Search

Function and the independent performance of daily activities are of critical importance to older adults. Although function was once a domain of interest primarily limited to geriatricians, transdisciplinary research has demonstrated its value across the spectrum of medical and surgical care. Nonetheless, integrating a functional perspective into medical and surgical therapeutics has yet to be implemented consistently into clinical practice. This article summarizes the presentations and discussions from a workshop, "Embedding/Sustaining a Focus on Function in Specialty Research and Care," held on January 31 to February 1, 2019. The third in a series supported by the National Institute on Aging and the John A. Hartford Foundation, the workshop aimed to identify scientific gaps and recommend research strategies to advance the implementation of function in care of older adults. Transdisciplinary leaders discussed implementation of mobility programs and functional assessments, including comprehensive geriatric assessment; integrating cognitive and sensory functional assessments; the role of culture, environment, and community in incorporating function into research; innovative methods to better identify functional limitations, techniques, and interventions to facilitate functional gains; and the role of the health system in fostering integration of function. Workshop participants emphasized the importance of aligning goals and assessments and adopting a team science approach that includes clinicians and frontline staff in the planning, development, testing, and implementation of tools and initiatives. This article summarizes those discussions., (© 2020 The American Geriatrics Society.)

Abstract The relationship between possible sarcopenia and mortality remains ambiguous within Asian populations. To clarify this, we investigated the association in older adults residing in Chinese communities. Utilizing data from the China Health and Retirement Longitudinal Study, this population-based cohort study included individuals aged ≥ 60 years, followed from 2011 to 2012 through 2020. Possible sarcopenia was defined in accordance with the Asian Working Group on Sarcopenia 2019 criteria, and Cox proportional hazards regression was used to analyze its impact on mortality, while exploratory analyses were conducted to investigate the associations of possible sarcopenia with chronic diseases, functional independence, and hospitalization frequency. The study encompassed 5,160 participants (median age: 66 years), nearly half of whom (48.8%) were identified with possible sarcopenia. Over a 9-year follow-up period, there were 1216 recorded deaths. Analysis indicated that individuals with possible sarcopenia faced a significantly elevated mortality risk compared to their counterparts (HR: 1.79, 95% CI: 1.58–2.03; P

Abstract 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 This study aimed to elucidate the impact of combining Beta-Alanine (BA) supplementation with short sprint interval training on cardiorespiratory fitness, anaerobic power, and bio-motor abilities in volleyball players. Twenty young male athletes were randomly divided into 2 equal groups and performed 8 weeks of short sprint interval training while supplementing 4.8 g daily BA or placebo (polydextrose). The players were evaluated for volleyball-specific bio-motor abilities (vertical jump, horizontal jump, spike jump, block jump, 10-m linear sprint, and T-test change of direction speed) and physiological parameters (cardiorespiratory fitness and anaerobic power) pre- and post-intervention. Both groups demonstrated significant (p ≤ 0.05) improvements in all measured variables over time. A time-regimen interaction was observed in jumping ability enhancement from pre- to post-training, wherein BA elicited more significant changes in both vertical and horizontal jumps compared to the placebo. Analyzing residuals in changes and the coefficient of variations (CV) in mean group changes demonstrated that BA supplementation results in uniformly inducing adaptive changes among individuals. Therefore, in light of these results, it is recommended that coaches and trainers take into consideration the utilization of BA as an ergogenic aid to enhance the vertical and horizontal jumps of volleyball players and increase the homogeneity in adaptive responses over the training period.

Abstract Osteoporosis, vertebral fractures, and spinal degenerative diseases are common conditions that often coexist in older adults. This study aimed to determine the factors influencing low back pain and its impact on activities of daily living (ADL) and physical performance in older individuals with multiple comorbidities. This cross-sectional study was part of a large-scale population-based cohort study in Japan, involving 1009 participants who underwent spinal magnetic resonance imaging (MRI) to assess cervical cord compression, radiographic lumbar spinal stenosis, and lumbar disc degeneration. Vertebral fractures in the thoracolumbar spine were evaluated using sagittal MRI with a semi-quantitative method. Bone mineral density was measured using dual-energy X-ray absorptiometry. Low back pain, Oswestry Disability Index (ODI), and physical performance tests, such as one-leg standing time, five times chair-stand time, maximum walking speed, and maximum step length, were assessed. Using clinical conditions as objective variables and image evaluation parameters as explanatory variables, multiple regression analysis showed that vertebral fractures were significantly associated with low back pain and ODI. Vertebral fractures and osteoporosis significantly impacted physical performance, whereas osteoporosis alone did not affect low back pain or ODI. Our findings contribute to new insights into low back pain and its impact on ADL and physical performance.

Abstract Background Magnesium is a micronutrient and an intracellular cation responsible for different biochemical reactions involved in energy production and storage, control of neuronal and vasomotor activity, cardiac excitability, and muscle contraction. Magnesium deficiency may result in impaired physical performance. Moreover, magnesium plays an important role on delayed onset muscle soreness after training. Thus, physically active individuals and sport specialists have to pay attention to magnesium supplementation (MgS). However, the type, timing and dosage of magnesium intake are not well elucidated yet. Hence, we aimed to systematically review the literature regarding the effects of MgS on muscle soreness in physically active individuals. We focused exclusively on MgS, excluding those studies in which magnesium was administered together with other substances. Methods Three electronic databases and literature sources (PUBMED, SCOPUS and Web of Sciences-Core Collection) were searched, in accordance with PRISMA guidelines. After the database search, 1254 articles were identified, and after excluding duplicates, 960 articles remained. Among these, 955 were excluded following the title and abstract screening. The remaining 5 articles were screened in full text and 4 study met the eligibility criteria. Results These studies showed that MgS reduced muscle soreness, improved performance, recovery and induced a protective effect on muscle damage. Conclusion To reach these positive effects, individuals engaged in intense exercise should have a Mg requirement 10–20% higher than sedentary people, to be taken in capsules and 2 h before training. Moreover, it is suggested to maintain magnesium levels in the recommended range during the off-season. Systematic review registration PROSPERO registration number: CRD42024501822.

Background Observational studies have documented increased serum IL-6 levels in elderly individuals afflicted with sarcopenia. Nevertheless, the relationship between serum IL-6 concentrations and sarcopenia prevalence in the aging population is yet to be defined.Methods We executed a systematic review and meta-analysis of cross-sectional studies that scrutinized serum IL-6 levels in older adults with and without sarcopenia. Relevant studies were sourced from PubMed, Scopus, Embase, Cochrane Library, and Web of Science from inception until 10 September 2023. The standard mean differences (SMDs) in serum IL-6 levels between studies were synthesized using a random-effects model. To examine the influence of demographic and clinical factors on these outcomes, we performed subgroup analyses and meta-regression, focusing on variables such as sex, age, and body mass index (BMI). We also assessed the relationship between serum IL-6 levels and the defining components of sarcopenia: muscle mass, muscle strength, and physical performance. We used Fisher’s Z transformation to standardize the interpretation of effect sizes from these relationships. The transformed values were then converted to summary correlation coefficients (r) for a clear and unified summary of the results.Results We included twenty-one cross-sectional studies involving 3,902 participants. Meta-analysis revealed significantly elevated serum IL-6 levels in older adults with sarcopenia compared with those without sarcopenia (SMD = 0.31; 95% CI 0.18, 0.44). The difference was highly pronounced in the subgroups of male and those with female percentage below 50% or a mean BMI below 24 kg/m2. Serum IL-6 levels were inversely correlated with muscle mass (summary r = −0.18; 95% CI −0.30, −0.06), but not with handgrip strength (summary r = −0.10; 95%CI: −0.25, 0.05) or gait speed (summary r = −0.09; 95%CI: −0.24, 0.07).Conclusions This meta-analysis establishes a link between increased serum IL-6 levels and sarcopenia in the elderly, particularly in relation to decreased muscle mass.

