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Objectives: Internet-based interventions may represent an efficacious supporting alternative for those family caregivers who are often limited to do physical exercise regularly due to lack of time and/or they reside away from conventional facilities, especially those who live in remote rural locations. This study aims to describe comprehensively a new methodology for a randomized controlled trial that will evaluate the efficacy and cost-effectiveness of a personalized Internet-based physical exercise intervention to improve the fitness and health-related quality of life of female family caregivers of relatives with dementia. Methods: The intervention will include three Internet-based 1-hour-long physical exercise sessions per week during 3 months; it will be supervised by a personal trainer, and it will be performed at the caregiver’s home by using online interaction in real-time. Results: The expected outcomes will be: (1) feasibility and adherence to the intervention; (2) positive effects on fitness and health-related quality of life; (3) lower risk of depression; (4) decrease in subjective burden and (5) reduction of other psychological symptoms. Analyses will also include the evaluation of the cost-effectiveness of the intervention. Discussion: This personalized intervention is a support strategy to overcome the constraints that the caregivers usually have to face when it comes to participating in a physical exercise program. This intervention might thus be a feasible and appropriate proposal to alleviate the physical and psychological impacts that arise from their role as primary caregiver, and might be an innovative cost-effective assistance intervention for this population. Conclusion: The present intervention might provide policymakers with potential solutions to promote the implementation of Internet-based care services at regional and national level, lessen caregivers’ demands for face-to-face health-care resources.

A total of 80% of fibromyalgia (FM) population have reported poor sleep. In this regard, the pineal gland, involved in circadian rhythm processes as a key neuroendocrine organ which mainly synthesises and secretes melatonin, has never been studied before in this population. Therefore, this study aimed to evaluate the parenchyma pineal volume and its relation to sleep hours, sleep quality index and melatonin level at night. A total of 50 participants, 30 women with FM and 20 healthy control women underwent cranial magnetic resonance imaging. The total pineal volume, cyst pineal volume and parenchyma pineal volume were manually calculated in cubic millimetres. Also, the total pineal volume was estimated using Hasehawa method. Parenchyma pineal volume was significantly correlated with sleep hours (p-value = 0.041) and nocturnal melatonin level (p-value = 0.027). Moreover, there was also a non-significant correlation between parenchyma pineal volume and sleep quality index (p-value = 0.055). Furthermore, a mean parenchyma pineal volume of 102.00 (41.46) mm³ was observed, with a prevalence of 29.60% cyst in FM group. This is the first study that has reported pineal gland volumes, cyst prevalence and correlative relationships between parenchyma pineal volume and sleep hours and melatonin levels in women with FM.

Background: Previous studies have reported good test–retest reliability for the 3 m backward test (3MBWT) in different populations. However, reliability of the 3MBWT has not been studied in fibromyalgia (FM) under single and dual-task conditions; Methods: A total of 21 women with FM participated in this study. Participants completed the Revised Fibromyalgia Impact Questionnaire and two physical fitness tests: the 3MBWT and the Timed Up and Go (TUG). The dual-task condition consisted of subtracting two by two while performing the test, starting from a random number less than 100; Results: Values showed that the 3MBWT can be considered reliable under single and dual-task conditions when measured with both a manual stopwatch and a Chronopic automatic stopwatch. A strong concurrent validity was shown of 3MBWT and TUG results in the test and retest and the different devices. The relationship between the performance of the 3MBWT in test and retest conditions under single and dual-task conditions measured with different devices and the impact of the disease were high; Conclusions: The 3MBWT is a reliable tool under the single and dual-task conditions in women with FM. It shows higher reliability values when time is taken using a Chronopic. This test also shows high concurrent validity with the TUG test. Its performance is related to the impact of the disease.

Background Physical fitness outcomes are considered major health biomarkers to assess and monitor exercise-based interventions across the lifespan. Recent studies provide evidence that many adult and childhood chronic diseases should have their origins in gestational or fetal life. To date, a few pioneering studies have showed associations between prenatal predictors and selected physical fitness tests (strength and cardiorespiratory). Nevertheless, there is a lack of knowledge about the influence of prenatal factors on childhood performance on a comprehensive fitness test battery including speed and coordination. The innovative purpose of the current study is to analyse the relative weight of prenatal predictors on schoolchildren's physical fitness outcomes. Methods We obtain data from1188 children (571 girls) aged 6-11 years and 1020 adolescents (495 girls) aged 12-17 years. Prenatal predictors (gestational anemia, gestational diabetes and length of gestation) were self-reported from offspring's mothers. The ALPHA fitness test battery for youth was used to assess offsprinǵs physical fitness (muscular strength, motor fitness and cardiorespiratory fitness). Regression analysis were performed to predict the different physical fitness outcomes. Results The main findings of the present study indicate that the presence of gestational anemia significantly predicted lower scores of lower-body explosive muscular strength (standing long jump) and motor fitness (4x10-m shuttle run) and predicted moderately lower scores of upper-body isometric muscular strength (handgrip strength test). (p>.005; p>.008; p>.075 respectively). Moreover, gestational anemia better predicted lower scores of muscular strength and motor fitness in children than in adolescents (standing long jump, handgrip strength test, 4x10-m shuttle run) (p>.001; p>.051; p > 0.18, respectively). While gestational age and length of gestation (>34- ?42 weeks) predict better cardiorespiratory fitness (20 m shuttle-run test) (p>.023; p>.023 respectively) and motor fitness (4x10 m shuttle; moderately for length of gestation). (p>.020; p > 0.55 respectively). Conclusion This evidence suggests that preventive strategies by health-care institutions, policy makers and technicians must be two-fold: a) to effectively reduce gestational anemia in order to prevent offsprinǵs predisposition to low levels of physical fitness, and b) to intervene with toddlers and children at risk to provide tailored physical activity programs and regular physical fitness evaluation.

