Kate L. Pumpa

Exercise interventions for cognitive function in adults older than 50: a systematic review with meta-analysis

Background Physical exercise is seen as a promising intervention to prevent or delay cognitive decline in individuals aged 50 years and older, yet the evidence from reviews is not conclusive. Objectives To determine if physical exercise is effective in improving cognitive function in this population. Design Systematic review with multilevel meta-analysis. Data sources Electronic databases Medline (PubMed), EMBASE (Scopus), PsychINFO and CENTRAL (Cochrane) from inception to November 2016. Eligibility criteria Randomised controlled trials of physical exercise interventions in community-dwelling adults older than 50 years, with an outcome measure of cognitive function. Results The search returned 12 820 records, of which 39 studies were included in the systematic review. Analysis of 333 dependent effect sizes from 36 studies showed that physical exercise improved cognitive function (0.29; 95% CI 0.17 to 0.41; p<0.01). Interventions of aerobic exercise, resistance training, multicomponent training and tai chi, all had significant point estimates. When exercise prescription was examined, a duration of 45–60 min per session and at least moderate intensity, were associated with benefits to cognition. The results of the meta-analysis were consistent and independent of the cognitive domain tested or the cognitive status of the participants. Conclusions Physical exercise improved cognitive function in the over 50s, regardless of the cognitive status of participants. To improve cognitive function, this meta-analysis provides clinicians with evidence to recommend that patients obtain both aerobic and resistance exercise of at least moderate intensity on as many days of the week as feasible, in line with current exercise guidelines.

Determinants of adherence to lifestyle intervention in adults with obesity: a systematic review.

Lifestyle intervention programmes are efficacious in the management of obesity but often report poor attendance and adherence rates that hinder treatment effectiveness and health outcomes. The aim of this systematic review is to identify (i) barriers to behaviour change and (ii) predictors of adherence to lifestyle intervention programmes in adults with obesity. Studies were identified by systematically reviewing the literature within Medline, PsycINFO, CINAHL, SPORTDiscus and Web of Science from inception to August 2016. Barriers to behaviour change include poor motivation; environmental, societal and social pressures; lack of time; health and physical limitations; negative thoughts/moods; socioeconomic constraints; gaps in knowledge/awareness; and lack of enjoyment of exercise. The most prominent predictors of adherence include early weight loss success, lower baseline body mass index (BMI), better baseline mood, being male and older age. The findings within this review provide novel insight to clinicians working in obesity and have important implications for lifestyle intervention programme design. Barriers to behaviour change need to be addressed early in treatment, with lifestyle intervention individualized accordingly. Predictors of adherence should also be taken into careful consideration, with negative moods and unrealistic weight loss expectations discussed at the outset. If adherence is improved, treatment effectiveness, health outcomes and the ultimate burden of chronic diseases could also be improved.

Behavioural treatment strategies improve adherence to lifestyle intervention programmes in adults with obesity: a systematic review and meta-analysis

Poor adherence to lifestyle intervention remains a key factor hindering treatment effectiveness and health outcomes for adults with obesity. The aim of this systematic review and meta‐analysis is to determine if behavioural treatment strategies (e.g. goal setting, motivational interviewing, relapse prevention, cognitive restructuring etc.) improve adherence to lifestyle intervention programmes in adults with obesity. Randomized controlled trials that investigated the use of behavioural treatment strategies in obesity management were identified by systematically reviewing the literature within Medline, PsycINFO, CINAHL, SPORTDiscus and Web of Science from their inception to August 2016. This meta‐analysis shows that behavioural treatment interventions have a significant positive effect on session attendance (percentage) and physical activity (total min/week) in adults with obesity (M = 17.63 (95% confidence interval (CI) = 10.77, 24.50), z =5.0337, P < 0.0001 and M = 105.98 (95% CI = 58.64, 153.32), z =4.3878, P < 0.0001, respectively). This meta‐analysis of randomized controlled trials provides evidence that behavioural treatment strategies improve adherence to lifestyle intervention programmes in adults with obesity. These strategies should be routinely incorporated into lifestyle intervention, obesity management and weight loss programmes with the aim of improving engagement and adherence. If adherence were improved, treatment effectiveness, health outcomes and the ultimate burden of chronic disease could also be improved.

