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We aimed to investigate the relationship between physical fitness and motivation in adolescents and analyze if the associations of physical fitness with volitional exercise intensity in adolescents are mediated by motivation. The participants were 108 adolescents (58 girls 16.0 ± 0.92 years). Cardiorespiratory fitness (CRF) was assessed using the Yo-YoITL1, and the push-up test was used to evaluate strength. Body composition was measured by bioelectrical impedance analysis. The intervention was applied in the first 10–15 min of each Physical Education class (PEC), twice a week, for 16 weeks and ranged from 14 to 20 all-out bouts intervals, adopting a 2:1 work to rest ratio. A cut-point of ≥90% of the maximal heart rate (HR) was used as a criterion for satisfactory compliance with high-intensity exercise. Volition intensity was assessed through a forearm wearable plethysmography heart rate sensor to ensure compliance with the exercise stimulus at the predetermined target HR zone. Motivation was estimated with a validated questionnaire (BREQ-3). Mediation effects were estimated using bootstrapped 95% confidence intervals and were deemed significant if zero was not included in the intervals, and values below 0.05 were considered to indicate statistical significance. The mediation analysis revealed a non-significant indirect effect of physical fitness through motivation on exercise intensity, specifically on CRF (B = −0.0355, 95% BootCI [−0.5838; 0.4559]), muscular fitness (B = −0.7284, 95% BootCI [−2.0272; 0.2219]) and body fat (B = 0.5092, 95% BootCI [−0.4756; 1.6934]). These results suggest that high or low values of motivation did not increase or decrease volitional high-intensity exercise, and lower levels of fitness (CRF, muscular and body fat) were associated with higher volitional exercise intensity. These findings highlight the need for regular moderate-to-vigorous physical exercise for maintaining or improving physical fitness, regardless of motivation regulations, and emphasize the importance of new strategies in PEC with acute vigorous-intensity activities that retain the health-enhancing effects.

Purpose: This review aimed to evaluate the utility of high-intensity interval training (HIIT) programs integrated into physical education classes. Method: Searches of electronic databases from January 2008 to March 2020. Inclusion criteria: Applied to adolescents aged 10–19 years; applied in school settings; reported results on physical fitness, physical activity (PA), and motivation; at least for 4 weeks; and randomized controlled trials. Studies with adolescents with physical or intellectual limitations were excluded, as well as other interventions parallel to HIIT. Results: Fourteen studies were included. All works present significant improvements in physical fitness and PA. Improvements in body composition recorded, at most, a moderate effect size. HIIT is presented as a powerful stimulus on cardiorespiratory fitness. Improvements in PA registered, a least, a moderate effect size. Conclusions: HIIT in the school context has great potential in improving physical fitness and PA in adolescents. HIIT efficiency (about 10 min) reflects the wide applicability that these protocols can have in physical education classes and great adaptation to the facilities.

O objetivo do presente estudo foi analisar os efeitos do exercício de vibração de corpo inteiro sobre os níveis de força nos membros inferiores de idosos. A amostra foi composta por 15 homens fisicamente ativos (idade: 62,5 ± 2,62 anos). Foram realizadas oito semanas de treinamento com plataforma vibratória, com sessões de 20 minutos de vibração utilizando frequências crescentes de 15 a 30 Hz, com exposição de 30 segundos de vibração e 30 segundos de descanso. A cada dois minutos houve um aumento de frequência de 1 Hz. Os indivíduos foram instruídos a ficar em pé, com os pés afastados na largura dos ombros, joelhos flexionados a 130°, braços estendidos, segurando firmemente a máquina. O procedimento foi realizado duas vezes por semana com intervalo de um dia. A força foi avaliada usando um dinamômetro dorsal em exercícios de extensão de joelho e extensão de coluna lombar. Os testes de força foram realizados na quarta e oitava semana após a última sessão de treinamento. Resultados: Ao final de oito semanas, foi possível observar ganhos significativos de força nos músculos envolvidos no exercício de extensão do joelho (p = 0,01) e na extensão da coluna lombar (p = 0,031). Conclusão: observou-se que o treinamento com vibrações de corpo inteiro promoveu melhora nos níveis de força nos membros inferiores dos idosos participantes do estudo.

Background: Rheumatoid arthritis (RA) is characterized by low physical fitness, pain, and depression. The present study aimed to examine the effects of a supervised aquatic exercise program on physical fitness, depression, and pain in women with RA and determine whether decreases in pain mediate depression. Methods: Forty-three women with RA, divided into an experimental group (EG; n = 21) and a control group (CG; n = 23), participated in a 12-week exercise program. Treatment effects were calculated via standardized difference or effect size (ES) using ANCOVA adjusted for baseline values (ES, 95% confidence interval (CI)). A simple panel of mediation was executed to determine whether changes in pain mediated improvements in depression after controlling for confounding variables, such as age, physical activity, and body mass index (BMI). Results: The aquatic exercise program had trivial and small effects on physical fitness, large effects on pain, and moderate effects on depression. The mediation model confirmed the indirect effect of pain on the decrease of depression in the participants of the aquatic exercise program. Conclusions: Participants with RA in the aquatic exercise program experienced improvements in physical fitness, depression, and joint pain. Moreover, the improvements in joint pain mediated improvements in depression.

