Aerobic capacity and mitochondrial function in bipolar disorder: a longitudinal study during acute phases and after clinical remission.

Background: Aerobic capacity has shown to predict physical and mental health-related quality of life in bipolar disorder (BD). However, the correlation between exercise respiratory capacity and mitochondrial function remains understudied. We aimed to assess longitudinally intra-individual differences in these factors during mood episodes and remission in BD. Methods: This study included eight BD patients admitted to an acute psychiatric unit. Incremental cardiopulmonary exercise test (CPET) was conducted during acute episodes (T0), followed by constant work rate cycle ergometry (CWRCE) to evaluate endurance time, oxygen uptake at peak exercise (VO2peak) and at the anaerobic threshold. The second test was repeated during remission (T1). Mitochondrial respiration rates were assessed at T0 and T1 in peripheral blood mononuclear cells. Results: Endurance time, VO2peak, and anaerobic threshold oxygen consumption showed no significant variations between T0 and T1. Basal oxygen consumption at T1 tended to inversely correlate with maximal mitochondrial respiratory capacity (r=-0.690, p=0.058), and VO2peak during exercise at T1 inversely correlated with basal and minimum mitochondrial respiration (r=-0.810, p=0.015; r=-0.786, p=0.021, respectively). Conclusions: Our preliminary data showed that lower basal oxygen consumption may be linked to greater mitochondrial respiratory capacity, and maximum oxygen uptake during the exercise task was associated with lower basal mitochondrial respiration, suggesting that lower oxygen requirements could be associated with greater mitochondrial capacity. These findings should be replicated in larger samples stratified for manic and depressive states.

Measurement protocols and determinants of peak oxygen consumption in adults with Down syndrome: a systematic review.

This systematic review aimed to provide an overview of test protocols used to measure peak oxygen uptake (VO2peak) in adults with Down syndrome (DS) and to determine how generalisable the outcomes are for the entire population of adults with DS by describing the sample characteristics of these studies and their impact on VO2peak. A literature search (PROSPERO CRD42022309560) was performed (18 July 2023) using the following databases: PubMed, CINAHL, APA PsycINFO, Web of Science, Embase and SPORTDiscus. For articles to be included, they had to be peer-reviewed pubications, reporting VO2peak or VO2max for individuals with DS separately, with a sample of n ≥ 5 and a mean age ≥18 years. Systematic reviews and meta-analyses were excluded but their reference lists were searched for additional papers to include. Studies were evaluated for risk of bias following the guidelines of Kmet et al. The results were summarised with frequency statistics. Forty-three studies were included in this systematic review. Sample sizes of included adults with DS ranged from n = 4-226, with a total of n = 1498 adults with DS being included. Most studies (29/43) used the same standardised maximal exercise treadmill protocol to measure VO2peak in adults with DS, and 33 out of 43 studies used at least one objective criterion to determine a valid maximal effort. Participants were predominantly male, under 40 years old, and overweight or obese. Additionally, the diversity of study samples was lacking or not reported. The most widely used, standardised, maximal exercise test treadmill protocol is recommended for future use in research and practice, including objective criteria to determine valid maximal effort. The current study samples are not representative of the population of adults with DS in terms of sex, age and diverse backgrounds and therefore likely overestimate VO2peak of this population.

Metabolic demands of a simulated smoke-diving drill.

The main goal of this study was to update the Finnish smoke-diving drill (FSDD) and to measure the physical strain of and recovery from the drill. Furthermore, the aim was to compare the physical strain of contract and professional firefighters and effect of floor materials. The associations between aerobic capacity and physical strain were also studied. The updates made included an added hose pull task and updating the equipment used. Heart rate (HR), oxygen consumption (V̇O2), and blood lactate concentration ([La-]) of 32 professional and 5 contract firefighters were measured before, during, and 10 and 30 min after the updated drill. The mean HR during the drill was 78% and V̇O2 59% of maximum. HR and [La-] had not recovered to baseline levels after 30-minute recovery period. Physical strain was higher among contract firefighters and [La-] accumulation on rough floor surfaces. Better aerobic capacity was associated with reduced physical strain.

