The Development of a Multi-Modal Cancer Rehabilitation (Including Prehabilitation) Service in Sheffield, UK: Designing the Active Together Service.

Cancer patients undergoing major interventions face numerous challenges, including the adverse effects of cancer and the side effects of treatment. Cancer rehabilitation is vital in ensuring cancer patients have the support they need to maximise treatment outcomes and minimise treatment-related side effects and symptoms. The Active Together service is a multi-modal rehabilitation service designed to address critical support gaps for cancer patients. The service is located and provided in Sheffield, UK, an area with higher cancer incidence and mortality rates than the national average. The service aligns with local and regional cancer care objectives and aims to improve the clinical and quality-of-life outcomes of cancer patients by using lifestyle behaviour-change techniques to address their physical, nutritional, and psychological needs. This paper describes the design and initial implementation of the Active Together service, highlighting its potential to support and benefit cancer patients.

Physically active primary care physicians consult more on physical activity and exercise for patients: A public teaching-hospital study.

Physical activity and exercise (PAE) improve quality of life and reduce the effects of chronic diseases. Primary care physicians (PCPs) play an important role to encourage PAE in patients. We aim to assess PCPs' current PAE consultation practices and their enablers/barriers in daily clinical practice. We had 64 PCPs (age [35.3 â€‹± â€‹4.7] y, 47 women) that completed self-administered questionnaires on PAE consultation practices, training, and confidence levels. PCPs (n â€‹= â€‹42) also completed the International Physical Activity Questionnaire-Short Form to assess their physical activity (PA) levels. We conducted correlation, one-way analysis of variance and a linear regression to assess the associations between enablers, barriers and PA levels to PAE consultation practices. On average, PCPs consulted on PAE in 49.7% of their daily clinical appointments. Majority of PCPs (70%) strongly agreed that more PAE knowledge were needed to increase consultation practices. Top three barriers related (p â€‹< â€‹0.001) to practices were lack of PAE education (r â€‹= â€‹0.47), patients' preference of pharmaceutical interventions (r â€‹= â€‹0.45) and lack of continuing education in PAE for PCPs (r â€‹= â€‹0.37). Physically active PCPs (health-enhancing PA levels, n â€‹= â€‹6) gave significantly more daily consultations in PAE, 73.2% â€‹± â€‹21.9%, compared to inactive PCPs (n â€‹= â€‹13), 37.4% â€‹± â€‹22.8% (p â€‹= â€‹0.013). In our regression output, PCPs who had higher PA levels consulted more on PAE daily (R2 â€‹= â€‹0.38, p â€‹< â€‹0.001) while controlling for age. Conclusion, PCPs require more knowledge on PAE and need be physically active themselves to increase PAE consultation for patients in their daily practice. Medical education should consider including more PA and exercise topics that may benefit both physicians and their patients.

Effects of Exercise Training Response on Quality of Life and Cardiovascular Risk Factor Profiles in People With Coronary Artery Disease: Insights From the HIIT or MISS UK Trial.

OBJECTIVE: To compare the characteristics of responders and nonresponders to 8 weeks of exercise training to determine differences in key cardiovascular disease outcomes in people with coronary artery disease (CAD). DESIGN: Secondary analysis of data from the HIIT or MISS UK trial. SETTING: Six outpatient National Health Service cardiac rehabilitation (CR) centers in the UK. In people with CAD attending CR, the HIIT or MISS UK trial reported that short-term, low-volume, high-intensity interval training (HIIT) was more effective than moderate-intensity steady state (MISS) exercise training for improving peak oxygen uptake (V̇o2peak). PARTICIPANTS: 382 participants with CAD (N=382) (mean age: 58.8±9.6y; mean body mass index: 29.0±4.3 kg/m2). MAIN OUTCOME MEASURES: We identified responders and nonresponders based on a meaningful change in V̇o2peak, using 2 established methods. Key clinical, quality of life (QoL), and cardiopulmonary exercise test (CPET)-derived outcomes were compared between groups. RESULTS: Responders were more likely to be younger (P<.05), and demonstrate greater improvement in CPET-related outcomes, for example, oxygen uptake efficiency slope, ventilatory efficiency, and peak power output (all comparisons, P<.001). Responders were more likely to observe improvements in QoL (EQ-5D-5L; mean Δ 13.6 vs mean Δ 9.4; P=.045), and high-density lipoprotein cholesterol (HDL-c) (mean Δ 0.09 mmol/L vs mean Δ 0.04 mmol/L; P=.004), compared to nonresponders. CONCLUSIONS: In people with CAD attending CR, responders to exercise training were more likely to be younger and demonstrate greater improvements in health-related QoL and HDL-c.