An Exercise Intervention During Chemotherapy for Women With Recurrent Ovarian Cancer: A Feasibility Study.

Objective The aim of this study was to determine the feasibility of a combined supervised and home-based exercise intervention during chemotherapy for women with recurrent ovarian cancer. Secondary aims were to determine the impact of physical activity on physical and psychological outcomes and on chemotherapy completion rates. Methods Women with recurrent ovarian cancer were recruited from 3 oncology outpatient clinics in Sydney and Canberra, Australia. All participants received an individualized exercise program that consisted of 90 minutes or more of low to moderate aerobic, resistance, core stability, and balance exercise per week, for 12 weeks. Feasibility was determined by recruitment rate, retention rate, intervention adherence, and adverse events. Aerobic capacity, muscular strength, fatigue, sleep quality, quality of life, depression, and chemotherapy completion rates were assessed at weeks 0, 12, and 24. Results Thirty participants were recruited (recruitment rate, 63%), with a retention rate of 70%. Participants averaged 196 ± 138 min · wk of low to moderate physical activity throughout the intervention, with adherence to the program at 81%. There were no adverse events resulting from the exercise intervention. Participants who completed the study displayed significant improvements in quality of life (P = 0.017), fatigue (P = 0.004), mental health (P = 0.007), muscular strength (P = 0.001), and balance (P = 0.003) after the intervention. Participants completing the intervention had a higher relative dose intensity than noncompleters (P = 0.03). Conclusions A program consisting of low to moderate exercise of 90 min · wk was achieved by two-thirds of women with recurrent ovarian cancer in this study, with no adverse events reported. Randomized control studies are required to confirm the benefits of exercise reported in this study.

The effects of Lyprinol(®) on delayed onset muscle soreness and muscle damage in well trained athletes: a double-blind randomised controlled trial.

OBJECTIVES The aim of the study was to determine if Lyprinol(®) is effective in reducing pain, indicators of inflammation and muscle damage, and in turn improving performance in well trained athletes suffering from delayed onset muscle soreness (DOMS). DESIGN A double blind randomised placebo controlled trial. SETTING Twenty well trained male volunteers, matched by VO(2max) were randomly assigned to consume 200mg of Lyprinol(®) or an indistinguishable placebo daily for 8 weeks prior to a downhill treadmill running episode designed to induce DOMS. MAIN OUTCOME MEASURES Performance measures (Kin-Com, counter movement and squat jump), pain assessments (visual analogue scale, algometer) and blood analyses (Interleukin-1, Interleukin-6, Interleukin-10, tumour necrosis factor-α, C-reactive protein, myoglobin, creatine kinase) were assessed at 7 time points over 5 days (pre, post, 4, 24, 48, 72 and 96h after the downhill run). RESULTS No statistically significant differences were identified in any parameters between the active and placebo groups at any time point. CONCLUSION After 2 months ingestion of Lyprinol(®) at the currently recommended dosage (200mg/day) and a demanding eccentric exercise intervention, Lyprinol(®) did not convincingly affect DOMS and indicators of muscle damage.

