Significance of health fitness appraisal in an aging society

Reliability and validity of the Healthy Fitness Measurement Scale Version 1.0 (HFMS V1.0) in Chinese people

OBJECTIVE

To investigate the reliability and validity of Healthy Fitness Measurement Scale Version 1.0 (HFMS V1.0) for different population cohorts in the city of Guangzhou, Guangdong, China and to provide evidence and tools for further evaluation of healthy fitness of Chinese population and related factors.

DESIGN

Cross-sectional study.

SETTING

Urban neighbourhood and Medical University.

PARTICIPANTS

Elderly people (n=393; mean age 68.27±6.38 years; 53.18% male), university students (n=390; mean age 19.29±1.29 years; 38.21% male) and urban residents (n=393; mean age 32.23±9.41 years; 44.78% male).

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcomes were evaluated the reliability and validity of HFMS V1.0 by internal consistency evaluation, split-half reliability, test-retest reliability, convergent and discriminant construct validity, and factor analysis.

RESULTS

The Cronbach's α coefficients for HFMS V1.0 were all greater than 0.85 for overall scale of total samples and three individual groups, and the split-half reliability and intragroup correlation coefficients were both greater than 0.70 (p<0.01). The correlation of each item, dimension and subscales ranged from 0.52 to 0.91 (p < 0.01). A total of 10 factors were screened by exploratory factor analysis with the cumulative contribution rate of 61.40%, basically consistent with the theoretical structure of scale. The confirmatory factor analysis indicated good fit: CMIN/DF=3.45, root mean square error of approximation=0.05, GFI=0.91, AGFI=0.90, IFI=0.90, comparative fit index=0.90.

CONCLUSION

HFMS V1.0 showed acceptable reliability and validity in the test of healthy fitness of general population in Guangzhou. This scale could be a reliable measurement tool for evaluation of healthy fitness and potential risk factors.

Reliability and validity of Healthy Fitness Measurement Scale Version1.0 (HFMS V1.0) in Chinese elderly people

Purpose

We examined the reliability and validity of the Healthy Fitness Measurement Scale Version 1.0 (HFMS V1.0) specifically on elderly people in China.

Methods

We carried out a cross-sectional study in December 2020 and enrolled 800 elderly people through stratified sampling technique, including 777 valid samples (with a mean age of 71.81 ± 8.36 years), of which 382 cases (49.2%) were women. The level of healthy fitness was measured using the HFMS V1.0. The Cronbach’s alpha coefficient, split-half reliability, test-retest reliability, convergent and discriminant validity, exploratory factor and confirmatory factor were calculated for assessing the reliability and validity of HFMS V1.0.

Results

HFMS V1.0 consists of 8 dimensions and 38 items. The scale had acceptable reliability (Cronbach’s alpha = 0.920, split-half = 0.946, test-retest = 0.878). Exploratory factor analysis showed KMO value =0.927, and uncovered 10 factors with the cumulative contribution rate of 65.71% and all factor loads over 0.40. The item distribution was consistent with the initial expectation of the scale. The confirmatory factor analysis indicated good fit: CMIN/DF = 2.796, RMSEA = 0.048, IFI =0.914, TLI = 0.902, CFI = 0.913.

Conclusion

HFMS V1.0 was shown to have acceptable reliability and validity indices for this sample. Collectively, HFMS V1.0 is reliable and efficient to measure the healthy fitness of elderly people. It is recommended to use it among the elderly in other Chinese cities in the future to ensure uniformity and objectivity. This scale can be carried out to evaluate of the effectiveness of public health measures in improving the healthy fitness level of the elderly and optimizing public health policies.

Force-Velocity Characteristics, Muscle Strength, and Flexibility in Female Recreational Marathon Runners

Physical fitness components that relate with performance in marathon running, e.g., aerobic capacity and body composition, have been studied extensively. On the other hand, data on components of the health-related physical fitness, such as flexibility and muscle strength, were missing in this sport. Therefore, the aim of the present study was to profile force-velocity (F-v) characteristics, muscle strength and flexibility in female recreational marathon runners and to examine their relationship with age, race time and anthropometric characteristics (body fat percentage, fat-free mass - FFM, and total thigh muscle cross-sectional area - CSA). Thirty three female marathon runners (age 40.0 ± 8.9 years, body fat percentage 19.5 ± 4.6% and personal record 4:34 ± 0:39 h:min), separated into three age groups (<35, 35-45 and >45 years) and three performance groups (race time <4:15 h:min, 4:15-4:45 h:min and >4:45 h:min), performed sit-and-reach test (SAR), isometric muscle strength tests, squat jump, countermovement jump and F-v test on a cycle ergometer. The main findings of the present study were that (i) participants had moderate scores of body composition and physical fitness considering norms of the general population, (ii) the <35 age group had better jumping ability than 35-45 and >45 age group, and the older age group had lower F₀, Pmax and rPmax than their younger counterparts, (iii) the slowest performance group scored the highest in SAR, and (iv) isometric strength, F₀ and Pmax correlated largely with body mass and FFM. Considering the lack of existing data on anaerobic power and neuromuscular fitness of female marathon runners, the findings reported in this study would be useful for strength and conditioning trainers to monitor the training of their athletes. Even if these parameters were not related to race time, they should be monitored regularly as they were either component of health-related physical fitness (muscle strength and flexibility) or could help runners (anaerobic power) under specific circumstances such as ascends during a race.

