Effects of Olympic Combat Sports on Health-Related Quality of Life in Middle-Aged and Older People: A Systematic Review

Olympic combat sports and mental health in children and adolescents with disability: A protocol paper for systematic review

INTRODUCTION

Mental health is important for children and adolescents, particularly those with disabilities. While the mental health advantages of sports participation are well-documented, the specific type of sport may have heightened relevance for children and adolescents with disabilities. The objective of this systematic review protocol is to outline the rationale and methodology for investigating how participation in Olympic combat sports influences the mental health outcomes of this unique population, which is more susceptible to developing mental health issues than their neurotypical counterparts.

METHODS AND ANALYSIS

A comprehensive search will be conducted across academic databases, including the Cochrane Library, ERIC, PsycINFO, PubMed, Scopus, SPORTDiscus, and Web of Science. The focus will be on identifying randomized and non-randomized controlled trials (RCTs and non-RCTs, respectively), and observational studies with control groups that explore the impact of Olympic combat sports on the mental health of children and adolescents with disabilities. To assess the risk of bias, the Rob 2.0 tool will be employed for RCTs, and the ROBINS-I tool for CTs. For longitudinal and cross-sectional studies, the National Institute of Health's Study Quality Assessment Tool for Observational Cohort and Cross-sectional Studies will be used. The review process will be conducted using Covidence, possibly utilizing JASP software for meta-analysis if the retrieved studies exhibit sufficient homogeneity. Data that cannot be included in the meta-analysis will be synthesized using the Synthesis without Meta-Analysis (SWiM) tool. Furthermore, the Consolidated Framework for Implementation Research (CFIR) will provide a framework consisting of five broad domains: intervention characteristics, outer setting, inner setting, characteristics of individuals, and the process of implementation.

Adapted Taekwondo Improves Postural Balance and Health-Related Quality of Life Concerning Multicomponent Training and Walking Exercise in Older Females: A Randomized Controlled Trial (TKD and Aging Project)

Background/Objectives: This study aimed to assess and compare the effects of an adapted taekwondo (TKD) program, multicomponent training (MCT), walking exercise (WE), and inactive control group (CG) on blood pressure, morphological variables, frequency of food consumption, cognitive status, health-related quality of life (HRQoL), physical fitness tests, and postural balance in independent older females. Methods: A randomized controlled trial study was conducted with the following groups: TKD (n = 13), MCT (n = 12), WE (n = 12), and CG (n = 14), considering three/weekly 60-min/sessions for 16-weeks. A two-factor mixed analysis of the variance model with repeated measures was performed. Results: TKD improved significantly more in phonetic fluency (p = 0.021; ES = 1.89) than WE and in general health (p = 0.033; ES = 1.11) than CG. Both TKD and MCT improved significantly more than CG in the 30 s chair stand, arm curl, chair sit-and-reach, timed up-and-go, maximal isometric handgrip strength, and postural balance for the eyes closed condition in the area and anteroposterior velocity (p < 0.05). Conclusions: Only TKD improved the area (p = 0.008; ES = 1.00) and mediolateral velocity (p = 0.019; ES = 0.79) for the eyes open condition, and mediolateral velocity (p = 0.021; ES = 1.57) for the eyes closed condition. Blood pressure, morphological variables, and food consumption frequency showed no significant intragroup or intergroup interactions. TKD equivalently improved HRQoL and physical fitness to MCT, with better postural balance in older females.

Personality traits and levels of anxiety and depression among martial artists: a cross-sectional study

BACKGROUND

In recent years, fighting arts (e.g., Karate, Judo, Jujitsu, Boxe) have gained broader attention due to their multiple benefits, involving both physical and psychological enhancements for practitioners. Despite that, studies revolving around specific psychological characteristics such as personality traits are scarce. This study explored potential connections between the personality traits of practitioners and the specific fighting art they engage in, and investigated levels of anxiety and depression in fighting artists.

METHODS

A web-based cross-sectional survey instrument was developed and disseminated across the entire Italian territory. Participants were eligible if adults (> 18 years old) engaged in any fighting arts for a minimum of one year, with no additional restrictions. The survey employed the Big Five Inventory (BFI) with 44 questions to explore personality traits using the OCEAN model, and the Hospital Anxiety and Depression Scale (HADS) to explore anxiety and depression levels.

