Effects of Resistance Training on Fatigue-Related Domains of Quality of Life and Mood During Pregnancy: A Randomized Trial in Pregnant Women With Increased Risk of Back Pain.

OBJECTIVE: The aim of the study was to test whether the adoption of twice weekly, low-to-moderate intensity resistance training during weeks 22 to 34 of pregnancy can improve quality of life and mood. METHODS: A parallel-group trial was conducted. Women in their second trimester (N = 134) were randomly assigned to 12 weeks of wait list, bimonthly pregnancy education classes, or twice weekly low-to-moderate intensity resistance training. Resistance training involved one abdominal exercise with no external load and five exercises (leg extension, leg press, arm lat pull, leg curl, and lumbar extension) with an external load that gradually progressed, and the total active exercise time during each exercise session was approximately 17 minutes. Quality of life and mood were measured before and after the interventions using the 36-item Short Form Health Survey and Profile of Mood States. Intent-to-treat mixed-model analyses of variance (3 groups by 2 times, pre- and postintervention) tested the hypothesis that outcomes would worsen for the controls and not change or improve for the resistance training group. RESULTS: The group by time interaction (F(2,131) = 3.144, η = .046, p = .046) for 36-item Short Form Health Survey vitality and subsequent simple main effects showed that scores were unchanged across time after resistance training (-1.8 (14.8)) but significantly decreased for the education (-6.44 (12.69), t = 3.408, df = 44, p = .001) and wait list (-9.11 (14.78), t = 4.135, df = 44, p < .001) groups, whereas posttest vitality scores for the pregnancy group (45.9 (16.9)) were significantly higher than the wait list (40.1 (16.3), t = 1.989, df = 87, p = .05) but not the education group (42.1 (15.4), p = .27). Profile of mood states fatigue scores showed a similar pattern. CONCLUSIONS: Adverse changes in symptoms of energy and fatigue during pregnancy are attenuated by adopting low-to-moderate intensity resistance training. CLINICAL TRIAL REGISTRATION: Clinicaltrials.gov, NCT02557893.

Evidence That Sleep Is an Indicator of Overtraining during the Competition Phase of Adolescent Sprinters.

Although sleep disturbance is a common complaint in overtrained athletes, the role of sleep in the overtraining process is not clear. This study aimed (i) to compare sleep efficiency/quantity at the start of a competition phase in elite adolescent sprinters who adapted to prior training with that in those who maladapt and (ii) to examine the influence of prior training, fatigue, and sleep on performance through a moderated mediation model. Fatigue (via Profile of Mood State) and internal training load (via session rating of perceived exertion and duration of training as volume) were measured in 20 sprinters (mean age: 15.9 ± 1.7 years) across 4 mesocycles (baseline (T1); preparatory (T2); precompetitive (T3); and competitive (T4) phases), over 26 weeks. Performances were assessed during the competitive period (T3, T4), while sleep was monitored (via actigraphy) for a week during T4. It was inferred that sprinters who had increasingly greater fatigue and concomitant decrements in performance (35%) were maladapted to training and the remaining sprinters who improved fatigue and performance (65%) were adapted to training. Sleep efficiency (91 ± 3% vs. 82 ± 3%, p < 0.001) and quantity (425 ± 33 min vs. 394 ± 20 min, p < 0.001) at the start of T4 were significantly greater in sprinters who adapted. Moreover, higher prior training volume (mean of T1 to T3 training volume) was associated with lower sleep efficiency at the start of T4 (R 2 = 0.55, p < 0.001) which was associated with poorer performance (R 2 = 0.82, p < 0.001). Fatigue moderated the indirect effect of prior training volume on performance through its moderation of the effect of sleep efficiency on performance (R 2 = 0.89, p < 0.001). Impaired sleep as a result of greater prior training volume may be related to performance decrements through fatigue. Athletes should improve sleep during periods of higher training volume to reduce fatigue for better adaptation to training.

Evidence that variations in pretraining hydration status are related to the frequency of endurance training in elite adolescent sprinters.