Safety and efficacy evaluation of personalized exercise prescription during chemotherapy for lung cancer patients.

BACKGROUND: To explore the safety and effectiveness of personalized exercise intervention during chemotherapy for lung cancer patients who were relatively weak and with compromised cardiopulmonary function. METHODS: Thirty-eight lung cancer patients treated with chemotherapy at Peking University Third Hospital were enrolled in this prospective study. The exercise group (N = 21) received individualized exercise guidance based on personal test results and exercised regularly, while the control group (N = 17) only received exercise education and planed exercise methods according to their own preferences. Both groups underwent three fitness tests and clinical indicator assessments at 0, 6, and 12 weeks after starting the exercise, and the differences in trends of various indicators between the two groups were compared. RESULTS: No exercise-related adverse events occurred during the 12-week exercise period. After 12 weeks of exercise training, in terms of fitness, the exercise group showed significant improvements in 6-min walk test (6MWT) (p < 0.001), peak oxygen consumption (VO2peak) (p = 0.005), muscle content (p < 0.001), muscle percentage (p < 0.001), and grip strength (p = 0.008) compared to the control group. In terms of clinical indicators, the exercise group showed significant improvements in vital capacity (p = 0.018), D-dimer (p = 0.031), and C-reactive protein (CRP) (p = 0.01), uric acid (p = 0.003), triglycerides (p < 0.001), functional average score (p < 0.001), and main symptom average score (p = 0.004) compared to the control group in trends over time. CONCLUSION: Rehabilitation exercises using individualized exercise prescriptions tailored by exercise prescription specialists during chemotherapy are safe for lung cancer patients. Adhering to exercise can achieve comprehensive improvements in physical fitness and quality of life at 12 weeks.

Artificial intelligence in sport: Exploring the potential of using ChatGPT in resistance training prescription.

OpenAI's Chat Generative Pre-trained Transformer (ChatGPT) technology enables conversational interactions with applications across various fields, including sport. Here, ChatGPT's proficiency in designing a 12-week resistance training programme, following specific prompts, was investigated. GPT3.5 and GPT4.0 versions were requested to design 12-week resistance training programmes for male and female hypothetical subjects (20-years-old, no injury, and 'intermediate' resistance training experience). Subsequently, GPT4.0 was requested to design an 'advanced' training programme for the same profiles. The proposed training programmes were compared with established guidelines and literature (e.g., National Strength and Conditioning Association textbook), and discussed. ChatGPT suggested 12-week training programmes comprising three, 4-week phases, each with different objectives (e.g., hypertrophy/strength). GPT3.5 proposed a weekly frequency of ~3 sessions, load intensity of 70-85% of one repetition-maximum, repetition range of 4-8 (2-4 sets), and tempo of 2/0/2 (eccentric/pause/concentric/'pause'). GPT4.0 proposed intermediate- and advanced programme, with a frequency of 5 or 4 sessions, 60-90% or 70-95% intensity, 3-5 sets or 3-6 sets, 5-12 or 3-12 repetitions, respectively. GPT3.5 proposed rest intervals of 90-120 s, and exercise tempo of 2/0/2. GPT4.0 proposed 60-180 (intermediate) or 60-300 s (advanced), with exercise tempo of 2/1/2 for intermediates, and 3/0/1/0, 2/0/1/0, and 1/0/1/0 for advanced programmes. All derived programmes were objectively similar regardless of sex. ChatGPT generated training programmes which likely require additional fine-tuning before application. GPT4.0 synthesised more information than GPT3.5 in response to the prompt, and demonstrated recognition awareness of training experience (intermediate vs advanced). ChatGPT may serve as a complementary tool for writing 'draft' programme, but likely requires human expertise to maximise training programme effectiveness.

