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This article adheres to UN guidelines concerning the Decade of Healthy Ageing (2021-2030) which aim to improve the lives of the older population. The objective of this study is to show how social dance with artistic-scenic purposes for a socially vulnerable group of older adults (third and fourth age) contributes to active ageing from social and health perspectives. The sample comes from a social group for the over-60s years and forms part of an artistic-community project in which participant observation has been carried out for five years. To obtain more data from the sample group, an "ad hoc" measurement instrument is developed based on a specific literature review on the topic. The results show that dance, group, and stage performance are a vital driver for members. The analysis shows that individual perspectives are higher than group perspectives. The research provides evidence that social dance groups improve motor expressiveness, stimulate the ability to think, memorize and create, among other aspects.

In this study, we frame learning in the tertiary-level contemporary dance class as a process of developing culturally situated shared patterns of skilled action and attention through dynamic engagement with kinetic experience. Extending existing scholarship on dance learning, we adopt the framework of cultural affordances to understand the developmental relationship between physical and general categories of attention during the learning process. Based on qualitative analysis of student and teacher interviews, we contend that the dance classes were laboratories in which cross-domain mapping (physical and general) was leveraged to develop students' kinetic and attentional skills. Understood in this way, the physical concepts and the general concepts worked in a helical fashion, cycling through dynamic engagement with kinetic experience and the development of attentional awareness, not as pure repetition, but as a progression toward more complex, skilled, and nuanced ways of moving.

The concept of 'flexible seating' has emerged as a possibility to meeting the goals of an active learning classroom. Recent scholarship has suggested that numerous student learning predictors are enhanced when interacting with flexible seating. This study aims to fill a gap in the literature by investigating the effects of flexible seating from a physical perspective in the higher education setting. Seventy-five participants engaged in mixed-method data collection and analysis strategies that included observations and field notes, a validated online survey, and open-ended question prompts. A thematic review and descriptive analysis revealed almost 80% of the respondents indicated that the flexible seating had a positive effect on their experience in the course related to the following themes: (a) Movement Opportunity; (b) Back Pain & Comfort; (c) Anxiety & Restlessness; and (d) Focus & Engagement. This research provides evidence that physically comfortable classrooms promote a sense of well-being, keep minds focused, and limit distractions, and that physically comfortable classrooms with increased movement opportunities for students make possible mental and emotional health benefits, as well. Results indicate the need for campuses to (re)consider the purposes and roles of seating styles within the 21st century classrooms, with seating selection based on principles of universal design.

With the projects implemented in the 'Design for the Disabled' course in Gazi University 2019- 2020 academic year, fourteen students are asked to develop solutions for the problems of disabled individuals, which is one of the real-world issues, while gaining professional knowledge such as critical thinking, idea generation and learning the conceptual design process. In addition, it is aimed to increase their learning motivation and interest in social design projects. It was learned that the students did not carry out a design project for disabled individuals in their previous projects. Throughout the semester, students developed their projects with a conceptual design matrix consisting of Data Collection, Primary Analysis, Secondary Analysis, Synthesis, Hypothesis, Preliminary Design and Final Design stages. Students were asked to present their projects at the Final Design stage. The course was conducted through online classes during the COVID-19 Pandemic for twelve weeks. Students are enabled to experience an interdisciplinary critical process. Thus, successful solutions and new models have been developed in projects in terms of product and space.

Issues related to old age and ageing are an imperative topic in a society of long life, concerning everyone. Wherever possible, the age-related issues should also be adequately addressed and integrated into school education. This article gives an overview of perceptions of students in regard to external and self-images of old age, as conceptions from students are an important starting point for the development of teaching approaches. So far, there is an insufficient research situation in Germany regrading images of old age of children and adolescents. Guideline-supported individual interviews with 10 ninth graders (M[subscript age] = 15.2 years) were conducted and analyzed in order to get an insight into prevalent conceptions of old age and ageing in this age cohort. The students' ideas result in a comprehensive category system. In summary, our investigation has shown that students do not hold one-sided positive or negative images of old age in general, although some aspects like the physical condition and exercise capacity are seen more negatively than for example the characteristics of older persons. Teaching approaches for biology lessons and other subjects, deducted from the students' perceptions, are given in the discussion.

The purpose of this study was to reveal the views of administrators working in institutions providing adult elderly education on teacher leadership. Ten administrators, who were determined via convenience sampling which is among purposeful sampling methods, participated in this study using qualitative research method. The study was conducted in phenomenological design, which is among qualitative research designs. The interview technique was used to collect data in the study, thus, a semi-structured interview form was prepared and used for this process. The data were analyzed via content analysis technique. All the data acquired in the study were coded, various dimensions and appropriate themes for these dimensions were determined in accordance with the purpose of the study, and percentages and frequencies related to the themes were calculated and the views of the administrators on teacher leadership were revealed. As a result, the concept of an enriched environment, including cognitive tasks, such as elder education courses (sports, physical activity, artistic and skill studies), can form the basis for systematic assessment of possible interventions for successful aging. It provides another effective possibility to achieve better physical, physiological and cognitive improvements, especially in older adult. Further efforts are needed on the basis of teacher leadership in older education courses to reduce weakness and dependency among older adults and maintain independent physical and cognitive function, mental health and well-being.

Educational policy guidelines mandate that all learning institutions, adopt, design and embrace programs that are conducive to learners with disabilities. In spite of inclusive education policy guidelines, disability remains a major course of discrimination in Kenyan schools. This study therefore, examined the structural modification challenges on the implementation of inclusive education policy in schools. The study adopted mixed-method research approach, which uses both qualitative and quantitative methods. The target population comprised all the principals, teachers and students in Tharaka-Nithi County. The study employed purposive sampling to select 16 extra-county and county secondary schools. The sample size constituted 161 respondents. The data were collected using questionnaires for 100 class teachers, teaching learners with disabilities, an interview guide for 11 learners with physical disabilities to discuss their personal experiences on structural modification challenges and focus groups discussions for 50 non-disabled students learning in the same classrooms with learners with disabilities. Quantitative data were analyzed by descriptive statistics of frequency counts and percentages while qualitative data were analyzed thematically. The research findings established lack of modified physical resources, poor attitude towards inclusive education policy, poverty among parents of children with disabilities, and lack of teachers' skills on Special Needs Education (SNE) were major challenges facing the implementation of inclusive education in public secondary schools. There are other structural modification challenges not in the scope of this study that could be affecting implementation of inclusive education policy and can be tackled at school level. The study established a clear link between structural modification challenges and weak policy guidelines. Therefore, the study concluded that weak inclusive education policy guidelines on structural modification in schools led to lack of modified physical resources, poor attitudes of key stakeholders, poverty and lack of teachers' skills on SNE, which contributed to poor implementation of inclusive education. Thus, a clear inclusive education policy guideline on structural modification is necessary to enable schools provide a learner-friendly environment, that nurtures learner diversity.

Access to tertiary education in the least developed countries, such as Lesotho, continues to be a rare experience for persons with disabilities who, despite being admitted to studies, struggle with meaningful participation. This article explores student experience of persons with disabilities studying at the National University of Lesotho. A combination of convenience and snowballing sampling techniques were used to recruit 15 staff members and 11 students enrolled in various programmes. A combination of individual semi-structured interviews and a focus group discussion were used to generate data. Findings reveal that various dimensions of student experiences are negatively affected. Students with disabilities encounter mobility challenges due to an inaccessible built environment; lecture timetables are not adapted to suit the needs of students with mobility challenges, blind students are not informed of potholes that are left uncovered and the students' request for their hostel to be adapted is not addressed. Additionally, students are not readily supported by their lecturers while some are subjected to bullying which goes unpunished and the victims receive no counselling for the resultant trauma. These factors affect the students' welfare and have an effect on their academic participation. The students are simply expected to conform to university practices. The summary of student experience, if used for assessment of quality education, demonstrates inequitable access to education for persons with disabilities. The study concludes that the institution provides poor-quality education as it fails to address the support needs of students with disabilities. The study recommends development of policies and practices that promote equity, and that student experience can be used to inform how the institution may improve access and the quality of its programmes. Equally, this study challenges students with disabilities to assert their right to an inclusive and equitable quality education.

