Effects of dual-task resistance exercise on cognition, mood, depression, functional fitness, and activities of daily living in older adults with cognitive impairment: a single-blinded, randomized controlled trial

BACKGROUND

Regular exercise is emphasized for the improvement of functional capacity and independence of older adults. This study aimed to compare the effects of a dual-task resistance exercise program and resistance exercise on cognition, mood, depression, physical function, and activities of daily living (ADL) in older adults with cognitive impairment.

METHODS

A total of 44 older adults participated in the study. Participants were randomly allocated to an experimental group (n = 22) performing a dual-task resistance exercise program for cognitive function improvement and a control group (n = 22) performing a resistance exercise program. Both groups performed the exercise for 40 min per session, three times a week, for 6 weeks (18 sessions). Cognition, mood, depression, functional fitness, and ADL were quantified before and after the intervention using the Mini-Mental State Examination (MMSE), profile of mood states (POMS), geriatric depression scale (GDS), senior fitness test (SFT), and Korean version of ADL, respectively.

RESULTS

There was a significant time and group interaction on the MMSE (p = 0.044). There were no significant time and group interactions in the POMS, GDS, SFT, or ADL. Cognitive function (p < 0.001), mood (p < 0.001), depression (p < 0.001), functional fitness (p < 0.001), and ADL (p < 0.001) significantly improved after dual-task resistance exercise, and cognitive function (p < 0.001), mood (p < 0.001), depression (p < 0.001), functional fitness (p < 0.001), and ADL (p < 0.001) significantly improved after resistance exercise.

CONCLUSIONS

Dual-task resistance exercise is more effective than resistance exercise in improving cognitive function in older adults with cognitive impairment. Both dual-task resistance exercise and resistance exercise improves mood, depression, functional fitness, and ADL after the intervention. We propose using dual-task resistance exercises for cognitive and physical health management in the older adults with cognitive impairment.

TRIAL REGISTRATION

This study was registered with the Clinical Research Information Service (WHO International Clinical Trials Registry Platform) (Registration ID, KCT0005389; Registration date, 09/09/2020).

Size or Strength? how components of muscle relate to behavioral and neuroelectric measures of executive function independent of aerobic fitness

While previous research has linked cognitive function with resistance exercise, the nuanced links between muscle strength, mass, and neuroelectric function are less understood. Therefore, this study investigated the association of muscle strength and mass with inhibitory control (IC), working memory (WM), and related neuroelectric activity. A total of 123 18-50-year-old adults completed maximal aerobic capacity and strength tests, a body composition scan, and IC and WM tasks while the N2 and P3 components of event-related potentials were recorded. Bivariate correlations revealed aerobic fitness, strength, and mass were associated with behavioral and neuroelectric outcomes. After accounting for age, sex, and aerobic fitness, strength was associated with intra-individual response time variability, accuracy, and P3 latency during WM. Muscle mass was associated with N2 latency during IC. While relationships with behavioral outcomes did not persist after controlling for the opposite muscle outcome, greater strength and mass were related to shorter P3 latency during WM and shorter N2 latency during IC, respectively. These results provide initial evidence that muscle outcomes are associated with executive function and neuroelectric processing speed, suggesting distinct contributions of strength and mass to cognition. This work highlights the significance of maintaining muscle strength and mass alongside aerobic fitness for optimal cognitive health.

Cardiorespiratory Fitness and Muscular Strength Do Not Predict Social Cognitive Capacity in Older Age

OBJECTIVES

Social cognitive function often declines in older age but the mechanisms underlying these declines are not completely clear. Cardiorespiratory fitness (CRF) and muscular strength are positively associated with broader cognitive function in older adults, yet surprisingly, no study has examined whether a similar relationship exists between CRF or muscular strength and social cognition in older age.

METHODS

We assessed whether higher CRF and muscular strength were associated with enhanced social cognitive function in a sample of fifty older adults (Mage = 70.08, standard deviation = 3.93). Participants completed a gold-standard cardiopulmonary exercise test to assess CRF, an isometric handgrip strength test to index muscular strength, and validated measures of social cognition to index emotion perception and theory of mind (ToM).

RESULTS

The results showed that CRF and muscular strength did not explain any unique variance in older adults' social cognitive performance. Bayesian analyses confirmed that the evidence for the null hypothesis was moderate for all tested relationships, except for the relationship between CRF and cognitive ToM where the evidence for the null was anecdotal.

DISCUSSION

This study has provided the first evidence to suggest that CRF and muscular strength-two important modifiable lifestyle factors-are not associated with social cognition in healthy older adults. However, replication studies are now needed to cross-validate these findings and to clarify whether any moderating variables may be important for understanding the relationship between fitness and social cognition in older age.

[Research on the association between the status of physical fitness and psychological distress among Chinese children and adolescents aged 13-18 years]

Objective: To describe the status of physical fitness of children and adolescents aged 13-18 years in China in 2019 and analyze its association with psychological distress. Methods: Data were drawn from the 2019 Chinese National Survey on Students' Constitution and Health, and 90 633 Han children and adolescents aged 13-18 years were included. Physical fitness was evaluated by "National Students Constitutional Health Standards" (2014 revised edition). Psychological distress was classified according to the scores of the Kessler Psychological Distress Scale: ≤19, 20-24, 25-29, and ≥30 scores indicated no, mild, moderate, and severe psychological distress, respectively, with moderate and severe psychological distress collectively referred to as high psychological distress. The χ2 test was used to compare the distribution differences between boys and girls, the Cochran-Armitage test was used to analyze the trend, and the multinomial logistic regression in the mixed effect model was established to analyze the association between physical fitness and psychological distress. Results: In 2019, the unqualified rate of physical fitness among children and adolescents aged 13-18 years in China was 17.2%, and the prevalence of excellent and good physical fitness was 18.2%, which was lower among boys (15.9%) than girls (20.5%) with a statistically significant difference (P<0.05). The excellent and good physical fitness rate showed a significantly decreasing trend with age (trend test P<0.05). The rate of high psychological distress among children and adolescents aged 13-18 years in China in 2019 was 39.3%, with boys (37.0%) having a lower prevalence than girls (41.6%), supported by a statistically significant difference (P<0.05), and a decreasing trend with the degree of physical fitness was observed both in boys and girls (trend test P<0.05). The multinomial logistic regression model showed that the prevalence of moderate (OR=0.83, 95%CI: 0.79-0.88, P<0.001) and severe (OR=0.81, 95%CI: 0.77-0.86, P<0.001) psychological distress were both lower in children and adolescents with excellent and good physical fitness. Conclusion: The status of physical fitness and psychological distress of Chinese children and adolescents aged 13-18 in 2019 was not optimistic, with physical fitness showing a significantly negative association with psychological distress.

Examining the relationship between aerobic fitness and cognitive control processes: An SFT and ERP study

Previous studies have demonstrated a positive relationship between aerobic fitness and cognitive control, the ability to inhibit distractions (conflict control) or impulsive actions (response inhibition). However, it is unknown whether these sub-processes and their underlying information processing capacity are differentially related to aerobic fitness. To address this question, we employed a go/no-go version of the redundant-target task, which was administered concurrently with the recording of event-related potentials (ERPs) and the use of a reaction-time based diagnostic tool known as system factorial technology (SFT). Our sample consisted of 46 young male adults with varying levels of aerobic fitness: the high-fit group (n = 23; aged 21.33 ± 2.44 years; VO2max 58.83 ± 6.93 ml/kg/min) and the low-fit group (n = 23; aged 22.30 ± 1.40 years; VO2max 41.90 ± 4.01 ml/kg/min). The results showed that the high-fit group exhibited a lower false-alarm rate compared to the low-fit group. However, there was no difference in processing speed between the two groups. The SFT analysis revealed that the high-fit group had more efficient information processing for earlier responses, but not later responses, compared to the low-fit group. Analysis of the ERPs indicated that the high-fit group had larger N2d amplitudes and shorter P3d latencies during conflict control compared to the low-fit group, while there were no such effects for the process of response inhibition. These findings suggest that aerobic fitness may be differentially related to the temporal dynamics and sub-processes of cognitive control.

Influence of Parental Perception of Child's Physical Fitness on Body Image Satisfaction in Spanish Preschool Children

It is well known that poor physical fitness is an exponential risk factor in the increase in chronic diseases, not only physical but also psychological. Even in childhood, a critical period of development, the perception of physical fitness plays a fundamental role in the individual's self-concept of body image.

