Evaluation of a football fitness implementation initiative for an older adult population in a small-scale island society

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.

Acute arm and leg muscle glycogen and metabolite responses to small-sided football games in healthy young men

PURPOSE

Studies have indicated upper body involvement during football, provoking long-term muscular adaptations. This study aimed at examining the acute metabolic response in upper and lower body skeletal muscle to football training organized as small-sided games (SSG).

METHODS

Ten healthy male recreational football players [age 24 ± 1 (± SD) yrs; height 183 ± 4 cm; body mass 83.1 ± 9.7 kg; body fat 15.5 ± 5.4%] completed 1-h 5v5 SSG (4 × 12 min interspersed with 4-min recovery periods). Muscle biopsies were obtained from m. vastus lateralis (VL) and m. deltoideus (DE) pre- and post-SSG for muscle glycogen and metabolite analyses. Blood lactate samples were obtained at rest, middle and end of the SSG.

RESULTS

Muscle glycogen in VL decreased (P < 0.01) by 21% and tended (P = 0.08) to decrease in DE by 13%. Muscle lactate increased in VL (117%; P < 0.001) and DE (81%; P < 0.001) during the game, while blood lactate rose threefold. Muscle ATP and PCr were unaltered, but intermuscular differences were detected for ATP at both time points (P < 0.001) and for PCr at pre-SSG (P < 0.05) with VL demonstrating higher values than DE, while muscle creatine rose in VL (P < 0.001) by 41% and by 22% in DE (P = 0.02). Baseline citrate synthase maximal activity was higher (P < 0.05) in VL compared to DE, whereas baseline muscle lactate concentration was higher (P < 0.05) in DE than VL.

CONCLUSION

The upper body may be extensively involved during football play, but besides a rise in muscle lactate in the deltoideus muscle similar to the leg muscles, the present study did not demonstrate acute metabolic changes of an order that may explain the previously reported training effect of football play in the upper extremities.

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.

Effects of small-sided recreational team handball training on mechanical muscle function, body composition and bone mineralization in untrained young adults-A randomized controlled trial

Prolonged physical inactivity in young adults may lead to deficiencies in musculoskeletal fitness, and thus a need exists to develop physical activity and exercise programmes that are effective of increasing musculoskeletal fitness. The aim of this study, therefore, was to investigate the effects of small-sided team handball training on lower limb muscle strength, postural balance and body composition in young adults. Twenty-six men and twenty-eight women were stratified for peak oxygen uptake (VO_2peak) and body fat percentage and randomly allocated to either 12 wks of small-sided recreational team handball training (THG: 14 men and 14 women, age 24.1±2.6 yrs (mean±SD), VO_2peak 39.8±5.9 ml/kg/min and body fat percentage 32.7±8.7%) or serving as non-exercising controls (CON: 12 men and 14 women, age 24.8±3.1 yrs, VO_2peak 39.7±5.0 ml/kg/min, body fat percentage 31.7±9.7%). THG trained on average 1.8 times/week for 12 wks. At 0 and 12 wks, lower limb muscle strength, rate of force development (RFD), vertical jump height and power, postural balance, body composition and muscle biopsies were assessed. No training effects were observed for maximal isokinetic or isometric knee extensor strength, maximal vertical jump height or take-off power, fibre type distribution or capillarization. Late phase (RFD) increased (+7.4%, p<0.05) and postural sway excursion length was improved after training (-9%, p<0.05) in THG with no difference from CON (p>0.05). Further, THG demonstrated a decrease in body fat percentage (-3.7%) accompanied by increases in whole-body fat free mass (FFM) (+2.2%), leg FFM (+2.5%), total bone mineral content (BMC) (+1.1%), leg BMC (+1.2%), total hip bone mineral density (+1.6%) and hip T-score (+50%) which differed from CON (all p<0.05). In conclusion, recreational small-sided team handball training appears to effectively improve rapid force capacity, postural balance, lean and fat body mass and bone health in previously untrained young adults. The study was registered at ClinicalTrials.gov (NCT04247724).

ClinicalTrials.gov ID number: NCT04247724

Impact of a novel home-based exercise intervention on health indicators in inactive premenopausal women: a 12-week randomised controlled trial

PURPOSE

This study tested the hypothesis that a novel, audio-visual-directed, home-based exercise training intervention would be effective at improving cardiometabolic health and mental well-being in inactive premenopausal women.

