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ABSTRACT Introduction The term “Mediterranean lifestyle” has gained increasing prominence in recent years, yet a specific definition remains elusive. In response, the Mediterranean Lifestyle Medicine Institute Board of Directors convened a multidisciplinary panel comprising international experts and leaders in lifestyle medicine. Their goal was to review existing literature and formulate a consensus definition of the “traditional Mediterranean lifestyle (tMedL),” referring to the historical way of living of the people in the Mediterranean region. This paper presents the agreed consensus statement and a comprehensive holistic definition of the term “traditional Mediterranean lifestyle.” Methods Major medical and social sciences electronic databases from inception to February 2023 were searched, employing keywords relevant to the Mediterranean lifestyle and its constituent elements (diet, physical activity, sleep, stress, socialization). Subsequently, definitions for each pillar were created and synthesized to derive a comprehensive definition of the “traditional Mediterranean lifestyle.” Results This proposed definition received ratification from the Mediterranean Lifestyle Medicine Institute's expert working group during the First International Mediterranean Lifestyle Medicine Conference held in June 2023 on the island of Leros, Greece. “The traditional Mediterranean lifestyle is characterized by its diverse and adaptable nature. Key facets encompass conviviality, lifelong social connectedness, purposeful living, strong community and familial bonds, harmony with nature and the environment, profound spirituality, adherence to religious practices, preservation of local customs, resilience cultivated through adversity, and a commitment to moderation across all spheres of life.” Conclusions This definition comprehensively outlines the primary lifestyle factors ingrained in Mediterranean inhabitants across generations. Its holistic nature furnishes a crucial conceptual framework for directing lifestyle medicine practitioners in assisting patients to mitigate diseases, promote overall well‐being, devise research initiatives to investigate the health ramifications of this lifestyle, and inform curriculum development.

Introduction: The term "Mediterranean lifestyle" has gained increasing prominence in recent years, yet a specific definition remains elusive. In response, the Mediterranean Lifestyle Medicine Institute Board of Directors convened a multidisciplinary panel comprising international experts and leaders in lifestyle medicine. Their goal was to review existing literature and formulate a consensus definition of the "traditional Mediterranean lifestyle (tMedL)," referring to the historical way of living of the people in the Mediterranean region. This paper presents the agreed consensus statement and a comprehensive holistic definition of the term "traditional Mediterranean lifestyle." Methods: Major medical and social sciences electronic databases from inception to February 2023 were searched, employing keywords relevant to the Mediterranean lifestyle and its constituent elements (diet, physical activity, sleep, stress, socialization). Subsequently, definitions for each pillar were created and synthesized to derive a comprehensive definition of the "traditional Mediterranean lifestyle." Results: This proposed definition received ratification from the Mediterranean Lifestyle Medicine Institute's expert working group during the First International Mediterranean Lifestyle Medicine Conference held in June 2023 on the island of Leros, Greece. "The traditional Mediterranean lifestyle is characterized by its diverse and adaptable nature. Key facets encompass conviviality, lifelong social connectedness, purposeful living, strong community and familial bonds, harmony with nature and the environment, profound spirituality, adherence to religious practices, preservation of local customs, resilience cultivated through adversity, and a commitment to moderation across all spheres of life." Conclusions: This definition comprehensively outlines the primary lifestyle factors ingrained in Mediterranean inhabitants across generations. Its holistic nature furnishes a crucial conceptual framework for directing lifestyle medicine practitioners in assisting patients to mitigate diseases, promote overall well‐being, devise research initiatives to investigate the health ramifications of this lifestyle, and inform curriculum development. [ABSTRACT FROM AUTHOR]

In recent years the number of people who exercise every day has increased dramatically. More precisely, due to COVID period many people have become recreational runners. Recreational running is a regular way to keep active and healthy at any age. Additionally, running is a popular physical exercise that offers numerous health advantages. However, recreational runners report a high incidence of musculoskeletal injuries due to running. The healthcare industry has been compelled to use information technology due to the quick rate of growth and developments in electronic systems, the internet, and telecommunications. Our proposed intelligent system uses data mining algorithms for the rehabilitation guidance of recreational runners with musculoskeletal discomfort. The system classifies recreational runners based on a questionnaire that has been built according to the severity, irritability, nature, stage, and stability model and advise them on the appropriate treatment plan/exercises to follow. Through rigorous testing across various case studies, our method has yielded highly promising results, underscoring its potential to significantly contribute to the well-being and rehabilitation of recreational runners facing musculoskeletal challenges.

