Exercise but not metformin improves health-related quality of life and mood states in older adults with type 2 diabetes

The aim of this cohort study is to analyse the effect of three types of treatment: (i) exercise training with multicomponent exercise (E); (ii) pharmacologic treatment with oral hypoglycaemic drug – metformin (M); and (iii) a combined therapy – exercise and metformin (E?+?M) on health-related quality of life (HRQoL) and mood states in older adults with type 2 diabetes (T2D) with comorbidity in an early stage of the disease. Participants (n?=?284) underwent 1 of the following 3 conditions: (i) E (n?=?59) trained three times/week; (ii) M (n?=?30) used 850?mg of metformin twice daily; and (iii) E?+?M (n?=?195) combined exercise and metformin. Furthermore, participants completed baseline and 2-year follow-up evaluations including a Shortform Health Survey 36, Profile of Mood States – Short-form, the health history questionnaires, anthropometric, and blood biochemistry. E and E?+?M revealed improved mood states, with large effect size on the vigour domain, and moderate effect size in the anger and total mood disturbance (TMD) domains (P?<?0.05), in comparison with the M group. After 24 months’ intervention, the E and E?+?M groups perceived better physical and mental HRQoL than the M group. The M group unchanged HRQoL domains (P?>?0.05). Metformin had no significant effect on the self-referred HRQoL in T2D participants aged above 60 years, in an early stage of the disease. The E and E?+?M were the most effective long-term therapies to improve mood states and HRQoL in older adults with T2D.     

Sport disciplines,types of sports,and waist circumference in young adulthood – a population-based twin study

Purpose: The benefits of physical activity (PA) in preventing abdominal obesity are well recognized, but the role of different sport disciplines remains open. We aimed, therefore, to investigate how participation in different sport disciplines, and the number and types of sports engaged in are associated with waist circumference (WC) in young adulthood. Methods: This population-based cohort study comprised 4027 Finnish twin individuals (1874 men), with a mean age of 34 y (32–37), who answered a survey, including self-measured WC. We extracted the number and identified the types (aerobic, power, and mixed) of the different sport disciplines respondents reported participating in. Results: The number of sport disciplines participated in was inversely associated with WC, the linear decrease averaging 1.38?cm (95% CI 1.10–1.65) per each additional sport discipline. The result persisted after adjustment for the main covariates, such as volume of PA and diet quality. Among dizygotic twin pairs discordant for sports participation (0–2 vs. 5 or more disciplines), the mean within-pair difference in WC was 4.8?cm (95% CI 0.4–9.1) for men and 11.2?cm (95% CI 4.4–18.0) for women; among discordant monozygotic pairs, no differences were observed. In men, all three types of sports were individually associated with smaller WC, while in women, only mixed and power sports showed this association. Conclusions: Participation in several sport disciplines and sport types was associated with smaller WC among young adults in their mid-30s. Shared genetic background may explain some of the associations.     

Symptoms of common mental disorders and related stressors in Danish professional football and handball

The aim of the study was twofold, namely (i) to determine the prevalence of symptoms of common mental disorders (CMDs) among current and retired professional football and handball players and (ii) to explore the relationship of psychosocial stressors with the outcome measures under study. A total of 1155 players were enrolled in an observational study based on a cross-sectional design. Questionnaires based on validated scales were set up and distributed among current and retired professional football and handball players by the Danish football and handball players’ union. In professional football, the highest prevalence (4 weeks) of symptoms of CMDs was 18% and 19% for anxiety/depression among current and retired players, respectively. In professional handball, the highest prevalence (4 weeks) of symptoms of CMDs was 26% and 16% for anxiety/depression among current and retired players, respectively. For both the current and retired professional football and handball players, a higher number of severe injuries and recent adverse life events (LE) were related to the presence of symptoms of CMD. Players exposed to severe injuries and/or recent adverse LE were 20–50% times more likely to report symptoms of CMD. The results suggest that it is possible to recognize the population of professional athletes that are more likely to develop symptoms of CMD. This could create the opportunity to intervene preventively on athletes that suffered from severe injury and/or recent adverse LE that could lead to a faster and safer recovery and psychological readiness to return to play.     

