Allotment gardening and other leisure activities for stress reduction and healthy aging

This study explored the potential benefits of allotment gardening for healthy aging, focusing on the opportunities for outdoor physical activity, social support, and contact with nature that allotment gardening provides. Participants included 94 individuals aged between 50 and 88 years who were members of various indoor and outdoor activity groups. The participants completed physiological measures and psychometric scales of self-rated health, perceived stress, physical activity level, and perceived social support. A significant difference in perceived stress levels was observed between the activity groups. Allotment gardeners reported significantly less perceived stress than participants of indoor exercise classes (P < 0.05). As there were no significant differences in reported levels of social support and physical activity, explanations for the allotment gardeners' lower stress levels focus on the potential contribution of engagement with nature and psychological restoration. These findings represent a step toward understanding the benefits of allotment gardening activity as a health-promoting behavior in later life

Interventions for reducing sedentary behaviour in people with stroke

BACKGROUND: Stroke survivors are often physically inactive as well as sedentary,and may sit for long periods of time each day. This increases cardiometabolic risk and has impacts on physical and other functions. Interventions to reduce or interrupt periods of sedentary time, as well as to increase physical activity after stroke, could reduce the risk of secondary cardiovascular events and mortality during life after stroke. OBJECTIVES: To determine whether interventions designed to reduce sedentary behaviour after stroke, or interventions with the potential to do so, can reduce the risk of death or secondary vascular events, modify cardiovascular risk, and reduce sedentary behaviour. SEARCH METHODS: In December 2019, we searched the Cochrane Stroke Trials Register, CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, Conference Proceedings Citation Index, and PEDro. We also searched registers of ongoing trials, screened reference lists, and contacted experts in the field. SELECTION CRITERIA: Randomised trials comparing interventions to reduce sedentary time with usual care, no intervention, or waiting‐list control, attention control, sham intervention or adjunct intervention. We also included interventions intended to fragment or interrupt periods of sedentary behaviour. DATA COLLECTION AND ANALYSIS: Two review authors independently selected studies and performed 'Risk of bias' assessments. We analyzed data using random‐effects meta‐analyses and assessed the certainty of the evidence with the GRADE approach. MAIN RESULTS: We included 10 studies with 753 people with stroke. Five studies used physical activity interventions, four studies used a multicomponent lifestyle intervention, and one study used an intervention to reduce and interrupt sedentary behaviour. In all studies, the risk of bias was high or unclear in two or more domains. Nine studies had high risk of bias in at least one domain. The interventions did not increase or reduce deaths (risk difference (RD) 0.00, 95% confidence interval (CI) ‐0.02 to 0.03; 10 studies, 753 participants; low‐certainty evidence), the incidence of recurrent cardiovascular or cerebrovascular events (RD ‐0.01, 95% CI ‐0.04 to 0.01; 10 studies, 753 participants; low‐certainty evidence), the incidence of falls (and injuries) (RD 0.00, 95% CI ‐0.02 to 0.02; 10 studies, 753 participants; low‐certainty evidence), or incidence of other adverse events (moderate‐certainty evidence). Interventions did not increase or reduce the amount of sedentary behaviour time (mean difference (MD) +0.13 hours/day, 95% CI ‐0.42 to 0.68; 7 studies, 300 participants; very low‐certainty evidence). There were too few data to examine effects on patterns of sedentary behaviour. The effect of interventions on cardiometabolic risk factors allowed very limited meta‐analysis. AUTHORS' CONCLUSIONS: Sedentary behaviour research in stroke seems important, yet the evidence is currently incomplete, and we found no evidence for beneficial effects. Current World Health Organization (WHO) guidelines recommend reducing the amount of sedentary time in people with disabilities, in general. The evidence is currently not strong enough to guide practice on how best to reduce sedentariness specifically in people with stroke. More high‐quality randomised trials are needed, particularly involving participants with mobility limitations. Trials should include longer‐term interventions specifically targeted at reducing time spent sedentary, risk factor outcomes, objective measures of sedentary behaviour (and physical activity), and long‐term follow‐up

Left ventricular mechanics in late second trimester of healthy pregnancy

Objective: To evaluate left ventricular (LV) mechanics in the second trimester of healthy pregnancy and to determine the influence of underpinning hemodynamics (heart rate (HR), preload and afterload) on LV mechanics during gestation. Methods: This was a cross‐sectional study of 18 non‐pregnant, 14 nulliparous pregnant (22–26 weeks' gestation) and 13 primiparous postpartum (12–16 weeks after delivery) women. All pregnant and postpartum women had uncomplicated, singleton gestations. Cardiac structure and function were assessed using echocardiography. LV mechanics, specifically longitudinal strain, circumferential strain and twist/untwist, were measured using speckle‐tracking echocardiography. Differences between groups were identified using ANCOVA, with age, HR, end‐diastolic volume (EDV) and systolic blood pressure (SBP) as covariates. Relationships between LV mechanics and hemodynamics were examined using Pearson's correlation. Results: There were no significant differences in LV structure and traditional measurements of systolic and diastolic function between the three groups. Pregnant women, compared with non‐pregnant ones, had significantly higher resting longitudinal strain (–22 ± 2% vs –17 ± 3%; P = 0.002) and basal circumferential strain (–23 ± 4% vs –16 ± 2%; P = 0.001). Apical circumferential strain and LV twist and untwist mechanics were similar between the three groups. No statistically significant relationships were observed between LV mechanics and HR, EDV or SBP within the groups. Conclusions: Compared to the non‐pregnant state, pregnant women in the second trimester of a healthy pregnancy have significantly greater resting systolic function, as assessed by LV longitudinal and circumferential strain. Contrary to previous work, these data show that healthy pregnant women should not exhibit reductions in resting systolic function between 22 and 26 weeks' gestation. The enhanced myocardial contractile function during gestation does not appear to be related to hemodynamic load and could be the result of other physiological adaptations to pregnancy

