Muscle strength and physical performance as predictors of mortality, hospitalization, and disability in the oldest old. A step towards understanding the mechanisms of running-related injuries. Physical fitness as a protective factor for cognitive impairment in a prospective population-based study in Germany. Risk factors of acute and overuse musculoskeletal injuries among young conscripts: a population-based cohort study Strength and endurance training in the treatment of lung cancer patients in stages IIIA/IIIB/IV A multicentre year-long randomised controlled trial of exercise training targeting physical functioning in men with prostate cancer previously treated with androgen suppression and radiation from TROG 03.04 RADAR. The relationship between pre-season fitness testing and injury in elite junior Australian football players. Changes in Physical Fitness Predict Improvements in Modifiable Cardiovascular Risk Factors Independently of Body Weight Loss in Subjects With Type 2 Diabetes Participating in the Italian Diabetes and Exercise Study (IDES) Effect of a general fitness program on musculoskeletal symptoms, clinical status, physiological capacity, and perceived work environment among home care service personnel The relationship of joint symptoms with exercise performance in older adults. Effect of physical exercise training on muscle strength and body composition, and their association with functional capacity and quality of life in patients with atrial fibrillation: a randomized controlled trial. Influence of acute endurance activity on leg neuromuscular and musculoskeletal performance. Endurance training in MS: short-term immune responses and their relation to cardiorespiratory fitness, health-related quality of life, and fatigue Physical activity, muscle function, falls and fractures Randomized Controlled Trial of a Structured Training Program in Breast Cancer Patients with Tumor-Related Chronic Fatigue Skeletal muscle strength and endurance in patients with mild COPD and the effects of weight training. Regular participation in sports is associated with enhanced physical fitness and lower fat mass in prepubertal boys
OBJECTIVES To evaluate the predictive value of muscle strength and physical performance in the oldest old for all-cause mortality ; hospitalization ; and the onset of disability , defined as a decline in activities of daily living ( ADLs ) , independent of muscle mass , inflammatory markers , and comorbidities . DESIGN A prospect i ve , observational , population -based follow-up study . SETTING Three well-circumscribed areas of Belgium . PARTICIPANTS Five hundred sixty participants aged 80 and older were followed for 33.5 months ( interquartile range 31.1 - 35.6 months ) . MEASUREMENTS  Grip strength , Short Physical Performance Battery ( SPPB ) score , and muscle mass  were measured at baseline ; ADLs at baseline and after 20 months ; and all-cause mortality and time to first hospitalization from inclusion onward . Kaplan-Meier curves and Cox proportional hazards models were calculated for all-cause mortality and hospitalization . Logistic regression analysis was used to determine predictors of decline in ADLs . RESULTS Kaplan-Meier curves showed significantly higher all-cause mortality and hospitalization in subjects in the lowest tertile of grip strength and SPPB score . The adjusted Cox proportional hazards model showed that participants with high grip strength or a high SPPB score had a lower risk of mortality and hospitalization , independent of muscle mass , inflammatory markers , and comorbidity . A relationship was found between SPPB score and decline in ADLs , independent of muscle mass , inflammation , and comorbidity . CONCLUSION In people aged 80 and older , physical performance is a strong predictor of mortality , hospitalization , and disability , and muscle strength is a strong predictor of mortality and hospitalization . All of these relationships were independent of muscle mass , inflammatory markers , and comorbidity OBJECTIVES To investigate the association between training-related characteristics and running-related injury using a new conceptual model for running-related injury generation , focusing on the synergy between training load and previous injuries , short-term running experience or body mass index ( > or < 25 kg m(-2 ) ) . DESIGN Prospect i ve cohort study with a 9-month follow-up . METHODS The data of two previous studies using the same methodology were revisited . Recreational runners ( n = 517 ) reported information about running training characteristics ( weekly distance , frequency , speed ) , other sport participation and injuries on a dedicated internet platform  . Weekly volume ( dichotomized into < 2h and ≥ 2 h ) and session frequency ( dichotomized into < 2 and ≥ 2 ) were the main exposures because they were considered necessary causes for running-related injury . Non-training-related characteristics were included in Cox regression analyses as effect-measure modifiers . Hazard ratio was the measure of association . The size of effect-measure modification was calculated as the relative excess risk due to interaction . RESULTS One hundred sixty-seven runners reported a running-related injury . Crude analyses revealed that weekly volume < 2h ( hazard ratio = 3.29 ; 95 % confidence intervals = 2.27 ; 4.79 ) and weekly session frequency < 2 ( hazard ratio = 2.41 ; 95 % confidence intervals = 1.71 ; 3.42 ) were associated with increased injury rate . Previous injury was identified as an effect-measure modifier on weekly volume ( relative excess risk due to interaction = 4.69 ; 95 % confidence intervals = 1.42 ; 7.95 ; p = 0.005 ) and session frequency ( relative excess risk due to interaction = 2.44 ; 95 % confidence intervals = 0.48 ; 4.39 ; p = 0.015 ) . A negative synergy was found between body mass index and weekly volume ( relative excess risk due to interaction = -2.88 ; 95 % confidence intervals = -5.10 ; -0.66 ; p = 0.018 ) . CONCLUSIONS The effect of a runner 's training load on running-related injury is influenced by body mass index and previous injury . These results show the importance to distinguish between confounding and effect-measure modification in running-related injury research To evaluate the predictive effects of subjective measures of physical activity ( PA ) and objective measures of physical fitness ( PF ) on dementia risk , Participants of the prospect i ve population -based ILSE- study ( * 1930 - 1932 ; 12-year follow-up ) were examined at three examination waves ( t1 : 1993/94 ; t2 : 1997/98 ; t3 : 2005/07 ) . 381 subjects of the original cohort ( n = 500 ) were re-examined at t3 . 29 % of the subjects who were cognitively healthy at baseline received the diagnosis of mild cognitive impairment ( MCI ) and 7 % of Alzheimer 's disease ( AD ) . Subjects were screened for physical and mental health using medical interviews , physical , and neuropsychological examinations . Participants completed a question naire on their current and past PA at t1 . Subjects were classified as physically active if they reported a regular sport activity for at least 2 hours per week in the past year . Muscular strength ( h and grip ) and motor coordination ( balance ) served as objective indicators of PF . Subjects who passed the balance-test at t1 had a reduced risk of developing MCI/AD at t3 ( OR = 0.35 , 95%CI 0.19 - 0.66 , p < 0.01 ) and performed significantly better on various neuropsychological measures . Muscular strength or subjective reports of PA did not predict MCI/AD development . Our results confirm the hypothesis that PF acts as a protective factor for the development of cognitive disorders . In our study , context , motor coordination served as a better predictor than muscular strength or self-rated PA . Since subjects with cognitive disorders due to cerebral and /or systemic disorders were excluded from the analyses , our findings suggest that the effect of skill-related PF extends beyond the reduction of cardiovascular risk factors Background Military service in Finl and is compulsory for all male citizens and annually about 80 % of 19-year-old men enter into the service . The elevated risk for many chronic diseases and loss of function among those who are inactive and unfit can be often detected already in youth . On the other h and , activity-induced injuries among young are true public health issue . The purpose of the present prospect i ve cohort follow-up study was to evaluate predictive associations between acute or overuse injuries and their various intrinsic risk factors . Methods Four successive cohorts of conscripts who formed a representative sample of Finnish young men were followed for 6 months . At the beginning of the service , the risk factors of injuries were measured and recorded and then the acute and overuse injuries treated at the garrison clinic were identified . Predictive associations between injuries and their risk