Health promotion: The impact of beliefs of health benefits, social relations and enjoyment on exercise continuation

Solving the High-Intensity Multimodal Training Prescription Puzzle: A Systematic Mapping Review

BACKGROUND

High-Intensity Multimodal Training (HIMT) refers to all styles of high-intensity combined aerobic, resistance and/or bodyweight exercise. Previous heterogeneity in exercise prescription and reporting in HIMT reduces the understanding of which factors should be considered when prescribing HIMT (e.g., exercise volume, intensity, duration). Previous studies have demonstrated positive effects of HIMT on health and performance outcomes. However, methodological disparities limit comparisons between findings. The objective of this systematic mapping review was to examine which prescriptive considerations and health and performance outcomes have been reported on in HIMT. This review also examined the quantity and trends of research conducted on HIMT.

METHODS

A systematic literature search was conducted using Ovid Medline, SPORTDiscus and Cochrane Library databases and additional sources to identify studies up until February 2023. A total of 37,090 records were retrieved, of which 220 were included for review. 246 individual HIMT protocols were included for categorical analysis against the Consensus on Exercise Reporting Template (CERT) and Applied Research Model for the Sport Sciences (ARMSS).

RESULTS

A total of 85 unique terms were used to describe HIMT. Included studies most commonly prescribed HIMT using a consistent exercise selection and circuit format. Exercise intensity was inconsistently reported on and a large proportion of studies prescribed 'high-intensity' exercise at a level lower than the American College of Sports Medicine criteria for high-intensity (i.e., < 77% heart rate maximum). Participation location, supervision and participation format were the most commonly reported non-training variables. The most frequently reported outcomes were cardiovascular health, perceptual outcomes, body composition and biochemical outcomes. A large proportion of previous HIMT research was experimental in design.

CONCLUSIONS

Previous HIMT research demonstrates a lack of standardisation in reporting. Future studies should seek to follow guidelines (i.e., CERT) to improve reporting rigour. Additionally, forthcoming research should attempt to actively involve practitioners in implementation studies to improve ecological validity among interventions. Finally, future outcome measures should be accessible in practice and reflect common training goals of participants.

REGISTRATION

This review adhered to PRISMA-ScR guidelines.

PREREGISTRATION

osf.io/yknq4.

Physical Demands of Walking Football in Patients With Cardiovascular Risk Factors and Diseases

OBJECTIVE

To compare the exercise intensity of walking football (WF) with walking (WA) and to describe specific movement characteristics of WF.

DESIGN

Cross-sectional study.

SETTING

Sports facilities Saarland University, Germany.

PATIENTS

Eighteen patients with cardiovascular risk factors CVRFs and diseases (13 men and 5 women, age: 69 ± 10 years).

INDEPENDENT VARIABLES

Patients completed a WF match and WA session of 2 x 10 min each. Video analysis was used to characterize movements during WF.

MAIN OUTCOME MEASURES

Rate of perceived exertion (RPE, Borg Scale 6-20), % maximum heart rate (HRmax), musculoskeletal pain on a visual analog scale (VAS, 1-100 mm) before and up to 72 hours after exercise, and movement patterns during WF.

RESULTS

The mean RPE during WF (12.1 ± 2.7) and WA (11.9 ± 3.0) did not differ (P = 0.63). The mean HR during WF (79 ± 12% of HRmax) was higher than during WA (71% ± 11%; P < 0.01). The HR variability coefficient of variation during WF (10.3% ± 5.8%) and WA (7.1 ± 5.5%) did not differ (P = 0.13). There was no influence of exercise mode (WF vs WA) on musculoskeletal pain perception (P = 0.96 for interaction). Injury-inciting activities such as lunges (median: 0.5 [interquartile range (IQR) 0-1.3]) and goal kicks (median: 4 [IQR: 1.8-5.3]) occurred rarely during WF.

CONCLUSIONS

Walking football might represent an alternative to WA for health prevention programs in patients with CVRF and diseases as it is characterized by a manageable cardiocirculatory strain, moderate RPE, low pain induction, and a low number of injury-inciting activities.

The Effects of Stretching Exercise on Levels of Blood Glucose: A Systematic Review with Meta-Analysis

BACKGROUND

Physical activity plays an important role in the management of blood glucose levels. However, compelling evidence exists only for aerobic and resistance training. In this review, we aimed to identify the potential effects of stretching exercises on blood glucose levels.

METHODS

A systematic literature search was performed using the following databases: Scopus, NLM PubMed, and Web of Science. Studies regarding the effects of stretching exercise in humans on blood glucose or any related variable were included. Further inclusion criteria were: (1) original articles (published from database inception to October 2022), (2) applying stretching as a unique exercise modality, (3) having either longitudinal or acute interventions, (4) including healthy and pathological populations, and (5) having within each study a pre- and post-intervention measure. Quality assessment of the studies was conducted using the Downs and Black checklist.

RESULTS

A total of 13 articles were included. The quality assessment revealed an overall moderate quality of the included records. Ten articles included patients with type 2 diabetes (T2D), whereas the remaining three included at-risk populations. A total of 731 people with a mean age of 56.7 ± 6.1 years old were analysed. Fasting blood glucose, 2 h post-oral glucose uptake, post-stretching intervention blood glucose levels, and HbA1c were identified as variables related to blood glucose within the studies. After the stretching interventions, a significant reduction was observed in either blood glucose (ES = - 0.79; p = 0.0174) or HbA1c (ES = - 1.11; p =  < 0.0001). Meta-analytic results highlighted greater effects in T2D patients (ES = - 1.15; p = 0.02) and for studies applying stretching as an exercise intervention (ES = - 1.27; p = 0.006) rather than considering stretching as a control exercise modality.

CONCLUSION

The results of this systematic review highlight the potential of stretching exercises to reduce blood glucose levels. In particular, if stretching is applied as a specific form of exercise intervention in patients with T2D greater effects are observed. However, further studies with more solid research designs are required, therefore, caution is needed before prescribing stretching as an exercise intervention for glycaemic management.

Bone health, body composition and physical fitness dose-response effects of 16 weeks of recreational team handball for inactive middle-to-older-aged males - A randomised controlled trial

In this study we aimed at analysing the effects of different weekly exercise volumes (1, 2 or 3 times 60-min) on bone health, body composition and physical fitness of inactive middle-to-older-aged males, after 16 weeks of recreational team handball (RTH). Fifty-four men (68 ± 4 years, stature 169 ± 6 cm; body mass 78.4 ± 10.7 kg; fat mass 27.1 ± 5.3%; BMI 27.4 ± 2.9 kg/m2; VO2peak 27.3 ± 4.8 mL/min/kg) were randomised into three intervention groups (TH1, n = 13; TH2, n = 15; or TH3, n = 12, performing 1, 2 and 3 weekly 60-min training sessions, respectively), and a control group (CG, n = 14). The training sessions consisted mainly of RTH matches played as small-sided and formal game formats (4v4, 5v5, 6v6 or 7v7) with adapted rules. Matches' mean and peak heart rate (HR) ranged from 78-80% and 86-89%HRmax, respectively, and distance covered from 4676 to 5202 m. A time x group interaction was observed for procollagen type-1 amino-terminal propeptide (P1NP), osteocalcin (OC), carboxy-terminal type-1 collagen crosslinks (CTX), sclerostin, upper and lower body dynamic strength, right arm fat mass, left and right arm, right leg and android total mass (TM; p ≤ 0.047) with the greatest effects being shown for TH2 and TH3 groups. Post-intervention group differences were observed in CTX, left arm and right leg TM (TH3 > TH1), P1NP (TH2 > CG), OC, right arm TM (TH3 > CG), upper (CG < TH1, TH2 and TH3) and lower body dynamic strength (CG < TH1 and TH3) (p ≤ 0.047). RTH was effective in enhancing bone health, body composition and physical fitness in middle-to-older-aged males, especially for the intervention groups that performed 2-3 weekly training sessions.ClinicalTrials.gov ID: NCT05295511.Trial registration: ClinicalTrials.gov identifier: NCT05295511.HighlightsAfter 16 weeks of recreational team handball small-sided and formal matches, inactive middle-to-older-aged males improved bone health, body composition and physical fitness, by performing 1, 2 or 3 60-min weekly sessions, however, greater improvements were shown in the groups that performed 2 or 3 weekly training sessions.Training intensity was similar across the intervention groups that performed recreational team handball for 1, 2 or 3 60-min weekly sessions, which means that training volume is most likely to be the reason for the different health effects shown.The very high fun levels reported by all intervention groups shows that recreational team handball is a social and fun exercise modality for middle-to-older-aged males, with potential to intrinsically motivate the participants and assure long-term adherence to exercise.