AIM

To find out how self-perceived physical fitness influences self-perceived body image in preschoolers.

METHODS

475 preschool pupils were recruited in the schools of Extremadura (Spain). They were administered a sociodemographic questionnaire, the Preschool Physical Fitness Index (IFIS) and the Preschool Body Scale (PBS).

FINDINGS

Significant correlations (p < 0.05) were observed between body dissatisfaction and perceived physical fitness (IFIS), being higher in girls. In terms of variables, general fitness (<0.001), cardio-respiratory fitness (<0.001), muscular strength (<0.001), speed/agility (<0.001) and balance (<0.001) have a negative, medium and significant association with body dissatisfaction in girls; however, this association was lower in the case of boys.

CONCLUSIONS

The influence of physical fitness had a clear impact on self-perceived body image. With better findings on self-perceived physical fitness variables (IFIS) there was less body dissatisfaction (PBS), especially in the female sex. The results also showed that parents who perceived their children to be in poorer physical condition had higher body dissatisfaction. Therefore, it would be interesting for the context involved, particularly parents, to implement strategies to improve positive body image through the promotion of physical education and physical fitness at an early age.

Impact of Physical Activity-Based Interventions on Children and Adolescents' Physical Self-Concept: A Meta-Analysis

Background: Observational studies associate physical activity (PA) with improved perceptions of children and adolescents' physical self-concept (PSC) and global self-concept (GSC). However, only a few PA-based interventions exist for improving PSC and their results have been inconclusive. Objective: To determine the effect of specific PA-based programmes on the PSC (including its sub-dimensions) and GSC of children and adolescents, and to assess possible moderators. Methods: The databases Web of Science, Scopus, SportDiscus, PubMed, CINAHL, and Cochrane Library were reviewed in February 2020. Only studies with pre-post measurements and control groups were included. The impact of PA-based interventions was explored through different meta-analyses and moderator analyses. Results: Altogether, 20 studies were included in the meta-analysis. Positive and significant effects of PA were determined on self-perceived physical appearance (g = 0.13; 95% CI = 0.03, 0.23), self-perceived sport competence (g = 0.30; 95% CI = 0.09, 0.51), self-perceived physical fitness (g = 0.19; 95% CI = 0.05, 0.32), PSC (g = 0.31; 95% CI = 0.10, 0.52), and GSC (g = 0.17; 95% CI = 0.01, 0.33). The existence of additional interventions in PA-based programmes (e.g., interventions focused on psychological factors or healthy habits) moderated the influence of PA on self-perceived sport competence and physical fitness. Moreover, environment and time were distinguished as moderators for self-perceived physical appearance and sport competence. Further, intervention type, gender, and frequency of intervention moderated the effects of PA on PSC. Conclusions: PA-based interventions, especially in school, seem to be beneficial for the development of positive physical self-perceptions.

The Nexus of Sports-Based Development and Education of Mental Health and Physical Fitness

Physical inactivity has increased globally, particularly in developed nations. A high proportion of the human population is unable to meet the physical activity recommendation of the World Health Organisation due to hypertension, metabolic syndrome, obesity, and other medical conditions. Non-communicable diseases and mental health problems are becoming more prevalent, particularly in low and middle-income nations. This study aimed to determine the effectivenessof a mentorship programmeon university students' mental health and physical fitness. The intervention comprised the effects of sports-based development and education on physical fitness and mental health. A total of 196 and 234 students from two universities were randomly assigned to the intervention and control groups, respectively. The primary outcomes were engagement in physical activities (number of push-ups for 1 min, the strength of hand grip (kg), and the Jump test while standing (cm)), body fat proportion and psychological resilience, self-efficacy, and relationship with family and schoolmates. Participants in the control group had access to a web-based health education game, whereas the intervention group wassubjected to intensive interventional activities for one month based on the eight principles of the National Research Council and Institute of Medicine. Data were analysed using Analysis of Variance (ANOVA) to compare the physical and mental components between the intervention and control groups. Relative to baseline, all the physical health components (push-ups, sit-ups, and jump tests), psychological resilience, relationship with family members, and self-efficacy increased significantly in the intervention compared to the control group. Body fat composition was significantly reduced in the intervention when compared tothe control group. In conclusion, the mentorship programme effectively improved the participants' physical and psychological health and could be developed further for application in a larger population.

Relationship between health-related quality of life and physical fitness in Norwegian adolescents

AIMS

This cross-sectional study investigated the association between health-related quality of life (HRQoL), cardiorespiratory fitness (CRF) and muscular fitness in 14-year-old adolescents.

METHODS

Norwegian adolescents (N = 1985) carried out a 10-min running test to assess cardiorespiratory fitness and three different muscular fitness tests (handgrip, sit-ups, and standing broad jump) and answered the KIDSCREEN-27 questionnaire to provide HRQoL data. Linear-mixed effect models were applied to detect relationships among the variables.

RESULTS

Running-test results were positively associated with higher scores in the following KIDSCREEN domains: physical well-being, psychological well-being, autonomy and parent relationships, and school environment (β = 0.01-0.04; p < .01 for all). Performance in sit-ups test was positively associated with higher scores in three out of five KIDSCREEN domains: physical well-being (β = 0.31; p < .001), social support and peers (β = 0.16; p = .023), and school environment scores (β = 0.19; p = .006). An inverse association was found between the handgrip test results and the score on psychological well-being domain (β = - 0.10; p = .013).

CONCLUSIONS

The associations between HRQoL and physical fitness were trivial (abdominal strength and handgrip strength) to small (CRF) but confirmed that earlier findings from children also are applied to adolescents. Explosive strength in the lower body showed no association with HRQoL. Further research should investigate the direction of causality.

TRIAL REGISTRATION

Clinicaltrials.gov ID nr: NCT03817047. Registered 01/25/2019 'retrospectively registered'.

Profiles of Health-Related Quality of Life and Their Relationships With Happiness, Physical Activity, and Fitness

Purpose: Health-related quality of life (HRQOL) reflects a perceived sense of physical and mental well-being over time, encompassing both physical health and psychosocial health. Although these two health concepts have been often examined as a whole, few studies have explored the possibility of mixed profiles. We designed this study to identify Chinese adolescents' HRQOL profiles and their associations with happiness, physical activity, and fitness. Method: 544 high-school students completed validated Chinese-version questionnaires assessing HRQOL, happiness, and physical activity behavior while their fitness level was evaluated based on China National Fitness Test Program. A two-step cluster analysis and MANOVAs were conducted. Results: We identified four distinct clusters: low HRQOL, psychosocial health-oriented, physical health-oriented, and high HRQOL. There were significant differences among clusters in happiness, physical activity, and fitness, with "high HRQOL" group being the most adaptive cluster while "low HRQOL" group the least. Both psychosocial health-oriented and physical health-oriented clusters demonstrated dimension-related features. Conclusion: Health-related quality of life in Chinese adolescents is a multidimensional construct. Although its physical and psychosocial functioning are often interacted, different dimensions have unique but specified roles. Particularly, physical functioning might not only be associated with physical and health condition but also with positive emotion, especially when psychosocial satisfaction is lacking. It is important to pay specific attention to the interactions among the dimensions and how the interactions combine and function together to influence adolescents' behavior.

Association of Cardiorespiratory Fitness and Cognitive Function with Psychological Well-Being in School-Aged Children

Background: Promotion of psychological well-being (PWB) is an emerging social, educational, and health objective, especially for school-aged children. Few studies have examined key correlates and determinants of PWB in school-aged children. This study aimed to examine associations of cardiorespiratory fitness and cognitive function with psychological well-being in school-aged children. Methods: The study participants were 752 fourth-grade students (mean _age = 9.61 years, SD = 0.608) recruited from six elementary schools. Students took the Progressive Aerobic Cardiovascular Endurance Run^® test to assess their cardiorespiratory fitness, and the d2 Test of Attention to assess concentration performance, attention span, and attention accuracy. They also completed the Warwick–Edinburgh Mental Well-Being Scale to assess their psychological well-being (PWB). After removing missing values and outliers from the original data set, the final data set, consisting of 689 cases (370 boys vs. 319 girls), was used for data analysis. Data were analyzed by means of descriptive statistics, bivariate correlation, multiple linear regression models, and independent sample t-tests. Results: The results indicated that cardiorespiratory fitness and cognitive function are significant correlates of PWB (r = −0.069, r = 0.161). Further, the results found that cardiorespiratory fitness, concentration performance, attention span, and attention accuracy were significantly collective predictors of psychological well-being (F = 13.299, p = 0.000), accounting for 12% of the total variance. Cardiorespiratory fitness was the most significantly individual predictor of PWB (β = 0.174, p = 0.000), followed by the attention accuracy (β = −0.090, p = 0.031). The Welch’s tests revealed that the high-PWB group scored significantly higher than the low-PWB group in cardiorespiratory fitness, concentration performance, and attention accuracy (t = 4.093, p = 0.000, Cohen’s d = 0.310; t = 3.340, p = 0.001, Cohen’s d = 0.256; t = −2.958, p = 0.003, Cohen’s d = 0.130). Conclusions: Cardiorespiratory fitness and cognitive function are significant correlates and predictors of PWB among school-aged children. The students with a higher level of psychological well-being showed a higher cardiorespiratory fitness, concentration performance, and attention accuracy compared to the lower level of PWB group.