factors were examined by multivariate Cox ’s proportional hazard models . Results Of the 1411 participants , 27 % sustained an acute injury and 51 % suffered from overuse injury . Concerning acute injuries , highest risk for severe injuries were detected among conscripts with low fitness level in both the st and ing long-jump and push-up tests ( hazard rate , HR=5.9 ; 95 % CI : 1.6‒21.3 ) . A history of good degree in school sports was not a protective factor against acute injuries . High waist circumference and , on the other h and , being underweight according to BMI increased the HR for overuse injuries . Brisk leisure time physical activity before military entry was a protective factor against overuse injuries . Poor result in Cooper ’s test was a warning signal of elevated risk of overuse injuries . Conclusion We confirmed previous findings that low level of physical fitness is predictor for musculoskeletal injuries during intensive physical training . The U-shaped relationship between body composition and overuse injuries was noticed indicating that both obesity and underweight are risk factors for overuse injuries . Persons with excellent sports skills according to their earlier degrees in school sports had similar HR for acute injuries than those with poorer degrees . This indicates that school-age sports skills and fitness do not carry far and therefore preventive programmes are needed to prevent activity-induced injuries Purpose This r and omized controlled trial tested the effects of a specially design ed strength and endurance training on the independence and quality of life in lung cancer patients in stages IIIA/IIIB/IV during palliative chemotherapy . Methods Between August 2010 and December 2011 , 46 patients were r and omized into two groups receiving either conventional physiotherapy or special physiotherapeutic training . The Barthel Index served as primary endpoint . The secondary endpoints were the European Organization for Research and Treatment of Cancer Quality of Life Question naire Core-30 ( EORTC QLQ C-30/LC-13 ) question naire , the 6-Minute Walk Test ( 6MWT ) , stair walking , the Modified Borg Scale , and muscle strength . Nonparametrical data were analyzed with the Wilcoxon and Mann – Whitney U test . For parametric , data student t tests were used . A p value of ≤.05 was accepted . Results Twenty-nine patients completed the trial ( Intervention group ( IG ) , n = 18 ; control group ( CG ) , n = 11 ) . Significant differences were detectable in the Barthel Index ( IGmean = 92.08 ; CGmean = 81.67 ; p = .041 ) , in single scores of the EORTC QLQ C-30/LC-13 question naire ( physical functioning , p = .025 ; hemoptysis , p = .019 ; pain in arms or shoulder , p = .048 ; peripheral neuropathy , p = .050 ; cognitive functioning , p = .050 ) , in the 6MWT , stair walking , strength capacity , and in the patient ’s dyspnoea perception during submaximal walking activities ( IG > CG ) . Conclusion According to these findings , lung cancer patients should receive enhanced physical activity intervention during palliative chemotherapy BACKGROUND Long-term prostate cancer ( PCa ) survivors are at increased risk for comorbidities and physical deconditioning . OBJECTIVE To determine the effectiveness of a year-long r and omised controlled trial of exercise training in PCa survivors > 5 yr postdiagnosis on physical functioning . DESIGN , SETTING , AND PARTICIPANTS Between 2010 and 2011 , 100 long-term PCa survivors from Trans-Tasman Radiation Oncology Group 03.04 R and omised And rogen Deprivation and Radiotherapy previously treated with and rogen-deprivation therapy and radiation therapy were r and omly assigned to 6 mo of supervised exercise followed by 6 mo of a home-based maintenance programme ( n=50 ) or printed educational material about physical activity ( n=50 ) for 12 mo across 13 university-affiliated exercise clinics in Australia and New Zeal and . INTERVENTION Supervised resistance and aerobic exercise or printed educational material about physical activity . OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The primary end point was a 400-m walk as a measure of cardiovascular fitness . Secondary end points were physical function , patient-reported outcomes , muscle strength , body composition , and biomarkers . Analysis of covariance was used to compare outcomes for groups at 6 and 12 mo adjusted for baseline values . RESULTS AND LIMITATIONS Participants undergoing supervised exercise