The objective of this study was to explore the feasibility and preliminary effectiveness of the Lifestyle-Integrated Functional Exercise for People with Dementia (LiFE4D) on health-related physical fitness, cognitive function, physical activity, and respiratory and upper limb functions. A randomized controlled pilot study was conducted (control group: usual care; experimental group: usual care and LiFE4D). The feasibility of LiFE4D was determined considering recruitment, protocol acceptability, adherence, and safety. Measures of health-related physical fitness, cognitive function, physical activity, and respiratory and upper limb functions were assessed at the baseline and 3 months. Twelve participants (8 [66.7%] female, 82 [72.2–84] years) were included, six per group. Recruitment was challenging. LiFE4D was acceptable with excellent adherence and no major adverse events. Cardiorespiratory endurance (effect size = 1.64, 95% confidence interval [CI; 0.33, 2.95]) and balance (effect size = 1.46, 95% CI [0.19, 2.73]) improved after LiFE4D. LiFE4D seems to be feasible and safe, and it shows potential to significantly improve the health-related physical fitness of people with dementia.
Sara Almeida, Cátia Paixão, Madalena Gomes da Silva, and Alda Marques
Rihab Borji, Firas Zghal, Nidhal Zarrouk, Sonia Sahli, and Haithem Rebai
The authors explored neuromuscular fatigue in athletes with intellectual disability (AID) compared with sedentary individuals with intellectual disability (SID) and individuals with typical development. Force, voluntary activation level, potentiated resting twitch, and electromyography signals were assessed during isometric maximal voluntary contractions performed before and immediately after an isometric submaximal exhaustive contraction (15% isometric maximal voluntary contractions) and during recovery period. AID presented shorter time to task failure than SID (p < .05). The three groups presented similar isometric maximal voluntary contraction decline and recovery kinetic. Both groups with intellectual disability presented higher voluntary activation level and root mean square normalized to peak-to-peak M-wave amplitude declines (p < .05) compared with individuals with typical development. These declines were more pronounced in SID (p < .05) than in AID. The AID recovered their initial voluntary activation level later than controls, whereas SID did not. SID presented lower potentiated resting twitch decline compared with AID and controls with faster recovery (p < .05). AID presented attenuated central fatigue and accentuated peripheral fatigue compared with their sedentary counterparts, suggesting a neuromuscular profile close to that of individuals with typical development.
Jacob Szeszulski, Kevin Lanza, Erin E. Dooley, Ashleigh M. Johnson, Gregory Knell, Timothy J. Walker, Derek W. Craig, Michael C. Robertson, Deborah Salvo, and Harold W. Kohl III
Background: Multiple models and frameworks exist for the measurement and classification of physical activity in adults that are applied broadly across populations but have limitations when applied to youth. The authors propose a conceptual framework specifically designed for classifying youth physical activity. Methods: The Youth Physical Activity Timing, How, and Setting (Y-PATHS) framework is a conceptualization of the when (timing), how, and where (setting) of children’s and adolescents’ physical activity patterns. The authors developed Y-PATHS using the design thinking process, which includes 3 stages: inspiration, ideation, and implementation. Results: The Y-PATHS includes 3 major components (timing, how, and setting) and 13 subcomponents. Timing subcomponents include (1) school days: in-school, (2) school days: out-of-school, and (3) nonschool days. How subcomponents include: (1) functional, (2) transportation, (3) organized, and (4) free play. Setting subcomponents include: (1) natural areas, (2) schools, (3) home, (4) recreational facilities, (5) shops and services, and (6) travel infrastructure. Conclusions: The Y-PATHS is a comprehensive classification framework that can help researchers, practitioners, and policymakers to better understand youth physical activity. Specifically, Y-PATHS can help to identify the domains of youth physical activity for surveillance and research and to inform the planning/evaluation of more comprehensive physical activity programming.
Ralph Beneke and Renate M. Leithäuser
Roberto Baldassarre, Cristian Ieno, Marco Bonifazi, and Maria Francesca Piacentini
Purpose: The sensation of fatigue experienced at a certain point of the race is an important factor in the regulation of pacing. The rating of perceived exertion (RPE) is considered one of the main mediators utilized by athletes to modify pacing. The aim was to analyze the relationship between pacing and RPE of elite open water swimmers during national indoor pool championships. Methods: A total of 17 elite open water swimmers (males, n = 9; females, n = 8) agreed to provide RPE every 500 m during the finals of the national championships 5-km indoor pool race. Time splits, stroke rate, and RPE were collected every 500 m. The Hazard score was calculated by multiplying the momentary RPE by the remaining fraction of the race. Athletes were placed in one of two categories: medalists or nonmedalists. For all variables, separate mixed analysis of variances (P ≤ .05) with repeated measures were used considering the splits (ie, every 500 m) as within-subjects factor and the groups (ie, medalists and nonmedalists) as between-subjects factor. Results: Average swimming speed showed a significant main effect for split for both males and females (P < .001). A significant interaction was observed between average swimming speed and groups for females (P = .032). RPE increased in both groups (P < .001) with no difference observed between groups. However, the female nonmedalists showed a disproportionate nonlinear increase in RPE (5.20 [2.31]) halfway through the event that corresponded to the point where they started significantly decreasing speed. Conclusions: The results of the present study show different pacing strategies adopted by medalists and nonmedalists despite a similar RPE.
