Beyond change scores: Employing an improved statistical approach to analyze the impact of entry fitness on physical performance during British Army basic training in men and women.

The aim was to use a robust statistical approach to examine whether physical fitness at entry influences performance changes between men and women undertaking British Army basic training (BT). Performance of 2 km run, seated medicine ball throw (MBT) and isometric mid-thigh pull (MTP) were assessed at entry and completion of Standard Entry (SE), Junior Entry-Short (JE-Short), and Junior Entry-Long (JE-Long) training for 2350 (272 women) recruits. Performance change was analyzed with entry performance as a covariate (ANCOVA), with an additional interaction term allowing different slopes for courses and genders (p < 0.05). Overall, BT courses saw average improvements in 2 km run performance (SE: -6.8% [-0.62 min], JE-Short: -4.6% [-0.43 min], JE-Long: -7.7% [-0.70 min]; all p < 0.001) and MBT (1.0-8.8% [0.04-0.34 m]; all p < 0.05) and MTP (4.5-26.9% [6.5-28.8 kg]; all p < 0.001). Regression models indicate an expected form of "regression to the mean" whereby test performance change was negatively associated with entry fitness in each course (those with low baseline fitness exhibit larger training improvements; all interaction effects: p < 0.001, η p 2 $$ {\eta}_{\mathrm{p}}^2 $$ > 0.006), particularly for women. However, when matched for entry fitness, men displayed considerable improvements in all tests, relative to women. Training courses were effective in developing recruit physical fitness, whereby the level of improvement is, in large part, dependent on entry fitness. Factors including age, physical maturity, course length, and physical training, could also contribute to the variability in training response between genders and should be considered when analyzing and/or developing physical fitness in these cohorts for future success of military job-task performance.

Evaluation of multi-directional speed qualities throughout adolescence in youth soccer: The non-linear nature of transfer.

Training and assessment of agility is often prioritised by soccer coaches and practitioners aiming to develop multi-directional speed. Although the importance of agility is advocated throughout childhood and adolescence, limited data evidence agility performance at different stages of adolescence. The purpose of this study was to examine differences in multi-directional speed performance in youth soccer players spanning an entire soccer academy. A total of 86 male junior-elite soccer players volunteered to participate. Anthropometric data were collected, alongside performance data from a battery of physical tests including sprinting, jumping, change of direction, reaction time, and agility. Bayesian models using log-likelihoods from posterior simulations of parameter values displayed linear or curvilinear relationships between both chronological and biological age and performance in all tests other than agility and reaction time. For agility and reaction time tests, performance improved until ~14 years of age or the estimated age of peak height velocity whereby arrested development in performance was observed. Our results demonstrate that while most performance skills improve as chronological or biological age increases, measures of agility and reaction time may not. These findings support the notion that agility performance is complex and multifaceted, eliciting unique, challenging physical demands and non-linear development.

Evaluation of the Value of the Y-Balance Test to Predict Lower Limb Injuries in Professional Male Footballers.

CONTEXT: The aim of this prospective cohort study was to identify whether Y-Balance Test (YBT) performance and asymmetry are associated with lower limb injury in elite adult football athletes. DESIGN: A prospective cohort study. METHODS: Preseason YBT measures were obtained from 121 male footballers participating in National League One across the 2021-2022 season. Lower limb injuries were tracked across the season to determine the relationship between YBT variables and injury incidence using logistic regression analysis. The statistical significance level was .05. RESULTS: The average YBT score was 111.0 (5.8) cm on the left limb and 112.0 (5.5) cm on the right limb, with an average asymmetry of 2.3 (1.4) cm. Athletes with lower YBT scores on both the left (odds ratio = 2.9; 95% confidence interval, 1.7 to 4.8: P ≤ .001) and right (odds ratio = 2.3; 95% confidence interval, 1.6 to 3.2: P ≤ .001) limbs were at a greater risk of injury. Similarly, athletes with greater amounts of asymmetry were also more likely to get injured (odds ratio = 2.1; 95% confidence interval, 1.3 to 3.3: P = .002). CONCLUSIONS: Results indicate that lower and asymmetrical YBT scores have a significant relationship with future lower limb injuries in professional male footballers. The YBT offers a simple, reliable, and effective screening tool that can be used by practitioners in football to help identify players at a greater risk of injury before the season commences.