RESULTS

A total of 770 questionnaires were collected from July to September 2023. Participants were mainly men (M = 571, 74.5%; F = 199, 25.8%; mean age 45.2 ± 14.8), and most of the participants practised in the North of Italy (N = 493, 64.0%). The mean age of practice was 28.5 ± 14.9 years and the most practised fighting arts were Judo (N = 349, 45.3%), Karate (N = 272, 35.3%) and Jujitsu (N = 42, 5.5%). Personality traits were identified as openness, conscientiousness, extroversion, agreeableness, neuroticism and the results were as follows: O) 40.1 ± 6.30; C) 37.1 ± 5.78; E) 28.2 ± 5.64; A) 35.1 ± 5.08; N) 19,8 ± 5,51. Anxiety and depression scored respectively 5.93 ± 3.14 and 3.67 ± 2.74.

CONCLUSIONS

Fighting artists exhibit elevated levels of positive personality traits, such as openness, conscientiousness, extraversion, and agreeableness. Conversely, neuroticism tends to be lower among them. Moreover, anxiety and depression levels among fighting artists are lower than the Italian normative values. Fighting arts, particularly Karate and Judo, emerge as promising avenues for adults seeking innovative or complementary strategies to foster positive personality traits (e.g., openness, conscientiousness) while mitigating anxiety and depression. Future studies could explore other personality traits, including Machiavellianism, and explore additional psychological characteristics such as aggressiveness to provide a more comprehensive understanding.

Hand-to-hand combat in the 21st century-INNOAGON warrior or modern gladiator?-a prospective study

Introduction

In being an important lifestyle factor, the physical activity influences people's health status, including life expectancy. Specific forms of physical activity are exercises related to hand-to-hand combat in the broadest sense, often overlapping and containing similar elements associated with combat sports (for Western culture) and martial arts (for Far Eastern culture). There are many types of forms of practising hand-to-hand combat exercises, which can be seen as opposing or in some ways complementary, e.g.: "traditional"-e.g., karate or kung fu, practised for hundreds or even thousands of years, usually adhering to moral codes of conduct, and drawing ideas from philosophy, religion vs. "modern"-e.g., American pro wrestling or mixed martial arts-MMA, suggesting a combination of various traditional forms of martial arts. In terms of shaping a healthy lifestyle with mental health elements based on the implementation of hand-to-hand combat exercises, an analysis of these fundamental insights into physical activity is warranted. This study aims to investigate the development direction of the hand-to-hand exercises in Western culture, opposing the "traditional" and "modern" forms.

Discussion

In this study, INNOAGON theory responds to the overuse of the term "science of martial arts". It is currently being used to promote extreme aggression and violence as an acceptable means of achieving success, and this model is expressively permeating other spheres of social interaction. In INNOAGON's understanding, hand-to-hand combat should be associated with the ancient thought of "doing good" (ancient Greece) or "wisdom" (Far Eastern cultures) including aesthetic and philosophical aspects. This links to numerous psychosocial benefits, self-esteem, discipline, body-mind coordination including breath control and relaxation, respect for others. The modern form of hand-to-hand combat, framed in these discussions as MMA or American pro wrestling, historically refers to the gladiatorial fights held during the Roman Games. The holding of fights in so-called "cages" refers to the arena in which Roman slave fights were held, and the athletes performing there are often referred to as modern-day "gladiators".

Conclusion

Proper education, including education in the area of physical culture, leading to the development of a society turned towards values broader than just fun or self-satisfaction should be the basis for the development of the next generations. It actually remains to decide which path of social change we will choose: in the case of INNOAGON a positive one, and in the case of modern gladiator a destructive one. Only a proper education combined with a broad programme of social role modelling, social facilitation-the foundations of which are laid by INNOAGON-including promotion on the Internet and social media can provide the right counterbalance to the pathology increasingly penetrating our lives, leading to the promotion of aggression and threats to physical and mental health.

Evaluating the feasibility and acceptability of an adapted fencing intervention in breast cancer surgery post-operative care: the RIPOSTE pilot randomized trial

Background

Adapted physical activity programs have shown promising results in reducing the physical, social and psychological side effects associated with breast cancer, but the extent to which they can be effectively adopted, implemented and maintained is unclear. The aim of this study is to use the framework to guide the planning and evaluation of programs according to the 5 following keys: Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework to evaluate a fencing program under the French acronym RIPOSTE (Reconstruction, Image de soi, Posture, Oncologie, Santé, Thérapie, Escrime) literally in English (Reconstruction, Self-Image, Posture, Oncology, Health, Therapy, Fencing). This program is an innovative intervention focused on improving the quality of life (QoL) of breast cancer surgery patients through fencing.

