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The aim of this study was to compare the effect of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) with equal energy expenditure on glycaemic and cardiometabolic risk factors in people with Type 2 Diabetes Mellitus (T2DM) when compared to the control. Sixty-three people with T2DM were randomly assigned to HIIT, MICT, or non-exercising controls. Individuals were trained with HIIT at 90 and 30% of their VO(2)peak (1:2 min ratio) starting from 8 up to 16 intervals and MICT at 50% of VO(2)peak, on a cycle ergometer, 3 times/week for 12 weeks under supervision. The primary outcome measure was the change in HbA1c. Aerobic capacity, cardiovascular responses, anthropometric measures, body composition, glycaemic, and cardiometabolic risk factors were measured at the beginning and the end of the 12-week training period. There was no significant difference between HIIT and MICT or when compared to the control for HbA1c, glucose, insulin resistance, blood lipids, cardiovascular responses, anthropometric measures, body composition, and abdominal and visceral fat (p(adj )> 0.05). HIIT and MICT increased VO(2)peak significantly compared to controls (p < 0.05) but not to each other (p > 0.05). Both HIIT and MICT improved VO(2)peak and HbA1c after 12 weeks of training compared to their baseline, furthermore, only MICT caused additional improvements in cardiovascular responses, anthropometric measures, and abdominal fat compared to baseline (p < 0.05). As a conclusion, isoenergetic HIIT or MICT did not improve HbA1c. The two protocols were equally efficient for improvement in aerobic capacity but had little effect on other cardiometabolic factors.

The first (VT1) and second ventilator (VT2) (anaerobic) thresholds are used to individually prescribe exercise training programs. The purpose of this research was to analyze inter- and intraobserver reliabilities of determining VT1 and VT2 in subjects with lower limb amputation (LLA) and able-bodied (AB) subjects during a peak exercise test on the arm-leg (Cruiser) ergometer. Previously published data of exercise tests on the Cruiser ergometer of subjects with LLA (n = 17) and AB subjects (n = 30) were analyzed twice by two observers. The VT1 and VT2 were determined based on ventilation plots. Differences in determining the VT1 and VT2 between the observers for the first and second analyses were analyzed. To quantify variation in measurement a variance component analysis was performed. Bland-Altmann plots were made, and limits of agreement were calculated. The number of observations in which thresholds could not be determined differed significantly between observers and analysis. Variation in VT1 between and within observers was small (0-1.6%) compared with the total variation, for both the subjects with an LLA and AB subjects. The reliability coefficient for VT1 was more than 0.75, and the limits of agreement were good. In conclusion, based on the results of this study on a population level, VT1 can be used to prescribe exercise training programs after an LLA. In the current study, the determination of VT2 was less reliable than VT1. More research is needed into the clinical application of VT1 and VT2 during a peak exercise test on the Cruiser ergometer.

Background: ‪‪Knowing all the features required for elite performance in sports disciplines under the name of combat sports is among the most important parameters for discipline-specific talent identification and selection. Material and methods: ‪‪The research group consists of male and female athletes within the age range of 12–17 who are licensed in taekwondo, karate, judo, and wrestling. A total of 70 athletes, 21 elite and 49 non-elite athletes, participated in the study voluntarily. Anthropometric, athletic and motor competency tests were applied to determine the elite performance elements of the groups. Results: Comparing the elite and non-elite athletes, statistically significant differences were found in favor of the elite group (p0.05). Conclusions: ‪There seem to be important distinctions between athletes who reach the national peak and those who do not, in terms of height, sitting height, body weight, speed, anaerobic power, grip strength, upper extremity and core strength, as well as motor competency related to anaerobic power.

Introduction: Prehabilitation aims for an optimal physical functioning level before, during, and after hospitalization for major surgery. The purpose of this case report was to illustrate the care pathway of a high-risk patient who opted for pylorus-preserving pancreaticoduodenectomy, including preparation for this procedure by participating in a community-based exercise prehabilitation program. The report describes patient examination, evaluation in decision-making for surgery, the prehabilitation program, and outcomes within the context of the Hypothesis-Oriented Algorithm for Clinicians II. Case Description: The patient was a 75-year-old woman with a history of several comorbidities and a polypoid mass in the descending segment of the duodenum. Based on the preoperative assessment, the level of physical functioning was expected to be insufficient to cope adequately with the stress of hospitalization and surgery. Intervention: A 4-week prehabilitation program, including aerobic, resistance, and functional task training in a community-based physical therapy practice. Outcomes: Prehabilitation had a beneficial impact on improving functional mobility preoperatively (timed up-and-go test score improved from 19.4 to 10.0 s, five times sit-to-stand test score improved from 30.1 to 10.1 s, and two-minute walk test distance improved from 55.0 to 107.0 m). Surgery and postoperative recovery proceeded without complications. She achieved independent physical functioning on postoperative day 6 and was discharged home on postoperative day 12. Conclusion: Preoperative risk-assessment can support clinical decision-making in a high-risk patient opting for major abdominal surgery. Furthermore, a remarkable improvement in physical functioning can be achieved by community-based prehabilitation in a high-risk surgical patient.

The results of numerous medical and kinesiological studies indicate the existence of differences in pulmonary function in relation to age, body height, and the relationship between certain parameters of body composition. The aim of this study was to determine the state of morphological characteristics and pulmonary function of naval saboteurs and ground Special Forces of the Armed Forces of Montenegro. The sample of participants included 30 naval saboteurs aged 30.3 +/- 6 years and 30 members of the ground special forces aged 25.6 +/- 5 years. The sample of measuring instruments included 4 indicators each for the evaluation of longitudinal dimensionality, transversal dimensionality, mass and body volume, subcutaneous fat, body composition, and pulmonary function. The central and dispersion parameters of the variables were calculated. The specificities of body composition of the naval saboteurs and members of the ground Special Forces of the AF of Montenegro were determined, while the parameters of lung volume and capacity and the parameters of airway flow indicated an excellent state of their respiratory function. Furthermore, it was determined that the studied members of the armed forces had no individual health risks in the sense of the onset of obesity or obstructive ventilatory defects. The results obtained indicate the need for further studies which would predominantly focus on the impact of individual morphological measurements and parameters of body composition on pulmonary function. This would provide important data both for the armed forces in the sense of improving the training system and the realization of specific tasks, as well as for kinesiology as a science from the aspect of determining certain regularities in the functioning of the human body in specific living and working conditions in the armed forces.