Background Falls in older adults are considered a major public health problem. Declines in cognitive and physical functions, as measured by parameters including reaction time, mobility, and dual-task performance, have been reported to be important risk factors for falls. The aim of this study was to investigate the effects of two multimodal programs on reaction time, mobility, and dual-task performance in community-dwelling older adults at risk of falling. Methods In this randomized controlled trial, fifty-one participants (75.4 ± 5.6 years) were allocated into two experimental groups (EGs) (with sessions 3 times per week for 24 weeks), and a control group: EG1 was enrolled in a psychomotor intervention program, EG2 was enrolled in a combined exercise program (psychomotor intervention program + whole-body vibration program), and the control group maintained their usual daily activities. The participants were assessed at baseline, after the intervention, and after a 12-week no-intervention follow-up period. Results The comparisons revealed significant improvements in mobility and dual-task performance after the intervention in EG1, while there were improvements in reaction time, mobility, and dual-task performance in EG2 (p ≤ 0.05). The size of the interventions’ clinical effect was medium in EG1 and ranged from medium to large in EG2. The comparisons also showed a reduction in the fall rate in both EGs (EG1: -44.2%; EG2: − 63.0%, p ≤ 0.05) from baseline to post-intervention. The interventions’ effects on reaction time, mobility, and dual-task performance were no longer evident after the 12-week no-intervention follow-up period. Conclusions The results suggest that multimodal psychomotor programs were well tolerated by community-dwelling older adults and were effective for fall prevention, as well as for the prevention of cognitive and physical functional decline, particularly if the programs are combined with whole-body vibration exercise. The discontinuation of these programs could lead to the fast reversal of the positive outcomes achieved. Trial registration ClinicalTrials.gov Identifier: NCT03446352. Date of registration: February 07, 2018.

Bariatric surgery is one of the treatments for severe obesity, with proven efficacy in reducing weight and diseases associated with obesity. Weight loss associated with bariatric surgery is greatly associated with a significant reduction of skeletal muscle and bone mineral mass, which leads us to induce that after bariatric surgery, patients incur an increased risk of sarcopenia. The need for prophylactic programs that prevent sarcopenia in bariatric surgery patients seems to be one of the crucial points for the long-term surgical success of bariatric and metabolic surgery. The aim of this randomized clinical trial will be to study the effects of a 16-week supervised exercise intervention program on the prevention of sarcopenia, in patients undergoing bariatric surgery. As a secondary purpose, it is also intended to characterize metabolic risk factors, physical fitness, and quality of life in post-bariatric surgery patients.A total of 45 patients on the waiting list for bariatric surgery and who have subsequently perfurgery, will be include on EXPOBAR (This study will provide the effects of a physical exercise on sarcopenia, in patients after bariatric surgery.The trial was registered at Clinicaltrials.gov NCT03497546.

To translate and perform the cross-cultural adaptation of the Young Spine Questionnaire (YSQ) into Portuguese, and to assess its reliability.Translation and cross-cultural adaptations were conducted according to accepted international standards. A preliminary version underwent pilot-testing with 32 children (11-14 years), equally divided by gender and age. Children were asked to rate each question in terms of clarity and comprehensibility, and to provide general feedback regarding the questionnaire. The final version of the questionnaire was approved by a committee consisting of experts from various fields. Test-retest reliability was assessed on 58 children using Cohen's and Fleiss' Kappa.Translation and cross-cultural adaptation of the YSQ only resulted in minor changes and the children rated all questions as "clear and understandable" in the pilot test, without gender or age differences being detected. Test-retest data was collected with a mean interval of 13 days. Reliability scores ranged from 0.56-0.97, equivalent to "moderate" to "almost perfect" agreement. Most questions (84%) had "substantial" or "almost perfect" agreement.The translation and cross-cultural adaptation of YSQ into Portuguese was successfully performed. This questionnaire was also shown to be reliable, supporting its future use in research projects.

This 24-week randomized controlled trial study evaluated the effects of two interactive cognitive–motor programs on body composition, lower-body strength, and processing speed in community dwellings at risk of falling. Forty-eight participants (75.0 ± 5.4 years) were allocated into EG1 (psychomotor intervention program), EG2 (combined program (psychomotor intervention + whole-body vibration)), and a control group. EG programs induced significant improvements in bone mass, lower-body strength, and processing speed (p < 0.05), with similar treatment effects on lower-body strength and processing speed and higher bone mineral content and density within EG2. The fall rate decreased in EG1 (44.2%) and EG2 (63%) (p < 0.05). After the 12-week no-intervention follow-up, improvements in lower-body strength were reversed in both EGs, but those in processing speed were maintained, mainly in EG2 (p < 0.05). In conclusion, both programs were accepted and well tolerated. The combined program led to additional benefits in bone mass. Both programs positively impacted physical and cognitive risk factors for falls and injuries. They induced similar improvements in lower-body strength and processing speed, decreasing the fall rate. These findings suggest that both programs are successful for fall and injury prevention in the studied population.