Comparison between Modelflow® and echocardiography in the determination of cardiac output during and following pregnancy at rest and during exercise

During pregnancy, assessment of cardiac output (Q ̇), a fundamental measure of cardiovascular function, provides important insight into maternal adaptation. However, methods for dynamic Q ̇ measurement require validation. The purpose of this study was to estimate the agreement of Q ̇ measured by echocardiography and Modelflow® at rest and during submaximal exercise in non-pregnant (n = 18), pregnant (n = 15, 22-26 weeks gestation) and postpartum women (n = 12, 12-16 weeks post-delivery). Simultaneous measurements of Q ̇ derived from echocardiography [criterion] and Modelflow® were obtained at rest and during low-moderate intensity (25% and 50% peak power output) cycling exercise and compared using Bland-Altman analysis and limits of agreement. Agreement between echocardiography and Modelflow® was poor in non-pregnant, pregnant and postpartum women at rest (mean difference ± SD: -1.1 ± 3.4; -1.2 ± 2.9; -1.9 ± 3.2 L.min-1), and this remained evident during exercise. The Modelflow® method is not recommended for Q ̇ determination in research involving young, healthy non-pregnant and pregnant women at rest or during dynamic challenge. Previously published Q ̇ data from studies utilising this method should be interpreted with caution

Igralište i tjelesna aktivnost za vrijeme školskog odmora u osnovnim školama

The aim of the present study was to describe the daily physical activity (PA) during recess of primary-school children and its relationship with the play area and their age. 738 children (8.5±1.7 years, range six to eleven years) participated in the study. The playground recess PA of each child was measured using accelerometry. An ANOVA was used to determine the differences in PA by play area (large >15 m2/child and small area <8 m2/child) in each age group. In general, the children in larger play areas were more active than the children in small play areas (effect size=.36). This difference was larger in nine-year (effect size =.81), ten-year (effect size =.60) and eleven-year old children (effect size =.55). It seems necessary to carry out strategies that provide a greater opportunity for PA in small playgrounds with a high density of children.Cilj je ovog istraživanja bio opisati dnevnu tjelesnu aktivnost osnovnoškolske djece za vrijeme školskog odmora i utvrditi njezinu povezanost s veličinom igrališta i dobi djece. U istraživanju je sudjelovalo 738 djece (8,5±1,7 godina, raspon godina 6–11 godina). Tjelesna aktivnost svakog djeteta na školskom igralištu za vrijeme školskog odmora mjerena je akcelerometrom. Za utvrđivanje razlika između razine tjelesne aktivnosti prema veličini površine igrališta u svakoj dobnoj grupi (veliko igralište >15m2/dijete i malo igralište >8m2/dijete) korištena je ANOVA. Općenito, djeca koja su provodila školski odmor na velikom igralištu bila su tjelesno aktivnija od djece koja su provodila školski odmor na malom igralištu. Razlika je bila veća u devetogodišnje (veličina efekta=0,81), desetogodišnje (veličina efekta=0,60) i jedanaestogodišnje djece (veličina efekta=0,55). Istraživanje pokazuje da je potrebno provesti strateške promjene koje bi omogućile povećanje tjelesne aktivnosti na manjim igralištima na kojima se odmara veći broj djece

High-intensity interval training versus moderate-intensity steady-state training in UK cardiac rehabilitation programmes (HIIT or MISS UK): study protocol for a multicentre randomised controlled trial and economic evaluation