The Barriers to Shared Decision-making in Exercise Prescription for Children With Asthma: A Qualitative Study From Parents' Perspective.

INTRODUCTION: The knowledge of barriers from the parental perspective is essential for facilitating shared decision-making in the field of pediatric asthma. METHOD: Participants who were parents of children with a diagnosis of asthma were recruited, and in-depth, semistructured interviews were conducted. The interview transcripts were analyzed thematically using framework methods. RESULTS: Seventeen participants undertook interviews. Three themes and nine subthemes emerged: (1) decision-making need level-limited understanding of decision-making knowledge, ambiguity regarding self-empowerment roles, and lack of family member support; (2) decision-making support level-insufficient ability to evaluate information, inefficient communication with health care professionals, and excessive use of professional terminology; and (3) decision-making outcome level-doubts about the final decision-making choices, time constraints on decision-making, and absence of mechanisms to track decisions made. DISCUSSION: The findings would serve as crucial foundations for the development of decision-aid programs within the context of pediatric asthma.

Physical activity and recovery following concussion in collegiate athletes: a LIMBIC MATARS Consortium Investigation.

OBJECTIVE: To investigate whether routine daily activities (RDA), non-prescribed exercise (Non-ERx), or prescribed exercise (ERx) were associated with recovery from sport-related concussion (SRC) in collegiate athletes. MATERIALS AND METHODS: Data for this cross-sectional, retrospective chart review of collegiate athletes diagnosed with SRC (n = 285[39.6% female], age = 19.5 ± 1.4 years) were collected during the 2015-16 to 2019-20 athletic seasons. The independent variable was group (RDA, Non-ERx, ERx). Dependent variables included days from date of diagnosis to symptom resolution (Dx-SR) and SR to return to sport (SR-RTS). RESULTS: Those in the Non-ERx group took nearly 1.3 times longer to achieve SR (IRR = 1.28, 95% CI: 1.11, 1.46) and, 1.8 times longer for RTS (IRR = 1.82, 95% CI: 1.11, 2.71) when compared to those in the RDA group. No other comparisons were significant. CONCLUSION: Collegiate athletes in the Non-ERx group took approximately 1 week longer to achieve SR as compared to the RDA and ERx groups. Our findings suggest that if exercise is recommended following SRC, it must be clearly and specifically prescribed. If exercise parameters cannot be prescribed, or monitored, RDA appear to be similarly beneficial during recovery for collegiate athletes with concussion.

Modeling the repetitions-in-reserve-velocity relationship: a valid method for resistance training monitoring and prescription, and fatigue management.

Establishing a relationship between repetitions left in reserve and the mean absolute velocity (RIR-velocity relationship) during resistance training (RT) could allow for objective monitoring, prescription, and real-time adjustment of the training load and set-volume. Therefore, we examined the goodness of fit and prediction accuracy of general and individual RIR-velocity relationships in the free-weight back squat exercise. The effects of sex, training status and history, as well as personality traits, on the goodness of fit and the accuracy of these relationships were also investigated. Forty-six resistance-trained people (15 females and 31 males) performed a one-repetition maximum (1RM) test, and two repetitions to failure (RTF) tests 72 h apart. We found greater goodness of fit of individual RIR-velocity relationships compared to general RIR-velocity relationships. Individual, but not general RIR-velocity relationships established in the first testing session yielded acceptable prediction accuracy of RIR (mean error <2 repetitions) in the subsequent testing session, regardless of the load used. Similar results were obtained when both general and individual RIR-velocity relationships were averaged across the loads, suggesting that a single RIR-velocity relationship covering a range of loads can be used instead of traditional RT methods, potentially allowing for better fatigue management and more efficient adaptation.