(1) Background: Several studies have shown that active breaks have led to different improvements in their participants. However, no studies have assessed how they affect physical literacy (PL). (2) Aims: Therefore, this study will examine the effect of the PLBreaks programme on school children’s PL and body composition. (3) Methods: A parallel-group randomised controlled trial will be conducted with assessments of PL (Canadian Assessment of Physical Literacy Development) and body composition (height, bodyweight, fat mass and fat-free mass) before and after an active breaks programme. PLBreak programme will run for 3 months and will be carried out 3 days a week for 20 min each day. The PLBreaks programme will consist of two blocks of 10 min of different physical activities (PA). The first block will be focused on the acquisition of knowledge and healthy life habits that will contribute to the development of the domains of knowledge and understanding and daily activity. The second block will be focused on physical competence and motivation throughout games. (4) Conclusions: The present study will investigate the efficacy of PLBreaks in schoolchildren in improving their PL and body composition. If the efficacy of the program is demonstrated, including the programme in public education programmes can be possible. This could be a scientific breakthrough in terms of health-related PA improvement and adherence, as well as the prevention of diseases associated with inactivity.

We aimed to investigate the relationship between physical activity (PA) and health-related physical fitness (PF) in adolescents and analyze if the associations of PA with body composition (BC) in adolescents are mediated by physical fitness or energy intake (EI). The participants were 236 adolescents (140 girls 16.1 ± 0.92 years). Cardiorespiratory fitness (CRF) was assessed using the Yo-YoITL1, and the push-up test was used to evaluate strength. BCs were measured on an electrical weight scale. Triaxial accelerometers were used to determine PA levels and moderate-to-vigorous PA (MVPA) levels. EI was estimated with a validated questionnaire. Mediation effects were estimated using bootstrapped 95% confidence intervals and were deemed significant if zero was not included in the intervals. The mediation analysis revealed an indirect effect of MVPA only through PF on BC, specifically through CRF on body fat (B = −0.0146, 95% BootCI (−0.0219; −0.0076)) and on lean body mass (B = 0.0096, 95% BootCI (0.0049; 0.0152)), as well as through upper body strength on body fat (B = −0.012, 95% BootCI (−0.0171; −0.0072)) and on lean body mass (B = 0.0059, 95% BootCI (0.003; 0.0095)). These results suggest that PA of at least a moderate intensity is relevant to BC and health-related PF in adolescents, regardless of the EI.

This systematic review aimed to identify the physical/motor fitness tests for nursing home residents and to examine their psychometric properties. Electronic databases were searched for articles published between January 2005 and October 2021 using MeSh terms and relevant keywords. Of the total of 4196 studies identified, 3914 were excluded based on title, abstracts, or because they were duplicates. The remaining 282 studies were full-text analyzed, and 41 were excluded, resulting in 241 studies included in the review. The most common physical component assessed was muscle strength; 174 (72.2%) studies assessed this component. Balance (138 studies, 57.3%) and agility (102 studies, 42.3%) were the second and third components, respectively, most widely assessed. In this review, we also describe the most used assessment tests for each physical/motor component. Some potentially relevant components such as manual dexterity and proprioception have been little considered. There are few studies assessing the psychometric properties of the tests for nursing home residents, although the data show that, in general, they are reliable. This review provides valuable information to researchers and health-care professionals regarding the physical/motor tests used in nursing home residences, helping them select the screening tools that could most closely fit their study objectives.

Introduction: Bariatric surgery is the treatment of severe obesity with associated pathologies, with proven evidence in its benefits. By treating overweight allows a better and even reversal of pathologies associated with obesity. Weight loss associated with bariatric surgery is greatly associated with a significant reduction of skeletal muscle and bone mineral mass, which leads us to induce that after bariatric surgery, patients incur an increased risk of sarcopenia. The need for prophylactic programs that prevent sarcopenia in bariatric surgery patients seems to be one of the crucial points for the framing of long-term surgical success of bariatric and metabolic surgery. The aim of this randomized clinical trial will be to study the effects of a 16-week supervised exercise intervention program on the prevention of sarcopenia after bariatric surgery Method: This randomized controlled trial study will include 60 patients of both sexes on the waiting list for bariatric surgery and who have subsequently performed the surgery. They will be randomized into 2 groups, experimental and control. The intervention will take place 1 month after surgery, for a total of 16 weeks. Parameters of body composition, metabolic risk, quality of life, physical activity and sedentary behavior will be determined. Results: Assessments will take place in five moments, the surgery, the intervention, the post-intervention, six months after the intervention, twelve months after the intervention.

This study evaluated the impact of a multicomponent exercise program on cognitive functions in participants with Type 2 Diabetes. Participants (n = 70, 65.6 ± 5.9 years) engaged in the program (75 min per session; 3 x week) for 32 weeks. A battery of cognitive tests was performed at baseline and study completion. Two groups were formed according to their attendance rate (low and high attendance), and statistical comparisons were computed on their changes in cognitive performance. Such changes were also associated with the attendance rate for all participants. Results showed no significant differences between groups in their change scores, although there were some within-group differences in both groups. Correlation analysis showed that the attendance rate was not associated with cognitive performance changes, except for one variable. As the exercise program did not improve cognitive function, we discuss the potential of future interventions to incorporate dual-task activities merging physical and cognitive stimulation. info:eu-repo/semantics/publishedVersion