For over a century, early childhood experts have discussed the importance of play for young children's growth and development. Play is critical for the development of young children as it increases learning (Barton, 2015), supports young children in gaining social and communication skills (Dennis & Stockall, 2015), and leads to social awareness and empathy skills (Brown, 2009). However, for young children with disabilities, accessing play and social interactions can prove to be challenging (Fallon & MacCobb, 2013). In order to support preschoolers with disabilities in learning through play, the authors recommend the use of assistive technologies (AT) for (a) communication, (b) mobility, and (c) independence. This article presents information about specific assistive technology devices and supports in each of these three areas.

Independent mobility in typically developing infants and young children has been linked to growth in many areas of child development and changes in family behavior and interaction. Research suggests similar benefits in young children with motor disability who use powered mobility. The purpose of this study was to gain an understanding of how families experienced their child's development, growth, and abilities after using a power wheelchair for 1 year with the intent to generate a preliminary model to capture the process and relationships among these experiences. Eight families participated in interviews, and using grounded theory methodology the research team investigated their experiences. Results informed the development of the preliminary model that framed three key themes: (a) child competence, (b) parenting experience, and (c) the influence of power wheelchair use along with the key category "It will help in the long run" that titled and anchored the model. This model provides a possible view into how the use of powered mobility may influence development by supporting both child competence and the parenting experience.

New evidence builds upon the Student Engagement IndexTM and Teacher Engagement IndexTM research (Scott-Webber, Konyndyk, & French, 2019; Scott-Webber, Konyndyk, French, & French, 2018; Scott-Webber, Konyndyk, French, Lembke, & Kinney, 2017) determining post-occupancy answers to, "Can we demonstrate that the design of the built environment for grades 6-8 impacts student academic engagement levels post-occupancy?" The early studies used respondents from grades 9-12. This one is from users in grades 6-8 ('alpha' pilot). All studies were conducted in the USA as convenience samples. Engagement performance is a high predictor of student success across multiple domains and learning/work experiences. Specifically, "Research that shows that engagement, the time and energy students devote to educationally purposeful activities, is the best single predictor of their learning and personal development" (Anonymous, NSSE, 2010, p. 2), and thus our research focus. From both the students and educators perspectives, design of the built space impacts engagement performance (p < 0.0001).

People who are visually impaired (that is, those who are blind or have low vision) use a wide variety of sensory information to understand the world around them. Hearing is a particularly useful sense because of its range. Many visually impaired people use some form of echolocation to monitor the space around them (for example, the sound of a cane tip reflected off a wall is a common way to keep a parallel path without trailing or shore lining). One purpose of this report is to introduce the generic, catchall word "echoidentification" to refer to this skill categorically. A second purpose of this paper is to emphasize that it is within an orientation and mobility (O&M) specialist's scope of practice to teach students techniques for obtaining the most meaning out of sensory information to interpret the space around them. The third purpose of this paper is to provide some concrete strategies that may be useful to instructors interested in teaching higher-level echoidentification skills.

The present study is designed to understand the adjustment of visually impaired students, attending the special and the integrated schools. This study has been conducted on the students of 60 visually impaired students, aged 14-16 years, attending special and the integrated schools in the selected schools of Varanasi city, UP, India. The method of survey has been used to elicit the information about their adjustment in the home area, school area and personal area in special and integrated set-up. Data were collected by using the adjustment scale developed and standardized by the investigator. Results indicate that there was a significant difference in the adjustment of the visually impaired students in the area of home, school and personal in special and integrated set-up.

Adapted fitness tests and tests for children without disabilities are used for evaluating the effects of physical training programs of children with disabilities. This study investigated the applicability of those frequently-used tests for children with different types of disability. A total of 282 children ages between 5 and 14 years with Cerebral Palsy, Spina Bifida, Brachlial Plexus Injury, Spinal Cord Injuries, Amputations, Neuromuscular Diseases, Traumatic Brain Injury, Orthopedic Deformity, Intellectual Disability, Down Syndrome were participated in the study. Gross Motor Function Measure, Modified Ashworth Scale, Posture Analysis, Berg Balance Scale, Sitting Balance, 9 Holed Peg, Sit and Reach, Pro-agility, Anticipation Time, Curl-up, Modified Curl-up, Lateral step-up, Hand grip, Medicine Ball Throw, Pull up and 6 Minute Walk tests were used for evaluation. The major result of this study is that the differences in physical fitness levels, functionality and severity of sequelae rule out using several tests commonly even if the type of disability is the same.

Children with physical challenges have developmental needs and rights like other children and due to their exceptionality they call for more attention in provision of adequate quality mobility and educational resources to enhance their holistic development. However, it is apparent that provision of resources to children with physical challenges has not been possible in Kenya due to various factors which are not yet understood. The study drive was to explore parental role in the provision of mobility and educational resources to children who are physically challenged. The study sought to establish parents' involvement in provision of mobility and educational resources. The study was carried out in Joytown Primary School for the Physically Challenged in Thika Town. The school was purposefully selected because it is best suited for the study since it caters for children in the category of special needs being addressed in the study that is physical challenges. Case study design was used. Target population of the study was 100 children with physical challenges, 200 parents and 4 teachers and the head teacher. Stratified random sampling method was employed to arrive at a Sample size of 30 children with physical challenges, purposive and opportunity sampling to arrive at 30 parents and purposive sampling to arrive at 4 teachers. Therefore, the total sample size was 64. The data were collected using various techniques which included questionnaires for the teachers, interview guides for parents and observation guides for children. Collected data were analyzed using both quantitative and qualitative methods. Quantitative methods entailed use of descriptive statistics such as frequencies and percentages which enhanced discussion of qualitative data which was organized into themes and categories and presented in discussion form. The study established that parental involvement in provision of mobility and educational resources is minimal. The main recommendation of the study is that government should have a budgetary allocation meant specifically for purchase of mobility and educational resources and maintenance of facilities since it's a noble course which would ensure that children are actively involved in learning activities therefore enhancing holistic development hence molding children with physical challenges to become self-reliant and productive citizens.

Postsecondary education programs have increased opportunities for students with and without intellectual disabilities to study abroad as inclusive classes. Using open-coding qualitative techniques, the authors examined an inclusive study abroad group's daily reflective journals during a study abroad trip to London and Dublin. Three shared categories emerged from analysis: personal development, bonding/social inclusion, and learning from English and Irish adults with intellectual disabilities. Each group reported two distinct categories as well. Students with intellectual disabilities described the importance of mobility/transportation and fun, while their classmates without intellectual disabilities described the importance of inclusive learning and an increasing awareness of barriers to full participation for people with disabilities. Student-constructed categories are used to describe the benefits of inclusive study abroad and build future inclusive international opportunities.

This article examines the outcomes of the ACEE program, which is a one-year transition program for youth with disabilities, preparing them for the workplace and adult life. In a mixed methods approach, the investigators surveyed sixty-six youth with disabilities who were alumni of the program and followed up in depth with ten alumni in in-depth interviews and focus groups. The results show that the youth are doing well in terms of community participation and mobility. Many of them are active and involved into different social networks, be it with family, friends or community organizations. On the other hand, the study highlights issues in regards to employment and independent living. Employment can be precarious and underpaid, and the alumni's living situation often depends on their families, as there are few other options to them available.

