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Body composition asymmetries in university ice hockey players and their implications for lower back pain and lower limb injury

Introduction: Right to left asymmetries in body composition has been examined across many sports, suggesting possible implications for lower back pain (LBP) and decreased level performance. However, we are not aware of any study that has examined the presence and implications of morphological asymmetries in ice hockey players. The purpose of this study was to 1) investigate body composition asymmetries in female and male university level ice hockey players and 2) examine whether the degree of body composition asymmetry is associated with the history of LBP and lower leg injury (LLI).

Methods: A total of 32 players (female=18, male=14) were included in this cross-sectional (e.g., university research center setting). Dual-energy X-ray absorptiometry (DEXA) was used to acquire body composition measurements. The parameters of interest included bone mass, lean body mass and fat mass, for the right and left sides and body segments (e.g. arm, leg, trunk, total), separately. History of LBP and LLI was obtained using a self-reported demographic questionnaire.

Results: Our findings revealed significant side-to-side asymmetry in arm and total bone mass in females, with higher values on the right side. Both males and females also had significantly greater trunk lean body mass on the left side. With the exception of greater arm bone mass asymmetry being associated with LBP in the past 3-months, there was no other significant association between the degree of asymmetry with LBP and LLI. Conclusion: The present study provides novel data regarding the presence of laterality in body composition in university level ice hockey players.

Arthritis and Functional Impairment Compound Nutritional Risk in Older Adults: Findings from the Canadian Longitudinal Study on Aging

Evidence suggests that people with arthritis (PWA) are vulnerable to nutritional problems. The role of functional impairment (FI) in this susceptibility is understudied. Nutritional risk (NR) screening facilitates the early detection of poor nutritional status. This study sought to investigate the cross-sectional association between NR and arthritis and to determine whether FI modified that association. Data were from the Canadian Longitudinal Study on Aging (CLSA), a nationally representative survey of community-dwelling Canadian adults. Arthritis was self-reported, NR was determined with the abbreviated Seniors in the Community: Risk Evaluating for Eating and Nutrition II (SCREEN II-AB) questionnaire, and functional status was measured with the Older American Resources and Services scale. We assessed the association between (1) arthritis and continuous NR score (final SCREEN II-AB score), and (2) arthritis with the odds of high NR status according to SCREEN II-AB's pre-established cut-off value, using multiple linear and logistic regressions respectively. Analyses were adjusted for demographic characteristics (age, sex, income, education, number of people in the household), any FI, and health (body mass index, self-rated general and mental health). Additional analyses stratified the models by FI. In total, 41153 respondents were included in this study (Male:49.7 , Mean age:59.2). PWA had lower NR scores (B:-0.36, SE:0.07, p<0.001) and were 12 more likely to have high NR status (95 CI:1.06-1.17 p<0.001). The likelihood of experiencing high NR status were 31 (95 CI:1.12-1.54, p=0.0008) and 10 higher (95 CI:1.04-1.16 p=0.0006) in PWA, with and without FI respectively. Arthritis is associated with high NR in community-dwelling adults over the age of 45 years, both with and without FI. These findings highlight the need for further research on these relationships to inform interventions and improve clinical practices. 

AdultsOlder AdultsNutritionChronic disease
Active Video Game Use (Exergaming) Over 10 Years (Including During COVID-19) Among Young Adults in Canada

Objectives: Playing active video games (also known as exergaming; combining physical activity (PA) with feedback from an external device such as a mobile phone) has been suggested as a viable way to increase PA. To date, there are few longitudinal studies investigating exergaming prevalence. The objectives of this study were to examine the prevalence of exergaming by gender among young adults and to examine minutes/week exergaming.

Methods: To describe exergaming use among 586 young adults (age 20-35), we drew data from the Nicotine Dependence in Teens (NDIT) study in three cycles in 2010-12 (T1), 2017-20 (T2) and 2020-21 (T3), when participants were ages 24.0 (0.7), 30.5 (1.0) years and 33.0 (0.5), on average. The last data collection was during the COVID-19 pandemic lockdown. We examined past year exergaming frequency as well as the average past week minutes of exergaming.

Results: Overall, 41.8 never exergamed, 35.2 exergamed in 1 survey cycle, 17.9 exergamed in 2 survey cycles and 5.1 exergamed in all 3 survey cycles. The overall prevalence of exergaming was 42.2 , 30.0 and 14.2 , in T1, T2 and T3, respectively. Among exergamers, 43.2 , 49.4 and 54.4 were female in T1, T2, and T3, respectively. In T2 women were statistically less likely to exergame then men (p<0.005). Past week (7 days) M(SD) exergaming minutes was 95.4(132.5), 186.9 (261.3), and 219.1 (230.1) among the 99, 47 and 77 exergamers from T1, T2 and T3, respectively.

Conclusions: In a population based sample of young adults, exergaming may be an activity that is cycled though (used during different phases of life). There is little difference in the prevalence of exergaming among young adult men and women, which differs from the adolescent literature (where girls report exergaming more than boys). Those who do exergame report levels that may contribute to meeting PA guidelines, with minutes per week of exergaming increasing during the COVID-19 pandemic lockdown from the previous year.

Morphological changes of deep extensor muscles in relation to the maximum level of Compression and canal compromise in patients with degenerative cervical myelopathy

Introduction: The deep extensor neck muscles (DENM) are often impaired in patients with cervical disorders. This study aimed to examine the relationship between morphological changes of the DENM in patients with degenerative cervical myelopathy (DCM) and the level of maximum spinal compression and canal compromise.