The purpose of this study was to update the Finnish smoke-diving drill. This paper describes the process of updating the drill, and the experimental measurements regarding the metabolic demands of the updated drill. The updates made included adding a hose pull task and updating the equipment used during the drill.

Acute effects of MitoQ on vascular endothelial function are influenced by cardiorespiratory fitness and baseline FMD in middle-aged and older adults.

A key mechanism promoting vascular endothelial dysfunction is mitochondrial-derived reactive oxygen species (mtROS). Aerobic exercise preserves endothelial function in preclinical models by lowering mtROS. However, the effects of mtROS on endothelial function in exercising and non-exercising adults is limited. In a double-blind, randomized, placebo-controlled crossover study design 23 (10 M/13 F, age 62.1 ± 11.5 years) middle-aged and older (MA/O, ≥45 years) adults were divided into two groups: exercisers (EX, n = 11) and non-exercisers (NEX, n = 12). All participants had endothelial function (brachial artery flow-mediated dilatation, FMDBA) measured before and ∼1 h after mitoquinone mesylate (MitoQ) (single dose, 80 mg) and placebo supplementation. A two-way repeated measures ANOVA was used to determine the effects of MitoQ and placebo on FMDBA. Pearson correlations assessed the association between the change in FMDBA with MitoQ and baseline FMDBA and cardiorespiratory fitness (CRF). Compared with placebo, MitoQ increased FMDBA in NEX by + 2.1% (MitoQ pre: 4.9 ± 0.4 vs. post: 7.0 ± 0.4 %, P = 0.004, interaction) but not in EX (P = 0.695, interaction). MitoQ also increased endothelial function in adults with a FMDBA <6% (P < 0.0001, interaction) but not >6% (P = 0.855, interaction). Baseline FMDBA and CRF were correlated (r = 0.44, P = 0.037), whereas the change in FMDBA with MitoQ was inversely correlated with CRF (r = -0.66, P < 0.001) and baseline FMDBA (r = -0.73, P < 0.0001). The relationship between the change in FMDBA and baseline FMDBA remained correlated after adjusting for CRF (r = -0.55, P = 0.007). These data demonstrate that MitoQ acutely improves FMDBA in NEX and EX adults who have a baseline FMDBA <6%. KEY POINTS: A key age-related change contributing to increased cardiovascular disease (CVD) risk is vascular endothelial dysfunction due to increased mitochondrial-derived reactive oxygen species (mtROS). Aerobic exercise preserves endothelial function via suppression of mtROS in preclinical models but the evidence in humans is limited. In the present study, a single dose of the mitochondria-targeted antioxidant, mitoquinone mesylate (MitoQ), increases endothelial function in non-exercisers with lower cardiorespiratory fitness (CRF) but not in exercisers with higher CRF. The acute effects of MitoQ on endothelial function in middle-aged and older adults (MA/O) are influenced by baseline endothelial function independent of CRF. These data provide initial evidence that the acute MitoQ-enhancing effects on endothelial function in MA/O adults are influenced, in part, via CRF and baseline endothelial function.

Effects of Supplementation with Microalgae Extract from Phaeodactylum tricornutum (Mi136) to Support Benefits from a Weight Management Intervention in Overweight Women.

