Walking football as sustainable exercise for older adults – A pilot investigation

Shuttle Time for Seniors: The Impact of 8-Week Structured Badminton Training on Markers of Healthy Aging and Evaluation of Lived Experiences-A Quasi-Experimental Study

BACKGROUND/OBJECTIVES

Engagement in sport offers the potential for improved physical and psychological well-being and has been shown to be beneficial for promoting healthy aging. Opportunities for older adults to (re)engage with sport are limited by a paucity of age-appropriate introductory sports intervention programs. As such, the study evaluated the efficacy of a newly designed 8-week badminton training program (Shuttle Time for Seniors) on markers of healthy aging and the lived experiences of participation.

METHODS

Forty-three older adults assigned to a control (N = 20) or intervention group (N = 23) completed pre-post assessment of physical and cognitive function, self-efficacy for exercise, and well-being. Focus groups were conducted for program evaluation and to understand barriers and enablers to sustained participation.

RESULTS

Those in the intervention group increased upper body strength, aerobic fitness, coincidence anticipation time, and self-efficacy for exercise. Objectively improved physical and cognitive functions were corroborated by perceived benefits indicated in thematic analysis. Shuttle Time for Seniors was perceived as appropriate for the population, where the age-appropriate opportunity to participate with likeminded people of similar ability was a primary motivator to engagement. Despite willingness to continue playing, lack of badminton infrastructure was a primary barrier to continued engagement.

CONCLUSION

Shuttle Time for Seniors offered an important opportunity for older adults to (re)engage with badminton, where the physical and psychosocial benefits of group-based badminton improved facets important to healthy aging. Significance/Implications: Age-appropriate introductory intervention programs provide opportunity for older adults to (re)engage with sport. However, important barriers to long-term engagement need to be addressed from a whole systems perspective.

Jogging football: a new concept optimizing internal/external demand for recreational football

BACKGROUND

The present investigation aimed to examine the movement patterns and cardiometabolic demand during jogging football (JF), which is a new concept of recreational football that allows walking and jogging with limiting running behavior.

METHODS

Twenty-three collegiate soccer players played soccer for 10 minutes while following three different rules: 1) the players moved by walking only (walking football [WF]); 2) the players moved by walking or jogging (JF); and 3) the players moved freely, i.e., a combination of walking, jogging, and running (usual football [UF]). A graded exercise test (GXT) was performed to determine individual relationships between heart rate (HR) and moving speeds.

RESULTS

The HR, metabolic equivalents (METs), and velocity differed significantly in the three conditions and significantly increased in the order of WF, JF, and UF (P<0.001). The speed was significantly higher in the recreational football compared to that in the GXT, but METs were significantly higher in all forms of recreational footballs than in the GXT (P<0.05). Based on the results of JF, the duration of the movement at the speed of <5 km/h was significantly shorter than that of WF, and that at speed of >10km/h, it was significantly shorter than that of UF (P<0.05).

CONCLUSIONS

The present investigation revealed the characteristics of the activity profiles of JF in comparison to WF and UF. JF is a recreational sport with an exercise intensity that falls between WF and UF, owing to the shorter durations of walking and running.

Physical Demands of Walking Football in Patients With Cardiovascular Risk Factors and Diseases

OBJECTIVE

To compare the exercise intensity of walking football (WF) with walking (WA) and to describe specific movement characteristics of WF.

DESIGN

Cross-sectional study.

SETTING

Sports facilities Saarland University, Germany.

PATIENTS

Eighteen patients with cardiovascular risk factors CVRFs and diseases (13 men and 5 women, age: 69 ± 10 years).

INDEPENDENT VARIABLES

Patients completed a WF match and WA session of 2 x 10 min each. Video analysis was used to characterize movements during WF.

MAIN OUTCOME MEASURES

Rate of perceived exertion (RPE, Borg Scale 6-20), % maximum heart rate (HRmax), musculoskeletal pain on a visual analog scale (VAS, 1-100 mm) before and up to 72 hours after exercise, and movement patterns during WF.

RESULTS

The mean RPE during WF (12.1 ± 2.7) and WA (11.9 ± 3.0) did not differ (P = 0.63). The mean HR during WF (79 ± 12% of HRmax) was higher than during WA (71% ± 11%; P < 0.01). The HR variability coefficient of variation during WF (10.3% ± 5.8%) and WA (7.1 ± 5.5%) did not differ (P = 0.13). There was no influence of exercise mode (WF vs WA) on musculoskeletal pain perception (P = 0.96 for interaction). Injury-inciting activities such as lunges (median: 0.5 [interquartile range (IQR) 0-1.3]) and goal kicks (median: 4 [IQR: 1.8-5.3]) occurred rarely during WF.

CONCLUSIONS

Walking football might represent an alternative to WA for health prevention programs in patients with CVRF and diseases as it is characterized by a manageable cardiocirculatory strain, moderate RPE, low pain induction, and a low number of injury-inciting activities.

