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Introduction: Elite sports pose potential health risks, but are vital to the well-being of society. In Cuban society, sport is an integral part of personal development and public health, fostering unity and promoting female participation for sustainable growth. Athletics is one of the most important sports in Cuban sport, and should be approached both from the point of view of sports training and sports psychology. Purpose: The aim of this study was to provide a description of conditional variables in a countermovement jump (CMJ), mood profile, self-efficacy, and the leg-hip height index among athletes from the Cuban national athletics pre-selection team, differentiated by gender. Methods: Our sample consisted of the Cuban national athletics pre-selection team. Results: Mood profile analysis using the Profile of Mood States (POMS) did not reveal significant gender differences, with a small effect size for gender. Men showed a slightly greater trend towards vigor compared to women. Significant differences in self-efficacy were observed between men and women in their confidence levels to achieve jump heights between 21 and 40 cm using the CMJ. However, no significant differences were found for jumps exceeding 40 cm, highlighting the importance of strategies to enhance athletes’ psychological needs and self-efficacy. Conclusions: This study suggests that the association between tension-related anxiety and performance indicators related to jump height may play a crucial role in determining specific profiles in male and female Cuban athletes. Our comprehensive analysis contributes to understanding gender differences in performance factors. These findings provide valuable insights for future research and athlete development strategies., Introdução: Os desportos de elite apresentam riscos potenciais para a saúde, mas são vitais para o bem-estar da sociedade. Na sociedade cubana, o desporto é parte integrante do desenvolvimento pessoal e da saúde pública, fomentando a unidade e promovendo a participação feminina para um crescimento sustentável. O atletismo é uma das modalidades mais importantes do desporto cubano e deve ser abordado tanto do ponto de vista do treino desportivo como da psicologia desportiva. Objetivo: O objetivo deste estudo foi fornecer uma descrição das variáveis condicionais em um salto com movimento (CMJ, sigla em inglês), perfil de humor, autoeficácia e o índice de altura da perna-quadril entre atletas da equipe de pré-seleção nacional de atletismo de Cuba, diferenciados por gênero. Métodos: Nossa amostra consistiu na equipe de pré-seleção nacional de atletismo de Cuba. Resultados: A análise do perfil de humor usando o Perfil de Estados de Humor (POMS) não revelou diferenças significativas de gênero, com um pequeno efeito de tamanho para o gênero. Os homens mostraram uma tendência ligeiramente maior para o vigor em comparação com as mulheres. Diferenças significativas na autoeficácia foram observadas entre homens e mulheres em seus níveis de confiança para alcançar alturas de salto entre 21 e 40 cm usando o CMJ. No entanto, não foram encontradas diferenças significativas para saltos superiores a 40 cm, destacando a importância de estratégias para aprimorar as necessidades psicológicas e a autoeficácia dos atletas. Conclusões: Este estudo sugere que a associação entre ansiedade relacionada à tensão e indicadores de desempenho relacionados à altura do salto pode desempenhar um papel crucial na determinação de perfis específicos em atletas cubanos do sexo masculino e feminino. Nossa análise abrangente contribui para entender as diferenças de gênero nos fatores de desempenho. Esses achados fornecem insights valiosos para futuras pesquisas e estratégias de desenvolvimento de atletas., Introducción: Los deportes de élite plantean riesgos potenciales para la salud, pero son vitales para el bienestar de la sociedad. En la sociedad cubana, el deporte forma parte integral del desarrollo personal y la salud pública, fomentando la unidad y promoviendo la participación femenina, para un crecimiento sostenible. El atletismo es uno de los deportes más importantes en el deporte cubano, y debe ser abordado tanto, desde el punto de vista del entrenamiento deportivo, como desde la psicología deportiva. Propósito: El objetivo de este estudio fue proporcionar una descripción de las variables condicionales en un salto con contramovimiento (CMJ, por sus siglas en inglés), el perfil anímico, la autoeficacia y el índice de altura pierna-cadera en atletas de la preselección nacional cubana de atletismo, diferenciados por sexo. Materiales y métodos: Nuestra muestra estuvo constituida por la preselección nacional de atletismo de Cuba. Resultados: El análisis del perfil del estado de ánimo mediante el Perfil de Estados de Ánimo (POMS) no reveló diferencias significativas entre sexos, con un tamaño del efecto pequeño para el sexo. Los hombres mostraron una tendencia ligeramente mayor hacia el vigor, en comparación con las mujeres. Se observaron diferencias significativas en la autoeficacia entre hombres y mujeres, en sus niveles de confianza para alcanzar alturas de salto de entre 21 y 40 cm utilizando el CMJ. Sin embargo, no se encontraron diferencias significativas para los saltos superiores a 40 cm, lo que pone de relieve la importancia de las estrategias para mejorar las necesidades psicológicas y la autoeficacia de los atletas. Conclusiones: Este estudio sugiere que, la asociación entre la ansiedad, relacionada con la tensión y los indicadores de rendimiento, vinculados con la altura del salto, pueden desempeñar un papel crucial en la determinación de perfiles específicos, en atletas cubanos, de ambos sexos. Nuestro análisis exhaustivo contribuye a comprender las di

Introduction: Elite sports pose potential health risks, but are vital to the well-being of society. In Cuban society, sport is an integral part of personal development and public health, fostering unity and promoting female participation for sustainable growth. Athletics is one of the most important sports in Cuban sport, and should be approached both from the point of view of sports training and sports psychology. Purpose: The aim of this study was to provide a description of conditional variables in a countermovement jump (CMJ), mood profile, self-efficacy, and the leg-hip height index among athletes from the Cuban national athletics pre-selection team, differentiated by gender. Methods: Our sample consisted of the Cuban national athletics pre-selection team. Results: Mood profile analysis using the Profile of Mood States (POMS) did not reveal significant gender differences, with a small effect size for gender. Men showed a slightly greater trend towards vigor compared to women. Significant differences in self-efficacy were observed between men and women in their confidence levels to achieve jump heights between 21 and 40 cm using the CMJ. However, no significant differences were found for jumps exceeding 40 cm, highlighting the importance of strategies to enhance athletes’ psychological needs and self-efficacy. Conclusions: This study suggests that the association between tension-related anxiety and performance indicators related to jump height may play a crucial role in determining specific profiles in male and female Cuban athletes. Our comprehensive analysis contributes to understanding gender differences in performance factors. These findings provide valuable insights for future research and athlete development strategies, Introducción: Los deportes de élite plantean riesgos potenciales para la salud, pero son vitales para el bienestar de la sociedad. En la sociedad cubana, el deporte forma parte integral del desarrollo personal y la salud pública, fomentando la unidad y promoviendo la participación femenina, para un crecimiento sostenible. El atletismo es uno de los deportes más importantes en el deporte cubano, y debe ser abordado tanto, desde el punto de vista del entrenamiento deportivo, como desde la psicología deportiva. Propósito: El objetivo de este estudio fue proporcionar una descripción de las variables condicionales en un salto con contramovimiento (CMJ, por sus siglas en inglés), el perfil anímico, la autoeficacia y el índice de altura pierna-cadera en atletas de la preselección nacional cubana de atletismo, diferenciados por sexo. Materiales y métodos: Nuestra muestra estuvo constituida por la preselección nacional de atletismo de Cuba. Resultados: El análisis del perfil del estado de ánimo mediante el Perfil de Estados de Ánimo (POMS) no reveló diferencias significativas entre sexos, con un tamaño del efecto pequeño para el sexo. Los hombres mostraron una tendencia ligeramente mayor hacia el vigor, en comparación con las mujeres. Se observaron diferencias significativas en la autoeficacia entre hombres y mujeres, en sus niveles de confianza para alcanzar alturas de salto de entre 21 y 40 cm utilizando el CMJ. Sin embargo, no se encontraron diferencias significativas para los saltos superiores a 40 cm, lo que pone de relieve la importancia de las estrategias para mejorar las necesidades psicológicas y la autoeficacia de los atletas. Conclusiones: Este estudio sugiere que, la asociación entre la ansiedad, relacionada con la tensión y los indicadores de rendimiento, vinculados con la altura del salto, pueden desempeñar un papel crucial en la determinación de perfiles específicos, en atletas cubanos, de ambos sexos. Nuestro análisis exhaustivo contribuye a comprender las di, Introdução: Os desportos de elite apresentam riscos potenciais para a saúde, mas são vitais para o bem-estar da sociedade. Na sociedade cubana, o desporto é parte integrante do desenvolvimento pessoal e da saúde pública, fomentando a unidade e promovendo a participação feminina para um crescimento sustentável. O atletismo é uma das modalidades mais importantes do desporto cubano e deve ser abordado tanto do ponto de vista do treino desportivo como da psicologia desportiva. Objetivo: O objetivo deste estudo foi fornecer uma descrição das variáveis condicionais em um salto com movimento (CMJ, sigla em inglês), perfil de humor, autoeficácia e o índice de altura da perna-quadril entre atletas da equipe de pré-seleção nacional de atletismo de Cuba, diferenciados por gênero. Métodos: Nossa amostra consistiu na equipe de pré-seleção nacional de atletismo de Cuba. Resultados: A análise do perfil de humor usando o Perfil de Estados de Humor (POMS) não revelou diferenças significativas de gênero, com um pequeno efeito de tamanho para o gênero. Os homens mostraram uma tendência ligeiramente maior para o vigor em comparação com as mulheres. Diferenças significativas na autoeficácia foram observadas entre homens e mulheres em seus níveis de confiança para alcançar alturas de salto entre 21 e 40 cm usando o CMJ. No entanto, não foram encontradas diferenças significativas para saltos superiores a 40 cm, destacando a importância de estratégias para aprimorar as necessidades psicológicas e a autoeficácia dos atletas. Conclusões: Este estudo sugere que a associação entre ansiedade relacionada à tensão e indicadores de desempenho relacionados à altura do salto pode desempenhar um papel crucial na determinação de perfis específicos em atletas cubanos do sexo masculino e feminino. Nossa análise abrangente contribui para entender as diferenças de gênero nos fatores de desempenho. Esses achados fornecem insights valiosos para futuras pesquisas e estratégias de desenvolvimento de atletas

