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Purpose In Football, the high-intensity running bouts during matches are considered decisive. Interestingly, recent studies showed that peak fat oxidation rates (PFO) are higher in football players than other athletes. This study aimed to investigate whether PFO increases following a pre-season. Secondarily, and due to COVID-19, we investigated whether PFO is related to the physical performance in a subgroup of semi-professional male football players. Methods Before and after 8 weeks of pre-season training, 42 sub-elite male football players (18 semi-professionals and 24 non-professionals) had a dual-energy x-ray absorptiometry scan and performed a graded exercise test on a treadmill for the determination of PFO, the exercise intensity eliciting PFO (Fatmax) and peak oxygen uptake (V̇O2peak). Additionally, the semi-professional players performed a Yo-Yo Intermittent Recovery Test level 2 (YYIR2) before and after pre-season training to determine football-specific running performance. Results PFO increased by 11 ± 10% (mean ± 95% CI), p = 0.031, and V̇O2peak increased by 5 ± 1%, p < 0.001, whereas Fatmax was unchanged (+12 ± 9%, p = 0.057), following pre-season training. PFO increments were not associated with increments in V̇O2peak (Pearson's r2 = 0.00, p = 0.948) or fat-free mass (FFM) (r2 = 0.00, p = 0.969). Concomitantly, YYIR2 performance increased in the semi-professional players by 39 ± 17%, p < 0.001, which was associated with changes in V̇O2peak (r2 = 0.35, p = 0.034) but not PFO (r2 = 0.13, p = 0.244). Conclusions PFO, V̇O2peak, and FFM increased following pre-season training in sub-elite football players. However, in a subgroup of semi-professional players, increments in PFO were not associated with improvements in YYIR2 performance nor with increments in V̇O2peak and FFM., Purpose: In Football, the high-intensity running bouts during matches are considered decisive. Interestingly, recent studies showed that peak fat oxidation rates (PFO) are higher in football players than other athletes. This study aimed to investigate whether PFO increases following a pre-season. Secondarily, and due to COVID-19, we investigated whether PFO is related to the physical performance in a subgroup of semi-professional male football players. Methods: Before and after 8 weeks of pre-season training, 42 sub-elite male football players (18 semi-professionals and 24 non-professionals) had a dual-energy x-ray absorptiometry scan and performed a graded exercise test on a treadmill for the determination of PFO, the exercise intensity eliciting PFO (Fatmax) and peak oxygen uptake (V̇O2peak). Additionally, the semi-professional players performed a Yo-Yo Intermittent Recovery Test level 2 (YYIR2) before and after pre-season training to determine football-specific running performance. Results: PFO increased by 11 ± 10% (mean ± 95% CI), p = 0.031, and V̇O2peak increased by 5 ± 1%, p < 0.001, whereas Fatmax was unchanged (+12 ± 9%, p = 0.057), following pre-season training. PFO increments were not associated with increments in V̇O2peak (Pearson's r2 = 0.00, p = 0.948) or fat-free mass (FFM) (r2 = 0.00, p = 0.969). Concomitantly, YYIR2 performance increased in the semi-professional players by 39 ± 17%, p < 0.001, which was associated with changes in V̇O2peak (r2 = 0.35, p = 0.034) but not PFO (r2 = 0.13, p = 0.244). Conclusions: PFO, V̇O2peak, and FFM increased following pre-season training in sub-elite football players. However, in a subgroup of semi-professional players, increments in PFO were not associated with improvements in YYIR2 performance nor with increments in V̇O2peak and FFM.

Purpose: To investigate the impact of soccer training on cardiac adaptations in mildly hypertensive middle-aged women. Methods: Hypertensive premenopausal women (n = 41; age (mean ± SD): 44 ± 7 years; height: 166 ± 6 cm; weight: 78.6 ± 11.6 kg; body fat: 43.3 ± 5.2%) were randomized to soccer training (SOC, n = 21) or control (CON, n = 20). SOC performed three weekly training sessions for 15 weeks, whereas CON had no training or lifestyle changes during the same period. Cardiac structure and function were assessed by echocardiography pre-intervention and post-intervention. Results: Soccer training increased (P = 0.001) left ventricular mass index by 10% [95% CI 4; 15], while no changes occurred in CON (time × group interaction, P = 0.005). In addition, only SOC demonstrated a within-group increase (P = 0.01) of 8% [95% CI 2; 14] in left ventricular septum diameter. For markers of right ventricular remodelling, a within-group increase (P = 0.02) occurred for tricuspid annulus plane systolic excursion of 8% [95% CI 1; 14] in SOC only. Left atrial diameter index increased (P < 0.001) by 6% [95% CI 3; 10] after SOC, while it was unaffected in CON (time × group interaction, P = 0.02). For makers of diastolic function, SOC demonstrated a within-group increase (P = 0.02) in the average early diastolic mitral annulus velocity of 10% [95% CI 2; 19]. In addition, a reduction (P < 0.001) in mitral valve A velocity of − 19% [95% CI − 29; − 10] was observed following soccer training, which manifested in increased (P < 0.001) mitral valve E/A ratio of 34% [95% CI 16; 53] in SOC. No within-group changes were apparent in CON. Conclusion: In sedentary, mildly hypertensive, middle-aged women, 15 weeks of soccer training increases left ventricular mass and left atrial diameter and improves indices of left ventricular diastolic function.

We studied the long-term effects of a multicomponent exercise training protocol (recreational team handball training, RTH) on global health status in inactive postmenopausal women. Participants (n = 45; age 65 ± 6 years, stature 157 ± 6 cm, body mass 66.2 ± 9.4 kg, fat mass 41.4 ± 5.5%, VO2peak 25.7 ± 3.6 mL/min/kg) were randomized into a control group (CG; n = 14) and a multicomponent exercise training group (EXG; n = 31, performing 2-3 weekly 60-min RTH sessions). Attendance was 2.0 ± 0.4 sessions/week (first 16 weeks) and 1.4 ± 0.5 (following 20 weeks) and mean heart rate (HR) loading was 77 and 79% of maximal HR (p = 0.002) for the first 16 and the following 20 weeks, respectively. Cardiovascular, bone, metabolic health, body composition and physical fitness markers were evaluated at baseline, and after 16 and 36 weeks. An interaction (p ≤ 0.046) was shown for the 2-h oral glucose tolerance test, HDL, Yo-Yo intermittent endurance level 1 test (YYIE1) and knee strength, in favour of EXG. At 36 weeks YYIE1 and knee strength were higher (p ≤ 0.038) for EXG vs CG. Also, within-group improvements (p ≤ 0.043) were observed after 36 weeks for EXG in VO2peak, lumbar spine bone mineral density, lumbar spine bone mineral content, P1NP, osteocalcin, total cholesterol, HDL, LDL, body mass, android fat mass, YYIE1, knee strength, handgrip strength and postural balance. At 36 comparatively to 16 weeks, EXG showed an increase (p ≤ 0.036) in fasting blood glucose, HDL, knee strength and handgrip strength, and a decrease (p ≤ 0.025) in LDL. Collectively, this multicomponent exercise training (RTH) induces beneficial changes in global health status in postmenopausal women.

This chapter focuses on football as a health-enhancing activity. Or more specifically, Football Fitness, which was launched in 2011 as a response to various developments in Danish sports. The sporting habits of Danes are changing, and there is a growing political desire to involve voluntary organised sport, including football, in public social and health-related tasks. The Danish Football Association (DBU) describes Football Fitness as football in a “completely new way in sporting and organisational terms”. Besides outlining how recreational football is an activity with wide-ranging impact on health, this chapter pursues the perception of Football Fitness as a football activity that breaks with traditional organisation, based on the idea of path-breaking concepts (Sydow et al., 2005). We show that Football Fitness breaks with the sporting form of recreational football, but not with the organisational form. This conclusion is challenged in the chapter's discussion, which stress that the degree of path breaking is dependent on each club's approach to managing Football Fitness.

The present study examined skeletal muscle metabolism and changes in repeated sprint performance during match play for n = 20 competitive elite women outfield players. We obtained musculus vastus lateralis biopsies and blood samples before, after, and following intense periods in each half of a friendly match, along with 5 × 30-meter sprint tests and movement pattern analyses (10-Hz S5 Global Positioning System [GPS]). Muscle glycogen decreased by 39% and 42% after an intense period of the second half and after the match, respectively, compared to baseline (p < 0.05). Post-match, 80% type I fibers and 69% type II fibers were almost empty or completely empty of glycogen. Muscle lactate was higher (p < 0.05) after the intense period of the first half and post-match compared to baseline (14.3 ± 4.6 (±SEM) and 12.9 ± 5.7 vs. 6.4 ± 3.7 mmol/kg d.w.). Muscle phosphocreatine was reduced (p < 0.05) by 16% and 12%, respectively, after an intense period in the first and second half compared to baseline. Blood lactate and glucose increased during the match and peaked at 8.4 ± 2.0 and 7.9 ± 1.2 mmol/L, respectively. Mean 5 × 30 m sprint time declined by 3.2 ± 1.7 and 7.0 ± 2.1% after the first and second half, respectively, and 4.7 ± 1.6% (p < 0.05) after an intense period in the first half compared to baseline. In conclusion, match play in elite female football players resulted in marked glycogen depletion in both fiber types, which may explain fatigue at the end of a match. Repeated sprint ability was impaired after intense periods in the first half and after both halves, which may be associated with the observed muscle metabolite perturbations.

