Relationship of accelerometer-measured inactivity and sleep efficiency with body mass index in prefrail elders

A decrease of body mass and body mass index (BMI) in frail and prefrail elders leads to adverse events, increasing the risk of morbimortality in this vulnerable population. Nevertheless, these events might be also modulated by physical inactivity and sleep quality. To analyse the relationship between physical inactivity time and sleep efficiency with the BMI of prefrail elders. This pilot study of the FRAGSALUD project included a first batch of 20 prefrail elders (13 women and 7 men, aged 73±6 years). Prefrailty was classified according to Fried criteria, meeting at least one criteria. Physical inactivity time (min/day) and sleep efficiency values were obtained using a GeneActiv triaxial accelerometer, set to 40Hz, and worn on the wrist of the non-dominant hand, 24 hours a day for seven consecutives days. Body mass and height were registered in order to calculate BMI. Spearman correlations were performed. Those prefrail elders with higher BMI showed a better sleep efficiency (r = 0.82, p 0.05). In our study, the higher the BMI presented, the better sleep efficiency achieved by prefrail elders, what has been previously related with a better quality of life and wellbeing. However, although sedentary behaviour and inactivity have been highlighted as relevant health factors, in our patients there was not found a relationship between inactivity and the BMI of prefrail elders. Future results of this project will show the impact on these outcomes of a health educational program in frail a prefrail elders.FEDE

Effects of a Rehabilitation Programme Using a Nasal Inspiratory Restriction Device in COPD

Chronic obstructive pulmonary disease (COPD) patients are characterised for presenting dyspnea, which reduces their physical capacity and tolerance to physical exercise. The aim of this study was to analyse the effects of adding a Feel-Breathe (FB) device for inspiratory muscle training (IMT) to an 8-week pulmonary rehabilitation programme. Twenty patients were randomised into three groups: breathing with FB (FBG), oronasal breathing without FB (ONBG) and control group (CG). FBG and ONBG carried out the same training programme with resistance, strength and respiratory exercises for 8 weeks. CG did not perform any pulmonary rehabilitation programme. Regarding intra group differences in the value obtained in the post-training test at the time when the maximum value in the pre-training test was obtained (Post(PRE)), FBG obtained lower values in oxygen consumption (VO2, mean = -435.6 mL/min, Bayes Factor (BF10) > 100), minute ventilation (VE, -8.5 L/min, BF10 = 25), respiratory rate (RR, -3.3 breaths/min, BF10 = 2), heart rate (HR, -13.7 beats/min, BF10 > 100) and carbon dioxide production (VCO2, -183.0 L/min, BF10 = 50), and a greater value in expiratory time (Tex, 0.22 s, BF10 = 12.5). At the maximum value recorded in the post-training test (Post(FINAL)), FBG showed higher values in the total time of the test (T-t, 4.3 min, BF10 = 50) and respiratory exchange rate (RER, 0.05, BF10 = 1.3). Regarding inter group differences at Pre(POST), FBG obtained a greater negative increment than ONBG in the ventilatory equivalent of CO2 (EqCO(2), -3.8 L/min, BF10 = 1.1) and compared to CG in VE (-8.3 L/min, BF10 = 3.6), VCO2 (-215.9 L/min, BF10 = 3.0), EqCO2 (-3.7 L/min, BF10 = 1.1) and HR (-12.9 beats/min, BF10 = 3.4). FBG also showed a greater Pre(POST) positive increment in Tex (0.21 s, BF10 = 1.4) with respect to CG. At Pre(FINAL), FBG presented a greater positive increment compared to CG in T-t (4.4 min, BF10 = 3.2) and negative in VE/VCO2 intercept (-4.7, BF10 = 1.1). The use of FB added to a pulmonary rehabilitation programme in COPD patients could improve tolerance in the incremental exercise test and energy efficiency. However, there is only a statically significant difference between FBG and ONBG in EqCO(2). Therefore, more studies are necessary to reach a definitive conclusion about including FB in a pulmonary rehabilitation programme