Materials/Methods: A total of 171 patients from a Prospective DCM-International cohort study database were included in this study. Total cross-sectional area (CSA), functional CSA (fat free area, FCSA), ratio of FCSA/CSA (fatty infiltration) and asymmetry of the MF+SCer together and DENM as a group were obtained bilaterally from axial T2-weighted MR images at mid-disc, at the level of maximum cord compression and the level below. The level and degree maximum spinal cord compression (MSCC) and maximum canal compromise (MCC) was determined using the following formulas MSCC= [1 −di (da + db)/ 2] × 100, and MCC = [1 −Di (Da + Db)/ 2] × 100 as defined by Fehlings et al. The relative percent asymmetry in CSA, FCSA and FCSA/CSA was calculated using: [(L − S)/L] x100, where L is the larger side, and S is the smaller side. The relationship between the muscle parameters of interest, MSCC and MCC was assessed using multivariate linear regression models.

Results: Greater MF+Scer fatty infiltration was associated with greater MCC (P= 0.025) and MSCC (p=0.049) at the same level. Greater asymmetry in MF+SCer CSA was also associated with greater MCC (p=0.006). Similarly, greater asymmetry in FCSA and FCSA/CSA of the entire DENM group was associated with greater MCC (p=0.011, p=0.013). There was no significant association between muscle measurements obtained at the level below the level of maximum compression, MCC and MSCC.

Conclusion: Greater MCC is associated with increased fatty infiltration and greater asymmetry of the DENM in patients with DCM. Our findings also suggest that MCC is a better indicator of cervical muscle morphological changes than MSCC.

AdultsChronic disease
Cranberry-derived proanthocyanidins improve grip strength and balance in a dyslipidemic rodent model

Cardiovascular disease is the leading cause of mortality worldwide and can be quite debilitating on functional capacity (FC) (Beverly and Budoff, 2020). FC reflects one's ability to perform activities of daily living and integrates health of the pulmonary, cardiovascular, and skeletal muscle systems (Arena et al, 2007). Lifestyle factors, such as modifying one's diet and exercise, are powerful tools used to improve FC in patients with cardiovascular disease (Tang and Hazen, 2014). The aim of this research project was to investigate the effect of A-type proanthocyanidins (PAC-1), a type of polyphenol, extracted from cranberries on measures of functional capacity in a dyslipidemic rodent model. ApoE -/- mice aged 12-16 weeks were used and randomly assigned to the control group (CON) or exposure group (EXP). All mice were fed the same high-fat diet, with the EXP group's diet enriched with PAC-1 (0.035 mg PAC-1/day). Baseline scores were obtained; then, animals were fed their respective diets for 4 weeks and were tested at weeks 2 and 4. Four tests were performed to measure FC: (1) Rotarod test for balance and motor coordination; (2) wire hang test for grip strength; (3) climbing test for dynamic muscular endurance; (4) treadmill test for aerobic endurance. Since the data were collected at three time points, we performed a repeated-measures ANOVA using IBM's SPSS version 27. P<0.05 was considered significant. We observed an increase of 40 on the Rotarod from baseline for the EXP group, whereas CON showed a decrease of 29 (p=0.03). The EXP group also improved by 50 on the wire hang test while CON did 24 worse compared to baseline (p=0.03). No significant changes were observed for the treadmill and climbing tests. PAC-1 supplementation over four weeks showed significant improvements on grip strength and motor control, two main components of FC. These results could be clinically meaningful and we plan on investigating these effects in humans in the near future.

NutritionExerciseChronic disease
Elderly patients with cancer cachexia experience different levels of symptom burden when compared to middle-aged and young patients

Introduction: Cancer cachexia is a syndrome characterized by muscle wasting and carries a heavy symptom burden. It is currently unknown whether or not elderly patients have similar symptom burden, nutritional issues, and distress as younger patients. The aim of this study is to provide critical information on the status of elderly cancer patients with cachexia and compare differences between patients considered as young (Y; < 50 y), middle-aged (M; 50 - 69 y), and elderly (E; ≥ 70 y).

Methods: To appropriately assess the status of young (n=18), middle-aged (n=106), and elderly patients (n=101), a retrospective chart review has been performed on data collected from the Distress Thermometer (DT) and accompanying Canadian Problem Checklist (CPC), the revised Edmonton Symptom Assessment System (ESAS-r) questionnaire and the abridged Patient-Generated Subjective Global Assessment (aPG-SGA). A 1x3 ANOVA was conducted on the dependent variables among the age ranges.

Results: Overall, the E patients expressed significantly (p<0.05) less worry about finances, work/school than the Y and M but had greater (p<0.05) worries about coping issues when compared to the M group. The E patients had significantly lower spiritual domain scores (e.g., meaning and purpose of life) than the Y group. With respect to the ESAS-r, the E group felt less nauseated than the Y group (E, 1.77±2.86 vs Y, 3.61±3.50). There were no group differences with respect to the distress thermometer or the aPG-SGA. Conclusion: Elderly cancer patients with cachexia experience different symptom burden than young and middle-aged patients. These age-related disparities should be considered when conducting patient assessments and specialized treatment

AdultsOlder AdultsNutritionExerciseCancer Cachexia
Intraindividual Variability of Proactive Control in Cognitive and Motor Aging

Older adults exhibit a significantly greater risk of falling than young adults partially as a function of normative age-related declines in executive control processes. The Dual Mechanisms of Control model examines age-sensitive executive functions, such as working memory, through the use of proactive and reactive modes of cognitive control [1]. However, age differences in cognitive control processes have yet to be examined in the context of intra-individual variability [2]. Given the known age-related declines in working memory capacity with normative aging, the current research investigated the role of intra-individual variability of proactive control in young and older adults using a computerized AX-CPT paradigm. The importance of postural control within the aging population led to further investigations on the translation of variability to the postural domain, which was examined using an adapted Balance AX-CPT paradigm. Proactive and reactive control were operationalized as anticipatory and compensatory postural adjustments in response to both predictable and unpredictable platform perturbations. An independent indicator of working memory (the Letter Number Sequencing task) significantly predicted our measure of intra-individual variability of proactive control (t = -3.012, p = .004, partial correlation r = -.410), which in turn predicted a moderate but not significant amount of variance in postural variability (partial correlation r = -.240). The present findings overall provide preliminary evidence that working memory processes are involved in age-related declines in postural control.

