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Background: Physical activity (PA) plays a vital role in maintaining the functional ability that enables well-being in older age (healthy aging), potentially also saving costs for the healthcare system and society. The aim of this study was to examine the association between PA and healthcare and societal costs in a sample of very mild to moderately frail older adults., Methods: This cross-sectional study is a secondary analysis using baseline data from the PromeTheus randomized-controlled trial, which included 385 very mild to moderately frail community-dwelling older adults (70 + years) from Germany. Participants self-reported their health-related resource use in the previous 6 months (FIMA questionnaire), which was monetarily valued using standardized unit costs. PA was also self-reported using the German Physical Activity Questionnaire for middle-aged and older adults (German-PAQ-50+) and categorized as 'insufficient'/'sufficient' or 'insufficient'/'moderate'/'high' in accordance with the World Health Organization guidelines for PA. Mean and median healthcare costs (including outpatient, inpatient, rehabilitation, formal care, and medication costs) and societal costs (healthcare costs plus informal care costs) for different PA groups were estimated using generalized linear models and quantile regression, with sociodemographic variables and physical capacity (Short Physical Performance Battery) as covariates., Results: Of the sample, 24% were classified as insufficiently, 23% as moderately, and 54% as highly active. Sufficient PA, especially high PA, was associated with lower costs in the 6 months prior to data collection compared to insufficient PA (-€6,237, 95% CI [-10,656; -1,817] and -€8,333, 95% CI [-12,183; -4,483], respectively). The cost difference between PA intensity groups was largely driven by differences in informal care costs and decreased substantially when physical capacity was accounted for in the analyses; e.g., the mean difference in societal costs between sufficient and insufficient PA decreased from -€7,615 (95% CI [-11,404; -3,825]) to -€4,532 (95% CI [-7,930; -1,133])., Conclusion: Promoting PA throughout the lifespan as a means of promoting healthy aging and reducing dependency in old age could potentially provide economic benefits and help to mitigate the economic consequences of an aging population with increasing health and long-term care needs. Future longitudinal studies should attempt to disentangle the mediating and confounding role of physical capacity and health status in the association between PA and costs., (© 2024. The Author(s).)

Introduction: Studies have described varying prevalences of frailty as determined by Fried's frailty phenotype. Comparability may be limited due to frailty phenotype modifications, especially the low physical activity criterion., Purpose: This study aimed to determine the variability of frailty phenotype prevalence according to the physical activity assessment method., Patients and Methods: In a cross-sectional analysis, frailty phenotype prevalence was assessed in community-dwelling older adults. The low physical activity criterion of the frailty phenotype was determined by using five different questionnaires and an accelerometer, and three different cut-point models., Results: In 47 participants, frailty phenotype prevalence varied between 14.9% and 31.9%, depending on the model used to assess physical activity., Conclusion: The method of physical activity assessment and the choice of cut-points for low physical activity considerably impact frailty phenotype prevalence. More efforts to standardize and adhere to the low physical activity criterion seem warranted. The calculation of correction factors between commonly used sets of low physical activity criteria might allow better comparisons of published prevalence rates., Competing Interests: The authors declare that there are no conflicts of interest in this work., (© 2020 Ziller et al.)

Previous studies suggest beneficial effects of aerobic exercise on executive functions, which are a core deficit in ADHD. The aim of the present fMRI study was to investigate acute effects of aerobic exercise on inhibitory control and related brain activation in adult patients with ADHD. 23 patients and 23 matched healthy controls performed on a Go/No-go task in an MRI scanner, following both, an exercise condition involving 30 min of cycling at moderate intensity, and a control condition. ADHD patients compared to healthy controls showed increased brain activation during successful inhibition in the exercise compared to the control condition in parietal, temporal, and occipital regions. Exercise did not improve behavioral performance in either group, but in ADHD patients, exercise-related increases in brain activation and behavioral task performance (i.e., correct inhibition rate) negatively correlated with correct inhibition rate in the control condition. Thus, patients with worse inhibition performance showed stronger exercise-related enhancements, indicating that the lack of improvements on the behavioral level for the whole patient group could be due to ceiling effects. Our findings might be an important step in understanding the neural basis of exercise effects and could, in the long term, help in developing alternative treatment approaches for ADHD.

