How much exercise are older adults living in nursing homes doing in daily life? A cross-sectional study

Information on the amount of exercise practised by nursing home (NH) residents is scarce. This study aimed at describing NH residents’ participation in exercise classes, as well as to examine whether the presence of a professional exercise instructor in the facilities is associated with residents’ exercise habits. The cross-sectional data of 5402 residents (median age = 88 years; mostly women (75.2%)) from 163 NHs in France were analysed. Adjusted logistic and linear regressions were performed to examine whether the presence of a professional exercise instructor in the NH was associated with exercise habits: exercise participation, frequency, duration, and levels. From the 5402 participants, 1914 were participating in exercise classes provided in the NH. Most of them had an exercise frequency of 1x/week or less. Median duration of exercise sessions was 45 min. Exercise levels were rated as: highly active (n = 487), intermediately active (n = 1096), and poorly active (n = 331). The presence of a professional exercise instructor working in the facility was significantly associated with exercise participation and with higher exercise frequencies and levels, and session duration. In conclusion, the presence of professional exercise instructors is associated with better exercise habits in NH residents. Improved exercise habits may potentially be translated into better health in this population.     

Does exercise have a protective effect on cognitive function under hypoxia? A systematic review with meta-analysis

ObjectiveThis study aimed to examine (1) the independent effects of hypoxia on cognitive function and (2) the effects of exercise on cognition while under hypoxia.MethodsDesign: Systematic review with meta-analysis. Data sources: PubMed, Scopus, Web of Science, PsychInfo, and SPORTDiscus were searched. Eligibility criteria for selecting studies: randomized controlled trials and nonrandomized controlled studies that investigated the effects of chronic or acute exercise on cognition under hypoxia were considered (Aim 2), as were studies investigating the effects of hypoxia on cognition (Aim 1).ResultsIn total, 18 studies met our inclusionary criteria for the systematic review, and 12 studies were meta-analyzed. Exposure to hypoxia impaired attentional ability (standardized mean difference (SMD) = –0.4), executive function (SMD = –0.18), and memory function (SMD = –0.26), but not information processing (SMD = 0.27). Aggregated results indicated that performing exercise under a hypoxia setting had a significant effect on cognitive improvement (SMD = 0.3, 95% confidence interval: 0.14 – 0.45, I² = 54%, p < 0.001). Various characteristics (e.g., age, cognitive task type, exercise type, exercise intensity, training type, and hypoxia level) moderated the effects of hypoxia and exercise on cognitive function.ConclusionExercise during exposure to hypoxia improves cognitive function. This association appears to be moderated by individual and exercise/hypoxia-related characteristics.     

Does exercise motivation predict engagement in objectively assessed bouts of moderate-intensity exercise? A self-determination theory perspective

This study examined the utility of motivation as advanced by self-determination theory (Deci & Ryan, 2000) in predicting objectively assessed bouts of moderate intensity exercise behavior. Participants provided data pertaining to their exercise motivation. One week later, participants wore a combined accelerometer and heart rate monitor (Actiheart; Cambridge Neurotechnology Ltd) and 24-hr energy expenditure was estimated for 7 days. After controlling for gender and a combined marker of BMI and waist circumference, results showed autonomous motivation to positively predict moderate-intensity exercise bouts of >or=10 min, or=20 min, and an accumulation needed to meet public health recommendations for moderate intensity activity (i.e., ACSM/AHA guidelines). The present findings add bouts of objectively assessed exercise behavior to the growing body of literature that documents the adaptive consequences of engaging in exercise for autonomous reasons. Implications for practice and future work are discussed.     

