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- Virtual reality gaming in rehabilitation after musculoskeletal injur: user experience pilot studyPublication . Gouveia, Élvio Rúbio; Campos, Pedro; França, Cristiano S.; Rodrigues, Louis M.; Martins, Francisco; França, Cíntia; Gonçalves, Frederica; Teixeira, Fernando; Ihle, Andreas; Gouveia, Bruna R.The purposes of this study were twofold: (1) to describe a new technological solution for the rehabilitation of musculoskeletal injuries based on virtual reality (VR) gaming, and (2) to analyze the variation in rated perceived exertion (RPE) and heart rate (HR) of the participants when undergoing a rehabilitation session based on different VR games. Thirty-seven participants aged 23.7 ± 7.0 years tested during five customized VR games to provide a complete rehabilitation session after a musculoskeletal injury. The results of the Friedman test indicated a statistically significant difference in RPE scale and HR across the five VR games throughout a complete rehabilitation session (χ2 (4, n = 35) = 75.59; p < 0.001 and χ2 (4, n = 35) = 27.75, p < 0.001, respectively). RPE and HR increased significantly from Game 1 to Game 2 (z = –5.16, p < 0.001), from Game 1 to Game 3 (z = – 5.05, p < 0.001), from Game 1 to Game 4 (z = –4.87, p < 0.001), and from Game 1 to Game 5 (z = –3.61, p < 0.001). Moreover, the results showed a high perceived usability of the system, greater intrinsic motivation to perform the rehabilitation exercises, a high level of immersion, and a good experience in the VR gaming environment. Our study stimulates extended intervention programs following up on this immersive virtual reality rehabilitation system to support soccer players recovering from musculoskeletal injuries.
- The association of healthy lifestyle behaviors with overweight and obesity among older adults from 21 countriesPublication . Marconcin, Priscila; Ihle, Andreas; Werneck, André O.; Gouveia, Élvio R.; Ferrari, Gerson; Peralta, Miguel; Marques, AdilsonThis study aimed to analyze the association of healthy lifestyle behaviors with overweight and obesity among Europeans aged 65+ years. Data were from the 2014 European Social Survey, analyzing 21 countries. Five lifestyle behaviors (physical activity, fruit and vegetable consumption, sleep quality, drinking alcohol, and smoking) were analyzed. Binary logistic regressions were performed. A total of 8938 participants (4099 men) 65 years and older, mean age—73.6 (SD: 6.6) presented prevalence of overweight of 42.3% (95% CI: 41.3 to 43.3) and obesity of 20.9% (95% CI: 20.1 to 21.8). Adopting five healthy behaviors was associated with lower odds of obesity (OR = 0.50, 95% CI: 0.39 to 0.63), but not overweight (OR: 0.93; 95% CI: 0.79 to 1.10). Physical activity (≥5 days/week) was the most protective behavior, reducing by 42% the odds of obesity. Sex moderated the association of fruits and vegetables consumption, alcohol use, and smoking with obesity. Strategies aiming to reduce obesity levels in older adults should focus on the promotion of multiple lifestyle health behaviors, particularly physical activity in order to decrease vulnerability risk in old age.
- Monitoring body composition and physical fitness of elite female basketball players after 16 weeks of in-season trainingPublication . França, Cíntia; França, Ana; Marques, Adilson; Ihle, Andreas; Lopes, Helder; Santos, Francisco; Gouveia, Élvio R.Understanding the physiological changes in players’ profiles during the season is crucial to optimize training prescription according to players’ needs towards a high-level game performance. The purpose of this study was to assess the variation in body composition and physical fitness of elite female basketball players after 16 weeks of in season training. The sample was composed of 13 elite female basketball players aged 19.7 ± 4.3 years (height: 173.7 ± 9.8 cm, body mass: 70.4 ± 11.3 kg). Body composition, static strength, lower-body explosive strength, speed, agility, and aerobic endurance, were assessed initially (T1) and 16 weeks after the regular season (T2). Significant improvements were found between T1 and T2 for the squat jump (t = -2.433, p ≤ 0.05, d = -0.39), the 20 m linear sprint (t = 2.493, p ≤ 0.05, d = 0.87), and the Yo-Yo Intermittent Endurance Test-Level 2 (t = -3.746, p ≤ 0.01, d = - 0.34). Lower-body explosive strength showed a significant contribution to agility and speed. The visceral fat area presented a greater negative correlation with the aerobic and anaerobic capacity. Sports practitioners and coaches should be aware of the importance of monitoring players’ body composition and physical fitness to assess the physiological responses to the training process and to optimize training prescription. Training contents may be adjusted according to the responses recorded to achieve the defined goals. The positive contribution of lower-body explosive strength to speed and agility, emphasizes the need to include in-season strength programs targeted to enhance players’ overall physical fitness.