Un programa educativo es capaz de reducir el riesgo de fragilidad con un aumento de la fuerza en mayores: Resultados preliminares del ensayo clínico FRAGSALUD

Introducción: Mejorar la salud y calidad de vida de las personas mayores es un reto de la sociedad actual donde el papel de la educación pueden jugar un papel clave. Método: Análisis de una primera tanda del proyecto FRAGSALUD, en 39 mayores frágiles o prefrágiles que fueron aleatorizados al grupo control (n = 21) o al grupo intervención (n = 17). Este último recibió cuatro sesiones educativas consistentes en: i) concienciación sobre la fragilidad, ii) recomendaciones de actividad física, iii) recomendaciones nutricionales, y iv) trabajo cognitivo y bienestar social y mental. Posteriormente se realizó un seguimiento telefónico con una llamada mensual. El grupo control siguió con sus hábitos. Se evaluó antes de la intervención (pre-test) y 6 meses después (post-test) los resultados del test sit-to-stand consistente en sentarse y levantarse de una silla 5 veces seguidas lo más rápido posible con los brazos cruzados en el pecho. Para el análisis estadístico se analizó la diferencia pre-post con una prueba no paramétrica de comparación de muestras independientes, considerándose significativo si p< 0,05. Resultados: Tras los 6 meses de seguimiento, los resultados preliminares del proyecto FRAGSALUD muestran que el grupo intervención disminuyó el tiempo de ejecución del test sit-to-stand en 6,5±14,3 segundos, mientras que el grupo control mantuvo valores medio similares tardando 0,2±11,9 segundos más en realizar el test. Las diferencias entre grupos fueron significativas con un p valor de 0,015 en la prueba U de Mann-Whitney para muestras independientes. Conclusión: El test sit-to-stand evalúa la fuerza del tren inferior donde mayor tiempo de ejecución supone menor nivel de fuerza. Esta variable es de gran importancia para las personas mayores al aumentar la agilidad y el equilibrio, evitando caídas y sus consecuencias. El programa tuvo un impacto beneficioso para la salud de los mayores frágiles y pre-frágiles.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech. Proyectos I+D+I en el marco del Programa Operativo FEDER Andalucía 2014-2020, referencia UMA20-FEDERJA-154

High-Intensity Interval Training (HIIT) as a therapeutic tool in patients with Type 2 Diabetes Mellitus: A narrative review

Introducción: El ejercicio físico es imprescindible para las personas con DMT2, aunque, con frecuencia se presentan problemas para practicarlo, siendo el más frecuente la falta de tiempo. No obstante, el auge de métodos como el HIIT aporta una solución a estas barreras, ya que permiten mejorar la salud con unos pocos minutos de ejercicio diarios. Objetivo: Realizar una revisión narrativa sobre los efectos del HIIT en diferentes parámetros de salud en personas con DMT2. Metodología: Tras la búsqueda en bases de datos (PubMed, SPORTDiscus y Medline) se obtiene un total de 52 artículos. Teniendo en cuenta los criterios de inclusión-exclusión, se incluyen 16 artículos. Todos los estudios incluidos son experimentales (ensayos clínicos) publicados en los últimos 10 años. Se excluyen los artículos a los que no se tiene acceso, las revisiones, los estudios cuya intervención sea similar pero no igual al HIIT y aquellos relacionados con genética. Resultados: De total de estudios incluidos (16), hay 14 que afirman que el HIIT mejora la salud de sujetos con DMT2. Se observan mejoras significativas en: perfil lipídico, control glucémico, resistencia a la insulina, HbA1c, tensión arterial, composición corporal, función endotelial y condición física. Hay 2 estudios en los que no se observa ninguna mejora. Conclusiones: El HIIT tiene efectos positivos en la salud de las personas con DMT2, ya que mejora la condición física, la salud cardio-metabólica, la composición corporal y la calidad de vida. El HIIT puede representar una buena estrategia para mejorar la salud en DMT2. Son necesarios más estudios.Introduction: Physical exercise is essential for people with T2DM, although there are often problems to practice it, the most frequent being the lack of time. However, the rise of methods such as HIIT provides a solution to these barriers, since they allow improving health with a few minutes of exercise per day. Objective: To carry out a narrative review about the effects of HIIT on different health parameters in people with T2DM. Methodology: After the search in databases (PubMed, SPORTDiscus and Medline) 52 articles were obtained. Taking into account the inclusion-exclusion criteria, 16 articles were included. All included studies are experimental (clinical trials) published in the last 10 years. Excluded are articles that cannot be accessed, reviews, studies whose intervention is similar but not equal to HIIT and those related to genetics. Results: Of the total number of included studies (16), there are 14 that affirm that HIIT improves the health of subjects with T2DM. Significant improvements were observed in: lipid profile, glycemic control, insulin resistance, HbA1c, blood pressure, body composition, endothelial function and physical fitness. There are 2 studies in which no improvement is observed. Conclusions: HIIT has positive effects on the health of people with T2DM, since it improves physical fitness, cardio-metabolic health, body composition and quality of life. HIIT may represent a good strategy to improve health in DMT2. More studies are nedeed