BACKGROUND: Microalgae like Phaeodactylum tricornutum (PT) contain the carotenoid, fucoxanthin, which has been purported to promote fat loss, lower blood lipids, and improve glucose management. This study examined whether dietary supplementation with microalgae extracts from PT containing 4.4 mg/d of fucoxanthin affects changes in body composition or health markers in overweight women during an exercise and diet intervention. MATERIALS AND METHODS: A total of 37 females (28.6 ± 7.9 years, 80.2 ± 14.9 kg, 29.6 ± 3.8 kg/m², 41.4 ± 4.2% fat) fasted for 12 h, donated a fasting blood sample, completed health and mood state inventories, and undertook body composition, health, and exercise assessments. In a counterbalanced, randomized, and double-blind manner, participants ingested a placebo (PL), or microalgae extract of Phaeodactylum tricornutum standardized to 4.4 mg of fucoxanthin (FX) for 12 weeks while participating in a supervised exercise program that included resistance-training and walking (3 days/week) with encouragement to accumulate 10,000 steps/day on remaining days of the week. The diet intervention involved reducing energy intake by about -300 kcal/d (i.e., ≈1400-1600 kcals/d, 55% carbohydrate, 30% fat, 15% protein) to promote a -500 kcal/d energy deficit with exercise. Follow-up testing was performed at 6 and 12 weeks. A general linear model (GLM) with repeated measures statistical analysis was used to analyze group responses and changes from baseline with 95% confidence intervals. RESULTS: Dietary supplementation with microalgae extract from PT containing fucoxanthin for 12 weeks did not promote additional weight loss or fat loss in overweight but otherwise healthy females initiating an exercise and diet intervention designed to promote modest weight loss. However, fucoxanthin supplementation preserved bone mass, increased bone density, and saw greater improvements in walking steps/day, resting heart rate, aerobic capacity, blood lipid profiles, adherence to diet goals, functional activity tolerance, and measures of quality of life. Consequently, there appears to be some benefit to supplementing microalgae extract from PT containing fucoxanthin during a diet and exercise program. Registered clinical trial #NCT04761406.

Aerobic Exercise Training Combined with Local Strength Exercise Restores Muscle Blood Flow and Maximal Aerobic Capacity in Long-Term Hodgkin Lymphoma Survivors.

BACKGROUND: It is unclear whether muscle blood flow (MBF) is altered in long-term Hodgkin Lymphoma (HL) survivors. We test the hypothesis that: 1) MBF response during mental stress (MS) is impaired in long-term HL survivors; 2) Aerobic exercise training combined with local strength exercise (ET) restores MBF responses during MS in these survivors. METHODS: Eighteen 5-year HL survivors and 10 aged-paired healthy subjects (HC) were studied. Twenty HL survivors were randomly divided into two groups: Exercise-trained (HLT, n=10) and untrained (HLUT, n=10). Maximal aerobic capacity was evaluated by a cardiopulmonary exercise test and forearm blood flow (FBF) by venous occlusion plethysmography. MS was elicited by Stroop Color Word Test. ET was conducted for four months, three/week for 60 minutes each session. The aerobic exercise intensity corresponded to anaerobic threshold up to 10% below the respiratory compensation point. The strength exercises consisted of 2-3 sets of chest press, pulley and squat exercises, 12-15 repetitions each exercise at 30-50% of the maximal voluntary contraction. RESULTS: Baseline was similar in HL survivors and HC, except peak oxygen consumption (peak VO2, p=0.013) and FBF (p=0.006) that were lower in the HL survivors. FBF responses during MS were lower in HL survivors (p<0.001). ET increased peak VO2 (11.59±3.07%, p=0.002), and FBF at rest (33.74±5.13%, p<0.001) and during MS (24±5.31%, p=0.001). Further analysis showed correlation between the changes in peak VO2 and the changes in FBF during MS (r=0.711, p=0.001). CONCLUSION: Long-term HL survivors have impaired MBF responses during MS. ET restores MBF responses during MS.

Lean body mass and the cardiorespiratory phenotype: An ethnic-specific relationship in Hans Chinese women and men.

BACKGROUND: Lean body mass (LBM) and the functional capacity of cardiovascular (CV) and respiratory systems constitute a female-specific relationship in European-American individuals. Whether this recent finding be extrapolated to the world's largest ethnic group, that is, Hans Chinese (HC, a population characterized by low LBM), is unknown. METHODS: Healthy HC adults (n = 144, 50% ♀) closely matched by sex, age and physical activity were included. Total and regional (leg, arm and trunk) LBM and body composition were measured via dual-energy X-ray absorptiometry. Cardiac structure, stiffness, central/peripheral haemodynamics and peak O2 consumption (VO2peak) were assessed via transthoracic echocardiography and pulmonary gas analyses at rest and during exercise up to peak effort. Regression analyses determined the sex-specific relationship of LBM with cardiac and aerobic phenotypes. RESULTS: Total and regional LBM were lower and body fat percentage higher in women compared with men (P < 0.001). In both sexes, total LBM positively associated with left ventricular (LV) mass and peak volumes (r ≥ 0.33, P ≤ 0.005) and negatively with LV end-systolic and central arterial stiffness (r ≥ -0.34, P ≤ 0.004). Total LBM strongly associated with VO2peak (r ≥ 0.60, P < 0.001) and peak cardiac output (r ≥ 0.40, P < 0.001) in women and men. Among regional LBM, leg LBM prominently associated with the arterio-venous O2 difference at peak exercise in both sexes (r ≥ 0.43, P < 0.001). Adjustment by adiposity or CV risk factors did not modify the results. CONCLUSIONS: LBM independently determines internal cardiac dimensions, ventricular mass, distensibility and the capacity to deliver and consume O2 in HC adults irrespective of sex.