Introduction: Systemic sclerosis (SSc) is a chronic multisystem disease. The condition is characterized by extensive vascular dysfunction and progressive fibrosis of the skin and internal organs. The musculoskeletal, cardiac, pulmonary, and gastrointestinal systems are involved, resulting in a broad range of symptoms. Diagnosis is based on skin and/or internal organ fibrosis, production of specific autoantibodies, and evidence of vasculopathy. Purpose of work: Synthesis of knowledge about physical activity in patients with SSc. Summary: Exercise and physiotherapy can improve the physical functions of patients with SSc. Physical activity in patients with SSc enhances hand function, enhances the function of the orofacial region, enhances sexual function, and also aids in coping with Raynaund's phenomenon, enhances physical capacity, alleviates fatigue as well and enhances general physical capacity. Furthermore, regular physical activity impeded the natural progression of progressive impairment of functional ability. Although, the literature regarding the efficacy and safety of exercise in patients with SSc is further insufficient. [ABSTRACT FROM AUTHOR]

Introduction: Some retrospective data sources, such as electronic health records in the USA, report composite outcome measures not fully validated in psoriatic arthritis (PsA). However, they often contain global assessments, such as a Physician Global Assessment (PhGA) and Patient Global Assessment (PatGA), along with patient-reported pain scores, which individually are considered validated in PsA. This research described the performance characteristics of a 3-item global assessment and pain (GAP) composite endpoint using data from the ixekizumab phase 3 PsA clinical trial program. Methods: Discrimination of GAP was assessed by comparing placebo to active treatment arms. The magnitude of treatment effect and responsiveness were compared to Disease Activity Index for PsA (DAPSA), clinical DAPSA, DAPSA28, and Psoriatic Arthritis Disease Activity Score (PASDAS) using effect size (ES) and standardized response mean (SRM), respectively. Construct validity was evaluated through correlation among the composite endpoints, and with other physician- and patient-reported outcomes. Change in GAP was compared in patients who reached low disease activity (LDA) levels based on DAPSA, cDAPSA, and PASDAS vs those who did not. Results: GAP discriminated between active treatment and placebo with statistically significant separation as early as week 1. The largest ES/SRM was seen with GAP (2.29/1.74) and PASDAS (2.47/1.68). GAP had the strongest correlation with PASDAS (0.81–0.92) and showed moderate correlations with patient-assessed physical function, low correlations with physician-assessed skin and nail psoriasis, and low to moderate correlation with physician-assessed enthesitis. A significantly greater improvement in GAP was seen in the groups achieving LDA states compared to those not (p < 0.001). Conclusion: The GAP composite, an abbreviated endpoint comprising measures common in electronic health records, has promising performance characteristics and could be used to address important clinical questions regarding outcomes and impact of PsA in existing datasets. ClinTrials.gov Identifier: NCT01695239; NCT02349295. Plain Language Summary: When doctors are assessing patients with psoriatic arthritis in clinical trials, they use tools, which include questions that patients answer and questions that doctors answer, in addition to a physical exam, to help evaluate how patients are doing. In a routine clinical practice setting, all of these same tools may not be used because they take a longer time to document information during a patient office visit. The goals of this research were to (1) create a new tool, which uses questions that patients and doctors answer, to help doctors evaluate how patients with psoriatic arthritis are doing in routine clinical practice, and (2) to assess if this new tool works as well as older tools. The new tool has fewer questions for the doctor and patient to answer and may take less time to document information but may result in some symptoms that patients experience not being regularly assessed. Data from clinical trials were used to compare the new tool to older tools to evaluate if doctors are able to assess psoriatic arthritis the same way. The results of the study showed that doctors are able to assess patients with psoriatic arthritis similarly with the new tool compared to older tools. This information will increase awareness of the new tool and could make it easier for doctors to evaluate patients with psoriatic arthritis in routine clinical practice. [ABSTRACT FROM AUTHOR]

Introduction : Hip arthroplasty, including hemiarthroplasty and total hip arthroplasty is a common surgical procedure for patients suffering from hip joint disorders with an aim of complication free early return to activities of daily living. Various minimally invasive surgical approaches have been described to achieve this aim including a relatively new SPAIRE approach. This case series shows our technique of hip arthroplasty using the SPAIRE technique with the help of conventional instruments in an Indian Scenario at a tertiary care center in Eastern India along with our short-term functional outcomes till a follow up period of 6 months. Materials and method : This was the prospective observational study done between May 2022 to Oct 2023 in Tata Main hospital, Jamshedpur. Total 35 patients were operated by this technique. Data including age, gender, time to return orthotic assisted mobility, Harris hip score at 2 months & any complications till the follow up of 6 months were recorded for each patient who underwent Hemiarthroplasty or Total Hip arthroplasty using the SPAIRE technique with conventional instruments for hip arthroplasty (performed by single surgeon – the senior author) in our tertiary care center. Results : 35 patients were operated during this span by using the SPAIRE technique. There were 30 cases of hip hemiarthroplasty and 5 cases of total hip arthroplasty (1 bilateral). 5 patients were lost to follow up during the period of 6 months. Harris hip score was measured for each patient at 2 months and mean Harris hip score was 83.16. Out of 35 patients, 9 patients had excellent outcome, 14 patients had good outcome and 7 patients had fair outcome. No patient had complications such as infection, delayed wound healing, periprosthetic fractures or sciatic nerve injury. One patient reported dislocation at 3 months following a fall. Mean time to return to orthotic assisted ambulation was 1.5 days for all 35 patients. Conclusion : SPAIRE technique is one of the safe surgical approaches for primary hip arthroplasties. This minimally invasive tendon sparing approach which preserves quadricep coxa provides excellent hip stability, early return to preinjury activities. It also reduces postoperative complications such as dislocation. [ABSTRACT FROM AUTHOR]

Purpose: Our objective was to synthesize and determine whether there are sex differences in physical function following exercise interventions in older adults. Materials and Methods: A systematic search was conducted in four databases from inception to July 8th, 2023 searching for prospective trials that conducted exercise interventions in older adults and results for physical function were reported by sex. Pooled standardized mean differences (SMDs) with their 95% confidence intervals (CIs) were estimated using a random-effects method. The Sidik-Jonkman estimator was used to calculate the variance of heterogeneity (I²). Results: A total of 19 studies involving 20,133 older adults (mean age ≥60 years, 33.7% female) were included. After exercise interventions, males reported significantly greater pre-post changes compared to females for upper body strength (SMD=- 0.40, 95% CI: -0.71 to -0.09; I² =75.6%; n=8), lower body strength (SMD=-0.32, 95% CI: -0.55 to -0.10; I² =52.0%; n=11), and cardiorespiratory fitness (SMD=-0.29, 95% CI: -0.48 to -0.10; I² =89.1%; n=12). Conversely, the pooled SMDs showed a significant effect favoring females for motor fitness (SMD=0.21, 95% CI: 0.03 to 0.39; I² =0%; n=7). Limited and inconsistent results were observed for flexibility. Conclusions: Our study suggests the existence of sex-related differences on physical function after an exercise intervention in the older population. [ABSTRACT FROM AUTHOR]

Declining physical function with aging is associated with structural and functional brain network organization. Gaining a greater understanding of network associations may be useful for targeting interventions that are designed to slow or prevent such decline. Our previous work demonstrated that the Short Physical Performance Battery (eSPPB) score and body mass index (BMI) exhibited a statistical interaction in their associations with connectivity in the sensorimotor cortex (SMN) and the dorsal attention network (DAN). The current study examined if components of the eSPPB have unique associations with these brain networks. Functional magnetic resonance imaging was performed on 192 participants in the BNET study, a longitudinal and observational trial of community-dwelling adults aged 70 or older. Functional brain networks were generated for resting state and during a motor imagery task. Regression analyses were performed between eSPPB component scores (gait speed, complex gait speed, static balance, and lower extremity strength) and BMI with SMN and DAN connectivity. Gait speed, complex gait speed, and lower extremity strength significantly interacted with BMI in their association with SMN at rest. Gait speed and complex gait speed were interacted with BMI in the DAN at rest while complex gait speed, static balance, and lower extremity strength interacted with BMI in the DAN during motor imagery. Results demonstrate that different components of physical function, such as balance or gait speed and BMI, are associated with unique aspects of brain network organization. Gaining a greater mechanistic understanding of the associations between low physical function, body mass, and brain physiology may lead to the development of treatments that not only target specific physical function limitations but also specific brain networks. [ABSTRACT FROM AUTHOR]

