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Chandhanayingyong C, Adulkasem N, Asavamongkolkul A, Chotiyarnwong P, Vanitcharoenkul E, Laohaprasitiporn P, Soparat K, Unnanuntana A. Establishing Normative Values for Performance-Based Tests in Older Thai Adults: A Nationwide Cross-Sectional Study. Arch Phys Med Rehabil 2024; 105:1133-1141. [PMID: 38367833 DOI: 10.1016/j.apmr.2024.01.023] [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: 08/09/2023] [Revised: 01/17/2024] [Accepted: 01/28/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVE To determine normative values and identify contributing factors for physical performance tests in older, Thai, community-dwelling adults. DESIGN Nationwide cross-sectional study. SETTING Thai older community-dwelling adults. PARTICIPANTS Thai older community-dwelling adults aged ≥60 years who had no major health problems (N=1430) between March 2021 and August 2022. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Normative values for the timed Up and Go (TUG) test, gait speed test, and 5-times sit-to-stand (5TSTS) test were determined for sex and age groups. Multivariable quantile regression analysis was employed to evaluate the participants, considering factors that may influence physical performance, such as height, and Charlson comorbidity index (CCI). RESULTS The study included 1430 eligible participants. Their mean age was 68.4±5.8 years, and 58.5% were women. Men demonstrated superior physical performance in the medians (p50) of the TUG (10.0 s vs 11.0 s), gait speed (0.98 m/s vs 0.91 m/s), and 5TSTS (14.0 s vs 16.1 s) tests compared with women. These differences were consistently observed across age groups. Moreover, age, sex, and height were significantly associated with poor physical performance. CONCLUSION This study observed variations in the normative values of TUG, gait speed, and 5TSTS tests among different age groups of older, Thai, community-dwelling adults. Additionally, our findings identified age, sex, and height as significant contributing factors to physical performance in this population.
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Affiliation(s)
| | - Nath Adulkasem
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Apichat Asavamongkolkul
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pojchong Chotiyarnwong
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Ekasame Vanitcharoenkul
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Panai Laohaprasitiporn
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Krabkaew Soparat
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Aasis Unnanuntana
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
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Deng N, Soh KG, Abdullah BB, Tan H, Huang D. Active video games for improving health-related physical fitness in older adults: a systematic review and meta-analysis. Front Public Health 2024; 12:1345244. [PMID: 38694976 PMCID: PMC11061467 DOI: 10.3389/fpubh.2024.1345244] [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: 11/27/2023] [Accepted: 04/03/2024] [Indexed: 05/04/2024] Open
Abstract
Background The global population is experiencing a rapid rise in the quantity and percentage of older people. In an effort to enhance physical activity among older adults, active video games (AVGs) are being suggested as a compelling alternative and are currently under scrutiny to evaluate their efficacy in promoting the health of older people. Objective This review aims to synthesize current studies and formulate conclusions regarding the impact of AVGs on the health-related physical fitness of older adults. Methods Seven databases (PubMed, Web of Science, SCOPUS, SPORTDiscus, EMBASE, MEDLINE, and CINAHL) were searched from inception to January 21, 2024. Eligible studies included randomized controlled trials examining the effect of AVGs compared to control conditions on health-related physical fitness outcomes in older adults. The methodological quality of the included trials was assessed using the PEDro scale, and the certainty of evidence was evaluated using the GRADE approach. A random-effects model was used to calculate effect sizes (ES; Hedge's g) between experimental and control groups. Results The analysis included 24 trials with a total of 1428 older adults (all ≥ 60 years old). Compared to controls, AVGs produced significant increases in muscular strength (moderate ES = 0.64-0.68, p < 0.05) and cardiorespiratory fitness (moderate ES = 0.79, p < 0.001). However, no significant effects were found for body composition (trivial ES = 0.12-0.14; p > 0.05) and flexibility (trivial ES = 0.08; p = 0.677). The beneficial effects of AVGs were greater after a duration of ≥ 12 vs. < 12 weeks (cardiorespiratory fitness; ES = 1.04 vs. 0.29, p = 0.028) and following ≥ 60 minutes vs. < 60 minutes of session duration (muscular strength; ES = 1.20-1.24 vs. 0.27-0.42, p < 0.05). Conclusion AVGs appear to be an effective tool for enhancing muscular strength and cardiorespiratory fitness in older adults, although their impact on improving body composition and flexibility seems limited. Optimal improvement in cardiorespiratory fitness is associated with a longer duration of AVGs (≥ 12 weeks). Moreover, a session duration of ≥ 60 minutes may provide greater benefits for the muscular strength of older adults. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=482568, identifier CRD42023482568.
