Stepping towards health: a scoping review of square-stepping exercise protocols and outcomes in older adults.

BACKGROUND: Square-Stepping Exercise (SSE) is a type of physical-cognitive exercise. Such exercise has been used as an exercise approach in different studies with older adults. This scoping review provides an overview of the protocols and outcomes of studies employing the SSE in older adults. METHODS: We searched in the PubMed, CINAHL, Scopus, CABI Global Health, and Web of Science databases for articles published between 2006 (first research article published on SSE) to December 2023 that met a robust inclusion criterion. The search yielded 424 articles, and after inclusion criteria being applied, 37 articles were included in the final analysis. RESULTS: A total of 37 studies were included in the final analysis. Thirty-three out of the 37 studies focused on apparently healthy older adults, while four were conducted with older adults with neurological disease (i.e., multiple sclerosis, Parkinson's disease, and stroke). Most studies (n = 25) adopted an experiment (i.e., randomized controlled trial) or quasi-experimental approach, while 12 were classified as non-randomized (i.e., cross-sectional, mixed methods). The studies were conducted in different parts of the globe and adopted three major formats of intervention delivery, namely in-person, online, and home-based. Frequency, SSE session duration and intervention length significantly varied among studies, and reported outcomes were in the domains of physical and cognitive function. CONCLUSION: This review comprehensively described the characteristics of 37 studies employing SSE in apparently healthy older adults and older adults with neurological diseases. The findings demonstrated that SSE has been used by researchers across the globe, adopting a variety of forms of delivery, and to particularly improve physical and cognitive function of different segments of the older adult population. The review further identified important gaps in research, including the restricted outcomes, and the lack of studies combining SSE with more traditional exercise modalities to address potential combinatory effects.

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.

Group-based physical activity as a means to reduce social isolation and loneliness among older adults.

Social isolation and loneliness are critical health epidemics among older adults. The present manuscript aimed to underscore group-based physical activity (GBPA) as an approach to prevent and/or reduce social isolation and loneliness among older adults and, therefore, avoid its negative health consequences. We compiled evidence from the literature to answer the following question: would GBPA be a better approach to prevent/reduce social isolation and loneliness among older adults compared to individual physical activity? There is evidence demonstrating that older adults participating in GBPA not only acquire the well-known physical benefits of physical activity but also experience improvements in social connectedness, due to the fact that individuals exercising with others. To this end, beyond providing physical health benefits, GBPA for older adults may have the potential to help prevent social isolation and loneliness by improving levels of social connectedness in this age group. Further research is much needed, as the literature seems to be scarce. This would help devise tailored exercise programs for those reporting to be isolated or feeling lonely.

Activity behavior and cognitive performance in older adults living in a senior housing facility: the impact of frailty status.

BACKGROUND: Frailty, a condition characterized by a reduced physiological reserve and resilience, is highly prevalent among older adults. AIMS: This study examined differences in physical activity (PA) level, sedentary behavior (SB) time, and cognitive performance in older adults living in a senior housing facility (SHF) as a function of frailty status. METHODS: This study assessed 100 older adults from a SHF in the Midwest area of the United States. Participants were categorized as frail or non-frail according to scores observed in the short physical performance battery (SPPB), using the cutoff of nine previously stated in the literature. PA level and SB time were self-reportedly assessed using the physical activity scale for the elderly (PASE) and SB using a specific questionnaire developed for the older adult population. Cognitive performance was assessed using a collection of tests measuring cognitive processing speed, verbal learning, visuospatial memory, and verbal fluency. RESULTS: Frail and non-frail older adults reported similar PA level and SB time (P > .05). Frail older adults performed significantly (P < .05) worse than their counterparts, non-frail in all measures of cognitive function. However, after controlling the analysis for age, only processing speed (SDMT scores) remained statistically different (P < .05) between groups. DISCUSSION/CONCLUSION: Older adults living in a SHF with different frailty status (i.e., frail vs. non-frail) report similar levels of PA level and SB time; but our findings suggest that non-frail older adults appear to have better cognitive function in terms of processing speed compared to the frail group.

