Test-Retest Reliability of Isokinetic Strength in Lower Limbs under Single and Dual Task Conditions in Women with Fibromyalgia

Background: Previous research has established good test-retest reliability for isokinetic dynamometry in fibromyalgia. However, the reliability of this test under dual-task conditions has not been investigated in fibromyalgia. Methods: A total of 10 women with fibromyalgia participated in this study. Participants completed the concentric/concentric test. The dual-task condition involved subtracting two by two while performing the test. Results: Reliability analysis under the single condition showed "poor" to "excellent" values for maximum peak torque in knee extension and "moderate" to "excellent" values for average. "Poor" to "excellent" reliability values were found in knee flexion for the maximum and average. Dual-task condition in knee extension ranged from "moderate" to "excellent" for maximum and average values, and in knee flexion, it ranged from "poor" to "excellent" for maximum value and from "moderate" to "excellent" for average value. Conclusions: Isokinetic dynamometry demonstrated sufficient reliability for measuring strength in knee extension maximum and average during single-task and dual-task conditions, along with knee flexion dual-task average in fibromyalgia. For knee flexion single-task maximum and average and knee flexion dual-task maximum, we did not obtain sufficiently reliable measurements. Only the concentric/concentric test has been studied, and future studies with a larger sample size are needed in order to generalize the results.

Effects of intermittent hypoxia and whole-body vibration training on health-related outcomes in older adults

BACKGROUND

Aging is associated with a health impairment and an increase of the vulnerability of the older people. Strength training under intermittent hypoxic conditions has been shown to have therapeutic effects on individual's health.

AIMS

The aim of this study was to investigate the effects of a combined intermittent hypoxia (IH) and whole-body vibration (WBV) training program on health-related outcomes in older people.

METHODS

A total of 60 adults (over the age of 65) voluntarily participated in an intervention that lasted 20 weeks (three 30-min sessions per week). The participants were divided into four experimental groups subjected to different environmental conditions (IH vs normoxia) and exercise (non-exercise vs WBV). Functional fitness, body composition, metabolic parameters, inflammatory biomarkers, and bone turnover were evaluated before and after the intervention. A multifactorial ANOVA with repeated measures was performed to explore differences within and between groups.

RESULTS

The results showed that IH and WBV had a positive synergistic effect on inflammatory parameters (CRP and IL-10), bone formation biomarker (PINP), and body composition (muscle and bone mass).

CONCLUSION

In conclusion, a combined IH and WVB training could be a useful tool to prevent the deterioration of health-related outcomes associated with aging. Clinical trial registration NCT04281264. https://clinicaltrials.gov/ .

Classification and Definitions of Compensatory Protective Step Strategies in Older Adults: A Scoping Review

BACKGROUND

The risk for an unexpected fall can be due to increasing age, health conditions, and loss of cognitive, sensory, or musculoskeletal functions. Falls have personal and economic consequences in many countries. Different disturbances can occur during gait, such as tripping, slipping, or other unexpected circumstances that can generate a loss of balance. The strategies used to recover balance depend on many factors, but selecting a correct response strategy influences the success of balance recovery.

OBJECTIVES

(1) To collect and clarify the definitions of compensatory protective step strategies to recover balance in older adults; (2) to identify the most used methods to induce loss of balance; and (3) to identify the most used spatiotemporal variables in analyzing these actions.

METHODS

The present review has followed the PRISMA guideline extension for Scoping Review (PRISMA-ScR) and the phases proposed by Askery and O'Malley. The search was conducted in three databases: PubMed, Web of Science, and Scopus.

RESULTS

A total of 525 articles were identified, and 53 studies were included. Forty-five articles were quasi-experimental studies, six articles were randomized controlled trials, and two studies had an observational design. In total, 12 compensatory protective step strategies have been identified.

CONCLUSIONS

There are 12 compensatory protective step strategies: lowering and elevating strategy, short- and long-step strategy, backward and forward stepping for slip, single step, multiple steps, lateral sidesteps or loaded leg sidestep unloaded leg sidestep, crossover step (behind and front), and medial sidestep. To standardize the terminology applied in future studies, we recommend collecting these strategies under the term of compensatory protective step strategies. The most used methods to induce loss of balance are the tether-release, trip, waist-pull, and slip methods. The variables analyzed by articles are the number of steps, the acceleration phase and deceleration phase, COM displacement, the step initiation or step duration, stance phase time, swing phase time and double-stance duration, stride length, step length, speed step, speed gait and the type of step.

Multicomponent Training Improves the Quality of Life of Older Adults at Risk of Frailty

Achieving a high quality of life in older adults can be difficult if they have limited physical function. The aims of this study were to evaluate the relationship between baseline values and variations in body composition, fitness, and nutritional status on health-related quality of life (HRQoL) and to describe the effects of a 6-month multicomponent training (MCT) programme and a 4-month detraining period on HRQoL. A total of 106 participants with limited physical function were included in this study (age: 80.8 ± 5.9 years; 74 females) and were divided into two groups: control (CON) and intervention (TRAIN). HRQoL was measured using the EQ-5D-3L questionnaire and a visual analogue scale (EQ-VAS). Information on body composition, physical fitness, Mediterranean diet adherence, and nutritional status were obtained. Healthier baseline values for body composition, fitness and nutritional status were associated with better HRQoL (explaining 23.7-55.4%). The TRAIN group showed increased HRQoL during this 6-month MCT, showing group-by-time interaction (p < 0.05) and a deleterious effect of detraining. Changes in weight, arm strength, and aerobic capacity contributed to explaining 36% of the HRQoL changes obtained with MCT (all p < 0.05). This MCT improved HRQoL in older adults with limited physical function. However, HRQoL returned to baseline values after detraining. This study highlights the importance of performing ongoing programs in this population.

Trends in Adherence to the Mediterranean Diet in Spanish Children and Adolescents across Two Decades

Unhealthy dietary habits determined during childhood may represent a risk factor to many of the chronic non-communicable diseases (NCDs) in adulthood. Mediterranean Diet (MD) adherence in children and adolescents (8-16 years) living in Spain was investigated using the KIDMED questionnaire in a comparative analysis of two cross-sectional nationwide representative studies: enKid (1998-2000, n = 1001) and PASOS (2019-2020, n = 3540). Taking into account the educational level of pupils, as well as the characteristics of the place of living, a significant association was found between a KIDMED score ≥ 8 (optimal MD adherence) and primary education as well as residency in an area of <50,000 inhabitants, while living in the southern regions was associated with non-optimal MD adherence (p < 0.001). Participants of the 2019-2020 study showed an increase in the consumption of dairy products (31.1% increase), pasta/rice (15.4% increase), olive oil (16.9% increase), and nuts (9.7% increase), as well as a decreased sweets and candies intake (12.6% reduction). In contrast, a significantly lower MD adherence was found when comparing the 2019-2020 (mean ± SE: 6.9 ± 0.04) and the 1998-2000 study (7.37 ± 0.08); p < 0.001), due to less consumption of fish (20.3% reduction), pulse (19.4% reduction), and fruits (14.9% reduction), and an increased intake of commercial goods/pastries or fast-food intake (both 19.4% increase). The lowest adherence was recorded for adolescents also in the most recent study, where 10.9% of them presented a KIDMED score ≤ 3. This study shows that eating habits are deteriorating among Spanish children and adolescents. Such findings point out the urgency of undertaking strong measures to promote the consumption of healthy, sustainable, and non-ultra-processed food, such as those available in an MD, not only at a scientific and academic level, but also at a governmental one.

Independent and Joined Association between Socioeconomic Indicators and Pediatric Obesity in Spain: The PASOS Study

Childhood obesity is a public health problem worldwide. An important determinant of child and adolescent obesity is socioeconomic status (SES). However, the magnitude of the impact of different SES indicators on pediatric obesity on the Spanish population scale is unclear. The aim of this study was to assess the association between three SES indicators and obesity in a nationwide, representative sample of Spanish children and adolescents. A total of 2791 boys and girls aged 8 to 16 years old were included. Their weight, height, and waist circumference were measured. SES was assessed using two parent/legal guardian self-reported indicators (educational level -University/non-University- and labor market status -Employed/Unemployed-). As a third SES indicator, the annual mean income per person was obtained from the census section where the participating schools were located (≥12.731€/<12.731€). The prevalence of obesity, severe obesity, and abdominal obesity was 11.5%, 1.4%, and 22.3%, respectively. Logistic regression models showed an inverse association of both education and labor market status with obesity, severe obesity, and abdominal obesity (all p < 0.001). Income was also inversely associated with obesity (p < 0.01) and abdominal obesity (p < 0.001). Finally, the highest composite SES category (University/Employed/≥12.731€ n = 517) showed a robust and inverse association with obesity (OR = 0.28; 95% CI: 0.16-0.48), severe obesity (OR = 0.20; 95% CI: 0.05-0.81), and abdominal obesity (OR = 0.36; 95% CI: 0.23-0.54) in comparison with the lowest composite SES category (Less than University/Unemployed/<12.731€; n = 164). No significant interaction between composite SES categories and age and gender was found. SES is strongly associated with pediatric obesity in Spain.