To optimize use of available resources, professional academies develop strategies to assess, monitor, and evaluate players as they progress through adolescence toward adulthood. However, few published reports exist using longitudinal study designs to examine performance throughout adolescence and the transition from youth to professional soccer. We examined differences in the age of player recruitment alongside longitudinal performance differences on field-based fitness tests of successful vs. unsuccessful graduates across the entire age spectrum recruited by a professional soccer academy. Altogether, 537 youth soccer players volunteered to participate. We recorded the age of recruitment, biannual fitness test performance, and subsequent success in attaining a senior professional contract at the club across a period of 12 years. Only 53 (10%) of players were successful in obtaining a professional contract, with 68% of players who became professional being recruited at 12 years of age or older. Individuals recruited at an earlier age did not display a higher probability of success in attaining a professional contract. Bayesian regression models reported a consistent interaction between age and group for data on all performance measures. Moreover, "successful" academy graduates only physically outperformed their "unsuccessful" counterparts from age similar to 13-14 years onward, with either no differences in performance, or performance on physical fitness tests favoring "unsuccessful" players prior to this age. Findings suggest that high achievers during childhood and early adolescence may not develop into successful senior professionals, raising concerns about the predictive utility of talent identification models.

Objectives This observational follow-up study investigated the associations of nutrition and body composition with cardiovascular disease (CVD) risk factors, including pro-inflammatory biomarkers, in soldiers during a 6-month deployment. Material and Methods Thirty-five male soldiers were assessed at months 0, 3 and 6, and their parameters, i.e., M±SD, were as follows: age 30.0±8.7 years, height 179±6 cm, and BMI 24.2±2.5 kg/m 2 . Three-day food diaries were used for monitoring macronutrient intake. Body composition was estimated using bioimpedance. Fasting blood samples for lipids and pro-inflammatory biomarkers were collected, and blood pressure measurements were performed. Results Carbohydrate intake increased and protein intake decreased at month 3 (p = 0.034, p < 0.001), while body composition remained stable. Systolic blood pressure increased at month 6, while other CVD risk factors remained within the reference values. Fat mass and body fat percentage were associated positively with total and low density lipoprotein (LDL) cholesterol concentrations at all measurement points. A negative association was found between the change in fiber intake vs. the change in total (r = –0.36, p = 0.033) and LDL cholesterol (r = –0.39, p = 0.019). Conclusions Lower fiber intake and a greater amount of body fat were associated with high total and LDL cholesterol concentrations. Nevertheless, the measured CVD risk factors remained within the reference values, except for the higher systolic blood pressure. A regular screening of body composition and a higher consumption of fiberrich foods may promote cardiometabolic health in soldiers. Int J Occup Med Environ Health. 2020;33(4):457–66

Steep ramp test (SRT) performance provides an estimation of preoperative aerobic fitness that is associated with postoperative outcomes. Patients with a better SRT-estimated aerobic fitness are less likely to develop postoperative complications and more likely to experience a shorter time to recovery. The SRT might be a useful and clinically accessible tool in preoperative risk assessment to identify patients at risk of postoperative morbidity and who might benefit from preoperative exercise interventions.

BackgroundIn Paralympic sports, classification of athletes based on the impact of impairments on the ability to perform is needed, to prevent a one-sided and predictable outcome of the competition in which the least impaired athlete has the best chance to win. Classification is developing from expert opinion based to evidence based. In wheelchair court sports, there is evidence to support the impact of impairment on wheeled mobility, but not on ball handling. To assess the impact of impairment on the ability to perform ball-handling activities, standardised tests for ball handling are needed.PurposeTo assess if reliable and valid standardised tests for the measurement of ball-handling proficiency in a wheelchair or able-bodied court sports exist; to assist in the development of Evidence-Based Classification (EBC) in wheelchair court sports according to the guidelines of the International Paralympic Committee (IPC).MethodsThe review was conducted according to the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) statement. Search terms used were “wheelchair,” “ball,” “ball sports,” “test,” and “performance.” Databases searched were Medline, Embase, PubMed, and Sport Discus. Study quality was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology checklist.ResultsTwenty-two articles were included. Foundational Movement Skills in ball-handling proficiency were assessed. Tests for throwing maximal distance showed sufficient reliability and validity. Precision in throwing showed low-to-moderate reliability and conflicting results in validity. Throwing techniques differed between studies. Dribbling the ball showed high reliability, but conflicting results in validity.ConclusionsTests for throwing maximal distance, throwing precision, and dribbling the ball can be used in standardised tests for activity limitation in wheelchair court sports. However, tests need to be adapted and standardised and then reassessed for reliability and validity in athletes with and without arm impairment.

BACKGROUND: Clinical laboratory testing of locomotor disorders is challenging in patients with intellectual disability (ID). Nevertheless, also in this population gait analysis has substantial value as motor problems are common. To promote its use, adequate protocols need to be developed and the impact on clinical decision making needs to be documented. RESEARCH QUESTION: What is the clinical usefulness of instrumented motion analysis in patients with ID? METHOD: This narrative review consists of three parts. A literature review was performed to describe the gait pattern of patients with ID. Next, benefits and challenges of standard gait analysis protocols are described. Finally, a case of a girl with ID due to genetic cause showing gait abnormalities is discussed. RESULTS: The literature review resulted in 20 studies on "gait" in patients with an "ID", published since August, 1st 2013. Gait deviations were observed in all studies investigating the ID population with an underlying genetic syndrome. Observed gait deviations in the ID population might be attributed to physical characteristics, cognitive components or both. The main goal of clinical gait assessment is the identification of gait deviations and the evaluation of their progress over time, in order to optimize the treatment plan. The choice of adequate method and measurement modalities depends on the clinical goal, the available resources and the abilities of the patient. In the case report we presented, we succeeded in performing an instrumented 3D gait analysis in a girl with severe ID at the ages of 4y4m, 6y0m, 7y2m and 8y2m. Progressive gait deviations were found suggesting a crouch gait pattern was developing. Results of the gait analysis led to the prescription of rigid ankle-foot orthoses. SIGNIFICANCE: Gait analysis has substantial value for patients with ID. Gait analysis allows clinicians to objectify the relationship between physical characteristics and gait features. ispartof: GAIT & POSTURE vol:71 pages:105-115 ispartof: location:England status: published

