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OBJECTIVE: Given the therapeutic and non-therapeutic use of the tadalafil, (phosphodiesterase-5 inhibitor, PDE-5i), we examined its effects on anaerobic performance indices. METHODS: In total, 12 well-trained subjects reported to the laboratory on two occasions 1 week apart to perform a 30 s Wingate anaerobic power test (WAnT) on a bicycle ergometer. The day before the WAnT, the subjects were double-blinded to receive an oral dose of tadalafil (20 mg) or placebo. Blood lactate value at rest and 1, 3, 6 and 10 minutes of recovery phase, mean power, peak power, time to peak power and fatigue index were assessed for each WAnT. RESULTS: Blood lactate values at the 3-min recovery WAnT increased significantly in the tadalafil condition (mean (SD) 13.9 (1.7) v 12.8 (1.3) mmol/l; p<0.05) and time to peak power decreased significantly (6.3 (1.3) v 5.7 (1.5) s; p = 0.05). No differences were observed in any other parameters between the two conditions. CONCLUSION: The primary finding of this investigation was that the administration of a single dose of a long-term PDE-5i does not substantially influence anaerobic performance indices. However, results demonstrated both an increase in lactate values at the 3-min point of the recovery phase and a decrease in time to peak power. [ABSTRACT FROM AUTHOR]

Whereas experimental studies showed that in healthy trained subjects, the phosphodiesterase-5 inhibitor (PDE-5i) sildenafil improves exercise capacity in hypoxia and not in normoxia, no studies on the effects of the long half-life PDE-5i tadalafil exist. In order to evaluate whether tadalafil influences functional parameters and performance during a maximal exercise test in normoxia, we studied 14 healthy male athletes in a double-blind cross-over protocol. Each athlete performed two tests on a cycle ergometer, both after placebo or tadalafil (at therapeutic dose: 20 mg) administration. Oxygen consumption (VO2), blood lactate, respiratory exchange ratio, rate of perceived exertion, arterial blood pressure (BP), heart frequency (HR) and oxygen pulse (VO2/HR) were evaluated before exercise, at individual ventilatory and anaerobic thresholds (IVT and IAT), at VO2max and during recovery. Compared to placebo, a single tadalafil administration significantly reduced systolic BP before and after exercise (p < 0.05), decreased VO2/HR at IVT (13.3 +/- 1.8 vs. 14.5 +/- 2.1 mL . beat (-1); p = 0.03), but did not modify individual VO2max, IVT, or IAT. In healthy athletes, 20 mg of tadalafil does not substantially influence physical fitness-related parameters, exercise tolerance, and cardiopulmonary responses to maximal exercise in normoxia; it remains to be verified if higher doses/prolonged use influence health and/or sport performance in field conditions. [ABSTRACT FROM AUTHOR]

Sedentary behaviours in adults with intellectual disabilities (ID) negatively impact health-related determinants and increase the risk of physical dysfunction or chronic health issues. Inclusive sport practice can enhance social inclusion and fitness, benefiting overall person development and life quality. This study aimed to assess fitness level variation in athletes with and without ID before and after a 9-month inclusive (INC) and non-inclusive (N&#95;INC) basketball training. 38 athletes with ID and 14 athletes without ID belonged to INC group, 38 athletes with ID belonged to N&#95;INC group and 23 participants with ID belonged to the control group (CG). Before and after the intervention period, all participants performed anthropometric (body weight, body mass index, body fat percentage) and fitness tests (muscle strength and power, cardiovascular endurance, balance, flexibility, agility, movement speed, and coordination). ID and non-ID athletes of both INC and N&#95;INC groups significantly improved in most of the tests (weight, balance, flexibility, muscle strength, endurance, agility, movement speed and coordination) while CG group significantly worsened weight, muscle endurance, flexibility, agility, movement speed and coordination, after the intervention (p < 0.05). These findings showed that sport training improved fitness in athletes with ID, decreasing health risks. Moreover, involving in the same training group persons with and without disabilities, does not limit the beneficial effects that training induce on persons without ID and could be a valid way to promote both social inclusion and physical health of persons with ID., (© 2024. The Author(s).)

The main purpose of this longitudinal study was to investigate football players' recovery status, through hormonal response, in relation to accumulated workload at two comparable time points of the first (T1) and second half (T2) of the competitive season. Moreover, this study investigated athletes' hormonal response to a typical weekly conditioning session (5 days before match: MD-5), at T1 and T2, to detect changes in players' recovery capability over time. Salivary cortisol (sC) and testosterone (sT) of 24 professional players (27.8 ± 4.1 years of age) were collected before, after, and 24 hours following MD-5 in two comparable microcycles of T1 and T2. GPS training data (total and high-intensity distance) of the 7 and 28 days before sampling were used to obtain athletes' acute and chronic workloads. Results showed a pre-training significant decrease of sT and an increase of sC (p<0.05) in T2, compared to T1. Moreover, athletes showed high sC and low sT levels before, after and 24 hours following MD-5 in T2. Workload analysis revealed significant correlations of chronic load with sC (r = 0.45, p = 0.056) and T/C ratio (r = -0.59; p = 0.007). These results suggested that, in professional football, chronic workload has a greater impact on players' recovery time than acute workload over the sport season. Moreover, athletes' hormonal response to the weekly conditioning session at T2 revealed an altered anabolic/catabolic balance, highlighting the key role of continuous internal and external workload monitoring during the season., Competing Interests: The authors report there are no competing interests to declare., (Copyright: © 2024 Curzi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

