Sports Med
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Exercise is a widely accepted treatment known to improve walking ability in persons with peripheral arterial disease (PAD); however, it has not been confirmed as to whether exercise improves fitness and performance-based function and, consequently, performance of activities of daily living (ADL). This systematic review aims to identify whether any mode of structured exercise improves physical fitness or performance-based tests of function and whether improvement in walking ability is related to an improvement in these outcomes. ⋯ Although data are limited, there is a strong significant relationship between plantar flexor muscle strength and treadmill walking ability. More research is needed to assess improvements in walking economy at specific timepoints and whether this translates to improvements in claudication outcomes and measurements pertaining to muscle strength. Future trials should focus on interventions that improve lower limb muscle strength and assess muscle strength, power and endurance across a variety of lower extremity muscle groups in order to understand these relationships further. The 6MW, muscle strength and performance-based tests of function such as chair stand, balance scale, stair climb and gait speed are understudied in PAD. Future trials should examine the effects of exercise on performance-based tests of function, which may predict actual ADL performance and incident disability.
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Effective regulation of pace enables the majority of runners to complete competitive endurance events without mishap. However, some runners do experience exercise-induced collapse associated with postural hypotension, which in rare cases results from life-threatening conditions such as cardiac disorders, cerebral events, heat stroke and hyponatraemia. Despite the experience of either catastrophic system failure or extreme peripheral muscle fatigue, some runners persist in attempting to reach the finish line, and this often results in a sequence of dynamic changes in posture and gait that we have termed the 'Foster collapse positions'. ⋯ The Foster collapse positions are indicative of a final, likely primordial, protective mechanism designed to attenuate postural hypotension, cardiac 'pump' insufficiency or cerebral blood flow deficiency. Continuing to attempt to reach the finish line in this impaired state is also perhaps indicative of a high psychological drive or a variety of neurological and psychological pathologies such as diminished sensitivity to interoceptive feedback, unrealistic situational appraisal or extreme motivational drives. A better understanding of the physiological, neurological and psychological antecedents of the Foster collapse sequence remains an important issue with practical implications for runner safety and theoretical understanding of collapses during exercise.
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Skiing and snowboarding are two activities that significantly contribute to the total number of sports-related injuries reported per year. Strength, endurance and cardiovascular fitness are central components in sports injury prevention. Providing exercises and training recommendations specific to recreational skiers and snowboarders is important in both injury prevention and reducing the prevalence and cost associated with alpine winter sports injuries. ⋯ The importance of targeting physical fitness in injury prevention is accepted in sports medicine and rehabilitation; yet, there was a paucity of articles included in this review that explicitly investigated this aspect with regards to recreational alpine skiing and snowboarding. The most frequent recommendations for preventing skiing and snowboarding injuries concerned equipment or the involvement of third parties. The dominance of equipment-related measures in the injury prevention literature may be rationalized from a sports biomechanics viewpoint, as these activities involve high velocities and impact forces. Nonetheless, this also indicates a need for appropriate levels of strength, endurance and conditioning to meet the technical demands of these sports. Bearing this in mind, future research is encouraged to investigate the role of physical fitness, exercise and training in decreasing the incidence and severity of skiing and snowboarding injuries in recreational athletes.
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The benefits of physical activity to maintain optimal health and well-being in children and adolescents are undisputed. The school environment offers opportunities for children to be physically active. ⋯ All of the studies used an objective measure to assess PA outcomes, although several criteria were consistently absent from the studies. The levels of evidence were not sufficient to establish conclusive intervention effects on children's recess PA. This could be due to the small number of published studies. There is a need for higher-quality intervention research to strengthen published findings to inform recess PA interventions. Intervention research is needed in adolescents due to the absence of school recess intervention research in this population.
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The heritability of specific phenotypical traits relevant for physical performance has been extensively investigated and discussed by experts from various research fields. By deciphering the complete human DNA sequence, the human genome project has provided impressive insights into the genomic landscape. The hope that this information would reveal the origin of phenotypical traits relevant for physical performance or disease risks has proven overly optimistic, and it is still premature to refer to a 'post-genomic' era of biological science. ⋯ In the future, epigenetic status and its potential influence on athletic performance will have to be considered, explored and validated using well controlled model systems before we can begin to extrapolate new findings to complex and heterogeneous human populations. A combination of the fields of genomics, epigenomics and transcriptomics along with improved bioinformatics tools and precise phenotyping, as well as a precise classification of the test populations is required for future research to better understand the inter-relations of exercise physiology, performance traits and also susceptibility towards diseases. Only this combined input can provide the overall outlook necessary to decode the molecular foundation of physical performance.