Sensor-Based Assessment of Time-of-Day-Dependent Physiological Responses and Physical Performances during a Walking Football Match in Higher-Weight Men

Monitoring key physiological metrics, including heart rate and heart rate variability, has been shown to be of value in exercise science, disease management, and overall health. The purpose of this study was to investigate the diurnal variation of physiological responses and physical performances using digital biomarkers as a precise measurement tool during a walking football match (WFM) in higher-weight men. Nineteen males (mean age: 42.53 ± 12.18 years; BMI: 33.31 ± 4.31 kg·m-2) were engaged in a WFM at two different times of the day. Comprehensive evaluations of physiological parameters (e.g., cardiac autonomic function, lactate, glycemia, and oxygen saturation), along with physical performance, were assessed before, during, and after the match. Overall, there was a significant interaction (time of day x WFM) for mean blood pressure (MBP) (p = 0.007) and glycemia (p = 0.039). Glycemia decreased exclusively in the evening after WFM (p = 0.001), while mean blood pressure did not significantly change. Rating of perceived exertion was significantly higher in the evening than in the morning (p = 0.04), while the heart rate recovery after 1 min (HRR60s) of the match was lower in the evening than in the morning (p = 0.048). Overall, walking football practice seems to be safe, whatever the time of day. Furthermore, HRR60, glycemia, and (MBP) values were lower in the evening compared to the morning, suggesting that evening exercise practice could be safer for individuals with higher weight. The utilization of digital biomarkers for monitoring health status during WFM has been shown to be efficient.

Walking football for Health - physiological response to playing and characteristics of the players

Walking Football (WF) is one type of recreational football increasing in popularity, targeting older adults. Further knowledge on the intensity and physical workload of WF, characteristics of the players, the social context, and reasons for playing WF is needed. Thus, the aim of the study was to characterize the individuals that regularly play WF and their experience of WF, and the physiological characteristics of the sport. Sixty-three players from three clubs taking part in organised WF in Sweden were included. The players participated in up to four WF-games and underwent performance tests and answered a questionnaire. The participants mean age was 70.9 years, ranging from 63 to 85 years with 71% (n = 27) of the men and 68% (n = 13) of the women having a BMI > 25. Fifty-one percent (n = 27) of the players had hypertension, and 73% (n = 39) regularly used prescription drugs due to illness. During WF, the players covered on average 2,409 m (2,509 m for men and 2,205 m for women, p = .001). Expressed in percentage of their age-estimated maximal heart rate, mean heart rate represented 80 ± 9 and 80 ± 8% of max for men, and 78 ± 9 and 79 ± 9% of max for women in the first and second halves, respectively, hence WF can be considered a moderate intensity activity for older adults. The main reason for WF participation was to socialize. WF includes a considerable number of accelerations and decelerations, making it more energetically and mechanically demanding than walking.

Predictors of intentions of adults over 35 years to participate in walking sport programs: A social-ecological mixed-methods approach

There is a growing need to identify acceptable and feasible opportunities to engage adults over 35 years in physical activity. Walking sports may be a potential means to engage adults in sport; however, there is limited evidence regarding appeal and feasibility to support its implementation and delivery. Using a two-step mixed-methods approach, we aimed (1) to quantitively identify significant predictors of intentions of adults over 35 years to participate in walking sports and (2) to understand why and how these identified predictors may be contextually relevant to the target group. In phase one, 282 adults over 35 years (M_age  = 46.08, SD = 9.75) without prior experience of walking sports completed an online questionnaire assessing personal, psychosocial, program-related, and environmental predictors, and intentions to participate in walking sports. Hierarchical multiple linear regressions showed that perceived health status, attitudes, subjective norms, and distance of venue were significant predictors of intentions. In phase two, interviews with a subset of 17 participants indicated that, when implementing walking sport programs, program labeling, fear of the unknown, and individual differences in the appeal of walking sport warrant consideration. Together, these findings offer insight into the complex interplay of personal, psychosocial, program-related, and environmental predictors of adults' intentions to participate in walking sports. Addressing these elements of a walking sport program would make such programs more appealing to potential participants, and ultimately, more feasible and sustainable to conduct in the long run.

"More than just a walk in the park": A multi-stakeholder qualitative exploration of community-based walking sport programmes for middle-aged and older adults

In spite of the large-scale growth of walking sport (WS) programmes globally, limited research has explored the experiences of the key stakeholders involved in such programmes (i.e. decision-makers, facilitators, and players). We aimed to explore stakeholder experiences of community-based WS programmes to better understand the appeal of such sport options for middle-aged and older adults, and propose tentative recommendations for the feasibility and sustainability of these types of programmes. We conducted semi-structured interviews with 21 stakeholders who were involved with WS programmes in Australia as decision-makers, facilitators, and/or players. Data were analysed with reflexive thematic analysis. Four key themes pertaining to the WS experience were identified - 'a renewed lease of life', 'navigating ageing stereotypes', 'tension between organisational demands and players' needs', and 'WS facilitators as catalysts of success'. Specifically, we found that WS participation enabled a positive ageing discourse for middle-aged and older adults. WS players had to negotiate stereotypes that, at times, were perceived as participation barriers. We also noted some tensions between the demands of sport organisations and the needs of middle-aged and older adults regarding sport participation. Finally, we also noted the importance of the facilitators' role in increasing accessibility of, and long-term participation in, such programmes. We suggest that to offer feasible and sustainable community-based WS programmes across Australia, incompatibilities across various stakeholders' perspectives need to be addressed.