Men and women differ in their interest and willingness to participate in exercise and sports science research.

Unequal proportions of male and female participants in exercise research might be attributed, in part, to differences in interest and willingness to participate. We tested if men and women are equally interested and willing to undergo exercise research procedures and if they consider different factors when deciding to participate. Two samples completed an online survey. Sample 1 (129 men, 227 women) responded to advertisements on social media and survey-sharing websites. Sample 2 (155 men, 504 women) was comprised of undergraduate psychology students. In both samples, men were significantly more interested to learn their muscle mass amount, running speed, jump height, and ball throwing ability, and more willing to receive electrical shocks, cycle or run until exhaustion, complete strength training that causes muscle soreness, and take muscle-building supplements (all p ≤ 0.013, d = 0.23-0.48). Women were significantly more interested to learn their flexibility, and more willing to complete surveys, participate in stretching and group aerobics interventions, and participate in home exercise with online instruction (all p ≤ 0.021, d = 0.12-0.71). Women rated the following significantly more important when deciding to participate: study's implications for society; personal health status; confidence in own abilities; potential anxiety during testing; type of research facility; time to complete study; and invasiveness, pain/discomfort, and possible side effects of procedures (all p < 0.05, d = 0.26-0.81). Differences in interest and willingness to participate in research probably contribute to different proportions of men and women as participants in exercise research. Knowledge of these differences might help researchers develop recruitment strategies aimed at encouraging both men and women to participate in exercise studies.

Student-led exercise testing and prescription has benefits for both students and their community volunteers.

Service learning opportunities allow students to apply their knowledge and skills through engagement with their community. Previous studies have suggested that student-led exercise testing and health screening can benefit both students and their community participants. In a third-year kinesiology course, "Physiological Assessment and Training," students at the University of Prince Edward Island are provided with an introduction to health-focused personal training and develop and manage personalized training programs for community volunteers. The purpose of this study was to investigate the impact of student-led training programs on student learning. A secondary purpose was to investigate the perceptions of community members participating in the program. Community participants included 13 men and 43 women with stable health (mean age: 52.3 ± 10.0 yr). Students led participants through aerobic and musculoskeletal fitness tests before and after completion of a 4-wk student-designed training program based on participants' fitness and interests. Students reported that the program was enjoyable and improved understanding of fitness concepts and confidence in personal training. Community participants rated the programs as enjoyable and appropriate and viewed students as professional and knowledgeable. These results suggest that student-led personal training programs provide meaningful benefits to students and their community volunteers.NEW & NOTEWORTHY Undergraduate kinesiology students oversaw exercise testing and 4 wk of supervised exercise for community volunteers. Both students and their community participants reported enjoying the experience, and students stated that it also improved their understanding and confidence. These results suggest that student-led personal training programs provide meaningful benefits to students and their community volunteers.

A qualitative evaluation of remote training to develop a fitness surveillance system.

Objectives: In the USA, 18% of school-aged young people are classified as obese, and rural populations appear to be particularly at risk. Achieving high levels of fitness reduces the risk of obesity and underlying health conditions. To better understand youth obesity trends and fitness levels, annual fitness testing ([FT], that is, surveillance) in schools has been recommended. Although many K-12 schools conduct FT, surveillance programmes that compile unified standardised test results are rare. Design: Qualitative design. Setting: Physical education teachers from 11 schools (n = 13; n = 4 men) participated in remote training about conducting FitnessGram FT. Methods: Data included two semi-structured interviews per teacher on experiences with distance fitness training, implementing FitnessGram, and data entry for annual surveillance. Results: Inductive analysis using axial and open coding identified four themes: (1) barriers prior to study, (2) study training, (3) implementation challenges and suggestions and (4) teacher feedback. Teachers had an interest in FT but lacked the recommended training and equipment needed to implement it annually. Conclusion: Teachers believed the training they received (as part of this study) prepared them to collect reliable and valid data, and that FT had benefits for their students and programmes. Every teacher expressed interest in reporting annual surveillance data. Efforts to train teachers for FT through virtual professional development may be a viable means of establishing a unified surveillance system.