Background & aims: Sarcopenic obesity (SO) is defined by a relatively low muscle mass in combination with obesity. Sarcopenic obesity was first noted as a health risk in geriatric populations but has recently been recognized as a scientific and clinical priority that may extend beyond geriatric settings. Obesity is generally preceded by overweight, so the prevalence and health risks of sarcopenia in those with overweight (SOW) is of interest for preventive purposes. The aim of this study, therefore, was to assess the prevalence and determinants of SO and SOW in a general population.Methods: Participants (n = 119,494), aged 18-90 years were included from the Dutch Lifelines cohort study. Muscle mass was assessed by 24-h urine creatinine excretion and stratified for gender for analysis, and obesity was defined as a Body Mass Index (BMI) >= 30 kg/m(2) and overweight >= 25 kg/m(2). Multivariate logistic regression models were applied to assess the relevant determinants of SO and SOW.Results: Respectively for men and women the prevalence of SO was 0.9% and 1.4%, and prevalence of SOW 6.5% and 6.0%. In subjects with sarcopenia, BMI was >= 25 kg/m(2) in 45.5% and >= 30 kg/m(2) in 6.1%. Overall females had a higher prevalence of SOW and SO in all age groups except for SOW in males between ages 40-59. Also, age was a significant determinant of SO and SOW, with a rise in prevalence as of age 50. Of all subjects with SO and SOW, respectively 82.5% and 80.4% were below the age of 70. Compared to those with no morbidities, the odds ratio of SO and SOW among participants with >3 comorbidities was 2.71 (95% CI: 1.62-4.54) and 1.33 (95% CI: 1.07-1.65) among males and 1.14 (95% CI: 0.79-1.65) and 1.28 (95% CI: 1.06-1.54) among females, independent of other determinants. Overall, an inverse association was found between SOW and SO and physical activity and macronutrient intake.Conclusion: The results support the need for more awareness of SO beyond the field of geriatrics, in particular in subjects with comorbidities. SOW is more prevalent than SO and may provide opportunities for preventive strategies for the general population. (C) 2021 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

The use of the short form of the Körperkoordinationstest für Kinder (KTK3) to evaluate children's and adolescents' motor competence (MC) is increasing. When combined with an alternating one-handed catching and throwing ball task, assessing eye-hand coordination (EHC), it has been shown that the different aspects of motor skills are adequately covered in one compact KTK3+ test battery, studied in 6- to 10-year-old children. The present study aimed to validate the KTK3+ test battery and to provide contemporary MC normative values for boys and girls from 6- to 19-year-olds. A total of 2,271 children and adolescents (1,112 boys, 1,159 girls) participated in this study and were evaluated on the four included test items: jumping sideways (JS), moving sideways (MS), balancing backwards (BB), supplemented by an EHC task. Children's participation in organised sport was registered using a demographic questionnaire. For the first objective, a factor analysis with multidimensional scaling demonstrated that the one-dimensional model provided the best fit, with all test items correlating to the same latent construct: “MC”. This was further supported with moderate to good correlations between all four test items (r = 0.453–0.799). Construct validity was investigated with a three-way MANOVA, demonstrating a significant multivariate interaction effect between sex and age group (p = 0.001) as well as a multivariate main effect of sex, age group, and organised sport participation (p < 0.001). Boys outperformed girls on two out of the four tests (JS and EHC, p < 0.005), while girls were better than boys on the BB test (p < 0.005). Performance scores increased across age groups on all tests (p < 0.001). Only for the BB test score, a plateau effect was noted around the age of 12 years. Children and adolescents participating in sports generally outperformed their peers who were not involved in organised sports, on the present KTK3+ test battery. For the second objective, raw score normative values are provided separately for both sexes between 6- to 19-year-olds. In combination with the one-factor structure confirmation, these sex, age, and sport participation effects demonstrate the validity of the test battery. The provided normative values are useful to evaluate MC in children and adolescents from 6 to 19 years old. The use of only four test items that are identical across all ages makes the KTK3+ test battery a practical instrument to assess and compare MC development.

Aim: The purpose of this study is to compare ball throwing velocity (BTV), counter movement jump (CMJ), anaerobic power, and some anthropometric characteristics among young and senior national female handball players (n: 54; age: 21.90 yrs). Methods: Elite female handball players, who play in different playing positions (19 playmakers, 18 pivot and 17 wing) voluntarily participated in the study. Data were analysed in terms of BTV, CMJ, anaerobic power and some anthropometric characteristics (waist circumference, body mass index, arm span and hand length). Results: Data were statistically described, and ANOVA test was used for the comparison. As a result of statistical analysis, there is no significant difference in waist circumference, anaerobic power, CMJ, hand length and mean BTV values (p>0.05). On the other hand, there is a significant difference between playing positions in the BMI, and arm span values (p

To determine prospectively gross and fine motor development of children

Objective: The aim of this study was to evaluate the upper extremity functions of individuals with type 2 diabetes mellitus and to compare them with those of healthy subjects. Methods: Thirty six diabetic participants (mean age: 55.05±5.85 years; 21 female, 15 male) and thirty six healthy participants (mean age: 53.52±7.74 years; 20 female, 16 male) were evaluated in this study. A hand dynamometer was used to examine grip strength of the participants. Upper extremities endurance was evaluated by using the Unsupported Upper Limb Exercise Test (UULEX). Disabilities of the Arm Shoulder and Hand Test (DASH-T) was used to determine upper extremity disability level. Results: Diabetic participants evaluated in this study showed lower scores in terms of upper extremity endurance (p0.05) Conclusion: In individuals with type 2 diabetes mellitus, there is a significant decrease in upper extremity endurance and an increase in the level of upper extremity disability level.