Background and Objective: Clinical practice guidelines recommend a multimodal intervention based on standardized screening for the treatment of frailty, which includes physical exercise as the main component. This study protocol describes a planned randomized controlled pilot study to evaluate the feasibility of a main study and first assessment of the effects of a multimodal, resource-oriented intervention program on frailty in older people., Methods and Analyses: A total of 50 community-dwelling older men and women with frailty, ≥65 years of age, will be randomly allocated to the intervention or control group. The intervention group receives usual care and a multimodal intervention program. This program consists of a multidimensional screening, verbal counselling, written instructions on individual functional and health status, a home-based physical exercise program (high-intensity functional exercise program, HIFE), and support related to cognition, mood, risk of falling, medication, nutrition and self-care as required. The control group participants will receive usual care only. The feasibility will be assessed by indicators for processes, resources and management (practicability), as well as for acceptance, safety and possible effects of the intervention. The frailty index and secondary clinical endpoints will be assessed before and after the 3‑month intervention, as well as after a 3-month follow-up to estimate the effects. Data will be analyzed according to the intention-to-treat principle., Ethics and Dissemination: Ethical approval was obtained from the Ethics Committee of the German Physiotherapy Association (ref. number: 2017-02). Outcomes will be disseminated in a peer-reviewed journal and at specialist conferences., Trial Registration Number: German Clinical Trial Register: DRKS00011831.

The present study should reveal differences in gait performance, quadriceps strength, and physical activity (PA) between fallers and nonfallers in women with osteoporosis. Forty-one women with osteoporosis (17 fallers, 24 nonfallers) participated. Gait analysis shows that fallers were walking with a slower walking speed (-9%, p = .033) and had a shorter stride length (-7%, p = .039). Moreover, fallers showed a decreased ankle power generation (-18%, p = .045). The quadriceps strength was decreased by 24% for fallers (p = .005) while PA showed no significant differences. Although a decrease in ankle power generation could have an effect on floor clearance for limb advancement in the swing phase, the causal relationship between spatiotemporal parameters (walking speed, stride length) and walking ankle joint power generation remains unknown and warrants further investigation. In conclusion, walking speed, stride length, ankle power generation, and quadriceps strength can be used to differentiate between fallers and nonfallers in women with osteoporosis.

Cognitive deficits are core symptoms in patients with schizophrenia (SZ) and major depressive disorder (MDD), but specific and approved treatments for cognitive deterioration are scarce. Experimental and clinical evidence suggests that aerobic exercise may help to reduce psychopathological symptoms and support cognitive performance, but this has not yet been systematically investigated. In the current study, we examined the effects of aerobic training on cognitive performance and symptom severity in psychiatric inpatients. To our knowledge, to date, no studies have been published that directly compare the effects of exercise across disease groups in order to acquire a better understanding of disease-specific versus general or overlapping effects of physical training intervention. Two disease groups (n=22 MDD patients, n=29 SZ patients) that were matched for age, gender, duration of disease and years of education received cognitive training combined either with aerobic physical exercise or with mental relaxation training. The interventions included 12 sessions (3 times a week) over a time period of 4 weeks, lasting each for 75 min (30 min of cognitive training+45 min of cardio training/mental relaxation training). Cognitive parameters and psychopathology scores of all participants were tested in pre- and post-testing sessions and were then compared with a waiting control group. In the total group of patients, the results indicate an increase in cognitive performance in the domains visual learning, working memory and speed of processing, a decrease in state anxiety and an increase in subjective quality of life between pre- and post-testing. The effects in SZ patients compared with MDD patients were stronger for cognitive performance, whereas there were stronger effects in MDD patients compared with SZ patients in individual psychopathology values. MDD patients showed a significant reduction in depressive symptoms and state anxiety values after the intervention period. SZ patients reduced their negative symptoms severity from pre- to post-testing. In sum, the effects for the combined training were superior to the other forms of treatment. Physical exercise may help to reduce psychopathological symptoms and improve cognitive skills. The intervention routines employed in this study promise to add the current psychopathological and medical treatment options and could aid the transition to a multidisciplinary approach. However, a limitation of the current study is the short time interval for interventions (6 weeks including pre- and post-testing).

Unemployment is associated with health risks. Physical activity produces health benefits. This study examined the effects of a physical activity counseling and exercise referral scheme on physical-activity behavior in long-term unemployed individuals. In this study, 51 long-term unemployed persons received physical-activity counseling and exercise referral. Further, 21 unemployed and 17 employed persons with no intervention were included. Physical activity was measured over 7 consecutive days prior to and 12 weeks after counseling by accelerometer. Participants who started exercising increased their amount of moderate physical activity from 26 ± 14 to 35 ± 25 minutes/day and total physical activity from 207 ± 86 to 288 ± 126 counts/minute. Generally, unemployed persons were less active and less healthy compared to employed persons. Persons who are willing and motivated benefit from structured physical activity counseling and exercise referral and increase physical activity to a health promoting level. Physical activity inequalities could be reduced.