showed improvement in cardiorespiratory fitness performance at 6 mo ( -19 s [ p=0.029 ] ) and 12 mo ( -13 s [ p=0.028 ] ) and better lower-body physical function across the 12-mo period ( p<0.01 ) . Supervised exercise also improved self-reported physical functioning at 6 ( p=.006 ) and 12 mo ( p=0.002 ) , appendicular skeletal muscle at 6 mo ( p=0.019 ) , and objective measures of muscle strength at 6 and 12 mo ( p<0.050 ) . Limitations included the restricted number of participants undertaking body composition assessment , no blinding to group assignment for physical functioning measures , and inclusion of well-functioning individuals . CONCLUSIONS Supervised exercise training in long-term PCa survivors is more effective than physical activity educational material for increasing cardiorespiratory fitness , physical function , muscle strength , and self-reported physical functioning at 6 mo . Importantly , these benefits were maintained in the long term with a home-based programme with follow-up at 12 mo . CLINICAL TRIAL REGISTRY The effect of an exercise intervention on cardiovascular and metabolic risk factors in prostate cancer patients from the RADAR study , ACTRN : ACTRN12609000729224 OBJECTIVES Australian Football ( AF ) is a collision sport containing high injury rates in junior competition . Successful performance at the elite junior level not only requires superior specific football knowledge and skills , but also well developed fitness qualities . However , no studies have examined the link between physical fitness qualities and injury in AF . DESIGN Prospect i ve cohort . METHODS Injury data were collected through the use of a Player Movement Record ( PMR ) and a st and ardized Injury Report Form ( IRF ) . Fitness test data was collected during the pre-season of the 2010 and 2011 seasons . RESULTS 382 players consented to participate in the study . The cohort experienced an injury incidence rate of 24.29/st and ardized club ( 40 players/club ) . A faster 5-m sprint was associated with ' injury status ' ( p=0.016 ) and a ' knee ' region ( p≤0.001 ) injury . A faster planned agility score was associated with an increased risk of a ' hip/groin/thigh ' region ( p=0.010 ) injury , and specifically a ' quadriceps strain ' ( p=0.005 ) . A lower 20-m shuttle run was associated with an increased risk of a ' shin/ankle/foot ' ( p=0.045 ) injury . Increased injury severity was associated with a higher left foot running vertical jump ( VJ ) ( p=0.040 ) , and faster 5-m sprint ( p=0.043 ) . CONCLUSIONS Lower aerobic endurance , faster 5-m acceleration and greater planned agility were associated with an increased risk of various injury types in elite junior AF players . Furthermore , a higher left foot running VJ and faster 5-m acceleration were associated with injury severity . These results may largely relate to a greater work capacity placing a higher load upon the musculoskeletal system in contact and non-contact situations OBJECTIVE Physical fitness is inversely related to mortality in the general population and in subjects with type 2 diabetes . Here , we present data concerning the relationship between changes in physical fitness and modifiable cardiovascular risk factors in subjects with type 2 diabetes from the Italian Diabetes and Exercise Study . RESEARCH DESIGN AND METHODS Sedentary patients with type 2 diabetes ( n = 606 ) were enrolled in 22 outpatient diabetes clinics and r and omized to twice-a-week supervised aerobic and resistance training plus exercise counseling versus counseling alone for 12 months . Baseline to end-of- study changes in cardiorespiratory fitness , strength , and flexibility , as assessed by Vo2max estimation , a 5–8 maximal repetition test , and a hip/trunk flexibility test , respectively , were calculated in the whole cohort , and multiple regression analyses were applied to assess the relationship with cardiovascular risk factors . RESULTS Changes in Vo2max , upper and lower body strength , and flexibility were significantly associated with the variation in the volume of physical activity , HbA1c , BMI , waist circumference , high-sensitivity C-reactive protein ( hs-CRP ) , coronary heart disease ( CHD ) risk score , and inversely , HDL cholesterol . Changes in fitness predicted improvements in HbA1c , waist circumference , HDL cholesterol , hs-CRP , and CHD risk score , independent of study arm , BMI , and in case of strength , also waist circumference . CONCLUSIONS Physical