BACKGROUND: Exercise improves cardiorespiratory fitness (CRF) and reduces depressive symptoms in people with depression. It is unclear if changes in CRF are a predictor of the antidepressant effect of exercise in people with depression. AIMS: To investigate whether an increase in CRF is a predictor of depression severity reduction after 12 weeks of exercise (trial registration: DRKS study ID, DRKS00008745). METHOD: The present study includes participants who took part in vigorous (n = 33), moderate (n = 38) and light (n = 39) intensity exercise and had CRF information (as predicted maximal oxygen uptake, V̇O2max) collected before and after the intervention. Depression severity was measured with the Montgomery-Åsberg Depression Rating Scale (MADRS). V̇O2max (L/min) was assessed with the Åstrand-Rhyming submaximal cycle ergometry test. The main analysis was conducted pooling all exercise intensity groups together. RESULTS: All exercise intensities improved V̇O2max in people with depression. Regardless of frequency and intensity of exercise, an increase in post-treatment V̇O2max was significantly associated with reduced depression severity at follow-up (B = -3.52, 95% CI -6.08 to -0.96); adjusting for intensity of exercise, age and body mass index made the association stronger (B = -3.89, 95% CI -6.53 to -1.26). Similarly, increased V̇O2max was associated with higher odds (odds ratio = 3.73, 95% CI 1.22-11.43) of exercise treatment response (≥50% reduction in MADRS score) at follow-up. CONCLUSIONS: Our data suggest that improvements in V̇O2max predict a greater reduction in depression severity among individuals who were clinically depressed. This finding indicates that improvements in V̇O2max may be a marker for the underpinning biological pathways for the antidepressant effect of exercise. DECLARATION OF INTEREST: None. ispartof: BJPSYCH OPEN vol:4 issue:5 pages:346-351 ispartof: location:England status: published

Background Hand grip strength (HGS) test is commonly used as an indicator of overall muscle strength in medical and sport practices. Recently, several studies have proposed that the measurement of the maximal HGS depends on dynamometer’s handle position. The aim of the present study was to identify the optimal handle position to obtain maximal HGS using the hand grip dynamometer (HGD) for school-aged children. Methods HGS was assessed with the Jamar digital HGD. Each participant performed three maximum contractions of each hand on three handle positions progressing from first to third position. Results A total of 135 healthy children aged 5–9 years participated in the study. Participants obtained significantly higher results using position 2 than using positions 1 or 3. The maximal mean (± SD) HGS achieved was 9.9 (± 3.1) kg with position 1, 10.4 (± 3.1) kg with position 2, and 9.0 (± 3.2) kg with position 3. Handle position 2 was the most comfortable position for 73% of participants. Conclusions Our results provide useful methodological information indicating that the second handle position of the Jamar digital HGD is optimal to measure maximal HGS in non-athletic healthy pediatric participants aged 5–9 years.

Predicting current and future tennis performance can lead to improving the development of junior tennis players. The aim of this study is to investigate whether age, maturation, or physical fitness in junior elite tennis players in U13 can explain current and future tennis performance. The value of current tennis performance for future tennis performance is also investigated. A total of 86 junior elite tennis players (boys, n = 44; girls, n = 42) U13 (aged: 12.5 +/- 0.3 years), and followed to U16, took part in this study. All players were top-30 ranked on the Dutch national ranking list at U13, and top-50 at U16. Age, maturation, and physical fitness, were measured at U13. A principal component analysis was used to extract four physical components from eight tests (medicine ball throwing overhead and reverse, ball throwing, SJ, CMJas, Sprint 5 and 10 meter, and the spider test). The possible relationship of age, maturation, and the physical components; "upper body power", "lower body power", "speed", and "agility" with tennis performance at U13 and U16 was analyzed. Tennis performance was measured by using the ranking position on the Dutch national ranking list at U13 and U16. Regression analyses were conducted based on correlations between variables and tennis performance for boys and girls, separately. In boys U13, positive correlations were found between upper body power and tennis performance (R-2 is 25%). In girls, positive correlations between maturation and lower body power with tennis performance were found at U13. Early maturing players were associated with a better tennis performance (R-2 is 15%). In girls U16, only maturation correlated with tennis performance (R-2 is 13%); later-maturing girls at U13 had better tennis performances at U16. Measuring junior elite tennis players at U13 is important for monitoring their development. These measurements did not predict future tennis performance of junior elite tennis players three years later. Future research should focus on other aspects in order to predict tennis performance better.

Background: A modified version of the Berg Balance Scale (mBBS) was developed for individuals with intellectual and visual disabilities (IVD). However, the concurrent and predictive validity has not yet been determined.Aim: The purpose of the current study was to evaluate the concurrent and predictive validity of the mBBS for individuals with IVD.Method: Fifty-four individuals with IVD and Gross Motor Functioning Classification System (GMFCS) Levels I and II participated in this study. The mBBS, the Centre of Gravity (COG), the Comfortable Walking Speed (CWS), and the Barthel Index (BI) were assessed during one session in order to determine the concurrent validity. The percentage of explained variance was determined by analyzing the squared multiple correlation between the mBBS and the BI, COG, CWS, GMFCS, and age, gender, level of intellectual disability, presence of epilepsy, level of visual impairment, and presence of hearing impairment. Furthermore, an overview of the degree of dependence between the mBBS, BI, CWS, and COG was obtained by graphic modelling. Predictive validity of mBBS was determined with respect to the number of falling incidents during 26 weeks and evaluated with Zero-inflated regression models using the explanatory variables of mBBS, BI, COG, CWS, and GMFCS.Results: The results demonstrated that two significant explanatory variables, the GMFCS Level and the BI, and one non-significant variable, the CWS, explained approximately 60% of the mBBS variance. Graphical modelling revealed that BI was the most important explanatory variable for mBBS moreso than COG and CWS. Zero-inflated regression on the frequency of falling incidents demonstrated that the mBBS was not predictive, however, COG and CWS were.Conclusions: The results indicated that the concurrent validity as well as the predictive validity of mBBS were low for persons with IVD. (C) 2017 Elsevier Ltd. All rights reserved.