Physical Fitness in Children With Developmental Coordination Disorder: A Systematic Review.

OBJECTIVE: To synthesize evidence about physical fitness levels in children with developmental coordination disorder (DCD) compared with typically developing (TD) children. METHODS: We searched four databases (PubMed, Scopus, Web of Science, and PsycINFO) for cross-sectional, case-control, and cohort studies comparing physical fitness between children with and without DCD. We assessed the methodological quality of the studies with the Newcastle-Ottawa Scale (NOS). We calculated Cohen's d effect sizes to provide clinical evidence of group differences in aerobic capacity, anaerobic capacity, muscle strength, body composition and flexibility. RESULTS: We included 32 studies for qualitative synthesis after applying eligibility criteria. All selected studies ranged from moderate to high research quality. Effect sizes in favor of typically developing children over children with DCD were large for aerobic capacity (d = 1.15), anaerobic capacity (d = 0.90), and muscle strength (d = 0.79), and small for body composition (d = 0.43) and flexibility (d = 0.21) outcomes. CONCLUSION: Children with DCD presented significantly lower physical fitness than their typically developing peers, particularly in aerobic and anaerobic capacity and in muscle strength.

Thalamic nuclei volume partially mediates the effects of aerobic capacity on fatigue in people with multiple sclerosis.

BACKGROUND: Fatigue is frequent in people with multiple sclerosis (pwMS) impacting physical and cognitive functions. Lower aerobic capacity and regional thalamic volume may be involved in the pathophysiology of fatigue in pwMS. OBJECTIVES: To identify associations between thalamic nuclei volumes, aerobic capacity and fatigue and to investigate whether the influence of aerobic capacity on fatigue in pwMS is mediated by thalamic integrity. METHODS: Eighty-three pwMS underwent a clinical evaluation with assessment of fatigue (Modified Fatigue Impact Scale [MFIS]), including physical (pMFIS) and cognitive (cMFIS) components, and peak of oxygen uptake (VO2peak). PwMS and 63 sex- and age-matched healthy controls (HC) underwent a 3 T brain MRI to quantify volume of the whole thalamus and its nuclei. RESULTS: Compared to HC, pwMS showed higher global MFIS, pMFIS and cMFIS scores, and lower VO2peak and thalamic volumes (p < 0.001). In pwMS, higher VO2peak was significantly associated with lower MFIS and pMFIS scores (r value = - 0.326 and - 0.356; pFDR ≤ 0.046) and higher laterodorsal thalamic nucleus (Dor) cluster volume (r value = 0.300; pFDR = 0.047). Moreover, lower Dor thalamic cluster volume was significantly associated with higher MFIS, pMFIS and cMFIS scores (r value range = - 0.305; - 0.293; pFDR ≤ 0.049). The volume of Dor thalamic cluster partially mediated the positive effects of VO2peak on both MFIS and cMFIS, with relative indirect effects of 21% and 32% respectively. No mediation was found for pMFIS. CONCLUSIONS: Higher VO2peak is associated with lower fatigue in pwMS, likely acting on Dor thalamic cluster volume integrity. Such an effect might be different according to the type of fatigue (cognitive or physical).

Effects of Multicomponent Home-Based Intervention on Muscle Composition, Fitness, and Bone Density After Hip Fracture.