The COVID-19 pandemic has resulted in significant alterations to and implications for the lives of millions of people, and especially for those with pre-existing medical conditions. The aim of this study was to explore the lived experience of older people with type 2 diabetes mellitus (T2DM) throughout the first 9 months of the pandemic, with emphasis on the habits of physical exercise. We conducted a qualitative study using semi-structured interviews. The data consist of telephone interviews of seventeen older people with T2DM (10 women and 7 men, aged 62–76 years). Using thematic analysis, five themes were generated: (1) an altered social and relational life; (2) changes in routine and attitude regarding physical activity behaviour; (3) home-related activities gained relevance; (4) health and well-being impact and management; and (5) thoughts about the post-pandemic period. The increase in the number of cases and the fear of becoming infected with COVID-19 limited the social (i.e., contact with family and/or friends) and functional (i.e., daily routine, the habit of exercising) lives of these people, reverberating negatively on their health and well-being. Feelings of isolation, loneliness, anxiety were common. The findings of this study help to better understand the impact of the pandemic and determine areas of need for future interventions. A multidisciplinary approach is necessary to provide support for older people with T2DM and tackle the negative effect of the pandemic, including the reduction in physical activity.

Cardiovascular diseases (CVD) are the leading cause of death globally. Cardiac rehabilitation (CR) programs’ benefits are overall consensual; however, during exercise, progressive physiological effects have not been studied yet in cardiac patients. Our study aims to analyze physiological parameters of thermography, heart rate variability (HRV), blood pressure, central nervous system (CNS) fatigue, and cortical arousal in heart attack patients (HAP) who belong to CR programs of High-Intensity Interval Training (HIIT) and Moderate-intensity Continuous Training (MICT) compared to healthy participants. In this case control study, two HAP patients (both male, age 35 and 48, respectively) and two healthy people (both male, age 38 and 46, respectively) were randomly assigned in a 1:1:1:1 allocation ratio to one of four groups: cardiac MICT, cardiac HIIT, control MICT, and control HIIT. The HIIT at ≈85–95% of peak heart rate (HR) was followed by a one-minute recovery interval at 40% peakHR, and MICT at ≈70–75% of peakHR. Outcome measurements included thermography, HRV, blood pressure, CNS fatigue, and cortical arousal; The HAP presents more than twice the CNS fatigue in MICT than control participants, but HIIT has almost the same CNS fatigue in HAP and control. In addition, both of the HAP groups presented higher temperatures in the chest. The HIIT protocol showed better physiological responses during exercise, compared to MICT in HAP.

This article empirically provides a global overview of physical literacy, which allows for the understanding of the structure of the epistemic community studying literacy for healthy living. Publications registered in the Web of Science are analyzed using bibliometrics (spatial, productive, and relational) based on data from 391 records, published between 2007 and April 2022, applying five bibliometric laws and using VOSviewer software for data and metadata processing and visualization. In terms of results, we observe an exponential increase in scientific production in the last decade, with a concentration of scientific discussion on physical literacy in seven journals; a production distributed in 46 countries situated on the five continents, but concentrated in Canada and the United States; co-authored research networks composed of 1256 researchers but with a production concentrated of around 2% of these, and an even smaller number of authors with high production and high impact. Finally, there are four thematic blocks that, although interacting, constitute three specific knowledge production communities that have been delineated over time in relation to health and quality of life, fitness and physical competence, education, and fundamental movement skills.

Background: This study aims to investigate the acute effects of an augmented reality session and a cycle ergometer session compared to no exercise on the reaction times, cognitive flexibility, and verbal fluency of older adults. Methods: Each participant did a familiarization with cognitive tests and the following three sessions: cycle ergometer, no exercise (control group), and augmented reality exergame (Portable Exergame Platform for Elderly) sessions. The participants were randomized in a within-group design into one of six possible combinations. Each moment had a 30 min duration, and after the session, the participants performed a Trail Making Test, a verbal fluency test, and a Deary–Liewald reaction time task. The data were analyzed with a one-way ANOVA with a Bonferroni adjustment. Results: The analysis between the no exercise, cycle ergometer, and augmented reality sessions showed no significant differences in the cognitive measurements. Conclusions: One session of the cycle ergometer exercise or the augmented reality exergames does not acutely improve the reaction times, cognitive flexibility, or verbal fluency in the elderly.

Background Cardiovascular diseases (CVD) are among the most prevalent illnesses worldwide, causing substantial mortality, morbidity and hospitalization. Understanding the correlation of thyroid function and glycemic metabolism and inflammation to body composition and cardiorespiratory and muscular function is imperative. This manuscript's main goal is to evaluate the association of thyroid function and glycemic metabolism to body mass composition and cardiovascular fitness (CRF) and muscular function in a group of coronary artery disease (CAD) patients. Methods To examine cross-sectional associations of thyroid function, glycemia, hemoglobin A1c (HgA1c) and C-reactive protein (CRP) with CRF, muscular function and body mass composition. Forty-five stable CAD patients were enrolled (aged 54.9 ± 10.0 years). Participants were assessed for body composition (DXA®), muscle strength (Biodex®), cardiorespiratory fitness (6-minute walking test) and blood biomarkers, including [CRP, Tyrode Hormones higher free thyroxine (FT4), lower total triiodothyronine (FT3) and metabolic parameters]. The Pearson correlation and t-test statistical measures were used for associations between thyroid function, glycemia, insulin, HgA1c and CRF/muscle strength, body composition. Results We found significant inter-correlations between body fat and FT4 (P < 0.01), HgA1c (P = 0.01), insulin (P = 0.01) and blood glucose (P = 0.05); lean mass and FT3 (P = 0.001); and a negative inter-correlation between C-reactive protein and knee extensor and flexor isokinetic peak torques (P < 0.01), and cardiorespiratory fitness (P < 0.05). Conclusions Our findings showed that THs function and body mass fat, HgA1c, blood glucose, insulin and CRP were associated with the CRF, muscle strength or body composition. These results highlight the importance of endocrine and metabolic mechanisms concerning CRF and muscle strength in a group of patients with CAD.