Background. People with intellectual disabilities (IDs) seem to have a lower physical fitness (PF) than their peers without disabilities, which coincides with reduced autonomy, life expectancy and quality of life. To assess PF in these individuals, it is necessary to use appropriate tools that permit the assessment of their physical capacities taking into account their specific characteristics. The aim of this work is to study the feasibility and reliability of the Assessing Levels of Physical Activity (ALPHA)‐Fit test battery for adults in a group of men and women with mild to moderate ID. Methods. Forty‐one adults with ID of both sexes, ranging in age from 20 to 60 years old, participated in the study. To identify the feasibility and reliability of the ALPHA‐Fit test battery for adults, two complete assessments were done for each one of the tests included in the battery. The assessments were performed for a period of no more than 2 weeks (test–retest). An intraclass correlation coefficient was used to determinate test–retest reliability, and a mixed analysis of variance factorial was used for each of the dependent variables. Bland–Altman plots were also used to assess consistency between the two measurements. Feasibility was calculated as the percentage of people who were able to perform the tests correctly (not feasible 75%). In order to determine other psychometric properties, minimal detectable change and standard error of measurement (SEM) were also calculated. Results. Of the 10 tests in the ALPHA‐Fit test battery, eight were shown to be feasible. High reliability was obtained (>0.90) for the variables related to body composition. In the hand‐grip test, reliability was high in the men's group but low in the women's group. Good reliability results were also found (0.80–0.89) in the dynamic sit‐up test for women, but not for men. Fair reliability (0.70–0.79) was found in jump‐and‐reach and neck‐shoulder mobility tests. The variables in the 2‐km walk and agility tests indicated poor reliability. All tests showed SEM values related to high variability. However, Bland–Altman plots showed results related to lack of consistency. Conclusions. The feasibility and reliability calculations, as well as the SEM values, confirm that not all the tests of the ALPHA‐Fit Test Battery for Adults are suitable for the assessment of PF in adults with ID, probably because of the complexity of the motor fitness tests. The authors emphasise the necessity of making adaptations to the protocols used or of using other tests more appropriate to the characteristics of people with mild to moderate ID.

Background Knowledge concerning the feasibility and effects of progressive resistance training (PRT) for persons with intellectual disabilities and visual impairment who are categorized in Gross Motor Function Classification System (GMFCS) Level 1 is limited. The aim of our study was to evaluate feasibility and effect of PRT on participants' Quadriceps strength and personal goals. Methods Eight Participants followed a PRT program for 10 weeks. Feasibility was determined by percentage of attendance and compliance. The effect of PRT was analyzed with a linear mixed model (p

Background: The development of childhood motor competence demonstrates a high degree of inter-individual variation. Some children’s competence levels increase whilst others’ competence levels remain unchanged or even decrease over time. However, few studies have examined this developmental change in motor competence across childhood and little is known on the influencing factors). Aim: Using latent growth curve modeling (LGCM), the present longitudinal study aimed to investigate children’s change in motor competence across a two-year timespan and to examine the potential influence of baseline weight status and physical fitness on their trajectory of change in motor competence. Method: 558 children (52.5% boys) aged between 6 and 9 years participated in this study. Motor assessments took place three times across a two-year timespan. Baseline measurements included weight status, motor competence (i.e., Korperkoordinationstest fur Kinder; KTK) and physical fitness (i.e., sit and reach, standing long jump and the 20m shuttle run test). LGCM was conducted to examine change in motor competence over time, based on the raw scores of the four KTK subtests. Results: The analyses showed a positive linear change in motor competence across two years (=28.48, p

El objetivo de este estudio fue analizar el efecto de un periodo competitivo de 10 semanas sobre las características antropométricas, la composición corporal y el somatotipo de árbitros de fútbol. 14 árbitros de fútbol (28,8 ± 5,1 años) de distintas categorías nacionales de fútbol de España participaron en este estudio. Se observó un descenso significativo tras este periodo competitivo en el sumatorio de ocho pliegues (Δ = -6,07%, p < 0,05, d = 0,38, bajo). Además, se observó un descenso significativo en el porcentaje de masa adiposa (Δ= -2,29%, p < 0,05, d = 0,19, trivial) y en el componente endomorfo (Δ= -6,82%, p < 0,05, d = 0,32, bajo) en el postest. Un periodo competitivo de 10 semanas parece ser suficiente como para provocar modificaciones en el somatotipo y un descenso del sumatorio de pliegues y de la masa adiposa en árbitros, The aim of this study was to analyze the effect of a 10-week competitive period on body composition, anthropometric characteristics and somatotype in soccer referees. Fourteen officials (28.8 ± 5.1 yr) from different national soccer categories of Spain took part in the study. A decrease in the sum of eight skinfold thicknesses (Δ = -6.07%, p < 0.05, d = 0.38, low) was observed after the competitive period. Moreover, decreases in adipose mass (Δ= -2.29%, p < 0.05, d = 0.19, trivial) and endomorphic component were also observed. A 10-week competitive period has demonstrated to decrease both skinfold thicknesses and adipose mass, changing the somatotype of the referees

The aim of this study was to quantify the seasonal perceived respiratory and muscular training loads (i.e., sRPEres-TL and sRPEmus-TL) completed by elite-oriented young professional soccer players. Twenty four players (20.3 +/- 2.0 years) belonging to the same reserve team of a Spanish La Liga club participated in this study. Only the players that were available to train for a whole week with the team and also to play the weekly game were considered: Starters, players that participated in the match for at least 45 min and NonStarters, players that did not participate or played less than 45 minutes in the match. The competitive period was analysed after the division into 5x6-8 week blocks and 35x1 week microcycles. Data were also analysed with respect to number of days before the immediate match. Weekly TL variation across the in-season blocks was trivial-small for both groups except between Block 2 and Block 3 (ES= moderate). Substantial TL differences (ES= small-very likely) were found between training days, the TL pattern being a progressive increase up to MD-3 followed by a decrease until MD-1. Except for the match, sRPEres-/sRPEmus-TL was very similar between Starters and Non-Starters. In summary, perceived TL across the season displayed limited variation. Coaches periodized training contents to attain the highest weekly TL 72 hours before the match to progressively unload the players between MD-3 and the match day. The data revealed that the TL arising from the weekly game was solely responsible for the observed higher weekly TL of Starters in comparison with Non-Starters.

