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Due to limited studies, we systematically reviewed evidence on the impact of physical exercise on intraocular pressure (IOP) in glaucoma patients, adhering to PRISMA guidelines. Using MEDLINE/Web of Science, PubMed, and Scopus, we selected English, Portuguese, or Spanish studies excluding case reports and yoga-based interventions. From 1001 records, 15 studies were independently evaluated. Evaluated through the MMAT scoring system, two quantitative randomised controlled studies scored 100% while 13 non-randomised studies averaged 84.62%. Our findings indicated that both aerobic and resistance training led to an immediate IOP reduction post-exercise. However, these findings were largely from single-session experiments. In contrast, the effects of longer-term exercise programmes on IOP varied. Although our review underscores the potential utility of exercise in IOP management, the evidence remains inconclusive due to variations in study design, participant demographics, and exercise parameters. This lack of consistency in the research highlights the necessity for larger, standardised, and longer-term studies to robustly corroborate these preliminary findings., (© 2024. The Author(s).)

The objective of this cross-sectional study was to explore sleep patterns and the potential relationship between sleep and tryptophan intake among Spanish university students. A total of 11,485 students self-reported their sleep and dietary patterns and habits. Tryptophan intake was calculated using a food intake matrix and results were presented as quartiles of total intake. Short sleep duration prevalence was 51.0%, with males exhibiting a significantly higher frequency. A total of 55.0% of participants presented inadequate sleep efficiency, with males again presenting a higher rate. Median tryptophan intake was 692.16 ± 246.61 mg/day, 731.84 ± 246.86 mg/day in males and 677.24 ± 244.87 mg/day in females ( p = 0.001). Dietary tryptophan intake below the first quartile (<526.43 mg/day) was associated with a higher risk of short sleep duration in males (1.26; 95%CI: 1.02-1.55) and females (1.19; 95%CI: 1.05-1.34) and with the Athens Insomnia Scale insomnia in males (2.56; 95%CI: 1.36-4.82) and females (1.47; 95%CI: 1.10-2.05). Regarding academic specializations, females in the humanities field showed a higher risk of Athens Insomnia Scale insomnia due to low tryptophan intake (Q1: 3.15; 95% CI: 1.04-9.55 and Q2: 3.41; 95%CI: 1.01-11.5). In summary, lower tryptophan consumption appears to be associated with poorer sleep quality in Spanish university students; however, other social factors affecting students may also influence sleep quality. These findings have important implications for nutritional recommendations aimed at enhancing tryptophan intake to improve sleep quality.

Introduction: Spinal cord injuries (SCI) have physiological, emotional, and economic consequences in the lives of affected people. Resistance training (RT) is efficient in improving several physiological factors, quality of life, and body composition. Due to the scarce literature on the analysis of isolated RT, the objective of this systematic review is to evaluate the effects of RT without the association of other techniques, in aspects related to the quality of life and body composition of people with SCI., Evidence Acquisition: The research was carried out in databases such as Pubmed, Cochrane, and Web of Science using the terms ("Spinal cord injury") AND (("Resistance Training") OR ("Strength training")). Given the lack of evidence on the subject, no deadline was set for the study to be eligible for analysis., Evidence Synthesis: The search for the articles was carried out in November of 2023 and returned 470 results, of which 315 remained after the elimination of duplicates, with 281 being excluded after title analysis. A total of 34 abstracts were analyzed and 29 studies were excluded, leaving 5 complete articles for thorough analysis., Conclusions: After analyzing the main results, we concluded that RT promotes significant improvements in body composition, pain, stress and depression symptoms, increased functionality, physical awareness, and quality of life., Competing Interests: Declaration of competing interest None, (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Purpose: Recreational and competitive slalom waterskiing is increasingly popular among individuals with spinal cord injuries (SCI), particularly for those with paraplegia using sit-skis. A key component of slalom skiing is the deep-water start (DWS), yet little is known about the physiological and physical demands of this activity when the athlete is seated. This study aims to fill this gap by focusing on the training requirements for a seated slalom athlete., Materials and Methods: Focusing on a young male athlete with paraplegia, this case study evaluates the effectiveness and efficiency of traditional (TDWS) and alternative (ADWS) DWS techniques during seated slalom waterskiing sessions. It assesses internal training load (TL) through heart rate (HR) zones and session rating of perceived exertion (sRPE), alongside pre- and post-session handgrip strength measurements to gauge peripheral muscle fatigue., Results and Conclusions: Performing the ADWS, achieving a full success rate, proved more effective but slightly more time-consuming than TDWS, which had limited success. HR during DWS maneuvers ranged from 63.2 to 81.3% of maximal HR, with most sessions occurring below the ventilatory threshold, thus perceived as hard effort. A moderate yet non-significant correlation was found between HR and sRPE-based TL. A significant reduction in handgrip strength post-session underscores the activity's demands. These insights illuminate the technical, physiological, and physical challenges in mastering DWS for seated slalom athletes with SCI, providing valuable guidance for the development of tailored training programs and techniques in this sport., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Suárez-Iglesias, Ayán, García-Fresneda, Villa-Vicente, Rodríguez-Medina and Rodríguez-Marroyo.)

Objective: We aimed to analyze and summarize the available scientific evidence on the benefits of Nordic walking for people with chronic pain and fatigue., Literature Survey: This systematic review adhered to PRISMA guidelines and conducted a comprehensive search across five databases using the PICO strategy., Methodology: Inclusion criteria encompassed randomized trials evaluating Nordic walking for pain and fatigue. Two authors independently screened studies, extracted data, and assessed methodological quality using the PEDro scale., Synthesis: A total of 14 studies were included, with sample sizes ranging from 20 to 136 participants. The methodological quality of the included studies varied from fair (five studies) to good (nine studies). The interventions consisted of supervised Nordic walking sessions lasting 6 to 24 weeks, with a frequency of 2 to 4 days per week and duration of 25 to 75 min. The results of this review suggest that Nordic walking had beneficial effects in six of the eight studies that analyzed participant fatigue. However, Nordic walking did not show greater beneficial effects on fatigue than walking (two studies) or than not performing physical activity (one study). Additionally, six of the nine studies that examined the effects of Nordic walking on participants' perceptions of pain showed beneficial results. However, five studies that compared Nordic walking with control groups did not find any significant inter-group differences on pain., Conclusions: Based on our findings, Nordic walking exercise programs provide a potentially efficient method for alleviating pain and fatigue in people with chronic conditions. Its straightforwardness and ease of learning make it accessible to a broad spectrum of participants, which can result in higher adherence rates and lasting positive effects.

There is evidence that elite soccer players live longer than general population, but there is no information on soccer coaches and referees. We aimed to analyze the longevity of both professionals, comparing them with soccer players and with general population. In this retrospective cohort study, a total of 328 male Spanish soccer coaches, 287 referees, and 1230 soccer players, all born before 1950, were divided in two cohorts, matched 2:1 with coaches and referees. We compared the survival of the cohorts with the Kaplan-Meier estimator and significance with the log-rank test. We calculated hazard ratios of death for coaches and referees compared with male Spanish general population of the same period. Differences in survival among cohorts were found, but they did not reach statistical significance. The estimated median survival time was 80.1 years (95% CI 77.7-82.4) for referees, 78 years (95% CI 76.6-79.3) for coaches, 78.8 years (95% CI 77.6-80) for referees matched with players, and 76.6 years (95% CI 75.3-77.9) for coaches matched with players. Both coaches and referees had lower mortality than general population, but this advantage disappeared after 80 years of age. We found no differences in longevity among Spanish elite soccer referees, coaches and players born before 1950. Both coaches and referees had lower mortality than general population, but this advantage disappeared after 80 years of age.