activity/exercise-induced increases in fitness , particularly muscular , predict improvements in cardiovascular risk factors in subjects with type 2 diabetes independently of weight loss , thus indicating the need for targeting fitness in these individuals , particularly in subjects who struggle to lose weight The aim of the present controlled study was to evaluate the effect of a general fitness program , performed by an occupational health service , using pre-post assessment for a number of different outcome measures . A total of 160 employees working in the central home care service district of Umeå , Sweden were asked to participate in a program of a 1-year long exercise program . Of the 160 selected , 54 subjects declined to participate and nine subjects were rejected after a medical check up . The remaining 97 subjects participated in a schedule consisting of pre-post medical and physiotherapy examinations , question naires concerning sociodemography , musculoskeletal and general health complaints and work environment , physiological tests of cardiovascular fitness , and of strength and endurance of shoulder flexors and knee extensors , and registration of sick leave . The subjects were r and omly assigned to an exercise ( treatment ) or control group . The exercise group trained twice a week for 1 year using a mixed program including exercises for coordination , strength/endurance , and fitness . The test schedule was repeated for both groups after 1 year . The exercise intervention was associated with positive changes in prevalence and intensity of musculoskeletal and psychosomatic complaints , better physiotherapy status ( less muscle tightness , better neck mobility , and less tender points ) , increased shoulder strength and increased coordination in thigh muscles . However , the exercise group reported worse situations post-exercise concerning aspects of their physical and psychosocial work-environment ( i.e. , concerning ergonomy , influence , appreciation and communication with work manager ) , which might have been due to stress associated with the exercise situation OBJECTIVES The objective of this study is to determine if exercise increases joint symptoms in older adults with a history of arthritis or produces symptoms in older adults without such history . In addition , we examine whether joint symptoms explain the large observed variation in strength gain in older adults undergoing vigorous strength training exercise  , and report the incidence of musculoskeletal injuries upon initiation of an exercise program . DESIGN A population -based , single blinded , r and omized controlled trial with three exercise groups and one control group . SETTING A large urban health maintenance organization . PARTICIPANTS Older men and women ( N = 105 ) aged 68 to 85 , with leg strength below the 50th percentile for their age , sex , height , and weight and without neuromuscular disease or active cardiovascular disease . INTERVENTIONS Supervised exercise in 1-hour sessions , three times each week , for 24 to 26 weeks . One exercise group did strength training ( ST ) using weight machines ( n = 25 ) ; another group did endurance training ( ET ) using stationary cycles ( n = 25 ) ; and the third group did combined strength training and endurance training ( ST+ET ) ( n = 25 ) . The control group ( n = 30 ) received no intervention . MEASUREMENTS Strength was measured at the ankle , knee , hip , and elbow using an isokinetic dynamometer . Joint symptoms were rated on a 6-point scale ( 0 = none , 5 = severe ) . Arthritis severity was based on self-reported use of arthritis medication . Health status was measured with subscales of the SF-36 and Sickness Impact Profile ( SIP ) . RESULTS Joint symptoms fluctuated over time in all exercise groups , but they did not improve or worsen significantly in any group . The physical dimension of the SIP and SF-36 subscale scores , including Bodily Pain Scores , did not change over time in any group . Subjects with arthritis and joint symptoms gained as much strength with strength training as did subjects without joint symptoms . Adjustment for age , gender , baseline strength , adherence , and exercise group did not affect this finding . The rate of minor musculoskeletal injuries was 2.2 injuries per 1000 exercise hours . CONCLUSIONS Moderate intensity stationary cycle exercise and vigorous intensity strength training do not appear to produce or exacerbate joint symptoms in older adults . Joint symptoms did not explain the large variation in gains in strength in older adults participating in a st and ardized strength training exercise program .  