POS1112 A RANDOMIZED, CROSS-OVER STUDY TO INVESTIGATE THE EFFECT OF WEIGHT-BEARING VS NON-WEIGHT-BEARING EXERCISE AND CARDIOVASCULAR STRESS ON TYPE II COLLAGEN TURNOVER IN KNEE OSTEOARTHRITIS PATIENTS – BIOMARKER DATA FROM THE EFEX-OA-02 STUDY

Background

Biomechanical stress is a prerequisite for OA development and studies have shown a difference in the effect of impact- and shear stress2, although studies of the direct impact of exercise on cartilage turnover have not demonstrated clear trends1.

Objectives

Exploring how weight-bearing (WB), non-weight-bearing (NWB) exercise and cardiovascular stress influence circulating biomarkers of cartilage extracellular matrix turnover in OA.

Methods

EFEX-OA-02 was a randomized, cross-over, clinical study investigating the direct effect of exercise on joint biomarkers in knee OA. Subjects were randomized to an order of cycling and running followed by adrenaline infusion and finally resting one week apart. Exercise and infusion sessions were multiphasic, consisting of 4x5-minute intervals. Peak cardiorespiratory stress (PCS) per interval was set to ≥80% of the heart rate reserve during exercise. Blood samples were obtained before, during, at five time points after and 24 h post exercise/infusion. For adrenaline infusion, 0.06 mg/kg of adrenaline was prepared in a 50 mL saline solution and administered intravenously. At rest, samples were collected at corresponding time points, except for the 24 h sample, which was omitted. Levels of serum C2M, T2CM (type II collagen degradation) and PRO-C2 (type II collagen formation) were measured using ELISA-assays (Nordic Bioscience). Coll2-1 and Coll2-1NO2 (type II collagen degradation) were measured using ELISA (Artialis).

Changes in biomarker concentrations after activity were compared to baseline (BL) and the corresponding resting samples. We used ANCOVA and Dunnett’s test with geometric means of change from BL up to 240 min as the dependent variable and subject and activity as covariates. Paired t-test was used to compare values at 24-hour to BL.

Results

Forty subjects were included. Mean age was 60.4 years (SD: 8.7), 24 (60%) were females, mean BMI was 27.0 kg/m2 (SD: 3.5), 18 had cumulated KL grade of 2 or 3 (45%) and 22 (55%) had KL 4, 5 or 6. and mean KOOS pain at BL was 67.5 (SD: 15.2) corresponding to mild-moderate pain. All subjects reached minimum PCS during exercise, but only an average of 70% (SD: 8.7) of that during infusion.

Cycling induced a small reduction in C2M (peak: -5.3%, 95%CI: -7.8 to -2.7%). PRO-C2 increased rapidly in response to cycling (peak: 11.7%, 95%CI: 4.3 to 19.1%) and running (peak: 12.9%, 95%CI: 3.54 to 22.2%). T2CM decreased up to one hour after cycling (peak: -10.8%, 95%CI: -15.1 to -6.5%) and running (peak: -9.5%, 95%CI: -15.5 to -3.6%), similar to adrenaline, then increased. Coll2-1NO2 increased rapidly following cycling (peak: 12.5%, 95%CI: 2.8 to 22.2%) and running (peak: 9.8%, 95%CI: 0.26 to 19.6%). Trends of increase was found in Coll2-1 (21.3%, 95%CI: 2.9 to 39.6) and Coll2-1NO2 (11.6%, 95%CI: -7.9 to 31.1%) in response to running at 240 min (Figure 1 – Error bars: SE, *Change to resting, †Change from BL, */†: P < 0.05, **/††: P < 0.01 ***/†††: P<0.001).

Figure 1.

At 24h PRO-C2 reduced -9.4% (95%CI: -18.2 to -0.5%) after cycling, Coll2-1NO2 reduced -8.33% (95%CI: -17.0 to 0.3%) after running and T2CM elevated by 6.0% (95%CI: -0.8 to 12.8%) after running and 7.1% (95%CI: 0.5 to 13.7%) after cycling.

Conclusion

Running, cycling and adrenaline infusion induced rapid small-to-moderate changes in circulating biomarkers reflecting type II collagen turnover. Changes after adrenaline-infusion suggests a cardiovascular contribution to exercise-induced changes. This model could potentially be used to evaluate treatment effects on collagen turnover.

References

[1]Bjerre-Bastos JJ, Karsdal MA, Boesen M, Bliddal H, Bay-Jensen A, Andersen JR, Bihlet AR: The acute and long-term impact of physical activity on biochemical markers and MRI measures in osteoarthritis—Perspectives for clinical osteoarthritis research. Transl Sport Med, 2020.

[2]Vincent TL: Mechanoflammation in osteoarthritis pathogenesis. Semin Arthritis Rheum, 2019.

Disclosure of Interests

Jonathan Bjerre-Bastos: None declared, Casper Sejersen: None declared, Henning Bay Nielsen: None declared, Mikael Boesen Speakers bureau: Speaker for Novartis and Eli Lilly, Niels Secher: None declared, Gregorio Distajo: None declared, Vincent Flood: None declared, Yves Henrotin Employee of: Founder and President of Artialis SA, Melanie Uebelhoer Employee of: Employee of Artialis, Abigail Mackey: None declared, Peter Krustrup: None declared, Carl-Christian Kitchen: None declared, Ema Petersen: None declared, Christian Thudium Shareholder of: Shareholder Nordic Bioscience A/S, Employee of: Full-time employee at Nordic Bioscience A/S, Jeppe Ragnar Andersen Employee of: Full-time employee of NBCD/Sanos Group A/S, Asger Reinstrup Bihlet Employee of: Full-time employee of NBCD/Sanos Group A/S