Background A slower reaction time (RT) performance is considered a risk factor for falls. Different approaches as a psychomotor intervention (involving neuromotor exercises) or the whole-body vibration (inducing neurophysiological changes) may reduce the risk of falls. Nevertheless, a combined program may promote greater gains. This study aimed to investigate the acceptability and the effect of two multimodal programs on RT in community-dwelling older adults fallers or balance-impaired. Methods A total of 37 participants (74.3 ± 5.2 years) were divided into two groups (3x/week): experimental group 1 (psychomotor intervention); experimental group 2 [EG2] (combined program: psychomotor intervention + whole-body vibration). The Deary-Liewald reaction time task assessed RT. Simple and choice reaction time [CRT] (ms) tasks were recorded under single and dual-task (DT) paradigms. DT cost was also computed. Results The attendance rate was 86.3%. Wilcoxon test comparisons revealed significant differences between baseline and post-intervention evaluations in the EG2. The improvement was observed in the variable ‘CRT-DT’, in which participants spent less time to perform the task (1026.0 ± 153.4 vs. 960.4 ± 160.9, P = 0.040). The correspondent effect size was medium (r = 0.33). The DT cost was also decreased in CRT-DT by 3.9%. No significant differences between groups were found. Conclusions This study demonstrated that both programs were safe and highly attended. The results suggest that a combined intervention (psychomotor intervention + whole-body vibration) should be privileged to improve RT and reduce the risk of falls. Trial Registration: ClinicalTrials.gov Identifier: NCT03446352. Funding: This study was supported by the ESACA Project (Grant ALT20-03-0145-FEDER-000007) and by FCT (SFRH/BD/147398/2019).

Relative age is a phenomenon broadly studied in sport sciences. Youth sports participants born earlier in the selection year tend to present a maturational advantage over their peers. As it is also dependent on physical performance, older physical education students may also benefit from this effect in this school subject. The main goal of this manuscript was to determine whether the relative age effect is present within physical fitness outcomes of Portuguese children and adolescents. The physical–aerobic fitness, strength, flexibility and body composition of 885 students (490 females and 395 males) were collected and compared by quarters of birth, segmented by gender and age groups (10–12, 12–14, 14–16 and 16–18 years). The results reveal a moderate to small effect in physical fitness outcomes, with a trend for children and adolescents born in the early part of the year to present higher performance levels. These differences were more evident in ages closer to the physical maturational onset (12–14 y) and more apparent in male students. This physical fitness advantage may lead to a biased assessment and development of students born earlier in the year.

The health benefits of sauna baths are attracting ever-increasing interest. Therefore, the purpose of this study was to evaluate the effects of 12 high-temperature (100 °C) sauna baths on body composition of 23 healthy young men, divided into a control group (CG) and a sauna group (SG). Both groups were initially evaluated by dual-energy X-ray absorptiometry (DXA), after which the SG experienced 12 sessions of sauna baths at high temperatures (100 °C). Initial measurements were carried out after the sauna sessions and after two weeks of decay in both groups. The muscle mass of the right leg (pre vs. decay: 9.50 (5.59) vs. 10.52 (5.15), p &lt, 0.05, Δ 1.07%), bone mineral density (pre vs. post: 1.221 (0.35) vs. 1.315 (0.45), Δ 7.7%) and bone mineral content (pre vs. post: 0.470 (0.21) vs. 0.499 (0.22), Δ 6.17%) of the left leg increased in the SG after the sauna baths. It seems that exposure to heat at high temperatures could produce improvements in bone and muscle mass.

Background: Reliability studies are used to verify the evaluation accuracy of a given device. Strength is an important factor for the development of daily activities and its correct management is fundamental. The objective of this study was to examine the reliability of a concentric strength test in people with type 2 diabetes mellitus (T2DM). Methods: Twenty-seven individuals with T2DM performed three repetitions of extension-flexion in concentric-concentric action at 60°/s, for both legs, using an isokinetic dynamometer. For the reliability analysis, we performed an intra-session test retest. Results: The total sample and men sub-group intra-class correlation coefficient (ICC) values were excellent for peak torque and work. In the women sub-group, ICC values were excellent for extensors in both peak torque and work; however, concerning flexor, the ICC values were good for peak torque while, for work, they were good for the right leg and moderate for the left leg. Standard error of measurement (SEM) percentage oscillated from 3.85% to 6.80%, with the smallest real difference (SRD) percentage being from 10.66% to 18.86% for peak torque. Furthermore, the SEM (%) was around 5.5% and SRD (%) was around 15% for work. Conclusions: The isokinetic dynamometry had “good” to “excellent” relative reliability for peak torque (0.862–0.983) and work (0.744–0.982) of extension-flexion in concentric-concentric action at 60°/s. In addition, our study showed that, in general, an SRD < 20% could indicate a true change in strength regarding this protocol in T2DM.