BACKGROUND: Mechanistic factors on the pathway to improving independent ambulatory ability among hip fracture patients by a multicomponent home-based physical therapy intervention that emphasized aerobic, strength, balance, and functional training are unknown. The aim of this study was to determine the effects of 2 different home-based physical therapy programs on muscle area and attenuation (reflects muscle density) of the lower extremities, bone mineral density (BMD), and aerobic capacity. METHODS: Randomized controlled trial of home-based 16 weeks of strength, endurance, balance, and function exercises (PUSH, n = 19) compared to seated active range-of-motion exercises and transcutaneous electrical neurostimulation (PULSE, n = 18) in community-dwelling adults >60 years of age within 26 weeks of hip fracture. RESULTS: In PUSH and PULSE groups combined, the fractured leg had lower muscle area and muscle attenuation and higher subcutaneous fat than the nonfractured leg (p < .001) at baseline. At 16 weeks, mean muscle area of the fractured leg was higher in the PUSH than PULSE group (p = .04). Changes in muscle area were not significantly different when compared to the comparative PULSE group. There was a clinically relevant difference in change in femoral neck BMD between groups (p = .05) that showed an increase after PULSE and decrease after PUSH. There were generally no between-group differences in mean VO2peak tests at 16-week follow-up, except the PUSH group reached a higher max incline (p = .04). CONCLUSIONS: The treatment effects of a multicomponent home-based physical therapy intervention on muscle composition, BMD, and aerobic capacity were not significantly different than an active control intervention in older adults recovering from hip fracture. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01783704.

The influence of cardiorespiratory fitness level on the relationship between work rates at the aerobic threshold (AerT) and the point of maximal fat oxidation (Fatmax) in untrained adults.

Introduction: In this study, we investigated the impact of cardiorespiratory fitness (CRF), quantified as peak oxygen consumption (VO2peak), on the relationship between work rates (WR) at the aerobic threshold (AerT) and the point of maximal fat oxidation rate (Fatmax). Methods: A total of 761 untrained adults aged 41-68 completed a one-minute incremental exercise test on a cycle ergometer, using breath-by-breath gas analysis to determine VO2peak, AerT, and Fatmax. AerT was determined using automatic and visual detection methods, and Fatmax was determined using indirect calorimetry. Participants were categorized into CRF-groups: low (<25th percentile), medium (≥25th percentile and <75th percentile), and high (≥75th percentile). Results: Fatmax was found at 43 ± 7% WRpeak, 37% ± 6% WRpeak and 35% ± 7% WRpeak in the low, medium, and high CRF-groups, respectively. In contrast, AerT was located at significantly higher relative work rates: 51% ± 8% WRpeak, 47% ± 10% WRpeak, and 47% ± 11% WRpeak in the respective CRF-groups. There was a weak agreement between Fatmax and AerT [intraclass correlation coefficient (ICC) = .19, p < .001], and the ICC decreased from .35 to .12 to .13, while the mean bias ±95% limits of agreement increased from 8% ± 14% WRpeak to 8% ± 19% WRpeak to 12% ± 44% WRpeak from CRF-low to CRF-medium to CRF-high. The mean difference between Fatmax and AerT was significantly different among the CRF subgroups: 8% ± 7% WRpeak vs. 10% ± 10% WRpeak vs. 12% ± 11% WRpeak in low, medium, and high CRF-groups, respectively. Nonetheless, multiple regression analysis revealed only a weak positive correlation between the difference in relative work rates (% WRpeak) between Fatmax and AerT (dependent variable) and the predictor variables CRF and sex, both identified as significant (R = .19, p < .001). Conclusion: Our study confirms substantial differences in exercise intensities between Fatmax and AerT in untrained adults (10% ± 19% WRpeak, ranging from -14% to 53% WRpeak). Importantly, this difference remains relatively consistent across varying CRF levels, emphasizing the distinct nature of Fatmax and AerT, with CRF playing a limited role in influencing their relationship in our study's untrained adults.

Gender and Body Mass Index Difference in Aerobic Capacity: A Study in Moroccan High School Students.