Behaviours involved in the role of victim and aggressor in bullying: Relationship with physical fitness in adolescents

Physical fitness is related to well-being and health. Adolescence is a key period in the psychological and social development of the person, in which interpersonal relationships gain strength, being bullying a type of violence that can affect the personality of those involved. At present, there is not enough research to determine the relationships between bullying and physical condition. The purpose of this study is to find out if there are any relationships among physical fitness, victimisation, and aggression in bullying, and to identify these behaviours. This is a descriptive study done in 1035 adolescents aged 12 to 17 years (M = 14.67, SD = 1.49). The European Bullying Intervention Project Questionnaire (EBIPQ) scale was used, and anthropometric characteristics of weight and height were measured. In addition, physical fitness tests from the Eurofit battery, sit-and-reach, 30-second sit-ups, horizontal jump, manual dynamometry, and 20-meter Multistage Shuttle Run Test (SRT) were included. The relationships between variables were analysed using Spearman correlations, linear regressions, and ordinal regressions. The most relevant findings indicate an inverse relationship between being a victim of bullying and having a better cardiorespiratory cardiovascular endurance. These also show a direct relationship between being a bully and skeletal muscle strength measured through the horizontal jump, 30-second sit-ups, and manual dynamometry tests. Theoretically, we can conclude that physical condition can be considered a predictor to consider in bullying. Specifically, cardiorespiratory fitness, in addition to its multiple physical and mental benefits, may be a protective element against bullying victimisation. In contrast, muscular strength, especially in boys, may be an important predictor, especially in the physical component, of aggression in bullying.

General and specific stress mindsets: Links with college student health and academic performance

The goal of this cross-sectional, correlational study was to evaluate (a) whether beliefs about stress as enhancing versus debilitating (i.e., stress mindsets) vary across sources of stress that differ in duration (acute vs. chronic) and controllability, and (b) how general and source-specific stress mindsets relate to health and academic performance. College students (n = 498) self-reported their general and source-specific stress mindsets, perceived distress, health, coping, and GPA. Stress mindsets varied as a function of duration and controllability, and general stress mindsets were only weakly associated with source-specific mindsets. Consistent with previous research, general stress mindsets were associated with health, but some source-specific mindsets were more predictive of health than others—viewing stress from chronic controllable sources as debilitating was most predictive of poor mental and physical health. Measures of stress were also associated with health, and this association was moderated by stress mindsets, suggesting that viewing stress as enhancing can provide a psychological “buffer” against the negative effects of stress. Approach coping and perceived distress were examined as potential mediators of the links between stress mindset and health. Viewing stress as enhancing was related to greater use of approach coping and lower perceived distress, which in turn was related to better health. This research suggests that stress mindset interventions may benefit students’ health, and that interventions targeting mindsets for chronic controllable sources of stress may be more effective than general stress mindset interventions.

A comparison of multidimensional qualities discriminant of selection in elite adolescent Australian basketball athletes

Purpose

The aims of this study were to (1) quantify the multidimensional attributes of male and female basketball athletes under 16 years of age (U16) and under 18 years of age (U18), and (2) identify attributes that distinguish selection into a talent pathway according to sex and age group.

Methods

67 male and 71 female athletes competing in U16 and U18 selection trials for a state based Australian basketball talent pathway completed a multidimensional testing battery. The test battery consisted of anthropometric, physical (20- linear sprint, countermovement jump height, Yo-Yo Intermittent Recovery Test Level 2), technical (Basketball Jump Shooting Accuracy Test), tactical (video decision making), and psychological (Sports Orientation Questionnaire, Psychological Performance Inventory-Alternative) assessments. Mean differences and independent t-tests were used to assess comparative differences between selected and non-selected athletes within each age and sex cohort. Stepwise discriminant analyses were used to identify attributes that were the strongest discriminators of selection in each group (male U16, male U18, female U16, and female U18).

Results

The discrimminant models showed for male U16 athletes smaller height (ES = -0.18) and greater shooting accuracy (ES = 0.52) was most discriminant of selection. Results were largely homogenous for male U18 athletes with lower visualisation score (ES = -0.62) most discriminant of selection. In female cohorts, faster 20-m sprint time (ES = -0.66) and taller height (ES = 0.58) was most discriminant of selection in U16 athletes while greater shooting accuracy (ES = 0.67), countermovement jump height (ES = 1.04), and height (ES = 0.65) was most discriminant of selection in U18 athletes.

Conclusions

These results emphasise the differing selection priorities within adolescent basketball cohorts according to sex and age group. The testing of anthropometric, physical and technical attributes may hold particular utility in adolescent female basketball given their identified importance to selection across U16 and U18 cohorts.

Smartphone measurements of physical activity and fitness are associated with early trial discontinuation of patients in (hemato)oncology phase I/II clinical trials

BACKGROUND

Patients, who discontinue early, do not benefit from phase I/II clinical trials (early-phase clinical trials (EPCT)). In this study, associations between objective smartphone measurements of physical activity and fitness and early trial discontinuation in patients with cancer participating in EPCT were investigated.

METHODS

Before start of treatment, physical activity (steps/day) and physical fitness (meters walked in 6 min) were measured with a smartphone, and patient-reported physical function (PRO-PF) was assessed (EORTC QLQ-C30-PF). Early trial discontinuation was defined as discontinuation ≤ 28 days. Univariable logistic regression analyses were performed to study associations of physical activity, fitness, and function with early trial discontinuation. Optimal cutoff values of physical activity and fitness were assessed with ROCs, based on positive predictive values (PPV).

RESULTS

Median (interquartile range (IQR)) step count was 4263 (2548-6897) steps/day, mean ± standard deviation 6-min walking distance was 477 ± 120 m and median (IQR) PRO-PF score was 83 (67-95) points. Fourteen patients (12%) discontinued the trial early. Smartphone measurements of physical activity in units of 100 steps per day (odds ratio (OR) = 0.96, 95% CI = 0.94-0.99, p = 0.01), physical fitness (OR = 0.99, 95% CI = 0.98-0.99, p < 0.01), and PRO-PF (OR = 0.97, 95% CI = 0.94-1.00, p = 0.03) were associated with early trial discontinuation. Optimal cutoff values were < 900 steps for physical activity and < 285 m for physical fitness. PPV for early trial discontinuation was 100% in patients who walked both < 1500 steps per day and < 300 m in 6 min.

CONCLUSIONS

Objective smartphone measurements of physical activity and fitness are associated with early trial discontinuation. However, cutoff values should be externally validated in a larger cohort before implementation in clinical practice.

HIV and three dimensions of Wisdom: Association with cognitive function and physical and mental well-being: For: Psychiatry Research

Wisdom is a unique human personality trait with cognitive, affective or compassionate, and reflective dimensions. We evaluated relationships of three specific dimensions of wisdom with cognitive function and physical and mental well-being in people with HIV (PWH) and HIV-negative (HIV-) participants. Subjects included 138 adults (61 PWH, 77 HIV-) from the San Diego community. Validated measures were used to assess wisdom and well-being. Cognitive function was assessed via the Montreal Cognitive Assessment. We conducted multivariate linear regressions to evaluate the associations of wisdom dimensions with cognitive function and physical and mental well-being. Compared to the HIV- group, PWH had lower mean scores on cognitive function, and physical and mental well-being, and cognitive and reflective dimensions of wisdom, but similar scores on affective or compassionate wisdom. Among PWH, higher total wisdom scores were associated with older age, lower likelihood of substance dependence, greater mental well-being, better cognitive function, higher resilience, social support, and optimism scores, as well as lower levels of perceived stress and nadir CD4 count. Our findings of an association of different dimensions of wisdom with physical and/or mental well-being in PWH would point to a possibility that enhancing these dimensions of wisdom might improve health outcomes in PWH.