METHODS

Twenty-four inactive premenopausal women (39 ± 10 years) were randomly assigned to an audio-visual-directed exercise training group (DVD; n = 12) or control group (CON; n = 12). During the 12-week intervention period, the DVD group performed thrice-weekly training sessions of 15 min. Training sessions comprised varying-intensity movements involving multiplanar whole-body accelerations and decelerations (average heart rate (HR) = 76 ± 3% HR_max). CON continued their habitual lifestyle with no physical exercise. A series of health markers were assessed prior to and following the intervention.

RESULTS

Following the DVD intervention, HDL cholesterol (pre: 1.83 ± 0.45, post: 1.94 ± 0.46 mmol/L) and mental well-being, assessed via the Warwick Edinburgh Mental Well-Being Scale, improved (P < 0.05). Conversely, [LDL cholesterol], [triglycerides], fasting [glucose], body composition and resting blood pressure and HR were unchanged following the DVD intervention (P > 0.05). There were no pre-post intervention changes in any of the outcome variables in the CON group (P > 0.05).

CONCLUSION

The present study suggests that a novel, audio-visual-directed exercise training intervention, consisting of varied-intensity movements interspersed with spinal and lower limb mobility and balance tasks, can improve [HDL cholesterol] and mental well-being in premenopausal women. Therefore, home-based, audio-visual-directed exercise training (45 min/week) appears to be a useful tool to initiate physical activity and improve aspects of health in previously inactive premenopausal women.

Fitness and health benefits of team handball training for young untrained women-A cross-disciplinary RCT on physiological adaptations and motivational aspects

PURPOSE

The present study evaluated the effects of regular participation in small-sided team handball training on body composition, osteogenic response, physical performance, and cardiovascular risk factors, as well as well-being and motivation, in young untrained women.

METHODS

Twenty-eight untrained 20- to 30-year-old women were randomized to a handball training group (HG; n = 14, height 170 ± 5 cm, weight 73 ± 11 kg, VO_2peak 37.7 ± 4.1 mL/min/kg) that trained 1.7 ± 0.3 times per week over 12 weeks (70 min 4 v 4 handball sessions) or an inactive control group (CG; n = 14, 169 ± 5 cm, 71 ± 12 kg, 38.1 ± 3.7 mL/min/kg). Physiological and psychological and motivational training adaptations were assessed pre- and post-intervention by dual-energy X-ray Absorptiometry (DXA) scans, blood sampling, physical tests, and questionnaires.

RESULTS

The average heart rate (HR) over all training sessions was equal to 85% ± 6% HR_max. Between-group intervention effects were observed in favor of HG for muscle mass (2.1%, p = 0.024), proximal femur bone mineral density (0.8%, p = 0.041), Yo-Yo IE1 intermittent endurance test level 1 (IE1) performance (35%, p < 0.001), and incremental treadmill test performance (11.5%, p = 0.003), but not total fat mass (p = 0.176), mean arterial blood pressure (p = 0.328), resting HR (p = 0.219), or blood lipids (p = 0.298-0.854). In CG, no changes were observed in any of the measured physiological variables after the training period. Compared to CG, HG had an increase in intrinsic motivation (p < 0.001) and in the well-being subscale "energy" (p = 0.010).

CONCLUSION

Participation in regular recreational team handball training organized as small-sided games has marked beneficial effects on physical performance, musculoskeletal fitness, well-being, and motivation in untrained young women.

Effects of recreational football on women's fitness and health: adaptations and mechanisms

