Reliability of ActiGraph GT3X+ placement location in the estimation of energy expenditure during moderate and high-intensity physical activities in young and older adults.

WHO defines physical activity (PA) as any bodily movement produced by skeletal muscles that requires energy expenditure (EE). The purpose of this study was to compare the EE estimations by ActiGraph GT3X+ with a gold standard measurement, the portable gas analyser in a set of 3 different PAs. This cross-sectional study involved 56 participants, age range (years, [min, max]: young people [20, 33], older adults [65, 83]). Participants completed a single session of three experimental PAs including biking, treadmill walking, and treadmill running. Each participant wore five GT3X+ triaxial accelerometers and a portable gas analyser used as the gold standard measurement. The GT3X+ were placed on the wrists, the waist (centred at the pelvis), and the ankles. ActiGraph GT3X+ and MetaMax3B records were investigated through intraclass correlation coefficient. Magnitude of measurement error was estimated using Effect Size. The GT3X+ wrist and GT3X+ waist underestimated EE regardless of the PA type. The GT3X+ ankles strongly overestimated EE during biking (mean bias = 489 ± 392%) and walking (mean bias = 106 ± 58%), while it underestimated EE during running (mean bias = -47 ± 27%). The ActiGraph GT3X+ does not provide accurate EE estimates across a range of placement locations during moderate and high-intensity PA.

Gonadal hormones may predict structural bone fragility in elite female soccer player.

Purpose: This study determined the impact of menstrual status on bone tissue in elite post-pubertal female soccer players over an entire season.Methods: Fifty-one elite female soccer players participated. At baseline, forty-one were assigned to the low hormonal androgenic profile (low-HAPL) and 10 to the high hormonal androgenic profile (high-HAPL).Results: An 8-month training program led to increased bone mineral density content (p<0.05). The low-HAPL athletes improved the Narrow neck average cortical thickness (ACT) by 1.4% and reduced the corresponding Buckling ratio (BR) by 2.6%, thus decreasing the fracture risk (p<0.05). The high-HAPL athletes decreased the Narrow neck ACT by 5.4% and increased the BR by 2.6%, increasing fracture risk (p<0.05). Differences were assigned as being "very likely beneficial" for the low-HAPL athletes, supported by very large (d=3.41) and large (d=1.58) effect sizes for the Narrow neck ACT and BR, respectively.Conclusion: A season of soccer training has induced bone geometry improvements in adolescent females. Bone health parameters improved in the two clusters. However, high-HAPL athletes decreased its resistance to loading compare to low-HAPL athletes. Even if female players do not present clinical symptoms related to their hormonal status, sport medicine physicians should pay attention to their structural bone fragility.

Awakening the control of the ankle dorsiflexors in the post-stroke hemiplegic subject to improve walking activity and social participation: the WAKE (Walking Ankle isoKinetic Exercise) randomised, controlled trial.

BACKGROUND: Stroke is the leading cause of acquired disability in France. While 90% of patients recover the ability to walk, it is often limited with a steady speed of approximately 0.7 m/s. This limitation of walking activity is partly related to a decrease in strength associated with more or less significant spasticity. In particular, it seems that the strength of the dorsiflexor muscles is directly related to walking speed. We hypothesise that a protocol based on gestural repetition targeted at the ankle during the subacute phase potentiates the recovery of motor control, improving walking activity, and participates in recovering better social participation. METHODS: An estimated total of 60 patients with subacute stroke will be recruited to participate in this multicentre, interventional, prospective, randomised controlled trial. All participants will benefit from conventional rehabilitation. In addition, the experimental group will take part in an ankle isokinetic rehabilitation programme for 6 weeks (at least 25 sessions). The control group will receive the same duration of conventional rehabilitation. The primary outcome measure will be a 10-m walking speed at post-intervention. Secondary outcomes will include social participation, walking spatio-temporal parameters, and dorsiflexor strength. Outcome measurements will be taken at baseline, immediately after treatment (6 weeks), then at 6 months and 1 year of follow-up. DISCUSSION: This study aims to provide scientific evidence that a protocol based on an early over-solicitation of the ankle dorsiflexor muscles to promote their "awakening" can serve to achieve a more effective walking activity, which in turn encourages social participation following discharge from the hospital. This protocol should also help optimise physical medicine and rehabilitation practices: the more systematic use of the isokinetic dynamometer as a technique associated with, and integrated into the conventional rehabilitation protocol would allow an objective evaluation of the rehabilitation benefits and should increase the rehabilitation gain in central nervous system disorders. TRIAL REGISTRATION: Limoges University Hospital is the sponsor of this research (Unique Protocol ID: 87RI18_0010) This research is supported by the French Ministry of Health (PHRC 2020-A03328-31) and is conducted with the support of DGOS (PHRC interregional - GIRCI SOHO). The study protocol was approved by the French Human Subjects Protection Review Board (Comité de Protection des Personnes Nord-Ouest III) on February 23, 2021. The trial was registered in the ClinicalTrials.gov registry ( NCT04800601 ) on March 16, 2021.