Background: Recreational football is an intense, versatile form of exercise with multiple high- and odd-impact actions. Recreational football is therefore hypothesized to be suitable for bone modeling and bone health.Objective: The aim of the present systematic review and meta-analysis was to evaluate the effects of recreational football on bone mineral density (BMD), bone mineral content (BMC) and bone turnover markers (BTM).Design: Systematic review and meta-analysis.Data sources: MEDLINE, PubMed, SPORTDiscus, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Google Scholar were searched prior to September 2021. A manual database search was also performed using the following key terms, either singly or in combination: recreational football/soccer, street football/soccer, recreational small-sided games, effect, influence, impact, bone turnover markers, bone mineral density, bone turnover marker, bone health, osteogenesis, CTX, osteocalcin, P1NP.Eligibility criteria for selecting studies: Randomised and matched controlled trials with participants allocated to a recreational football group or any other type of training intervention or passive control group were included. The primary outcome measures were total BMD, lower limb BMD, total BMC, lower limb BMC, osteocalcin, procollagen type 1N-terminal propeptide (P1NP) and collagen type 1 cross-linked C-telopeptide (CTX). A total of 17 papers met the inclusion criteria and were included.Statistical analysis: Comprehensive Meta-analysis V.2 software (Biostat, Englewood, New Jersey, USA) was used for the meta-analyses.Risk of bias: Agreement between the two reviewers was assessed using RoB2 tool and k statistics for full-text screening and rating of relevance and risk of bias. The k agreement rate between reviewers was k = 0.92.Results: The football interventi

This study investigated the relationship between leisure-time sports club activities and well-being as well as physical health parameters in 10-12-year-old Danish girls. Two thousand two hundred three girls took part in the study, which included questionnaires on participation in leisure-time sports clubs, well-being, Yo-Yo intermittent recovery level 1 children's test, long jump, balance tests, body composition, blood pressure (BP), and resting heart rate (RHR). Data were analyzed according to whether the girls participated in leisure-time sport and according to the 5 most frequently reported sports. Girls enrolled in leisure-time sports had higher physical well-being (49.3 ± 8.6 vs. 45.2 ± 8.3), psychological well-being (50.4 ± 9.0 vs. 49.4 ± 9.8), experienced more peer and social support (50.2 ± 10.0 vs. 48.9 ± 10.7), and perceived a more positive school environment (52.5 ± 8.0 vs. 50.5 ± 9.3), as well as showing higher Yo-Yo (+39%), long jump (+10%), and balance performance (+15%) than girls not involved in sport clubs. The girls active in sports clubs had higher relative muscle mass (+5%), lower fat percentage (-11%), body mass index (-5%), RHR (-3.4 b·min-1), and diastolic BP (-1.4 mm Hg) compared with girls not involved in sport (p<0.05). Girls who played soccer showed higher aerobic fitness compared with inactive girls (+67%), dancers (+39%), swimmers (+38%), and gymnasts (+16%). Gymnasts had a lower fat percentage than inactive girls (-19%), team handballers (-10%), swimmers (-12%), and soccer players (-4%). Girls participating in club-based leisure-time sports showed higher well-being and better fitness and health profiles than girls not involved in any sports club activities. Girls involved in soccer had better aerobic fitness and gymnasts a lower fat percentage. Copyright © 2020 National Strength and Conditioning Association., Funding: Nordea-fonden, the Danish Football Association (DBU), and Aase and Ejnar Danielsens Foundation.

Objective: People with schizophrenia and bipolar disorder are at increased risk of having comorbid somatic illness. This is partly due to lack of physical activity, which may originate from childhood. Sleep disturbances are associated with schizophrenia and bipolar disorder. We aimed to assess physical activity and sleep in children at familial high risk of schizophrenia or bipolar disorder and population-based controls. Methods: This study is part of The Danish High Risk and Resilience Study - VIA 11. Children aged 11 born to parents with schizophrenia (FHR-SZ) (N = 133), bipolar disorder (FHR-BP) (N = 84), or controls (C) (N = 150) were assessed by accelerometry for an average of 6.9 days. Results: High-intensity physical activity was significantly lower in children at FHR-SZ and FHR-BP compared to controls, (mean hours per day for FHR-SZ: 0.29, SD 0.19, for FHR-BP: 0.27, SD 0.24, and for controls 0.38, SD 0.22, P = <.001). Sleep did not differ between the groups. Conclusion: Children at FHR-SZ or FHR-BP had less physical activity compared to controls. Our study highlights a research area that reveals a hitherto unexplored disadvantage of being born to parents with schizophrenia or bipolar disorder. Further research is needed to enhance better understanding of causal pathways and consequences of reduced physical activity in children with FHR-SZ and FHR-BP.

We evaluated the cardiometabolic effects of a 15-week combined exercise program, implemented in sports clubs, for 50-70-year-olds with low aerobic fitness. In a randomized controlled trial, 45 participants (26 women) with low fitness were randomly assigned (2:1-ratio) to a training group (TG, n=30) or inactive control group (CG, n=15). TG had 15 weeks with one weekly 90-min supervised group-based session in a recreational sports club with combined aerobic exercise and strength training and were encouraged to perform home-based training 30 min/wk. Evaluations of relative VO2max (mLO2/min/kg), blood pressure, resting heart rate (HR), echocardiography, peripheral arterial tonometry, body composition, lipid profile and HbA1c were performed at 0 and 15 wks. Average HR during supervised training was 113±13 bpm (68.6±7.0%HRmax), with 4.3±6.6% spent >90%HRmax. At 15-wk follow-up, intention-to-treat analyses revealed no between-group difference for VO2max/kg (0.4 mLO2/min/kg, 95%CI -0.8 to 1.5, P=0.519; -3 mL/min, 95%CI -123 to 117, P=0.966) or other cardiovascular outcomes (all P>0.05). Compared to CG, total fat mass (-1.9 kg; 95%CI -3.2 to -0.5, P=0.005), total fat percentage (-1.3%, 95%CI -2.2 to -0.3, P=0.01) and total/HDL cholesterol ratio (P=0.032) decreased in TG. Regular adherence to supervised training was high (81%), but 0% for home-based exercise. In conclusion, the group-based supervised training was associated with high adherence and moderate exercise intensity, whereas insufficiently supported home-based training was not feasible. Together, 15 wks of combined exercise training did not improve aerobic fitness or affected cardiovascular function in 50-70-yr-olds with low aerobic fitness, whereas some positive effects were observed in metabolic parameters.

Elite football can make players feel nervous, and personality characteristics, as well as experience, affect how well pressure is handled before important games. Studying the psychological characteristics of female football players can provide information on how well psychological pressure is handled and generate knowledge on how to support players in order to improve performance. Based on a sample of 128 female elite football players from 8 top-level teams, the present study investigates whether psychological characteristics and football experience/player stus in elite female football players can predict state anxiety before important matches. Our results outline that high age and national team experience negatively predicted most of the trait anxiety subscales. In line with previous research, no psychological differences were found between goalkeepers, defenders, midfielders, and strikers while starting players revealed to have significantly lower trait anxiety. When measuring before important matches, we found that somatic state anxiety was negatively associated with senior national team experience and positively associated with worry trait anxiety and fear of failure. Cognitive state anxiety was negatively associated with hope for success and positively associated with somatic and worry trait anxiety. Self-confidence was positively associated with youth national team experience and negatively associated with worry trait anxiety. It can be concluded that psychological characteristics and national team experience are both important for optimal state anxiety before important matches in elite-level women's football. Implications for practice and future research are discussed. © 2020 The Authors. Scandinavian Journal of Medicine & Science In Sports published by John Wiley & Sons Ltd., Funding: The Danish FA (DBU). Open access funding: Projekt DEAL.