The reliability of handgrip strength (HGS) measurement has been confirmed in adults but has been sparsely addressed in pediatric populations. The aims of this study are twofold: to determine whether sex, age and/or hand-dominance influence the test&ndash, retest differences and to establish the reliability level of the HGS measurement in typical developing pediatric participants. A total of 338 participants aged 7&ndash, 13 years were tested using a digital handgrip strength (HGS) dynamometer (Jamar Plus+ Dynamometer) by the same rater on two testing trials separated by a one-day interval between sessions. The HGS testing was conducted according to the American Society of Hand Therapists recommendations. Relative and absolute reliability statistics were calculated. Age influenced the test&ndash, retest difference of the HGS measurement as children compared to preadolescents had lower intraclass correlation coefficients (0.95 vs. 0.98), standard error of measurement (SEM) (0.74 vs. 0.78 kg), smallest detectable difference (SDD) (2.05 vs. 2.16 kg) and higher values of the percentage value of SEM (5.48 vs. 3.44%), normalized SDD (15.52 vs. 9.61%) and a mean difference between the test and retest values (0.50 vs. 0.02 kg) for the dominant hand. The results indicate that the protocol using the Jamar digital handgrip dynamometer is a reliable instrument to measure HGS in participants aged 7&ndash, 13 years with typical development. Clinicians and researchers therefore can have confidence in determining the minimally clinical effect for HGS.

BACKGROUND: Yoga is an ancient body-mind practice which originated in India and is popular in the Western world as a form of relaxation and exercise. It has been of interest for people with schizophrenia to determine the efficacy of yoga delivered as a package of care versus non-standard care. OBJECTIVES: To examine the effects of yoga as part of a package of care versus non-standard care for schizophrenia. SEARCH METHODS: We searched the Cochrane Schizophrenia Group Trials Register (latest 15 May 2018) which is based on regular searches of MEDLINE, PubMed, Embase, CINAHL, BIOSS, AMED, PsychINFO, and registries of clinical trials. We searched the references of all included studies. There are no language, date, document type, or publication status limitations for inclusion of records in the register. SELECTION CRITERIA: All randomised controlled trials (RCTs) including people with schizophrenia comparing yoga as part of a package of care with non-standard care. DATA COLLECTION AND ANALYSIS: There were no data to analyse as no studies met the inclusion criteria. MAIN RESULTS: The searches identified 30 studies that could be relevant to this review. After careful inspection, 29 were excluded and one is awaiting classification. No data were available for analyses. AUTHORS' CONCLUSIONS: In view of the lack of evidence from RCTs, it is currently not possible for us to comment on the use of yoga as part of a package of care versus non-standard care. ispartof: COCHRANE DATABASE OF SYSTEMATIC REVIEWS vol:4 issue:4 ispartof: location:England status: published

Background: The ability to perform activities of daily living (ADL) as a component of participation is one of the factors that contribute to quality of life. The ability to perform ADL for persons experiencing severe/profound intellectual disability (ID) may be reduced due to their cognitive and physical capacities. However, until recently, the impact of the significantly prevalent visual impairments on the performance of activities of daily living has not yet been revealed within this group.Aim: The purpose of this prospective cross-sectional study was to investigate the impact of visual impairment on the performance of activities of daily living for persons with a severe/profound intellectual disability.Method: The Barthel Index (BI) and Comfortable Walking Speed (CWS) were used to measure the ability of performing activities of daily living (ADL) in 240 persons with severe/profound ID and having Gross Motor Functioning Classification System (GMFCS) levels I, II or III; this included 120 persons with visual impairment. The impact of visual impairment on ADL was analyzed with linear regression.Results: The results of the study demonstrated that visual impairment slightly affects the ability of performing activities of daily living (BI) for persons experiencing a severe/profound intellectual disability. GMFCS Levels II or III, profound ID level, and visual impairment each have the effect of lowering BI scores. GMFCS Levels II or III, and profound ID level each have the effect of increasing CWS scores, which indicates a lower walking speed. A main effect of visual impairment is present on CWS, but our results do show a substantive interaction effect between GMFCS level III and visual impairment on Comfortable Walking Speed in persons with a severe/profound intellectual disability.Conclusions: Visual impairment has a slight effect on ability to perform ADL in persons experiencing severe/profound ID. (C) 2015 Elsevier Ltd. All rights reserved.

The aim of the study was to investigate whether an increased risk of injury occurrence can be determined through frequent anthropometric measurements in elite-standard youth soccer players. Over the course of one season, we followed 101 male elite-standard youth soccer players between 11 and 19 years of age. Height and body mass were monitored at monthly measurement intervals and fat percentage was assessed every 3 months by use of the sum of skinfold method. Growth in height (cm), alternations in body mass index (kg/m(2)), fat percentage and fat-free mass index (kg/m(2)) were calculated. Injuries were recorded in accordance with the recommendations of the FIFA Consensus Model for Injury Registration. Odds ratio scores and 95 % confidence intervals were calculated using binary logistic regression analyses. The following anthropometric injury risk factors were identified: >= 0.6 centimeter growth per month (p = 0.03; OR = 1.63; 95 % CI: 1.06-2.52), >= 0.3 kg/m(2) increase of body mass index value per month (p = 0.03; OR = 1.61; 95 % CI: 1.04-2.49) and low fat percentage; i.e.

This study investigated the role of maturity timing in selection procedures and in the specialisation of playing positions in youth male basketball. Forty-three talented Dutch players (14.66 ± 1.09 years) participated in this study. Maturity timing (age at peak height velocity), anthropometric, physiological, and technical characteristics were measured. Maturity timing and height of the basketball players were compared with a matched Dutch population. One-sample t-tests showed that basketball players were taller and experienced their peak height velocity at an earlier age compared to their peers, which indicates the relation between maturity timing and selection procedures. Multivariate analysis of variance (MANOVA) showed that guards experienced their peak height velocity at a later age compared to forwards and centres (P.01). In addition, positional differences were found for height, sitting height, leg length, body mass, lean body mass, sprint, lower body explosive strength, and dribble (P.05). Multivariate analysis of covariance (MANCOVA) (age and age at peak height velocity as covariate) showed only a significant difference regarding the technical characteristic dribbling (P.05). Coaches and trainers should be aware of the inter-individual differences between boys related to their maturity timing. Since technical characteristics appeared to be least influenced by maturity timing, it is recommended to focus more on technical characteristics rather than anthropometric and physiological characteristics.