- Muscle strength and balance as mediators in the association between physical activity and health-related quality of life in community-dwelling older adultsPublication . Maio Nascimento, Marcelo de; Gouveia, Bruna R.; Gouveia, Élvio Rúbio; Campos, Pedro; Marques, Adilson; Ihle, AndreasLower extremity muscle strength (LEMS) and body balance (BB) are essential for older adults to maintain an upright posture and autonomously perform their basic activities of daily living. This study aimed to examine whether LEMS and BB mediate the relationship between physical activity (PA) and health-related quality of life (HRQoL) in a large sample of community-dwelling older adults. This is a cross-sectional study carried out with 802 individuals, 401 males and 401 females (69.8 ± 5.6 years), residents of the Autonomous Region of Madeira, Portugal. PA and HRQoL were assessed by the Baecke Questionnaire and e SF-36, respectively. LEMS was assessed by the Senior Fitness Test and BB by the Fullerton Advance Balance (FAB). The serial mediation pathway model pointed out that LEMS and BB partially mediated the association between PA and HRQoL in approximately 39.6% and 47%, respectively. The total variance in HRQoL explained by the entire model was 98%. Our findings may indicate the role that LEMS and BB play in the relationship between PA and HRQoL in the older population.
- The efficacy of a multicomponent functional fitness program based on exergaming on cognitive functioning of healthy older adults: a randomized controlled trialPublication . Gouveia, Élvio R.; Smailagic, Asim; Ihle, Andreas; Marques, Adilson; Gouveia, Bruna R.; Cameirão, Mónica; Sousa, Honoratoé Santos Correia de; Kliegel, Matthias; Siewiorek, DanielBackground and Objectives: Regular physical exercise can attenuate age-related cognitive decline. This study aimed to investigate the effect of a physical exercise multicomponent training based on exergames on cognitive functioning (CF) in older adults. Research Design and Methods: This randomized controlled trial included older adults aged 61–78. Participants were randomly allocated to an intervention group (IG; n = 15) or active control group (CG; n = 16). The IG was exposed to a combined training with traditional exercise and exergaming, twice a week over a period of 12 weeks. The CG performed only traditional sessions. CF was assessed by the Cognitive Telephone Screening Instrument. The time points for assessment were at zero (pretest), 12 (posttest), and 17 weeks (follow-up). Results: Active CG and IG increased from pretest to posttest in short-term memory (STM), long-term memory (LTM), and Cognitive Telephone Screening Instrument total score 1.98 > Z < 3.00, ps < .005, with moderately large positive effects (.36 > r < .54). A significant increase was seen from posttest to follow-up in STM, Z = 2.74, p = .006, and LTM, Z = 2.31, p < .021, only in IG. Across the two time periods posttest to follow-up, there were significant interaction effects between program type and time for STM (p = .022, η2 p = .17) and LTM (p = .004, η2 p = .25), demonstrating a more beneficial effect of the exergames intervention compared to the CG. Discussion and Implications: The integration of exergaming in a multicomponent functional fitness exercise might have the potential to maintain and improve CF (in particular, STM and LTM) in older adults.