Effects of walking football on adherence, safety, quality of life and physical fitness in patients with prostate cancer: Findings from the PROSTATA_MOVE randomized controlled trial

Aims

To analyze the feasibility and impact of a walking football (WF) program on quality of life (QoL), cardiorespiratory fitness (CRF), muscle strength, and balance program in men with prostate cancer under androgen deprivation therapy (ADT).

Methods

Fifty patients with prostate cancer (stages IIb-IVb) under ADT were randomized to a 16-week WF program plus usual care (n=25) or usual care control group (n=25). The WF program consisted of three 90-minute sessions per week. Recruitment, withdrawal, adherence, enjoyment rate, and safety of the intervention were recorded throughout the study. Cardiorespiratory fitness was assessed before and after the interventions, while handgrip strength, lower limb muscle strength, static balance, and QoL were assessed before, during (week 8), and after (week 16) the interventions. Adverse events during sessions were also recorded.

Results

The WF group showed high levels of adherence (81.6 ± 15.9%) and enjoyment rate (4.5 ± 0.5 out of 5 points). In the intention-to-treat analysis, the WF group showed an improvement in chair sit-to-stand (p=0.035) compared to the control group. Within-group comparisons showed that handgrip strength in the dominant upper limb (p=0.024), maximal isometric muscle strength in the non-dominant lower limb (p=0.006), and balance in the dominant limb (p=0.009) improved over time in the WF group but not in the usual care group. The results obtained from the per-protocol analysis indicate that CRF improved significantly in the WF group as compared to the control group (p=0.035). Within-group analysis revealed that CRF (p=0.036), muscle strength in dominant (p=0.006) and non-dominant (p=0.001) lower limbs, and balance in the non-dominant lower limb (p=0.023) improved after 16 weeks of WF, but not in the control group. One major traumatic injury (muscle tear) was reported with a complete recovery before the end of the intervention.

Conclusion

This study suggests that WF is feasible, safe, and enjoyable in patients with prostate cancer under hormonal therapy. Furthermore, patients who adhere to the WF program can expect cardiorespiratory fitness, muscle strength, and balance improvements.

Clinical trials registration

clinicaltrials.gov, identifier NCT04062162.

"Football- It's in Your Blood"-Lived Experiences of Undertaking Recreational Football for Health in Older Adults

Physical inactivity is prevalent in older adults and contributes to age-related decline in function, health, well-being, and quality of life. Recreational football for older adults has shown promise for promoting health benefits. This study explores the lived experiences of older adults engaging in a walking and recreational football intervention and identifies factors that affect behaviours and can encourage change in this population. A purposive sample (n = 14; aged 67 ± 5 years) of the lived experiences of those participating in a recreational football intervention took part in two focus groups. The participants' responses were grouped into three-time reflecting specific points in their lives: what stopped them from playing football, what got them playing, and what is needed for them to continue playing in the future. Within each of these time points in their lives, themes were identified. The key findings and practical recommendations were that football needs to be adapted and local, that the priority to play football changes over time, and that football itself is a fundamentally intrinsic motivator; 'it's in your blood'. The findings can be used to inform future interventions, encourage participation, and advise on the best practices for key stakeholders in the physical activity domain.

The Effect of 12-Weeks Recreational Football (Soccer) for Health Intervention on Functional Movement in Older Adults

There is growing evidence that recreational football offers health benefits for older adults and an important pathway for physical activity for older adult groups. Despite anecdotal evidence that recreational football is beneficial for older adults, no empirical data are available to support this assertion. This study addressed this issue and examined the effects of a 12-week recreational football intervention on the functional fitness of older adults. Using a pre-post case-control design, thirteen males, aged 61-73 years (mean age ± SD = 66 ± 4 years) undertook a twice-weekly, 12-week recreational football for health intervention, and were matched with a control group, comprising thirteen males, aged 62-78 years (mean age ± SD = 66 ± 4 years) who maintained their typical exercise habits during the intervention period. Pre- and postintervention, participants underwent assessment of functional fitness, using the Rikli and Jones functional fitness battery as well as an assessment of body fatness, via bioelectrical impedance analysis and dominant handgrip strength using handgrip dynamometry. Results from a series of 2 (pre-post) X 2 (intervention vs. control) repeated-measures ANOVAs indicate significant pre-post X group interactions for the 30-second chair stand (p = 0.038, Pƞ² = 0.168), 8-foot timed up and go (p = 0.001, Pƞ² = 0.577) and 6 min walk test (p = 0.036, Pƞ² = 0.171). In all cases, performance improved significantly after the intervention for the football intervention group but not the control group. There were no significant differences in the 30 s arm curl test or dominant handgrip strength (p > 0.05). There was a non-significant trend (p = 0.07, Pƞ² = 0.127) towards a pre-post X group interaction for body fatness, showing a decreased percent body fat for the intervention group over the control group. The results of the present study demonstrate the utility of recreational football as a physical activity intervention in older adults to improve functional movement.