Background: Small non-coding RNAs (ncRNAs) have recently emerged as potential biomarkers of sarcopenia. However, previous studies have rarely explored the association of small ncRNAs with sarcopenic components, especially muscle strength and physical performance. We aimed to examine circulating small ncRNA profiles to detect low muscle strength and physical performance in older adults. Methods: Ninety-eight older adults were randomly selected from Korean Frailty and Aging Cohort Study and classified into the “Normal,” “Low muscle strength (MS) only,” “Low physical performance (PP) only,” and “Low MS and PP” groups by Asian Working Group for Sarcopenia 2019 criteria. We used high-throughput sequencing to delineate small ncRNA profiles in plasma. Differentially expressed small ncRNAs were analyzed to reveal distinct patterns based on muscle strength and physical performance status. Results: In “Low MS and PP” group, 119 miRNAs, 86 piRNAs, 92 snoRNAs, 106 snRNAs, and 15 tRNAs were differentially expressed compared to “Normal” group (p 0.05). Conclusion: The expression of circulating small ncRNAs were comprehensively characterized, revealing distinct signatures in older adults with both low muscle strength and physical performance compared to normal individuals. Although preliminary, this characterization can advance small ncRNA research on age-related declines in muscle strength and physical performance by providing foundational data for further investigation.

Background Although My Jump 2® consistently presented excellent values of reliability and validity when compared to force platforms (FPs) and contact mats, to date no scientific investigation assessed the validity and reliability of My Jump 2® to measure jump height in visually impaired five-a-side soccer athletes. Thus, the study aimed at analyzing the validity and reliability of the My Jump 2® to measure the vertical jump of five-a-side soccer athletes. Methods Twelve visually impaired five-a-side soccer athletes, volunteered for this study. Each player performed five countermovement jumps (CMJs) and squat jumps (SJs) on a contact platform (CP) while they were simultaneously recorded using My Jump 2®. Results There was almost perfect agreement between the My Jump 2® and the contact platform measurements of CMJ (intraclass correlation coefficient = 0.99; p < 0.001) and SJ (intraclass correlation coefficient = 0.99; p < 0.001), heights for athletes during the first and second measurement days. Bland-Altman analysis showed a bias of 0.25 ± 0.5 cm; maximum SD = 1.3; minimum SD = −0.88 for CMJ, while that Bland-Altman analysis showed bias 0.18 ± 0.5 cm; maximum SD = 1.3; minimum SD = −0.96, for SJ. Conclusion We can conclude that the My Jump 2® is a valid and reliable method to measure CMJ and SJ in visually impaired five-a-side soccer athletes.

Introduction and Aim: Osteoarthritis (OA) is a noninflammatory joint disease. If OA of the knee causes pain, decreased muscle strength and joint stiffness, exercise therapy is one of the most effective treatments for the disease. The aim of the present study was to evaluate the effect of aquatherapy on pain intensity and performance in women with OA with the assumption that it causes weightlessness. Methods: This is a quasiexperimental study. The sample size included 60 people who were randomly divided into experimental and control groups. The visual analogue scale was used to assess pain and timed up and go test (TUG), 30 Second Sit to Stand Test (30-S-CS), and 40-meter fast-paced walk test (40 MW) were used to assess performance. Data analysis was carried out using SPSS ver. 22. Results: The results of the present study showed a decrease in pain intensity from moderate to mild intensity. Also, physical performance dimensions in patients with OA were improved, so that the average TUG increased from 14.06 to 8.8 s. The average S-CS frequency increased from 4.86 to 8.4 s and 90 MW decreased from the average 93.43 to 72.66 s. Discussion and Conclusion: Lower limb muscle strength, and physical performance can be improved and pain intensity can be reduced in patients with OA by performing aquatherapy three times a week for 8 weeks.

Abstract Optimal physical fitness is essential for military personnel to effectively meet their rigorous physical demands. This study aimed to investigate the effectiveness of a suspension training program on physical fitness, biomechanical risk factors for lower extremity injury, mental health, and work-related factors in Navy personnel. A total of 50 young men participated in a randomized controlled trial. The participants were randomly assigned to two groups (n = 25): the intervention group and the control group. The intervention group performed an eight-week suspension training session three times per week, while the control group maintained their daily duties. The primary outcome was physical performance. The secondary outcomes were determined biomechanical risk factors for lower extremity injuries, mental health, and work-related factors. The data were analyzed using the analysis of covariance (ANCOVA). Compared with the control group, the intervention group showed significant improvements in physical performance, biomechanical risk for lower extremity injuries, and work-related factors from baseline to follow-up (p ≤ 0.05). However, there was no improvement in mental health. Based on these findings, suspension training positively impacted physical fitness, reduced injury risk, and enhanced the work-related factors of Navy personnel. This study provides new insights for various related experts and military coaches because it is an easy-to-use and feasible method with minimal facilities.

The most important factors that determine the risk of fractures are not only the presence of osteoporosis (OP), but also the risk of falls. In addition to sufficient physical activity, medications are needed that have a positive effect on the strength and functional performance of the skeletal muscles. Vitamin D supplements play a key role in this therapeutic approach.Objective: to investigate the tolerability, safety and efficacy of the generic drug Alfacalcidol Canon on the functional status of patients with reduced bone mineral density in clinical practice.Material and methods. The study involved 30 women with OP or osteopenia who were at high risk of falls (mean age 68.0±7.2 years) and who were administered Alfacalcidol Canon at a dose of 1 mcg/day for 3 months. The follow-up period included 4 visits to the clinic, during which laboratory tests were performed and falls and fractures, adverse reactions and patients' adherence to treatment were registered. At the first and last visits, quality of life was assessed using the EQ-5D and the functional status of the skeletal muscles was examined. At the 4th visit, the tolerability of the medication was assessed.Results and discussion. After 3 months of therapy, an increase in muscle strength of the dominant arm was observed by an average of 15.4% (p=0.00002). The time for the "Chair Stand Test" and the "Time up and go" test decreased by 17.4% (p=0.000012) and 13.6% (p=0.00004) respectively. The gait speed test increased on average by 13.9% (p=0.000013), it increased in 26 (86.7%) women. The SPPB test score increased on average by 12.5% (p=0.000001), and achievement of the best indicators was found in 23 (76.7%) women. There were no cases of hypercalcemia, hyperphosphatemia and hypermagnesemia, but 1 case of hypercalciuria was detected. Falls occurred in 2 women (6.7%) who had fallen in the previous year, one of whom suffered a fracture of humeral neck. Adverse reactions were observed in 3 (10 %) women, one of whom stopped taking the drug. 90% of the patients tolerated the treatment excellently. The average compliance rate was 94.3%.Conclusion. Alfacalcidol Canon is a safe and effective drug that can be used to improve the physical performance of skeletal muscles in patients with a high risk of falls.