Methods

A convergent mixed methods pilot study was conducted to preliminary evaluate the different RE-AIM dimension of the pilot program. Twenty-four participants who have just undergone surgery for invasive breast cancer were randomly allocated in two groups: one group started immediately after their inclusion (Early RIPOSTE group) and the other started 3 months following their inclusion (Delayed RIPOSTE group). Participants answered a questionnaire at inclusion and at the end of the program on QoL, shoulder functional capacity, fatigue, anxiety-depression and physical activity.

Results

RIPOSTE program was able to reach mainly young and dynamic participants, attracted by the originality of fencing and keen to improve their physical condition. Regarding effectiveness, our results suggest a trend to the improvement of QoL, shoulder functional capacity, fatigue and anxiety-depression state, even without any significant differences between the Early RIPOSTE group and the Delayed RIPOSTE group.

Discussions

The cooperation, exchanges and cohesion within the group greatly facilitated the adoption of the program, whereas interruptions during school vacations were the main barriers. The intervention was moderately well implemented and adherence to the protocol was suitable.

Conclusion

RIPOSTE is an acceptable and effective program for involving breast cancer survivors in physical activity, that needs to be tested at a larger scale to investigate its effectiveness, but has the potential to be transferred and scaled up worldwide.

Association between Quality of Life, Confinement, and Sex in Adults: A Multigroup Structural Equation Analysis

The state of confinement during the COVID-19 pandemic affected the quality of life of the general population. This study aims to define and contrast an explanatory model of the quality of life in adults and to analyze the relationships between these variables based on the state of confinement and sex. A total of 872 people from Chile aged between 17 and 50 (M = 21.70 years; SD= 3.272), of both sexes (60.90% male and 39.1% female) participated in this research, of whom 46.6% were not confined when tested and 53.4% were confined, analyzing the quality of life. A model of multi-group structural equations was performed, which adjusted very well (χ2 = 559.577; DF = 38; p < 0.001; IFC = 0.934; NFI = 0.916; IFI = 0.934; RMSEA = 0.061). The results show a positive and direct relationship among all the variables studied and the structural equation model proposed according to confinement and sex reveals a good fit in all the evaluation indexes. Stress and sleep, personality, and introspection were the indicators with the greatest influence in the four models, followed by the family and friends indicator with a medium correlation strength, such as the health monitoring dimension, although this was not as influential in confined individuals. The main conclusions are that the best adjustments are obtained in confined adults and females, and the data show that the psychological indicators obtained (stress and sleep, personality, and introspection) have the greatest influence on adults in the four models proposed with regard to their quality of life.

Effects of combat sports on cognitive function in older people: a systematic review

INTRODUCTION

This systematic review aimed to analyze the available body of published peer-reviewed studies on the effects of combat sports compared with active/passive control on cognitive function and electrophysiological markers of brain activity in older people.

EVIDENCE ACQUISITION

The studies were searched in Scopus, Web of Science, PubMed, MEDLINE, and PsycINFO databases from deadline to June 2023. The PRISMA, TESTEX, RoB, and GRADE scales assessed the evidence's methodological quality and certainty of evidence. The protocol was registered in PROSPERO (code: CRD42022361695).

EVIDENCE SYNTHESIS

After reviewing 3768 studies, seven combat sports interventions (score ≥60% in methodological quality) were selected, composed of 381 older people (63% female), with a mean age of 66 years. In the selected studies, interventions based on judo, karate, and taekwondo were carried out, where it was not possible to verify the benefits of combat sports in cognitive function and electrophysiological markers of brain activity regarding active/passive control groups, although the individual results of the analyzed studies indicate that the practice of combat sports favor selective attention, divided attention, executive function, visual perception, and cognitive processing speed in older people.

CONCLUSIONS

The available evidence does not allow a definite recommendation regarding combat sports as an effective cognitive function intervention in older people.

Implementation of a Budo group therapy for psychiatric in- and outpatients: a feasibility study

Introduction

Physical exercise has been shown to have numerous health benefits on co-morbid somatic conditions in psychiatry and can also enhance mental health. Thus, it is not difficult to recommend physical training programs as part of an integrated and holistic treatment approach for mental health disorders. However, getting patients to participate and keeping them engaged is a major challenge. Programs based on martial arts training could be interventions improving physical and mental health with higher attachment rates. The structured discipline, holistic approach integrating physical and mental elements, and empowering activities, may explain higher participant attachment rates.