Effects of Sport-Based Exercise Interventions on Executive Function in Older Adults: A Systematic Review and Meta-Analysis

Exercise programs of moderate-to-vigorous intensity have been shown to improve the cognitive performance of older people. However, the specific effects of sports-based exercise programs on cognitive performance, particularly executive functions, remain unclear. Therefore, the purpose of this study is to clarify the effects of sports-based exercise programs on executive functions in older adults using a systematic review and meta-analysis of the scientific literature. A systematic review was conducted between 1 March and 1 July 2022, to look for published scientific evidence that analyzed different sports programs that may have affected executive function in healthy older adults. Longitudinal studies, which assessed the effects of sports interventions on healthy older adults, were identified through a systematic search of the four principal electronic databases: Web of Science, PubMed, Scopus, and EBSCO. A total of nine studies with a total of 398 subjects met the inclusion criteria and were classified based on one or more of the following categories: working memory, inhibition, and cognitive flexibility. The DerSimonian and Laird random-effects model was performed using the Comprehensive Meta-Analysis software to facilitate the analysis of the studies. Statistical significance was set at p ≤ 0.05. In terms of working memory, a small but positive significant effect was noted for the intervention group compared to the control group (effect size (ES) = 0.35, 95% confidence interval (CI) = 0.04-0.67; p = 0.029; I² = 36.7%); in terms of inhibition, the intervention had a small favoring but no significant effect compared to the control group (ES = 0.20, 95% CI = -0.42-0.84; p = 0.517; I² = 78.8%); and in terms of cognitive flexibility, the intervention had a small favoring but no significant effect compared to the control group (ES = 0.39, 95% CI = -0.11-0.89; p = 0.131; I² = 75.5%). Our findings suggest that healthy older adults should be encouraged to participate in sports to improve their working memory; however, more studies are required in this area to reach more robust conclusions. This systematic review was registered with the International Prospective Register of Systematic Reviews (registration number: CRD42022284788).

Effects of Sport-Based Interventions on Executive Function in Older Adults: A Systematic Review and Meta-Analysis Protocol

Background: Moderate-to-vigorous intensity exercise programs have proven to exert positive effects on the cognitive performance of older people. However, the specific effects sport-based exercise programs have on cognitive performance, upon executive functions, remain unclear. Therefore, the purpose of this study is to clarify the effects of sport-based exercise programs on executive functions in older adults, through a systematic review protocol of the scientific literature, with a meta-analysis. Methods: The search was performed in the Web of Science, PubMed, Scopus, and EBSCO electronic databases by combining keywords and different medical subject headings (MeSH) to identify and evaluate the relevant studies from inception up until June 2022. This study considers longitudinal studies with at least one experimental group and pre- and post-intervention measurements involving healthy older adults of 60 years of age or older. Studies have to consider one or more measures of executive function, including dimensions of working memory, inhibition, and cognitive flexibility, in order to meet the eligibility criteria for inclusion in this report. The Physiotherapy Evidence Database (PEDro) scale was used for methodological quality assessment studies. The DerSimonian and Laird random-effects model was used to compute the meta-analyses and report effect sizes (ES, i.e., Hedges’ g) with 95% confidence intervals (95% CIs), and a statistical significance set at p ≤ 0.05. The ES values were calculated for executive function globally and for each dimension of executive function (e.g., working memory, inhibition, cognitive flexibility) in the experimental and control/comparator groups using the mean and standard deviation values before and after the intervention period. Conclusions: Our systematic review aims to clarify the effects of sport-based exercise programs on executive functions in older adults. The results may help practitioners and stakeholders to provide better evidence-based decisions regarding sport-based exercise program implementation for older adults, and to help them to optimize cognitive functions during the aging process. Ethical permission is not required for this study. Systematic review registration: this systematic review is registered with the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42022284788).

Effects of Walking Football During Ramadan Fasting on Heart Rate Variability and Physical Fitness in Healthy Middle-Aged Males

This study aimed to investigate the effect of a walking football (WF) program during Ramadan fasting (RF) on heart rate variability (HRV) indices, body composition, and physical fitness in middle-aged males. Thirty-one healthy sedentary men were randomized to WF (n = 18) and control (n = 13) groups. Both groups participated in RF. The WF group were involved in a training program (small-sided games) of three sessions a week during RF. The time and frequency domains of HRV, body composition, handgrip, lumbar strength, Modified Agility Test (MAT), and 6-minute walk test (6MWT) were measured before Ramadan (BR), during Ramadan (DR), and after Ramadan (AR). We reported that RF has significantly altered some parameters of HRV DR; the mean HR decreased while the mean RR, LF, and HF increased. WF had a significant effect on HRV and mean HR DR compared with BR and AR decreased while mean RR, HF and LF increased. DR, body mass decreased in both groups, while body mass index (BMI) decreased and lean mass increased only in WF group. Lower body mass and BMI levels were reported AR only in WF group. Physical capacity improved AR, compared with BR, only in the WF group with longer distance in 6MWT, shorter time(s) in MAT, and higher lumbar strength levels. We conclude that RF increases parasympathetic system activity. WF practice during RF is safe and might improve body composition, physical fitness, autonomic cardiac function, and physical fitness in middle-aged males.