Perceived and Measured Physical Fitness of Police Students

The physical fitness of police officers needs to support good health and physical performance. Physical fitness comprises a considerable amount of training for police students who are to become police officers. However, to what degree police students are able to perceive their fitness level and differentiate between health-related and performance-related physical fitness is unknown. Therefore, the first aim of this study was to investigate the possibility of differentiation between health-related and performance-related physical fitness using physical self-concept and measured indicators of physical fitness. The second aim of this study was to investigate the association between components of physical self-concept and measured indicators of physical fitness of police students. The sample of 177 police students of both sexes (98 males and 79 females) completed a 40-item physical self-description questionnaire and their physical abilities were assessed for handgrip strength, standing long jump, 30 s sit-ups, and 12-min running. Principal component analysis established health-related and performance-related physical fitness from both perceived and measured physical fitness measures. Correlation analysis revealed a significant relationship between the perceived and measured physical fitness. Results suggest small to moderate ability to recognize the level of certain physical abilities, indicating the association between psychological mechanisms and biological functioning.

Current Perspectives on Aerobic Exercise in People with Parkinson's Disease

Parkinson's disease (PD) is a progressive neurological disorder characterized by motor and non-motor symptoms for which only symptomatic treatments exist. Exercise is a widely studied complementary treatment option. Aerobic exercise, defined as continuous movement of the body's large muscles in a rhythmic manner for a sustained period that increases caloric requirements and aims at maintaining or improving physical fitness, appears promising. We performed both a scoping review and a systematic review on the generic and disease-specific health benefits of aerobic exercise for people with PD. We support this by a meta-analysis on the effects on physical fitness (VO2max), motor symptoms (Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) motor section), and health-related quality of life (39-item Parkinson's disease Questionnaire (PDQ-39)). Aerobic exercise has generic health benefits for people with PD, including a reduced incidence of cardiovascular disease, a lower mortality, and an improved bone health. Additionally, there is level 1 evidence that aerobic exercise improves physical fitness (VO2max) and attenuates motor symptoms (MDS-UPDRS motor section) in the off-medication state, although the long-term effects (beyond 6 months) remain unclear. Dosing the exercise matters: improvements appear to be greater after training at higher intensities compared with moderate intensities. We found insufficient evidence for a beneficial effect of aerobic exercise on health-related quality of life (PDQ-39) and conflicting results regarding non-motor symptoms. Compliance to exercise regimes is challenging for PD patients but may be improved by adding exergaming elements to the training program. Aerobic exercise seems a safe intervention for people with PD, although care must be taken to avoid falls in at-risk individuals. Further studies are needed to establish the long term of aerobic exercise, including a focus on non-motor symptoms and health-related quality of life.

Metacognitive beliefs and their relationship with anxiety and depression in physical illnesses: A systematic review

Anxiety and depression are common among patients with chronic physical illnesses and have a significant impact on morbidity, quality of life, and health service utilisation. Psychological treatment of anxiety and depression has small to moderate efficacy in this group and is not commonly based on a model of causal mechanisms. A novel approach to understanding and improving mental health outcomes in physical illnesses is needed. One approach may be to explore the role of metacognitive beliefs which are reliably associated with anxiety and depression in individuals with mental health difficulties. The current systematic review aimed to evaluate the contribution of metacognitive beliefs to anxiety and depression across physical illnesses. Systematic searches were conducted on Web of Science, PsychINFO, MEDLINE, Embase, and CINAHL of studies published between 1997 and January 2019. 13 eligible studies were identified that in sum comprised 2851 participants. Metacognitive beliefs were found to have reliable, moderate, positive and significant associations with anxiety and depression symptoms across a range of physical illnesses. There appeared to be commonality and some specificity in the relationships. Negative metacognitive beliefs concerned with uncontrollability and danger of worry were associated with both anxiety and depression across all physical illnesses assessed, whilst more specific associations emerged for individual medical conditions where positive beliefs about worry, cognitive confidence and cognitive self-consciousness were unique correlates. Negative metacognitive beliefs of uncontrollability and danger significantly and positively predicted symptoms of anxiety and depression after controlling for factors including age, gender, disease factors and cognition (illness perceptions and intolerance of uncertainty). The results suggest that the metacognitive model of psychological disorder is applicable to psychological symptoms of anxiety and depression across a range of chronic medical conditions, implying that metacognitive therapy might be helpful in improving outcomes in multiple morbidities that involve poor mental and medical health.

Fitness information-seeking behavior among female university students: A qualitative study

Obsession with the physique and appearance is a by-product of consumer societies. As such, fitness and slimming have now become major concerns of Iranian females. This study endeavors to elaborate on information-seeking behaviors among female students of Isfahan University of Medical Sciences concerning fitness. This study conducted in 2018, employs a qualitative approach using conventional content analysis. The research population includes female students of Isfahan University of Medical Sciences, 16 of whom were selected with use of purposive sampling. Data were collected through face-to-face semi-structured interviews and their trustworthiness was confirmed by the criteria of 'credibility', 'confirmability', 'dependability', and 'transferability' proposed by Guba and Lincoln. Results reveal four sub-categories and nineteen codes on information-seeking behavior. Sub-categories and codes including information-seeking motivations (achieving physical health, physical appearance, social acceptability, self-confidence, family and friends' pressure) information resources (electronic information resources, social media, printed information resources, doctors and nutritionists, family and friends, traditional & Islamic medicine, radio and TV), information validation (asking the doctors and specialists, matching the information with scientific references, consulting with friends and relatives) and obstacles to seeking information (lack of time, high costs, distrust, access limitation). by increasing the students' informational and media literacy, providing authentic and low-cost online resources of information and specialized TV programs, the damages rooted in using invalid information resources concerning fitness can be substantially diminished.

Relationships among Leisure Physical Activity, Sedentary Lifestyle, Physical Fitness, and Happiness in Adults 65 Years or Older in Taiwan

The purpose of this study is to understand the relationship among leisure physical activity, sedentary lifestyle, physical fitness, and happiness in healthy elderly adults aged over 65 years old in Taiwan. Data were recruited from the National Physical Fitness Survey in Taiwan, which was proposed in the Project on the Establishment of Physical Fitness Testing Stations by the Sports Administration of the Ministry of Education. Participants were recruited from fitness testing stations set up in 22 counties and cities from October 2015 to May 2016. A total of 20,111 healthy older adults aged 65-102 years were recruited as research participants. The fitness testing procedure was described to all participants, who were provided with a standardized structured questionnaire. Participants' data included sex, city or county of residence, living status (living together with others or living alone), education level, and income. Physical fitness testing was conducted in accordance with The Fitness Guide for Older Adults published by the Sports Administration of the Ministry of Education. The testing involved cardiorespiratory endurance, muscle strength, muscle endurance, flexibility, balance, and body composition. The t-test was used to evaluate the differences between continuous and grade variables under the two classification variables of sex, city or county of residence, and living status. We used the MARS (multivariate adaptive regression splines) model to analyze the effects of physical fitness variables and leisure physical activity variables on happiness. Among healthy elderly adults, sex, age, living status, body mass index, and leisure physical activity habits proved to be related to happiness. Aerobic endurance (2-min step test), muscular strength and endurance (30-s arm curl and 30-s chair stand tests), flexibility (back stretch and chair sit-and-reach tests), and balance ability (8-foot up-and-go tests and one-leg stance with eyes open tests) were found to be related to happiness. The results of this study indicate that increased physical activity and intensity, as well as physical fitness performance, are associated with improved happiness.

A latent class analysis of heavy substance use in Young adulthood and impacts on physical, cognitive, and mental health outcomes in middle age

BACKGROUND

This study examines whether longitudinal patterns of persistent or experimental heavy substance use across young adulthood were associated with physical and mental health in midlife.

METHODS

Data (N = 21,347) from Monitoring the Future from adolescence (age 18) to midlife (age 40) were used. Repeated measures latent class analysis modeled patterns of patterns of cigarettes, alcohol, marijuana, and other illicit drugs across young adulthood (ages 18-30). Latent classes were then used as predictors of physical health problems, cognitive problems, self-rated health, and psychological problems in midlife (age 40), while controlling for sociodemographic variables (i.e., gender, race/ethnicity, parental education).