Magnitude and Composition of Sedentary Behavior in Older Adults Living in a Retirement Community.

High amount of sedentary behavior (SB) has been associated with a multitude of adverse health events in older adults. There are limited data regarding SB in older adults living in retirement communities (RC). This study described the magnitude and composition of SB [non-screen sedentary time (NSST) and screen sedentary time (SST)] in older adults living in a RC and documented variation in this behavior as a function of demographic, health, health behavior and clinical variables. This cross sectional descriptive study enrolled and assessed 100 older males and females living a RC located in the Midwest region of United States. Participants completed a questionnaire for sample characterization and a SB questionnaire. Metric of SB (i.e., TST, NSST and SST) were analyzed overall and separated by the variables of interest. Participants reported on average 10 h/day of sedentary activity (65% on NSST and 35% on SST). Older adults reported to spend most of their awaking hours in activities such as reading, watching TV and computer use. Significant variations on NSST and SST were observed for gender, BMI, perceived health, mobility aid use and number of chronic diseases. These findings may help in the development of tailored strategies and interventions focusing on reducing SB in this particular under-researched subgroup.

Validity of the Timed Up and Go Test as a Measure of Functional Mobility in Persons With Multiple Sclerosis.

OBJECTIVE: To examine the validity of the timed Up and Go (TUG) test as a measure of functional mobility in persons with multiple sclerosis (MS) by using a comprehensive framework based on construct validity (ie, convergent and divergent validity). DESIGN: Cross-sectional study. SETTING: Hospital setting. PARTICIPANTS: Community-residing persons with MS (N=47). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Main outcome measures included the TUG test, timed 25-foot walk test, 6-minute walk test, Multiple Sclerosis Walking Scale-12, Late-Life Function and Disability Instrument, posturography evaluation, Activities-specific Balance Confidence scale, Symbol Digits Modalities Test, Expanded Disability Status Scale, and the number of steps taken per day. RESULTS: The TUG test was strongly associated with other valid outcome measures of ambulatory mobility (Spearman rank correlation, rs=.71-.90) and disability status (rs=.80), moderately to strongly associated with balance confidence (rs=.66), and weakly associated with postural control (ie, balance) (rs=.31). The TUG test was moderately associated with cognitive processing speed (rs=.59), but not associated with other nonambulatory measures (ie, Late-Life Function and Disability Instrument-upper extremity function). CONCLUSIONS: Our findings support the validity of the TUG test as a measure of functional mobility. This warrants its inclusion in patients' assessment alongside other valid measures of functional mobility in both clinical and research practice in persons with MS.

The need to modify physical activity messages to better speak to older African American women: a pilot study.

BACKGROUND: Combating the physical inactivity crisis and improving health and quality of life is a challenge and a public health priority, especially in underserved populations. A key role of public health consists of informing, educating, and empowering individuals and communities about health issues. Researchers have found that mass communication messages often have limited effectiveness in reaching and impacting the health of underserved populations. The present pilot study was designed to explore perceptions of older African American women (AAW) in response to widely disseminated public information pertaining to physical activity (PA) and aging. METHODS: A total of 10 older AAW aged 60 years and over participated in this study. Participants were evenly assigned in one of the 2 focus groups (i.e. active, n = 5; and inactive, n = 5) based on their PA level. The focus group approach was employed to gather information about widely available public information materials related to PA that target the adult and older adult population. The three guides used were: (1) Exercise and Physical Activity: Your Everyday Guide; (2) The Physical Activity Guidelines for Older Adults; and (3) Be Active Your Way: A Guide for Adults. NVIVO 10 software was used to help in the qualitative data analysis. Descriptive thematic analysis was employed in identifying, analyzing and reporting patterns/themes within the data. RESULTS: Older AAW in the present study identified some shortcomings in current public health materials. Participants from both focus groups raised concerns regarding language and the types of activities used as examples in the materials. After analysis, two themes emerged: "We may have trouble in reading it" and "It does not reflect us". Participants' evaluation was found to be similar between the active and inactive focus groups. CONCLUSIONS: Older AAW's perceptions of the materials suggest that materials intended to educate and motivate the general public towards PA need to be modified to better speak to older African American women, especially to those who are sedentary and have difficulty in building PA into their daily lives.

