Self-rated physical fitness and estimated maximal oxygen uptake in relation to all-cause and cause-specific mortality

Near-InfraRed Spectroscopy Provides a Reproducible Estimate of Muscle Aerobic Capacity, but Not Whole-Body Aerobic Power

Near-infrared spectroscopy (NIRS) during repeated limb occlusions is a noninvasive tool for assessing muscle oxidative capacity. However, the method's reliability and validity remain under investigation. This study aimed to determine the reliability of the NIRS-derived mitochondrial power of the musculus vastus lateralis and its correlation with whole-body (cycling) aerobic power (V̇O2 peak). Eleven healthy active men (28 ± 10 y) twice (2 days apart) underwent repeated arterial occlusions to induce changes in muscle oxygen delivery after 15 s of electrical muscle stimulation. The muscle oxygen consumption (mV̇O2) recovery time and rate (k) constants were calculated from the NIRS O2Hb signal. We assessed the reliability (coefficient of variation and intraclass coefficient of correlation [ICC]) and equivalency (t-test) between visits. The results showed high reproducibility for the mV̇O2 recovery time constant (ICC = 0.859) and moderate reproducibility for the k value (ICC = 0.674), with no significant differences between visits (p > 0.05). NIRS-derived k did not correlate with the V̇O2 peak relative to body mass (r = 0.441, p = 0.17) or the absolute V̇O2 peak (r = 0.366, p = 0.26). In conclusion, NIRS provides a reproducible estimate of muscle mitochondrial power, which, however, was not correlated with whole-body aerobic capacity in the current study, suggesting that even if somewhat overlapping, not the same set of factors underpin these distinct indices of aerobic capacity at the different (peripheral and whole-body systemic) levels.

Effects of two exercise programs on health-related fitness, quality of life and exercise enjoyment in adults with visual impairment: a randomized crossover trial

Background

So far there is no study comparing two distinct exercise interventions in people with visual impairment. This study aimed to evaluate the effects of two exercise programs on health-related fitness, quality of life, and exercise enjoyment in people with visual impairment.

Methods

Two exercise interventions were conducted: sports (i.e., Goalball, Football 5-a-side and Martial Arts) and functional training (i.e., Bodyweight exercises). Physical fitness was assessed by handgrip strength, flexibility, abdominal endurance, and cardiorespiratory fitness. The Physical Activity Enjoyment Scale (PACES) measured the pleasure in the practice of physical exercises, and the quality of life was measured by the WHOQOL-Bref.

Results

A significant time x group interaction terms were observed for flexibility (P < 0.001; Cohen d = 0.08), abdominal muscular endurance (P < 0.001; Cohen d = 0.15), and distance covered in the 6-min walk/run test (P = 0.018; Cohen d = 0.02). An improvement of 13.3% and 5.1% on the distance covered on the 6-min walk/run test after sports and functional training was also observed.

Conclusion

The functional training program was reported as more pleasant for participants. Sports-related exercises and functional training improved health-related fitness and quality of life for people with visual impairment.

Effect of Physical Activity/Exercise on Oxidative Stress and Inflammation in Muscle and Vascular Aging

Functional status is considered the main determinant of healthy aging. Impairment in skeletal muscle and the cardiovascular system, two interrelated systems, results in compromised functional status in aging. Increased oxidative stress and inflammation in older subjects constitute the background for skeletal muscle and cardiovascular system alterations. Aged skeletal muscle mass and strength impairment is related to anabolic resistance, mitochondrial dysfunction, increased oxidative stress and inflammation as well as a reduced antioxidant response and myokine profile. Arterial stiffness and endothelial function stand out as the main cardiovascular alterations related to aging, where increased systemic and vascular oxidative stress and inflammation play a key role. Physical activity and exercise training arise as modifiable determinants of functional outcomes in older persons. Exercise enhances antioxidant response, decreases age-related oxidative stress and pro-inflammatory signals, and promotes the activation of anabolic and mitochondrial biogenesis pathways in skeletal muscle. Additionally, exercise improves endothelial function and arterial stiffness by reducing inflammatory and oxidative damage signaling in vascular tissue together with an increase in antioxidant enzymes and nitric oxide availability, globally promoting functional performance and healthy aging. This review focuses on the role of oxidative stress and inflammation in aged musculoskeletal and vascular systems and how physical activity/exercise influences functional status in the elderly.

Combined effects of maximal oxygen uptake and glucose status on mortality: The prospective KIHD cohort study

Objective

To examine the combined effects of cardiorespiratory fitness (CRF) and prediabetes or diabetes on cardiovascular and noncardiovascular mortality.