The study evaluated how ingestion of nicotinamide mononucleotide (NMN) for 12 weeks by older adults affected blood nicotinamide adenine dinucleotide (NAD +) levels and physical function, particularly walking function. Information concerning sleep, and stress was also collected as secondary endpoints. In this randomized, placebo-controlled, double-blind, parallel-group comparison study, 60 participants were randomly allocated into a placebo group or NMN group. Members of the NMN group consumed 250 mg/day NMN for 12 weeks. Motor function tests, blood NAD metabolite analysis, and questionnaires were conducted at the start of the study and 4 and 12 weeks after intake. This trial was registered at umin.ac.jp/ctr as UMIN000047871 on June 22nd, 2022. At primary outcome, at both 4 weeks and 12 weeks, the NMN and placebo groups had no significant differences in a stepping test. At secondary outcomes, after 12 weeks of NMN intake, the NMN group had a significantly shorter 4-m walking time than the placebo group as well as significantly higher blood levels of NAD + and its metabolites. A significant negative correlation was observed between the change in the 4-m walking time and the change in blood NAD + , N1-methyl-2-pridone-5-carboxamide (2-PY), and N1-methyl-4-pridone-3-carboxamide (4-PY) at 12 weeks. The NMN group had improved sleep quality at 12 weeks relative to the placebo group as evidenced by lower scores for "Daytime dysfunction" and "Global PSQI" on the Pittsburgh Sleep Questionnaire. No adverse effects related to test substance consumption were observed. Together, these results indicate that NMN intake could increase blood NAD + levels, maintain walking speed, and improve sleep quality in older adults. Interventions involving NMN aimed at maintaining walking speed could contribute to extended healthy life expectancy. [ABSTRACT FROM AUTHOR]

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The influence of biological maturity status on talent identification and development in youth soccer has been debated extensively. Alternative methods have thus recently emerged to estimate maturity status, such as the Pubertal Development Scale (PDS), but their relationship with physical capabilities of young soccer players still needs to be determined. The present study investigated the relationships of different PDS-derived pubertal status measures, chronological age, and relative age with selected performance variables in youth soccer. Sixty-one male soccer players were assessed for physical capabilities using field tests for sprinting, vertical jumps (countermovement jump, CMJ), intermittent high-intensity endurance, and repeated sprint ability. Chronological age was defined as the number of days since birth, and relative age was defined in terms of age quarters. PDS-derived measures of puberal status, otherwise, were determined as an average PDS score, a PDS category score, and a pubertal category. Chronological age, relative age, and measures of pubertal status were scarcely related (p > 0.05) to selected measures of soccer performance. Significant correlations were only found between different measures of pubertal status and the variable "work" in the CMJ test (range r = 0.33-0.36; p < 0.01) and between chronological age and CMJ height (r = -0.297; p = 0.02). The present results suggest that physical performance of young soccer players is poorly related to chronological age, relative age, and pubertal status. Potential effects of biological maturity status on physical capabilities may not be easily identifiable in a group of young soccer players narrowed in terms of chronological age and training status. [ABSTRACT FROM AUTHOR]

Deformation plays an important role in dam monitoring, especially in judging potential damage. Excessive deformation serves as an indicator of the abnormal evolution of dam structures, but the pivotal issue lies in definition for "excessive" precisely. Deformation prediction serves as reference for detection, but it is challenged by multiple factors. Sequence decomposition is an approach to select related factors and predict precisely, but the mechanism in application is a critical problem. This study proposes a decomposition Long short-term memory (DLSTM) model for the deformation prediction of arch dams. Segmented correlation feature extraction method balances feature correlation and consistency. Multiple linear regression is introduced for the integration, and the periodic extension is used to simplify unnecessary predicting operations. The proposed DLSTM model is evaluated using monitoring data from the LYX arch dam. The results show an 18% improvement in the accuracy, as well as better stability of the prediction model. The DLSTM-based multiple linear regression outperforms nonlinear neural network methods in terms of both physical interpretation and performance. The superiority of the proposed model over BP neural network, wavelet neural network, and LSTM model demonstrates that the DLSTM model is a promising approach for practical applications in dam deformation monitoring. [ABSTRACT FROM AUTHOR]

Virtual reality (VR) has significantly expanded the possibilities of medical treatment, particularly in the realm of rehabilitation. VR utilizes advanced technologies to create simulated environments that users perceive as analogous to the real world. Researchers have demonstrated that VR can effectively train motor, sensory, and cognitive functions. This manuscript offers a concise review of recent evidence concerning the effects of VR training on key clinical symptoms in people with multiple sclerosis (pwMS), with the aim of highlighting VR's potential as a complementary rehabilitative tool for improving ubiquitous symptoms of multiple sclerosis (MS)—a neurodegenerative, often disabling, disease. In addition to presenting a brief overview of recent literature on VR for pwMS, this narrative review seeks to provide health professionals with a foundational understanding of VR as a rehabilitative tool in MS. Furthermore, it may aid in identifying gaps in the literature and stimulate the development of new hypotheses and theories regarding the use of VR in patients with a neurodegenerative disease. [ABSTRACT FROM AUTHOR]

Background: Maintenance of physical function, mobility, and independent living are important goals for older adults. However, concerns about falling (CaF) play a central role in the vicious cycle of CaF, inflammation, loss of muscle mass, and decreasing physical function ultimately resulting in negative health outcomes. CaF, like other states of chronic stress and anxiety, can be considered as enduring adverse stimuli affecting the stress systems and the inflammatory system. Therefore, the aim of this study is to investigate whether a reduction of CaF leads to a reduction of stress and therefore possibly reduces chronic low-grade inflammation. Understanding the role and directionality of the effects of inflammation on CaF increases our understanding of age-related loss of mobility and physical function. Methods: In this study, community-dwelling older adults, aged 70 years and older, will be randomly assigned to either a 4-month, multi-component intervention with exercise training and cognitive-behavioral components or to a sham control group with light stretching exercises, cognitive training, and educational health lectures. For the operationalization of specific CaF, the Falls Efficacy Scale—International will be used. Stress and related psychological symptoms will be monitored using established self-reports and by measuring salivary cortisol. Concentrations of C-reactive protein, interleukin 6, interleukin 10, and tumor-necrosis-factor-alpha, as well as gene expression of selected inflammatory transcripts, will be used as surrogate parameters of the inflammatory status at baseline, after the 4-month intervention and 8-month follow-up. Discussion: This study will be the first to test whether CaF are related with stress system activity or reactivity or with markers of inflammation in the context of a multi-component intervention with exercise training and cognitive-behavioral components addressing CaF. The reduction of specific CaF or general psychological symptoms should reverse alterations in stress systems, and / or slow down low-grade inflammation. Changes in activity, as well as psychological and biological pathways leading from CaF to muscle loss will be measured, to disentangle the individual contribution to sarcopenia, and to provide an additional pathway to break or slow-down the vicious cycle of CaF and sarcopenia. Trial registration: German Clinical Trials Register (DRKS): DRKS00029171. Registered 22 July 2022. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer (CRC) and its treatments cause significant acute, chronic, or latent adverse effects, leading to decreased physical function and quality of life. Robust evidence supports the positive effects of physical activity (PA) on various health outcomes in CRC patients. However, there is limited understanding regarding the factors that influence PA engagement, including facilitators, preferences, and barriers in this population. Purpose: This scoping review aims to document the breadth and depth of literature concerning the various aspects of PA participation among patients with CRC. We conducted a scoping review of PA among CRC patients. Methods: We searched several databases, including PubMed, Web of Science, Embase, and Cochrane, from their inception to 25 July 2023. Multiple reviewers were involved in all screening and data abstractions. The search yielded 834 individual citations after removing duplicates. After screening the titles and abstracts, 20 articles underwent full-text review, and 11 were included. Results: Our research findings indicate that among CRC patients, the most prevalent facilitators/preferences for PA are understanding its importance and perceiving its benefits, whereas treatment-related effects and lack of time are the most common barriers. Conclusion: CRC patients have unique facilitators and barriers concerning PA. Further research and clinical interventions are required to support and encourage this population to participate in and maintain regular PA. [ABSTRACT FROM AUTHOR]

Dyadic conditions of patients with heart failure and their caregivers may affect both patient self-care and caregiver contribution to patient self-care (CCPS). The purpose of this study was to examine the relationships of patient-caregiver physical function and depressive symptoms to the patient self-care (maintenance and management) and CCPS. Data from 55 were analyzed using an Actor–Partner Interdependence Model to address the aim through AMOS. Patient self-care was very poor. Better patient physical function was related to better patient self-care management (actor effect) and poorer CCPS maintenance (partner effect). Better caregiver physical function was related to CCPS management (actor effect). Severer patient depressive symptoms were related to poorer patient self-care maintenance (actor effect) and poorer CCPS management (partner effect). Physical function and depressive symptoms in patient-caregiver dyads were related to patient self-care and CCPS. To improve patient self-care and CCPS, dyadic support for physical function and depressive symptoms is needed. [ABSTRACT FROM AUTHOR]