Developing a Culturally Sensitive Lifestyle Behavior Change Program for Older Latinas.

Despite the burgeoning U.S. Latino population and their increased risk of chronic disease, little emphasis had been placed on developing culturally sensitive lifestyle interventions in this area. This article examines older Latinas' sociocultural context relative to health with the goal of developing a culturally sensitive health behavior intervention. Photo-elicitation indicated two emerging themes that influenced lifestyle choices: family caregiving and religion. Researchers partnered with a faith-based organization to develop and implement a 6-month lifestyle intervention for Latinas ages 50 and older: Abuelas en Acción (AEA). At completion, interviews were conducted to understand women's experiences and the influence AEA had on their lifestyles and health. Findings suggest that religious content empowered and deeply affected women; however, the intergenerational content presented significant challenges for instruction, retention, and implementation. We discuss findings in relation to the health intervention literature and provide suggestions for future interventions drawing on religion, family, and health behavior change.

Health related quality of life is differently associated with leisure-time physical activity intensities according to gender: a cross-sectional approach.

BACKGROUND: Several studies have demonstrated a positive association between physical activity (PA) and health-related quality of life (HRQL). However, studies have suggested that this association depends both on the PA intensity and the domain of HRQL evaluated. This study aimed to explore the association between physical, mental and overall HRQL with recommended levels of PA. PA levels were divided into moderate and vigorous intensity leisure-time PA and total leisure-time PA. METHODS: The study included 1001 adults, 582 women (46 ± 17 years) and 419 men (43 ± 16 years), residents in Rio Claro-SP, Brazil. All participants completed the SF-36 questionnaire to assess HRQL and the long version of the International Physical Activity Questionnaire (IPAQ) to assess level and intensities of leisure-time PA. Total leisure-time PA at moderate intensity was classified as: less than 9 min/week, 10-149 min/week, 150-299 min/week and 300 min/week or more. Total leisure-time PA at vigorous intensity was classified as: less than 9 min/week, 10 to 74.9 min/week, 75-149 min/week and 150 min/week or more. Multiple linear regression was performed in STATA version 12.0. RESULTS: Among women, moderate intensity and total leisure-time PA were associated with physical health. Among men, moderate and vigorous intensity and total leisure-time PA were associated with physical health and overall HRQL. Furthermore, moderate intensity and total leisure-time PA were associated with mental health in men. However, vigorous intensity PA was not associated with mental health for this group. CONCLUSION: The different domains of HRQL were associated with different levels and intensities of PA in leisure-time according to gender of adults. These findings indicate the complexity and importance of evaluating the HRQL stratified by gender and consider the different levels and intensities of PA.

Fear of Falling in Older Adults Living in a Community-Dwelling Facility: Prevalence and Its Impact on Activity Behavior and Physical Function.

This study examined the prevalence and the impact of fear of falling (FOF) on physical activity (PA), sedentary behavior (PA), and physical function in older adults living in a continuing care retirement community (CCRC). Ninety-three older adults were included and self-reported assessed on PA and SB. Further, participants' physical function was assessed using a collection of measures of valid objective tests. Independent t test was used to compare the dependent variables between FOF groups, and analysis of covariance (ANCOVA) was used to control for assistive device usage. FOF was prevalent in 47.3% of the sample and PA and SB did not differ between FOF groups (p > .05). ANCOVA revealed that performance on several physical function tests remained significantly better (p < .05) for the no FOF group compared to the yes group. Our findings demonstrated similar levels of PA and SB between FOF groups, but worse physical function for older adults reporting FOF.

Reinforcement feedback impairs locomotor adaptation and retention.