Differences in Older Adults Walking Football Initiation and Maintenance Influences Across Respondent Characteristics: A Cross-Sectional Survey

Despite health benefits gained from physical activity and sport participation, older adults are less likely to be active. This study investigates what influences 50- to 75-year-olds (N = 439) to initiate and maintain walking football, across gender, socioeconomic status, number of health conditions, and physical activity level. It also considers relationships between participant characteristics and influences, and intentions to play after a forced break (COVID-19). Results of a U.K. online cross-sectional survey found those with two or more health conditions rated social influences significantly higher in initiation and maintenance than participants with no health conditions. Multiple regression analysis found a positive walking football culture, and perceived use of maintenance resources contributed significantly to intentions to return to play after COVID-19 restrictions eased. Practitioners should consider providing opportunities for social connection, foster a positive walking football culture, and encourage players to utilize maintenance resources (e.g., scheduling sessions) in older adult walking football sessions.

Walking Football During Ramadan Fasting for Cardiometabolic and Psychological Health Benefits to the Physically Challenged and Aged Populations

Concurrent exercise and intermittent fasting regimens for long periods have been shown to enhance cardiometabolic health in healthy individuals. As exercise and fasting confer health benefits independently, we propose that Muslims who are fasting, especially those experiencing health and clinical challenges, continually engage in physical activity during the Ramadan month. In this opinion piece, we recommend walking football (WF) as the exercise of choice among Muslims who are fasting. WF can be played by any individual regardless of the level of fitness, skills, and age. WF has been shown to elicit cardiovascular and metabolic stress responses, which are suitable for populations with low fitness levels. Most importantly, WF has the inherent characteristics of being a fun team activity requiring social interactions among participants and, hence, likely to encourage long-term consistent and sustainable participation.

Effectiveness of a Walking Football Program for Middle-Aged and Older Men With Type 2 Diabetes: Protocol for a Randomized Controlled Trial

Background

Studies on walking football have found positive effects on health; however, there are still several research gaps when applying walking football programs for patients with type 2 diabetes.

Objective

This study aims to test the effectiveness of a walking football exercise program on glycemic control and cardiovascular risk factors in middle-aged and older men with type 2 diabetes.

Methods

The study will be run as a randomized controlled trial with a 6-month duration in Portugal. Eligible participants will be randomized using a 1:1 ratio for intervention or control groups and compared using an intention-to-treat analysis. The intervention will consist of a walking football exercise program. The control group will continue with usual care in primary health care units. The primary outcome will be the mean difference in glycated hemoglobin between intervention and control groups after 6 months. Secondary outcomes include the mean differences in fasting blood glucose, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, systolic and diastolic blood pressure, body mass index, waist circumference, fat-free mass, and fat mass. Additionally, secondary outcomes include the incidence of exercise-related injuries and adverse events and the walking football exercise program’s cost-utility.

Results

The study protocol is being prepared to be submitted to the Health Ethics Committee of the Northern Regional Health Administration, Portugal. After approval, participant recruitment will start in primary health care units in Porto's metropolitan area by family medicine doctors.

Conclusions

Walking football might have the potential to be effective in improving glycemic control and cardiovascular risk factors, with a low rate of exercise-related injuries and adverse events and a good cost-utility ratio. Therefore, walking football may be a sustainable intervention strategy for type 2 diabetes management.

International Registered Report Identifier (IRRID)

PRR1-10.2196/28554

Is walking netball an effective, acceptable and feasible method to increase physical activity and improve health in middle- to older age women?: A RE-AIM evaluation

Background

Physical activity is a modifiable risk factor for health and wellbeing, all-cause mortality and healthy aging. However, for middle- to older-age females less is known about the benefits of sports participation on these outcomes. Further, the acceptability and feasibility of setting-up, implementing and maintaining sports-based programmes for an aging population is an understudied area of inquiry. The current study used the RE-AIM framework to investigate a nationwide Walking Netball (WN) programme.

Methods

The evaluation used a mixed-methods approach incorporating a multiple-baseline study, quasi-experimental study, programme monitoring data and qualitative studies to evaluate the programme in the Women’s Institutes (WI) in England. Data were analysed using multilevel growth modelling, mixed-design ANOVAs, multilevel regression, t-testing, and thematic analysis. Data were triangulated to address each dimension of the RE-AIM framework.

Findings

The programme reached 1.4% (n = 3148) of the WI population across 82.0% of WI regions in England and attracted inactive members at risk of ill-health. WN contributed to adaptations in physical function, mental health and wellbeing, social isolation, quality of life and increased physical activity. The adoption of the programme was successful with 87.7% WN groups’ maintaining participation beyond the 20-session initial delivery phase. Adoption was effective because of its set-up, peer-mentorship and long-term delivery; these factors likewise shaped implementation. Adapting and tailoring WN to the varying characteristics of participants within the WI and the facilities available, along with training delivery staff and providing resources are key programme components. The Walking Netball programme can be maintained through promotion within the local community, sustainable funding, inter-WI competitions, festivals and networks, multiple-hosts and continued host development.

Conclusions

WN was found to be an acceptable, feasible and effective intervention to increase physical activity and improve health in middle- to older- aged women. Future programmes may consider adapted styles of set-up and delivery. These include adapting to people, places and spaces through personalised support and providing a range of resources. Future designs may seek to understand how participation can contribute to healthy aging through longitudinal research beyond 12-months.

