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Skoradal MB, Sjúrðarson T, Olsen HW, Leifsson EN, Pelikan V, Mohr M, Davidsen AH. Evaluation of a football fitness implementation initiative for an older adult population in a small-scale island society. Front Public Health 2024; 12:1406601. [PMID: 39081349 PMCID: PMC11286383 DOI: 10.3389/fpubh.2024.1406601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 07/04/2024] [Indexed: 08/02/2024] Open
Abstract
Background The proportion of older people increases globally, which calls for sustainable interventions promoting healthy aging. Therefore, we aimed to evaluate the potential of Football Fitness as a sustainable model to promote quality of life, mental health, and physical function for older adult. Methods The study was conducted in collaboration with a municipality, a football club, and a university, and was designed as a randomized controlled trial. A total of 66 people (34 women, 32 men) older than 60 years were randomly assigned (60/40) to a Football Fitness (FOT) (n = 38, 20 women, 18 men) and a control group (CON) (n = 28, 14 women, 14 men). FOT participated in Football Fitness for 12 weeks. Quality of life (QoL) and mental wellbeing were determined pre-and post-intervention. Physical loading and Flow experience were measured in one representative training session. Blood pressure (BP), Yo-Yo Intermittent endurance test level 1 (Yo-Yo IE1), sprint performance, postural balance, and body composition were also performed pre-and post-intervention. Results An improvement in mental wellbeing was observed for both groups from pre- to post-intervention (p values <0.001) with no between-group differences. Regarding QoL, the environment domain improved in FOT compared to CON (p = 0.02). Mean Flow (M = 5.69; SD = 1.07) and perceived importance (M = 4.20; SD = 1.42) and average experienced difficulty was M = 5.23 (SD = 2.67), perceived skill (M = 5.23; SD = 2.56), and perceived balance (M = 5.64; SD = 1.56). These levels of flow can be characterized as being high. A between-group effect (p = 0.02) existed for systolic BP, which decreased (p < 0.01) by -5% [-8; -1%] in CON and remained unchanged in FOT. Both groups improved the Yo-Yo IE1 to a similar extent, with 28% [11; 44%] (p = 0.001) in FOT and 27% [9; 46%] in CON (p = 0.005). Postural balance improved (p = 0.004) by 38% [13; 63%] in FOT only, resulting in a superior (p = 0.01) balance score in FOT compared to CON post-intervention (p = 0.004). Conclusion Football Fitness improved the environmental quality of life domain and postural balance in older adults. Additionally, it appears to be a feasible group activity for older adults that promotes high flow and physical loading during training.
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Affiliation(s)
- May-Britt Skoradal
- Centre of Health Science, Faculty of Health, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Tórur Sjúrðarson
- Centre of Health Science, Faculty of Health, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Helgi Winther Olsen
- Centre of Health Science, Faculty of Health, University of the Faroe Islands, Tórshavn, Faroe Islands
- Faculty of Education, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Eli Nolsøe Leifsson
- Centre of Health Science, Faculty of Health, University of the Faroe Islands, Tórshavn, Faroe Islands
- FSF Sport Science Unit, Faroese Football Association, Tórshavn, Faroe Islands
| | - Vincent Pelikan
- Faculty of Sport Science, University of Leipzig, Leipzig, Germany
| | - Magni Mohr
- Centre of Health Science, Faculty of Health, University of the Faroe Islands, Tórshavn, Faroe Islands
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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Mohr M, Sjúrðarson T, Skoradal MB, Nordsborg NB, Krustrup P. Long-term continuous exercise training counteracts the negative impact of the menopause transition on cardiometabolic health in hypertensive women - a 9-year RCT follow-up. Prog Cardiovasc Dis 2024; 85:54-62. [PMID: 38070694 DOI: 10.1016/j.pcad.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 12/03/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE The study examined effects of 9-yrs of multicomponent exercise training during the menopause interval on cardiometabolic health in hypertensive women. METHODS Sedentary, middle-aged women (n = 25) with mild-to-moderate arterial hypertension were randomized into a soccer training (multicomponent exercise; EX; n = 12) or control group (CON; n = 13). EX took part in 1-h football training sessions, 1-3 times weekly, for a consecutive 9-years, totaling ∼800 training sessions, while CON did not take part in regular exercise training. 22 participants entered menopause during the intervention. RESULTS A time×group interaction effect (P = 0.04) of 8.5 mmHg in favour of EX was observed for changes in mean arterial pressure (MAP) (EX: -4.8 [-10.7;1.1] mmHg, CON +3.7 [-2.0;9.3] mmHg). Time×group interaction effects in favour of EX were also observed for total body weight (4.6 kg, P = 0.008, EX: +0.7 [-1.7;3.0] kg, CON: +5.3 [3.0;7.6] kg, total fat percentage (5.7%-points, P = 0.02; EX (-1.9 [-4.4;0.6] %-points; P = 0.13), CON +3.8 [1.4;6.2] %-points and for total cholesterol (1.2 mmol/l, P = 0.03, EX: -0.5 [-1.0;-0.1] mmol/l, CON: +0.7 [0.2;1.1] mmol/l. EX reduced (P = 0.02) plasma low-density lipoprotein cholesterol by -0.4 [-0.8;-0.1] mmol/l, whereas an increase (P = 0.01) of 0.4 [0.1;0.8] mmol/l occurred in CON (interaction. P < 0.001). A time×group interaction (P = 0.004) existed for changes in exercise capacity in favour of EX. Fasting glucose remained unchanged in EX and increased (P < 0.001) by 0.7 [0.4;1.0] mmol/l in CON (time×group interaction P = 0.02). CONCLUSION In conclusion, long-term multicomponent exercise training fully counteracts the detrimental effects of the menopause transition on cardiometabolic health in hypertensive women.
