Effect of the COVID-19 pandemic on the physical and psychoaffective health of older adults in a physical exercise program

[EN]COVID-19 lockdowns restricted physical activity levels for individuals in many countries. In particular, older adults experienced limited access to their usual activities, including physical exercise programs. How such restrictions and interruptions in physical exercise programs might impact the physical and mental health of older adults has not yet been studied. We sought to analyse changes in the physical and mental health of older adults enrolled in a group-based multicomponent physical exercise (MPE) program that was interrupted due to the COVID-19 pandemic. We followed 17 participants of this program from October 2018 to October 2020, including the interruption of the program during the pandemic. The MPE program included strength, balance, and stretching exercises. We compared anthropometric and cardiovascular parameters, physical fitness, frailty, quality of life, and psychoaffective status of participants before and during the COVID-19 pandemic. Most parameters followed the same pattern, improving after 8 months of the first MPE season (Oct. 2018-Jun. 2019), worsening after 4 months of summer rest, improving from October 2019 to January 2020 in the second MPE season (Oct. 2019-Jan. 2020), and severely worsening after 7 months of program interruption. We show that an MPE program has clear benefits to the physical and psychoaffective health of older adults, and interruption of these programs could adversely impact participants. These results highlight the need to maintain physical exercise programs or facilitate engagement in physical activity and reduce sedentary behaviour in older adults, particularly in situations such as the COVID-19 pandemic.This work was supported by Siel Bleu and Basque Government (SAN 20/12)

Survival of frail elderly with delirium

This study aims to determine when frailty increases the risks of delirium mortality. Hospital patients falling into the elderly frail or pre-frail category were recruited, some without delirium, some with delirium at admission, and some who developed delirium during admission. We screened for frailty, cognitive status, and co-morbidities whenever possible and extracted drug information and mortality data from electronic health records. Kaplan–Meier estimates of survival probability functions were computed at four times, comparing delirium versus non delirium patients. Differences in survival were assessed by a log-rank test. Independent Cox’s regression was carried out to identify significant hazard risks (HR) at 1 month, 6 months, 1 year, and 2 years. Delirium predicted mortality (log-rank test, p < 0.0001) at all four censoring points. Variables with significant HRs were frailty indicators, comorbidities, polypharmacy, and the use of specific drugs. For the delirium cohort, variables with the most significant 2-year hazard risks (HR(95%CI)) were: male gender (0.43 20 (0.26,0.69)), weight loss (0.45 (0.26,0.74)), sit and stand up test (0.67 (0.49,0.92)), readmission within 30 days of discharge (0.50 (0.30,0.80)), cerebrovascular disease (0.45 (0.27,0.76)), head trauma (0.54 22 (0.29,0.98)), number of prescribed drugs (1.10 (1.03,1.18)), and the use of diuretics (0.57 (0.34,0.96)). These results suggest that polypharmacy and the use of diuretics increase mortality in frail elderly patients with delirium.The work in this paper was partially supported by FEDER funds for the MINECO project TIN2017-85827-P, and 2016111138 of the health funding program of the Basque Government. This project received funding from the European Union's Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement no. 777720

Influence of the biomechanical variables of the gait cycle in running economy. [Influencia de variables biomecánicas del ciclo de paso en la economía de carrera].