Exploring subjective responses in high-intensity multimodal training: an online cross-sectional survey

OBJECTIVES

The purpose of this study was to investigate exercise enjoyment in high-intensity multimodal training (HIMT) in current and previous HIMT participants and identify factors associated with HIMT that mediate exercise enjoyment and motivation.

DESIGN AND SETTING

A 124-item web-based survey was distributed to a cross-sectional voluntary convenience sample from August to the end of September 2021.

PARTICIPANTS

Global current and previous HIMT participants.

RESULTS

The final sample included 469 responses (completion rate: 61.6%). Among eligible respondents (n=434), 379 were current HIMT participants, 55 were previous HIMT participants. Current participants demonstrated high enjoyment (Physical Activity Enjoyment Scale). The most frequently reported reasons for increased enjoyment and motivation to continue HIMT in current participants included (1) it keeps me fit, (2) training in a group and (3) variety in a session. The most frequently reported reasons for reduced motivation to continue HIMT among previous HIMT participants included (1) other (injury, COVID-19 restrictions, low motivation, personal preferences), (2) work commitments and (3) I started another type of sport, exercise or training.

CONCLUSIONS

These findings indicate that HIMT is an enjoyable training method among current participants. The most commonly reported reasons for increased enjoyment and motivation were associated with the combined training method and the group environment. Reasons for reduced motivation to continue HIMT among previous HIMT participants may be related to commonly reported barriers to exercise and personal factors.

Mixed-gender small-sided recreational team handball games in middle-aged and elderly are physiologically more demanding for women than men

This study examined the physical and physiological demands and perceived experience of a multicomponent exercise mode, recreational team handball (TH), for middle-aged/elderly men and women, played as same- vs. mixed-gender 6v6 game formats. Matches' heart rate (HR), blood lactate (BL), perceived experience, activity profile, player load and accelerometer variables were assessed. Forty-one participants, with at least 12 weeks of experience with recreational TH (22 men; 69±4 years, 19 women; 66±6 years), performed 2 same- and 2 mixed-gender matches on an indoor 40x20 m TH court. A game format-by-gender interaction was observed for mean HR (%HRmax), time spent ˃80 and ˃90%HRmax, respiratory rating of perceived exertion and for several of the external load variables (p≤0.05). During mixed-gender matches, time spent ˃80 and ˃90%HRmax, was higher for women vs. men (p≤0.017). During same- and mixed-gender matches, BL was lower for women than men (p≤0.015). Time spent ˃90%HRmax was lower for women (p = 0.036), whereas time spent ˃80%HRmax was higher for men during same- vs. mixed-gender matches (p = 0.034). The frequency, %total match time and distance covered with high-demanding movements were higher for men during same-gender than during mixed-gender matches (p≤0.036), and higher for men vs. women in same- and mixed-gender matches (p≤0.046). The frequency of high-intensity actions, accelerations, time spent in the higher player load zones and total accumulated player load, were higher for men vs. women during same- and mixed-gender matches (p≤0.044). Fun levels were very high (9.1-9.3 AU, 0-10). Mixed-gender small-sided recreational TH games are physiologically more demanding for middle-aged/elderly women compared to men. Men showed higher cardiovascular and activity profile demands when playing same-gender matches, which was opposite to women. Nevertheless, TH is a high-intensity and motivating exercise mode for both genders, regardless the gender game format, meaning that exercise interventions may use same- and mixed-gender matches to promote participants' health.

Association between enjoyment, physical activity, and physical literacy among college students: a mediation analysis

Background

Physical literacy and enjoyment are important factors that affect physical activity.

Purpose

This work studies whether physical activity enjoyment (PAE) mediates the association between moderate to vigorous physical activity (MVPA) and physical literacy (PL) among college students.

Methods

Chinese college students were recruited using the Perceived Physical Literacy Instrument Scale (PPLI-SC), the International Physical Activity Questionnaire Short Form (IPAQ-SF), and the Physical Activity Enjoyment Scale. The SPSS Hayes process macro (model 4) was used to analyze the direct impact and the indirect impact. Pearson correlation, independent sample t-tests, and linear regression were used to analyze the relationship between indicators.

Results

The study surveyed 587 boys and 1,393 girls with a total of 1,980 valid questionnaires. MVPA, PAE, and PL of boys were significantly higher than girls (p < 0.01). The correlation analysis showed that MVPA, PL, and PAE were significantly correlated (p < 0.01). The results showed the direct effect of PL on MVPA was still statistically significant (β = 0.067, p < 0.05) after adding PAE variables; PAE has a positive effect on MVPA after controlling PL (β = 0.170, p < 0. 01). PL has a positive effect on PAE (β = 0.750, p < 0.01). PL impacted MVPA as explained by a 65.58% mediating effect of enjoyment.

Conclusion

Physical activity enjoyment mediates the relationship between PL and MVPA among college students. This means that even high PL among student may not imply that they are physically active if they do not enjoy physical activity.

Socio-cultural attitudes toward the body as a predictor of motivation for physical activity in young people brought up in Asian and European culture-Chinese-Polish comparison

The influence of sociocultural attitudes toward the body on young people's physical activity has received increasing attention. However, there is a lack of cross-cultural research in this area. The main aim of this research was to identify the similarities and differences in the sociocultural attitudes toward the body of Polish and Chinese young people who grew up in European and Asian cultures and to analyze their effect on the motivation for physical activity. A cross-sectional research study was conducted among 18- to 30-year-old Polish (n = 259) and Chinese (n = 208) young people. The variables were measured using the Sociocultural Attitudes towards Appearance Questionnaire 3 (SATAQ 3) and the Inventory of Physical Activity Objectives (IPAO). Descriptive and comparative statistics, Spearman's rho, and the stepwise multiple regression analysis were used. The main analysis showed There are both similarities and significant differences in the performance of young Polish and Chinese men and women on the variables studied; Internalization-Athlete, Pressures, and Internalization-General are universal sociocultural predictors of motivation for physical activity among young people in Poland and China; Information is a specific sociocultural predictor of motivation for physical activity in Polish young people. The cultural nuances need to be considered in understanding young people's Motivation for undertaking physical activity.

The Practice of Physical Exercise and Sports in Portuguese Trans Youth: A Case Study

The following case study aims to analyze the experience of a Portuguese trans individual regarding their practice of physical exercise (PE) and sports in Portuguese gyms and sports clubs. A 30-min interview was conducted through the Zoom platform. Before the interview, four questionnaires-Satisfaction with Life Scale (SWLS), Positive and Negative Affect Schedule (PANAS), Hospital Anxiety and Depression Scale (HADS), and EUROHIS-QOL 8-item index-were also applied, all in their Portuguese version. The interview was digitally video recorded after consent was obtained, transcribed verbatim, and subject to thematic analysis. Findings suggest positive values for satisfaction with life and quality of life. The values of positive affect were higher than those of negative affect, and there was an absence of depressive and anxious symptomatology. In the qualitative analysis, mental health was the main motive for the practice, while locker rooms separated by gender and university life were the main barriers mentioned. Mixed changing rooms were identified as facilitators of PE practice. This study highlights the importance of developing strategies for the creation of mixed changing rooms and sports teams in order to promote a comfortable and safe practice for all individuals.

Sociocultural predictors of obligatory exercise in young men: A Polish-Chinese comparison

Background

Obligatory exercise has been shown to have negative physical and mental effects on exercisers and is more prevalent among young people. However, there is limited research on obligatory exercise among young men. Social comparison theory offers a novel perspective to explore the relationship between sociocultural factors and obligatory exercise among young men, which offers an opportunity to understand potential factors contributing to obligatory exercise among young men across different cultures.

Method

We recruited a purposive sample of young people aged 18-30 from Poland (n=79) and China (n=194). Participants completed self-report measures including the Sociocultural Attitudes Toward Appearance Questionnaire3, Inventory of Physical Activity Objectives, and Obligatory Exercise Questionnaire. In the data analysis stage, we examined the strength of the relationships between the independent variables and the dependent variable through multiple regression analysis, and tested the role of the mediating variables.

Results

The main analyses revealed that Internalization-Athlete was a common direct predictor of obligatory exercise for both Polish and Chinese young men; that there were direct sociocultural predictors of obligatory exercise that were only used in relation to Polish or Chinese young men; and that social adaptation goals for motivation for physical activity mediated the development of obligatory exercise for Polish and Chinese young men, and that there were cross-cultural differences.

Conclusion

Attention should be paid to their attitudes towards the idea of a muscular and athletic body and socially adapted physical activity motivations when understanding young men's obligatory exercise, while also considering cross-cultural differences.