Musculoskeletal injuries occurred relatively infrequently , and no major injuries occurred . In evaluating joint pain that occurs in older adults in well regulated exercise programs , clinicians should consider other etiologies before attributing pain to exercise per se OBJECTIVE Atrial fibrillation diminishes cardiac function , exercise tolerance and quality of life . The objective of this study was to determine whether exercise training in atrial fibrillation affects muscle strength , body composition , maximal exercise capacity and walking capacity positively , thus improving quality of life . DESIGN R and omized clinical trial . Twelve weeks of physical exercise training or control . PATIENTS Forty-nine patients in permanent atrial fibrillation were r and omized to training or control . METHODS Intervention consisted of aerobic training for 1 h 3 times per week at 70 % of maximal exercise capacity vs control . Muscle strength , exercise capacity , 6-minute walk test , lean body mass , fat percentage , and quality of life were assessed . RESULTS Muscle strength increased in the training group ( p = 0.01 ) , but no change was observed in controls . Lean body mass was unchanged in both groups . Fat percentage decreased in both groups , but there was no significant difference between the groups . Exercise capacity improved in the training group ( p < 0.001 ) , with no change in the control group . There was a significant difference after the training period between the training and control groups in terms of exercise capacity . ( p = 0.001 ) . Six-min walk test improved in the training group compared with controls ( p < 0.01 ) . Overall quality of life score , as measured by the Minnesota Living with Heart Failure Question naire , improved in the training group ( p = 0.03 ) . Quality of life , measured by Short Form-36 , improved in the training group in 3 out of 8 subscales : physical functioning ( p = 0.02 ) , general health perceptions ( p = 0.001 ) and vitality ( p = 0.02 ) . CONCLUSION Muscle strength , exercise capacity and quality of life increased with exercise training in subjects with atrial fibrillation . Lean body mass was unchanged PURPOSE The purpose of this study was to investigate the effect of endurance activities design ed to simulate the physiological dem and s of soccer match-play and training , on leg strength , electromechanical delay , and knee laxity . METHODS Eight recreational soccer players completed four exercise trials in r and om order : 1 ) a prolonged intermittent high intensity shuttle run ( PHISR ) which required subjects to complete a total distance of 9600 m in a form simulating the pattern of physical activity in soccer match-play ( activity mode ; rest-to-work intervals ; approximately 90 min duration ) , 2 ) a shuttle-run ( SR ) , ( 3 ) a treadmill run ( TR ) which required subjects to complete an equivalent distance at a running speed corresponding to 70 % VO2max , and 4 ) a control condition consisting of no exercise . RESULTS Results from repeated measures ANOVA revealed significant condition ( PHISR ; SR ; TR ; control ) by time ( pre ; mid ; post ) interactions for peak torque ( PT : knee extension and flexion : 1.05 rad.s-1 ) , EMD and anterior tibio-femoral displacement ( TFD ) ( P < 0.05 ) . Impairment to indices of knee joint performance was observed in PHISR , SR , and TR trials . The greatest decrement occurred in PHISR and SR trials ( up to 44 % ) . Knee extensor and flexor strength performance near to full knee extension ( 0.44 rad knee flexion ) was not changed following the functionally-relevant endurance activities . CONCLUSIONS Even though strength performance near to full knee extension was preserved following acute endurance activities , the risk of ligamentous injury may be increased by concomitant impairment to EMD and anterior TFD The influences of exercise on cytokine response , health-related quality of life ( HR-QoL ) , and fatigue are important aspects of MS rehabilitation . Physical exercises performed within these programs are often practice d in water , but the effects of immersion have not been investigated . To investigate the influences of short-term immune responses and cardiorespiratory fitness on HR-QoL and fatigue during 3 weeks endurance training conducted on a cycle-ergometer or an aquatic-bike . R and omized controlled clinical trial in 60 MS patients .  