<p algn="justify">The aim of this study was to investigate the relationships between biomechanical variables and running economy (RE). Eleven recreational (RR) and 14 well-trained runners (WT) completed 4 min stages on a treadmill at different speeds. During the test, biomechanical variables such as ground contact time (tc), swing time (tsw), stride length, frequency and angle and the length of the different subphases of ground contact were calculated using an optical measurement system. VO2 was measured in order to calculate RE. The WT runners were more economical than the RR at all speeds and presented lower tc, higher tsw, longer strides, lower stride frequencies and higher stride angles (P<0.05). Similarly, the WT runners experienced a later propulsion subphase than the RR runners (P<0.05). RE was positively related to tc, stride frequency and 10-km race pace, whereas it was negatively related to tsw, stride length, stride angle and the propulsive subphase. Our results suggest that running patterns characterized by longer stride lengths and higher stride angles, lower stride frequencies and tc, higher tsw and later propulsion suphases may enable an efficient energy use per stride. </p> Resumen <p align="justify">El objetivo de este estudio fue el investigar las relaciones entre diferentes variables biomecánicas y la economía de carrera (RE). Once atletas populares (RR) y 14 atletas altamente entrenados (WT) completaron estadios de 4 min en tapiz rodante a diferentes velocidades. Durante el test, el tiempo de contacto (tc) y de vuelo (tsw), la longitud, frecuencia y ángulo de zancada y la duración de las diferentes sub-fases del tiempo de contacto se calcularon usando un sistema óptico. Se midió el VO2 para calcular la RE. Los atletas WT fueron más económicos que los RR y presentaron menores tc, mayores tsw, zancadas más largas, frecuencias más bajas y ángulos mayores (P<0.05). Además, los atletas WT experimentaron la sub-fase propulsiva más tarde que los RR (P<0.05). La RE estuvo positivamente relacionada con el tc, la frecuencia de zancada y el ritmo de 10 km, mientras que estuvo negativamente relacionada con el tsw, longitud y ángulo de zancada y la sub-fase propulsiva. Estos resultados sugieren que una biomecánica caracterizada por zancadas más largas, ángulos de zancada y tsw mayores, menores frecuencias y tc, y sub-fases propulsivas más tardías pueden favorecer un uso energético más eficiente.</p

The relative age effect in young athletes: a countywide analysis of 9–14-year-old participants in all competitive sports

[EN] The relative age effect (RAE) has primarily been investigated in male athletes involved in popular sports and high-level competitions. However, occurrence of RAE in other types of sports at the grassroots level, particularly in female athletes, is less well-studied. Thus, we examined the RAE in a large cohort of young athletes who participated in all competitive sports in Bizkaia, Spain, according to gender and specificity of the sport. The birth dates of 38,381 participants (65.1% males and 34.9% females) aged 9–14 years old in 37 competitive sports were analyzed. Birth dates were divided into four birth-quarters and compared to those of all children born in the same period using a χ2 goodness-of-fit test and standardized residuals. The effect size Cramer’s V was measured, and odds ratio and 95% confidence intervals were calculated to determine the odds of athletes born in January playing in the highest leagues. In the total sample, in boys RAE was evident in football, but only in highercompetition leagues (p<0.001, large effect size). In girls, RAE was evident in the most popular team sports: basketball (p<0.001, large effect size in basketball 1st league), handball and football (p<0.05, both small effect sizes). Players born in January were 3.23- and 2.89-times more likely to play in the 1st leagues than those born in December, for boys (football) and girls (basketball) respectively. In the overall analysis and in the remaining sports, presence of RAE was negligible. Therefore, the date of birth does not seem to be a constraint to participating in most sports in Bizkaia. The potential mechanisms for RAE are multifactorial and complex, yet a combination of factors, such as the popularity of a sport and the depth of competition, physicality and social influences may be involved. We discuss these mechanisms and potential measures to mitigate RAE.This work was partially supported by the University of the Basque Country (UPV/EHU) (https://www.ehu.eus/es/) under grant PPGA19/53 and the Basque government (https://www.euskadi. eus/gobierno-vasco/inicio/) under grant IT922-16. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Jarduera fisikoa, guztion osasuna eta ongizatea hobetzeko tresna