Different tests are used to evaluate the aerobic capacity of a person. This study aims to investigate the gender and Body Mass Index (BMI) difference in aerobic capacity measured by using shuttle and Spartacus test. The study was conducted on 230 high school students (135 girls and 95 boys) followed their study in public establishment in kenitra city (Morocco). All participants were classified according to their gender (male vs. female) and their BMI (normal weight vs. overweight-obese) and performed the both test of shuttle and Spartacus. Running speed at the last completed stage, run time, maximum heart rate (max HR) max HR and perceived exertion were measured and analyzed. For each test, VO2max was estimated by using the proposed equation. There was significant BMI difference in the measured parameters (p<0.001). Difference in VO2max between male and female remained significant with high-speed level in boys. A significant difference between males and females (p < 0.001) was observed in shuttle test. Participants with normal weight or physical activity had good aerobic capacity. Compared to the Shuttle test, the Spartacus provides a 11.5% higher final speed (11.2 vs. 9.7km/h) and a total test time 2.3 times longer (11.3vs. 4.9 min) (p < 0.001). Our study underlines the interest of the Spartacus test and is preliminary. Indeed, these results must now be replicated in a larger sample of obese adolescents.

Effect of repeated prolonged exercise on liver fat content and visceral adipose tissue in well-trained older men.

INTRODUCTION: Liver fat (LF) and visceral adipose tissue (VAT) content decreases with training, however, this has mainly been investigated in sedentary obese or healthy participants. The aim of this study was to investigate the effects of repeated prolonged exercise on LF and VAT content in well-trained older men and to compare baseline LF and VAT content to recreationally active older men. METHOD: A group of five well-trained older men were tested before and after cycling a total distance of 2558 km in 16 consecutive days. VAT content and body composition was measured using DXA before a bicycle ergometer test was performed to determine maximal fat oxidation (MFO), maximal oxygen consumption ( VO 2 max $$ {\mathrm{VO}}_{2_{\mathrm{max}}} $$ ), and the relative intensity at which MFO occurred (Fatmax). LF content was measured on a separate day using MRI. For comparison of baseline values, a control group of eight healthy age- and BMI-matched recreationally active men were recruited. RESULTS: The well-trained older men had lower VAT (p = 0.02), and a tendency toward lower LF content (p = 0.06) compared with the control group. The intervention resulted in decreased LF content (p = 0.02), but VAT, fat mass, and lean mass remained unchanged. VO 2 max $$ {\mathrm{VO}}_{2_{\mathrm{max}}} $$ , MFO, and Fatmax were not affected by the intervention. CONCLUSION: The study found that repeated prolonged exercise reduced LF content, but VAT and VO 2 max $$ {\mathrm{VO}}_{2_{\mathrm{max}}} $$ remained unchanged. Aerobic capacity was aligned with lower LF and VAT in older active men.

Metabolic adjustments to winter severity in two geographically separated great tit (Parus major) populations.

Understanding the potential limits placed on organisms by their ecophysiology is crucial for predicting their responses to varying environmental conditions. A main hypothesis for explaining avian thermoregulatory mechanisms is the aerobic capacity model, which posits a positive correlation between basal (basal metabolic rate [BMR]) and summit (Msum) metabolism. Most evidence for this hypothesis, however, comes from interspecific comparisons, and the ecophysiological underpinnings of avian thermoregulatory capacities hence remain controversial. Indeed, studies have traditionally relied on between-species comparisons, although, recently, there has been a growing recognition of the importance of intraspecific variation in ecophysiological responses. Therefore, here, we focused on great tits (Parus major), measuring BMR and Msum during winter in two populations from two different climates: maritime-temperate (Gontrode, Belgium) and continental (Zvenigorod, Russia). We tested for the presence of intraspecific geographical variation in metabolic rates and assessed the predictions following the aerobic capacity model. We found that birds from the maritime-temperate climate (Gontrode) showed higher BMR, whereas conversely, great tits from Zvenigorod showed higher levels of Msum. Within each population, our data did not fully support the aerobic capacity model's predictions. We argued that the decoupling of BMR and Msum observed may be caused by different selective forces acting on these metabolic rates, with birds from the continental-climate Zvenigorod population facing the need to conserve energy for surviving long winter nights (by keeping their BMR at low levels) while simultaneously being able to generate more heat (i.e., a high Msum) to withstand cold spells.

Non-Immersive Virtual Reality-Based Therapy Applied in Cardiac Rehabilitation: A Systematic Review with Meta-Analysis.