Purpose: To examine efficacy of 12 months Football Fitness offered twice per week on bone mineral density (BMD), bone turnover markers (BTM), postural balance, muscle strength and body composition in women treated for early-stage breast cancer (BC).Methods: Women treated for early-stage BC were randomised to Football Fitness (FFG, n=46) or control (CON, n=22) in a 2:1 ratio for 12 months, with assessments performed at baseline, 6 months and 12 months. Outcomes were total body-, lumbar spine- and proximal femur BMD, total body lean and fat mass, leg muscle strength, postural balance, and plasma amino-terminal propeptide of type 1 procollagen (P1NP), osteocalcin and C-terminal telopeptide of type 1 collagen (CTX). Intention-to-treat (ITT) analyses and per-protocol analyses (≥50% attendance in FFG) were performed using linear mixed models.Results: Participants in FFG completing the 12-month intervention (n=33) attended 0.8 (SD=0.4) sessions per week. Intention to treat analysis of mean changes over 12 months showed significant differences in L1-L4 BMD (0.029 g/cm2 , 95%CI: 0.001 to 0.057), leg press strength (7.2 kg, 95%CI: 0.1 to 14.3) and postural balance (-4.3 n need of support, 95%CI: -8.0 to -0.7) favouring FFG compared to CON. In the per-protocol analyses, L1-L4 and trochanter major BMD were improved (p=0.012 and 0.030, respectively) in FFG compared to CON. No differences were observed between groups in BTMs in the ITT or per protocol analyses.Conclusion: One year of Football Fitness training may improve L1-L4 BMD, leg muscle strength and postural balance in women treated for early-stage breast cancer.

Purpose: Low bone mineral density (BMD) and fractures are a major concern in the female population and preventative strategies are needed. Whether team sports participation may reduce age-related bone loss in elderly women is still uncertain.Methods: One hundred and thirty healthy, non-smoking women participated in this cross-sectional study, i.e., elderly (60-80 years) team handball players (EH, n = 35), elderly untrained controls (EC, n = 35), young (18-30 years) elite football players (YF, n = 30) and young untrained controls (YC, n = 30). A whole-body and two regional dual-energy X-ray absorptiometry (DXA) scans were performed to evaluate BMD and a blood sample was collected for measurement of bone turnover markers (BTMs).Results: EH had higher BMD in all regions of the lumbar spine, except for L1, compared to EC (8-10%), and higher BMD in the femoral Ward's triangle (9%) and trochanter (7%) of the left leg. Furthermore, EH had higher mean leg BMD (8%) and whole-body BMD (5%) than EC. EH and YC had similar BMD in femoral trochanter, L1-L4 and mean leg despite an age difference of ~ 40 years. YF had higher BMD in all regions of the proximal femur (18-29%) and lumbar spine (12-16%) compared to YC, as well as higher mean leg BMD (20%) and whole-body BMD (13%). Sclerostin was 14% lower in EH compared to EC. YF showed higher PINP (98%), osteocalcin (57%), and CTX (83%) compared to YC.Conclusion: Lifelong team handball training and elite football training are associated with superior bone mineralization and changed bone turnover in elderly and young women.

This study reports the effects of a recreational team handball exercise programme (randomised controlled trial, RCT) on bone health, postural balance and body composition in untrained postmenopausal women without previous experience of the sport. Sixty-seven postmenopausal women without previous experience of team handball practice (68.3±6.2 years, stature 156.9±5.8 cm, body mass 65.6±9.6 kg, body fat 40.9±5.9%, VO2peak 25.2±3.6 mL.min-1.kg-1) were randomised into team handball (THG, n=41) and control (CG, n=26) groups. During the 16-week intervention period, THG performed two to three 60-min training sessions per week, while CG continued with their habitual physical activity. Bone mineral density (BMD) and content (BMC), biochemical bone formation (osteocalcin (OC), procollagen type-1 amino-terminal propeptide (P1NP)) and resorption markers (carboxy-terminal type-1 collagen crosslinks (CTX)), postural balance, body fat and lean mass were evaluated at baseline and post intervention. A time x group interaction (p≤0.02) was shown for lumbar spine BMD (+1.5%) and BMC (+2.3%), P1NP (+37.6±42.4%), OC (+41.9±27.0%) and postural balance (-7±37% falls), in favour of THG with no changes in CG. This RCT showed that short-term recreational team handball practice had an impact on bone turnover and was effective for improving bone health and postural balance in postmenopausal women without previous experience of the sport, hence potentially helping to reduce the risk of falls and fractures.

Background: Breast cancer survivors are encouraged to be physically active. A recent review suggests that football training is an effective exercise modality for women across the lifespan, positively influencing health variables such as strength, fitness and social well-being. However, football is a contact sport, potentially posing an increased risk of trauma-related injury. Against this backdrop, breast cancer survivors are advised to avoid trauma or injury to the affected or at-risk arm in order to protect against lymphedema onset or exacerbation. The aim of this study was therefore to evaluate the feasibility and safety of Football Fitness training in relation to lymphedema and upper-extremity function after treatment for breast cancer.Material and methods: Sixty-eight women aged 18-75 years, who had received surgery for stage I-III breast cancer and completed (neo) adjuvant chemotherapy and/or radiotherapy within five years, were randomized (2:1) to a Football Fitness group (FFG, n = 46) or a control group (CON, n = 22) for twelve months. Secondary analyses using linear mixed models were performed to assess changes in upper-body morbidity, specifically arm lymphedema (inter-arm volume % difference, dual energy X-ray absorptiometry; extracellular fluid (L-Dex), bioimpedance spectroscopy), self-reported breast and arm symptoms (EORTC breast cancer-specific questionnaire (BR23) and upper-extremity function (DASH questionnaire) at baseline, six- and twelve-month follow-up.Results: We observed similar point prevalent cases of lymphedema between groups at all time points, irrespective of measurement method. At the six-month post-baseline assessment, reductions in L-Dex (extracellular fluid) were found in FFG versus CON. These significant findings were not maintained at the twelve-month assessment. No difference between groups was observed for inter-limb volume difference %, nor any of the remaining outcomes.

Background: In Denmark, the first COVID-19 pandemic lockdown resulted in a compact season finisher for elite footballers, potentially impacting their mental health.Purpose: This study aimed to investigate the protective role of resilience and the impeding role of trait anxiety on elite footballers’ level and variability of well-being and emotional stability. Material and Methods: One hundred and twenty-five male elite-level players (Mage = 25.04 ± 4.82) completed baseline measures on trait anxiety and resilience. Additionally, well-being and positive and negative affect were assessed before games (n = 24) over 62 days. Separate two-level regression analysis using Bayesian statistics was conducted to test potential relationships. Results: Results show a credible positive relationship between the average level of well-being and within-person variability over time as well as the average level in positive affect. This indicates that resilience might be a protector for mental health. In addition, higher levels of trait anxiety (i.e., subscale concentration disruption) were associated with higher levels of negative affect and higher variability over time. This indicates that trait anxiety might facilitate negative affect. No other credible relationships were found. Conclusion: High resilience and low trait anxiety are identified as relevant factors for mental health within elite footballers during COVID-19. Implications for practice are discussed. © 2021 Informa UK Limited, trading as Taylor & Francis Group.

[Abstract]: The aim of this study was to investigate training load and cardiorespiratory fitness in a top-level Spanish (LaLiga) football team (n = 17). The submaximal Yo-Yo intermittent recovery test level 1 (Yo-Yo IR1SUB)was performed in four moments of the competitive period from early February (E1) to early May (E4). Training load was quantified using a 10-Hz global positioning system and heart rate (HR) recording (n =837 individual training sessions), while match load was quantified using semi-automated cameras (n =216 individual match observations). Cardiorespiratory fitness moderately improved as the season progressed (P <0.05; effect sizes = 0.8 to1.2). Cumulative total distance covered during training between E1 and E4 was negatively correlated with percentage of changesin meanHRduring thelast30sofYo-YoIR1SUB(P=0.049; r =−0.47 [−0.71; −0.14]; moderate). HRduringthe last30s ofYo-Yo IR1SUB was negatively correlated to total distance covered during the match (P = 0.024; r = −0.56 [−0.80; −0.17]; moderate). Yo-Yo IRSUB can be used to monitor seasonal changes in cardiorespiratory fitness without the need to have players work until exhaustion. Cardiorespiratory fitness given by mean HR during the last 30 s of the test seems meaningful in relation to match performance.

This study aimed to examine the health effects of fitness training and team-sport training in a pragmatic community health centre set-up for women with lifestyle diseases. The methods included training intensity evaluations and measurements of VO2max, blood pressure, body composition and exercise performance. In all, 40 women in the fitness training group (FG) and 34 women in the team-sport training group (TG) completed a test before they were offered 12–16 weeks of twice-weekly training sessions lasting 60–90 min and after. Mean heart rate during training was not significantly different (P = 0.569) between FG (72.7 ± 4.2%HRmax) and TG (71.4 ± 6.8%HRmax). TG achieved improvements in aerobic fitness of 0.9 ± 2.0 mlO2·kg·min−1 (P = 0.034) and in resting heart rate of 3.7 ± 9.1 bpm (P = 0.026), as well as in sit-to-stand performance (STS: 3.5 ± 3.3 stands · 30 s−1; P = 0.003) and 6‑min walking test performance (6MWT: 53 ± 29 m; P < 0.001), while fat percentage was reduced by 0.6 ± 1.6% (P = 0.038). FG achieved within-group improvements (P < 0.001) in STS performance (3.1 ± 2.8 stands · 30 s−1) and 6MWT performance (41 ± 47 m), with fat percentage reduced by 0.9 ± 1.7% (P = 0.003). Overall, the study revealed no significant between-group differences in training effects. However, there was a between-group difference in training attendance (P = 0.001), with the fitness group having the highest attendance (1.5 ± 0.4 vs. 1.1 ± 0.5 per week). In conclusion, small-sided team-sport training and fitness training conducted in a pragmatic set-up induce similar positive health effects for women with lifestyle diseases. Team-sport training is considered a feasible and worthy alternative to fitness training for sedentary women in community health centres.

