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Jost J, Völker K, Brandt R, Stummer W, Urbschat S, Ketter R, Wiewrodt D, Wiewrodt R. Maximal cardiopulmonary exercise testing in glioblastoma patients undergoing chemotherapy: assessment of feasibility, safety, and physical fitness status. J Neurooncol 2024; 168:35-45. [PMID: 38561565 PMCID: PMC11093868 DOI: 10.1007/s11060-024-04629-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 03/02/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE Maximal cardiopulmonary exercise testing (max. CPET) provides the most accurate measurement of cardiorespiratory fitness. However, glioblastoma (GBM) patients often undergo less intensive tests, e.g., 6-min walk test or self-rating scales. This study aims to demonstrate feasibility and safety of max. CPET in GBM patients, concurrently evaluating their physical fitness status. METHODS Newly diagnosed GBM patients undergoing adjuvant chemotherapy were offered participation in an exercise program. At baseline, max. CPET assessed cardiorespiratory fitness including peak oxygen consumption (VO2peak), peak workload, and physical work capacity (PWC) at 75% of age-adjusted maximal heart rate (HR). Criteria for peak workload were predefined based on threshold values in HR, respiratory quotient, respiratory equivalent, lactate, and rate of perceived effort. Data were compared to normative values. Adverse events were categorized according to standardized international criteria. Further, self-reported exercise data pre- and post-diagnosis were gathered. RESULTS All 36 patients (median-aged 60; 21 men) met the predefined criteria for peak workload. Mean absolute VO2peak was 1750 ± 529 ml/min, peak workload averaged 130 ± 43 W, and mean PWC was 0.99 ± 0.38 W/kg BW, all clinically meaningful lower than age- and sex-predicted normative values (87%, 79%, 90%, resp.). Only once (3%) a minor, transient side effect occurred (post-test dizziness, no intervention needed). Self-reported exercise decreased from 15.8 MET-h/week pre-diagnosis to 7.2 MET-h/week post-diagnosis. CONCLUSION Max. CPET in this well-defined population proved feasible and safe. GBM patients exhibit reduced cardiorespiratory fitness, indicating the need for tailored exercise to enhance health and quality of life. CPET could be essential in establishing precise exercise guidelines.
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Affiliation(s)
- Johanna Jost
- Department of Neurosurgery, University Hospital, University Münster, Münster, Germany.
- Department of Neurosurgery, University Hospital, Saarland University, Saarbrücken, Germany.
- Pulmonary Research Division, Department of Medicine A, University Hospital, University Münster, Münster, Germany.
| | - Klaus Völker
- Institute of Sports Science, University Hospital, University Münster, Münster, Germany
| | - Ralf Brandt
- Department of Neurosurgery, University Hospital, University Münster, Münster, Germany
| | - Walter Stummer
- Department of Neurosurgery, University Hospital, University Münster, Münster, Germany
| | - Steffi Urbschat
- Department of Neurosurgery, University Hospital, Saarland University, Saarbrücken, Germany
| | - Ralf Ketter
- Department of Neurosurgery, University Hospital, Saarland University, Saarbrücken, Germany
| | - Dorothee Wiewrodt
- Department of Neurosurgery, University Hospital, University Münster, Münster, Germany
| | - Rainer Wiewrodt
- Pulmonary Research Division, Department of Medicine A, University Hospital, University Münster, Münster, Germany
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van Kampen V, Marek EM, Sucker K, Jettkant B, Kendzia B, Strauß B, Ulbrich M, Deckert A, Berresheim H, Eisenhawer C, Hoffmeyer F, Weidhaas S, Behrens T, Brüning T, Bünger J. Influence of face masks on the subjective impairment at different physical workloads. Sci Rep 2023; 13:8133. [PMID: 37208370 DOI: 10.1038/s41598-023-34319-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/27/2023] [Indexed: 05/21/2023] Open
Abstract
To quantify the subjective and cognitive impairment caused by wearing face masks at work, 20 men and 20 women (median age 47 years, range 19-65) were tested under different ergometer workloads while wearing surgical mask, community mask, FFP2 respirator or no mask in a randomized and partially double-blinded design. Masks were worn also at the workplace for four hours. Subjective impairment was recorded by questionnaires. Cognitive performance was tested before and after the workplace examination. Subjective feeling of heat, humidity, and difficult breathing increased with rising physical exertion and wearing time for all three mask types, most notably for FFP2. Even when blinded, participants with FFP2 reported difficult breathing already at rest. During physical exertion, individuals with low tolerance to discomfort reported significantly stronger impairment (OR 1.14, 95% CI 1.02-1.27). Regarding light work, older subjects (OR 0.95, 95% CI 0.92-0.98) and women (OR 0.84, 95% CI 0.72-0.99) showed significantly lower and atopic subjects stronger impairment (OR 1.16, 95% CI 1.06-1.27). No significant influence of mask wearing was detected on cognitive performance. Wearing a mask had no effect on cognitive performance, but led to discomfort which increased with physical exertion and wearing time. Individuals who tolerate discomfort poorly felt more impaired by wearing a mask during physical exertion.