Abstract We investigated the effects of acute-phase intensive electrical muscle stimulation (EMS) on physical function in COVID-19 patients with respiratory failure requiring invasive mechanical ventilation (IMV) in the intensive care unit (ICU). Consecutive COVID-19 patients requiring IMV admitted to a university hospital ICU between January and April 2022 (EMS therapy group) or between March and September 2021 (age-matched historical control group) were included in this retrospective observational case–control study. EMS was applied to both upper and lower limb muscles for up to 2 weeks in the EMS therapy group. The study population consisted of 16 patients undergoing EMS therapy and 16 age-matched historical controls (median age, 71 years; 81.2% male). The mean period until initiation of EMS therapy after ICU admission was 3.2 ± 1.4 days. The EMS therapy group completed a mean of 6.2 ± 3.7 EMS sessions, and no adverse events occurred. There were no significant differences between the two groups in Medical Research Council sum score (51 vs. 53 points, respectively; P = 0.439) or ICU mobility scale at ICU discharge. Addition of upper and lower limb muscle EMS therapy to an early rehabilitation program did not result in improved physical function at ICU discharge in severe COVID-19 patients.

Aim. To determine serological markers of sarcopenia (SP) for use in general medical practice in people aged 65 years and older living independently.Materials and methods. The study included 230 people aged 65 years and older (70 men and 160 women, median age 75 [68; 79] years) were consulted in a medical institution in St. Petersburg. The diagnosis of SP was made according to the criteria of EWGSOP2 (2018). The laboratory examination included clinical and biochemical blood analysis, determine the level of 25(OH)D, parathyroid hormone (PTH), C-reactive protein (CRP).Results. The risk of SP increased at levels 25(OH)D less than 21 ng/mL (odds ratio 4.989; 95 % confidence interval 1.321–12.626; р = 0.0420), total protein less than 65 g/l (OR 8.567; 95 % CI 2.658–27.617; р = 0.00032), serum CRP 6 mg/l or more (OR 14.279; 95 % CI: 3.511–58.071; р = 0.00020) and decrease in the estimated glomerular filtration rate (eGFR) less than 62 ml/min/1.73 m2 (OR 12.108; 95 % CI 3.944–37.170; р = 0.00001). Conclusion. Serological markers of SP, such as vitamin D, total protein, C-reactive protein in blood serum and eGFR can be used in general medical practice.

Objective To investigate the feasibility and effects of a mobile app-based home cycling exercise program compared to home cycling exercise without additional monitoring system. Compared with fitness facilities or outdoor exercise, home-based exercise programs effectively improve physical performance in an indwelling community. However, a flexible, informal environment may decrease motivation and impair adherence to physical exercise. Mobile devices for aerobic exercise and mobile applications provide real-time monitoring, immediate feedback, and encouragement to increase motivation and promote physical performance. We investigated the feasibility and effects of a mobile app-based home exercise program on body composition, muscular strength, and cardiopulmonary function. Methods Between February and May 2023, 20 participants were randomly allocated to the intervention (mobile application with a tablet) and control groups, and they performed aerobic exercise using a stationary bicycle for ≥150 minutes per week for 6 weeks (≤30-minute exercise session, with 3-minute warm-up and 3-minute cool-down). Karvonen formula-based heartrate defined the weekly increase in exercise intensity. Outcome measures included body-composition parameters, isokinetic knee flexor and extensor strength tests, cardiopulmonary exercise test results, and rate of target heart rate (HR) achievement. Participants were assessed at baseline and after the intervention. Results Unrelated personal events led two participants to drop out. The intervention and control groups had similar baseline characteristics. Compared with the control group, in the post-intervention isokinetic strength test, bilateral knee flexor and extensor power, and time to target HR achievement significantly increased each week in the intervention group. Conclusion Home-based exercise to achieve long-term cardiovascular fitness with portable electronic/mobile devices facilitates individualized exercise using real-time feedback to improve motivation and adherence.

Purpose: to investigate the occurrence of dystonic type response to physical activity in the form of submaximal PWC170 test in soccer players. Material & Methods: 741 soccer players divided into 3 groups according to their sports qualification were examined. The data of 68 high-class soccer players with "infinite tone" and 69 high-class soccer players without "infinite tone" were compared, 251 advanced soccer players with "infinite tone" with 179 advanced soccer players without "infinite tone", and 69 intermediate soccer players with "infinite tone" with 105 similarly qualified soccer players without "infinite tone". Blood pressure was measured by the Korotkoff method using an aneroid sphygmomanometer (Romed, Netherlands) on the right arm. Three measurements were taken 5 minutes apart, and the lowest reading was used. Physical working capacity was assessed on a bicycle ergometer (Corival, Netherlands). Results: it was found that physical working capacity didn't differ significantly between athletes with and without "infinite tone", and in the group of advanced athletes was significantly higher in players with "infinite tone". The same number of soccer players with signs of metabolic cardiomyopathy was found with and without “infinite tone” (p=0.916). Conclusions: dystonic type of reaction of cardiovascular system to physical load in the form of submaximal PWC170 test with "infinite tone" is found in 52,4% of examined soccer players, more often in advanced athletes aged 19 (18; 22) years – 64,7%, in comparison with intermediate players aged 16 (15; 17) years – 17,8%, p

Purpose The aim of this study was to assess the reliability and validity of the My Jump 2® app in measuring jump height, flight time, and peak power among elite women beach volleyball players on sand surfaces. Methods Eleven elite female beach volleyball players (aged 23.6 ± 6.2 years; weight 66.3 ± 5.8 kg; height 174.4 ± 5.8 cm; with 8.4 ± 4.8 years of professional experience) participated in this study. Each player performed six countermovement jumps in a wooden box filled with sand on a force platform while simultaneously recording a video for subsequent analysis using the My Jump 2® app. Results We found excellent agreement for flight time, jump height and peak power between observers (ICC = 0.92, 0.91 and 0.97, respectively). No significant differences between force platform and My Jump 2® app were detected in the values obtained for the three variables (P > 0.05). For the force platform and the My Jump 2® app, we found a good agreement measuring jump height and flight time (ICC = 0.85 and 0.85, respectively). However, we only found a moderate agreement for peak power (ICC = 0.64). The difference in jump height showed a limit of agreement between −4.10 and 4.74 cm in Bland-Altman, indicating a high level of agreement between the two measurement tools. Conclusion Based on our findings, the My Jump 2® app reveals a valid tool for measuring jump height and flight time of CMJ on sand surfaces. However, more caution is needed when measuring peak power.

Aim. To evaluate skeletal muscle mass, muscle strength and physical performance in rheumatoid arthritis (RA) women with biological therapy.Materials and methods. The study included 63 women (average age 60.3 ± 8.9 years) with confirmed RA treated with biological therapy and 117 age-matched RA patients who had never previously treated with biological therapy. Clinical and laboratory examination, evaluation of body composition using dual-energy X-ray densitometry and tests to assess muscle strength and physical performance were carried out.Results. The frequency of sarcopenic phenotype among RA patients was 23.3 %: in those who received biological medication – 27.0 %, in the control – 21.4 % (p > 0.05). There were no differences between the groups based on the results of muscle strength assessment tests, however, patients on biological therapy performed significantly better the short physical performance battery (SPPB) and had a higher walking speed (p = 0.016 and p = 0.002, respectively). Univariate linear regression analysis confirmed the relationship of the presence of biological therapy with the functional status of the muscles according to the results of SPPB (b* = 0.24; p = 0.018) and walking speed (b* = 0.28; p = 0.006).Conclusion. The frequency of sarcopenic phenotype among patients with RA was 23.3 % and was comparable in those who received biological therapy and without it. There were no differences in muscle strength depending on the presence of biological therapy, but the functional status of skeletal muscles was significantly better in women who received such treatment.