Nazio Batuen Garapen Jasangarrirako 2030 Agendaren hirugarren helburua guztiontzat eta adin guztie- tan bizimodu osasungarria bermatzea eta ongizatea sustatzea da. Osasunaren Mundu Erakundearen arabera, jarduera fisikoa munduko hilkortasun-arriskua murrizten duen faktore garrantzitsuetako bat da. Lan honen helburua honako hau da: jarduera fisikoak eta haren modu egituratuak -hots, ariketa fisikoak- pertsona ororentzat dituen onurak laburbiltzea eta pertsona nagusietan eta populazio zaurgarrienetan dituen eraginetan sakontzea. Gaur egun, jakina da jarduera fisikoa eta ariketa fi- sikoa eraginkorrak direla gaixotasun kroniko nagusien prebentzioan eta tratamenduan. Aldi berean, pertsonen ongizatea eta bizi-kalitatea hobetzen laguntzen dute. Oro har, ikertzaileak bat datoz jarduera fisikoak eta ariketa fisikoak onura nabariak sortzen dituztela adin eta egoera fisiko ia guztietako pertsonetan, baita hauskor eta zaurgarrienetan ere. Azken urteetan, au- rrerapen handiak egin dira talde horiei buruzko ikerketan. Orain dela gutxi arte, oso intentsitate baxuko mugikortasun-pro- gramak proposatzen zitzaizkien, eta gaur egun frogatu da indarra eta erresistentzia aerobikoa intentsitate handiagoan lan- tzeak onura gehiago dakarzkiela. Jarduera fisikoaren eta ariketa fisikoaren eragina ez da arlo fisikora mugatzen, zeren behatu baita eragin positiboa duela kognizioan, ongizate emozionalean eta gizarte-sareen eraketan ere. Hala ere, jarduera fisikoa onuragarria izateko, banakoari egokitua, progresiboa eta egingarria izan behar du. Etorkizunerako erronka zera da: pertsona guztiek beren neurriko jarduera fisikoa egiteko aukera izatea, guztien osasuna eta ongizatea hobetzeko. Horrek Nazio Batuen 2030 Agendaren hirugarren helburua betetzen lagunduko digu.; The third goal of the United Nations 2030 Agenda for Sustainable Development is to ensure healthy lives and promote wellbeing at all ages. According to the World Health Organization, physical activity is an important factor that reduces the risk of global mortality.The aim of this revision is to summarize the benefits of physical activity and exercise and to delve deeper on their benefits on elder and vulnerable population. Nowdays, it is widely accepted that hysical activity and exercise have proved their effectiveness in the prevention and treatment of the main chronic diseases. At the same time, they contribute to improving well-being and quality of life. In general, researchers agree, physical activity and exercise have benefits for people of all ages and almost all physical conditions, even the most frail and vulnerable. In these groups, there have been important advances in research in the last few years. Until recently, very low intensity mobility programs were proposed to them and today it has been shown that working out on strength and aerobic endurance at higher intensities gives them greater benefits. The impact of physical activity and exercise is not limited to physical parameters, as it has been observed that it also has positive effects on cognition, emotional well-being and the formation of social networks. However, to be beneficial physical activity must be individually adappted, progressive and feasible. The challenge for the future is that each individual has the opportunity to perform tailored physical activity to improve health and well-being of everybody. This will bring us closer to achieve the third goal of the United Nations 2030 Agenda

Mortality risks after two years in frail and pre-frail older adults admitted to hospital