To investigate how contextual or environmental factors may influence the athletic performance of female soccer players during competitions, this study aimed to assess the impact of match-related variables (playing surface; opponent levels; opponent result trends; match status, and match outcomes) on the athletic performance of professional female soccer athletes. Seventeen athletes (25.5 ± 4.3 years of age) from the same team competing in the Italian second division were divided into two groups according to their roles and athletic characteristics: Group A (central defenders and forwards) and Group B (right/left full-backs and midfielders). Total distance (TD) and sprint distance (SD); high-speed running (HSR), acceleration (ACC), and deceleration numbers (DEC); average and maximal heart rate (HR&#95;avg; HR&#95;max); and match-related factors were collected during the 22 regular season matches. A T -test and ANOVA were used to calculate the differences between groups in GPS and HR variables and the effects of match-related factors, respectively. Results showed higher running performance in the B group compared to the A group during matches. Increased ACC number was seen in matches played on artificial turf; winning was associated with decreased HR&#95;max and increased DEC number. Athletes covered higher TD reaching lower HR&#95;max when playing against lower-ranking opponents while matches lost/drawn resulted in higher HSR. High HRs (max and avg) were found when playing against a team with a positive performance trend. In summary, match-related factors and opponents' characteristics can affect athletic performance in female soccer athletes. These factors should be considered during in-seasonal training to personalize match preparation and optimize athlete performance.

Purposes: First, to examine the relationship between primary school children's academic achievement and healthy lifestyle habits. Second, to evaluate the effectiveness of two different 5-month physical education interventions (traditional physical education vs. coordinative physical education) on children's academic achievement. Third, to examine whether variations of anthropometric variables, fitness level, gross motor coordination, physical activity level, sedentary time, attentional performance, fruit and vegetable consumption, meal frequency and type of physical education intervention could predict children's academic achievement variations., Methods: Before and after the intervention, Italian language and mathematics skills, anthropometric variables (weight, height, body fat percentage, BMI), physical fitness (aerobic fitness, muscular strength, flexibility), gross motor coordination, attentional performance (processing speed, concentration performance, performance accuracy, attentional and inhibitory control), physical activity level, sedentary time and eating habits (meal frequency, fruit and vegetable consumption) were assessed in 161 Italian primary school children, randomly assigned to a traditional physical education group or to a coordinative physical education group., Results: Physical activity level, gross motor coordination and aerobic fitness moderately predicted mathematics skill (R 2  = 17%). Moreover, physical activity level, aerobic fitness and muscular strength moderately predicted Italian language skill (R 2  = 21%). Intervention type differently affected academic achievement. Specifically, Italian language and mathematics skills significantly improved only after traditional intervention. Fruit consumption increase was positively associated with the improvement in academic achievement. Coordinative physical education intervention was associated with a lower probability of improvement in Italian language and mathematical skills., Conclusion: Motor ability and lifestyle habits may have a positive influence on academic achievement in children. Unexpectedly, traditional physical education intervention resulted to be more effective on both Italian language and mathematical skills., 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 Gallotta, Bonavolontà, Zimatore, Curzi, Falcioni, Migliaccio, Guidetti and Baldari.)

Aims: The aims of this study were to verify if a 5-week cognitive-motor training (CMT) using FitlightsTM induced changes in young adult judo athletes compared to a non-intervention group. Specifically, it was verified if CMT influenced executive functions (EFs), physical fitness and brain-derived neurotrophic factor (BDNF) levels. Additionally, athletes' competitive results were compared between groups., Method: Twenty-seven athletes (14 males and 13 females; age = 19.5 ± 2.0 years) were assigned to the Fitlight (FG) and control (CG) groups which performed 5 weeks of CMT, respectively, including 25 min per day of Fitlight training or traditional judo practice. All participants performed cognitive (flanker task and forward/backward digit span) and fitness tests (counter movement jump, handgrip test, dynamic and isometric chin up). In addition, BDNF was collected by saliva sampling and competitive results after the intervention period were considered., Results: RM-ANOVA showed significant differences in FG for the accuracy of flanker (p = 0.028) and backward digit span (p < 0.001). Moreover, significant differences in FG were found for relative dynamic chin up (p = 0.027) and counter movement jump (p = 0.05). In addition, a significant difference in FG was found for competitive results after the intervention period (p < 0.01).No significant differences were found for BDNF and other cognitive and fitness measures (p > 0.05)., Conclusion: A 5-week judo-specific CMT improved EFs and motor performance in élite judo athletes. It seems that CMT with Fitlight™ could be considered an additional support to coaches during the training period., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Although I am serving as associate editor for Heliyon I do not have any access to the reviewing process (Maurizio Bertollo) If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Background: Gross motor coordination (GMC) development could be influenced by age, gender, weight status, geographical area, living setting, home environment, socio-economic status, sports practice., Purpose: To verify whether practicing sports and practicing different sports could influence children's GMC level., Methods: A total of 295 children aged 8-11 years were involved in the study and divided into 5 groups in relation to the sport they practiced: gymnastics group ( n  = 67; 51F, 16M), cycling group ( n  = 64; 15F, 49M), athletics group ( n  = 47; 22F, 25M), swimming group ( n  = 35; 20F, 15M), control group ( n  = 82; 42F, 40M). The four subtests of the Körperkoordinations Test für Kinder (KTK) assessed children's GMC level. The scores from each of the four subtests were summed into the KTK total raw score (RS) and then converted into a gender- and age-specific motor quotient (MQ)., Results: Children practicing sports showed significantly higher RS and MQ score than children of control group (203.14 ± 38.55 vs. 163.63 ± 43.50 and 98.56 ± 15.79 vs. 83.01 ± 16.71, respectively; p  < 0.001). Children practicing gymnastics had a significantly higher RS and MQ than children of cycling, swimming, and control groups ( p  < 0.05), children of control group had a significantly lower RS and MQ than children of all other groups ( p  < 0.05). Children practicing gymnastics performed better walking backwards subtest than all other children's groups ( p  < 0.001). Children of control group performed worse jumping sideways subtest than children of gymnastics, athletics and swimming groups ( p  < 0.01). Children practicing gymnastics performed better moving sideways subtest than children of athletics, cycling and control groups ( p  < 0.01); children of control group performed worse than children of all other groups ( p  < 0.01). Children of control group performed worse hopping for height subtest than children of gymnastics, athletics and cycling groups ( p  < 0.05); children practicing gymnastics performed better than children of swimming and control groups ( p  < 0.05)., Conclusions: The performance model and therefore the specialized training that each sport discipline required, could justified the differences in children's GMC level among sports groups. Thus, coaches should plan individualized interventions and choose activity contents to support children's GMC development., 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. The authors declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (© 2023 Biino, Giustino, Gallotta, Bellafiore, Battaglia, Lanza, Baldari, Giuriato, Figlioli, Guidetti and Schena.)