The review describes the fitness and health effects of recreational football in women aged 18-65 years. The review documents that 2 × 1 h of recreational football training for 12-16 weeks causes marked improvements in maximal oxygen uptake (5-15%) and myocardial function in women. Moreover, mean arterial blood pressure was shown to decrease by 2-5 mmHg in normotensive women and 6-8 mmHg in hypertensive women. This review also show that short-term (< 4 months) and medium-term (4-16 months) recreational football training has major beneficial impact on metabolic health profile in women, with fat losses of 1-3 kg and improvements in blood lipid profile. Lastly, 2 × 1 h per week of recreational football training for women elevates lower extremity bone mineralisation by 1-5% and whole-body bone mineralization by 1-2% within 4-12-month interventions. These training adaptations are related to the high heart rates, high number of fast runs, and multiple changes of direction and speed occurring during recreational football training for untrained women. In conclusion, regular small-sided football training for women is an intense and versatile type of training that combines elements of high-intensity interval training (HIIT), endurance training and strength training, thereby providing optimal stimuli for cardiovascular, metabolic and musculoskeletal fitness. Recreational football, therefore, seems to be an effective tool for prevention and treatment of lifestyle diseases in young and middle-aged women, including hypertension, type 2 diabetes and osteopenia. Future research should elucidate effects of football training for elderly women, and as treatment and rehabilitation of breast cancer patients and other women patient groups.

The Effect of Unicycle Riding Course on Trunk Strength and Trunk Stability Functions in Children

Kocjan, A and Sarabon, N. The effect of unicycle riding course on trunk strength and trunk stability functions in children. J Strength Cond Res 34(12): 3560-3568, 2020-The aim of the study was to assess the effect of unicycling on trunk strength and timing of automatic stability actions of the selected trunk muscles (multifidus, obliquus externus, and erector spine). Twenty healthy 12-year-old children (12 boys, 8 girls; age 12.1 ± 0.2 years; body height 1.57 ± 0.05 m; body mass 52.8 ± 10.6 kg) were assigned to experimental and control group. Experimental group performed a supervised 12-session course of unicycling. Trunk strength was measured with a multipurpose diagnostic machine in frontal and sagittal planes in standing position. Trunk reflex responses and anticipatory actions were assessed through unexpected loading over the hands and rapid shoulder flexion, respectively. After the intervention, strength increased significantly (p < 0.01) in the experimental group in all analyzed positions. A significant interaction effect was observed during trunk extension (p < 0.01) and lateral flexion exertions (p < 0.03). Postural reflex latency improved significantly (p < 0.001) in the experimental group with a significant interaction effect in all analyzed muscles (p < 0.001). Anticipatory postural adaptations improved significantly (p ≤ 0.05) in multifidus and obliquus externus of the experimental group only. Unicycling proved to be an effective and funny tool to develop proximal stability and strength, which prevents low back pain and improves the efficiency of energy transfer between body segments. To improve the efficiency of physical education classes, unicycling should be considered a useful tool to increase trunk strength and stability among prepubertal children.

Physical and Physiological Demands of Recreational Team Handball for Adult Untrained Men

Lack of motivation to exercise was reported as a major cause of sedentary behavior in adulthood. This descriptive study examines the acute physical and physiological demands of recreational team handball and evaluates whether it could be suggested as an exercise mode for fitness and health enhancement in 33-55-year-old untrained men. Time-motion, heart rate (HR), and blood lactate analyses were obtained from 4 recreational matches. Mean distance covered during the 60 min matches was 6012 ± 428 m. The players changed match activity 386 ± 70 times, of which high-intensity runs and unorthodox movements amounted to 59 ± 18 and 26 ± 26 per match, respectively. The most frequent highly demanding playing actions were jumps and throws. Match average and peak HR were 82 ± 6% and 93 ± 5%  HRmax, respectively. Players exercised at intensities between 81 and 90%  HRmax for 47% (28 ± 14 min) and >90%  HRmax for 24% (14 ± 15 min) of total match time. Match average and peak blood lactate values were 3.6 ± 1.3 and 4.2 ± 1.2 mM, respectively. Recreational team handball is an intermittent high-intensity exercise mode with physical and physiological demands in the range of those found to have a positive effect on aerobic, anaerobic, and musculoskeletal fitness in adult individuals. Training studies considering recreational team handball as a health enhancing intervention are warranted.