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Affiliation(s)
- Vera van Kampen
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany.
| | - Eike-Maximillian Marek
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Kirsten Sucker
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Birger Jettkant
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Benjamin Kendzia
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Bianca Strauß
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Melanie Ulbrich
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Anja Deckert
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Hans Berresheim
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Christian Eisenhawer
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Frank Hoffmeyer
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Simon Weidhaas
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Thomas Behrens
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Jürgen Bünger
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
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Steinhilber B, Seibt R, Gabriel J, Bär M, Dilek Ü, Brandt A, Martus P, Rieger MA. Influence of Face Masks on Physiological and Subjective Response during 130 Min of Simulated Light and Medium Physical Manual Work-An Explorative Study. Healthcare (Basel) 2023; 11:1308. [PMID: 37174850 PMCID: PMC10178085 DOI: 10.3390/healthcare11091308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 04/24/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Undesirable side effects from wearing face masks during the ongoing COVID-19 pandemic continue to be discussed and pose a challenge to occupational health and safety when recommending safe application. Only few studies examined the effects of continuously wearing a face mask for more than one hour. Therefore, the influence of wearing a medical mask (MedMask) and a filtering facepiece class II respirator (FFP2) on the physiological and subjective outcomes in the course of 130 min of manual work was exploratively investigated. Physical work load and cardiorespiratory fitness levels were additionally considered as moderating factors. METHODS Twenty-four healthy subjects (12 females) from three different cardiorespiratory fitness levels each performed 130 min of simulated manual work with light and medium physical workload using either no mask, a MedMask or FFP2. Heart rate, transcutaneous oxygen and carbon dioxide partial pressure (PtcO2, PtcCO2) as well as perceived physical exertion and respiratory effort were assessed continuously at discrete time intervals. Wearing comfort of the masks were additionally rated after the working period. RESULTS There was no difference in time-dependent changes of physiological outcomes when using either a MedMask or a FFP2 compared to not wearing a mask. A stronger increase over time in perceived respiratory effort occurred when the face masks were worn, being more prominent for FFP2. Physical workload level and cardiorespiratory fitness level were no moderating factors and higher wearing comfort was rated for the MedMask. CONCLUSION Our results suggest that using face masks during light and medium physical manual work does not induce detrimental side effects. Prolonged wearing episodes appeared to increase respiratory effort, but without affecting human physiology in a clinically relevant way.
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Affiliation(s)
- Benjamin Steinhilber
- Institute of Occupational and Social Medicine and Health Services Research, Medical Faculty, University Hospital Tuebingen, 72074 Tuebingen, Germany; (R.S.); (J.G.); (M.B.); (Ü.D.); (A.B.); (M.A.R.)
| | - Robert Seibt
- Institute of Occupational and Social Medicine and Health Services Research, Medical Faculty, University Hospital Tuebingen, 72074 Tuebingen, Germany; (R.S.); (J.G.); (M.B.); (Ü.D.); (A.B.); (M.A.R.)
| | - Julia Gabriel
- Institute of Occupational and Social Medicine and Health Services Research, Medical Faculty, University Hospital Tuebingen, 72074 Tuebingen, Germany; (R.S.); (J.G.); (M.B.); (Ü.D.); (A.B.); (M.A.R.)
| | - Mona Bär
- Institute of Occupational and Social Medicine and Health Services Research, Medical Faculty, University Hospital Tuebingen, 72074 Tuebingen, Germany; (R.S.); (J.G.); (M.B.); (Ü.D.); (A.B.); (M.A.R.)
| | - Ümütyaz Dilek
- Institute of Occupational and Social Medicine and Health Services Research, Medical Faculty, University Hospital Tuebingen, 72074 Tuebingen, Germany; (R.S.); (J.G.); (M.B.); (Ü.D.); (A.B.); (M.A.R.)
| | - Adrian Brandt
- Institute of Occupational and Social Medicine and Health Services Research, Medical Faculty, University Hospital Tuebingen, 72074 Tuebingen, Germany; (R.S.); (J.G.); (M.B.); (Ü.D.); (A.B.); (M.A.R.)
| | - Peter Martus
- Institute for Clinical Epidemiology and Applied Biometry, Medical Faculty, University Hospital Tuebingen, 72076 Tuebingen, Germany;
| | - Monika A. Rieger
- Institute of Occupational and Social Medicine and Health Services Research, Medical Faculty, University Hospital Tuebingen, 72074 Tuebingen, Germany; (R.S.); (J.G.); (M.B.); (Ü.D.); (A.B.); (M.A.R.)
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Marek EM, van Kampen V, Jettkant B, Kendzia B, Strauß B, Sucker K, Ulbrich M, Deckert A, Berresheim H, Eisenhawer C, Hoffmeyer F, Weidhaas S, Behrens T, Brüning T, Bünger J. Effects of wearing different face masks on cardiopulmonary performance at rest and exercise in a partially double-blinded randomized cross-over study. Sci Rep 2023; 13:6950. [PMID: 37117320 PMCID: PMC10141827 DOI: 10.1038/s41598-023-32180-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 03/23/2023] [Indexed: 04/30/2023] Open
Abstract
The use of face masks became mandatory during SARS-CoV-2 pandemic. Wearing masks may lead to complaints about laboured breathing and stress. The influence of different masks on cardiopulmonary performance was investigated in a partially double-blinded randomized cross-over design. Forty subjects (19-65 years) underwent body plethysmography, ergometry, cardiopulmonary exercise test and a 4-h wearing period without a mask, with a surgical mask (SM), a community mask (CM), and an FFP2 respirator (FFP2). Cardiopulmonary, physical, capnometric, and blood gas related parameters were recorded. Breathing resistance and work of breathing were significantly increased while wearing a mask. During exercise the increase in minute ventilation tended to be lower and breathing time was significantly longer with mask than without mask. Wearing a mask caused significant minimal decreases in blood oxygen pressure, oxygen saturation, an initial increase in blood and inspiratory carbon dioxide pressure, and a higher perceived physical exertion and temperature and humidity behind the mask under very heavy exercise. All effects were stronger when wearing an FFP2. Wearing face masks at rest and under exercise, changed breathing patterns in the sense of physiological compensation without representing a health risk. Wearing a mask for 4-h during light work had no effect on blood gases.