Objective:To translate the “Functional Evaluation of Physical Performance for the Geriatric Population (Alusti test)” into Turkish to examine validity and reliability.Materials and Methods:During the translation period, the cross-cultural adaptation design proposed using the guideline was used. The patients evaluated the Turkish version of the Alusti test and it was applied again a week later. To determine the reliability and internal consistency, Cronbach’s alpha coefficient was calculated. Test-retest reliability was determined using intraclass correlation coefficient (ICC) and Pearson’s correlation analysis. Construct validity was examined with factor analysis. Convergent validity was examined by comparing Alusti test with Short Physical Performance Battery (SPPB) and Barthel index (BI), and criterion validity was examined by comparing Alusti test with Tinetti balance and gait assessment, timed up and go test (TUGT), 6-meter walking speed test, and Rivermead mobility index (RMI) scores.Results:Cronbach’s alpha coefficient was 0.701. The ICC for the test-retest reliability was 0.948. The Alusti test was explained by four factors. SPPB (r=0.586, p=0.000), BI (r=0.321, p=0.005) and Tinetti gait test (r=0.512, p=0.000) were moderately positively correlated with the Alusti test total score. The Tinetti balance test (r=0.662, p=0.000), Tinetti balance and gait assessment total score (r=0.655, p=0.000) and RMI (r=0.715, p=0.000) were highly positive correlated.Conclusion:The Turkish version of the Alusti test is a valid and reliable scale for the geriatric population.

Introduction: Caffeine, a widely consumed stimulant, is recognized for its ability to block adenosine receptors, thereby enhancing alertness and possibly physical performance. Recent research examines caffeine's effectiveness in enhancing athletic performance, with numerous athletes supplementing with caffeine to gain a competitive edge. The aim of this study: This article examines the complex relationship between caffeine and the physical performance of athletes, including its effects on the central nervous system, metabolism, muscle function, and its application in a variety of sports, as well as potential gender differences and individual response variations. Materials and methods: This review was based on available data collected in the PubMed database and Google Scholar web search engine using the key words caffeine, athletic performance, physical performance Conclusions: Caffeine boosts muscle, cognitive, and metabolic function in volleyball and cycling. Caffeine boosts muscle contractility, endurance, and focus, but details matter. Caffeine effects and sports outcomes vary by gender, emphasizing the need for individualized supplementation. Dosage, timing, and physiological conditions affect results, research shows. Caffeine boosts performance, but athletes, coaches, and practitioners should be careful. To maximize caffeine's benefits and minimize side effects, athletes must be treated individually and by sport.

The essence of the preconditioning effect is the activation of urgent defense mechanisms of adaptation as a result of a short episode of weak, non-damaging hypoxic or ischemic exposure, which contributes to an increase in the tolerance of the subsequent delayed, more severe exposure to hypoxia or ischemia. Aim of the study was to assess the literature data on the possibility of using the method of remote ischemic preconditioning (RIP) as a non-pharmacological method for correcting physical performance. Material and methods. In the Scopus, PubMed and eLibrary databases, a selection and analysis of modern literature sources devoted to the issues of increasing human performance, especially by nonpharmacological methods, as well as the use of distant preconditioning to increase physical performance and the mechanisms for implementing this effect, were carried out. Results. Since the discovery of the phenomenon until now, researchers have considered RIP, mainly as a way to protect organs and cells from ischemic damage in clinical practice. The article presents the literature data on the use of RIP as a non-drug method for improving physical performance with single and course use cases. In addition, the article focuses on the mobilization of the body’s own resources through the mechanisms of adaptation to hypoxia developing during RIP. Conclusions. Among the non-pharmacological methods of increasing physical performance, one of the most promising, in our opinion, is RIP that mobilizes the body’s own resources through the mechanisms of adaptation to hypoxia. The advantage of the method based on short-term cessation of blood circulation in the lower extremities and subsequent reperfusion does not apply to the ways prohibited in sports, does not require the use of drugs and the availability of special equipment, signifcant costs of economic and organizational resources.

AbstractObjectives To investigate possible persistent performance deficits after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in elite athletes.Methods A prospective cohort study in three Belgian professional male football teams was performed during the 2020 − 2021 season. Participants were submitted to strength, jump, and sprint tests and an aerobic performance test (the Yo-Yo Intermittent Recovery test (YYIR)). These tests were repeated at fixed time intervals throughout the season. Assessment of SARS-CoV-2 infection was performed by a polymerase chain reaction (PCR) test before each official game.Results Of the 84 included participants, 22 were infected with SARS-CoV-2 during follow-up. At the first testing after infection (52.0 ± 11.2 days after positive PCR testing) significantly higher percentages of maximal heart rate (%HRmax) were seen – within the isolated group of infected players- during (p = .006) and after the YYIR (2 min after, p = .013), compared to pre-infection data. This increase in %HRmax was resolved at the second YYIR testing after infection (127.6 ± 33.1 days after positive PCR testing). Additionally, when comparing the first test after infection in formerly infected to non-infected athletes, significantly higher %HRmax were found during (p

Muscle echo intensity, as measured by ultrasonography, could be used as a new marker of functional performance in older populations. This scoping review aimed to present evidence on the utility of muscle echo intensity as determined by ultrasonography for assessing functional performance in older adults. The eligibility criterion included observational studies that investigated the associations between muscle echo intensity and functional performance in older adults. Terms, such as “echo intensity” and “older adults”, were searched for in databases, such as PubMed, Web of Science, the Cochrane database of systematic reviews, and the Cumulative Index of Nursing and Allied Health Literature, in April 2021. Two independent reviewers screened and extracted the data; 46 papers, of which almost one-third were Japanese, were subsequently identified for inclusion. The representative functional performances included in this review were muscle strength, gait speed, sit-to-stand test results, and timed up-and-go test results. Poor to moderate associations were found between muscle echo intensity and functional performance; however, heterogeneities were observed in the characteristics of study participants. Moreover, the accurate effect size and causal inferences between muscle echo intensity and functional performance remained unclear. Further longitudinal studies are needed to determine these causal inferences.

Highlights: • Sarcopenia can cause deleterious effects on patients. • The Asian Working Group for Sarcopenia (AWGS) and the European Working Group on Sarcopenia in Older People (EWGSOP) provide the most widely used criteria to diagnose sarcopenia. • Knowledge of sarcopenia should be a trigger for clinicians and surgeons to evaluate the treatment plan and anticipate the implications experienced by the patients. Abstract: Sarcopenia is a condition of low muscle strength, mass, and low physical performance that is affected by age (primary sarcopenia) and one or combination of systemic diseases, physical inactivity, and insufficient intake of energy (secondary sarcopenia). This condition affects one in ten healthy adults aged ≥60 years. There are two widely used criteria to diagnose sarcopenia, the Asian Working Group for Sarcopenia (AWGS) and the European Working Group on Sarcopenia in Older People (EWGSOP). These working groups created algorithms to facilitate the diagnosis. Establishing the diagnosis is crucial because it has deleterious impacts on patients, such as increasing risks of mortality, morbidity, falls, complications during and after surgery, disability, prolonged hospitalization, and fractures. Sarcopenia is considered an independent mortality risk. It is paramount for physicians to assess this condition before treating the patients because it can predict the risk and plan better treatment options to achieve better outcomes. Early assessment is crucial, even for surgeons. Sarcopenia also negatively impacts patients who had surgery. Up to 44% patients who underwent orthopedic trauma surgery had sarcopenia. The high percentage was affected by the increased risk of falls and fractures. On that account, this condition needs to be treated. The main treatments for this condition are exercise dan adequate nutrition intake. The recommended exercise as a first-line treatment is resistance or strength training. Overall, knowledge on sarcopenia can prepare clinicians and surgeons in anticipating the implications of sarcopenia.