Unhealthy dietary habits determined during childhood may represent a risk factor to many of the chronic non-communicable diseases (NCDs) in adulthood. Mediterranean Diet (MD) adherence in children and adolescents (8–16 years) living in Spain was investigated using the KIDMED questionnaire in a comparative analysis of two cross-sectional nationwide representative studies: enKid (1998–2000, n = 1001) and PASOS (2019–2020, n = 3540). Taking into account the educational level of pupils, as well as the characteristics of the place of living, a significant association was found between a KIDMED score ≥ 8 (optimal MD adherence) and primary education as well as residency in an area of

Background: Kinesiophobia is defined as fear of movement due to the painful experience of it. The main symptom of fibromyalgia is persistent and widespread pain associated with other symptoms. This study analyzes the kinesiophobia between women with fibromyalgia and apparently healthy women and investigates the relationship between kinesiophobia and physical fitness tests, fear of falling, and the impact of the fibromyalgia. Methods: Fifty-one women participated in this study were divided into two groups: (1) women with fibromyalgia and (2) apparently healthy women. Participants completed questionnaires to assess kinesiophobia, fear of falling, and the impact of fibromyalgia. Subsequently, participants completed the physical tests Timed Up and Go, 10-step stair ascent, and handgrip strength. Results: Women with fibromyalgia had significant differences in kinesiophobia and fear of falling compared to apparently healthy women. Similarly, performance in the physical tests was lower, except for the handgrip strength, which maintained similar values to the apparently healthy women. Significant relationships were found only in the fibromyalgia group between kinesiophobia, the impact of the disease, fear of falling, and the Timed Up and Go and 10-step stair ascent tests. Conclusions: Women with fibromyalgia showed higher kinesiophobia scores, worse performance in mobility tests, and higher fear of falling than apparently healthy women. Kinesiophobia score is related to Timed Up and Go performance, the 10-step stair ascent, the fear of falling, and the impact of the disease in women with fibromyalgia.

BACKGROUND The prevalence of sexual problems is very high among women with fibromyalgia. OBJECTIVE To evaluate the prevalence of sexual problems in women with FM and the potential association among physical activity, quality of life and sexual function. We aimed to contribute in the understanding of the relationships between sexual function and the symptoms of FM. METHODS The sample of this cross-sectional study comprised 113 women with FM and 116 age-matched women without FM. Sexual function was assessed using the 15D questionnaire. Health-related quality of life (using EQ-5D-5L and 15D questionnaires), impact of fibromyalgia and physical activity were also assessed. RESULTS The prevalence of sexual problems among women with fibromyalgia was 76%, while it was 15% in healthy controls. This prevalence was even higher among those aged 50 or over. Sexual function was significantly associated with quality of life, distance walked, impact of fibromyalgia and four of the symptoms: depression, anxiety, tenderness and memory problems. CONCLUSION More than three out of four women with fibromyalgia have any kind of sexual problem. Depression, anxiety and tenderness seems to be the most relevant symptoms associated with sexual function. Physical activity may be protective and reduce the risk of having sexual problems.

To systematically review the effectiveness of dance-based programs to improve motor-cognitive dual-task performance in middle-aged and older adults.Five scientific databases were selected to identify the articles included in this systematic review. Ninety-one articles were found in the electronic databases. Fourteen articles fulfilled all inclusion and exclusion criteria. The methodological quality of the studies was assessed with a modified version of Downs and Black checklist. PRISMA guidelines were followed in the data extraction process. The overall effect size of the improvements was calculated through a meta-analysis.All the studies had an acceptable methodological quality. Dance-based interventions had a duration of 8-52 weeks, 1-3 sessions per week, with sessions lasting 40-90 min. According to the overall effect size, dance-based interventions significantly improved dual-task performance (-0.48 with a 95% confidence interval from -0.88 to -0.08).Dance-based intervention programs may be effective at improving the performance on motor-cognitive dual-task in middle-aged and older adults. Apart from the effects on the cognitive Time Up and Go test, dance interventions may also improve speed walking with a cognitive task. All these conclusions must be taken with caution due to the heterogeneity and the small number of articles. Future research can be developed to increase the knowledge on these issues.Implications for rehabilitationInterventions based on dance as part of rehabilitation can improve the performance on TUG under dual-task condition in aging.Interventions based on dance can be effective to improve the development of some tasks of daily life by reducing time in a motor task under dual task condition in aging.Physical therapists, personal trainers and other clinicians can use different types of dance for improving dual-tasking among the adults.