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Affiliation(s)
- Eike-Maximillian Marek
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany.
| | - Vera van Kampen
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
| | - Birger Jettkant
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
| | - Benjamin Kendzia
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
| | - Bianca Strauß
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
| | - Kirsten Sucker
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
| | - Melanie Ulbrich
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
| | - Anja Deckert
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
| | - Hans Berresheim
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
| | - Christian Eisenhawer
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
| | - Frank Hoffmeyer
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
| | - Simon Weidhaas
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
| | - Thomas Behrens
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
| | - Jürgen Bünger
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle‑de‑la‑Camp Platz 1, 44789, Bochum, Germany
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Steinhilber B, Seibt R, Gabriel J, Brountsou J, Muljono M, Downar T, Bär M, Bonsch R, Brandt A, Martus P, Rieger MA. Effects of Face Masks on Physical Performance and Physiological Response during a Submaximal Bicycle Ergometer Test. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1063. [PMID: 35162087 PMCID: PMC8834111 DOI: 10.3390/ijerph19031063] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/21/2021] [Accepted: 12/30/2021] [Indexed: 02/04/2023]
Abstract
The ongoing COVID-19 pandemic requires wearing face masks in many areas of our daily life; hence, the potential side effects of mask use are discussed. Therefore, the present study explores whether wearing a medical face mask (MedMask) affects physical working capacity (PWC). Secondary, the influence of a filtering facepiece mask with exhalation valve class 2 (FFP2exhal) and a cotton fabric mask (community mask) on PWC was also investigated. Furthermore, corresponding physiological and subjective responses when wearing face masks as well as a potential moderating role of subjects' individual cardiorespiratory fitness and sex on face mask effects were analyzed. Thirty-nine subjects (20 males, 19 females) with different cardiorespiratory fitness levels participated in a standardized submaximal bicycle ergometer protocol using either a MedMask, FFP2exhal, community mask, or no mask (control) on four days, in randomized order. PWC130 and PWC150 as the mechanical load at the heart rates of 130 and 150 beats per minute were measured as well as transcutaneous carbon dioxide partial pressure, saturation of peripheral capillary oxygen, breathing frequency, blood pressure, perceived respiratory effort, and physical exhaustion. Using the MedMask did not lead to changes in PWC or physiological response compared to control. Neither appeared changes exceeding normal ranges when the FFP2exhal or community mask was worn. Perceived respiratory effort was up to one point higher (zero-to-ten Likert scale) when using face masks (p < 0.05) compared to control. Sex and cardiorespiratory fitness were not factors influencing the effects of the masks. The results of the present study provide reason to believe that wearing face masks for infection prevention during the COVID-19 pandemic does not pose relevant additional physical demands on the user although some more respiratory effort is required.
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Affiliation(s)
- Benjamin Steinhilber
- Medical Faculty, Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, 72074 Tuebingen, Germany; (R.S.); (J.G.); (J.B.); (M.M.); (T.D.); (M.B.); (R.B.); (A.B.); (M.A.R.)
| | - Robert Seibt
- Medical Faculty, Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, 72074 Tuebingen, Germany; (R.S.); (J.G.); (J.B.); (M.M.); (T.D.); (M.B.); (R.B.); (A.B.); (M.A.R.)
| | - Julia Gabriel
- Medical Faculty, Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, 72074 Tuebingen, Germany; (R.S.); (J.G.); (J.B.); (M.M.); (T.D.); (M.B.); (R.B.); (A.B.); (M.A.R.)
| | - Joulia Brountsou
- Medical Faculty, Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, 72074 Tuebingen, Germany; (R.S.); (J.G.); (J.B.); (M.M.); (T.D.); (M.B.); (R.B.); (A.B.); (M.A.R.)
| | - Markus Muljono
- Medical Faculty, Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, 72074 Tuebingen, Germany; (R.S.); (J.G.); (J.B.); (M.M.); (T.D.); (M.B.); (R.B.); (A.B.); (M.A.R.)
| | - Tomasz Downar
- Medical Faculty, Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, 72074 Tuebingen, Germany; (R.S.); (J.G.); (J.B.); (M.M.); (T.D.); (M.B.); (R.B.); (A.B.); (M.A.R.)
| | - Mona Bär
- Medical Faculty, Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, 72074 Tuebingen, Germany; (R.S.); (J.G.); (J.B.); (M.M.); (T.D.); (M.B.); (R.B.); (A.B.); (M.A.R.)
| | - Rosina Bonsch
- Medical Faculty, Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, 72074 Tuebingen, Germany; (R.S.); (J.G.); (J.B.); (M.M.); (T.D.); (M.B.); (R.B.); (A.B.); (M.A.R.)
| | - Adrian Brandt
- Medical Faculty, Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, 72074 Tuebingen, Germany; (R.S.); (J.G.); (J.B.); (M.M.); (T.D.); (M.B.); (R.B.); (A.B.); (M.A.R.)
| | - Peter Martus
- Medical Faculty, Institute for Clinical Epidemiology and Applied Biometry, University Hospital Tuebingen, 72076 Tuebingen, Germany;
| | - Monika A. Rieger
- Medical Faculty, Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, 72074 Tuebingen, Germany; (R.S.); (J.G.); (J.B.); (M.M.); (T.D.); (M.B.); (R.B.); (A.B.); (M.A.R.)