RESULTS

Identified classes were "Extreme Heavy Users" (3.9%), "Early Young Adult Users" (8.9%), "Cigarette Smokers" (9.2%), "All But Cigarette Smokers" (5.0%), "Frequent Alcohol Bingers" (10.4%), and "Not-Heavy Users" (62.6%). Extreme Heavy Users, Early Young Adult Users, and Cigarette Smokers had significantly poorer overall health based on a number of physical conditions and self-rated health. Extreme Heavy Users, Early Young Adult Users, Cigarette Smokers, and All But Cigarette Smokers had more cognitive problems than other classes. Extreme Heavy Users, Early Young Adult Users, Cigarette Smokers, and All But Cigarette Smokers were more likely to see a health professional for a psychological problem.

CONCLUSIONS

Patterns of heavy substance use were associated with health across decades. Regular cigarette smokers and heavy users across substances and ages had the worst health in midlife, although even those with time-limited use during young adulthood were at risk for later physical and cognitive health problems.

What do we know about physical activity interventions in vocational education and training? A systematic review

BACKGROUND

Although the health benefits of physical activity (PA) are well known, young people's level of PA is often insufficient and tends to decline in adolescence. Numerous studies have investigated the effectiveness of PA-promoting interventions among young people, but none have reviewed the effectiveness of PA interventions in the vocational education and training (VET) setting. This systematic review aims to (1) synthesize and review the available literature on PA-promoting interventions in VET and (2) examine the effects of these interventions on PA-related outcomes such as PA level, physical fitness, physiological parameters, or psychological factors.

METHODS

Five electronic databases were searched for studies involving adolescents aged 15 to 20 years that took place in VET settings and evaluated the effects of interventions with a PA component on PA-related outcomes such as PA level, physical fitness, physiological parameters, or psychological factors. The screening process and the quality assessment were conducted by two independent reviewers; data extraction was conducted by one reviewer and verified by another.

RESULTS

The literature search identified 18,959 articles and 11,282 unique records. After the screening process, nine studies, all coming from European or Asian countries, met the pre-defined eligibility criteria and were included in qualitative analyses. All but two studies reported significant improvements for at least one PA-related outcome. The interventions substantially differed in their development approaches (top-down vs. bottom-up approaches), complexity (multi- vs. single-component), and addressed behavior (multi-behavioral vs. single-behavioral). The most conspicuous finding was that bottom-up approaches tend to improve outcomes at the psychological level and top-down approaches at the physical level. Regarding the interventions' complexity and addressed behavior, we did not reveal any conclusive results.

CONCLUSION

This systematic review highlights the varying effects of PA-promoting interventions in VET. Nevertheless, heterogeneous effects, overall weak study quality and availability of studies only from two continents limited our ability to draw clear conclusions about the potentially most effective intervention strategies. Therefore, future research should focus on high-quality studies with long-term follow-ups to make recommendations for practical use.

TRIAL REGISTRATION

PROSPERO CRD42018109845.

Does Emotion Regulation Predict Gains in Exercise-Induced Fitness? A Prospective Mixed-Effects Study with Elite Helicopter Pilots

Emotion regulation (ER) is a strong predictor of different aspects of mental health and wellbeing. However, only recently has ER been examined in relation to physical activity and its effects on fitness. In the present study, 26 elite helicopter pilots, serving in the Spanish Air Force, were physically trained for 6 months, and their level of fitness (maximum oxygen consumption and time to exhaustion in a treadmill-running test) was assessed before and after that period. Additionally, two indices of emotion regulation (general adaptiveness of ER strategies, as measured by the Emotion Regulation Questionnaire (ERQ), and negative urgency, as measured by the UPPS-P questionnaire) measured at baseline were used as prospective predictors of fitness improvement. After controlling for individual features, baseline fitness, and type of training, better emotion regulation strategies (more cognitive reappraisal plus less expressive suppression) predicted larger fitness gains (p = 0.028). Incidental emotion regulation, as measured by the negative urgency index, failed to predict pre–post-fitness changes (p = 0.734). These results suggest that fostering emotion regulation skills may improve the effectiveness of fitness training programs.

Fit to fight - from military hygiene to wellbeing in the British Army

This paper reviews the historical evolution of the language and organization surrounding the health of personnel in the British Army from 'hygiene' through  to 'wellbeing'. It starts by considering the health of the army in the mid-nineteenth century and the emergence of military hygiene as a professional subject. It continues by looking at advances in military hygiene in the two world wars. Hygiene was replaced by the term 'health' in the 1950s as the collective noun used by professionals working in this field. This unity split when the professions of occupational medicine and public health established separate faculties and training pathways. However, the health issues for the armed forces remain fundamentally unchanged. Going forward, the term 'wellbeing' is helping to refresh the close relationships between executives, their medical advisers and those within the population of health professions charged with keeping the British Army healthy. The core theme is the collaborations between civil society, executive leadership and medical services in maximizing the health of the military population from recruitment through to life as a veteran.

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.

School-Based Intervention Programs for Preventing Obesity and Promoting Physical Activity and Fitness: A Systematic Review

With the significant decrease in physical activity rates, the importance of intervention programs in the schools, where children spend a significant part of the day, has become indisputable. The purpose of this review is to systematically examine the possibility of school-based interventions on promoting physical activity and physical fitness as well as preventing obesity. A systematic approach adopting PRISMA statement was implemented in this study. Three different databases (2010-2019) were screened and primary and secondary school-based intervention programs measuring at least one variable of obesity, physical activity, or physical fitness were included. The risk of bias was assessed using the validated quality assessment tool for quantitative studies. Among 395 potentially related studies, 19 studies were found to meet the eligibility criteria. A general look at the studies examined reveals that among the outcomes, of which most (18/19) were examined, a significant improvement was provided in at least one of them. When the program details are examined, it can be said that the success rate of the physical activity-oriented programs is higher in all variables. School-based interventions can have important potential for obesity prevention and promotion of physical activity and fitness if they focus more on the content, quality, duration and priority of the physical activity.

Motivational Interviewing to Increase Physical Activity Behavior in Cancer Patients: A Pilot Randomized Controlled Trials

OBJECTIVE

This pilot randomized controlled trial (RCT) aimed at evaluating the feasibility and potential efficacy of a motivational interviewing (MI) intervention to increase physical activity (PA) behavior in cancer patients.

METHODS

Participants were randomly assigned to an experimental group with standard care plus 12 MI sessions within 12 weeks or a control group with standard care only. The number of recruited participants and the modality of recruitment were recorded to describe the reach of the study. The acceptability of the study was estimated using the attrition rate during the intervention phase. The potential efficacy of the intervention was evaluated by analyzing the PA behavior.

RESULTS

Twenty-five participants were recruited within the 16-month recruitment period (1.6 participants per month). Five participants (38.5%) from the experimental group (n = 13) and one participant (8.3%) from the control group (n = 12) dropped out of the study before the end of the intervention phase. No group by time interaction effect for PA behavior was observed at the end of the intervention.

CONCLUSION

Due to the low recruitment rate and compliance, no conclusion can be drawn regarding the efficacy of MI to increase PA behavior in cancer patients. Moreover, the current literature cannot provide any evidence on the effectiveness of MI to increase PA in cancer survivors. Future RCTs should consider that the percentage of uninterested patients to join the study may be as high as 60%. Overrecruitment (30% to 40%) is also recommended to accommodate the elevated attrition rate.

Physical Activity-Related Health Competence, Physical Activity, and Physical Fitness: Analysis of Control Competence for the Self-Directed Exercise of Adolescents

(1) Background: Individuals have to effectively manage their physical activity in order to optimize the associated physical and psychological health benefits. Control competence allows the individual to structure and pace physical activity in a health-enhancing way. The concept was developed within a model of physical activity-related health competence, and is related to the concepts of health literacy and physical literacy. Therefore, the study firstly aimed to validate a self-report scale to measure the physical and psychological facets of control competence in adolescents. Secondly, relationships between control competence and its basic elements, knowledge and motivation, as well as between control competence, sport activity, and fitness, were investigated. (2) Methods: In two cross-sectional studies, ninth grade adolescents (study A: n = 794, 51% female; study B: n = 860, 52% female) were tested using self-report scales (study A and B), a test for health-related fitness knowledge (study B), and cardiovascular and muscular fitness tests (study B). (3) Results: Confirmatory factor analyses confirmed the two-factor structure of the self-report scale for control competence in studies A and B. In addition, the results of structural equation modeling in study B showed a relationship between motivation (via control competence) and sport activity, and a relationship between control competence and fitness. (4) Conclusion: The questionnaire extends the ability to assess control competence in adolescents. Moreover the findings support the importance of control competence in order to achieve health benefits through physical activity.