Previous studies have associated brain abnormalities in people with fibromyalgia with accelerated brain ageing. The prefrontal cortex is located in the anterior pole of the mammalian brain. It is defined as the part of the cerebral cortex that receives projections from the mediodorsal nucleus of the thalamus.This study aimed to evaluate the volumetric differences in the prefrontal cortex subfields between healthy women and women with fibromyalgia using magnetic resonance imaging (MRI) and controlling for age, estimated intracranial volume, depression, and cognitive impairment.A total of 47 women with fibromyalgia (recruited from a fibromyalgia local association) and 43 healthy women (retrieved from the Open Access Series of Imaging Studies database) participated in this cross-sectional study. Multiple linear regressions were used to predict the value of the prefrontal cortex subfields as well as to determine if there were volumetric differences between the groups.Volume of all prefrontal cortex regions decreased with each year of age. Healthy women showed higher volume in all the prefrontal cortex subfields than women with fibromyalgia. Regarding partial correlations performed, no significant relation were found between the fibromyalgia impact and the brain volumes analyzed, controlling for depression.Women with fibromyalgia showed reduced volume in the right caudal middle frontal gyrus, rostral middle frontal gyrus, left inferior frontal gyrus pars opercularis, inferior frontal gyrus pars triangularis, inferior frontal gyrus pars orbitalis, lateral orbitofrontal cortex, right medial orbitofrontal cortex, right rostral anterior cingulate gyrus subfields of the prefrontal cortex and total gray matter compared to healthy women. Furthermore, through an analysis of multiple linear regressions, the left rostral middle frontal gyrus and left lateral orbitofrontal cortex showed significantly volumetric decreases related to depression levels. The total gray matter also shows a significant decrease related to age observed through the analysis of multiple linear regressions. No significant relation were found between the impact of the disease and the brain volumes analyzed, controlling for depression in women with fibromyalgia.

Childhood obesity is a public health problem worldwide. An important determinant of child and adolescent obesity is socioeconomic status (SES). However, the magnitude of the impact of different SES indicators on pediatric obesity on the Spanish population scale is unclear. The aim of this study was to assess the association between three SES indicators and obesity in a nationwide, representative sample of Spanish children and adolescents. A total of 2791 boys and girls aged 8 to 16 years old were included. Their weight, height, and waist circumference were measured. SES was assessed using two parent/legal guardian self-reported indicators (educational level -University/non-University- and labor market status -Employed/Unemployed-). As a third SES indicator, the annual mean income per person was obtained from the census section where the participating schools were located (≥12.731€/

Background Physical fitness and body composition are important health indicators; nevertheless, their combined pattern interrelationships and their association with mortality are poorly investigated. Methods This longitudinal study is part of the Spanish EXERNET-Elder project. Person-months of follow-up were calculated from the interview date, performed between June 2008 and November 2009, until the date of death or censoring on March 2018 (whichever came first). In order to be included, participants had to fulfill the following criteria: (a) be older than 65 years, (b) live independently at home, (c) not suffer dementia and/or cancer, and (d) have a body mass index above 18.5. Body fat and weight were assessed by a bioelectrical impedance analyzer. Fitness was measured with the Senior Fitness and the one-leg static balance tests. The Spanish Death Index was consulted for the death’s identification. Cluster analysis was performed to identify Fat–Fit patterns and traditional cut-points and percentiles to create the Fat–Fit groups. Cox proportional hazards regression models were used to calculate the hazard ratios (HRs) of death in clustered Fat–Fit patterns and in traditional Fat–Fit groups. Results A total of 2299 older adults (76.8% of women) were included with a baseline mean age of 71.9 ± 5.2 years. A total of 196 deaths (8.7% of the sample) were identified during the 8 years of follow-up. Four clustered Fat–Fit patterns (Low fat–Fit, Medium fat–Fit, High fat–Unfit, and Low fat–Unfit) and 9 traditional Fat–Fit groups emerged. Using the Low fat–Fit pattern as the reference, significantly increased mortality was noted in High fat–Unfit (HR: 1.68, CI: 1.06–2.66) and Low fat–Unfit (HR: 2.01, CI: 1.28–3.16) groups. All the traditional Fit groups showed lower mortality risk when compared to the reference group (obese–unfit group). Conclusion Physical fitness is a determinant factor in terms of survival in community-dwelling older adults, independently of adiposity levels.