Background: Frailty is characterized by a progressive decline in the physiological functions of multiple body systems that lead to a more vulnerable condition, which is prone to the development of various adverse events, such as falls, hospitalization, and mortality. This study aims to determine whether frailty increases mortality compared to pre-frailty and to identify variables associated with a higher risk of mortality. Materials: Two cohorts, frail and pre-frail subjects, are evaluated according to the Fried phenotype. A complete examination of frailty, cognitive status, comorbidities and pharmacology was carried out at hospital admission and was extracted through electronic health record (EHR). Mortality was evaluated from the EHR. Methods: Kaplan–Meier estimates of survival probability functions were calculated at two years censoring time for frail and pre-frail cohorts. The log-rank test assessed significant differences between survival probability functions. Significant variables for frailty (p < 0–05) were extracted by independent sample t-test. Further selection was based on variable significance found in multivariate logistic regression discrimination between frail and pre-frail subjects. Cox regression over univariate t-test-selected variables was calculated to identify variables associated with higher proportional hazard risks (HR) at two years. Results: Frailty is associated with greater mortality at two years censoring time than pre-frailty (log-rank test, p < 0.0001). Variables with significant (p < 0.05) association with mortality identified in both cohorts (HR 95% (CI in the frail cohort) are male sex (0.44 (0.29–0.66)), age (1.05 (1.01–1.09)), weight (0.98 (0.96–1.00)), and use of proton-pump inhibitors (PPIs) (0.60 (0.41–0.87)). Specific high-risk factors in the frail cohort are readmission at 30 days (0.50 (0.33–0.74)), SPPB sit and stand (0.62 (0.45–0.85)), heart failure (0.67 (0.46–0.98)), use of antiplatelets (1.80 (1.19–2.71)), and quetiapine (0.31 (0.12–0.81)). Specific high-risk factors in the pre-frail cohort are Barthel’s score (120 (7.7–1700)), Pfeiffer test (8.4; (2.3–31)), Mini Nutritional Assessment (MNA) (1200 (18–88,000)), constipation (0.025 (0.0027–0.24)), falls (18,000 (150–2,200,000)), deep venous thrombosis (8400 (19–3,700,000)), cerebrovascular disease (0.01 (0.00064–0.16)), diabetes (360 (3.4–39,000)), thyroid disease (0.00099 (0.000012–0.085)), and the use of PPIs (0.062 (0.0072–0.54)), Zolpidem (0.000014 (0.0000000021–0.092)), antidiabetics (0.00015 (0.00000042–0.051)), diuretics (0.0003 (0.000004–0.022)), and opiates (0.000069 (0.00000035–0.013)). Conclusions: Frailty is associated with higher mortality at two years than pre-frailty. Frailty is recognized as a systemic syndrome with many links to older-age comorbidities, which are also found in our study. Polypharmacy is strongly associated with frailty, and several commonly prescribed drugs are strongly associated with increased mortality. It must be considered that frail patients need coordinated attention where the diverse specialist taking care of them jointly examines the interactions between the diversity of treatments prescribed.The work in this paper has been partially supported by FEDER funds for the MICIN project PID2020-116346GB-I00, and 2016111138 of the health funding program of the Basque Government. The author M.G. has received research funds from the Basque Government as the head of the Grupo de Inteligencia Computacional, Universidad del Pais Vasco, UPV/EHU since 2007 until 2025. The current code for the grant is IT1689-22. Additionally, the authors are participating in Elkartek projects KK-2022/00051 and KK-2021/00070

Degradación enzimática de TRH y análogos en semen humano. Posible función en la fertilidad

Recientemente se ha descrito la presencia en semen humano de un péptido similar a la hormona liberadora de tirotropina (TRH) directamente implicado en la fertilidad, habiéndose denominado FPP (péptido promotor de la fertilidad). Se han determinado las actividades de las peptidasas más importantes en la degradación de estos péptidos en semen en distintos diagnósticos. Aunque se registran diferencias significativas en la actividad enzimática entre los distintos diagnósticos, dichas variaciones no son lo suficientemente claras como para aceptar estas peptidasas como marcadores válidos.Ugalkortasun arloan egindako azken aurkikuntzen artean tirotropinaren hormona askatzailearen (TRH) antzeko peptido baten aurkikuntza azpimarratzekoa da. Peptido honek ugalkortasunaren prozesuan eragin zuzena duela aurkitu da, izan ere ugalkortasuna errazten duen peptidoa izendatu diote (FPP). Haziko zatikietan ematen den peptido hauen apurketan peptidasa garrantzitsuenen funtzioa ezartzeko asmoz eta ugalkortasunarekin erlazionatutako diagnostiko adierazle bezala balio dezaketen frogatzeko asmoz, bere aktibitate entzimatikoak neurtu dira. Diagnostiko desberdinen artean aldaketa adierazgarriak badira ere, diferentziak ez dira nahiko argiak peptidasa hauek adierazle baliogarri bezala onartzeko.Parmi les derniers découvertes réalisées dans le champ de la fertilité il faut détacher la présence dans le liqueur seminale humain d'un peptide similaire à l'hormone libératrice de tirotropina (TRH) directèment impliqué dans ce procés qui a été nommé FPP (fertilization promoting peptide). A fin d'etablir le rol des peptidases les plus importants dans la dégradation de ses peptides dans les fractions seminales et de vérifier s'ils peuvent servir comme marqueurs des divers diagnostiques seminalesm rélationés avec la fertilité, les activités enzimatiques ant été déterminés. Malgré les differences significatives parmi les deux diagnostiques, ces variations ne sont pas suffisamment clairs pour accepterces peptidases comme des marqueurs valids.Recently it has been described the presence in human semen of a thyrotropin-releasing hormone (TRH) like peptide, directly implicated in the fertility and therefore it has been called fertilization promoting peptide (FPP). We have measured the activities of the most important peptidases in the degradation of these peptides in semen in different diagnostics. Although there are significative differences among the diagnostics, these variations are not clear enough to accept these peptidases like valid markers