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Affiliation(s)
- Magni Mohr
- Center of Health Science, Faculty of Health Science, University of the Faroe Islands, Tórshavn, Faroe Islands; Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
| | - Tórur Sjúrðarson
- Center of Health Science, Faculty of Health Science, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - May-Britt Skoradal
- Center of Health Science, Faculty of Health Science, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Nikolai B Nordsborg
- Department of Nutrition, Exercise and Sport Science, University of Copenhagen, Copenhagen, Denmark
| | - Peter Krustrup
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Sport and Health Sciences, University of Exeter, Exeter, United Kingdom; Danish Institute for Advanced Study (DIAS), University of Southern Denmark, Odense, Denmark
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Fox IN, Wassersug R. Case studies on psychosocial factors that help make exercise programmes for prostate cancer patients self-sustaining. BMJ Support Palliat Care 2024; 13:e1056-e1063. [PMID: 35101863 DOI: 10.1136/bmjspcare-2021-003370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 01/01/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Patients with prostate cancer (PCa) benefit from regular exercise, but it is difficult for patients to maintain an exercise regime. We examined two exercise programmes that have proven to be self-sustaining with the goal of identifying features they share that may contribute to their success. METHODS We compared the FC Prostata football (soccer) league in Denmark and the 'Butts in a Boat' (BIAB) dragon-boating team in Canada. The FC Prostata Project Coordinator and the BIAB team leaders provided information on their programmes' history and structure. RESULTS Both programmes are team-based with regularly scheduled intense exercise at their core. In both cases, social activities evolved spontaneously, starting with the men going out for food and/or drinks after practices. The sustainability of these programmes may be driven by the regular socialisation linked to the fitness activities. CONCLUSIONS Our case studies suggest that exercise programmes for PCa patients may have a good chance of being self-sustaining, if they are: (1) centred around intense exercise, (2) of a team nature, (3) structured to promote egalitarianism and avoid one-on-one competition within teams, yet (4) have some competitions between teams. The data suggest that informal social activities organised by patients after team practices may be important for building fellowship and strengthening patients' commitment to exercise both for themselves and for their team members.
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Affiliation(s)
| | - Richard Wassersug
- Department of Cellular and Physiological Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
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Gao H, Zhao Y, Zhao L, Wang Z, Yan K, Gao B, Zhang L. The Role of Oxidative Stress in Multiple Exercise-Regulated Bone Homeostasis. Aging Dis 2023; 14:1555-1582. [PMID: 37196112 PMCID: PMC10529750 DOI: 10.14336/ad.2023.0223] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 02/23/2023] [Indexed: 05/19/2023] Open
Abstract
Bone is a tissue that is active throughout the lifespan, and its physiological activities, such as growth, development, absorption, and formation, are always ongoing. All types of stimulation that occur in sports play an important role in regulating the physiological activities of bone. Here, we track the latest research progress locally and abroad, summarize the recent, relevant research results, and systematically summarize the effects of different types of exercise on bone mass, bone strength and bone metabolism. We found that different types of exercise have different effects on bone health due to their unique technical characteristics. Oxidative stress is an important mechanism mediating the exercise regulation of bone homeostasis. Excessive high-intensity exercise does not benefit bone health but induces a high level of oxidative stress in the body, which has a negative impact on bone tissue. Regular moderate exercise can improve the body's antioxidant defense ability, inhibit an excessive oxidative stress response, promote the positive balance of bone metabolism, delay age-related bone loss and deterioration of bone microstructures and have a prevention and treatment effect on osteoporosis caused by many factors. Based on the above findings, we provide evidence for the role of exercise in the prevention and treatment of bone diseases. This study provides a systematic basis for clinicians and professionals to reasonably formulate exercise prescriptions and provides exercise guidance for patients and the general public. This study also provides a reference for follow-up research.