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Affiliation(s)
- Nuannuan Deng
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Kim Geok Soh
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Borhannudin Bin Abdullah
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Hermione Tan
- School of Computer Information Sciences, University of the Cumberlands, Williamsburg, KY, United States
| | - Dandan Huang
- College of Physical Education, Chongqing University, Chongqing, China
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Yeh PC, Syu DK, Ho CC, Lee TS. Associations of lower-limb muscle strength performance with static and dynamic balance control among older adults in Taiwan. Front Public Health 2024; 12:1226239. [PMID: 38414890 PMCID: PMC10896829 DOI: 10.3389/fpubh.2024.1226239] [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: 05/21/2023] [Accepted: 01/12/2024] [Indexed: 02/29/2024] Open
Abstract
Background Aging is an inevitable process of life development. These physical changes can cause a decline in the functional adaptability and health status of older adult individuals. Aims The purpose of this study was to investigate the association of lower-limb muscle strength performance with static and dynamic balance control among older adults in Taiwan. Methods We conducted a cross-sectional study and reviewed data derived from the National Physical Fitness Survey in Taiwan 2015-2016. A total of 20,846 Taiwanese older adult individuals aged 65 years old or older were recruited as study participants. Demographic characteristics, anthropometric assessments, lifestyle habits, and health-related physical fitness measurements from this dataset were analyzed using the chi-square test, one-way analysis of variance, and linear regression analysis. Lower-limb muscle strength performance was classified into 4 groups based on quartile (Quartile 1 [Q1], Quartile 2 [Q2], Quartile 3 [Q3], and Quartile 4 [Q4]) values. Results Increased lower-limb muscle strength levels were significantly associated with static balance in men (Q2: β = 2.539, p < 0.0001; Q3: β = 4.590, p < 0.0001; Q4: β = 7.700, p < 0.0001) and women (Q2: β = 2.022, p < 0.0001; Q3: β = 4.179, p < 0.0001; Q4: β = 6.920, p < 0.0001) after adjusting for potential confounders. In addition, we observed that increased lower-limb muscle strength levels were significantly associated with dynamic balance in men (Q2: β = -1.661, p < 0.0001; Q3: β = -2.434, p < 0.0001; Q4: β = -3.091, p < 0.0001) and women (Q2: β = -1.660, p < 0.0001; Q3: β = -2.548, p < 0.0001; Q4: β = -3.196, p < 0.0001) after adjusting for potential confounders. Conclusion Lower-limb muscle strength was the most important factor, as it was an improved method for static and dynamic balance control in both genders.
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Affiliation(s)
- Ping-Chun Yeh
- Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City, Taiwan
- Sports Medicine Center, Fu Jen Catholic Hospital, New Taipei City, Taiwan
| | - De-Kai Syu
- Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City, Taiwan
- Sports Medicine Center, Fu Jen Catholic Hospital, New Taipei City, Taiwan
| | - Chien-Chang Ho
- Sports Medicine Center, Fu Jen Catholic Hospital, New Taipei City, Taiwan
- Department of Physical Education, Fu Jen Catholic University, New Taipei City, Taiwan
- Research and Development Center for Physical Education, Health and Information Technology, College of Education, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Tian-Shyug Lee
- Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City, Taiwan
- Artificial Intelligence Development Center, Fu Jen Catholic University, New Taipei City, Taiwan
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Kumari R, Nath B, Singh Y, Mallick R. Health-related physical fitness, physical activity and its correlates among school going adolescents in hilly state in north India: a cross sectional survey. BMC Public Health 2024; 24:401. [PMID: 38326821 PMCID: PMC10848408 DOI: 10.1186/s12889-024-17808-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 01/18/2024] [Indexed: 02/09/2024] Open
Abstract