Methods

Thus, the main objective of this feasibility study is to describe a newly established group therapy program incorporating interventions from martial arts training with its physical and philosophical parts including mindfulness and breath work.

Results

During the 14-month study period from April 2021 to May 2022, a Budo group therapy was used by 215 individual persons with a total of 725 group therapy participations. Retention in the program was good across all settings and very good for persons who participated as outpatients. The mean age of the participants was 33.5 years with a range from 14 to 69 years of age, and about 41% of the participants were female. The therapy program was able to address patients over the whole spectrum of psychiatric diagnoses. Satisfaction and motivation were uniformly self-reported as very good. Patients self-reported improved mental and physical health after participating in a Budo session compared to pre-session.

Discussion

Budo group therapy thus can be seen as a feasible, well-accepted and promising new transdiagnostic treatment approach, combining physical activation with resilience enhancement. With minimal contraindications, a broad spectrum of individuals seeking mental health support can engage in this group therapy.

Older Persons Participation in Hard Martial Arts: Opportunities to Improve Psychological Well-Being? A Scoping Review

This study aims to explore the potential psychological and cognitive advantages for older individuals engaged in hard martial arts (HMA), through a comprehensive scoping review of literature up to 2023. Specifically, it examines the extent of changes in cognition, mental state, and quality of life among elderly participants of HMA. Inclusion criteria were studies conducted on healthy persons who were over 50 years of age. Only papers published in the English language were included. The search was undertaken in electronic databases and sources of grey literature. Thirteen papers with a total of 514 participants met the inclusion criteria. Improved cognition and decreased levels of anxiety and depression were emerging themes. Together, these factors contributed to the quality of life of participants. HMA was found to benefit cognitive abilities and psychological well-being, increasing quality of life more than traditional exercise alone. Findings suggested duration of training influenced change more than frequency. The limited number of studies exploring the effects of HMA on mental wellness and cognitive ability in older adults underscores the need for further research. The findings of this review suggest cognitive and quality of life improvements and reduced depression and anxiety in individuals engaging in HMA. This review serves as a foundation for soundly designed future research.

Martial arts, combat sports, and mental health in adults: A systematic review

Martial arts (MA) and combat sports (CS) are physical activities that may be associated with health-related outcomes. The aim of this systematic review was to synthesize and evaluate the available evidence on the relationship between MA and CS training and mental health of adult practitioners (≥18 years). CochraneLibrary, EBSCOhost, Web-of-Science, and Scopus databases were searched up to September 2022 for measures of self-related constructs, ill-being and well-being, cognition and brain structure/function, in adult MA/CS practitioners. Seventy cross-sectional and two longitudinal studies were retained and submitted to risk of bias assessments through an adapted version of the Cochrane Collaboration's Tool. Associations between MA/CS practice and self-related constructs were inconclusive for both consistency and strength of evidence. Limited evidence of significant associations emerged for sub-domains of ill-being (i.e., externalizing and internalizing emotion regulation), and well-being. In regard to cognitive and brain structural/functional variables, evidence of positive association with MA/CS practice was consistent with respect to perceptual and inhibition abilities but limited with respect to attention and memory. Evidence on negative associations of boxing with changes of brain structure integrity due to concussions was also inconclusive. Functional imaging techniques could shed light onto brain activation mechanisms underlying complex cognitive performance. In relation to moderators, mixed results were found for activity exposure, expertise, level of competitive engagement (which often covary with the length of training) and sex and type of MA/CS. The MA/CS' multifaceted nature may produce different, sometimes conflicting outcomes on mental health. Studies on MA/CS represent a flourishing research area needing extensive improvement in theoretical and practical approaches.