Introduction: Elite sports pose potential health risks, but are vital to the well-being of society. In Cuban society, sport is an integral part of personal development and public health, fostering unity and promoting female participation for sustainable growth. Athletics is one of the most important sports in Cuban sport, and should be approached both from the point of view of sports training and sports psychology. Purpose: The aim of this study was to provide a description of conditional variables in a countermovement jump (CMJ), mood profile, self-efficacy, and the leg-hip height index among athletes from the Cuban national athletics pre-selection team, differentiated by gender. Methods: Our sample consisted of the Cuban national athletics pre-selection team. Results: Mood profile analysis using the Profile of Mood States (POMS) did not reveal significant gender differences, with a small effect size for gender. Men showed a slightly greater trend towards vigor compared to women. Significant differences in self-efficacy were observed between men and women in their confidence levels to achieve jump heights between 21 and 40 cm using the CMJ. However, no significant differences were found for jumps exceeding 40 cm, highlighting the importance of strategies to enhance athletes’ psychological needs and self-efficacy. Conclusions: This study suggests that the association between tension-related anxiety and performance indicators related to jump height may play a crucial role in determining specific profiles in male and female Cuban athletes. Our comprehensive analysis contributes to understanding gender differences in performance factors. These findings provide valuable insights for future research and athlete development strategies, Introducción: Los deportes de élite plantean riesgos potenciales para la salud, pero son vitales para el bienestar de la sociedad. En la sociedad cubana, el deporte forma parte integral del desarrollo personal y la salud pública, fomentando la unidad y promoviendo la participación femenina, para un crecimiento sostenible. El atletismo es uno de los deportes más importantes en el deporte cubano, y debe ser abordado tanto, desde el punto de vista del entrenamiento deportivo, como desde la psicología deportiva. Propósito: El objetivo de este estudio fue proporcionar una descripción de las variables condicionales en un salto con contramovimiento (CMJ, por sus siglas en inglés), el perfil anímico, la autoeficacia y el índice de altura pierna-cadera en atletas de la preselección nacional cubana de atletismo, diferenciados por sexo. Materiales y métodos: Nuestra muestra estuvo constituida por la preselección nacional de atletismo de Cuba. Resultados: El análisis del perfil del estado de ánimo mediante el Perfil de Estados de Ánimo (POMS) no reveló diferencias significativas entre sexos, con un tamaño del efecto pequeño para el sexo. Los hombres mostraron una tendencia ligeramente mayor hacia el vigor, en comparación con las mujeres. Se observaron diferencias significativas en la autoeficacia entre hombres y mujeres, en sus niveles de confianza para alcanzar alturas de salto de entre 21 y 40 cm utilizando el CMJ. Sin embargo, no se encontraron diferencias significativas para los saltos superiores a 40 cm, lo que pone de relieve la importancia de las estrategias para mejorar las necesidades psicológicas y la autoeficacia de los atletas. Conclusiones: Este estudio sugiere que, la asociación entre la ansiedad, relacionada con la tensión y los indicadores de rendimiento, vinculados con la altura del salto, pueden desempeñar un papel crucial en la determinación de perfiles específicos, en atletas cubanos, de ambos sexos. Nuestro análisis exhaustivo contribuye a comprender las di, Introdução: Os desportos de elite apresentam riscos potenciais para a saúde, mas são vitais para o bem-estar da sociedade. Na sociedade cubana, o desporto é parte integrante do desenvolvimento pessoal e da saúde pública, fomentando a unidade e promovendo a participação feminina para um crescimento sustentável. O atletismo é uma das modalidades mais importantes do desporto cubano e deve ser abordado tanto do ponto de vista do treino desportivo como da psicologia desportiva. Objetivo: O objetivo deste estudo foi fornecer uma descrição das variáveis condicionais em um salto com movimento (CMJ, sigla em inglês), perfil de humor, autoeficácia e o índice de altura da perna-quadril entre atletas da equipe de pré-seleção nacional de atletismo de Cuba, diferenciados por gênero. Métodos: Nossa amostra consistiu na equipe de pré-seleção nacional de atletismo de Cuba. Resultados: A análise do perfil de humor usando o Perfil de Estados de Humor (POMS) não revelou diferenças significativas de gênero, com um pequeno efeito de tamanho para o gênero. Os homens mostraram uma tendência ligeiramente maior para o vigor em comparação com as mulheres. Diferenças significativas na autoeficácia foram observadas entre homens e mulheres em seus níveis de confiança para alcançar alturas de salto entre 21 e 40 cm usando o CMJ. No entanto, não foram encontradas diferenças significativas para saltos superiores a 40 cm, destacando a importância de estratégias para aprimorar as necessidades psicológicas e a autoeficácia dos atletas. Conclusões: Este estudo sugere que a associação entre ansiedade relacionada à tensão e indicadores de desempenho relacionados à altura do salto pode desempenhar um papel crucial na determinação de perfis específicos em atletas cubanos do sexo masculino e feminino. Nossa análise abrangente contribui para entender as diferenças de gênero nos fatores de desempenho. Esses achados fornecem insights valiosos para futuras pesquisas e estratégias de desenvolvimento de atletas

Outline of this thesis General introduction Chapter 1, the general introduction and first part of this thesis, consists of an introduction that provides more background on the regulation of growth hormone secretion and the growth hormone/insulin-like growth factor-1 axis. Next, different subject and patient groups studied in this thesis are addressed. This is followed by the description of several hormonal and metabolic factors involved in body composition, hunger and satiety. Last, functional imaging in obesity and PWS is described. Part I: Healthy elderly and patients with growth hormone deficiency Chapter 2 contains a study within LASA in which we were able to investigate associations between serum IGF-1 levels and handgrip strength, physical performance and falls in healthy elderly. Furthermore, we studied whether serum IGF-1 concentration could be used to predict a decrease in handgrip strength, physical performance and increased risk of falls in the next three years in elderly participants of LASA. In chapter 3 patient characteristics and diagnostic test procedures used in patients with severe growth hormone deficiency registered in the Dutch National Registry of Growth Hormone Treatment in Adults in The Netherlands in the period mid-1998 to 2008 are described. Chapter 4 is a review in which studies on cognitive functioning in patients with growth hormone deficiency, in particular in adults with childhood-onset growth hormone deficiency growth hormone deficiency, and the effects of growth hormone replacement therapy in these patients are discussed. Part II: Adults with Prader-Willi Syndrome Chapters 5 to 8 all focus on adults with Prader-Willi syndrome. The first chapter, chapter 5, contains a study of the GH/IGF-1 axis and pituitary function and size in adults with Prader-Willi Syndrome. Next to basal laboratory tests, a growth hormone stimulation test (GHRH-arginine test) was carried out to investigate the prevalence of growth hormone deficiency. Also, struc

Objective To review the body of evidence on cardiorespiratory fitness, muscle strength, and physical performance in children with newly diagnosed cancer, five databases (MEDLINE, Embase, CINAHL, CENTRAL, and Web of Science) were searched on December 19, 2022. Methods Thirteen studies, embodying 594 participants within 1 month of cancer diagnosis and 3674 healthy controls were included. Eighteen different outcomes on cardiorespiratory fitness (n = 2), muscle strength (n = 5), physical performance (n = 10), and adverse events (n = 1) were analyzed. Results Fifteen out of 17 outcomes on physical capacity showed severe impairments compared with healthy controls. Where possible, random-effects meta-analysis was conducted to synthesize the results. No adverse events were reported related to testing. Conclusion Children with cancer have impaired cardiorespiratory fitness, muscle strength, and physical performance within the first month after diagnosis. However, the evidence is based on a small number of studies with large clinical heterogeneity, limiting the certainty of evidence., Objective: To review the body of evidence on cardiorespiratory fitness, muscle strength, and physical performance in children with newly diagnosed cancer, five databases (MEDLINE, Embase, CINAHL, CENTRAL, and Web of Science) were searched on December 19, 2022. Methods: Thirteen studies, embodying 594 participants within 1 month of cancer diagnosis and 3674 healthy controls were included. Eighteen different outcomes on cardiorespiratory fitness (n = 2), muscle strength (n = 5), physical performance (n = 10), and adverse events (n = 1) were analyzed. Results: Fifteen out of 17 outcomes on physical capacity showed severe impairments compared with healthy controls. Where possible, random-effects meta-analysis was conducted to synthesize the results. No adverse events were reported related to testing. Conclusion: Children with cancer have impaired cardiorespiratory fitness, muscle strength, and physical performance within the first month after diagnosis. However, the evidence is based on a small number of studies with large clinical heterogeneity, limiting the certainty of evidence.

Objective To review the body of evidence on cardiorespiratory fitness, muscle strength, and physical performance in children with newly diagnosed cancer, five databases (MEDLINE, Embase, CINAHL, CENTRAL, and Web of Science) were searched on December 19, 2022. Methods Thirteen studies, embodying 594 participants within 1 month of cancer diagnosis and 3674 healthy controls were included. Eighteen different outcomes on cardiorespiratory fitness (n = 2), muscle strength (n = 5), physical performance (n = 10), and adverse events (n = 1) were analyzed. Results Fifteen out of 17 outcomes on physical capacity showed severe impairments compared with healthy controls. Where possible, random-effects meta-analysis was conducted to synthesize the results. No adverse events were reported related to testing. Conclusion Children with cancer have impaired cardiorespiratory fitness, muscle strength, and physical performance within the first month after diagnosis. However, the evidence is based on a small number of studies with large clinical heterogeneity, limiting the certainty of evidence., Objective: To review the body of evidence on cardiorespiratory fitness, muscle strength, and physical performance in children with newly diagnosed cancer, five databases (MEDLINE, Embase, CINAHL, CENTRAL, and Web of Science) were searched on December 19, 2022. Methods: Thirteen studies, embodying 594 participants within 1 month of cancer diagnosis and 3674 healthy controls were included. Eighteen different outcomes on cardiorespiratory fitness (n = 2), muscle strength (n = 5), physical performance (n = 10), and adverse events (n = 1) were analyzed. Results: Fifteen out of 17 outcomes on physical capacity showed severe impairments compared with healthy controls. Where possible, random-effects meta-analysis was conducted to synthesize the results. No adverse events were reported related to testing. Conclusion: Children with cancer have impaired cardiorespiratory fitness, muscle strength, and physical performance within the first month after diagnosis. However, the evidence is based on a small number of studies with large clinical heterogeneity, limiting the certainty of evidence.

Background: Declining physical performance in old age is associated with a wide range of negative health related outcomes, including disability, poor quality of life, admission to hospital, admission to residential care, and death (1 3). However, it is unclear which physical capabilities should be prioritized to obtain prognostic information in older adults. Methods: ilSIRENTE was a prospective cohort study of older adults residing in the mountain community of the Sirente geographic area in Central Italy. The study was designed by the Department of Geriatrics of the Università Cattolica del Sacro Cuore (Rome, Italy) an d the teaching nursing home Opera Santa Maria della Pace (Fontecchio, L’Aquila, Italy) in partnership with local administrators and primary care physicians of the Sirente Mountain Community Municipalities. The protocol was approved by the Ethics Committee of the Université Cattolica del Sacro Cuore. Prior to enrollment, all participants or their proxies, when appropriate, provided signed informed consent. Baseline assessments began in December 2003 and were completed in September 2004. Follow up visits took place after 24 months of baseline assessment. Information about medical history, medications, and lifestyle habits (e.g., smoking, alcohol consumption, physical activity) was collected using validated questionnaires. Physical performance was assessed usin g isometric handgrip strength, walking speed at usual and fast pace, 5 time sit to stand test, and sit to stand power measures. Absolute, relative, allometric, and specific muscle power values of lower extremities were calculated using the equations validated by Alcazar et al. (5). Appendicular skeletal muscle mass was estimated from calf circumfe rence using a validated equation (6). History of falls, incident falls, and disability status according to basic Activities of Daily Living (ADLs) were recorded over two years. Survival status was obtained from the participants’ general practitioners a

Objectives: The present study examined the agreement and associations of the 5-time sit-to-stand (5STS) test, the countermovement jump test, and lower-limb muscle power equations with a set of physical performance tests in older adults. Methods: Five hundred and thirty-four community-dwelling older adults were recruited for the study. Lower-limb muscle power measures included 5STS, the countermovement jump test, and muscle power equations. Isometric handgrip strength, timed “up-and-go!”, the 6 min walking test, one-leg stand, and walking speed at usual and fast paces were used to assess physical performance. Pearson’s correlations and Bland–Altman analyses were conducted to examine associations among muscle power measures. Linear and multiple regressions were run to explore associations of 5STS, the countermovement jump test, and muscle power equations with physical performance tests. Results: Weak correlations were observed among lower-limb muscle power measures. Bland–Altman results indicated important differences among the countermovement jump test, 5STS, and muscle power equations. Results of multiple linear regressions indicated that 5STS, the countermovement jump test, and muscle power equations were significantly associated with measures of muscle strength and mobility. However, only 5STS was significantly associated with balance. Conclusions: Our results indicate that the performance on the countermovement jump test and 5STS is weakly correlated with lower-limb muscle power equations. The only exception was the correlation found between the countermovement jump test and relative muscle power, highlighting the importance of accounting for body mass in muscle power evaluations. Muscle power measures were similarly associated with performance on handgrip strength, timed “up-and-go!”, and the 6 min walking test. The exclusive association of 5STS with balance suggests that a reassessment of 5STS muscle power equations may be warranted.