Impact of being physically active on the brain electrocortical activity, brain volumetry and performance in the Stroop color and word test in women with fibromyalgia

Physical exercise is one of the treatment approaches with the most robust evidence against fibromyalgia (FM) symptoms. This study aimed to investigate the impact of being physically active on the Stroop Color and Word Test (SCWT) performance as well as to investigate and compare the brain electrocortical activity during SCWT. A total of 31 women completed the SCWT while EEG was recorded. People with FM were divided into two groups (physically and non-physically active) according to the WHO guidelines. Furthermore, magnetic resonance imaging was acquired and health-related quality of life, the impact of the disease, and the six-minute walking test were administered. Physically active group showed better performance in the SCWT, exhibiting less error in name different color patches condition (C), more correct responses in named color-word condition (CW) and higher interference score than non-physically active group. Moreover, a significantly higher theta power spectrum in the Fp1 during the condition C in the SCWT and a higher volume in the right rostral middle frontal gyrus have been found in the physically active group. Furthermore, physically active women with FM showed positively correlations between correct responses in names of colors printed in black condition (W) in the SCWT and theta power in the F3, Fz, Fp2 and F4 scalp positions. Regarding non-physically active women with FM, errors in condition CW negatively correlated with the volume of left superior frontal gyrus, left rostral middle frontal gyrus, right rostral middle frontal gyrus, left caudal middle frontal gyrus and right caudal middle frontal gyrus. Furthermore, physically active group showed increased performance in the 6 min walking test and lower disease impact. Fulfil the physical activity recommendation seems to protect brain health since better SCWT performance, greater frontal theta power and higher volume in the right rostral middle frontal gyrus have been found in physically active women with FM.

Neurophysiological Response of Adults with Cerebral Palsy during Inclusive Dance with Wheelchair

A total of 16 adults with cerebral palsy (age = 37.50 (7.78)) participated in this cross-sectional study. The electroencephalographic (EEG) data were recorded under three conditions: (1) baseline; (2) while listening to music; (3) while performing inclusive dance choreography with wheelchair. EEG data was banded into theta (4-7 Hz), alpha (8-12 Hz), and beta (13-30 Hz). Significantly higher values of theta, alpha, and beta bands were found in dance conditions than in the baseline. Significant differences between baseline and listening to music conditions were not found in any of the power spectrum bands. Differences between listening to music conditions and inclusive dance with wheelchair were observed in theta and beta power spectrum band studies in the F4 electrode. Inclusive dance with wheelchair increases theta, alpha, and beta power spectra when compared to baseline. In addition, the beta power spectrum is greater only during inclusive dance conditions, which could be modulated by emotions. However, future studies should corroborate this hypothesis.

Psychometric Properties of the Spanish Versions of EQ-5D-Y-3L and EQ-5D-Y-5L in Children with Cancer: A Comparative Study

(1) Background: The recent published version with five levels of response of EQ-5D-Y needs to be studied in children with chronic illness. For this, the aim of the present study was to assess and compare the psychometric properties of EQ-5D-Y-3L and EQ-5D-Y-5L in terms of feasibility, ceiling effect, redistribution properties, informativity and inconsistence responses in children with cancer. (2) Methods: A core set of self-report tools, including the Spanish version of EQ-5D-Y-3L and EQ-5D-Y-5L, were administered to children drawn from the population with cancer. EQ-5D-Y-3L and EQ-5D-Y-5L were evaluated in terms of feasibility, ceiling effects, redistribution properties and differences in absolute and relative informativity. (3) Results: A total of 73 children (9.7 ± 2.3 years old) from the population with cancer participated in the study. No missing data in the new EQ-5D-Y-5L were visualized, so the feasibility was acceptable. EQ-5D-Y-5L showed a low ceiling effect in all dimensions with relative changes from EQ-5D-Y-3L to EQ-5D-Y-5L of between 15.3% and 42.4% for the dimensions and 44.6% for the overall system. Compared to EQ-5D-Y-3L, EQ-5D-Y-5L provided a better distribution of the severity of the problem in the five levels of response. The absolute informativity (Shannon's index) did not show statistically significant differences between EQ-5D-Y-3L and EQ-5D-Y-5L in all dimensions and the overall system. (4) Conclusions: EQ-5D-Y-5L is feasible, presenting a low ceiling effect and high discriminative power.

O3-7 Prenatal predictors and physical fitness in Spanish Youth: the UP&DOWN study

Background

Physical fitness outcomes are considered major health biomarkers to assess and monitor exercise-based interventions across the lifespan. Recent studies provide evidence that many adult and childhood chronic diseases should have their origins in gestational or fetal life. To date, a few pioneering studies have showed associations between prenatal predictors and selected physical fitness tests (strength and cardiorespiratory). Nevertheless, there is a lack of knowledge about the influence of prenatal factors on childhood performance on a comprehensive fitness test battery including speed and coordination. The innovative purpose of the current study is to analyse the relative weight of prenatal predictors on schoolchildren's physical fitness outcomes.

Methods

We obtain data from1188 children (571 girls) aged 6-11 years and 1020 adolescents (495 girls) aged 12-17 years. Prenatal predictors (gestational anemia, gestational diabetes and length of gestation) were self-reported from offspring's mothers. The ALPHA fitness test battery for youth was used to assess offsprinǵs physical fitness (muscular strength, motor fitness and cardiorespiratory fitness). Regression analysis were performed to predict the different physical fitness outcomes.

Results

The main findings of the present study indicate that the presence of gestational anemia significantly predicted lower scores of lower-body explosive muscular strength (standing long jump) and motor fitness (4x10-m shuttle run) and predicted moderately lower scores of upper-body isometric muscular strength (handgrip strength test). (p&gt;.005; p&gt;.008; p&gt;.075 respectively). Moreover, gestational anemia better predicted lower scores of muscular strength and motor fitness in children than in adolescents (standing long jump, handgrip strength test, 4x10-m shuttle run) (p&gt;.001; p&gt;.051; p &gt; 0.18, respectively). While gestational age and length of gestation (&gt;34- ?42 weeks) predict better cardiorespiratory fitness (20 m shuttle-run test) (p&gt;.023; p&gt;.023 respectively) and motor fitness (4x10 m shuttle; moderately for length of gestation). (p&gt;.020; p &gt; 0.55 respectively).

Conclusion

This evidence suggests that preventive strategies by health-care institutions, policy makers and technicians must be two-fold: a) to effectively reduce gestational anemia in order to prevent offsprinǵs predisposition to low levels of physical fitness, and b) to intervene with toddlers and children at risk to provide tailored physical activity programs and regular physical fitness evaluation.

Are there neurophysiological differences behind the play of different chess modalities?: An international grandmaster case study

The study of mental load is an emerging research topic in the field of sport sciences. In the sport of chess, there is a need to understand the mental demands of the sport of chess in order to manage training loads. The present study aimed to analyze the electrical brain pattern of an elite chess player during different chess games: 15 + 10, blindfold 15 + 10, lightning game, and problem-solving chess tasks. The participant was a male 33-year-old chess player with 2562 points of ELO and more than 26 years of chess experience, training between 3 and 4 h a day. The 15 + 10 game consisted of 15 min + 10 s increment per move. In the blindfold game, the participant cannot see the positions of the pieces and does not touch them. In the lightning game, the participant played four consecutive one minute game. In addition, two high-level, two low-level, and two medium-level chess problems were performed. Electroencephalographic (EEG) and heart rate variability (HRV) responses were measured to assess the electrical brain pattern and autonomic modulation respectively. The participant won both games at 15 + 10 (normal and blindfold), lost three and drew one of the four lightning games, solved the two low-level and the two medium-level problems and solved one of the two high-level problems. Although in both games the player achieved victory the average player move quality measured with both pure analysis and analysis with additional limitations were lower in 15 + 10 blindfold game than in 15 + 10 game. Increments in theta and alpha power spectrums can be observed during the most demanding chess games (blindfold chess, lightning game, and the chess problem at difficult- level). Furthermore, the highest alpha power spectrum values can be observed during blindfold chess. In conclusion, this is the first study investigating the EEG pattern of a International Chess Grandmaster during a blindfold chess game. We found that in the chess games where lower performance is exhibited, theta and alpha power spectrums increased.

Relationship between Kinesiophobia and Mobility, Impact of the Disease, and Fear of Falling in Women with and without Fibromyalgia: A Cross-Sectional Study

Background: Kinesiophobia is defined as fear of movement due to the painful experience of it. The main symptom of fibromyalgia is persistent and widespread pain associated with other symptoms. This study analyzes the kinesiophobia between women with fibromyalgia and apparently healthy women and investigates the relationship between kinesiophobia and physical fitness tests, fear of falling, and the impact of the fibromyalgia. Methods: Fifty-one women participated in this study were divided into two groups: (1) women with fibromyalgia and (2) apparently healthy women. Participants completed questionnaires to assess kinesiophobia, fear of falling, and the impact of fibromyalgia. Subsequently, participants completed the physical tests Timed Up and Go, 10-step stair ascent, and handgrip strength. Results: Women with fibromyalgia had significant differences in kinesiophobia and fear of falling compared to apparently healthy women. Similarly, performance in the physical tests was lower, except for the handgrip strength, which maintained similar values to the apparently healthy women. Significant relationships were found only in the fibromyalgia group between kinesiophobia, the impact of the disease, fear of falling, and the Timed Up and Go and 10-step stair ascent tests. Conclusions: Women with fibromyalgia showed higher kinesiophobia scores, worse performance in mobility tests, and higher fear of falling than apparently healthy women. Kinesiophobia score is related to Timed Up and Go performance, the 10-step stair ascent, the fear of falling, and the impact of the disease in women with fibromyalgia.

