Effects of Exergames and Conventional Physical Therapy on Functional Physical Performance in Older Adults: A Randomized Controlled Trial

Objective: To evaluate the effects of exergames added to a conventional physical therapy (CPT) program on functional fitness and dynamometric muscle performance for the sit-to-stand (STS) maneuver in older adults and to compare their results concerning a CPT-only intervention. Materials and Methods: Fifty independent older adults were randomly assigned to CPT and exergames (CPT+ExG group; n = 25; age = 71.8 ± 6.8 years) or CPT alone (CPT group; n = 25; age = 71.3 ± 7.4 years). CPT was performed twice a week (60 min/session) for 8 weeks. The CPT+ExG group added exergames for 30 minutes in each session. The Senior Fitness Test was applied, considering the 30-second chair stand test as the primary outcome. Additionally, dynamometric muscle performance during the STS maneuver was assessed. Results: The CPT+ExG group improved the 30-second chair stand (lower body strength), back scratch (upper body flexibility), and 8-foot up-and-go (agility/dynamic balance) tests (all P < 0.05). Both groups improved the kinetic dynamometric variables peak force, peak power, and total work (all P < 0.05). Also, both groups improved the 30-second arm curl test (upper body strength) (P < 0.05), although the increase was higher in the CPT+ExG group compared with the CPT group (time × group; P < 0.05). Conclusion: Adding exergames to a CPT program only significantly increases upper limb strength compared with CPT alone. The findings of this study have implications for the design of future exergame interventions focused on improving STS maneuver performance in older adults.

Swimming and L-arginine loaded chitosan nanoparticles ameliorates aging-induced neuron atrophy, autophagy marker LC3, GABA and BDNF-TrkB pathway in the spinal cord of rats

Aging is associated with muscle atrophy, and erosion and destruction of neuronal pathways in the spinal cord. The study aim was to assess the effect of swimming training (Sw) and L-arginine loaded chitosan nanoparticles (LA-CNPs) on the sensory and motor neuron population, autophagy marker LC3, total oxidant status/total antioxidant capacity, behavioural test, GABA and BDNF-TrkB pathway in the spinal cord of aging rats. The rats were randomized to five groups: young (8-weeks) control (n = 7), old control (n = 7), old Sw (n = 7), old LA-CNPs (n = 7) and old Sw + LA-CNPs (n = 7). Groups under LA-CNPs supplementation received 500 mg/kg/day. Sw groups performed a swimming exercise programme 5 days per week for 6 weeks. Upon the completion of the interventions the rats were euthanized and the spinal cord was fixed and frozen for histological assessment, IHC, and gene expression analysis. The old group had more atrophy in the spinal cord with higher changes in LC3 as an indicator of autophagy in the spinal cord compared to the young group (p < 0.0001). The old Sw + LA-CNPs group increased (improved) spinal cord GABA (p = 0.0187), BDNF (p = 0.0003), TrkB (p < 0.0001) gene expression, decreased autophagy marker LC3 protein (p < 0.0001), nerve atrophy and jumping/licking latency (p < 0.0001), improved sciatic functional index score and total oxidant status/total antioxidant capacity compared to the old group (p < 0.0001). In conclusion, swimming and LA-CNPs seems to ameliorate aging-induced neuron atrophy, autophagy marker LC3, oxidant-antioxidant status, functional restoration, GABA and BDNF-TrkB pathway in the spinal cord of aging rats. Our study provides experimental evidence for a possible positive role of swimming and L-arginine loaded chitosan nanoparticles to decrease complications of aging.

Plyometric-Jump Training Effects on Physical Fitness and Sport-Specific Performance According to Maturity: A Systematic Review with Meta-analysis

BACKGROUND

Among youth, plyometric-jump training (PJT) may provide a safe, accessible, and time-efficient training method. Less is known on PJT effectiveness according to the maturity status.

OBJECTIVE

This systematic review with meta-analysis set out to analyse the body of peer-reviewed articles assessing the effects of PJT on measures of physical fitness [i.e., maximal dynamic strength; change of direction (COD) speed; linear sprint speed; horizontal and vertical jump performance; reactive strength index] and sport-specific performance (i.e., soccer ball kicking and dribbling velocity) according to the participants' maturity status.