Study registration

The evaluation protocol was published in Open Science Framework in December 2018 prior to follow-up data collection being collected (https://www.osf.io/dcekz). Date of registration: 17 December 2018.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-021-01204-w.

Fußball – neue Wege in der Prävention und Behandlung des Typ-2-Diabetes

Über die Hälfte der Bevölkerung in westlichen Ländern ist übergewichtig, und nahezu jeder Vierte ist adipös. In den nächsten Jahren wird es deshalb zu einem enormen Anstieg der Zahl an nicht übertragbaren Erkrankungen wie Diabetes, kardiovaskuläre Erkrankungen und Krebs kommen. Eine ausgewogene Ernährung, begleitet von regelmäßiger Bewegung, ist entscheidend bei der Prävention der Entwicklung und des Fortschreitens nicht übertragbarer Erkrankungen. Gesundheitsfördernde Programme besitzen eine große Bedeutung bei der langfristigen Verbesserung des Gesundheitsstatus unserer Bevölkerung, jedoch nehmen insbesondere Männer selten an gesundheitsfördernden Programmen teil. Deshalb gilt es nach neuen Wegen zu suchen, um effizienter Menschen mit einem erhöhten Risiko zu erreichen. Fußball verfügt über ein großes Potenzial, Menschen und vor allem Männer mit einem erhöhten Risiko für nicht übertragbare Erkrankungen, die üblichen gesundheitsfördernden Maßnahmen ablehnend gegenüberstehen, für die Teilnahme an Gesundheitsprogrammen zu gewinnen. Für ältere Spieler ist Walking Football eine neue Fußball-Variante mit einem geringeren Risiko für Verletzungen und eine körperliche Überlastung. Die vorliegende Arbeit gibt einen Überblick über die metabolischen Auswirkungen von Freizeitfußball und insbesondere Walking Football sowie Maßnahmen zur Gesundheitsförderung, die von professionellen Fußballvereinen angeboten werden, bei Menschen mit einem erhöhten Risiko für oder mit bereits bestehenden nicht übertragbaren Erkrankungen, wie insbesondere Typ-2-Diabetes.

Improved metabolic fitness, but no cardiovascular health effects, of a low-frequency short-term combined exercise programme in 50-70-year-olds with low fitness: A randomized controlled trial

We evaluated the cardiometabolic effects of a 15-week combined exercise programme, implemented in sports clubs, for 50-70-year-olds with low aerobic fitness. In a randomized controlled trial, 45 participants (26 women) with low fitness were randomly assigned (2:1-ratio) to a training group (TG, n = 30) or inactive control group (CG, n = 15). TG had 15 weeks with one weekly 90-min supervised group-based session in a recreational sports club with combined aerobic exercise and strength training and were encouraged to perform home-based training 30 min/wk. Evaluations of relative VO_2max (mLO₂/min/kg), blood pressure, resting heart rate (HR), echocardiography, peripheral arterial tonometry, body composition, lipid profile and HbA1c were performed at 0 and 15 wks. Average HR during supervised training was 113 ± 13 bpm (68.6 ± 7.0%HR_max), with 4.3 ± 6.6% spent >90%HR_max. At 15-wk follow-up, intention-to-treat analyses revealed no between-group difference for VO_2max/kg (0.4 mLO₂/min/kg, 95%CI -0.8-1.5, P = 0.519; -3 mL/min, 95%CI -123-118, P = 0.966) or other cardiovascular outcomes (all P > 0.05). Compared to CG, total fat mass (-1.9 kg; 95%CI -3.2 to -0.5, P = 0.005), total fat percentage (-1.3%, 95%CI -2.2 to -0.3, P = 0.01) and total/HDL cholesterol ratio (P = 0.032) decreased in TG. Regular adherence to supervised training was high (81%), but 0% for home-based exercise. In conclusion, the group-based supervised training was associated with high adherence and moderate exercise intensity, whereas insufficiently supported home-based training was not feasible. Together, 15 wks of combined exercise training did not improve aerobic fitness or affected cardiovascular function in 50-70-yr-olds with low aerobic fitness, whereas some positive effects were observed in metabolic parameters.HighlightsCombined exercise training implemented in a sports club elicited moderate aerobic intensity in 50-70-year-old untrained individuals.Supervised group-based training had high adherence whereas unsupported home-based training had very low adherence.15 weeks of low-frequency combined moderate intensity exercise training improved lipid profile and fat mass, but had no effect on cardiovascular fitness.

Experiences and Strategies Influencing Older Adults to Continue Playing Walking Football

Adults aged 55+ years are most likely to be inactive, despite research suggesting that older adults experience multiple benefits when participating in physical activity and sport. Limited research focuses on long-term continuation of sport participation in this population, especially in "adapted sports" like walking football. This study explored the experiences of walking football maintenance in 55- to 75-year-old players. Semistructured interviews were conducted, with 17 older adults maintaining walking football play over 6 months. The inductive analysis revealed five higher-order themes representing maintenance influences and two higher-order themes relating to maintenance mechanisms (i.e., the conscious process by which players maintain). Influences when maintaining walking football included individual- and culture-level influences (e.g., perceived benefits of maintenance and ability acceptance). Maintenance mechanisms included cognitions and behaviors (e.g., scheduling sessions and redefining physical activity expectations). Findings highlight novel implications for policy and practice, which are important to consider when delivering walking football to older adults.