An Investigation of the Sled-Push Exercise Using a Resisted Sled Machine in Apparently Healthy Older Adults: An Exploratory Study.

Physical function is regarded as the cornerstone of healthy aging, and exercise is an important determinant of healthy aging. This study examined the feasibility and physiological (heart rate, blood pressure, blood lactate, and rate of perceived exertion) and psychological (enjoyment) response resulting from an acute progressive sled-push (SLP) exercise session using the novel XPO Sled Trainer in older adults and compared that with walking (WKC) condition. The exercise session comprised six exercise bouts at 75%, 85%, 100% (2×), and 125% (2×) of normal velocity with a 2-min rest between bouts. Thirty-six older adults were randomly allocated into either the SLP or WKC conditions. No adverse events were observed during the exercise session, and all participants completed the exercise protocol as prescribed. One-third of the participants in the SLP group reported minimal body discomfort. Significantly higher responses were observed for all physiological variables as the intensity of the exercise increased in the SLP group compared with the WKC group (p < .001). The SLP group presented a decline in enjoyment as the intensity of the exercise increased (during), but similar enjoyment level than the WKC group for the overall exercise session (p = .711). Our findings support the viability and safety of SLP exercise using the XPO Sled Trainer in older adults. Such exercise demonstrated an intensity-driven modality that may have potential to elucidate positive adaptations in the cardiovascular system of older adults with acceptable levels of enjoyment.

Exercise Prescription Practices Among Mental Health Professionals on College Campuses: Testing the Information-Motivation-Behavioral Skills Model.

BACKGROUND: The co-occurrence of physical inactivity and poor mental health in the college student population can lead to chronic health issues that have negative short-term effects (e.g., academic success). Poor mental health is associated with long-term conditions (e.g., obesity, serious mental illness) that are linked to premature mortality. The purpose of this study was to examine the information-motivation-behavioral (IMB) skills model and evaluate its ability to explain the variance in the use of exercise prescription in mental health treatment. METHOD: Mental health professionals (MHPs) (n = 255) were recruited from college counseling centers in the USA. Structural equation modeling was used to examine the relationship between the predictor variables of information (exercise knowledge and benefits of exercise), motivation (personal beliefs, perceived barriers, and organizational support), and behavioral skills (self-efficacy), and the outcome variable of exercise prescription (i.e., brief counseling and referral for exercise). RESULTS: The predictors accounted for 23% of the variance in exercise prescription (p = .001). Organizational support had a significant direct effect on exercise prescription (ß = 0.27, p = .05). Personal beliefs (ß = 0.96, p = .05) and organizational support (ß = 0.31, p = .04) had significant direct effects on self-efficacy for prescribing exercise. MHP personal exercise behavior was associated with exercise prescription. CONCLUSION: MHPs may be willing to support physical activity promotion and exercise prescription, but organizational structures are critical to enhance and sustain the delivery of this adjunctive therapy. The personal exercise history of MHPs may be an important consideration for behavior change interventions. The development and validation of scales are important considerations for future intervention study design.

Comprehensiveness, Accuracy, and Readability of Exercise Recommendations Provided by an AI-Based Chatbot: Mixed Methods Study.