People with fibromyalgia could experience physical and cognitive impairments. Furthermore, when performing two tasks at the same time, people with fibromyalgia showed a higher dual-task cost compared to a single task than healthy people. This may result in poorer performance of activities of daily living that are commonly presented as a combination of two or more tasks. Transcranial direct current stimulation (tDCS) is a promising nonpharmacological therapy. However, there is controversy regarding the intensities and the effectiveness of this therapy. Thus, the present study will aim: (1) to compare the effectiveness and the impact of two tDCS intensities (1 mA and 2 mA) on cognitive, motor, brain functions, and cardiac autonomic modulation; (2) to study the impact of tDCS on the dual-task performance and creativity after applying tDCS in dorsolateral prefrontal cortex. In this study, 26 women will participate and will be divided into two groups: women with fibromyalgia (n = 13), and healthy controls (n = 13). A reduction in cognitive-motor interference in dual-task performance is expected, as well as a modification in neurophysiological parameters and an improvement in cardiac autonomic modulation. Lastly, no different effects are expected depending on the stimulation intensity applied. The obtained results will help to determine if tDCS in the dorsolateral prefrontal cortex could improve the occupational performance of women with fibromyalgia.

Background: Age-related changes negatively affect physical fitness, body composition, and executive function and produce a decrease in regucalcin level expression in blood. The square-stepping exercise (SSE) is a balance and lower-limb strength training programme used to prevent falls and stimulate cognitive function in older adults. This project aims to analyse the effects of SSE on executive function, regucalcin expression, fall prevention, body composition, and physical fitness in people over 65 years old. Methods: A randomized controlled trial will be conducted. A total of 90 older people over 65 years old will be recruited and randomly assigned to 2 groups: experimental (n = 45) and control (n = 45). The experimental group will perform an SSE-based intervention for 6 months (2 times per week), while the control group do not follow any treatment. Results: The main outcome will be balance, but other motor (body mass index, upper- and lower-limb strength, flexibility, and speed-agility) and cognitive variables (executive functions and attention) will be assessed. The expression of regucalcin levels will also be evaluated. Therefore, this project aims to analyse the effect of a 6-month SSE intervention on cognitive and motor competence, physical fitness, regucalcin levels, fall risk, and body composition in older people. If the intervention proves to be effective, it could be implemented in centres, entities, and associations specialized in elderly care.

Background Hypoxic conditioning has been proposed as a new tool to mitigate the sarcopenia and enhance health-related function, but decrements in standing balance have been observed during hypoxia exposure. The aim of the study was to evaluate the effect of a hypoxic conditioning training on functional fitness, balance and fear of falling in healthy older adults. Methods A total of 54 healthy older adults (aged 65–75 years), who voluntarily participated in the study, were randomly divided into three groups: the control group (CON), the normoxia training group (NT) that performed strength training in normoxia, and the hypoxia training group (HT) that trained under moderate hypoxic conditions at a simulated altitude of 2500 m asl. The training programme that was performed during 24 weeks was similar in both experimental groups and consisted of a full-body workout with elastic bands and kettlebells (three sets × 12–15 reps). The Senior Fitness Test (SFT), the Single Leg Stance test (SLS) and the Short Falls Efficacy Scale-International (FES-I) were assessed before and after the intervention. Results Results showed that after training, either in normoxia or in hypoxia, the participants increased upper and lower body strength, and the aerobic endurance, and decreased the fear of falling. Conclusions The moderate hypoxic conditioning seems to be a useful tool to increase the functional capacity in healthy older adults without observing a decline in balance. Trial registration ClinicalTrials.gov NCT04281264. Registered February 9, 2019-Retrospectively registered.

The present study aimed to analyse the effects of 12 months of participation in a public physical activity program linked to primary care on depression level and fitness, and to determine which fitness components were responsible for the improvement in depression using mediation analysis. Participants of this program were 2768 middle-aged and older adults from 67 municipalities throughout the Spanish region of Extremadura. In the analysis only participants with depression and without any missing values for fitness variables were included. This sample was 303 for exercise group and 74 for control group. Socio-demographic data, Geriatric Depression Scale and some fitness tests were applied at baseline and 1 year later. Exercise group performed the program 3 days/week for 50–60 min per session involving brisk walking with intermittent flexibility, strength and balance activities/exercises. Socializing within the group was encouraged in all sessions. Data analysis included analysis of covariance, chi-squared and effect size statistics. Additionally, a parallel model of mediation analysis was performed to determine the indirect effect of the participation in the exercise program on depression through improvements in fitness. A considerable reduction from mild, moderate or severe depression to non-depression were obtained for exercise group (68%) P-value