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Affiliation(s)
- Haoyang Gao
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Yilong Zhao
- Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Linlin Zhao
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Zhikun Wang
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Kai Yan
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Bo Gao
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Lingli Zhang
- College of Athletic Performance, Shanghai University of Sport, Shanghai, China
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Mohr M, Fatouros IG, Asghar M, Buono P, Nassis GP, Krustrup P. Football training as a non-pharmacological treatment of the global aging population-A topical review. FRONTIERS IN AGING 2023; 4:1146058. [PMID: 36844000 PMCID: PMC9947510 DOI: 10.3389/fragi.2023.1146058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023]
Abstract
In the present topical mini-review, the beneficial impact of small-sided game football training for the increasing elderly global population is presented. As a multicomponent type of physical activity, football training executed on small pitched with 4-6 players in each team is targeting a myriad of physiological systems and causes positive adaptations of relevance for several non-communicable diseases, of which the incidence increases with advancing age. There is strong scientific evidence that this type of football training promotes cardiovascular, metabolic and musculo-skeletal health in elderly individuals. These positive adaptations can prevent cardiovascular disease, type 2 diabetes, sarcopenia and osteoporosis, and lower the risk of falls. Also, football training has been proven an efficient part of the treatment of several patient groups including men with prostate cancer and women after breast cancer. Finally, regular football training has an anti-inflammatory effect and may slow the biological aging. Overall, there is a growing body of evidence suggesting that recreational football training can promote health in the elderly.
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Affiliation(s)
- Magni Mohr
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense, Denmark,Centre of Health Science, Faculty of Health, University of the Faroe Islands, Tórshavn, Faroe Islands,*Correspondence: Magni Mohr,
| | - Ioannis G. Fatouros
- Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | | | - Pasqualina Buono
- Department of Movement Sciences and Wellness, University Parthenope, Naples, Italy,CEINGE-Biotecnologie avanzate Francesco Salvatore, Napoli, Italy
| | - George P. Nassis
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense, Denmark,Department of Physical Education, College of Education, United Arab Emirates, University, Al Ain, Abu Dhabi, United Arab Emirates
| | - Peter Krustrup
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense, Denmark,Danish Institute for Advanced Study (DIAS), University of Southern Denmark, Odense, Denmark,Sport and Health Sciences, University of Exeter, Exeter, United Kingdom
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Duncan MJ, Mowle S, Noon M, Eyre E, Clarke ND, Hill M, Tallis J, Julin M. The Effect of 12-Weeks Recreational Football (Soccer) for Health Intervention on Functional Movement in Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013625. [PMID: 36294203 PMCID: PMC9602977 DOI: 10.3390/ijerph192013625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/14/2022] [Accepted: 10/19/2022] [Indexed: 06/03/2023]
Abstract
There is growing evidence that recreational football offers health benefits for older adults and an important pathway for physical activity for older adult groups. Despite anecdotal evidence that recreational football is beneficial for older adults, no empirical data are available to support this assertion. This study addressed this issue and examined the effects of a 12-week recreational football intervention on the functional fitness of older adults. Using a pre-post case-control design, thirteen males, aged 61-73 years (mean age ± SD = 66 ± 4 years) undertook a twice-weekly, 12-week recreational football for health intervention, and were matched with a control group, comprising thirteen males, aged 62-78 years (mean age ± SD = 66 ± 4 years) who maintained their typical exercise habits during the intervention period. Pre- and postintervention, participants underwent assessment of functional fitness, using the Rikli and Jones functional fitness battery as well as an assessment of body fatness, via bioelectrical impedance analysis and dominant handgrip strength using handgrip dynamometry. Results from a series of 2 (pre-post) X 2 (intervention vs. control) repeated-measures ANOVAs indicate significant pre-post X group interactions for the 30-second chair stand (p = 0.038, Pƞ2 = 0.168), 8-foot timed up and go (p = 0.001, Pƞ2 = 0.577) and 6 min walk test (p = 0.036, Pƞ2 = 0.171). In all cases, performance improved significantly after the intervention for the football intervention group but not the control group. There were no significant differences in the 30 s arm curl test or dominant handgrip strength (p > 0.05). There was a non-significant trend (p = 0.07, Pƞ2 = 0.127) towards a pre-post X group interaction for body fatness, showing a decreased percent body fat for the intervention group over the control group. The results of the present study demonstrate the utility of recreational football as a physical activity intervention in older adults to improve functional movement.