Changes in anthropometric and fitness profile of Italian regional academy rugby union players.

In rugby union, physical characteristics may partially contribute to long-term career progression, especially during adolescence. Therefore, the primary purpose of the study was to evaluate Italian regional rugby union academy players' (i.e., under-18) anthropometric and physical characteristics during a competitive season. Body mass, height, upper- and lower-body maximal strength, sprint, and high-intensity running ability were assessed in 29 elite players (backs, n = 13, forwards, n = 16). A mixed-design analysis of variance (ANOVA) for repeated measures showed that backs were shorter (ES = 0.59), lighter (ES = 0.94), stronger relative to body mass (bench press; ES = 0.60; deadlift; ES = 0.63; clean ES = 0.63; rowing ES = 0.67), and fitter (shuttle run max; ES = 0.38; shuttle run tot; ES = 0.79) than forwards. However, the forwards achieved greater sprint momentum (initial sprint momentum; ES = 0.97; maximal sprint momentum; ES = 0.98). During the season, players changed in stature, upper-body maximal strength, jumping, and high intensity running (p < 0.05), but not in body weight or lower-body maximal strength (p > 0.05). Maximal strength improved in the first part of the season, whereas jumping and sprinting performances increased in the last part of the season. Therefore, these findings highlight the importance of regularly monitoring the physical development in a long-term perspective, even suggesting that physiological adaptations are heterochronic between positional roles.

Physiological and Performance Correlates of Squash Physical Performance.

The physiological and performance attributes of elite squash players were investigated. Thirty-one players (21 males, world ranking [WR] 42-594; 10 females, WR 7-182) completed a battery of fitness tests which included an aerobic squash-specific physical performance test (SPPT), repeated-sprint ability (RSA), change-of-direction speed (COD), acceleration (5-m sprint), body composition and force development (countermovement jump) assessments. The SPPT provided a finishing lap score, V̇O2max, average movement economy and the lap corresponding to a blood lactate concentration of 4 mM.L-1. Players were ranked and assigned to HIGH or LOW performance tiers. Two-way ANOVA (performance level*sex) revealed higher ranked players performed better (p < 0.05) for SPPT final lap (d = 0.35), 4 mM.L-1 lap (d = 0.52) and COD (d = 0.60). SPPT displayed a 'very-large' correlation with 4 mM.L-1 lap (r = 0.86), 'large' correlations with COD (r = 0.79), RSA (r = 0.79), sum-of-7 skinfolds (r = 0.71) and V̇O2max (r = 0.69), and a 'trivial' correlation with average movement economy (r = 0.02). Assessments of cardiovascular fitness (i.e. 4 mM.L-1 lap), RSA, COD and body composition appear highly pertinent for performance profiling of squash players. Regular, submaximal assessment of the 4 mM.L-1 lap during the SPPT may offer a practical athlete monitoring approach for elite squash players.

Stay True to Your Workout: Does Repeated Physical Testing Boost Exercise Attendance? A One-Year Follow-Up Study.

No prospective studies have investigated if repeated testing of physical performance and body composition are associated with exercise attendance or patterns in fitness club members. This study aimed to investigate if repeated physical testing was associated with exercise attendance and patterns in gym members and to report prospective data on use of the fitness club`s facilities and products. Untrained new members were recruited and divided into a test group (n = 125) and as controls (n = 125). All participants answered a survey including exercise involvement, at onset, and after 3, 6, and 12 months follow-up. The test group also measured body composition, maximal oxygen uptake, and maximal muscle strength (onset, and after 3 and 12 months). In total 73.6% answered all surveys, and in the test group, 44.8% completed all physical tests. Regular exercise attendance was defined as ≥2 sessions/week. Repeated testing showed no association with long-term regular exercise attendance (test group: 19.6%, controls: 19.8%; p = 0.638). At 3 months, a lower proportion in the test group reported engagement in resistance exercise (35.3% and 60.2%; p = 0.003) and had lower exercise frequency (2.0 and 2.6 days/week; p = 0.008) than controls. The test group had higher participation in group exercise classes (28.0% and 13.6%; p = 0.040). Exercise frequency decreased from onset to 12 months (from 2.6 to 2.2 days/week; p = 0.025) At 3, 6, and 12 months, 51.8%, 37.6%, and 37.4% reported regular exercise attendance, and 16.9% at all follow-ups. At all time-points, most common workout mode was individual resistance exercise (43.8% to 46.3%). Few attended group exercise classes (7.5% to 13.8%) or used a personal trainer (22.5% to 27.5%). Repeated physical testing did not improve exercise attendance, and we found no changes in members` use of the fitness club`s facilities and products. Only 16.9% reported regular exercise attendance throughout the first year of membership.