Videoconference-Based Physical Performance Tests: Reliability and Feasibility Study

Validated tools to evaluate physical performance remotely with real-time supervision are lacking. We assessed test–retest and inter-rater reliability, as well as the feasibility of carrying out the five-repetition sit-to-stand (5RSTS), kneeling push-up (KPU) and Shirado–Ito trunk flexor endurance (SIF) tests by 1:1 real-time videoconference. We also evaluated the correlation of these tests with measures of self-reported physical fitness, physical activity, health state and pain. A total of 96 healthy adults participated in the study (18–65 years). Relative and absolute reliabilities were assessed with the intraclass correlation coefficient (ICC) and standard error of measurement (SEM), respectively. Feasibility outcomes included testing duration, participant acceptability (1–5 Likert scale) and presence of adverse events. Self-reported measures were obtained with validated online questionnaires, and correlations were analyzed with Pearson’s partial correlation coefficients controlling for age. ICCs were excellent (>0.9), and SEMs were generally low (2.43–16.21%). The mean duration of all tests was <5 min, mean acceptability was ≥4.5, and adverse events were few. The KPU showed statistically significant correlations with various self-reported measures (p < 0.05). In conclusion, the 5RSTS, KPU and SIF were reliable and feasible when conducted by 1:1 real-time videoconference. This study provides a tool that could be logistically and economically advantageous.A.E. is a recipient of a predoctoral grant from the Basque Government (Eusko Jaurlaritza), grant number PRE_2020_2_0163. The Ageing On Research Group is supported by the University of the Basque Country (UPV/EHU), aid number GIU20/06

Effects of a videoconference-based therapeutic exercise intervention on the musculoskeletal pain of eldercare workers: protocol for the ReViEEW randomized controlled trial

Background Prevalence of musculoskeletal pain is high among eldercare workers, and therapeutic exercise has shown to be effective for its management. Although telerehabilitation is an increasingly used alternative for delivering therapeutic exercise, no studies have assessed synchronous group telerehabilitation interventions for the manage‑ ment of musculoskeletal disorders. Thus, the aim of this article is to describe the protocol of a randomized controlled trial that will assess the effects of a videoconference‑based group therapeutic exercise intervention on the musculo‑ skeletal pain of eldercare workers. Methods This multicenter trial will randomly assign 130 eldercare workers to either a control or experimental group. Participants in the control group will not receive any intervention, and participants in the experimental group will take part in a 12‑week remote supervised videoconference‑based intervention, consisting of 2 weekly 45‑min group ses‑ sions. Each session will include 4 sets of 6 progressive resistance exercises for the lower limbs, upper limbs and trunk, performed with bodyweight and elastic bands at moderate‑high intensity. Following the 12 weeks, participants in the experimental group will be provided with material for autonomously carry on the therapeutic exercises and advised to continue performing 2 weekly sessions on their own until a 48‑week follow‑up. Assessments will be performed at baseline, 12 and 48 weeks. Primary outcome will be average pain intensity in the low back during the last 7 days, measured by the 0–10 Numerical Rating Scale. Secondary outcomes will include additional measures of musculoskel‑ etal pain, psycho‑affective state, work‑related variables, and physical fitness. Discussion This will be the first trial, to our knowledge, assessing whether a remote delivery of a group therapeutic exercise intervention via videoconference is effective for reducing the musculoskeletal pain, improving the psycho‑ affective state and physical fitness, and enhancing the work‑related parameters in eldercare workers. If successful, this study will provide innovative tools for implementing effective, scalable and affordable interventions to tackle mus‑ culoskeletal disorders in the workplace. It will also highlight the utility of telehealth, and address the importance of therapeutic exercise to manage musculoskeletal pain in a critical population for the future of the aging societies as it is the eldercare workers.This work is funded by the Basque Government (IT1538‑22 and PRE_2021_2_0056) and the University of the Basque Country (GIU20/06). The funders played no role in the design, conduct, or reporting of this stud