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Klemm K, Krell-Roesch J, De Clerck IL, Brehm W, Boes K. Health-Related Fitness in Adults From Eight European Countries-An Analysis Based on Data From the European Fitness Badge. Front Physiol 2021; 11:615237. [PMID: 33488403 PMCID: PMC7820748 DOI: 10.3389/fphys.2020.615237] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 12/10/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND There are conflicting reports about the fitness status of European adults, partly due to the lack of a standardized fitness test battery used across Europe. The European Fitness Badge (EFB) was developed in 2017 as an online-based tool to assess the health-related fitness of persons aged ≥ 18 years residing in European countries. We examined the demographic characteristics and fitness status of persons who completed the EFB between June 2017 and May 2019. METHODS We conducted a multinational study in eight European countries. Participants completed the EFB which includes 11 validated motor tests to measure endurance, strength, coordination, and flexibility performance, under the supervision of an EFB instructor in different settings (e.g., sports club sessions, public events). Two different test batteries [test profiles (TPs)] are available to distinguish between less active (TP1) and active individuals (TP2). We calculated descriptive statistics and conducted analyses of variance to examine sample characteristics and a potential impact of sex, age, body mass index (BMI), physical activity, and posture on fitness as assessed by the EFB. RESULTS The sample included 6,019 adults (68.7% females; mean age 52.7 years; age range 18-89 years). Participants who completed TP1 were older (TP1: 61.4 years; TP2: 44.2 years; p = 0.00), reported a lower level of physical activity (TP1: 3.8; TP2: 4.0; p = 0.00), had a higher BMI (TP1: 25.7; TP2: 24.3; p = 0.00) and a higher frequency of postural abnormalities (TP1: 43%; TP2: 33%; p = 0.00) than TP2 participants. Among 3,034 participants who completed TP2, males had higher performance in endurance, strength, and overall fitness, whereas females performed better in coordination and flexibility tests. In addition, younger age, lower BMI, and higher level of physical activity engagement were associated with better EFB test performance. CONCLUSION The EFB can be used to assess the health-related fitness status of individuals aged ≥ 18 years. Our results show that TP1 and TP2 were completed by persons from the respective target groups (i.e., less active vs. active), and also confirm findings from previous studies on potential determinants of fitness such as sex or age.
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Affiliation(s)
- Katja Klemm
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Janina Krell-Roesch
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Ine Lucia De Clerck
- Department of Health and Care, Artevelde University of Applied Sciences, Ghent, Belgium
| | - Walter Brehm
- Department of Sport Science, University of Bayreuth, Bayreuth, Germany
| | - Klaus Boes
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
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Zeiher J, Duch M, Kroll LE, Mensink GBM, Finger JD, Keil T. Domain-specific physical activity patterns and cardiorespiratory fitness among the working population: Findings from the cross-sectional German Health Interview and Examination Survey. BMJ Open 2020; 10:e034610. [PMID: 32345698 PMCID: PMC7213860 DOI: 10.1136/bmjopen-2019-034610] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 03/06/2020] [Accepted: 03/12/2020] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES This study aimed to investigate associations between occupational physical activity patterns (physical work demands linked to job title) and leisure time physical activity (assessed by questionnaire) with cardiorespiratory fitness (assessed by exercise test) among men and women in the German working population. DESIGN Population-based cross-sectional study. SETTING Two-stage cluster-randomised general population sample selected from population registries of 180 nationally distributed sample points. Information was collected from 2008 to 2011. PARTICIPANTS 1296 women and 1199 men aged 18-64 from the resident working population. OUTCOME MEASURE Estimated low maximal oxygen consumption ([Formula: see text]), defined as first and second sex-specific quintile, assessed by a standardised, submaximal cycle ergometer test. RESULTS Low estimated [Formula: see text] was strongly linked to low leisure time physical activity, but not occupational physical activity. The association of domain-specific physical activity patterns with low [Formula: see text] varied by sex: women doing no leisure time physical activity with high occupational physical activity levels were more likely to have low [Formula: see text] (OR 6.54; 95% CI 2.98 to 14.3) compared with women with ≥2 hours of leisure time physical activity and high occupational physical activity. Men with no leisure time physical activity and low occupational physical activity had the highest odds of low [Formula: see text] (OR 4.37; 95% CI 2.02 to 9.47). CONCLUSION There was a strong association between patterns of leisure time and occupational physical activity and cardiorespiratory fitness within the adult working population in Germany. Women doing no leisure time physical activity were likely to have poor cardiorespiratory fitness, especially if they worked in physically demanding jobs. However, further investigation is needed to understand the relationships between activity and fitness in different domains. Current guidelines do not distinguish between activity during work and leisure time, so specifying leisure time recommendations by occupational physical activity level should be considered.
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Affiliation(s)
- Johannes Zeiher
- Department of Epidemiology and Health Monitoring, Robert Koch Institut, Berlin, Germany
| | - Maurice Duch
- Department of Epidemiology and Health Monitoring, Robert Koch Institut, Berlin, Germany
- Department of Sports and Health Sciences, University of Potsdam, Potsdam, Brandenburg, Germany
| | - Lars E Kroll
- Department for Health Services Research, System Analysis and Data Science, Central Research Institute of Ambulatory Health Care, Berlin, Germany
| | - Gert B M Mensink
- Department of Epidemiology and Health Monitoring, Robert Koch Institut, Berlin, Germany
| | - Jonas D Finger
- Department of Epidemiology and Health Monitoring, Robert Koch Institut, Berlin, Germany
| | - Thomas Keil
- State Institute of Health, Bavarian Health and Food Safety Authority, Bad Kissingen, Bayern, Germany
- Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
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8
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Kluttig A, Zschocke J, Haerting J, Schmermund A, Gastell S, Steindorf K, Herbolsheimer F, Hillreiner A, Jochem C, Baumeister S, Sprengeler O, Pischon T, Jaeschke L, Michels KB, Krist L, Greiser H, Schmidt G, Lieb W, Waniek S, Becher H, Jagodzinski A, Schipf S, Völzke H, Ahrens W, Günther K, Castell S, Kemmling Y, Legath N, Berger K, Keil T, Fricke J, Schulze MB, Loeffler M, Wirkner K, Kuß O, Schikowski T, Kalinowski S, Stang A, Kaaks R, Damms Machado A, Hoffmeister M, Weber B, Franzke CW, Thierry S, Peters A, Kartschmit N, Mikolajczyk R, Fischer B, Leitzmann M, Brandes M. [Measuring physical fitness in the German National Cohort-methods, quality assurance, and first descriptive results]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:312-321. [PMID: 32072217 DOI: 10.1007/s00103-020-03100-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Physical fitness is defined as an individual's ability to be physically active. The main components are cardiorespiratory fitness (CRF), muscle strength, and flexibility. Regardless of physical activity level, physical fitness is an important determinant of morbidity and mortality.The aim of the current study was to describe the physical fitness assessment methodology in the German National Cohort (NAKO) and to present initial descriptive results in a subsample of the cohort.In the NAKO, hand grip strength (GS) and CRF as physical fitness components were assessed at baseline using a hand dynamometer and a submaximal bicycle ergometer test, respectively. Maximum oxygen uptake (VO2max) was estimated as a result of the bicycle ergometer test. The results of a total of 99,068 GS measurements and 3094 CRF measurements are based on a data set at halftime of the NAKO baseline survey (age 20-73 years, 47% men).Males showed higher values of physical fitness compared to women (males: GS = 47.8 kg, VO2max = 36.4 ml·min-1 · kg-1; females: GS = 29.9 kg, VO2max = 32.3 ml · min-1 · kg-1). GS declined from the age of 50 onwards, whereas VO2max levels decreased continuously between the age groups of 20-29 and ≥60 years. GS and VO2max showed a linear positive association after adjustment for body weight (males β = 0.21; females β = 0.35).These results indicate that the physical fitness measured in the NAKO are comparable to other population-based studies. Future analyses in this study will focus on examining the independent relations of GS and CRF with risk of morbidity and mortality.
