Medicine and Science in Sports and Exercise最新文献

Purpose: This study aimed to evaluate the impact of a supervised exercise program, including pelvic floor muscle training, throughout pregnancy on Urinary Incontinence (UI).

Methods: A randomized clinical trial (NCT04563065) was conducted. Initially, 600 pregnant women were screened for eligibility, with data from 356 participants eventually analyzed. Of these, 172 were allocated to the exercise group (EG) and 184 to the control group (CG). Participants in the EG engaged in a supervised moderate exercise program 3 d·wk -1 , each session lasting 60 min, from 8-10 to 38-40 wk of gestation, achieving an adherence rate of 73.5%.

Results: A lower prevalence of UI in the EG compared with the CG was observed during late pregnancy ( χ2 = 20.04; P = 0.001) and at 3 months postpartum ( χ2 = 12.52; P = 0.03), as well as in birth weight ( F = 4.16; P = 0.04). No significant differences were found between the groups in other maternal and newborn outcomes.

Conclusions: Supervised exercise during pregnancy, which included pelvic floor muscle training, effectively reduced the incidence of UI in late pregnancy and at 3 months postpartum.

Purpose: Personal activity intelligence (PAI) translates heart rate during physical activity (PA) into a weekly score, which credits vigorous over low- and moderate-intensity PA. We prospectively investigated the association between PAI and fatal and nonfatal coronary heart disease (CHD) in self-reported healthy participants from Norway, with specific reference to improving the accuracy of conventional coronary risk assessment.

Methods: We studied 40,961 healthy adults (56% women) from the population-based Trøndelag Health Study (the HUNT study). Individual data were linked to hospital and cause of death registries. The weekly PAI score of each participant was divided into four groups (PAI scores of 0, ≤50, 51-99, or ≥100). Adjusted hazard ratios and 95% confidence intervals for fatal and nonfatal CHD related to PAI were estimated using Cox proportional hazard regression analyses.

Results: During a median follow-up period of 13.1 yr (interquartile range, 12.7-13.6), 3303 (3109 nonfatal, 194 fatal) CHD events occurred. Compared with the inactive group (0 PAI), weekly PAI scores at baseline of 51-99 and ≥100 were associated with a lower risk of CHD [0.80 (0.71-0.91) and 0.86 (0.78-0.95), respectively]. By adding PAI to traditional risk factors, the net reclassification improvement of CHD was 0.472 ( P < 0.001).

Conclusions: PAI was inversely associated with CHD risk among healthy participants at baseline, and its cardioprotective effect persisted across diverse risk factor profiles. A PAI score >50 was substantially associated with a reduced risk of CHD. These findings have implications for improving the accuracy of conventional coronary risk assessments with PAI.

Purpose: This study assessed the impact of a 12-wk, home-based exercise training (HBET) program on health-related quality of life (HRQOL; primary outcome), and cardiovascular and metabolic parameters in pediatric COVID-19 patients.

Methods: This was a single-center, randomized controlled trial conducted in a tertiary hospital in Sao Paulo, from October 2020 to January 2022. Thirty-two patients (mean age, 12 ± 3.3 yr) were randomly assigned to either HBET or standard of care (CONTROL) in a 2:1 ratio 4 months (range: 0.7-6.6 months) after COVID-19 discharge ( n = 25 mild, n = 4 moderate, n = 3 severe illness). The HBET group underwent supervised and unsupervised sessions three times a week for 12 wk emphasizing aerobic and body weight exercises, while the CONTROL group received standard care, which included general advice for a healthy lifestyle with no prescribed exercise intervention. HRQOL (evaluated by the Pediatric Quality of Life Inventory), cardiopulmonary exercise test, brachial endothelial function and echocardiography assessments were conducted in both groups. Statistical analysis was performed using an intention-to-treat approach for the primary analysis and complete case (per-protocol) as sensitivity analysis.The significance was set at P ≤ 0.05 and P ≤ 0.10 was considered as trend.