Introduction: Locomotor adaptation is a motor learning process used to alter spatiotemporal elements of walking that are driven by prediction errors, a discrepancy between the expected and actual outcomes of our actions. Sensory and reward prediction errors are two different types of prediction errors that can facilitate locomotor adaptation. Reward and punishment feedback generate reward prediction errors but have demonstrated mixed effects on upper extremity motor learning, with punishment enhancing adaptation, and reward supporting motor memory. However, an in-depth behavioral analysis of these distinct forms of feedback is sparse in locomotor tasks. Methods: For this study, three groups of healthy young adults were divided into distinct feedback groups [Supervised, Reward, Punishment] and performed a novel locomotor adaptation task where each participant adapted their knee flexion to 30 degrees greater than baseline, guided by visual supervised or reinforcement feedback (Adaptation). Participants were then asked to recall the new walking pattern without feedback (Retention) and after a washout period with feedback restored (Savings). Results: We found that all groups learned the adaptation task with external feedback. However, contrary to our initial hypothesis, enhancing sensory feedback with a visual representation of the knee angle (Supervised) accelerated the rate of learning and short-term retention in comparison to monetary reinforcement feedback. Reward and Punishment displayed similar rates of adaptation, short-term retention, and savings, suggesting both types of reinforcement feedback work similarly in locomotor adaptation. Moreover, all feedback enhanced the aftereffect of locomotor task indicating changes to implicit learning. Discussion: These results demonstrate the multi-faceted nature of reinforcement feedback on locomotor adaptation and demonstrate the possible different neural substrates that underly reward and sensory prediction errors during different motor tasks.

Impact of the COVID-19 Pandemic on the Scientific Production of Physical Education Researchers: A Five-Year Follow-Up Study.

The COVID-19 pandemic caused significant changes in society's dynamics, particularly affecting the landscape of education. Research in several areas may have been affected during periods of social restrictions. This study analyzed the curricula of 558 researchers across 27 graduate programs in physical education in Brazil to investigate the potential impact of the COVID-19 pandemic on scientific publications. Researchers' production from 2018 to 2022 underwent a comprehensive analysis, considering the total number of publications, Qualis rank, and journal impact factor. Data were analyzed using chi-squared and Kruskal-Wallis tests. Significance was set at 5%. Overall, the analyzed researchers published a total of 17,932 manuscripts from 2018 to 2022. During the COVID-19 pandemic, there was a decline of 16.4% in the number of articles published (p = 0.001). This decline was similar between men and women (p = 0.603) and was associated with a worsening in Qualis rank (p = 0.001). The number of studies published in journals with impact factors was also affected (p = 0.001). The findings suggest a potential impact of the COVID-19 pandemic on the scientific production of Brazilian researchers in the field of physical education. Funding agencies should consider the challenges associated with the COVID-19 pandemic before evaluating researchers and programs.

The effect of lower back and lower-extremity kinesiology taping on static balance and physical function performance in people with multiple sclerosis: A pilot study.

INTRODUCTION: Multiple sclerosis (MS) can lead to numerous deficits in body functions, including balance and mobility impairment. This study examined the effect of lower back and lower extremity kinesiology tape (KT) application on static balance and physical functioning performance in people with MS (pwMS) and compared that to a non-elastic tape. METHODS: This pilot randomized study recruited and enrolled 10 participants with MS that were allocated into two groups: kinesio (n = 6) and non-elastic (n = 4) tape. Participants were assessed with and without the respective tape on static balance with eyes open and closed and various physical function tests. RESULTS: Effect sizes for the Kinesio tape intervention were found to be small, while effect sizes for the sham tape/place condition varied from small to high. For both groups, the tendency was to reduce or maintain performance on the tests comparing tape and no tape. A subsequent, mixed-factor ANOVA revealed no significant difference between KT or sham tape/placebo. CONCLUSION: Our findings suggest that KT applied on lower back and lower extremity muscles does not seem to improve static balance and physical function performance in pwMS.

Handgrip strength asymmetry cut points to identify slow gait speed in six low- and middle-income countries: A cross-sectional analysis with 12,669 older adults.