Does the individual zones of optimal functioning model discriminate between successful and less successful athletes? A meta-analysis

According to the individual zones of optimal functioning (IZOF) model, an athlete's performance is successful when his or her pre-competition anxiety is within or near the individually optimal zone. When anxiety falls outside the optimal zone, performance deteriorates. The model also suggests that skilled athletes are aware of, and are able to accurately recall and anticipate, their pre-competition anxiety. A meta-analysis of 19 studies from 1978 to 1997 (146 effect sizes based on 6387 participants) was conducted to examine the validity of the assumptions regarding the in-out of the zone notion and the accuracy of recalls and anticipatory measures of anxiety. The findings provide fairly good empirical support for the IZOF anxiety model, with an overall effect size (d) for the in-out of the zone notion of d = +0.44 (41 effect sizes, n = 3175). In other words, the performance of athletes who were within their individually optimal zones were almost one-half a standard deviation unit better than that of athletes who were outside their zones. Furthermore, both effect sizes (r(w)) for accuracy of precompetition anxiety measures, recall (r(w) = +0.71, 24 effect sizes, n = 369) and anticipatory (r(w) = +0.69, 81 effect sizes, n = 2843), exceeded the 'large effect' suggested for correlations by Cohen. The implications for future research extending the IZOF model to a wider range of positive and negative emotions are discussed.     

Does a resistance exercise session with continuous or intermittent blood flow restriction promote muscle damage and increase oxidative stress?

The aim of this study was to compare the effect of low-load resistance exercise (LLRE) with continuous and intermittent blood flow restriction (BFR) on the creatine kinase (CK), lactate dehydrogenase (LDH), protein carbonyl (PC), thiobarbituric acid-reactive substance (TBARS) and uric acid (UA) levels in military men. The study included 10 recreationally trained men aged 19 ± 0.82 years who underwent the following experimental protocols in random order on separate days (72–96 h): 4 LLRE sessions at a 20% 1RM (one-repetition maximum [1RM]) with continuous BFR (LLRE + CBFR); 4 LLRE sessions at 20% 1RM with intermittent BFR (LLRE + IBFR) and 4 high-intensity resistance exercise (HIRE) sessions at 80% 1RM. The CK and LDH (markers of muscle damage) levels were measured before exercise (BE), 24 h post-exercise and 48 h post-exercise, and the PC, TBARS and UA (markers of oxidative stress) levels were measured BE and immediately after each exercise session. There was a significant increase in CK in the HIRE 24 post-exercise samples compared with the LLRE + CBFR and LLRE + IBFR (P = 0.035, P = 0.036, respectively), as well as between HIRE 48 post-exercise and LLRE + CBFR (P = 0.049). Additionally, there was a significant increase in CK in the LLRE + CBFR samples BE and immediately after each exercise (Δ = 21.9%) and in the HIRE samples BE and immediately after each exercise, BE and 24 post-exercise, and BE and 48 post-exercise (Δ values of 35%, 177.6%, and 177.6%, respectively). However, there were no significant changes in LDH, PC, TBARS, and UA between the protocols (P > 0.05). Therefore, a physical exercise session with continuous or intermittent BFR did not promote muscle damage; moreover, neither protocol seemed to affect the oxidative stress markers.     

Does intensity really matter regarding aerobic exercise reductions in wave reflection and central hemodynamics? Commentary on "The effect of acute aerobic exercise on central arterial stiffness,wave reflections,and hemodynamics in adults with diabetes: A randomized cross-over design"by Way et al.

We read with great interest the study by Way et al.1 pub-lished in this journal, which described and compared the acute changes in central arterial stiffness (A...     

Relative age effect and soccer refereeing: A ‘Strategic Adaptation’ of relatively younger children?