Results: There was no difference in HRQOL between groups. Intention-to-treat analysis indicated a trend toward increased oxygen uptake (V̇O 2 ) at anaerobic threshold following the intervention in the HBET group. In addition, a sensitivity analysis showed significant changes in peak heart rate and 1-min recovery, respiratory exchange ratio, and chronotropic response. A trend toward significance was observed in ventilation-to-maximum voluntary ventilation ratio and chronotropic response in the HBET group. No other between-group differences were detected for the cardiopulmonary exercise test, brachial flow-mediated dilation, and echocardiography variables (all P > 0.05).

Conclusions: In this randomized controlled trial, a 12-wk HBET intervention did not impact HRQOL in pediatric COVID-19 patients. However, exercise was able to improve the V̇O 2 at the ventilatory anaerobic threshold, heart rate peak and 1-min recovery, ventilation-to-maximum voluntary ventilation ratio, and chronotropic response, with no changes observed in other cardiovascular parameters. Further studies are needed to investigate the long-term effects of exercise interventions on the recovery of pediatric COVID-19 patients with and without preexisting chronic conditions.

Purpose: There is controversy whether there are meaningful physiological differences between hypobaric (HH) and normobaric hypoxia (NH). This study aimed to compare the cardiorespiratory responses to acute HH and NH under strictly controlled conditions. We hypothesized no differences at rest and during submaximal exercise, whereas during maximal exercise, a higher maximal ventilation (V̇ Emax ), peripheral oxygen saturation (SpO 2 ), and maximal oxygen consumption (V̇O 2max ) in HH than in NH.

Methods: In a randomized, single-blind, crossover design, eight young healthy subjects (three females) were studied in an environmental chamber in which either the barometric pressure (HH) or the inspired oxygen fraction (NH) was reduced to the equivalent of ~4000 m altitude. Measurements were taken at rest, and during submaximal (moderate and high intensity) and maximal cycling exercise.

Results: All resting parameters were similar between HH and NH, except for a lower root mean square of the successive R-R interval differences in HH ( P < 0.05). SpO 2 was 2% higher in HH at all exercise intensities ( P < 0.05). During submaximal exercise, minute ventilation was similar between HH and NH. However, HH yielded a 7% lower tidal volume during moderate-intensity exercise ( P < 0.05) and a lower respiratory exchange ratio during high-intensity exercise ( P < 0.01). V̇ Emax and V̇O 2max were 11% and 6% higher in HH, respectively ( P < 0.01 for both). SpO 2 at maximal exercise was positively correlated with V̇ Emax , V̇ Emax /V̇O 2max , and V̇O 2max .

Conclusions: The higher V̇O 2max found in HH than in NH can be attributed to the higher V̇ Emax counteracting desaturation at maximal exercise. Conversely, submaximal SpO 2 improved in HH through mechanisms other than increased ventilation. These findings are likely due to respiratory muscle unloading in HH, which operated through different mechanisms depending on exercise intensity.

Purpose: The associations between work time, leisure-time, and non-workday physical activity (PA) and sedentary behavior (SED), and 24-h ambulatory blood pressure (BP) are not well known. Therefore, the aim of this study was to evaluate the associations between domain-specific activity behavior and 24-h BP.

Methods: A hundred fifty-six aging workers (mean age, 62.4 (SD 1.0) yr; body mass index, 26.2 (4.5) kg·m -2 ; 84% women; 75% nonmanual occupation) from the Finnish Retirement and Aging study were included. Standing, light and moderate-to-vigorous PA, and SED were measured using thigh-worn accelerometers and work time, leisure-time, and non-workdays were distinguished using a diary. Ambulatory 24-h BP was analyzed as mean daytime and nighttime systolic and diastolic BP, and the nocturnal BP dipping percentage was calculated. Associations were examined with linear regression analysis adjusting for age, sex, occupation, work time mode, job strain, body mass index, BP medication, and accelerometer wear time.

Results: Higher work time SED was associated with lower nighttime diastolic BP ( B = -0.92; 95% confidence interval (CI), -1.83 to -0.01). In addition, higher work time standing was associated with higher daytime diastolic BP ( B = 1.34; 95% CI, 0.03 to 2.65), and higher work time light PA was associated with less diastolic BP dipping ( B = -3.57; 95% CI, -6.80 to -0.34). Moderate-to-vigorous PA in any domain was not associated with ambulatory BP.