Effect of a 12-Week Concurrent Training Intervention on Cardiometabolic Health in Obese Men: A Pilot Study

The present study aimed to investigate the effects of a 12-week concurrent training intervention on cardiometabolic health in obese men. Twelve obese men (42.5 +/- 5.3 years old) participated in the current 12-week randomized controlled trial with a parallel group design. The participants were randomly assigned to a concurrent training group or to a no-exercise control group. Anthropometry and body composition assessment were determined by electrical bio-impedance. Blood samples were obtained and a cardiometabolic risk Z-Score was calculated. Energy metabolism-related parameters [i.e., resting metabolic rate (RMR), respiratory quotient (RQ), and substrate oxidation in both resting conditions and during exercise] were determined by indirect calorimetry. Echocardiographic studies were performed using an ultrasound system equipped with a transducer to measure cardiac function. A significant decrease of weight (Delta = -4.21 kg; i.e., primary outcome), body mass index (Delta = -1.32 kg/m(2)), fat mass (FM; Delta = -3.27 kg), blood pressure (BP; Delta = -10.81 mmHg), and cardiometabolic risk Z-Score (Delta = -0.39) was observed in the exercise group compared with the control group (all P 0.1). Moreover, a significant increment of left ventricular (LV) end diastolic diameter (Delta = -4.35 mm) was observed in the exercise group compared with the control group (P = 0.02). A 12-week concurrent training intervention is an effective strategy to induce weight and fat loss with simultaneous reductions of BP and cardiometabolic risk, and improving cardiac function in obese men.LCurrent research activities of DJ-P are supported by a grant from the Spanish Ministry of Science and Innovation-MINECO (RYC-2014-16938) and the Spanish Ministry of Economy and Competitiveness-MINECO/FEDER (DEP2016-76123R), the Government of Andalusian, Integrated Territorial Initiative 2014-2020 for the province of Cadiz (PI-00022017); the European Union's ERASMUS C SPORT program (Grant Agreement: 603121-EPP-1-2018-1-ES-SPO-SCP), and the EXERNET Research Network on Exercise and Health in Special Populations (DEP2005-00046/ACTI). Technology Fund-FEDER funds (R&D&I Operating Program) by and for the benefit of companies (Technology Fund) INNTERCONECTA (BRISA Contract-University of Cadiz). The results of the study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation

Fitness and academic performance in adolescents. The mediating role of leptin: DADOS study.