Bone geometry and strength adaptations to physical constraints inherent in different sports: comparison between elite female soccer players and swimmers.

Sports training characterized by impacts or weight-bearing activity is well known to induce osteogenic effects on the skeleton. Less is known about the potential effects on bone strength and geometry, especially in female adolescent athletes. The aim of this study was to investigate hip geometry in adolescent soccer players and swimmers compared to normal values that stemmed from a control group. This study included 26 swimmers (SWIM; 15.9 ± 2 years) and 32 soccer players (SOC; 16.2 ± 0.7 years), matched in body height and weight. A group of 15 age-matched controls served for the calculation of hip parameter Z-scores. Body composition and bone mineral density (BMD) were assessed by dual-energy X-ray absorptiometry (DXA). DXA scans were analyzed at the femoral neck by the hip structure analysis (HSA) program to calculate the cross-sectional area (CSA), cortical dimensions (inner endocortical diameter, ED; outer width and thickness, ACT), the centroid (CMP), cross-sectional moment of inertia (CSMI), section modulus (Z), and buckling ratio (BR) at the narrow neck (NN), intertrochanteric (IT), and femoral shaft (FS) sites. Specific BMDs were significantly higher in soccer players compared with swimmers. At all bone sites, every parameter reflecting strength (CSMI, Z, BR) favored soccer players. In contrast, swimmers had hip structural analysis (HSA) Z-scores below the normal values of the controls, thus denoting weaker bone in swimmers. In conclusion, this study suggests an influence of training practice not only on BMD values but also on bone geometry parameters. Sports with high impacts are likely to improve bone strength and bone geometry. Moreover, this study does not support the argument that female swimmers can be considered sedentary subjects regarding bone characteristics.

Can energy expenditure be accurately assessed using accelerometry-based wearable motion detectors for physical activity monitoring in post-stroke patients in the subacute phase?

Background In the subacute stroke phase, the monitoring of ambulatory activity and activities of daily life with wearable sensors may have relevant clinical applications. Do current commercially available wearable activity trackers allow us to objectively assess the energy expenditure of these activities? The objective of the present study was to compare the energy expenditure evaluated by indirect calorimetry during the course of a scenario consisting of everyday activities while estimating the energy expenditure using several commercialised wearable sensors in post-stroke patients (less than six months since stroke). Method Twenty-four patients (age 68.2 ± 13.9; post-stroke delay 34 ± 25 days) voluntarily participated in this study. Each patient underwent a scenario of various everyday tasks (transfer, walking, etc.). During the implementation, patients wore 14 wearable sensors (Armband, Actigraph GT3X, Actical, pedometer) to obtain an estimate of the energy expenditure. The actual energy expenditure was concurrently determined by indirect calorimetry. Results Except for the Armband worn on the non-plegic side, the results of our study show a significant difference between the energy expenditure values estimated by the various sensors and the actual energy expenditure when the scenario is considered as a whole. Conclusion The present results suggest that, for a series of everyday tasks, the wearable sensors underestimate the actual energy expenditure values in post-stroke patients in the subacute phase and are therefore not accurate. Several factors are likely to confound the results: types of activity, prediction equations, the position of the sensor and the hemiplegia side.

Multilevel Approach of a 1-Year Program of Dietary and Exercise Interventions on Bone Mineral Content and Density in Metabolic Syndrome--the RESOLVE Randomized Controlled Trial.

BACKGROUND: Weight loss is a public health concern in obesity-related diseases such as metabolic syndrome (MetS). However, restrictive diets might induce bone loss. The nature of exercise and whether exercise with weight loss programs can protect against potential bone mass deficits remains unclear. Moreover, compliance is essential in intervention programs. Thus, we aimed to investigate the effects that modality and exercise compliance have on bone mineral content (BMC) and density (BMD). METHODS: We investigated 90 individuals with MetS who were recruited for the 1-year RESOLVE trial. Community-dwelling seniors with MetS were randomly assigned into three different modalities of exercise (intensive resistance, intensive endurance, moderate mixed) combined with a restrictive diet. They were compared to 44 healthy controls who did not undergo the intervention. RESULTS: This intensive lifestyle intervention (15-20 hours of training/week + restrictive diet) resulted in weight loss, body composition changes and health improvements. Baseline BMC and BMD for total body, lumbar spine and femoral neck did not differ between MetS groups and between MetS and controls. Despite changes over time, BMC or BMD did not differ between the three modalities of exercise and when compared with the controls. However, independent of exercise modality, compliant participants increased their BMC and BMD compared with their less compliant peers. Decreases in total body lean mass and negative energy balance significantly and independently contributed to decreases in lumbar spine BMC. CONCLUSION: After the one year intervention, differences relating to exercise modalities were not evident. However, compliance with an intensive exercise program resulted in a significantly higher bone mass during energy restriction than non-compliance. Exercise is therefore beneficial to bone in the context of a weight loss program. TRIAL REGISTRATION: ClinicalTrials.gov NCT00917917.