Evaluation of Physical Fitness, Body Composition, and Adherence to Mediterranean Diet in Adolescents from Estonia: The AdolesHealth Study

Unhealthy lifestyles, low levels of physical fitness, and adherence to the Mediterranean diet (MD) are associated with bad quality of life and the development of a wide range of non-communicable diseases (NCDs). The current study aimed to evaluate the level of adherence to the MD in physical fitness performance and body composition parameters in children and adolescents of Estonia. Therefore, 413 adolescents (56% boys) from the city of Tartu completed the Mediterranean Diet Questionnaire (KIDMED) for analyzing the adherence to MD and performed the Alpha Fitness Test for measuring physical fitness and body composition. A 41.67% of low, 44.05% of average, and 14.28% of high adherence to MD was detected, without difference between genders (p = 0.747). In the Alpha Fitness battery, a higher performance was observed in all tests for boys vs. girls (p < 0.05). In relation to body composition, higher height, weight, and waist values were observed in boys (p < 0.05) and a lower body fat percentage (p < 0.01) without differences in body mass index (BMI; p = 0.906). The adherence to the MD is classified as average/low. Gender significantly influences all variables of the Alpha Fitness battery and anthropometrics measures excepting BMI. According the levels of adherence to the MD, no statistically different prevalence was observed for Non-Overweight (N-O_weight), Non-Overfat (N-O_fat), or Non-Overwaist (N-O_waist). Still, a risk factor for Overweight (O_weight) in boys with low adherence was observed in comparison to those with a mid-level of adherence to the MD.

Aerobic fitness relates to differential attentional but not language-related cognitive processes

Compelling evidence supports an association between the attribute of aerobic fitness and achievement scores on standardized tests of reading. However, such standardized assessments provide only a broad valuation of a complex network of language related sub-processes that contribute to reading and are heavily confounded by other attention-related processes. The present investigation sought to clarify the nature of the association between aerobic fitness and language processing in a sample of college-aged adults. Participants were bifurcated based on aerobic fitness level and on a separate day were asked to complete a lexical decision task while neuroelectric activity was recorded. Analysis of word-level language-related ERP components revealed no fitness differences. However, lower aerobically-fit individuals elicited smaller amplitude for attention-related ERP components relative to the higher aerobically-fit group. These data provide initial evidence to suggest that fitness-related differences in reading achievement may result from attentional processes rather than acting upon specific language-related processes.

Community-based exercise for health promotion and secondary cancer prevention in Canada: protocol for a hybrid effectiveness-implementation study

INTRODUCTION

Cancer care has expanded from a disease-focused, survival-oriented model to an approach that now considers how survivors can live well in the aftermath of intensive therapy, where they may deal with significant changes to their bodies, mental health or emotional well-being. Research evidence supports the benefit of exercise during and following cancer treatments for cancer-related symptoms, physical functioning and fitness, and health-related quality of life. To move this efficacy evidence into practice, we designed and launched a 5-year study to evaluate the relative benefit from implementing a clinic-to-community-based cancer and exercise model of care.

METHODS AND ANALYSIS

A hybrid effectiveness and implementation trial design is being used to evaluate the effectiveness of delivery of community-based exercise and to collect data on implementation of the programme. The study opened in January 2017, with estimated completion by January 2022. The programme will be delivered in seven cities across the province of Alberta, Canada, with sites including three academic institutions, six YMCA locations, Wellspring Edmonton and Calgary, and six municipal fitness centres. Participants are adult cancer survivors (n=2500) from all tumour groups and stages and at any time point along their cancer treatment trajectory, up to 3 years post treatment completion. Survivors take part in a minimum of 60 min of mild-to-moderate intensity full body exercise twice weekly for a 12-week period. The primary effectiveness outcome is the proportion of participants meeting or exceeding 150 min of moderate intensity exercise per week at 1-year follow-up. The Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework will be utilised to capture individual-level and organizational-level impact of the exercise programme at 12 and 24 weeks and 1-year follow-up. The cohort of survivors participating in the study will allow for long-term (>5-year) evaluation of rates of cancer recurrence and secondary cancers beyond the funding period.

ETHICS AND DISSEMINATION

The study was approved by the Health Research Ethics Board of Alberta. The study is funded by Alberta Innovates and the Alberta Cancer Foundation. The study will help to answer critical questions on the effectiveness of cancer-specific community-based exercise programming in both the short-term and the long-term. Collectively, the findings will help to inform the acceptability, adoption, feasibility, reach and sustainability of community-based exercise.

TRIAL REGISTRATION NUMBER

NCT02984163; Pre-results.

Relative Age Effect in the Sport Environment. Role of Physical Fitness and Cognitive Function in Youth Soccer Players

The need to achieve short-term competitive outcomes in sports may influence the emergence of talent selection strategies, which could bias individuals’ opportunities. The present study aimed to further explore the relative age effect (RAE), a phenomenon that strongly influences youth sport development. The RAE refers to a disproportionately high percentage in sport teams of athletes born early in the selection year. Our primary focus was to explore whether the RAE is supported by behavioral evidence in favor of better fitness—and especially cognitive-attentional functioning—of early as compared to late-born players. A cross-sectional study was conducted on 105 young athletes (u10, n = 52; 9.8 ± 0.3 years old, and u12, n = 53; 11.8 ± 0.2 years old) attending two youth elite soccer academies. Attentional functioning, anthropometrics, physical fitness, and game intelligence were compared across two Age Groups (u10 vs. u12) and four Birth Quarters (BQ1–BQ4). The RAE was statistically significant (p < 0.001), showing that about 50% of participants were born in the first quarter and 75% were born in the first half of the year. More importantly, U12 players outperformed u10 players in measures that were related to sustained attention (with faster and less variable responses; p < 0.001 and p < 0.05, respectively), and in all anthropometric measures (p < 0.001), physical-fitness capacities (p < 0.05). Crucially, neither the attentional measures, game intelligence, anthropometrics, nor physical fitness were affected by BQ (all ps > 0.1 and BF₁₀ between 0.08 and 0.6, showing strong evidence for the null hypothesis). The present findings suggest that the early selection process that occurs during scouting in youth soccer academies offsets the age-related differences that could be anticipated in cognitive skills, anthropometrics, and physical abilities, due to growth and maturation. These birth asymmetries could lead teams to disregard later maturation athletes and athletes born later in the year inducing a larger dropout of those players with the consequent reduction in the talent pool.

Effects of Physical Exercise Intervention on Psychological and Physical Fitness in Lymphoma Patients

Background and objectives: Lymphoma patients experience a psychological and physiological decline that could be reversed by exercise. However, little is known about the effects of the exercise on psychological and physical fitness variables. Therefore, the purpose of this longitudinal study was to assess self-efficacy, fatigue and physical fitness before and after an eight-week exercise intervention. Materials and Methods: Thirty-six participants (54.4 ± 19.1 years) performed a supervised exercise program (~60 min, 2d·wk^-1). Each session included a combined progressive training of cardiorespiratory, resistance, flexibility and postural education exercises. Self-efficacy and fatigue were measured with the Regulatory Emotional Self-Efficacy scale and 0-10 rating scale, respectively. Physical fitness was assessed with the body mass index, lower back flexibility, static balance, muscle strength and functional mobility. Results: Adherence to exercise was high (91.2% ± 4.8%) and no major health problems were noted in the patients over the intervention period. At baseline, significant differences were found between Hodgkin's lymphoma and non-Hodgkin's lymphoma patients by age and all dependent measures (p < 0.05). Fatigue significantly decreased and the perceived capability to regulate negative affect and to express positive emotions improved after exercise (p < 0.001). Significant improvements were found for body mass index, trunk lateral flexibility, monopodalic balance, isometric handgrip force and functional mobility (p < 0.001). Fatigue was significantly correlated with handgrip force (r = -0.56, p < 0.001) and functional mobility (r = -0.69, p < 0.001). Conclusions: The supervised exercise program improved psychological and physical fitness without causing adverse effects and health problems. Therefore, exercise to improve fitness levels and reduce perceived fatigue should be considered in the management of lymphoma patients.