Position specific physical performance and running intensity fluctuations in elite women's football

The purpose of the present study was to investigate the physical performance of elite female football players during match play along with transient alterations in running performance following 1- and 5-min univariate peak periods. 54 elite female players from four top-level Norwegian teams were monitored for one season (n = 393 match observations), and physical performance data collected using STATSport GPS APEX. Results revealed significant differences in physical performance between the positions during full match play, particularly between wide and central players. Both full backs (FBs) and wide midfielders (WMs) covered more total distance (TD), high-speed running distance (HSRD), and sprint distance (SpD) than center backs (CBs) (p < 0.05-0.001), while WMs also covered more HSRD than both central midfielders (CMs) (p < 0.01) and forwards (FWs) (p < 0.05), and more acceleration -and deceleration distance (Acc_dist and Dec_dist ) than both CBs and CMs (p < 0.01-0.001). A similar pattern was observed for the peak period analysis, with FBs and WMs covering more SpD in peak 1 min than CBs and CM (p < 0.001) and more SpD in peak 5-min than CBs, CMs, and FWs (p < 0.001). Irrespective of the variable analyzed, greater distances were covered during the peak 5-min period than in the next-5 and mean 5-min periods (p < 0.001). Significant (p < 0.001), but small to trivial (Cohen's D_z : 0.07-0.20), decreases in distance covered were also observed for each variable following each univariate peak 5-min period. In conclusion, practitioners should account for differences in physical performance when developing training programs for female football players and be aware of transient reductions in physical performance following univariate peak 1- and 5-min periods. Specifically, the very high intensity in 1-min peak periods adds support to the principal of executing speed endurance activities during training to mirror and be prepared for the physical demands of match play.

Correction to: Cardiovascular, muscular, and skeletal adaptations to recreational team handball training: a randomized controlled trial with young adult untrained men

The author would like to correct the errors in the publication of the original article. The corrected details are given below for your reading.

Cardiovascular, muscular, and skeletal adaptations to recreational team handball training: a randomized controlled trial with young adult untrained men

PURPOSE

The prevalence of lifestyle diseases has escalated, and effective exercise training programmes are warranted. This study tested the hypothesis that regular participation in small-sided team handball training could provide beneficial health effects on cardiovascular, skeletal, and muscular parameters in young adult untrained men.

METHOD

Twenty-six untrained 20-30-year-old men were randomly allocated to either a team handball training group (HG; n = 14), which completed 1.9 ± 0.3 training sessions per week over 12 weeks, or an inactive control group (CG; n = 12). Physiological training adaptations were assessed pre- and post interventions by DXA scans, blood samples, muscle biopsies, and physical tests.

RESULTS

The average heart rate during training was equivalent to 84 ± 4% of maximal heart rate. Compared to CG, HG displayed significant increases in VO_2max (11 ± 6%), proximal femur bone mineral density (2 ± 1%), whole-body bone mineral content (2 ± 1%), intermittent endurance performance (32 ± 16%), incremental treadmill test performance (16 ± 7%) and muscle citrate synthase activity (22 ± 28%) as well as decreases in total fat mass (7 ± 7%) and total fat percentage (6 ± 7%) (all p < 0.05). There were no significant changes in muscle mass, blood pressure, resting heart rate, muscle hydroxyl-acyl-dehydrogenase activity, or blood lipids (all p > 0.05).

CONCLUSION

Participation in regular recreational team handball training was associated with positive cardiovascular, skeletal, and muscular adaptations, including increased maximal oxygen uptake, increased muscle enzymatic activity, and improved bone mineralization as well as lower fat percentage. These findings suggest that recreational team handball training may be an effective health-promoting activity for young adult men.

"FIFA 11 for Health" for Europe in the Faroe Islands: Effects on health markers and physical fitness in 10- to 12-year-old schoolchildren

We evaluated effects of the school-based intervention "FIFA 11 for Health" for Europe on health and fitness profile in 10- to 12-year-old Faroese schoolchildren. 392 fifth-grade children were randomized into a control group (CG: n = 100, 11.1 ± 0.3 years, 149.0 ± 6.7 cm, 42.4 ± 10.2 kg) and an intervention group (IG: n = 292, 11.1 ± 0.3 years, 150.6 ± 6.9 cm, 44.2 ± 9.4 kg). IG underwent an 11-week intervention in which 2 weekly sessions of 45 minutes were included in the school curriculum focusing on health aspects, football skills, and 3v3 small-sided games. CG continued with their regular activities. Body composition, blood pressure, and resting heart rate, as well as Yo-Yo intermittent recovery children's test (YYIR1C) performance, horizontal jumping ability and postural balance were assessed pre and post intervention. Systolic blood pressure decreased more (-2.8 ± 9.9 vs 2.9 ± 8.4 mm Hg, P < .05) in IG than in CG. Lean body mass (1.0 ± 1.7 vs 0.7 ± 1.6 kg), postural balance (0.3 ± 3.9 vs -1.2 ± 5.9 seconds) and horizontal jump performance (5 ± 9 vs -5 ± 10 cm) increased more (P < .05) in IG than in CG. YYIR1C performance improved in CG (17%, 625 ± 423 to 730 ± 565 m) and IG (18%, 689 ± 412 vs 813 ± 391 m), but without between-group differences. A within-group decrease from 23.1 ± 8.4 to 22.5 ± 8.3% (P < .05) was observed in body fat percentage in IG only. In conclusion, the "FIFA 11 for Health" for Europe program had beneficial effects on SBP, body composition, jump performance and postural balance in 10- to 12-year-old Faroese schoolchildren, supporting the notion that school-based football interventions can facilitate health of children in a small-scale society and serve as an early step in the prevention of non-communicable diseases.