Introduction: Limited research has explored the influence of quality of life (QoL) and disease severity on physical activity (PA) in Parkinson's disease (PD) patients, and the sources of PA prescription and advice for this population. This study aims to expand scientific knowledge on these topics., Patients and Methods: Two-hundred eleven PD patients were personally interviewed to collect data on PA levels using the International Physical Activity Questionnaire-Short Form and QoL using the Parkinson's Disease Questionnaire-8. An ad hoc questionnaire gathered information on disease severity (Hoehn and Yahr stages), PA behaviors, and PA recommendations., Results: Weak but significant associations were found between PA levels, disease severity (r: -0.218; p = 0.004), and QoL (r: -0.244; p = 0.001). Most participants (85%) received PA counselling, predominantly from neurologists, either at diagnosis (52%) or shortly after (28%). Before PD onset, ~86% engaged in PA, decreasing to 66% post-diagnosis. Approximately 78% reported changes in PA, including reduced frequency (18.4%) and duration (32.8%), with walking as the primary activity., Conclusions: Disease severity and QoL significantly affect PA levels in PD patients. Diagnosis is associated with decreased PA frequency and duration, and walking is the preferred activity. Neurologists primarily provide PA advice.

Background and Objective: To revise and critically summarize the available scientific evidence regarding the effect of exercise on sleep quality in patients with chronic kidney disease (CKD)., Methods: A systematic review of randomized controlled trials (RCTs) and comparative studies was conducted, searching MEDLINE/PubMed, SPORTDiscus, and Scopus using keywords "Exercise", "Physical Activity", "Chronic Kidney Disease," and "Sleep". The methodological quality of included studies was assessed using the PEDRo and MINORS scales., Results: A total of 8 RCTs and 3 comparative studies were included, showing a low (n = 1), fair (n = 7), and good (n = 3) methodological quality. Most of the studies included patients undergoing hemodialysis (HD) (n = 8). Self-reported sleep quality (n = 9), sleepiness (n = 2), and objective sleep status (n = 2) were the main outcomes analyzed. The most frequent exercise interventions included aerobic training (n = 7), resistance training (n = 2), or a combination of both (n = 4). Generally, exercise induced positive effects on the reported outcomes. Data synthesis indicated that participants who exercised obtained significant improvements on their self-reported sleep quality in comparison with those included in the control groups, with a mean difference in the Pittsburgh Sleep Quality Index of - 5.27 points (95% CI - 7.76, - 2.77; p < 0.001)., Conclusion: Preliminary scientific evidence indicates that patients with CKD, especially those undergoing HD, report improvements in self-reported sleep quality after taking part in aerobic exercise programs, while combined training interventions yielded diverse findings. The effects of exercise on sleepiness and objective sleep status were backed by few studies with mixed results., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Objective: To examine the joint associations between physical activity and abdominal obesity with the risk of cardiovascular disease (CVD) events., Methods: We included 70 830 UK Biobank participants (mean age±SD=61.6 ± 7.9 years; 56.4% women) with physical activity measured by wrist-worn accelerometers and without major chronic diseases. Participants were jointly categorised into six groups based on their physical activity level (tertiles of total volume and specific intensity levels) and presence or absence of abdominal obesity based on measured waist circumference. Associations with incident CVD (fatal and non-fatal events) were determined using proportional subdistribution hazard models with multivariable adjustment., Results: After excluding events during the first 2 years of follow-up, participants were followed for a median of 6.8 years, during which 2795 CVD events were recorded. Compared with the low abdominal adiposity and highest tertile of physical activity, abdominal obesity was associated with higher risk of incident CVD, especially in those with low levels of vigorous-intensity physical activity (HR 1.42, 95% CI 1.22 to 1.64). Approximately 500 min per week of moderate-to-vigorous intensity and approximately 30-35 min of vigorous-intensity physical activity offset the association of abdominal obesity and the risk of having a CVD event., Conclusion: Physical activity equivalent to approximately 30-35 min of vigorous intensity per week appears to offset the association between abdominal obesity and incident CVD. About 15 times more physical activity of at least moderate intensity is needed to achieve similar results., 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.)

The Cooper test (CT) is used to assess cardiorespiratory fitness (CRF) in pre-adolescents and adolescents, although it was originally developed to assess healthy adults. The aim of this study is to examine the available scientific evidence on the reliability and criterion validity of CT when administered to pre-adolescents and adolescents. Systematic searches were performed in three electronic databases (MEDLINE/PubMed, SPORTDiscuss and Scopus). To examine reliability and validity, four separate meta-analyses were implemented, finding high heterogeneity in studies with low methodological quality. There was a paucity of research regarding absolute reliability, while studies attempting to develop or cross-validate VO 2max /VO 2peak equations were almost non-existent. Information on the psychometric properties of CT in pre-adolescents under 12 years of age is scarce. The findings of this review cast doubt on the usefulness of CT both in identifying CRF and in determining the impact of strategies developed to improve CRF among pre-adolescents and adolescents.

Background: Basketball referees are a vital part of the organised competition system, although they remain an "outgroup" in sport. While physical development and fitness programming are deemed necessary for basketball officiating excellence, there is a paucity of literature exploring strategies for physical fitness management in this population., Methods: This research was a nationwide cross-sectional, self-administered online survey conducted in 2021. A sample of 628 (531 males, 97 females) referees from 18 regional referee organisations in Spain provided individual responses to gather information on demographic details, level of participation in refereeing, physical fitness practices, and match-day exercise-based regimens. The data were described using summary statistics, and the associations of the assessed variables were subsequently calculated using contingency tables., Results: Our findings reveal that a large fraction of the Spanish basketball referee population focuses on aerobic (83%) and strength (73.6%) activities, while less attention is paid to speed (36.9%) and flexibility (23.2%), and agility, coordination, and balance tasks are somewhat overlooked. No significant differences were observed among the referee categories regarding weekly training days or session duration, with most training for 15-60 min per session. Elite referees were more likely to hire personal trainers and engage in strength and flexibility exercises. Sub-elite referees showed a higher tendency to perform stretching and joint mobility activities post-match, while regional referees did so less frequently. Approximately 30.7% of referees across all competitive levels engaged in re-warm-up (RW-U) activities, with stretching and joint mobility being the most prevalent., Conclusions: Spanish basketball referees participate in routine physical exercise and fitness practices, irrespective of their competition level. While warm-up activities are prevalent, some sub-elite and regional referees do not consistently perform them, and re-warm-up routines are not extensively embraced., Competing Interests: Alejandro Vaquera and David Suárez-Iglesias serve as fitness coordinators for the International Basketball Federation (FIBA) and FIBA Europe, respectively. Alberto Sánchez-Sixto is responsible for physical preparation for the Spanish Basketball Federation Refereeing Area., (© 2024 Suárez-Iglesias et al.)

Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Abstract: This scoping review aimed to summarize the literature on Para judo comprehensively. A systematic search on WOS, PubMed, SPORTDiscus, and Scopus was carried out up to July 2022, combining the key words "judo" and "visual impairment," "visual disability," "visual deficiency," "visually handicapped," "low vision," "sight loss," "blind," "disability," "deficiency," and "Paralympic." The research question was focused on athletes with visual impairment who practiced judo at a competitive level. The following five methodological phases were followed: (1) identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, and (5) collating, summarizing, and reporting the results. A total of 44 studies were analyzed. Three lines of research emerged: physical fitness ( n = 18), performance and/or sport class ( n = 15), and physical and mental health ( n = 11). Findings indicated that judokas with visual impairment showed a similar fitness level to able-sighted judokas. In addition, it was observed that Para judo shows a considerable injury incidence, which is not influenced by the degree of visual impairment. The temporal structure of the combats, together with the studies focused on the optimal cutoff points between sports classes, confirmed the appropriateness of the recent changes in the regulations by which partially sighted judokas and functional blind judokas compete separately., Competing Interests: Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

This review aimed to systematically evaluate and meta-analyze the available data on the effects of Brain Gym (BG) on cognitive function in older people. Six electronic databases were searched systematically using: "Brain Gym" AND "elderly, "Brain Gym" AND "older people". The PEDro and MINORS scales were used to evaluate methodological quality. For the meta-analysis, inverse variance or generic inverse variance was used and heterogeneity was assessed with the Chi2 test and I2 test. Ten research studies with a high to low quality. Significant changes intra- and inter-group were observed for neurocognitive outcomes in the BG groups. Findings from the metaanalysis indicated changes in the BG groups, on cognitive function by means of the Mini-Mental State Examination, were not greater than those reported in the control/comparison groups. BG will not lead to improvements in cognitive function in people with and without cognitive impairment, supported by low to high evidence., Competing Interests: Declaration of Competing Interest The authors report that this study has been conducted without funding and that they have no competing interests to declare., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Adults with intellectual disabilities often experience mobility limitations. Baduanjin, a mindfulness-based exercise intervention, can exert positive effects on functional mobility and balance. This study examined the impact of Baduanjin on physical functioning and balance of adults with intellectual disabilities., Method: Twenty-nine adults with intellectual disabilities participated in the study. Eighteen received a Baduanjin intervention for 9-months; 11 participants did not receive any intervention (comparison group). Physical functioning and balance were assessed using the short physical performance battery (SPPB) and stabilometry., Results: Participants in the Baduanjin group experienced significant changes in the SPPB walking test (p = .042), chair stand test (p = .015), and SPPB summary score (p = .010). No significant changes between groups were observed in any of the variables assessed at the end of the intervention., Conclusions: Baduanjin practice may cause significant, albeit small, improvements in physical functioning of adults with intellectual disabilities., (© 2023 The Authors. Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

Introduction and Hypothesis: Studies on the prevalence of urinary incontinence (UI) among CrossFit practitioners are on the rise. This systematic review with meta-analysis was aimed at determining the prevalence of UI among CrossFit practitioners., Methods: A systematic review of the literature was performed by searching MEDLINE/PubMed, Scopus, and SPORTDiscus through January 2021. The search strategy included the keywords CrossFit, urine incontinence, exercise, high impact and pelvic floor dysfunction. The inclusion criterion was any study with a sample of CrossFit practitioners and results separated from the other fitness modalities analysed. The subjects were women with no restriction of age, parity, experience or frequency of training. Quality assessment of the studies included was conducted using the Oxford Centre of Evidence-Based Medicine scale and the Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies., Results: Thirteen studies (6 comparative and 7 non-comparative) were included for the systematic review, all using a cross-sectional design. The level of evidence was 4, with their quality ranging from poor (n = 10) to fair (n = 3). A total of 4,823 women aged 18 to 71 were included, 91.0% participated in CrossFit, and 1,637 presented UI, which indicates a prevalence of 44.5%. Also, 55.3% and 40.7% presented mild or moderate UI respectively. Stress UI was the most common type reported (81.2%)., Conclusions: The factors that increased the likelihood of UI were age, body mass index and parity. Exercises based on jumps were commonly associated with urine leakage. CrossFit practitioners presented higher UI than control groups., (© 2022. The International Urogynecological Association.)

Introduction: We aimed to identify the utility, reliability, and validity of an adapted version of the OMNI self-perceived exertion (PE) rating scale in preschoolers., Population and Methods: Firstly, 50 (mean age ± standard deviation [SD] = 5.3 ± 0.5 years, 40% girls) performed a cardiorespiratory fitness (CRF) test twice, with a one-week interval between assessments, and rated their PE either individually or in groups. Secondly, 69 children (mean age ± SD = 4.5 ± 0.5 years, 49% girls) performed two CRF tests, separated by a one-week interval, twice and rated their self-PE. Thirdly, the heart rate (HR) of 147 children (mean age ± SD = 5.0 ± 0.6 years, 47% girls) were compared against self-rated PE after finishing the CRF test., Results: Self-assessed PE differed when the scale was administered individually (e.g., 82% rated PE with 10) or in groups (42% rated PE with 10). The scale showed poor test-retest reliability (ICC:0.314-0.031). No significant associations were found between the HR and PE ratings., Conclusions: An adapted version of the OMNI scale was found not suitable for assessing self-PE in preschoolers.

Re-warm-up activities are recommended in team sports due to loss of muscle temperature during half-time. This study aimed to evaluate the effects of a half-time re-warm-up strategy on female basketball players. Ten players U14, separated into two teams of five players, performed either a passive rest condition or repeated sprints (5×14 m) plus 2 min of a shooting wheel (re-warm-up condition), during the half-time break (10 min) of a simulated basketball match, where only the first three quarters were played. The re-warm-up did not elicit significant effects on jump performance and locomotory responses during the match, except for the distance covered at a very light speed, which was significantly higher than in the passive rest condition (1767 ± 206 vs 1529 ± 142 m; p  < 0.05). Mean heart rate (74 ± 4 vs 70 ± 5%) and rate of perceived exertion (4.5 ± 1.5 vs 3.1 ± 1.44 a.u.) were higher in the re-warm-up condition during half-time ( p  < 0.05). In conclusion, performing re-warm-up activities based on sprints could be a valuable strategy to avoid the reduction of sport performance during prolonged breaks, but given the limitations of the study, these relationships need to be further explored in official competitions.

Background: Studies suggest that physical exercise lead to improvements in the psychosocial dimension, associated comorbidities as well as to a higher quality of life (QoL) in people with epilepsy. However, there is a need to provide evidence-based guidelines for its prescription. Therefore, this review aimed to systematically evaluate and meta-analyze the available data on the potential effects of physical exercise training programs in people with epilepsy., Methods: Four electronic databases (MEDLINE/PubMed, PEDro, SPORTDiscuss and Scopus) were searched systematically from their inception until April 2022 for randomized controlled trials (RCTs), comparative studies and non-controlled studies that provided information regarding the effects of physical exercise training programs on people with epilepsy. The studies' methodological quality assessment was performed using the PEDro, the MINORS and the Quality Assessment Tool for Before-After Studies with No Control Group scales. For the meta-analysis, inverse variance or generic inverse variance was use to report mean difference or standardized mean difference for continuous data and their 95% confidence intervals (CI). Heterogeneity was assessed with the Chi-squared test and I 2 test., Results: After removing duplicated studies, 82 results were retrieved by the literature search and 14 were eligible for full text search. Finally, 14 studies with a methodological quality ranging from good to low quality met the inclusion criteria. Totally, 331 people with epilepsy were evaluated. Significant changes between preand post-intervention results in the exercise intervention groups were observed for QoL, fitness level, psycho-affective and neurocognitive outcomes. Findings from the meta-analysis indicated that moderate exercise led to a non-significant decrease (p = 0.08, Chi-squared test) in seizure frequency (SMD 0.33 95% CI 0.04; 0.70), while a significant effect of exercise was observed on QoL with a mean improvement of 4.72 percentage points (95% CI 0.58; 8.86, p = 0.03)., Conclusion: Improvements on QoL, fitness level, psycho-affective and neurocognitive outcomes can be achieved through exercise training in people with epilepsy. Altogether, the findings suggest that people with epilepsy can benefit from exercising., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Purpose: Yoga may be a beneficial treatment for people with Parkinson's disease (PD). However, no studies have critically reviewed and meta-analyzed the scientific evidence for yoga's benefits regarding motor and non-motor symptoms. The purpose of this study was to conduct a systematic review and meta-analysis on the effectiveness of yoga as a rehabilitation strategy for PD., Materials and Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a literature search was performed using MEDLINE/PubMed, PEDro, SPORTDiscus, and Scopus. Studies addressing any concepts on the impact of yoga intervention on physical and psychological outcomes in people with PD were included., Results: Fourteen RCTs were selected, with heterogeneous protocols and outcomes measures. Yoga interventions were safe and well-accepted for patients with mild to moderate PD. The descriptive analysis indicated that its practice might provide both physical and psychological benefits. Preliminary evidence showed that yoga has comparable or superior efficacy to exercise. A subsequent meta-analysis on five RCTs detected that yoga was more effective than passive control in ameliorating motor symptoms., Conclusions: Yoga appears to be a promising rehabilitative therapy for individuals with PD. Recommendations are proposed for future studies.IMPLICATIONS FOR REHABILITATIONYoga is a safe and feasible therapy for people with mild to moderate PD.Yoga practice positively impacts physical and mental health in this population.When compared to exercise, yoga showed to have similar or even greater effects.