Fibromyalgia impact in the prefrontal cortex subfields: An assessment with MRI

INTRODUCTION

Previous studies have associated brain abnormalities in people with fibromyalgia with accelerated brain ageing. The prefrontal cortex is located in the anterior pole of the mammalian brain. It is defined as the part of the cerebral cortex that receives projections from the mediodorsal nucleus of the thalamus.

AIM

This study aimed to evaluate the volumetric differences in the prefrontal cortex subfields between healthy women and women with fibromyalgia using magnetic resonance imaging (MRI) and controlling for age, estimated intracranial volume, depression, and cognitive impairment.

MATERIAL AND METHODS

A total of 47 women with fibromyalgia (recruited from a fibromyalgia local association) and 43 healthy women (retrieved from the Open Access Series of Imaging Studies database) participated in this cross-sectional study. Multiple linear regressions were used to predict the value of the prefrontal cortex subfields as well as to determine if there were volumetric differences between the groups.

RESULTS

Volume of all prefrontal cortex regions decreased with each year of age. Healthy women showed higher volume in all the prefrontal cortex subfields than women with fibromyalgia. Regarding partial correlations performed, no significant relation were found between the fibromyalgia impact and the brain volumes analyzed, controlling for depression.

CONCLUSIONS

Women with fibromyalgia showed reduced volume in the right caudal middle frontal gyrus, rostral middle frontal gyrus, left inferior frontal gyrus pars opercularis, inferior frontal gyrus pars triangularis, inferior frontal gyrus pars orbitalis, lateral orbitofrontal cortex, right medial orbitofrontal cortex, right rostral anterior cingulate gyrus subfields of the prefrontal cortex and total gray matter compared to healthy women. Furthermore, through an analysis of multiple linear regressions, the left rostral middle frontal gyrus and left lateral orbitofrontal cortex showed significantly volumetric decreases related to depression levels. The total gray matter also shows a significant decrease related to age observed through the analysis of multiple linear regressions. No significant relation were found between the impact of the disease and the brain volumes analyzed, controlling for depression in women with fibromyalgia.

Relationship between pineal gland, sleep and melatonin in fibromyalgia women: a magnetic resonance imaging study

A total of 80% of fibromyalgia (FM) population have reported poor sleep. In this regard, the pineal gland, involved in circadian rhythm processes as a key neuroendocrine organ which mainly synthesises and secretes melatonin, has never been studied before in this population. Therefore, this study aimed to evaluate the parenchyma pineal volume and its relation to sleep hours, sleep quality index and melatonin level at night. A total of 50 participants, 30 women with FM and 20 healthy control women underwent cranial magnetic resonance imaging. The total pineal volume, cyst pineal volume and parenchyma pineal volume were manually calculated in cubic millimetres. Also, the total pineal volume was estimated using Hasehawa method. Parenchyma pineal volume was significantly correlated with sleep hours (p-value = 0.041) and nocturnal melatonin level (p-value = 0.027). Moreover, there was also a non-significant correlation between parenchyma pineal volume and sleep quality index (p-value = 0.055). Furthermore, a mean parenchyma pineal volume of 102.00 (41.46) mm³ was observed, with a prevalence of 29.60% cyst in FM group. This is the first study that has reported pineal gland volumes, cyst prevalence and correlative relationships between parenchyma pineal volume and sleep hours and melatonin levels in women with FM.

Effect of hypoxic conditioning on functional fitness, balance and fear of falling in healthy older adults: a randomized controlled trial

Background

Hypoxic conditioning has been proposed as a new tool to mitigate the sarcopenia and enhance health-related function, but decrements in standing balance have been observed during hypoxia exposure. The aim of the study was to evaluate the effect of a hypoxic conditioning training on functional fitness, balance and fear of falling in healthy older adults.

Methods

A total of 54 healthy older adults (aged 65–75 years), who voluntarily participated in the study, were randomly divided into three groups: the control group (CON), the normoxia training group (NT) that performed strength training in normoxia, and the hypoxia training group (HT) that trained under moderate hypoxic conditions at a simulated altitude of 2500 m asl. The training programme that was performed during 24 weeks was similar in both experimental groups and consisted of a full-body workout with elastic bands and kettlebells (three sets × 12–15 reps). The Senior Fitness Test (SFT), the Single Leg Stance test (SLS) and the Short Falls Efficacy Scale-International (FES-I) were assessed before and after the intervention.

Results

Results showed that after training, either in normoxia or in hypoxia, the participants increased upper and lower body strength, and the aerobic endurance, and decreased the fear of falling.

Conclusions

The moderate hypoxic conditioning seems to be a useful tool to increase the functional capacity in healthy older adults without observing a decline in balance.

Trial registration

ClinicalTrials.gov NCT04281264. Registered February 9, 2019-Retrospectively registered.

Comparison of the Psychometric Properties of the EQ-5D-3L-Y and EQ-5D-5L-Y Instruments in Spanish Children and Adolescents

OBJECTIVES

The study aimed to assess the reliability and validity of EQ-5D-5L-Y and to compare the performance of EQ-5D-5L-Y with EQ-5D-3L-Y in children and adolescents.

METHODS

The Spanish versions of the 3L and 5L of EQ-5D for youths, were administered to children and adolescents from the general population. Feasibility and reliability were determined for the EQ-5D-5L-Y. The EQ-5D-5L-Y and EQ-5D-3L-Y were evaluated in terms of ceiling effects, informativity, and correlations with other generic measurements of health-related quality of life.

RESULTS

A total of 714 healthy children and adolescents (10.7 ± 2.1 years old) from the general population participated in the study. Most of the sample reported full health status. The feasibility and reliability for the EQ-5D-5L-Y were acceptable, but the questionnaire showed a low convergent validity. Absolute informativity (Shannon index) showed a slight increase in all dimensions of the 5L compared with the 3L; nevertheless, there were only statistically significant differences between 5L and 3L in the dimension "feeling worried, sad, or unhappy" and also on the overall system. Relative informativity (Shannon evenness index) showed a decrease in the 5L compared with 3L for all dimensions, except for "looking after myself." Correlations with other health measurements, in both 3L and 5L, showed similar results to those observed in the international EQ-5D-3L-Y validation study.

CONCLUSION

The results show that EQ-5D-5L-Y is feasible, consistent, and reliable, but there are minor differences in the ceiling effect and informativity between the EQ-5D-5L-Y and EQ-5D-3L-Y versions in the general population.

Validity, reliability, and calibration of the physical activity unit 7 item screener (PAU-7S) at population scale

BACKGROUND

Validation of self-reported tools, such as physical activity (PA) questionnaires, is crucial. The aim of this study was to determine test-retest reliability, internal consistency, and the concurrent, construct, and predictive validity of the short semi-quantitative Physical Activity Unit 7 item Screener (PAU-7S), using accelerometry as the reference measurement. The effect of linear calibration on PAU-7S validity was tested.

METHODS

A randomized sample of 321 healthy children aged 8-16 years (149 boys, 172 girls) from the nationwide representative PASOS study completed the PAU-7S before and after wearing an accelerometer for at least 7 consecutive days. Weight, height, and waist circumference were measured. Cronbach alpha was calculated for internal consistency. Test-retest reliability was determined by intra-class correlation (ICC). Concurrent validity was assessed by ICC and Spearman correlation coefficient between moderate to vigorous PA (MVPA) derived by the PAU-7S and by accelerometer. Concordance between both methods was analyzed by absolute agreement, weighted kappa, and Bland-Altman statistics. Multiple linear regression models were fitted for construct validity and predictive validity was determined by leave-one-out cross-validation.

RESULTS

The PAU-7S overestimated MVPA by 18%, compared to accelerometers (106.5 ± 77.0 vs 95.2 ± 33.2 min/day, respectively). A Cronbach alpha of 0.76 showed an acceptable internal consistency of the PAU-7S. Test-retest reliability was good (ICC 0.71 p < 0.001). Spearman correlation and ICC coefficients of MVPA derived by the PAU-7S and accelerometers increased from 0.31 to 0.62 and 0.20 to 0.62, respectively, after calibration of the PAU-7S. Between-methods concordance improved from a weighted kappa of 0.24 to 0.50 after calibration. A slight reduction in ICC, from 0.62 to 0.60, yielded good predictive validity. Multiple linear regression models showed an inverse association of MVPA with standardized body mass index (β - 0.162; p < 0.077) and waist to height ratio (β - 0.010; p < 0.014). All validity dimensions were somewhat stronger in boys compared to girls.

CONCLUSION

The PAU-7S shows a good test-retest reliability and acceptable internal consistency. All dimensions of validity increased from poor/fair to moderate/good after calibration. The PAU-7S is a valid instrument for measuring MVPA in children and adolescents.

TRIAL REGISTRATION

Trial registration number ISRCTN34251612 .