Background: Military aircrew frequently report cervico-thoracic pain and injury. The relationship between risk factors and future pain episodes is, however, uncertain. The aim of this study was to identify risk factors for cervico-thoracic pain and to determine the 1-yr cumulative incidence of such pain. Methods: A total of 47 Swedish aircrew (fighter and helicopter pilots and rear crew) without pain in the cervico-thoracic region were surveyed about work-related and personal factors and pain prevalence using the Musculoskeletal Screening Protocol questionnaire. They also performed tests of movement control, active cervical range of motion, and isometric neck muscle strength and endurance. Aircrew were followed for a year with questionnaires. Logistic regressions were used to identify potential risk factors for future cervico-thoracic pain. Results: Previous cervico-thoracic pain (OR: 22.39, CI: 1.79-280.63), lower cervical flexion range of motion (OR: 0.78, CI: 0.64-0.96), and lower neck flexor muscular endurance (OR: 0.91, CI: 0.83-0.99) were identified as risk factors for reporting cervico-thoracic pain. At follow-up, 23.4% (CI: 13.6-37.2) had reported cervico-thoracic pain during the 12-mo follow-up period. Discussion: The Musculoskeletal Screening Protocol can identify risk factors for cervico-thoracic pain. The link between cervico-thoracic pain and previous pain, as well as lower performance of neck range of motion and muscular endurance, highlights the need for primary and secondary preventive action. The findings from this study can facilitate the development of such pain prevention programs for aircrew.

Background: Military aircrew frequently report cervico-thoracic pain and injury. The relationship between risk factors and future pain episodes is, however, uncertain. The aim of this study was to identify risk factors for cervico-thoracic pain and to determine the 1-yr cumulative incidence of such pain. Methods: A total of 47 Swedish aircrew (fighter and helicopter pilots and rear crew) without pain in the cervico-thoracic region were surveyed about work-related and personal factors and pain prevalence using the Musculoskeletal Screening Protocol questionnaire. They also performed tests of movement control, active cervical range of motion, and isometric neck muscle strength and endurance. Aircrew were followed for a year with questionnaires. Logistic regressions were used to identify potential risk factors for future cervico-thoracic pain. Results: Previous cervico-thoracic pain (OR: 22.39, CI: 1.79-280.63), lower cervical flexion range of motion (OR: 0.78, CI: 0.64-0.96), and lower neck flexor muscular endurance (OR: 0.91, CI: 0.83-0.99) were identified as risk factors for reporting cervico-thoracic pain. At follow-up, 23.4% (CI: 13.6-37.2) had reported cervico-thoracic pain during the 12-mo follow-up period. Discussion: The Musculoskeletal Screening Protocol can identify risk factors for cervico-thoracic pain. The link between cervico-thoracic pain and previous pain, as well as lower performance of neck range of motion and muscular endurance, highlights the need for primary and secondary preventive action. The findings from this study can facilitate the development of such pain prevention programs for aircrew.

Background:Knee osteoarthritis (KOA) is highly prevalent in older women, and previous studies suggest the involvement of hormonal factors play a role in the pathogenesis of osteoarthritis. KOA causes musculoskeletal impairment, resulting in decreased physical activity, muscle mass, and strength, which leads to sarcopenia and further increases the burden on healthcare systems. Oestrogen replacement therapy (ERT) improves joint pain and muscle performance in early menopausal women. Muscle resistance exercise (MRE) is a non-pharmacological method that preserves the physical functions of patients with KOA. However, data on short-term oestrogen administration combined with MRE in postmenopausal women, especially in those aged > 65 years, are limited. Therefore, this study presents a protocol of a trial aimed to examine the synergistic effect of ERT and MRE on lower-limb physical performance in older women with KOA. Methods:We will conduct a double-blinded, randomised placebo-controlled trial in 80 Japanese women aged > 65 years living independently with knee pain. The participants will be randomly categorised into two groups: (1) 12-week MRE programme with transdermal oestrogen gel containing 0.54 mg oestradiol per push and (2) 12-week MRE programme with placebo gel. The primary outcome measured using the 30-s chair stand test, and secondary outcomes (body composition, lower-limb muscle strength, physical performance, self-reported measure of knee pain, and quality of life) will be measured at baseline, 3 months, and 12 months, and these outcomes will be analysed based on the intention-to-treat. Discussion:The EPOK trial is the first study to focus on the efficacy of ERT on MRE among women aged > 65 years with KOA. This trial will provide an effective MRE to prevent KOA-induced lower-limb muscle weakness, confirming the benefit of short-term oestrogen administration.

BackgroundDifferent programs promote healthy ageing through the optimization of intrinsic capacity. However, a major challenge is to assess their sustained effects over time. +AGIL Barcelona, a consolidated multidomain program, aims to optimize older adults' intrinsic capacity through a coordinated approach among primary care, geriatrics and community resources, in agreement with the integrated care for older people (ICOPE) guidelines. We aimed to evaluate the +AGIL Barcelona longitudinal effect on older adults' physical performance. MethodsAll +AGIL Barcelona consecutive participants since 2016 were enrolled. After a comprehensive geriatric assessment, a tailored, multidisciplinary intervention aligned with the ICOPE guidelines is offered. It includes a 10-week boost multicomponent exercise program, nutritional and sleep-hygiene counselling, revision and optimization of pharmacological treatments and screening for cognitive impairment, depression and loneliness. Changes in physical performance after 3 and 6 months were assessed using mixed models including baseline frailty degree, time and all potential significant confounders. ResultsWe included 194 participants in the analysis (mean age = 81.6 [standard deviation = 5.8], 68% women). An independent, clinically and statistically significant improvement in physical performance (Short Physical Performance Battery [SPPB] test, combining gait speed, strength and balance) was found at 3 months (SPPB mean change: 1.4; 95% CI: 1.1-1.6) and 6 months (SPPB mean change: 1.1; 95% CI 0.8-1.5). Equivalent results were observed for all the SPPB sub-tests. ConclusionsA coordinated, multidisciplinary and integrated program can benefit older adults' intrinsic capacity. The participants' empowerment and the connection with the available community resources are critical points for a successful intervention.

BACKGROUND: Past research has not investigated both lower-extremity power and upper-extremity strength in the same fall injury study, particularly nonfracture fall injuries. METHODS: In the Osteoporotic Fractures in Men Study (baseline: N = 5 994; age 73.7 ± 5.9 years; 10.2% non-White), fall injuries (yes/no) were assessed prospectively with questionnaires approximately every 3 years over 9 years. Maximum leg power (Watts) from Nottingham single leg press and maximum grip strength (kg) from handheld dynamometry were assessed at baseline and standardized to kg body weight. Physical performance included gait speed (6-m usual; narrow walk) and chair stands speed. RESULTS: Of men with ≥1/4 follow-ups (N = 5 178; age 73.4 ± 5.7 years), 40.4% (N = 2 090) had ≥1 fall injury. In fully adjusted repeated-measures logistic regressions, lower power/kg and grip strength/kg had higher fall injury risk (trend across quartiles: both p < .0001), with lower quartiles at significantly increased risk versus highest Q4 except for grip strength Q3 versus Q4. Fall injury risk was 19% higher per 1 standard deviation (SD) lower power/kg (95% confidence interval [CI]: 1.12-1.26) and 16% higher per SD lower grip strength/kg (95% CI: 1.10-1.23). In models including both leg power/kg and grip strength/kg, odds ratios (ORs) were similar and independent of each other and physical performance (leg power/kg OR per SD = 1.13, 95% CI: 1.06-1.20; grip strength/kg OR per SD = 1.11, 95% CI: 1.05-1.17). CONCLUSIONS: Lower leg power/kg and grip strength/kg predicted future fall injury risk in older men independent of physical performance. Leg power potentially identifies fall injury risk better than grip strength at higher muscle function, though grip strength may be more suitable in clinical/practice settings.

Background:Knee osteoarthritis (KOA) is highly prevalent in older women, and previous studies suggest the involvement of hormonal factors play a role in the pathogenesis of osteoarthritis. KOA causes musculoskeletal impairment, resulting in decreased physical activity, muscle mass, and strength, which leads to sarcopenia and further increases the burden on healthcare systems. Oestrogen replacement therapy (ERT) improves joint pain and muscle performance in early menopausal women. Muscle resistance exercise (MRE) is a non-pharmacological method that preserves the physical functions of patients with KOA. However, data on short-term oestrogen administration combined with MRE in postmenopausal women, especially in those aged > 65 years, are limited. Therefore, this study presents a protocol of a trial aimed to examine the synergistic effect of ERT and MRE on lower-limb physical performance in older women with KOA. Methods:We will conduct a double-blinded, randomised placebo-controlled trial in 80 Japanese women aged > 65 years living independently with knee pain. The participants will be randomly categorised into two groups: (1) 12-week MRE programme with transdermal oestrogen gel containing 0.54 mg oestradiol per push and (2) 12-week MRE programme with placebo gel. The primary outcome measured using the 30-s chair stand test, and secondary outcomes (body composition, lower-limb muscle strength, physical performance, self-reported measure of knee pain, and quality of life) will be measured at baseline, 3 months, and 12 months, and these outcomes will be analysed based on the intention-to-treat. Discussion:The EPOK trial is the first study to focus on the efficacy of ERT on MRE among women aged > 65 years with KOA. This trial will provide an effective MRE to prevent KOA-induced lower-limb muscle weakness, confirming the benefit of short-term oestrogen administration.