Purpose: We tested the hypothesis that participation in small-sided team handball training could provide beneficial effects on cardiovascular and metabolic parameters in overweight premenopausal women with special focus on the importance of prior team handball experience.Methods: A 16-week RCT training intervention was conducted in overweight premenopausal women randomized into three groups; a team handball training group without prior experience (UN; n=13), a team handball group with prior experience (EXP; n=10), and an inactive control group (CON; n=9). Both UN and EXP completed 1.6±0.3 training sessions per week with average heart rates of 84±5 and 85±9% of maximal heart rate, respectively. Cardiovascular and metabolic parameters were assessed before and after the intervention.Results: Compared to CON, UN had significant increases in VO2max (7±4%) and intermittent endurance performance (26±14%) as well as reduced total fat mass (4±6%), total fat percentage (4±5%) and android fat mass (7±12%), respectively (all p<0.05). Compared to UN and CON, EXP displayed increased left ventricular mass and left ventricular mass index (both p<0.05) after the training period. There were no significant changes between any of the groups in muscle mass, blood lipids, resting heart rate, and blood pressure (all p>0.05).Conclusion: Small-sided team handball training in overweight premenopausal women resulted in improvement of VO2max and body composition for participants with minimal team handball experience, indicating that prior team handball experience is not a prerequisite for improving physiological parameters of importance for health. Furthermore, EXP displayed cardiac adaptations, including enhanced left ventricular mass and left ventricular mass index.

This study investigated whether street soccer might be proposed as an alternative to recreational small-sided games on grass as a health-enhancing activity and, specifically, the effects of the boards surrounding the pitch. Eleven recreationally active young men (28.4 ± 4.2 SD years, 19.9 ± 4.2% body fat, and 47.7 ± 6.0 ml·min-1·kg-1), after familiarization, completed one to 2 sessions of 20 × 13-m 3v3 street soccer games with boards (WBs) and one to 2 sessions without boards (WOBs) in a randomized order. Movement pattern was measured using global positioning system, and heart rate recordings, blood sampling, and rating of perceived exertion (RPE) scales were used to evaluate exercise intensity and physiological strain. Total number of accelerations (19%) and player load (18%) were higher (p ≤ 0.005) in WB than in WOB, whereas total distance covered (12%), high-speed running (59%), and peak speed (11%) were lower (p ≤ 0.003) in WB than in WOB. Moreover, HRmean was higher in WB than in WOB (85.7 ± 5.4 vs. 81.3 ± 8.2% HRmax, p = 0.012, ES = 0.64), whereas time with HR > 90% HRmax did not differ between WB and WOB (42 ± 34 vs. 32 ± 30%, p = 0.243, ES = 0.32). Plasma ammonia increased more in WB than in WOB, with no differences found in mean and peak blood lactate. Rating of perceived exertion was higher after WB than after WOB (7.1 ± 1.0 vs. 5.5 ± 1.2, p < 0.001, ES = 1.39). In conclusion, intensity was sufficiently high in both game formats to expect short- and long-term health improvements as a result of regular participation. Boards affected movement pattern and physiological demands, producing higher number of accelerations, player load, average heart rate, plasma ammonia, and RPE but lower total distance, number of intense runs, and peak speed.

In order for football to be effective as medicine it is important that participants actively engage in playing football on a regular basis. One of the key factors for regular participation in football activities is the participant’s motivation. As motivation is an interplay between the person and situation, the chapter is divided into two major sections: Personal motivational factors and situational motivational sectors. The first section, focusing on personal motivational factors, gives an overview of two frequently used motivational frameworks in physical activity, namely the Self-Determination Theory and the flow concept. It is then argued that football and similar team sports elicit more intrinsic and extrinsic motivation, as well as more flow experiences, compared to individual physical activity. Lastly, it is investigated why football and similar team sports are more motivating, and suggested that it is due to a higher degree of satisfaction of the basic psychological needs, a higher degree of social relations and better conditions for eliciting flow. The second section, focusing on situational motivational factors, starts by giving an overview of the mastery and performance climate distinction in the Achievement Goal Theory. It is subsequently argued that the theory-driven TARGET and Empowering Coaching frameworks can inform football as medicine activities that will engage participants and contribute to their long-term participation in recreational football activities.

Prolonged physical inactivity in young adults may lead to deficiencies in musculoskeletal fitness, and thus a need exists to develop physical activity and exercise programmes that are effective of increasing musculoskeletal fitness. The aim of this study, therefore, was to investigate the effects of small-sided team handball training on lower limb muscle strength, postural balance and body composition in young adults. Twenty-six men and twenty-eight women were stratified for peak oxygen uptake (VO2peak) and body fat percentage and randomly allocated to either 12 wks of small-sided recreational team handball training (THG: 14 men and 14 women, age 24.1±2.6 yrs (mean±SD), VO2peak 39.8±5.9 ml/kg/min and body fat percentage 32.7±8.7%) or serving as non-exercising controls (CON: 12 men and 14 women, age 24.8±3.1 yrs, VO2peak 39.7±5.0 ml/kg/min, body fat percentage 31.7±9.7%). THG trained on average 1.8 times/week for 12 wks. At 0 and 12 wks, lower limb muscle strength, rate of force development (RFD), vertical jump height and power, postural balance, body composition and muscle biopsies were assessed. No training effects were observed for maximal isokinetic or isometric knee extensor strength, maximal vertical jump height or take-off power, fibre type distribution or capillarization. Late phase (RFD) increased (+7.4%, p<0.05) and postural sway excursion length was improved after training (-9%, p<0.05) in THG with no difference from CON (p>0.05). Further, THG demonstrated a decrease in body fat percentage (-3.7%) accompanied by increases in whole-body fat free mass (FFM) (+2.2%), leg FFM (+2.5%), total bone mineral content (BMC) (+1.1%), leg BMC (+1.2%), total hip bone mineral density (+1.6%) and hip T-score (+50%) which differed from CON (all p<0.05). In conclusion, recreational small-sided team handball training appears to effectively improve rapid force capacity, postural balance, lean and fat body ma

Purpose: To examine the exercise intensity and impact of 12 months of twice-weekly recreational football training on cardiorespiratory fitness (CRF), blood pressure (BP), resting heart rate (HRrest), body fat mass, blood lipids, inflammation, and health-related quality of life in women treated for early-stage breast cancer (BC).Methods: Sixty-eight women who had received surgery for stage I-III BC and completed adjuvant chemo- and/or radiation therapy within 5 years were randomized in a 2:1 ratio to a Football Fitness group (FFG, n = 46) or a control group (CON, n = 22). Football Fitness sessions comprised a warm-up, drills and 3-4 × 7 min of small-sided games (SSG). Assessments were performed at baseline, 6 months and 12 months. Outcomes were peak oxygen uptake (VO2peak), blood pressure (BP), HRrest, total body fat mass, and circulating plasma lipids and hs-CRP, and the 36-Item Short Form Health Survey (SF36). Intention-to-treat (ITT) analyses were performed using linear mixed models. Data are means with SD or 95% confidence intervals.Results: Adherence to training in participants completing the 12-months follow-up (n = 33) was 47.1% (22.7), and HR during SSG was ≥80% of HRmax for 69.8% (26.5) of total playing time. At baseline, VO2peak was 28.5 (6.4) and 25.6 (5.9) ml O2/kg/min in FFG and CON, respectively, and no significant changes were observed at 6- or 12 months follow-up. Systolic BP (SBP) was 117.1 (16.4) and 116.9 (14.8) mmHg, and diastolic BP (DBP) was 72.0 (11.2) and 72.4 (8.5) mmHg in FFG and CON, respectively, at baseline, and a 9.4 mmHg decrease in SBP in CON at 12 months resulted in a between-group difference at 12 months of 8.7 mmHg (p = .012). Blood lipids and hs-CRP were within the normal range at baseline, and there were no differences in changes between groups over the 12 months. Similarly, no differences between groups were observed

