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Objectives: Living within a larger body brings unique challenges to exercise participation, which are poorly understood. This qualitative study explored the attitudes towards, and experiences of, exercise participation in adults with class III obesity. Design: Individual semi‐structured qualitative interviews. Methods: We recruited 30 adults with class III obesity (body mass index: 45.8 ± 8.6 kg/m2) from a specialist multidisciplinary weight management service. Participants took part in semi‐structured interviews while participating in a 6‐month home‐based aerobic and resistance exercise intervention. Open‐ended questions were used flexibly to explore their views and experiences of exercise, encompassing barriers, motives and perceived benefits. Transcripts were analysed using reflexive thematic analysis. Results: Three themes were developed: (1) a web of barriers; (2) tailored exercise facilitates positive experiences; and (3) a desire to live a normal life. People with class III obesity perceived that they were unable to do exercise; a view that was attributed to perceived judgement, low physical function, pain during everyday activities and failed weight loss attempts. These complex physical and psychosocial barriers to exercise were described as contributing to exercise avoidance. High value was placed on tailored exercise that accommodates the unique needs of moving in a larger body. A desire to carry out everyday tasks underpinned motivations for exercise. Conclusions: Our findings suggest that multi‐component obesity interventions should move away from generic exercise prescriptions designed to maximize energy expenditure, and instead move towards addressing the unique physical and psychosocial needs of people who have class III obesity with tailored person‐centred and weight‐neutral exercise prescriptions. [ABSTRACT FROM AUTHOR]

The aim was to determine the validity and test – retest reliability of the Sit to Stand App variables (rising time, vertical velocity, and power) for measuring single-leg sit-to-stand (STS) test compared to those derived from ground reaction force data. Twenty-seven female athletes performed the single-leg STS test over three consecutive sessions simultaneously recorded with a force plate and the smartphone app. Validity was assessed with Pearson's correlation coefficient, intra-class correlation coefficient (ICC), and percentage error. Reliability was assessed with the ICC. Almost perfect correlations (r ≥ 0.95) and excellent agreement (ICC = 0.96–0.97) between the app and force plate measures with low percentage errors (≤7.3%) were found. The app showed good-to-excellent reliability (ICC = 0.88–0.92) with no differences in inter-limb asymmetry over three sessions. The app was highly valid and reliable for measuring single-leg STS performance. Practitioners can use this app to assess lower-limb performance in female athletes. [ABSTRACT FROM AUTHOR]

The Tendo Unit (TU) and GymAware (GA) are the two most frequently used linear transducers for assessing muscle power in older adults via the sit-to-stand (STS) test. Unlike TU, GA incorporates a sensor mechanism to correct for non-vertical movements, which may lead to systematic differences between devices. The aim of this study therefore was to compare GA to TU for measuring STS power in community-dwelling older adults. Community-dwelling adults (n = 51, aged ≥65 years, 61% female) completed a single chair stand, with peak power measured simultaneously using GA and TU. Participants also completed the pneumatic leg press, 8-Foot Up and Go (TUG) test, Short Physical Performance Battery (SPPB), and self-reported measures of physical function. Intraclass correlations (ICC) were used to assess agreement, and Pearson's correlations were used to assess correlations. The study protocol was prospectively registered on the Open Science Framework. In alignment with our pre-registered hypothesis, peak power demonstrated an ICC of 0.93 (95% CI: 0.88, 0.96). For secondary aims, both transducers showed a correlation greater than 0.8 compared to pneumatic leg press power. For physical performance outcomes, both TU and GA showed similar correlations, as hypothesized: SPPB (r = 0.29 for TU vs. 0.33 for GA), Chair Stands (r = −0.41 vs. -0.38), TUG Fast (r = −0.53 vs. -0.52), mobility questionnaire (r = 0.52 vs. 0.52) and physical function questionnaire (r = 0.44 vs. 0.43). GA and TU peak power showed a high degree of agreement and similar correlations with physical and self-reported performance measures, suggesting that both methods can be used for assessing STS power in older adults. [ABSTRACT FROM AUTHOR]