Physical activity has been shown to enhance circulating brain-derived neurotrophic factor (BDNF) in animals and humans. However, the exact time course and sex-specific modulation of peripheral BDNF in response to exercise are still poorly understood. We examined the kinetics of BDNF serum concentrations in response to perceived high-intensity and low-intensity exercise, and during a subsequent recovery period by taking several blood samples during each phase. Furthermore, we compared the BDNF concentration between young men and women taking oral contraceptives. We found transient BDNF elevations during physical activity only for the high-intensity condition. Here, BDNF reached its maximum serum concentration after 20 min of exercise, and returned to baseline after approximately 10 min of recovery. Although there were no sex differences during baseline or recovery, the increase in the BDNF concentration during the exercise phase was more pronounced in men than in women.

The study explored the interdependence of changes in oxygen uptake, quality of life and cancer-related side-effect fatigue during a 4-month exercise intervention. Participants were during adjuvant (curative) or palliative therapy and post-adjuvant therapy (finished within the previous 12 months). Aerobic exercise capacity ( VO2peak), quality of life and fatigue symptom ( EORTC QLQ- C30) were obtained in 101 cancer patients (30-77 years). After initial examination, patients participated in supervised and/or home-based training interventions. Patients were re-examined after 16-20 weeks and stratified into 3 subgroups (terciles) with respect to the absolute change in VO2peak. The ANCOVA, with significant covariate effect for pretest fatigue score ( F(5,101) = 8.150, P < 0.001), indicated significant differences between groups in outcome measures ( P < 0.001). Based on the absolute change of VO2peak (1.9 ± 1.7; 1.8 ± 0.8; 5.7 ± 2.8 ml/kg/min) there were significant differences in the quality of life improvement (17.2 ± 15.1 vs. 4.8 ± 22.0 points, P < 0.05) and cancer-related fatigue reduction (−6.1 ± 30.7; −11.5 ± 20.9; −21.2 ± 21.4 points) between upper and lower tercile. The findings point towards a relationship of exercise capacity enhancement, quality of life improvement and fatigue symptom reduction during and shortly after cancer treatment. [ABSTRACT FROM AUTHOR]

The present study evaluated the effects of physical exercise on heart rate variability (HRV) in cancer patients. 3 matched groups of each 15 tumour patients (60.4 ± 8.9 years, 27 male, 18 female) were recruited: Physical exercise group 1 (acute treatment), Physical exercise group 2 (post treatment) and non-intervention group (acute treatment, no exercise). Exercise group patients received counselling for exercise and participated in a Nordic-Walking program. Short-term HRV-recordings, assessments of fatigue and quality of life (QoL) were performed prior to and 16 weeks after the exercise program initiation. MANCOVA revealed group × time differences in total power frequency domain of HRV and QoL (p < 0.05). TP follow-up scores [logms² ] differed significantly between non-intervention and intervention post treatment (2.0 ± 0.5 vs. 2.6 ± 0.5), but not between non-intervention and intervention during acute treatment. QoL follow-up scores differed significantly between non-intervention and intervention during acute treatment (47 ± 15 vs. 64 ± 18) and post treatment (47 ± 15 vs. 69 ± 19). Exercise enhances cardiac autonomic regulation of tumour patients during and after acute treatment. Because of the association of higher HRV-parameters and prolonged survival in cancer patients, improvement in autonomic control may be an important goal of exercise. [ABSTRACT FROM AUTHOR]

The article reports on the result of the study concerning on maximum oxygen uptake (VO2max) affects the performance of professional tennis players during tournaments. It shows that professional tennis players should have cardiorespiratory capacity of 55-65 milliliter/minute/kilogram (mL/min/kg). The study was participated by a tennis athlete who has competed at the Association of Tennis Professionals (ATP) tour where a treadmill test was conducted from 1999 to 2006. It reveals that the athlete has reached a maximum speed of 16-17.5 kilometers/hour with VO2max averaging to 61.1 milliliter/minute/kilogram. The study shows that an evaluation of the athlete's aerobic capacity plays significant role in achieving the highest ranking in the ATP tournament.