Effects of a 4 week touch rugby and self-paced interval running intervention on health markers in active young men

Background

Modified team sport activity has been proposed as effective exercise modality for promoting markers of health that are comparable or greater than continuous forms of activity. However, research using modified team sports is currently limited to sedentary populations using 2–3 sessions across a minimum of 8 weeks.

Aim

To investigate the effects of a 4-week touch rugby and self-paced interval running intervention on a range of health markers in active men.

Methods

Sixteen participants (age 26.4 ± 6.4 years) were matched for age, demographic and physical activity before completing a single touch rugby (n = 8) or running (n = 8) session per week for 4 weeks. Measures of systolic and diastolic blood pressure, resting heart rate (RHR), body composition and biochemical status were recorded pre- and post-intervention.

Results

ANCOVA analysis revealed between-group differences for impedance (P = 0.027), fat mass (P = 0.008), percentage body fat (P = 0.008) and fat-free mass (P = 0.002), with greater changes after touch rugby. Systolic blood pressure decreased for both groups with greater reductions observed after touch rugby (P = 0.002). No between-group difference was observed for RHR, interleukin-6 or C-reactive protein (P > 0.05). Contrasting internal, external and perceptual loads were observed.

Conclusion

The results of this study suggest that a single session of touch rugby over a 4-week period elicited greater improvements in body composition and SBP than self-paced running, with both being equally beneficial for improving RHR, diastolic blood pressure and inflammatory status in active young men.

Football - Novel Approaches to Tackle Diabetes

Balanced diet and regular physical activity are of key importance to the prevention of the development and progression of non-communicable diseases. In 2050, 50% of the European population is expected to be obese. Cardiovascular diseases, diabetes mellitus, cancer, as well as joint impairments, will further increase. Therefore, programmes are critical to the improvement of the population's health status in the long run. New ways have to be found that allow addressing more people than with the current approaches. Football has a great potential to attract people at risk for or with already existing non-communicable diseases, such as type 2 diabetes, to participate in health-promoting programmes. The novel football version, walking football was developed for elderly players, aiming at avoiding injuries and physical overload. The present article gives a brief overview on the metabolic effects of recreational football, particularly walking football, as well as health-promoting programmes offered by professional football clubs in humans at risk for or with already existing non-communicable diseases.

Experiences Influencing Walking Football Initiation in 55- to 75-Year-Old Adults: A Qualitative Study

Adults aged 55 and older are least likely to play sport. Despite research suggesting this population experiences physical and psychological benefits when doing so, limited research focuses on older adult sport initiation, especially in "adapted sports" such as walking football. The aim of this study was to explore initiation experiences of walking football players between 55 and 75 years old. Semistructured interviews took place with 17 older adults playing walking football for 6 months minimum (Mage = 64). Inductive analysis revealed six higher order themes representing preinitiation influences. Eight further higher order themes were found, relating to positive and negative experiences during initiation. Fundamental influences preinitiation included previous sporting experiences and values and perceptions. Emergent positive experiences during initiation included mental development and social connections. Findings highlight important individual and social influences when initiating walking football, which should be considered when encouraging 55- to 75-year-old adults to play adapted sport. Policy and practice recommendations are discussed.

The Physiological, Physical, and Biomechanical Demands of Walking Football: Implications for Exercise Prescription and Future Research in Older Adults

The aim of this investigation was to profile the physiological, physical, and biomechanical responses during walking football. A total of 17 male participants (aged 66 ± 6 years) participated. Heart rate; blood lactate; accelerometer variables (biomechanical load [PlayerLoad™], changes of direction); and rating of perceived exertion were measured. Participants mean percentage of maximum heart rate was 76 ± 6% during the sessions, with rating of perceived exertion across all sessions at 13 ± 2. Blood lactate increased by ∼157% from presession (1.24 ± 0.4 mmol/L) to postsession (3.19 ± 1.7 mmol/L; p ≤ .0005). PlayerLoad™ values of 353 ± 67 arbitrary units were observed, as well as ∼100 changes of direction per session. In conclusion, walking football is a moderate- to vigorous-intensity activity. The longitudinal health benefits of walking football remain to be elucidated, particularly on bone health, cardiovascular fitness, and social and mental well-being.

Recreational football is medicine against non-communicable diseases: A systematic review

The purpose of this research was to conduct a systematic review of published articles related to the effect of recreational football on non-communicable diseases. A systematic review of Web of Science, SPORTDiscus, MEDLINE, and PubMed databases was performed according to PRISMA guidelines. Only empirical studies were included. There were no restrictions on the types of study design eligible for inclusion. The primary outcome measures result from the potential effects of recreational football on non-communicable diseases (eg, blood pressure, bone density, LDL cholesterol, and fat mass). A total of 44 articles met the inclusion criteria and were included. Recreational football is shown to: (a) decrease blood pressure and resting heart rate, improve cardiac structure and functioning, as well as increase maximal oxygen uptake in both sexes; (b) reduce cholesterol and triglycerides levels, increase insulin sensitivity, and have a positive impact on glycemic control; (c) improve bone mineralization, increase both bone mineral density and content, as well as acting as a stimulus for osteogenesis; and (d) be clearly beneficial for bone health, while slightly beneficial for body composition, muscle strength, and maximal oxygen uptake in adults with prostate cancer. The present systematic review demonstrated the benefits of recreational football practice on non-communicable diseases related to cardiovascular and bone health, body composition, type 2 diabetes, and prostate cancer. The effectiveness of recreational football on the aforementioned diseases may be related to age and gender; however, further research is required.