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Affiliation(s)
- Michael J. Duncan
- Centre for Sport, Exercise, and Life Sciences, Coventry University, Coventry CV1 5FB, UK
| | - Sophie Mowle
- Centre for Sport, Exercise, and Life Sciences, Coventry University, Coventry CV1 5FB, UK
| | - Mark Noon
- Centre for Sport, Exercise, and Life Sciences, Coventry University, Coventry CV1 5FB, UK
| | - Emma Eyre
- Centre for Sport, Exercise, and Life Sciences, Coventry University, Coventry CV1 5FB, UK
| | - Neil D. Clarke
- Centre for Sport, Exercise, and Life Sciences, Coventry University, Coventry CV1 5FB, UK
| | - Mathew Hill
- Centre for Sport, Exercise, and Life Sciences, Coventry University, Coventry CV1 5FB, UK
| | - Jason Tallis
- Centre for Sport, Exercise, and Life Sciences, Coventry University, Coventry CV1 5FB, UK
| | - Mikko Julin
- Research, Development and Innovation (RDI) Unit, Laurea University of Applied Sciences, 02650 Espoo, Finland
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Recreational Football and Bone Health: A Systematic Review and Meta-analysis. Sports Med 2022; 52:3021-3037. [DOI: 10.1007/s40279-022-01726-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2022] [Indexed: 11/26/2022]
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Andersen MF, Midtgaard J, Bjerre ED. Do Patients with Prostate Cancer Benefit from Exercise Interventions? A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:972. [PMID: 35055794 PMCID: PMC8776086 DOI: 10.3390/ijerph19020972] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/06/2022] [Accepted: 01/12/2022] [Indexed: 01/02/2023]
Abstract
Men diagnosed and treated for prostate cancer experience severe adverse effects on quality of life (QoL) and metabolic health, some of which may be preventable or reversible with exercise, the benefits of which healthcare providers and patients increasingly acknowledge, though existing evidence on its effects varies in significance and magnitude. We aimed to review the effect of exercise on QoL and metabolic health in a broad prostate cancer population. A systematic search was conducted in nine databases and eligible trials were included in the meta-analytic procedure. All outcomes were stratified into aerobic exercise, resistance exercise, and a combination of both. The review identified 33 randomised controlled trials (2567 participants) eligible for inclusion. Exercise had a borderline small positive effect on cancer-specific QoL (standardised mean difference (SMD) = 0.10, 95% confidence interval (CI) -0.01-0.22), and a moderate to large effect on cardiovascular fitness (SMD = 0.46, 95% CI 0.34-0.59) with aerobic exercise being the superior modality (SMD = 0.60, 95% CI 0.29-0.90). A positive significant effect was seen in lower body strength, whole-body fat mass, general mental health, and blood pressure. No significant effect was seen in fatigue, lean body mass, and general physical health. We thereby conclude that exercise is effective in improving metabolic health in men diagnosed with prostate cancer, with aerobic exercise as the superior modality. The effect of exercise on QoL was small and not mediated by choice of exercise modality.
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Affiliation(s)
- Martin Færch Andersen
- Department of Physiotherapy, University College of Northern Denmark, Selma Lagerløfs Vej 2, DK-9200 Aalborg, Denmark
| | - Julie Midtgaard
- Mental Health Centre Glostrup, University of Copenhagen, Nordstjernevej 41, DK-2600 Glostrup, Denmark;
- Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, DK-2200 Copenhagen, Denmark
| | - Eik Dybboe Bjerre
- The University Hospitals’ Centre for Health Research, Rigshospitalet, Ryesgade 27, DK-2200 Copenhagen, Denmark;
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Reimer N, Hafke R, Wrensch M, Horst P, Bloch W, Hahn T, Kirchhoff A, Kluck KL, Stein J, Baumann F. Influence of a 12-month supervised, intensive resistance, aerobic and impact exercise intervention on muscle strength in prostate cancer patients undergoing anti-hormone therapy: Study protocol for the randomized, controlled Burgdorf study. Contemp Clin Trials 2022; 114:106685. [DOI: 10.1016/j.cct.2022.106685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 12/09/2021] [Accepted: 01/14/2022] [Indexed: 11/12/2022]
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Zemlin C, Stuhlert C, Schleicher JT, Wörmann C, Altmayer L, Lang M, Scherer LS, Thul IC, Müller C, Kaiser E, Stutz R, Goedicke-Fritz S, Ketter L, Zemlin M, Wagenpfeil G, Steffgen G, Solomayer EF. Longitudinal Assessment of Physical Activity, Fitness, Body Composition, Immunological Biomarkers, and Psychological Parameters During the First Year After Diagnosis in Women With Non-Metastatic Breast Cancer: The BEGYN Study Protocol. Front Oncol 2021; 11:762709. [PMID: 34737966 PMCID: PMC8560964 DOI: 10.3389/fonc.2021.762709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 10/01/2021] [Indexed: 12/24/2022] Open
Abstract
Background Moderate physical activity is associated with an improved prognosis and psychosocial outcome in breast cancer patients. Although exercise and physical activity are associated with multiple physiological and psychological effects, many of the underlying mechanisms remain obscure. The BEGYN study (Influence of physical activity in breast cancer patients on physiological and psychological parameters and on biomarkers) aims at identifying potential associations between the extent of physical activity, fitness, body composition, immunological biomarkers, psycho-emotional parameters, and the course of treatment during the first year after diagnosis of breast cancer. Methods The prospective observational BEGYN study will include 110 non-metastatic breast cancer patients. The patients will be assessed during a base line visit prior to the initiation of the antineoplastic therapy and after 3, 6, 9 and 12 months. The physical activity will be measured using a fitness tracker and a self-assessment diary during the entire study. Each visit will include the assessment of (i) cardiorespiratory fitness measured by spiroergometry, (ii) body composition, (iii) psycho-emotional parameters (quality of life, mental health, fatigue, depression, distress, anxiety, well-being), and (iv) extensive blood tests including routine laboratory, vitamin D, selenium and immunologically relevant biomarkers (e.g., leukocyte subpopulations and cytokine profiles). Discussion Whereas most studies investigating the influence of physical activity in breast cancer patients focus on specific activities for three months or less, the BEGYN study will quantify the daily physical activity and cardiorespiratory fitness of breast cancer patients based on objective measurements in the context of the oncological therapy for 12 months after diagnosis. The study will reveal potential associations between exercise, immune status and physical as well as psycho-emotional outcome and the clinical course of the disease. Moreover, complementary therapies such as Vit D and Selenium supplementation and parameters investigating the motivation of the patients are part of the study. Due to this holistic approach, the BEGYN study will guide towards confirmatory studies on the role of physical activity in breast cancer patients to develop individualized counselling regarding the recommended type and extent of exercise. Trial Registration This study has been registered at the German Clinical Trials Register DRKS00024829.