Changes in Health Behaviors, Mental and Physical Health among Older Adults under Severe Lockdown Restrictions during the COVID-19 Pandemic in Spain

We used data from 3041 participants in four cohorts of community-dwelling individuals aged ≥65 years in Spain collected through a pre-pandemic face-to-face interview and a telephone interview conducted between weeks 7 to 15 after the beginning of the COVID-19 lockdown. On average, the confinement was not associated with a deterioration in lifestyle risk factors (smoking, alcohol intake, diet, or weight), except for a decreased physical activity and increased sedentary time, which reversed with the end of confinement. However, chronic pain worsened, and moderate declines in mental health, that did not seem to reverse after restrictions were lifted, were observed. Males, older adults with greater social isolation or greater feelings of loneliness, those with poorer housing conditions, as well as those with a higher prevalence of chronic morbidities were at increased risk of developing unhealthier lifestyles or mental health declines with confinement. On the other hand, previously having a greater adherence to the Mediterranean diet and doing more physical activity protected older adults from developing unhealthier lifestyles with confinement. If another lockdown were imposed during this or future pandemics, public health programs should specially address the needs of older individuals with male sex, greater social isolation, sub-optimal housing conditions, and chronic morbidities because of their greater vulnerability to the enacted movement restrictions.

Psychophysiological response of military pilots in different combat flight maneuvers in a flight simulator

OBJECTIVE

To analyze the psychophysiological response during takeoff, landing, air-air attack and air-ground attack maneuvers.

METHODS

A total of 11 expert pilots (age=33.36 (5.37)) from the Spanish Air Force participated in this cross-sectional study. Participants had to complete in a flight simulator the following missions: 1) takeoff; 2) Air-air attack; 3) Air-Ground attack, and 4) Landing. The electroencephalographic activity (EEG) and heart rate variability (HRV) were collected during all these maneuvers.

RESULTS

Significant higher values of theta (during takeoff, air-air attack and air-ground attack) EEG power spectrum were obtained when compared to baseline. Significant difference in the P3 scalp location was observed between landing and takeoff maneuvers in the beta EEG power spectrum. Furthermore, significant lower values of HRV were obtained during takeoff, landing, air-air attack and air-ground attack when compared to baseline values. Also, landing showed a higher sympathetic response when compared to takeoff maneuver.

CONCLUSION

Takeoff, landing, air-air attack or air-ground attack maneuvers performed in a flight simulator produced significant changes in the electroencephalographic activity and autonomic modulation of professional pilots. Beta EEG power spectrum modifications suggest that landing maneuvers induced more attentional resources than takeoff. In the same line, a reduced HRV during landing was obtained when compared to takeoff. These results should be considered to training purposes.

Association between 30-s Chair Stand-Up Test and Anthropometric Values, Vibration Perception Threshold, FHSQ, and 15-D in Patients with Type 2 Diabetes Mellitus

Simple Summary

Type 2 diabetes mellitus is a chronic global disease with a series of complications that lead to problems in the somatosensory system, the cardiovascular system, health-related quality of life, foot health, and even balance. These balance problems arise from deficits in lower limb strength, among other causes. The 30-s chair stand-up test is a test that evaluates leg strength and is an easy, quick, inexpensive, and predictive test of different parameters. How this test relates to health-related quality of life, vibration sensitivity threshold, and foot health has not been studied. This study tests the degree of the relationships of the 30-s chair stand-up test with the 15-dimensional (15-D) questionnaire, Foot Health Status Questionnaire (FHSQ), vibration sensitivity threshold, and body composition questionnaires.

Abstract

Background: Type 2 diabetes mellitus (T2DM) is a chronic, worldwide disease affecting more than 400 million people. This pathology involves several associated problems, such as diabetic neuropathy complications, obesity, and foot problems, both in terms of health and sensitivity. Objective: The objective of this study was to explore the relationships of the 30-s chair stand-up test with the Foot Health Status Questionnaire (FHSQ), the vibration perception threshold (VPT), and the 15-dimensional (15-D) questionnaire in T2DM people. Methodology: Ninety participants with T2DM were assessed in terms of fat mass percentage, VPT, foot health, health-related quality of life (HRQoL), and the 30-s chair stand-up test. Results: The 30-s chair stand-up test was found to exhibit a moderate relationship with “physical activity” (rho = 0.441; p ≤ 0.001) and “vigor” (rho = 0.443; p ≤ 0.001) from FHSQ. The 30-s chair stand-up test was also found to be weakly associated with foot pain (rho = 0.358; p = 0.001), 15-D total score (rho = 0.376; p ≤ 0.001), “sleeping” (rho = 0.371; p < 0.001), and “depression” (rho = 0.352; p = 0.001). Conclusions: The 30-s chair stand-up test is associated with “physical activity”, “vigor”, and “foot pain” from the FHSQ and the 15-D questionnaire total score and its dimensions “sleeping” and “depression” in type 2 diabetes mellitus patients. Therefore, following the results obtained, qualified clinicians can use the 30-s chair stand-up test as a good tool for monitoring and managing type 2 diabetes.

Screen Time and Parents' Education Level Are Associated with Poor Adherence to the Mediterranean Diet in Spanish Children and Adolescents: The PASOS Study

The aim of this study is to evaluate if screen time and parents' education levels are associated with adherence to a Mediterranean dietary pattern. This cross-sectional study analyzed a representative sample of 3333 children and adolescents (8 to 16 years) included in the Physical Activity, Sedentarism, lifestyles and Obesity in Spanish youth (PASOS) study in Spain (which ran from March 2019 to February 2020). Data on screen time (television, computer, video games, and mobile phone) per day, Mediterranean diet adherence, daily moderate or vigorous physical activity, and parents' education levels were gathered using questionnaires. A descriptive study of the variables according to sex and parents' education level was performed. Logistic regression models (adjusted by sex and weight status) were fitted to evaluate the independent association between screen time and Kids' level of adherence to the Mediterranean diet (KIDMED) index, as well as some of its items. A greater amount of screen time was associated with worse adherence to the Mediterranean diet; a lower consumption of fruit, vegetables, fish, legumes, and nuts; and a greater consumption of fast food, sweets, and candies. A lower parents' education level was associated with worse adherence to the Mediterranean diet. It is necessary to promote the responsible, limited use of screen time, especially in children with parents with a lower education level.

Impact of Fibromyalgia in the Hippocampal Subfields Volumes of Women-An MRI Study

Patients with fibromyalgia (FM) show widespread pain associated with other symptoms such as cognitive problems, depression, and anxiety among others associated with alterations in the central nervous system. The hippocampal subfields had differences in function, histology, and connectivity with other brain regions, and are altered in different diseases. This study evaluates the volumetric differences between patients with FM compared with a healthy control group. A total of 49 women with, and 43 healthy women completed this study. T1-weighted MRI was used to assess brain volume, and FreeSurfer software was used to segment the hippocampal subfields. Women with FM had a significant reduction in most of the hippocampal subfields. The regression equation models were obtained to predict the volume of specific subfields of the right and left hippocampus. These findings provide that women with FM have lower hippocampal subfields volumes compared with healthy women. Besides, regression models show that different covariates, such as age, cognitive impairment, or depression, are related to specific subfields.

Impact of COVID-19 Confinement on Physical Activity and Sedentary Behaviour in Spanish University Students: Role of Gender

During the COVID-19 pandemic, entire populations were instructed to live in home-confinement to prevent the expansion of the disease. Spain was one of the countries with the strictest conditions, as outdoor physical activity was banned for nearly two months. This study aimed to analyse the changes in physical activity and sedentary behaviours in Spanish university students before and during the confinement by COVID-19 with special focus on gender. We also analysed enjoyment, the tools used and motivation and impediments for doing physical activity. An online questionnaire, which included the International Physical Activity Questionnaire Short Form and certain "ad hoc" questions, was designed. Students were recruited by distributing an invitation through the administrative channels of 16 universities and a total of 13,754 valid surveys were collected. Overall, university students reduced moderate (-29.5%) and vigorous (-18.3%) physical activity during the confinement and increased sedentary time (+52.7%). However, they spent more time on high intensity interval training (HIIT) (+18.2%) and mind-body activities (e.g., yoga) (+80.0%). Adaptation to the confinement, in terms of physical activity, was handled better by women than by men. These results will help design strategies for each gender to promote physical activity and reduce sedentary behaviour during confinement periods.

MoCA vs. MMSE of Fibromyalgia Patients: The Possible Role of Dual-Task Tests in Detecting Cognitive Impairment

Fibromyalgia is a syndrome that is characterized by widespread pain; fatigue; stiffness; reduced physical fitness; sleep disturbances; psychological symptoms, such as anxiety and depression; and deficits in cognitive functions, such as attention, executive function, and verbal memory deficits. It is important to analyze the potentially different performance on the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) test in patients with fibromyalgia as well as examine the relationship of that performance with physical and cognitive performance. A total of 36 women with fibromyalgia participated in the study. Participants completed the MoCA test, the MMSE, and the TUG physical fitness test under dual-task conditions. The results obtained on cognitive tests were 28.19 (1.74) on the MMSE and 25.17 (2.79) on the MoCA. The participants' performance on cognitive tests was significantly related to the results of the TUG dual-task test. In this way, cognitive performance on a dual-task test can be used to support the diagnosis of cognitive impairment in patients with fibromyalgia. The MoCA test may be a more sensitive cognitive screening tool than the MMSE for patients with fibromyalgia.