Background. Altered balance is a common and debilitating symptom of fibromyalgia. Previous studies have investigated balance under single-task conditions that do not reflect real-life situations. The present study evaluated the impact of a simultaneous cell-phone conversation on balance performance in a case-control cohort from Spain. Methods. A cross-sectional case-control study was performed in 34 women recruited from local self-help organizations and university facilities (n = 18 fibromyalgia cases; n = 16 healthy, pain-free controls). Participants performed the 30 s postural stability test, as implemented in the Biodex Balance System, under two conditions: (a) as a single task and (b) as a dual task, i.e., while holding a simultaneous cell-phone conversation with a technician. Intergroup differences in dual task costs were calculated. Findings. Compared with controls, women with fibromyalgia showed higher dual-task costs in balance variables, such as overall sway (pp value = 0.039) and anterior/posterior sway (p value = 0.007). In the dual-task condition, overall (p value = 0.004) and anterior/posterior (p value = 0.012) sway indices significantly decreased in women with fibromyalgia but not in controls. Interpretation. In women with fibromyalgia, balance performance was adversely impacted by the holding of a simultaneous cell-phone conversation. The inability to conduct two tasks simultaneously may be related to reduced attention and may increase the risk of falling in this population.

Objective To evaluate the effects of 24-week exergame intervention in the physical fitness of women with fibromyalgia in both single- and dual-task conditions. Design Single-blinded, randomized controlled trial. Setting University facilities. Participants Fifty-five women with fibromyalgia, recruited from the local fibromyalgia association, were randomly assigned to one of the two groups: exercise group and control group. Intervention The exercise group completed 24 weeks of supervised and group-based exergame protocol, divided into two sessions of 60 minutes. The intervention was focused on mobility, postural control, upper and lower limbs coordination, aerobic fitness, and strength. Main outcome measures The strength of the upper limbs was measured using the arm curl test. The mobility skill was assessed through the timed-up and go test, and the flexibility of both upper and lower limbs was measured using the back scratch and the sit and reach tests, respectively. Results Fifty participants completed the study. In the single-task condition, exergame intervention led to significantly higher effects in the arm curl test (P = 0.008), sit and reach test (P = 0.033), and timed-up and go test (P = 0.021). Moreover, under dual-task condition, exergames led to significant effects in all the physical fitness tests (arm curl test, timed-up and go test, back scratch test, and sit and reach test) compared to the control group. Conclusions Exergame is an effective tool to improve the physical fitness in women with fibromyalgia under single or dual-task conditions.

Background Fibromyalgia symptoms cause a significant reduction in the ability to perform daily life activities. These activities require the ability to perform more than one task simultaneously. The main objective of this study was to evaluate how dual-task could modify range of movement, duration of repetitions and performance in the arm curl test in healthy controls and patients with fibromyalgia. Methods Twenty women participated in this study, divided into two groups: 1) patients with fibromyalgia (N = 10, age = 52.00 [5.08]) and 2) age- and gender-matched healthy controls (N = 10; age = 51.60 [4.09]). The participants had to perform the arm curl test in two conditions: single test condition and performing a dual-task. The dual-task condition consisted of remembering three random unrelated words. Results Patients with fibromyalgia completed fewer repetitions than controls during dual-task condition (p-value = 0.015). Furthermore, both groups showed a significant decrease in the range of movement in the dual-task condition when comparing the mean of the three first repetitions with the three last ones (p-value Interpretation The motor task might be prioritized over the cognitive task at the beginning of the test. However, at the end of the test, the cognitive task could require more attention due to the increased time since the words were heard, and also the motor task could require less attention after some repetitions have been performed. Thus, the addition of a cognitive task could lead to a less conscious execution of the motor task at the end of the test, which may be consistent with a reduced range of movement.

The study of mental load is an emerging research topic in the field of sport sciences. In the sport of chess, there is a need to understand the mental demands of the sport of chess in order to manage training loads. The present study aimed to analyze the electrical brain pattern of an elite chess player during different chess games: 15 + 10, blindfold 15 + 10, lightning game, and problem-solving chess tasks. The participant was a male 33-year-old chess player with 2562 points of ELO and more than 26 years of chess experience, training between 3 and 4 h a day. The 15 + 10 game consisted of 15 min + 10 s increment per move. In the blindfold game, the participant cannot see the positions of the pieces and does not touch them. In the lightning game, the participant played four consecutive one minute game. In addition, two high-level, two low-level, and two medium-level chess problems were performed. Electroencephalographic (EEG) and heart rate variability (HRV) responses were measured to assess the electrical brain pattern and autonomic modulation respectively. The participant won both games at 15 + 10 (normal and blindfold), lost three and drew one of the four lightning games, solved the two low-level and the two medium-level problems and solved one of the two high-level problems. Although in both games the player achieved victory the average player move quality measured with both pure analysis and analysis with additional limitations were lower in 15 + 10 blindfold game than in 15 + 10 game. Increments in theta and alpha power spectrums can be observed during the most demanding chess games (blindfold chess, lightning game, and the chess problem at difficult- level). Furthermore, the highest alpha power spectrum values can be observed during blindfold chess. In conclusion, this is the first study investigating the EEG pattern of a International Chess Grandmaster during a blindfold chess game. We found that in the chess games where lower performance is exhibited, theta and alpha power spectrums increased.