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Affiliation(s)
- Cosima Zemlin
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Medical Center, Homburg, Germany
| | - Caroline Stuhlert
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Medical Center, Homburg, Germany
| | - Julia Theresa Schleicher
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Medical Center, Homburg, Germany
| | - Carolin Wörmann
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Medical Center, Homburg, Germany
| | - Laura Altmayer
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Medical Center, Homburg, Germany
| | - Marina Lang
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Medical Center, Homburg, Germany
| | - Laura-Sophie Scherer
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Medical Center, Homburg, Germany
| | - Ida Clara Thul
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Medical Center, Homburg, Germany
| | - Carolin Müller
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Medical Center, Homburg, Germany
| | - Elisabeth Kaiser
- Department for General Pediatrics, Saarland University Medical Center, Homburg, Germany
| | - Regine Stutz
- Department for General Pediatrics, Saarland University Medical Center, Homburg, Germany
| | | | - Laura Ketter
- Department of Behavioural and Cognitive Sciences, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Michael Zemlin
- Department for General Pediatrics, Saarland University Medical Center, Homburg, Germany
| | - Gudrun Wagenpfeil
- Institute for Medical Biometry, Epidemiology and Medical Informatics (IMBEI), Saarland University, Homburg, Germany
| | - Georges Steffgen
- Department of Behavioural and Cognitive Sciences, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Erich-Franz Solomayer
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Medical Center, Homburg, Germany
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Uth J, Fristrup B, Sørensen V, Helge EW, Christensen MK, Kjaergaard JB, Møller TK, Helge JW, Jørgensen NR, Rørth M, Vadstrup ES, Krustrup P. One year of Football Fitness improves L1-L4 BMD, postural balance, and muscle strength in women treated for breast cancer. Scand J Med Sci Sports 2021; 31:1545-1557. [PMID: 33794005 DOI: 10.1111/sms.13963] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/24/2021] [Accepted: 03/26/2021] [Indexed: 01/31/2023]
Abstract
PURPOSE To examine efficacy of 12 months Football Fitness offered twice per week on bone mineral density (BMD), bone turnover markers (BTM), postural balance, muscle strength, and body composition in women treated for early-stage breast cancer (BC). METHODS Women treated for early-stage BC were randomized to Football Fitness (FFG, n = 46) or control (CON, n = 22) in a 2:1 ratio for 12 months, with assessments performed at baseline, 6 months and 12 months. Outcomes were total body-, lumbar spine- and proximal femur BMD, total body lean and fat mass, leg muscle strength, postural balance, and plasma amino-terminal propeptide of type 1 procollagen (P1NP), osteocalcin, and C-terminal telopeptide of type 1 collagen (CTX). Intention-to-treat (ITT) analyses and per-protocol analyses (≥50% attendance in FFG) were performed using linear mixed models. RESULTS Participants in FFG completing the 12-month intervention (n = 33) attended 0.8 (SD = 0.4) sessions per week. Intention to treat analysis of mean changes over 12 months showed significant differences (p<.05) in L1-L4 BMD (0.029 g/cm2 , 95%CI: 0.001 to 0.057), leg press strength (7.2 kg, 95%CI: 0.1 to 14.3), and postural balance (-4.3 n need of support, 95%CI: -8.0 to -0.7) favoring FFG compared to CON. In the per-protocol analyses, L1-L4 and trochanter major BMD were improved (p = .012 and .030, respectively) in FFG compared with CON. No differences were observed between groups in BTMs in the ITT or per protocol analyses. CONCLUSION One year of Football Fitness training may improve L1-L4 BMD, leg muscle strength, and postural balance in women treated for early-stage breast cancer.