Aim. To determine the frequency and assess the risk factors of sarcopenia (SP) in elderly people living at home.Materials and methods. The study included 230 people aged 65 years and older who lived at home and were observed in outpatient clinic. To detect SP, grip strength was measured and muscle mass was determined using dual-energy absorptiometry (DXA). Severe SP was diagnosed based on the results of Short physical performance battery (SPPB) and the “Up and Go” test. The diagnosis of SP was made according to the criteria of EWGSOP2 (2018). The laboratory examination included clinical and biochemical blood analysis, determination of the level of 25 (OH) D.Results. Probable SP was found in 64.8 %, confirmed SP – in 28.7 %, and severe SP – in 21.3 % of older people. The frequency of SP increased with age from 19.6 % in 65–74 years to 52.9 % in 85 years and older (p

Background Optimizing the soccer players’ match preparation is one of the most relevant concerns of coaches for strength and conditioning training. Thus, the aim of this study was to analyze the effects of three pre-match warm-up structures on the physical condition of male professional soccer players. Materials & Methods Seventeen male professional soccer players (age: 20.9 ± 2.4 years) of one Tunisian Professional Soccer League team participated in this study. Players performed three times a typical pre-match warm-up (WU) [aerobic phase (AE); neuromuscular phase (NM); velocity phase (VL); and ball-specific phase (BS) variating the order of the included phases/exercises: WU1 (AE + BS + NM + VL); WU2 (AE + NM + VL + BS); and WU3 (AE + VL + BS + NM). After each warm-up phase, players completed the following physical fitness tests: linear sprint test, countermovement jump test, 15-m ball dribbling agility test and ball shooting test. Additionally, the rate of perceived exertion (RPE) was registered after each warm-up. Results The results indicated significant differences between WU1 and WU3, with better results in the ball shooting test and RPE in WU3. In addition, there were no significant differences in the other variables and between other warm-up structures. These findings could be of great interest for coaches to the strength and conditioning coaches for professional soccer teams in order to improve the players physical performance and perceived exertion.

OBJECTIVES The long-term trends of cognitive function and its associations with physical performance remain unclear, particularly in Asian populations. The study objectives were to determine cognitive trajectories in middle-aged and elderly Chinese individuals, as well as to examine differences in physical performance across cognitive trajectory groups. METHODS Data were extracted from the China Health and Retirement Longitudinal Study. A total of 5,701 participants (47.7% male) with a mean age of 57.8 (standard deviation, 8.4) years at enrollment were included. A group-based trajectory model was used to identify cognitive trajectory groups for each sex. Grip strength, repeated chair stand, and standing balance tests were used to evaluate physical performance. An ordered logistic regression model was employed to analyze differences in physical performance across cognitive trajectory groups. RESULTS Three cognitive trajectory groups were identified for each sex: low, middle, and high. For both sexes, higher cognitive trajectory groups exhibited smaller declines with age. In the fully adjusted model, relative to the low trajectory group, the odds ratios (ORs) of better physical performance in the middle cognitive group were 1.37 (95% confidence interval [CI], 1.17 to 1.59; p

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

Sarcopenia is one of the primary risk factors for various adverse health events in later life. However, its pathophysiology in the very old population remains unclear. Hence, this study aimed to examine whether plasma free amino acids (PFAAs) correlate with major sarcopenic phenotypes (i.e., muscle mass, muscle strength, and physical performance) in community-dwelling adults aged 85–89 years living in Japan. Cross-sectional data from the Kawasaki Aging Well-being Project were used. We included 133 adults aged 85–89 years. In this study, fasting blood was collected to measure 20 plasma PFAAs. Measures for the three major sarcopenic phenotypes included appendicular lean mass assessed by multifrequency bioimpedance, isometric handgrip strength, and gait speed from a 5 m walk at a usual pace. Furthermore, we used phenotype–specific elastic net regression models adjusted for age centered at 85 years, sex, body mass index, education level, smoking status, and drinking habit to identify significant PFAAs for each sarcopenic phenotype. Higher histidine and lower alanine levels were associated with poor gait speed, but no PFAAs correlated with muscle strength or mass. In conclusion, PFAAs such as plasma histidine and alanine are novel blood biomarkers associated with physical performance in community-dwelling adults aged 85 years or older.

Slow gait speed is associated with poorer clinical outcomes and higher rates of functional limitation and mortality in older adults, especially when combined with overweight or obesity. Aging is also associated with nutritional deficits. The aim of our study was to assess the potential association between dietary practice and gait speed performance in community-dwelling older adults with overweight and obesity. Participants underwent body composition measurement with the Tanita MC-780MA Bioimpedance Analyzer (BIA). Dietary patterns were assessed with the Mini Nutritional Assessment (MNA) questionnaire, and a dietary adequacy (DA) score system was constructed. The four-meter gait speed test was performed in order to assess gait speed. Of 222 participants, aged 67.6 ± 6.6 years, with a body mass index (BMI) of 31.9 ± 4.5 kg/m2, 34.7% had reduced gait speed and lower DA compared to those with normal gait speed (2.99 ± 1.12 vs. 3.37 ± 1.07; p < 0.05). The DA score of participants with slower gait speed was more likely to fall below the median than that of participants with normal gait speed (70.1% vs. 51.7%; p < 0.05). Participants with slower gait speed were more likely to be nutritionally at risk of low DA (22.1% vs. 10.3%; p < 0.05). Logistic regression analysis, after adjustment for confounders, showed that the risk of having a slow gait speed was 75% lower among those with a higher DA score (OR = 0.25; 95% CI = 0.11–0.53). Older adults with overweight or obesity in community dwellings might need to be supported with nutritional interventions that can improve their gait speed.

Aim. To evaluate the frequency of different body composition phenotypes, physical performance (PP) and their relationship with quality of life in women with rheumatoid arthritis (RA). Materials and methods. The study included 157 women (average age 58.68.8 years) with RA. Clinical and laboratory examination, dual-energy X-ray absorptiometry, quality of life assessment according to the questionnaires EQ-5D (European Quality of Life Questionnaire), HADS (Hospital Anxiety and Depression Scale) and RAID (Rheumatoid Arthritis Impact of Disease), determination of muscle strength and the PP of skeletal muscles were carried out. Results. Osteoporotic, sarcopenic and osteosarcopenic phenotypes of body composition were identified in 27 (17%), 16 (10%) and 16 (10%) patients, respectively; 139 (88.5%) people had low muscle strength, and 96 (61.1%) had reduced PP. Quality of life according to the EQ-5D index and RAID, the severity of depression according to HADS in women with different phenotypes of body composition did not differ. Women with osteosarcopenic phenotype had worse indicators for EQ-5D-VAS (VAS visual analog scale), and patients with sarcopenic phenotype had more severe anxiety according to the HADS questionnaire compared to those with normal phenotype (p=0.014 and p=0.027, respectively). The quality of life according to all questionnaires was significantly worse in patients with reduced PP. Conclusion. Pathological phenotypes of body composition were found in 37% of RA patients. A decrease in muscle strength was revealed in 88.5%, and a low PP in 61.1% of patients. The relationship between quality of life and body composition has not been established, at the same time quality of life associated with the PP of skeletal muscles.