Athletic background is related to superior trunk proprioceptive ability, postural control, and neuromuscular responses to sudden perturbations

Trunk motor control is essential for athletic performance, and inadequate trunk motor control has been linked to an increased risk of developing low back and lower limb injury in athletes. Research is limited in comparing relationships between trunk neuromuscular control, postural control, and trunk proprioception in athletes from different sporting backgrounds. To test for these relationships, collegiate level long distance runners and golfers, along with non-athletic controls were recruited. Trunk postural control was investigated using a seated balance task. Neuromuscular control in response to sudden trunk loading perturbations was measured using electromyography and kinematics. Proprioceptive ability was examined using active trunk repositioning tasks. Both athlete groups demonstrated greater trunk postural control (less centre of pressure movement) during the seated task compared to controls. Athletes further demonstrated faster trunk muscle activation onsets, higher muscle activation amplitudes, and less lumbar spine angular displacement in response to sudden trunk loading perturbations when compared to controls. Golfers demonstrated less absolute error and variable error in trunk repositioning tasks compared to both runners and controls, suggestive of greater proprioceptive ability. This suggests an interactive relationship between neuromuscular control, postural control, and proprioception in athletes, and that differences exist between athletes of various training backgrounds.

Short Duration Small Sided Football and to a Lesser Extent Whole Body Vibration Exercise Induce Acute Changes in Markers of Bone Turnover

We aimed to study whether short-duration vibration exercise or football sessions of two different durations acutely changed plasma markers of bone turnover and muscle strain. Inactive premenopausal women (n = 56) were randomized to complete a single bout of short (FG15) or long duration (FG60) small sided football or low magnitude whole body vibration training (VIB). Procollagen type 1 amino-terminal propeptide (P1NP) was increased during exercise for FG15 (51.6 ± 23.0 to 56.5 ± 22.5 μg·L⁻¹, mean ± SD, P < 0.05) and FG60 (42.6 ± 11.8 to 50.2 ± 12.8 μg·L⁻¹, P < 0.05) but not for VIB (38.8 ± 15.1 to 36.6 ± 14.7 μg·L⁻¹, P > 0.05). An increase in osteocalcin was observed 48 h after exercise (P < 0.05), which did not differ between exercise groups. C-terminal telopeptide of type 1 collagen was not affected by exercise. Blood lactate concentration increased during exercise for FG15 (0.6 ± 0.2 to 3.4 ± 1.2 mM) and FG60 (0.6 ± 0.2 to 3.3 ± 2.0 mM), but not for VIB (0.6 ± 0.2 to 0.8 ± 0.4 mM) (P < 0.05). Plasma creatine kinase increased by 55 ± 63% and 137 ± 119% 48 h after FG15 and FG60 (P < 0.05), but not after VIB (26 ± 54%, NS). In contrast to the minor elevation in osteocalcin in response to a single session of vibration exercise, both short and longer durations of small sided football acutely increased plasma P1NP, osteocalcin, and creatine kinase. This may contribute to favorable effects of chronic training on musculoskeletal health.

Effects on muscle strength, maximal jump height, flexibility and postural sway after soccer and Zumba exercise among female hospital employees: a 9-month randomised controlled trial

This 9-month randomised controlled workplace physical activity trial investigated the effects of soccer and Zumba exercise, respectively, on muscle strength, maximal jump height, sit-and-reach flexibility and postural sway among female workers. A total of 107 female hospital employees aged 25-63 were cluster-randomised to a soccer group, a Zumba group or a control group. Training was conducted outside working hours as two to three 1-h weekly sessions the first 3 months and once a week the last 6 months. Tests were conducted at baseline, after 3 and 9 months. The soccer group improved maximal neck extension strength both after 3 (1.2 kg; P < 0.05) and 9 months (1.7 kg; P < 0.01) compared to the control group. The Zumba group improved maximal trunk extension strength (3.1 kg; P = 0.04) after 3 months, with improvements in postural sway velocity moment (-9.2 mm(2)/s; P < 0.05) and lower limb lean mass (0.4 kg; P < 0.05) after 9 months. No significant intervention effects were revealed in vertical jump height or sit-and-reach flexibility. The present study indicates that workplace-initiated soccer and Zumba exercise may be beneficial for improvement of the neck and trunk strength, which may have preventive effects with regard to future perceived muscle pain in the respective body regions. Furthermore, the Zumba group revealed positive effects on lower limb lean mass and postural sway compared to the control group.