Purpose: Exercise has transient effects on the immune system that could influence infection risk and tissue recovery after exercise. Little is known about how the menstrual cycle interacts with the immune responses to acute exercise. This exploratory study sought to evaluate the effect of menstrual-cycle phase on peripheral blood mononuclear cell counts before and immediately after a bout of intense aerobic exercise. Methods: Seven naturally menstruating women (age: 27 [3] y) completed three 5-km cycling time trials coinciding with the early-follicular, late-follicular, and mid-luteal stage, confirmed by hormonal measurement. Venous blood samples were taken and examined for the presence of immune cell types using flow cytometry. Results: Reductions in circulating CCR7+CD45RA+ naïve CD4+ T cells, CD4+CD25+ regulatory T cells, and CD56+CD57+ natural killer cells observed during the early-follicular phase were attenuated when exercise was performed during the late-follicular phase. Similarly, reductions in circulating CD56+CD57+ natural killer cells and CD14+TLR4+ monocytes following exercise in the early-follicular phase were abolished when exercise was performed in the midluteal phase. Conclusions: These preliminary findings indicate that the effect of acute high-intensity exercise on immune-cell mobilization and activation varies across the menstrual cycle, potentially impacting the anti-inflammatory effects of regulatory T cells and the cell-mediated effects of both natural killer CD57+ cells and monocytes expressing TLR4. [ABSTRACT FROM AUTHOR]

Purpose: To compare the effects of variable-resistance complex training (VRCT) versus traditional complex training (TCT) on muscle architecture in rugby league players during a 6-week mesocycle. Methods: Twenty-four rugby league players competing in the British University & Colleges Sport (BUCS) Premier North Division were randomized to VRCT (n = 8), TCT (n = 8), or control (n = 8). Experimental groups completed a 6-week lower-body complex training intervention (2×/wk), which involved alternating high-load resistance exercise with plyometric exercise in the same session. The VRCT group performed resistance exercises at 70% of 1-repetition maximum (1RM) + 0% to 23% of 1RM from band resistance with a 90-second intracontrast rest interval, whereas the TCT group performed resistance exercise at 93% of 1RM with a 4-minute intracontrast rest interval. Muscle thickness (MT), pennation angle, and fascicle length (Lf) were assessed for the vastus lateralis (VL) and gastrocnemius medialis using ultrasound imaging. Results: Both TCT and VRCT groups significantly improved VL MT and VL Lf compared with control (all P <.05). Standardized within-group changes in MT and Lf (Cohen dav ± 95% CI) were moderate for TCT (dav = 0.91 ± 1.0; dav = 1.1 ± 1.1) and unclear for VRCT (dav = 0.44 ± 0.99; dav = 0.47 ± 0.99), respectively. Differences in change scores between TCT and VRCT were unclear. Conclusions: VRCT and TCT can be utilized during the competitive season to induce favorable MT and Lf muscle architecture adaptations for the VL. TCT may induce greater muscle architecture adaptations of the VL, whereas VRCT may be of more practical value given the shorter intracontrast rest interval between resistance and plyometric exercises. [ABSTRACT FROM AUTHOR]

Purpose: To compare the effects of variable-resistance complex training (VRCT) versus traditional complex training (TCT) on strength, power, speed, and leg stiffness (Kleg) in rugby league players during a 6-week mesocycle. Methods: Twenty-four rugby league players competing in the British University and Colleges Sport Premier North Division were randomized to VRCT (n = 8), TCT (n = 8), or control (CON; n = 8). Experimental groups completed a 6-week lower-body complex training intervention (2×/wk) that involved alternating high-load resistance exercise with plyometric exercise within the same session. The VRCT group performed resistance exercises at 70% of 1-repetition maximum (1RM) + 0% to 23% of 1RM from band resistance with a 90-second intracontrast rest interval, whereas the TCT group performed resistance exercise at 93% of 1RM with a 4-minute intracontrast rest interval. Back-squat 1RM, countermovement jump peak power, reactive strength index, sprint times, and Kleg were assessed pretraining and posttraining. Results: VRCT and TCT significantly improved 1RM back squat, countermovement jump peak power, and 5-m sprint time (all P <.05). VRCT also improved Kleg, whereas TCT improved 10- and 20-m sprint times (all P <.05). Between groups, both VRCT and TCT improved 1RM back squat compared with CON (both P <.001). Additionally, VRCT improved Kleg compared with CON (right leg: P =.016) and TCT improved 20-m sprint time compared with CON (P =.042). Conclusions: VRCT and TCT can be implemented during the competitive season to improve strength, power, and 5-m sprint time. VRCT may lead to greater improvements in reactive strength index and Kleg, whereas TCT may enhance 10- and 20-m sprint times. [ABSTRACT FROM AUTHOR]