Lighten UP! A Community-Based Group Intervention to Promote Eudaimonic Well-Being in Older Adults: A Multi-Site Replication with 6 Month Follow-Up

Objectives: Eudaimonic well-being (EWB), increasingly recognized as a critical component of health, typically declines in later life, and there are no existing programs to sustain or increase EWB in older adults. Lighten UP! is an 8-week program to promote EWB through facilitated group sessions in community settings and at-home practice. Building on earlier pilot research, the current study assessed the effect of the Lighten UP! Program using a longitudinal, multi-site design. Methods: Men and women (N = 169) aged 60 and over were recruited from three Wisconsin communities. EWB, life satisfaction, depression, and diverse aspects of health were assessed before and after the program and at 6-month follow up. Results: Participants reported significantly increased EWB; these changes were maintained 6 months later. The specific EWB domains of self-acceptance, positive relations, and personal growth showed the most robust gains. Participants also showed significant and sustained declines in depressive symptoms, anxiety, and hostility. Conclusions: Lighten UP! Program confirmed its positive effects for enhancing EWB in older adults living in multiple community settings. Clinical Implications: Programs that sustain or enhance EWB in older adults can be expected to yield improvements in diverse aspects of mental and physical health.

Military-style fitness boot camps: contested resources in accounting for fatness

In this article, we examine the social management of fatness via an analysis of 4 years of participant-observation in military-style fitness boot camps and interviews with camp participants, trainers and organisers/owners. We begin by focusing on popular imagery of the 'boot camp'. The boot camp model takes various forms; yet, whether it involves civilian participants, as on reality television shows, or the imagined military ones of films, the boot camp model emphasises the re-fashioning of the individual via the disciplining of bodies and selves. Such constructions of boot camps were employed by our respondents to lay claim to identities which highlight their hard work, strength of character, fundamental 'goodness' and self-discipline, as those qualities are demonstrated through the body - even though participants' actual bodies change little at camp. Such meanings stand in direct contradiction to broader social constructions of fatness and participants' own negative perceptions of fat people. Moreover, even within the camps themselves, such identity claims are contested, both by camp trainers and by slimmer and 'fitter' attendees. These counterclaims are grounded in ideas about the characterological implications of the fat body, beliefs about the purpose of boot camp and notions of the body's capacity for change.

The Effects of Multi-Component Exercise Training on Cognitive Functioning and Health-Related Quality of Life in Older Adults

PURPOSE

Exercise has been shown to have various proximal and distal benefits among older adults such as improving physical fitness, cognitive functioning, and health-related quality of life (HR-QOL). Despite this evidence, limited research has investigated pathway change of these outcomes. The primary purpose of this study was to test if older adults who improved in physical fitness measures from engaging in multicomponent exercise training for 12 weeks predicted change in proximal (cognitive functioning) and distal (HR-QOL) outcomes, respectively.

METHODS

Participants (n = 110) were healthy, older adults (M = 72, SD = 7.24) that comprised an exercise-intervention and control group. The intervention consisted of exercising in a supervised laboratory setting for 12 weeks.

RESULTS

Structural equation modeling revealed group type to predict change in physical performance and the maximum walking test with comparable effect sizes. Physical performance in turn predicted improvement in processing speed (β = 0.23, p = 0.013) executive functioning (β = 0.26, p = 0.006), and HR-QOL (β = 0.13, p = 0.031). However, only executive functioning was found to significantly predict HR-QOL (β = 0.49, p < 0.001) over processing speed (p > 0.05).

CONCLUSIONS

Between two fitness measures, the physical performance test demonstrated better predictive validity in proximal and distal health outcomes. In addition to physical fitness, older adults who engage in multi-component exercise sessions regularly can improve their executive functioning, which in turn enhances their HR-QOL.

Generalizability of an adult-validated model for predicting increased physical activity in after-school program children: Effects of treatment formats on fitness indicators

Inappropriately high weight in children is a persistent problem in the United States, and physical activity is often reduced in schools due to academic demands. Effective after-school programs could positively impact both physical activity and overweight/obesity, however previous reviews and meta-analyses have indicated minimal effects. Both 4- and 3-day/week versions of a social cognitive theory-driven physical activity/nutrition after-school program were evaluated against unstructured care to assess effects in children (overall M_age = 10.00 years, SD = .80). For changes over 9 months in body mass index (BMI), effects sizes (Cohen's d) were .68, .40, and .07 in the 4-day (n = 70), 3-day (n = 70), and unstructured (n = 50) groups, respectively. Similar patterns of effects were found for changes in free-time physical activity and cardiovascular endurance. Incorporating a theory-based prediction model previously supported in teens through older adults, with and without medical disorders and health-risk factors, improvements in exercise-related self-regulation and self-efficacy, and mood, significantly predicted increased free-time physical activity (R² = .48). Effects significantly strengthened to R² = .62 when completion/non-completion of the recommended 300 min/week of physical activity was also accounted for. Change in BMI was inversely related to physical activity change, β=-.14, p < .05. The present evaluation process indicated promising effects, and indicated theory-based targets to foster future program improvements.

Men's Bodily Attractiveness: Muscles as Fitness Indicators

Bodily attractiveness is an important component of mate value. Musculature-a crucial component of men's bodily attractiveness-provides women with probabilistic information regarding a potential mate's quality. Overall musculature is comprised of several muscle groups, each of which varies in information value; different muscles should be weighted differently by attractiveness-assessment adaptations as a result. In the current study, women and men ( N = 1,742) reported size preferences for 14 major muscle groups. Women's reported preferences provided only partial support for our hypotheses that women will prefer muscles that most reliably differentiate between potential mates to be larger; men tended to prefer larger upper-body muscles. We discuss possible interpretations of these mixed findings. Ultimately, our findings suggest that attractiveness-assessment adaptations are sensitive to the information contained within specific muscle groups and they highlight the potential for additional research on the nuances of bodily attractiveness assessment.

Determinants of Physical Activity for Latino and White Middle School-Aged Children

BACKGROUND

Physical activity (PA) has long been acknowledged to contribute health benefits among children. However, research has consistently shown that PA declines as children grow older. Thus, this study examined the factors which are associated to children's PA in order to identify potential barriers to PA.

METHODS

Using data from the KidQuest Program, we conducted bivariate and multivariate analyses on survey data collected from fifth to seventh grade students in a small Midwestern city.

RESULTS

We found that food knowledge, eating breakfast, and talking with family about eating healthy foods, are positively related to PA. On the other hand, screen time is negatively related to PA. In addition, our results evinced differences between ethnicities and found that Latino children's screen time affects their PA levels more than their white counterpart.

CONCLUSIONS

There are different factors which can be tapped to increase PA among middle school-aged children. Given the differences between the Latino and white samples especially in screen time, schools should consider individualized intervention, rather than a "one size fits all" program, to increase PA participation.

Autonomic changes induced by pre-competitive stress in cyclists in relation to physical fitness and anxiety

Cycling is a sport which requires great physical effort from athletes. The stress and anxiety of competition might interfere greatly with performance, by impacting the autonomic system. Physiological alterations, such as situations that irritate, frighten or excite the individual can cause a stress response, defined as a response of the organism to reestablish the homeostasis, regardless of its relationship to a sports situation. The aim of this study was to present data on the autonomic changes induced by precompetitive stress in cyclists and their relation with physical fitness and anxiety. Twelve healthy cyclists aged between 18 and 40 years, with previous experience in competition at the regional level, participated in the study. Heart rate variability (HRV) and physical fitness (body mass index, body fat and aerobic capacity) were measured 5 days before the Mountain Bike championship and remeasured 45 minutes before the start of the race (HRV and Anciety). Paired T test, effect size and correlational test were used. Cycling competition is a stressful situation capable of altering autonomic and hemodynamic parameters. We observed the increase in SDNN, reflecting an increase in sympathetic autonomic control. There were correlations between physical fitness with some autonomic parameters, while anxiety correlated with the years of experience in competition.

Body pride and physical activity: Differential associations between fitness- and appearance-related pride in young adult Canadians

Body-related pride has been associated with health behaviors such as physical activity; however, researchers have overlooked distinctions between different domains of pride (appearance/fitness) and the two facets of pride (authentic/hubristic). The objective of the present research was to examine relationships between fitness- and appearance-related authentic and hubristic pride and physical activity. In Study 1, participants (N = 115) completed measures of fitness-related pride and participation in moderate-to-vigorous physical activity (MVPA). Both authentic and hubristic pride were positively associated with MVPA. In Study 2, participants (N = 173) completed measures of appearance-related pride and MVPA. Neither facet of pride predicted engagement in MVPA. In Study 3, participants (N = 401) completed measures of both fitness-related pride and appearance-related pride as well as MVPA. Authentic and hubristic fitness-related pride were associated with MVPA, while appearance-related hubristic pride was negatively associated with MVPA. Results support the adaptive nature of pride in motivating engagement in health behaviors when it is experienced around the body's functionality rather than appearance.