Conclusions: Higher work time SED was associated with a more favorable diastolic BP, and higher work time PA was associated with more adverse diastolic BP among aging workers. In conclusion, work time, rather than leisure time or non-workday, activity behavior seems to be associated with 24-h ambulatory BP.

Purpose: To examine how development of motor competence (locomotor, object control, stability) and development of musculoskeletal fitness (upper body and abdominal) are related during adolescence in a large sample of Finnish youth over 4 yr.

Methods: Study participants were students ( n = 1147; 11.27 ± 0.33 yr at baseline) attending public schools in Finland. Data were collected yearly (2017-2021). Motor competence was assessed using the throwing-catching combination test, the 5-leaps test, and the side-to-side jumping test. Musculoskeletal fitness was assessed using the curl-up and the push-up tests. To answer the research question, a parallel latent growth curve model was implemented. Covariates were sex, body mass index, and peak height velocity.

Results: Improvements in all motor competencies were positively associated with improvements in push-ups. Subsequently, improvements in 5-leaps and side-to-side jumping test scores were related to improvements in curl-ups. Our covariate results indicate sex (male), healthy body mass index, and undergoing peak height velocity were associated with greater increases in motor competency and musculoskeletal fitness.

Conclusions: Given fitness has been shown to mediate the relationship between physical activity and motor competence, positive practices are needed to enhance adolescents' experiences in physical activities and sports requiring adequate intensity to improve fitness and motor competence.

Purpose: Aging is associated with declines in cognition and mental health that might be ameliorated by physical activity (PA). Dance integrates multiple physical, cognitive, and social elements, and might be an avenue for improving cognition and mood. This systematic review and meta-analysis examined the effects of formal and traditional dance on cognition, depression, and anxiety in older adults.

Methods: Five database searches yielded 17 randomized control trials (RCTs). RCTs were included if participants were ≥60 yr and healthy or living with mild cognitive impairment. We examined interventions of dance against any comparison group. Records were independently screened, and data were extracted by two reviewers. We performed random-effects models using robust variance estimation and tested individual treatment, study, and outcome-level moderators using the approximate Hotelling-Zhang test.

Results: Seventeen RCTs were included in the systematic review, but 13 RCTs were included in the meta-analysis, which included 1174 participants with a mean age of 70.7 yr, and 66.3% were female. There were 76 effect sizes (Hedges g) calculated from the 13 RCTs with a range between -0.97 and 2.88. The overall effect of dance interventions on cognition was significant, yet small (g = 0.27; 95% confidence interval, 0.05-0.50; P = 0.022), and the effect on depression was significant and nearly moderate (g = 0.43; 95% confidence interval, 0.06-0.80; P = 0.036); only one RCT examined anxiety and was not included. No moderator variables significantly explained variation in the effects of dance on cognitive function or depression (P > 0.05).

Conclusions: Dance interventions can improve cognition and depression in older adults. Additional research is needed regarding the effects of dance on anxiety and depression in older adults.

Purpose: Cardiac rehabilitation participation rates are low despite strong recommendations, and many chronic heart failure patients remain physically inactive. Rural living, long travel distance, costs, age, and frailty might be factors explaining this. To increase cardiac rehabilitation uptake, we designed an exercise-based randomized controlled telerehabilitation trial enabling chronic heart failure patients unable or unwilling to participate in outpatient cardiac rehabilitation to exercise at home. Aim was to evaluate the long-term effects of telerehabilitation on physical activity levels.

Methods and results: Chronic heart failure patients ( n = 61) with reduced (≤40%), mildly reduced (41%-49%), or preserved ejection fraction (≥50%) were randomized (1:1) to telerehabilitation ( n = 31) with an initial 3-month group-based high-intensity exercise telerehabilitation program or control ( n = 30), with regular follow-up visits over a 2-yr period. All participants attended a "Living with heart failure" course. Outcomes were measures of physical activity, peak oxygen uptake, 6-min walk test distance, quality of life, morbidity, and mortality. We found no significant differences between groups for long-term changes in moderate to vigorous activity (MVPA) or peak oxygen uptake from baseline to the 2-yr follow-up. Nor quality of life differed between groups, but both groups had significant within-group improvements in score on the Minnesota Living with Heart Failure Questionnaire ( P = 0.000) and improvement in EQ-5D visual analog scale score was significant ( P = 0.05) in the telerehabilitation group.