BACKGROUND: Although the effect of dehydration on performance is widely studied, limited data concerning the levels of risk training types pose to hydration status exists. This study sought to determine: 1) pretraining hydration status in adolescent sprinters relative to non-athletes; 2) changes in hydration markers across a season of adolescent sprinters relative to non-athletes; and 3) if frequency of training type explains unique variance in hydration. METHODS: Hydration (via pretraining urine osmolality [UOsm] and thirst perception [TP]), daily water intake (TWI) (via 24-h food/fluid diaries) and frequencies of resistance, endurance and sprint training types (via training regime questionnaires) were assessed in 26 sprinters (age: 15.6±1.9 years) and 26 non-athletes (age: 16.0±1.6 years), during 4 mesocycles (general [T1] and specific [T2] preparation; precompetitive [T3] and peaking [T4] phases), over 26 weeks. RESULTS: Most athletes (62-81%) and non-athletes (73-92%) were underhydrated (UOsm>700 mOsmol/kg) pretraining across the season, despite a low TP. There were significant time (P=0.042) and group (P=0.006) effects, and a main group by time interaction for UOsm (P=0.006) but not TP across the season, after controlling for TWI. Greater UOsm (in mOsmol/kg) were observed during T1 (906.3±250.1) and T2 (934.5±257.0) compared to T3 (852.1±268.8) and T4 (854.2±218.8). There was no significant change across the season for non-athletes. Frequencies of endurance training were positively associated with UOsm and explained unique variances across the season (R2 range from 7%-16%). CONCLUSIONS: Underhydration is high in the adolescent population. Training type may be related to the variations in hydration throughout a season, which may help to inform hydration practices of sprint athletes.

Contextual factors and sporting success: The relationship between birth date and place of early development on the progression of Jamaican track and field athletes from junior to senior level.

Understanding determinants associated with dropout from sport is important for talent development. This study aimed (i) to determine dropout rates for Jamaican track and field athletes and (ii) to examine contextual factors (i.e., relative age effect and place of development) as potential determinants of junior athletes progressing to the senior level. A sample of 1552 track and field athletes (mean age 18.57±0.41 years) who were finalists at the national high school (junior) championships in Jamaica between 2000 and 2017 were evaluated from the Jamaica Athletics Administrative Association database. The database provided birth date, school attendance and performance results. A retrospective analysis was completed to investigate the relationship between junior and senior successes and dropout rates. Chi-square analyses were conducted to examine the distribution of birth date quartiles based on the selection year. Using the Jamaican census information, the population size of regions where participants attended school were categorized and used as a proxy for athletes' place of development. Results showed that the majority of the participants did not progress to senior levels (81%). The relative age effect was evident for athletes who progressed to the senior level but was not evident for athletes who did not progress. There was a bias towards participants who attended school in regions with a population size between 5000-29 999. This study illuminates some of the contextual factors that may influence the likelihood of progressing from junior to senior levels which may help to inform talent identification, selection and development in the sport of track and field.

A review of physical activity patterns in pregnant women and their relationship to psychological health.

Regular physical activity contributes positively to physical and psychological health. Adverse consequences of inactivity may be an especially important problem among pregnant women. Up to 60% are inactive during pregnancy. This review found consistent evidence that physical activity is reduced during pregnancy; however, few investigators have sought to quantify physical activity patterns among pregnant women using well validated measures. Some of the barriers to physical activity during pregnancy, such as depression, anxiety and fatigue, have been shown to be attenuated by regular exercise performed by non-pregnant samples. There is a need to better understand the relationships between these factors and physical activity during pregnancy. Available retrospective and prospective results suggest that both leisure time and work-related physical activities are decreased across pregnancy. Intensity and duration decrease both during pregnancy compared with pre-pregnancy and in the third trimester compared with the first. There is a need for well designed longitudinal investigations that document pregnancy-related changes in physical activity at frequent intervals during pregnancy using validated and more precise measures of physical activity. Reductions in physical activity and a worsening mood are common during pregnancy. If the relationship between physical inactivity and mood disturbances is indeed observed and maintained during pregnancy, then decreases in physical activity in the third trimester would be expected to result in a worsening mood. In recent years, increased attention has been paid to antenatal mood disturbances, and this research has yielded a host of important findings. Prior correlational and experimental research with non-pregnant samples has demonstrated a consistent relationship between physical inactivity and mood disturbances. Whether this relationship occurs among pregnant women and/or is maintained as women progress during pregnancy is uncertain. Prior investigations have revealed that there is higher rate of mood disturbance during pregnancy than following pregnancy but little is known about the mechanisms that cause these mood disturbances. It is important to better understand changes in mood with pregnancy because mood disturbances can have major negative consequences for a pregnant woman. The major adverse consequences of depression among pregnant women are largely the same as those of non-pregnant individuals. Only six investigations have quantified the relationship between changes in physical activity and changes in mood during pregnancy. The available evidence suggests that inactivity is associated with worse mood. Additional research into this topic is warranted due to the limited number of published papers and the design and methodology limitations of these investigations.