We tested the mediating effect of leptin on the association between physical fitness (PF) components and academic performance indicators in healthy adolescents. A total of 263 adolescents (13.9 ± 0.3 years, 47.5% girls, 12.5% overweight) from the DADOS (Deporte, ADOlescencia y Salud) Study were included in the analysis. PF components were assessed by the handgrip test for upper-limb muscular strength, standing long jump test for lower-limb muscular strength, 4 × 10-m shuttle run test for speed-agility, and 20-m shuttle run test for cardiorespiratory fitness. Plasma leptin concentration was assessed from antecubital vein blood after an overnight fast using a sensitive ELISA kit. Academic performance indicators were assessed through final school grades and through the Spanish version of the SRA Test of Educational Ability. Body composition was assessed by body mass index and skinfold thicknesses. Boot-strapped mediation procedures were performed and indirect effects with confidence intervals not including zero were interpreted as statistically significant. Our findings suggest that the positive associations observed between cardiorespiratory fitness and lower-limb muscular strength with academic performance indicators were mediated by leptin concentration after adjusting for sex, pubertal stage, socioeconomic status, and adiposity (percentage of mediation ranging from 54.61 to 82.02%). Conclusions: Improvements on PF components, particularly in cardiorespiratory fitness and lower-limb muscular strength, might reduce leptin concentration with potential benefits on academic performance in adolescents, independently of adiposity

A New Nasal Restriction Device Called FeelBreathe(R)Improves Breathing Patterns in Chronic Obstructive Pulmonary Disease Patients during Exercise

A device called FeelBreathe (FB)(R)was designed, developed, and patented for inspiratory muscle training. The main aim was to determine the acute responses on lung ventilation, gas exchange, and heart rate during exercise in patients with chronic obstructive pulmonary disease (COPD) with and without the use of FB. In this study, a randomized cross-over trial was performed with 18 men diagnosed with COPD (FEV(1)between 30% and 70% of its predicted value). Each participant randomly conducted two trials with 30 min of rest between them with the same protocol on a treadmill for 10 min at a constant rate of 50% of VO2peak. Each test was performed randomly and in a crossover randomized design in two different conditions: (1) oronasal breathing; and (2) nasal breathing with FB (nasal ventilatory flow restriction device). It was observed that FB had positive effects on dynamic hyperinflation, breathing pattern, and breathing efficiency, with higher expiratory and inspiratory time. Despite these differences, blood oxygen saturation percentage, oxygen uptake, and heart rate showed a similar response for both conditions during exercise. The results suggest that exercise performed with FB improved ventilatory responses compared to the oronasal mode in COPD patients. This new tool could be used during most daily tasks and exercise programs

Hamstring extensibility in female elite soccer players

El objetivo de este estudio fue evaluar la extensibilidad de la musculatura isquiosural en futbolistas femeninas de élite. Se realizó un estudio descriptivo transversal en una muestra de 75 jugadoras de élite de fútbol de cuatro categorías: Sub12 (n=20, edad: 11,42 ± 0,90 años), Sub15 (n=21, edad: 13,38 ± 1,50 años), Provincial (amateur) (n=15, edad: 17,13 ± 1,85 años), y Nacional (profesional) (n=20, edad: 22,80 ± 5,25 años). Como instrumentos de medición se utilizaron el test sit and reach (SRT) y el test de flexión profunda (FP) de tronco. Los valores medios presentados en el SRT fueron de 9,74 ± 5,62 cm. para el grupo Sub12, 13,86 ± 4,82 cm. para el grupo Sub15, 9,73 ± 3,58 cm para el grupo Provincial (amateur) y 7,55 ± 8,39 cm para el grupo Nacional (profesional). En el SRT las participantes del grupo Sub15 obtuvieron resultados significativamente superiores que las participantes del grupo Nacional (p<.05), mientras que en la prueba FP el grupo Sub12 obtuvo resultados significativamente superiores que el grupo Nacional (p<.05). En el análisis de correlaciones bivariadas, se observaron correlaciones moderadas entre la altura y los resultados en las pruebas de FP (r=.561; p<.05) y SRT (r=.491; p<.05) en el grupo Sub12. En conclusión, los resultados de este estudio indican que la extensibilidad isquiosural de las jugadoras de élite de fútbol estudiadas es limitada, por lo que deberíamos implementar programas específicos de estiramientos de la musculatura isquiosural en futbolistas féminas desde las categorías inferiores hasta las categorías profesionales. Palabras clave. flexibilidad, fútbol femenino, flexión profunda, sit and reach test.The aim of this study was to evaluate hamstring extensibility in female elite soccer players. A descriptive transversal study was carried out with a sample of 75 female elite soccer players into four categories: Under12 (n=20, age: 11,42 ± 0,90 years), Under15 (n=21, age: 13,38 ± 1,50 years), Provincial (amateur) (n=15, age: 17,13 ± 1,85 years), and National (professional) (n=20, age: 22,80 ± 5,25 years). The sit and reach test (SRT) and the deep trunk flexion test were used as measurement tools. The average values showed in the SRT were 9,74 ± 5,62 cm. for the Under12 group, 13,86 ± 4,82 cm. for the Under15 group, 9,73 ± 3,58 cm for the Provincial (amateur) group and 7,55 ± 8,39 cm for the National (professional) group. In the SRT the members of Under15 group showed significantly higher results than the members of National group (p<.05), while in the deep trunk flexion test the Under12 group showed significantly higher results than the National group (p<.05). In the analysis of bivariate correlations, in the Under12 group moderate correlations were observed between height and scores in the deep trunk test (r = .561; p <.05) and SRT (r = .491; p <.05). In conclusion, the results of this study indicate that the hamstring extensibility in female elite soccer players studied is limited, so we should implement stretching specific programs of the hamstring muscles in female soccer players from the lower categories to the professional categories. Key words. flexibility, female soccer, deep trunk, sit and reach test