HR-QoL , fatigue , cardiorespiratory fitness , and short-term immune changes ( serum concentrations in response to cardiopulmonary exercise test ) of brain-derived neurotrophic factor ( BDNF ) , nerve growth factor ( NGF ) , interleukin-6 , and the soluble receptor of IL-6 ( sIL-6R ) were determined at the beginning and end of 3 weeks of training intervention . Subjects performed daily 30 min training at 60 % of their VO2peak . SF-36 total ( p = 0.031 ) , physical ( p = 0.004 ) , and mental health ( p = 0.057 ) scores show time effects within both groups . Between-group effects were shown for FSMC total ( p = 0.040 ) and motor function score ( p = 0.041 ) . MFIS physical fatigue showed time effects ( p = 0.008 ) for both groups . Linear regression models showed relationships between short-term immune responses and cardiorespiratory fitness with HR-QoL and fatigue after the intervention . This study indicates beneficial effects of endurance training independent of the training setting . Short-term immune adaptations and cardiorespiratory fitness have the potential to influence HR-QoL and fatigue in persons with MS . The specific immune responses of immersion to exercise need further clarification Study design A thematic review . Objectives To evaluate if physical activity enhances muscle strength , improves balance , and reduces the fall frequency and the fracture incidence .  Background One of the major medical problems of today is the increasing incidence of fragility fractures .  Muscle strength and fall is one of the major determinants of a fracture . If physical activity could increase muscle strength , improve balance and reduce the fall frequency , then training could be recommended as prevention for fractures . Methods The review used Medline ( Pub Med ) and the search words exercise , physical activity , muscle strength , balance , falls , fractures . R and omized controlled trials ( RCT ) were predominantly included , although this not is a systematic review . Results The evidence that physical activity modifies the risk factors for fall is compelling , although RCT with fractures as end point are lacking . Physical activity is associated with improved muscle strength , co-ordination and balance .  Physical training increases muscle strength also in octogenarians by up to 200 % , i.e. a much more pronounced effect than the corresponding increase in muscle volume or bone mass . There is also evidence that physical activity decreases the actual number of falls . Observational cohort and case-control studies imply that physical activity is associated with reduced hip fracture risk . If exercise reduces the number of vertebral fractures and other fragility fractures are less evaluated . Conclusions Physical activity in older ages can be recommended to improve muscle strength and balance , to reduce the risk to fall and fractures , although the highest level of evidence – RCT with fracture as endpoint – is lacking Cancer-related fatigue is the most disabling symptom experienced by breast cancer patients following the cancer treatment . The positive effects of physical activity in the rehabilitation of breast cancer patients are documented in several studies . In a r and omized controlled study the effects of a structured physical training program on fatigue and health-related quality of life were evaluated . Patients and Methods : 63 breast cancer patients with cancer-related chronic fatigue were r and omized at the beginning of the inpatient rehabilitation . The control group received the st and ard complex rehabilitation program , the intervention group a structured physical training program and additional muscle strength and aerobic exercises . The effects of the treatment were evaluated by question naires at the start of rehabilitation ( t1 ) , end of rehabilitation ( t2 ) , and 3 months after t2 ( t3 ) . Isometric muscle strength and aerobic capacity were evaluated at t1 and t2 . Results : There was an improvement of muscle strength at the end of rehabilitation for both groups . The increase from t1 to t2 was significantly higher for the training group . The scores for global quality of life , physical well-being , and functionality increased from t1 to t2 , but further improvement in the follow-up ( t3 ) was only observed in the training group . The cancer-related fatigue was significantly reduced in the training group from