Acute physiological response to different recreational team handball game formats in over 60-year-old inactive men

This study described the physical and physiological demands, activity profile and fun levels of recreational team handball (TH) game formats in over 60-year-old men with no previous experience with this sport (n = 17, 67.4±3.3 years). The participants performed 5v5, 6v6 and 7v7 matches (3x15-min periods) with fixed pitch size (40x20 m). In all testing sessions, heart rate (HR), differential ratings of perceived exertion and blood lactate were evaluated to measure internal load. Locomotor profile, game actions and accelerometer data were used to access external load. Also, fun levels were registered at the end of all testing sessions. Mean (76–77%HR_max) and peak HR (84–86%HR_max) decreased from the first to the third match period, in 6v6 and 7v7 (p≤0.034, d = 0.730). Blood lactate increased from baseline to the first period and decreased from the first to the third period in all game formats (p<0.001, d = 1.646). The participants covered longer total distances in 6v6 vs 5v5 (p≤0.005, d = 0.927) and spent more time in fast running in 6v6 vs 5v5 and 7v7 (p<0.001, d = 1.725) and in 5v5 vs 7v7 (p = 0.007, d = 0.912). A higher number of throws was performed in 5v5 vs 6v6 and 7v7 (p<0.001, d = 1.547), and in 6v6 vs 7v7 (p = 0.031, d = 0.779). The number of stops and total actions in 7v7 was significantly lower vs 5v5 and 6v6 (p≤0.003, d = 1.025). Recreational TH is a high-intensity and motivating exercise mode for middle-aged and older men, regardless the game format. However, higher high-intensity demands were observed during 5v5 and 6v6 game formats. Therefore, it is suggested a multiple game format (5v5, 6v6 and 7v7) training plan, with more use of 5v5 and 6v6 game formats, with training sessions lasting up to 15-min of warm-up and 3x15-min periods of match-play, when prescribing recreational TH to improve cardiovascular and musculoskeletal health in this population.

Affective components in promoting physical activity: A randomized controlled trial of message framing

Although the study of the affective components involved in predicting physical activity is spreading faster and faster, there is a lack of studies testing their role when promoting physical activity through message interventions. In the present study, we considered these components by focusing on how anticipated affective reactions and emotional processing of the messages influence receivers’ affective attitude toward physical activity, concurrent behavior, and future intention. A sample of 250 participants was involved in an intervention relying on prefactual (i.e., “If … then…”) messages promoting physical activity. All messages were sent through a research app and were focused on the expected consequences of exercising (or not exercising). Four experimental conditions involving messages differing as to their outcome sensitivity framing (i.e., gain, non-loss, non-gain, and loss) were compared to a control condition. Results showed that reading gain and non-gain messages enhanced the positive affective attitude toward physical activity, compared to control. Enhanced affective attitude after the intervention increased, in turn, self-reported physical activity and future intention. Interestingly, gain messages were even more persuasive for people with a low level of positive anticipated affective reactions. Furthermore, their effectiveness was especially attributable to the elicitation of hope in receivers. Discussion focuses on the advantages of considering affective components and their implications when promoting physical activity.

The effect of 5 years of team sport on elderly males' health and social capital—An interdisciplinary follow‐up study

Background and Aims

Floorball training induces positive effects on health among untrained older adults. However, the effect of long‐term participation (>2 years) in floorball training among elderly males has not been investigated. The aim of the present study was to examine the effect of 5 years of floorball training on risk factors for lifestyle diseases, fitness, physical function, and social capital of elderly males and compare to a control group that continued their usual lifestyle.

Methods

Twenty‐nine recreationally active elderly men aged 75.1 ± 3.3 (mean ± SD; range: 69–81) years with a height, body mass, and body mass index of 1.78 ± 0.06 m, 79.8 ± 10.9 kg, and 25.8 ± 4.1 kg/m², respectively, volunteered to take part in follow‐up investigations about 5 years after participating in a study on the effect of 12 weeks of floorball or petanque training. At the end of the parental study 15 subjects chose to participate in floorball training (floorball group [FG]) whereas 14 subjects (control group [CG]), resumed their usual lifestyle. FG participated in small‐sided floorball training 1 h ~1.75 times/week for 5 years in a local sports club.

Results

From baseline to 5 years, FG had reduced fat percentage, android, and visceral fat, increased total and leg bone mineral density, leg extension maximal voluntary contraction, maximal walk distance in 6 min and 30 s sit‐to‐stand repetitions, decreased time for 5 sit‐to‐stand repetitions and Timed Up and Go (p < 0.05). These changes were all different from less favorable changes in CG (p < 0.05). In FG there was a decline in maximum oxygen uptake which was smaller than the decline in CG (p < 0.05). In addition, FG had developed social capital through the 5 years strengthening their social connectedness and group cohesion.

Conclusion

In conclusion, both from a sociological and physiological perspective, small‐sided floorball training can be considered a health‐promoting activity for older men.

Effects of Low vs Moderate Dose of Recreational Football on Cardiovascular Risk Factors

This study aimed to compare the effectiveness of recreational football performed once (LOW) vs. twice (MOD) a week on cardiovascular risk factors in healthy, sedentary men. Body composition, resting blood pressure, blood lipid profile and maximal oxygen consumption (VO₂max) were measured at baseline, after a 12-week control and training period, using an interrupted time series study (study 1, n=18: n=8, LOW and n=10, MOD) nested in a randomised parallel trial (study 2, n=34: n=18 LOW and n=16 MOD). After the intervention in the study 1, LDL-Cholesterol (-12.3 mg•dL-¹ [-22.7 to -2.0]) and VO₂max (4.5 ml•kg-¹•min-¹ [1.2 to 7.8 ]) changed in LOW whereas differences were found in weight (-2.1 kg [-3.7 to -0.4]), BMI (-0.7 kg•m^-2 [-1.2 to -0.1]), total cholesterol (-22.2 mg•dL-¹ [-36.0 to -8.4]), no-HDL-cholesterol (-17.5 mg•dL-¹ [-30.5 to -4.5]), LDL-cholesterol (-14.9 mg•dL-¹ [-23.6 to -6.2]) and VO₂max (5.7 ml•kg-¹•min-¹ [2.8 to 8.6]) in MOD. Study 2 showed no evidence of differences between groups. Our results therefore, suggest positive health effects of recreational football even when performed at low frequency as it can happen in real context.

Outdoor Community Ambulation Interventions to Improve Physical and Mental Health in Older Adults: A Systematic Review and Meta-Analysis

Limited community ambulation, defined as independent mobility outside the home, predicts adverse outcomes in older adults. We performed a systematic review and meta-analysis to examine outdoor community ambulation intervention effectiveness in older adults. We searched six databases until October 2021. Studies with an evaluative research objective, older adult population, and outdoor community ambulation interventions were eligible. After reviewing 23,172 records, five studies were included. The meta-analysis found no significant difference in walking endurance and depression outcomes between outdoor community ambulation and comparison interventions. For outcomes not suitable for meta-analysis, studies showed no significant difference in walking activity, anxiety, and general and health-related quality of life, and possible improvements in gait speed and lower extremity function and strength. Most evidence was of low to very low certainty. Considering the limited evidence base, the design, implementation, and evaluation of outdoor community ambulation interventions in older adults should be prioritized in primary research.

Lessons learned from a pandemic: implications for a combined exercise and educational programme for medical students

BACKGROUND

The 'MED-WELL' programme is a combined exercise and educational intervention designed to promote well-being among medical students and educate students about prescribing exercise as medicine in clinical practice. Due to COVID-19 public health restrictions of social distancing the 'MED-WELL' programme was offered online instead of in-person in 2021. The aim of this study is to compare the experiences of participants in the 'MED-WELL' programme online to those that previously participated in the same programme in-person to understand the student experience and optimize programme delivery.

METHODS

Purposive sampling was used to recruit 20 participants to a qualitative study using semi-structured interviews. Ten study participants took part in the 'MED-WELL' programme when it was offered in-person, and the other ten study participants took part in the programme when it was offered online. All interviews were audio-recorded and transcribed using Microsoft Teams. A combined inductive and deductive approach was used for analysis. An inductive thematic analysis was utilized to categorize data into higher order codes, themes, and overarching themes. The theory of online learning provided the theoretical framework for a deductive approach.

RESULTS

Analysis of the data produced five overarching themes: 'student-student', 'student-teacher', 'student-content', 'student-environment', and 'effects of a pandemic'. The first four themes detail distinct types of interaction that participants had with various entities of the 'MED-WELL' programme and the effects that these interactions had on participant experiences. 'Effects of a pandemic' refers to the context of delivering the 'MED-WELL' programme online during a pandemic and how this mode of delivery influenced participants and the programme.