The aim of this study was to determine the absolute and relative reliability and validity of two reaction time (RT) tests in older adults using long-term facility: the ruler drop test (RDT, a simple RT) and the Deary-Liewald RT task (DLRT, simple and four-choice RT). Participants (≥65 years old) using long-term facilities were distributed into a group without cognitive impairment (GWCI, n = 41), and a group with mild cognitive impairment (GCI, n = 32). The tests were administered one week apart, by the same evaluator. Relative reliability was measured by the Intraclass Correlation Coefficient (ICC3.1), absolute reliability by the standard error of measurement (SEM) and minimal detectable change (MDC95) and convergent validity by the Pearson correlation. The results showed that the relative reliability was good for the RDT (GWCI, ICC = 0.84; GCI, ICC = 0.80) and moderate for the Deary Liewald RT simple (DLRT-S) (GWCI, ICC = 0.61; GCI, ICC = 0.65). The relative reliability of the Deary Liewald RT choice (DLRT-C) was good (ICC = 0.89) for the GWCI and excellent (ICC = 0.93) for the GCI. However, the DLRT-C had low feasibility in the GCI, as most participants were unable to complete the test. Measurement precision was acceptable for the RDT and DLRT-C (GWCI) and for the DLRT-C (GCI). There were no significant associations between the RDT and DLRT scores. We conclude that the RDT could be more suitable than the DLRT-S for assessing simple RT in older adults. Future studies should explore if fewer than the four stimulus-response alternatives used in the DLRT-C could be more appropriate for assessing choice RT in older adults with cognitive impairment.

This study aimed to determine the absolute and relative test-retest reliability of the functional reach test (FRT) and the handgrip strength test (HGST) in older adults using nursing homes. Participants (≥ 65 years old), living in nursing homes or using their day care services, were distributed into a group without cognitive impairment (GWCI, n = 43) and a group with mild cognitive impairment (GCI; n = 22). A 1-week test-retest was performed for the FRT and the HGST. Relative reliability was measured by the intraclass correlation coefficient (ICC3.1), and absolute reliability by the standard error of measurement (SEM), minimal detectable change (MDC95), and Bland-Altman plots. The ICC showed high reliability for the FRT (GWCI, ICC = 0.83; GCI, ICC = 0.87) and the HGST (ICC ≥ 0.95 in both hands and participant groups). The absolute reliability was good: FRT, SEM = 2.96/2.29, MDC95 = 8.20/6.35 for the GWCI and the GCI, respectively; HGST dominant hand SEM = 1.26/0.82, MDC95 = 3.50/2.29, and HGST non-dominant hand SEM = 1.05/0.80, MDC95 = 2.90/2.21, for the GWCI and the GCI, respectively. Bland-Altman showed that there was not a systematic bias for the tests in both groups. Findings show that the FRT and the HGST are reliable, have acceptable measurement error, and may be used for research and clinical purposes to assess functional balance and strength of the hands in older adults using nursing homes.

Background and objectives: Peritoneal dialysis (PD) patients are expected to present lower levels of physical activity, unhealthy changes at the body composition level, and low levels of strength. Firstly, this study aimed to report the sex differences in physical activity, body composition and muscle strength and the relations among these variables. Secondly, we analyze the relationship between physical activity and biochemical parameters. Materials and Methods: Thirty-four patients (13 women and 21 men) participated in this study. Body composition was assessed by bioimpedance and dual-energy X-ray absorptiometry (DXA), and maximum isokinetic unilateral strength, analytical parameters and physical activity levels were evaluated. Results: The men showed higher values for weight, height, lean body mass, bone mineral content, bone mineral density (BMD) and total body water, while women showed higher values for the percentage of fat mass and hydration of lean body mass (p &lt, 0.05). No differences between the sexes were found in different levels of physical activity, however, males registered significantly higher values for isokinetic strength variables except for knee extensor strength. BMD was positively related to sedentary activity and negatively related to moderate and vigorous activity (r = 0.383 and r = −0.404, respectively). Light physical activity was negatively correlated with albumin (r = −0.393) and total protein (r = −0.410) levels, while moderate/vigorous activity was positively correlated with urea distribution volume (r = 0.446) and creatinine clearance (r = 0.359) and negatively correlated with the triglyceride level (r = −0.455). Conclusions: PD patients with higher levels of physical activity present better results in terms of body composition and biochemical parameters. Additional studies should be conducted to clarify the relation between physical activity level and BMD.