Identifying the Incidence of Exercise Dependence Attitudes, Levels of Body Perception, and Preferences for Use of Fitness Technology Monitoring

Background: The study was focused on identifying the relationship between the incidence of exercise dependence attitudes, the level of body perception, and preferences for use of fitness technology monitoring. Methods: We investigated 241 students from physical education and sports specializations. We used a questionnaire structured in 5 parts: personal information (age, gender, weight, height, and institutional membership), Exercise Dependence Scale-R (EDS-21), the Compulsive Exercise Test (CET), Body perception questionnaire, and Fitness Monitoring Technology. Results: Application of EDS-21 revealed 8.3% with dependence and CET with 13.4%. Body mass index (BMI) in combination with self-image body: 18 (7.4%) of subjects over-estimated themselves, 18 (7.4%) of subjects underestimated themselves, 38.6% of the subjects were satisfied with their appearance, 17% were very satisfied and none were dissatisfied. A total of 36.1% thought they had the correct weight and 8.7% thought of losing weight. The most preferred monitoring technologies were the treadmill and the smartphone's fitness applications. A total of 11.6% of the subjects always used technologies, and 17% of subjects never did so. Conclusions: In order to identify the level of incidence of exercise dependence, body perception, and preference and frequency of use of monitoring technology, it is necessary to expand the level of knowledge about health and physical activities. The approach would diminish medical incidences of addiction, improve proactive behaviors, and correct prohealth.

Structured physical exercise and recovery from first episode psychosis in young adults, the FitForLife study

Optimising autonomy is increasingly important in recovery from psychosis. To date, physical exercise has shown promise in the treatment of severe, enduring mental illnesses including psychosis - when used as an adjunct treatment. To assess the association between physical exercise and autonomy in young adults, a simple pre-post experimental design was utilised. Individuals aged 18-35 years, treated at one of three specialist outpatient units for first-episode psychosis in Stockholm, Sweden were invited to participate in a 12-week programme of structured group exercise. Autonomy was measured using four questions from the Camberwell Assessment of Needs questionnaire (physical health, social and close relationship and daily tasks). Comparisons were made between: 'no attendance' and 'any attendance'. The latter group was bisected into higher and lower categories. Ninety-four participants enrolled with a post-intervention response rate of 61%. Significant reductions were seen in self-rated needs for care, though there was no significant change in total scores or evidence of a dose response association. The results suggest a plausible association between physical exercise and autonomy which may represent the recovery process following the first episode of psychosis. Further randomised control trials are needed to explore the potential causality and robustness of this change.

Differences in working memory as a function of physical activity in children

OBJECTIVE

Given previous research examining the relationship between physical activity (PA) and working memory in children has not taken into account of potentially confounders, this study specifically controlled for the effects of intelligence and fitness-related factors (i.e., aerobic and motor fitness) on this relationship.

METHOD

Thirty-two children were assigned to either the higher PA group (HP) (n = 16) or lower PA group (LP) (n = 16) based on their amount of PA as measured by an accelerometer. Working memory was measured by the delayed-matching test, with concurrent recordings of event-related potentials including the P3 and the positive slow wave (PSW) components.

RESULTS

Data analysis controlling for the effects of potential confounders found that the HP group had higher response accuracy in both task conditions relative to the LP group. For reaction times (RT), the HP group showed shorter RT than the LP group in the delayed condition. Furthermore, the HP group had similar P3 amplitudes across task conditions, whereas amplitudes in the delayed condition were smaller than that in the non-delayed condition in the LP group. In addition, the HP group also showed larger PSW amplitudes than the LP group. Supplementary partial correlations analysis indicated negative correlations between levels of PA with RT in both task conditions, and positive correlations with P3 amplitude and PSW amplitude in the delayed condition.

CONCLUSIONS

Children with higher levels of PA, while controlling for individual differences in intelligence and fitness-related factors, have better working memory as assessed by both behavioral and neuroelectric measures. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Orthorexia nervosa in a sample of Portuguese fitness participants

PURPOSE

Orthorexia Nervosa (ON) is described as an obsessive behaviour motivated by great concern for following a healthy diet. Although it was first described in 1997, ON remains inconspicuous and poorly characterized in the literature. The aims of this study were to evaluate the prevalence of ON in a sample of ambulatory individuals and to investigate their common characteristics, attempting to better characterize this entity.

METHODS

A non-random sample of 193 adult gym members answered a questionnaire based on a Portuguese version of ORTO-15, supplemented with additional questions. Possible associations between the different variables and pathological scores on ORTO-15 were analysed using logistic regression models.

RESULTS

ON behaviour was documented in 51.8% of the sample, mean age 30.96 years (± 1.03 years), and this condition tended to be correlated with younger ages. Physical appearance and frequent exercising were also associated with ON, while no correlation between orthorexic tendencies and both gender and educational field was found. Furthermore, consumption of special food, dissatisfaction with physical appearance and frequent exercising could predict the presence of ON in the sample.

CONCLUSIONS

Despite the use of a convenience sample, results place us in a different perspective, considering the idea that orthorexic individuals are exclusively concerned about pursuing a pure diet. The presence of ON was associated with other non-dietary behaviours allied to a healthy lifestyle and aesthetic concerns.

LEVEL OF EVIDENCE

Level V: Descriptive study.

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.

Association of walking pace and handgrip strength with all-cause, cardiovascular, and cancer mortality: a UK Biobank observational study

Aims

To quantify the association of self-reported walking pace and handgrip strength with all-cause, cardiovascular, and cancer mortality.

Methods and results

A total of 230 670 women and 190 057 men free from prevalent cancer and cardiovascular disease were included from UK Biobank. Usual walking pace was self-defined as slow, steady/average or brisk. Handgrip strength was assessed by dynamometer. Cox-proportional hazard models were adjusted for social deprivation, ethnicity, employment, medications, alcohol use, diet, physical activity, and television viewing time. Interaction terms investigated whether age, body mass index (BMI), and smoking status modified associations. Over 6.3 years, there were 8598 deaths, 1654 from cardiovascular disease and 4850 from cancer. Associations of walking pace with mortality were modified by BMI. In women, the hazard ratio (HR) for all-cause mortality in slow compared with fast walkers were 2.16 [95% confidence interval (CI): 1.68–2.77] and 1.31 (1.08–1.60) in the bottom and top BMI tertiles, respectively; corresponding HRs for men were 2.01 (1.68–2.41) and 1.41 (1.20–1.66). Hazard ratios for cardiovascular mortality remained above 1.7 across all categories of BMI in men and women, with modest heterogeneity in men. Handgrip strength was associated with cardiovascular mortality in men only (HR tertile 1 vs. tertile 3 = 1.38; 1.18–1.62), without differences across BMI categories, while associations with all-cause mortality were only seen in men with low BMI. Associations for walking pace and handgrip strength with cancer mortality were less consistent.

Conclusion

A simple self-reported measure of slow walking pace could aid risk stratification for all-cause and cardiovascular mortality within the general population.

The Link Between Nutrition and Physical Activity in Increasing Academic Achievement

BACKGROUND

Research demonstrates a link between decreased cognitive function in overweight school-aged children and improved cognitive function among students with high fitness levels and children engaging in regular physical activity (PA). The purpose of this study was to examine whether regular PA and proper nutrition together had a significant effect on academic achievement.

METHODS

Using the seventh wave of the Early Childhood Longitudinal Study, Kindergarten Class 1998-99 (ECLS-K) dataset, linear regression analysis with a Jackknife resampling correction was conducted to analyze the relationship among nutrition, PA, and academic achievement, while controlling for socioeconomic status, age, and sex. A nonactive, unhealthy nutrition group and a physically active, healthy nutrition group were compared on standardized tests of academic achievement.

RESULTS

Findings indicated that PA levels and proper nutrition significantly predicted achievement scores. Thus, the active, healthy nutrition group scored higher on reading, math, and science standardized achievement tests scores.

CONCLUSIONS

There is a strong connection between healthy nutrition and adequate PA, and the average performance within the population. Thus, results from this study suggest a supporting relationship between students' health and academic achievement. Findings also provide implications for school and district policy changes.