Muscle strengthening exercises during pregnancy are associated with increased energy and reduced fatigue.

INTRODUCTION: Physical inactivity likely contributes to fatigue and low energy during pregnancy but whether acute resistance exercise attenuates these symptoms is unknown. METHODS: Twenty-six women performed six low-to-moderate intensity resistance exercises twice per week from weeks 23 to 35 of pregnancy and measurements were made before and after each workout using the Mental and Physical State Energy and Fatigue Scales. RESULTS: Acute resistance exercise usually increased perceived physical and mental energy (92% to 96% of workouts, respectively). These increases did not differ significantly across the 24 exercise sessions for feelings of physical energy or mental energy, even after adjusting for variations in attendance (median = 22/24 workouts). Acute resistance exercise usually decreased perceived physical and mental fatigue (79% to 88% of workouts, respectively), and ANCOVA showed these decreases did not differ significantly across the 24 exercise sessions for feelings of physical fatigue or mental fatigue even after adjusting for variations in attendance. DISCUSSION: The results suggest acute, low-to-moderate intensity muscle strengthening exercise during pregnancy is effective for transiently improving feelings of energy and fatigue.

Physical activity and mood during pregnancy.

PURPOSE: To compare three physical activity (PA) measures in pregnant women and examine mood correlates of physical activity changes during pregnancy. METHODS: A sample of 12 pregnant women (PW) was recruited during their first trimester and 12 nonpregnant women (NPW) (baseline age = 30.7 +/- 4.4 yr) were matched to the PW (29.8 +/- 4.2 yr). Once monthly, for seven consecutive months, total weekly energy expenditure (TWEE) was assessed using a physical activity diary (PAD) and a recall interview (PAR). Accelerometers were worn for 3 d each month. Mood was also assessed. A two-factor mixed-model ANOVA was used to analyze the data (2 groups [PW vs NPW] x 7 times across pregnancy). RESULTS: Mean PAR TWEE and daily mean MTI counts were positively and moderately correlated with mean PAD TWEE (PW: r = 0.40 and NPW: r = 0.50, P < 0.001). The MTI counts decreased significantly in PW by 23% from gestational weeks 12 to 36 compared with a 5% decrease in NPW. Fatigue and vigor scores improved from gestational weeks 12 to 16 and worsened from weeks 32 to 36 in PW. Changes in PA were not correlated to changes in mood in either group. CONCLUSIONS: The results provide some evidence for the validity of the 7-d PAR and accelerometer as measures of physical activity in pregnancy. Healthy women who maintain an above average level of physical activity during the second and third trimesters can enjoy mood stability.

A conceptual framework for managing modifiable risk factors for cardiovascular diseases in Fiji.

AIMS: The current review will look at modifiable lifestyle (physical inactivity, poor nutrition, risky alcohol behavior and cigarette smoking) and cardio-metabolic (obesity, diabetes mellitus, high cholesterol and high blood pressure) cardiovascular disease (CVD) risk factors among Indigenous-Fijian and Indo-Fijian subgroups. A framework for monitoring and managing these risk factors will be presented. METHODS: National health surveys were identified where available. Electronic databases identified sources for filling missing data. The most relevant data were identified, organized and synthesized. RESULTS: Compared to Indo-Fijians, Indigenous-Fijians have higher rates of obesity (17% vs 11%) and hypertension (21% vs 16%), but lower rates of diabetes mellitus (12% vs 21%) and high cholesterol (33% vs 39%). Indigenous-Fijians report higher rates of prescribed physical activity (25% vs 21%), but poorer recommended vegetable intake (48% vs 56%), greater risky alcohol behavior (17% vs 15%) and a much greater prevalence of cigarette smoking (45% vs 24%). Both Indigenous-Fijians and Indo-Fijians report a low prevalence of recommended fruit intake (17% vs 15%). CONCLUSIONS: Fiji is progressing through demographic and epidemiological transitions, including a decline in infectious diseases and improved life expectancy. However, in concert with other developing nations, 'modernization' is accompanied by increased mortality from non-communicable diseases, with CVD being the most prevalent. This transition has been associated with changes to socio-cultural aspects of Fiji, including poor lifestyle choices that may contribute to a cluster of cardio-metabolic conditions which precede CVD.