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Affiliation(s)
- Alexander Kluttig
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Deutschland.
| | - Johannes Zschocke
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Deutschland.,Institut für Physik, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - Johannes Haerting
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Deutschland
| | | | - Sylvia Gastell
- NAKO Studienzentrum, Deutsches Institut für Ernährungsforschung, Potsdam-Rehbrücke, Deutschland
| | - Karen Steindorf
- Abteilung Bewegung, Präventionsforschung und Krebs, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
| | - Florian Herbolsheimer
- Abteilung Bewegung, Präventionsforschung und Krebs, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
| | - Andrea Hillreiner
- Institut für Epidemiologie und Präventivmedizin, Universität Regensburg, Regensburg, Deutschland
| | - Carmen Jochem
- Institut für Epidemiologie und Präventivmedizin, Universität Regensburg, Regensburg, Deutschland
| | - Sebastian Baumeister
- Lehrstuhl für Epidemiologie der LMU München, UNIKA-T, Augsburg, Deutschland.,Selbstständige Forschungsgruppe Klinische Epidemiologie, Helmholtz Zentrum München, Deutsches Forschungszentrum für Gesundheit und Umwelt, München, Deutschland
| | - Ole Sprengeler
- BIPS, Leibniz Institut für Präventionsforschung und Epidemiologie, Bremen, Deutschland
| | - Tobias Pischon
- Forschergruppe Molekulare Epidemiologie, Max-Delbrück-Centrum für Molekulare Medizin in der Helmholtz-Gemeinschaft (MDC), Berlin, Deutschland.,Charité - Universitätsmedizin Berlin, Berlin, Deutschland.,MDC/BIH Biobank, Max-Delbrück-Centrum für Molekulare Medizin in der Helmholtz-Gemeinschaft (MDC) und Berlin Institute of Health (BIH), Berlin, Deutschland.,Partnerstandort Berlin, Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Berlin, Deutschland
| | - Lina Jaeschke
- Forschergruppe Molekulare Epidemiologie, Max-Delbrück-Centrum für Molekulare Medizin in der Helmholtz-Gemeinschaft (MDC), Berlin, Deutschland
| | - Karin B Michels
- Institut für Prävention und Tumorepidemiologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
| | - Lilian Krist
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Halina Greiser
- Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
| | | | - Wolfgang Lieb
- Institut für Epidemiologie, Christian-Albrechts-Universität Kiel, Kiel, Deutschland
| | - Sabina Waniek
- Institut für Epidemiologie, Christian-Albrechts-Universität Kiel, Kiel, Deutschland
| | - Heiko Becher
- Institut für Medizinische Biometrie und Epidemiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Annika Jagodzinski
- Epidemiologisches Studienzentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.,Partnerstandort Hamburg, Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Hamburg, Deutschland
| | - Sabine Schipf
- Institut für Community Medicine, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - Henry Völzke
- Institut für Community Medicine, Universitätsmedizin Greifswald, Greifswald, Deutschland.,Partnerstandort Greifswald, Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Greifswald, Deutschland
| | - Wolfgang Ahrens
- BIPS, Leibniz Institut für Präventionsforschung und Epidemiologie, Bremen, Deutschland.,Institut für Statistik, Fachbereich Mathematik und Informatik, Universität Bremen, Bremen, Deutschland
| | - Kathrin Günther
- BIPS, Leibniz Institut für Präventionsforschung und Epidemiologie, Bremen, Deutschland
| | - Stefanie Castell
- Helmholtz-Zentrum für Infektionsforschung (HZI), Braunschweig, Deutschland
| | - Yvonne Kemmling
- Helmholtz-Zentrum für Infektionsforschung (HZI), Braunschweig, Deutschland
| | - Nicole Legath
- Institut für Epidemiologie und Sozialmedizin, Universität Münster, Münster, Deutschland
| | - Klaus Berger
- Institut für Epidemiologie und Sozialmedizin, Universität Münster, Münster, Deutschland
| | - Thomas Keil
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.,Institut für Klinische Epidemiologie und Biometrie, Universität Würzburg, Würzburg, Deutschland.,Landesinstitut für Gesundheit, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Bad Kissingen, Deutschland
| | - Julia Fricke
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Matthias B Schulze
- Abteilung Molekulare Epidemiologie, Deutsches Institut für Ernährungsforschung, (DIfE), Nuthetal, Deutschland
| | - Markus Loeffler
- Institut für Medizinische Informatik, Statistik und Epidemiologie (IMISE), Universität Leipzig, Leipzig, Deutschland
| | - Kerstin Wirkner
- LIFE - Leipziger Forschungszentrum für Zivilisationserkrankungen, Universität Leipzig, Leipzig, Deutschland
| | - Oliver Kuß
- Institut für Biometrie und Epidemiologie, Deutsches Diabetes-Zentrum (DDZ), Leibniz-Zentrum für Diabetes-Forschung an der Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - Tamara Schikowski
- IUF - Leibniz-Institut für umweltmedizinische Forschung, Düsseldorf, Deutschland
| | - Sonja Kalinowski
- Institut für Medizinische Informatik, Biometrie und Epidemiologie (IMIBE), Universitätsklinikum Essen, Essen, Deutschland
| | - Andreas Stang
- Institut für Medizinische Informatik, Biometrie und Epidemiologie (IMIBE), Universitätsklinikum Essen, Essen, Deutschland
| | - Rudolf Kaaks
- Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
| | | | - Michael Hoffmeister
- Abteilung Klinische Epidemiologie und Alternsforschung, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
| | | | - Claus-Werner Franzke
- Institut für Prävention und Tumorepidemiologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
| | - Sigrid Thierry
- Institut für Epidemiologie, Helmholtz Zentrum München, Neuherberg, Deutschland
| | - Anette Peters
- Institut für Epidemiologie, Helmholtz Zentrum München, Neuherberg, Deutschland
| | - Nadja Kartschmit
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Deutschland