AdultsOlder Adults
Association between physical activity and psychological distress during COVID-19: A longitudinal study of older adults in Quebec

Background: In response to the COVID-19 pandemic, the Quebec government imposed physical distancing and confinement measures to curb the spread of the SARS-CoV-2 virus. The collateral consequences of these measures may result in increased psychological distress, especially among older adults who are already prone to feelings of isolation and loneliness. Some health behaviours, such as engaging in physical activity (PA), can act as resilience factors against psychological distress [1,2,3]. Therefore, it is important to identify coping strategies that may mitigate the risk of psychological distress in older adults.

Objectives: To examine the association of psychological distress with PA in older adults across three time points during the COVID-19 pandemic, during the first wave (T1-Spring 2020), the first deconfinement period (T2-Summer 2020), and the second confinement period (T3-Fall 2020). 

Methods: Our sample included 577 older adults at T1 (mean age = 79.13 yr, SD=5.43); 390 participants remained involved at T3 (attrition rate: 67.5 ). During telephone-based interviews, participants completed the Kessler Psychological Distress Scale (K-10) to assess psychological distress and the International Physical Activity Questionnaire (IPAQ) to measure PA at each assessment. Total physical activity scores were computed as a weighted average of engagement in walking, moderate, and vigorous exercise (METS). 

Results: There was no significant change in psychological distress scores over time. However, PA significantly decreased over time with total PA significantly lower at T2 and T3 compared to T1. Furthermore, higher levels of PA were associated with reduced psychological distress at each time point, r = -.14 to r = -.18 (p<0.01).

Conclusion: These findings suggest that although psychological distress is not changing across time, individuals engaging in more PA tend to show on average increased resilience against psychological distress during the COVID-19 pandemic.

AdultsOlder AdultsExerciseCOVID-19
Influence of Auditory Load and Beat Perception in Rhythmic Auditory Cueing

Stride time variability is associated with falls among seniors. Adding a secondary task to walking can be detrimental to old adults' gait. Beat perception measured from beat alignment task (BAT) was correlated with better synchronization to the beat in rhythmic auditory cueing (RAC). Also, patients with Parkinson's disease showed to benefit from RAC. It is unknown whether walking performance improved across cognitive load and whether beat perception could benefit RAC in healthy old adults.

Participants were 11 young adults and 5 old adults without cognitive, motor, and sensory impairments. In session 1, participants completed background tasks including BAT. In session 2, they performed walking and listening tasks separately and simultaneously. The complexities of dual-tasks were 1) Simple condition, synchronization of walking to low tones, 2) Moderate condition, to high and low tones, and 3) Complex condition, to high and low while responding to a particular series of tones via a clicker. 

For outcome measures, a negative dual-task cost of stride time variability indicates a facilitation and a positive value, detriments. BAT was scored as the number of correct responses. Overall, older adults showed greater dual-task cost of stride time variability, whereas young adults showed negligible costs. Notably, young adults showed a dual-task facilitation in the Complex condition, supporting that alleviating the internal focus on movement could benefit walking. For old adults, auditory-motor dual-tasks were detrimental due to the allocation of attentional resources. Performance on the BAT differently impacted old adults and young adults across conditions. 

In conclusion, older adults had more variability during dual-task walking compared to walking at preferred speed, therefore did not benefit from RAC. Young adults performed the best in the most complex dual-task. BAT affected the dual-task cost of stride time variability more in older than younger adults.

AdultsOlder Adults
Cancer symptoms and nutritional status are inversely associated with health-related quality of life in patients awaiting liver resection

Introduction: The purpose of this study was to determine associations between health-related quality of life (HRQoL) and functional capacity, body composition, cancer symptoms and nutritional status in patients upon enrolment to a surgical prehabilitation program. 

Methods: This is a sub-analysis of baseline measures from a prehabilitation study for patients with a suspected hepatobiliary cancer awaiting liver resection. All patients performed a six-minute walk test (6MWT) and underwent a full-body dual-energy X-ray absorptiometry scan. We calculated the appendicular skeletal muscle mass index (ASMI) for all patients. Patients completed the revised Edmonton Symptom Assessment System (ESAS-r) questionnaire to measure symptom burden. Patients also completed the abridged Patient-Generated Subjective Global Assessment (aPG-SGA) to determine nutritional status. Finally, patients completed the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire to determine HRQoL. Statistical methods included the Pearson's correlation coefficient and robust univariate regression analysis. 

Results: Thirty-five patients (male=26, age=63.6±11.9 y) were included in this analysis. Mean 6MWT distance was 506.2±100.8 m, ASMI was 6.82±1.09 kg/m2, ESAS-r total score was 13.6±10.6 and aPG-SGA score was 4.8±4.3. The mean FACT-G score was 82.5±13.8. Moderate negative associations with HRQoL were found for symptom burden (ESAS-r: r=-0.63, p<0.001) and nutritional status (aPG-SGA: r=-0.50, p<0.01). A 1.1 unit increase in ESAS-r and a 1.5 unit increase in aPG-SGA scores (denoting deterioration) were associated with a 1-unit deterioration in FACT-G score (R2=0.32 and R2=0.19 respectively). 

Conclusion: HRQoL is negatively affected by cancer symptoms and poor nutritional status in patients awaiting liver resection. Prehabilitation programs for these patients should include a dietary intervention and supportive medical management of cancer symptoms.

Difference in symptom burden and distress among cancer patients undergoing antineoplastic treatment

Introduction: Cancer affects people of all ages. However, factors affecting quality of life may vary among different age groups. The purpose of this study was to assess differences in nutritional status, symptom burden, and distress among cancer patients undergoing antineoplastic treatment.