BACKGROUND: Handgrip strength (HGS) asymmetry is associated with slow gait speed. Both mark muscle dysfunction, potential risk of falls, and adverse health outcomes. This association was found in older adults from high-income countries, but not yet studied in low- and middle-income countries. Moreover, there is no HGS asymmetry referential to identify the disabling process. Thus, our study aims to verify the association of HGS asymmetry with slowness in older adults from six low- and middle-income countries and to propose cut points to slowness. METHODS: A cross-sectional study with data from 12,669 older adults (≥60 years) of the Study on Global Aging and Adult Health (SAGE) conducted in six low- and middle-income countries were analyzed. Based in the difference between upper body sides HGS (asymmetry), participants were categorized in groups as 0.0-10.0% (reference group), 10.1-20.1%, 20.1-30.0% or >30.0%. Slow gait speed was established as <0.59 (men) and <0.51 (women) m/s. Associations of HGS asymmetry with gait speed were ascertained with logistic regression. HGS asymmetry index "[(HGS asymmetry*HGS)/(BMI*Age)]*100" cut points to identify slowness were generated with the ROC curve and Youden index (α = 5%). RESULTS: Compared to HGS reference group, those with HGS asymmetry of 10.1-20%, 20.1-30.0% and >30.0% had a superior odds for slowness [1.18(CI:1.02,1.42); 1.17(CI: 0.97; 1.44); and 1.21(CI:1.03;1.43), respectively]. HGS asymmetry index cut points to identify slowness were ≤1.14 (women) and ≤1.77 (men). CONCLUSIONS: HGS asymmetry association with slowness is present in economically disadvantaged countries. We proposed a new index for impaired muscle function with acceptable sensibility and specificity.

The experiences of inaccessibility and ableism related to physical activity: a photo elicitation study among individuals with multiple sclerosis.

PURPOSE: Strong evidence supports the benefits of physical activity (PA) and exercise for adults with multiple sclerosis (MS) and multidisciplinary PA guidelines exist. Previous research indicates that healthcare professionals may not yet widely promote exercise to their patients with MS. Before active promotion of PA/exercise becomes widespread practice for healthcare professionals, it is essential to understand the disability and inaccessibility-related barriers to exercise for this population. We sought to understand the barriers to PA/exercise among individuals with MS across a spectrum of MS impairment. METHODS: Participants were instructed to take pictures of people, places and things that make PA/exercise easier or more difficult in preparation for a semi-structured interview. This photo elicitation approach allowed individuals to explain the barriers they faced even if they would not attribute those barriers to ableism or inaccessibility themselves. Interviews were analyzed using Interpretative Phenomenological Analysis. RESULTS: Twenty-three persons with MS participated. Three main themes were: inaccessibility limits PA/exercise participation, ableism happens in the PA space, and assistive devices both provide access to PA and are associated with disability stigma. CONCLUSION: This study adds nuance to current understandings of the barriers and facilitators of PA in this population by illustrating the disability-specific barriers and experiences with inaccessibility. With increasing efforts to promote PA, there must be an increased awareness of the structural inequalities and barriers that physically and psychologically affect decision-making around PA.IMPLICATIONS FOR REHABILITATIONThere are many barriers to exercise for individuals with multiple sclerosis which prevent this population from experiencing the benefits of exercise.Rehabilitation professionals may play a role in drawing attention to accessible resources when providing recommendations or discussing barriers with their patients/clients.Rehabilitation professionals should consider that people with MS make decisions about assistive technology based on their needs, the meanings they attribute to it, expectations and attitudes of people around them.People with MS experience disability stigma as they participate in exercise and physical activity and this may extend into the rehabilitation space in the form of perceived compulsory ablebodiedness.

Perceptions on activity behavior during the COVID-19 pandemic "second wave" among US adults: results of a short online survey.