Introduction: Current international guidelines for cardiac rehabilitation (CR) advocate moderate-intensity exercise training (MISS, moderate-intensity steady state). This recommendation predates significant advances in medical therapy for coronary heart disease (CHD) and may not be the most appropriate strategy for the ‘modern’ patient with CHD. High-intensity interval training (HIIT) appears to be a safe and effective alternative, resulting in greater improvements in peak oxygen uptake (VO2 peak). To date, HIIT trials have predominantly been proof-of-concept studies in the laboratory setting and conducted outside the UK. The purpose of this multicentre randomised controlled trial is to compare the effects of HIIT and MISS training in patients with CHD attending UK CR programmes. Methods and analysis: This pragmatic study will randomly allocate 510 patients with CHD to 8 weeks of twice weekly HIIT or MISS training at 3 centres in the UK. HIIT will consist of 10 high-intensity (85–90% peak power output (PPO)) and 10 low-intensity (20–25% PPO) intervals, each lasting 1 min. MISS training will follow usual care recommendations, adhering to currently accepted UK guidelines (ie, >20 min continuous exercise at 40–70% heart rate reserve). Outcome measures will be assessed at baseline, 8 weeks and 12 months. The primary outcome for the trial will be change in VO2 peak as determined by maximal cardiopulmonary exercise testing. Secondary measures will assess physiological, psychosocial and economic outcomes. Ethics and dissemination: The study protocol V.1.0, dated 1 February 2016, was approved by the NHS Health Research Authority, East Midlands— Leicester South Research Ethics Committee (16/EM/ 0079). Recruitment will start in August 2016 and will be completed in June 2018. Results will be published in peer-reviewed journals, presented at national and international scientific meetings and are expected to inform future national guidelines for exercise training in UK CR. Trial registration number: NCT02784873; pre-results

A longitudinal study of muscle strength and function in patients with cancer cachexia

Purpose Patients with cancer frequently experience an involuntary loss of weight (in particular loss of muscle mass), defined as cachexia, with profound implications for independence and quality of life. The rate at which such patients’ physical performance declines has not been well established. The aim of this study was to determine the change in muscle strength and function over 8 weeks in patients with already established cancer cachexia, to help inform the design and duration of physical activity interventions applicable to this patient group. Methods Patients with thoracic and gastrointestinal cancer, with unintentional weight loss of >5% in 6 months or BMI < 20 plus 2% weight loss were included. Physical and functional assessments (baseline, 4 weeks, 8 weeks) included: isometric quadriceps and hamstring strength, handgrip, standing balance, 10m walk time and timed up and go. Results Fifty patients (32 male), mean ±SD age 65 ±10 years and BMI 24.9 ±4.3kg/m2 were recruited. Thoracic cancer patients had lower muscle strength and function (p0.05). Baseline variables did not differentiate between completers and non-completers (p>0.05). Conclusions More than a third of patients with established cancer cachexia in our study were stable over 8 weeks, suggesting a subgroup who may benefit from targeted interventions of reasonable duration. Better understanding the physical performance parameters which characterize and differentiate these patients has important clinical implications for cancer multidisciplinary team practice

Static and Dynamic Lung Volumes in Swimmers and Their Ventilatory Response to Maximal Exercise

Purpose While the static and dynamic lung volumes of active swimmers is often greater than the predicted volume of similarly active non-swimmers, little is known if their ventilatory response to exercise is also different. Methods Three groups of anthropometrically matched male adults were recruited, daily active swimmers (n = 15), daily active in fields sport (Rugby and Football) (n = 15), and recreationally active (n = 15). Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and maximal voluntary ventilation (MVV) was measured before and after exercise to volitional exhaustion. Results Swimmers had significantly larger FVC (6.2 ± 0.6 l, 109 ± 9% pred) than the other groups (5.6 ± 0.5 l, 106 ± 13% pred, 5.5 ± 0.8, 99% pred, the sportsmen and recreational groups, respectively). FEV1 and MVV were not different. While at peak exercise, all groups reached their ventilatory reserve (around 20%), the swimmers had a greater minute ventilation rate than the recreational group (146 ± 19 vs 120 ± 87 l/min), delivering this volume by breathing deeper and slower. Conclusions The swimmers utilised their larger static volumes (FVC) differently during exercise by meeting their ventilation volume through long and deep breaths

One hour cycling performance is not affected by ingested fluid volume

This study investigated the effect of differing fluid volumes consumed during exercise, on cycle time-trial (TT) performance conducted under thermoneutral conditions (20 degrees C, 70% RH). Ten minutes after consuming a bolus of 6 ml x kg(-1) body mass (BM) of a 6.4% CHO solution and immediately following a warm-up, 8 male cyclists undertook a 1-h self-paced TT on 4 separate occasions. During a "familiarization" trial, subjects were given three 5-min periods (15-20 min, 30-35 min, and 45-50 min) to consume fluid ad libitum. Thereafter subjects undertook, in random order, trials consuming high (HF), moderate (MF), or low fluid (LF) volumes, where 300, 150, and 40 ml of fluid were consumed at 15, 30, and 45 min of each trial, respectively, and total CHO intake was maintained at 57.6 g. During exercise, power output and heart rate were monitored continuously, whilst stomach fullness was rated every 10 min. Additionally, BM loss and BM loss corrected for fluid intake was calculated during each trial. At 40, 50, and 60 min differences in ratings of stomach fullness were found between trials (LF vs. HF and MF vs. HF). There were however no differences in performance or physiological variables (heart rate or BM loss) between trials. These results indicate that when a pre-exercise CHO bolus is consumed, there is no effect of subsequent consumption of different fluid volumes when trained cyclists undertake a 1-h performance task in a thermoneutral environment