Background The Short Physical Performance Battery (SPPB) is a well-established functional assessment tool used for the screening and assessment of frailty and sarcopenia. However, the SPPB requires trained staff experienced in conducting the standardized protocol, which may limit its widespread use in clinical settings. The automated SPPB (eSPPB) was developed to address this potential barrier; however, its validity among frail older adults remains to be established. Therefore, this exploratory study compared the eSPPB and manual SPPB in patients attending a tertiary fall clinic in relation to their construct validity, reliability, and agreement. Methods We studied 37 community-dwelling older adults (mean age, 78.5±6.8 years; mean FRAIL score, 1.2±1.0; 65% pre-frail) attending a tertiary falls clinic. The participants used the mSPPB and eSPPB simultaneously. We evaluated the convergent validity, discriminatory ability, reliability, and agreement using partial correlation adjusted for age and sex, an SPPB cutoff of ≤8 to denote sarcopenia, intraclass correlation coefficients (ICC), and Bland-Altman plots, respectively. Results The eSPPB showed strong correlations with the mSPPB (r=0.933, p

Abstract Background The evidence base for the role of dietary protein in maintaining good muscle health in older age is strong; however, the importance of protein source remains unclear. Plant proteins are generally of lower quality, with a less favourable amino acid profile and reduced bioavailability; therefore, it is possible that their therapeutic effects may be less than that of higher quality animal proteins. This review aims to evaluate the effectiveness of plant and animal protein interventions on muscle health outcomes. Methods A robust search strategy was developed to include terms relating to dietary protein with a focus on protein source, for example dairy, meat and soy. These were linked to terms related to muscle health outcomes, for example mass, strength, performance and sarcopenia. Five databases will be searched: MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, Embase and Web of Science. Studies included will be randomised controlled trials with an adult population (≥ 18) living in the community or residential homes for older adults, and only English language articles will be included. Two independent reviewers will assess eligibility of individual studies. The internal validity of included studies will be assessed using Cochrane Risk of Bias 2.0 tool. Results will be synthesised in narrative format. Where applicable, standardised mean differences (SMD) (95% confidence interval [CI]) will be combined using a random-effects meta-analysis, and tests of homogeneity of variance will be calculated. Discussion Dietary guidelines recommend a change towards a plant-based diet that is more sustainable for health and for the environment; however, reduction of animal-based foods may impact protein quality in the diet. High-quality protein is important for maintenance of muscle health in older age; therefore, there is a need to understand whether replacement of animal protein with plant protein will make a significant difference in terms of muscle health outcomes. Findings from this review will be informative for sustainable nutritional guidelines, particularly for older adults and for those following vegan or vegetarian diets. Systematic review registration PROSPERO CRD420201886582

Brucellosis infection causes non-specific symptoms such as fever, chills, sweating, headaches, myalgia, arthralgia, anorexia, fatigue, and mood disorders. In mouse models, it has been associated with increased levels of IL-6, TNF-α, and IFN-γ, a decrease in serotonin and dopamine levels within the hippocampus, induced loss of muscle strength and equilibrium, and increased anxiety and hopelessness. Imipramine (ImiP), a tricyclic antidepressant, is used to alleviate neuropathic pain. This study evaluated the effects of ImiP on Balb/c mice infected with Brucella abortus 2308 (Ba) at 14- and 28-days post-infection. Serum levels of six cytokines (IFN-γ, IL-6, TNF-α, IL-12, MCP-1. and IL-10) were assessed by FACS, while the number of bacteria in the spleen was measured via CFU. Serotonin levels in the hippocampus were analyzed via HPLC, and behavioral tests were conducted to assess strength, equilibrium, and mood. Our results showed that mice infected with Brucella abortus 2308 and treated with ImiP for six days (Im6Ba14) had significantly different outcomes compared to infected mice (Ba14) at day 14 post-infection. The mood was enhanced in the forced swimming test (FST) (p < 0.01), tail suspension test (TST) (p < 0.0001), and open-field test (p < 0.0001). Additionally, there was an increase in serotonin levels in the hippocampus (p < 0.001). Furthermore, there was an improvement in equilibrium (p < 0.0001) and muscle strength (p < 0.01). Lastly, there was a decrease in IL-6 levels (p < 0.05) and CFU count in the spleen (p < 0.0001). At 28 days, infected mice that received ImiP for 20 days (Im20Ba28) showed preservation of positive effects compared to infected mice (Ba28). These effects include the following: (1) improved FST (p < 0.0001) and TST (p < 0.0001); (2) better equilibrium (p < 0.0001) and muscle strength (p < 0.0001); (3) decreased IL-6 levels (p < 0.05); and (4) reduced CFU count in the spleen (p < 0.0001). These findings suggest the potential for ImiP to be used as an adjuvant treatment for the symptoms of brucellosis, which requires future studies.

The aim of the work is to assess dynamic changes in heart rate variability (HRV), central hemodynamics and physical performance in female swimmers at a distance of 50–200 meters and female runners at a distance of 400 meters in the preparatory and competitive periods of the training process. Materials and methods. At the beginning of the preparatory period and at the end of the competitive period, 11 female swimmers were examined, including 1 athlete – Master of Sports of Ukraine (MSU), 7 athletes – Candidate Masters of Sports (CMS), 1 – first-class athlete, 2 – second-class athletes, and 22 female runners, including 1 athlete – Master of Sports of Ukraine of International Class (MSUIC), 3 athletes – Candidate Masters of Sports, 7 first-class athletes, 8 – second-class athletes and 3 – third-class athletes. Time- and frequency domain methods of HRV analysis were used to assess the mechanisms of heart neurohumoral regulation. Central hemodynamic parameters were examined by an automated tetrapolar rheography according to W. Kubiček et al. (1970) modified by Yu. T. Pushkar et al. (1970). Physical working capacity (PWC) was measured using a submaximal PWC170 test. The functional state index (FSI) was calculated according to the formula that we had proposed and patented. Results. Analysis of HRV indices in female swimmers revealed the prevalence of parasympathetic influences in the competitive period. There was a central hemodynamics-related significant decrease in cardiac index (CI) in the competitive period, although its value corresponded to the eukinetic circulatory type (CT). The ratio of CTs was 18.2 %: 81.8 %: 0.0 %, hypokinetic, eukinetic and hyperkinetic CT, respectively, indicating a tendency towards eukinetic CT prevalence over hypokinetic one (P = 0.075) and the absence of athletes with physiologically unfavorable hyperkinetic CT. The PWC170/kg value increased by an average of 12.44 %, from 12.860 ± 0.732 kgm·min-1·kg-1 to 14.460 ± 0.823 kgm·min-1·kg-1 (P = 0.002), and FSI – of 22.21 % (P = 0.0005) and corresponding to “below average” score. In the competitive period, 2 CMS female athletes qualified for MSU, 1 first-class athlete qualified for CMS, and 2 second-class athletes achieved the first-class sport qualification. Conclusions. Female swimmers demonstrated the significant prevalence of parasympathetic effects of the ANS, the tendency towards the eukinetic CT predominance and the absence of hyperkinetic CT, significantly increased PWC170/kg value by 12.44 % and FSI – by 22.21 % in the competitive period as compared with the preparatory period. The correlation analysis to assess both periods revealed the important relationship between heart rate (HR) and autonomic rhythm index (ARI), HR and indicator of the adequacy of regulation processes (IARP), indicating that training-induced bradycardia shifted the autonomic balance towards the predominance of the parasympathetic arm of the ANS. Decreased ARI caused the decrease in СI, resulting in the transformation of hyperkinetic CT into eukinetic one and the absence of physiologically unfavorable hyperkinetic CT in the athletes. The increased functional state of female swimmers in the competitive period helped to achieve improvements in their athletic performance.