Temporal trends in handgrip strength for older Japanese adults between 1998 and 2017.

OBJECTIVE: to estimate temporal trends in handgrip strength (HGS) for older Japanese adults between 1998 and 2017. DESIGN AND METHODS: adults aged 60-79 years were included. Annual nationally representative HGS data (n = 176,449) for the 19-year study period were obtained from the Japanese Ministry of Education, Culture, Sports, Science and Technology. Temporal trends in mean HGS were estimated by sample-weighted regression models relating the year of testing to mean HGS. National trends in absolute, percent and standardised HGS were estimated by a post-stratified population-weighting procedure. Temporal trends in variability were estimated as the ratio of coefficients of variation (CVs). RESULTS: collectively, there was a small improvement in mean HGS of 1.4 kg (95% confidence interval [CI]: 1.3-1.5), 4.5% (95%CI: 4.3-4.7) or 0.27 standard deviations (95%CI: 0.26-0.28) between 1998 and 2017. The rate of improvement progressively increased over time, with more recent values (post-2008) 1.5-fold larger than earlier values. Gender- and age-related temporal differences were negligible. Variability in HGS declined substantially over time (ratio of CVs [95%CI]: 0.88 [0.86-0.90]), with declines 1.9-fold larger in women compared to men and 1.7-fold larger in 70- to 79-year-olds compared to 60- to 69-year-olds. CONCLUSIONS: there has been a small, progressive improvement in mean HGS for older Japanese adults since 1998, which is suggestive of a corresponding improvement in strength capacity. The substantial decline in variability indicates that the improvement in mean HGS was not uniform across the population.

Combining physical performance and Functional Movement Screen testing to identify elite junior Australian Football athletes at risk of injury.

The Functional Movement Screen (FMS) and physical performance testing are often suggested to be related to sports injury risk. This study explored if the combination of FMS and physical performance testing improved identification of non-contact injury risk over FMS testing alone in an elite junior Australian football cohort. Over a 3-year period, 573 players completed pre-season injury history questionnaires, FMS, physical performance testing (20-m sprint, vertical jump, planned agility testing, and shuttle run test), and subsequent in-season injury surveillance. Results: Neither previous injury or FMS score <14 were related to an increased risk of subsequent injury in isolation. The combination of FMS composite score ≤14 and previous injury moderately increased the risk of injury (Hazard ratio [HR] = 2.22 [1.09-4.54]). None of the physical performance measures improved the ability to predict injuries based on FMS composite score. FMS asymmetry was only associated with injury when combined with previous injury and vertical jump performance. Players with ≥1 FMS asymmetry and history of previous injury experienced a large increase in injury risk when vertical jump was poor (HR = 4.26 [1.35-13.42]) or good (HR = 3.17 [1.08-9.29]). Players with a combination of a good vertical jump, no previous injury, and no FMS asymmetries were also at moderately increased risk of injury (HR = 3.41 [1.11-10.42]). No physical performance tests improved the ability to identify non-contact injury risk using an FMS composite score threshold. However, a U-shaped relationship between vertical jump and injury risk was identified with both poor and good vertical jump height associated with a moderate-large increase in non-contact injury risk in the presence of ≥1 asymmetrical FMS sub-test.

High-intensity endurance capacity assessment as a tool for talent identification in elite youth female soccer.