| | - Rafael Mikolajczyk
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Deutschland
| | - Beate Fischer
- Institut für Epidemiologie und Präventivmedizin, Universität Regensburg, Regensburg, Deutschland
| | - Michael Leitzmann
- Institut für Epidemiologie und Präventivmedizin, Universität Regensburg, Regensburg, Deutschland
| | - Mirko Brandes
- BIPS, Leibniz Institut für Präventionsforschung und Epidemiologie, Bremen, Deutschland
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9
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Zeiher J, Manz K, Kuntz B, Perumal N, Keil T, Mensink GBM, Finger JD. Individual and interpersonal correlates of cardiorespiratory fitness in adults - Findings from the German Health Interview and Examination Survey. Sci Rep 2020; 10:445. [PMID: 31949174 PMCID: PMC6965149 DOI: 10.1038/s41598-019-56698-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 12/17/2019] [Indexed: 12/23/2022] Open
Abstract
Cardiorespiratory fitness (CRF) is an established predictor of adverse health outcomes. The aim of this study is to investigate potential behavioral, interpersonal and socioeconomic correlates of CRF among men and women living in Germany using data from a population-based nationwide cross-sectional study. 1,439 men and 1,486 women aged 18-64 participated in the German Health Interview and Examination Survey (2008-2011) and completed a standardized sub-maximal cycle ergometer test. Maximal oxygen consumption ([Formula: see text]) in ml·min-1·kg-1 was estimated. Mean values of VO2max for various anthropometric, behavioral, interpersonal, and sociodemographic variables were estimated. Linear regression analyses using multiple imputations technique for missing values was performed to analyze the influence of potential correlates on CRF. Women with high alcohol consumption had higher [Formula: see text], (β = 2.20; 95% CI 0.98 to 3.42) than women with low alcohol consumption and women with high occupational status had higher [Formula: see text] (β = 1.83; 95% CI 0.21 to 3.44) in comparison to women with low occupational status. Among men, high fruit intake (β = 1.52; 95% CI 0.63 to 2.40), compared to low or medium fruit intake and performing at least 2.5 hours of total PA per week (β = 2.19; 95% CI 1.11 to 3.28), compared to less than 2.5 hours was associated with higher [Formula: see text]. Among both men and women, lower body mass index, lower waist circumference and higher levels of physical exercise were considerably associated with higher [Formula: see text]. Among women, those in higher age groups showed a considerably lower level of [Formula: see text] compared with those aged 18-24. Furthermore, mean estimated [Formula: see text] was higher among men (36.5; 95% CI 36.0 to 37.0) than among women (30.3; 95% CI 29.8 to 30.7). Despite the cross-sectional nature of the current study, we conclude that several behavioral, anthropometric, and sociodemographic factors are associated with CRF in the general adult population in Germany. These results can provide evidence to tailor prevention measures according to the needs of specific subgroups.
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Affiliation(s)
- Johannes Zeiher
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
| | - Kristin Manz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Benjamin Kuntz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Nita Perumal
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Thomas Keil
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- Institute for Health Resort Medicine and Health Promotion, Bavarian Health and Food Safety Authority, Bad Kissingen, Germany
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Gert B M Mensink
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Jonas D Finger
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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10
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Finger JD, Banzer W, Baumeister SE, Brandes M, Bös K, Gabrys L, Gößwald A, Härtel S, Kluttig A, Kuhnert R, Leitzmann M, Löllgen HH, Manz K, Mensink GM, Niessner C, Rosario AS, Kurth BM. [Reference Values for Cardiorespiratory Fitness of the General Population: The German National Health Interview and Examination Survey for Adults (DEGS1) 2008-2011]. DAS GESUNDHEITSWESEN 2019; 83:114-121. [PMID: 31746446 DOI: 10.1055/a-1026-6220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AIM OF STUDY This study aims to provide population-based reference values for heart rate-based indicators of cardiorespiratory fitness for adults with physical activity readiness aged 18 to 64 years living in Germany. METHODS Based on data on 2,826 individuals who participated in a submaximal cycle ergometer exercise test as part of the German National Health Interview and Examination Survey for Adults (DEGS1) between 2008 and 2011, we calculated the following indicators: physical working capacity at 150 and 130 beats/min and at 75% of estimated maximum heart rate (PWC150, PWC130 and PWC75%) as well as heart rate-based estimated maximum oxygen uptake (VO2max). We used the LMS method by Cole & Green 1992 to calculate reference values. RESULTS 25th, 50th and 75th percentiles of PWC150 were 1.5, 1.77 and 2.08 watts/kg among men and 1.18, 1.44 and 1.69 among women. 25th, 50th and 75th percentiles of PWC130 were 1.16, 1.41 and 1.68 watts/kg among men and 0.81, 1.05 and 1.29 among women. Age-dependent median PWC75% values among men and women were 1.87 - age in years× 0.01 and 1.31 - (age in years/100)2× 0.98, respectively, and VO2max among men is 41.7 - age× 0.15. CONCLUSIONS The references values presented can be used for individual rating of cardiorespiratory fitness among adults living in Germany. Furthermore, they can serve as a basis for regular monitoring purposes.