The oxygen-conserving potential of the diving response: A kinetic-based analysis

We investigated the oxygen-conserving potential of the human diving response by comparing trained breath-hold divers (BHDs) to non-divers (NDs) during simulated dynamic breath-holding (BH). Changes in haemodynamics [heart rate (HR), stroke volume (SV), cardiac output (CO)] and peripheral muscle oxygenation [oxyhaemoglobin ([HbO₂]), deoxyhaemoglobin ([HHb]), total haemoglobin ([tHb]), tissue saturation index (TSI)] and peripheral oxygen saturation (SpO₂) were continuously recorded during simulated dynamic BH. BHDs showed a breaking point in HR kinetics at mid-BH immediately preceding a more pronounced drop in HR (?0.86 bpm.%^?1) while HR kinetics in NDs steadily decreased throughout BH (?0.47 bpm.%^?1). By contrast, SV remained unchanged during BH in both groups (all P > 0.05). Near-infrared spectroscopy (NIRS) results (mean ± SD) expressed as percentage changes from the initial values showed a lower [HHb] increase for BHDs than for NDs at the cessation of BH (+24.0 ± 10.1 vs. +39.2 ± 9.6%, respectively; P < 0.05). As a result, BHDs showed a [tHb] drop that NDs did not at the end of BH (?7.3 ± 3.2 vs. ?3.0 ± 4.7%, respectively; P < 0.05). The most striking finding of the present study was that BHDs presented an increase in oxygen-conserving efficiency due to substantial shifts in both cardiac and peripheral haemodynamics during simulated BH. In addition, the kinetic-based approach we used provides further credence to the concept of an “oxygen-conserving breaking point” in the human diving response.     

Effects of heat acclimation on hand cooling efficacy following exercise in the heat

This study examined the separate and combined effects of heat acclimation and hand cooling on post-exercise cooling rates following bouts of exercise in the heat. Seventeen non-heat acclimated (NHA) males (mean ± SE; age, 23 ± 1 y; mass, 75.30 ± 2.27 kg; maximal oxygen consumption [VO₂ max], 54.1 ± 1.3 ml·kg^?1·min^?1) completed 2 heat stress tests (HST) when NHA, then 10 days of heat acclimation, then 2 HST once heat acclimated (HA) in an environmental chamber (40°C; 40%RH). HSTs were 2 60-min bouts of treadmill exercise (45% VO₂ max; 2% grade) each followed by 10 min of hand cooling (C) or no cooling (NC). Heat acclimation sessions were 90–240 min of treadmill or stationary bike exercise (60–80% VO₂ max). Repeated measures ANOVA with Fishers LSD post hoc (α < 0.05) identified differences. When NHA, C (0.020 ± 0.003°C·min^?1) had a greater cooling rate than NC (0.013 ± 0.003°C·min^?1) (mean difference [95%CI]; 0.007°C [0.001,0.013], P = 0.035). Once HA, C (0.021 ± 0.002°C·min^?1) was similar to NC (0.025 ± 0.002°C·min^?1) (0.004°C [?0.003,0.011], P = 0.216). Hand cooling when HA (0.021 ± 0.002°C·min^?1) was similar to when NHA (0.020 ± 0.003°C·min^?1) (P = 0.77). In conclusion, when NHA, C provided greater cooling rates than NC. Once HA, C and NC provided similar cooling rates.     

A new footwear technology to promote non-heelstrike landing and enhance running performance: Fact or fad?

This study sought to compare the kinetics and kinematics data in a group of habitual shod runners when running in traditional running shoes and newly designed minimalist shoes with lug platform. This novel footwear design claims to simulate barefoot running and reduce energy loss during impact. We compared footstrike angle (FSA), vertical average (VALR) and instantaneous (VILR) loading rates, energy loss and initial vertical stiffness between two shoe conditions. Runners demonstrated a decreased FSA while running in minimalist shoes with lug platform than traditional shoes (P = 0.003; Cohen’s d = 0.918). However, we did not observe a landing pattern transition. VALR and VILR between two footwear conditions showed no significant difference (P = 0.191–0.258; Cohen’s d = 0.304–0.460). Initial vertical stiffness (P = 0.032; Cohen’s d = 0.671) and energy loss (P = 0.044; Cohen’s d = 0.578) were greater when running in minimalist shoes with lug platform. The results show that minimalist shoes with lug platform reduce the FSA but may not lead to a landing pattern switch or lower vertical loading rates. Interestingly, the new shoe design leads to a greater energy loss than traditional running shoes, which could be explained by a higher initial vertical stiffness.     