Purpose: To compare the effects of velocity-based training (VBT) vs percentage-based training (PBT) on strength, speed, and jump performance in academy rugby league players during a 7-wk in-season mesocycle. Methods: A total of 27 rugby league players competing in the Super League U19s Championship were randomized to VBT (n = 12) or PBT (n = 15). Both groups completed a 7-wk resistance-training intervention (2×/wk) that involved the back squat. The PBT group used a fixed load based on a percentage of 1-repetition maximum (1-RM), whereas the VBT group used a modifiable load based on individualized velocity thresholds. Biomechanical and perceptual data were collected during each training session. Back-squat 1-RM, countermovement jump, reactive strength index, sprint times, and back-squat velocity at 40–90% 1-RM were assessed pretraining and posttraining. Results: The PBT group showed likely to most likely improvements in 1-RM strength and reactive strength index, whereas the VBT group showed likely to very likely improvements in 1-RM strength, countermovement jump height, and back-squat velocity at 40% and 60% 1-RM. Sessional velocity and power were most likely greater during VBT compared with PBT (standardized mean differences = 1.8–2.4), while time under tension and perceptual training stress were likely lower (standardized mean differences = 0.49–0.66). The improvement in back-squat velocity at 60% 1-RM was likely greater following VBT compared with PBT (standardized mean difference = 0.50). Conclusion: VBT can be implemented during the competitive season, instead of traditional PBT, to improve training stimuli, decrease training stress, and promote velocity-specific adaptations. [ABSTRACT FROM AUTHOR]

Objectives: (i) To assess whether exercise training attenuates the adverse effects of treatment in patients with newly diagnosed prostate cancer beginning androgen‐deprivation therapy (ADT), and (ii) to examine whether exercise‐induced improvements are sustained after the withdrawal of supervised exercise. Patients and Methods: In all, 50 patients with prostate cancer scheduled for ADT were randomised to an exercise group (n = 24) or a control group (n = 26). The exercise group completed 3 months of supervised aerobic and resistance exercise training (twice a week for 60 min), followed by 3 months of self‐directed exercise. Outcomes were assessed at baseline, 3‐ and 6‐months. The primary outcome was difference in fat mass at 3‐months. Secondary outcomes included: fat‐free mass, cardiopulmonary exercise testing variables, QRISK®2 (ClinRisk Ltd, Leeds, UK) score, anthropometry, blood‐borne biomarkers, fatigue, and quality of life (QoL). Results: At 3‐months, exercise training prevented adverse changes in peak O2 uptake (1.9 mL/kg/min, P = 0.038), ventilatory threshold (1.7 mL/kg/min, P = 0.013), O2 uptake efficiency slope (0.21, P = 0.005), and fatigue (between‐group difference in Functional Assessment of Chronic Illness Therapy‐Fatigue score of 4.5 points, P = 0.024) compared with controls. After the supervised exercise was withdrawn, the differences in cardiopulmonary fitness and fatigue were not sustained, but the exercise group showed significantly better QoL (Functional Assessment of Cancer Therapy‐Prostate difference of 8.5 points, P = 0.034) and a reduced QRISK2 score (−2.9%, P = 0.041) compared to controls. Conclusion: A short‐term programme of supervised exercise in patients with prostate cancer beginning ADT results in sustained improvements in QoL and cardiovascular events risk profile. [ABSTRACT FROM AUTHOR]

This study examined the relationship between sit-to-stand (STS) power and physical function in adults with severe obesity. Thirty-eight adults (age: 44 ± 12 years; body mass index [BMI]: 45.2 ± 7.8 kg/m2) completed evaluations of STS power, strength and functional performance. STS power was measured with a wearable inertial sensor, strength was assessed with the isometric mid-thigh pull, and function was measured with the timed up-and-go (TUG), six-minute walk test (6MWT) and 30-s chair STS. Power and strength (normalised to body mass) entered regression models in addition to age, gender, BMI and physical activity (daily step count). Power displayed large univariate associations with TUG (r = 0.50) and 30-s chair STS (r = 0.67), and a moderate association with 6MWT (r = 0.49). Forward stepwise regression revealed that power independently contributed to TUG (β = −0.40, p = 0.010), 30-s chair STS (β = 0.67, p < 0.001) and 6MWT performance (β = 0.27, p = 0.007). Power also appeared to be a superior determinant of function compared with strength. Power generated via the STS transfer largely underpins the ability to perform functional tasks in adults with severe obesity, although intervention studies are required to investigate a potentially causal relationship. [ABSTRACT FROM AUTHOR]