Objective: Self-perception questionnaires are considered a useful alternative to assess the level of physical fitness (PF) of a specific population. However, very few questionnaires of this type have been validated in the Spanish population. The aim of this study was to identify the reliability and validity of the Perceived Physical Fitness Scale (PPFS) in Spanish students., Methods: After a back-translation process, the PPFS questionnaire was administered twice to 722 students (primary school, n=207; secondary school, n=515) to determine its reliability. To identify its convergent validity, the International Fitness Scale (IFIS) was administered, as well as a set of PF field-based tests from the Eurofit battery. The questionnaire internal consistency, reliability and convergent validity of the questionnaire were assessed by means of the Cronbach's alpha, intraclass correlation coefficient and Pearson corelation coefficient., Results: The internal consistency of the PPFS was accurate among Primary (α=0.702) and good among Secondary (α=0.888) students., Reliability was poor among Primary (ICC=0.490; 95% CI [0.298-0.665]) and good among Secondary (ICC=0.797; 95% CI [0.760-0.829]) students. The PPFS showed significant associations with PF levels assessed by means of the Eurofit (Primary; r=0.421; p<0.001 / Secondary; r=0.533; p<0.001) and with the IFIS scale (Primary; r=0.356; p<0.001 / Secondary r=0.792; p<0.001)., Conclusions: The Spanish adapted version of the PPFS questionnaire shows good reliability and acceptable convergent validity when used as a tool to assess PF among secondary school students. Its poor reliability, together with the weak association demonstrated against the IFIS scale among primary school students discourages the PPFS use at this educational level., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Nordic walking (NW) may be a beneficial treatment for people with Parkinson's disease (PD). Since high-quality research has been published on the effects of NW on people with PD by now, an actualised and comprehensive, in-depth review is recommended to guide practitioners in prescribing this exercise modality. The purpose of this study was to conduct a systematic review and meta-analysis on the effectiveness of NW as a rehabilitation strategy for PD. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a literature search was performed using Pubmed, SportDiscus and Scopus up to May 2021. Randomised controlled trials (RCTs) addressing the impact of a NW intervention on any outcomes in people with PD were included. The critical appraisal of the RCTs was retrieved from the Physiotherapy Evidence Database (PEDro) or evaluated using the PEDro scale. The Cochrane Collaboration's risk of bias tool was also employed. The review was not registered a priori on any database and a review protocol was not published. Twelve studies were included in the review. The investigations were mostly good-to-fair methodological quality, and risk of bias was acceptable. None of the reported statistically significant benefits of NW were clinically meaningful, except for walking ability. Although adherence to NW programs was good, some adverse effects derived from its practice were informed. The practice of Nordic Walking does not lead to clinically significant changes in global motor impairment, functional mobility, balance and physical fitness in patients with PD. This therapy seems to improve walking ability and quality of life, although further research in this latter outcome is needed., (© 2022 John Wiley & Sons Ltd.)

Objective: This study aimed to determine the prevalence, severity and type of urinary incontinence (UI) in female and male CrossFit® practitioners., Study Design: The study design is an online cross-sectional survey distributed to CrossFit® practitioners across all Spanish regions. The questionnaire included categorical questions related to CrossFit® practice, multiple-choice questions to determine the exercises performed during reported UI symptoms, and The International Consultation on Incontinence Questionnaire Short-Form questionnaire items., Results: Five hundred seventy-one practitioners (34.0 ± 8.37 years, Body Mass Index 24.20 ± 3.34 kg/m 2 ) met inclusion criteria and completed the survey. There were and 316 females and 255 males. Around 45 % of women and 6 % of men reported having UI (p < 0.001). The severity of UI mainly was slight (30.3 % women, 3.5 % men) and moderate (11.7 % women, 2.3 % men) (p < 0.001). Stress and urgent UI were the most prevalent types among women (36 %) and men (5 %) (p < 0.001)., Conclusions: This study found that UI is relatively common among female CrossFit® practitioners, especially in repetitive jumps. The practitioners' profile (amateur/competitor) does not affect the prevalence or severity of UI. Male athletes can also experience urine leakage while performing CrossFit®, although its prevalence is much lower when compared to female practitioners., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Health-related physical fitness (HRPF) has emerged as an important marker of health among children. It is usually defined as a multidimensional construct consisting of cardiorespiratory endurance; muscular strength and endurance; and flexibility. Currently, health policies are aimed at getting children to increase their HRPF levels. Understanding the relationship between the perceived and the desired levels of fitness can be important to avoid the abandoning of physical activity practice. We analyzed the associations between the self-perceived and the desired health-related physical fitness. A modified version of the self-perceived HRPF questionnaire was completed by 330 children (148 girls, mean age: 10.78 ± 0.67 years, and 182 boys, mean age: 10.82 ± 0.61 years). Fitness was measured through tests selected from the Eurofit battery. The questions regarding desired HRPF showed moderate internal consistency (Cronbach's α: 0.671) and good test-retest reliability (ICC: 0.761). In general, children shared a desire to improve their self-perceived HRPF. Those who perceived themselves as already being fit were the ones who showed the strongest desire for achieving higher HRPF levels.

Handball is a team sport involving a great physical demand from its practitioners in which a high number of injuries occur, affecting individual and collective performance. Knowledge of the injuries is of great importance for their prevention. The objective of the present study was to identify, locate and compare the most frequent injuries and injury mechanisms in handball practice. It was carried out following the Preferred Informed Item for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The source of data collection was direct consultation of the PubMed and Medline databases. Several keywords were used for the documentary retrieval, and the quality of the studies that were selected was evaluated. Of the 707 studies retrieved, only 27 were considered appropriate for the review, and quality scores were obtained that ranged from 10 to 26 points, out of a maximum of 28. The most frequent injuries in handball players are located in the lower limbs (thigh, knee and ankle), and in the shoulder in the upper limbs. Regarding the playing position, the players who play over the 6-m line are the most affected by injuries, while the women players have a higher probability of injury. Most injuries occur during competition.