Predicting current and future tennis performance can lead to improving the development of junior tennis players. The aim of this study is to investigate whether age, maturation, or physical fitness in junior elite tennis players in U13 can explain current and future tennis performance. The value of current tennis performance for future tennis performance is also investigated. A total of 86 junior elite tennis players (boys, n = 44; girls, n = 42) U13 (aged: 12.5 +/- 0.3 years), and followed to U16, took part in this study. All players were top-30 ranked on the Dutch national ranking list at U13, and top-50 at U16. Age, maturation, and physical fitness, were measured at U13. A principal component analysis was used to extract four physical components from eight tests (medicine ball throwing overhead and reverse, ball throwing, SJ, CMJas, Sprint 5 and 10 meter, and the spider test). The possible relationship of age, maturation, and the physical components; "upper body power", "lower body power", "speed", and "agility" with tennis performance at U13 and U16 was analyzed. Tennis performance was measured by using the ranking position on the Dutch national ranking list at U13 and U16. Regression analyses were conducted based on correlations between variables and tennis performance for boys and girls, separately. In boys U13, positive correlations were found between upper body power and tennis performance (R-2 is 25%). In girls, positive correlations between maturation and lower body power with tennis performance were found at U13. Early maturing players were associated with a better tennis performance (R-2 is 15%). In girls U16, only maturation correlated with tennis performance (R-2 is 13%); later-maturing girls at U13 had better tennis performances at U16. Measuring junior elite tennis players at U13 is important for monitoring their development. These measurements did not predict future tennis performance of junior elite tennis players three years later. Future research should focus on other aspects in order to predict tennis performance better.

Cardiorespiratory fitness is the ability of the circulatory, respiratory and muscular systems to supply oxygen during sustained physical activity. Low cardiorespiratory fitness levels have been found in individuals with intellectual disabilities (ID), which puts them at higher risk for cardiovascular diseases and all-cause mortality. The aims of this review were to update previous reviews about (a) the cardiorespiratory fitness levels and their determinants in individuals with ID, and (b) the validity and reliability of cardiorespiratory fitness testing in individuals with ID. We searched the databases of Pubmed and Embase for relevant studies, resulting in 31 included articles. These studies mainly included younger participants with mild to moderate ID. Results confirmed previous findings of low cardiorespiratory fitness levels in individuals with ID. Cardiorespiratory fitness levels of children and adolescents with ID are already low, with further decline with increasing age. Furthermore, females have lower cardiorespiratory fitness levels than males. Physical inactivity and chronotropic incompetence are most likely to contribute to low cardiorespiratory fitness levels. Peak cardiorespiratory fitness levels of individuals with ID can be assessed with maximal treadmill protocols, after allowing for familiarization sessions. Although, predicting maximal oxygen uptake from field tests is problematic, field tests have been found valid and reliable as indicators of cardiorespiratory fitness. (C) 2013 Elsevier Ltd. All rights reserved.

Cardiorespiratory fitness is the ability of the circulatory, respiratory and muscular systems to supply oxygen during sustained physical activity. Low cardiorespiratory fitness levels have been found in individuals with intellectual disabilities (ID), which puts them at higher risk for cardiovascular diseases and all-cause mortality. The aims of this review were to update previous reviews about (a) the cardiorespiratory fitness levels and their determinants in individuals with ID, and (b) the validity and reliability of cardiorespiratory fitness testing in individuals with ID. We searched the databases of Pubmed and Embase for relevant studies, resulting in 31 included articles. These studies mainly included younger participants with mild to moderate ID. Results confirmed previous findings of low cardiorespiratory fitness levels in individuals with ID. Cardiorespiratory fitness levels of children and adolescents with ID are already low, with further decline with increasing age. Furthermore, females have lower cardiorespiratory fitness levels than males. Physical inactivity and chronotropic incompetence are most likely to contribute to low cardiorespiratory fitness levels. Peak cardiorespiratory fitness levels of individuals with ID can be assessed with maximal treadmill protocols, after allowing for familiarization sessions. Although, predicting maximal oxygen uptake from field tests is problematic, field tests have been found valid and reliable as indicators of cardiorespiratory fitness. (C) 2013 Elsevier Ltd. All rights reserved.

BackgroundInformation concerning exercise tolerance and aerobic capacity is imperative for generating effective and safe exercise programs. However, for older people with a lower-limb amputation, a standard exercise test is not available.ObjectiveThe primary aim of the present study was to determine whether a graded 1-legged peak exercise test is feasible and provides a valid assessment of peak aerobic capacity in older people walking with a lower-limb prosthesis.DesignThis was a quasi-experimental case-control study.MethodsA total of 36 older people with a lower-limb prosthesis and 21 people who were able-bodied (controls) (overall mean age=61.7 years, SD=6.1) performed a discontinuous graded 1-legged exercise test. The peak respiratory exchange ratio was used as an indicator of maximal effort. The controls performed an additional 2-legged exercise test to provide insight into differences between the testing modes.ResultsAll participants were able to perform the exercise test. Electrocardiographic tracings and blood pressure were adequately monitored. The controls and the people with a lower-limb amputation were able to stress the cardiovascular system to a similar extent. Analyses of construct validity revealed that the peak aerobic capacity measured with the 1-legged exercise test was able to distinguish between participants on the basis of age, body mass index, and sex to a similar extent as the conventional 2-legged exercise test.LimitationsThe results can be generalized only to people who are able to ambulate with their prosthesis.ConclusionsThe graded 1-legged exercise test was feasible and provided a valid assessment of peak aerobic capacity and exercise tolerance in older people walking with a lower-limb prosthesis.

Background The purpose of this study is to describe feasibility and test-retest reliability of the six-minute walking distance test (6MWD) and an adapted shuttle run test (aSRT) in persons with severe intellectual and sensory (multiple) disabilities.Materials and Methods Forty-seven persons with severe multiple disabilities, with Gross Motor Function Classification System (GMFCS) grade I and II and wearing a heart rate monitor, performed the 6MWD and the aSRT twice.Results Ninety-six per cent of the participants completed both tests successfully. Wilcoxon signed-rank test revealed no significant differences between test and retest (P = 0.90. Limits of agreement for aSRT in GMFCS II subjects were insufficient.Conclusion Six-minute walking distance test is feasible and reliable for measuring functional exercise capacity in GMFCS I and II participants with severe multiple disabilities. aSRT is feasible and reliable for measuring aerobic capacity in GMFCS I participants. Compared with others, participants with severe multiple disabilities achieved poor results in 6MWD.