CONCLUSIONS

Optimizing the 'MED-WELL' programme relies on an understanding of how participants interact with different entities of the programme and are motivated to attend and engage. Participants tended to favour an in-person mode of delivery, however certain advantages of delivering the programme online were also identified. The findings from this study can be used to inform similar experiential and educational exercise interventions, and may help plan for potential future restrictions on in-person educational and exercise-based programmes.

The Effects of High-Intensity Multimodal Training in Apparently Healthy Populations: A Systematic Review

Background

High-intensity multimodal training (HIMT) is emerging as a popular training method that combines aerobic and resistance training throughout a single exercise session. The current literature is limited by a lack of terminology that broadly encompasses all styles of combined aerobic and resistance training. The magnitude of chronic or long-term (i.e.  ≥ 4 weeks) effects of HIMT participation on aerobic and muscular fitness also remains unclear. Additionally, one of many complex reasons for the growing popularity of HIMT may be attributed to the affective response to exercise, namely levels of enjoyment. However, this concept is not yet well understood across all styles of HIMT. A comprehensive systematic review is required to synthesise the available literature and attempt to provide an operational definition of HIMT to capture the breadth of combined training styles that exist.

Objective

The objective of this systematic review was to determine the chronic effects of HIMT participation on aerobic and muscular fitness and to compare HIMT to established concurrent training methods. Enjoyability and other adherence-related subjective responses were also examined in HIMT participants. This review critically assessed the level of evidence and feasibility of current HIMT guidelines.

Methods

A systematic literature search was conducted on PubMed, Web of Science and SPORTDiscus to identify studies up until March 2021.

Results

A total of 20 studies were included for review. Studies generally reported moderate to large effects on aerobic fitness and subjective responses in favour of HIMT interventions. Mixed outcomes were demonstrated in muscular fitness. These results should be treated with caution due to high risk of bias among included studies.

Conclusions

Few studies have assessed the chronic effects of HIMT participation on aerobic, and musculoskeletal adaptations and subjective responses, in particular exercise enjoyment. Research conclusions are limited by heterogeneity of experimental protocols and outcome measures. Furthermore, the inability of the literature to make adequate comparisons between various styles of HIMT and other concurrent training protocols limits understandings of the efficacy of HIMT.

Registration This systematic review was registered on the Open Science Framework (10.17605/OSF.IO/2RE4B; 26 March 2021).

Supplementary Information

The online version contains supplementary material available at 10.1186/s40798-022-00434-x.

Adherence and satisfaction in Argus II prosthesis users: a self determination theory model

BACKGROUND

Self-determination theory (SDT) of human motivation was used to examine associations between different forms of motivation in Argus II retinal prosthesis users and their engagement and satisfaction with the Argus device.

MATERIALS AND METHODS

Nine subjects were administered: 1) a Situational Motivation Scale (SIMS) questionnaire to measure intrinsic motivation, identified regulation, external regulation, and amotivation, and 2) the Argus questionnaire (AQ) which was organized into 5 categories to measure 'Decision to get an Argus implant,' 'Self-perception as an Argus user', 'Utility of Argus,' 'Perceived competence,' and 'Family support.' Spearman correlations (r_s) were used to find associations between measures from SIMS and AQ.

RESULTS

Nine subjects completed both questionnaires. Statistically significant associations were observed between identified regulation and AQ items from categories: Decision to get Argus, Self-perception, Utility of Argus, and Perceived competence; and between intrinsic motivation and AQ items from Self-perception and Utility. External regulation was negatively associated with Family support, and amotivation was associated with one item from Self-perception. Engagement with the device and satisfaction were associated to both identified regulation and intrinsic motivation. There was no significant relationship between external regulation and adherence to the device.

CONCLUSIONS

The SDT model can be used to investigate the types of motivation that influence uptake and engagement of the Argus device. Clinicians can use this knowledge to improve outcomes by supporting confidence in users and by encouraging them to maintain internalization and continued commitment to adherence.

Enjoyment as a Predictor of Exercise Habit, Intention to Continue Exercising, and Exercise Frequency: The Intensity Traits Discrepancy Moderation Role

Given the need to explore the factors that can account for a better understanding of the intention-behavior gap in exercise practice in health club settings, and considering the emergence of hedonic assumptions related to exercise adherence, this cross-sectional study aimed to test the moderation effect of the intensity traits agreement/disagreement in three relevant outcomes of exercise enjoyment: exercise habit, intention to continue exercising, and exercise frequency. A sample consisted of 273 exercisers (male = 127; M age = 36.21; SD = 11.29) enrolled in nine health clubs who voluntarily fulfilled a battery of questionnaires. All analyses were performed using SPSS v. 23.0/PROCESS v. 3.5. The results of the study presented a moderation effect of exercise intensity traits agreement on three relevant enjoyment outcomes: exercise habit, intention to continue exercising, and exercise frequency. No relevant results emerged from intensity traits disagreement. The results suggest that assessing and tailoring exercise prescription and supervision in order to customize exercise intensity may influence future exercise participation.

Effectiveness of workplace exercise interventions in the treatment of musculoskeletal disorders in office workers: a systematic review

OBJECTIVE

To determine the effectiveness of workplace exercise interventions in the treatment of musculoskeletal disorders.

DESIGN

Systematic review of randomised controlled trials (RCTs).

DATA SOURCES

The bibliographical databases PubMed, CINAHL Plus, Cochrane, Scopus, ISI WoS and PeDRO were searched, with studies from 1 January 2010 to 31 December 2020 eligible for inclusion.

ELIGIBILITY CRITERIA

We included RCTs, reported in English or Spanish, with at least an intervention group performing workplace exercises among office workers with musculoskeletal disorders.

DATA EXTRACTION AND SYNTHESIS

Two independent reviewers extracted data and assessed the risk of bias. A narrative synthesis was carried out with a tabular method specifying the study characteristics following the SWiM (Synthesis Without Meta-Analysis) guideline for synthesis without meta-analysis. The revised Cochrane Risk of Bias (RoB-2) tool was used to analyse the risk of bias of the included studies.

RESULTS

Seven studies with a total of 967 participants met the inclusion criteria and were included in this review. Due to heterogeneity in different workplace exercise interventions, outcome measures and statistical analyses, it was not possible to conduct a meta-analysis and a narrative synthesis was performed. The interventions were classified into three categories: multiple body regions, neck and shoulder, and lower back. The seven studies concluded that workplace exercise interventions were effective in reducing musculoskeletal disorders and pain compared with other types of interventions or with control groups with no interventions. The RoB-2 tool found a high risk of bias in six of the seven studies.

CONCLUSIONS

The findings of the RCTs on workplace exercise interventions suggest that interventions were effective in treating musculoskeletal disorders among office workers. However, due to the high risk of bias of the included studies, no firm conclusions could be drawn and more high-quality studies are needed.

PROSPERO REGISTRATION NUMBER

CRD42020177462.

Does stammering act as a barrier to exercise and sport in Irish adults who stammer?

PURPOSE

Exercise and sport participation lead to many physical and psychosocial benefits. However, barriers to exercise and sporting participation exist. This study aims to examine if stammering acts as a barrier to exercise and sporting participation in adults.

METHODS

One hundred and six adults who stammer (male n = 74, female n = 32; 33.83 ± 14.5 years) completed an anonymous questionnaire which evaluated their stammering history, exercise and sporting participation, views on why they exercise, whether stammering prevented or negatively influenced their participation in exercise or sport. Descriptive statistics were then calculated.

RESULTS

The majority (90.6 %) of participants take part in some form of exercise/sport. However, their stammer prevented them from taking part in a specific exercise/sport at least once (49.1 %), due to being too nervous to introduce themselves, nervous or fear of stammering or being judged. Their stammer also negatively impacted their involvement when participating at least once (42.4 %), with not feeling part of the team and fear of speaking reported. Self-disclosure of their stammer and improving awareness of stammering were identified as common facilitators for taking part in exercise/sport.

CONCLUSION

Stammering was not found to impact general participation in exercise and sport but was identified as a barrier to partaking in specific exercise and sport and their enjoyment thereof. Encouraging those who stammer to inform those involved in sport and exercise (e.g. fellow players, coaches) about their stammer and improving stammer awareness across the general and sporting population may encourage further participation in exercise and sport in those who stammer.