Mohamed Romdhani, Nizar Souissi, Imen Moussa-Chamari, Yassine Chaabouni, Kacem Mahdouani, Zouheir Sahnoun, Tarak Driss, Karim Chamari, and Omar Hammouda
Purpose: To compare the effect of a 20-minute nap opportunity (N20), a moderate dose of caffeine (CAF; 5 mg·kg−1), or a moderate dose of caffeine before N20 (CAF+N) as possible countermeasures to the decreased performance and the partial sleep deprivation–induced muscle damage. Methods: Nine male, highly trained judokas were randomly assigned to either baseline normal sleep night, placebo, N20, CAF, or CAF+N. Test sessions included the running-based anaerobic sprint test, from which the maximum (P max), mean (P mean), and minimum (P min) powers were calculated. Biomarkers of muscle, hepatic, and cardiac damage and of enzymatic and nonenzymatic antioxidants were measured at rest and after the exercise. Results: N20 increased P max compared with placebo (P < .01, d = 0.75). CAF+N increased P max (P < .001, d = 1.5; d = 0.94), P min (P < .001, d = 2.79; d = 2.6), and P mean (P < .001, d = 1.93; d = 1.79) compared with placebo and CAF, respectively. Postexercise creatine kinase increased whenever caffeine was added, that is, after CAF (P < .001, d = 1.19) and CAF+N (P < .001, d = 1.36). Postexercise uric acid increased whenever participants napped, that is, after N20 (P < .001, d = 2.19) and CAF+N (P < .001, d = 2.50) and decreased after CAF (P < .001, d = 2.96). Conclusion: Napping improved repeated-sprint performance and antioxidant defense after partial sleep deprivation. Contrarily, caffeine increased muscle damage without improving performance. For sleep-deprived athletes, caffeine before a short nap opportunity would be more beneficial for repeated sprint performance than each treatment alone.
Sara Birch, Torben Bæk Hansen, Maiken Stilling, and Inger Mechlenburg
Background: Pain catastrophizing is associated with pain both before and after a total knee arthroplasty (TKA). However, it remains uncertain whether pain catastrophizing affects physical activity (PA). The aim was to examine the influence of pain catastrophizing on the PA profile, knee function, and muscle mass before and after a TKA. Methods: The authors included 58 patients with knee osteoarthritis scheduled for TKA. Twenty-nine patients had a score >22 on the Pain Catastrophizing Scale (PCS), and 29 patients had a score <11. PA was measured with a triaxial accelerometer preoperative, 3 months, and 12 months after TKA. Other outcome measures consisted of the Knee Osteoarthritis Outcome Score and dual-energy X-ray absorptiometry scans. Results: The authors found no difference in PA between patients with a better/low or a worse/high score on the PCS, and none of the groups increased their mean number of steps/day from preoperative to 12 months postoperative. Patients with better/low PCS scores had higher/better preoperative scores on the Knee Osteoarthritis Outcome Score subscales (symptoms, pain, and activity of daily living), and they walked longer in the 6-min walk test. Further, they had lower body mass index, lower percent fat mass, and higher percent muscle mass than patients with worse/high PCS scores both before and after a TKA. Conclusion: Preoperative pain catastrophizing did not influence PA before or after a TKA. Although the patients improved substantially in self-reported knee function, their PA did not increase. This may be important to consider when the clinicians are informing the patients about the expected benefits from the operation.
Isabel B. Rodrigues, Matteo Ponzano, Debra A. Butt, Joan Bartley, Zahra Bardai, Maureen C. Ashe, Philip D. Chilibeck, Lehana Thabane, John D. Wark, Jackie Stapleton, and Lora M. Giangregorio
Walking is a common activity among older adults. However, the effects of walking on health-related outcomes in people with low bone mineral density (BMD) are unknown. The authors included randomized controlled trials comparing walking to control in individuals aged ≥50 years with low BMD and at risk of fractures. The authors identified 13 randomized controlled trials: nine multicomponent interventions including walking, one that was walking only, and three Nordic walking trials. Most studies had a high risk of bias. Nordic walking may improve the Timed Up-and-Go values (1.39 s, 95% CI [1.00, 1.78], very low certainty). Multicomponent interventions including walking improved the 6-min walk test (39.37 m, 95% CI [21.83, 56.91], very low certainty) and lumbar spine BMD (0.01 g/cm2, 95% CI [0.00, 0.03], low certainty evidence). The effects on quality of life or femoral neck BMD were not significant. There were insufficient data on fractures, falls, or mortality. Nordic walking may improve physical functioning. The effects on other outcomes are less certain; one may need to combine walking with other exercises to be of benefit.
Naroa Etxebarria, Jackson Wright, Hamish Jeacocke, Cristian Mesquida, and David B. Pyne
Negative or evenly paced racing strategies often lead to more favorable performance outcomes for endurance athletes. However, casual inspection of race split times and observational studies both indicate that elite triathletes competing in Olympic-distance triathlon typically implement a positive pacing strategy during the last of the 3 disciplines, the 10-km run. To address this apparent contradiction, the authors examined data from 14 International Triathlon Union elite races over 3 consecutive years involving a total of 725 male athletes. Analyses of race results confirm that triathletes typically implement a positive running pace strategy, running the first lap of the standard 4-lap circuit substantially faster than laps 2 (∼7%), 3 (∼9%), and 4 (∼12%). Interestingly, mean running pace in lap 1 had a substantially lower correlation with 10-km run time (r = .82) than both laps 2 and 3. Overall triathlon race performance (ranking) was best associated with run performance (r = .82) compared with the swim and cycle sections. Lower variability in race pace during the 10-km run was also reflective of more successful run times. Given that overall race outcome is mainly explained by the 10-km run performance, with top run performances associated with a more evenly paced strategy, triathletes (and their coaches) should reevaluate their pacing strategy during the run section.