METHODS

Systematic searches were conducted in three electronic databases using the following inclusion criteria: (i) Population: healthy participants aged < 18 years; (ii) Intervention: PJT program including unilateral and/or bilateral jumps; (iii) Comparator: groups of different maturity status with control groups; (iv) Outcomes: at least one measure of physical fitness and/or sport-specific performance before and after PJT; (v) experimental design with an active or passive control group, and two or more maturity groups exposed to the same PJT. The DerSimonian and Laird random-effects models were used to compute the meta-analysis. The methodological quality of the studies was assessed using the PEDro checklist. GRADE was applied to assess certainty of evidence.

RESULTS

From 11,028 initially identified studies across three electronic databases, 11 studies were finally eligible to be meta-analysed (n total = 744; seven studies recruited males; four studies recruited females). Three studies were rated as high quality (6 points), and eight studies were of moderate quality (5 points). Seven studies reported the maturity status using age at peak height velocity (PHV; pre-PHV values up to - 2.3; post-PHV up to 2.5). Another four studies used Tanner staging (from Tanner I to V). The training programmes ranged from 4 to 36 weeks, using 1-3 weekly training sessions. When compared to controls, pre-PHV and post-PHV participants obtained small-to-moderate improvements (ES = 0.35 - 0.80, all p < 0.05) in most outcomes (i.e., sport-specific performance; maximal dynamic strength; linear sprint; horizontal jump; reactive strength index) after PJT. The contrast of pre-PHV with post-PHV youth revealed that PJT was similarly effective in both maturity groups, in most outcome measures except for COD speed (in favour of pre-PHV). PJT induces similar physical fitness and sport-specific performance benefits in males and females, with a minimal exercise dosage of 4 weeks (8 intervention sessions), and 92 weekly jumps. Results of this meta-analysis are based on low study heterogeneity, and low to very low certainty of evidence (GRADE analysis) for all outcomes.

CONCLUSION

Compared to control participants, PJT resulted in improved maximal dynamic strength, linear sprint speed, horizontal jump performance, reactive strength index, and sport-specific performance (i.e., soccer ball kicking and dribbling velocity). These effects seem to occur independently of the maturity status, as both pre-PHV and post-PHV participants achieved similar improvements after PJT interventions for most outcomes. However, several methodological issues (e.g., low sample sizes and the pooling of maturity categories) preclude the attainment of more robust recommendations at the current time. To address this issue, consistency in maturity status reporting strategies must be improved in future studies with the general youth population and youth athletes.

The effects of repeated backward running training on measures of physical fitness in youth male soccer players

This study explored the effects of an 8-week repeated backward running training (RBRT) programme on measures of physical fitness in youth male soccer players. Youth male soccer players were randomly allocated into a RBRT group (n = 20; 13.95 ± 0.22y) or a control group (CG; n = 16; 14.86 ± 0.29y). The CG continued normal soccer training, while the RBRT group replaced some soccer drills with RBRT twice per week. Within-group analysis revealed that RBRT improved all performance variables (∆-9.99% to 14.50%; effect size [ES] = -1.79 to 1.29; p ≤ 0.001). Meanwhile, trivial-to-moderate detrimental effects on sprinting and change of direction (CoD) speed (∆1.55% to 10.40%; p ≤ 0.05) were noted in the CG. The number of individuals improving performance above the smallest worthwhile change ranged from 65-100% across all performance variables in the RBRT group, whereas<50% in the CG reached that threshold. The between-group analysis indicated that the RBRT group improved performance on all performance tasks more than the CG (ES = -2.23 to 1.10; p ≤ 0.05). These findings demonstrate that substituting part of a standard soccer training regimen with RBRT can enhance youth soccer players' sprinting, CoD, jumping, and RSA performance.

Effects of six weeks outdoor versus treadmill running on physical fitness and body composition in recreationally active young males: a pilot study

Background

Running as exercise may be performed either on an outdoor surface or treadmill surface. However, previous research has indicated that the nature of both the surfaces differ significantly and therefore the training outcomes from running in these surfaces may also vary.

Aim

Therefore, the aim of this pilot study was to compare the effects of 6-weeks of supervised outdoor running (OT) vs treadmill running (TT) on physical fitness and body composition in recreationally active young males.