Patients and methods

This prospective study evaluated a population‐based cohort of 1562 men aged 42–60 years at baseline (1984–1989). We utilized maximal oxygen uptake (VO_2max) for assessing aerobic capacity and CRF in the cohort and stratified participants into six groups according to both their glucose status (diabetes, prediabetes, or no diabetes) and whether they were below‐ or above‐median VO_2max. Deaths in the cohort were recorded till December 31 2016. Cox regression was used to calculate hazard ratios (HR) with 95% confidence intervals (CI) for cardiovascular and noncardiovascular mortality. Smoking, alcohol consumption, BMI, blood pressure, cholesterol, diagnosis of ischemic heart disease, and socioeconomic status served as covariates in the mortality analyses.

Results

During the follow‐up (mean 24.2 years), 341 men died from cardiovascular and 468 men from noncardiovascular causes. When compared to men with no diabetes and above‐median VO_2max, the presence of either diabetes (HR = 4.10, 95% CI: 2.27–7.40) or prediabetes (HR = 2.10, 95% CI: 1.18–3.73) combined with below‐median VO_2max increased the risk of cardiovascular death. Noncardiovascular mortality was increased by low oxygen uptake in men with prediabetes (HR = 2.24, 95% CI: 1.30–3.84), and among men with diabetes, the increase was not statistically significant (HR = 1.99, 95% CI: 0.91–4.32).

Conclusions

Cardiorespiratory fitness modifies the risk of death related to prediabetes and diabetes. This highlights the importance of CRF assessment and interventions to support the uptake of regular physical activity among aging men with disturbed glucose metabolism.

The favourable association of self-reported physical fitness with depression and anxiety during pregnancy. The GESTAFIT project

We explored the association of self-reported physical fitness with depressive symptoms and anxiety levels during pregnancy. One hundred fifty-five pregnant women (32.9 ± 4.7 years old) participated in the study. Self-reported physical fitness was assessed with the International Fitness Scale, depressive symptoms and state anxiety levels with the Center for Epidemiological Studies-Depression Scale and the State Trait Anxiety Index, respectively, at the 16 and 34 weeks of gestation. In model 1 (adjusted for age and gestational weight gain), greater overall self-reported physical fitness was associated with fewer depressive symptoms at the 16 weeks (p = .004). Greater self-reported cardiorespiratory fitness and muscular strength were associated with lower anxiety levels at the 16 weeks (all, p > .05). Greater overall self-reported physical fitness, cardiorespiratory fitness and speed-agility were associated with lower anxiety levels at the 34 weeks (all, p > .05). These results were also confirmed in model 2 (additionally adjusted for the exercise intervention, sleep quality, educational level, working status and cohabitating), except for cardiorespiratory fitness and anxiety levels at the 16 weeks (p = .09). Greater self-reported physical fitness was associated with lower psychological ill-being during pregnancy. Specifically, at the 16 weeks, greater self-reported overall physical fitness was associated with fewer depressive symptoms, greater self-reported muscular strength with lower anxiety levels; greater self-reported overall physical fitness and speed-agility with lower anxiety levels at the 34 weeks and greater self-reported cardiorespiratory fitness with lower anxiety levels during the pregnancy. Screening of physical fitness may reduce the risk of depression and anxiety and generally improve pregnancy mental health-related quality of life.HighlightsMaternal depression and anxiety have prevalence rates between 8 and 36%.Physical fitness enhancement during pregnancy results in less depression and anxiety.Greater physical fitness may provide benefits for the mother mental health.Self-reported physical fitness screening during pregnancy may be useful in clinical settings.

Association of performance in a stair-climbing test with complications and survival after lung cancer resection in the video-assisted thoracoscopic surgery era: population-based outcomes

Introduction

With a population-based cohort in the video-assisted thoracoscopic surgery (VATS) era, we aimed to evaluate the value of the stair-climbing test (SCT) on short- and long-term outcomes of lung cancer surgery.

Methods

All patients operated due to primary lung cancer in Central Finland and Ostrobothnia from 2013 to June 2020 were included. For the analysis, clinical variables including the outcome of SCT and cause-specific mortality were available. Short- and long-term outcomes were compared between <11 m (n=66) and >12 m SCT (n=217) groups.

Results

Patients with poor performance (<11 m) had more comorbidities and worse lung function but did not differ in tumour stage or treatment. No differences between groups were observed in major morbidity rate (10.6% versus 11.1%, p=0.918) or median hospital stay (5 (IQR 4–7) versus 4 (IQR 3–7), p=0.179). At 1-year, fewer patients were alive and living at home in the climbing <11 m group (81.3%) compared to the >12 m group (94.2%), p=0.002. No difference was observed in cancer-specific 5-year survival. Non-cancer-specific survival (62.9% versus 83.1%, p<0.001) and overall survival (49.9% versus 70.0%, p<0.001) were worse in the <11 m group. After adjustment for confounding factors, SCT remained as a significant predictor for non-cancer-specific (HR 4.28; 95% CI 2.10–8.73) and overall mortality (HR 2.38; 95% CI 1.43–3.98).