Purpose: The present study investigated muscle metabolism and fatigue during simulated elite male ice hockey match-play.Methods: Thirty U20 male national team players completed an experimental game comprising three periods of 8x1-min shifts separated by 2-min recovery intervals. Two vastus lateralis biopsies were obtained either during the game (n = 7) or pre- and post-game (n = 6). Venous blood samples were drawn pre-game and at the end of the first and last period (n = 14). Activity pattern and physiological responses were continuously monitored using local positioning system and heart rate recordings. Further, repeated-sprint ability was tested pre-game and after each period.Results: Total distance covered was 5980±199 m with almost half the distance covered at high skating speeds (>17 km·h-1). Average and peak on-ice heart rate was 84±2 and 97±2% of maximum heart rate, respectively. Muscle lactate increased (P≤0.05) more than 5- and 3-fold, while muscle pH decreased (P≤0.05) from 7.31±0.04 pre-game to 6.99±0.07 and 7.13±0.11 during the first and last period, respectively. Muscle glycogen decreased by 53% post-game (P≤0.05) with ~65% of fast- and slow-twitch fibers depleted of glycogen. Blood lactate increased 6-fold (P≤0.05), while plasma free fatty acid levels increased 1.5- and 3-fold (P≤0.05) after the first and last period. Repeated-sprint ability was impaired (~3%; P≤0.05) post-game concomitant with a ~10% decrease in the number of accelerations and decelerations during the second and last period (P≤0.05).Conclusion: Our findings demonstrate that a simulated ice hockey match-play scenario encompasses a high on-ice heart rate response and glycolytic loading resulting in a marked degradation of muscle glycogen, particularly in specific sub-groups of fibers. This may be of importance both for fatigue in the final stages of a g

The present study examined cardiovascular adaptations in 8-10-year-old schoolchildren after a full school year (10 months) of 5 × 12 min/wk. of intense physical training, including small-sided ball games (soccer, basketball and floorball) or interval running. The study involved 8-10-year-old healthy Danish schoolchildren (n = 232), who were cluster-randomized to a small-sided games group (SSG, n = 60), an interval running group (IR, n = 57) or a control group (CON, n = 115). Comprehensive transthoracic echocardiography, resting heart rate and blood pressure measurements were performed at baseline and post intervention. For interval running, analysis of baseline-to-10-months changes showed significant (P < 0.05) between-group differences in delta scores for diastolic blood pressure (BP) and mean arterial BP (IR -3.2 ± 5.7 and - 2.2 ± 6.5 mmHg vs. CON 0.2 ± 5.3 and 0.4 ± 6.4 mmHg, respectively). Delta scores also showed a trend for reduction of mean arterial BP in SSG compared to CON (-2.1 ± 6.0 vs. 0.2 ± 5.3 mmHg, P = 0.067). Moreover, there were between-group differences in delta scores (P < 0.05) for selected echocardiographic parameters, i.e. in SSG vs. CON for interventricular septum thickness and peak transmitral flow velocity in early diastole, and in IR vs. CON for left ventricular systolic diameter. In conclusion, 10 months of 5 × 12 min/wk. of IR in 8-10-year-old children decreased diastolic BP, while both IR and SSG elicited cardiac adaptations. The results suggest that frequent low volume, intense physical training can have effects on the cardiovascular health profile in healthy children.

The body of evidence analysing the potential of football as a vehicle to deliver health outcomes has developed substantially. Football arguably provides the largest potential global reach of all sports and often receives significant national amounts of government investment. Despite this, the policy and politics of a country can potentially hamper the implementation of football for health strategies, which creates issues particularly in community (or grassroots) football contexts. This chapter offers a brief insight into the challenges of the implementation of Football for health in the policy and politics context of England, measured against the political environment found in Denmark. This includes the potential missed opportunity of policymakers in England to capitalise on football as a vehicle to attend to the health agenda. The chapter concludes with a development of the Krustrup and Krustrup (2018) model for Football is Medicine, calling for more engagement and action at a policy level.

We have recently seen an increasing focus on football as prevention and adjunct to medical treatment. This will arguably result in the development of ‘football for health’ initiatives, holding the potential to attract and activate participants which in many cases are unfamiliar to the game. It is very plausible that the organisation of these will require a different form than ‘traditional’ association football which holds a rather strong focus on skill development and competitive aspects. This chapter scrutinises central issues important to the implementation process of an activity titled Football Fitness realised by local voluntary organised football clubs. Moreover, we discuss future perspectives of the initiative. Shortly, Football Fitness (FF), developed by the Danish Football Association, has a focus on health and enjoyment rather than skills and tactics, and the aim is to promote football as a health-improving, easily accessible, low-cost/sustainable, flexible and fun type of exercise. The target group is primarily adults (25+) of both gender and the clubs can adopt and organise FF in a form they feel suitable. Following our analysis, we argue for strong awareness regarding the cooperation of implementational actors and how the content, including expected outcomes, of a given initiative match the organisational context in which it is to be realised.

Physical inactivity is increasingly becoming a major public health concern. Consequently, there is an urgent need to develop programmes to promote active and healthy lifestyles among children and adolescents. Football, one of the most popular and practised sports in the world, has recently been tested as a strategy for promoting physical activity and the health status of children and adolescents. The findings have shown that benefits are especially evident for cardiovascular, metabolic, muscular, bone and mental health. In addition, given that football is accessible, economical, easy to play and able to offer its practitioners – regardless of gender, age, and nutritional and economic status – opportunities for fun, recreation and success, it has the potential to be an effective public health strategy for promoting active and healthy lifestyles in children and adolescents.

Homeless and socially deprived people have elevated morbidity and mortality rates, and the remaining life expectancy of young homeless people is approximately 20 years lower than that of the general population. One of the major contributors to the elevated mortality rate is cardiovascular disease, where the combination of traditional cardiovascular risk factors and risk factors associated with homelessness, including poorly controlled or undiagnosed hypertension and diabetes, smoking, drug abuse and mental illness, play a prominent part. Moreover, homeless people experience a four- to five-fold higher risk of hospitalisation as a result of sudden trauma and bone fractures, which may partly be explained by poorer postural balance and weaker bones. Thus, marginalisation and social exclusion have a huge impact on a wide range of health parameters. This chapter examines how football interventions with a special emphasis on street football can be used to effectively engage with a marginalised and hard-to-reach population with a view to promoting health and creating long-term adherence to a physically active lifestyle.

Over the past decades, the world population has become more physically inactive, leading to, obesity, elevated blood pressure and lipid profile, and decreased maximal oxygen uptake (VO2max), which are risk factors for several non-communicable diseases. Health care workers are reported to have an unhealthy lifestyle with a high prevalence of obesity and low VO2max combined with relatively physically demanding work tasks. Female hospital employees were cluster-randomised to either a football group (FG, n=37) or a control group (CG, n=35). FG were encouraged to perform twice-weekly 1-hour training sessions outside working hours for 40 weeks. Based on ITT-analyses after 12 weeks, FG improved (P<0.05) VO2max and fat percentage compared with CG. Furthermore, FG increased (P<0.05) plasma osteocalcin by 21%. After 40 weeks, FG reduced fat mass and increased lower limb bone mineral content (BMC), bone mineral density (BMD) and plasma osteocalcin (P<0.05). Moreover, FG reduced (P<0.05) pain intensity in the neck-shoulder region after 12 and 40 weeks and improved (P<0.05) maximal neck extension strength after 12 and 40 weeks. With regards to long-term compliance, 30% of the original participants have played football together year-round over a 9-year period. The study indicates that football training at a workplace may improve fitness and prevent osteoporosis by promoting physiological health and having preventive effects on future perceived muscle pain in the neck-shoulder region among female hospital employees.

Cardiovascular disease (CVD) is a global health problem, and the negative health effects associated with inadequate physical activity have become a major societal challenge. It has been known for centuries that regular exercise training may lower the risk of developing CVD, and in the last two decades solid scientific evidence collected from randomised controlled trials (RCTs) indicate that football, due to the intense and intermittent exercise elements of the sport, is effective for lowering cardiovascular risk factors. In this chapter, we discuss the treatment potential of recreational football training and how to prescribe it as ‘medicine’ for CVD patients. We also demonstrate the broad-spectrum impact of football on CVD risk factors, such as adaptations of myocardial structure and function, reductions in resting heart rate, lowering of blood pressure and arterial stiffness and amelioration of plasma lipid profile, favorable changes in body composition and marked increases in maximal oxygen uptake. In this chapter, we review all factors of importance for cardiovascular health from a gender- and age-specific perspective. Finally, we consider the implementation of football for CVD patients, and describe areas of uncertainty and potential new avenues of research into the treatment of CVD with football training.