Objective: Analysis of the use of phytotherapics and medicinal plants with ergogenic properties in a gym in the city of Itaqui-RS. Materials and Methods: A semi-structured and self-completed questionnaire was applied to practitioners of physical exercises who attended a gym in the city of Itaqui-RS. The participants signed an informed consent form and the research was approved by the Research Ethics Committee of the Federal University of Pampa. Results: The sample consisted of 119 participants, 58% female and 42% male, with a predominance of ages between 18 and 23 years (42% of the total). Among the 119 interviewees, 74 claimed to use or had already used herbal medicines/ergogenic medicinal plants (62.18% of the total). As for the use, 12 different ergogenic phytotherapics/medicinal plants were mentioned, the 4 main ones being: green tea (58), tribulus (12), guarana (10) and Peruvian maca (8). Although the purposes of use of the main substances mentioned are in accordance with their scientific characteristics, the indication of use was inadequate. Conclusion: It is possible to conclude that the use of phytotherapics and medicinal plants with ergogenic purposes is a common practice among the interviewees of the academy where this work was carried out, but most of the time it does not come from the prescription by professionals marked out by the legislation., Obiettivo: Analisi dell'uso di erbe medicinali e piante medicinali con proprietà ergogeniche in una palestra di bodybuilding nella città di Itaqui-RS. Materiali e Metodi: Un questionario semi-strutturato e autocompilato è stato applicato a praticanti di esercizio fisico che frequentavano una palestra nella città di Itaqui-RS. I partecipanti hanno firmato un modulo di consenso informato e la ricerca è stata approvata dal Comitato etico della ricerca dell'Università federale di Pampa. Risultati: Il campione era composto da 119 partecipanti, suddivisi in 58% femmine e 42% maschi, prevalentemente di età compresa tra 18 e 23 anni (42% del totale). Dei 119 intervistati, 74 dichiarano di utilizzare o hanno già utilizzato fitoterapici/piante officinali ergogene (62,18% del totale). Per quanto riguarda l'uso, sono stati menzionati 12 diversi fitoterapici/piante medicinali ergogene, di cui i 4 principali citati: tè verde (58), tribulus (12), guaranà (10) e maca peruviana (8). Nonostante le finalità d'uso delle principali sostanze citate fossero conformi alle loro caratteristiche scientifiche, l'indicazione d'uso era inadeguata. Conclusione: è possibile concludere che l'uso di erbe medicinali e piante medicinali a scopo ergogenico è una pratica comune tra gli intervistati presso l'accademia in cui è stato svolto questo lavoro, ma il più delle volte non deriva dalla prescrizione di professionisti guidati da legislazione., Objetivo: Análise da utilização de fitoterápicos e plantas medicinais com propriedades ergogênicas em uma academia de musculação da cidade de Itaqui-RS. Materiais e Métodos: Foi aplicado um questionário semiestruturado e autopreenchido em praticantes de exercícios físicos que frequentavam uma academia do município de Itaqui-RS. Os participantes assinaram Termo de Consentimento Livre e Esclarecido e a pesquisa foi aprovada pelo Comitê de Ética em Pesquisa da Universidade Federal do Pampa. Resultados: A amostra foi composta por 119 participantes, distribuídos em 58% do sexo feminino e 42% do sexo masculino, predominando a faixa etária de 18 a 23 anos (42% do total). Dentre os 119 entrevistados, 74 alegaram utilizar ou já terem utilizado fitoterápicos/plantas medicinais ergogênicas (62,18% do total). Quanto à utilização, foram citados 12 diferentes fitoterápicos/plantas medicinais ergogênicos, sendo os 4 principais citados: chá verde (58), tribulus (12), guaraná (10) e maca peruana (8). Apesar das finalidades de uso das principais substâncias citadas estarem de acordo com a característica científica delas, a indicação de uso foi inadequada. Conclusão: É possível concluir que a utilização de fitoterápicos e plantas medicinas com propósitos ergogênicos é uma prática comum entre os entrevistados da academia onde este trabalho foi realizado, porém na maioria das vezes não é oriunda da prescrição por profissionais balizados pela legislação., Objetivo: Análisis del uso de fitoterápicos y plantas medicinales con propiedades ergogénicas en un gimnasio de musculación en la ciudad de Itaqui-RS. Materiales y Métodos: Se aplicó un cuestionario semiestructurado y autocumplimentado a practicantes de ejercicio físico que asistían a un gimnasio en la ciudad de Itaqui-RS. Los participantes firmaron un consentimiento informado y la investigación fue aprobada por el Comité de Ética en Investigación de la Universidad Federal de Pampa. Resultados: La muestra estuvo conformada por 119 participantes, divididos en 58% mujeres y 42% hombres, predominantemente de 18 a 23 años (42% del total). Entre los 119 entrevistados, 74 afirmaron utilizar o ya han utilizado fitoterápicos/plantas medicinales ergogénicas (62,18% del total). En cuanto al uso, se mencionaron 12 fitoterapias/plantas medicinales ergogénicas diferentes, siendo las 4 principales citadas: té verde (58), tribulus (12), guaraná (10) y maca peruana (8). A pesar de que los fines de uso de las principales sustancias citadas estaban de acuerdo con sus características científicas, la indicación de uso era inadecuada. Conclusión: Es posible concluir que el uso de fitoterápicos y plantas medicinales con fines ergogénicos es una práctica común entre los encuestados de la academia donde se realizó este trabajo, pero la mayoría de las veces no proviene de prescripción por parte de profesionales guiados por legislación.

Physical performance is elemental in karate, because of the requirements that training and competition imply, where it is determined the karateka’s sports performance, showing the level they have reached through practice. For the present investigation, it was made through a systematic review to establish the relationship between physical performance and sports performance of adult karatekas. The information was extracted from different bibliographic sources which were found on databases such as Scholar Google, Dialnet and Scielo, where the keywords “Physical Performance”, “Sports Performance”, “Karate” and “Phyisical Abilities” were used for the research. The documents found went through some filters to find the ones which were the most adequate and were an input with relevance for the investigation. At the end there were 15 papers and thesis which were reviewed and analyzed deepening on the most essential information for the present work. With that, it was found that physical performance determines the sports performance that a karateka will have. Ergo, a sportsman who has been through a great training and, therefore, has a great physical performance, will be able to develop themselves in the best way possible on a competition, showing they have an excellent sports performance. Also, it was found that it was necessary to take into account not only physical elements, but also technical and psychological ones, for the karateka to have an integral training, El rendimiento físico es fundamental en el karate deportivo, debido a las exigencias que implica su entrenamiento y participación en competencias deportivas, donde se determina el desempeño deportivo de un karateca, demostrando el nivel que ha alcanzado a través de la práctica. Para la presente investigación se realizó una revisión sistemática para determinar, justamente, la relación entre el rendimiento físico y el desempeño (deportivo) en karatecas adultos. La información obtenida se tomó de diversas fuentes bibliográficas encontradas en bases de datos como Google Académico, Dialnet y Scielo, donde se realizaron búsquedas con las palabras clave “Rendimiento Físico”, “Desempeño Deportivo”, “Karate” y “Capacidades Físicas”. Los documentos encontrados pasaron por varios filtros para conseguir aquellos que fueran más adecuados y fueran un aporte de relevancia a la investigación, siendo así, que finalmente se tomaron un total de 15 artículos y tesis que se revisaron y analizaron profundizando en la información esencial para el presente artículo. Con ello se encontró que el rendimiento físico determina el desempeño deportivo que tendrá un karateca. Es decir, un deportista que tenga un buen entrenamiento y, por lo tanto, un excelente rendimiento físico, será capaz de desenvolverse de mejor manera en diferentes competencias, demostrando así, tener un desempeño deportivo óptimo. Además, se encontró que para que existan un buen rendimiento físico y desempeño deportivo, deben considerarse los factores no solo físicos, sino también técnicos y psicológicos, para así tener una formación integral en el karate

Background: Military aircrew frequently report cervico-thoracic pain and injury. The relationship between risk factors and future pain episodes is, however, uncertain. The aim of this study was to identify risk factors for cervico-thoracic pain and to determine the 1-yr cumulative incidence of such pain. Methods: A total of 47 Swedish aircrew (fighter and helicopter pilots and rear crew) without pain in the cervico-thoracic region were surveyed about work-related and personal factors and pain prevalence using the Musculoskeletal Screening Protocol questionnaire. They also performed tests of movement control, active cervical range of motion, and isometric neck muscle strength and endurance. Aircrew were followed for a year with questionnaires. Logistic regressions were used to identify potential risk factors for future cervico-thoracic pain. Results: Previous cervico-thoracic pain (OR: 22.39, CI: 1.79-280.63), lower cervical flexion range of motion (OR: 0.78, CI: 0.64-0.96), and lower neck flexor muscular endurance (OR: 0.91, CI: 0.83-0.99) were identified as risk factors for reporting cervico-thoracic pain. At follow-up, 23.4% (CI: 13.6-37.2) had reported cervico-thoracic pain during the 12-mo follow-up period. Discussion: The Musculoskeletal Screening Protocol can identify risk factors for cervico-thoracic pain. The link between cervico-thoracic pain and previous pain, as well as lower performance of neck range of motion and muscular endurance, highlights the need for primary and secondary preventive action. The findings from this study can facilitate the development of such pain prevention programs for aircrew.

Background: Muscle power is associated with health-related parameters. Simple equations were validated to estimate lower extremity muscle power measures based on the time to complete the five-repetition sit-to-stand test. The present study was conducted to provide lower extremity muscle power estimates and produce centile values in a large and relatively unselected population across a wide age spectrum. Methods: Data were from the Longevity Check-up 7+ (Lookup 7+) project, an ongoing initiative conducted in unconventional settings (e.g., exhibitions, shopping centres and health promotion campaigns) across Italy to foster adoption of healthy lifestyles. Absolute, relative, allometric and specific muscle power measures of the lower extremities were estimated using validated formulas. Cross-sectional centile and normative values for muscle power measures from 18 to 81+ years were produced for the two sexes. Smoothed normative curves for men and women were constructed using the lambda-mu-sigma method. Results: From 1 June 2015 to 31 October 2021, 13 515 participants were enrolled of whom 12 864 were eligible for the present study. Mean age was 55.9 years (standard deviation: 14.8 years; range: 18-98 years), and 7217 (56.%) were women. Absolute, relative, allometric and specific muscle power declined significantly with age. Specific patterns of decline were observed according to sex and muscle power parameter. Absolute muscle power peaked at 41-50 and 31-40 years in men and women, respectively. Afterwards, a decline rate of approximately 12% per decade was observed, regardless of sex. Relative muscle power showed the largest reduction with age, such that it was 40.6% and 46.4% smaller in men and women older than 80, respectively, compared with those aged 18-30 years. Age-related changes in allometric and specific muscle power measures were similar between men and women. Conclusions: Data from the Lookup 7+ project indicate that lower ex

Background: Military aircrew frequently report cervico-thoracic pain and injury. The relationship between risk factors and future pain episodes is, however, uncertain. The aim of this study was to identify risk factors for cervico-thoracic pain and to determine the 1-yr cumulative incidence of such pain. Methods: A total of 47 Swedish aircrew (fighter and helicopter pilots and rear crew) without pain in the cervico-thoracic region were surveyed about work-related and personal factors and pain prevalence using the Musculoskeletal Screening Protocol questionnaire. They also performed tests of movement control, active cervical range of motion, and isometric neck muscle strength and endurance. Aircrew were followed for a year with questionnaires. Logistic regressions were used to identify potential risk factors for future cervico-thoracic pain. Results: Previous cervico-thoracic pain (OR: 22.39, CI: 1.79-280.63), lower cervical flexion range of motion (OR: 0.78, CI: 0.64-0.96), and lower neck flexor muscular endurance (OR: 0.91, CI: 0.83-0.99) were identified as risk factors for reporting cervico-thoracic pain. At follow-up, 23.4% (CI: 13.6-37.2) had reported cervico-thoracic pain during the 12-mo follow-up period. Discussion: The Musculoskeletal Screening Protocol can identify risk factors for cervico-thoracic pain. The link between cervico-thoracic pain and previous pain, as well as lower performance of neck range of motion and muscular endurance, highlights the need for primary and secondary preventive action. The findings from this study can facilitate the development of such pain prevention programs for aircrew.