Methods: A retrospective chart review was conducted in patients referred to the Cancer Rehabilitation Program at the McGill University Health Centre between November 2013 and August 2019. All patients were undergoing cancer treatment at that time. Patients were divided into young (<50 y), middle (50-69 y), and old (≥70 y) age groups. Distress and its contributing factors were assessed using the Distress Thermometer (DT) and the Canadian Problem Checklist (CPC), respectively. Nutritional status was evaluated with the Abridged Patient-Generated Subjective Global Assessment (aPG-SGA) and symptoms with the revised Edmonton Symptom Assessment Scale (ESAS-r).

Results: Sample size was 310 (53 young ;41.9±6.7 y, 163 middle; 60.2±5.4 y, and 94 old; 75.7±4.9 y). There was no significant difference in aPG-SGA total score among different age groups. For ESAS-r scores, fatigue and drowsiness were significantly higher in the young group relative to the middle group (p<0.05). Distress thermometer scores were significantly higher in the young relative to the old group (4.56±2.70 vs 3.35±2.81; p<0.05). Finances and work/school were two factors of distress with the largest differences among age groups. The young group reported significantly more financial and school/work problems relative to the middle and old group. The middle group expressed more frustration and anger than the old, but not the young group.

Conclusion: Fatigue, drowsiness, and problems in practical and emotional domains differed between ages, especially between the young and old groups. This research will contribute towards finding the best suitable treatment for cancer patients by taking age into consideration.

AdultsOlder AdultsNutritionChronic disease
Body Composition and Morphological Asymmetries in University Level Soccer Players

Context: While soccer is considered a lateral dominant sport, few studies have examined if limb dominancy leads to asymmetries in body composition and their possible associations with injury (1). 

Objective: The purpose of this study was to 1) investigate body composition morphological asymmetries in male and female university-level soccer players, and 2) examine whether the degree of body composition asymmetry is associated with lower leg injuries (LLI) and lower back pain (LBP). 

Design: A total of 27 soccer players (12 females, 15 males) from Concordia University were included in the study. Body composition measurements were acquired by dual-energy x-ray absorptiometry (DEXA). A self-reported questionnaire was used to gather demographic information and history of LBP and LLI. 

Results: Our findings revealed some significant side-to-side asymmetries in arm bone mass (p=0.02), arm lean body mass (0.02) and total bone mass (p=0.04) (e.g. all parameters were greater on the right side) in male players, while total lean mass was significantly greater on the left side in female players (p=0.02). The pattern of asymmetry was not consistent between male and females and no asymmetry in the leg or trunk body segments were observed. We found no association between the degree of right-to-left asymmetry with LBP and LLI. 

Conclusion: Lateral dominance and expected morphological asymmetries in university-level soccer players may be attenuated by other factors within the sports that warrant further investigation.

Cellular senescence is similar between regional adipose tissue depots in individuals with obesity and type 2 diabetes

Background: Cellular senescence, cell growth cycle arrest, is a marker of cellular aging. Obesity is considered a disease of accelerated aging as it shares several co-morbidities with aging, such as type 2 diabetes mellitus (T2DM).

Objective: To determine regional differences in markers of cellular senescence and how these compare in obese individuals with and without T2DM. Methods: Pre-menopausal females undergoing bariatric surgery were categorized as obese-metabolically healthy (OB, n=5) or obese-T2DM (DM, n=5). AT biopsies were acquired by needle aspiration (AB & TH) or excised during surgery (VAT). AT was digested with collagenase and pre-adipocytes were sub-sequentially isolated and cultured. Once confluent, cultured cells were fixed with paraformaldehyde and stained for senescence associated- β-galactosidase (SA-β-gal) activity, or immunofluorescence staining which quantified the protein abundance of H2AX (marker of DNA damage), PML nuclear bodies (marker of cellular stress), and P53&P21 (markers of committed senescent state). 

Results: Regional differences in SA-β-gal were observed in OB but not DM where TH had greater (AB: p=0.01, VAT: p=0.05) SA-β-gal emittance than AB and VAT (AB: 1.48±0.21, TH: 3.61±0.47, VAT: 2.16±0.62). Regional differences in the number of H2AX foci were observed in DM and not OB, where VAT has less (AB: p=0.02, TH: p=0.04) H2AX foci than AB and TH (AB: 2.05±0.04, TH: 0.22±0.03, VAT: 0.12±0.02). Comparing OB to DM, OB TH had greater (p<0.01 & p<0.01) p53 and p21 mean fluorescence (0.07±0.001 vs. 0.06±0.001 and 0.07±0.01 vs. 0.05±0.01, respectively). OB AB also had greater (p=0.03) p53 mean fluorescence than DM AB (0.07±0.01 vs. 0.06±0.001). 

Conclusion: There were no OB/DM or regional differences in PML. Subcutaneous AT depots are positive for more cellular senescence markers than VAT. Many regional patterns of senescence are similar between OB and DM however, overall OB participants had greater levels of senescence.

Chronic disease
Heart Rate Recovery & Oxygen Recovery Kinetics in Individuals with Comorbid Insomnia and Obstructive Sleep Apnea Before and After Exercise alone or in combination with Cognitive Behavioural Therapy for Insomnia

Background: Recovery kinetics following cardiopulmonary exercise testing (CPET) have yet not been described in people with OSA and comorbid insomnia (COMISA). Our objectives were to i) describe heart rate recovery (HRR), oxygen recovery slopes (VO2/t) and time to half recovery of VO2max (T½) following CPET in COMISA; and ii) investigate their response to either one of the following: 16 weeks of exercise training (Ex) or 8 week-relaxation control intervention followed by 8 weeks of exercise and cognitive-behavioural therapy for insomnia (CBTi-Ex).Ex consisted of 3 weekly sessions of aerobic and resistance training. The CBTi-Ex program included the same exercise plan in addition to four 60 minutes modules (each offered every other week) emphasizing proper sleep behavioural principles.