Objectives: The study aimed to assess the feasibility, acceptability and safety of delivering a home-based telehealth exercise intervention to older patients with hepatocellular carcinoma (HCC)., Design: Non-randomised feasibility study., Setting: Patients were recruited from UK outpatient liver cancer clinics., Participants: Patients were aged ≥60 years with HCC, with post-treatment imaging reporting a complete response, partial response or stable disease., Intervention and Data Collection: Patients were invited to attend synchronous online exercise sessions, twice weekly for 10 weeks. Physical function and patient-reported outcomes were assessed pre-intervention and post-intervention. Qualitative data were collected via semistructured interviews after intervention completion., Primary Outcome Measures: Recruitment, retention, exercise adherence and safety., Results: 40 patients were invited to participate and 19 (mean age 74 years) provided consent (recruitment rate 48%). Patients completed 76% of planned exercise sessions and 79% returned to the clinic for follow-up. Hand grip strength (95% CI 1.0 to 5.6), Liver Frailty Index (95% CI -0.46 to -0.23) and time taken to perform five sit-to-stands (95% CI -3.2 to -1.2) improved from pre-intervention to post-intervention. Patients reported that concerns they had relating to their cancer had improved following the intervention (95% CI 0.30 to 5.85). No adverse events occurred during exercise sessions.Qualitative data highlighted the importance of an instructor in real time to ensure that the sessions were achievable, tailored and well balanced, which helped to foster motivation and commitment within the group. Patients reported enjoying the exercise intervention, including the benefits of peer support and highlighted perceived benefits to both their physical and mental health. Patients felt that the online sessions overcame some of the barriers to exercise participation and preferred attending virtual sessions over face-to-face classes., Conclusions: It is feasible, acceptable and safe to deliver supervised group exercise via videoconferencing to patients with HCC in their own homes. These findings will inform the design of a future, adequately powered randomised controlled trial to evaluate the efficacy of the intervention., Trial Registration Number: ISRCTN14411809., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Purpose: To compare the effects of variable-resistance complex training (VRCT) versus traditional complex training (TCT) on muscle architecture in rugby league players during a 6-week mesocycle., Methods: Twenty-four rugby league players competing in the British University & Colleges Sport (BUCS) Premier North Division were randomized to VRCT (n = 8), TCT (n = 8), or control (n = 8). Experimental groups completed a 6-week lower-body complex training intervention (2×/wk), which involved alternating high-load resistance exercise with plyometric exercise in the same session. The VRCT group performed resistance exercises at 70% of 1-repetition maximum (1RM) + 0% to 23% of 1RM from band resistance with a 90-second intracontrast rest interval, whereas the TCT group performed resistance exercise at 93% of 1RM with a 4-minute intracontrast rest interval. Muscle thickness (MT), pennation angle, and fascicle length (Lf) were assessed for the vastus lateralis (VL) and gastrocnemius medialis using ultrasound imaging., Results: Both TCT and VRCT groups significantly improved VL MT and VL Lf compared with control (all P < .05). Standardized within-group changes in MT and Lf (Cohen dav ± 95% CI) were moderate for TCT (dav = 0.91 ± 1.0; dav = 1.1 ± 1.1) and unclear for VRCT (dav = 0.44 ± 0.99; dav = 0.47 ± 0.99), respectively. Differences in change scores between TCT and VRCT were unclear., Conclusions: VRCT and TCT can be utilized during the competitive season to induce favorable MT and Lf muscle architecture adaptations for the VL. TCT may induce greater muscle architecture adaptations of the VL, whereas VRCT may be of more practical value given the shorter intracontrast rest interval between resistance and plyometric exercises.

Purpose: To compare the effects of velocity-based training (VBT) vs percentage-based training (PBT) on strength, speed, and jump performance in academy rugby league players during a 7-wk in-season mesocycle., Methods: A total of 27 rugby league players competing in the Super League U19s Championship were randomized to VBT (n = 12) or PBT (n = 15). Both groups completed a 7-wk resistance-training intervention (2×/wk) that involved the back squat. The PBT group used a fixed load based on a percentage of 1-repetition maximum (1-RM), whereas the VBT group used a modifiable load based on individualized velocity thresholds. Biomechanical and perceptual data were collected during each training session. Back-squat 1-RM, countermovement jump, reactive strength index, sprint times, and back-squat velocity at 40-90% 1-RM were assessed pretraining and posttraining., Results: The PBT group showed likely to most likely improvements in 1-RM strength and reactive strength index, whereas the VBT group showed likely to very likely improvements in 1-RM strength, countermovement jump height, and back-squat velocity at 40% and 60% 1-RM. Sessional velocity and power were most likely greater during VBT compared with PBT (standardized mean differences = 1.8-2.4), while time under tension and perceptual training stress were likely lower (standardized mean differences = 0.49-0.66). The improvement in back-squat velocity at 60% 1-RM was likely greater following VBT compared with PBT (standardized mean difference = 0.50)., Conclusion: VBT can be implemented during the competitive season, instead of traditional PBT, to improve training stimuli, decrease training stress, and promote velocity-specific adaptations.