Short-term reliability of inflammatory mediators and response to exercise in the heat

Prospective application of serum cytokines, lipopolysaccharide (LPS), and heat shock proteins (eHSPs) requires reliable measurement of these biomarkers that can signify exercise-induced heat stress in hot conditions. To accomplish this, both short-term (7 day) reliability (at rest, n = 12) and the acute responsiveness of each biomarker to exercise in the heat (pre and post 60-min cycling, 34.5°C and 70% RH, n = 20) were evaluated. Serum was analysed for the concentration of C-reactive protein (CRP), interleukin-6 (IL-6), heat shock protein 72 (eHSP72), immunoglobulin M (IgM) and LPS. Test–retest reliability was determined as the coefficient of variation (CV). Biomarkers with the least short-term within-participant variation were IL-6 (19%, ±20%; CV, ±95% confidence limits (CL)) and LPS (23%, ±13%). Greater variability was observed for IgM, eHSP72 and CRP (CV range 28–38%). IL-6 exhibited the largest increase in response to acute exercise (95%, ±11%, P = < 0.001) and although CRP had a modest CV (12%, ±7%), it increased substantially post-exercise (P = 0.02, ES; 0.78). In contrast, eHSP72 and LPS exhibited trivial changes post-exercise. It appears variation of common inflammatory markers after exercise in the heat is not always discernible from short-term (weekly) variation.     

A knock to the system: A new sociotechnical systems approach to sport-related concussion

Broader contextual factors that influence concussion management have tended to be overlooked. To address this, the present study used a sociotechnical systems approach to identify perceived responsibilities and applied strategies for three domains of concussion management (i.e., prevention, identification and treatment). Participants were 118 members of the community rugby union system in Australia (69.2% male). Participants from throughout the rugby system (e.g., players, parents, coaches, club management) were asked open-ended questions about their perceived responsibilities and the strategies they use for concussion management. It was found that (a) proper training, technique correction and education were recurrent prevention themes; (b) the majority of key stakeholders felt that they could consistently identify concussion; however, medical aids (medics) were the only system actors who stated a responsibility to use standardised concussion assessment measures and (c) less than one third of the respondents indicated their involvement in treating concussion. This study identifies specific junctures in the system that prevents effective concussion management strategies. A sociotechnical systems approach improves the understanding of concussion prevention, and management beliefs and behaviours.     

Short-term heat acclimation prior to a multi-day desert ultra-marathon improves physiological and psychological responses without compromising immune status

Multistage, ultra-endurance events in hot, humid conditions necessitate thermal adaptation, often achieved through short term heat acclimation (STHA), to improve performance by reducing thermoregulatory strain and perceptions of heat stress. This study investigated the physiological, perceptual and immunological responses to STHA prior to the Marathon des Sables. Eight athletes (age 42 ± 4 years and body mass 81.9 ± 15.0 kg) completed 4 days of controlled hyperthermia STHA (60 min·day^?1, 45°C and 30% relative humidity). Pre, during and post sessions, physiological and perceptual measures were recorded. Immunological measures were recorded pre-post sessions 1 and 4. STHA improved thermal comfort (P = 0.02), sensation (P = 0.03) and perceived exertion (P = 0.04). A dissociated relationship between perceptual fatigue and T_re was evident after STHA, with reductions in perceived Physical (P = 0.04) and General (P = 0.04) fatigue. Exercising T_re and HR did not change (P > 0.05) however, sweat rate increased 14% (P = 0.02). No changes were found in white blood cell counts or content (P > 0.05). Four days of STHA facilitates effective perceptual adaptations, without compromising immune status prior to an ultra-endurance race in heat stress. A greater physiological strain is required to confer optimal physiological adaptations.     

Effect of Active Lessons on Physical Activity,Academic, and Health Outcomes: A Systematic Review

Purpose: The purpose of this study was to conduct a systematic review of classroom-based physical activity interventions that integrate academic content and assess the effectiveness of the interventions on physical activity, learning, facilitators of learning, and health outcomes. Method: Six electronic databases (ERIC, PubMed, Google Scholar, Science Direct, Cochrane Library, and EMBASE) and reference lists were searched for English-language articles, published January 1990 through March 2015, reporting classroom-based interventions that deliberately taught academic content using physically active teaching methods for at least 1 week duration, with physical activity, health, learning, or facilitators-of-learning outcomes. Two authors reviewed full-text articles. Data were extracted onto an Excel spreadsheet, and authors were contacted to confirm accuracy of the information presented. Results: Fifteen studies met the inclusion criteria. Six studies reporting on physical activity levels were found to have medium-to-large effect sizes. All 4 studies reporting learning outcomes showed positive effects of intervention lessons. Teachers and students were pleased with the programs, and enhanced on-task behavior was identified (n = 3). Positive effects were also reported on students’ body mass index levels (n = 3). Conclusions: Physically active academic lessons increase physical activity levels and may benefit learning and health outcomes. Both students and teachers positively received and enjoyed these teaching methods. These findings emphasize the need for such interventions to contribute toward public health policy.