Introduction Performing a dual-task (DT), mainly while walking and performing another task simultaneously, is seen as determinants factors for falls and injuries in older adults. A psychomotor intervention relying on the prevention of sensorimotor and neurocognitive deterioration may prevent falls. The whole-body vibration (WBV) promotes the increase of agility, reducing the risk of falling. However, an intervention that combines both methods can lead to additional benefits, particularly as regards DT. Objectives To evaluate the feasibility and the effect of two multimodal programs designed for community-dwelling older adults, fallers or at high risk of falling, on DT performance ability. Methodology Thirty-seven participants (74.3±5.2 years) were randomly assigned into experimental group 1 [EG1] (psychomotor intervention); or experimental group 2 [EG2] (psychomotor intervention + WBV). DT performance (TUGcog) was assessed by the Timed Up and Go Test (s) performed simultaneously with the counting backward cognitive task. Results Adherence rate was 86.3%. Wilcoxon test comparisons showed improvements from baseline to post-intervention on EG1 (time (s): 10.1±2.7 vs. 9.0±2.7, p = 0.001; cognitive stops (n): 0.9±1.0 vs. 0.2±0.4, p = 0.012; motor stops (n): 0.3±0.5 vs. 0.0±0.0, p = 0.025), corresponding to an effect size (cohen’s d) ranging from 0.41 (small) to 0.92 (medium) and on EG2 (time (s): 9.9±2.5 vs. 8.5±1.8, p = 0.010; cognitive stops (n): 1.1±0.7 vs. 0.4±0.5, p = 0.004), corresponding to a d ranging from 0.64 (medium) to 1.15 (medium). There were no significant differences between groups. Conclusion These preliminary results suggested that the multimodal programs were feasible and effective in reducing the risk of falling by improving the determinant risk factor DT performance. Trial Registration: ClinicalTrials.gov Identifier: NCT03446352. Funding: This study was funded by ESACA Project (Grant ALT20-03-0145-FEDER-000007) and by FCT (SFRH/BD/147398/2019).

The aim of this study was to analyse the effect of four types of re-warm-up (R-WU) activity, namely rest in normoxia (RN) at FiO2 = 20.9%, rest in hypoxia (RH) at FiO2 = 15%, activity (4 &times, 5 jumps/15 s) in normoxia (AN) and activity in hypoxia (AH) on physical performance. Ten elite male rugby players completed a 15-min warm-up followed by one of the 15-min randomized R-WU strategies. After R-WU, countermovement jump (CMJ), 20 m sprint and repeat sprint ability (RSA) tests were assessed. Compared to passive strategies (RN and RH), tympanic temperature was higher after active R-WU (AN and AH) (p = 0.016). Higher values of CMJ height (p = 0.037) and 20 m sprint (p = 0.02) were found in AH than in RN. In addition, mean RSA was lower (p = 0.008) in AH than in RN and RH. Blood lactate concentration was higher (p = 0.007) after RN and AN strategies than after AH. Muscle O2 saturation (p = 0.021) and total Hb (p = 0.042) were higher after AH than after the other three conditions and after RN, respectively. Therefore, an active R-WU under hypoxia could be useful to elite rugby players, once it had attenuated the decline in tympanic temperature during a 15-min period after warm-up, improving jump, sprint and RSA performance.

Background Falls and fall-related injuries along with fear of falling (FoF) seem to restrict activities of daily living (ADL), resulting in physical dependence. However, it is still unclear how falls and related injuries or FoF by themselves explain general and specific ADL dependence. Objectives To investigate the relationships between falls and related injuries, FoF and physical dependence on ADL in community-dwelling older adults, controlling for age, gender, physical activity and physical fitness as confounders. Methods This cross-sectional descriptive study assessed 588 community-dwelling older adults. Falls and fall-related injuries, ADL dependence on basic, instrumental and advanced activities, FoF, demographic characteristics and health conditions were assessed through a questionnaire. Physical activity was measured through the International Physical Activity Questionnaire. Physical fitness was assessed by the Senior Fitness Test and the Fullerton Advanced Balance Scale. Body composition was measured through bioimpedance. Results Severe injuries occurrence increased the likelihood of moderate and high physical dependence by 3 and 6 times, while FoF increased this likelihood by 3 and 7 times, respectively. Also, the occurrence of previous falls, resulting in severe injuries, increased the likelihood of dependence in two instrumental ADL (3 and 4 times), while FoF increased this likelihood in numerous basic, instrumental and advanced ADL (2-3 times). The FoF was shown to explain overall physical functioning dependence, by itself, representing a constraint on the performance of most basic, instrumental and advanced ADL. Conclusion The FoF showed to be a greater threat to ADL dependence than falls and related injuries. Assessment guidelines for older adults living in the community should include the FoF in clinical evaluation. Implications for practice Understand the isolated interplay of FoF and previous falls and injuries on ADL dependence among older adults allows healthcare professionals to perform more accurate clinical evaluations and develop more successful interventions to prevent further dependence.

Aim To examine the test-retest reliability of two upper-limb proprioception tests (Weight Detection Test, or WDT, and Arm Ruler Positioning Test, or ARPT) and two balance tests (Functional Reach Test, or FRT, and Timed Up and Go test, or TUG) in older nursing home residents. Methods Fifty-three nursing home residents (85.9 ± 3.9 years) participated in this study. Outcome measures were assessed on two occasions, 10–14 days apart. The same rater administered all tests. The relative reliability was estimated using the intraclass correlation coefficients (ICCs) with a two-way mixed-effects model. The absolute reliability was analyzed using the standard error of the mean (SEM) to estimate the minimal detectable change (MDC) at the 95 % confidence level. Systematic bias was studied using the paired-samples t-test or the Wilcoxon signed-rank test. Results The WDT (ICC = 0.84), ARPT (ICC = 0.87) and FRT (ICC = 0.85) had good relative reliability, and the TUG (ICC = 0.99) had excellent reliability. Our results suggest acceptable measurement precision: the SEMs were equal to 1.0 points, and 0.3 cm, 1.5 cm, and 0.5 s for the WDT, ARPT, FRT, and TUG, respectively. The mean difference between sessions was 0.3 points (1.4 %; w=-1.37, p = 0.17) in the WDT, 0.1 cm (-0.74 %; t = 0.41, p = 0.68) in the ARPT, 0.1 cm (0.45 %; w=-0.33, p = 0.74) in the FRT, and 0.2 s (1.37 %; w=-2.28, p = 0.02) in the TUG. Conclusions This study showed that the four field-usable motor tests had good to excellent test-retest reliability and had acceptable measurement precision in older nursing home residents. These tests could be valuable clinical tools for assessing proprioception and balance in nursing home residents.