Although women live longer, they experience relatively more unhealthy years (i.e. disabilities in ADLs) during their life and with an earlier onset compared to men, also referred to as the gender health-survival paradox. The female disability disadvantage pinpoints older women as an important target group for prevention strategies that stimulate healthy ageing. THIS THESIS CONSIST OF THREE MAIN OBJECTIVES: 1. To identify differences between older women and men in four domains of healthy ageing and investigate potential socio-demographic subgroups (age, educational level, migration background and birth cohort) for a more pronounced difference. 2. To explore contributing determinants to the female disadvantage in physical and self-rated health by investigating differences between older women and men in sensitivity and exposure. 3. To identify motivators and barriers for a healthy lifestyle and investigate perspectives on determinants of healthy ageing among older (migrant) women and men separately. DIFFERENCES BETWEEN OLDER WOMEN AND MEN IN HEALTHY AGEING DOMAINS Our longitudinal analysis among older adults aged 55 years and older demonstrated that women have a significantly worse mental health (Chapter 2), worse (height-adjusted) physical performance (Chapter 3) and worse self-reported physical functioning (Chapter 6) compared to men of the same age. There was, however, no significant difference observed in self-rated health among Dutch older adults (Chapter 4) and there was a female advantage in cognitive functions of memory and processing speed (Chapter S1). The female disadvantage was not consistently more pronounced during ageing or for different educational levels, migration backgrounds or birth cohorts, with respect to mental health (Chapter 2), physical performance (Chapter 3), self-reported physical functioning (Chapter 6), self-rated health (Chapter 4) and cognitive functioning (Chapter S1). However, there was a significant female disadvantage in self-rated

Background: Different programs promote healthy ageing through the optimization of intrinsic capacity. However, a major challenge is to assess their sustained effects over time. +AGIL Barcelona, a consolidated multidomain program, aims to optimize older adults’ intrinsic capacity through a coordinated approach among primary care, geriatrics and community resources, in agreement with the integrated care for older people (ICOPE) guidelines. We aimed to evaluate the +AGIL Barcelona longitudinal effect on older adults’ physical performance. Methods: All +AGIL Barcelona consecutive participants since 2016 were enrolled. After a comprehensive geriatric assessment, a tailored, multidisciplinary intervention aligned with the ICOPE guidelines is offered. It includes a 10-week boost multicomponent exercise program, nutritional and sleep-hygiene counselling, revision and optimization of pharmacological treatments and screening for cognitive impairment, depression and loneliness. Changes in physical performance after 3 and 6 months were assessed using mixed models including baseline frailty degree, time and all potential significant confounders. Results: We included 194 participants in the analysis (mean age = 81.6 [standard deviation = 5.8], 68% women). An independent, clinically and statistically significant improvement in physical performance (Short Physical Performance Battery [SPPB] test, combining gait speed, strength and balance) was found at 3 months (SPPB mean change: 1.4; 95% CI: 1.1–1.6) and 6 months (SPPB mean change: 1.1; 95% CI 0.8–1.5). Equivalent results were observed for all the SPPB sub-tests. Conclusions: A coordinated, multidisciplinary and integrated program can benefit older adults’ intrinsic capacity. The participants’ empowerment and the connection with the available community resources are critical points for a successful intervention.

INTRODUCTION: The extent to which additional health benefits of accumulating twice the minimum amount of time in moderate-to-vigorous physical activity (MVPA) affects indicators of physical function in older adults is unclear. Therefore, the aim of the present study was to assess indicators of physical function in older adults who accumulate at least 150 but less than 300 min/week of MVPA compared to those accumulating at least 300 min/week. METHODS: Indicators of physical function, including handgrip strength, 5 times sit-to-stand test (5-STS), squat jump and 6-min walk test (6MWT) were assessed in a sample of 193 older men (n = 71, 67 ± 2 years), and women (n = 122, 67 ± 2 years), who all accumulated at least 150 weekly minutes of MVPA. Time in MVPA was assessed by accelerometry during 1 week and engagement in muscle strengthening activities (MSA) was assessed by self-report. Protein intake was assessed by a food-frequency-questionnaire. Participants were classified as physically active (≥150 but <300 min of MVPA per week) or as highly physically active (≥300 min of MVPA per week). RESULTS: Factorial analysis of variance revealed that older adults accumulating at least 300 min of MVPA per week had a significantly (p < 0.05) better 6MWT performance and overall physical function compared to the less active group. These findings remained significant after further adjustment for MSA, sex, waist circumference and protein intake. In contrast, no significant differences in indicators of muscle strength were observed between the two groups. DISCUSSION: Adherence to twice the recommended minimum amount of weekly MVPA time is related to a better physical function, evidenced by a better walking performance compared to adherence to the minimum weekly amount of MVPA. This finding emphasizes the benefits of accumulating daily MVPA beyond the minimum recommended amount to optimize the ability to perform activities of daily living, thus reducing the burden of physical disab, Funding agency:Kamprad Family Foundation for Entrepreneurship, Research and Charity 20210070

The present study was conducted to provide normative values for lower-limb muscle power estimated through equations based on the 5 times sit-to-stand (5STS) test in Brazilian older women. In addition, we investigated the association between muscle power parameters and age. The study followed a cross-sectional design. Participants were community-dwelling women. Candidates were considered eligible if they were 18 years or older, lived independently, and possessed sufficient physical and cognitive abilities to perform all measurements required by the protocol. The 5STS test was performed as fast as possible using a standard protocol. Absolute, relative, and allometric muscle power measures were estimated using 5STS-based equations. Two thousand four-hundred seventy-one women participated in the present study. Results indicated that muscle power-related parameters decreased linearly with age. Women 60-69 years showed a marginal reduction in absolute (- 5.2%), relative (- 7.9%), and allometric (- 4.0%) muscle power. A larger reduction was observed in those 70-79 years and reached 1⁄4 of loss in participants ≥ 80, in comparison to middle-aged participants. Pearson's correlation and linear regression analyses indicated that power-related parameters were negatively associated with age. In conclusion, data of the present study provide normative values for lower-limb muscle power parameters according to 5STS-based equations. We observed that muscle power-related parameters declined with age, such that participants 60-69, 70-79, and ≥ 80 years displayed lower absolute and relative muscle power compared middle-aged women. A later decline was observed in allometric muscle power. Relative muscle power declined to a greater extent than other parameters, suggesting a possible window of opportunity for interventions.

Declines in physical performance and cognition are commonly observed in older adults. The geroscience paradigm posits that a set of processes and pathways shared among age-associated conditions may also serve as a molecular explanation for the complex pathophysiology of physical frailty, sarcopenia, and cognitive decline. Mitochondrial dysfunction, inflammation, metabolic alterations, declines in cellular stemness, and altered intracellular signaling have been observed in muscle aging. Neurological factors have also been included among the determinants of sarcopenia. Neuromuscular junctions (NMJs) are synapses bridging nervous and skeletal muscle systems with a relevant role in age-related musculoskeletal derangement. Patterns of circulating metabolic and neurotrophic factors have been associated with physical frailty and sarcopenia. These factors are mostly related to disarrangements in protein-to-energy conversion as well as reduced calorie and protein intake to sustain muscle mass. A link between sarcopenia and cognitive decline in older adults has also been described with a possible role for muscle-derived mediators (i.e., myokines) in mediating muscle-brain crosstalk. Herein, we discuss the main molecular mechanisms and factors involved in the muscle-brain axis and their possible implication in cognitive decline in older adults. An overview of current behavioral strategies that allegedly act on the muscle-brain axis is also provided.

Muscle strength is a relevant metric of aging. Greater adherence to Mediterranean diet is associated with better health outcomes across all life stages; however, evidence on the relationship between Mediterranean diet and muscle strength in older adults is inconclusive. In this study, we evaluated the relationship between adherence to Mediterranean diet and handgrip strength in a large sample of community-dwelling older adults from the Longevity Check-up 7+ project. A total of 2963 participants (mean age 72.8 +/- 5.7 years; 54.4% women) were analyzed. Mediterranean diet adherence was evaluated using a modified Medi-Lite score and categorized as low (<= 8), good (9 to 11), or high (>= 12). Handgrip strength was categorized as normal or low according to cut-points by the European Working Group on Sarcopenia in Older People 2. Older adults with lower Mediterranean diet adherence had a significantly higher prevalence of probable sarcopenia (25.9%) than those with good (19.1%) or high (15.5%) adherence. The proportion of participants with probable sarcopenia increased with age, but it remained lower in the good and high adherence groups. Logistic regression showed that greater Mediterranean diet adherence was associated with a lower risk of probable sarcopenia. Older age, female sex, and physical inactivity were associated with a greater risk of probable sarcopenia. Our findings emphasize the positive association between healthy lifestyles, including adherence to Mediterranean diet, and physical function in old age.

The maintenance of functional health is pivotal for achieving independent life in older age. The aged muscle is characterized by ultrastructural changes, including loss of type I and type II myofibers and a greater proportion of cytochrome c oxidase deficient and succinate dehydrogenase positive fibers. Both intrinsic (e.g., altered proteostasis, DNA damage, and mitochondrial dysfunction) and extrinsic factors (e.g., denervation, altered metabolic regulation, declines in satellite cells, and inflammation) contribute to muscle aging. Being a hub for several cellular activities, mitochondria are key to myocyte viability and mitochondrial dysfunction has been implicated in age-associated physical decline. The maintenance of functional organelles via mitochondrial quality control (MQC) processes is, therefore, crucial to skeletal myofiber viability and organismal health. The autophagy-lysosome pathway has emerged as a critical step of MQC in muscle by disposing organelles and proteins via their tagging for autophagosome incorporation and delivery to the lysosome for clearance. This pathway was found to be altered in muscle of physically inactive older adults. A relationship between this pathway and muscle tissue composition of the lower extremities as well as physical performance was also identified. Therefore, integrating muscle structure and myocyte quality control measures in the evaluation of muscle health may be a promising strategy for devising interventions fostering muscle health.