Aquatic Physical Literacy: The Effectiveness of Applied Pedagogy on Parents' and Children's Perceptions of Aquatic Motor Competence

The goal of swimming school during early school age is to promote physical literacy. According to linear or non-linear pedagogy, a linear or non-linear approach teaching style can be used. The aim of our study was to investigate whether a different teaching methodology, as in using a teacher-centered approach (linear pedagogy), or a student-centered approach (non-linear pedagogy), could differently influence the perceptions of aquatic activity of children and parents. Parents of 100 children (53 females and 47 males, age 5.9 ± 0.3 years old) participating in the study were previously interviewed to ascertain their expectations regarding the swimming course. Participants were in a medium-high social context. Subsequently, considering the data of the incoming aquatic motor competence's tests, children were divided into a linear (LI) and non-linear (NL) pedagogy group. A total of 4 instructors were enrolled. Upon completing the swimming course, the aquatic motor competence's test was repeated, a pictorial scale of perceived motor competence was administered, and a questionnaire regarding the course was proposed to children's parents. Physical development and learn to swim resulted two of the most important reasons leading parents to choose swimming courses. LI achieved greater progress than the NL in actual motor competence (A.M.C.), while NL perceived a higher aquatic motor competence (P.M.C.) in 7 out of 10 items of the pictorial scale. Parents of children in LI, gave greater importance to the teacher's role, while NL's parents pointed the acquisition of children's abilities as pivotal. In conclusion, NL approach was more appreciated by children, while LI method was more rewarding for parents because initial expectations were satisfied.

Metacognition and Self-determination, Impulsivity and Emotional intelligence, and its relation with wellbeing and health indicators in young adults

Background: From the evidence, it is inferred the influence of cognitive or motivational variables over the emotional ones and from these on the perception and self-reported wellbeing and health, with direct implications for health promotion and prevention. Method: a quantitative approach, descriptive, correlational cross-sectional with statistical explanatory analysis investigation was conducted, analyzing the data through path modeling of the partial least squares approach of the structural equations model, by using the Smart PLS software 3.3.2 version, analyzing consequently the convergent and discriminant validity of the model. A total 223 undergraduate university young adult students was evaluated, 41 men (18,4%) and 182 women (81,6%) with ages between 18 and 30 years old (µ= 24,26 y σ=±3,30), from Bogotá Colombia participated. Results: The results allowed to significant relations between the self – determination with the impulsivity and emotional intelligence, and from these with the psychological well-being and healthy habits. There were not identified significant relations between the metacognition and the impulsivity, although there are between metacognition and emotional intelligence. Conclusions: The proposed model about the significant relations between metacognition and self-determination with impulsivity and emotional intelligence and between these and the psychological well-being and healthy habits was confirmed. The specific result related to the absence of significant relations between metacognition and the impulsivity suggest for futures research, to emphasize on the metacognitive process implicated on the emotional components. The results are discussed, its implications and the necessity to be considered more determinants for the promotion of health.

Randomised controlled trial comparing two group-based exercise programmes (team sport vs circuit training) on men's health: study protocol

Introduction

Physical activity promotes physical, psychological and social health. Despite this, almost half of middle-aged (35–54 years) Australian men are insufficiently active. Exercise adherence is increased with social interaction in a group setting. Team sport can leverage the power of groups and has shown to be more intrinsically motivating than discrete exercise modes. Evaluation of the effect of team sport compared with traditional group exercise on health, particularly psychological and social health, and physical activity levels of middle-aged men is limited. This study aims to compare the effects of team sport participation and group circuit training on physical activity levels and health in insufficiently active middle-aged men.

Methods and analysis

In this parallel randomised controlled trial, n=128 men aged 35–54 years will complete a 12-week team sport or group circuit exercise programme. Participants must self-report to not be meeting Australian physical activity guidelines or participating in team sport before recruitment. Health-related quality of life, exercise motivation, psychological needs satisfaction, sleep and physical activity levels (accelerometry), blood lipids, glucose and metabolic syndrome risk score will be assessed at baseline, end of the programme and 12 weeks follow-up. Linear mixed effect models will be used.

Ethics and dissemination

The study has received ethical approval from the University of South Australia’s Human Research Ethics Committee (Ethics Protocol 203274). Study results will be disseminated via publication in disciplinary-specific journals, conference presentations, and as part of a Doctoral thesis.

Trial registration number

ANCTRN12621000483853.

Did You Enjoy It? The Role of Intensity-Trait Preference/Tolerance in Basic Psychological Needs and Exercise Enjoyment

Promoting exercise regimens that aim at enhancing the quality of individuals’ subjective exercise experience can be challenging. Given the recent theoretical contributions regarding the possible interaction of exercise intensity-traits and several motivational variables, as well as their potential value for exercise adherence, the objective of this study was to examine the mediation role of basic psychological needs in the relationship between preference for and tolerance of exercise intensity and enjoyment. This cross-sectional study comprised a total of 160 exercisers (Mage = 34.12, SD = 9.23, 73 males) enrolled in several health clubs. All analyses were performed using SPSS v. 23.0/PROCESS v. 3.4. The results indicate that intensity-traits presented positive associations with enjoyment, and negative associations with all of needs frustration variables. A mediation role of needs frustration emerged in the intensity-traits and enjoyment associations that was analyzed according to relatable theoretical considerations.

What Intervention Techniques Are Effective in Changing Positive Affective Variables and Physical Activity? A Systematic Review and Meta-Analysis

A recent meta-analysis has demonstrated that positive affective variables (PAVs) partially mediate physical activity (PA) interventions. However, the effectiveness of each intervention technique on PAVs and PA is still unknown. Thus, this meta-analytic review included two primary objectives: (1) to summarize intervention effects on PA and PAVs; (2) to examine each behavior change technique's effectiveness in modifying PAVs and PA. Following PRISMA protocols, we had searched five electronic databases by April 1, 2020. The random-effect model in the Comprehensive Meta-Analysis Version 3 was adopted to perform these meta-analytic analyses. The search identified 1,742 articles, and 37 studies (49 datasets) met our inclusion criteria. Finally, inferential statistics yielded that: the utilization of "teach to use prompts/cues," "facilitate social comparison," and "provide information on consequences of behavior in general" had positive effects on PA or PAVs outcomes; the utilization of "barrier identification/problem solving" and "plan social support/social change" negatively affected on PA or PAVs outcomes. However, there was considerable heterogeneity in the findings. Nonetheless, this paper has considerable implications for guiding future comparative intervention studies to achieve more reliable outcomes.

Effect of Boards in Small-Sided Street Soccer Games on Movement Pattern and Physiological Response in Recreationally Active Young Men

Randers, MB, Brix, J, Hagman, M, Nielsen, JJ, and Krustrup, P. Effect of boards in small-sided street soccer games on movement pattern and physiological response in recreationally active young men. J Strength Cond Res 34(12): 3530-3537, 2020-This study investigated whether street soccer might be proposed as an alternative to recreational small-sided games on grass as a health-enhancing activity and, specifically, the effects of the boards surrounding the pitch. Eleven recreationally active young men (28.4 ± 4.2 SD years, 19.9 ± 4.2% body fat, and 47.7 ± 6.0 ml·min·kg), after familiarization, completed one to 2 sessions of 20 × 13-m 3v3 street soccer games with boards (WBs) and one to 2 sessions without boards (WOBs) in a randomized order. Movement pattern was measured using global positioning system, and heart rate recordings, blood sampling, and rating of perceived exertion (RPE) scales were used to evaluate exercise intensity and physiological strain. Total number of accelerations (19%) and player load (18%) were higher (p ≤ 0.005) in WB than in WOB, whereas total distance covered (12%), high-speed running (59%), and peak speed (11%) were lower (p ≤ 0.003) in WB than in WOB. Moreover, HRmean was higher in WB than in WOB (85.7 ± 5.4 vs. 81.3 ± 8.2% HRmax, p = 0.012, ES = 0.64), whereas time with HR > 90% HRmax did not differ between WB and WOB (42 ± 34 vs. 32 ± 30%, p = 0.243, ES = 0.32). Plasma ammonia increased more in WB than in WOB, with no differences found in mean and peak blood lactate. Rating of perceived exertion was higher after WB than after WOB (7.1 ± 1.0 vs. 5.5 ± 1.2, p < 0.001, ES = 1.39). In conclusion, intensity was sufficiently high in both game formats to expect short- and long-term health improvements as a result of regular participation. Boards affected movement pattern and physiological demands, producing higher number of accelerations, player load, average heart rate, plasma ammonia, and RPE but lower total distance, number of intense runs, and peak speed.