Neurophysiological Differences Between Women With Fibromyalgia and Healthy Controls During Dual Task: A Pilot Study

Background

Women with FM have a reduced ability to perform two simultaneous tasks. However, the impact of dual task (DT) on the neurophysiological response of women with FM has not been studied.

Objective

To explore both the neurophysiological response and physical performance of women with FM and healthy controls while performing a DT (motor–cognitive).

Design

Cross-sectional study.

Methods

A total of 17 women with FM and 19 age- and sex-matched healthy controls (1:1 ratio) were recruited. The electroencephalographic (EEG) activity was recorded while participants performed two simultaneous tasks: a motor (30 seconds arm-curl test) and a cognitive (remembering three unrelated words). Theta (4–7 Hz), alpha (8–12 Hz), and beta (13–30) frequency bands were analyzed by using EEGLAB.

Results

Significant differences were obtained in the healthy control group between single task (ST) and DT in the theta, alpha, and beta frequency bands (p-value < 0.05). Neurophysiological differences between ST and DT were not found in women with FM. In addition, between-group differences were found in the alpha and beta frequency bands between healthy and FM groups, with lower values of beta and alpha in the FM group. Therefore, significant group^∗condition interactions were detected in the alpha and beta frequency bands. Regarding physical condition performance, between groups, analyses showed that women with FM obtained significantly worse results in the arm curl test than healthy controls, in both ST and DT.

Conclusion

Women with FM showed the same electrical brain activity pattern during ST and DT conditions, whereas healthy controls seem to adapt their brain activity to task commitment. This is the first study that investigates the neurophysiological response of women with FM while simultaneously performing a motor and a cognitive task.

Impact of fibromyalgia on sexual function in women

BACKGROUND

The prevalence of sexual problems is very high among women with fibromyalgia.

OBJECTIVE

To evaluate the prevalence of sexual problems in women with FM and the potential association among physical activity, quality of life and sexual function. We aimed to contribute in the understanding of the relationships between sexual function and the symptoms of FM.

METHODS

The sample of this cross-sectional study comprised 113 women with FM and 116 age-matched women without FM. Sexual function was assessed using the 15D questionnaire. Health-related quality of life (using EQ-5D-5L and 15D questionnaires), impact of fibromyalgia and physical activity were also assessed.

RESULTS

The prevalence of sexual problems among women with fibromyalgia was 76%, while it was 15% in healthy controls. This prevalence was even higher among those aged 50 or over. Sexual function was significantly associated with quality of life, distance walked, impact of fibromyalgia and four of the symptoms: depression, anxiety, tenderness and memory problems.

CONCLUSION

More than three out of four women with fibromyalgia have any kind of sexual problem. Depression, anxiety and tenderness seems to be the most relevant symptoms associated with sexual function. Physical activity may be protective and reduce the risk of having sexual problems.

Study protocol of a population-based cohort investigating Physical Activity, Sedentarism, lifestyles and Obesity in Spanish youth: the PASOS study

INTRODUCTION

Physical activity (PA) is essential to healthy mental and physical development in early life. However, the prevalence of physical inactivity, which is considered a key modifiable driver of childhood obesity, has reached alarming levels among European youth. There is a need to update the data for Spain, in order to establish if current measures are effective or new approaches are needed.

METHODS AND ANALYSIS

We present the protocol for Physical Activity, Sedentarism, lifestyles and Obesity in Spanish youth (PASOS). This observational, nationally representative, multicentre study aims to determine the PA levels, sedentary behaviours and prevalence of physical inactivity (defined as <60 min of moderate to vigorous PA per day) in a representative sample of Spanish children and adolescents. The PASOS study has recruited a representative random sample of children and adolescents aged 8-16 years from 242 educational centres in the 17 'autonomous regions' into which Spain is divided. The aim is to include a total of 4508 youth participants and their families. Weight, height and waist circumference will be measured by standardised procedures. Adherence to the Mediterranean diet, quality of life, sleep duration, PA and sedentary behaviour are being measured by validated questionnaires. PA is measured by the Physical Activity Unit 7-item Screener. A representative subsample (10% of participants) was randomly selected to wear accelerometers for 9 days to obtain objective data on PA. Parents are asked about their educational level, time spent doing PA, diet quality, self-perceived stress, smoking habit, weight, height, their child's birth weight and if the child was breast fed.

ETHICS AND DISSEMINATION

The study was approved by the Ethics Committee of the Fundació Sant Joan de Déu, Barcelona, Spain. Main findings of the study will be disseminated to the scientific community and to general public by media conferences, social media and a website.

TRIAL REGISTRATION NUMBER

ISRCTN34251612.

Effects of 24-Week Exergame Intervention on the Gray Matter Volume of Different Brain Structures in Women with Fibromyalgia: A Single-Blind, Randomized Controlled Trial

BACKGROUND

Exergame-induced changes in the volume of brain gray matter have not been studied in fibromyalgia (FM). This study evaluates the effects of a 24-week exergame-based intervention on the gray matter volume of different brain structures in patients with FM through magnetic resonance imaging (MRI).

METHODS

A total of 25 FM patients completed 24 weeks of intervention program, and another 25 FM patients did not receive any intervention. T1-weighted MRI was used to assess brain volume, and FreeSurfer software was used to segment the brain regions.

RESULTS

No significant effects on gray matter volume of different structures and total gray matter were found.

CONCLUSIONS

FM patients did not show significant changes in gray matter brain volume between the control and experimental groups after 24 weeks. FM patients showed significant relationships between peak oxygen consumption (pVO2) and the left and right regions of the hippocampus and the left and right regions of the amygdala.

The effects of Age, Organized Physical Activity and Sedentarism on Fitness in Older Adults: An 8-Year Longitudinal Study

The aims of the present study were (1) to describe the changes in physical fitness during an 8 year follow-up in a large sample of Spanish adults aged 65 or over that are initially engaged in organized physical activity (OPA), (2) to compare fitness changes according to different age groups (65 to 69 vs. 70 to 74 vs. ≥75 years-old), (3) to evaluate the independent and combined effects of changes in OPA engagement and sitting time (ST) on physical fitness. A total of 642 (147 males) non-institutionalized over 65 years-old participants completed the EXERNET battery fitness tests and completed a validated questionnaire from which information regarding OPA and ST were collected. All participants completed evaluations in 2008–2009 and in 2016–2017. An impairment of fitness-related variables happens after 65 years of age in both males and females, with the older participants (≥75), showing the largest decreases. Males who continued performing OPA demonstrated lower decreases in balance, leg flexibility and agility when compared to those who stopped performing OPA during the follow-up. Females who continued performing OPA demonstrated lower decreases of all variables except for balance when compared to those who stopped performing OPA during the follow-up.

Twelve Weeks of Whole Body Vibration Training Improve Regucalcin, Body Composition and Physical Fitness in Postmenopausal Women: A Pilot Study

(1) Background: Regucalcin or senescence marker protein 30 (SMP30) is a Ca2+ binding protein discovered in 1978 with multiple functions reported in the literature. However, the impact of exercise training on SMP30 in humans has not been analyzed. Aging is associated with many detrimental physiological changes that affect body composition, functional capacity, and balance. The present study aims to investigate the effects of whole body vibration (WBV) in postmenopausal women. (2) Methods: A total of 13 women (aged 54.3 ± 3.4 years) participated in the study. SMP30, body composition (fat mass, lean mass, and bone mass) and physical fitness (balance, time up and go (TUG) and 6-min walk test (6MWT)) were measured before and after the 12 weeks of WBV training. (3) Results: The WBV training program elicited a significant increase in SPM30 measured in plasma (27.7%, p = 0.004) and also in 6MWT (12.5%, p < 0.001). The WBV training also significantly reduced SPM30 measured in platelets (38.7%, p = 0.014), TUG (23.1%, p < 0.001) and total body fat mass (4.4%, p = 0.02). (4) Conclusions: There were no significant differences in balance, lean mass or bone mass. The present study suggests that 12 weeks of WBV has the potential to improve SPM30, fat mass, TUG and 6MWT in postmenopausal women.

Mobility Assessment under Dual Task Conditions in Women With Fibromyalgia: A Test-Retest Reliability Study

OBJECTIVE

To assess the test-retest reliability of the 10-step stair ascent test, Timed Up and Go (TUG) test, and 10-meter walking test under dual-task conditions in patients with fibromyalgia.

DESIGN

Test-retest reliability.

SETTINGS

Local fibromyalgia association and university facilities.

PARTICIPANTS

Thirty-eight women with fibromyalgia.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Fear of falling and the number of falls in the last year were measured using a visual analogue scale. The 10-step stair ascent test, TUG test, and 10-meter walking test were conducted under single- and dual-task conditions. The order between single- and dual-task condition was randomized in both test and retest. Retest measurement was assessed the week following the test.

RESULTS

The reliability of the performance on the 10-step stair ascent test under dual and single conditions ranged between good (>0.75 to < 0.9) and excellent (≥0.9), but there were significant differences between test and retest. The reliability of the TUG is between good (≥0.75 to < 0.9) and excellent (≥0.9) under the dual-task condition as well as moderate (≥0.5 to <0.75) and excellent (≥0.9) under the single-task condition. The reliability of the 10-meter walking dual-task test is between moderate (≥0.5 to <0.75) and good (≥0.75 to < 0.9) under dual- and single-task condition, respectively.