Health Effects of 12 Weeks of Team-Sport Training and Fitness Training in a Community Health Centre for Sedentary Men with Lifestyle Diseases

This study compares the effects of team-sport training, for sedentary men with lifestyle diseases, with fitness training in a pragmatic set-up in a community health centre (CHC). Thirty-two men in the fitness group (FiG) and 36 men in the team-sport group (TsG) completed the training and trained for 60-90 min, two times/week for 12-16 weeks. In FiG and TsG, mean heart rate (HR) during training was 73.2% and 74.5% of HRmax, respectively. Percentage of training time above 90%HRmax was 6 ± 9% and 10 ± 15% and the percentage of participants who spent > 10% of total training time with HR > 90%HRmax was 20% and 41%, in FiG and TsG, respectively. In FiG, total fat mass was reduced by 3.5%  (P < 0.01), while performance in the 6 min walking test (6MWT) increased by 11%  (P < 0.001). In TsG, total fat mass was reduced by 2.2%  (P < 0.01), while 6MWT performance improved by 5%  (P < 0.05). Between-group differences were observed for systolic BP (P = 0.041) and mean arterial pressure (P = 0.050) in favour of TsG and for sit-to-stand test (P = 0.031) in favour of FiG. In conclusion, small-sided team sport is a worthy alternative to fitness training since the overall health effects are comparable, for example, improved balance and reduced fat mass. Team sport elicits high heart rates and improves cardiovascular health by reducing blood pressure, while fitness training improves sit-to-stand test performance related to activity of daily living.

Football training improves metabolic and cardiovascular health status in 55- to 70-year-old women and men with prediabetes

We examined the effects of 16 weeks of football training and dietary advice on blood glucose control and health status in 55- to 70-year-old women and men with prediabetes. Fifty participants with prediabetes (age; 61 ± 6 years, BMI; 29.6 ± 4.7; VO_2max 22.3 ± 5.7 mL·min^-1 ·kg^-1 ) were randomized into a football and dietary advice group (F+D; n = 27) and a dietary advice group (D; n = 23). F+D performed football training (twice weekly 30- to 60-minutes sessions) and received dietary advice, while D only received dietary advice. An oral glucose tolerance test (OGTT) was completed pre and post the 16-week period. Body composition, blood pressure, and maximal oxygen uptake (VO_2max ) were additionally measured. Both groups demonstrated a decrement (P < .05) in fasting blood glucose (-0.4 ± 0.5 mmol·L^-1 ) and lowered blood glucose throughout OGTT. F+D displayed lower values than D (P < .05) after 60 minutes (9.0 ± 2.7 vs 10.6 ± 2.9 mmol·L^-1 ) and 120 minutes (5.7 ± 1.6 vs 7.5 ± 2.4 mmol·L^-1 ). VO_2max increased by 14% in F+D, with a higher (P < .05) change score than in D (2%). Mean arterial pressure declined more (P < .05) in F+D than in D (-8 ± 9 vs -4 ± 11 mm Hg). Fat loss was greater (P < .05) in F+D than in D (-3.4 ± 2.8 vs -1.2 ± 2.0 kg), and the increase in lean body mass was also greater (P < .05) in F+D than in D (0.7 ± 1.5 vs -0.3 ± 1.6 kg). In conclusion, football training combined with dietary advice has broad-spectrum effects on metabolic and cardiovascular health profile with greater overall effects than professional dietary advice per se for 55- to 70-year-old women and men with prediabetes.

Broad-spectrum health improvements with one year of soccer training in inactive mildly hypertensive middle-aged women

The study tested the hypothesis that long-term soccer training has positive impact on cardiovascular profile, body composition, bone health, and physical capacity in inactive, pre-menopausal women with mild hypertension. The study applied a randomized controlled design in which physically inactive middle-aged women were separated into a soccer training group (n=19; SOC) and a control group (n=12; CON). SOC performed 128±29 (±SD) one-h small-sided soccer training sessions over one year. Blood pressure, body composition, blood lipid profile, and fitness level were determined pre- and post-intervention. Over one year, mean arterial pressure decreased more in SOC than in CON (-5±7 vs +4±5 mmHg; P<.05). Total-body fat mass decreased more (P<.05) in SOC than in CON (-2.5±2.5 vs +0.6±3.2 kg; P<.05), while the change scores for lean body mass were not significantly different in SOC (2.6±2.7 kg) compared to CON (1.1±1.9 kg, P=.09). Over one year, change scores in whole-body bone mineral density (0.004±0.032 vs -0.019±0.026 g·cm² ) as well as bone mineral content (30±70 vs -39±113 g) were positive in SOC compared to CON (P<.05). Post-intervention plasma triglycerides decreased more (-0.1±0.7 vs +0.2±0.2 mmol·L^-1 ) and HDL cholesterol increased more (0.2±0.7 vs -0.2±0.2 mmol·L^-1 ) in SOC than in CON (P<.05). Yo-Yo intermittent endurance level 1 (122±105 vs 2±21%) and 20-m sprint performance (6±6 vs -1±2%) increased more (P<.05) in SOC than in CON. In conclusion, long-term soccer training resulted in broad-spectrum improvements in the health profile of untrained, pre-menopausal women with mild hypertension, including cardiovascular, metabolic, and musculo-skeletal benefits.

Combination of Recreational Soccer and Caloric Restricted Diet Reduces Markers of Protein Catabolism and Cardiovascular Risk in Patients with Type 2 Diabetes

BACKGROUND

Moderate calorie-restricted diets and exercise training prevent loss of lean mass and cardiovascular risk. Because adherence to routine exercise recommendation is generally poor, we utilized recreational soccer training as a novel therapeutic exercise intervention in type 2 diabetes (T2D) patients.