Introduction: The aim of the study was to investigate the influence of training status on cardiovascular function in young male recreational and competitive rowers., Methods: Ejection duration in percentage to the heart rate period (ED%), subendocardial viability ratio (SEVR), augmentation index at 75 bpm (AIx75) and carotid to femoral pulse wave velocity (cf-PWV) of competitive rowers (CR) (age 17.6 ± 4.1 years), recreational rowers (RR) (age 16.7 ± 2.70 years) and athletes practicing other recreational sports (ORS) (age 15.3 ± 1.4 years) were assessed., Results: ED% was lower in CR compared to ORS (31.9 ± 3.9% vs. 38.4 ± 4.8%; p  = 0.026) and cf-PWV was higher in CR compared to ORS (5.5 ± 1.0 m/s vs. 4.7 ± 0.5 m/s; p  = 0.032). SEVR was higher in CR compared to RR and ORS (165.8 ± 33.7% vs. 127.4 ± 30.4% and 128.3 ± 27.8%; p  = 0.022) and AIx75 was lower in CR compared to RR and ORS (-15.7 ± 8.6% vs. 1.2 ± 9.9% and 1.5 ± 9.1; p  = 0.001)., Discussion: Healthy, young competitive male rowers reported higher myocardial performance and better cardiovascular health than recreational athletes. Interpretations of cf-PWV in competitive rowers should be performed alongside other cardiovascular indicators., 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., (© 2023 Falcioni, Gallotta, Baldari, Cardinali, Campanella, Ferrari, Guidetti and Meucci.)

The relation between specific sport practice and possible spine modifications is unclear. The aim of this study was to investigate the effects of different sports on the spine in adult varsity athletes across a six month sports season. Forty-four athletes (24.5 ± 3 years) were divided into two groups according to the typology of the sport practiced: the symmetric sports group (S, 22 athletes: track and field running, n = 14; cycling, n = 8), and the asymmetric sports group (A, 22 athletes: tennis, n = 22). The participants' spines were evaluated with Formetric ® 4D rasterstereographic analysis at the beginning (BL), in the middle (INT), and at the end (FIN) of the season. Twenty-five parameters were measured in an average 4D modality. The results showed that the intervention factor (BL vs. FIN) had a significant effect on dimple distance ( p < 0.05) and on left lateral deviation (BL vs. FIN and INT vs. FIN, p < 0.01 and p < 0.01, respectively). Statistical differences were found for the sport typology factor for pelvic antero-retroversion and right lateral deviation. For left lateral deviation, no modulation was found for the sport typology. Asymmetric versus symmetric sport loads showed small statistical differences in a non-professional sample of adult athletes. The practice of asymmetric sports should also be encouraged without exceeding the total number of hours per week.

During exercise with increasing intensity, the human body transforms energy with mechanisms dependent upon actual requirements. Three phases of the body's energy utilization are recognized, characterized by different metabolic processes, and separated by two threshold points, called aerobic (AerT) and anaerobic threshold (AnT). These thresholds occur at determined values of exercise intensity(workload) and can change among individuals. They are considered indicators of exercise capacities and are useful in the personalization of physical activity plans. They are usually detected by ventilatory or metabolic variables and require expensive equipment and invasive measurements. Recently, particular attention has focused on AerT, which is a parameter especially useful in the overweight and obese population to determine the best amount of exercise intensity for weight loss and increasing physical fitness. The aim of study is to propose a new procedure to automatically identify AerT using the analysis of recurrences (RQA) relying only on Heart rate time series, acquired from a cohort of young athletes during a sub-maximal incremental exercise test (Cardiopulmonary Exercise Test, CPET) on a cycle ergometer. We found that the minima of determinism, an RQA feature calculated from the Recurrence Quantification by Epochs (RQE) approach, identify the time points where generic metabolic transitions occur. Among these transitions, a criterion based on the maximum convexity of the determinism minima allows to detect the first metabolic threshold. The ordinary least products regression analysis shows that values of the oxygen consumption VO 2 , heart rate (HR), and Workload correspondent to the AerT estimated by RQA are strongly correlated with the one estimated by CPET (r > 0.64). Mean percentage differences are <2% for both HR and VO 2 and <11% for Workload. The Technical Error for HR at AerT is <8%; intraclass correlation coefficients values are moderate (≥0.66) for all variables at AerT. This system thus represents a useful method to detect AerT relying only on heart rate time series, and once validated for different activities, in future, can be easily implemented in applications acquiring data from portable heart rate monitors.