Methods

Participants (age: 19.82 ± 1.28 years, height: 172.6 ± 4.9 cm, body mass: 64.3 ± 8.7 kg) were randomly assigned to OT (n = 14) or TT (n = 14), and assessed for physical fitness, i.e., 50 m sprint, cardiorespiratory endurance (i.e., 1,600 m run time-trial), standing long jump (SLJ), flexibility (i.e., sit-and-reach test), and upper-body muscle endurance (i.e., push-ups repetitions), alongside body composition, i.e., body mass, body mass index (BMI), fat percentage, fat free mass, and leg skeletal muscle mass (SMM). A two (pre-post intervention) by two (OT, TT) mixed ANOVA analysed exercise-specific effects. For significant group-by-time interactions, Bonferroni adjusted paired (within-group) and independent (between-group comparisons at post) t-tests were used for post-hoc analyses.

Results

Significant time-effect was found in all physical fitness variables (all p < 0.001, η_p ² = 0.67-0.91), body mass (p = 0.23, η_p ² = 0.18), BMI (p = 0.009, η_p ² = 0.24), body fat percentage (p = 0.001, η_p ² = 0.38), and leg SMM (p = 0.002-0.007, η_p ² = 0.25-0.33). Significant group-by-time interaction was found for 50 m sprint (p = < 0.001, η_p ² = 0.74), 1,600 m run (p = 0.001, η_p ² = 0.35), and SLJ (p < 0.001, η_p ² = 0.43), favouring OT. Group-specific post-hoc tests showed improvements in all physical fitness variables after OT (p = < 0.001-0.001, g = 0.69-2.32, %Δ = 3.0-12.4) and TT (p = < 0.001-0.017, g = 0.15-0.65, %Δ = 0.9-11.7), and fat percentage after OT and TT (p = 0.002-0.041, g = 0.14-0.26, %Δ = 4.3-6.0). However, leg SMM decreased in TT (p = 0.001-0.004, g = 0.14-0.15, %Δ = 6.2-6.7).

Conclusions

Both OT and TT improved physical fitness and decreased fat percentage. However, compared to TT, the OT intervention preserved leg SMM and induced greater physical fitness improvements.

Electromyographic analysis of the serratus anterior and upper trapezius in closed kinetic chain exercises performed on different unstable support surfaces: a systematic review and meta-analysis

Background

Multiple investigations have compared the electromyographic (EMG) activity of the scapular muscles between stable and unstable support surfaces during the execution of closed kinetic chain exercises. However, these comparative analyses have grouped different unstable surfaces (wobble board, BOSU, therapeutic ball, and suspension equipment) into a single data pool, without considering the possible differences in neuromuscular demand induced by each unstable support surface. This study aimed to analyze the individual effect of different unstable support surfaces compared to a stable support surface on scapular muscles EMG activity during the execution of closed kinetic chain exercises.

Methodology

A literature search was conducted of the Pubmed Central, ScienceDirect and SPORTDiscus databases. Studies which investigated scapular muscles EMG during push-ups and compared at least two support surfaces were included. The risk of bias of included articles was assessed using a standardized quality assessment form for descriptive, observational and EMG studies, and the certainty of the evidence was measured with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. A random-effects model was used to calculate effect sizes (ES, Hedge's g).

Results

Thirty studies were selected in the systematic review. Of these, twenty-three low-to-high quality studies (498 participants) were included in the meta-analysis. The main analyzes revealed, in decreasing order, greater UT EMG activity during push-ups performed on suspension equipment (ES = 2.92; p = 0.004), therapeutic ball (ES = 1.03; p < 0.001) and wobble board (ES = 0.33; p = 0.003); without effect on the BOSU ball. In addition, no effect was observed for SA on any unstable device. The certainty of the evidence ranged from low to very low due to the inclusion of descriptive studies, as well as high imprecision, inconsistency, and risk of publication bias.

Conclusion

These findings could be applied in scapular muscles strengthening in healthy individuals. The use of suspension equipment achieves higher UT activation levels. Conversely, the use of any type of unstable devices to increase the activation levels of the SA in shoulder musculoskeletal dysfunctions is not recommended. These conclusions should be interpreted with caution as the available evidence showed a low to very low certainty of evidence, downgraded mostly by inconsistency and imprecision.