Background: Frailty is a geriatric syndrome characterized by chronic inflammation and metabolic insufficiency that creates vulnerability to poor outcomes with aging. We hypothesize that interventions which target common underlying mechanism of aging could ameliorate frailty. Ketone bodies are metabolites produced during fasting or on a ketogenic diet that have pleiotropic effects on inflammatory and metabolic aging pathways in laboratory animal models. Ketone esters (KEs) are compounds that induce ketosis without dietary changes, but KEs have not been studied in an older adult population. Our long-term goal is to examine if KEs modulate aging biology mechanisms and clinical outcomes relevant to frailty in older adults. Objectives: The primary objective of this randomized, placebo-controlled, double-blinded, parallel-group, pilot trial is to determine tolerability of 12-weeks of KE ingestion in a broad population of older adults (≥ 65 years). Secondary outcomes include safety and acute blood ketone kinetics. Exploratory outcomes include physical function, cognitive function, quality of life, aging biomarkers and inflammatory measures. Methods: Community-dwelling adults who are independent in activities of daily living, with no unstable acute medical conditions (n = 30) will be recruited. The study intervention is a KE or a taste, appearance, and calorie matched placebo beverage. Initially, acute 4-hour ketone kinetics after 12.5g or 25g of KE consumption will be assessed. After collection of baseline safety, functional, and biological measurements, subjects will randomly be allocated to consume KE 25g or placebo once daily for 12-weeks. Questionnaires will assess tolerability daily for 2-weeks, and then via phone interview at bi-monthly intervals. Safety assessments will be repeated at week 4. All measures will be repeated at week 12. Conclusion: This study will evaluate feasibility, tolerability, and safety of KE consumption in older adults and provide exploratory data across a range of aging-related endpoints. This data will inform design of larger trials to rigorously test KE effects on aging mechanisms and clinical outcomes relevant to frailty. [ABSTRACT FROM AUTHOR]

Physical networks are made of nodes and links that are physical objects embedded in a geometric space. Understanding how the mutual volume exclusion between these elements affects the structure and function of physical networks calls for a suitable generalization of network theory. Here, we introduce a network-of-networks framework where we describe the shape of each extended physical node as a network embedded in space and these networks are bound together by physical links. Relying on this representation, we introduce a minimal model of network growth and we show for a general class of physical networks that volume exclusion induces heterogeneity in both node volume and degree, with the two becoming correlated. These emergent properties strongly affect the dynamics on physical networks: by calculating their Laplacian spectrum as a function of the coupling strength between the nodes we show that degree-volume correlations suppress the role of hubs as early spreaders in diffusive dynamics. We apply the network-of-networks framework to describe several real systems and find properties analog to the minimal model networks. The prevalence of these properties points towards general growth mechanisms that do not depend on the specifics of the systems. In analysis of physically embedded complex networks, their nodes are usually considered as localized spheres connected by links, neglecting possible differences of nodes spatial shapes. The authors develop a representation of physical networks that captures arbitrary node shapes to characterize structural and dynamical network properties. [ABSTRACT FROM AUTHOR]

Background: CrossFit® combines different types of activities (weightlifting, gymnastics, and cardiovascular training) that challenge aerobic and anaerobic pathways. Over the last few years, the scientific interest in CrossFit® has increased considerably. However, there have been no published reviews characterizing the physical demands and physiological responses to CrossFit®. The present study synthesizes current evidence on the physical demands and physiological responses to CrossFit®. Methods: The search was performed in three electronic databases (PubMed, Scopus, and Web of Science). Manuscripts related to the physical and physiological performance of adult CrossFit® participants written in English, Portuguese, and Spanish were retrieved for the analysis. Results: In addition, a meta-correlation was conducted to examine the predictors of CrossFit® performance. A total of 68 papers were included in the review. Physical and physiological markers differed between the different workouts analyzed. In addition, 48 to 72 h are needed to recover from a CrossFit® challenge. Specific tests that involve CrossFit® movements were more related to CrossFit® performance than non-specific. Conclusion: Although the characterization of CrossFit® is dependent on the workout examined, the benefits of muscle hypertrophy are aligned with the recent findings of concurrent training. The characterization of CrossFit® entire sessions and appropriate recovery strategies should be considered in future studies to help coaches manipulate and adjust the training load. [ABSTRACT FROM AUTHOR]

Introduction: Special Operations Forces (SOF) often conduct operations in physiologically stressful environments such as severe heat, cold, or hypoxia, which can induce decreases in a variety of cognitive abilities. Given the promising empirical demonstration of the efficacy of exogenous ketone monoester (KME) supplementation in attenuating cognitive performance decrease during hypoxia at rest in a laboratory setting, we conducted a real-world, field experiment examining KME's efficacy during high-altitude mountaineering, an austere environment in which US SOF have conducted increasing numbers of operations over the past two decades. Methods: Specifically, 34 students and cadre at the US Army 10th Special Forces Group Special Operations Advanced Mountaineering School (SOAMS) participated in a randomized, double-blind, placebo (PLA)-controlled crossover trial (KME vs. PLA) over 2 days of tactical mountain operations training. The participants ascended from 7,500 ft in altitude (basecamp) to 12,460 ft on 1 day and 13,627 ft the other day (in randomized order), while performing various training activities inducing high physical and cognitive loads over 8-12 h, and consumed six doses of KME or PLA 2-3 h apart throughout each training day. Results and Discussion: While KME increased blood ketone levels and decreased glucose levels, there were no clear indications that the elevated ketone level enhanced physical or cognitive performance. KME also produced a greater incidence of heartburn, nausea, and vomiting. In these elite operators, highaltitude mountaineering had a limited impact on cognitive performance, and KME supplementation did not demonstrate any benefit. [ABSTRACT FROM AUTHOR]

Withania somnifera, commonly known as ashwagandha, has gained popularity in recent years among individuals interested in healthy lifestyles, natural medicine, and sports. This review aims to summarize the current knowledge regarding the effects of ashwagandha supplementation on various aspects of physical performance, particularly in the context of resistance training. Studies have shown that ashwagandha can positively impact muscle strength, with significant increase of muscle force and power output. Additionally, it has demonstrated potential in modulating body composition, with reduction of body fat percentage noted in certain populations. However, results of studies on ashwagandha's effect on muscle size remain inconclusive and may depend on various factors such as training status and individual responses. In terms of endurance, ashwagandha supplementation has been associated with improvement in maximal oxygen uptake, indicating enhanced aerobic capacity and delayed exhaustion during endurance activities. Furthermore, ashwagandha was shown to aid muscle recovery by reducing exercise-induced muscle damage and inflammatory response, potentially accelerating the muscle regeneration process. Ashwagandha may also influence hormone levels, such as testosterone and cortisol, with potential implications for muscle growth and recovery. However, further research is needed to fully understand the mechanisms underlying these effects. Overall, ashwagandha supplementation appears to hold promise for enhancing physical performance and overall well-being. Further research is needed to elucidate optimal dosages, long-term safety, and potential interactions with other supplements or medications. [ABSTRACT FROM AUTHOR]

This study aims to address and improve the low physical activity levels among people with mild dementia by implementing a novel shared decision-making and motivational support program, named "Changing the Focus". It will utilise a pre-post mixed methods approach, aiming to recruit 60 community living older people with mild dementia and their care-partners. The shared decision-making process will involve the person living with dementia, their care-partner, and a research therapist, using a purpose-designed discussion tool including factors such as preferred physical activities, health status, local opportunities and program accessibility. This process aims to identify personalised local physical activity opportunities. Participants will be supported with the help of a research therapist to engage in targeted community-based physical activities for 12-months, to progress towards the recommended physical activity guidelines of 150 minutes per week. The intervention provided by the research therapist will include three home visits (baseline, 6- and 12-months) and seven motivational support phone calls (within the first six months). Research therapists may provide additional home visits and support calls as needed. Primary outcomes include program participation (participants living with dementia continuing with the program after 12-months), total physical activity time per week (measured using the Active Australia Survey at baseline, 6- and 12- months) and program acceptability (assessed through semi-structured interviews with participants, care-partners, referrers, and physical activity providers). Secondary outcomes include physical performance, mental health, wellbeing measures, and impact on care-partners (evaluated through physical tests or validated scales at baseline, 6- and 12-months). Other implementation aspects include reach, maintenance, safety (falls, other adverse events) and an economic evaluation. Results will inform feasibility, potential benefits, and challenges associated with this innovative shared decision-making and supported physical activity program for people living with mild dementia. Findings will guide future large-scale studies and contribute to enhancing physical activity opportunities for this population. [ABSTRACT FROM AUTHOR]