Conclusions

With SCT-based exercise testing, VATS can be performed safely, with a similar major morbidity rate in the poor performance group (<11 m) compared to >12 m group. Poor exercise performance increases non-cancer-specific mortality. Being a major predictor of survival, exercise capacity should be included in prognostic models.

According to stair-climbing-based testing, VATS surgery is safe, with similar major morbidity rates as in those with better exercise capacity. However, patients with poorer exercise capacity have significantly increased non-cancer-specific mortality.https://bit.ly/3aLB76w

Physical Activity and Perceived Physical Fitness during the COVID-19 Epidemic: A Population of 40- to 69-Year-Olds in Japan

The COVID-19 pandemic has caused an abrupt change in lifestyle for many people with restrictions, often leading to a decrease in physical activity (PA), and thus contributing to a negative perception of health status. The purpose of this study was to examine the effects of the COVID-19 epidemic on physical activity and perceived physical fitness in Japanese adults aged 40 to 69 years. Data were collected from an online survey conducted between October 19 and 28, 2020. The analytic sample consisted of 1989 Japanese adults (mean age, 50.1 ± 6.9 years; women, 38.9%) who were aged between 40 and 69 years and completed the online survey. Overall, the PA time per week decreased by 32.4% between October 2019 and April 2020. A decrease in PA time was recorded in October 2020; however, a decline of 15.5% was observed. Compared to individuals who did not perceive a decline in physical fitness, individuals who perceived declining physical fitness during the COVID-19 state of emergency demonstrated a greater decrease in PA time in April 2020 (-50.5%), and this trend continued into October 2020 (-25.0%). These findings may indicate that Japanese adults aged 40 to 69 years who perceived declining physical fitness experienced a greater decrease in physical activity.

Association of Self-Reported Physical Fitness with Pregnancy Related Symptoms the GESTAFIT Project

We explored the association of physical fitness (PF) with pregnancy-related symptoms, at the 16th and 34th gestational weeks (g.w.). The International Fitness Scale and the Pregnancy Symptoms Inventory were employed to assess self-reported PF and pregnancy-related symptoms, respectively. At the 16th g.w. greater self-reported overall PF was associated with lower incidence of urinary frequency (p = 0.020); greater overall PF, cardiorespiratory fitness (CRF), muscular strength and speed-agility were associated with lower incidence of tiredness-fatigue (all, p < 0.05); greater overall PF and speed-agility were associated with lower incidence of poor sleep (both, p < 0.05); greater CRF and flexibility were associated with lower limitations by tiredness-fatigue (both, p < 0.05); and greater flexibility was associated with lower limitations by poor sleep (p = 0.021). At the 34th g.w. greater self-reported overall PF, CRF and muscular strength were associated with lower incidence of tiredness-fatigue (all, p < 0.05); greater CRF was associated with lower incidence of poor sleep (p = 0.019); and, greater flexibility was associated with lower incidence of increased vaginal discharge (p = 0.023). Adequate levels of PF, especially CRF, may help women to cope with the most endorsed pregnancy-related symptoms and its limitations, especially tiredness-fatigue and poor sleep.

Influence of Cardiorespiratory Fitness on Risk of Dementia and Dementia Mortality: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

The purpose of this meta-analysis was to investigate the influence of cardiorespiratory fitness (CF) levels on dementia risk and dementia mortality. MEDLINE and EMBASE databases were used to search for eligible studies from January 1990 to September 2019. To be included, the study was required to be a prospective cohort study that provided CF measurements and indicated relative risk and confidence intervals for the associations between CF and dementia risk and mortality. A total of six studies were selected for this meta-analysis. Low-level CF was associated with nearly three times greater risk of dementia (2.93, 95% confidence interval [1.31, 6.57]; p < .05) compared with a high-level CF. Enhanced CF levels decreased the risk of dementia, and an increase of one metabolic equivalent of task in the CF level reduced the risk of dementia and dementia mortality. Maintaining more than 12 metabolic equivalents of task of CF level was required to substantially decrease dementia risk and dementia mortality.

Individualized physical training in the therapy of Primary Ciliary Dyskinesia - A case report

Background

Primary Ciliary Dyskinesia (PCD) is an autosomal recessive disease, characterized by ciliary dysfunction and impaired mucociliary clearance. Previous studies have indicated a low physical fitness in PCD patients but currently it is not known whether physical training beneficially affects fitness, inflammatory markers and quality of life.

Case presentation

The patient was a Caucasian male (67.0 kg, 183.3 cm), born in 1984 and was diagnosed with the Kartagener Syndrome (i.e. PCD) right after birth. He was prescribed structured physical training over a period of almost two years (from August 2017-June 2019) and was assessed regularly. Aerobic fitness improved throughout the intervention period, but no systematic changes were observed in inflammatory markers and overall quality of life.

Conclusions

Our data provides reasoning to stress the implementation of structured physical training to enhance physical performance also in the management of PCD.