Lack of both sex differences and influence of resting blood pressure on muscle pain intensity.

OBJECTIVE: To test whether muscle pain intensity caused by different intensities of unaccustomed eccentric exercise was moderately and negatively associated with resting blood pressure, and whether women reported higher pain ratings compared with men in response to such exercise. DESIGN AND SUBJECTS: The repeated measures design involved random assignment of 42 young adults (21 women, 7 per condition) to complete elbow extension exercises with a weight that was 80%, 100%, or 120% of their maximal voluntary concentric strength. Total work was equated by manipulating the number of repetitions performed in the 80% (n = 45), 100% (n = 36), and 120% (n = 30) condition groups. SETTING: A clinical laboratory in a large university in the southeastern U.S. OUTCOME MEASURES: Pain intensity ratings averaged over 3 days and resting blood pressure measurements averaged over 6 days. RESULTS: For both sexes there was a dose-response relation between the relative intensity of the unaccustomed eccentric exercise and mean pain intensity ratings. Mean pain intensity was not significantly related to systolic or diastolic blood pressure. There was no significant sex difference in pain intensity, although men's ratings, in contrast to expectations, tended to be higher than the women's ratings. CONCLUSIONS: The negative findings, contrary to those predicted from previous experiments in which other types of noxious stimuli have been used, suggest that sex and blood pressure associations with pain intensity are stimulus dependent.

Perceived exertion responses to novel elbow flexor eccentric action in women and men.

PURPOSE: The primary aim was to describe perceived exertion responses to different intensities of eccentric exercise in women and men. METHODS: 42 adults (21 men and 21 women, 7 per condition) completed elbow extension exercises with a weight corresponding to 80%, 100%, or 120% of maximal voluntary concentric strength. Total work was equated by manipulating the number of repetitions in the 80% (N = 45), 100% (N = 36), and 120% (N = 30) conditions. RESULTS: A two-way ANOVA showed significant main effects for the intensity and sex factors. Perceived exertion ratings were strongly dependent on exercise intensity, and women reported lower RPEs than men. A separate three-way mixed model ANOVA that included a repetition factor showed that perceived exertion ratings increased similarly across the first 30 repetitions in all exercise conditions. Significant partial correlations were found between mean RPE during the eccentric exercise bout, and the mean intensity of delayed-onset muscle pain measured from 12- to 72-h postexercise after controlling for the relative exercise intensity (r12.3 = 0.28) or the maximum concentric strength of the elbow flexors (r12.3 = 0.33). CONCLUSIONS: 1) for both women and men, there is a positive association between the intensity of eccentric exercise performed with the elbow flexors and RPE; 2) perceived exertion ratings increase significantly then plateau when repeated eccentric muscle actions are performed at constant, submaximal absolute intensities; 3) women rate eccentric exercise performed at the same intensity (relativized to MVC-C) as being less effortful compared with men; and 4) RPE during eccentric exercise can account for a small but significant amount of variability in delayed-onset muscle pain after statistically controlling for differences in strength or relative intensity.

Modifiable cardiovascular disease risk factors among indigenous populations.

Objective. To identify modifiable cardio-metabolic and lifestyle risk factors among indigenous populations from Australia (Aboriginal Australians/Torres Strait Islanders), New Zealand (Maori), and the United States (American Indians and Alaska Natives) that contribute to cardiovascular disease (CVD). Methods. National health surveys were identified where available. Electronic databases identified sources for filling missing data. The most relevant data were identified, organized, and synthesized. Results. Compared to their non-indigenous counterparts, indigenous populations exhibit lower life expectancies and a greater prevalence of CVD. All indigenous populations have higher rates of obesity and diabetes, hypertension is greater for Maori and Aboriginal Australians, and high cholesterol is greater only among American Indians/Alaska Natives. In turn, all indigenous groups exhibit higher rates of smoking and dangerous alcohol behaviour as well as consuming less fruits and vegetables. Aboriginal Australians and American Indians/Alaska Natives also exhibit greater rates of sedentary behaviour. Conclusion. Indigenous groups from Australia, New Zealand, and the United States have a lower life expectancy then their respective non-indigenous counterparts. A higher prevalence of CVD is a major driving force behind this discrepancy. A cluster of modifiable cardio-metabolic risk factors precede CVD, which, in turn, is linked to modifiable lifestyle risk factors.