Purpose: To compare the effects of upper versus the lower-body resistance exercise on cognitive and physical functions of institutionalized older people., Methods: This was a non-randomized multi-center comparative and crossover study (clincialtrials.gov code NCT03831373). Two experimental groups performed a 12-week intervention of resistance exercises with low-intensity elastic bands, one program focused on exercises of the upper body (n = 20, mean age 87.6 ± 6.4 years, 75% women) and the other on the lower body (n = 29, mean age 81.4 ± 7.7 years, 55% women). Following 12 weeks of detraining, the groups performed the other intervention. After another 12 weeks, a follow-up assessment was carried. The control group (n = 19, mean age 81.3 ± 9.5, 68% women) performed a full body stretching exercise program in both phases. Before and after each period, cognitive and physical function was assessed by standardized test (Mini-Mental State Examination, Trail Making test and Phototest; Timed Up and Go, Back Scratch, Chair Sit and Reach and had grip strength, respectively). Intention-to-treat and per-protocol analyses were carried., Results: After the first intervention, significant improvements (p < 0.05) were observed in the cognitive function in both experimental groups, and in the hand grip strength in the group that performed lower-body exercise. After the second phase, all groups showed improvements in lower-body and shoulder flexibility and a significant worsening in hand grip strength. The lower-body exercise group showed a worsening in cognitive function, and the upper-body group in functional mobility and dynamic balance., Conclusions: Resistance exercise with elastic bands showed beneficial effects on cognitive function and functional independence in institutionalized older adults. While upper body exercises seemed to be more effective on cognitive function, lower limb exercises showed better results on physical function parameters., (© 2022. The Author(s).)

Background: The feasibility and reliability of the Functional Movement Screen (FMS) battery for predicting injury risk have been widely studied in athletic, military, public service and healthy populations. However, scant research has been carried out in people with disabilities. This study aimed at identifying the feasibility and reliability of the FMS battery when administered to adults with intellectual disability (ID)., Methods: Adults from a residential and day care centre over 18 years of age, diagnosed with ID and able to follow simple instructions, were included in the study. All participants with behavioural or health problems that prevented the completion of the FMS battery were excluded. All exercises were video recorded to assure proper scoring. Three assessors (one trained and two novices) scored each of the FMS subtests performed separately from the videos. Feasibility was based on completion rates. Reliability of the composite test scores was analysed using intraclass correlation coefficients (ICCs)., Results: A total of 30 people with ID (mean age: 35.5 ± 7.12 years; 33.3% women) completed all assessments. The battery showed to be feasible, although difficulties when performing two of the subtests were observed among those with moderate and severe ID. Mean total scores from the three assessors ranged from 7.83 to 8.90. An inverse trend was observed indicating that the higher the ID level, the lower the total FMS score. Test-retest reliability was good for the trained assessor (ICC = 0.89) and mostly moderate for both novice assessors (ICC range: 0.60 to 0.76). Moderate to good inter-rater reliability was observed (ICC range: 0.65 to 0.80)., Conclusion: The FMS battery is a reliable tool that can be performed by people with ID, albeit with certain difficulties, especially in those with moderate to severe impairment. The battery does not seem to be useful for identifying people with ID at risk of suffering a sport injury. Adequately powered, well-designed studies are required to determine if the FMS battery is appropriate for identifying changes in functional performance in this population., (© 2022 The Authors. Journal of Intellectual Disability Research published by MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.)

Objective: Las estrategias restrictivas de movilidad derivadas de la pandemia por COVID-19 podrían afectar negativamente al estado de salud de la población debido a la disminución de los niveles de actividad física. El objetivo de este estudio es estimar el aumento del tiempo de sedentarismo durante los confinamientos en comparación con la situación anterior al brote de COVID-19 en muestras de población adulta de diferentes países del mundo., Methods: Se realizó una búsqueda sistemática en tres bases de datos electrónicas, hasta el 27 de febrero de 2021, de estudios que informaran sobre el tiempo total de sedentarismo antes y durante los confinamientos por COVID-19 utilizando una herramienta validada. Se realizó un metanálisis utilizando modelos de efectos aleatorios para calcular las diferencias de medias ponderadas en el tiempo sedentario diario total antes y durante los confinamientos. El análisis se repitió estratificado y comparando por sexo., Results: Se incluyeron 20 estudios, con una calidad metodológica buena (n=15) y regular (n=5). Para el metanálisis se agruparon los datos de 18 estudios, con 47.245 participantes. Los confinamientos por COVID-19 en todo el mundo condujeron a un aumento medio ponderado de 2,40 horas diarias en el tiempo total de comportamiento sedentario (intervalo de confianza del 95%: 1,95; 2,85). El análisis estratificado y comparativo por sexo en 8 estudios indicó un aumento similar para mujeres (n=20.455) y hombres (n=11.825)., Conclusions: El tiempo total de sedentarismo diario aumentó en 2,40 horas en todo el mundo durante los confinamientos en comparación con la situación anterior al brote de COVID-19, sin diferencias significativas entre sexos.

Scientific evidence regarding whether intellectually gifted children show similar physical activity habits and physical fitness levels in comparison to typically developed children, is inconclusive. This is in part due to the scant research that has directly compared both groups of people. In this study, physical activity prevalence, self-perceived and objectively assessed physical fitness levels, and body image were assessed in a sample of 74 intellectually gifted children (mean age 11.6 ± 1.2 years). Seventy-four non-gifted children matched by age and sex were selected as a comparison cohort. Results indicated that both groups showed similar self-perceived and objectively assessed fitness levels. Physical activity habits were also similar, although significant differences were observed indicating that intellectually gifted girls were less active in comparison with non-gifted girls. Both cohorts perceived their body image accurately, although intellectually gifted children were much more satisfied with their physical appearance.

Background: Students spend a high number of hours being seated while at school. In order to find the correct adjustment between school furniture and the anthropometric characteristics, specific knowledge and tools are necessary., Objective: The objective of the study is to evaluate the accuracy and reliability of the measurers with different instruments, as well as contrast the differences between the values that were obtained by the different examiners., Methods: Measurements were taken independently by one expert examiner and two inexperienced teachers from the school. They used a measuring tape, a segmometer and an anthropometer for the anthropometric measurements. The statistical tests conducted: Kolmogorov-Smirnov test, Intraclass Correlation Coefficient, Bland and Altman method, Standard Error of Measurement, Technical Error of Measurement and relative TEM with a level of significance of ρ ≤ 0.05., Results: A total of 108 students (8.87±1.67 years; 40.7% girls) participated in the study. The non-expert measurers had good accuracy and reliability, but they far exceeded the error percentages of the expert, obtaining the worst results in the shoulder measurement. The instrument with the lowest affinity between the inexperienced measurers was the anthropometer., Conclusions: In order to assign furniture in the schools, the experts should continue using the anthropometer. The inexperienced measurers can use more accessible instruments in the school environment such as a measuring tape and segmometer.

Introduction: School furniture affects the sitting position of students in the classroom, as well as their health and learning. Therefore, it is necessary to determine the existence of a potential mismatch between school furniture dimensions and students' anthropometric characteristics, as well as to propose dimensions based on classroom actuality and the regulations in place in both Galicia and the European Union., Population and Methods: An evaluator with experience in anthropometry measured weight, height, popliteal height, sitting shoulder height, and sitting elbow height using an anthropometer and then compared values with the chairs and desks currently used. Analysis techniques were descriptive (measures of central tendency), single-factor analysis of variance, t test, χ² test (using the SPSS® software), and effect size (Cohen's d test). The significance level was established at p ≤ 0.05., Results: The sample was made up of 108 Spanish children in primary school (aged 6-12 years). Of them, 91.7 % and 97.2 % use, respectively, a chair and a desk that do not adjust to their anthropometric characteristics and use furniture that is larger than what they need. The regulations for furniture dimensions currently in place for the studied population are not adequate because the chairs and desks included are not adequate for the first grades of primary school., Conclusions: There is a high mismatch level between school furniture and students' anthropometric characteristics. We propose the use of the European regulations for furniture dimensions, with varying heights per grade or adjustable furniture that can be adapted to the anthropometric characteristics of all students., Competing Interests: None, (Sociedad Argentina de Pediatría.)