BACKGROUND: The aim of this systematic review with meta-analysis was to assess the effectiveness of non-immersive virtual reality (niVR) active videogames in patients who underwent cardiac rehabilitation (CR). METHODS: A systematic review with meta-analysis, according to the PRISMA guidelines and previously registered in PROSPERO (CRD42023485240), was performed through a literature search in PubMed (Medline), SCOPUS, WOS, and PEDro since inception to 21 November 2023. We included randomized controlled trials (RCTs) that assessed the effectiveness of an niVR intervention, in comparison with conventional CR and usual care, on aerobic capacity and cardiovascular endurance (physical function), anxiety, depression, and quality of life (QoL). The risk of bias in individual studies was assessed using the Cochrane risk of bias tool. Effect size was estimated using Cohen's standardized mean difference (SMD) and its 95% confidence interval (95% CI) in a random-effects model. RESULTS: Nine RCT that met the inclusion criteria were included in the meta-analysis. The meta-analysis showed a moderate-to-large effect favoring niVR active videogames included in CR in increasing aerobic capacity and cardiovascular endurance (SMD = 0.74; 95% CI 0.11 to 1.37; p = 0.021) and reducing anxiety (SMD = -0.66; 95% CI -1.13 to -0.2; p = 0.006). Only 4.8% of patients reported adverse events while performing niVR active videogames. CONCLUSIONS: Inclusion of niVR active videogames in CR programs is more effective than conventional CR in improving aerobic capacity and cardiovascular endurance and in reducing anxiety.

Exercise training response according to baseline ferrokinetics in heart failure with preserved ejection fraction: A substudy of the TRAINING-HF trial.

BACKGROUND: Iron deficiency (ID) is associated with impaired functional capacity in patients with heart failure (HF), even in those with preserved ejection fraction (HFpEF). This study aimed to evaluate the effect of baseline ferrokinetics on peak oxygen consumption (peakVO2) improvement after a 12-week physical therapy programme in patients with stable HFpEF. METHODS: This study is a post-hoc sub-analysis of a randomized clinical trial in which 59 stable patients with HFpEF were randomized to receive a 12-week programme of inspiratory muscle training (IMT), functional electrical stimulation (FES), IMT + FES or usual care (UC) to evaluate change in peakVO2 (NCT02638961). Serum ferritin and transferrin saturation (TSAT) determinations were assessed at baseline. ID was defined as ferritin <100 ng/mL and/or TSAT <20% if ferritin was within 100-299 ng/mL. We used a linear mixed regression model to analyse between-treatment changes in peakVO2 across ferrokinetics status at 12 and 24 weeks. RESULTS: The mean age was 74 ± 9 years, and 36 (61%) had ID. The mean of peakVO2 was 9.9 ± 2.5 mL/kg/min. The median of ferritin and transferrin saturation (TSAT) was 91 (50-181) ng/mL and 23% (16-30), respectively. A total of 52 patients completed the trial (13 patients per arm). Compared with those patients on UC, patients allocated to any of the active arms showed less improvement in peak VO2 when they showed ID (P-value for interaction <0.001), lower values of ferritin (P-value for interaction <0.001), or TSAT (P-value for interaction <0.001). CONCLUSIONS: Ferrokinetics status plays an essential role in modifying the aerobic capacity response to physical therapies in patients with HFpEF. Further studies are required to confirm these findings.

Effects of Age and Playing Position on Field-Based Physical Fitness Measures in Adolescent Female Netball Players.