INTRODUCTION Health-related physical fitness, which includes body composition, cardiorespiratory fitness, muscular endurance, flexibility, power, and strength are associated with risks of chronic diseases and promote good health and wellness. There have been reports of increasing levels of physical inactivity among children and adolescents, leading to increasing rates of obesity and decreased physical fitness. The present study was conducted among school going adolescents to estimate the levels and correlates of PF for timely intervention. METHODOLOGY School based cross-sectional study was done among students of class 8-11th in Government schools of Garhwal division of Uttarakhand. Multistage stratified random sampling was applied for recruitment of study participants. We recruited a final sample size of 634 students. Validated questionnaires and standard methods for assessment of physical fitness, physical activity levels and other variables such as waist circumference, hip circumference, BMI and hemoglobin estimation were done. RESULTS Average and above average cardiorespiratory fitness score as per Harvard step test among boys (54.3%) was significantly higher as compared to girls (21.3%) (χ2 = 88.93, p < 0.001). There was a significant association between gender and dominant handgrip strength (χ2 = 8.02, p = 0.01) as well as between gender and Shoulder stretch test (SST) of dominant (χ2 = 17.5, p < 0.05) as well as nondominant arm (χ2 = 13.5, p < 0.05). Sit and reach test results also showed a significant association with gender (χ2 = 27.17, p < 0.001). Gender, hemoglobin level, BMI and PAL scores significantly predicted cardiorespiratory fitness scores (R2 = 0.188, F value of the model = 37.69, p =< 0.001)). CONCLUSION Physical fitness of school going adolescents in Garhwal division of Uttarakhand was better than other parts of India, with significant gender differences. Physical activity levels (PAL) were poor and are also a significant predictor of physical fitness. More emphasis needs to be paid on the health and fitness of girl students. School based policies to increase PAL among students through innovation and rewards may go a long way in improving the long-term health of the students.
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Affiliation(s)
- Ranjeeta Kumari
- Present Address: All India Institute of Medical Sciences Rishikesh, Rishikesh, Uttarakhand, 249203, India
| | - Bhola Nath
- Present Address: All India Institute of Medical Sciences Raebareli, Raebareli, Uttar Pradesh, 229405, India.
| | - Yogesh Singh
- Present Address: All India Institute of Medical Sciences Rishikesh, Rishikesh, Uttarakhand, 249203, India
| | - Rupsha Mallick
- Present Address: All India Institute of Medical Sciences Rishikesh, Rishikesh, Uttarakhand, 249203, India
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Su YJ, Ho CC, Lee PF, Lin CF, Hung YC, Chen PC, Hung CT, Chang YC. Gender and Age Differences in Anthropometric Characteristics of Taiwanese Older Adults Aged 65 Years and Older. Healthcare (Basel) 2023; 11:healthcare11091237. [PMID: 37174779 PMCID: PMC10178594 DOI: 10.3390/healthcare11091237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 04/09/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
A previous study provided reference data on the age and gender distribution of anthropometric parameters in Taiwanese adults. However, there are very few large-scale analyses of anthropometric data of older adults in Taiwan. Therefore, the main purpose of this study was to describe gender- and age-specific distributions of anthropometric measurements and anthropometry assessments of Taiwanese older adults. This was a cross-sectional study conducted on 22,389 adults aged 65 years or older (8017 males and 14,372 females) who participated in Taiwan's National Physical Fitness Survey 2014-2015. All participants were recruited using stratified convenience sampling from 46 physical fitness test stations in 22 cities or counties in Taiwan. The anthropometric measurements and anthropometry assessments included in the present study were the assessments of height, weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), and waist-to-hip ratio (WHR). The results showed statistically significant differences in weight, height, WC, and WHR across all age groups among both male and female individuals aged 65 years and older in Taiwan. However, there was no significant difference in BMI and HC between males and females in all age groups. Anthropometric status provides an initial assessment of the overall health of the population. This study uses a representative population of Taiwanese older adults over the age of 65 for analysis and provides detailed information on anthropometric data distribution.