33 p. -- Bibliogr.: p. 29-33, [EUS] Espainiako liga gorenaren (LaLiga Santander) taldeen mailaren araberako errendimendu fisikoen konparaketa egin zen. Talde bakoitzaren maila zehazteko, 2021-2022 denboraldiko lehenengo 19 jardunaldietan eskuratutako puntu kopuruak hartu ziren kontuan, taldeak 4 maila ezberdinetan sailkatuz (TOP1, TOP2, TOP3 eta TOP4). Datuen analisirako, guztira 20 taldeen eskakizun fisikoak aztertu izan ziren 190 futbol partida eta 380 artxibo aztertuz. Errendimendu fisikoen konparaketarako, talde bakoitzak baloi jabetzarekin eta baloi jabetzarik gabe, guztira minutuko egindako distantzia totala eta 21 km/h baino gehiagoko abiaduran minutuko egindako distantzia aztertu ziren, joko efektiboko denbora (JED) kontuan hartuz. Hauek ziren aztertutako aldagai fisikoak: baloi jabetzarekin minutuko egindako distantzia totala (DTPOS/min); baloi jabetzarik gabe minutuko egindako distantzia totala (DTnoPOS/min); baloi jabetzarekin eta 21 km/h baino gehiagoko abiaduran minutuko egindako distantzia (DT21POS/min); baloi jabetzarik gabe eta 21 km/h baino gehiagoko abiaduran minutuko egindako distantzia (DT21noPOS/min). Aurkikuntzen artean, aztertutako kasu guztietan, baloi jabetzarekin, baloi jabetzarik gabe baino distantzia gutxiago betetzen direla behatu izan zen. Alde batetik, baloi jabetzarekin, sailkapenaren eremu gorenenean dauden taldeek lortu zituzten balio txikienak. Bestalde, baloi jabetzarik gabe balio txikienak eskuratutako taldeak, sailkapenaren beheko postuetan kokatzen dira. Horrez gain, partidaren lekuaren arabera eskakizun fisikoen aldetik aldaketarik zegoen behatzeko, etxean eta kanpoan jokatutako partidak aztertu ziren inolako ezberdintasun esanguratsurik (p>0.05) behatu gabe. Ikerketa honen emaitzek, dimentsio fisikoa eta taktikoak elkartzen dituen lehiaketaren analisi sakon bat egiteko aukera eskaintzen digu, aurrean ditugun partidak eskatzen dituzten eskakizun fisikoak aurreikusiz. Behin, partidan zehar aurkituko ditugun eskakizun fisikoak jakinda, astearen karga zein es, [ES] Se realizó una comparación de los rendimientos físicos según el nivel de los equipos de la máxima liga española, LaLiga Santander. Para determinar el nivel de cada equipo, se tuvieron en cuenta los puntos obtenidos en las 19 primeras jornadas de la temporada 2021-2022, clasificando a los equipos en 4 categorías diferentes (TOP1, TOP2, TOP3 y TOP4). Para el análisis de los datos, se analizaron los requerimientos físicos de un total de 20 equipos analizando 190 partidos y 380 archivos. Para la comparación de rendimientos físicos, se analizó la distancia total recorrida por minuto y la distancia recorrida por minuto a más de 21 km/h de cada equipo con y sin posesión de balón, teniendo en cuenta el tiempo de juego efectivo (TJE). Las variables físicas analizadas fueron: distancia total por minuto con posesión de balón (DTPOS/min); distancia total por minuto sin posesión de balón (DTnoPOS/min); distancia por minuto con posesión de balón y velocidad superior a 21 km/h (DT21POS/min); distancia por minuto sin posesión de balón y a más de 21 km/h (DT21noPOS/min). Entre los hallazgos se observó que en todos los casos analizados se cumplen menos distancias con la posesión de balón que sin ella. Por un lado, con la posesión de balón, los equipos situados en la zona más alta de la clasificación alcanzaron los valores más bajos. Por otro lado, los equipos que menos valor tienen sin posesión de balón, se sitúan en los puestos bajos de la clasificación. Además, se analizaron los partidos jugados en casa y fuera de casa sin observar ninguna diferencia significativa. Los resultados de esta investigación nos ofrecen la posibilidad de realizar un análisis en profundidad de la competición que aúna dimensiones físicas y tácticas, previendo las exigencias físicas que exigen los partidos que tenemos por delante. Una vez que sepamos las exigencias físicas que encontraremos durante el partido, tendremos la oportunidad de controlar tanto la carga como la estrategia del microziclo., [EN] A comparison of the physical performances was made according to the level of the teams of the Spanish top league, Liga Santander. To determine the level of each team, the points obtained in the first 19 matches of the season 2021-2022, were taken into account, classifying the teams in 4 different categories (TOP1, TOP2, TOP3 and TOP4). For the analysis of the data, the physical requirements of a total of 20 teams were analyzed, analyzing 190 games and 380 files. For the comparison of physical performances, the total distance traveled per minute and the distance traveled per minute at more than 21 km/h of each team, with and without possession of the ball were analyzed, taking into account the effective play time (EPT). Physical variables analyzed are: Distance per minute with possession of the ball (DTPOS/min); distance per minute without possession of the ball (DTnoPOS/min); distance per minute with possession of the ball and speed greater than 21 km/h (DT21POS/min); distance per minute without possession of the ball and more than 21 km/h (DT21noPOS/min). Among the findings, it was observed that in all the analyzed cases, less distances were met with possession of the ball than without it. On the one hand, with the possession of the ball, the teams located in the highest zone of the classification reached the lowest values. On the other hand, the teams that have the least value without possession of the ball, are placed in the lowest places of the classification. In addition, the matches played at home and away from home were analyzed without any significant difference. The results of this research offer us the possibility of carrying out an in-depth analysis of the competition that combines physical and tactical dimensions, anticipating the physical demands demanded by the games ahead of us. Once we know the physical demands we will encounter during the game, we will have the opportunity to control both the load and the strategy of the week.

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Background: Eccentric resistance training is recognised as an effective stimulus for enhancing measures of muscular strength and power in adult populations; however, its value in youth athletes is currently not well understood. Objective: The aim of this systematic review was to critically appraise the effects of eccentric resistance training on measures of physical performance (i.e. muscular strength, jump, sprint and change of direction) in youth athletes 18 years of age and under. Methods: Original journal articles published between 1950 and June 2022 were retrieved from electronic search engines of PubMed, SPORTDiscus and Google Scholar’s advanced search option. Full journal articles investigating the acute and chronic effects of eccentric resistance training on measures of physical performance in youth athletes (i.e. a person 18 years of age or under who competes in sport) were included. The methodological quality and bias of each study were assessed prior to data extraction using a modified Downs and Black checklist. Results: The search yielded 749 studies, of which 436 were duplicates. Three-hundred studies were excluded based upon title and abstract review and a further 5 studies were removed following the modified Downs and Black checklist. An additional 14 studies were identified during backward screening. Accordingly, 22 studies were included in our systematic review. The Nordic hamstring exercise and flywheel inertial training were the most frequently used eccentric resistance training methods in youth athletes. Improvements in physical performance following the Nordic hamstring exercise are dependent upon an increase in the breakpoint angle, rather than training volume (sets and repetitions), and are further elevated with the addition of hip extension exercises or high-speed running. A minimum of 3 familiarisation trials is necessary to elicit meaningful adaptations following flywheel inertial training. Furthermore, an emphasis should be placed upon dec

Altered mitochondrial quality and function in muscle may be involved in age-related physical function decline. The role played by the autophagy-lysosome system, a major component of mitochondrial quality control (MQC), is incompletely understood. This study was undertaken to obtain initial indications on the relationship between autophagy, mitophagy, and lysosomal markers in muscle and measures of physical performance and lower extremity tissue composition in young and older adults. Twenty-three participants were enrolled, nine young (mean age: 24.3 ± 4.3 years) and 14 older adults (mean age: 77.9 ± 6.3 years). Lower extremity tissue composition was quantified volumetrically by magnetic resonance imaging and a tissue composition index was calculated as the ratio between muscle and intermuscular adipose tissue volume. Physical performance in older participants was assessed via the Short Physical Performance Battery (SPPB). Protein levels of the autophagy marker p62, the mitophagy mediator BCL2/adenovirus E1B 19 kDa protein-interacting protein 3 (BNIP3), the lysosomal markers transcription factor EB, vacuolar-type ATPase, and lysosomal-associated membrane protein 1 were measured by Western immunoblotting in vastus lateralis muscle biopsies. Older adults had smaller muscle volume and lower tissue composition index than young participants. The protein content of p62 and BNIP3 was higher in older adults. A negative correlation was detected between p62 and BNIP3 and the tissue composition index. p62 and BNIP3 were also related to the performance on the 5-time sit-to-stand test of the SPPB. Our results suggest that an altered expression of markers of the autophagy/mitophagy-lysosomal system is related to deterioration of lower extremity tissue composition and muscle dysfunction. Additional studies are needed to clarify the role of defective MQC in human muscle aging and identify novel biological targets for drug development.

The scientific literature about probiotic intake and its effect on sports performance is growing. Therefore, the main aim of this systematic review, meta-analysis and meta-regression was to review all information about the effects of probiotic supplementation on performance tests with predominance of aerobic metabolism in trained populations (athletes and/or Division I players and/or trained population: ≥8 h/week and/or ≥5 workouts/week). A structured search was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA®) statement and PICOS guidelines in PubMed/MEDLINE, Web of Science (WOS), and Scopus international databases from inception to 1 November 2021. Studies involving probiotic supplementation in trained population and execution of performance test with aerobic metabolism predominance (test lasted more than 5 min) were considered for inclusion. Fifteen articles were included in the final systematic review (in total, 388 participants were included). After 3 studies were removed due to a lack of data for the meta-analysis and meta-regression, 12 studies with 232 participants were involved. With the objective of assessing the risk of bias of included studies, Cochrane Collaboration Guidelines and the Physiotherapy Evidence Database (PEDro) scale were performed. For all included studies the following data was extracted: authors, year of publication, study design, the size of the sample, probiotic administration (dose and time), and characteristics of participants. The random effects model and pooled standardized mean differences (SMDs) were used according to Hedges’ g for the meta-analysis. In order to determine if dose and duration covariates could predict probiotic effects, a meta-regression was also conducted. Results showed a small positive and significant effect on the performance test with aerobic metabolic predominance (SMD = 0.29; CI = 0.08–0.50; p < 0.05). Moreover, the subgroup analysis displayed sign

Background: This study compared the physical demands and effect of field location for different phases of play (offence, defence and contested), and examined the physical and technical demands of successful and unsuccessful phases of play during Australian Football matches. Methods: Global positioning system (GPS) and technical performance data were collected from 32 male Australian Football players in one club over 19 games in the 2019 season. The GPS data was aligned with phases of play acquired using Champion Data. Linear mixed models were used to detect differences between phases of play and field location which were further contextualized using Cohen’s d effect size. Results: Physical demands were greatest (p < 0.001) in defensive phases for backs (ES 0.61 to 1.42), and offensive phases for midfielders (ES 0.65 to 0.96) and forwards (ES 0.84 to 1.94). Additionally, distance and high-speed running were lowest in contested phases irrespective of playing position. Distance and high-speed running were greatest in larger field locations (e.g., full ground). No pattern was evident for accelerations or decelerations. Successful offensive plays demonstrated greater physical and technical outputs for midfielders and forwards, whereas the opposite was found for backs. Physical output was largely greater in unsuccessful defensive plays for all positions; however, the rate of tackles and marks was greater during successful defence. Conclusion: These findings enable a greater understanding of the demands of Australian Football matches, and can be utilized to inform both representative training design, and the evaluation of player performance.