Effect of Workplace- versus Home-Based Physical Exercise on Muscle Response to Sudden Trunk Perturbation among Healthcare Workers: A Cluster Randomized Controlled Trial

Objectives. The present study investigates the effect of workplace- versus home-based physical exercise on muscle reflex response to sudden trunk perturbation among healthcare workers. Methods. Two hundred female healthcare workers (age: 42 [SD 11], BMI: 24 [SD 4], and pain intensity: 3.1 [SD 2.2] on a scale of 0–10) from 18 departments at three hospitals were randomized at the cluster level to 10 weeks of (1) workplace physical exercise (WORK) performed in groups during working hours for 5 × 10 minutes per week and up to 5 group-based coaching sessions on motivation for regular physical exercise, or (2) home-based physical exercise (HOME) performed during leisure time for 5 × 10 minutes per week. Mechanical and neuromuscular (EMG) response to randomly assigned unloading and loading trunk perturbations and questions of fear avoidance were assessed at baseline and 10-week follow-up. Results. No group by time interaction for the mechanical trunk response and EMG latency time was seen following the ten weeks (P = 0.17–0.75). However, both groups demonstrated within-group changes (P < 0.05) in stopping time during the loading and unloading perturbation and in stopping distance during the loading perturbation. Furthermore, EMG preactivation of the erector spinae and fear avoidance were reduced more following WORK than HOME (95% CI −2.7–−0.7 (P < 0.05) and −0.14 (−0.30 to 0.02) (P = 0.09)), respectively. WORK and HOME performed 2.2 (SD: 1.1) and 1.0 (SD: 1.2) training sessions per week, respectively. Conclusions. Although training adherence was higher following WORK compared to HOME this additional training volume did not lead to significant between-group differences in the responses to sudden trunk perturbations. However, WORK led to reduced fear avoidance and reduced muscle preactivity prior to the perturbation onset, compared with HOME. This trial is registered with Clinicaltrials.gov (NCT01921764).

Health-Related Physical Fitness in Healthy Untrained Men: Effects on VO2max, Jump Performance and Flexibility of Soccer and Moderate-Intensity Continuous Running

The purpose of this study was to determine the effects of recreational soccer (SOC) compared to moderate-intensity continuous running (RUN) on all health-related physical fitness components in healthy untrained men. Sixty-nine participants were recruited and randomly assigned to one of three groups, of which sixty-four completed the study: a soccer training group (SOC; n = 20, 34±4 (means±SD) years, 78.1±8.3 kg, 179±4 cm); a running group (RUN; n = 21, 32±4 years, 78.0±5.5 kg, 179±7 cm); or a passive control group (CON; n = 23, 30±3 years, 76.6±12.0 kg, 178±8 cm). The training intervention lasted 12 weeks and consisted of three 60-min sessions per week. All participants were tested for each of the following physical fitness components: maximal aerobic power, minute ventilation, maximal heart rate, squat jump (SJ), countermovement jump with arm swing (CMJ), sit-and-reach flexibility, and body composition. Over the 12 weeks, VO2max relative to body weight increased more (p<0.05) in SOC (24.2%, ES = 1.20) and RUN (21.5%, ES = 1.17) than in CON (-5.0%, ES = -0.24), partly due to large changes in body mass (-5.9, -5.7 and +2.6 kg, p<0.05 for SOC, RUN and CON, respectively). Over the 12 weeks, SJ and CMJ performance increased more (p<0.05) in SOC (14.8 and 12.1%, ES = 1.08 and 0.81) than in RUN (3.3 and 3.0%, ES = 0.23 and 0.19) and CON (0.3 and 0.2%), while flexibility also increased more (p<0.05) in SOC (94%, ES = 0.97) than in RUN and CON (0-2%). In conclusion, untrained men displayed marked improvements in maximal aerobic power after 12 weeks of soccer training and moderate-intensity running, partly due to large decreases in body mass. Additionally soccer training induced pronounced positive effects on jump performance and flexibility, making soccer an effective broad-spectrum fitness training intervention.

Effects of recreational soccer in men with prostate cancer undergoing androgen deprivation therapy: study protocol for the 'FC Prostate' randomized controlled trial

BACKGROUND

Androgen deprivation therapy (ADT) is a cornerstone in the treatment of advanced prostate cancer. Adverse musculoskeletal and cardiovascular effects of ADT are widely reported and investigations into the potential of exercise to ameliorate the effects of treatment are warranted. The 'Football Club (FC) Prostate' study is a randomized trial comparing the effects of soccer training with standard treatment approaches on body composition, cardiovascular function, physical function parameters, glucose tolerance, bone health, and patient-reported outcomes in men undergoing ADT for prostate cancer.