OBJECTIVE

We compared the effects of acute and chronic soccer training plus calorie-restricted diet on protein catabolism and cardiovascular risk markers in T2D.

DESIGN, SETTING AND SUBJECTS

Fifty-one T2D patients (61.1±6.4 years, 29 females: 22 males) were randomly allocated to the soccer+diet-group (SDG) or to the diet-group (DG). The 40-min soccer sessions were held 3 times per week for 12 weeks.

RESULTS

Nineteen participants attended 100% of scheduled soccer sessions, and none suffered any injuries. The SDG group showed higher levels of growth hormone (GH), free fatty acids and ammonia compared with DG. After 12 weeks, insulin-like growth factor binding protein (IGFPB)-3 and glucose levels were lower in SDG, whereas insulin-like growth factor (IGF)-1/ IGFBP-3 ratio increased in both groups. After the last training session, an increase in IGF-1/IGFBP-3 and attenuation in ammonia levels were suggestive of lower muscle protein catabolism.

CONCLUSIONS

Recreational soccer training was popular and safe, and was associated with decreased plasma glucose and IGFBP-3 levels, decreased ammoniagenesis, and increased lipolytic activity and IGF-1/IGFBP-3 ratio, all indicative of attenuated catabolism.

Kicking Velocity and Effect on Match Performance When using a Smaller, Lighter Ball in Women's Football

The present study evaluated the effect of a smaller, lighter ball on kicking speed and technical-tactical and physical match performance in high-level adult female footballers. In the laboratory test setting, the peak ball velocity was 6% higher with the new ball (NB) than the standard ball (SB) (26.5±0.5 vs. 25.1±0.5 m·s^-1, p<0.05). However, during match-play, no differences were observed in mean heart rate (87±5 vs. 87±5%HR_max; p>0.05), blood lactate (90 min: 4.7±1.7 and 4.0±1.7 mmol·l^-1; p>0.05), total distance covered (10.6±0.9 and 10.4±0.8 km; p>0.05), intense running (>16 km/h) (2.08±0.42 and 1.94±0.38 km; p>0.05) and match-induced decrement in Yo-Yo IR1 performance (28 vs. 31%, respectively, p<0.05) using NB compared to SB. Likewise, no difference was observed in the number of short, medium-range or long passes during matches played with the 2 ball types, and there was no difference in passing success rate (NB: 68±1% and SB: 68±1%, p>0.05). In conclusion, high-level adult female footballers had a higher kicking speed when using a smaller, lighter ball, but no differences were observed during match-play with the 2 ball types in respect of technical-tactical and physical match performance. The physical loading was high for the players when playing with both ball types.

Efficacy of recreational football on bone health, body composition, and physical functioning in men with prostate cancer undergoing androgen deprivation therapy: 32-week follow-up of the FC prostate randomised controlled trial

Androgen deprivation therapy (ADT) for prostate cancer (PCa) impairs musculoskeletal health. We evaluated the efficacy of 32-week football training on bone mineral density (BMD) and physical functioning in men undergoing ADT for PCa. Football training improved the femoral shaft and total hip BMD and physical functioning parameters compared to control.

INTRODUCTION

ADT is a mainstay in PCa management. Side effects include decreased bone and muscle strength and increased fracture rates. The purpose of the present study was to evaluate the effects of 32 weeks of football training on BMD, bone turnover markers (BTMs), body composition, and physical functioning in men with PCa undergoing ADT.

METHODS

Men receiving ADT >6 months (n = 57) were randomly allocated to a football training group (FTG) (n = 29) practising 2-3 times per week for 45-60 min or to a standard care control group (CON) (n = 28) for 32 weeks. Outcomes were total hip, femoral shaft, femoral neck and lumbar spine (L2-L4) BMD and systemic BTMs (procollagen type 1 amino-terminal propeptide, osteocalcin, C-terminal telopeptide of type 1 collagen). Additionally, physical functioning (postural balance, jump height, repeated chair rise, stair climbing) was evaluated.

RESULTS

Thirty-two-week follow-up measures were obtained for FTG (n = 21) and for CON (n = 20), respectively. Analysis of mean changes from baseline to 32 weeks showed significant differences between FTG and CON in right (0.015 g/cm(2)) and left (0.017 g/cm(2)) total hip and in right (0.018 g/cm(2)) and left (0.024 g/cm(2)) femoral shaft BMD, jump height (1.7 cm) and stair climbing (-0.21 s) all in favour of FTG (p < 0.05). No other significant between-group differences were observed.

CONCLUSIONS

Compared to standard care, 32 weeks of football training improved BMD at clinically important femoral sites and parameters of physical functioning in men undergoing ADT for PCa.

Self-reported previous knee injury and low knee function increase knee injury risk in adolescent female football

Knee injuries are common in adolescent female football. Self-reported previous knee injury and low Knee injury and Osteoarthritis Outcome Score (KOOS) are proposed to predict future knee injuries, but evidence regarding this in adolescent female football is scarce. The aim of this study was to investigate self-reported previous knee injury and low KOOS subscale score as risk factors for future knee injuries in adolescent female football. A sample of 326 adolescent female football players, aged 15-18, without knee injury at baseline, were included. Data on self-reported previous knee injury and KOOS questionnaires were collected at baseline. Time-loss knee injuries and football exposures were reported weekly by answers to standardized text-message questions, followed by injury telephone interviews. A priori, self-reported previous knee injury and low KOOS subscale scores (< 80 points) were chosen as independent variables in the risk factor analyses. The study showed that self-reported previous knee injury significantly increased the risk of time-loss knee injury [relative risk (RR): 3.65, 95% confidence (CI) 1.73-7.68; P < 0.001]. Risk of time-loss knee injury was also significantly increased in players with low KOOS subscale scores (< 80 points) in Activities of Daily Living (RR: 5.0), Sport/Recreational (RR: 2.2) and Quality of Life (RR: 3.0) (P < 0.05). In conclusion, self-reported previous knee injury and low scores in three KOOS subscales significantly increase the risk of future time-loss knee injury in adolescent female football.