Talent identification and development programmes have received broad attention in the last decades, yet evidence regarding the predictive utility of physical performance in female soccer players is limited. Using a retrospective design, we appraised the predictive value of performance-related measures in a sample of 228 youth female soccer players previously involved in residential Elite Performance Camps (age range: 12.7-15.3 years). With 10-m sprinting, 30-m sprinting, counter-movement jump height, and Yo-Yo Intermittent Recovery Test Level 1 (IR1) distance as primary predictor variables, the Akaike Information Criterion (AIC) assessed the relative quality of four penalised logistic regression models for determining future competitive international squads U17-U20 level selection. The model including Yo-Yo IR1 was the best for predicting career outcome. Predicted probabilities of future selection to the international squad increased with higher Yo-Yo IR1 distances, from 4.5% (95% confidence interval, 0.8 to 8.2%) for a distance lower than 440 m to 64.7% (95% confidence interval, 47.3 to 82.1%) for a score of 2040 m. The present study highlights the predictive utility of high-intensity endurance capacity for informing career progression in elite youth female soccer and provides reference values for staff involved in the talent development of elite youth female soccer players.

A case study comparison of objective and subjective evaluation methods of physical qualities in youth soccer players.

Subjective and objective assessments may be used congruently when making decisions regarding player recruitment in soccer, yet there have been few attempts to examine the level of agreement between these methods. Therefore, we compare levels of agreement between subjective and objective assessments of physical qualities associated with youth soccer performance. In total, 80 male youth soccer players (13.2 ± 1.9 years), and 12 professional coaches volunteered to participate. Players were objectively assessed using five fitness measures: Yo-Yo Intermittent Recovery Test Level 1; Countermovement vertical jump; Functional Movement Screen™; 5/20 m sprint; alongside anthropometric measures. Additionally, coaches subjectively rated each player on the same five physical qualities using 5-point Likert scales. Inter-rater agreement between ratings from lead and assistant coaches was established for each age group. Moreover, Bayesian regression models were fitted to determine how well coach ratings were able to predict fitness test performance. Although inter-rater agreement between lead and assistant coaches was moderate-to-substantial (ω = 0.48-0.68), relationships between coaches subjective rating's and corresponding fitness test performance were only highly related for the highest and lowest performing players. We suggest that while ratings derived from objective and subjective assessment methods may be related when attempting to differentiate between distinct populations, concerns exist when evaluating homogeneous samples using these methods. Our data highlight the benefits of using both types of measures in the talent identification process.

Temporal trends in the sit-ups performance of 9,939,289 children and adolescents between 1964 and 2017.

We estimated international/national temporal trends in sit-ups performance for children and adolescents, and examined relationships between national trends in sit-ups performance and national trends in health-related/sociodemographic indicators. Data were obtained by systematically searching studies reporting on temporal trends in sit-ups performance for apparently healthy 9-17 year-olds, and by examining nationally representative fitness datasets. Trends at the country-sex-age level were estimated by sample-weighted regression models relating the testing year to mean sit-ups performance. International/national trends were estimated by a post-stratified population-weighting procedure. Pearson's correlations quantified relationships between national trends in sit-ups performance and national trends in health-related/sociodemographic indicators. A total of 9,939,289 children and adolescents from 31 countries/special administrative regions between 1964 and 2017 collectively showed a large improvement of 38.4% (95% CI: 36.8 to 40.0) or 7.1% per decade (95% CI: 6.8 to 7.4). Large international improvements were experienced by all age and sex groups, with the rate of improvement slowing from 1964 to 2000, stabilizing near zero until 2010, before declining. Trends differed between countries, with national trends in vigorous physical activity a strong, positive correlate of national trends in sit-ups performance. More sit-ups data are needed from low- and middle-income countries to better monitor trends in muscular fitness. PROSPERO REGISTRATION NUMBER: CRD42013003657.

Using the 6-minute walk test to predict disability-free survival after major surgery.