CONCLUSIONS

The TUG and 10-meter walking tests are reliable for assessing mobility under the dual-task condition in women with fibromyalgia. The performance on the TUG, 10-step stair ascent, and 10-meter walking test under single- and dual-task conditions was significantly related to fear of falling. These results may help healthcare professionals and researchers to interpret the effect of interventions in women with fibromyalgia.

Effects of exergames on heart rate variability of women with fibromyalgia: A randomized controlled trial

The objective of the present manuscript was to evaluate the effects of 24-weeks exergame intervention on the heart rate variability (HRV) of women with fibromyalgia. First, 56 women with fibromyalgia were assessed for eligibility. A total of 55 women fulfilled the inclusion criteria and participated in this single-blinded, randomized controlled trial. A 24-weeks of exergames were completed by the exercise group in the university facilities. It was focused on the mobility, postural control, upper and lower limbs coordination, aerobic fitness and strength. A total of 120 min per week, divided into two sessions of 60 min, was completed. A short-term 5 min record at rest was used to assess the HRV. Time (SDNN and RMSSD) and non-linear indexes (Higuchi´s Fractal Dimension, SD1, SD2, ln stress score, and SD1/SD2) of HRV were extracted. Fifty participants (achieving an 89.28% of adherence), recruited from the local fibromyalgia association completed the study. They were randomly divided into an exercise (age = 54.04[8.45]) and a control group (52.72[9.98]). Significant interaction (group*time) effects in SDNN, ln stress score, SD2, and SD1/SD2 ratio were found. The EG showed an increase of SDNN and a decreased ln stress score and SD2. The CG showed an increased ln stress score, SD1/SD2. In conclusion, 24-weeks of exergame intervention based on the tool VirtualEx-FM improved the autonomic control in patients with fibromyalgia. However, significant effects on Higuchi´s fractal dimension were not found. This is the first study using exergame as a therapy in women with fibromyalgia which has led to an improvement the autonomic balance in these patients.

Association between TUG and Anthropometric Values, Vibration Perception Threshold, FHSQ and 15-D in Type 2 Diabetes Mellitus Patients

Background: Diabetes Mellitus (DM) is a chronic disease and it is characterized by reduced insulin sensitivity and/or impaired insulin production. It affects approximately 415 million people worldwide and involves a variety of complications. DM has a number of complications, including diabetic neuropathy. All of these complications can have effects on body composition, vibration perception threshold (VPT), foot health and health-related quality of life (HRQoL). Objective: The aim of this study is to determine the correlation between the Timed Up and Go (TUG), VPT, Foot Health Status Questionnaire and 15-D Questionnaire in type 2 diabetes mellitus (T2DM) patients. Methodology: A total of 90 T2DM patients (56 men and 34 women) were evaluated on their body composition, VPT, the foot health status through the FHSQ, the HRQoL was evaluated through the 15-D Questionnaire and the TUG test was performed. Results: Statistically significant associations were found between TUG and lean and fat mass, VPT, the sections "General Foot Health" and "Physical Activity" in the FHSQ questionnaire, and the 15D total score and its sections "Mobility" and "Depression". Conclusions: There is a moderate direct correlation between the Timed Up and Go and the fat mass percentage and the vibration perception threshold. Moreover, there is a moderate inverse correlation between Timed Up and Go and fat-free mass, foot health and health-related quality of life in T2DM patients. Therefore, Timed Up and Go can be a tool to assist clinicians in monitoring and managing T2DM patients.

Effect of dance therapies on motor-cognitive dual-task performance in middle-aged and older adults: a systematic review and meta-analysis

Purpose: To systematically review the effectiveness of dance-based programs to improve motor-cognitive dual-task performance in middle-aged and older adults.Materials and methods: Five scientific databases were selected to identify the articles included in this systematic review. Ninety-one articles were found in the electronic databases. Fourteen articles fulfilled all inclusion and exclusion criteria. The methodological quality of the studies was assessed with a modified version of Downs and Black checklist. PRISMA guidelines were followed in the data extraction process. The overall effect size of the improvements was calculated through a meta-analysis.Results: All the studies had an acceptable methodological quality. Dance-based interventions had a duration of 8-52 weeks, 1-3 sessions per week, with sessions lasting 40-90 min. According to the overall effect size, dance-based interventions significantly improved dual-task performance (-0.48 with a 95% confidence interval from -0.88 to -0.08).Conclusions: Dance-based intervention programs may be effective at improving the performance on motor-cognitive dual-task in middle-aged and older adults. Apart from the effects on the cognitive Time Up and Go test, dance interventions may also improve speed walking with a cognitive task. All these conclusions must be taken with caution due to the heterogeneity and the small number of articles. Future research can be developed to increase the knowledge on these issues.Implications for rehabilitationInterventions based on dance as part of rehabilitation can improve the performance on TUG under dual-task condition in aging.Interventions based on dance can be effective to improve the development of some tasks of daily life by reducing time in a motor task under dual task condition in aging.Physical therapists, personal trainers and other clinicians can use different types of dance for improving dual-tasking among the adults.

Fitness as a Mediator of the Enhancement of Quality of Life after a 6-Months Exercise Program

Purpose: The study aimed to test whether improvement in fitness components, mediates the changes in Health-related Quality of Life (HRQoL) after exercise intervention in overweight and obese children. Methods and design: 170 obese and overweight children (121 exercise group and 49 control group) participated in a public exercise program based on sports practice for 6 months, 2 h per week. Anthropometry, physical fitness, and HRQoL were measured. Magnitude-based inferences and Cohen's effect size were performed to analyze the program effect. To know which physical fitness components mediated the improvement on children's HRQoL, multiple mediation analyses were performed. Results: the analysis showed a moderate effect on some fitness components and a moderate and small effect on HRQoL. The improvement of agility or cardiorespiratory fitness showed a significant indirect effect on the enhancements in some HRQoL dimensions. Conclusion: after a 6-months exercise program in overweight and obese children, all physical fitness components improved, being responsible for the improvement of the HRQoL, agility and cardiorespiratory fitness.

Effects of 8-Week Whole-Body Vibration Training on the HbA1c, Quality of Life, Physical Fitness, Body Composition and Foot Health Status in People with T2DM: A Double-Blinded Randomized Controlled Trial

The aim of this study was to analyze the effects of an 8-week whole-body vibration (WBV) on the quality of life, physical fitness, body composition, glycosylate hemoglobin (HbA1c), lipid profile, and foot health status in people with type II diabetes mellitus (T2DM). It was performed as a double-blinded randomized controlled trial of 90 people with T2DM. Primary care facilities were used. The 8-week WBV training consisted of maintaining a knee flexion at 45° during five to nine series of 30-60 s in a vibration frequency that oscillated between 12.5-18.5 and 30 s of recovery between series. The placebo group had to perform the same protocol but without vibration. Participants performed the protocol three times per week. The WBV training significantly reduced the fat mass (%) of people with T2DM. However, significant effects of WBV training were not found in the quality of life, physical fitness, foot health status, lipid profile, blood pressure, fasting blood glucose, or HbA1c. Nevertheless, within groups enhances were found in HbA1c, blood pressure, fasting blood glucose, foot health status, health-related quality of life, timed-up and go test, and chair-stand test in both WBV and placebo groups. WBV was shown to be beneficial for reducing the fat mass and lipid profile of people with T2DM. The improvements of the placebo group could be due to both the social benefits of enrolling in an intervention and the physical fitness benefits of isometric contractions. Further studies are needed to clarify the effects of WBV and to establish a dose-response relationship in people with T2DM.

Effect of Exergame Training and Detraining on Lower-Body Strength, Agility, and Cardiorespiratory Fitness in Women with Fibromyalgia: Single-Blinded Randomized Controlled Trial

The aim of this study was to analyze the effects of a 24 week exergame intervention and 24 weeks of detraining on lower-limb strength, agility, and cardiorespiratory fitness in women with fibromyalgia (FM). It was performed as a single-blinded randomized controlled trial of 55 women with FM. University facilities were used. The 24 week exergame intervention was focused on mobility, postural control, upper- and lower-limb coordination, aerobic fitness, and strength. Participants performed 120 min of exergaming per week, which was divided into two sessions. Twenty-four weeks after the end of the intervention, participants were re-evaluated. A chair–stand test, 10 step stair test, and six-minute walk test were conducted to assess lower-body strength, agility, and cardiorespiratory fitness, respectively. The exergame intervention significantly improved lower-limb strength and cardiorespiratory fitness. However, no significant effects on agility were observed. After the detraining period, lower-limb strength and agility returned to their baseline level, but improvements in cardiorespiratory fitness were sustained over time. Exergaming was therefore shown to be beneficial for physical fitness in people with FM. However, exergames had to be played regularly to maintain the benefits. This long-term intervention (24 weeks) may have changed the lifestyle of women with FM, which could explain why cardiorespiratory fitness improvements remained after the detraining period. Future research should focus on lifestyle changes after long-term interventions.