The aim of the present study was to determine the time course changes in hand grip strength performance and hand position sense in novice climbers after one bout of two minutes continuing climbing on an artificial vertical wall. In addition, the rate of perceived fatigue of the participant felt right after the trial was recorded. Sixty five novice climbers aged 20 to 22 years (age 20.50± 0.65 years), were randomly assigned into two training groups with different tests protocols, the Grip strength test group (n=23), versus Joint position sense test group (n=14), and two control groups (n=14 each). The training protocol included one bout of two minutes continuing climbing on an artificial wall for both training groups whereas the control groups did not receive any kind of training during the study. Subjects were pre and post-tested for the selected variables. Statistical analysis showed that the grip strength was significantly decreased only for the training group F(6,216) = 30.460, p < .0005, partial η2 = .489. Similarly, the rate of perceived exertion changed significant F(2,563, 41,001) = 24.397, p < .0005, partial η2 = 0.604, with the training group to be more tired than the control after two minutes continuing climbing. Also, the wrist position sense of training group significantly deteriorated at post-test with F(3,78)=2,977, p

Mental imagery (MI) is a psychological technique traditionally applied outside exercise contexts. However, recent studies indicate its potential benefits during physical activity, particularly for enhancing positive emotions and self-regulation of exercise behavior. While existing questionnaires capture aspects of MI regarding the exercise, none are specifically designed to evaluate MI during training. Therefore, it is necessary to create a new questionnaire. Establishing its content validity (CV) is the initial step in this process. Despite its importance for subsequent validity assessments and the reliability of the measurement instrument, CV is often overlooked or superficially addressed, possibly owing to a lack of comprehensive guidelines. In response to these needs, the aim of this study was to develop the "Imagery during Exercise Questionnaire-Gym Version" (IdEQ-GV) to assess the functions of MI during exercise and to measure its CV. This study also provides a step-by-step presentation of the content validation process. The development of the IdEQ-GV involved instrument design and judgmental evidence from academic experts and lay experts (i.e., potential research subjects). The first version of the questionnaire, consisting of 34 items across 6 dimensions, was assessed by three content experts who evaluated its CV in terms of relevance, essentiality, clarity, and comprehensiveness and provided feedback. The second version, comprising 28 items across 5 dimensions, was re-evaluated by content experts and discussed in cognitive interviews with 13 gym members, who also provided feedback and scores regarding comprehensibility and comprehensiveness. After making the necessary modifications, the third version of the IdEQ-GV, containing 24 items, was evaluated by a new sample of 20 exercisers for comprehensibility. The methods used to quantify CV included the content validity index (CVI), the scale-level CVI (S-CVI), which comprises the average CVI (S-CVI/Ave) and universal agreement (UA) among experts (S-CVI/UA), and the content validity ratio (CVR). The IdEQ-GV was found to have an excellent CV regarding relevance, with an S-CVI/UA of 1.00. For clarity, the S-CVI/Ave was 0.95. For essentiality, the average CVR of the scale was 0.83. For comprehensiveness, according to the content experts' scores, the S-CVI/Ave was 0.93, while the first sample of exercisers gave it a perfect score. Regarding comprehensibility, the final sample of exercisers rated the SCVI/Ave at 0.93. Through this analytical process, it has been established that the IdEQ-GV has excellent content validity and is now ready for widespread distribution to establish additional psychometric properties. [ABSTRACT FROM AUTHOR]

Objective: To pilot a newborn screening program for sickle cell disease (SCD) in St. Vincent and the Grenadines using a novel partnership method to determine the feasibility of a universal newborn screening program in this country. Methods : A prospective study of mothers and their newborns was conducted between January 1, 2015, and November 1, 2015, at the country’s main hospital. Mothers of infants born at this hospital were offered screening for SCD for their infants. If accepted, the newborn’s heel-stick blood specimen was obtained and mailed to the South Carolina Department of Health and Environmental Control Newborn Screening Laboratory for testing. Samples were analyzed for variant hemoglobins using standard laboratory techniques and results were communicated to local physicians. Feasibility was determined by a benchmark of having >50% of SCD patients receive the diagnosis and initiate disease-specific care by 3 months of age. Descriptive statistics were completed using SAS 9.4. Results : There were 1147 newborn infants screened for SCD. Of these, 123 (10.7%) had results indicative of sickle trait and 3 patients (0.3%) were diagnosed with SCD: 1 with HbSS and 2 with HbSC. All 3 patients with SCD received treatment before 3 months of age. Conclusions : A newborn screening program is feasible in this population when partnered with an established newborn screening laboratory.