This study aimed to compare the effects of a 6-week upper body plyometric training (UBPT) on maximal strength and anaerobic power performance of male and female subjects. Forty collegiate physically active male and female subjects participated in the study and were assigned to either UBPT group (M-UBPT, n = 10, F-UBPT, n = 10) or control group (M-CON, n = 10; F-CON, n = 10). The training groups performed 6 weeks of progressive overload UBPT three times per week using six exercises and were evaluated for upper-body anaerobic power and maximal strength, 3-kg medicine ball throw (MBT), push-up endurance, and reaction time at pre- and post-intervention. After the training intervention, the M-CON and F-CON groups did not show significant (p > 0.05) changes in the variables, while both the M-UBPT and F-UBPT groups demonstrated significant (p = 0.001) medium to very large improvements in their performance as follows: maximal strength (effect size [ES] = 0.55, 0.92), MBT (ES = 1.96, 0.89) peak power output (ES = 2.31, 1.52), mean power output (ES = 2.19, 1.11), push-up endurance (ES = 1.26, 0.70), and reaction time (ES = − 2.16, − 1.56), respectively. Nevertheless, the male group experienced more significant improvements in the MBT (p = 0.001), peak (p = 0.001) and mean power output (p = 0.01), as well as reaction time (p = 0.01) compared to the female group when utilizing UBPT. In conclusion, it is imperative to take sex into account as a crucial factor when incorporating UBPT, particularly if the objective is to enhance anaerobic power output, muscular power, and reaction time. [ABSTRACT FROM AUTHOR]

Background: Total knee arthroplasty (TKA) successfully alleviates pain from knee osteoarthritis, but muscle strength and function are reduced for a long period postoperatively. Postoperative active resistance exercise may play a relevant role. Purpose: To systematically evaluate effects of lower-limb active resistance exercise (ARE) on mobility, physical function, muscle strength and pain intensity in patients with TKA. Methods: A search was conducted in PubMed, EMBASE, and Cochrane Library databases from inception to September 2023. Only randomized controlled trials (RCTs) that compared the effects of ARE and no intervention or other rehabilitation program without PRE were included. The outcome variables were mobility (Maximal walking speed [MWS]/6-Minute Walk Test[6MWT]), physical function (Stair Climb Test [SCT]/Timed Up and Go [TUG]), knee extension/ flexion power(KEP/KFP), joint range of motion (ROM) and pain. Standardized Mean Differences (SMD) or Mean Differences (MD) and 95% confidence intervals (CI) were calculated and combined in meta-analyses. The Cochrane Collaboration's Handbook were used for the methodological quality assessments. GRADE was used to assess the quality of evidence. The meta-analysis was performed using the RevMan 5.4 software. Results: A total of 14 randomized controlled trials, involving 880 patients, were finally included. The lower-limb ARE exhibited significantly greater improvement in MWS (MD 0.13, 95%CI 0.08–0.18, P < 0.00001), TUG(MD -0.92, 95%CI -1.55– -0.28, P = 0.005), KEP (SMD 0.58, 95%CI 0.20–0.96, P = 0.003), KFP (SMD 0.38, 95%CI 0.13–0.63, P = 0.003), ROM-flexion (MD 2.74, 95%CI 1.82–3.67, P < 0.00001) and VAS (MD − 4.65, 95% CI − 7.86– -1.44, p = 0.005) compared to conventional exercise(CE) immediately post-intervention. However, there were no statistically significant differences between both groups in regard to 6MWT (MD 7.98, 95%CI -4.60–20.56, P = 0.21), SCT (MD -0.79, 95%CI -1.69–0.10, P = 0.08) and ROM-extension (MD -0.60, 95%CI -1.23–0.03, P = 0.06). Conclusions: According to the results of meta-analysis, patients undergoing TKA who receive the lower extremity ARE show better clinical effects in terms of pain relief, strength recovery and knee ROM. Simultaneously, it may be beneficial to improve mobility and physical function of patients after TKA. [ABSTRACT FROM AUTHOR]

Background: Exercise is associated with improved survival, physical functioning, treatment tolerability, and quality of life in early-stage breast cancer. These same endpoints matter in metastatic breast cancer (MBC). Prior trials in MBC have found exercise to be not feasible or of limited benefit, possibly due to inclusion of patients with heterogeneous disease trajectories. Patients with MBC have variable disease trajectories and supportive care needs; those with indolent MBC have longer life expectancy, lower symptom burden and distinct priorities, and are well-positioned to participate in and benefit from an exercise program. The EMBody trial aims to determine the impact of a multimodal exercise intervention on cardiorespiratory fitness, physical function, body composition, and patient-reported outcomes, specifically in patients with stable, indolent MBC. Methods: Eligible patients have MBC with no evidence of disease progression on current therapy in the prior 12 months and cannot be receiving cytotoxic chemotherapy. The trial aims to enroll 100 patients, randomized 1:1 to the exercise intervention versus usual care, stratified by baseline function. The virtually-delivered exercise intervention arm achieves moderate intensity exercise with exercise physiologists 3 days/week for 16 weeks. The 60-minute sessions include aerobic, resistance, balance and stretching exercises. The exercise arm receives informational sessions on the role of exercise in cancer and principles of habit and self-efficacy. The primary endpoint is 16 week change in fitness on a ramp treadmill test between the exercise and control arms. Secondary endpoints include change in a physical function, muscle mass assessed by CT scans, and PROs of fatigue and quality of life. Exploratory analysis includes behavioral modifiers of exercise adherence and effectiveness and serologic measures of inflammatory, metabolic, and immune pathway biomarkers. Discussion: The EMBody trial evaluates exercise in a unique patient population with indolent, non-progressive MBC. Patients living with MBC experience similar symptom burden to those undergoing therapy for early-stage disease and the benefits achieved with exercise could be similarly impactful. This trial will contribute evidence to support expansion of exercise recommendations, among other survivorship care efforts, to those living with metastatic disease. Clinical trial information: NCT05468034. Trial registration: NCT05468034. Date of registration: 7/12/2022. [ABSTRACT FROM AUTHOR]

Introduction: Mental fatigue (MF) significantly affects both cognitive and physical performance. However, the precise mechanisms, particularly concerning neurotransmission, require further investigation. An implication of the role of dopamine (DA) and noradrenaline (NA) is stated, but empirical evidence for this theory still needs to be provided. To address this gap, we aim to investigate the role of brain neurotransmission in elucidating if, and how prolonged cognitive activity induces MF and its subsequent impact on cognitive performance. Methods: This study (registration number: G095422N) will adopt a randomized cross-over design with sixteen healthy participants aged 18–35 years. The sessions include a familiarization, two experimental (DA: 20mg Methylphenidate; NA: 8mg Reboxetine) conditions, and one placebo (lactose tablet: 10mg) condition. A 60-minute individualized Stroop task will be used to investigate whether, and how the onset of MF changes under the influence of reuptake inhibitors. Attention and response inhibition will be assessed before and after the MF-inducing task using a Go/NoGo task. The integration of physiological (electroencephalography, heart rate), behavioral (attention, response inhibition), and subjective indicators (scales and questionnaires) will be used to detect the underlying mechanisms holistically. Data analysis will involve linear mixed models with significance at p<0.05. Discussion: The integration of diverse techniques and analyses offers a comprehensive perspective on the onset and impact of MF, introducing a novel approach. Future research plans involve extending this protocol to explore the connection between brain neurotransmission and physical fatigue. This protocol will further advance our understanding of the complex interplay between the brain and fatigue. [ABSTRACT FROM AUTHOR]