METHODS/DESIGN

Using a single-center randomized controlled design, 80 men with histologically confirmed locally advanced or disseminated prostate cancer undergoing ADT for 6 months or more at The Copenhagen University Hospital will be enrolled on this trial. After baseline assessments eligible participants will be randomly assigned to a soccer training group or a control group receiving usual care. The soccer intervention will consist of 12 weeks of training 2-3 times/week for 45-60 min after which the assessment protocol will be repeated. Soccer training will then continue bi-weekly for an additional 20 weeks at the end of which all measures will be repeated to allow for additional analyses of long-term effects. The primary endpoint is changes in lean body mass from baseline to 12 weeks assessed by dual X-ray absorptiometry scan. Secondary endpoints include changes of cardiovascular, metabolic, and physical function parameters, as well as markers of bone metabolism and patient-reported outcomes.

DISCUSSION

The FC Prostate trial will assess the safety and efficacy of a novel soccer-training approach to cancer rehabilitation on a number of clinically important health outcomes in men with advanced prostate cancer during ADT. The results may pave the way for innovative, community-based interventions in the approach to treating prostate cancer.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT01711892.

Effects of kettlebell training on postural coordination and jump performance: a randomized controlled trial

The aim of this study was to investigate the effectiveness of a worksite intervention using kettlebell training to improve postural reactions to perturbation and jump performance. This single-blind randomized controlled trial involved 40 adults (n = 40) from occupations with a high prevalence of musculoskeletal pain and discomfort (mean age 44 years, body mass index 23 kg·m, 85% women). A blinded examiner took measures at baseline and follow-up. Participants were randomly assigned to a training group-doing kettlebell swings 3 times a week for 8 weeks-or to a control group. The outcome measures were postural reactions to sudden perturbation and maximal countermovement jump height. Compared with the control group, the training group had a significant decreased stopping time after perturbation (-109 ms, 95% confidence interval [-196 to -21]). Jump height increased significantly in the training group (1.5 cm, 95% confidence interval [0.5 to 2.5]), but this was nonsignificantly different from control. Kettlebell training improves postural reactions to sudden perturbation. Future studies should investigate whether kettlebell training can reduce the risk of low back injury in occupations with manual material handling or patient handling where sudden perturbations often occur.

Randomized controlled trial of the effects of a trunk stabilization program on trunk control and knee loading

BACKGROUND

Many athletic maneuvers involve coordination of movement between the lower and upper extremities, suggesting that better core muscle use may lead to improved athletic performance and reduced injury risk.

PURPOSE

To determine to what extent a training program with quasistatic trunk stabilization (TS) exercises would improve measures of core performance, leg strength, agility, and dynamic knee loading compared with a program incorporating only resistance training (RT).

METHODS

Thirty-seven male subjects were randomly assigned to either an RT-only or a resistance and TS training program, each lasting 6 wk. Core strength and endurance, trunk control, knee loading during unanticipated cutting, leg strength, and agility were collected pre- and posttraining.

RESULTS

Between-group analyses showed that the TS group significantly improved only core endurance when compared with the RT group (side bridge, P = 0.050). Within-group analyses showed that the TS group improved lateral core strength (maximum pull, cable on nondominant side; 44.5 ± 61.3 N, P = 0.037). Both groups increased leg strength (deadlift 1 repetition maximum; TS: 55.1 ± 46.5 lb, P = 0.003; RT: 33.4 ± 17.5 lb, P < 0.001) and decreased sagittal plane trunk control (sudden force release test; cable in front; TS: 2.54° ± 3.68°, P = 0.045; RT: 3.47° ± 2.83°, P = 0.004), but only the RT group decreased lateral trunk control (sudden force release; cable on dominant side; 1.36° ± 1.65°, P = 0.029). The RT group improved standing broad jump (73.2 ± 108.4 mm, P = 0.049) but also showed increased knee abduction moment during unanticipated cutting (1.503-fold increase (percentage body weight × height), P = 0.012).

CONCLUSIONS

Quasistatic TS exercises did not improve core strength, trunk control, or knee loading relative to RT potentially because of a lack of exercises, including unexpected perturbations and dynamic movement. Together, these results suggest the potential importance of targeted trunk control training to address these known anterior cruciate ligament injury risk factors.