Methods: Participants with COMISA underwent 3 maximal exercise tests on a cycle ergometer pre- (n=17), mid- (Ex n=6, CBTi-Ex n=8), post-intervention (Ex n=7, CBTi-Ex n=8). HRR and VO2/t (at minutes 1, 2 and 5), and T½ were calculated post- peak exercise intensity. Descriptive statistics [Mean (SD)] and repeated measures ANOVA were used.

Results: At baseline, HRR at minutes 1, 2 and 5 were 20(7), 35(8), 49(13) bpm, respectively, VO2/t slopes were 0.731(0.521), 0.590(0.288) and 0.222(0.096) L/min2 respectively and T½ was 97(64) sec. Significant time effects with large effect sizes were found pre- to post- intervention for VO2/t 2 (p = 0.045; partial eta squared (ηp2) = 0.275) and VO/t 5 (p = 0.017; ηp2 = 0.367). Large effect size of time by group interaction was found pre- to mid- intervention for HRR 5 (ηp2 = 0.232).

Conclusion: Despite people with COMISA showing poor exercise recovery kinetics initially, encouraging improvements in oxygen kinetics obtained through Ex or CBTi-Ex confirm the relevance of those interventions on COMISA, and should motivate similar studies including larger sample size and stricter recovery protocols to be done.

AdultsOlder AdultsSleepExerciseChronic disease
In Vivo Investigate the Effect of the Lactate on the Apoptosis, Necrosis, and Survival of the of Peripheral Blood Mononuclear Cells

Background: Different exercise intensity has a various effect on the immune system. Lactate is one of the factors that releases in exercise, on one hand, higher lactate concentration not also apoptosis of peripheral blood mononuclear cells (PBMCs) decrease but also the survival of the PBMCs increase (Elsaser et al., 2017), on the other hand, lactate enhance proinflammatory cytokines in the lymphocytes (Pedersen, 2000). 

Methods: In this study, ten sedentary young women aged 22 to 29 years performed walking or running on the treadmill at either 60 percent and 90 percent of maximal heart rate (HRmax). After two weeks, subjects switched crossover their groups and began working with other intensity, 60 or 90 percent, that they did not do the last two weeks. Blood samples were taken before and five minutes after the test for measuring lactate level, apoptosis, necrosis, and survival of peripheral blood mononuclear cells (PBMCs). 

Results: The main effect of the two different types of the intensity of the exercise on the lactate was statistically significant (p< 0.001). Moreover, the main effect of the two different types of the intensity of the exercise on apoptosis and survival of the PBMCs were statistically significant (p< 0.031 and p< 0.038, respectively). 

In conclusion, Increase the level of the amount of lactate during the exercise with 90 HRmax may influence the immune system through enhance survival and decrease the apoptosis of the PBMCs.

Heart Rate Variability Before and After an Exercise intervention in Individuals with Comorbid Insomnia and Obstructive Sleep Apnea

Background: Obstructive sleep apnea (OSA) and chronic insomnia frequently coexist, with 39 -58 of the OSA population suffering also from insomnia. This combination known as COMISA has scarcely been studied despite its health impact. The objectives of this study were to: i) characterize heart rate variability (HRV), a non-invasive indicator of autonomic nervous function, in people with COMISA, and ii) compare changes in HRV pre- to post-intervention in this population. 

Methods: Individuals with mild-to-moderate OSA (AHI: 5-30) and comorbid insomnia were recruited, assessed, and randomly assigned to either three weekly sessions of exercise training (Ex) or self-guided relaxation (R) for 8 weeks. HRV was measured from ECG recordings obtained at rest the morning after sleep assessments at baseline (N=6 Ex; N=8 R) and post-intervention (N=5 Ex; N=6 R). ECG was manually inspected and cleaned using an HRV analysis software (Mindware Technologies, USA). HRV indices included time domain measures (SDNN, RMSSD) and frequency domain measures (LF/HF, LF, HF). Descriptive statistics were obtained, and a two-way repeated-measures ANOVA was conducted.

Results: HRV outcomes generally fell within the normal expected range for healthy adults. No significant time-by-intervention interaction or main effect of intervention (exercise vs relaxation) was found. A significant main effect of time (pre to post) was observed for LF/HF (F(1,9) =8.710; p= 0.016) and LF (F(1,9) = 6.380; p= 0.032); both outcomes decreased in 8/11 participants, suggesting an improved HRV.

Conclusion: Individuals with COMISA are characterized with normal HRV when compared to normative values for healthy individuals. Nevertheless, exercise and relaxation training may improve certain HRV outcomes and preserve autonomic function in this population.

AdultsOlder AdultsSleepExerciseChronic disease
Sex differences in cerebrovascular reactivity and cerebral blood flow across the lifespan

Evidence consistently demonstrates that aging is associated with declines to cerebrovascular health. Sex distinctions have been identified as well, where studies have shown that cerebral blood flow (CBF) declines linearly across the lifespan in both sexes, yet females have greater CBF compared to males [1]. Cerebrovascular reactivity (CVR) has also been identified as a marker of cerebrovascular health and is shown to decline with age [1,2], but the potential sex differences are currently unclear. One study using Doppler Ultrasound showed higher CVR values in females compared to males [3], but another study using MRI found the opposite [4]. Given the distinct time course of cerebrovascular disease between sexes, the likely impact of female sex hormones and menopause on cerebrovascular health in females, sex-specific analyses of cerebrovascular health are crucial to further understand the impact of aging on cerebrovascular health. Here, we investigated the time-course of cerebrovascular aging in adult females across five decades of life.