BACKGROUND: The 6-min walk test (6MWT) is a common means of functional assessment. Its relationship to disability-free survival (DFS) is uncertain. METHODS: This sub-study of the Measurement of Exercise Tolerance for Surgery study had co-primary outcome measures: correlation of the preoperative 6MWT distance with 30 day quality of recovery (15-item quality of recovery) and 12 month WHO Disability Assessment Schedule scores. The prognostic utility of the 6MWT and other risk assessment tools for 12 month DFS was assessed with logistic regression and receiver-operating-characteristic-curve analysis. RESULTS: Of 574 patients recruited, 567 (99%) completed the 6MWT. Twelve months after surgery, 16 (2.9%) patients had died and 444 (77%) had DFS. The 6MWT correlated weakly with 30 day 15-item quality of recovery (ρ=0.14; P=0.001) and 12 month WHO Disability Assessment Schedule (ρ=-0.23; P<0.0005) scores. When the cohort was split into 6MWT distance tertiles, the adjusted odds ratio of low vs high tertiles for DFS was 3.13 [95% confidence interval (CI): 1.54-6.35]. The only independent variable predictive of DFS was the Duke Activity Status Index (DASI) score (adjusted odds ratio: 1.06; P<0.0005). The area under the receiver-operating-characteristic curve for DFS was 0.63 (95% CI: 0.57-0.70) for the 6MWT, 0.60 (95% CI: 0.53-0.67) for cardiopulmonary-exercise-testing-derived peak oxygen consumption, and 0.70 (95% CI: 0.64-0.76) for the DASI score. CONCLUSIONS: Of the risk assessment tools analysed, the DASI was the most predictive of DFS. The 6MWT was safe and comparable with cardiopulmonary exercise testing for all predictive assessments. Future research should aim to determine the optimal 6MWT distance thresholds for risk prediction.

A Preliminary Study of Physical Fitness in 8- to 10-Year-Old Primary School Children From North East England in Comparison With National and International Data.

Purpose: Despite recent updates to international normative values for physical fitness in young people, contemporary data sets from England are sparse with no published data available from the North East. We compared physical fitness in children from one primary school in North East England to International and European reference data, and other English regions. Methods: Eighty participants (mean age [SD]: 9.1 [0.6] y) completed a testing battery of 20-m shuttle run test, handgrip strength, standing broad jump, and sit-and-reach. Scores for each component were assessed against International or European age- and sex-specific centiles, then grouped into quintiles. Differences between our sample and European and English data sets were explored using z scores and t tests. Results: For all components, ≥58% of participants were classified as having "moderate" or lower levels. Twenty-meter shuttle run test performance was not substantially different compared with other English data sets. For handgrip and sit-and-reach, our sample scored significantly worse than South East children. Standing broad jump distance in girls, and handgrip in boys and girls, was significantly lower than North West equivalents. Conclusion: Physical fitness levels in primary school children from North East England are suboptimal, highlighting a need for large-scale monitoring studies to build on our preliminary findings.

Age-related influence on physical fitness and individual on-duty task performance of Portuguese male non-elite police officers.

(a) to analyse the effect of age on physical fitness (PF) and on-duty task (ODT) performance of male police officers (PO); (b) to analyse the relationship between PF and ODT performance of male PO; and (c) to identify the set of PF attributes which better predicts the ODT performance of male PO. A total of 97 Portuguese male non-elite PO (Public Security Police) took part in this cross-sectional study. Participants were allocated to four age categories (20-29, 30-39, 40-49, and >49 years old), and performed fourteen PF evaluations and one on-duty task simulation test (ODT-ST). MANOVA, partial correlations and multiple linear regression analysis were used. We observed (a) a significant decrease of performance with aging (PF attributes, partial eta-squared=0.763; total time on ODT-ST, partial eta-squared=0.498); (b) significant positive associations between body mass index and fat mass with total time on ODT-ST; (c) a significant negative association between standing broad jump (SBJ), sit-up, push-up, bench-press ratio and aerobic capacity with total time on ODT-ST; and (d) that SBJ, abdominal muscular endurance and aerobic capacity were significant predictors of total time on ODT-ST (R2=0.983). PF attributes and ODT performance of Portuguese male non-elite PO decrease significantly with aging. To prevent the observed decrease of performance it seems advisable to implement regular strength and conditioning programmes, which should include muscular power, core strength and aerobic fitness development, to maintain physical capacity and occupational duties.