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Affiliation(s)
- Yan-Jhu Su
- Department of Gerontology, University of Massachusetts Boston, Boston, MA 02125, USA
| | - Chien-Chang Ho
- Department of Physical Education, Fu Jen Catholic University, New Taipei City 24205, Taiwan
- Research and Development Center for Physical Education, Health and Information Technology, College of Education, Fu Jen Catholic University, New Taipei City 24205, Taiwan
- Sports Medicine Center, Fu Jen Catholic Hospital, New Taipei City 243, Taiwan
| | - Po-Fu Lee
- Department of Leisure Industry and Health Promotion, National Ilan University, Yilan County 260, Taiwan
- College of Humanities and Management, National Ilan University, Yilan County 260, Taiwan
| | - Chi-Fang Lin
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei City 106, Taiwan
| | - Yi-Chuan Hung
- Department of Sport Management, National Taiwan University of Sport, Taichung City 404, Taiwan
- Sports Administration, Ministry of Education, Taipei City 104, Taiwan
| | - Pin-Chun Chen
- Graduate Institute of Sports Training, University of Taipei, Taipei City 111, Taiwan
| | - Chang-Tsen Hung
- Department of Health and Leisure Management, Yuanpei University of Medical Technology, Hsinchu City 306, Taiwan
| | - Yun-Chi Chang
- Department of Physical Education, Fu Jen Catholic University, New Taipei City 24205, Taiwan
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Liang C, Lee PF, Yeh PC. Relationship between Regular Leisure-Time Physical Activity and Underweight and Overweight Status in Taiwanese Young Adults: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:284. [PMID: 36612603 PMCID: PMC9819382 DOI: 10.3390/ijerph20010284] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/18/2022] [Accepted: 12/20/2022] [Indexed: 06/16/2023]
Abstract
The aim of this study was to determine the association between regular leisure-time physical activity (LTPA) and various body mass index (BMI) categories in Taiwanese young adults. A total of 10,802 young adults (18−44 years) were enrolled in a national telephone survey. The questionnaire data from this survey included socio-demographic characteristics, zip code of residence, LTPA behaviors, self-reported health status, and self-evaluated anthropometric measurements, which included height, body weight, and BMI. Regular and non-regular LTPA behaviors were defined as follows: (1) Regular LTPA: participants who reported breathing quickly and sweating when participating in 150−300 min per week of moderate-intensity LTPA or 75−150 min per week of vigorous-intensity LTPA. (2) Non-regular LTPA: the rest of the participants. The various BMI categories were defined as (1) underweight (BMI < 18.5 kg/m2), (2) normal weight (18.5 ≤ BMI < 24 kg/m2), (3) overweight (24 ≤ BMI < 27 kg/m2), and (4) obese (BMI ≥ 27 kg/m2). When compared with participants with non-regular LTPA, participants with regular LTPA exhibited lower risks of being overweight (odds ratio [OR], 0.837; 95% confidence interval [CI] 0.738−0.948) and underweight (OR, 0.732; 95% CI 0.611−0.876). However, there was no significant relationship between regular LTPA and obesity risk when using non-regular LTPA as the baseline after adjusting for potential confounders. The study results revealed that regular LTPA effectively reduced the risks of being underweight and overweight. However, for people with obesity, regular LTPA was unable to significantly decrease their obesity risk.
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Affiliation(s)
- Chyi Liang
- Graduate Institute of Sport, Leisure and Hospitality Management, National Taiwan Normal University, Taipei City 106, Taiwan
| | - Po-Fu Lee
- Department of Leisure Industry and Health Promotion, National Ilan University, Yilan County 260, Taiwan
- College of Humanities and Management, National Ilan University, Yilan County 260, Taiwan
- Exercise and Recreation Development Center, National Ilan University, Yilan County 260, Taiwan
| | - Ping-Chun Yeh
- Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City 242, Taiwan
- Sports Medicine Center, Fu Jen Catholic University Hospital, New Taipei City 243, Taiwan
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Su YJ, Hsu CT, Liang C, Lee PF, Lin CF, Chen HT, Ho CC. Association between health-related physical fitness and self-reported health status in older Taiwanese adults. BMC Geriatr 2022; 22:235. [PMID: 35313813 PMCID: PMC8939111 DOI: 10.1186/s12877-022-02929-4] [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: 07/03/2021] [Accepted: 03/11/2022] [Indexed: 11/25/2022] Open
Abstract
Background Aging is an inevitable process of life development. These physical changes may cause a decline in the functional adaptability and health of older adults. This study aims to determine if an association exists between health-related physical fitness measurements and self-reported health status in older Taiwanese adults. Methods A total of 22,389 Taiwanese adults aged 65 years or older were recruited as study participants. Demographic characteristics, life habits, anthropometric assessments, health-related physical fitness measurements, and self-reported health status from this dataset were analyzed using the chi-square test, one-way analysis of variance, and logistic regression analysis. Results The results showed that there was significant association between back scratch and self-reported health status (excellent/good) (odds ratio [OR], 1.003; 95% CI 1.000–1.006) after adjusting potential confounders (gender, height, weight, body mass index, education, monthly income, marital status, smoking status, and chewing betel nuts). However, adjusted OR for unhealthy status (poor/very poor) significantly decreased for chair sit-and-reach test (OR 0.994, 95% CI 0.988–0.999). Conclusions The present study reveals significant associations between health-related physical fitness measurements and self-reported health status in older Taiwanese adults. In particular, the waist-to-hip ratio could be involved in the cognitive process of one’s subjective health status, since individuals’ perception of their physical appearance affects their self-reported health. Future researches are suggested to investigate the causality between health-related physical fitness and subjective health status.