BACKGROUND: Regular physical activity is critical for health and disease prevention. Yet, health care providers and patients face barriers to implement evidence-based lifestyle recommendations. The potential to augment care with the increased availability of artificial intelligence (AI) technologies is limitless; however, the suitability of AI-generated exercise recommendations has yet to be explored. OBJECTIVE: The purpose of this study was to assess the comprehensiveness, accuracy, and readability of individualized exercise recommendations generated by a novel AI chatbot. METHODS: A coding scheme was developed to score AI-generated exercise recommendations across ten categories informed by gold-standard exercise recommendations, including (1) health condition-specific benefits of exercise, (2) exercise preparticipation health screening, (3) frequency, (4) intensity, (5) time, (6) type, (7) volume, (8) progression, (9) special considerations, and (10) references to the primary literature. The AI chatbot was prompted to provide individualized exercise recommendations for 26 clinical populations using an open-source application programming interface. Two independent reviewers coded AI-generated content for each category and calculated comprehensiveness (%) and factual accuracy (%) on a scale of 0%-100%. Readability was assessed using the Flesch-Kincaid formula. Qualitative analysis identified and categorized themes from AI-generated output. RESULTS: AI-generated exercise recommendations were 41.2% (107/260) comprehensive and 90.7% (146/161) accurate, with the majority (8/15, 53%) of inaccuracy related to the need for exercise preparticipation medical clearance. Average readability level of AI-generated exercise recommendations was at the college level (mean 13.7, SD 1.7), with an average Flesch reading ease score of 31.1 (SD 7.7). Several recurring themes and observations of AI-generated output included concern for liability and safety, preference for aerobic exercise, and potential bias and direct discrimination against certain age-based populations and individuals with disabilities. CONCLUSIONS: There were notable gaps in the comprehensiveness, accuracy, and readability of AI-generated exercise recommendations. Exercise and health care professionals should be aware of these limitations when using and endorsing AI-based technologies as a tool to support lifestyle change involving exercise.

Role of the exercise professional in metabolic and bariatric surgery.

BACKGROUND: Physical activity (PA) is important for the long-term health and weight management of patients who undergo metabolic and bariatric surgery (MBS). However, the roles of exercise professionals in MBS settings have not been systematically determined. OBJECTIVES: To investigate: (1) who are the professionals implementing PA programming in MBS clinical settings; and (2) what patient-centric tasks do they perform? SETTING: Clinical and academic exercise settings worldwide. METHODS: This multimethod study included a scoping review of PA programs in MBS described in the research literature. Data about job tasks were extracted and provided to 10 experts to sort into categories. Cluster analysis was utilized to find the hierarchical structure of tasks. A Delphi process was used to agree on a final model. RESULTS: The majority of PA professionals were exercise physiologists in the USA and physiotherapists or other types of exercise professionals elsewhere. Forty-three tasks were identified, the most reported being supervision of exercise, fitness testing, and exercise prescription. Seven higher-order categories were determined: (1) Exercise-related health assessment, (2) Body composition and physical fitness assessment, (3) Lifestyle physical activity and sedentary behavior assessment, (4) Education, instruction, and prescription, (5) Exercise monitoring, (6) Behavioral counseling and psychosocial support, and (7) Dietary support. The following statements were rated an average of 9.0, classifying them as "imperative": 1) "Pre- and postoperative PA/exercise guidelines for MBS patients are needed", 2) "MBS programs need to include PA/exercise as part of multidisciplinary care". CONCLUSIONS: The expert group reached a consensus on 7 major classifications of job tasks for the exercise professional. It is important for governing medical associations across the world to formally recognize experienced exercise professionals as playing pivotal roles in continuing, multidisciplinary care for MBS patients. These findings also provide evidence-based information in the effort to solidify these positions within the greater context of healthcare.

Unsupervised Exercise Intervention vs. Adherence to a Mediterranean Diet Alone: The Role of Bioelectrical Impedance Vector Analysis and Cardiovascular Performance in Liver-Transplanted Recipients.

(1) Background: Cardiovascular disease is one of the leading causes of mortality after liver transplantation. Body composition and cardiovascular performance assessment represent a potential approach for modulating lifestyle correction and proper follow-up in chronic disease patients. This study aimed to verify the additional role of an unsupervised physical activity program in a sample of male liver transplant recipients who follow the Mediterranean diet. (2) Methods: Thirty-three male liver transplant recipients were enrolled. Sixteen subjects followed a moderate-intensity home exercise program in addition to nutritional support, and seventeen received advice on the Mediterranean diet. After six months, bioelectrical vector impedance analysis (BIVA) and cardiopulmonary exercise testing (CPET) were performed. (3) Results: No differences in CPET (VO2 peak: exercise 21.4 ± 4.1 vs. diet 23.5 ± 6.5 mL/kg/min; p = 0.283) and BIVA (Z/H: exercise 288.3 ± 33.9 vs. diet 310.5 ± 34.2 Ω/m; p = 0.071) were found. Furthermore, the BIVA values of resistance correlate with the submaximal performance of the Ve/VCO2 slope (R = 0.509; p < 0.05) and phase angle with the maximal effort of the VO2 peak (R = 0.557; p < 0.05). (4) Conclusions: Unsupervised physical exercise alone for six months does not substantially modify liver transplant recipients' cardiovascular performance and hydration status, despite their adherence to a Mediterranean diet. The body composition analysis is useful to stratify the risk profile, and it is potentially associated with better outcomes in transplanted subjects.