Abstract

Previous research suggested that the relative age effect (RAE) has a psychological influence on children and their decision to engage in a particular sport. Relatively younger children seem to have lower self-esteem. Indeed, because of the disadvantages of being younger, it is assumed that these players experience more situations of failure and inferiority. Because of these negative performance cues, it is likely that these young players feel less competent, which eventually leads to a higher dropout rate. These children can also decide to participate in sports in which physical attributes are less important. This shift from one sport to another can be interpreted as a ‘strategic adaptation’. The purpose of this study was thus to investigate whether refereeing could be another form of ‘strategic adaptation’. If a child chooses a specific sport but then does not feel competent enough to be a player, refereeing might be an alternate path followed to stay in the environment of a sport they like. Given the minimal age limits for refereeing, two hypotheses were formulated: (1) ‘reversed’ RAE would be observed in district referees younger than 18 years old and (2) no RAE would be observed in district referees older than 18 years old, regional referees and national referees. The birthdates of all official male soccer referees (n=13,952) were collected from the federation database. Results show that the distribution of all district referees was significantly unbalanced (χ²=18.73, df=3, P<0.001) with an over-representation of individuals who were born in the second half of the competitive year. As expected, this imbalance was exclusively located in district referees of 18 years old and less (χ²=8.03, df=3, P<0.05), while the distribution was uniform for adults (χ²=5.17, df=3, P<0.16). Concerning regional referees (χ²=2.09, df=3, P<0.554) and national referees (χ²=3.75, df=3, P<0.290), the results also provide support for our initial hypothesis as uniform distributions were found for both groups. This study brings to light new elements in the potential relationship between relative age and refereeing. Qualitative and/or longitudinal research is needed to confirm our quantitative data.     

Should,and how can,exercise be done during a coronavirus outbreak? An interview with Dr. Jeffrey A. Woods

The Coronavirus disease(COVID-19)crisis is now present in China.It started in December,2019 and has,so far,led 213 individuals died and at least 9066 infected in China by local time 17:26,r January 30,2020.It has also spread to a number of Asian countries,as well as to Canada,France,Germany,and the United States.As a result,the Chinese government has put several major cities in Hubei Province on lockdown and has thrown plans for the Lunar New Year holiday into chaos for millions of people.On January 30,2020,the World Health Organization also declared the COVID-19 outbreak a global health emergency because it could spread to countries that are not prepared.     

Does local dynamic stability of kayak paddling technique affect the sports performance? A pilot study

During competition, kayak athletes must optimally adapt to environmental factors (e.g. wind, waves) to achieve peak performance. However, the ability to adapt to such perturbations has never been assessed in kayak paddling. Therefore, the aim of the current study was to evaluate the local dynamic stability in sports technique of youth sprint kayak athletes. In a cross-sectional study, 14 healthy male athletes were recruited from an elite youth sprint kayak squad. During an incremental kayak ergometer test, mean power, heart rates and local dynamic technique stability of hands, arms, trunk and paddle were registered and the association with the athletes 2000?m free-water times were estimated using mixed models. The 2000?m free-water performance significantly predicted the paddles (p?=?.037) local dynamic stability whereas no association was found for the trunk or the upper extremity kinematics. In conclusion, kayak athletes with high-performance capability over 2000?m paddling depict high local dynamic technique stability. This emphasizes the importance of a stable technique for advanced kayak skills, especially regarding paddling movements.     

Response to McAvoy and Tudor-Locke on their commentary on our manuscript: "Association of accelerometer-derived step volume and intensity with hospitalizations and mortality in older adults:A prospective cohort study"

<正>Dear Editor,We have read with interest the commentary by McAvoy and Tudor-Locke¹ on our article entitled "Association of accelerometer-derived step volume and intensity with ho spitalizations and mortality in older adults:A prospective cohort study".² The authors expressed some concerns about our methodology used to define accelerometer-derived step intensity and the analytical approach applied in our study.     

Does it really matter? A study on soccer fans’ perceptions of ethical leadership and their role as “stakeowners”

Ethical leadership is increasingly studied in the context of soccer clubs, as it is believed to represent an effective answer to soccer’s “dark side.” However, current academic understanding is limited to key internal stakeholders’ perspectives, such as coaches and players. A highly relevant stakeholder group that is still largely neglected is fans, as they are believed to be uniquely able to influence leadership in sport clubs, while some of soccer’s ethical issues, such as violence and discrimination are strongly associated with fans. This study highlights this duality by referring to fans as “stakeowners,” namely legitimate stakeholders with certain rights as well as responsibilities. Moreover, the authors examine whether ethical leadership by soccer club leaders really matters to fans. Drawing on a qualitative case study in a Belgian professional soccer club, findings indicate fans care mainly about those aspects of ethical leadership that impact their own position, such as clear communication and fan empowerment. On the other hand, findings suggest fan influence on the leadership of their club should not be exaggerated. After all, the club’s leadership questions the critical importance of fans as being core to (soccer) management’s activities and leadership.     