Conclusions: Telerehabilitation performed as home-based real-time high-intensity exercise sessions provided by videoconferencing for participants unable or unwilling to participate in standard outpatient cardiac rehabilitation did not affect long-term physical activity levels or physical capacity as expected. Still, a positive effect on health-related quality of life was seen in both groups.

Purpose: Ingestion of whey protein increases myofibrillar but not muscle connective protein synthesis rates. Recently, we defined a whey and collagen protein blend (5:1 ratio) to optimize post-prandial plasma amino acid availability. Here, we assessed the ability of this blend to increase myofibrillar and muscle connective protein synthesis rates at rest and during early recovery from exercise.

Methods: In a randomized, double-blind, parallel design, 28 men (age: 25 ± 5 yr; body mass index: 23.6 ± 2.3 kg·m -2 ) were randomly allocated to ingest either 30 g of protein (25 g whey/5 g collagen; BLEND, n = 14) or a noncaloric placebo (PLA, n = 14) following a single session of unilateral leg resistance-type exercise. Participants received primed continuous l -[ ring - 13 C 6 ]-phenylalanine infusions with blood and muscle biopsy samples collection for 5 h post-prandially to assess myofibrillar and muscle connective protein synthesis rates.

Results: Protein ingestion strongly increased plasma amino acid concentrations, including plasma leucine and glycine concentrations ( P < 0.001), with no changes following placebo ingestion ( P > 0.05). Post-prandial myofibrillar and muscle connective protein synthesis rates were higher in the exercised compared with the rested leg ( P < 0.001). In addition, myofibrillar protein synthesis rates were higher in BLEND compared with PLA in both the rested (0.038 ± 0.008 and 0.031 ± 0.006%·h -1 , respectively; P < 0.05) and exercised (0.052 ± 0.011 and 0.039 ± 0.009%·h -1 , respectively; P < 0.01) leg. Muscle connective protein synthesis rates were higher in BLEND compared with PLA in the rested (0.062 ± 0.013 and 0.051 ± 0.010%·h -1 , respectively; P < 0.05), but not the exercised (0.090 ± 0.021 and 0.079 ± 0.016%·h -1 , respectively; P = 0.11) leg.

Conclusions: Ingestion of a whey (25 g) plus collagen (5 g) protein blend increases both myofibrillar and muscle connective protein synthesis rates at rest and further increases myofibrillar but not muscle connective protein synthesis rates during recovery from exercise in recreationally active, young men.

Objective: Hamstring injuries are common in field-based sports and reinjury rates are high. Recent evidence suggests that hamstring injuries often occur during accelerative running, but investigations of hamstring mechanics have primarily considered constant-speed running. Thus, our objective was to compare hamstring lengths and velocities between accelerative running and constant-speed running.

Methods: We recorded videos of 10 participants during six accelerative running trials and six constant-speed running trials. We used OpenCap to estimate body segment kinematics and a three-dimensional musculoskeletal model to compute peak length and step-average lengthening velocity of the biceps femoris (long head) muscle-tendon unit. We compared running conditions using linear mixed models with running speed as the independent variable.

Results: At running speeds below 75% of top speed, accelerative running resulted in greater peak lengths than constant-speed running. For example, the peak hamstring muscle-tendon length when a person accelerated from running at only 50% of top speed was equivalent to running at a constant 88% of top speed. Lengthening velocities were greater during accelerative running at all running speeds. Differences in hip flexion kinematics drove the greater peak lengths and lengthening velocities observed in accelerative running.

Conclusions: Hamstrings are subjected to longer lengths and faster lengthening velocities in accelerative running than in constant-speed running. This provides a potential biomechanical perspective toward understanding the occurrence of hamstring injuries during acceleration. Our results suggest that coaches and sports medicine staff should consider the accelerative nature of running in addition to running speed to quantify exposure to high-risk circumstances with long lengths and fast lengthening velocities of the hamstrings.