Background: As a novel and time-efficient exercise form, high-intensity interval training (HIIT) has shown great potential in improving health-related physical fitness among diverse populations. However, empirical evidence on its efficacy among the elderly has not been well summarized. This systematic review and meta-analysis aimed to determine the effect of HIIT interventions on the parameters related to physical fitness and health of older adults, including resting heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), cardiorespiratory fitness (CRF), body mass index (BMI), body fat percent (BF%), waist circumference (WC), muscular endurance (ME), muscular strength (MS), muscular power (MP), balance and flexibility, compared to non-exercise and other-exercise (e.g., moderate-intensity continuous training, resistance training) conditions. Methods: Literature published from January 2000 to May 2023 was collected through extensive searches across eight databases and relevant review papers. Randomized controlled trials (RCTs) featuring a minimum 2-week exercise intervention for older adults (≥ 60 years) were included. The pooled effect size of Hedges'g was estimated using random-effects models in R. Meta-regression was performed for both categorical (health status, duration of training programme, and frequency) and continuous moderators (mean age, male rate, and attrition rate). Results: Forty-four eligible RCTs with 1863 participants (52.1% female; 60.5–81.2 years) were included in the quantitative analysis. Compared to non-exercise condition, HIIT significantly improved resting HR (g = -0.36, 95%CI = [-0.67, -0.05], P = 0.032), SBP (g = -0.29, 95%CI = [-0.54, -0.03], P = 0.008), CRF (g = 0.77, 95%CI = [0.51, 1.04], P < 0.001), BF% (g = -0.26, 95%CI = [-0.41, -0.11], P = 0.006), MS (g = 0.47, 95%CI = [0.23, 0.71], P = 0.004), ME (g = 0.65, 95%CI = [0.10, 1.19], P = 0.036), and balance (e.g., timed-up-and-go) (g = -0.79, 95%CI = [-1.19, -0.40], P = 0.035). Compared to other-exercise condition, HIIT significantly improved resting HR (g = -0.11, 95%CI = [-0.21, -0.01], P = 0.029), SBP (g = -0.14, 95%CI = [-0.28, -0.01], P = 0.038), and CRF (g = 0.23, 95%CI = [0.07, 0.38], P = 0.008). No significant difference was found between HIIT and non-exercise condition for DBP, BMI and WC, as well as between HIIT and other-exercise condition for DBP, BMI, BF%, WC, ME, and balance (all P > 0.05). Meta-regression indicated that mean age moderated the HIIT effect on resting HR (b = -0.02, P = 0.014; HIIT vs. other-exercise condition) and SBP (b = 0.03, P = 0.048; HIIT vs. non-exercise), and attrition rate moderated the effect on CRF (b = 0.03, P = 0.007; HIIT vs. non-exercise). Conclusion: This study supports the efficacy of HIIT in improving resting HR, SBP, CRF, BF%, MS, ME and balance among older adults. More empirical evidence is needed to determine the efficacy of HIIT for MP and flexibility in this population. Trial Registration: PROSPERO CRD42022316246. Key Points: • HIIT is an effective approach for improving older adults' resting heart rate (HR), systolic blood pressure (SBP), cardiorespiratory fitness (CRF), body fat percent (BF%), muscular strength (MS), and balance, compared with non-exercise condition. • HIIT outperformed the other exercise interventions in improving older adults' resting HR, SBP, CRF, and muscular endurance (ME). • Mean age and attrition rate were identified as potential moderators for the HIIT effects on resting HR, SBP and CRF. [ABSTRACT FROM AUTHOR]

Background: Ageing populations and care workforce shortages across Europe are causing challenges for care services for older people. Therefore, it is paramount that limited care resources are allocated optimally, based on the clients' care needs. Multiple functioning-related factors have been identified that determine the amount of care time clients receive, while organizational and other factors remain largely unexplored. The aim was to examine how various individual and organizational factors are associated with clients' received care time in different care settings. Methods: Cross-sectional observational study design with data from time and motion study, registers, and surveys was used. In total, 1477 home care clients and 1538 residents from assisted living facilities with 24/7 service participated, from 61 Finnish care units. Linear mixed-effect modeling was used to examine the association between individual and organizational-level variables and received care time. Results: Physical functioning was the strongest predictor of received care time in both care settings. In home care, greater pain, more unstable health, and higher team autonomy were associated with increased care time. In assisted living, depressive mood and higher staffing level of the organization were associated with care time. Clients who received informal care also received significantly more care time from nurses in both care settings. Conclusions: Physical functioning was the main driver of received care time. Interventions that maintain or improve physical functioning can help restrain the growing need of care resources, although it is important to ensure that each client receives care according to their holistic care needs. [ABSTRACT FROM AUTHOR]

Background: The University of Jyvaskyla Active Aging Scale (UJACAS) assesses active aging through willingness, ability, opportunity, and frequency of involvement in activities. Recognizing the lack of a German version, the Finnish original was translated (UJACAS-G). This study aimed: (1) to evaluate the test-retest reliability of UJACAS-G; and (2) to explore correlations with health-related parameters (concurrent validity). Methods: The study (test-retest design) targeted healthy older adults aged 65+. Reliability of UJACAS-G (total and subscores) was assessed using Bland-Altman analyses and Intraclass Correlation Coefficients (ICCs). Furthermore, correlations (Spearman's rho) between UJACAS-G scores and physical function (walking speed, handgrip strength, balance, 6-minute walk distance), physical activity (International Physical Activity Questionnaire), life-space mobility (Life-Space Assessment), and health-related quality of life (Short Form-36 Health Survey) were calculated. Results: Bland-Altman analyses (N = 60; mean age 72.3, SD 5.9 years; 50% women) revealed mean differences close to zero and narrow limits of agreement for all scores (total score: mean difference −1.9; limits −31.7 to 27.9). The ability subscore showed clustering at its upper limit. ICC was 0.829 (95% CI 0.730 to 0.894) for the total score and ranged between 0.530 and 0.876 for subscores (all p-values < 0.001). The total score correlated with walking speed (rho = 0.345; p = 0.008), physical activity (rho = 0.279; p = 0.033) and mental health (rho = 0.329; p = 0.010). Conclusions: UJACAS-G is reliable for assessing active aging among German-speaking healthy older adults. A potential 'ceiling effect' regarding the ability subscore should be considered when applying UJACAS-G to well-functioning populations. Analyses of concurrent validity indicated only weak correlations with health-related parameters. [ABSTRACT FROM AUTHOR]

Background: The psychosocial impact of medical marijuana use is not yet known. This study evaluated short-term changes in health-related quality of life (HRQoL) over the first three months of medical marijuana use. Methods: This prospective, observational, longitudinal study followed adults newly recommended for medical marijuana by a physician for any of the more than 20 qualifying medical conditions in Pennsylvania. Participants (N = 438) provided their clinical status and demographic information, and completed semi-structured interviews prior to medical marijuana initiation (baseline) and at three months. HRQoL was assessed by the Short Form-36 (SF-36). Paired-samples t-tests evaluated changes in HRQoL over time. Results: Participants (M age = 46.4 years [15.6]; 66.4% female) were mostly commonly referred for medical marijuana to treat anxiety disorders (61.9%) or severe chronic or intractable pain (53.6%). Participants reported rapid and significant improvements in all of the domains of HRQoL from baseline to three months after initiating medical marijuana use (physical functioning, role limitations due to physical health problems, emotional well-being, role limitations due to emotional problems, bodily pain, social functioning, energy/fatigue and general health, P <.001 for all). Age was negatively predictive of level of improvement over time for the physical functioning (P <.0001), role limitations due to physical health problems (P <.001), and pain (P <.0001) domains after controlling for baseline, with older participants displaying less improvement than younger participants. Conclusions: Gains were observed in all HRQoL domains assessed after three months of medical marijuana use. In several domains, age was a significant predictor of degree of improvement. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia is a muscle disorder causing a progressive reduction of muscle mass and strength, but the mechanism of its manifestation is still partially unknown. The three main parameters to assess are: muscle strength, muscle volume or quality and low physical performance. There is not a definitive approach to assess the musculoskeletal condition of frail population and often the available tests to be performed in those clinical bedridden patients is reduced because of physical impairments. In this paper, we propose a novel instrumental multi-domain and non-invasive approach during a well-defined protocol of measurements for overcoming these limitations. A group of 28 bedridden elder people, subjected to surgery after hip fracture, was asked to perform voluntary isometric contractions at the 80% of their maximum voluntary contraction with the non-injured leg. The sensor employed before and/or during the exercise were: ultrasound to determine the muscle architecture (vastus lateralis); force acquisition with a load cell placed on the chair, giving an indication of the muscle strength; surface electromyography (EMG) for monitoring muscular electrical activity; time-domain (TD) near-infrared spectroscopy (NIRS) for evaluating muscle oxidative metabolism. Results: A personalized "report card" for each subject was created. It includes: the force diagram (both instantaneous and cumulative, expected and measured); the EMG–force diagram for a comparison between EMG derived median frequency and measured force; two graphs related to the hemodynamic parameters for muscle oxidative metabolism evaluation, i.e., oxy-, deoxy-, total-hemoglobin and tissue oxygen saturation for the whole exercise period. A table with the absolute values of the previous hemodynamic parameters during the rest and the ultrasound related parameters are also included. Conclusions: In this work, we present the union of protocols, multi-domain sensors and parameters for the evaluation of the musculoskeletal condition. The novelties are the use of sensors of different nature, i.e., force, electrical and optical, together with a new way to visualize and combine the results, by means of a concise, exhaustive and personalized medical report card for each patient. This assessment, totally non-invasive, is focused on a bedridden population, but can be extended to the monitoring of rehabilitation progresses or of the training of athletes. [ABSTRACT FROM AUTHOR]

