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Elective hip and knee joint replacement for osteoarthritis are cost-effective surgical procedures requiring specific rehabilitation programs. Actigraphy is widely used in both research and clinical practice to study activity patterns with great accuracy and validity but it has never been utilized in orthopedic patients. Therefore, the aim of this study was to objectively assess, through actigraphy, physical activity (PA) levels and rest-activity daily rhythm (RAR) in patients undergoing hip or knee joint replacement and hospitalized for ten days after surgery. Twenty subjects (11 males and 9 females; age: 62.68 +/- 10.39 years old; BMI: 29.03 +/- 3.92 kg/m(2)) wore the Actiwatch 2 actigraph (Philips Respironics, Portland, OR) to record both PA levels and RAR for 11 consecutive days and data on subjective scores of pain, by a visual analog scale (VAS), and functional and clinical scores were collected. The following time-points were considered for the statistical analysis: pre-surgery (PRE), the first (POST1), the fourth (POST4) and the tenth (POST10) day after surgery. RAR were processed with the population mean cosinor to describe the rhythm's characteristics (acrophase, amplitude and MESOR) while data on actigraphy-based PA, VAS, and functional clinical scores were compared among PRE, POST1, POST4 and POST 10 with the RM-ANOVA or the non-parametric Friedman test. The day after surgery the subjects had a flattened RAR compared to the other conditions: lower values were detected in POST1 compared to both PRE, POST4 and POST10 for MESOR (p < .0001; eta(2)(p) = .71, large) and amplitude (p < .0001; eta(2)(p) = .63, large) while RAR's acrophase (p < .0001; eta(2)(p) = .61, large) was delayed in PRE (16:45) compared to POST1 (12:42), POST4 (14:38), and POST10 (14:38). PA levels were significantly lower at POST 1 (76.7 +/- 33.4) compared to PRE (192.3 +/- 91.5; p < .0001 and ES: 1.68, large), POST4 (137.9 +/- 45.9; p < .0001 and ES: 1.54, large), and POST10 (131.2 +/- 54.3; p < .0001 and ES: 1.21, large) whereas VAS and functional clinical values significantly improved at POST10. Hip and knee joint replacement negatively influenced RAR and PA the first day after surgery but a progressive improvement in the circadian pattern of rest-activity cycle, PA levels, VAS and functional ability was recorded from POST4 to POST10. Actigraphy has the ability to collect real-life data without interfering with clinical practice and give clinicians a new measure of performance that is currently not available. This tool could allow to identify patients with disrupted circadian rhythm and reduced PA in the peri-operative period in orthopedic surgery, and timely intervene on these subjects with personalized rehabilitative intervention.

Background. The aim of this study was to evaluate the effect of a six-month home-based resistance-training program on muscle health and physical performance in healthy older subjects during the unique condition of home confinement caused by the COVID-19 pandemic. Methods. This was a randomized-controlled study that enrolled older participants that were allocated to either an experimental group performing the six-months exercise prescription (EXE) or a control group (CON). At the beginning (PRE), and after 6 months (POST), participants were assessed for muscle strength, balance, gait assessment and body composition by dual energy X-ray absorptiometry and magnetic resonance imaging. Normality distribution of data was checked with the D&rsquo, Agostino and Pearson test and changes between PRE and POST were assessed by paired Student&rsquo, s t-test while percentage and absolute changes between groups at POST were tested by unpaired t-test. Results. Nine participants were included for the final analysis: EXE, n = 5 (age: 66 &plusmn, 4, BMI: 27.5 &plusmn, 3.7) and CON, n = 4 (age: 71 &plusmn, 9, BMI: 24.2 &plusmn, 4.1). Significant PRE-to-POST changes were observed in the EXE group only in the chair-stand test (+19.8%, p = 0.048 and ES:1.0, moderate) and in total fat mass (+5.0%, p = 0.035 and ES:1.4, large) with no between-group differences. Moreover, EXE had significantly higher absolute thigh CSA values than CON at POST (14.138 &plusmn, 2977 vs. 9039 &plusmn, 1015, p = 0.0178, ES = 1.7). No other within- and between-group differences were detected. Conclusions. The home-based resistance-training program during the lockdown period, caused by the COVID-19 outbreak, determined only within-group improvement in lower limb muscle strength but not in muscle mass and composition in older subjects. Home confinement may partially explain the increase in total body fat due to a reduced daily PA regime and altered diet pattern.

Italy is one of the first European epicenters of the COVID-19 pandemic. In attempts to hinder the spread of the novel coronavirus disease, Italian government hardened protective measures, from quarantine to lockdown, impacting millions of lives dramatically. Amongst the enacted restrictions, all non-essential activities were prohibited as well as all outdoor activities banned. However, at the first spur of the outbreak, for about a dozen of days, physical and sports activities were permitted, while maintaining social distancing. In this timeframe, by administering measures coming from self-determination theory and theory of planned behavior and anxiety state, in an integrated approach, we investigated the prevalence of these activities by testing, via a Structural Equation Model, the influence of such psychosocial variables on the intention to preserve physical fitness during the healthcare emergency. Through an adequate fit of the hypothesized model and a multi-group analysis, we compared the most COVID-19 hit Italian region – Lombardy – to the rest of Italy, finding that anxiety was significantly higher in the Lombardy region than the rest of the country. In addition, anxiety negatively influenced the intention to do physical activity. Giving the potential deleterious effects of physical inactivity due to personal restrictions, these data may increase preparedness of public health measures and attractiveness of recommendations, including on the beneficial effects of exercise, under circumstances of social distancing to control an outbreak of a novel infectious disease.

The aims of this study were 1) to investigate Global Positioning System (GPS)-based match physical performance according to players’ playing position in three different playing formations (4-4-2, 3-5-2, 4-3-3) and 2) to analyse the differences in match performance between 1st and 2nd half. Twenty-three U19 elite male soccer players (age: 18±1 year, height: 1.80±0.04 m, body mass: 70.65±6.02 kg), categorized as Central Back (CB, n =5), Full Back (FB, n =4), Central Midfielders (CM, n =4), Wingers (W, n =3), Strikers (S, n =7), were monitored using 10Hz GPS during 31 competitive matches. The results showed that FB and W always had the highest very high-speed running distance and number of sprints in all playing formations. Significant decrease in all GPS variables was observed in the 2nd half of the match for all playing positions. Strength coaches should adopt specific training regimes in accordance with players’ playing position.