The number of individuals living with and beyond cancer is growing worldwide due to improvements in diagnosis and treatment. Late effects of treatment that negatively impact patients’ health and quality of life may be counteracted by physical exercise, but only a minority of cancer survivors follow public guidelines for physical activity levels. This is also the case for men with prostate cancer, who are prone to numerous side effects of castration-based treatment but mostly do not take up exercise spontaneously after the point of diagnosis. Given this background, the FC Prostate RCT (n=57) was initiated in 2012 in Copenhagen, Denmark, and the results of the study indicate that football is an intense, intermittent training modality that elicits high heart-rate frequencies and improves muscle mass and strength after 12 weeks, and bone mineral density of the hip and physical function after 32 weeks. The relatively small sample and injuries sustained during football training highlighted the need for larger, pragmatic studies. In 2015, a community-based study (n=214) was initiated nationwide in Denmark in close collaboration between universities, hospitals and local football clubs, and the results of this trial will provide highly valuable data to inform clinicians and policymakers concerning the relevance and safety of football training in the rehabilitation of prostate cancer patients.

The prevalence of osteoporosis and fragility fractures is expected to increase due to the increasing life expectancy of the population worldwide. Determinants of osteoporosis include the genetic predisposition and environmental factors, such as exercise and diet, which can affect peak bone mass attainment. Peak bone mass is achieved between the second and third decade of life, with 80–90% acquired by late adolescence followed by a decrease of ~1% annually from the fifth decade of life. Weight-bearing exercise has an important role on bone development and maintenance of skeletal bone mass due to the mechanical loads produced and the repetitive forces applied on the skeleton. Football includes a wide variety of intermittent high-intensity movements which produce large ground reaction forces. Cross-sectional, longitudinal and randomised controlled trials provide evidence that football exercise can have positive effects on bone development and structure in both male and female children and adolescents. During adulthood, football participation can maintain and improve bone health in young, middle-aged and older men and women, including various clinical patient groups with evidence indicating structural, cellular and clinically relevant bone adaptations. The skeletal benefits are site-specific and adaptations are observed particularly at the skeletal regions stimulated by mechanical loads. In summary, it is concluded that football participation is an effective strategy to promote bone health during childhood, adolescence and in adulthood.

Background: The present study investigates the well‐being effects for 10‐ to 12‐year‐old children who participated in the school‐based intervention “11 for Health in Denmark,” which comprises physical activity (PA) and health education. Subgroup analyses were carried out for boys and girls. Method: Three thousand sixty‐one children were randomly assigned to an intervention group (IG) or a control group (CG) by 5:1 cluster randomization by school. 2533 children (mean age 11.5 ± 0.4; 49.7% boys) were assigned to IG and 528 children (mean age 11.4 ± 0.5; 50.8% boys) were assigned to CG. IG participated in the “11 for Health in Denmark” 11‐week program, consisting of 2 × 45 min per week of football drills, small‐sided games, and health education. CG did not participate in any intervention and continued with their regular education. Before and after the intervention period, both groups answered a shortened version of the multidimensional well‐being questionnaire KIDSCREEN‐27. Results: The “11 for Health in Denmark” intervention program had a positive effect on physical well‐being in girls (IG: 48.6 ± 8.5 to 50.2 ± 9.3), whereas the improvement was not significant in boys. The program also had a positive impact on well‐being scores for peers and social support (IG: 50.2 ± 10.2 to 50.8 ± 10.1), though when analyzed separately in the subgroups of boys and girls the changes were not significant. No between‐group differences were found for psychological well‐being or school environment. Conclusion: The intervention program had a positive between‐group effect on physical well‐being in girls, whereas the change was not significant in boys. The overall scores for peers and social support improved during the intervention period, but no subgroup differences were found. © 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Recent studies suggest that a single bout of exercise can lead to transient performance improvements in specific cognitive domains in children. However, more knowledge is needed to determine the key exercise characteristics for obtaining these effects and how they translate into real-world settings. In the present study, we investigate how small-sided football games of either high or moderate-intensity affect measures of inhibitory control in a school setting. Eighty-one children (mean age 11.8, 48 boys) were randomly allocated to three groups performing 20-min of high-intensity small-sided real football games (SRF), moderate-intensity small-sided walking football games (SWF) or resting (RF). Behavioural measures of inhibitory control and neurophysiological measures of attention (P300 latency and amplitude) were obtained during a flanker task performed at baseline and 20 minutes following the intervention. Retention of declarative memory was assessed in a visual memory task 7 days after the intervention. Measures of inhibitory control improved more in children performing SRF compared to SWF 19ms, 95% CI [7, 31ms], (p=0.041). This was paralleled by larger increases in P300 amplitudes at Fz in children performing SRF compared both to RF in congruent (3.54μV, 95% CI [0.85, 6.23 μV], p=0.039) and incongruent trials (5.56μV, 95% CI [2.87, 8.25 μV], p<0.001) and compared to SWF in incongruent trials (4.10μV, 95% CI [1.41, 6.68 μV], p=0.010). No effects were found in measures of declarative memory. Together this indicates that acute high-intensity small-sided football games can transiently improve measures of inhibitory control and neurophysiological correlates of attention. Intense small-sided football games are easily implementable and can be employed by practitioners, for example, during breaks throughout the school day.

Aging is a physiological process characterized by a progressive decline of biological functions and an increase in destructive processes in cells and organs. Physical activity and exercise positively affects the expression of skeletal muscle markers involved in longevity pathways. Recently, a new mechanism, autophagy, was introduced to the adaptations induced by acute and chronic exercise as responsible of positive metabolic modification and health-longevity promotion. However, the molecular mechanisms regulating autophagy in response to physical activity and exercise are sparsely described. We investigated the long-term adaptations resulting from lifelong recreational football training on the expression of skeletal muscle markers involved in autophagy signaling. We demonstrated that lifelong football training increased the expression of messengers: RAD23A, HSPB6, RAB1B, TRAP1, SIRT2, and HSBPB1, involved in the auto-lysosomal and proteasome-mediated protein degradation machinery; of RPL1, RPL4, RPL36, MRLP37, involved in cellular growth and differentiation processes; of the Bcl-2, HSP70, HSP90, PSMD13, and of the ATG5-ATG12 protein complex, involved in proteasome promotion and autophagy processes in muscle samples from lifelong trained subjects compared to age-matched untrained controls. In conclusion, our results indicated that lifelong football training positively influence exercise-induced autophagy processes and protein quality control in skeletal muscle, thus promoting healthy aging.

There is strong evidence that considerable health benefits can be achieved even with small amounts of physical activity. However, getting people to exercise regularly is a major challenge not least in the elderly population. This study investigated the feasibility and physiological health effects of a pragmatic 15-week exercise programme for sedentary elderly. In a single-blind randomised controlled trial, 45 sedentary 60-83-year-olds (25 women, 20 men) were randomly assigned (2:1 ratio) to a training group (TG, n=30) or a control group (CG, n=15). The training in TG consisted of a combination of exercise modalities (i.e., strength, aerobic fitness, stability, and flexibility training) performed once a week as supervised group-based training and a weekly home-based training for 15 weeks. Feasibility outcomes were exercise intensity, adherence, and adverse events. The primary outcome was change in aerobic fitness (VO2max/kg). Adherence was high (81%) for the supervised exercise and low (0%) for the home-based exercise. No acute injuries occurred in TG, but 4 subjects (13%) reported considerable joint pain related to training. Average heart rate (HR) during the supervised training was 104±12 beats/min (69.3±8.0%HRmax), with 3.9±7.3% of training time >90%HRmax. Intention-to-treat analyses revealed no between-group differences for aerobic fitness (P=0.790) or any secondary cardiovascular outcomes at 15-week follow-up (resting HR or blood pressure; P>0.05). Compared to CG, bodyweight (-2.3 kg, 95% CI -4.0 to -7.0; P=0.006), total fat mass (-2.0 kg, 95% CI -3.5 to -0.5; P=0.01), and total fat percentage (-1.6%, 95% CI -2.8 to -0.3; P=0.01) decreased in TG. The group-based supervised training had high adherence and moderate exercise intensity, whereas the home-based training was not feasible in this study population. This exercise programme performed once a week did not improve aerobic fitness. Thus, supervised training with more vigorous intensity cont