Periodization and Physical Performance in Elite Female Soccer Players

PURPOSE To investigate the variation in training demands, physical performance, and player well-being across a womens soccer season. METHODS Seventeen elite female players wore GPS tracking devices during every training session (N=90) throughout 1 national-league season. Intermittent high-speed-running capacity and 5-, 15-, and 25-m-sprint testing were conducted at the beginning of preseason, end of preseason, midseason, and end of season. In addition, subjective well-being measures were self-reported daily by players over the course of the season. RESULTS Time over 5 m was lowest at the end of preseason (mean 1.148 s, SE 0.017 s) but then progressively deteriorated to the end of the season (P<.001). Sprint performance over 15 m improved by 2.8% (P=.013) after preseason training, while 25-m-sprint performance peaked at midseason, with a 3.1% (P=.05) improvement from the start of preseason, before declining at the end of season (P=.023). Training demands varied between phases, with total distance and high-speed distance greatest during preseason before decreasing (P<.001) during the early- and late-season phases. Endurance capacity and well-being measures did not change across training phases. CONCLUSIONS Monitoring training demands and subsequent physical performance in elite female soccer players allow coaches to ensure that training periodization goals are being met and related positive training adaptations are being elicited.

Validity of the SenseWear Armband to assess energy expenditure during intermittent exercise and recovery in rugby union players.

Abstract Zanetti, S, Pumpa, KL, Wheeler, KW, and Pyne, DB. Validity of the SenseWear armband to assess energy expenditure during intermittent exercise and recovery in rugby union players. J Strength Cond Res 28(4): 1090–1095, 2014—Portable wearable devices that assess energy expenditure during intermittent exercise and recovery would be useful in team sports. Fourteen state-level male rugby union players (mean ± SD: age, 22 ± 4 years; body mass, 88.8 ± 11.2 kg; height, 1.81 ± 0.07 m, body fat, 18 ± 6% ) participated in this study. Energy expenditure was measured by the SenseWear Armband (SWA) and validated against indirect calorimetry as the criterion measure during a 42-minute rugby-specific intermittent exercise test and an immediate postexercise 10-minute recovery period. Energy expenditure measurements from indirect calorimetry and the SWA were only moderately correlated during both the exercise test (r = 0.55, ±0.34; mean, ±90% confidence limits) and recovery period (r = 0.58, ±0.33). The SWA estimate of energy expenditure during exercise was unclear, with a mean bias of −1.9% (±5.3%), and during recovery energy expenditure was overestimated, with a mean bias of 17% (±12%) at the mean estimated energy expenditure. Typical error of SWA energy expenditure estimates expressed as a coefficient of variation (±90% confidence interval) was 10% (8–16%) during exercise and 19% (14–30%) during recovery. The SWA did not provide a valid measure of energy expenditure during rugby-specific intermittent exercise or 10-minute postexercise recovery. Further improvements are required in the performance of the SWA before it can be used routinely in intermittent sports and provide worthwhile information in relation to workloads of athletes for sport scientists and coaches.

A pilot study examining the effects of low-volume high-intensity interval training and continuous low to moderate intensity training on quality of life, functional capacity and cardiovascular risk factors in cancer survivors

Purpose The aim of this study was to evaluate the effects of low-volume high-intensity interval training and continuous low to moderate intensity training on quality of life, functional capacity and cardiovascular disease risk factors in cancer survivors. Methods Cancer survivors within 24 months post-diagnosis were randomly assigned into the low-volume high-intensity interval training group (n = 8) or the continuous low to moderate intensity training group (n = 8) group for 36 sessions (12 weeks) of supervised exercise. The low-volume high-intensity interval training (LVHIIT) group performed 7 × 30 s intervals (≥85% maximal heart rate) and the continuous low to moderate intensity training (CLMIT) group performed continuous aerobic training for 20 min (≤55% maximal heart rate) on a stationary bike or treadmill. Results Significant improvements (time) were observed for 13 of the 23 dependent variables (ES 0.05–0.61, p ≤ 0.05). An interaction effect was observed for six minute walk test (18.53% [32.43–4.63] ES 0.50, p ≤ 0.01) with the LVHIIT group demonstrating greater improvements. Conclusion These preliminary findings suggest that both interventions can induce improvements in quality of life, functional capacity and selected cardiovascular disease risk factors. The LVHIIT program was well tolerated by the participants and our results suggest that LVHIIT is the preferred modality to improve fitness (6MWT); it remains to be seen which intervention elicits the most clinically relevant outcomes for patients. A larger sample size with a control group is required to confirm the significance of these findings.