MRI acquisitions were completed as part of larger studies wherein 62 females participated. A T1 sequence was acquired as was a pseudo-continuous arterial spin labelling sequence at rest and during a hypercapnia manipulation. Resting CBF and CVR maps were estimated after preprocessing and registered to MNI space. Regression analyses, accounting for age and education, revealed a significant negative relationship between age and CBF, as well as CVR.

Our results confirm cerebrovascular health declines in females during the healthy aging process, for both CBF and CVR. This is likely due to changes in vascular stiffness during aging [5]. The role of sex hormones in mediating these changes should be ascertained in future cross-sectional and longitudinal studies. Finally, similar studies should investigate the effects of aging and hormones in males to obtain a comprehensive picture of healthy cerebrovascular aging across the population.

Effects of Multicomponent Injury Prevention Strategies on the Biomechanics and Neuromuscular Performance of Fundamental Movement Skills in Children and Adolescents

Background: Promoting physical activity (PA) is a global objective; however, participating in PA has an inherent injury risk. Injury prevention strategies (IPS) aim at reducing injury risk and enhancing physical fitness. Fundamental movement skills (FMS) are commonly used in IPS and physical literacy, which focuses in promoting lifelong PA. Understanding the overall effect of IPS on FMS may help to promote PA safely.
Objective: To summarize the evidence on the effects of IPS on the biomechanics and neuromuscular performance of FMS in children and adolescents.

Methods: We conducted a systematic review with meta-analysis of four databases (PubMed, SPORTDiscus, Web of Science, SCOPUS). We included randomized controlled trials analyzing the effects of IPS in injury-free participants younger than 18 years of age. We evaluated eligibility and methodological quality and extracted means and standard deviations for each outcome. We used the inverse-variance random-effects model for the statistical analyses.

Results: We included 29 studies conducted on 1487 participants (median age 13.7 years; range [10.0,17.3]). Studies reported positive effects of IPS on lower limb biomechanics and postural stability. IPS induced positive effects on vertical jump (g=0.38; 95 CI[0.23,0.52]; p< 0.01), basic speed (g=0.47;95 CI[0.05,0.90];p=0.03), acceleration (g=0.65; 95 CI[0.06,1.25]; p<0.03), dynamic balance (g=0.20; 95 CI[-0.01,0.41]; p=0.06), and dribbling (g=0.25; 95 CI[-0.58,2.31]; p<0.45). We did not observe a positive effect in Horizontal jump (g=-0.04; 95 CI[-0.28,0.20]; p<0.45). Subgroup analyses showed significant differences (p<0.01) only for intervention type in basic speed and dynamic balance.

Conclusion: Including IPS in different contexts (e.g., physical literacy, physical education) may help to promote PA safely. IPS can lead to functional and structural adaptations that may reduce potential biomechanical risk factors for injury and improve neuromuscular performance of FMS.

ChildrenTeensExerciseInjury Prevention
Investigating Remotely Delivered Strategies that Promote Physical Activity Participation in Community-Dwelling Older Adults: A Scoping Review

The effects of physical inactivity among older adults have been established as a "public health crisis" because of their heightened risk of cardiovascular, autoimmune, neurocognitive, and mental health problems (Wu, 2020). While physical distancing is essential in the fight against COVID-19, long-term self-isolation protocols established to protect the elderly population have created new health risks, as older adults are now left more socially isolated and inactive than before. Making an investment in physically distant human connection is crucial to enable community-dwelling older adults to age-in-place independently. Further, public health officials have has identified a need to transition to remote methods to best support older adults and recognize that remote public health measures should be taken long-term. The purpose of this systematic review is to identify current remotely delivered strategies that best engages community-dwelling older adults to participate in physical activity during and beyond the COVID-19 Pandemic. A standardized approach outlined by Levac et al. was followed to complete a scoping review (Levec et al., 2010). At least three reviewers were involved in the screening process to correct for potential bias using the Covidence Platform. All reviews included in the data extraction process identified outcomes pertaining to increasing physical activity levels. This project confirms the effectiveness of remotely delivered strategies that are multi-faceted to promote physical activity for community-dwelling older adults. The effectiveness of the interventions seemed to be tied to the following themes - presence of ongoing social support, availability of personalized educational content and tailored advice, goal-setting modalities and journaling behaviours, and intervention useability.

AdultsOlder Adults
Measurement of Centre of Pressure using the Wii Balance Board in Older Adults with Simulated Visual Impairment

Postural stability is a complex skill dependent upon the coordination of motor, sensory and cognitive systems (Woollacott & Shumway-Cook, 2002). The purpose of this project was therefore to explore how older adults' balance performance is impacted by increased cognitive load, hearing loss, and simulated vision loss. Twenty-seven older adults between the ages of 56 and 90 years (M = 74.74, SD = 9.51) were tested. Participants underwent standard sensory acuity, and cognitive functioning tests. The balance trials varied as a function of cognitive load and visual challenge resulting in five conditions: (1) eyes closed, (2) normal vision clear goggles (NV), (3) simulated low vision goggles (LV), (4) NV and math task, (5) LV and math task. Postural stability was assessed with three key center of pressure parameters: total path length (TPL), anterior-posterior amplitude (APA) and medial-lateral amplitude (MLA). Significant effects of balance complexity were observed in anterior-posterior sway amplitude (p < .017), while MLA (p < .08) and TPL approached significance (p < .107). T-tests revealed significant (p < .05) decreases in balance performance across all 3 centre of pressure parameters when comparing single-task NV to dual-task NV, single-task NV vs. eyes closed and single-task NV vs. low vision dual-task.

There were significant positive correlations between hearing loss and balance (MLA) under single-task normal vision (r = .517) and low vision goggle conditions (r = .498). Results suggest the attentional demands from increased cognitive load and sensory loss lead to decreases in older adults' single- and dual-task balance performance. Finally, older adults with age-related hearing loss seemed to prioritize the cognitive task over the postural task, resulting in cognitive facilitation. This prioritization may be an ineffective dual-task strategy putting older adults with age-related hearing loss at risk of falling.