Football training improves lean body mass in men with prostate cancer undergoing androgen deprivation therapy

Androgen deprivation therapy (ADT) remains a cornerstone in the management of patients with prostate cancer (PCa) despite adverse effects on body composition and functional parameters. We compared the effects of football training with standard care in PCa patients managed with ADT (> 6 months). Fifty-seven men aged 67 (range: 43-74) were randomly assigned to a football group (FG, n = 29) or a usual care control group (CON, n = 28). The primary outcome was change in lean body mass (LBM) assessed by dual-energy X-ray absorptiometry scanning. Secondary outcomes included changes in knee-extensor muscle strength (one repetition maximum), fat percentage, and maximal oxygen uptake (VO2max ). Mean heart rate during training was 137.7 (standard deviation 13.7) bpm or 84.6 (3.9)% HRmax. In FG, LBM increased by 0.5 kg [95% confidence interval (CI) 0.1-0.9; P = 0.02] with no change in CON (mean group difference 0.7 kg; 95% CI 0.1-1.2; P = 0.02). Also, muscle strength increased in FG (8.9 kg; 95% CI 6.0-11.8; P < 0.001) with no change in CON (mean group difference 6.7 kg; 95% CI 2.8-10.7; P < 0.001). In FG, VO2max increased (1.0 mL/kg/min; 95% CI 0.2-1.9; P = 0.02) and fat percentage tended to decrease (0.7%; 95%CI 1.3-0.0; P = 0.06), but these changes were not significantly different from CON. In conclusion, football training over 12 weeks improved LBM and muscle strength compared with usual care in men with prostate cancer receiving ADT.

Effect of game format on heart rate, activity profile, and player involvement in elite and recreational youth players

The purpose of this study was to evaluate activity profile, aerobic load, and player involvement in two game formats of recreational and elite youth football for two age groups. A total of 152 youth players participated, with 45 U10 players playing 5v5 and 8v8 games, and 41 U13 players playing 8v8 and 11v11 (20 min) games. Activity profile, heart rate (HR), and technical actions were measured during all games using 10 Hz GPS, video filming, and HR monitors. For U10, no difference was found in total distance covered (1754 ± 237 vs 1771 ± 314 m, P = 0.650, d = 0.06), whereas mean HR (174 ± 10 vs 168 ± 12 bpm, P = 0.001, d = 0.59) and number of technical actions (65.1 ± 24.0 vs 36.9 ± 20.4, P    0.001, d = 1.27) were higher in 5v5 than in 8v8. For U13, lower total distance covered (1821 ± 325 vs 2038 ± 328 m, P < 0.001, d = 0.66) and higher number of technical actions (36.2 ± 14.9 vs 26.9 ± 14.1, P < 0.001, d = 0.64) were observed in 8v8 than in 11v11, with no difference in mean HR (170 ± 10 vs 171 ± 10 bpm, P = 0.679, d = 0.10). In conclusion, HR is high in youth football matches irrespective of the level of play and the game format. Playing with fewer players on smaller pitches results in minor changes to the physical loading but elevates the technical involvement of youth players both at elite level and recreational level.

Football training improves cardiovascular health profile in sedentary, premenopausal hypertensive women

The present study examined the effects of short-term recreational football training on blood pressure (BP), fat mass, and fitness in sedentary, 35-50-year-old premenopausal women with mild hypertension. Forty-one untrained, hypertensive women were randomized into a football training group (n = 21; FTG) and a control group (n = 20; CON). FTG performed 45 ± 1 1-h small-sided football training sessions during the 15-week intervention period. BP, body composition (dual-energy x-ray absorptiometry), blood lipid profile, and fitness level were determined pre- and post-intervention. After 15 weeks, systolic and diastolic BP, respectively, were lowered more (P < 0.05) in FTG (-12 ± 3 and -6 ± 2 mmHg) than in CON (-1 ± 1 and 1 ± 2 mmHg). Total body fat mass decreased more (P < 0.05) in FTG than in CON during the 15-week intervention period (-2.3 ± 0.5 kg vs 0.4 ± 0.3 kg). After 15 weeks, both total cholesterol (-0.4 ± 0.1 mmol/L vs 0.1 ± 0.2 mmol/L) and triglyceride (-0.2 ± 0.1 mmol/L vs 0.3 ± 0.2 mmol/L) were lowered more (P < 0.05) in FTG than in CON. Yo-Yo intermittent endurance level 1 test performance increased more (P < 0.05) in FTG than in CON (111 ± 18% vs 1 ± 3%) during the 15-week intervention period. In conclusion, short-term football training resulted in a marked reduction in BP and induced multiple improvements in fitness and cardiovascular health profile of untrained, premenopausal women with mild hypertension.