The effects of Panax notoginseng on delayed onset muscle soreness and muscle damage in well-trained males: A double blind randomised controlled trial

OBJECTIVES The aim of the study was to determine if Panax notoginseng is effective in reducing pain, indicators of inflammation and muscle damage, and in turn improve performance in well trained males who underwent a bout of eccentric exercise designed to induce delayed onset muscle soreness (DOMS). DESIGN A double blind randomised placebo controlled trial. SETTING Twenty well trained male volunteers, matched by maximum aerobic capacity were randomly assigned to consume a regime of 4000 mg of P. notoginseng capsules or an indistinguishable placebo before and after a downhill treadmill running episode designed to induce DOMS. MAIN OUTCOME MEASURES Performance measures (Kin-Com, counter movement and squat jump), pain assessments (visual analogue scale (VAS), algometer) and blood analyses (interleukin-1, interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-α), C-reactive protein, myoglobin, creatine kinase) were assessed at 7 time points over 5 days (pre, post, 4, 24, 48, 72 and 96 h after the downhill run). RESULTS The placebo group demonstrated a significant decrease in squat jump performance immediately post the downhill run, with a mean change ± 95% confidence interval (CI) of 0.8 cm (-3.53 to 1.93). The placebo group also experienced increased pain in the quadriceps 96 h after the downhill run, with a mean VAS change ± 95% CI of -0.32 cm (-0.34 to 0.98).The serum concentration of IL-6 and TNF-α were significantly lower in the placebo group 24h after the downhill run. Mean IL-6 change ± 95% CI of 0.50 pg/mL (-1.59 to 0.59), and mean TNF-α change ± 95% CI was 0.98 pg/mL (-2.04 to 0.09). No other significant differences were identified between the groups for any other outcome measure. CONCLUSION Considering all data from this study, P. notoginseng did not convincingly have an effect on performance, muscular pain or assessed blood markers in well-trained males after an intense bout of eccentric exercise that induced DOMS.

Variable Changes in Body Composition, Strength and Lower-Body Power During an International Rugby Sevens Season

Abstract Mitchell, JA, Pumpa, KL, Williams, KJ, and Pyne, DB. Variable changes in body composition, strength and lower-body power during an international rugby sevens season. J Strength Cond Res 30(4): 1127–1136, 2016—This study determined whether body composition, strength, and power changes that occur during preseason can be maintained during an international rugby sevens season. Fourteen male international rugby sevens players (age 21.4 ± 2.2 years; mean ± SD) were categorized as forward (n = 7) or back (n = 7), and assessed for height, mass (M), skinfolds (S) (∑7), upper-body (UB) strength, lower-body (LB) strength, and LB power. Bench press, back squat, and a countermovement jump were used to measure strength and power at 3 time points: initial, early season, and late season. Forwards were taller (185 ± 4 cm), heavier (95 ± 6 kg), and possessed a greater lean body mass (55.5 ± 4.0 M·S−0.14) than backs (181 ± 8 cm, 88.5 ± 5.5 kg, and 51.9 ± 3.4 M·S−0.14). Over the full season, small (∼5 ± 5%; mean ± 90% confidence limits) positive changes occurred in body composition. Lower-body strength gained during the preseason, decayed in-season, whereas UB strength increased moderately (∼10 ± 3%) across the season. Power showed inconsistencies between measured variables with a moderate positive change across the season in mean velocity and relative peak power. Forwards showed a small decrease in peak power (relative and absolute). Moderate changes were observed in mean power over the season, forwards decreasing (∼6 ± 6%) and backs increasing (∼8 ± 6%). Rugby sevens forwards in this study found it difficult to maintain and improve power qualities in-season. Training loads of forwards and backs should be differentiated to maximize strength and power in-season.