Purpose: COVID-19 pandemic has disrupted the lives of people of all nations. This study examined physical activity (PA) behavior, barriers and facilitators to PA during the COVID-19 pandemic. Methods: This cross-sectional study assessed adults using a survey comprised of two parts: (a) demographics and general health and; (b) PA-related questions. The survey link was disseminated via email and various social media, and was active from September to October 2020. Results: A total of 277 adults (Mean ± SD; age = 32.6 ± 13.6 years, BMI = 27.1 ± 16.5 kg/m2) were evaluated. A majority of the sample was female (67%), single (53%) and White (70%). About a third of the participants reported good mental and physical health, with a similar amount reporting weight gain during the pandemic. Participants further reported on average 271 min of PA/week, and 5.7 h/day of sitting time. Overall, 41.5% of the participants reported a decrease in PA during the COVID-19 pandemic, but those not meeting PA recommendations reported higher rates (67.9%) of decrease in levels of PA than their active counterparts (23.6%); x 2 (2, N = 277) = 55.757, p < 0.01. Over 50% of the participants reported engaging in PA at home, with significantly more females (43.5%) than males (17.6%) making use of live stream PA/exercise session opportunities; x 2 (2, N = 277) = 18.896, p < 0.001. "Closed gyms" and "more time" were reported as the main negative and positive factors, respectively, affecting PA during the pandemic. Conclusions: Our findings suggest that PA behavior was negatively affected in US adults during the COVID-19 pandemic, and that "closed gym" (i.e., barrier), and "more time" (i.e., facilitator), were the main factors reported affecting PA participation. Given the well-known public health importance of PA, it is paramount that public health initiatives focus on providing not only educational but also environmental opportunities and support for PA during this period.

Higher Body Mass Index Values Do Not Impact Physical Function and Lower-Extremity Muscle Strength Performance in Active Older Individuals.

This study examined the potential impact of BMI on physical function and lower-extremity muscle strength (leg extension and flexion peak torque) performance in active/trained older individuals. Sixty-four active/trained older individuals were enrolled, and later allocated to groups according to BMI categories (normal [≤ 24.9 kg/m2], overweight [25 to 29.9 kg/m2] and obese [≥ 30 kg/m2]). Sixty-four active/trained older individuals were enrolled, and later allocated to groups according to BMI categories (normal [≤ 24.9 kg/m2], overweight [25 to 29.9 kg/m2] and obese [≥ 30 kg/m2]). Assessments were conducted in two separate visits to the laboratory. In the first visit, participants underwent measures of height, body mass, and peak torque leg extension and flexion using an isokinetic dynamometer. On visit two, participants performed the 30-second Sit and Stand test (30SST), Timed Up and Go (TUG), and 6-minute Walk (6MW) tests. ANOVA one-way was used to analyze the data and significance was set at P < .05. One-way ANOVAs did not reveal significance differences among BMI categories for leg extension peak torque (F(2,61) = 1.11; P = 0.336), leg flexion peak torque (F(2,61) = 1.22; P = 0.303), 30SST (F(2,61) =1.28; P = 0.285), TUG (F(2,61) = 0.238; P = 0.789), and 6MW (F(2,61) = 2.52; P = 0.089)]. Our findings indicated that for older individuals who exercise regularly, physical function tests which mimic ordinary activities of daily living, are not impacted by BMI status. Thus, being physically active may counteract some of the negative effects of high BMI observed in the older adult population.

Is BDNF related to spatial-temporal gait parameters in people with multiple sclerosis? An observational study.