The SARS-CoV-2 outbreak led to an inevitable and drastic transition to online training systems. This study aimed to analyze the differences between live-streaming and pre-recorded training modalities in rhythmic gymnastics (RG) with coaches and gymnasts of different technical levels. A total of 238 coaches and 277 athletes affiliated with the Italian Gymnastics Federation (FGI) participated in the study. The data collection tool was a self-collected questionnaire structured in three sections: participant's information, characteristics of live-streaming training, and characteristics of pre-recorded training. A 2 × 2 ANOVA was used for each numeric variable. A Pearson's chi-squared test was used for each categorical variable. For the athletes, training frequency, motivation, and efficacy were significantly higher ( p < 0.05) with live streaming (3.7 ± 1.5 day/week, 3.8 ± 0.9 score and 3.8 ± 0.8 score, respectively) than with a pre-recorded modality (2.2 ± 1.7 day/week, 3.1 ± 1.2 score and 3.7 ± 0.9 score, respectively), while for coaches, significant differences ( p < 0.005) were found between the two modalities only for training frequency (live streaming, 3.6 ± 1.8 days/week vs. pre-recorded, 2.1 ± 1.7 days/week). The adherence (number of No:Yes) was significantly higher ( p < 0.05) for the live-streaming modality than for the pre-recorded modality in gold athletes (1:74 vs. 14:61, respectively), silver athletes (12:190 vs. 28:174, respectively), and gold coaches (3:63 vs. 11:55, respectively), but it was not for silver coaches. Physical preparation was performed significantly ( p < 0.005) more often (number of No:Yes) for live streaming than for the pre-recorded modality by gold athletes (9:66 vs. 34:41, respectively), silver athletes (25:177 vs. 77:125, respectively), gold coaches (8:58 vs. 37:29), and silver coaches (33:139 vs. 85:87, respectively). Free body technical preparation was performed significantly ( p < 0.005) more often (number of No:Yes) for live streaming than for the pre-recorded modality by gold athletes (15:60 vs. 39:36, respectively), silver athletes (84:118 vs. 121:81, respectively), gold coaches (10:56 vs. 38:28), and silver coaches (60:112 vs. 105:67, respectively), while no differences were found for silver athletes' and coaches' technical preparations for apparatus training between the two modalities. In conclusion, live streaming had greater positive effects on RG training during home confinement. However, pre-recorded training could be more effective for some types of training, depending on the technical level of the athletes.

Heart rate time series are widely used to characterize physiological states and athletic performance. Among the main indicators of metabolic and physiological states, the detection of metabolic thresholds is an important tool in establishing training protocols in both sport and clinical fields. This paper reviews the most common methods, applied to heart rate (HR) time series, aiming to detect metabolic thresholds. These methodologies have been largely used to assess energy metabolism and to identify the appropriate intensity of physical exercise which can reduce body weight and improve physical fitness. Specifically, we focused on the main nonlinear signal evaluation methods using HR to identify metabolic thresholds with the purpose of identifying a method which can represent a useful tool for the real-time settings of wearable devices in sport activities. While the advantages and disadvantages of each method, and the possible applications, are presented, this review confirms that the nonlinear analysis of HR time series represents a solid, robust and noninvasive approach to assess metabolic thresholds.

Background: The oxygen uptake efficiency slope (OUES) is considered a reliable indicator of cardiorespiratory fitness in young and clinical populations who cannot achieve maximal effort during a graded exercise test. However, OUES accuracy depends on the data points used for its calculation and it is still not clear if the submaximal OUES can accurately assess CRF in healthy young males., Objective: We investigated the association between peak oxygen uptake and peak and submaximal OUES, and the agreement between submaximal OUES and peak OUES in male adolescents and young adults., Methods: In this cross-sectional, observational study, fifty normal weight healthy participants (age 14-22 years, peak oxygen uptake 43.8 ± 7.3 mL·min -1 ·kg -1 ) performed a graded exercise test on a cycle ergometer and pulmonary gas exchange was assessed using breath-by-breath analysis. Peak oxygen uptake, and oxygen consumption at the aerobic and at the anaerobic threshold were determined as the 30-s average of the oxygen consumption values. Peak OUES (up to peak) and submaximal OUES (up to the aerobic and anaerobic thresholds) were calculated from the logarithmic relation between oxygen consumption and pulmonary ventilation., Results: Very strong correlations were observed between peak oxygen uptake and peak OUES ( r = 0.80-0.88) while fair-to-very strong correlations were observed between the peak oxygen uptake and the two submaximal OUES ( r = 0.32-0.81). The level of agreement between peak OUES and OUES up to the anaerobic threshold ( r = 0.89-0.93; Typical percentage error 6%; Intraclass correlation coefficient = 0.89-0.93) was greater than the one between the peak oxygen uptake with OUES up to the aerobic threshold ( r = 0.39-0.56; Typical percentage error 15%; Intraclass correlation coefficient = 0.38-0.56)., Conclusions: . The peak OUES is a better indicator of aerobic fitness than the OUES up to the anaerobic threshold in healthy, young males. The OUES up to the anaerobic threshold is a valid alternative to peak OUES., Competing Interests: Laura Guidetti is an Academic Editor for PeerJ., (© 2022 Falcioni et al.)

The COVID-19 restrictions could preclude children from participating in physical education (PE) interventions. This study aimed to evaluate the efficacy of a PE intervention conducted on the beach on children's skill- and health-related outcomes, as a possible alternative PE intervention that could be also applied during the COVID-19 pandemic. The study involved 106 primary school children, randomly assigned to the traditional indoor (TI) intervention or to the experimental outdoor (EO) intervention. The intervention period lasted 4 months and consisted of two 1-h sessions per week. Intervention was conducted just before the beginning of the COVID-19 pandemic. Children's anthropometric parameters (height, weight, BMI, body fat percentage, and abdominal circumference), fitness parameter (VO 2peak ), health parameters (resting heart rate, and systolic and diastolic blood pressure), gross motor coordination, and physical activity level were assessed before and after intervention. Both groups significantly improved fitness and motor coordination but worsened some anthropometric parameters (weight, abdominal circumference) after the intervention period. The EO group showed a higher increase of gross motor coordination than the TI group. Results of this study demonstrated that children benefited from a well-structured PE intervention conducted in the natural environment of the beach improving physical fitness and gross motor coordination. Therefore, planning outdoor PE interventions could be an alternative and safe way to encourage and implement physical activity at school during the particular period of COVID-19 pandemic.