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Affiliation(s)
- Jonas David Finger
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin
| | - WinfriedE Banzer
- Institut für Sportwissenschaften, Goethe-Universität Frankfurt am Main, Frankfurt am Main
| | | | - Mirko Brandes
- Abteilung für Prävention und Evaluation, Leibniz-Institut für Präventionsforschung und Epidemiologie - BIPS GmbH, Bremen
| | - Klaus Bös
- Karlsruher Institut für Technologie (KIT), Institut für Sport und Sportwissenschaft, Karlsruhe
| | - Lars Gabrys
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin.,Abteilung für Gesundheitssport und Prävention, Fachhochschule für Sport und Management Potsdam, Potsdam
| | - Antje Gößwald
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin
| | - Sascha Härtel
- Karlsruher Institut für Technologie (KIT), Institut für Sport und Sportwissenschaft, Karlsruhe
| | - Alexander Kluttig
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle
| | - Ronny Kuhnert
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin
| | - MichaelF Leitzmann
- Institut für Epidemiologie und Präventivmedizin, Universität Regensburg, Regensburg
| | - Herbert H Löllgen
- European Federation of Sports Medicine Associations (EFSMA), S&E Commission, Remscheid
| | - Kristin Manz
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin
| | - GertB M Mensink
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin
| | - Claudia Niessner
- Karlsruher Institut für Technologie (KIT), Institut für Sport und Sportwissenschaft, Karlsruhe
| | | | - Bärbel-Maria Kurth
- Leiterin der Abt. für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Insitut, Berlin
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11
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Zeiher J, Ombrellaro KJ, Perumal N, Keil T, Mensink GBM, Finger JD. Correlates and Determinants of Cardiorespiratory Fitness in Adults: a Systematic Review. SPORTS MEDICINE-OPEN 2019; 5:39. [PMID: 31482208 PMCID: PMC6722171 DOI: 10.1186/s40798-019-0211-2] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 08/05/2019] [Indexed: 01/17/2023]
Abstract
Background Enhanced cardiorespiratory fitness (CRF) is now a well-established predictor of numerous adverse health outcomes. Knowledge about the pathways leading to enhanced CRF is essential for developing appropriate interventions. Hence, the aim of this review was to provide a detailed overview of the current state of research regarding individual factors associated with or influencing CRF among the general adult population. Methods We searched the PubMed, EMBASE, and Cochrane Library databases and also conducted a search for grey literature (Google Scholar). Eligible indicators of CRF were objectively assessed measures of CRF by submaximal or maximal exercise testing measured using treadmill or cycle ergometer tests. We included quantitative observational studies of the general adult population. Using a semi-quantitative approach, we compiled summary tables aggregating the study results for each potential correlate or determinant of CRF. Results We identified 3005 studies, 78 of which met the inclusion criteria. Almost all of these studies were conducted in high-income countries. Study quality scores assessing the risk of bias in the individual studies ranged from 40 to 100%. Male sex, age (inverse), education, socioeconomic status, ethnicity, body mass index (inverse), body weight (inverse), waist circumference, body fat (inverse), resting heart rate (inverse), C-reactive protein (inverse), smoking (inverse), alcohol consumption, and multiple measures of leisure-time physical activity were independently and consistently associated with CRF. Conclusions In synthesizing the current research on the correlates and determinants of CRF among adults, this systematic review identified gaps in the current understanding of factors influencing CRF. Beyond the scope of this review, environmental and interpersonal determinants should be further investigated. Systematic Review Registration PROSPERO, CRD42017055456. Electronic supplementary material The online version of this article (10.1186/s40798-019-0211-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Johannes Zeiher
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, 12101, Berlin, Germany.