Evaluating machine learning-enabled and multimodal data-driven exercise prescriptions for mental health: a randomized controlled trial protocol.

Background: Mental illnesses represent a significant global health challenge, affecting millions with far-reaching social and economic impacts. Traditional exercise prescriptions for mental health often adopt a one-size-fits-all approach, which overlooks individual variations in mental and physical health. Recent advancements in artificial intelligence (AI) offer an opportunity to tailor these interventions more effectively. Objective: This study aims to develop and evaluate a multimodal data-driven AI system for personalized exercise prescriptions, targeting individuals with mental illnesses. By leveraging AI, the study seeks to overcome the limitations of conventional exercise regimens and improve adherence and mental health outcomes. Methods: The study is conducted in two phases. Initially, 1,000 participants will be recruited for AI model training and testing, with 800 forming the training set, augmented by 9,200 simulated samples generated by ChatGPT, and 200 as the testing set. Data annotation will be performed by experienced physicians from the Department of Mental Health at Guangdong Second Provincial General Hospital. Subsequently, a randomized controlled trial (RCT) with 40 participants will be conducted to compare the AI-driven exercise prescriptions against standard care. Assessments will be scheduled at 6, 12, and 18 months to evaluate cognitive, physical, and psychological outcomes. Expected outcomes: The AI-driven system is expected to demonstrate greater effectiveness in improving mental health outcomes compared to standard exercise prescriptions. Personalized exercise regimens, informed by comprehensive data analysis, are anticipated to enhance participant adherence and overall mental well-being. These outcomes could signify a paradigm shift in exercise prescription for mental health, paving the way for more personalized and effective treatment modalities. Registration and ethical approval: This is approved by Human Experimental Ethics Inspection of Guangzhou Sport University, and the registration is under review by ChiCTR.

An investigation into exercise prescription post-COVID-19 pandemic amongst Non-Consultant Hospital Doctors in an acute hospital setting.

BACKGROUND: Being sedentary is an independent risk factor for severe COVID-19 infection, suggesting the important role physical activity (PA) has as a modifiable risk factor for COVID-19 outcome. AIMS: The aim of this study was to evaluate NCHD's exercise prescribing practices and establish how these related to their knowledge, attitudes, and demographics and if their practices had changed since the COVID-19 pandemic began. METHODS: An online survey was emailed to NCHDs working in city centre teaching hospitals in southern Ireland. Using a combination of forced choice items and five-point Likert scales, questions examined NCHD's knowledge, attitudes, and practices of exercise prescription. RESULTS: For education, 30% of participants were able to correctly answer both WHO PA guidelines. 10% agreed that they knew where to refer patients for specialist exercise programs. For attitudes, 100% of participants in this study agreed that PA played a role in the prevention of disease. For practices, 36% of participants did not prescribe exercise at all. No participant strongly agreed with being confident in prescribing exercises. 90% did not increase their exercise prescribing practices since the introduction of pandemic restrictions. CONCLUSIONS: Despite an overall positive attitude towards PA in this study, findings suggest exercise prescribing was not carried out regularly amongst the majority of participants. There was a lack of confidence and knowledge regarding exercise prescribing amongst NCHDs. The majority of NCHDs have not changed their exercise prescribing practices since the COVID-19 pandemic began. Findings suggest there is an urgent need for educational tools and supports to assist doctors with exercise prescribing.

Acute Exercise Effect on Neurocognitive Function Among Cognitively Normal Late-Middle-Aged Adults With/Without Genetic Risk of AD: The Moderating Role of Exercise Volume and APOE Genotype.