This study was aimed (i) to examine the effect of living setting (rural vs. urban), geographical area (North vs. Center vs. South), and gender (boys vs. girls) on weight status, motor coordination, and physical activity (PA) level of Italian school-age children; (ii) to examine differences in the neighborhood walkability of different school areas from different geographical areas and living settings; and (iii) to examine whether motor coordination, PA level, geographical areas, living setting, neighborhood walkability, and gender could predict children's weight status. We assessed anthropometric parameters, gross motor coordination, and PA level in 1,549 children aged between 8 and 13 years. Results revealed that Central children had higher BMI than Northern and Southern children (η 2 = 0.01). Moreover, Northern children showed the highest motor quotient (η 2 = 0.148) and PA level (η 2 = 0.02), followed by Southern and Central children, respectively. Children from the South of Italy attended schools located in neighborhoods with the highest Walk Score®. Urban children attended schools located in neighborhoods with a higher Walk Score® than rural children. Lower motor quotient (MQ), lower PA level, and living in a rural setting and in a car-dependent neighborhood were associated with a higher relative risk for obesity. Being a girl was associated with a lower relative risk for obesity. The alarming high percentage of overweight and obesity in children as well as motor coordination impairments revealed the urgent need of targeted PA interventions in pediatric population., 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 © 2022 Gallotta, Zimatore, Falcioni, Migliaccio, Lanza, Schena, Biino, Giuriato, Bellafiore, Palma, Battaglia, Baldari and Guidetti.)

The main goal of our cross-sectional research was to determine the current values of gross motor coordination (GMC) of Italian boys and girls between 6 and 13 years of age. Secondary goals were to study gender differences, and the four subtests trend with ages. Results were compared with the references proposed by KTK authors and with similar searches. Anthropometric measurements and KTK data from 2,206 schoolchildren (girls: n = 1,050; boys: n = 1,156) were collected. The KTK raw score (RS) increased with the age of the subjects ( r = 0.678; p < 0.001). In 11-13-year-old subjects, the increase in results is less than in younger subjects. RS showed differences by gender ( F = 5.899; p = 0.015) and age ( F = 269.193; p < 0.001) without interaction gender × age. Motor quotient (MQ) tended to decrease with age ( r = -0.148; p < 0.001); it showed differences by gender ( F = 79.228; p < 0.001), age ( F = 14.217; p < 0.001), and an interaction gender × age ( F = 2.249; p < 0.05). Boys showed better performance than did girls in the raw scores of three of four subtests (JS: F = 24.529; MS: F = 9.052; HH: F = 11.105). Girls show better performances than did boys in the WB ( F = 14.52). Differences between genders make us believe it appropriate to maintain a differentiated standardization. RS increased with age, and it seems reasonable, therefore, to maintain a GMC age-based normalization. On the contrary, MQ tended to decrease. All this makes us speculate that today's young people accumulate less significant motor experiences over the years compared to those achieved by their peers in the 1970s. Italian data were lower than German references and Belgian results but slightly higher than the Brazilian ones. The comparison among these four searches confirmed a worrying downward trend in GMC and its characterization by geographical and sociocultural areas. Updated parameters of the KTK can provide helpful references to improve policies to support physical activity, sport, and physical education in youth., 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 © 2021 Giuriato, Biino, Bellafiore, Battaglia, Palma, Baldari, Guidetti, Gallotta, Schena and Lanza.)

Aims of this study were: to verify if Recurrence Quantification Analysis (RQA) of Heart Rate Variability (HRV) time series could determine both ventilatory thresholds in individuals with different fitness levels, and to assess the validity of RQA method compared to gas-exchange method (GE). The two thresholds were estimated in thirty young individuals during incremental exercise on cycle-ergometer: Heart rate (HR), Oxygen consumption (VO2) and Workload were measured by the two methods (RQA and GE). Repeated measures ANOVA was used to assess main effects of methods and methods-by-groups interaction effects for HR, VO2 and Workload at aerobic (AerT) and anaerobic (AnT) thresholds. Validity of RQA at both thresholds was assessed for HR, VO2 and Workload by Ordinary Least Products (OLP) regression, Typical Percentage Error (TE), Intraclass Correlation Coefficients (ICC) and the Bland Altman plots. No methods-by-groups interaction effects were detected for HR, VO2 and Workload at AerT and AnT. The OLP analysis showed that at both thresholds RQA and GE methods had very strong correlations (r >0.8) in all variables (HR, VO2 and Workload). Slope and intercept values always included the 1 and the 0, respectively. At AerT the TE ranged from 4.02% (5.48 bpm) to 10.47% (8.53 Watts) (HR and Workload, respectively) and in all variables ICC values were excellent (≥0.85). At AnT the TE ranged from 2.53% (3.98 bpm) to 6.64% (7.81 Watts) (HR and Workload, respectively) and in all variables ICC values were excellent (≥0.90). Therefore, RQA of HRV time series is a new valid approach to determine both ventilatory thresholds in individuals with different physical fitness levels, it can be used when gas analysis is not possible or not convenient., Competing Interests: The authors have declared that no competing interests exist.

Although numerous evidences reported a negative correlation between motor coordination (MC) and overweight/obesity in children and adolescents, the interrelationship between age, gender, and weight status is still debatable. Hence, the aim of this cross-sectional study was to examine the association between MC and weight status according to age and gender across childhood and early adolescence in a large sample of Italian elementary and middle school students. A number of 1961 Italian school students (1,026 boys, 935 girls) was stratified in three consecutive age groups (6-7, 8-10, and 11-13 years) and four weight status categories (underweight, normal weight, overweight, and obese) according to Cole's body mass index (BMI) cut-off points for children. MC performance was assessed measuring motor quotient (MQ) with the Körperkoordinationstest für Kinder (KTK). Results showed significantly lower MQ levels in children in overweight (OW) and with obesity (OB) in both sexes for all age groups than peers in normal weight (NW), except in 6-7-year-old boys. Girls in OW and with OB had similar MQ levels across all age groups, while younger boys in OW and with OB showed higher MQ levels than older ones ( p < 0.05). The 6-7-year-old boys showed better MQ levels than girls peers in NW, OW, and with OB, while 8-10-year-old boys in underweight (UW), NW, and OW; and 11-13-year-old boys only in NW ( p < 0.05). No interaction effect was found between age, gender, and weight status on MQ levels. These outcomes showed the negative impact of higher weight status on MC performance according to age and gender, pointing out the importance of planning targeted motor programs that consider these variables to improve MC performance., 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 © 2021 Battaglia, Giustino, Tabacchi, Lanza, Schena, Biino, Giuriato, Gallotta, Guidetti, Baldari, Gennaro, Palma and Bellafiore.)