BACKGROUND: It has been suggested that the protein Brain-derived Neurotrophic Factor (BDNF) plays a neuroprotective role in people with multiple sclerosis (pwMS). Also, BDNF seems to play a role in cognition performance. In the same line, gait in pwMS requires a higher cognitive resource, mainly during complex walking. Thus, maybe BDNF could be related to gait in pwMS. OBJECTIVE: To investigate the relationship between BDNF and gait spatial-temporal parameters during unobstructed and obstructed conditions and the Timed Up and Go (TUG) in pwMS and healthy controls (HC). METHODS: The study included 20 pwMS (11F/9M, 33.1±7.5 years, Expanded Disability Status Scale- EDSS 2.2±1.2) and 18 HC (13F/5M, 35.5±5.9 years). Both groups performed 20 gait attempts in two conditions: unobstructed walking (10 trials) and avoiding an obstacle. The obstacle was 15 cm in height and made of foam material. The BDNF serum concentration was collected with participants in fasting and completed before the clinical, gait, and mobility assessments. Clinical variables included the Symbol Digit Modality Test (SDMT), the Fatigue Severity Scale (FSS), and the International Physical Activity Questionnaire (IPAQ- short version). Associations between BDNF and spatial-temporal gait parameters, clinical variables, and TUG were determined by Pearson/Spearman correlations with Bonferroni's correction being applied (p<0.0013). Gait was compared by a two-way, repeated-measures ANOVA (group and condition) to characterize our cohort. RESULTS: Reduced BDNF was observed for pwMS (41.66±4.45 ng/ml) in comparison with HC (61.67±7.07, p<0.001). However, although some correlations presented a moderate correlation between BDNF with gait variables, the correlations didn't reach a significant p-value after Bonferroni's correction. Lastly, pwMS presented shorter step length and slower step velocity for both gait conditions, with more evidence for obstacle conditions. Only pwMS changed gait behavior from unobstructed walking to obstacle avoidance conditions (i.e., reduced step length and velocity and increased step duration). CONCLUSION: BDNF is not related to either clinical (i.e., EDSS, SDMT, FSS, or IPAQ) or gait parameters in pwMS and HC, even in a condition involving higher cognitive demand. These results may suggest that BDNF does not play a role in these parameters' performance.

The role of physical activity in the clinical outcomes of people diagnosed with Covid-19: A systematic review.

Objective: This review aimed to compile the evidence on PA and clinical outcomes of people receiving a positive diagnosis of covid-19. Design: Systematic review. Methods: The search was performed in five databases: EMBASE, MEDLINE via PubMed portal, Scopus, SPORTDiscus via EBSCO platform, and Web of Science. In addition, the "gray" literature was searched through Google Scholar and medRxiv published between January 2020 and July 2022. Studies were assessed for risk of bias, with the extraction of relevant data. Our search revealed a total of 10,028 studies. Results: After applying the eligibility criteria 32 studies were included. Thirty-one studies were at low to moderate risk of bias. Physically active individuals, who were diagnosed with covid-19, presented attenuation of clinical outcomes, such as decreased risk of hospitalization, recovery time, number of symptoms, severity, and ICU and death when compared to individuals with low levels of PA or classified as sedentary. Conclusions: Physically active individuals when diagnosed with covid-19 may have decreased risk of several clinical outcomes related to covid-19, including but not limited to hospitalization and number of symptoms. Public health authorities should develop strategies and initiatives that promote safe PA environments to improve the clinical prognosis of people diagnosed with covid-19. Study registration: Open Science Framework (OSF), DOI registry 10.17605/OSF.IO/PV6NF. It can be consulted through the access link: https://doi.org/10.17605/OSF.IO/PV6NF, October 07, 2021.

Bone Mineral Content Estimation in People Living with HIV: Prediction and Validation of Sex-Specific Anthropometric Models.

People living with HIV (PWH) experience an accelerated reduction in bone mineral content (BMC), and a high risk of osteopenia and osteoporosis. Anthropometry is an accurate and low-cost method that can be used to monitor changes in body composition in PWH. To date, no studies have used anthropometry to estimate BMC in PWH. To propose and validate sex-specific anthropometric models to predict BMC in PWH. This cross-sectional study enrolled 104 PWH (64 males) aged >18 years at a local university hospital. BMC was measured using dual energy X-ray absorptiometry (DXA). Anthropometric measures were collected. We used linear regression analysis to generate the models. Cross-validations were conducted using the "leave one out", from the predicted residual error sum of squares (PRESS) method. Bland-Altman plots were used to explore distributions of errors. We proposed models with high coefficient of determination and reduced standard error of estimate for males (r2 = 0.70; SEE = 199.97 g; Q2PRESS = 0.67; SEEPRESS = 208.65 g) and females (r2 = 0.65; SEE = 220.96 g; Q2PRESS = 0.62; SEEPRESS = 221.90 g). Our anthropometric predictive models for BMC are valid, practical, and a low-cost alternative to monitoring bone health in PWH.