Background: Scientific evidence has shown that equine-assisted therapies (EAT) lead to improvements in the physical function and the quality of life (QoL) of people with disabilities through the practice of hippotherapy or therapeutic riding (TR). There is a need to confirm whether people with multiple sclerosis (PwMS) can also benefit from its practice. This review aimed to systematically evaluate and meta-analyze the available data on the potential health benefits of EAT in PwMS., Methods: Four electronic databases (MEDLINE/PubMed, Web of Science, SPORTDiscus, and Scopus) were searched systematically from their inception until June 2021 for randomized controlled trials (RCTs) and comparative studies that provided information regarding the effects of EAT on PwMS. The studies' methodological quality assessment was performed using the PEDro and the MINORS scales. For the meta-analysis, heterogeneity across studies was quantified using the I 2 statistic. Fixed-effect or random-effects models were applied to obtain the pooled results in the case of low (I 2 < 30%) or high (I 2 > 30%) heterogeneity values, respectively. Standardized mean differences (SMD) and 95% confidence intervals (CIs) were calculated to assess the change in each outcome., Results: After removing duplicated studies, 234 results were retrieved by the literature search and 11 were eligible for full text search. Finally, 9 studies with a methodological quality ranging from good to low quality met the inclusion criteria. Six of them focused on hippotherapy and 4 of them were included in the quantitative analysis. Totally, 225 PwMS patients were evaluated. Findings from the meta-analysis indicated that this therapy improved static (SMD = 0.42; 95% CI: 0.05, 0.78) but not dynamic balance (SMD = 0.51; 95% CI: -0.04, 1.06), while significant benefits were observed on the patients' QoL (SMD = 0.37; 95% CI: 0.00, 0.73). Hippotherapy showed effectiveness for reducing self-perceived fatigue (SMD = 0.70; 95% CI: 0.33, 1.07), while TR showed mixed effects on balance and QoL., Conclusion: The actual evidence on the effectiveness of EAT in PwMS is mainly limited to hippotherapy. This rehabilitation approach seems to have beneficial effects on static balance, QoL and fatigue, but not directly on gait and dynamic balance. Altogether, the findings suggest that hippotherapy could be incorporated as a complementary therapy when developing comprehensive care plans for PwMS., (Copyright © 2021. Published by Elsevier B.V.)

This systematic review aimed to identify and summarize the reliability and validity of the questionnaires that have been designed for assessing self-perceived physical fitness (PF) in elderly people. Three electronic databases (MEDLINE/PubMed, SPORTDiscuss and Scopus) were searched systematically from their inception until March 2021 in order to find investigations that provided information on the reliability and/or validity of questionnaires used for identifying self-perceived PF in this population. Nine studies fulfilled these criteria, and seven questionnaires were found, five of them being specifically designed for the elderly. Concurrent validity was mostly obtained by correlating the items of the questionnaires with PF field-based tests, and poor to moderately strong associations were obtained. Test-retest reliability was informed in five questionnaires, and high values were generally observed. The SRFit questionnaire showed the best rates of concurrent validity and test-retest reliability, although these results were partially affected by the mean age of the sample. The lack of a rigorous methodological approach when designing these questionnaires detected in this review, asks for further studies using quantitative and qualitative approaches in order to create more solid and valid measurement tools., (Copyright © 2021 Elsevier Inc. All rights reserved.)

To provide information regarding the anthropometric and fitness profile of young karatekas and to study its evolution with age. Data from top-level karatekas were included in the analysis: 97 athletes in the U14 category (12-13 years old), 238 in cadet (14-15 years old), 261 in junior (16-17 years old) and 177 in U21 (18-20 years old), which makes a total of 773 athlete data sets. Karatekas underwent anthropometric (weight, height, body mass index and body fat percentage) and fitness (sit and reach, 20-m shuttle run, standing long jump, overhead 3-kg ball throw, 10x5-m shuttle run, and plate-tapping) assessments during the training camps organized by the Spanish National Karate Federation between 1999 and 2016. Male karatekas were taller and heavier, and performed better than females in all the fitness dimensions assessed, except for flexibility and speed of upper limb movements. The obtained cardiovascular and lower-body muscular values indicated that karatekas in this study were placed between the 80th and the 90th percentile when compared with the general population. The results of the agility, coordination and speed of upper limb movements, and flexibility tests showed that the karatekas obtained much higher scores than those observed in age-matched populations. Young karatekas show a high fitness level in comparison with the general population, especially with regards to aerobic performance, lower-body muscular power and upper-limb movement speed. Reference values of anthropometric and fitness dimensions are provided in order to be used by coaches, conditioning trainers and sport scientists when testing young male and female karatekas., (Copyright © Biology of Sport 2021.)

Background: Exercise performed at home could be a useful therapy for people with chronic kidney disease. This systematic review and meta-analysis aimed at describing the characteristics, main findings, methodological quality, and adherence rate reported in the existent randomized controlled trials that have provided information regarding the impact of home-based exercise programs on people with chronic kidney disease., Methods: Electronic databases (MEDLINE/PubMed, SPORTDiscus, Scopus, and CENTRAL) were searched up to April 2021, using the keywords: "Exercise"; "Home"; "Kidney Disease." Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was adopted. Jadad scale and Cochrane's tool were used to assess the methodological quality and risk of bias., Results: Out of the 14 studies finally selected, 11 were included in the meta-analysis and most presented high methodological quality. The meta-analysis showed significant effects of home-based exercise on fitness and quality of life, but a little impact on renal function. Although exercise performed at home was mostly feasible and safe, adherence was not high and a considerable number of dropouts were observed., Conclusion: Home-based exercise has positive effects on the fitness' level and on the quality of life on people with chronic kidney disease. Future studies are needed to identify whether exercise performed at home is a better physical therapy option than center-based exercise.

Background and objectives : Handball is a popular sport among women whose practice can lead to marked health benefits but could also show a high injury risk. There is a lack of research on intermediate level female players. We aimed to identify the prevalence of sport injuries in amateur and young intermediate level female handball players and the potential influence of the sport category. Materials and Methods : A group of cadets, juvenile and senior female players of three handball clubs participating in the Spanish regional league were followed throughout the 2018-2019 season. Information on injuries and exposure was collected via questionnaires. Results : Out of 114 players (34 seniors, 33 juvenile and 47 cadets), 77 of them sustained at least one injury. Most of the injuries were either moderate or severe, regardless of the category. A total of 7.93, 5.93 and 4.16 injuries per 1000 h of exposure were registered in the senior, juvenile and cadet categories respectively. The risk of sustaining an injury was 2.14 times higher for senior players Confidence Interval (CI 95%: 1.51-3.03) and 1.92 higher for juvenile players (CI 95%: 1.32-2.78) when compared with cadets. Conclusions : Senior and young female handball athletes playing at an amateur and intermediate level, are exposed to a substantial risk of sustaining a moderate or severe injury. The players' category does not seem to have a great impact on the injury rate and on the characteristics of the sport injuries registered.