The purpose of this study was to validate the Volition in Exercise Questionnaire in Italian language (VEQ-I). The translation and cultural adaptation of the VEQ-I was conducted using the forward-backward translation method. VEQ-I eighteen items correspond to the six-factors structure of the original version. The construct validity was verified by the confirmatory factor analysis (CFA) (CFI = 0.960; TLI = 0.943; RMSEA = 0.039; and SRMR = 0.040). The eighteen items were well distributed in six subscales and the six-factors structure of the questionnaire was supported. Internal Consistency value of the questionnaire was investigated for each subscale of the VEQ-I. Cronbach's alpha and Omega values of the Reasons, Postponing Training, Unrelated Thoughts, Self-Confidence, Approval from Others and Coping with Failure subscales were 0.76 (α) and 0.76 (ω), 0.76 (α) and 0.76 (ω), 0.87 (α) and 0.88 (ω), 0.85 (α) and 0.85 (ω), 0.70 (α) and 0.72 (ω) and 0.74 (α) and 0.74 (ω), respectively. They were acceptable in all the six subscales. The concurrent validity was assessed using the correlation among the subscales of VEQ-I measures and those contained in two questionnaires: Psychobiosocial States in Physical Education (PBS-SPE) and Exercise Motivations Inventory (EMI-2)., Competing Interests: The authors have declared that no competing interests exist.

Denosumab is a human monoclonal antibody that neutralizes RANKL, a cytokine able to interact with the RANK receptor on preosteoclasts and osteoclasts, decreasing their recruitment and differentiation, leading to a decreased bone resorption. The aim of this observational real-life study was to analyze adherence to denosumab therapy and assess its efficacy in increasing bone mineral density (BMD) and modulating biochemical skeletal markers following previous treatments with bisphosphonates in a group of post-menopausal women with osteoporosis. Women were recruited in the specialized center from March 2012 to September 2019. Biochemical markers were recorded at baseline and every six months prior to subsequent drug injection. Dual X-ray absorptiometry was requested at baseline and after 18/24 months. Comparing BMD at baseline and after denosumab therapy in naive patients and in those previously treated with bisphosphonates, a positive therapeutic effect was observed in both groups. The results of our real-life study demonstrate, as expected, that BMD values significantly increased upon denosumab treatment. Interestingly, denosumab showed an increased efficacy in patients previously treated with bisphosphonates. Moreover, biochemical markers data indicate that osteoporotic patients, without other concomitant unstable health conditions, could be evaluated once a year, decreasing the number of specialistic center access.

The present paper concerns a new description of changing in metabolism during incremental exercises test that permit an individually tailored program of exercises for obese subjects. We analyzed heart rate variability from RR interval time series (tachogram) with an alternative approach, the recurrence quantification analysis, that allows a description of a time series in terms of its dynamic structure and is able to identify the phase transitions. A transition in cardiac signal dynamics was detected and it perfectly reflects the aerobic threshold, as identified by gas exchange during an incremental exercise test, revealing the coupling from the respiratory system toward the heart. Moreover, our analysis shows that, in the recurrence plot of RR interval, it is possible to identify a specific pattern that allows to identify phase transitions between different dynamic regimes. The perfect match of the occurrence of the phase transitions with changes observed in the VO 2 consumption, the gold standard approach to estimate thresholds, strongly supports the possibility of using our analysis of RR interval to detect metabolic threshold. In conclusion, we propose a novel nonlinear data analysis method that allows for an easy and personalized detection of thresholds both from professional and even from low-cost wearable devices, without the need of expensive gas analyzers.

A new form of Motor Imagery (MI), called dynamic Motor Imagery (dMI) has recently been proposed. The dMI adds to conventional static Motor Imagery (sMI) the presence of simultaneous actual movements partially replicating those mentally represented. In a previous research conducted on young participants, dMI showed to be temporally closer than sMI in replicating the real performance for some specific locomotor conditions. In this study, we evaluated if there is any influence of the ageing on dMI. Thirty healthy participants were enrolled: 15 young adults (27.1±3.8 y.o.) and 15 older adults (65.9±9.6y.o.). The performance time and the number of steps needed to either walk to a target (placed at 10m from participants) or to imagine walking to it, were assessed. Parameters were measured for sMI, dMI and real locomotion (RL) in three different locomotor conditions: forward walking (FW), backward walking (BW), and lateral walking (LW). Temporal performances of sMI and dMI did not differ between RL in the FW, even if significantly different to each other (p = 0.0002). No significant differences were found for dMI with respect to RL for LW (p = 0.140) and BW (p = 0.438), while sMI was significantly lower than RL in LW (p<0.001). The p-value of main effect of age on participants' temporal performances was p = 0.055. The interaction between age and other factors such as the type of locomotion (p = 0.358) or the motor condition (p = 0.614) or third level interaction (p = 0.349) were not statistically significant. Despite a slight slowdown in the performance of elderly compared to young participants, the temporal and spatial accuracy was better in dMI than sMI in both groups. Motor imagery processes may be strengthened by the feedback generated through dMI, and this effect appears to be unaffected by age., Competing Interests: The authors have declared that no competing interests exist.