In a randomized, controlled study, whole-body electromyostimulation (WB-EMS) was investigated as a promising alternative treatment technique compared to conventional strength training for the management of knee osteoarthritis (OA). Seventy-two overweight participants with symptomatic knee OA were randomly assigned to WB-EMS (n = 36) or a usual care group (UCG, n = 36). For seven months, the WB-EMS group received three times per fortnight a WB-EMS training, while the UCG was prescribed six-times physiotherapeutic treatments. We observed significant effects for the primary outcome "pain", as determined by the Knee injury and Osteoarthritis Outcome Score (KOOS), with more favourable changes in the WB-EMS group vs UCG (between-group difference 9.0 points, 95%CI 2.9–15.1, p = 0.004). Secondary outcomes, including the other KOOS subscales (symptoms, function in daily living, function in sports/recreational activities and quality of life), 7 day pain diary, hip/leg extensor strength and lower limb function (30s sit-to-stand test), were also statistically significant in favour of the WB-EMS group. Overall, WB-EMS was found to be effective in relieving knee pain symptoms and improving physical function in individuals with symptomatic knee OA compared to usual care treatment. WB-EMS could be used as an alternative therapy in the management of knee OA; particularly for patients that cannot be motivated for conventional training. [ABSTRACT FROM AUTHOR]

Background: Urinary incontinence (UI) is a highly prevalent condition in women with a profound influence on their well-being and quality of life. Pelvic floor muscle training (PFMT) is a widely accepted conservative management of incontinence. Adequate knowledge of PFMT can enhance the ability of individuals to perform them effectively unsupervised. Objectives: This study aimed to determine the prevalence of UI and knowledge of PFMT among older women in a selected suburban community in Nigeria. Design: A cross-sectional design. Methods: This study consecutively recruited 121 older women (65 years and above) with a mean age of 68.59 ± 4.94 years in Nnewi North LGA Anambra state, Nigeria. The International Consultation on Incontinence Questionnaire Short Form and an adopted pre-tested questionnaire were used to assess the prevalence of UI and knowledge of PFMT. Data was analyzed using Statistical Package of Social Sciences (SPSS) version 26 Descriptive statistics, and the chi-square test was utilized with significance determined at an alpha level of 0.05. Results: The results revealed that 33.88% of the respondents experience UI, and 3.3% of them have heard about PFMT. There was significant association between prevalence of UI and number of pregnancies (χ2 = 11.16, p = 0.03) and children (χ2 = 9.77, p = 0.04). There was no significant association between the prevalence of UI and level of education (χ2 = 4.20, p = 0.12) and knowledge of PFMT (χ2 = 0.48, p = 0.42). There was no significant association between knowledge of PFMT and number of pregnancies (χ2 = 04.25, p = 0.37), and number of children (χ2 = 4.02, p = 0.40). There was a significant association between knowledge of PFMT and level of education among the participants (χ2 = 7.46, p = 0.02). Conclusion: The study showed a significant prevalence of UI and poor knowledge of PFMT in older women. Health professionals should sensitize older women in hospitals and care homes on the benefits of PFMT to improve their knowledge of PFMT. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia leads to functional disability, dependence in activities of daily living (ADL), and is a key contributor to frailty. Reducing and breaking up sedentary time is associated with improved sarcopenia and frailty-related outcomes. The aim of this study was to determine the feasibility of delivering and evaluating a remote sedentary behaviour intervention to improve sarcopenia and independent living in older adults with frailty. Methods: A two-arm randomised controlled feasibility trial was conducted with a target of 60 older adults (mean age 74 ± 6 years) with very mild or mild frailty. Participants were randomised to the Frail-LESS (LEss Sitting and Sarcopenia in Frail older adults) intervention or usual care control group for six months. The intervention included tailored feedback on sitting, standing and stepping; an education workbook that included goal setting and action planning; one-to-one health coaching; peer support; and a wearable device to self-monitor sedentary behaviour. Participant recruitment (percentage of eligible individuals recruited), retention and data completion rates were used to assess trial feasibility. Acceptability of the trial was explored through interviews and safety was evaluated via unplanned healthcare utilisation and number of falls. Sitting, standing, stepping and sarcopenia were measured to evaluate potential intervention effects. Results: Sixty participants were recruited. Recruitment and retention rates were 72% and 83%, respectively. Completion rates for outcome measures ranged from 70 to 100%. The trial was safe (< 1 fall per participant on average at each timepoint) and trial procedures were acceptable. Descriptive analysis (mean ± SD) showed that daily sitting was 25.1 ± 82.1 min/day lower in the intervention group, and 6.4 ± 60.5 min/day higher in the control group, at 6 months compared with baseline. Hand grip strength and sit-to-stand score were improved by 1.3 ± 2.4 kg and 0.7 ± 1.0, respectively, in the intervention group. Conclusions: This study demonstrates the feasibility and safety of delivering and evaluating a remote intervention to reduce and break up sitting in older adults with frailty. The intervention showed evidence towards reducing daily sitting and improving sarcopenia, supporting its evaluation in a definitive randomised controlled trial. Trial registration: ISRCTN registry (registration number: ISRCTN17158017). Registered 6th August 2021. [ABSTRACT FROM AUTHOR]

Background: This systematic review and meta-analysis aim to evaluate the effects of cognitively engaging Physical Activity (PA) interventions on Executive Function (EF) in children and adolescents. It examines how different intervention modalities, durations, frequencies, and session lengths influence these effects. Methods: We followed the PRISMA guidelines and searched PubMed, SPORTDiscus, Embase, and Web of Science for relevant studies. Studies were included if they were Randomized Controlled Trials (RCTs) focusing on PA with cognitive elements targeting EF in healthy children and adolescents. Data were extracted and effect sizes computed using Standardized Mean Differences (SMDs). Results: From an initial 1,635 articles, 23 studies with 2,857 participants were included. The overall effect of cognitively engaging PA on EF was significant (SMD = 0.32, 95% CI 0.14-0.51), with notable improvements in inhibitory control (SMD = 0.35) and working memory (SMD = 0.34). High heterogeneity was observed (I2 = 91.1%). Moderator analyses revealed that interventions lasting more than 6 weeks, with sessions over 20 min and conducted more than twice a week, were particularly effective. Conclusion: Cognitively engaging PA interventions positively impact EF in children and adolescents, particularly in inhibitory control. Effective interventions are characterized by longer duration, higher frequency, and extended session lengths. These findings underscore the importance of integrating cognitive challenges within PA programs to enhance EF, warranting future research and practical applications in educational and developmental settings. [ABSTRACT FROM AUTHOR]