BACKGROUND: Acute exercise is a behavior that benefits cognitive function; however, its effect on populations with different risks for Alzheimer's disease (AD) and the role of exercise variance and Apolipoprotein E (APOE) genotype on this effect remains unknown. This study explores the acute exercise effect on behavioral and neurocognitive function, and its potential moderation by exercise intensity and duration and APOE genetic risk. METHODS: Fifty-one cognitively normal adults (~36% APOE ε4 carriers) performed the Stroop task under a rest condition and 3 exercise conditions while electroencephalographic activity was assessed. RESULTS: Acute exercise improved cognitive performance assessed through both behavioral and neuroelectrical indices. These benefits were observed regardless of adjustments of intensity and duration at a predetermined exercise volume as well as being evident irrespective of APOE ɛ4 carrier status. CONCLUSIONS: Acute exercise could be proposed as a lifestyle intervention to benefit neurocognitive function in populations with and without genetic risk of AD. Future exploration should further the precise exercise prescription and also the mechanisms underlying the beneficial effects of acute exercise for neurocognitive function. CLINICAL TRIALS REGISTRATION NUMBER: NCT05591313.

Adaptations to Optimized Interval Training in Soccer Players: A Comparative Analysis of Standardized Methods for Individualizing Interval Interventions.

Accurately prescribing supramaximal interval training facilitates targeting desired physiological adaptations. This study compared the homogeneity of adaptations in cardiorespiratory parameters to supramaximal [i.e., intensities beyond maximal aerobic speed (MAS)] interval interventions prescribed using anaerobic speed reserve (ASR), the speed attained at the end of 30-15 Intermittent Fitness Test (VIFT), and MAS. Using repeated-measures factorial design, and during the off-season phase of the athletes' yearly training cycle, thirty national-level soccer players (age = 19 ± 1.6 years; body mass = 78.9 ± 1.6 kg; height = 179 ± 4.7 cm; Body fat = 11 ± 0.9%) were randomized to interventions consisting of 2 sets of 6, 7, 8, 7, 8, and 9-min intervals (from 1st to 6th week), including 15 s running at Δ%20ASR (MAS + 0.2 × ASR), 120%MAS, or 95%VIFT followed by 15 s passive recovery. All ASR, VIFT, and MAS programs sufficiently stimulated adaptive mechanisms, improving relative maximal oxygen uptake [V̇O2max (p < 0.05; ES = 1.6, 1.2, and 1.1, respectively)], absolute V̇O2max (p < 0.05; ES = 1.5, 1.1, and 0.7), ventilation [V̇E (p < 0.05; ES = 1.6, 1.1, and 1.1)], O2 pulse [V̇O2/HR (p < 0.05; ES = 1.4, 1.1, and 0.6)], first and second ventilatory threshold [VT1 (p < 0.05; ES = 0.7, 0.8, and 0.7) and VT2 (p < 0.05; ES = 1.1, 1.1, and 0.8)], cardiac output [Q̇max (p = 1.5, 1.0, and 0.7)], and stroke volume [SVmax (p < 0.05; ES = 0.9, 0.7, and 0.5)]. Although there was no between-group difference for the change in the abovementioned variables over time, supramaximal interval training prescribed using ASR and VIFT resulted in a lower coefficient of variation [CV (inter-individual variability)] in physiological adaptations compared to exercise intensity determined as a proportion of MAS. Expressing the intensity of supramaximal interval programs according to the athlete's ASR and VIFT would assist in accurately prescribing interventions and facilitate imposing mechanical and related physiological stimulus according to the athletes' physiological ceiling. Such an approach leads to identical stimulation across athletes with differing profiles and potentially facilitates more homogenized adaptations.

Role of Physical Activity in the Prevention and Treatment of Influenza: A Review.