Background: Physical activity has been shown to mitigate the unwanted psychological and physiological side effects of prostate cancer treatments, but sustainable exercise possibilities are limited. Objective: Our objective was to examine whether football in a real-world setting (i.e., local football clubs) was safe and feasible in practice and could improve quality of life, mitigate decline in muscle mass and bone density, and increase fat mass in patients with prostate cancer. Methods: In this pragmatic, multicentre, parallel randomized controlled trial, men diagnosed with prostate cancer were recruited from five Danish urological departments. Men (N = 214) diagnosed with prostate cancer were randomly allocated, using random generated lists (block size 4–8) stratified for center and androgen-deprivation therapy status, to either 1 h of football twice weekly in a local football club or to usual care, which was a 15- to 30-min telephone session covering their options for physical activity or free-of-charge rehabilitation delivered as standard in Denmark. Allocation was concealed from the trial investigator performing the randomization, but—given the nature of the intervention—this was not possible for personnel and participants. Assessments were performed at baseline, 12 weeks, and 6 months. The primary outcome was mean change difference in prostate cancer-specific quality of life at 12 weeks. Secondary outcomes were body composition, 12-Item Short Form Health Survey (SF-12) physical and mental health, and safety—reported as fractures, falls, and serious adverse events. Results: Attrition was 1 and 3% at 12 weeks, and 5% and 5% at 6 months for the usual care and football groups, respectively. Prostate cancer-specific quality of life was equal between groups at 12 weeks (mean difference + 1.9 points, 95% confidence interval [CI] –1.0–4.8; P = 0.20) and at 6 months (+ 0.5 points, 95% CI –2.8–3.8; P = 0.76). Fractures were equally distributed, with two fractures in t

Purpose: The prevalence of lifestyle diseases has escalated, and effective exercise training programmes are warranted. This study tested the hypothesis that regular participation in small-sided team handball training could provide beneficial health effects on cardiovascular, skeletal, and muscular parameters in young adult untrained men.Method: Twenty-six untrained 20-30-year-old men were randomly allocated to either a team handball training group (HG; n = 14), which completed 1.9 ± 0.3 training sessions per week over 12 weeks, or an inactive control group (CG; n = 12). Physiological training adaptations were assessed pre- and post interventions by DXA scans, blood samples, muscle biopsies, and physical tests.Results: The average heart rate during training was equivalent to 84 ± 4% of maximal heart rate. Compared to CG, HG displayed significant increases in VO2max (11 ± 6%), proximal femur bone mineral density (2 ± 1%), whole-body bone mineral content (2 ± 1%), intermittent endurance performance (32 ± 16%), incremental treadmill test performance (16 ± 7%) and muscle citrate synthase activity (22 ± 28%) as well as decreases in total fat mass (7 ± 7%) and total fat percentage (6 ± 7%) (all p < 0.05). There were no significant changes in muscle mass, blood pressure, resting heart rate, muscle hydroxyl-acyl-dehydrogenase activity, or blood lipids (all p > 0.05).Conclusion: Participation in regular recreational team handball training was associated with positive cardiovascular, skeletal, and muscular adaptations, including increased maximal oxygen uptake, increased muscle enzymatic activity, and improved bone mineralization as well as lower fat percentage. These findings suggest that recreational team handball training may be an effective health-promoting activity for young adult men.

BACKGROUND: Physical exercise has been shown to be effective in relation to fatigue, aerobic fitness, and lower body strength in men with prostate cancer. However, research into the clinically relevant effects of interventions conducted in heterogeneous patient populations and in real-life clinical practice settings is warranted. METHODS AND FINDINGS: We conducted a pragmatic, multicentre, parallel randomised controlled trial in 5 Danish urological departments. Recruitment began in May 2015, the first participant was randomised in June 2015, and the last participant was included in February 2017. In total, 214 men with prostate cancer were randomly assigned to either 6 months of free-of-charge football training twice weekly at a local club (football group [FG]) (n = 109) or usual care (usual care group [UG]) (n = 105), including brief information on physical activity recommendations at randomisation. Participants were on average 68.4 (SD 6.2) years old, 157 (73%) were retired, 87 (41%) were on castration-based treatment, 19 (9%) had received chemotherapy, and 41 (19%) had skeletal metastases at baseline. In this 1-year follow-up study, we evaluated the effects of community-based football training on the following outcomes: primary outcome, quality of life; secondary outcomes: continuation of football after 6 months, hip and lumbar spine bone mineral density (BMD), mental health score, fat and lean body mass, and safety outcomes, i.e., fractures, falls, and hospital admissions. Intention to treat (ITT) and per protocol (PP) analyses were conducted. No statistically significant between-group difference was observed in change in prostate-cancer-specific quality of life (ITT: 1.9 points [95% CI -1.9 to 5.8], p = 0.325; PP: 3.6 points [95% CI -0.9 to 8.2], p = 0.119). A statistically significant between-group difference was observed in change in total hip BMD, in favour of FG (0.007 g/cm2 [95% CI 0.004 to 0.013], p = 0.037). No differences were observed in change in l

Background: The Yo-Yo test is widely used both in the practical and research contexts; however, its true test-retest reliability remains unclear.Objective: The present systematic review aims to identify studies that have examined the test-retest reliability of the Yo-Yo test and summarize their results.Methods: A search of ten databases was performed to find studies that have investigated test-retest reliability of any variant of the Yo-Yo test. The COSMIN checklist was employed to assess the methodological quality of the included studies.Results: Nineteen studies of excellent or moderate methodological quality were included. When considering all variants of the Yo-Yo test, the included studies reported intra-class correlation coefficients for test-retest reliability ranging from 0.78 to 0.98 where 62% of all intra-class correlation coefficients were higher than 0.90, while 97% of intra-class correlation coefficients were higher than 0.80. The coefficients of variation ranged from 3.7 to 19.0%. Regardless of the variant of the test, the participants' familiarization with the test, and previous sport experience, the intra-class correlation coefficients generally seem high (≥ 0.90) and coefficients of variation low (< 10%).Conclusions: The results of this review indicate that the Yo-Yo test (in all its variants) generally has good-to-excellent test-retest reliability. The evidence concerning reliability arises from 19 included studies that were of moderate or high methodological quality. Considering that most of the included studies examined the Yo-Yo intermittent recovery level 1 test while including Association Football players, more reliability studies examining Yo-Yo intermittent recovery level 2 test and Yo-Yo intermittent endurance level 1 and level 2 tests, and in the context of sports other than Association Football as well as in non-athletic

PURPOSE: To examine the skeletal muscle and performance responses across two different exercise training modalities which are highly applied in soccer training.METHODS: Using an RCT design, 39 well-trained male soccer players were randomized into either a speed endurance training (SET; n = 21) or a small-sided game group (SSG; n = 18). Over 4 weeks, thrice weekly, SET performed 6-10 × 30-s all-out runs with 3-min recovery, while SSG completed 2 × 7-9-min small-sided games with 2-min recovery. Muscle biopsies were obtained from m. vastus lateralis pre and post intervention and were subsequently analysed for metabolic enzyme activity and muscle protein expression. Moreover, the Yo-Yo Intermittent Recovery level 2 test (Yo-Yo IR2) was performed.RESULTS: Muscle CS maximal activity increased (P < 0.05) by 18% in SET only, demonstrating larger (P < 0.05) improvement than SSG, while HAD activity increased (P < 0.05) by 24% in both groups. Na(+)-K(+) ATPase α1 subunit protein expression increased (P < 0.05) in SET and SSG (19 and 37%, respectively), while MCT4 protein expression rose (P < 0.05) by 30 and 61% in SET and SSG, respectively. SOD2 protein expression increased (P < 0.05) by 28 and 37% in SET and SSG, respectively, while GLUT-4 protein expression increased (P < 0.05) by 40% in SSG only. Finally, SET displayed 39% greater improvement (P < 0.05) in Yo-Yo IR2 performance than SSG.CONCLUSION: Speed endurance training improved muscle oxidative capacity and exercise performance more pronouncedly than small-sided game training, but comparable responses were in muscle ion transporters and antioxidative capacity in well-trained male soccer players.

This study investigated whether the physical fitness and body composition of 10-12-year-old Danish children are related to participation in leisure-time club-based sporting activities. The study involved 544 Danish 10-12-year-old 5th-grade municipal schoolchildren (269 boys and 275 girls, 11.1 ± 0.4 years). After answering a questionnaire about leisure-time sporting activities, the children were divided into four groups: football club participation (FC; n=141), other ball games (OBG; n=42), other sports (OS; n=194), and no sports-club participation (NSC; n=167). The children completed a battery of health and fitness tests, including a 20 m sprint test, a standing long-jump test, the Yo-Yo IR1 children's test (YYIR1C), and body composition, blood pressure, resting heart rate (HRrest), and the flamingo balance test. The children engaged in club-based ball games (FC and OBG) had higher (p<0.05) lean body mass than NSC (FC: 17.5 ± 2.9; OBG: 18.4 ± 2.6; OS: 16.7 ± 2.9; NSC: 16.4 ± 2.8 kg), performed better (p<0.05) in the YYIR1C test (FC: 1083 ± 527; OBG: 968 ± 448; OS: 776 ± 398; NSC: 687 ± 378 m), and had lower (p<0.05) %HRmax after 1, 2, and 3 min of YYIR1C. Moreover, HRrest was lower (p<0.05) for FC than for OS and NSC (FC: 68 ± 9 vs OS: 72 ± 10 and NSC: 75 ± 10 bpm), and lower (p<0.05) for OBG than for NSC (OBG: 70 ± 10 vs NSC: 75 ± 10 bpm). This study found that 10-12-year-old Danish children engaged in club-based football and other ball games had better exercise capacity, lower resting heart rate, and higher muscle mass than children not engaged in leisure-time sports. Thus, participation in club-based leisure-time ball-game activities seems to be of importance for the fitness and health profile of prepubertal children.