BackgroundThe purpose of this study was to determine the feasibility and reliability of the modified Berg Balance Scale (mBBS) in persons with severe intellectual and visual disabilities (severe multiple disabilities, SMD) assigned Gross Motor Function Classification System (GMFCS) grades I and II.MethodThirty-nine participants with SMD and GMFCS grades I and II performed the mBBS twice with 1-week interval. Feasibility was assessed by the percentage of successful measurements per task and of the total score. First, test-retest reliability was determined by intraclass correlation coefficients (ICC) for each task and for the total score of all tasks combined. Second, level of agreement between test-retest scores was assessed with the proportion of equal scores for each task. Finally, internal consistency of the distinct tasks was assessed by Cronbach's alpha.ResultsThe results indicated that 92% of the measurements by the mBBS for all selected tasks were successful, indicating that the mBBS is a feasible instrument for the tested target group. ICC for the test-retest of the total score was 0.95. The proportion of equal scores for test-retest of the tasks was 0.80 or more, except for tasks 9 and 10. Cronbach's alpha of distinct tasks was 0.84. Test-retest reliability of tasks 9 and 10 was not acceptable.ConclusionsFeasibility of all tasks and test-retest reliability of 10 out of 12 mBBS tasks is acceptable. The mBBS is a both feasible and reliable test for evaluating the functional balance of persons with SMD and GMFCS grades I and II.

With the introduction of prophylaxis, restricting children with haemophilia to participate in physical activities was no longer necessary. Subsequently, many studies report on improved physical functioning in children and adolescents with haemophilia. However, little is known about psychological aspects such as perceived competence and impact of disease. Therefore, the aims of this study were to explore: (i) perceived competence, (ii) perceived impact of illness, and (iii) analyse associations between perceived competence and demographic factors, disease-related factors and joint status in young haemophiliacs in the Netherlands. Fifty-four children (age 8-12 years) and 72 adolescents (12-18 years) with haemophilia participated in this cross-sectional, multi-centre, explorative study. Measurements included perceived competence (Self Perception Profile for Children/Adolescents; range 6-24/5-20), impact of disease (Revised Perception Illness Experience; range 1-5), demographic factors, disease-related factors, joint status and functional status. Mean (SD) scores for perceived competence in the children ranged from 17.3 (+/- 4.0) to 19.6 (+/- 4.0), and for adolescents from 13.3 (+/- 2.4) to 15.7 (+/- 2.8) points. In general, scores were comparable with those of healthy peers, but children with haemophilia had a lower global self-worth score and competence in close friendship was lower for adolescents when compared with those of healthy peers. Mean (SD) scores for impact of disease ranged from 1.2 (+/- 0.4) to 2.3 (+/- 0.8) in children and from 1.3 (+/- 0.4) to 2.0 (+/- 0.8) in adolescents. Severe haemophilia, prophylactic medication, high impact of disease and a shorter walking distance showed a weak to moderate association with perceived competence. Children and adolescents with haemophilia in general have a perceived competence that is nearly comparable with that of healthy peers, with the exception of a lower global self-worth in children and a lower competence for close friendship in adolescents. Haemophiliacs seem to perceive their disease as having relatively low impact on their life. Severe disease, prophylactic treatment and low functional status seemed to be associated with lower perceived competence.

Introduction: This study investigates the effect of a modest weight loss either by a calorie restricted diet or mainly by increased physical exercise on health related quality of life (HRQoL) in overweight-to-obese and inactive postmenopausal women. We hypothesize that HRQoL improves with weight loss, and that exercise-induced weight loss is more effective for this than diet-induced weight loss. Methods: The SHAPE-2 trial was primarily designed to evaluate any additional effect of weight loss by exercise compared with a comparable amount of weight loss by diet on biomarkers relevant for breast cancer risk. In the present analysis we focus on HRQoL. We randomly assigned 243 eligible women to a diet (n = 97), exercise (n = 98), or control group (n = 48). Both interventions aimed for 5-6 kg weight loss. HRQoL was measured at baseline and after 16 weeks by the SF-36 questionnaire. Results: Data of 214 women were available for analysis. Weight loss was 4.9 kg (6.1%) and 5.5 kg (6.9%) with diet and exercise, respectively. Scores of the SF-36 domain 'health change' increased significantly by 8.8 points (95% CI 1.6;16.1) with diet, and by 20.5 points (95% CI 13.2;27.7) with exercise when compared with control. Direct comparison of diet and exercise showed a statistically significantly stronger improvement with exercise. Both intervention groups showed a tendency towards improvements in most other domains, which were more pronounced in the exercise group, but not statistically different from control or each other. Conclusion: In a randomized trial in overweight-to-obese and inactive postmenopausal women a comparable 6%-7% weight loss was achieved by diet-only or mainly by exercise and showed improvements in physical and mental HRQoL domains, but results were not statistically significant in either the diet or exercise group. However, a modest weight loss does lead to a positive change in self-perceived health status. This effect was significantly larger with exercise-induced weight loss than with comparable diet-induced weight loss. Trial Registration: ClinicalTrials.gov NCT01511276.

Background: The purpose of this study was to determine whether joint mobility is associated with motor performance in children referred for Developmental Coordination Disorder (DCD-group) in contrast to a randomly selected group of children between 3-16 years of age (Random-Group).Methods: 36 children with DCD and 352 typically developing children (Random-Group) participated. Hypermobility was classified based on the Beighton score (cut-off >= 5 for 3-9 years and >= 4 for 10-16 years) using goniometry. Motor performance was assessed with the Movement Assessment Battery for Children (MABC).Results: The mean Beighton score in the DCD-group was 5.0 versus 2.6 in the Random group. Prevalence of hypermobility was higher in the DCD-group than in the Random Group (64% and 33% respectively; X-2 = 16.09, p Conclusion: The extremely high prevalence of hypermobility when applying the recommended cut-off scores stresses the need for an international agreement on firm cut-off points and the use of standardized measurement of Beighton mobility manoeuvres. The results of this study show that a cut-off of 7 is more appropriate, resulting in a prevalence of 6% in children aged 3-16 years. Although in the general population motor performance and joint mobility are not related, this is the case in children referred for DCD. We argue that more mobility of the joints may be a disadvantage when motor coordination is poorly developed.

The purpose of this study was to increase the nutrition knowledge and to create perdurable changes in children's behaviour with nutrition education-educational material. A quasi-experimental design was utilized with 78 volunteer female participants aged 8-12 who were attending a volleyball school. Education materials were given to education group to study at homes with their families during 1.5 months in order to support the education. The increase in nutrition knowledge was significant comparing to control group (p