Chess Players Increase the Theta Power Spectrum When the Difficulty of the Opponent Increases: An EEG Study

The present study aimed to analyze differences in the electroencephalogram (EEG) power spectrum (theta, alpha, and beta) between participants who won (winning group) and those who lost (losing group) in three different chess games: against their same Elo (100% chess games), 25% over their Elo (125% chess games), and 25% under their Elo (75% chess games). EEG was assessed at baseline and during the chess games. Method: 14 male chess players (age: 35.36 ± 13.77 and Elo: 1921 ± 170) played three games of 3 min, plus two additional seconds per move, while EEG was assessed. There were three difficulty levels (75%, 100%, and 125%), with two games (one with white pieces and another with black pieces) per level. The winning group showed higher theta power in the frontal, central, and posterior brain regions when difficulty increased (p-value <0.05). Besides this, alpha power showed higher values (p-value <0.05) in 125% games than in 75% chess games in C3, T3, T4, T5, and T6. The losing group showed a significant decrease (p-value <0.05) in the beta and alpha power spectrum in frontal, central, parietotemporal, and occipital areas, when the opponent's difficulty increased. Moreover, between groups, analyses showed higher theta power in the losing group than in the winning group, in C3, T5, T6, P4, and Pz (p-value <0.05). Therefore, the winning group was able to adapt to each difficulty level, increasing theta power in the frontal, central, and posterior brain areas, as the efficiency hypothesis postulated. These changes were not observed in the losing group. Moreover, increases in alpha power during the most difficult games, in comparison with the easier, could have been caused by creative ideation and divergent thinking, as participants looked for alternative solutions against a higher-skilled opponent.

Strength Assessment Under Dual Task Conditions in Women with Fibromyalgia: A Test-Retest Reliability Study

The present study aimed to: (1) analyze the test-retest reliability of the 30 s chair stand test and the 30 s arm curl test under dual-task conditions; (2) analyze the test-retest reliability of a new variable which assesses the total performance (cognitive + physical) in both tests. A total of 37 women with fibromyalgia participated in the study. Participants completed the 30 s arm curl test and 30 s chair stand test in both simple and dual-task conditions. These tests were repeated after seven days. In the 30 s chair stand dual-task test the reliability was low to good whereas that of the total performance variable was low to moderate. The reliability in both the 30 s arm curl dual-task test and the total performance variable were good to moderate. Both the 30 s chair stand test and 30 s arm curl test under dual-task conditions and the total performance variables had good test-retest reliability. However, it is necessary to consider the fluctuations of the intraclass correlation coefficient (ICC).

Efectos de la tarea dual sobre el tiro libre en baloncesto

El objetivo de este estudio fue estudiar los efectos de una tarea dual en el tiro libre en baloncesto, comparando esa influencia en función de la categoría y el sexo de los jugadores. Los resultados muestran que existe un descenso del rendimiento provocado por la tarea dual de los baloncestistas de categoría infantil y junior (p<0,05), no observándose lo mismo en la categoría senior. Tampoco se detectaron diferencias significativas entre el rendimiento de hombres y mujeres. Puede afirmarse, por tanto, que las tareas duales provocan un descenso en el rendimiento, sobre todo en etapas de formación, posiblemente por la automatización del patrón motor debido a un mayor tiempo de práctica en categorías senior. Por ello, las tareas duales pueden ser incluidas en los entrenamientos para crear situaciones estresantes y bajo presión similares a las que se pueden encontrar los deportistas en situaciones competitivas reales.

Effects of 24-week exergame intervention on physical function under single- and dual-task conditions in fibromyalgia: A randomized controlled trial

OBJECTIVE

To evaluate the effects of 24-week exergame intervention in the physical fitness of women with fibromyalgia in both single- and dual-task conditions.

DESIGN

Single-blinded, randomized controlled trial.

SETTING

University facilities.

PARTICIPANTS

Fifty-five women with fibromyalgia, recruited from the local fibromyalgia association, were randomly assigned to one of the two groups: exercise group and control group.

INTERVENTION

The exercise group completed 24 weeks of supervised and group-based exergame protocol, divided into two sessions of 60 minutes. The intervention was focused on mobility, postural control, upper and lower limbs coordination, aerobic fitness, and strength.

MAIN OUTCOME MEASURES

The strength of the upper limbs was measured using the arm curl test. The mobility skill was assessed through the timed-up and go test, and the flexibility of both upper and lower limbs was measured using the back scratch and the sit and reach tests, respectively.

RESULTS

Fifty participants completed the study. In the single-task condition, exergame intervention led to significantly higher effects in the arm curl test (P = 0.008), sit and reach test (P = 0.033), and timed-up and go test (P = 0.021). Moreover, under dual-task condition, exergames led to significant effects in all the physical fitness tests (arm curl test, timed-up and go test, back scratch test, and sit and reach test) compared to the control group.

CONCLUSIONS

Exergame is an effective tool to improve the physical fitness in women with fibromyalgia under single or dual-task conditions.

Benefits of 24-Week Exergame Intervention on Health-Related Quality of Life and Pain in Women with Fibromyalgia: A Single-Blind, Randomized Controlled Trial

Objective: To evaluate the effects of 24-week exergame-based intervention on health-related quality of life (HRQoL) and pain in patients with fibromyalgia as well as to analyze the effectiveness of the intervention in subgroups of patients with different pain intensity levels. Design: Single-blinded, randomized controlled trial. Setting: University facilities Participants: Fifty-five women with fibromyalgia participated in the study. Intervention: The exercise group (EG) completed 24 weeks of exergames focused on mobility, postural control, upper and lower limbs coordination, aerobic fitness, and strength. A total of 120 minutes per week, divided into two sessions of 60 minutes, was completed. Main outcome measures: The Euroqol-5 Dimensions-5 Levels (EQ-5D-5L) was used to assess the HRQoL. In addition, pain intensity was measured using a visual analog scale (VAS). Results: Twenty-five out of 28 women allocated to the EG completed the intervention, which means an 89.29% of adherence. They were randomly divided into an exercise (age = 54.04 [8.45]) and a control group (52.72 [9.98]). Significant effects on the perceived health status and pain intensity (P < 0.05) were found. K-means clustering procedure revealed two groups with different response to the intervention. The respond group obtained significant effects of the exergame intervention in EQ-5D-5L, pain VAS, and VAS-EQ, compared with those who did not respond. Conclusions: Exergames could be a useful tool to improve perceived health status and pain intensity level in women with fibromyalgia with a reduced health-related quality of life.

Influence of depressive feelings in the brain processing of women with fibromyalgia: An EEG study

Depression is one of the most common mental health problems which affects more than 10% of the global population. The prevalence of this disorder is higher in fibromyalgia patients. However, the influence of the combination of depression and fibromyalgia in the brain processing is poorly understood.To explore the modifications of EEG power spectrum in women with fibromyalgia when depressive feelings are elicited.Twenty eight women with fibromyalgia participated in this cross-sectional study. They were classified as women with depression or women without depression according to the score in the Geriatric Depression Scale. This questionnaire was used to elicit depression symptoms during the EEG recording. Analyses were performed with the standardized LOw Resolution Electric Tomography (sLORETA) software. Power spectrum were compared in the following frequency bands: delta, theta, alpha-1, alpha-2, beta-1, beta-2, and beta-3.Fibromyalgia patients with untreated depression showed a hypoactivation of the left hemisphere when compared with fibromyalgia patients without depression. In addition, when compared fibromyalgia patients without depression and women with both fibromyalgia and depression who were taking antidepressant medications, differences in EEG power spectrum in the studied frequency bands were not found.The current study contributes to the understanding on the influence of the combination of fibromyalgia and depression in the brain activity patterns. Patients with untreated depression showed a hypoactivation of the left hemisphere while eliciting depression symptoms. However, further research is needed, antidepressant medication might reduce the differences between patients with depression and those who do not suffer from depression symptoms.

Impact of adding a simultaneous cognitive task in the elbow's range of movement during arm curl test in women with fibromyalgia

BACKGROUND

Fibromyalgia symptoms cause a significant reduction in the ability to perform daily life activities. These activities require the ability to perform more than one task simultaneously. The main objective of this study was to evaluate how dual-task could modify range of movement, duration of repetitions and performance in the arm curl test in healthy controls and patients with fibromyalgia.

METHODS

Twenty women participated in this study, divided into two groups: 1) patients with fibromyalgia (N = 10, age = 52.00 [5.08]) and 2) age- and gender-matched healthy controls (N = 10; age = 51.60 [4.09]). The participants had to perform the arm curl test in two conditions: single test condition and performing a dual-task. The dual-task condition consisted of remembering three random unrelated words.

RESULTS

Patients with fibromyalgia completed fewer repetitions than controls during dual-task condition (p-value = 0.015). Furthermore, both groups showed a significant decrease in the range of movement in the dual-task condition when comparing the mean of the three first repetitions with the three last ones (p-value < 0.05).

INTERPRETATION

The motor task might be prioritized over the cognitive task at the beginning of the test. However, at the end of the test, the cognitive task could require more attention due to the increased time since the words were heard, and also the motor task could require less attention after some repetitions have been performed. Thus, the addition of a cognitive task could lead to a less conscious execution of the motor task at the end of the test, which may be consistent with a reduced range of movement.