Background: The recent published version with five levels of response of EQ-5D-Y needs to be studied in children with chronic illness. For this, the aim of the present study was to assess and compare the psychometric properties of EQ-5D-Y-3L and EQ-5D-Y-5L in terms of feasibility, ceiling effect, redistribution properties, informativity and inconsistence responses in children with cancer. (2) Methods: A core set of self-report tools, including the Spanish version of EQ-5D-Y-3L and EQ-5D-Y-5L, were administered to children drawn from the population with cancer. EQ-5D-Y-3L and EQ-5D-Y-5L were evaluated in terms of feasibility, ceiling effects, redistribution properties and differences in absolute and relative informativity. (3) Results: A total of 73 children (9.7 ± 2.3 years old) from the population with cancer participated in the study. No missing data in the new EQ-5D-Y-5L were visualized, so the feasibility was acceptable. EQ-5D-Y-5L showed a low ceiling effect in all dimensions with relative changes from EQ-5D-Y-3L to EQ-5D-Y-5L of between 15.3% and 42.4% for the dimensions and 44.6% for the overall system. Compared to EQ-5D-Y-3L, EQ-5D-Y-5L provided a better distribution of the severity of the problem in the five levels of response. The absolute informativity (Shannon’s index) did not show statistically significant differences between EQ-5D-Y-3L and EQ-5D-Y-5L in all dimensions and the overall system. (4) Conclusions: EQ-5D-Y-5L is feasible, presenting a low ceiling effect and high discriminative power, This work was financially supported by the EuroQol Research Foundation. EuroQol Research Foundation by 1226-RA project. (The EuroQoL Research Foundation is a non-profit organization) : Regional Association of Parents of Children with Cancer (ANDEX), Spain

Background: Type 2 diabetes mellitus (T2DM) is a chronic, worldwide disease affecting more than 400 million people. This pathology involves several associated problems, such as diabetic neuropathy complications, obesity, and foot problems, both in terms of health and sensitivity. Objective: The objective of this study was to explore the relationships of the 30-s chair stand-up test with the Foot Health Status Questionnaire (FHSQ), the vibration perception threshold (VPT), and the 15-dimensional (15-D) questionnaire in T2DM people. Methodology: Ninety participants with T2DM were assessed in terms of fat mass percentage, VPT, foot health, health-related quality of life (HRQoL), and the 30-s chair stand-up test. Results: The 30-s chair stand-up test was found to exhibit a moderate relationship with “physical activity” (rho = 0.441, p ≤ 0.001) and “vigor” (rho = 0.443, p ≤ 0.001) from FHSQ. The 30-s chair stand-up test was also found to be weakly associated with foot pain (rho = 0.358, p = 0.001), 15-D total score (rho = 0.376, p ≤ 0.001), “sleeping” (rho = 0.371, p &lt, 0.001), and “depression” (rho = 0.352, p = 0.001). Conclusions: The 30-s chair stand-up test is associated with “physical activity”, “vigor”, and “foot pain” from the FHSQ and the 15-D questionnaire total score and its dimensions “sleeping” and “depression” in type 2 diabetes mellitus patients. Therefore, following the results obtained, qualified clinicians can use the 30-s chair stand-up test as a good tool for monitoring and managing type 2 diabetes.

[Abstract] The aim of this study is to evaluate if screen time and parents’ education levels are associated with adherence to a Mediterranean dietary pattern. This cross-sectional study analyzed a representative sample of 3333 children and adolescents (8 to 16 years) included in the Physical Activity, Sedentarism, lifestyles and Obesity in Spanish youth (PASOS) study in Spain (which ran from March 2019 to February 2020). Data on screen time (television, computer, video games, and mobile phone) per day, Mediterranean diet adherence, daily moderate or vigorous physical activity, and parents’ education levels were gathered using questionnaires. A descriptive study of the variables according to sex and parents’ education level was performed. Logistic regression models (adjusted by sex and weight status) were fitted to evaluate the independent association between screen time and Kids’ level of adherence to the Mediterranean diet (KIDMED) index, as well as some of its items. A greater amount of screen time was associated with worse adherence to the Mediterranean diet; a lower consumption of fruit, vegetables, fish, legumes, and nuts; and a greater consumption of fast food, sweets, and candies. A lower parents’ education level was associated with worse adherence to the Mediterranean diet. It is necessary to promote the responsible, limited use of screen time, especially in children with parents with a lower education level. The PASOS study was funded by Fundación PROBITAS and the Gasol Foundation. Additional funds were received from the Barça Foundation, Banco Santander, IFA, Vienna and the Fundación Deporte Jóven. J.A.T. and M.M.B. are funded by the official funding agency for biomedical research of the Spanish government, the Institute of Health Carlos III (ISCIII), which is co-funded by the European Regional Development Fund (CIBEROBN CB12/03/30038).