Purpose: This study aimed to examine the validity, reliability and minimum detectable change (MDC) of the Cosmed K5 in breath by breath (BxB) mode, against VacuMed metabolic simulator. Intra and inter-units reliability was also assessed., Methods: Fourteen metabolic rates (from 0.9 to 4 L.min-1) were reproduced by a VacuMed system and pulmonary ventilation (VE), oxygen consumption (VO2) and carbon dioxide production (VCO2) were measured by two different K5 units. Validity was assessed by ordinary least products (OLP) regression analysis, Bland-Altman plots, intraclass correlation coefficients (ICC), mean percentage differences, technical errors (TE) and MDC for VE, VO2, and VCO2. Intra- and inter-K5 reliability was evaluated by absolute percentage differences between measurements (MAPE), ICCs, TE, and MDC., Results: Validity analysis from OLP regression data and Bland- Altman plots indicated high agreement between K5 and simulator. ICC values were excellent for all variables (>0.99). Mean percentage differences in VE (-0.50%, p = 0.11), VO2 (-0.04%, p = 0.80), and VCO2 (-1.03%, p = 0.09) showed no significant bias. The technical error (TE) ranged from 0.73% to 1.34% (VE and VCO2 respectively). MDC were lower than 4% (VE = 2.0%, VO2 = 3.8%, VCO2 = 3.7%). The intra and inter K5 reliability assessment reveled excellent ICCs (>0.99), MAPE <2% (no significant differences between trials), TE < or around 1%, MDC

Objective: Prescribing individualized moderate exercise intensity is a useful method to reach positive effects on health status in obese adults. This study aimed to establish a practical reference equation to estimate the heart rate (HR) at individual ventilatory threshold (IVT) (HRIVT)., Methods: One hundred sixty-one obese subjects were clinically evaluated and characterized by anthropometric and body composition. Participants performed the six-minute walking test (6-MWT) and the cardiopulmonary exercise test to assess IVT. Multiple regression analysis for HRIVT, including 6-MWT, anthropometric, and body composition parameters, as independent variables, was performed for both gender separately. A cross-validation study was also performed to determine the accuracy of the prediction equation., Results: Whereas HRIVT was not significantly different between males (121.5±18.3 bpm) and females (117.6±17.1 bpm), it differently correlated with physical and performance parameters. Therefore, two sex-specific equations were developed including 6-MWTHR and HRrest (R2 = 0.69 and 0.65 and root mean square errors of 8.8 and 10.1 bpm for females and males, respectively)., Conclusion: In conclusion, in female and male obese adults, the 6-MWT might be used to predict HR at IVT. These outcomes are useful to prescribe optimal physical activity intensity when gold standard methods (e.g. gas exchange analysis) are unavailable.

Purpose: Evaluation of the effects of an individualized home-based unsupervised aerobic training on body composition, physical and physiological parameters in female and male obese adults., Methods: Two hundred and twenty obese adults (age 47.9 ± 12.4 years; BMI 38.0 ± 7.2 kg/m 2 ) entered the 4-month training program. Body composition, physiological and functional capacities were assessed pre- and post-intervention. All subjects were requested to perform unsupervised aerobic training with the intensity based on heart rate, walking speed and OMNI-RPE score corresponding to the individual ventilatory threshold for at least 5 days/week., Results: After 4-month study period, 40% of patients completed the protocol, 24% had high compliance (HC) (exercise ≥ 3 days/week), while 16% had low compliance (LC) to exercise prescription (exercise < than 3 days/week). In HC group, a significant improvement of body composition variables after training was performed. Moreover, oxygen uptake and metabolic equivalent at peak significantly increased after training. Six-minute walking test (6MWT) distance significantly increased while heart rate during 6MWT was significantly lower after training. No significant differences were found in LC group between pre- and post-intervention in all variables. Interestingly, gender does not influence the effects of training., Conclusions: Our results indicate that subjects, independent of gender, with high compliance to the aerobic training based on a new individualized method can achieve a significant reduction in weight loss and also an improvement in physical and physiological parameters. This innovative personalized prescription could be a valuable tool for exercise physiologist, endocrinologists, and nutritionists to approach and correct life style of obese subjects.

Aim of this study was to evaluate the effectiveness of two different 5-month physical education (PE) interventions conducted by a specialist PE teacher on primary school children's skill- and health-related outcomes. About 230 children were randomly assigned to one of three intervention groups: experimental&#95;1 group, experimental&#95;2 group or control group (school curriculum given by the generalist teacher). Pre- and post-intervention tests assessed pupils' fitness (pacer, curl-up, push-up, trunk lift, sit and reach tests) and gross motor coordination (shifting platforms, balance beam, jumping laterally, hopping on one leg over an obstacle tests). Both experimental groups significantly improved some fitness and coordinative tests after the intervention period when compared with control group. However, no differential changes on coordinative development were observed between the 2 experimental groups. Results of this study demonstrated that children benefitted from a well-structured PE intervention conducted and supervised by a specialist PE teacher improving their motor skills and fitness.

Background. A multidisciplinary approach seems to be effective in creating healthy habits in children. The aim of this study was to evaluate the efficacy of three 5-month combined physical education (PE) and nutritional interventions on body composition, physical activity (PA) level, sedentary time and eating habits of schoolchildren. Methods. Anthropometric data, weekly PA level, sedentary time and eating habits of 230 healthy students were analysed using a repeated-measures ANOVA with Group (experimental group 1 vs experimental group 2 vs control group), Adiposity Status (under fat vs normal fat vs obese), and Time (pre vs post) as factors. Results. Body fat mass percentage increased after intervention (18.92 ± 8.61% vs 19.40 ± 8.51%) in all groups. The weekly PA level significantly increased after intervention in both experimental groups. Sedentary time significantly decreased after the intervention period (565.70 ± 252.93 vs 492.10 ± 230.97 min/week, p < 0.0001). Moreover, obese children were more sedentary than under fat and normal fat children. Children significantly changed the consumption of some specific foods after intervention. Discussion. This study revealed the effectiveness of a combined PE and nutritional intervention to improve children's healthful dietary practices and to encourage an active lifestyle. However, it needs a further appropriate development to establish patterns of healthful dietary practices that encourage an active lifestyle with which to maintain healthy habits through life.