Effects of a Rehabilitation Programme with a Nasal Inspiratory Restriction Device on Exercise Capacity and Quality of Life in COPD

Objective: The objective was to assess the effects of a nasal restriction device for inspiratory muscle training, called Feelbreathe((R)), added to a rehabilitation program (RP) on exercise capacity, quality of life, dyspnea and inspiratory muscle strength in patients with stable COPD. Methods: Patients were randomized into three groups, one performed a supervised RP using the Feelbreathe((R)) device (FB group), the second group developed the same RP with oronasal breathing without FB (ONB group) and the third was the control group (CG). We evaluated inspiratory muscle strength (PImax), dyspnea (mMRC), quality of life (CAT) and exercise capacity (6MWT) before and after 8-week of RP. Results: A total of 16 patients completed the study, seven in FB group, five in ONB group and four in the CG. After the RP, the FB group showed a significant increase in PImax (93.3 +/- 19.1 vs. 123.0 +/- 15.8 mmHg) and in the 6MWT distance (462.9 +/- 71.8 m vs. 529.1 +/- 50.1 m) and a decrease in the CAT score (9.7 +/- 6.5 vs. 5.9 +/- 6.0) and in the mMRC dyspnea score. FB provides greater improvement in PImax, dyspnea, quality of life and 6MWT than ONB. Conclusions: The Feelbreathe((R)) device provides greater improvements in quality of life, dyspnea, exercise capacity and inspiratory muscle strength compared to patients that did not use it

The Federated Practice of Soccer Influences Hamstring Flexibility in Healthy Adolescents: Role of Age and Weight Status

The aim of this study was to compare the hamstring flexibility between federated soccer and non-federated adolescents, and also to evaluate the effect of age and weight status on hamstring flexibility. The participants were 234 students (11-18 years old) divided into: (i) G1: non-federated (n = 127), and (ii) G2: federated in soccer (n = 107). The deep flexion of the trunk (DF) test and the sit and reach test (SRT) were performed. G2 showed higher values for the DF and SRT compared to G1 (p < 0.05). Both flexibility tests correlated positively (r = 0.4, p < 0.001). Body mass index (BMI) was negatively correlated with the DF test (r = -0.3, p < 0.001), but not with the SRT. Divided by BMI, the underweight and normal weight groups had higher scores in the DF test compared with the overweight and obese groups (p < 0.001). BMI was negatively correlated with hamstring flexibility. Federated soccer students present higher scores of hamstring flexibility