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Affiliation(s)
- Jacob Uth
- University Hospitals Centre for Health Research, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Section of Sport and Health Sciences, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Bjørn Fristrup
- Section of Sport and Health Sciences, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Victor Sørensen
- University Hospitals Centre for Health Research, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Biochemistry, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Eva Wulff Helge
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | | | - Julie Boye Kjaergaard
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Trine Kjeldgaard Møller
- Section of Sport and Health Sciences, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Jørn Wulff Helge
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Niklas Rye Jørgensen
- Department of Clinical Biochemistry, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mikael Rørth
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Eva Soelberg Vadstrup
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Peter Krustrup
- Section of Sport and Health Sciences, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Danish Institute for Advanced Study (DIAS), University of Southern Denmark, Odense, Denmark
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12
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Luo H, Galvão DA, Newton RU, Fairman CM, Taaffe DR. Sport Medicine in the Prevention and Management of Cancer. Integr Cancer Ther 2020; 18:1534735419894063. [PMID: 31838880 PMCID: PMC6913064 DOI: 10.1177/1534735419894063] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
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.
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Affiliation(s)
- Hao Luo
- Guangdong Vocational Institute of Sport, Guangzhou, Guangdong, China.,Edith Cowan University, Joondalup, Western Australia, Australia
| | - Daniel A Galvão
- Edith Cowan University, Joondalup, Western Australia, Australia
| | - Robert U Newton
- Edith Cowan University, Joondalup, Western Australia, Australia.,University of Queensland, Brisbane, Queensland, Australia.,The University of Hong Kong, Hong Kong
| | | | - Dennis R Taaffe
- Edith Cowan University, Joondalup, Western Australia, Australia.,University of Queensland, Brisbane, Queensland, Australia
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13
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Imperlini E, Mancini A, Orrù S, Vitucci D, Di Onofrio V, Gallè F, Valerio G, Salvatore G, Liguori G, Buono P, Alfieri A. Long-Term Recreational Football Training and Health in Aging. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062087. [PMID: 32245237 PMCID: PMC7143141 DOI: 10.3390/ijerph17062087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 03/13/2020] [Accepted: 03/17/2020] [Indexed: 12/18/2022]
Abstract
This narrative review aims to critically analyze the effects of exercise on health in aging. Here we discuss the main clinical and biomolecular modifications induced by long-term recreational football training in older subjects. In particular, the effects induced by long-term recreational football training on cardiovascular, metabolic and musculo-skeletal fitness, together with the modifications in the muscle expression of hallmarks related to oxidative metabolism, DNA repair and senescence suppression pathways and protein quality control mechanisms will be provided. All these topics will be debated also in terms of preventing non-communicable metabolic diseases, in order to achieve successful aging over time.
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Affiliation(s)
| | - Annamaria Mancini
- Department of Movement Sciences and Wellbeing, Università Parthenope, 80133 Naples, Italy; (A.M.); (S.O.); (D.V.); (F.G.); (G.V.); (G.L.)
- CEINGE-Biotecnologie Avanzate, 80131 Naples, Italy
| | - Stefania Orrù
- Department of Movement Sciences and Wellbeing, Università Parthenope, 80133 Naples, Italy; (A.M.); (S.O.); (D.V.); (F.G.); (G.V.); (G.L.)
- CEINGE-Biotecnologie Avanzate, 80131 Naples, Italy
| | - Daniela Vitucci
- Department of Movement Sciences and Wellbeing, Università Parthenope, 80133 Naples, Italy; (A.M.); (S.O.); (D.V.); (F.G.); (G.V.); (G.L.)
- CEINGE-Biotecnologie Avanzate, 80131 Naples, Italy
| | - Valeria Di Onofrio
- Department of Science and Technology, Università Parthenope, 80143 Naples, Italy;
| | - Francesca Gallè
- Department of Movement Sciences and Wellbeing, Università Parthenope, 80133 Naples, Italy; (A.M.); (S.O.); (D.V.); (F.G.); (G.V.); (G.L.)
| | - Giuliana Valerio
- Department of Movement Sciences and Wellbeing, Università Parthenope, 80133 Naples, Italy; (A.M.); (S.O.); (D.V.); (F.G.); (G.V.); (G.L.)
| | - Giuliana Salvatore
- IRCCS SDN, 80143 Naples, Italy; (E.I.); (G.S.)
- Department of Movement Sciences and Wellbeing, Università Parthenope, 80133 Naples, Italy; (A.M.); (S.O.); (D.V.); (F.G.); (G.V.); (G.L.)
- CEINGE-Biotecnologie Avanzate, 80131 Naples, Italy
| | - Giorgio Liguori
- Department of Movement Sciences and Wellbeing, Università Parthenope, 80133 Naples, Italy; (A.M.); (S.O.); (D.V.); (F.G.); (G.V.); (G.L.)
| | - Pasqualina Buono
- Department of Movement Sciences and Wellbeing, Università Parthenope, 80133 Naples, Italy; (A.M.); (S.O.); (D.V.); (F.G.); (G.V.); (G.L.)