The purpose of the study was to compare 2 different balance training programs, based on distinct exercise frequencies, with the aim of improving proprioceptive ability. Thirty eight professional soccer players, were randomly assigned into 3 groups: the A group, exercised with a frequency of 6 times per week, for 3 weeks, the B group exercised with a frequency of 3 times per week, for 6 weeks and the C group (control) did not follow a highly specific balance training, but only a standard soccer training. All participants were evaluated with the use of an electronic stability system (indices-deviations) and of a wooden balance board (time on balance) before (pre test) and after the training period (post test). Analyses of variance (ANOVAs), with repeated measures on the last factor, were conducted to determine effect of training programs and measures (pre-test, post-test) on balance test indices (SI, API, and MLI) and time on balance board. The results showed that both training groups improved their balance ability similarly (p

The purpose of the present study was to investigate the effects of a soccer training session on the balance ability of the young soccer players. Participants were twenty-six young soccer players. Standard testing balance boards and Biodex Stability System were used to assess balance ability before (pre-training) and immediately after (post-training) the completion of a soccer training session. Also, Isokinetic knee joint moment measurements (60°/sec and 180°/sec) were carried out pre- and post-soccer training. The results revealed that no differences (p>0.05) were found in balance ability and knee joint moment production between pre- and post-soccer training. Result is in contrast to the notion of a link between fatigue induced by a soccer training session or game and injury caused by impaired balance.

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The objectives of the present investigation were to study the inflammatory and performance responses after an acute bout of intense plyometric exercise during a prolonged recovery period. Participants were randomly assigned to either an experimental group (P, n = 12) that performed intense plyometric exercises or a control group (C, n = 12) that rested. The delayed onset of muscle soreness (DOMS), knee range of motion (KROM), creatine kinase (CK) and lactate dehydrogenase (LDH) activities, white blood cell count, C reactive protein (CRP), uric acid (UA), cortisol, testosterone, IL-6, IL-1b strength (isometric and isokinetic), and countermovement (CMJ) and static (SJ) jumping performance were measured at rest, immediately postexercise and at 24, 48, 72, 96, and 120 hours of recovery. Lactate was measured at rest and postexercise. Strength remained unchanged throughout recovery, but CMJ and SJ declined (p < 0.05) by 8-20%. P induced a marked rise in DOMS, CK, and LDH (peaked 24-48 hours postexercise) and a KROM decline. An acute-phase inflammatory response consisting of leukocytosis (postexercise and at 24 hours), an IL-6, IL-1b, CRP, and cortisol elevation (during the first 24 hours of recovery) and a delayed increase of UA (peaked at 48 hours) and testosterone (peaked at 72 hours) was observed in P. The results of this investigation indicate that performing an acute bout of intense plyometric exercise may induce a short-term muscle damage and marked but transient inflammatory responses. Jumping performance seems to deteriorate for as long as 72 hours postexercise, whereas strength appears to remain unchanged. The acute-phase inflammatory response after a plyometric exercise protocol appears to follow the same pattern as in other exercise models. These results clearly indicate the need of sufficient recovery between successive plyometric exercise training sessions. Key Words plyometric exercise, muscle soreness, stress hormones, strength

The purpose of the present study was to investigate the effect of a tennis training session on the balance performance of young tennis players. The study was conducted on 36 elite tennis players (age 14 [+ or -] 2 years; body mass 55 [+ or -] 6 kg; body height 165 [+ or -] 6 cm; mean [+ or -] SD) participating in the national young tennis championship. Balance performance was assessed before and immediately after a tennis training session (pre-training and post-training, respectively). The balance assessment was performed with 2 different balance boards and the Biodex Stability System. In addition, dynamometric measurements of peak isokinetic moment in the knee flexors and extensors were performed pre and post tennis training session, to quantify the degree of muscle fatigue induced by the tennis training session. One-way analysis of variance with repeated measures was used to test for differences in balance performance and in isokinetic performance between pre and post tennis training session. The data analysis revealed no significant differences (p > 0.05) in balance performance, whereas there were significant differences in knee joint moment production between pre and post tennis training measures. Although the tennis training session of the present study had no significant effect (p > 0.05) on any of the balance performance indicators examined, there was a decline in balance performance, which suggests that different level of fatigue for an extended period (games) will have greater effect on balance performance. It is suggested that a tennis-specific balance exercise program should be included in the tennis training session. KEY WORDS elite tennis players, coordination, training fatigue

The aim of the study was to investigate the effect of a muscular training program on soccer players' performance which initially appeared imbalanced or bilaterally asymmetrical. During the preparation period, 35 soccer players perforated an isokinetic measurement of knee flexors and extensors ([60[degrees].sup.-1] and 180[degrees] [sec.sup.-1]). 15 of these had muscular imbalances or deficits and followed a specific isokinetic training program for 2 mo., 3 times per week. After the completion of the isokinetic training program, the 35 players underwent the same isokinetic test. Significant differences were noted between the pre- and posttraining measures at botln angular velocities in peak torque values, in differences from one limb to the other, and in peak torque ratios for flexors and extensors. Consequently, the application of this specific isokinetic training program can restore imbalances in knee muscle strength efficiently.