Positive effects of football on fitness, lipid profile, and insulin resistance in Brazilian patients with type 2 diabetes

We evaluated the effects of recreational football training combined with calorie-restricted diet (football + diet) vs calorie-restricted diet alone (diet) on aerobic fitness, lipid profile, and insulin resistance indicators in type 2 diabetes (T2D) patients. Forty-four T2D patients aged 48-68 years (27 females, 17 males) were randomly allocated to the football + diet group (FDG; n = 22) or to the diet group (DG; n = 22), of whom 19 FDG and 15 DG subjects completed the study. The football training was performed for 3 × 40 min/week for 12 weeks. Dual-energy X-ray absorptiometry scanning, treadmill testing, and fasting blood samplings were performed pre and post-intervention. After 12 weeks, maximal oxygen uptake (VO₂max ) was elevated (P < 0.05) by 10 ± 4% in FDG but not in DG (-3 ± 4%, P < 0.05). After 12 weeks, reductions in blood triglycerides (0.4 ± 0.1 mmol/L), total cholesterol (0.6 ± 0.2 mmol/L), low-density lipoprotein, and very low-density lipoprotein levels were observed only in FDG. Fat mass decreased (P < 0.05) by 3.4 ± 0.4 kg in FDG and 3.7 ± 0.4 kg in DG. The lower (P < 0.05) glucagon and homeostatic model assessment of insulin resistance indicated an improvement in insulin sensitivity in FDG. In conclusion, football combined with restricted diet was effective in enhancing VO₂max , reducing total cholesterol and triglycerides, and increasing insulin sensitivity, potentially providing better tools for the prevention of T2D complications than diet alone.

Effects of long-term football training on the expression profile of genes involved in muscle oxidative metabolism

We investigated whether long-term recreational football training affects the expression of health-related biochemical and molecular markers in healthy untrained subjects. Five untrained healthy men trained for 1 h 2.4 times/week for 12 weeks and 1.3 times/week for another 52 weeks. Blood samples and a muscle biopsy from the vastus lateralis were collected at T0 (pre intervention) and at T1 (post intervention). Gene expression was measured by RTqPCR on RNA extracted from muscle biopsies. The expression levels of the genes principally involved in energy metabolism (PPARγ, adiponectin, AMPKα1/α2, TFAM, NAMPT, PGC1α and SIRT1) were measured at T0 and T1. Up-regulation of PPARγ (p < 0.0005), AMPKα1 (p < 0.01), AMPKα2 (p < 0.0005) and adiponectin was observed at T1 vs T0. Increases were also found in the expression of TFAM (p < 0.001), NAMPT (p < 0.01), PGC1α (p < 0.01) and SIRT1 (p < 0.01), which are directly or indirectly involved in the glucose and lipid oxidative metabolism. Multiple linear regression analysis revealed that fat percentage was independently associated with NAMPT, PPARγ and adiponectin expression. In conclusion, long-term recreational football training could be a useful tool to improve the expression of muscle molecular biomarkers that are correlated to oxidative metabolism in healthy males.

Effect of football or strength training on functional ability and physical performance in untrained old men

The effects of 16 weeks of football or strength training on performance and functional ability were investigated in 26 (68.2 ± 3.2 years) untrained men randomized into a football (FG; n = 9), a strength training (ST; n = 9), or a control group (CO; n = 8). FG and ST trained 1.6 ± 0.1 and 1.5 ± 0.1 times per week, respectively, with higher (P < 0.05) average heart rate (HR) (∼140 vs 100 bpm) and time >90%HRmax (17 vs 0%) in FG than ST, and lower (P < 0.05) peak blood lactate in FG than ST (7.2 ± 0.9 vs 10.5 ± 0.6 mmol/L). After the intervention period (IP), VO₂ max (15%; P < 0.001), cycle time to exhaustion (7%; P < 0.05), and Yo-Yo Intermittent Endurance Level 1 performance (43%; P < 0.01) were improved in FG, but unchanged in ST and CO. HR during walking was 12% and 10% lower (P < 0.05) in FG and ST, respectively, after IP. After IP, HR and blood lactate during jogging were 7% (P < 0.05) and 30% lower (P < 0.001) in FG, but unchanged in ST and CO. Sit-to-stand performance was improved (P < 0.01) by 29% in FG and 26% in ST, but not in CO. In conclusion, football and strength training for old men improves functional ability and physiological response to submaximal exercise, while football additionally elevates maximal aerobic fitness and exhaustive exercise performance.

Structural and functional cardiac adaptations to 6 months of football training in untrained hypertensive men

We investigated the effects of 3 and 6 months of regular football training on cardiac structure and function in hypertensive men. Thirty-one untrained males with mild-to-moderate hypertension were randomized 2:1 to a football training group (n = 20) and a control group receiving traditional recommendations on healthy lifestyle (n = 11). Cardiac measures were evaluated by echocardiography. The football group exhibited significant (P < 0.05) changes in cardiac dimensions and function after just 3 months: Left ventricular (LV) end-diastolic volume increased from 104 ± 25 to 117 ± 29 mL. LV diastolic function improved measured as E/A ratio (1.15 ± 0.32 to 1.54 ± 0.38), early diastolic velocity, E' (11.0 ± 2.5 to 11.9 ± 2.6 cm/s), and isovolumetric relaxation time (74 ± 13 to 62 ± 13 ms). LV systolic function improved measured as longitudinal displacement (10.7 ± 2.1 to 12.1 ± 2.3 mm). Right ventricular function improved with respect to tricuspid annular plane systolic excursion (21.8 ± 3.2 to 24.5 ± 3.7 mm). Arterial blood pressure decreased in both groups, but significantly more in the football training group. No significant changes were observed in the control group. In conclusion, short-term football training improves LV diastolic function in untrained men with mild-to-moderate arterial hypertension. Furthermore, it may improve longitudinal systolic function of both ventricles. The results suggest that football training has favorable effects on cardiac function in hypertensive men.