- CEINGE-Biotecnologie Avanzate, 80131 Naples, Italy
- Correspondence: (P.B.); (A.A.)
| | - Andreina Alfieri
- Department of Movement Sciences and Wellbeing, Università Parthenope, 80133 Naples, Italy; (A.M.); (S.O.); (D.V.); (F.G.); (G.V.); (G.L.)
- CEINGE-Biotecnologie Avanzate, 80131 Naples, Italy
- Correspondence: (P.B.); (A.A.)
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14
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Vear NK, Coombes JS, Bailey TG, Skinner TL. The Interplay between Vascular Function and Sexual Health in Prostate Cancer: The Potential Benefits of Exercise Training. Med Sci (Basel) 2020; 8:medsci8010011. [PMID: 32053955 PMCID: PMC7151583 DOI: 10.3390/medsci8010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 01/24/2020] [Accepted: 02/03/2020] [Indexed: 11/17/2022] Open
Abstract
Prostate cancer and its associated treatments can cause significant and lasting morbidities, such as cardiovascular and sexual dysfunctions. Various interventions have attempted to prevent or mitigate these dysfunctions. This review summarises the available evidence on the effects of exercise training on markers of cardiovascular disease (as assessed via vascular health outcomes) and sexual health in this prevalent cancer population. Current studies predominantly report blood pressure outcomes as a marker of vascular health, as well as various questionnaires assessing sexual health parameters, in men on active treatment (i.e., hormone or radiation therapies) or post-treatment. Preliminary evidence suggests that exercise interventions may elicit improvements in sexual function, but not blood pressure, in these populations. Future studies in more advanced and varied prostate cancer populations (i.e., those on chemotherapies or immunotherapies, or undergoing active surveillance) are required to ascertain the duration, intensity and frequency of exercise that optimises the effects of exercise training on cardiovascular and sexual dysfunctions (and their relationship) in men during and following treatment for prostate cancer.
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15
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Sarmento H, Manuel Clemente F, Marques A, Milanovic Z, David Harper L, Figueiredo A. Recreational football is medicine against non-communicable diseases: A systematic review. Scand J Med Sci Sports 2019; 30:618-637. [PMID: 31834941 DOI: 10.1111/sms.13611] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 07/17/2019] [Accepted: 12/09/2019] [Indexed: 12/15/2022]
Abstract
The purpose of this research was to conduct a systematic review of published articles related to the effect of recreational football on non-communicable diseases. A systematic review of Web of Science, SPORTDiscus, MEDLINE, and PubMed databases was performed according to PRISMA guidelines. Only empirical studies were included. There were no restrictions on the types of study design eligible for inclusion. The primary outcome measures result from the potential effects of recreational football on non-communicable diseases (eg, blood pressure, bone density, LDL cholesterol, and fat mass). A total of 44 articles met the inclusion criteria and were included. Recreational football is shown to: (a) decrease blood pressure and resting heart rate, improve cardiac structure and functioning, as well as increase maximal oxygen uptake in both sexes; (b) reduce cholesterol and triglycerides levels, increase insulin sensitivity, and have a positive impact on glycemic control; (c) improve bone mineralization, increase both bone mineral density and content, as well as acting as a stimulus for osteogenesis; and (d) be clearly beneficial for bone health, while slightly beneficial for body composition, muscle strength, and maximal oxygen uptake in adults with prostate cancer. The present systematic review demonstrated the benefits of recreational football practice on non-communicable diseases related to cardiovascular and bone health, body composition, type 2 diabetes, and prostate cancer. The effectiveness of recreational football on the aforementioned diseases may be related to age and gender; however, further research is required.