AdultsOlder Adults
White matter microstructure associated with functional connectivity changes following short-term learning of a visuomotor sequence

Efficient neural transmission is crucial for optimal brain function, yet the plastic potential of white matter (WM) has long been overlooked. Growing evidence now shows that modifications to axons and myelin occur not only as a result of long-term learning, but also after short training periods [1]. Motor sequence learning (MSL) has been shown to occur in overlapping learning stages where different neural circuits are involved at each stage [2]. However, most studies investigating short-term WM plasticity have used a pre-post design, in which the temporal dynamics of changes across learning stages cannot be assessed [1,3]. In this study, we used multiple magnetic resonance imaging (MRI) scans at 7 Tesla to investigate changes in WM in a group learning a complex visuomotor sequence (LRN) and in a control group (SMP) performing a simple sequence, for 5 consecutive days. Consistent with behavioural results, where most improvements occurred between the two first days, structural changes in WM were observed only in the early phase of learning (d1-d2), and in overall learning (d1-d5). In LRNs, WM microstructure was altered in the tracts underlying the primary motor and sensorimotor cortices. Moreover, our structural findings in WM were related to changes in functional connectivity, assessed with resting-state functional MRI data in the same cohort. Significant changes in WM microstructure were found in a region of interest underlying the right supplementary motor area, where a decrease in functional connectivity was also found [4]. Together, our findings provide evidence for highly dynamic WM plasticity in the sensorimotor network during short-term MSL, where the SMA would play a key role in linking the spatial and motor aspects of MSL [2,5]. A better understanding of how learning can structurally shape neural networks could have important implications in other fields of research such as in stroke rehabilitation, to optimize interventions through motor learning.

AdultsNeuroscienceBrain Plasticity
The Belief in Health Benefits of Digital Play Modulates Physiological Responses to Games Played for Cognitive Benefits

Background: To create games that target older adults' interests in engaging in cognitively-boosting activities is a rising trend [1,2]. But, the novelty of the digital me-dium of play, and the implicit expectation of cognitive performance can create stressful experiences for them [3]. We have previously proposed an empirical framework, Affective Game Planning for Health Applications (AGPHA) based on Lazarus's Transactional Theory of Stress Appraisal and Coping [4], to study interactions between primary appraisal (PA) and secondary appraisal (SA) of game challenge in relation to individual beliefs, and their cognitive and physiological abilities, to predict whether players will adopt the intervention in their lifestyle. 

bjective: The current study aimed to examine the sensitivity of the AGPHA framework to detect a relationship between PA of the health-benefits of digital play and subsequent physiological responses to the game experience, in predicting SA factors that modulate stress and the desire to replay.

Material and Methods: 18 healthy older adults (65+) participated in a repeated-measures study involving playing three types of presumably cognition-benefiting games (brain training, car racing and exercise game), while monitoring their physiological (EDA, HR, cortisol), and administering game-experience and STAI questionnaires after each session.

Results: PA had a significant effect on physiological measures during play. Physiological variations explained differences in SA variables of games benefits in terms of mental health and cognitive stimulation, but not with subjective perception of game difficulty. Finally, interactions between physiological and SA factors were more sensitive predictors of the desire to replay than were physiological factors or SA alone.

Conclusion: Our findings show that AGPHA provides a suitable framework for investigating the interactions between appraisal of interventions, and physiological and experiential responses to them.

Older Adults
The Potential of Probiotics in Preventing Diet-Induced Mitochondrial Dysfunction

According to the oxidative stress theory, reactive species are key drivers of inflammation and cardiovascular disease (1). The electron transport chain of the mitochondria accounts for ≈90 of the intracellular radioactive oxygen species (2). Interestingly, while low-carbohydrate high-protein diets promote weight loss, animal experiments show that they could also lead to mitochondrial dysfunction and therefore, oxidative stress and inflammation (3). In parallel, research in the last decade has unravelled the role of the healthy gut microbiome in preventing diseases, and probiotic supplements that alter the gut's composition show promise as a nutraceutical intervention to improve systemic low-grade inflammation, oxidative stress, body weight as well as insulin resistance and blood lipids (4,5). The objective of the study was to evaluate the potential of anti-inflammatory probiotics (B. Bifidum Rossel-71 and L. Helveticus) in preventing mitochondrial dysfunction. Apolipoprotein-E knockout mice were placed in 3 diet groups including a control, western type (high fat and carbohydrates), and low-carbohydrate high-protein diet. Each group was then further divided in 3 subgroups based on the dose of probiotics administered, including a control, low (0.5 B/does) and high (5 B/dose) dose of probiotics, for a total of 9 groups. Mitochondrial respiration data will be shown for 4-8 animals/group from our ongoing study. The animals' body weight and water consumption were monitored weekly. After 6 weeks, the liver's mitochondrial function was analyzed in depth using a sequential substrate addition protocol. This project will contribute to our understanding of the potential of probiotics in preventing oxidative stress, which could have immense economic and clinical implications.

NutritionChronic disease
Acute Effects of Urolithin A on Mitochondrial Respiration in Vascular Smooth Muscle Cells of ApoE-/- Mice

Background: During atherosclerotic plaque development, vascular smooth muscle cells (VSMC) undergo dedifferentiation, resulting in a synthetic, less contractile progenitor state. This transition is marked by changes in mitochondrial respiration and increased reactive oxygen species (ROS) production. These changes in bioenergetics play a critical role in atherogenesis via facilitation of VSMC migration towards the intima. 

Objective: The objective of this study was to evaluate the effect Urolithin A (UA), an antioxidant, has on mitochondrial respiration in VSMCs derived from a murine model of atherosclerosis.