Cardiovascular adaptations to 4 and 12 months of football or strength training in 65- to 75-year-old untrained men

The study examined the effects of 1 year of football or strength training on cardiovascular function in 65- to 75-year-old men. Twenty-six untrained men (age: 68.2 ± 3.2 years) were randomized to football training (FTG; n = 9), strength training (STG; n = 9), or control (CG; n = 8). In FTG, left ventricular (LV) internal diastolic diameter, end-diastolic volume, and mass index were 8%, 21%, and 18% higher (P < 0.01), respectively, after 12 months, with no changes in STG and CG. After 12 months, LV ejection fraction was increased (P < 0.05) by 8% and 5% in FTG and STG, respectively, and systolic longitudinal two-dimensional strain by 8% and 6%, whereas right ventricular systolic function improved (P < 0.05) by 22% in FTG, but not in STG and CG. In FTG, LV diastolic mitral inflow (E/A) ratio and peak early diastolic velocity (E') improved (P < 0.05) by 25% and 12%, respectively, after 12 months, with no changes in STG and CG. In FTG, maximum oxygen uptake was 16% and 18% higher (P < 0.001) after 4 and 12 months, respectively, and resting heart rate was 6 and 8 beats per minute lower (P < 0.001), respectively, with no changes in STG and CG. In conclusion, football training elicited superior cardiovascular effects compared with strength training in elderly untrained men.

A preliminary study: effects of football training on glucose control, body composition, and performance in men with type 2 diabetes

The effects of regular football training on glycemic control, body composition, and peak oxygen uptake (VO₂ peak) were investigated in men with type 2 diabetes mellitus (T2DM). Twenty-one middle-aged men (49.8 ± 1.7 years ± SEM) with T2DM were divided into a football training group (FG; n = 12) and an inactive control group (CG; n = 9) during a 24-week intervention period (IP). During a 1-h football training session, the distance covered was 4.7 ± 0.2 km, mean heart rate (HR) was 83 ± 2% of HRmax, and blood lactate levels increased (P < 0.001) from 2.1 ± 0.3 to 8.2 ± 1.3 mmol/L. In FG, VO₂ peak was 11% higher (P < 0.01), and total fat mass and android fat mass were 1.7 kg and 12.8% lower (P < 0.001), respectively, after IP. After IP, the reduction in plasma glucose was greater (P = 0.02) in FG than the increase in CG, and in FG, GLUT-4 tended to be higher (P = 0.072) after IP. For glycosylated hemoglobin (HbA1), an overall time effect (P < 0.01) was detected after 24 weeks. After IP, the number of capillaries around type I fibers was 7% higher (P < 0.05) in FG and 5% lower (P < 0.05) in CG. Thus, in men with T2DM, regular football training improves VO₂ peak, reduces fat mass, and may positively influence glycemic control.

Half-time re-warm up increases performance capacity in male elite soccer players

This study investigated the acute effects of a half-time re-warm up on performance and movement patterns in soccer match play. Using a crossover design, 22 professional male players performed traditional passive rest (CON) or a low-intensity re-warm up (RW) during the half-time period of two soccer matches. Before and after the first half and before the second half, maximal sprint and jump performance were evaluated. Time-motion analysis of the first 15 min of each half was conducted. Sprint and jump performance were reduced (P < 0.05) by 2.6% and 7.6%, respectively, during the half-time period in CON, whereas sprint performance was maintained and the decrement in jump performance (3.1%; P < 0.05) was lower after RW. No significant interaction for high-intensity running was observed, but less defensive high-intensity running was observed after RW than CON (0.14 ± 0.06 vs 0.22 ± 0.07 km; P < 0.01). Moreover, RW had more possession of the ball in the beginning of the second half. In conclusion, traditional passive half-time rest leads to impaired sprint and jump performance during the initial phase of the second half in professional soccer players whereas a re-warm up effectively attenuates such deteriorations. Less defensive high-intensity running and more ball possession were observed after RW, indicating a game advantage at the onset of the second half.

Cardiovascular function is better in veteran football players than age-matched untrained elderly healthy men

The aim of the study was to determine whether lifelong football training may improve cardiovascular function, physical fitness, and body composition. Our subjects were 17 male veteran football players (VPG; 68.1 ± 2.1 years) and 26 healthy age-matched untrained men who served as a control group (CG; 68.2 ± 3.2 years). Examinations included measurements of cardiac function, microvascular endothelial function [reactive hyperemic index (RHI)], maximum oxygen uptake (VO2max), and body composition. In VPG, left ventricular (LV) end-diastolic volume was 20% larger (P < 0.01) and LV ejection fraction was higher (P < 0.001). Tissue Doppler imaging revealed an augmented LV longitudinal displacement, i.e., LV shortening of 21% (P < 0.001) and longitudinal 2D strain was 12% higher (P < 0.05), in VPG. In VPG, resting heart rate was lower (6 bpm, P < 0.05), and VO2max was higher (18%, P < 0.05). In addition, RHI was 21% higher (P < 0.05) in VPG. VPG also had lower body mass index (P < 0.05), body fat percentage, total body fat mass, android fat percentage, and gynoid fat percentage (all P < 0.01). Lifelong participation in football training is associated with better LV systolic function, physical fitness, microvascular function, and a healthier body composition. Overall, VPG have better cardiovascular function compared with CG, which may reduce their cardiovascular morbidity and mortality.

One-legged endurance training: leg blood flow and oxygen extraction during cycling exercise

AIM

As a consequence of enhanced local vascular conductance, perfusion of muscles increases with exercise intensity to suffice the oxygen demand. However, when maximal oxygen uptake (VO(2)max) and cardiac output are approached, the increase in conductance is blunted. Endurance training increases muscle metabolic capacity, but to what extent that affects the regulation of muscle vascular conductance during exercise is unknown.

METHODS

Seven weeks of one-legged endurance training was carried out by twelve subjects. Pulmonary VO(2) during cycling and one-legged cycling was tested before and after training, while VO(2) of the trained leg (TL) and control leg (CL) during cycling was determined after training.