Trunk muscle reflex amplitudes increased in patients with subacute, recurrent LBP treated with a 10-week stabilization exercise program

Altered trunk muscle reflexes have been observed in patients with low back pain (LBP). Altered reflexes may contribute to impaired postural control, and possibly recurrence of LBP. Specific stabilization exercise (SSE) programs have been shown to decrease the risk of LBP recurrence in a select group of patients with acute, first episode LBP. It is not known if trunk muscle reflex responses improve with resolution of subacute, recurrent LBP when treated with a SSE program. A perturbation test was used to compare trunk muscle reflexes in patients with subacute, recurrent LBP, before and after 10 weeks of a SSE program and a group of matched control subjects (CNTL). The LBP group pre therapy had delayed trunk muscle reflexes compared with the CNTL group. Post therapy reflex latencies remained delayed, but amplitudes increased. Increased reflex amplitudes could limit excessive movement of the spine when perturbed; potentially helping prevent recurrence.

The effect of strength training, recreational soccer and running exercise on stretch-shortening cycle muscle performance during countermovement jumping

The purpose of the present study was to evaluate the effect of contrasting training modalities on mechanical muscle performance and neuromuscular activity during maximal SSC (stretch-shortening cycle) countermovement jumps (CMJ). Bilateral countermovement jumping, surface electromyography (EMG) and muscle fiber size (CSA) were studied in untrained individuals (n=49, 21-45 yrs) pre and post 12 weeks of progressive heavy-resistance strength training (ST, n=8), recreational soccer training (SOC, n=15), high-intensity interval running (INT, n=7), continuous running (RUN, n=9) or continuation of an inactive life-style (CON, n=10). ST displayed shortened CMJ take-off time (p<.05) and increased (p<.05) maximal CMJ jump height, peak down- and upward velocity of center of mass (COM), rate of vertical force development (RFD: ΔF(Z)/Δt), peak power production, rate of power development (RPD), mean plantar flexor EMG and peak hamstring rate of EMG rise (RER). Peak quadriceps EMG rate of rise increased in SOC (p<.05). Moreover, ST and SOC demonstrated increased quadriceps muscle fiber CSA and lean leg mass. Positive relationships (r>.70) were observed following ST between training-induced changes in CMJ SSC muscle performance, neuromuscular activity and muscle fiber CSA, respectively. ST induced a more rapid CMJ take-off phase and elevated muscle power production, indicating a more explosive-type SSC muscle performance. No effects were detected in CMJ performance after continuous running, high-intensity interval running and recreational soccer, despite an increased muscle fiber CSA and quadriceps muscle activity in SOC. Enhanced neuromuscular activity in the hip extensors (hamstrings) and plantar flexors, and increased myofiber fiber size were responsible for the enhanced CMJ SSC muscle performance with ST.

Long-term musculoskeletal and cardiac health effects of recreational football and running for premenopausal women

We examined long-term musculoskeletal and cardiac adaptations elicited by recreational football (FG, n=9) and running (RG, n=10) in untrained premenopausal women in comparison with a control group (CG, n=9). Training was performed for 16 months ( approximately 2 weekly 1-h sessions). For FG, right and left ventricular end-diastolic diameters were increased by 24% and 5% (P<0.05), respectively, after 16 months. Right ventricular systolic function measured by tricuspid annular plane systolic excursion (TAPSE) increased (P<0.05) in FG after 4 months and further (P<0.05) after 16 months (15% and 32%, respectively). In RG and CG, cardiac structure, E/A and TAPSE remained unchanged. For FG, whole-body bone mineral density (BMD) was 2.3% and 1.3% higher (P<0.05) after 16 months, than after 4 and 0 months, respectively, with no changes for RG and CG. FG demonstrated substantial improvements (P<0.05) in fast (27% and 16%) and slow (16% and 17%) eccentric muscle strength and rapid force capacity (Imp30ms: 66% and 65%) after 16 months compared with 4 and 0 months, with RG improving Imp30ms by 64% and 46%. In conclusion, long-term recreational football improved muscle function, postural balance and BMD in adult women with a potential favorable influence on the risk of falls and fractures. Moreover, football training induced consistent cardiac adaptations, which may have implications for long-term cardiovascular health.