The Use of a Wheelchair Propulsion Field Test to Determine Peak Heart Rate in Children and Adolescents With Myelomeningocele.

PURPOSE: We analyzed the evolution and pattern of heart rate (HR) during the 12-minute wheelchair propulsion field test (WPFT) and compared the peak HR (HRpeak) from the WPFT to the HRpeak obtained in the progressive cardiopulmonary exercise test on arm cranking ergometer (ACT). We aimed to determine if the field test detects the HRpeak consistently and could be used in clinical practice. METHODS: Eleven wheelchair-using children and adolescents with myelomeningocele (aged 8-15 y) performed a maximal ACT and a 12-minute WPFT. HR was recorded continuously at rest, during each minute of the tests, and at recovery. Mixed analysis of variance was used to compare the variables at rest and peak. Bland-Altman plot and Lin's concordance correlation coefficient were used to show agreement between the tests. RESULTS: During minute 2 of the WPFT, participants reached 73%-96% of the HRpeak values recorded in the ACT. From minutes 4 to 12, participants reached HRpeak values ranging 86%-109% of the values recorded in the ACT. There is agreement between the ACT and the WPFT tests. CONCLUSION: WPFT with minimal duration of 4 minutes may be an alternative tool to obtain HRpeak in children and adolescents with myelomeningocele.

Fit for surgery? Perspectives on preoperative exercise testing and training.

There is a consistent relationship between physical activity, physical fitness, and health across almost all clinical contexts, including the perioperative setting. Physiological measurements obtained during physical exercise may be used to infer the risk of adverse outcome after major surgery. In particular, data obtained from perioperative cardiopulmonary exercise testing have an expanding role in perioperative care. Such information may be used to inform a variety of changes in clinical practice, including interventions that may reduce the risk of perioperative adverse events. Specifically, for patients undergoing major cancer surgery there is a complex interplay between different cancer treatments, including neoadjuvant therapies (chemo- and chemo- plus radiotherapy), surgery, and physical fitness, and the modulation of these relationships by perioperative exercise interventions. Preoperative cardiopulmonary exercise testing provides an objective evaluation of physical fitness and has been used to provide an individualized risk profile in order to guide collaborative decision-making, inform the consent process, characterize and optimize co-morbidities, and to triage patients to perioperative care. Furthermore, studies evaluating exercise interventions aimed at increasing preoperative exercise capacity have established that training improves physical fitness. However, to date, this literature is largely composed of feasibility and pilot studies with small sample sizes, which are in general underpowered to assess clinical outcomes. Adequately powered prospective multicentre studies are needed to characterize the most effective means of improving patient fitness before surgery and to evaluate the impact of such improvements on surgical and disease-specific (e.g. cancer) outcomes.

Association of physical fitness with health-related quality of life in early postmenopause.

OBJECTIVE: To assess the association of different components of physical fitness with HRQoL in early postmenopause and to test which physical fitness components are independently associated with the physical and mental components of HRQoL. METHODS: The final sample comprised 67 early postmenopausal women. Physical fitness was assessed with the Senior Fitness Test battery (additionally including handgrip strength test), and HRQoL was evaluated with the Short-Form Health Survey-36 (SF-36). We also analyzed plasma gonadotropic hormones and estradiol. RESULTS: Overall, most of the fitness components were positively associated with HRQoL. Lower-body flexibility, upper-body muscle strength and cardiorespiratory fitness were the fitness components more strongly associated with HRQoL (r range from 0.28 to 0.56). Static balance was especially associated with mental health (r = -0.46, P < 0.001). Lower-body flexibility (assessed with the chair sit-and-reach test) and upper-body muscle strength (assessed with handgrip dynamometry) were independently associated with the SF-36 Physical Component Summary (both, P < 0.001). Upper-body muscle strength (P < 0.01) and cardiorespiratory fitness (assessed with the 6-min walk test, P < 0.05) were independently associated with the SF-36 Mental Component Summary. CONCLUSIONS: Higher physical fitness is associated with better HRQoL in early postmenopause. Lower-body flexibility and upper-body muscle strength were the most important independent fitness indicators, explaining ~30 % of HRQoL.