BACKGROUND: Many concerns regarding respiratory diseases, including influenza, emerged during the epidemic of COVID-19. There were relevant research findings and suggestions for influenza prevention and treatment through physical activity, but little report about the total efficiency. So, this review was to summarize the role of physical activity in influenza prevention and treatment. MAIN BODY: The databases Web of Science, Google Scholar, EBSCO, PubMed, CNKI, and Science Direct were used to search the related literatures. The first search ran from July to October, 2021, and the second search was conducted in September, 2023. Those publications that reported the effects of physical activity, exercise, and sport on influenza, flu, and cold were included. It found that long-term adherence to moderate physical activity is beneficial in enhancing the body's ability to resist influenza viruses. However, high-intensity endurance physical activity can cause an open window in the human immune system, which increases the risk of infection by influenza viruses. The patients with influenza infections can participate in moderate physical activity during the pre-onset period, but some of the researchers do not recommend physical activity for patients with influenza, avoiding the transmission of influenza viruses to others through human contact of physical activity. Moreover, animal studies have shown that physical activity may worsen influenza disease. While studies found that moderate physical activity is beneficial for preventing influenza, as most experimental studies were conducted on animals, the mechanisms in human with physical activity are still unclear. No study has yet suggested exercise prescriptions to prevent and control influenza, and there is currently no way to prevent or control influenza just through physical activity. The follow-up research is needed to increase human clinical experiments, elucidate the effect of physical activity on influenza, develop exercise prescriptions and gradually promote physical activity as a practical means for preventing and treating influenza. SHORT CONCLUSIONS: Overall, participating in moderate physical activity regularly should be beneficial in influenza prevention, alleviating the patients' symptoms and increasing the recovery efficiency, but this needs more testing in clinical human trials.

Exercise as Medicine: Evaluation and Prescription for Adults with Congenital Heart Disease.

PURPOSE OF REVIEW: Understanding exercise physiology as it relates to adult congenital heart disease (ACHD) can be complex. Here we review fundamental physiologic principles and provide a framework for application to the unique ACHD patient population. RECENT FINDINGS: ACHD exercise participation has changed dramatically in the last 50 years. A modern approach focuses on exercise principles and individual anatomic and physiologic considerations. With an evolving better understanding of ACHD exercise physiology, we can strategize plans for patients to participate in dynamic and static exercises. Newly developed technologies including wearable devices provide additive information for ACHD providers for further assessment and monitoring. Preparation and assessment for ACHD patients prior to exercise require a thoughtful, personalized approach. Exercise prescriptions can be formulated to adequately meet the needs of our patients.

Evaluation of Exercise Mobile Applications for Adults with Cardiovascular Disease Risk Factors.

OBJECTIVE: To conduct a systematic review to determine if there are exercise mobile applications (apps) that can produce evidence-based, individualized exercise plans. MATERIALS AND METHODS: We searched the Apple Store and Google Play for exercise apps with terms related to exercise and health. Exercise apps were eligible if they: (1) had a ≥4 out of 5 overall rating with ≥1000 reviews; (2) were free to download; and (3) were not gender specific. Exercise apps were evaluated via the evidence-based exercise prescription (ExRx) standards of the American College of Sports Medicine (ACSM) and American Heart Association. For the exercise app evaluation criteria, an app was included if it (1) was evidence-based; (2) contained a preparticipation health screening protocol; (3) built a cardiovascular disease (CVD) risk factor profile; (4) prioritized one chronic disease or health condition to focus on; (5) framed the exercise plan by the frequency, intensity, time, and type principle (FITT) of ExRx; and (6) specified special considerations. RESULTS: Of the 531 potentially qualifying apps, 219 qualified. The qualifying apps were rarely evidenced-based (0.5%) or had a preparticipation screening protocol (3.7%). Only 27.7% built CVD risk factor profiles. Most apps (64.8%) focused on body image and/or athletic performance. Only 4.3% focused on chronic diseases or health conditions, while the remainder (34.5%) did not disclose a focus. No app framed the exercise plans by the FITT of ExRx. Only 1.4% of the apps specified special considerations. CONCLUSION: There are no commercially available exercise apps that generate an evidence-based, individualized exercise plan for adults with CVD risk factors.