Patients with fibromyalgia (FM) show widespread pain associated with other symptoms such as cognitive problems, depression, and anxiety among others associated with alterations in the central nervous system. The hippocampal subfields had differences in function, histology, and connectivity with other brain regions, and are altered in different diseases. This study evaluates the volumetric differences between patients with FM compared with a healthy control group. A total of 49 women with, and 43 healthy women completed this study. T1-weighted MRI was used to assess brain volume, and FreeSurfer software was used to segment the hippocampal subfields. Women with FM had a significant reduction in most of the hippocampal subfields. The regression equation models were obtained to predict the volume of specific subfields of the right and left hippocampus. These findings provide that women with FM have lower hippocampal subfields volumes compared with healthy women. Besides, regression models show that different covariates, such as age, cognitive impairment, or depression, are related to specific subfields.

Physical exercise is one of the most effective interventions to reduce fibromyalgia symptoms. Previous studies have reported benefits of dance-based intervention on the fibromyalgia impact, health-related quality of life and pain, regardless the interventions were based on creative- or repetitive dance. This study aimed to compare the effectiveness of creative and repetitive dance interventions.PRISMA guidelines were followed in this systematic review. The Cochrane Library, PubMed, Trip, Google Scholar, Web of Science (WOS), Embase and Scopus databases were selected to identify potential articles. Studies were included if they met the following inclusion criteria: to be a clinical trial or a randomized controlled trial, include people with fibromyalgia, have a comparison group and evaluate the impact of the disease, pain or quality of life. Fifteen articles fulfilled the inclusion criteria. The methodological quality of the studies was assessed using the Cochrane Collaboration's tool.Dance-based interventions significantly reduced fibromyalgia impact (standardized mean difference = -0.69), pain (standardized mean difference = -0.70 and increased quality of life (standardized mean difference = 0.43) of people with fibromyalgia. The effectiveness of dance interventions is increased when a creative component is added, since it can lead to higher improvements in pain, impact of the disease and improving quality of life.Dance-based interventions are significantly effective in reducing the impact of fibromyalgia, pain as well as increasing health-related quality of life. Subgroup analyses suggest that creative dance-based interventions could be more effective than repetitive dance-based interventions to reduce pain and fibromyalgia impact. However, results must be taken with caution due to the large heterogeneity and the small number of articles.

During the COVID-19 pandemic, entire populations were instructed to live in home-confinement to prevent the expansion of the disease. Spain was one of the countries with the strictest conditions, as outdoor physical activity was banned for nearly two months. This study aimed to analyse the changes in physical activity and sedentary behaviours in Spanish university students before and during the confinement by COVID-19 with special focus on gender. We also analysed enjoyment, the tools used and motivation and impediments for doing physical activity. An online questionnaire, which included the International Physical Activity Questionnaire Short Form and certain &ldquo, ad hoc&rdquo, questions, was designed. Students were recruited by distributing an invitation through the administrative channels of 16 universities and a total of 13,754 valid surveys were collected. Overall, university students reduced moderate (&minus, 29.5%) and vigorous (&minus, 18.3%) physical activity during the confinement and increased sedentary time (+52.7%). However, they spent more time on high intensity interval training (HIIT) (+18.2%) and mind-body activities (e.g., yoga) (+80.0%). Adaptation to the confinement, in terms of physical activity, was handled better by women than by men. These results will help design strategies for each gender to promote physical activity and reduce sedentary behaviour during confinement periods.

The online version contains supplementary material available at https://doi.org/10.1186/s12966-021-01169-w Additional file 1 Supplementary Table 1.Characteristics of the validation study participants and the remaining participants of the population-based PASOS cohort. Additional file 2 Supplementary Table 2.Correlation coefficients and between-method agreement of moderate to vigorous physical activity measurements derived by the Physical Activity Unit 7-item screener, non-calibrated and calibrated, and the reference method (accelerometer),stratified by age [Abstract] Background Validation of self-reported tools, such as physical activity (PA) questionnaires, is crucial. The aim of this study was to determine test-retest reliability, internal consistency, and the concurrent, construct, and predictive validity of the short semi-quantitative Physical Activity Unit 7 item Screener (PAU-7S), using accelerometry as the reference measurement. The effect of linear calibration on PAU-7S validity was tested. Methods A randomized sample of 321 healthy children aged 8–16 years (149 boys, 172 girls) from the nationwide representative PASOS study completed the PAU-7S before and after wearing an accelerometer for at least 7 consecutive days. Weight, height, and waist circumference were measured. Cronbach alpha was calculated for internal consistency. Test-retest reliability was determined by intra-class correlation (ICC). Concurrent validity was assessed by ICC and Spearman correlation coefficient between moderate to vigorous PA (MVPA) derived by the PAU-7S and by accelerometer. Concordance between both methods was analyzed by absolute agreement, weighted kappa, and Bland-Altman statistics. Multiple linear regression models were fitted for construct validity and predictive validity was determined by leave-one-out cross-validation. Results The PAU-7S overestimated MVPA by 18%, compared to accelerometers (106.5 ± 77.0 vs 95.2 ± 33.2 min/day, respectively). A Cronbach alpha of 0.76 showed an acceptable internal consistency of the PAU-7S. Test-retest reliability was good (ICC 0.71 p