Respiratory problems can aggravate pain located in the coincident areas with tender points in the upper half of the body in patients with fibromyalgia (FM) and easily become fatigued, thus can lead to a decrease in the functionality of daily activities. The purpose of this study was to examine the effects of a breathing exercises program on pain thresholds tolerance on tender points and FM impact on daily life.Thirty-five women with FM (age 34-67 years) were randomly assigned to an exercise group (n = 18), performing breathing exercises (30 min/session, 7 times/week; for 12 weeks), or to a control group (n = 17). Pain thresholds tolerance on tender points were measured by the physician using digital pressure algometer and FM impact on daily life was evaluated with the Portuguese version of the Fibromyalgia Impact Questionnaire (FIQ).After 12 weeks of breathing exercises significant improvements were observed in the mean values of the treatment effects on pain thresholds tolerance on tender points and in the functional capacity to perform daily life, pain, and fatigue in favor of the exercise group. Gains in second rib, occiput, and supraspinatus pairs of the tender points predict improvements in the functional capacity, pain, and fatigue.Our study demonstrated that breathing exercises produced relevant benefits on pain thresholds tolerance on tender points located in the upper half of the body, some of which predicted improvements in the impact of FM in the functional capacity to perform daily life, pain, and fatigue. These results provide further support of an idea that breathing exercises are a real and effective intervention to consider in women with FM.International Standard Randomized Controlled Trial Number ISRCTN37081460, available information in www.isrctn.com/ ISRCTN37081460.

The main purpose of this pilot study was to examine the feasibility and the effects of a multimodal exercise intervention on the physical and cognitive functioning of institutionalized older people. Twenty-one older adults (83.5 ± 4.9 years) living in two nursing home residences, were tested on two occasions 4 weeks apart to establish a baseline measure, and then engage in the exercise program twice weekly for 8 weeks. Participants were tested again after the exercise program. Almost all physical fitness and cognitive tests were unchanged at baseline measures, but after the exercise program, significant improvements (p 0.05) were found in all physical fitness variables (strength, cardiorespiratory endurance, flexibility and balance) and in the majority of cognitive variables (visual attention, executive functioning and information processing speed). Exercise merging physical and cognitive stimulation could have broad impacts in the individual's level of functioning and should be promoted in nursing home residences for the elderly.

Aim The aim of this study is to examine the relationship between motor skill competence and body composition of 6- to 10-year-old children. Methods Seventy girls and 86 boys participated. Body composition was measured by body mass index and skinfold thickness. Motor proficiency was evaluated through the Bruininks-Oseretsky Test of Motor Proficiency-Short Form, which included measures of gross motor skills and fine motor skills. Results Significant associations were found for both sexes between the percentage of body fat and (i) the performance in each gross motor task, (ii) the composite score for gross motor skills and (iii) the motor proficiency score. The percentage of body fat was not significantly associated with the majority of the fine motor skills items and with the respective composite score. Considering body weigh categories, children with normal weight had significantly higher scores than their peers with overweight or with obesity in gross motor skills and in overall motor proficiency. Conclusions Children's motor proficiency is negatively associated with body fat, and normal weight children show better motor competence than those who are overweight or obese. The negative impact of excessive body weight is stronger for gross motor skills that involve dynamic body movements than for stationary object control skills; fine motor skills appear to be relatively independent of the constraints imposed by excessive body weight.

Although there are studies assessing the effects of interventions on the knee strength of patients undergoing dialysis, there are no previous studies investigating the test&ndash, retest reliability of isokinetic measures in people undergoing peritoneal dialysis. The objective of this study was to determine the relative and absolute reliability of peak torque and work measurements for isokinetic concentric knee and elbow extension and flexion in peritoneal dialysis patients. Thirty-one patients undergoing peritoneal dialysis (19 males) participated in the current study. All isokinetic tests were performed using a Biodex System 3. Participants performed three concentric repetitions of each test (flexion or extension) with the dominant limb (knee and elbow) at 60&deg, /s. Peak torque (Nm) and work (J) were extracted. The intraclass correlation coefficient (ICC), standard error of measurement (SEM), and smallest real difference (SRD) were calculated. The results showed that all knee peak torque and work measures had an ICC of &gt, 0.90. On the other hand, the ICC for peak torque and work in the elbow concentric extension was &lt, 0.90, while the remaining elbow-related variables achieved an excellent reliability. Therefore, isokinetic dynamometry is a reliable technique to evaluate peak torque and work for concentric flexion and extension in both the knee and elbow joints in patients undergoing peritoneal dialysis.