Can losing teams cope with destructive voice behaviour? The role of game results and athletes’ perceived motivational climate

This study examined the relation between losing a game and players’ destructive voice about the coach. As team performances would suffer when such behaviours are not managed properly, we tested the motivational climate as a potential mechanism by which coaches can manage these destructive behaviours. Twelve volleyball and basketball teams (N = 136) were weekly assessed during eight weeks using questionnaires. Players rated the extent to which their teammates expressed destructive voice about their coach. Each player’s indegree centrality (i.e. the average score received from all teammates) functioned as measurement of his/her destructive voice about the coach. As hypothesized, losing a game increased players’ expression of destructive voice about the coach. At both the within- and between-person level, perceived mastery (performance) climate negatively (positively) predicted players’ destructive voice about the coach. When players perceived a more salient performance climate than usual after a loss, their increase in destructive voice about the coach was magnified. These results highlight the dynamics of players’ destructive voice about the coach and how a single loss can start the utterance of such voice. A coach would be able to counter this process by increasing the focus on a mastery rather than a performance climate.     

Heart rate response and recovery during exercise predict future delirium risk—A prospective cohort study in middle- to older-aged adults

BackgroundDelirium is a neurocognitive disorder characterized by an abrupt decline in attention, awareness, and cognition after surgical/illness-induced stressors on the brain. There is now an increasing focus on how cardiovascular health interacts with neurocognitive disorders given their overlapping risk factors and links to subsequent dementia and mortality. One common indicator for cardiovascular health is the heart rate response/recovery (HRR) to exercise, but how this relates to future delirium is unknown.MethodsElectrocardiogram data were examined in 38,740 middle- to older-aged UK Biobank participants (mean age = 58.1 years, range: 40–72 years; 47.3% males) who completed a standardized submaximal exercise stress test (15-s baseline, 6-min exercise, and 1-min recovery) and required hospitalization during follow-up. An HRR index was derived as the product of the heart rate (HR) responses during exercise (peak/resting HRs) and recovery (peak/recovery HRs) and categorized into low/average/high groups as the bottom quartile/middle 2 quartiles/top quartile, respectively. Associations between 3 HRR groups and new-onset delirium were investigated using Cox proportional hazards models and a 2-year landmark analysis to minimize reverse causation. Sociodemographic factors, lifestyle factors/physical activity, cardiovascular risk, comorbidities, cognition, and maximal workload achieved were included as covariates.ResultsDuring a median follow-up period of 11 years, 348 participants (9/1000) newly developed delirium. Compared with the high HRR group (16/1000), the risk for delirium was almost doubled in those with low HRR (hazard ratio = 1.90, 95% confidence interval (95%CI): 1.30–2.79, p = 0.001) and average HRR (hazard ratio = 1.54, 95%CI: 1.07–2.22, p = 0.020)). Low HRR was equivalent to being 6 years older, a current smoker, or ≥3 additional cardiovascular disease risks. Results were robust in sensitivity analysis, but the risk appeared larger in those with better cognition and when only postoperative delirium was considered (n = 147; hazard ratio = 2.66, 95%CI: 1.46–4.85, p = 0.001).ConclusionHRR during submaximal exercise is associated with future risk for delirium. Given that HRR is potentially modifiable, it may prove useful for neurological risk stratification alongside traditional cardiovascular risk factors.     