Physical Activity Levels of Adult Virtual Football Players

Esports, including virtual football, are a worldwide phenomenon. Yet, little is known about the physical activity levels of individuals engaged in virtual football game play. Therefore, we aimed to perform a preliminary evaluation of the levels of physical activity, sedentarism, and habits of physical training of adults engaged with virtual football in Portugal. This was a cross-sectional investigation based on a structured online survey using the International Physical Activity Questionnaire (IPAQ) and a set of questions regarding habits of physical training. The participants (n = 433) reported spending a median of 5,625 MET-min⋅week⁻¹ being physically active. Still, the participants spent 320 min/day sitting, and 150 min/day practicing virtual football. According to the IPAQ scores, high physical activity levels were reported by 84.5% of the participants, and 87.1% were considered physically active considering the WHO guidelines on physical activity and sedentary behavior. Overall, 60.0% of the participants reported planning their own physical training. Maintaining or improving overall physical health was one of the main reasons for doing physical training (66.7%), with only 6.1% responding being active to improve virtual football performance. Overall, the results showed that virtual football players accomplished the standard recommendations for physical activity, with high levels of physical activity, and encompassing regular physical training focused mostly on health promotion, rather than improved virtual football performance.

Effects of football fitness training on lymphedema and upper-extremity function in women after treatment for breast cancer: a randomized trial

BACKGROUND

Breast cancer survivors are encouraged to be physically active. A recent review suggests that football training is an effective exercise modality for women across the lifespan, positively influencing health variables such as strength, fitness and social well-being. However, football is a contact sport, potentially posing an increased risk of trauma-related injury. Against this backdrop, breast cancer survivors are advised to avoid trauma or injury to the affected or at-risk arm in order to protect against lymphedema onset or exacerbation. The aim of this study was therefore to evaluate the feasibility and safety of Football Fitness training in relation to lymphedema and upper-extremity function after treatment for breast cancer.

MATERIAL AND METHODS

Sixty-eight women aged 18-75 years, who had received surgery for stage I-III breast cancer and completed (neo) adjuvant chemotherapy and/or radiotherapy within five years, were randomized (2:1) to a Football Fitness group (FFG, n = 46) or a control group (CON, n = 22) for twelve months. Secondary analyses using linear mixed models were performed to assess changes in upper-body morbidity, specifically arm lymphedema (inter-arm volume % difference, dual energy X-ray absorptiometry; extracellular fluid (L-Dex), bioimpedance spectroscopy), self-reported breast and arm symptoms (EORTC breast cancer-specific questionnaire (BR23) and upper-extremity function (DASH questionnaire) at baseline, six- and twelve-month follow-up.

RESULTS

We observed similar point prevalent cases of lymphedema between groups at all time points, irrespective of measurement method. At the six-month post-baseline assessment, reductions in L-Dex (extracellular fluid) were found in FFG versus CON. These significant findings were not maintained at the twelve-month assessment. No difference between groups was observed for inter-limb volume difference %, nor any of the remaining outcomes.

CONCLUSION

While superiority of Football Fitness was not observed, the results support that participation in Football Fitness training is feasible and suggests no negative effects on breast cancer-specific upper-body morbidity, including lymphedema.

TRIAL REGISTRATION

The trial was registered at ClinicalTrials.gov. NCT03284567.

Recreational beach tennis reduces 24-h blood pressure in adults with hypertension: a randomized crossover trial

PURPOSE

To evaluate the effect of a beach tennis session on 24-h ambulatory blood pressure in adults with hypertension.

METHODS

In this randomized crossover trial, 24 participants (12 men and 12 women) randomly performed two experimental sessions: a beach tennis session and a non-exercise control session. The beach tennis session started with a standardized 5-min warm-up consisting of basic techniques, followed by three 12-min beach tennis matches with 2-min intervals between them. Heart rate was continuously recorded and rating of perceived exertion was assessed in the middle and at the end of each set during the beach tennis session. Enjoyment was also assessed after the beach tennis session. The control session was performed in seated rest. Both experimental sessions lasted 45 min. Ambulatory blood pressure was measured continuously for 24 h after sessions.

RESULTS

Systolic blood pressure (24-h: 6 mmHg, P = 0.008; daytime: 6 mmHg, P = 0.031; nighttime: 6 mmHg, P = 0.042) and diastolic blood pressure (24-h: 3 mmHg, P = 0.021; daytime: 3 mmHg, P = 0.036; nighttime: 4 mmHg, P = 0.076) decreased after beach tennis when compared with control. The participants presented a reserve heart rate of 59-68%, and a rating of perceived exertion score of 3.4-4.7 using Borg's CR10 Scale. The enjoyment scores after beach tennis session were higher than 90%.

CONCLUSION

A single session of recreational beach tennis reduces 24-h ambulatory blood pressure in adults with hypertension. Additionally, the participants can achieve a high physiological stress but perceive less effort during the practice.

TRIAL REGISTRATION

Date: April 10, 2019; identifier number NCT03909308 (Clinicaltrials.gov).

A Pilot Study of the Feasibility and Effects of Table Tennis Training in Parkinson Disease

Objective

To investigate feasibility and effects of table tennis training on balance control and physical function in individuals with Parkinson disease.

Design

Single group, observational, before-after trial.

Setting

Table tennis training in a gymnasium.

Participants

Community-dwelling individuals with Parkinson disease (N=9; 5 men, 4 women) with an average age of 66.9 years, average time since diagnosis of 8.6 years, and a modified Hoehn and Yahr score between 2 and 2.5 participated in this study. Participants were recruited via newspaper advertisement, at the patient organization, and at the university hospital outpatient clinic. Eight participants completed the study. One participant withdrew for logistical reasons.

Interventions

Group training program consisting of 2 table tennis training sessions per week (120min each) for 10 weeks.

Main Outcome Measures

The primary outcome was feasibility, including attendance rate, drop-out rate, a final questionnaire assessing the participants' experience during the intervention, and any adverse events. The primary effect outcome was the Mini Balance Evaluation Systems Test (Mini-BESTest). Secondary effect outcomes were Parkinson's disease questionnaire-8, European quality of life questionnaire, Montgomery Åsberg Depression Rating Scale (MADRS), Unified Parkinson's Disease Rating Scale, 10-meter walk test, generic walking scale, activities-specific balance confidence scale, and physical activity measured with an accelerometer and the Frändin-Grimby scale.

Results

The average attendance rate was 84%. There were no adverse events reported. The participants reported that the training improved well-being. The mean total score on the Mini-BESTest before and after intervention was 21.2 versus 23.3 (P=.093). Statistically significant positive effects without adjustment for multiple comparisons were found for MADRS and the Frändin-Grimby scale.

Conclusions

This study demonstrates that table tennis training is safe and feasible, and may have the potential to improve balance control, mental well-being, and self-reported physical activity level. Further studies are required before table tennis can be considered an evidence-based recommendation for individuals with Parkinson disease.

Effects of a 4 week touch rugby and self-paced interval running intervention on health markers in active young men

Background

Modified team sport activity has been proposed as effective exercise modality for promoting markers of health that are comparable or greater than continuous forms of activity. However, research using modified team sports is currently limited to sedentary populations using 2–3 sessions across a minimum of 8 weeks.

Aim

To investigate the effects of a 4-week touch rugby and self-paced interval running intervention on a range of health markers in active men.

Methods

Sixteen participants (age 26.4 ± 6.4 years) were matched for age, demographic and physical activity before completing a single touch rugby (n = 8) or running (n = 8) session per week for 4 weeks. Measures of systolic and diastolic blood pressure, resting heart rate (RHR), body composition and biochemical status were recorded pre- and post-intervention.

Results

ANCOVA analysis revealed between-group differences for impedance (P = 0.027), fat mass (P = 0.008), percentage body fat (P = 0.008) and fat-free mass (P = 0.002), with greater changes after touch rugby. Systolic blood pressure decreased for both groups with greater reductions observed after touch rugby (P = 0.002). No between-group difference was observed for RHR, interleukin-6 or C-reactive protein (P > 0.05). Contrasting internal, external and perceptual loads were observed.

Conclusion

The results of this study suggest that a single session of touch rugby over a 4-week period elicited greater improvements in body composition and SBP than self-paced running, with both being equally beneficial for improving RHR, diastolic blood pressure and inflammatory status in active young men.

Can Positive Affective Variables Mediate Intervention Effects on Physical Activity? A Systematic Review and Meta-Analysis

Well-developed theories are necessary to guide the public in increasing physical activity (PA) and promoting physical health. The role of positive affective variables (PAVs) in exercise is gaining more attention, but none of the literature has provided a systematic review and quantitative analysis of its mediating role. Therefore, the purposes of this study are (1) to systematically review studies of PA interventions, that use PAVs as the mediating variables, in order to evaluate and provide narrative summaries of these studies; (2) to statistically synthesize evidence for the mechanism of the effects of PAVs on PA outcomes. To conduct an extensive search, a PRISMA-compliant protocol was completed, and five electronic databases had been searched by 1 April 2020. We used a two-stage structural equation modeling (TSSEM) analysis approach to test how interventions trigger the critical PA change process to influence outcomes. The search strategy generated 1,732 papers potentially relevant to this study; forty of these studies met the data extraction criteria for meta-analytic mediation analysis. The path coefficient from intervention to PAV a = 0.26 (95% CI = 0.08 to 0.44), the path coefficient from PAV to PA b = 0.21 (95% CI = 0.13 to 0.28), and the direct effect from intervention to PA is also significant (c = 0.19, 95% CI = 0.12 to 0.26). In addition, the indirect effect of intervention on PA via PAV was statistically significant (c' = 0.05, 95% CI = 0.02 to 0.10). This reveals that PAVs partially mediate the relationship between interventions and PA. Our study is the first to systematically summarize the effects of experimental studies to increase PA through PAVs. It is highly recommended to make future interventions more innovative and to target the PAVs as mediators with higher fidelity.