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Affiliation(s)
- Yan-Jhu Su
- Department of Gerontology, University of Massachusetts Boston, Boston, MA, 02125, USA
| | - Chen-Te Hsu
- Department of Recreation and Sport Management, Shu Te University, Kaohsiung City, 82445, Taiwan
| | - Chyi Liang
- Department of Economics, Shih Hsin University, Taipei City, 116, Taiwan
| | - Po-Fu Lee
- Department of Leisure Industry and Health Promotion, National Ilan University, Yilan County, 260, Taiwan
| | - Chi-Fang Lin
- Department of Physical Education and Sport Science, National Taiwan Normal University, Taipei City, 106, Taiwan
| | - Hung-Ting Chen
- Physical Education Office, Ming Chuan University, Taipei City, 111, Taiwan
| | - Chien-Chang Ho
- Department of Physical Education, Fu Jen Catholic University, No. 510, Zhongzheng Rd., Xinzhuang Dist., New Taipei City, 24205, Taiwan. .,Research and Development Center for Physical Education, Health and Information Technology, College of Education, Fu Jen Catholic University, New Taipei City, 24205, Taiwan. .,Department of Kinesiology, National Tsing Hua University, Hsinchu City, 30014, Taiwan.
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Mollinedo-Cardalda I, Ferreira M, Bezerra P, Cancela-Carral JM. Health-Related Functional Fitness within the Elderly Communities of Five European Countries: The in Common Sports Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312810. [PMID: 34886536 PMCID: PMC8657484 DOI: 10.3390/ijerph182312810] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/28/2021] [Accepted: 12/01/2021] [Indexed: 01/13/2023]
Abstract
(1) Background: The purpose of this study was to analyse the functional fitness and the anthropometric values of older adults participating in the “IN COMMON SPORTS” project. (2) Methods: A total of 418 participants (eastern European Group (GEE, n = 124) and southern European Groups (GES, n = 294) have been evaluated for anthropometric characteristics and fitness. (3) Results: The GES participants presented significant differences in anthropometric values and fitness, with the best values for upper and lower limb strength and aerobic resistance, while those from the GEE presented significantly better values for lower limb flexibility. (4) Conclusion: Older adults present differences in fitness in accordance with their country of residence, with the GES having the best functional fitness.
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Affiliation(s)
- Irimia Mollinedo-Cardalda
- Faculty of Physiotherapy, University of Vigo, 36005 Pontevedra, Spain
- HealthyFit Research Group, Institute Health Research Galicia Sur (IISGS), Hospital University Complex of Pontevedra (CHOP), Sergas, University of Vigo, 36005 Pontevedra, Spain;
- Correspondence: ; Tel.: +34-986801750
| | - Manuela Ferreira
- Camara Municipal of Vilanova da Cerveira, 4920-284 Vilanova da Cerveira, Portugal;
| | - Pedro Bezerra
- Escola Superior de Desporto e Lezer, Instituto Politécnico de Viana do Castelo, 4960-320 Melgaço, Portugal;
- The Research Centre in Sports Sciences, Health Sciences and Human Development, 5001-801 Vila Real, Portugal
| | - José María Cancela-Carral
- HealthyFit Research Group, Institute Health Research Galicia Sur (IISGS), Hospital University Complex of Pontevedra (CHOP), Sergas, University of Vigo, 36005 Pontevedra, Spain;
- Faculty of Education and Sports Science, University of Vigo, 36005 Pontevedra, Spain
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