The effect of physical exercise during radiotherapy on physical performance in patients with head and neck cancer: a trial within cohorts study protocol, the vital study

BACKGROUND: During the last decade, twelve studies have been published investigating physical exercise interventions (PEIs) in patients with head and neck cancer (HNC) during radiotherapy (RT), chemoradiation (CRT) or bioradiation (BRT). These studies showed that these PEIs are safe and feasible. However, only two of these studies were randomised clinical trials (RCTs) with a satisfying sample size. Thereby, there is no cost-effectiveness study related to a PEI during RT, CRT or BRT ((C/B)RT) for patients with HNC. Therefore, the aim of this study is to investigate and compare physical performance, muscle strength, fatigue, quality of life (QoL), body mass index (BMI), nutritional status, physical activity, treatment tolerability, and health care related costs in patients with HNC with and without a 10 week PEI during (C/B)RT. METHODS: This study, based on a trial within cohorts (TwiCs) design, will contain a prospective cohort of at least 112 patients. Fifty-six patients will randomly be invited for an experimental 10 week PEI. This PEI consists of both resistance and endurance exercises to optimize physical performance, muscle strength, fatigue, QoL, BMI, nutritional status, physical activity, and treatment tolerability of (C/B)RT. Measurements are at baseline, after 12 weeks, 6 months, and at 12 months. Statistical analyses will be performed for intention-to-treat and instrumental variable analysis. DISCUSSION: This study seeks to investigate physical, QoL, and economic implications of a PEI. With a substantial sample size, this study attempts to strengthen and expand knowledge in HNC care upon PEI during (C/B)RT. In conclusion, this study is dedicated to provide additional evidence for PEI in patients with HNC during (C/B)RT. TRIAL REGISTRATION: protocol was registered at clinicaltrials.gov with number NCT05988060 on 3 August 2023

Voluntary movement frequencies in submaximal one- and two-legged knee extension exercise and pedaling

Understanding of behavior and control of human voluntary rhythmic stereotyped leg movements is useful in work to improve performance, function, and rehabilitation of exercising, healthy, and injured humans. The present study aimed at adding to the existing understanding within this field. To pursue the aim, correlations between freely chosen movement frequencies in relatively simple, single-joint, one- and two-legged knee extension exercise were investigated. The same was done for more complex, multiple-joint, one- and two-legged pedaling. These particular activities were chosen because they could be considered related to some extent, as they shared a key aspect of knee extension, and because they at the same time were different. The activities were performed at submaximal intensities, by healthy individuals (n=16, thereof 8 women; 23.4±2.7 years; 1.70±0.11 m; 68.6±11.2 kg).High and fair correlations (R-values of 0.99 and 0.75) occurred between frequencies generated with the dominant leg and the nondominant leg during knee extension exercise and pedaling, respectively. Fair to high correlations (R-values between 0.71 and 0.95) occurred between frequencies performed with each of the two legs in an activity, and the two-legged frequency performed in the same type of activity. In general, the correlations were higher for knee extension exercise than for pedaling. Correlations between knee extension and pedaling frequencies were of modest occurrence.The correlations between movement frequencies generated separately by each of the legs might be interpreted to support the following working hypothesis, which was based on existing literature. It is likely that involved central pattern generators (CPGs) of the two legs share a common frequency generator or that separate frequency generators of each leg are attuned via interneuronal connections. Further, activity type appeared to be relevant. Thus, the apparent common rhythmogenesis for the two legs appeared to be stronger for the relatively simple single-joint activity of knee extension exercise as compared to the more complex multi-joint activity of pedaling. Finally, it appeared that the shared aspect of knee extension in the related types of activities of knee extension exercise and pedaling was insufficient to cause obvious correlations between generated movement frequencies in the two types of activities

Development of a Global Physical Literacy (GloPL) Action Framework: Study protocol for a consensus process

peer reviewedBACKGROUND: The holistic concept of physical literacy (PL) has gained growing attention in recent research, policy, and practice. Many important policy documents of the physical activity and educational fields (e.g., Global Action Plan on Physical Activity 2018-2030 by the World Health Organization, UNESCO's Quality Physical Education guidelines for policymakers) have specified PL. However, a clear framework for action is needed, as most initiatives across the world are fragmented, lack a prospective orientation, can benefit from conceptual clarification, and are not linked to effective translation into practice. Therefore, we aim to consensually develop a Global Physical Literacy (GloPL) Action Framework to define goals and principles (asking what is needed) as well as actions and ways (asking how these can be achieved) to move PL forward. MATERIALS AND METHODS: We apply a three-stage group Delphi technique involving three representation groups: (a) geographical representatives to achieve global coverage of perspectives; (b) representatives of special thematic interest reflecting prominent gaps of current PL activities; and (c) representatives of societies from the broad field of physical activity and health to facilitate dissemination. The process will begin with an individual pre-Delphi exercise, in which experts generate initial ideas for the framework, followed by a four-eye document analysis to derive themes for the discussion. Subsequently, the experts will meet face-to-face in three online rounds to discuss and prioritize the themes. Interspersed formal voting with pre-defined agreement thresholds (via descriptive statistics) will inform the inclusion of themes within the final framework. CONCLUSIONS: A global consensus on goals, principles, actions, and ways for the development of PL has the potential to provide a largely accepted roadmap for future activities in research, policy, and practice. The co-production approach will help disseminate the GloPL Action Framework and benefit work in relevant application fields of physical activity and health worldwide.3. Good health and well-being4. Quality educatio

Landbouwproblematiek bij economische g-roei. Fogelijkheden en grenzen van instrumenten van beleid in economische ontwikkelde landen.

Leicien, H.E.Stenfert Kroe.se, 19 5 . 8u, 206 pCG11ERRORMISSING26

Physical literacy assessment and its potential for identification and treatment of children with neuro-developmental behavioral intellectual disorders

The following commentary proposes that the current identification protocols for identifying children with neuro-developmental behavioral intellectual disorders (NDBIDs) are limited. Increasing prevalence of physical inactivity in children and those diagnosed with NDBIDs creating public health concerns, new methods of identification, and treatment may be warranted. We suggest the diagnostic and treatment protocols for all children (not just those with NDBIDs) may be enhanced by using the concept of physical literacy as a philosophical premise for assessment instrument design and strength-based treatment.5 page(s