The bone tissue of children and adolescents with Down syndrome is sensitive to mechanical stress in certain skeletal locations: a 1-year physical training program study.

The systemic complications of Down syndrome (DS) attenuate the osteogenic response to physical activity in DS patients. Through an interventional study we showed the effects of physical training on development of bone mineral content (BMC) and density (BMD) as well as on quantitative bone ultrasound (QUS) parameters in individuals with DS. A total of 42 children with DS were randomly assigned to either an exercising (DS-E, n=20, age 16 ± 1.8 years) or non-exercising group (DS-NE, n=22, age 16.9 ± 1.5 years). DS-E group was assigned to a program of osteogenic activities with 60 min sessions twice a week, over 12 month period. Bone mass measures were performed by dual X-ray absorpsiometry (DXA) at the spine and hip, and ultrasound attenuation (BUA) and velocity (SOS) assessed from the calcaneus by QUS device. All bone parameters had evolved with age, except for neck BMD. One year of training increased BMC values at lumbar spine (7%, p<.005) and total hip (10%, p<.05), and BMD values only at lumbar spine (4%, p<.05). Changes in BUA and SOS values were not evident following training. Trained individuals increased their motor skills measured through Eurofit tests. It was concluded that a program of osteogenic physical training may induce bone improvement in children with DS, but with a lower magnitude than that reported in the specialized literature for individuals without DS.

Bone health during late adolescence: effects of an 8-month training program on bone geometry in female athletes.

OBJECTIVES: This study investigated the short term changes in hip structural parameters in high level adolescent soccers and swimmers. METHODS: Twenty-six girl swimmers (15.9±2 years) and 32 girl soccer players (16.2±0.7 years) were investigated before and after 8 months of training. Fifteen non-active age-matched adolescents were enrolled at baseline to serve as a reference group. The geometric contributions to bone strength in the proximal femur were quantified using the hip structural analysis technique. RESULTS: Eight months of training had increased the bone density in soccer players but not in swimmers. At the total hip, swimmers conserved their baseline low Z-score values while soccers remained above the normal. At the femoral shaft, the cross sectional area had increased for the two groups with a higher magnitude in soccers (3.17% vs 2.31%; P<0.05). The sub-periosteal width had increased in soccer players (P<0.01) but not in swimmers. The Z-score showed an improvement of cross sectional moment of inertia and section modulus at femoral shaft section for soccers (P<0.001), without any change in swimmers. Remarkably, swimmers had improved the Z-score of buckling ratio (P<0.005), while soccers did not. DISCUSSION/CONCLUSION: A season of training for sport characterized by impact had induced significant bone geometry improvement in late adolescent females despite expectations that this period of growth represents a plateau in bone maturation. This study adds to the existing literature describing intensive swimming practice as lacking an osteogenic effect when assessed by dual energy X-ray absorptiometry.

Agreement between anthropometric and dual-energy X-ray absorptiometry assessments of lower-limb volumes and composition estimates in youth-club rugby athletes.

The purpose of this study was to assess the agreement of lower-limb volume estimates based on anthropometry and dual-energy X-ray absorptiometry (DXA) as a reference method in male rugby athletes. Predictive models using body mass and skinfolds were tested to improve the relative agreement between protocols (anthropometry, DXA). Rugby players (n = 41; 19.9 ± 2.2 years) volunteered for the study. Lower-limb total and fat-free volumes were estimated by anthropometry and also derived using DXA. Cross-validation between the anthropometry technique and DXA was then performed. Lower-limb volume estimates by anthropometry overestimated reference values and tended to be further from the reference values with the increase of scale. For the total sample, standard errors of measurement for volume estimates by anthropometry were 1.99 L and 1.34 L for total and fat-free volumes, respectively. Correlations with reference values were 0.81 for lower-limb volume and 0.90 for lower-limb fat-free volume. Correlations between estimated prediction equations and reference values showed higher correlations (r = 0.96 for lower-limb volume and r = 0.93 for lower-limb fat-free volume) compared with anthropometric estimates. Overall, the agreement of anthropometry method to quantify lower-limb volumes with DXA as a reference in young adult rugby players is acceptable and is a practical method when more expensive and complex techniques are not available. The consideration of body mass and lower-limb skinfolds increases the precision of lower-limb volume estimates using anthropometry in the young adult rugby players.