Supplementation with Citrulline (Cit) has been shown to have a positive impact on aerobic exercise performance and related outcomes such as lactate, oxygen uptake (VO2) kinetics, and the rate of perceived exertion (RPE), probably due to its relationship to endogenous nitric oxide production. However, current research has shown this to be controversial. The main objective of this systematic review and meta-analysis was to analyze and assess the effects of Cit supplementation on aerobic exercise performance and related outcomes, as well as to show the most suitable doses and timing of ingestion. A structured literature search was carried out by the PRISMA® (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and PICOS guidelines in the following databases: Pubmed/Medline, Scopus, and Web of Science (WOS). A total of 10 studies were included in the analysis, all of which exclusively compared the effects of Cit supplementation with those of a placebo group on aerobic performance, lactate, VO2, and the RPE. Those articles that used other supplements and measured other outcomes were excluded. The meta-analysis was carried out using Hedges’ g random effects model and pooled standardized mean differences (SMD). The results showed no positive effects of Cit supplementation on aerobic performance (pooled SMD = 0.15; 95% CI (−0.02 to 0.32); I2, 0%; p = 0.08), the RPE (pooled SMD = −0.03; 95% CI (−0.43 to 0.38); I2, 49%; p = 0.9), VO2 kinetics (pooled SMD = 0.01; 95% CI (−0.16 to 0.17); I2, 0%; p = 0.94), and lactate (pooled SMD = 0.25; 95% CI (−0.10 to 0.59); I2, 0%; p = 0.16). In conclusion, Cit supplementation did not prove to have any benefits for aerobic exercise performance and related outcomes. Where chronic protocols seemed to show a positive tendency, more studies in the field are needed to better understand the effects.

Abstract Background Adequate dietary protein intake is recommended for older adults to optimise muscle health and function, and support recovery from illness, however, its effect on health-related quality of life (HRQoL) is unclear. The aim of this study was to examine the association between total protein intake and different sources of dietary protein and HRQoL in Australians aged 60 years and older over a 12-year period. Methods This study used data from the Australian Diabetes, Obesity and Lifestyle study (AusDiab), a 12-year population-based prospective study. The sample included 752 (386 females) adults aged 60 years and older. Protein intake was estimated at baseline (1999/2000) from a 74-item Food Frequency Questionnaire, and HRQoL using the 36-item Short-form Health Survey assessed at baseline (1999/2000) and after 12 years (2011/12). The association between protein intake and change in HRQoL was evaluated using multivariate regression analysis adjusted for relevant confounders. The difference in change in HRQoL between participants with total protein intakes of < 1.0 g/kg/day, intakes of between 1.0–1.2 g/kg/day and intakes of > 1.2 g/kg/day were assessed using one-way ANCOVA. Results Total protein intake at baseline was not associated with 12-year changes in physical component summary (PCS) or mental component summary (MCS) scores of HRQoL. Higher animal, red meat and processed animal protein intakes were associated with deteriorations in PCS scores after adjusting for relevant confounders (β = − 0.04; 95% CI: − 0.07, −0.01 ; p = 0.009; β = − 0.05; 95% CI: −&thi

The scientific literature about probiotic intake and its effect on sports performance is growing. Therefore, the main aim of this systematic review, meta-analysis and meta-regression was to review all information about the effects of probiotic supplementation on performance tests with predominance of aerobic metabolism in trained populations (athletes and/or Division I players and/or trained population: ≥8 h/week and/or ≥5 workouts/week). A structured search was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA®) statement and PICOS guidelines in PubMed/MEDLINE, Web of Science (WOS), and Scopus international databases from inception to 1 November 2021. Studies involving probiotic supplementation in trained population and execution of performance test with aerobic metabolism predominance (test lasted more than 5 min) were considered for inclusion. Fifteen articles were included in the final systematic review (in total, 388 participants were included). After 3 studies were removed due to a lack of data for the meta-analysis and meta-regression, 12 studies with 232 participants were involved. With the objective of assessing the risk of bias of included studies, Cochrane Collaboration Guidelines and the Physiotherapy Evidence Database (PEDro) scale were performed. For all included studies the following data was extracted: authors, year of publication, study design, the size of the sample, probiotic administration (dose and time), and characteristics of participants. The random effects model and pooled standardized mean differences (SMDs) were used according to Hedges’ g for the meta-analysis. In order to determine if dose and duration covariates could predict probiotic effects, a meta-regression was also conducted. Results showed a small positive and significant effect on the performance test with aerobic metabolic predominance (SMD = 0.29; CI = 0.08–0.50; p < 0.05). Moreover, the subgroup analysis displayed sign

Muscle strength and physical performance are associated with incident fractures and mortality. However, their role in the risk of subsequent fracture and postfracture mortality is not clear. We assessed the association between muscle strength (grip strength) and performance (gait speed and chair stands time) and the risk of subsequent fracture and mortality in 830 men with low-trauma index fracture, who participated in the Osteoporotic Fractures in Men (MrOS) USA Study and had their index measurements assessed within 5 years prior to the index fracture. The annual decline in muscle strength and performance following index fracture, estimated using linear mixed-effects regression, was also examined in relation to mortality. The associations were assessed using Cox proportional hazards models adjusted for age, femoral neck bone mineral density (FN BMD), prior fractures, falls, body mass index (BMI), index fracture site, lifestyle factors, and comorbidities. Over a median follow-up of 3.7 (interquartile range [IQR], 1.3-8.1) years from index fracture to subsequent fracture, 201 (24%) men had a subsequent fracture and over 5.1 (IQR, 1.8-9.6) years to death, and 536 (65%) men died. Index measurements were not associated with subsequent fracture (hazard ratios [HRs] ranging from 0.97 to 1.07). However, they were associated with postfracture mortality. HR (95% confidence interval [CI]) per 1 standard deviation (1-SD) decrement in grip strength: HR 1.12 (95% CI, 1.01-1.25) and gait speed: HR 1.14 (95% CI, 1.02-1.27), and 1-SD increment in chair stands time: HR 1.08 (95% CI, 0.97-1.21). Greater annual declines in these measurements were associated with higher mortality risk, independent of the index values and other covariates. HR (95% CI) per 1-SD annual decrement in change in grip strength: HR 1.15 (95% CI, 1.01-1.33) and in gait speed: HR 1.38 (95% CI, 1.13-1.68), and 1-SD annual increment in chair stands time: HR 1.28 (95% CI, 1.07-1.54). Men who were unable to complete

Background: age-adapted definition of chronic kidney disease (CKD) does not take individual risk factors into account. We aimed at investigating whether functional impairments influence CKD stage at which mortality increases among older people. Methods: our series consisted of 2,372 outpatients aged 75 years or more enrolled in a multicentre international prospective cohort study. The study outcome was 24-month mortality. Kidney function was assessed by estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (ACR). Geriatric assessments included handgrip strength, short physical performance battery (SPPB), cognitive impairment, dependency in basic activities of daily living (BADL) and risk of malnutrition. Analysis was carried out by Cox regression, before and after stratification by individual functional impairments. Survival trees including kidney function and functional impairments were also investigated, and their predictivity assessed by C-index. Results: overall, mortality was found to increase starting from eGFR = 30-44.9 ml/min/1.73 m2 (hazard ratio [HR] = 3.28, 95% confidence interval [CI] = 1.81-5.95) to ACR = 30-300 mg/g (HR = 1.96, 95%CI = 1.23-3.10). However, in survival trees, an increased risk of mortality was observed among patients with impaired handgrip and eGFR = 45-59.9 ml/min/1.73 m2, as well as patients with ACR < 30 mg/g and impaired handgrip and SPPB. Survival tree leaf node membership had greater predictive accuracy (C-index = 0.81, 95%CI = 0.78-0.84 for the eGFR survival tree and C-index = 0.77, 95%CI = 0.71-0.81 for the ACR survival tree) in comparison with that of individual measures of kidney function. Conclusions: physical performance helps to identify a proportion of patients at an increased risk of mortality despite a mild-moderate impairment in kidney function and improves predictive accuracy of individual measures of kidney function. © 2022 The Author(s). Published by Oxford University Press on behalf of the B

Background One’s physical function and physical activity levels can predispose or protect from the development of respiratory infections. We aimed to explore the associations between pre-pandemic levels of physical function and physical activity and the development of COVID-19-like symptoms in Swedish older adults. Methods We analyzed data from 904 individuals aged ≥ 68 years from the population-based Swedish National study on Aging and Care in Kungsholmen. COVID-19-like symptoms were assessed by phone interview (March–June 2020) and included fever, cough, sore throat and/or a cold, headache, pain in muscles, legs and joints, loss of taste and/or odor, breathing difficulties, chest pain, gastrointestinal symptoms, and eye inflammation. Muscle strength, mobility, and physical activity were examined in 2016–2018 by objective testing. Data were analyzed using logistic regression models in the total sample and stratifying by age. Results During the first outbreak of the pandemic, 325 (36%) individuals from our sample developed COVID-19-like symptoms. Those with slower performance in the chair stand test had an odds ratio (OR) of 1.5 (95% confidence interval [CI] 1.1–2.1) for presenting with COVID-19-like symptoms compared to better performers, after adjusting for potential confounders. The association was even higher among people aged ≥ 80 years (OR 2.6; 95% CI 1.5–4.7). No significant associations were found between walking speed or engagement in moderate-to-vigorous physical activity and the likelihood to develop COVID-19-like symptoms. Conclusion Poor muscle strength, a possible indicator of frailty, may predispose older adults to higher odds of developing COVID-19-like symptoms, especially among the oldest-old.

This prospective study evaluated cognitive and physical trajectories of nursing home (NH) residents after fall occurrence and their predictors. In 167 residents aged ≥60, we considered the closest pre-fall assessment and up to the first three post-fall assessments of cognitive and physical functions performed through Mini-Mental State Examination (MMSE) and Tinetti tests. Mixture models identified three post-fall cognitive and physical trajectories: stability, slow decline, and rapid decline. At logistic regression, older age, fewer informal visits, and falls within one month from institutionalization increased the probability of experiencing a decline in MMSE and Tinetti scores. Worse pre-fall cognitive function increased the likelihood of cognitive and physical decline, while worse pre-fall Tinetti score negatively impacted only physical decline. In conclusion, the impact of falls on the cognitive and physical health of NH residents may be modulated by their pre-fall cognitive function and some modifiable factors, such as social interactions and physical function.