Objective: The purpose of this study was to analyze the validity and provide normative values for the three-min shuttle run test in Spanish preschoolers., Methods: A total of 497 children (mean age 4.83±0.57 years; 47.8% girls) performed the three-min shuttle run test. Posttest body mass index and heart rate values were taken as internal validity indicators., Results: Age- and sex-specific percentiles for cardiorespiratory fitness were provided. Boys performed better than girls in the test. A significant association was observed between the total distance covered and heart rate (p=0.002). No correlation was found between body mass index and the test score, although the total distance covered by normal weight and obese children was significantly different (296.9 versus. 271.3 m; p=0.013)., Conclusions: This study provides age- and sex-specific cardiorespiratory fitness normative values for the three-min shuttle run test when performed by Spanish preschoolers. This test is an interesting option when the lack of resources limits the measurement of cardiorespiratory fitness in the preschool setting.

We analyzed whether male Spanish elite soccer players live longer than the general population. Secondly, we compared their mortality with a cohort of soccer players who continued working as soccer elite coaches after retirement. Using age and calendar-date adjusted life tables, we analyzed the mortality hazard ratio of 1333 Spanish male players born before 1950, and who played in elite leagues from 1939, compared with the Spanish population. Using Cox proportional hazards model we compared their mortality with a cohort of 413 players who continued as coaches. Players showed significantly lower mortality than the general population, but this advantage decreased with advanced age, disappearing after 80 years. Coaches showed a similar pattern. Comparing players versus coaches, date of birth and years as professional were associated with survival, but debut age and player position were not. Unadjusted median survival time was 79.81 years (IQR 72.37-85.19) for players and 81.8 years (IQR 74.55-86.73) for coaches. Kaplan-Meier estimator adjusted for covariables showed no difference between cohorts (p=0.254). In conclusion, former Spanish male players showed lower mortality than the general population, but this effect disappeared after 80 years of age. Continuing their career as coaches after retirement from playing did not confer major benefits., Competing Interests: The authors declare that they have no conflict of interest, (Thieme. All rights reserved.)

Objective: In college students, higher risk alcohol consumption (drunkenness and binge drinking-BD) has negative consequences on their development and and probably facilitates risk sexual behaviors. The objective was to study if risky sexual behaviors when consuming alcohol (RSBA) are associated with higher risk consumption., Methods: Cross-sectional multicenter study with UniHcos Project, 1 st year university students from 11 universities in Spain, academic years 2011-2012 to 2017-2018 data. This data were collected by self-administered questionnaire. A uni and bivariate analysis was performed, evaluated the statistical significance of the differences in prevalence with chi-square. Mean and standard deviation were used for quantitative variables and Student's t test statistic was used., Results: 9,862 subjects (72.2% women). 90.3% reported having consumed alcohol and 60.9% had drunk the last year, 49% BD in last month. It was deteded in men, significantly higher consumption in the last month and drunkenness. Last month consumption and drunkenness were significantly higher in men and in <21 years. The RSBA were significantly higher among who were drunk (15.7% unprotected sex, 1.9% sexual abuse and 0.7% taking sexual advantage) and had BD (17.1%, 1.9% and 0.7 %). Women with both risk consumptions had more sexual abuse (2.2%), and men had greater behaviors of taking sexual advantage of someone (drunk: 1.2%; BD: 1.3%)., Conclusions: Alcohol consumption was above similar groups. BD consumption was similar by gender and age. Risk sexual behaviors appear mainly in problematic consumption. Gender differences are not detected in alcohol consumers in unprotected sex but deteded in the rest., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Background: Apolipoprotein ε4 allele ( APOE4 ) is the strongest genetic risk factor for Alzheimer's disease and seems to be related to cognitive decline and damaged event-related potential P300, which is a sensitive measure to assess cognitive processing., Objective: This research aims to critically review the existing scientific evidence regarding the association between APOE4 and P300., Methods: A systematic review was carried out up to January 2020 on the following databases: Web of Science, Scopus and Medline/PubMed. Articles were considered for inclusion if they are original research that provided information regarding the association between APOE4 and P300, available in English, Spanish, or Portuguese, and available in full text. The methodological quality of the studies selected was evaluated using the quality assessment tool for observational cohort and cross-sectional studies recommended by Cochrane., Results: Out of 993 studies, 14 met the inclusion criteria. The results obtained showed that APOE4 is related to a longer P300 latency. However, the data supplied do not allow us to confirm if this relationship also occurs in amplitude measures. Moreover, it was observed that APOE genotype may influence P300 in different ages, from younger individuals to demented older people., Conclusion: Evidence shows that APOE4 negatively influences cortical activities related to cognitive functions, as indicated by P300.

Objective: Few physical exercise programs for children with limb loss have been described in detail recently. We provided information regarding the characteristics and effectiveness of an alternative rehabilitation exercise developed for children with lower-limb amputation., Methods: An 8-year-old boy with a below-knee amputation and a 9-year-old bilateral amputee girl performed an exercise program of one 2-h session per week for 20 weeks, aimed at developing muscular strength and coordination. Walking ability and walking speed were assessed by using the L-test of functional mobility and 10-m walk test, respectively. Mechanical and neuromuscular muscle function was assessed by using tensiomyography., Results: In case 1, a decrement of 9.5% and 10.5% was found in the L-test (42 s vs. 38 s) and in the 10-m test (19 s vs. 17 s) scores, respectively. In case 2, walking ability remained unchanged (L-test score: 38 s), while a 5.2% reduction in walking speed was observed (10-m test score: 19 s vs. 18 s). No relevant changes were observed in the muscular tone in both cases., Conclusions: Practitioners should be aware that, contrary to what could be expected, a multidisciplinary training program held once per week for 5 months had a minimal impact on the gait pattern and neuromuscular function of two children with lower-limb amputation.

Objective: Stressful situations may have a negative effect on population's mental health, including impaired sleep quality. Thus, we analysed the effect on sleep during the confinement due to the COVID-19 outbreak, in a Galicia population sample, measuring subjective sleep satisfaction, and insomnia intensity and incidence., Methods: Through an adapted questionnaire from the Cuestionario Oviedo de Sueño, distributed telematically and printed, using a convenience sampling in Galicia, we compared sleep situation, before and during the first two weeks of confinement for COVID-19. We compared the results of the questionnaire before and during confinement with the Wilcoxon signed-rank test and McNemar's test., Results: In 451 analysed subjects, there was about half point decrease in sleep satisfaction (in a 1 to 7 scale), three points increase in insomnia score (9 to 45 scale) and an increase from 23.1 to 36.3% in the insomnia incidence (p<0.001 for all the comparisons). There existed less affectation in the insomnia incidence in elderly above 65 years (from 21.7 to 26.1%, p=1) and in subjects that telecommuted (unchanged 28.1% incidence, p=1). In a post-hoc analysis of a health workers subgroup, sleep affectation was similar to that of others workers., Conclusions: Confinement situation in COVID-19 outbreak context in our environment has caused important alterations in the population's sleep quality, increasing the symptoms and incidence of insomnia.