Uremic sarcopenia, which is highly prevalent in dialysis patients, leads to an increased risk of adverse outcomes, such as poor quality of life, falls, fracture, hospitalization, and even mortality. Therefore, early detection of uremic sarcopenia is crucial for administering quick and adequate multidisciplinary therapy to improve clinical outcomes. This review updates the current information about uremic sarcopenia assessment in chronic dialysis patients. We discuss the methods of assessing skeletal muscle mass, strength, and physical performance. We also discuss surrogate markers derived from serum and dialysate creatinine, in addition to emerging screening tools. The prevalence, clinical relevance, and impact of uremic sarcopenia on survival are reviewed and we discuss the limitations and challenges in applying the current working definition of sarcopenia based on the senior population to dialysis patients. The review shows that dialysis patients with skeletal muscle weakness or poor physical performance, either with or without low skeletal muscle mass, should undergo multidisciplinary therapy, included nutritional counseling, lifestyle modification, and exercise intervention, to mitigate the detrimental effects of uremic sarcopenia.

Abstract Background Sex influences outcome of patients with acute coronary syndrome (ACS). If there is a relationship between sex and physical performance is unknown. Methods The analysis is based on older (≥70 years) ACS patients included in the FRASER, HULK, and LONGEVO SCA prospective studies. Physical performance was assessed by Short Physical Performance Battery (SPPB). The primary outcome was all-cause mortality. Results The study included 1388 patients, and 441 (32%) were women. At presentation, women were older and more compromised than men. After a median follow-up of 998 [730–1168] days, all-cause death occurred in 334 (24.1%) patients. At univariate analysis, female sex was related to increased risk of death. After adjustments for confounding factors, female sex was no longer associated with mortality. Women showed poor physical performance compared with men (p < 0.001). SPPB values emerged as an independent predictor of death. Including clinical features and SPPB in the multivariable model, we observed a paradigm shift in the prognostic role of female sex that becomes a protective factor (HR 0.73, 95% CI 0.56–0.96). Sex and physical performance showed a significant interaction (p = 0.03). For lower SPPB values (poor physical performance), sex-related changes in mortality were not recorded, while in patients with higher SPPB values (preserved physical performance), female sex was associated with better survival. Conclusions Two key findings emerged from the present real-life cohort of older ACS patients: (i) physical performance strongly influences long-term mortality; (ii) women with preserved physical performance have a better outcome compared to men. Trial registration www.clinicaltrials.gov NCT02386124 and NCT03021044

Background: Core stability training (CST) is used to enhance sports performance. The relationship between core endurance and physical performance in rugby players had not been evaluated before in Asia. Aims and Objectives: This study aims to determine the effects of a 6-week specific CST program on the core endurance and physical performances (speed, upper body power, lower body power, and agility) following a CST intervention in male rugby players. Materials and Methods: Professional rugby players (n=8, intervention and n=8, control) were randomly selected. Mean (SD) age, height and weight of intervention group were 25.25 (2.4) years, 1.64 (0.03) m, and 69.6 (14.9) kg, respectively. In the control group, corresponding values were 29.75 (4) years, 1.66 (0.04) m, and 72.3 (19.1) kg, respectively. Intervention group was trained CST sessions complementary to the usual physical training, 3 times/week for 6 weeks. The control group followed the usual physical training. Subjects were tested for four physical performances (using 40 m sprint, vertical jump, 3 kg medicine ball put, and agility T tests) and four core endurance tests (back extension, abdominal fatigue [AF], and left and right bridges). Results: AF, left bridge, right bridge, and total core endurance were significantly increased in the intervention group (P=0.028, P=0.006, P= 0.008, and P=0.001, respectively). Agility and AF were increased significantly in the control group (P=0.048, P=0.027). The right side bridge endurance (P=0.024) was significantly increased in the intervention group compared to the control group. Conclusion: The results suggest that the CST improves core endurance without improving physical performances in rugby players.

Objective: Dry cupping (DC) is widely used to improve sports performance. The purpose of this study was to examine the effect of DC on muscle strength, anaerobic power, cognitive function, and mood states of athletes. Methods: In this counterbalanced quasi-experimental study with randomized crossover design, 12 male athletes participated. After signing a consent form, they randomly experienced two conditions (10 min of DC or no treatment) in two sessions one week apart. Muscle strength using a back and leg dynamometer, power anaerobic using the 30-second Wingate test, mood states using the Profile of Mood States questionnaire, and cognitive function using the Tower of London test were measured after intervention. Data were analyzed using paired sample t-test considering a significance level of 0.05. Results: DC significantly increased mean power (t11=-2.625, p=0.024), with no significant effect on muscle strength (t11=1.106, p=0.293) and peak power (t11=-1.389, p=0.192). Treatment with DC had no significant effect on tension, depression, anger, vigor, confusion, calmness or happiness of subjects (p>0.05). In contrast, a significant decrease in mental fatigue (t11=2.209, p=0.049) and cognitive function (t11=-2.602, p=0.025) were observed after DC. Conclusion: DC can improve mean anaerobic power and cognitive function, and reduce fatigue of the athletes.

Background and Objective: Vitamin D increases muscle strength through protein synthesis and myogenesis and may play an important role in anaerobic and aerobic activities. This study was done to determine the vitamin D status and its relationship with physical function indexes in young Taekwondo athletes. Methods: This descriptive-analytical study was conducted on 75 young male Taekwondo athletes, aged 18-23 years that were selected using randomized sampling method. Serum 25-hydroxyvitamin D level was measured by ELISA method. The 20-meter shuttle run, running based anaerobic sprint (RAST), vertical jump, 36-meter sprint and Illinois agility tests were used to determine aerobic and anaerobic capacities, explosive anaerobic power of the lower limbs, speed and agility, respectively. Body mass index and percent body fat was measured for each subject. Level below 20, 20-30 and more than 30 ng/ml of serum 25-hydroxyvitamin D were considered as vitamin D deficiency, insufficiency and normal status, respectively. Results: The results showed that 48% (36 athletes) and 42.66% (32 athletes) of taekwondo athletes had deficient and insufficiency levels of vitamin D, respectively. Also, a significant correlation was detected between serum 25-hydroxyvitamin D concentration and aerobic power (r=0.897), anaerobic power (r=0.901), vertical jump performance (r=0.855), fatigue index (r=-0.838), agility (r=-0.634) and 36 meters sprint (r=-0.793) times (P

Sarcopenia affects performance in simple activities of daily life, directly impacting the quality of life of the elderly. The objective of the present study was to analyse the correlation between age, sarcopenia index and functional capacity in community-dwelling elderly. The sample comprised 40 community-dwelling elderly, 12 men (69.16 ± 8.13 years) and 28 women (67.96 ± 6.23 years). All participants underwent the Electrical Bioimpedance (BIA), Handgrip Strength test (HS), and Timed-Up-and-Go test (TUG). A strong correlation was found between age x TUG in men (r = 0.733; p = 0.021), between age x fat mass in women (r = 0.775; p = 0.032), between HS and TUG in men (r = − 0.713; p = 0.0003), and a weak correlation between HS and Free Fat Mass in women (r = 0.394; p = 0.043). Weak negative correlations were found regarding age in both men and women. In functional performance, concerning test time and age, strong correlations were found for men and weak correlations for women.