Objective: To analyze the psychophysiological response during takeoff, landing, air-air attack and air-ground attack maneuvers. Methods: A total of 11 expert pilots (age=33.36 (5.37)) from the Spanish Air Force participated in this cross-sectional study. Participants had to complete in a flight simulator the following missions: 1) takeoff; 2) Air-air attack; 3) Air-Ground attack, and 4) Landing. The electroencephalographic activity (EEG) and heart rate variability (HRV) were collected during all these maneuvers. Results: Significant higher values of theta (during takeoff, air-air attack and air-ground attack) EEG power spectrum were obtained when compared to baseline. Significant difference in the P3 scalp location was observed between landing and takeoff maneuvers in the beta EEG power spectrum. Furthermore, significant lower values of HRV were obtained during takeoff, landing, air-air attack and air-ground attack when compared to baseline values. Also, landing showed a higher sympathetic response when compared to takeoff maneuver. Conclusion: Takeoff, landing, air-air attack or air-ground attack maneuvers performed in a flight simulator produced significant changes in the electroencephalographic activity and autonomic modulation of professional pilots. Beta EEG power spectrum modifications suggest that landing maneuvers induced more attentional resources than takeoff. In the same line, a reduced HRV during landing was obtained when compared to takeoff. These results should be considered to training purposes.

We used data from 3041 participants in four cohorts of community-dwelling individuals aged ≥65 years in Spain collected through a pre-pandemic face-to-face interview and a telephone interview conducted between weeks 7 to 15 after the beginning of the COVID-19 lockdown. On average, the confinement was not associated with a deterioration in lifestyle risk factors (smoking, alcohol intake, diet, or weight), except for a decreased physical activity and increased sedentary time, which reversed with the end of confinement. However, chronic pain worsened, and moderate declines in mental health, that did not seem to reverse after restrictions were lifted, were observed. Males, older adults with greater social isolation or greater feelings of loneliness, those with poorer housing conditions, as well as those with a higher prevalence of chronic morbidities were at increased risk of developing unhealthier lifestyles or mental health declines with confinement. On the other hand, previously having a greater adherence to the Mediterranean diet and doing more physical activity protected older adults from developing unhealthier lifestyles with confinement. If another lockdown were imposed during this or future pandemics, public health programs should specially address the needs of older individuals with male sex, greater social isolation, sub-optimal housing conditions, and chronic morbidities because of their greater vulnerability to the enacted movement restrictions, The Seniors-ENRICA-2 study was supported by Instituto de Salud Carlos III (Spain), State Secretary of R+D+I and FEDER/FSE research grants PI16/609, PI18/287, and 19/319; CIBERESP (16/01); and Cátedra de Epidemiología y Control del Riesgo Cardiovascular at UAM (#820024). ELS was supported by a Juan de la Cierva Contract from the Ministy of Universities. DMG and MSP were supported by supported by a “Ramon y Cajal”contract. Edad con Salud was funded by the Seventh Framework Programme (grant number 223071-COURAGE Study); the Insti tuto de Salud Carlos III (grants number PS09/00295(JMH), PS09/01845 (JLA), PI12/01490 (JMH), PI13/00059 (JLA), PI16/00212 (JMH), PI16/00218 (MM), PI16/01073 (JLA)); the European Regional Development Fund (ERDF) “A Way to Build Europe” (grant numbers PI12/01490, PI13/00059, PI16/00212 and PI16/01073);and CIBERSAM. EL was supported by the Sara Borrell postdoctoral programme (CD18/00099) from the Instituto de Salud Carlos III and co-funded by the European Union (FEDER/FSE, “Investing in your future”). BO was supported by the Miguel Servet programme (reference CP20/00040), funded by Instituto de Salud Carlos III and co-funded by European Union (ERDF/ESF, "Investing in your future"). The Toledo Study for Healthy Ageing was funded by the Spanish Ministry of Economy, Industry and Competitiveness, cofinanced by FEDER (RD120001/0043), CIBERFES (CB16/10/00464) and DIABFRAIL-LATAM (contract number 825546, Horizon 2020). The Elderly EXERNET multicenter study was supported by the Ministerio de Economía, Industria y Competitividad (DEP2016-78309-R (GVR)), the Ministerio de Educación y Ciencia (Red EXERNET DEP2005-00046 JAC)), the High Council of Sports (Consejo Superior de Deportes) of the Ministe rio de Cultura y Deportes (09/UPB/19 (JAC) and 45/UPB/20 (JAC)), CIBERFES, the 4IE+ project (0499_4IE_PLUS_4_E (NG)) funded by the Interreg V-A España-Portugal (POCTEP) 2014-2020 pro gram, and FEDER funds from the European Union (CB16/10/00477 (IA)). The funding agencies had no role in study design, data collection and analysis, interpretation of results, manuscript preparation or the decision to submit this manuscript for publication