How acceptable do older adults find the concept of being physically active? A systematic review and meta-synthesis

Despite the significant health benefits of regular physical activity for older adults, only a minority achieve recommended levels. To develop effective interventions, the reasons for the low levels of physical activity in this population must be understood. The present review identifies and synthesizes qualitative studies concerning the acceptability of physical activity to community dwelling older adults. A systematic search of four electronic databases identified 10 studies meeting inclusion criteria. These were appraised, and findings were combined and compared using thematic synthesis. Older adults construed physical activity as a by-product of other activities, rather than as a purposeful activity within itself. This seemed to be linked to their self-perception as an ageing member of society, with physical activity considered irrelevant, and competing roles and responsibilities (e.g., family) taking precedence. Additionally, older adults appeared to experience conflict between maintaining their autonomy and accepting the physical and social vulnerabilities associated with ageing. As older adults do not see physical activity as purposeful within itself, interventions promoting moderate or vigorous physical activity are likely to have limited success. As even small increases in physical activity benefit older adults, future interventions may wish to target the reduction of sedentary behaviour in this population.     

Do people with low back pain walk differently? A systematic review and meta-analysis

BackgroundThe biomechanics of the trunk and lower limbs during walking and running gait are frequently assessed in individuals with low back pain (LBP). Despite substantial research, it is still unclear whether consistent and generalizable changes in walking or running gait occur in association with LBP. The purpose of this systematic review was to identify whether there are differences in biomechanics during walking and running gait in individuals with acute and persistent LBP compared with back-healthy controls.MethodsA search was conducted in PubMed, CINAHL, SPORTDiscus, and PsycINFO in June 2019 and was repeated in December 2020. Studies were included if they reported biomechanical characteristics of individuals with and without LBP during steady-state or perturbed walking and running. Biomechanical data included spatiotemporal, kinematic, kinetic, and electromyography variables. The reporting quality and potential for bias of each study was assessed. Data were pooled where possible to compare the standardized mean differences (SMD) between back pain and back-healthy control groups.ResultsNinety-seven studies were included and reviewed. Two studies investigated acute pain and the rest investigated persistent pain. Nine studies investigated running gait. Of the studies, 20% had high reporting quality/low risk of bias. In comparison with back-healthy controls, individuals with persistent LBP walked slower (SMD = –0.59, 95% confidence interval (95%CI): –0.77 to –0.42)) and with shorter stride length (SMD = –0.38, 95%CI: –0.60 to –0.16). There were no differences in the amplitude of motion in the thoracic or lumbar spine, pelvis, or hips in individuals with LBP. During walking, coordination of motion between the thorax and the lumbar spine/pelvis was significantly more in-phase in the persistent LBP groups (SMD = –0.60, 95%CI: –0.90 to –0.30), and individuals with persistent LBP exhibited greater amplitude of activation in the paraspinal muscles (SMD = 0.52, 95%CI: 0.23–0.80). There were no consistent differences in running biomechanics between groups.ConclusionThere is moderate-to-strong evidence that individuals with persistent LBP demonstrate differences in walking gait compared to back-healthy controls.     

Does regional disadvantage affect health-related sport and physical activity level? A multi-level analysis of individual behaviour

This study examines the role of regional government quality in health-related participation in sport and physical activity among adults (18–64 years) in 28 European countries. The importance of the analysis rests in the relative autonomy that regional and local governments have over policy decisions connected with sport and physical activity. While existing studies have focussed on economic and infrastructural investment and expenditure, this research investigates the quality of regional governments across 208 regions within 28 European countries. The individual-level data stem from the 2013 Eurobarometer 80.2 (n?=?18,675) and were combined with regional-level data from Eurostat. An individual's level of participation in sport and physical activity was measured by three variables reflecting whether an individual's activity level is below, meets, or exceeds the recommendations of the World Health Organization. The results of multi-level analyses reveal that regional government quality has a significant and positive association with individual participation in sport and physical activity at a level meeting or exceeding the guidelines. The impact is much larger than that of regional gross domestic product per capita, indicating that regional disadvantage in terms of political quality is more relevant than being disadvantaged in terms of economic wealth.