Adequate cardiorespiratory fitness is critical for firefighters since an insufficient level of fitness threatens the integrity of their operations and could be dangerous for their lives. In fact, the leading cause of mortality for on-duty firefighters is not injury but sudden cardiac death. Therefore, to mitigate these risks, potential firefighter recruits are often required to perform a graded exercise test to determine their cardiorespiratory fitness as part of the recruitment process. However, there are currently limited data available to prospective firefighters on the amounts and types of exercises needed to be successful in the graded exercise test, commonly known as a V̇O2max test. Physiological parameters for the current secondary analysis were collected on firefighter applicants who performed the graded exercise test where 72% were successful and 28% were unsuccessful to meet the minimum standard set at 42.5 ml kg−1 min−1. Prior to their test, applicants were asked to describe their exercise training routine by indicating the number of minutes per week spent exercising. Activities were then divided into one of two categories: endurance exercise or strength and power exercise training. The total exercise training describes the sum of all activities performed each week. The sum of endurance exercise activities and the sum of strength and power exercise activities were compared between the successful and the unsuccessful groups and results showed that successful applicants had a higher training volume and performed more endurance exercise training as compared to unsuccessful applicants. Therefore, practical recommendations related to exercise training regime are presented for firefighter applicants to embrace as guidance to prepare for their graded exercise test as part of their recruitment process.

ABSTRACT Objective: Evaluating the prevalence of sarcopenia in women submitted to bariatric surgery – Roux-en-Y gastric bypass. Design: Observational, cross-sectional study. Subjects and methods: Women (18-65 years old) who underwent bariatric surgery (BG) ≥ 2 years and reached stable weight ≥ 6 months, were investigated. Control group (CG) comprised non-operated matched women with obesity. Body composition was determined through dual-energy X-ray absorptiometry. Low lean mass (LLM) was defined as appendicular lean mass index (ALM kg/height m2) < 5.5 kg/m2. Physical strength was assessed through dynamometer and sit-to-stand test (SST), whereas performance was assessed through 4-m gait speed and Short Physical Performance Battery Tests (SPPB). Sarcopenia was diagnosed in the presence of LLM and low strength. Results: One-hundred and twenty women (60 in each group, 50 ± 9.7 years old) were investigated. All anthropometric and body composition parameters were lower in BG than in CG, whereas strength and performance were similar between groups. Women with reduced strength presented high total fat mass and low physical activity level (p < 0.005). LLM was observed in 35% of BG and in 18.3% of CG (p = 0.04), whereas sarcopenia was diagnosed in 28.3% of BG and in 16.6% of CG (p = 0.12). Sarcopenic women in BG had better performance both in SST (p = 0.001) and SPPB (p = 0.004). Total lean mass (OR:1.41, 95% CI [1.18; 1.69], p < 0.001) and obesity (OR: 38.2 [2.27; 644.12], p < 0.001) were associated with sarcopenia in the multivariate analysis. Conclusion: Despite great weight loss, sarcopenia prevalence did not increase in BG and its presence was influenced by total lean mass and obesity.

ABSTRACT Objective: The fibroblast growth factor 23 (FGF23) has been related to biological aging, but data in elderly individuals are scant. We determined the profile of serum FGF23 levels in a population of very-old individuals and studied their correlations with parameters of bone metabolism and health markers, as functional performance. Materials and methods: This cross-sectional study was performed on 182 community dwellers aged ≥ 80 years. Serum levels of FGF23, PTH, calcium, albumin, phosphorus, creatinine, bone markers, and bone mineral density data were analyzed. Physical performance was evaluated with the stationary march (Step), Flamingo, and functional reach tests, along with questionnaires to assess falls and fractures in the previous year, energy expenditure (MET), and the Charlson index (CI). Physical activity was evaluated with the International Physical Activity Questionnaire (IPAQ). Results: Most participants (75%) had FGF23 levels between 30-120 RU/mL (range: 6.0-3,170.0 RU/mL). FGF23 levels correlated with estimated glomerular filtration rate (eGFR; r = -0.335; p = 0.001) and PTH (r = 0.318; p < 0.0001). Individuals with FGF23 in the highest tertile had more falls in the previous year (p = 0.032), worse performance in the Flamingo (p = 0.009) and Step (p < 0.001) tests, worse CI (p = 0.009) and a trend toward sedentary lifestyle (p = 0.056). On multiple regression, FGF23 tertiles remained significant, independently of eGFR, for falls in the previous year, performance in the Flamingo and stationary march tests, lean mass index, and IPAQ classification. Conclusion: In a population of very elderly individuals, FGF23 levels were inversely associated with neuromuscular and functional performances. Higher concentrations were related to more falls, lower muscle strength and aerobic capacity, and poorer balance, regardless of renal function, suggesting a potentially deleterious role of high FGF23 concentrations in musculoskeletal health.

Background We evaluated the validity of the Timed Up and Go test (TUG) to screen for physical frailty and low physical performance in a nationwide community-dwelling Korean older population. Methods We used baseline records of 3,010 ambulatory participants with TUG data from the Korean Frailty Aging Cohort Study from 2016 to 2017. The population-specific distribution of TUG was assessed. Physical frailty was defined as ≥3 positive items in the 5-item Cardiovascular Health Study (CHS) frailty scale, and low physical performance was assessed as Short Physical Performance Battery (SPPB) scores ≤9 (ranging from 0 to 12). Results In men (n=1,429) and women (n=1,581), the mean TUG times were 10.3±2.7 seconds and 10.2±3.0 seconds, respectively. The cut-off TUG times for the worst quintile were 11.8 seconds in men and 12.5 seconds in women. The TUG time was correlated with both the CHS frailty scale score (standardized beta [B]=0.36, p

ABSTRACT BACKGROUND: Environmental and population characteristics seem to influence the variation in cutoff points of the Short Physical Performance Battery (SPPB) for diagnosing frailty syndrome among older adults. OBJECTIVE: To verify the validity of the SPPB for screening for frailty syndrome among older adults in the Amazonian context. DESIGN AND SETTING: Cross-sectional population-based study on older adults in the urban area of Coari (AM), Brazil. METHODS: In total, 264 older adults (60 years of age or over) were included. Frailty syndrome was defined using the Fried phenotype criteria. The SPPB cutoff points were compared in relation to frailty and validity measurements were calculated for the test. RESULTS: A strong association between poor physical performance and frailty was identified (P < 0.001). The cutoff point of 6 demonstrated the best validity measurements for frailty in the sample studied (sensitivity: 0.28; specificity: 0.94; accuracy: 0.88; area under the receiver operating characteristic curve, AUC-ROC: 0.61; likelihood ratio, LR+: 4.44; LR-: 0.77; prevalence: 8.3%; post-test probability, PTP+: 0.32; PTP-: 0.07), with emphasis on high specificity and the positive likelihood ratio value. CONCLUSION: The SPPB was shown to be useful for screening frail older adults in the Amazon region. The score of 6 demonstrated the best cutoff point for this population. This could be used in healthcare services for diagnostic screening for frailty among older people within the Amazonian context.