Impact of adapted taekwondo vs. multicomponent training on health status in independent older women: a randomized controlled trial

This study, called the TKD and Aging Project, aimed to analyze and compare the effects of an adapted taekwondo program concerning multicomponent training on blood pressure, morphological variables, food consumption frequency, health-related quality of life (HRQoL), physical fitness, handgrip strength, and postural balance in independent older women. A randomized controlled trial study was conducted with parallel groups for 8 weeks (24 sessions of 60 min each), employing a double-blind design and incorporating repeated measures. Twenty-eight older women initially participated in the intervention. Three participants were excluded because they did not participate in the re-assessments. Thus, 14 older women from the adapted taekwondo group (TKD; age: 62.86 ± 2.38 years) and 11 from the multicomponent training group (MCT; age: 63.18 ± 1.94 years) participated in the final analysis. A two-factor mixed analysis of variance (ANOVA) model with repeated measures was performed to measure the time × group effect. The TKD showed significant improvements in the mental health (p = 0.024; ES = 0.91) and general health (p < 0.001; ES = 0.75) dimensions of the HRQoL, as well as in the chair stand (p = 0.001; ES = 1.18), arm curl (p < 0.001; ES = 2.10), 2-min step (p < 0.001; ES = 1.73), and chair sit-and-reach (p = 0.001; ES = 0.91) tests. Additionally, it showed a significant reduction in postural balance for the eyes-closed condition in the center of the pressure area (p = 0.021; ES = 0.89), mean velocity (p = 0.004; ES = 0.79), and mediolateral velocity (p < 0.001; ES = 1.26). However, the MCT showed significant increases in the general health (p = 0.013; ES = 0.95) dimension of the HRQoL and a significant reduction (p = 0.039; ES = 0.28) in the mediolateral velocity of postural balance for the eyes-closed condition. Multiple comparisons showed that the TKD scored significantly higher in the chair stand (p = 0.017; ES = 1.79), arm curl (p = 0.003; ES = 1.77), and 2-min step (p = 0.018; ES = 0.91) tests than the MCT. Compared to multicomponent training, taekwondo improves postural balance and provides better benefits in terms of physical fitness and HRQoL for older women. Therefore, it is possible to recommend it as a safe physical activity strategy, as long as it is well-dosed, since it showed high adherence to intervention in older women.

Judo-based exercise programs to improve health outcomes in middle-aged and older adults with no judo experience: A scoping review

The practice of judo appears to impact positively on physical performance, muscle strength and flexibility in older people, while also benefiting bone mineral density in middle-aged adults. This scoping review aimed to map the range, scope and type of relevant studies conducted to examine the safety, feasibility and effects of judo interventions on various health-related outcomes designed for middle-aged and older adults (≥45 years) with no previous experience in judo. Six databases as well as gray literature were searched using a developed search strategy. Two independent reviewers screened the titles and abstracts, as well as full-texts of relevant articles using data extraction tools developed for the purpose of this study. Fifteen original studies were included, comprising 648 participants (mean age 45-77.8 years). All 15 studies reported significant positive results of ≥1 health-related outcome. Quality of life and bone mineral density seemed to improve only after longer interventions (≥9 or ≥12 months, respectively), while results regarding fear of falling and physical activity levels were mixed. Five studies showed improvements in fear of falling while four studies reported no change. Similarly, two studies showed improvements in physical activity, while another study showed no change. Five studies reported on safety and deemed their intervention to be safe (no adverse events), with two studies confirming feasibility. Findings suggest that judo interventions can positively impact health-related outcomes in middle-aged and older adults. However, studies had small sample sizes and more research is needed to confirm these findings. Geriatr Gerontol Int 2023; 23: 163-178.

Effectiveness of Adapted Taekwondo, Multi-Component Training and Walking Exercise on Health Status in Independent Older Women: Study Protocol for a Randomized Controlled Trial (TKD & Aging Project)

This study protocol aims to analyze and compare the effects of an adapted taekwondo program with respect to multi-component training and walking exercise on health status in independent older women. Secondarily, we analyze the variability of the inter-individual response and compare it according to the designated training system. The sample will consist of 64 women between 60 and 65 years, randomly assigned to experimental group 1 (n = 16; adapted taekwondo), experimental group 2 (n = 16; multi-component training), experimental group 3 (n = 16, walking exercise) or control group (n = 16; no intervention). The experimental groups will perform the designated training for three sessions (60 min per session) per week over 16-weeks, while the control group will not receive any treatment. The main outcome will provide information about (i) blood pressure, (ii) lipid profile, (iii) frequency of food consumption, (iv) body composition, (v) cognitive status, (vi) brain activity, (vii) health-related quality of life (HRQoL) and (viii) physical-functional fitness. Our hypothesis indicates that adapted taekwondo produces more significant effects and greater inter-individual responses in cognitive status, brain activity, HRQoL, and postural balance than the others training methods. If this intervention proves effective, it could be an alternative for older women.