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Affiliation(s)
- Hugo Sarmento
- Research Unit for Sport and Physical Activity, Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal.,Spertlab, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | - Filipe Manuel Clemente
- Instituto Politécnico de Viana do Castelo, Escola Superior de Desporto e Lazer, Melgaço, Portugal.,Instituto de Telecomunicações, Delegação da Covilhã, Covilhã, Portugal.,Complexo Desportivo e Lazer Comendador Rui Solheiro - Monte de Prado, Melgaço, Portugal
| | - Adilson Marques
- Centro Interdisciplinar do Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal.,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Zoran Milanovic
- Faculty of Sport and Physical Education, University of Niš, Niš, Serbia.,Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
| | - Liam David Harper
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - António Figueiredo
- Research Unit for Sport and Physical Activity, Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
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16
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Shapiro CL, Van Poznak C, Lacchetti C, Kirshner J, Eastell R, Gagel R, Smith S, Edwards BJ, Frank E, Lyman GH, Smith MR, Mhaskar R, Henderson T, Neuner J. Management of Osteoporosis in Survivors of Adult Cancers With Nonmetastatic Disease: ASCO Clinical Practice Guideline. J Clin Oncol 2019; 37:2916-2946. [DOI: 10.1200/jco.19.01696] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
PURPOSE The aim of this work is to provide evidence-based guidance on the management of osteoporosis in survivors of adult cancer. METHODS ASCO convened a multidisciplinary Expert Panel to develop guideline recommendations based on a systematic review of the literature. RESULTS The literature search of the 2018 systematic review by the US Preventive Services Task Force in the noncancer population was used as the evidentiary base upon which the Expert Panel based many of its recommendations. A total of 61 additional studies on topics and populations not covered in the US Preventive Services Task Force review were also included. Patients with cancer with metastatic disease and cancer survival outcomes related to bone-modifying agents are not included in this guideline. RECOMMENDATIONS Patients with nonmetastatic cancer may be at risk for osteoporotic fractures due to baseline risks or due to the added risks that are associated with their cancer therapy. Clinicians are advised to assess fracture risk using established tools. For those patients with substantial risk of osteoporotic fracture, the clinician should obtain a bone mineral density test. The bone health of all patients may benefit from optimizing nutrition, exercise, and lifestyle. When a pharmacologic agent is indicated, bisphosphonates or denosumab at osteoporosis-indicated dosages are the preferred interventions.
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Affiliation(s)
| | | | | | - Jeffrey Kirshner
- Hematology-Oncology Associates of Central New York, Syracuse, NY
| | | | | | | | - Beatrice J. Edwards
- University of Texas Dell Med School and Central Texas Veterans Healthcare System, Austin, TX
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17
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Mohr M, Skoradal MB, Andersen TR, Krustrup P. Gender-dependent evaluation of football as medicine for prediabetes. Eur J Appl Physiol 2019; 119:2011-2024. [PMID: 31346789 DOI: 10.1007/s00421-019-04188-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 07/08/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Training intensity and health effects of football were investigated gender specifically in individuals with prediabetes. METHODS Participants with prediabetes (age 60 ± 6 years) were randomised into a football and dietary advice group (FD-men n = 13 and FD-women n = 14) or a dietary advice only group (D-men n = 12 and D-women n = 11). FD performed football training (twice/week for 16 weeks), while both groups received dietary advice. Body composition, bone variables, blood pressure, blood lipid profile and peak oxygen uptake (VO2peak) were determined pre- and post-intervention. RESULTS Mean heart rate during football training was 79 ± 2 and 80 ± 3% HRmax for FD-men and FD-women, respectively, with peak heart rate values of 96 ± 1 and 97 ± 2% HRmax, with no gender differences. VO2peak increased more (P < 0.05) in FD-men and FD-women than in D-men and D-women. However, relative delta change in VO2peak was 21 ± 14% in FD-women, which was greater (P < 0.05) than in FD-men (11 ± 12%). Reduction in SBP and DBP, respectively, was similar in FD-men (- 10.8 ± 13.0 and - 7.3 ± 11.8 mmHg) and FD-women (- 11.3 ± 11.0 and - 7.1 ± 6.2 mmHg), with within-gender differences for men. Total plasma cholesterol and LDL cholesterol decreased (P < 0.05) by - 0.7 ± 1.1 and - 0.5 ± 0.9 mmol L-1, respectively, in FD-women and - 0.2 ± 0.4 and - 0.2 ± 0.3 mmol L-1 in FD-men, with no significant gender differences (P = 0.08). Body fat content was lowered (P < 0.05) by 3 and 4%-points in FD-men and FD-women, respectively. CONCLUSION Gender-mixed football training combined with dietary advice causes broad-spectrum health effects for men and women with prediabetes, with minor gender-specific differences. Thus, the intensity and training-induced effects of football training are also high for elderly women with prediabetes.
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Affiliation(s)
- Magni Mohr
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
- Centre of Health Science, Faculty of Health Sciences, University of the Faroe Islands, Jónas Broncksgøta 25, 3rd floor, Tórshavn, Faroe Islands.
- Centre for Health and Performance, University of Gothenburg, Gothenburg, Sweden.
| | - May-Britt Skoradal
- Centre of Health Science, Faculty of Health Sciences, University of the Faroe Islands, Jónas Broncksgøta 25, 3rd floor, Tórshavn, Faroe Islands
| | - Thomas Rostgaard Andersen
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Peter Krustrup
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
- Department of Sports Science, Shanghai University of Sport, Shanghai, China
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18
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Brito J, Williams CA, Randers MB. Executive summary: Recreational football training as medicine. Scand J Med Sci Sports 2018; 28 Suppl 1:74-76. [PMID: 30058232 DOI: 10.1111/sms.13246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 06/19/2018] [Indexed: 11/29/2022]
Affiliation(s)
- João Brito
- Portugal Football School, Portuguese Football Federation, Oeiras, Portugal
| | - Craig A Williams
- Children's Health and Exercise Research Centre (CHERC), University of Exeter, Exeter, UK
| | - Morten B Randers
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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