Study Design: systematic review and meta-analysis., Background: Despite existing scientific evidence alluding to the positive effects of physical exercise on people with amputations, there is a lack of consistency between the results of past studies., Objective: To identify if people with amputations taking part in an exercise training programme can benefit from improvements in their health status as measured by changes in their physiological fitness and functionality levels., Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) were performed after searching within several databases up to October 2019., Results: Ten RCTs with satisfactory methodological quality were found. Five RCTs were pooled in the meta-analysis. Exercise programmes with a combination of activities were most commonly delivered. Exercise had positive effects on aerobic and muscular fitness parameters. Findings from the meta-analysis indicated that exercise improved distance walked but did not have a significant impact on functional mobility or self-reported functional capacity., Conclusion: Combined exercise of muscular endurance and functional physical exercise appear to have greater positive effects on cardiorespiratory fitness, muscular fitness and functionality levels in adult prosthesis users with unilateral lower limb amputation. Future studies should include different profiles of patients with amputations that are poorly represented in the current scientific literature., Competing Interests: Declaration of competing interest The authors declare that there is no conflict of interest, (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Patients with multiple sclerosis (MS) show fatigue, impaired gait and decreased functional mobility, which lead to a low quality of life (QoL). Low-cost and easy to perform exercise modalities having a positive impact on the aforementioned symptoms are needed. The performance of Nordic Walking (NW) could be a useful rehabilitation strategy but, to our knowledge, no study has been published in this regard as yet. This case series study aims at providing information regarding the usefulness and impact of a three-month NW program on self-perceived fatigue, functional mobility, physical fitness and QoL on a group of people with mild relapsing-remitting MS., Methods: A case series study with multiple assessments was performed. Three data collection points at 1-week intervals for three weeks were done at baseline. The intervention consisted of a 12-weeks NW program with a total of four measurement occasions, one every three weeks. The Fatigue Severity Scale (FSS), the Timed up and Go test (TUG), the 6-Minute Walk test (6MWT) and the Multiple Sclerosis Impact Scale (MSIS-29), were used to assess the outcomes of the program on the participants' self-perceived fatigue, functional mobility, physical fitness and QoL, respectively., Results: Of the 14 participants who volunteered for the study, five completed at least 80% of the planned sessions and were included in the final analysis. The intervention did not have a clinical significant impact on the participants' fatigue while its impact on their QoL showed mixed results. Positive trends were found for all the participants in their functional mobility and physical fitness. Regarding functional mobility, clinically important changes were observed in three participants. None of the observed changes in physical fitness achieved clinical significance., Conclusion: A 12-week Nordic walking program did not appear to be particularly feasible and had little impact on the functional levels on a group of people with mild relapsing-remitting MS. Given that beneficial effects were seen in some participants, and taken into account the low adherence rate observed, future studies should explore the feasibility of NW programs performed under different environmental conditions (i.e. outdoors) and including motivational strategies aimed at increasing participation., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Purpose: This research was aimed at evaluating the effects of a five-month detraining period on the functional fitness level of a group of non-institutionalized and active older adults after taking part in a multi-component training program. A secondary aim was to determine how usual physical activity (PA) levels vary due to cessation of the program., Methods: We tested sixty-five older people (mean age: 77.1 ± 6.2; 83% women) during the final week of an 8-month multi-component training program and during the first week after its resumption (five months later). We used the senior fitness test and the Minnesota Questionnaire to assess their functional fitness and their PA levels respectively., Results: We observed a significant worsening of lower-limb strength (p = 0.008), shoulder range of motion (p = 0.004), and dynamic balance (p < 0.001) once the detraining period was completed. There was a slight downward trend in the remaining functional fitness dimensions, and there were significant differences when comparing the amount of PA estimated at pre-detraining and post-detraining (5155 ± 2258 vs 3937 ± 2087 MET-min·wk -1 ; p < 0.001). Older adults classified as very active showed a non-significant trend to smaller decreases in functional fitness once the detraining period was over, in comparison with those considered active., Conclusions: Active older people who regularly participated in a multicomponent training program showed a significant reduction in their strength, range of motion, and dynamic balance levels after a five-month detraining period. Self-reported PA decreased significantly during this time frame. Effective strategies are needed to increase PA levels in older people when systematic training programs are temporarily interrupted., Competing Interests: Declaration of Competing Interest All authors declare to have no conflict of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: To provide information regarding injury incidence, injury pattern, and associated injury risk factors in elite Paralympic judokas., Methods: Participants in this observational research were elite judokas taking part in the IBSA 2018 World Judo Championship. The entire championship was videotaped, and all injuries were prospectively documented using an all-complaints definition., Results: The tournament featured 267 judokas, (B1 = 58; B2 = 105; B3 = 104). The injury proportion was estimated at 18.9 injuries/100 fighters (B1 = 13.8; B2 = 22.3; B3 = 18.5). A total of 745 athletic exposures were registered. The overall injury rate was 68.5 (95% CI, 52.5-89.2); 62.5 (95% CI, 32-122.3); 79.6 (95% CI, 53.8-17.8); and 61.2 (95% CI, 40-93.5) for the total sample, B1, B2, and B3 judokas, respectively. When only injuries resulting in medical attention were analyzed, the overall injury rate was calculated to be 22.8 (95% CI, 14.3-36.5), and the injury proportion was estimated at 6.3 injuries/100 fighters. No significant differences were found for sex, weight, and visual class regarding injury proportion and injury rates., Conclusion: Paralympic judokas show a high injury rate. However, when only injuries that needed medical attention were taken into account, the proportion of athletes injured was low. The degree of visual impairment was not considered as an injury risk factor.

Background: Physical exercise has been identified as a health promotion strategy for the oldest old. However, scientific evidence regarding the benefits of exercise on nonagenarians is scarce. This systematic review aimed to evaluate the characteristics and methodological quality of investigations that have examined the effects of physical exercise on nonagenarians., Methods: A systematic review and evidence synthesis were conducted. The MEDLINE/PubMed, CINAHL, Scopus, SPORTDiscus, and Cochrane Library were systematically searched up to November 2018. Investigations were included if they tested the effects of an exercise intervention on people 90 years or older. The methodological quality of the randomized controlled trials was evaluated using the PEDro scale. Quality appraisal tools developed by the National Heart, Lung and Blood Institute were used to evaluate the uncontrolled and observational investigations., Results: Three randomized controlled trials, 1 retrospective study, 2 case reports, and 1 single-subject A-B design met the eligibility criteria. The methodological quality scores obtained from the scales ranged from poor to good. Most interventions were based on muscular strengthening, balance exercises, or a combination of both. No adverse effects were registered. In general, exercise showed a significant impact on muscular strength, while mixed effects were found regarding gait and balance. Pooled analyses indicated that interventions had significant improvements in global lower body functioning (standardized mean difference, SMD = 0.47; 95% confidence interval = 0.04, 0.90; P < .01)., Conclusions: Exercise is a feasible therapy for nonagenarians, which can lead to improvements in physical functioning. Future research should focus on the effects of aerobic interventions, as well as the impact that exercise has on the cognitive functioning of nonagenarians.

There is a need for developing tools aimed at assessing fitness in children, due to its relationship with health. This study is aimed at testing the reliability and the validity of a questionnaire designed for assessing self-perceived health-related fitness in Spanish children. The questionnaire was created based on the model of physical self-concept developed by Fox and Corbin (1989) who conceived four sub-domains: Sport competence, attractive body, strength and physical condition. A total of 283 children (mean age: 10.80 ± 0.69 years; 45.6% girls) answered the questionnaire twice, in order to determine its test-retest reliability. The results obtained in the International Fitness Scale (IFIS) and on a fitness battery were used to determine its validity evidence based on relations to other variables. Exploratory and factorial analyses were performed to check its validity evidence based on internal structure. The obtained results indicated that the questionnaire showed an accurate validity evidence based on internal structure and a very good test-retest reliability, Intraclass correlation coefficient: .88; 95% CI [.84, .90]. The questionnaire established moderate correlations with the IFIS questionnaire (ρ = -.51 to -.68) and the fitness level showed by the children (ρ = -.53). These findings indicate that the questionnaire can be a useful research tool for assessing self-perceived health-related fitness in children.