The purpose of this study was to compare 2 different training modes in improving shoulder cuff muscular performance. Thirty-nine participants were randomly assigned into 3 groups: the isolated group exercised using 2-kg dumbbells; the complex group used a protocol with complex exercises; and the control group had no training. All participants trained for 6 weeks (3 times per week) and were evaluated isokinetically before (pretest) and after the training period (posttest). Results showed that the complex group significantly improved their muscular performance, but the isolated group did not, indicating that isolated exercises are only effective when the training goal is to strengthen the weaker muscle group, but they must be replaced by more complex and closed-kinetic exercises in order to obtain considerable improvement of the rotator cuff strength. The authors propose that a strengthening program should start with isolated movements for better stimulation of the weaker muscles and continue with complex exercise for more impressive strengthening. KEY WORDS. internal/external rotators, peak torque values isolated exercise

The objectives of this research were to evaluate two different functional training programmes with body weight, «Flowbility» (FB) which promote the fascial health and «Authentic Pilates» (AP), on physical abilities of muscles, in healthy adult students. Participants (n=58) were randomly divided into three groups, the «FB», that performed a prechoreographed programme, the «AP», that applied the authentic series of Pilates exercises on mat, and the «Control» group, that rested. The load was increased progressively. The intervention lasted 6 weeks, with frequency 3 sessions of 45 min. per week, for each group. Three measurements were carried out (initial, final and detraining one month after the intervention). Functional tests were used to measure: strength, flexibility-mobility and functionality-balance, as an ultrasound device to measure transverse abdominal and multifidus muscle thickness. Used ANOVA analysis of variance of repeated measurements, the degree of significance was set at p=0.05. The analysis of results showed that there is statistically significant difference in performance from initial to final and retention measurement. In conclusion, practicing with «Flowbility» and «Authentic Pilates» significantly improved the physical abilities of adults, at the same level and contributed to reduction of TrA thickness at the resting phase and increased its activation. [ABSTRACT FROM AUTHOR]

The traditional approach of the use of mental imagery (MI) considers it to be held in other moments than physical practice, and the person only imaging the movement/situation without experiencing it physically. On the other hand, in the dance field, MI is often used during movement serving multiple functions. In the exercise field, the information regarding exercise imagery (EI) during movement derives mostly from researches and questionnaires that have mainly investigated its nature (types and functions) outside of practice, so the full potential of this psychological technique, when used during exercise, remains unknown. The aim of the present study was to construct a questionnaire in order to explore the nature of EI used by gym members during their workouts, to control it through a pilot research and to acquire a first piece of knowledge on the EI used by them, initiating the scientific dialogue about this underinvestigated subject. 15 gym members completed the questionnaire [named Exercise Imagery Pilot Questionnaire-Gym Version (EIPQ-GV)] and also provided feedback for its refinement. According to the results produced by EIPQ-GV, EI is used during exercise, it serves all known cognitive and motivational functions, it differs in some aspects from the use of EI outside of practice and its use makes exercise more pleasant and less monotonous, indicating that it is a promising technique that deserves further research. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the effects of the injury prevention program FIFA 11+ (level 2) application, on lower limb balance ability and strength, as an effective approach of reducing injury risk in male soccer players. Thirty-two players were randomly divided into two groups (N = 16 each), one control group (CON group), and one training group (INT group). The INT group followed the FIFA 11+ injury prevention program, 3 times per week for 8 weeks. The CON group continued the usual warm-up. Biodex Stability System was used to assess balance ability in both groups at baseline and after the completion of FIFA 11+ program. Additional isokinetic knee joint moment measurements (concentric flexors/extensors and eccentric flexors) performed at two different angular velocities, first at 60°/s and then at 180°/s. Statistical significant differences were found, after the completion of the FIFA 11+ training program, in stability index (total and anterior -- posterior) (p < .05), in concentric and eccentric flexors strength (p < .05) and conventional H/Q ratio (p < .05). Application of the FIFA 11+ injury prevention program for 8 weeks can improve lower limbs balance ability and hamstrings muscle strength, elements which are very important for prevention of hamstring muscle strains and lower limb ligament injuries in soccer. [ABSTRACT FROM AUTHOR]