Physical fitness and activity changes after a 24-week soccer-based adaptation of the U.S diabetes prevention program intervention in Hispanic men

PURPOSE

One third of the U.S. adult population is estimated to have prediabetes. Hispanics have a 50% higher type 2 diabetes (T2DM) death rate compared to non-Hispanic whites, yet low participation in lifestyle change programs, making this subgroup an important target for prevention efforts. The purpose of this study was to determine the effects of an exercise intervention implementing the Center for Disease Control and Prevention National Diabetes Prevention Program (NDPP) plus recreational soccer (RS) in Hispanic men.

METHODS

Overweight and obese Hispanic men, aged 30-57 years with prediabetes at screening were recruited from the community. Trained soccer coaches led 30-min facilitated discussion of the NDPP modules after each RS session, with two weekly sessions delivered over 12 wks, then once a wk until 24 wks. The 1-h RS sessions followed the Football Fitness curriculum structure. Standardized study assessments included objectively measured physical activity via fitness tracker, physical fitness via validated field tests, global positional system soccer specific metrics and behavior change questionnaires. Mixed models assessed the outcomes as a function of time and cohort and incorporated an unstructured covariance structure to examine the difference between baseline, 12 and 24 wks. All analyses were conducted as intent-to-treat and generated using SAS v 9.4.

RESULTS

Hispanic males (n = 41; mean age 41.9 [6.2 SD] years) were obese at baseline (mean BMI 32.7, standard error [0.7]). After 24 wks of the NDPP+RS intervention, there were significant beneficial changes in vertical jump (2.8 [1.3] cm; p = 0.048), agility and lower extremity muscular power (figure 8-run) at 12 wks (-4.7% change; p = 0.001) and 24 wks (-7.2% change; p < 0.0001), predicted VO2 max (12 wks: 1.9%; p = 0.007; 24 wks 1.0%; p = 0.036), modified push-ups increased 22% (p < 0.0001) at 12 wks and 31% (p < 0.0001) at 24 wks, dynamic sit-ups increased 10% (p = 0.005) at 12 wks and 15% (p < 0.0001) at 24 wks.

CONCLUSION

Among middle-aged Latino men, broad-ranging significant improvements in physical fitness were observed after 24 wks participating in lifestyle education plus RS in a single arm feasibility trial.

Psychological variables of CrossFit participants: a systematic review

Objective

This study aimed to review the existing literature concerning the psychological variables of CrossFit participants.

Methodology

This review followed the PRISMA guidelines and was documented in the PROSPERO registry (CRD42018091177). Six electronic databases (SCOPUS, PubMed, SPORTDiscus, Web of Science, EMBASE, and Cochrane) were searched from their inception through July 2020. The methodological quality of the studies was assessed.

Results

Thirty-four studies met the inclusion criteria. We observed an increase in satisfaction, clinical addiction, and enjoyment among participants related to exercise, social improvement, and high intrinsic motivation to participate for the purpose of enjoyment, challenge, and affiliation. Perceptions of effort were high among CrossFit participants. Some studies found that the reaction time was impaired after the CrossFit session, whereas others found no changes in mental health, self-esteem, and well-being after training.

Conclusion

Adherence and maintenance of the practice of CrossFit are related to psychological variables such as motivation and satisfaction of basic psychological needs. CrossFit participants demonstrated high perception of effort, intrinsic motivation, and reasons for practice such as enjoyment, challenge, and affiliation. The quality assessment demonstrated the need for more detail in the methods section of future investigations. Additional high-quality studies are needed to investigate the effects of CrossFit training on the mental health of participants.

Electronic supplementary material

The online version of this article (10.1007/s11332-020-00685-9) contains supplementary material, which is available to authorized users.

Increased prostacyclin formation after high-intensity interval training in late postmenopausal women

PURPOSE

Aging impairs vascular function in women, with the largest detrimental effects occurring during the menopausal transition. Deficiency in the nitric oxide system has been suggested to be responsible for impairment in vascular function with aging, but recent observations suggest that the prostacyclin system, acting in redundancy with the nitric oxide system, may be of importance too. Improvement in vascular function is a hallmark of exercise training and we hypothesize that leg vascular function is improved by exercise training in late postmenopausal women, and that the underlying mechanism is increased endothelial formation of prostacyclin and responsiveness to prostacyclin by the vascular smooth muscle cells.

METHOD

Femoral-arterial infusion of acetylcholine and epoprostenol was used to assess vascular function and prostacyclin release in ten late postmenopausal women (62 ± 7 years) before and after 10 weeks of high-intensity interval training (floorball conducted as small-sided games).

RESULT

The training intervention increased fitness level (V̇O_2max) by 7 ± 7% and reduced systolic and diastolic blood pressure by 10 ± 10 and 5 ± 6 mmHg, respectively. Leg vascular responsiveness to during acetylcholine and epoprostenol infusion was unchanged with training, whereas the release of prostacyclin during acetylcholine infusion increased by 125%.

CONCLUSIONS

In late postmenopausal women, vascular function assessed by femoral-arterial infusion of acetylcholine was not improved after 10 weeks of floorball training, but acetylcholine-induced prostacyclin formation and blood pressure were substantially improved. It is possible that a longer training period could lead to improvements in vascular function and that the observed increase in prostacyclin formation is one of the initial underlying changes.

Sport Medicine in the Prevention and Management of Cancer

Physical inactivity is a major concern in cancer patients despite the established preventative and therapeutic effects of regular physical exercise for this patient group. Sport not only plays an important role in supporting the development and maintenance of a physically active lifestyle but also is increasingly used as a health promotion activity in various populations. Nevertheless, the potential of sport as an effective strategy in the prevention and management of cancer has gained little attention. Based on the scant evidence to date, participation of cancer patients in supervised, well-tailored sport programs appears to be safe and feasible and is associated with an array of physical and psychological benefits. We propose that sport participation may serve as an alternative strategy in the prevention of cancer and sport medicine in the management of cancer. As with the traditional exercise modes, benefits derived from sport participation will be dependent on the sport undertaken and the physical/physiological, motor, and cognitive demands required. To this end, further work is required to develop a solid evidence base in this field so that targeted sport participation can be recommended for cancer patients.

The "11 for Health in Denmark" intervention in 10- to 12-year-old Danish girls and boys and its effects on well-being-A large-scale cluster RCT

BACKGROUND

The present study investigates the well-being effects for 10- to 12-year-old children  who participated in the school-based intervention "11 for Health in Denmark," which comprises physical activity (PA) and health education. Subgroup analyses were carried out for boys and girls.

METHOD

Three thousand sixty-one children were randomly assigned to an intervention group (IG) or a control group (CG) by 5:1 cluster randomization by school. 2533 children (mean age 11.5 ± 0.4; 49.7% boys) were assigned to IG and 528 children (mean age 11.4 ± 0.5; 50.8% boys) were assigned to CG. IG participated in the "11 for Health in Denmark" 11-week program, consisting of 2 × 45 min per week of football drills, small-sided games, and health education. CG did not participate in any intervention and continued with their regular education. Before and after the intervention period, both groups answered a shortened version of the multidimensional well-being questionnaire KIDSCREEN-27.

RESULTS

The "11 for Health in Denmark" intervention program had a positive effect on physical well-being in girls (IG: 48.6 ± 8.5 to 50.2 ± 9.3), whereas the improvement was not significant in boys. The program also had a positive impact on well-being scores for peers and social support (IG: 50.2 ± 10.2 to 50.8 ± 10.1), though when analyzed separately in the subgroups of boys and girls the changes were not significant. No between-group differences were found for psychological well-being or school environment.

CONCLUSION

The intervention program had a positive between-group effect on physical well-being in girls, whereas the change was not significant in boys. The overall scores for peers and social support improved during the intervention period, but no subgroup differences were found.