Methods: Tissue samples of the descending aorta were extracted from 1-2-month-old ApoE-/- mice. The exposure group (EXP) received 0.0398 mg of UA per mg of aortic tissue while only the vehicle, Dimethyl Sulfoxide (DMSO), was added to the control group (CON). Complex I of the electron transport chain was then activated in an ADP restricted environment via sequential addition of malate (2 mM), pyruvate (6 mM), and glutamate (10 mM). ATP synthase and Complex II were activated via addition of ADP (5 mM) and succinate (10 mM) respectively. Integrity of the outer mitochondrial membrane was tested by addition of cytochrome C (10 μM).

Results: Addition of UA significantly reduced maximal mitochondrial respiration during parallel electron transport through Complex I and II with a mean decrease of 2.665 pmol/s*mg (p<0.05) compared to the CON group. A trend towards reduced Complex V mediated respiration in the EXP group compared to the CON was also observed with a mean difference of 0.7807 pmol/s*mg (p=0.377), along with a decrease in the acceptor control ratio (ACR) of the EXP group with a mean difference of 0.6663 (p=0.112) compared to the CON group.

Conclusions: Acute exposure of UA in aortic VSMCs significantly reduces complex II respiration however, further research

NutritionChronic disease
Art-based Rehabilitation Therapy (ART) for Sensorimotor Recovery Post-stroke: A Pilot Study

Post stroke, ~85 of survivors present with upper limb (UL) contralateral hemiparesis (Dobkin, 2003). There has been a sufficient amount of literature that suggests that intense rehabilitation is beneficial to patient functional recovery, but at best, individuals receive only one hour of therapy per day, with only a portion of this time focused on the arm and hand. Furthermore, therapy commonly includes less than a 100 actual movements per session (Lang et al., 2007; Waddell et al., 2014). This low number of repetitions is at odds with studies on motor learning where many thousands of volitional motor actions are required to regain good motor skills. 

A potential strategy to increase motor repetitions is Art-based Rehabilitation Therapy (ART), a novel therapeutic intervention that has been introduced at Providence Care Hospital (PCH). The ART program acts as an adjunct to conventional therapies and works to promote upper limb sensorimotor recovery by engaging participants in task-directed, frequent, challenging activities, while augmenting overall the intensity of UL therapy. This pilot program includes a series of art lessons that begins with basic motor skills needed to draw lines and then progresses to drawing more complex objects.

We recruited over 30 individuals from PCH to assess the feasibility and potential benefits of art therapy. Feasibility was assessed by several measures (i.e. ART program completion rate, participant feedback). Secondly, we quantified the amount of movement generated during Art Therapy sessions using accelerometers on a subset of participants. sensorimotor and cognitive functions were assessed using the Kinarm robot, as well as traditional clinical measures of motor impairment (Chedoke-McMaster Stroke Assessment, Functional Independence Measure). Preliminary results suggest that ART is an enjoyable and feasible UL therapy capable of augmenting upper limb therapy activity.

NeuroscienceRehabilitation Science
Loneliness and sleep quality during the COVID-19 pandemic: A longitudinal study

Although social distancing directives are important public health measures to reduce the spread of SARS-cov-2, they can contribute to negative emotional outcomes such as loneliness due to the isolation. Furthermore, individuals have been reporting poorer sleep quality since the beginning of the COVID-19 pandemic. The aim of this study is to investigate the association between loneliness and sleep quality during the COVID-19 confinement. About 136 female participants (Mage = 50.55, SD = 6.0) completed Loneliness Scale, Pittsburg Sleep Quality Index, and a homemade measure of COVID-related worries one week and one month after the confinement measures were established in Quebec, and during the deconfinement period following the first wave of the epidemic. During the first week of confinement, loneliness explained a significant proportion of variance in sleep quality scores, R2=.11, F(4,131)=3.97, p<.01 when controlled for age, chronic health condition, and financial worry due to the pandemic. Sleep quality increased by .215 standard deviations for each standard deviation unit increase in loneliness above and beyond the other variables. However, loneliness did not predict change in sleep quality over time. Therefore, increased loneliness is associated with poorer sleep quality early in the pandemic. The results suggest that increasing social connectedness during periods of confinement may improve sleep quality.

The Child Focused Injury Risk Screening Tool (ChildFIRST) - Normative Values, Correlations, and Sex Differences for a group of Children aged 8-12.

Childhood obesity and physical inactivity are growing problems across Canada, so the concept of physical literacy is used to promote physical activity (PA) participation in children. When children increase their PA participation, their exposure to musculoskeletal injury is also increased, but the concepts of physical literacy do not address injury prevention concepts. The Child Focused Injury Risk Screening Tool (ChildFIRST) is a novel process-based assessment of movement competence and injury risk for children aged 8-12 years of age. The ChildFIRST has 10 movement skills with 4 evaluation criteria for each movement. The ChildFIRST has validity and reliability evidence, but no normative data. The purpose of this study is to establish norms and trends in the 8-12 age group. 

A cross-sectional design was used to evaluate 146 participants aged 8-12 years. There were 3 modes for participation, in-person, live online evaluation, or video upload. Participants viewed a demonstration of the movement skills. After the a demonstration, the child performed the movement until all movements were completed. 

All movements were normally distributed except running.  No significant differences between males and females were identified except for the single leg sideways hop and hold. Higher levels of PA participation were positively associated with higher scores on the ChildFIRST. Higher BMI was negatively associated with lower scores on the vertical jump and bodyweight squat movement.

This is the first study to present normative data for the ChildFIRST. The findings are support the utility of the ChildFIRST in the 8-12 age group. The ChildFIRST demonstrated the ability to distinguish between higher and lower levels of movement competence. Children who reported higher weekly PA levels scored higher on the ChildFIRST. The normative data in this study can be used by physical education teachers, clinicians, and other users to compare individual data to scores on the ChildFIRST.

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