t1 to t3 , however , not in the control group . Conclusions : Structured physical training programs initiated during inpatient rehabilitation and continuously practice d in the time thereafter can improve symptoms of chronic fatigue and quality of life in breast cancer patients This study poses two questions : 1 ) is there an abnormality in isokinetic skeletal muscle strength and endurance in mild chronic obstructive pulmonary disease ( COPD ) ? and 2 ) what is the effect of a r and omized , controlled , 12 week hospital outpatient weight training programme in terms of skeletal muscle function and exercise tolerance ? Upper and lower limb isokinetic maximum and sustained muscle function were compared in 43 COPD patients ( age 49+/-11 yrs ) , mean forced expiratory volume in one second ( FEV1 ) 77+/-23 % pred and 52 healthy , sedentary subjects ( age 51 ( 10 ) yrs ) , mean FEV1 109+/-16 % pred . The 43 COPD patients were r and omly allocated into training ( n=26 ) and control ( n=17 ) groups . Isokinetic and isotonic muscle function , whole body endurance , maximal exercise capacity and lung function were measured . The COPD patients had reduced isokinetic muscle function ( with the exception of sustained upper limb strength ) as compared with healthy sedentary subjects . Muscle function improved after weight training in the COPD patients . Whole body endurance during treadmill walking also improved with no change in maximal oxygen consumption . A deficit in skeletal muscle function can be identified in patients with mild chronic obstructive pulmonary disease which can not be explained by factors such as hypoxaemia and malnutrition . Intervention with weight training is effective in countering this deficit which the authors conclude is probably due to muscle deconditioning OBJECTIVE : To study the effect of physical activity on whole body fat ( BF ) , its regional deposition and the influence of body fatness on physical performance in prepubertal children . DESSIGN : Cross-sectional study .SUBJECTS : A total of 114 boys ( 9.4±1.5 y , Tanner I – II ) , r and omly sample d from the population of Gran Canaria ( Spain ) , 63 of them physically active ( PA , at least 3 h per week during the previous year ) and 51 nonphysically active ( non-PA ) .  MEASUREMENTS : Body composition ( DXA ) , anthropometric variables ( body circumferences and skinfolds ) and physical fitness were determined in all subjects . RESULTS : The PA obtained better results in maximal oxygen uptake , isometric leg extension force , vertical jump ( muscular power ) , and 300 m ( anaerobic capacity ) and 30 m running tests ( speed ) than the non-PA . A lower percentage of body fat ( % BF ) ( 4 U less , P<0.05 ) , whole BF mass ( 36 % less , P<0.05 ) and regional fat mass ( 28 , 25 , and 30 % less in the trunk , legs and arms , respectively , all P<0.05 ) was observed in the PA compared to the non-PA . The waist and hip circumferences correlated more closely with both the fat mass accumulated in the trunk region and the % BF ( r=0.81–0.95 , P<0.001 ) than the waist-to-hip ratio ( WHR ) . The WHR correlated with the percentage of the whole fat mass accumulated in the trunk ( PFT ) ( r=0.52–0.53 , P<0.001 ) . In both groups , the PFT increased curvilinearly with the % BF , regardless of the level of physical activity . ANCOVA analysis revealed that total and regional fat masses explained less than 40 % of the difference in performance between the PA and non-PA group . The mean speed in the 30 m running test ( V30 ) , combined with the height and whole body mass , has predictive value for the BF mass ( R=0.98 , P<0.001 ) . The % BF may be estimated from the body mass index ( BMI ) and V30 ( % BF=8.09 + 2.44 · BMI ( kg m−2)–5.8·V30 ( m s−1 ) , R=0.94 , P<0.001 ) in prepubertal boys . CONCLUSIONS : Regular participation in at least 3 h per week of sports activities and competitions on top of the compulsory physical education program is associated with increased physical fitness , lower whole body and trunkal fat mass in prepubertal boys
Future studies should also consider measures of ME and MS as a function of upper body , lower body , and core strength , and their potential association with specific , rather than general ,
Abstract de la Motte , SJ , Gribbin , TC , Lisman , P , Murphy , K , and Deuster , PA .
A systematic review of the association between physical fitness and musculoskeletal injury risk : part 2—muscular endurance and muscular strength .