- Relationship between Objective and Subjective Fatigue Monitoring Tests in Professional SoccerPublication . Lourenço, João; Gouveia, Élvio Rúbio; Sarmento, Hugo; Ihle, Andreas; Ribeiro, Tiago; Henriques, Ricardo; Martins, Francisco; França, Cíntia; Ferreira, Ricardo Maia; Fernandes, Luís; Teques, Pedro; Duarte, DanielStudying fatigue is challenging because it is influenced by physiological, psychological, and sociological states. Fatigue can be assessed objectively or subjectively, but the literature has difficulty understanding how an analytical test relates to a response via a questionnaire. Thus, the purpose of this study was to evaluate the relationships between objective fatigue variables (Squat Jump (SJ) and Countermovement Jump (CMJ)) measured on day-2 to the game and subjective fatigue (Rating Perceived Exertion (RPE) measured on day-3 to the game and Hooper Index (HI) measured on day-2). The sample comprised 32 professional football players from the First Portuguese League aged 25.86 ± 3.15 years. The Spearman correlations and regression analyses were used to study the relationships between the variables. The results showed statistically significant (p < 0.05) but small correlations (0.113–0.172) between several objective metrics and the subjective metrics evaluated. In addition, we found two weak models with statistical significance (p < 0.05) between the dependent objective variables (contact time, height, and elasticity index) and the HI (R 2 = 3.7%) and RPE (R 2 = 1.6%). Also, nine statistically significant (p < 0.05) but weak models were observed between the subjective dependent variables (HI and RPE) and contact time (R 2 = 1.8–2.7%), flight time (R 2 = 1.1–1.9%), height (R 2 = 1.2–2.3%), power (R 2 = 1.4%), pace (R 2 = 1.2–2.1%), and elasticity index (R 2 = 1.6%). In conclusion, objective and subjective fatigue-monitoring tests in professional soccer do not measure identical but rather complementary aspects of fatigue, and therefore, both need to be considered to gain a holistic perspective.
- Associations between Age, Body Composition, Balance, and Other Physical Fitness Parameters in Youth SoccerPublication . França, Cíntia; Martins, Francisco; Marques, Adilson; Nascimento, Marcelo de Maio; Ihle, Andreas; Przednowek, Krzysztof; Gouveia, Élvio RúbioIn sports, balance ability has been related to game performance and injury prevention. This study’s aims were twofold: (1) to analyze the balance performance of adolescent soccer players from different age groups; and (2) to examine the relationship between players’ age, body composi tion, balance, and other physical fitness parameters, such as strength and flexibility. In this study, 112 players from the under 15 (U15), under 16 (U16), and under 17 (U17) age groups participated. A one-way analysis of the variance was conducted to investigate differences between groups. Pearson correlations and hierarchical multiple regression were used to explore the relationship between variables. Regarding balance, the older group performed significantly worse in the stability indexes for both legs but significantly better in dynamic balance tests. Height correlated significantly and negatively with balance indicators. Both jumping tasks showed medium to large correlations with the sway indexes (−0.23 > r < −0.51). Although not significantly, body fat negatively affected balance, underlining the importance of monitoring body composition for players’ development. Overall, no substantial relationship was found between static and dynamic balance variables, and therefore, it is crucial to include both as complementary measures while evaluating youngsters’ postural balance.
- Exploring the Role of Physical Activity in Mediating the Association between Educational Level and Health-Related Quality of Life in an Adult Lifespan Sample from Madeira IslandPublication . García-Mayor, Jesús; Gouveia, Élvio Rúbio; Marques, Adilson; De la Cruz-Sánchez, Ernesto; Moreno-Llamas, Antonio; França, Cíntia; Gouveia, Bruna R.; Ihle, AndreasPeople more socioeconomically vulnerable tend to have a poorer health related quality of life (HRQoL). Studies are trying to analyse the factors that may condition this relationship, including physical activity (PA), which may influence the relationship between socioe conomic status (SES) and HRQoL. This study aimed to analyse the relationship between SES and HRQoL through specific domains of PA. Methods: A total of 381 adults (≥18 years) from the Au tonomous Region of Madeira completed the measurements. Mediation analyses using bootstrapping methods adjusted for confounding variables were performed to relate SES and HRQoL; the latter was evaluated using the physical component score (PCS) of the SF-12, the mental component score (MCS) of the SF-12, and the total score in the SF-12 questionnaire (SF-12 score), through physical activity. Results: Educational level was positively related to PCS and SF-12 score. Leisure-time PA (not including sports PA) and PA at work, as single mediating variables, did not mediate the relationship between SES and HRQoL. The total PA suppressed the socioeconomic gradient of HRQoL by 8–10%, 39–46%, and 15–16%, respectively, for the PCS, MCS, and the SF-12 score; sports PA mediated the relationship by 13–16%, 50%, and 15–21%, respectively. Conclusions: The results suggest that sports PA contributes to reducing the socioeconomic gradient of HRQoL.