This cross-sectional study investigated the impact of age and playing position, controlling for maturity, on physical fitness indicators in 303 adolescent female netball players aged 12.0 to 15.9 years. Assessments included estimated maximal oxygen uptake (VO2max) via the 20 m shuttle run test, 10 m and 20 m sprints, change of direction speed (CODS) using the 505 test, and muscle power via the medicine ball chest throw (MBCT) and countermovement vertical jump (CMJ). Participants were grouped by age (12 to 15 years) and playing position (non-circle and circle players), with age at peak height velocity as a covariate for maturity. Results revealed that, at 15 years, CMJ height was greater than at 12 years and 13 years (p < 0.05, partial η2 = 0.048). MBCT distance increased across age groups (p < 0.01, partial η2 = 0.323). Age had no impact on sprints, VO2max, or CODS. Non-circle players outperformed circle players in the 10 m sprint (p = 0.042, partial η2 = 0.016) and 20 m sprints (p = 0.010, partial η2 = 0.025) and displayed higher VO2max (p < 0.001, partial η2 = 0.036). Circle players were taller (p = 0.046, partial η2 = 0.014) and heavier (p < 0.001, partial η2 = 0.040) than non-circle players. Playing positions showed no differences in CMJ and MBCT. In adolescent female netball players, only muscle power is influenced by age, while non-circle players exhibit superior aerobic fitness and speed compared to circle players. Coaches may be able to utilize the distinct age and playing position traits of adolescent netballers to inform player selection and design targeted training programs.

Do players with superior physiological attributes outwork their less-conditioned counterparts? A study in Gaelic football.

This study investigated the association of physiological attributes with in-game workload measures during competitive Gaelic football match-play. Fifty-two male developmental level Gaelic football players (mean ± SD; age: 22.9 ± 3.8 years) underwent measurements of anthropometric characteristics, running speed, muscular strength and power, blood lactate (BLa), running economy and aerobic capacity during two separate testing visits. Global Positioning System units (18-Hz) were used to record players in-game workloads during a competitive match 1-week following the baseline physiological assessments. Results indicated that players body fat percentage, drop jump height (DJ) and running velocity at 4 mmol · L-1 BLa were significantly associated with the number of high-speed runs completed (Adjusted R2 26.8% to 39.5%; p < 0.05) while 20 m running speed, running velocity at 2 mmol · L-1 BLa and DJ were significantly associated with the number of accelerations completed (Adjusted R2 17.2% to 22.0%; p < 0.05) during match-play. Additionally, aerobic capacity and body fat percentage were significantly associated with total distance (Adjusted R2 14.4% to 22.4%; p < 0.05) while body fat percentage, DJ and 20 m running speed were significantly associated with high-speed distance (Adjusted R2 17.8% to 22.0%; p < 0.05). Players were also divided into higher-standard and lower-standard groups using a median split of these physiological attributes. Players in the higher-standard groups completed significantly more high-speed runs and accelerations and covered significantly larger total and high-speed distances (+10.4% to +36.8%; ES = 0.67 to 0.88; p < 0.05) when compared to the lower-standard groups. This study demonstrates that superior levels of physical conditioning are associated with larger in-game workloads during Gaelic football match-play.

Climbing the Ranks: A Study of Firefighter Health Disparities.

The fire service command structure encompasses recruit, incumbent firefighter, and officer positions. The purpose of this study was to quantify the effect of rank (recruits, incumbent firefighters, and officers) on health and physical ability characteristics within the fire service. Retrospective data from thirty-seven recruits (age = 29 ± 5 yrs, BMI = 26.5 ± 2.3 kg/m2); eighty-two incumbent firefighters (age = 30 ± 7 yrs, BMI = 28.8 ± 4.3 kg/m2); and forty-one officers (age = 41 ± 6 yrs, BMI = 28.6 ± 4.3 kg/m2) from a single department were used. Participants completed body composition tests (i.e., body fat percentage [%BF] and body mass index [BMI]), an air consumption test (ACT), and cardiopulmonary exercise testing. The ACT consisted of 10 standardized tasks. Five separate one-way analyses of co-variance (ANCOVA) were calculated, accounting for age. Partial eta squared statistics were calculated and Bonferroni-corrected post-hoc analyses were employed. The results demonstrated a significant effect of rank on %BF (F = 9.61, p < 0.001, η2 = 0.10); BMI (F = 3.45, p = 0.02, η2 = 0.05); relative VO2MAX (F = 12.52, p < 0.001; η2 = 0.11); and HRMAX (F = 18.89, p < 0.001, η2 = 0.03), but not on ACT time (F = 0.71, p = 0.55, η2 = 0.01). These outcomes suggest there are variations in anthropometric and physiological metrics of health across firefighter ranks. Administrators should be aware how these markers of health may vary across firefighter ranks.