQuest, MEDLINE, and ERIC databases were searched up to February 2021. Studies that measured the acute effect of caffeine on basketball performance were included and analyzed. Eight studies published between 2000 and 2021 were included in the analysis. Pre-exercise caffeine intake increased vertical jump height, running time at 10 and 20 m without the ball, overall basketball performance (number of body impacts, number of free throws, rebounds, and assists) during simulated games, and reduced the time required to perform a basketball-specific agility test. Equivocal results between caffeine and placebo groups were found for aerobic capacity, free throw and three-point accuracy, and dribbling speed. Pre-exercise caffeine ingestion did not affect RPE, but insomnia and urinary excretion were increased. The pre-exercise ingestion of 3 and 6 mg/kg caffeine was found to be effective in increasing several physical performance variables in basketball players during sport-specific testing and simulated matches. However, considering the intermittent nature and complexity of basketball, and individual differences between players, future studies are needed.

Modelling 5-km Running Performance on Level and Hilly Terrains in Recreational Runners.

Incline and level running on treadmills have been extensively studied due to their different cardiorespiratory and biomechanical acute responses. However, there are no studies examining the performance determinants of outdoor running on hilly terrains. We aimed to investigate the influence of anthropometrics, muscle strength, and cardiorespiratory and gait spatiotemporal parameters during level (0%) and inclined (+7%) running on performance in level and hilly 5-km races. Twenty male recreational runners completed two 5-km outdoor running tests (0% vs. +7% and −7%), and two submaximal (10 km·h−1) and incremental treadmill tests at 0 and 7% slopes, after complete laboratory evaluations. The velocity at maximal oxygen consumption (VO2max) evaluated at 7% incline and level treadmill running were the best performance predictors under both hilly (R2 = 0.72; p < 0.05) and level (R2 = 0.85; p < 0.01) conditions, respectively. Inclusion of ventilatory and submaximal heart rate data improved the predictive models up to 100%. Conversely, none of the parameters evaluated in one condition contributed to the other condition. The spatiotemporal parameters and the runners' strength levels were not associated to outdoor performances. These results indicate that the vVO2max evaluated at similar slopes in the lab can be used to predict 5-km running performances on both level and hilly terrains.

Margins of stability and trunk coordination during Nordic walking.

Although it has already been demonstrated that Nordic walking has some peculiar biomechanical features with respect to walking, the effects on balance and trunk coordination are still unknown. Our aim here was to compare margins of stability, hip stabilizer muscle activation and scapular-pelvis coordination (mean and variability of continuous relative phase) between walking and two different pole walking techniques (observational design). Eleven Nordic walking instructors were asked to walk at 5.5 km·h-1 on a flat treadmill while 1) walking, 2) Nordic walking and 3) pole walking with just elbow flexion-extension motion allowed and constrained shoulder motion (elbow technique). The 3D movements of limbs and poles were measured by an optoelectronic motion capture system, and gluteus medius activation was measured through surface electromyography. Both techniques using poles show larger mediolateral margins of stability and similar anterior-posterior margins of stability in comparison with walking (p < 0.001). The larger mediolateral margin of stability using poles (conditions 2 and 3) is accompanied by greater trunk coordination stability (greater continuous relative phase variability) than walking. Although the Nordic walking (condition 2) technique results in a similar range of scapular and pelvis transverse rotation, the general pattern of scapular-pelvis coordination was temporally delayed by approximately 20% of the gait cycle in relation to other conditions (1 and 3). In conclusion, Nordic walking provides enhanced mediolateral support and coordination stability of trunk compared with walking, suggesting that it could be proposed as a safer exercise modality than walking.

Association between mental health and physical activity levels in people with Parkinson's disease during the COVID-19 pandemic: an observational cross-sectional survey in Brazil.

Aims: (1) To evaluate mental health symptoms in people with Parkinson's (PwP) in self-isolation, before and during the COVID-19 pandemic, in Brazil; (2) to explore associations between mental health and physical activity levels. Methods: An observational cross-sectional survey using retrospective data. PwP from the Brazilian territory, both sexes, no age limit, in self-isolation due to COVID-19 pandemic, were invited to complete an online self-administered and validated questionnaire. Demographic data (sex, age, Brazilian state they lived in, levels of education, and household income), days in self-isolation, time of diagnosis, and symptoms that bothered most were reported. Self-reported levels of physical activity and mental health symptoms (depression, anxiety, fear, and thoughts of death), before and during the COVID-19 pandemic, were assessed. Results: The participants were 156 individuals with PD (64 ± 11 years), from both sexes (50% women; 50% men), resident in the 5 Brazilian regions. There was a worse on mental health symptoms over the time: anxiety [effect size = - 0.52; 95% CI (- 0.70; - 0.28); p < .001], fear [effect size = - 0.58; 95% CI (- 0.76; - 0.34); p < .001], and thoughts of death [effect size = - 0.43; 95% CI (- 072;-0.02); p = .001]. A lower physical activity level during the pandemic is related to increased probability of thoughts of death [crude OR = 1.84; 95% CI (0.98; 3.46); p = 0.05; adjusted OR = 2.98; 95% CI (- 0.01; 2.19); p = 0.05]. Anxiety, fear and depression were not associated with physical activity levels. Conclusions: Anxiety, fear and thoughts of death worsened during the COVID-19 pandemic in comparison with the period before COVID-19. Lower physical activity level during the pandemic was related to an increased probability of thoughts of death. Supplementary Information: The online version contains supplementary material available at 10.1007/s11332-021-00868-y.