Background: age-adapted definition of chronic kidney disease (CKD) does not take individual risk factors into account. We aimed at investigating whether functional impairments influence CKD stage at which mortality increases among older people. Methods: our series consisted of 2,372 outpatients aged 75 years or more enrolled in a multicentre international prospective cohort study. The study outcome was 24-month mortality. Kidney function was assessed by estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (ACR). Geriatric assessments included handgrip strength, short physical performance battery (SPPB), cognitive impairment, dependency in basic activities of daily living (BADL) and risk of malnutrition. Analysis was carried out by Cox regression, before and after stratification by individual functional impairments. Survival trees including kidney function and functional impairments were also investigated, and their predictivity assessed by C-index. Results: overall, mortality was found to increase starting from eGFR = 30-44.9 ml/min/1.73 m2 (hazard ratio [HR] = 3.28, 95% confidence interval [CI] = 1.81-5.95) to ACR = 30-300 mg/g (HR = 1.96, 95%CI = 1.23-3.10). However, in survival trees, an increased risk of mortality was observed among patients with impaired handgrip and eGFR = 45-59.9 ml/min/1.73 m2, as well as patients with ACR < 30 mg/g and impaired handgrip and SPPB. Survival tree leaf node membership had greater predictive accuracy (C-index = 0.81, 95%CI = 0.78-0.84 for the eGFR survival tree and C-index = 0.77, 95%CI = 0.71-0.81 for the ACR survival tree) in comparison with that of individual measures of kidney function. Conclusions: physical performance helps to identify a proportion of patients at an increased risk of mortality despite a mild-moderate impairment in kidney function and improves predictive accuracy of individual measures of kidney function. © 2022 The Author(s). Published by Oxford University Press on behalf of the B

Background: age-adapted definition of chronic kidney disease (CKD) does not take individual risk factors into account. We aimed at investigating whether functional impairments influence CKD stage at which mortality increases among older people. Methods: our series consisted of 2,372 outpatients aged 75 years or more enrolled in a multicentre international prospective cohort study. The study outcome was 24-month mortality. Kidney function was assessed by estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (ACR). Geriatric assessments included handgrip strength, short physical performance battery (SPPB), cognitive impairment, dependency in basic activities of daily living (BADL) and risk of malnutrition. Analysis was carried out by Cox regression, before and after stratification by individual functional impairments. Survival trees including kidney function and functional impairments were also investigated, and their predictivity assessed by C-index. Results: overall, mortality was found to increase starting from eGFR = 30-44.9 ml/min/1.73 m2 (hazard ratio [HR] = 3.28, 95% confidence interval [CI] = 1.81-5.95) to ACR = 30-300 mg/g (HR = 1.96, 95%CI = 1.23-3.10). However, in survival trees, an increased risk of mortality was observed among patients with impaired handgrip and eGFR = 45-59.9 ml/min/1.73 m2, as well as patients with ACR < 30 mg/g and impaired handgrip and SPPB. Survival tree leaf node membership had greater predictive accuracy (C-index = 0.81, 95%CI = 0.78-0.84 for the eGFR survival tree and C-index = 0.77, 95%CI = 0.71-0.81 for the ACR survival tree) in comparison with that of individual measures of kidney function. Conclusions: physical performance helps to identify a proportion of patients at an increased risk of mortality despite a mild-moderate impairment in kidney function and improves predictive accuracy of individual measures of kidney function. © 2022 The Author(s). Published by Oxford University Press on behalf of the B

Padel is a modern doubles racket sport which has become popular around the world in the last decades. There has been an increase in the quantity of scientific research about this sport in the last years. Therefore, the main objective of this scoping review is to provide an updated contextualization of research regarding padel. PRISMA ScR was used in order to search for articles fulfilling the inclusion criteria in five fields of interest: the anthropometric profile, physiology and physical performance, biomechanics, the epidemiology of injuries, and match analyses Seventy-seven records were included in the study. Padel is an emerging sport both in sport and research terms. This scoping review provides coaches and researchers with all the knowledge available in the five fields of interest. Furthermore, this study enables them to make a map of the current state of the research about padel, and it opens up doors to future investigations.

Bakgrund: Under menstruationscykeln, som består av follikelfasen och lutealfasen, så varierar hormonerna kraftigt. Det anabola hormonet östrogen är dominerande under follikelfasen och det katabola hormonet progesteron är dominerande under lutealfasen. Detta talar för att prestationen i styrketräning kan vara högre under follikelfasen än under lutealfasen. Syfte: Syftet med denna studie var att undersöka om kvinnor i fertil ålder upplevde variationer i sin prestation inom styrketräning under menstruationscykelns olika faser. Metod: I denna studie användes en kvalitativ studiedesign där datainsamling genomfördes med semistrukturerade intervjuer. Fem kvinnor i fertil ålder (24-32 år) med erfarenhet av styrketräning förde träningsdagbok under en menstruationscykel och intervjuades därefter. Intervjuerna analyserades med konventionell kvalitativ innehållsanalys. Resultat: Resultatet visade att kvinnornas upplevelse av prestation varierade under menstruationscykels faser. Vid analysen utkristalliserade sig fyra övergripande teman ”Varierande mentala och fysiska upplevelser i den tidiga follikelfasen”, ” Framför allt toppad prestation under sena follikelfasen”, ”Brytpunkt vid ägglossning” och ”Varierande mentala och fysiska upplevelser under lutealfasen”. Konklusion: Kvinnor i fertil ålder verkar uppleva variationer i sin prestation i styrketräning under menstruationscykelns olika faser. Det kan därför vara fördelaktigt att periodisera styrketräningen utifrån menstruationscykeln., Background: During the menstrual cycle, which consists of the follicular phase and the luteal phase, the hormones vary greatly. The anabolic hormone estrogen dominates the follicular phase and the catabolic hormone progesterone dominates during the luteal phase. This suggests that performance in strength training may be higher during the follicular phase than during the luteal phase. Purpose: The aim was to investigate whether women of childbearing age experienced variations in their performance in strength training during the different phases of the menstrual cycle. Method: In this study, a qualitative study design was used where data collection was carried out with semi-structured interviews. Five women of childbearing age (24-32 years) with experience in strength training kept an exercise diary during a menstrual cycle and were subsequently interviewed. Results: The results showed that women's experience of performance varied during the phases of the menstrual cycle. Four categories were identified "Varying mental and physical experiences in the early follicle phase", "Mostly peak performance during the late follicle phase", "Breakpoint in ovulation" and "Varying mental and physical experiences during the luteal phase". Conclusion: Women of childbearing age seem to experience variations in strength training performance during the different phases of the menstrual cycle. Thus, periodizing strength training program, based on the menstrual cycle, might be beneficial.

BackgroundMuscle mass declines with age, while body adiposity increases. Sarcopenic obesity has been proposed to be particularly deleterious. However, previous methods for estimating muscle mass have been inadequate, and the relative contributions of total body fat versus muscle fat to adverse outcomes have been unclear.MethodIn a large cohort of older men (N = 1 017), we measured muscle mass (D3-creatine dilution), muscle density (high-resolution peripheral quantitative computed tomography in the diaphyseal tibia) as a proxy of muscle fat, and total body fat (dual-energy x-ray absorptiometry). We examined their associations with physical performance (walking speed, grip strength, chair stand time), the risk of mobility outcomes (mobility limitations, mobility disability), and the risk of death over ~5 years.ResultsIn combined models, lower muscle mass and muscle density were independently associated with worse physical performance and the risk of adverse outcomes, while total body fat was minimally related to physical performance and not related to mobility outcomes or mortality. For example, the relative risks for mortality per 1 standardized unit increase in muscle density, muscle mass, and total body fat were 0.84 (95% confidence interval: 0.74, 0.96), 0.70 (0.57, 0.86), and 0.90 (0.64, 1.25), respectively.ConclusionsMuscle mass and muscle density were associated with physical performance and adverse outcomes, and had independent, additive effects. There was little additional contribution of total body fat.

Muscle strength and physical performance are associated with incident fractures and mortality. However, their role in the risk of subsequent fracture and postfracture mortality is not clear. We assessed the association between muscle strength (grip strength) and performance (gait speed and chair stands time) and the risk of subsequent fracture and mortality in 830 men with low-trauma index fracture, who participated in the Osteoporotic Fractures in Men (MrOS) USA Study and had their index measurements assessed within 5 years prior to the index fracture. The annual decline in muscle strength and performance following index fracture, estimated using linear mixed-effects regression, was also examined in relation to mortality. The associations were assessed using Cox proportional hazards models adjusted for age, femoral neck bone mineral density (FN BMD), prior fractures, falls, body mass index (BMI), index fracture site, lifestyle factors, and comorbidities. Over a median follow-up of 3.7 (interquartile range [IQR], 1.3-8.1) years from index fracture to subsequent fracture, 201 (24%) men had a subsequent fracture and over 5.1 (IQR, 1.8-9.6) years to death, and 536 (65%) men died. Index measurements were not associated with subsequent fracture (hazard ratios [HRs] ranging from 0.97 to 1.07). However, they were associated with postfracture mortality. HR (95% confidence interval [CI]) per 1 standard deviation (1-SD) decrement in grip strength: HR 1.12 (95% CI, 1.01-1.25) and gait speed: HR 1.14 (95% CI, 1.02-1.27), and 1-SD increment in chair stands time: HR 1.08 (95% CI, 0.97-1.21). Greater annual declines in these measurements were associated with higher mortality risk, independent of the index values and other covariates. HR (95% CI) per 1-SD annual decrement in change in grip strength: HR 1.15 (95% CI, 1.01-1.33) and in gait speed: HR 1.38 (95% CI, 1.13-1.68), and 1-SD annual increment in chair stands time: HR 1.28 (95% CI, 1.07-1.54). Men who were unable to complete

Insight into, and measurements of, muscle contraction during movement may help improve the assessment of muscle function, quantification of athletic performance, and understanding of muscle behavior, prior to and during rehabilitation following neuromusculoskeletal injury. A self-adhesive, elastic fabric, nanocomposite, skin-strain sensor was developed and validated for human movement monitoring. We hypothesized that skin-strain measurements from these wearables would reveal different degrees of muscle engagement during functional movements. To test this hypothesis, the strain sensing properties of the elastic fabric sensors, especially their linearity, stability, repeatability, and sensitivity, were first verified using load frame tests. Human subject tests conducted in parallel with optical motion capture confirmed that they can reliably measure tensile and compressive skin-strains across the calf and tibialis anterior. Then, a pilot study was conducted to assess the correlation of skin-strain measurements with surface electromyography (sEMG) signals. Subjects did biceps curls with different weights, and the responses of the elastic fabric sensors worn over the biceps brachii and flexor carpi radialis (i.e., forearm) were well-correlated with sEMG muscle engagement measures. These nanocomposite fabric sensors were validated for monitoring muscle engagement during functional activities and did not suffer from the motion artifacts typically observed when using sEMGs in free-living community settings.

Padel is a modern doubles racket sport which has become popular around the world in the last decades. There has been an increase in the quantity of scientific research about this sport in the last years. Therefore, the main objective of this scoping review is to provide an updated contextualization of research regarding padel. PRISMA ScR was used in order to search for articles fulfilling the inclusion criteria in five fields of interest: the anthropometric profile, physiology and physical performance, biomechanics, the epidemiology of injuries, and match analyses Seventy-seven records were included in the study. Padel is an emerging sport both in sport and research terms. This scoping review provides coaches and researchers with all the knowledge available in the five fields of interest. Furthermore, this study enables them to make a map of the current state of the research about padel, and it opens up doors to future investigations.

Based on many empircal studies, nature play a cruical role in improving every aspect of children´s development—from the physical to the social, cognitive and even emotional. Unfortunately, today’s children are much less connected to the natural world. They spend in average 90% of their time indoors in artificial built environments away from nature; the natural connection has been replaced with more virtual technological interactions and less unstructured outdoor play. The negative outcomes for children of this disconnection include very high rates of childhood obesity, social disorder and increased psychological stress. This paper investigates a biophilic architectural approach that focuses on creating an interconnection between life, nature and the built environment to enriches children's daily lives in educational spaces. The research method consists of a wide range of literature review to explore the concept of nature connection, biophilia, biophilic design principles, and their impact on creating educational spaces for children. The findings took the form of biophilic toolbox that could help in promoting physical and mental performance of children in educational spaces.