- The Cognitive Telephone Screening Instrument (COGTEL): a reliable and valid tool for the assessment of cognitive functioning in the Brazilian elderlyPublication . Tinôco, Maria Antonieta; Gouveia, Élvio Rúbio; Ihle, Andreas; Marques, Adilson; Gouveia, Bruna R.; Kliegel, MatthiasObjectives: To study the reliability/stability of the Cognitive Telephone Screening Instrument (COGTEL) for the assessment of cognitive functions, and to investigate the concurrent validity (that is, the relationship between the COGTEL scores and external variables, such as level of education and MMSE results) in a pilot study of elderly persons residing in the community in the municipal regions of Apuí, Fonte Boa and Manaus (Amazonas, Brazil). Method: This pilot study included 90 elderly persons (29 men and 61 women) aged 60-85 years of age [68.2 (± 6.7)]. The COGTEL, the MMSE and socio-economic survey were applied in the form of two interviews, a week apart and under the same conditions. Results: The test-retest intraclass correlation coefficient of the COGTEL total score (and respective six subtests), MMSE and educational level ranged from acceptable to high (0.708 < R <0.946). There was a strong positive correlation between the total score of the COGTEL with the MMSE (r =0.682; p <0.001), as well as with educational level (r =0.604; p <0.001). Conclusion: This study presents preliminary evidence of the reliability/ stability and concurrent validity of the COGTEL in the evaluation of cognitive functions in elderly persons residing in the community. The results of this study support the use of COGTEL as a short, reliable and valid instrument for analyzing differences in cognitive functioning in inter-individual studies with elderly persons.
- The Mediating Role of Physical Activity and Physical Function in the Association between Body Mass Index and Health-Related Quality of Life: A Population-Based Study with Older AdultsPublication . Nascimento, Marcelo de Maio; Gouveia, Élvio Rúbio; Gouveia, Bruna R.; Marques, Adilson; Campos, Pedro; García-Mayor, Jesús; Przednowek, Krzysztof; Ihle, AndreasThis study aimed (1) to investigate the association between body mass index (BMI), physical activity (PA), and physical function (PF) with health-related quality of life (HRQoL), and (2) to examine in-depth whether PA and PF mediate the relationship between BMI and HRQoL in older adults. We investigated 802 individuals (mean age 69.8 ± 5.6 years), residents of the Autonomous Region of Madeira, Portugal. Harmol and PA were assessed using the SF-36 and Baecke questionnaires, respectively, and PF by the Senior Fitness Test. The prevalence of overweight was 71.3%, 26.5% for normal weight, and 2.1% for underweight. We verified a small correlation between age and sex with BMI, PA, PF, and medium borderline with HRQoL. After adjusting for covariates (i.e., sex, age, comorbidities), the multivariate regression analysis indicated a 93.1% chance of improvement in HRQoL for low BMI, while PA and PF revealed a chance of increasing HRQoL by 91.8% and 60.0%, respectively. According to the serial mediation pathway, PA and PF partially mediated the association between BMI and HRQoL by 32.3% and 81.5%, respectively. The total variance of the model was 90%. It was concluded that BMI can negatively affect HRQoL. On the other hand, PA and PF are able to increase HRQoL levels during the aging process.