| | - Katherine J Ombrellaro
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, 12101, Berlin, Germany
| | - Nita Perumal
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Thomas Keil
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.,Institute for Health Resort Medicine and Health Promotion, Bavarian Health and Food Safety Authority, Bad Kissingen, Germany.,Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Gert B M Mensink
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, 12101, Berlin, Germany
| | - Jonas D Finger
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, 12101, Berlin, Germany
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12
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A pilot study of exercise-induced changes in mitochondrial oxygen metabolism measured by a cellular oxygen metabolism monitor (PICOMET). Biochim Biophys Acta Mol Basis Dis 2019; 1865:749-758. [DOI: 10.1016/j.bbadis.2018.12.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 11/29/2018] [Accepted: 12/03/2018] [Indexed: 01/25/2023]
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13
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Ombrellaro KJ, Perumal N, Zeiher J, Hoebel J, Ittermann T, Ewert R, Dörr M, Keil T, Mensink GBM, Finger JD. Socioeconomic Correlates and Determinants of Cardiorespiratory Fitness in the General Adult Population: a Systematic Review and Meta-Analysis. SPORTS MEDICINE - OPEN 2018; 4:25. [PMID: 29882063 PMCID: PMC5992110 DOI: 10.1186/s40798-018-0137-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 05/13/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND This review aims to (1) consolidate evidence regarding the association between socioeconomic status (SES) and cardiorespiratory fitness (CRF), (2) conduct a meta-analysis of the association between SES and CRF using methodologically comparable data, stratified by sex, and (3) test whether the association varies after adjustment for physical activity (PA). METHODS A systematic review of studies from MEDLINE, EMBASE, Latin American and Caribbean Health Sciences (LILACS), Scientific Electronic Library Online (ScIELO), and Cochrane Library without time or language restrictions, which investigated associations between SES and CRF. Risk of bias within studies was assessed using a customized quality assessment tool. Results were summarized in table format and methodologically similar studies were synthesized using meta-analysis of Hedges' g effect sizes. Synthesized results were appraised for cross-study bias. Results were tested for the impact of PA adjustment using meta-regression. RESULTS Compared to individuals with low education, both men and women showed higher CRF among individuals with high education (men 0.12 [0.04-0.20], women 0.19 [0.02-0.36]), while participants with medium education showed no significant difference in CRF (men 0.03 [- 0.04-0.11], women 0.09 [- 0.03-0.21]). Adjustment for PA did not significantly impact the association between education and CRF. CONCLUSIONS There is fair evidence for an association between high levels of education and increased CRF. This could have implications for monitoring, of health target compliance and of chronic disease risk among higher risk populations, to detect and prevent non-communicable diseases (NCDs) and to diminish social health inequalities. TRIAL REGISTRATION PROSPERO, CRD42017055456.
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Affiliation(s)
- Katherine J. Ombrellaro
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- Institute of Tropical Medicine and International Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Nita Perumal
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Johannes Zeiher
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Jens Hoebel
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Till Ittermann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Ralf Ewert
- Department of Internal Medicine B - Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, Greifswald, Germany
| | - Marcus Dörr
- Department of Internal Medicine B - Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), partner site, Greifswald, Germany
| | - Thomas Keil
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Gert B. M. Mensink
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Jonas D. Finger
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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14
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Perumal N, Mensink GBM, Keil T, Finger JD. Why are some people more fit than others? Correlates and determinants of cardiorespiratory fitness in adults: protocol for a systematic review. Syst Rev 2017; 6:102. [PMID: 28521801 PMCID: PMC5437494 DOI: 10.1186/s13643-017-0497-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 05/09/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiorespiratory fitness (CRF) is a physical condition that is now well established as a predictor of numerous adverse health outcomes, independent of physical activity levels. In order to be able to improve CRF at the population level and to develop effective interventions and public health programmes, it is important to understand why some people are more fit than others. Therefore, the primary aim of the systematic review described in this protocol is to examine individual and interpersonal factors that are correlated with or determine CRF among adults. METHODS The review will focus on quantitative studies that investigate any personal and interpersonal correlates and/or determinants of objectively measured CRF among the general, non-symptomatic, non-institutionalized adult population (aged 18-65 years) worldwide. The databases MEDLINE, Embase, and Cochrane Library will be searched to identify all relevant published journal articles, and Google Scholar and Scopus will be searched for grey literature. Studies where CRF is not an outcome variable and experimental studies where participants specifically receive a fitness intervention that increases CRF will be excluded. For each study, data extracted will include, among other variables, study characteristics, methodology for selecting participants into the study as well as the participants' demographic characteristics, types of correlates and determinants of CRF investigated and their measurement methods, the objective measure of CRF used and its measurement method and validity, and the main reported results on the association between the correlates or determinants and CRF. In addition, observational studies will be assessed for methodological quality and risk of bias using a customized version of the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies by the National Heart, Lung, and Blood Institute. Experimental studies will be assessed using the 27-item Downs and Black "Checklist for Measuring Study Quality". The final results will be presented as a narrative synthesis of the main findings of all included studies. DISCUSSION By consolidating and synthesizing the current research on possible individual and interpersonal correlates and determinants of CRF among adults worldwide, we aim to aid future public health actions, as well as identify gaps in our full understanding of what influences CRF. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017055456 .
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Affiliation(s)
- Nita Perumal
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape Str. 62-66, 12101, Berlin, Germany.
| | - Gert B M Mensink
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape Str. 62-66, 12101, Berlin, Germany
| | - Thomas Keil
- Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center Berlin, Luisenstr. 57, 10117, Berlin, Germany
| | - Jonas David Finger
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape Str. 62-66, 12101, Berlin, Germany
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[Socioeconomic differences in physical activity in the middle-aged working population: The role of education, occupation, and income]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2017; 59:188-96. [PMID: 26620205 DOI: 10.1007/s00103-015-2278-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Regular physical activity has positive effects on health at all ages. This study aims to investigate how far physical activity and regular sports engagement, as a more specific type of physical activity, are associated with socioeconomic factors in the middle-aged working population. METHODS Data were obtained from 21,699 working men and women aged between 30 and 64 years who participated in the 2009 and 2010 population-based national German Health Update (GEDA) surveys conducted by the Robert Koch Institute. Besides a multi-dimensional index of socioeconomic status (SES), three single dimensions of SES (education, occupation, and income) were used to analyse socioeconomic differences in total physical activity and regular sports engagement. RESULTS While the prevalence of total physical activity increased with lower SES, the proportion of people with regular sports engagement decreased with lower SES. These associations remained after adjusting for age in men and women. After mutual adjustment of the three single socioeconomic dimensions, physical activity was independently associated with lower education and lower occupational status. Regular sports engagement was observed to be independently associated with higher education, higher occupational status, as well as higher income after mutual adjustment. CONCLUSIONS This study demonstrates significant socioeconomic differences in physical and sports activity in the middle-aged working population. Education, occupation, and income show varying independent associations with physical activity behaviour. Such differences need to be considered when identifying target groups for health-enhancing physical activity interventions.
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Fit für die Rettung? Notf Rett Med 2016. [DOI: 10.1007/s10049-016-0143-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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