The everyday lives of in- and outpatients when beginning therapy: The importance of values-consistent behavior

Background/Objective

The manifestation of functional impairment in patients’ daily lives and interference with things they value is poorly understood. If values are compromised in patients, as theory suggests, social contexts (and the lack thereof) are especially important – though this is currently unexplored. We therefore examined whether daily values-consistent behavior was associated with the importance of a value and whether it involved social or non-social activity.

Method

Using Event Sampling Methodology, we examined daily values-consistent behavior in 57 transdiagnostic inpatients and 43 transdiagnostic outpatients at the beginning of treatment. Patients’ values-consistent behavior, its importance, and (social vs non-social) context was sampled six times per day during a one-week intensive longitudinal examination.

Results

Across both groups, the probability of subsequent values-consistent behavior increased if (1) it was judged as more important by the patient or (2) if it was embedded in a social context. The probability of reporting values-consistent behavior was higher for outpatients than inpatients.

Conclusions

Clinicians are encouraged to examine the values of their patients more closely and to especially monitor important and/or social values. Incorporating these into clinical work might increase patients’ values-consistent behavior, which can play a role in reducing suffering.

Psychometric validation of Czech version of the Sport Motivation Scale

The Sport Motivation Scale (SMS) is a widely used instrument that assesses motivational processes within sport and exercise environments. The scale has demonstrated validity and reliability in multiple cultures, however, there is yet no empirical evidence regarding its psychometric properties in the Czech population. In this study we therefore set out to examine the reliability and construct validity of the SMS in a sample of Czech university-aged athletes. We first examined the SMS factor structure using a nonparametric item response theory model (Mokken monotone homogeneity model) and identified six items violating the unidimensionality of the particular subscales. Remaining items were then subjected to test of hypothesized seven-factor structure and several different forms of measurement invariance examined based on gender, competition level and type of sport (individual vs team sports). The hypothesized seven-factor fit well and there was sufficient evidence supporting full invariance across the examined groups. All SMS subscales had adequate internal consistencies ranging from 0.66 to 0.89. Results of correlational analysis among the SMS subscales and between the SMS and two outcomes of interest further supported validity of the scale. Observed differences in SMS subscales between males and females, recreational and competitive athletes, as well as between individual and team-based sport activities, comported with prior empirical studies using a self-determination theory framework. In conclusion, results reinforce the utility and performance of the SMS in a sample of Czech university athletes. The SMS may therefore be recommended for measurement of the multidimensional motivational processes taking place in the exercise and sport domain.

Cardiovascular and metabolic health effects of team handball training in overweight women: Impact of prior experience

PURPOSE

We tested the hypothesis that participation in small-sided team handball training could provide beneficial effects on cardiovascular and metabolic parameters in overweight premenopausal women with special focus on the importance of prior team handball experience.

METHODS

A 16-week RCT training intervention was conducted in overweight premenopausal women randomized into three groups: a team handball training group without prior experience (UN; n = 13), a team handball group with prior experience (EXP; n = 10), and an inactive control group (CON; n = 9). Both UN and EXP completed 1.6 ± 0.3 training sessions per week with average heart rates of 84 ± 5 and 85 ± 9% of maximal heart rate, respectively. Cardiovascular and metabolic parameters were assessed before and after the intervention.

RESULTS

Compared to CON, UN had significant increases in VO_2max  (7 ± 4%) and intermittent endurance performance (26 ± 14%) as well as reduced total fat mass (4 ± 6%), total fat percentage (4 ± 5%), and android fat mass (7 ± 12%), respectively (all P < .05). Compared to UN and CON, EXP displayed increased left ventricular mass and left ventricular mass index (both P < .05) after the training period. There were no significant changes between any of the groups in muscle mass, blood lipids, resting heart rate, and blood pressure (all P > .05).

CONCLUSION

Small-sided team handball training in overweight premenopausal women resulted in improvement of VO_2max and body composition for participants with minimal team handball experience, indicating that prior team handball experience is not a prerequisite for improving physiological parameters of importance for health. Furthermore, EXP displayed cardiac adaptations, including increased left ventricular mass and left ventricular mass index.

Exercise Maintenance in Older Adults 1 Year After Completion of a Supervised Training Intervention

BACKGROUND/OBJECTIVE

Barriers and facilitators of exercise maintenance and residual effects of exercise training intervention on physical and cognitive function after the cessation of training are inadequately described in older adults.

DESIGN AND SETTING

One year after the cessation of a supervised exercise training intervention, a mixed methods approach employed a quantitative phase that assessed body composition and physical and cognitive function and a qualitative phase that explored determinants of exercise maintenance after participation in the intervention.

PARTICIPANTS

Community-dwelling older Irish adults (aged >65 years) who had completed 12 weeks of supervised exercise training 1 year previously.

MEASUREMENTS

Fifty-three participants (male/female ratio = 30:23; age = 70.8 ± 3.9 years) completed the follow-up testing comprising body composition and physical and cognitive function. Semistructured interviews were conducted with 12 participants (male/female ratio = 6:6) using the Theoretical Domains Framework to inform the interview guide.

RESULTS

At 1 year follow-up, body fat increased (mean = 4.3%; 95% confidence limit = 2.2% to 6.3%), while lean body mass (mean = -0.6%; 95% confidence limit = -1.2% to -0.1%), strength (leg press, mean = -5.6%; 95% confidence limit = -8.3% to -2.8%; chest press, mean = -11.0%; 95% confidence limit = -14.8% to -7.8%), and cognitive function (mean = -3.7%; 95% confidence limit = -5.7% to -1.8%) declined (all P < .05). Interviews revealed key facilitators (social aspects and beliefs about benefits of exercise) and barriers (affordability and general aversion to gyms) to exercise maintenance in this population.

CONCLUSION

Key barriers and facilitators to exercise maintenance were identified, which will inform the development of future behavior change interventions to support exercise participation and maintenance in older adults to mitigate adverse changes in body composition and physical and cognitive function with advancing age. J Am Geriatr Soc 68:163-169, 2019.

Multiple Fitness Improvements Found after 6-Months of High Intensity Functional Training

While short-term high intensity functional training (HIFT) effects have been established, fitness improvements from program participation exceeding 16 weeks are unknown. This study examined the effectiveness of participation in HIFT through CrossFit. During 2013–2014, fitness performance testing was incorporated into an ongoing university CrossFit program. Participants included 45 adults (23 women, 22 men) with 0–27 months of HIFT experience (grouped into 0–6 months and 7+ months). Participants completed three separate days of assessments across 10 fitness domains before and after participating in the program for six months. For each sex, 2 (Time) × 2 (Group) RANOVA were used for each fitness test. For women, significant Time effects were found for four fitness domains (i.e., flexibility, power, muscular endurance, and strength), and a Group × Time interaction for cardiorespiratory endurance, with the 0–6-month group improving more. For men, significant Time effects were found for flexibility, muscular endurance, and strength. These data provide evidence for multiple fitness improvements after six months of CrossFit participation with greater 1.5 mile run time improvement among women with less experience.

A mixed-methods case study exploring the impact of participation in community activity groups for older adults on physical activity, health and wellbeing

BACKGROUND

Regular physical activity (PA) has many health benefits but declines with age. Community multi-activity groups offering volunteer-led socially-oriented activity programs could provide an opportunity for older people to maintain or increase PA levels and promote their health. The aim of this study was to examine the potential effect of becoming a member of an existing community activity group on PA levels, physical and mental health-related quality of life (HR QoL), comparing any impacts associated with participation in physical activity or social activity programs.

METHODS

This mixed-methods case study, combining a longitudinal quantitative-survey with qualitative focus groups to contextualise the survey results, focused on an Australian community organisation called Life Activities Clubs (LACs). LACs provide various physical activities (e.g. walking, cycling, dancing) and social activities (e.g. book groups, dine-outs, craft). Data were collected using a self-report survey administered at baseline, six and twelve-months after joining and group differences between participants of PA programs (PA group) and social programs (social group) were analysed using linear mixed-models. Two focus groups with LAC members were held, one representing each activity type and analysed using content and thematic analysis.

RESULTS

35 people (mean age 67) completed the surveys and 11 people participated in the focus groups. PA levels and physical health-related QoL were maintained over 1 year in the PA group, and declined between baseline and 12-months in the social group. Focus groups suggested social aspects of PA programs increased motivation to maintain regular attendance and do more PA than participants would on their own and that physical activities provided health benefits. Mental HR QoL did not change in either group, focus groups suggested this was because the social aspects of both types of program provide benefits relating to mental health including stress relief, enjoyment and adapting to major life events, to prevent a decline in QoL.

CONCLUSIONS

Community PA programs appear to maintain PA levels and physical HR QoL in older adults, and both social and PA programs may maintain mental HR QoL. Incorporating both types of program into one organisation may also encourage less physically active members to try physical activities.