EQ-5D-Y-5L: developing a revised EQ-5D-Y with increased response categories

Purpose

EQ-5D-Y is a generic measure of health status for children and adolescents aged 8–15 years. Originally, it has three levels of severity in each dimension (3L). This study aimed to develop a descriptive system of EQ-5D-Y with an increased number of severity levels and to test comprehensibility and feasibility.

Methods

The study was conducted in Germany, Spain, Sweden and the UK. In Phase 1, a review of existing instruments and focus group interviews were carried out to create a pool of possible labels for a modified severity classification. Participants aged 8–15 rated the severity of the identified labels in individual sorting and response scaling interviews. In Phase 2, preliminary 4L and 5L versions were constructed for further testing in cognitive interviews with healthy participants aged 8–15 years and children receiving treatment for a health condition.

Results

In Phase 1, a total of 233 labels was generated, ranging from 37 (UK) to 79 labels (Germany). Out of these, 7 to 16 possible labels for each dimension in the different languages were rated in 255 sorting and response scaling interviews. Labels covered an appropriate range of severity on the health continuum in all countries. In Phase 2, the 5L version was generally preferred (by 68–88% of the participants per country) over the 4L version.

Conclusions

This multinational study has provided a version of the EQ-5D-Y with 5 severity levels in each dimension. This extended version (EQ-5D-Y-5L) requires testing its psychometric properties and its performance compared to that of the original EQ-5D-Y-3L.

Electronic supplementary material

The online version of this article (10.1007/s11136-019-02115-x) contains supplementary material, which is available to authorized users.

Is Sitting Time Related with Physical Fitness in Spanishelderly Population? The EXERNET Multicenter Study

BACKGROUND

Older adults spend most of their waking hours performing sedentary activities. The influence of these lifestyle patterns on the physical fitness (PF) levels of this population has not yet been sufficiently investigated.

OBJECTIVE

The aim of the study was to examine whether sedentary behavior (SB) (h•d-1sitting) is associated with PF, and specifically to analyze whether sitting >4 h•d-1 is associated with higher risk of having lower levels of fitness in seniors.

DESIGN

EXERNET multi-center study.

PARTICIPANTS AND SETTINGS

A representative sample of 3136 non-institutionalized elderly (aged 72.2±5.3 years), from 6 Regions of Spain were included in the study.

MEASUREMENTS

PF was assessed using 8 different tests from the EXERNET battery. Lifestyle patterns were collected using a validated questionnaire. ANOVA was used to compare the groups according to the hours of sitting. Binary logistic regression was used to calculate the association between the SB and low levels of fitness.

RESULTS

For both genders, those who spent sitting >4 h•d-1 had lower levels of balance, agility, walking speed and aerobic endurance (p<0.001). Sedentary men also had less strength of lower extremities (p<0.05), whereas, sedentary women were less flexible in the lower extremities (p<0.001). More than 4 h•d-1 sitting was associated, in men, to higher odds for having low strength (lower extremities), agility, flexibility (lower extremities) and aerobic endurance (p<0.05); and in women, to higher risk of low balance, strength (lower and upper extremities), flexibility (lower extremities), agility, walking speed and aerobic endurance (p<0.05).

CONCLUSIONS

Seniors that sit >4 h•d-1 have lower levels of fitness and this behavior is related with an increased risk of having low levels of PF in this population.

Impact of adding a cognitive task while performing physical fitness tests in women with fibromyalgia: A cross-sectional descriptive study

Fibromyalgia symptoms cause a significant reduction in the ability to perform daily life activities. These activities often require the ability to perform more than 1 task at the same time.The aim was to investigate how the addition of a cognitive task modifies the performance in physical fitness tests in fibromyalgia and healthy controls.A total of 61 women participated in this study, 31 of them diagnosed with fibromyalgia by a rheumatologist. They performed 3 physical fitness tests (arm curl, handgrip, and 10-steps stair tests) in 2 conditions:The dual task cost was calculated as the difference between the performances in the regular and dual-task (DT) conditions.Healthy controls obtained significantly better results than fibromyalgia in both, dual and single-task conditions. Women with fibromyalgia significantly decreased the performance in the 10-steps stair test when a cognitive task was added. Between-group differences in the dual-task costs (DTC) were not found.Women with fibromyalgia showed lower physical performance than healthy controls in both, single and dual task conditions. In addition, differences between single and dual task conditions were observed in the 10-steps stair test in women with fibromyalgia. This could be related with a reduction in the ability to perform daily life activities. However, results regarding DTC indicate that both groups may be similarly influenced by the addition of a secondary cognitive. Thus, further research with different difficulty levels of DT conditions is needed in fibromyalgia.

Effects of Dance on Pain in Patients with Fibromyalgia: A Systematic Review and Meta-Analysis

OBJECTIVE

The aim of this study was to perform a systematic review on the effectiveness of dance-based programs in patients with fibromyalgia, as well as calculate the overall effect size of the improvements, through a meta-analysis.

METHODS

The Cochrane Library, Physiotherapy Evidence Database (PEDro), PubMed, TRIP, and Web of Science (WOS) were selected to identify the articles included in this systematic review and meta-analysis. A total of seven articles fulfilled all inclusion and exclusion criteria. PRISMA guidelines were followed in the data extraction process. The level of evidence was established following guidelines from the Dutch Institute for Healthcare Improvement (CBO).

RESULTS

The studies were all randomized controlled trials, but not double-blind. Duration of dance programs ranged from 12 to 24 weeks. Sessions lasted between 60 and 120 minutes and were performed 1-2 times per week. The overall effect size for pain was -1.64 with a 95% CI from -2.69 to -0.59 which can be interpreted as large. In addition, significant improvements were observed in quality of life, depression, impact of the disease, anxiety, and physical function.

CONCLUSION

Dance-based intervention programs can be an effective intervention for people suffering from fibromyalgia, leading to a significant reduction of the level of pain with an effect size that can be considered as large. However, findings and conclusions from this meta-analysis must be taken with caution due to the small number of articles and the large heterogeneity.

Fitness as mediator between weight status and dimensions of health-related quality of life

BACKGROUND

There is evidence that overweight and obesity in children is associated with poor Physical Fitness and consequently lower Health-related Quality of Life (HRQoL). However, this linear-causal relationship between Weight Status → Physical Fitness → HRQoL is not enough to fully understand this phenomenon. Therefore, need to know, through mediation analysis, how operate the Physical Fitness between weight status and HRQoL dimensions.

PURPOSE

The aim of this study was to determine which HRQoL dimensions are mediated through Physical Fitness in obese (including overweight) and normal weight children. The study also examined the association between Physical Fitness, Body Mass Index (BMI) and HRQoL.

METHODS

A total of 233 overweight/obese children and 105 normal-weight children participated in the study. Children were recruited from public educational centers and a public weight loss program. BMI, Physical Fitness (upper limb, central body and lower limb strength; agility and range of motion) and HRQoL (PedsQL and VAS) were measured. Simple mediation analyses by gender, through PROCESS macro developed by Preacher and Hayes, were performed in order to analyze whether Physical Fitness computed as z-score, is a mediator in the relation between weight status (normal weight or overweight/obesity) and HRQoL dimensions. \itionally, unequal-variances t statistics were executed to know differences in BMI, Physical Fitness components and HRQoL dimensions between groups, and correlations to know the associations between weight status, Physical Fitness z-score and HRQoL.

RESULTS

Our results, indicated association between the Physical Fitness z-score and HRQoL dimensions in overweight/obese children. Regarding to mediation analysis, the results showed that the negative association between overweight/obesity and HRQoL is softened by the level of Physical Fitness. Therefore Physical Fitness is a mediator in the relationship between overweight/obesity children and the most of dimensions of HRQoL, except the School functioning in boys and the School and Emotional functioning in girls.

CONCLUSIONS

The negative effect of overweight or obesity on HRQoL inn children, is mitigated by Physical Fitness. Consequently, the Physical Fitness is a mediator on HRQoL in most dimensions, especially daily living, in schoolchildren.

Does anthropometric and fitness parameters mediate the effect of exercise on the HRQoL of overweight and obese children/adolescents?

BACKGROUND

There is sufficient evidence about the effects of physical exercise programs on health-related quality of life (HRQoL) in obese and overweight children.

OBJECTIVES

The purpose of this study was to observe the effects on physical fitness and HRQoL in overweight and obesity children and their parents and find out whether the effect of intervention on anthropometric and physical fitness parameters mediated the improvements found in the proxies' perception of participant quality of life.

METHODS

151 overweight and obese children (106 intervention and 45 control) participated in a public exercise program. Anthropometrics characteristics, physical fitness, and HRQoL (EQ-5D-Y) were measured. Analysis of Covariance and effect size were performed to analyze the improvement. Mediation analyzed with bootstrap to observe whether anthropometric or physical fitness improvements mediate of the changes in the proxies' assessment of HRQoL.

RESULTS

Significant improvements were found in waist circumference, physical fitness, and HRQoL. The improvement of waist circumference showed a significant indirect effect on the change in the proxy perception of quality of life.

CONCLUSION

The reduction of waist circumference mediates the change on proxies' perception of quality of life and not by the improvement in physical fitness.

TRIAL REGISTRATION

ISRCTN97887613.