Purpose: Recently, Motor Imagery (MI) has been associated with the execution of movements miming in part the mentally represented action (dynamic MI, dMI). Preliminary studies have reported as dMI may improve trainings in sport, with imagery timing close to the physical execution one. This study was aimed to investigate time and spatial parameters of dMI with actual locomotion in people with stroke., Methods: Twelve patients (stroke group, SG) were compared with twelve healthy elderly (elderly group, EG) and twenty young adults (young group, YG). Subjects performed mental representations of different walking (forward, FW; lateral, LW, backward, BW), accompanied or not by movements imitating walking (dMI and static MI, sMI). Then, they performed actual locomotion (AL). Outcome measures were related to the time and the number of steps spent for completing the tasks for all the given locomotor conditions., Results: Significant differences were found in patients with respect to healthy subjects, with time in sMI significantly shorter than in dMI (p < 0.004) and AL (p < 0.002), but not between dMI and AL in FW (p = 0.806). In patients, times obtained in sMI and dMI was significantly shorter with respect to those of AL in LW and BW. Patients performed imagery tasks with similar times in all locomotion. Healthy groups did not reveal differences among tasks in BW, while significant differences were found in LW. Analogous results were found in terms of number of performed steps., Conclusions: In patients with stroke, a spatiotemporal functional equivalence with AL was found only for dMI, and not for sMI, in forward walking. This could be due to familiarity with this task. These results might have implications for the rehabilitative techniques based on MI.

This study aims to evaluate the effectiveness of two school-based physical education (PE) programmes (exercise-based and games-based) compared with traditional PE, on health- and skill-related physical fitness components in children in Tirana, Albania. Participants were 378 first-grade (6.8 years) and 389 fourth-grade (9.8 years) children attending four randomly selected schools in Tirana. Twenty-four school classes within these schools were randomly selected (stratified by school and school grade) to participate as exercise group (EG), games group (GG) and control group (CG). Both EG and GG intervention programmes were taught by professional PE teachers using station/circuit teaching framework while CG referred to traditional PE school lessons by a general teacher. All programmes ran in parallel and lasted 5 months, having the same frequency (twice weekly) and duration (45 min). Heart rate (HR) monitoring showed that intensity during PE lessons was significantly higher in the intervention groups compared with control (P < 0.001). Both PE exercise- and games programmes significantly improved several health- and skill-related fitness indicators compared with traditional PE lessons (e.g. gross motor skill summary score: 9.4 (95% CI 7.9; 10.9) for exercise vs. control and 6.5 (95% CI 5.1; 8.1) for games vs. control, cardiorespiratory fitness: 2.0 ml O2 · min(-1) · kg(-1) (95% CI 1.5; 2.4) for exercise vs. control and 1.4 ml O2 · min(-1) · kg(-1) (95% CI 1.0; 1.8) for games vs. control). Furthermore, compared to games-based PE, exercise-based PE showed more positive changes in some gross motor coordination skills outcomes, coordination skills outcomes and cardiorespiratory fitness. The results from this study show that exercise- and games-based PE represents a useful strategy for improving health- and skill-related physical fitness in Albanian elementary school children. In addition, the study shows that exercise-based PE was more effective than games-based PE in improving gross motor function and cardiorespiratory fitness.

Aim of the study was to examine cardiorespiratory parameters at individual ventilatory threshold (IVT) and peak exercise capacity ([Formula: see text]) in outpatient diabetic and sarcopenic obese subjects. Seventeen obese subjects (BMI: 36.6 ± 4.1 kg·m(-1)) and sixteen SO subjects (BMI: 37.0 ± 7.3 kg·m(-1)) were compared with sixteen T2DM subjects (BMI: 37.7 ± 5.6 kg·m(-1)). All groups performed an incremental exercise test on a treadmill according to their physical ability. [Formula: see text], %HRmax, and maximal metabolic equivalent (METmax) were evaluated at maximal effort. Moreover, [Formula: see text], %[Formula: see text], %HRmax, %HRR, ΔHR, and METivt were assessed at IVT. No significant differences were found in any physiological parameters at maximal effort ([Formula: see text], %HRmax, and METmax) in all groups. On the contrary, [Formula: see text], %[Formula: see text], %HRmax, %HRR, ΔHR, and METivt were significantly lower in T2DM subjects as compared to OB and SO subjects at IVT (p < 0.05). Our results show that while at maximal effort there are no differences among groups, at IVT the physiological parameters are lower in T2DM subjects than in OB and SO subjects. Therefore, due to the differences observed in the groups, we suggest usng the IVT as a useful parameter to prescribe aerobic exercise in obese with sarcopenia or diabetes mellitus conditions.

The aim of the study was to compare the psychophysical effects of rock climbing with a supervised fitness training in adults. Thirty-three healthy participants (M age=32 yr., SD=7) participated in rock climbing or in fitness training. The participants' functional fitness, anxiety, and mood states were tested before and after 3 mo. of training. There was significant improvement of physical fitness in both groups after the intervention period. Anxiety significantly decreased after each single training session at the end of both courses. Differential effects in the rock-climbing group, as compared to the fitness group, emerged only on Vigor. Specifically, the rock-climbing group showed a decreasing trend in Vigor while the fitness group showed an increasing trend of Vigor after the intervention.

This study investigated the efficacy of a physical activity (PA) program to improve the attention span in normal weight vs. overweight/obese children. The study was designed as a cluster-randomized controlled intervention. One hundred fifty-seven normal weight and overweight/obese primary school children were randomly divided in three cohorts: Traditional PA, Coordinative PA and a Control group (not attending any PA). Before and after 5 months of intervention, children were administered the d2-R test of attention. Results showed that participants' attentional performances were significantly affected by Time (pre vs. post; P < 0.01) and by Time × Group interaction (traditional vs. coordinative vs. control; P < 0.001), revealing significant different effects of intervention/exercise modality on children's attentional performance, independently of their weight status. These data suggest that a 5-month school-based PA intervention can improve the cognitive performance in children. Further, the Coordinative PA intervention resulted in the most significant improvement in children's attention.