Feasibility and Health Effects of a 15-Week Combined Exercise Programme for Sedentary Elderly: A Randomised Controlled Trial

There is strong evidence that considerable health benefits can be achieved even with small amounts of physical activity. However, getting people to exercise regularly is a major challenge not least in the elderly population. This study investigated the feasibility and physiological health effects of a pragmatic 15-week exercise programme for sedentary elderly. In a single-blind randomised controlled trial, 45 sedentary 60-83-year-olds (25 women, 20 men) were randomly assigned (2:1 ratio) to a training group (TG, n=30) or a control group (CG, n=15). The training in TG consisted of a combination of exercise modalities (i.e., strength, aerobic fitness, stability, and flexibility training) performed once a week as supervised group-based training and a weekly home-based training for 15 weeks. Feasibility outcomes were exercise intensity, adherence, and adverse events. The primary outcome was change in aerobic fitness (VO_2max/kg). Adherence was high (81%) for the supervised exercise and low (0%) for the home-based exercise. No acute injuries occurred in TG, but 4 subjects (13%) reported considerable joint pain related to training. Average heart rate (HR) during the supervised training was 104±12 beats/min (69.3±8.0%HR_max), with 3.9±7.3% of training time >90%HR_max. Intention-to-treat analyses revealed no between-group differences for aerobic fitness (P=0.790) or any secondary cardiovascular outcomes at 15-week follow-up (resting HR or blood pressure; P>0.05). Compared to CG, bodyweight (-2.3 kg, 95% CI -4.0 to -7.0; P=0.006), total fat mass (-2.0 kg, 95% CI -3.5 to -0.5; P=0.01), and total fat percentage (-1.6%, 95% CI -2.8 to -0.3; P=0.01) decreased in TG. The group-based supervised training had high adherence and moderate exercise intensity, whereas the home-based training was not feasible in this study population. This exercise programme performed once a week did not improve aerobic fitness. Thus, supervised training with more vigorous intensity control appears advisable. Clinical Study registration number is H-15016951.

[Access to public physical activity programs in Brazil: National Health Survey, 2013]

The article sought to describe awareness of public physical activity programs, practice of physical activity in public programs and barriers related to non-participation in these programs in a national representative sample according to sex, age, skin color, income, state and having been visited by a family health team (EqSF, in Portuguese) in the previous year. This is a cross-sectional survey with data from the Brazilian National Health Survey, 2013. We carried out descriptive analyses using the distribution of relative frequencies and their respective 95% confidence intervals, weighted in the sample design. We included 60,202 individuals. We found a 20% prevalence of awareness and, of these, 9.7% reported practicing physical activity in public programs. Most commonly reported barriers were lack of time (41.4%) and lack of interest in available activities (29.7%). Women have greater awareness when compared with men, but levels of physical activity were similar in both sexes. Awareness and physical activity were higher in the older age groups. Awareness increased with income, but the poorest participate more in public physical activity programs when compared with the other income categories. Awareness and physical activity were similar among those who were and were not visited by EqSF. Prevalences of awareness and participation in public physical activity programs are not expressive, with nearly 30% of individuals disinterested in current programs. Local-regional efforts are needed so that physical activity can be established as a health promotion tool.

Recreational soccer as sport medicine for middle-aged and older adults: a systematic review

Background

Strategies to prevent or attenuate the age-related decline in physical and physiological function and reduce chronic disease risk factors are of clinical importance.

Objective

To examine the health benefits of recreational soccer in middle-aged and older adults.

Design

Systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Data sources

All available records up until 9 June 2017 in PubMed, Web of Science, SPORTDiscus, MEDLINE, Embase, CINAHL Plus, PsycINFO and Cochrane Library databases.

Eligibility criteria for selecting studies

All randomised trials with or without a control group (randomised controlled trials or randomised uncontrolled trials) and non-randomised controlled trials that used recreational soccer, which includes small-sided soccer games, as the sole or principal intervention, and reported relevant effects in untrained/sedentary, healthy or unhealthy adults aged 40 years and above were included.

Results

Five trials described in 13 articles were included, which scored 6–9 out of 12 points on the modified Delphi quality rating scale. The duration was from 12 to 52 weeks, with various frequencies, volumes and game formats performed both outdoors and indoors with men and women. The trials indicate that recreational soccer may result in improvement in cardiovascular function, body composition and functional ability, although no significant changes were observed in postural balance.

Conclusion

Recreational soccer should be considered an alternative exercise modality for untrained, healthy or unhealthy middle-aged and older adults of both sexes to maintain an active lifestyle and mitigate a wide array of physical and physiological age-related changes.

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

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