Examination of the effectiveness of peppermint aromatherapy on nausea in women post C-section.

PURPOSE: This study examined the effect of peppermint spirits on postoperative nausea in women following a scheduled C-section. DESIGN: A pretest-posttest research design with three groups was used. The peppermint group inhaled peppermint spirits, the placebo aromatherapy control group inhaled an inert placebo, green-colored sterile water, and the standard antiemetic therapy control group received standard antiemetics, usually intravenous ondansetron or promethazine suppositories. METHODS: Women were randomly assigned to a group on admission to the hospital. If they became nauseated, nurses on the mother-baby unit assessed their nausea (baseline), administered the assigned intervention, and then reassessed participants' nausea 2 and 5 minutes after the initial intervention. Participants rated their nausea using a 6-point nausea scale. FINDINGS: Thirty-five participants became nauseated post-operatively. Participants in all three intervention groups had similar levels of nausea at baseline. The nausea levels of participants in the peppermint spirits group were significantly lower than those of participants in the other two groups 2 and 5 minutes after the initial intervention. CONCLUSIONS: Peppermint spirits may be a useful adjunct in the treatment of postoperative nausea. This study should be replicated with more participants, using a variety of aromatherapies to treat nausea in participants with different preoperative diagnoses.

Safety and efficacy of supervised strength training adopted in pregnancy.

OBJECTIVE: Describe safety and efficacy of a supervised, low-to-moderate intensity strength training program adopted during pregnancy among women at increased risk for back pain. METHODS: 32 women adopted strength training twice per week for 12 weeks. Data on musculoskeletal injuries, symptoms, blood pressure, and the absolute external load used for 5 of 6 exercises were obtained during each session. A submaximal lumbar extension endurance exercise test was performed at weeks 5, 10, and 13. RESULTS: The mean (± SD) exercise session attendance rate was 80.5% (± 11.3%). No musculoskeletal injuries occurred. Potentially adverse symptoms (eg, dizziness) were infrequent (2.1% of sessions). Repeated-measures ANOVA showed large increases in the external load across 12 weeks (all P values < .001) and the percentage increases in external load from weeks 1 to 12 were 36% for leg press, 39% for leg curl, 39% for lat pull down, 41% for lumbar extension and 56% for leg extension. Training was associated with a 14% increase in lumbar endurance. Blood pressure was unchanged following acute exercise sessions and after 12 weeks of exercise training. CONCLUSION: The adoption of a supervised, low-to-moderate intensity strength training program during pregnancy can be safe and efficacious for pregnant women.

Body images of 4-8-year-old girls at the outset of their first artistic gymnastics class.

OBJECTIVE: The primary objective of this investigation was to compare body images of 54 girls (4-8 years old) who were beginning their first gymnastics class to 54 age-matched (+/-1 year) and % body fat-matched (+/-3%) girls not participating in gymnastics. METHOD: Ratings of actual and ideal body size and a computed measure of body dissatisfaction (actual minus ideal) were obtained. Body composition was measured with dual-energy x-ray absorptiometry. RESULTS: Girls beginning gymnastics did not differ significantly from controls on (mean +/- SD) actual (2.2 +/- 1.4 vs. 2.1 +/- 1.4), ideal (1.8 +/- 1.3 vs. 1.8 +/- 1.5), or body dissatisfaction (0.39 +/- 1.8 vs. 0.26 +/- 1.4) scores. DISCUSSION: Body images of 4-8-year-old girls beginning their first artistic gymnastics class do not differ from non-gymnast controls matched on age and % body fat. This observation casts doubt on the idea that young girls who are dissatisfied with their body and want to be smaller are more likely to enroll in gymnastics classes than girls without this type of body dissatisfaction.