RESULTS

VO(2) max for cycling was unaffected by training, although one-legged VO(2) max became 6.7 (2.3)% (mean ± SE) larger with TL than with CL. Also TL citrate synthase activity was higher [30 (12)%; P < 0.05]. With the two legs working at precisely the same power during cycling at high intensity (n = 8), leg oxygen uptake was 21 (8)% larger for TL than for CL (P < 0.05) with oxygen extraction being 3.5 (1.1)% higher (P < 0.05) and leg blood flow tended to be higher by 16.0 (7.0)% (P = 0.06).

CONCLUSION

That enhanced VO(2) max for the trained leg had no implication for cycling VO(2) max supports that there is a central limitation to VO(2) max during whole-body exercise. However, the metabolic balance between the legs was changed during high-intensity exercise as oxygen delivery and oxygen extraction were higher in the trained leg, suggesting that endurance training ameliorates blunting of leg blood flow and oxygen uptake during whole-body exercise.

Effect of whey protein- and carbohydrate-enriched diet on glycogen resynthesis during the first 48 h after a soccer game

The effect of a whey protein- and carbohydrate (CHO)-enriched diet on the rate of muscle glycogen resynthesis after a soccer match was examined. Sixteen elite soccer players were randomly assigned to a group ingesting a diet rich in carbohydrates and whey protein [CHO, protein, and fat content was 71, 21, and 8E%, respectively; high content of carbohydrates and whey protein (HCP), n = 9] or a group ingesting a normal diet (55, 18, and 26E%; control [CON], n = 7) during a 48-h recovery period after a soccer match. CON and three additional players carried out a 90- and 60-min simulated match without body contacts (SIM90 and SIM60). Muscle glycogen was lowered (P < 0.05) by 54, 48, 53, and 38% after the matches in CON, HCP, SIM90, and SIM60, respectively. Glycogen resynthesis during the first 48 h after the match was not different between CON and HCP, whereas glycogen resynthesis was slower (P < 0.05) during the first 24 h after SIM60 than SIM90 (2.88 ± 0.84 vs 4.32 ± 0.54 mmol/kg dw/h). In HCP, glycogen content in type II muscle fibers was still lowered 48 h after the match. In conclusion, glycogen resynthesis 48 h after a soccer match is not elevated by ingestion of a HCP diet. Furthermore, glycogen resynthesis does not appear to be impaired by body contacts during a match.

Aerobic fitness testing in 6- to 9-year-old children: reliability and validity of a modified Yo-Yo IR1 test and the Andersen test

This study analysed the reliability and validity of two intermittent running tests (the Yo-Yo IR1 test and the Andersen test) as tools for estimating VO(2max) in children under the age of 10. Two groups, aged 6-7 years (grade 0, n = 18) and 8-9 years (grade 2, n = 16), carried out two repetitions of a modified Yo-Yo IR1 test (2 × 16 m) and the Andersen test, as well as an incremental treadmill test, to directly determine the VO(2max). No significant differences were observed in test-retest performance of the Yo-Yo IR1 test [693 ± 418 (±SD) and 670 ± 328 m, r (2) = 0.79, CV = 19%, p > 0.05, n = 32) and the Andersen test (988 ± 77 and 989 ± 87 m, r (2) = 0.86, CV = 3%, p > 0.05, n = 31). The Yo-Yo IR1 (r (2) = 0.47, n = 31, p < 0.002) and Andersen test performance (r (2) = 0.53, n = 32, p < 0.001) correlated with the VO(2max). Yo-Yo IR1 performance correlated with Andersen test performance (r (2) = 0.74, n = 32, p < 0.0001). In conclusion, the Yo-Yo IR1 and the Andersen tests are reproducible and can be used as an indicator of aerobic fitness for 6- to 9-year-old children.

Sub-maximal and maximal Yo-Yo intermittent endurance test level 2: heart rate response, reproducibility and application to elite soccer

The aims of this study were to (1) determine the reproducibility of sub-maximal and maximal versions of the Yo-Yo intermittent endurance test level 2 (Yo-Yo IE2 test), (2) assess the relationship between the Yo-Yo IE2 test and match performance and (3) quantify the sensitivity of the Yo-Yo IE2 test to detect test-retest changes and discriminate between performance for different playing standards and positions in elite soccer. Elite (n = 148) and sub-elite male (n = 14) soccer players carried out the Yo-Yo IE2 test on several occasions over consecutive seasons. Test-retest coefficient of variation (CV) in Yo-Yo IE2 test performance and heart rate after 6 min were 3.9% (n = 37) and 1.4% (n = 32), respectively. Elite male senior and youth U19 players Yo-Yo IE2 performances were better (P < 0.01) than elite youth U16s and sub-elite players (2,603 ± 451 and 2,534 ± 549 vs. 1,855 ± 535 vs. 1,749 ± 382 m). The intra- and inter-season CV for Yo-Yo IE2 test performance were 4.2 and 5.6%, respectively. A correlation was observed (P < 0.05) between Yo-Yo IE2 test performance and the total (r = 0.74) and high-intensity (r = 0.58) running distance covered in a match. A correlation was also evident (P < 0.01) between Yo-Yo IE2 test heart rate after 6 min expressed in percentage of maximal heart rate and the peak values for high-intensity running performed by midfielders in 5-min (r = -0.71), 15-min (r = -0.75) and 45-min periods (r = -0.77). The present data demonstrate that the Yo-Yo IE2 test is reproducible and can be used to determine the capacity of elite soccer players to perform intense intermittent exercise. Furthermore, the Yo-Yo IE2 test was shown to be a sensitive tool that not only relates to match performance but can also differentiate between intermittent exercise performance of players in various standards, stages of the season and playing positions.

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.