Performance and age of African and non-African runners in half- and full marathons held in Switzerland, 2000-2010

Background

Endurance running performance of African (AF) and non-African (NAF) athletes is investigated, with better performances seen for Africans. To date, no study has compared the age of peak performance between AF and NAF runners. The present research is an analysis of the age and running performance of top AF and NAF athletes, using the hypothesis that AF athletes were younger and faster than NAF athletes.

Methods

Age and performance of male and female AF and NAF athletes in half-marathons and marathons held in Switzerland in 2000–2010 were investigated using single and multilevel hierarchical regression analyses.

Results

For half-marathons, male NAF runners were older than male AF runners (P = 0.02; NAF, 31.1 years ± 6.4 years versus AF, 26.2 years ± 4.9 years), and their running time was longer (P = 0.02; NAF, 65.3 minutes ± 1.7 minutes versus AF, 64.1 minutes ± 0.9 minutes). In marathons, differences between NAF and AF male runners in age (NAF, 33.0 years ± 4.8 years versus AF, 28.6 years ± 3.8 years; P < 0.01) and running time (NAF, 139.5 minutes ± 5.6 minutes versus AF, 133.3 minutes ± 2.7 minutes; P < 0.01) were more pronounced. There was no difference in age (NAF, 31.0 years ± 7.0 years versus AF, 26.7 years ± 6.0 years; P > 0.05) or running time (NAF, 75.0 minutes ± 3.7 minutes versus AF, 75.6 minutes ± 5.3 minutes; P > 0.05) between NAF and AF female half-marathoners. For marathoners, NAF women were older than AF female runners (P = 0.03; NAF, 31.6 years ± 4.8 years versus AF, 27.8 years ± 5.3 years), but their running times were similar (NAF, 162.4 minutes ± 7.2 minutes versus AF, 163.0 minutes ± 7.0 minutes; P > 0.05).

Conclusion

In Switzerland, the best AF male half-marathoners and marathoners were younger and faster than the NAF counterpart runners. In contrast to the results seen in men, AF and NAF female runners had similar performances. Future studies need to investigate performance and age of AF and NAF marathoners in the World Marathon Majors Series.

Participation and performance trends in 'Ultraman Hawaii' from 1983 to 2012

BACKGROUND

Participation and performance trends have been investigated in a single stage Ironman triathlon such as the 'Ironman Hawaii,' but not for a multi-stage ultra-triathlon such as the 'Ultraman Hawaii' covering a total distance of 515 km. The aims of this study were to analyze (1) changes in participation and performance, (2) sex-related differences in overall and split time performances, and (3) the age of peak performance in Ultraman Hawaii.

METHODS

Age and race times including split times for 98 women and 570 men who successfully finished Ultraman Hawaii (day 1 with 10-km swimming and 145-km cycling, day 2 with 276-km cycling, and day 3 with 84-km running) between 1983 and 2012 were analyzed. Changes in variables over time of annual winners and annual top three women and men were investigated using simple linear regression analyses.

RESULTS

The number of female finishers increased (r2 = 0.26, p < 0.01), while the number of male finishers remained stable (r2 = 0.03, p > 0.05). Overall race times decreased for both female (r2 = 0.28, p < 0.01) and male (r2 = 0.14, p < 0.05) winners and for both the annual top three women (r2 = 0.36, p < 0.01) and men (r2 = 0.14, p = 0.02). The sex difference in performance decreased over time from 24.3% to 11.5% (r2 = 0.39, p < 0.01). For the split disciplines, the time performance in cycling on day 1 (r2 = 0.20, p < 0.01) and day 2 decreased significantly for men (r2 = 0.41, p < 0.01) but for women only on day 2 (r2 = 0.45, p < 0.01). Split times showed no changes in swimming and running. The age of the annual winners increased from 28 to 47 years for men (r2 = 0.35, p < 0.01) while it remained stable at 32 ± 6 years for women (r2 < 0.01, p > 0.05). The age of the annual top three finishers increased from 33 ± 6 years to 48 ± 3 years for men (p < 0.01) and from 29 ± 7 years to 49 ± 2 years for women (p < 0.01).

