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)

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

Sub-Saharan African immigrant women's experiences of (lack of) access to appropriate healthcare in the public health system in the Basque Country, Spain

BackgroundImmigrant populations face diverse barriers to accessing appropriate healthcare services on several levels. In the Basque Country, Sub-Saharan African women were identified as facing the largest barriers to access them. The aim of the study is to analyse Sub-Saharan African immigrant women's perceptions and experiences of access to appropriate healthcare in the public health system in the Basque Country, Spain.MethodsFourteen women from eight Sub-Saharan African countries who have used the Basque public healthcare services were interviewed. A qualitative content analysis was applied: meaning that units were identified, coded and the resulting codes were then organized into three categories.ResultsThe first category, Fearing to enter a health system perceived as not friendly for immigrants, included factors, mainly those related to legal conditions for accessing healthcare services and lack of lawful documentation, that made women avoid or discontinue seeking out healthcare.The second category, Being attended on professionals' own communication terms, comprised how the lack of effective communication compromised not only the access of the immigrant women to healthcare services, but also their health.Lastly, the third category, Is mistreatment based on racism or merely on bad luck? described how being an immigrant and black influenced the way they were (mis)treated in the health system.ConclusionFor Sub-Saharan African immigrant women, accessing appropriate healthcare in the Basque Country was perceived to be subject to institutional barriers. At the legal level, barriers included lack of entitlement, difficulties in fulfilling legal access conditions and lack of documentation. The lack of communication with health centre staff and their attitudes, guided by a stereotyped social image of immigrants and black people, also hindered their possibilities of receiving appropriate healthcare. Facilitators for accessing healthcare included strategies from individual professionals, personal networks and social actors to help them to cope with the barriers. There is a need of reinforcing inclusion values and rights-based approach to attention among staff at the health centres to have more non-discriminatory and culturally appropriate health systems.We thank the participants in this study who willingly shared their experiences. We also thank the NGO and social associations for their support in the recruitment of this study

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

Sex Differences in Frailty Factors and Their Capacity to Identify Frailty in Older Adults Living in Long-Term Nursing Homes

Frailty is a phenomenon that precedes adverse health events in older people. However, there is currently no consensus for how to best measure frailty. Several studies report that women have a higher prevalence of frailty than men, but there is a gap in studies of the high rates of frailty in older people living in long-term nursing homes (LTNHs) stratified by sex. Therefore, we analyzed health parameters related to frailty and measured their capacity to identify frailty stratified by sex in older people living in LTNHs. According to the Fried Frailty Phenotype (FFP), anxiety increased the risk of frailty in women, while for men functionality protected against the risk of frailty. Regarding the Tilburg Frailty Indicator (TFI), functionality had a protective effect in men, while for women worse dynamic balance indicated a higher risk of frailty. The analyzed parameters had a similar capacity for detecting frailty measured by the TFI in both sexes, while the parameters differed in frailty measured by the FFP. Our study suggests that assessment of frailty in older adults should incorporate a broad definition of frailty that includes not only physical parameters but also psycho-affective aspects as measured by instruments such as the TFI.This research was funded by Gipuzkoako Foru Aldundia-Diputación Foral de Gipuzkoa (ADINBERRI DG18/25) and the Professional Association of Nurses of Gipuzkoa (COEGI Nursing Research Grants 2019–2020)

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

(Pro)renin Receptor Is Present in Human Sperm and It Adversely Affects Sperm Fertility Ability

Sperm fertility ability may be modulated by different molecular systems, such as the renin-angiotensin system (RAS). Although renin is one of its most relevant peptides, the presence and role of the (pro)renin receptor (PRR) is completely unknown. We have proved for the first time the existence of PRR and its transcript in human sperm by western blot and RT-PCR. Immunofluorescence studies showed that this receptor is mainly located in the apical region over the acrosome and in the postacrosomal region of the sperm head and along the sperm tail. In addition, this prospective cohort study also proves that semen samples with higher percentages of PRR-positive spermatozoa are associated with poor sperm motility, worse blastocyst development and no-viable blastocysts. Our results provide insight into how PRR play a negative role in sperm physiology that it may condition human embryo quality and development. An in-depth understanding of the role of PRR in sperm fertility can help elucidate its role in male infertility, as well as establish biomarkers for the diagnosis or selection of sperm to use during assisted reproductive techniques.This research was funded by grants from the Basque Government (GIC12/173; to M.G. and I.M.-H.) and University of the Basque Country (UPV/EHU; to M.G. and I.U.-A.) (EHUA14/17)

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

Nutritional Status Is Associated with Function, Physical Performance and Falls in Older Adults Admitted to Geriatric Rehabilitation: A Retrospective Cohort Study

Nutritional status is relevant to functional recovery in patients after an acute process requiring rehabilitation. Nevertheless, little is known about the impact of malnutrition on geriatric rehabilitation. This study aimed to determine the association between nutritional status at admission and the evolution of functional and physical outcomes, as well as the capability of nutritional status to identify fallers among patients admitted to geriatric rehabilitation for different reasons. This was a retrospective cohort study of 375 patients. Data collected included age, gender, diagnosis at admission, comorbidities, cognitive and nutritional status, functional and physical measurements, length of stay, mortality and falls. Orthogeriatric patients with worse nutritional status according to the Mini Nutritional Assessment-Short Form (MNA-SF) had a significantly lower Barthel Index at admission and discharge with worse functional gain and poorer outcomes in the Short Physical Performance Battery (SPPB). However, in hospital-deconditioned patients, the MNA-SF score was not significantly associated with functional and physical recovery. Poor nutritional status at admission increased the risk of experiencing at least one fall during rehabilitation in orthogeriatric patients. However, hospital-deconditioned patients who fell had better SPPB scores than those who did not fall. Our results demonstrate the importance of nutritional status in the clinical evolution of orthogeriatric patients throughout the rehabilitation process.This research was supported by the Basque Government (ELKARTEK 19/78; N°. EXPT: KK-2019/00047)