The effects of football training on bone health were examined in 55- to 70-year-old sedentary women and men with prediabetes. Patients (n = 50) with prediabetes (age; 61 ± 9 years, BMI 29.7 ± 0.6 kg/m2 , body fat content; 37 ± 1%, VO2max ; 22.7 ± 0.8 mL/min/kg and mean arterial pressure; 104 ± 3 mm Hg) were randomized into a football training group (FTG; n = 27, 14 women) and a control group (CON; n = 23, 11 women). At baseline, 73% and 24% were diagnosed with femur osteopenia and osteoporosis, respectively. FTG performed football training twice weekly 30-60-minute sessions in 16 weeks, and both FTG and CON received professional dietary advice. Pre- and post-intervention whole-body and regional bone mineral content (BMC) and density (BMD) were determined with DXA-scans, and venous blood samples were drawn and analyzed for plasma bone turnover markers. Change scores were greater (P < 0.05) in FTG compared to CON in leg BMD (0.023 ± 0.005 vs -0.004 ± 0.001 g/cm2 ) and in leg BMC (32 ± 8 vs -4 ± 6 g). Between-group changes in favor of FTG (P < 0.05) also occurred in the femur neck BMD (3.2%) and femur shaft BMD (2.5%). Whole-body BMC and BMD were unchanged in both groups during the intervention. In FTG, resting plasma osteocalcin, P1NP, and CTX-1 rose (P < 0.05) by 23 ± 8, 52 ± 9 and 38 ± 7%, with greater change scores (P < 0.05) than in CON. Finally, P1NP (formation)/CTX-1 (resorption) ratio increased (P < 0.05) in FTG (127 ± 15 vs 150 ± 11) from pre- to post-intervention, with no change in CON (124 ± 12 and 123 ± 12). In conclusion, football training provides a powerful osteogenic stimulus and improves bone health in 55- to 70-year-old women and men diagnosed with prediabetes.

To examine the skeletal muscle and performance responses across two different exercise training modalities which are highly applied in soccer training. Using an RCT design, 39 well-trained male soccer players were randomized into either a speed endurance training (SET; n = 21) or a small-sided game group (SSG; n = 18). Over 4 weeks, thrice weekly, SET performed 6-10 x 30-s all-out runs with 3-min recovery, while SSG completed 2 x 7-9-min small-sided games with 2-min recovery. Muscle biopsies were obtained from m. vastus lateralis pre and post intervention and were subsequently analysed for metabolic enzyme activity and muscle protein expression. Moreover, the Yo-Yo Intermittent Recovery level 2 test (Yo-Yo IR2) was performed. Muscle CS maximal activity increased (P < 0.05) by 18% in SET only, demonstrating larger (P < 0.05) improvement than SSG, while HAD activity increased (P < 0.05) by 24% in both groups. Na+-K+ ATPase alpha(1) subunit protein expression increased (P < 0.05) in SET and SSG (19 and 37%, respectively), while MCT4 protein expression rose (P < 0.05) by 30 and 61% in SET and SSG, respectively. SOD2 protein expression increased (P < 0.05) by 28 and 37% in SET and SSG, respectively, while GLUT-4 protein expression increased (P < 0.05) by 40% in SSG only. Finally, SET displayed 39% greater improvement (P < 0.05) in Yo-Yo IR2 performance than SSG. Speed endurance training improved muscle oxidative capacity and exercise performance more pronouncedly than small-sided game training, but comparable responses were in muscle ion transporters and antioxidative capacity in well-trained male soccer players.

We evaluated effects of the school-based intervention "FIFA 11 for Health" for Europe on health and fitness profile in 10- to 12-year-old Faroese schoolchildren. 392 fifth-grade children were randomized into a control group (CG: n = 100, 11.1 ± 0.3 years, 149.0 ± 6.7 cm, 42.4 ± 10.2 kg) and an intervention group (IG: n = 292, 11.1 ± 0.3 years, 150.6 ± 6.9 cm, 44.2 ± 9.4 kg). IG underwent an 11-week intervention in which 2 weekly sessions of 45 minutes were included in the school curriculum focusing on health aspects, football skills, and 3v3 small-sided games. CG continued with their regular activities. Body composition, blood pressure, and resting heart rate, as well as Yo-Yo intermittent recovery children's test (YYIR1C) performance, horizontal jumping ability and postural balance were assessed pre and post intervention. Systolic blood pressure decreased more (-2.8 ± 9.9 vs 2.9 ± 8.4 mm Hg, P < .05) in IG than in CG. Lean body mass (1.0 ± 1.7 vs 0.7 ± 1.6 kg), postural balance (0.3 ± 3.9 vs -1.2 ± 5.9 seconds) and horizontal jump performance (5 ± 9 vs -5 ± 10 cm) increased more (P < .05) in IG than in CG. YYIR1C performance improved in CG (17%, 625 ± 423 to 730 ± 565 m) and IG (18%, 689 ± 412 vs 813 ± 391 m), but without between-group differences. A within-group decrease from 23.1 ± 8.4 to 22.5 ± 8.3% (P < .05) was observed in body fat percentage in IG only. In conclusion, the "FIFA 11 for Health" for Europe program had beneficial effects on SBP, body composition, jump performance and postural balance in 10- to 12-year-old Faroese schoolchildren, supporting the notion that school-based football interventions can facilitate health of children in a small-scale society and serve as an early step in the prevention of non-communicable diseases.

This study examined cardiovascular adaptations in 8- to 10-year-old schoolchildren after 10 months (a full school year) of 3 × 40 minute per week of small-sided ball games (SSG, including football, basketball, and/or floorball) or circuit strength training (CST). The study involved 291 Danish schoolchildren, 8-10 years old, cluster-randomized to SSG (n = 93, 4 schools, 5 classes), CST (n = 83, 4 schools, 4 classes), or a control group (CON, n = 115, 2 schools, 5 classes). Before and after the 10-month intervention, resting heart rate and blood pressure measurements were performed as well as comprehensive transthoracic echocardiography and peripheral arterial tonometry (PAT). Analysis of baseline-to-10-months changes showed between-group differences (P < 0.05) after both training interventions in diastolic blood pressure (delta scores: SSG -2.1 ± 6.0 mm Hg; CST -3.0 ± 7.1 mm Hg; CON 0.2 ± 5.3 mm Hg). Moreover, there were between-group differences in delta scores (P < 0.05) in interventricular septum thickness (SSG 0.17 ± 0.87 mm; CST 0.30 ± 0.94 mm; CON -0.15 ± 0.68 mm), left-atrial volume index (SSG 0.32 ± 5.13 mL/m2 ; CON 2.60 ± 5.94 mL/m2 ), and tricuspid annular plane systolic excursion (SSG -0.4 ± 3.3 mm; CON: 0.1 ± 3.6 mm). No significant between-group differences were observed for the PAT-derived reactive hyperemia index. In conclusion, 10 months of 3 × 40 minutes per week of SSG and CST in 8- to 10-year-old children decreased diastolic blood pressure and elicited discrete cardiac adaptations, suggesting that intense physical exercise in school classes can have effects on cardiovascular health in children.

This study investigated the association between long-term adherence to football training and retaining bone mineralization and physical capacity in men with prostate cancer (PCa) managed with androgen deprivation therapy (ADT). Patients completing follow-up at 32 weeks in the FC Prostate Randomized Controlled Trial (RCT) in 2012 or 2013 were invited to 5-year follow-up assessments in May 2017 (n = 30). Changes in physiological outcomes over time between the football participants (FTG) and nonparticipants (CON) were examined. Twenty-two men accepted the invitation of which 11, aged 71.3 ± 3.8 years, had continued to play self-organized football 1.7 (SD 0.5) times per week for 41/2 years (±8 months). At 5 years, right femoral neck bone mineral density (BMD) had improved significantly in the FTG compared to CON (P = .028). No other significant between-group differences were observed. In FTG, RHR decreased by 4.3 bpm (P = .009) with no changes in CON. Muscle mass, knee-extensor muscle strength, VO2 max, and postural balance decreased in both groups. In FTG, the fraction of training time with HR between 80%-90% or >90% of HRmax was 29.9% (SD 20.6) and 22.8% (SD 28.7), respectively. Average distance covered during 3 × 20 minutes of football training was 2524 m (SD 525). Football training over a 5-year period was associated with preserved femoral neck BMD in elderly men with PCa managed on ADT. Intensity during football training was >80% of HRmax for 51% of training time after 5 years. Body composition and physical capacity deteriorated over 5 years regardless of football participation.