CONCLUSIONS

Both the annual top three women and men improved performance in Ultraman Hawaii during the 1983-2012 period although the age of the annual top three women and men increased. The sex-related difference in performance decreased over time to reach approximately 12% similar to the reports of other endurance and ultra-endurance events. Further investigations are required to better understand the limiting factors of the multi-activities ultra-endurance events taking place over several days.

Do older athletes reach limits in their performance during marathon running?

In the last decades, the participation of elderly trained people in endurance events such as marathon running has dramatically increased. Previous studies suggested that the performance of master runners (>40 years) during marathon running has improved. The aims of the study were (1) to analyze the changes in participation and performance trends of master marathon runners between 1980 and 2009, and (2) to compare the gender differences in performance as a function of age across the years. Running times of the best male and female runners between 20 and 79 years of age who competed in the New York City Marathon were analyzed. Gender differences in performance times were analyzed for the top 10 male and female runners between 20 and 65 years of age. The participation of master runners increased during the 1980-2009 period, to a greater extent for females compared to males. During that period, running times of master runners significantly (P < 0.01) decreased for males older than 64 years and for females older than 44 years, respectively. Gender differences in running times decreased over the last three decades but remained relatively stable across the ages during the last decade. These data suggest that male (≥65 years) and female (≥45 years) master runners have probably not yet reached their limits in marathon performance. The relative stability of gender differences in marathon running times across the different age groups over the last decade also suggests that age-related declines in physiological function do not differ between male and female marathoners.

Master triathletes have not reached limits in their Ironman triathlon performance

The purpose of this study was to analyze the participation and performance trends of male triathletes in the "Ironman Switzerland" from 1995 to 2010. Participation trends of all finishers aged between 18 and 64 years were analyzed over the 16-year period by considering four 4-year periods 1995-1998, 1999-2002, 2003-2006, and 2007-2010, respectively. The 3.8-km swimming, 180-km cycling, 42-km running times, and total race times were analyzed for the top 10 triathletes in each age group from 18 to 64 years. The participation of master triathletes (≥40 years old) increased over the years, representing on average 23%, 28%, 37%, and 48% of total male finishers during the four 4-year periods, respectively. Over the 1995-2010 period, triathletes older than 40 years significantly improved their performance in swimming, cycling, running, and in the total time taken to complete the race. The question whether master Ironman triathletes have yet reached limits in their performance during Ironman triathlon should be raised. Further studies investigating training regimes, competition experience, or socio-demographic factors are needed to gain better insights into the phenomenon of the relative improvement in ultra-endurance performance with advancing age.

Independent from muscle power and balance performance, a creatinine clearance below 65 ml/min is a significant and independent risk factor for falls and fall-related fractures in elderly men and women diagnosed with osteoporosis

We assessed in a cross-sectional study in elderly men and women with osteoporosis, the association between the creatinine clearance (CrCl) and the performance in different balance and muscle power and function tests and found that a decreasing creatinine clearance was significantly associated with lower balance and muscle power.

INTRODUCTION

To determine if a creatinine clearance of <65 ml/min is significantly associated with decreasing muscle power and balance and an increased risk for falls and fractures.

METHODS

We assessed in a cross-sectional-study in 1781 German osteoporotic patients, the association between the CrCl, the physical performance, and the number of falls and fractures.

RESULTS

Controlling for age, gender, BMI, and osteoporosis treatment (fracture analysis only), a decreasing CrCl was associated with lower physical performance in the timed-up-and-go test (corr -0.2337, P < 0.0001), chair-rising test (corr -0.1706, P < 0.001), and tandem-stand test (corr 0.2193, P < 0.0001), and a CrCl of <65 ml/min was associated with a significantly higher risk for falls (47.7% vs. 36.2%, P = 0.0008) and fall-related fractures (33.1% vs. 22.9%, P = 0.0003) compared with a CrCl of >or=65 ml/min.

CONCLUSIONS

In this study, we found a significant gender-independent correlation between decreasing CrCl and lower performance in balance and muscle power tests. Reduced muscle power and balance may therefore be involved in the low creatinine clearance associated increased risk for falls and fall-related fractures. Furthermore, we found that a CrCl <65 ml/min., independent from the performance in muscle power, muscle function, and balance tests, is a significant risk factor for falls and fractures.