Leisure-time physical activity, occupational physical activity and the physical activity paradox in healthcare workers: A systematic overview of the literature.

BACKGROUND: Physical activity positively influences cardiovascular health. Results from male-dominated physically active occupations suggest that a high level of occupational physical activity may be detrimental to cardiovascular health. This observation is referred to as the physical activity paradox. Whether this phenomenon can also be observed in female-dominated occupations remains unknown. OBJECTIVE: We aimed to provide an overview of (1) leisure-time and occupational physical activity in healthcare workers. Therefore, we reviewed studies (2) to assess the relationship between the two physical activity domains and analyzed (3) their effects on cardiovascular health outcomes in relation to the paradox. METHODS: Five databases (CINAHAL, PubMed, Scopus, Sportdiscus, Web of Science) were systematically searched. Both authors independently screened the titles, abstracts, and full texts and assessed the quality of the studies using the National Institutes of Health's quality assessment tool for observational cohort and cross-sectional studies. All studies that assessed leisure-time and occupational physical activity in healthcare workers were included. The two authors independently rated the risk of bias using the ROBINS-E tool. The body of evidence was evaluated using the GRADE approach. RESULTS: The review included 17 studies that assessed the leisure-time and occupational physical activity of people working in healthcare, determined the relationship between the domains (n = 7) and/or examined their effects on the cardiovascular system (n = 5). Measurements for leisure-time and occupational physical activity varied between studies. Leisure-time physical activity typically ranged between low and high intensity, with a short duration (approx. 0.8-1.5 h). Occupational physical activity was typically performed at light to moderate intensity with a very long duration (approx. 0.5-3 h). Moreover, leisure-time and occupational physical activity were almost negatively related. The few studies investigating effects on cardiovascular parameters revealed a rather unfavorable effect of occupational physical activity, while leisure-time physical activity was beneficial. The study quality was rated as fair and the risk of bias was moderate to high. The body of evidence was low. CONCLUSIONS: This review confirmed that leisure-time and occupational physical activity of healthcare workers are opposed in their duration and intensity. Moreover, leisure-time and occupational physical activity seem to be negatively related and should be analyzed according to their relation to each other in specific occupations. Furthermore, results support the relationship between the paradox and cardiovascular parameters. REGISTRATION: Preregistered on PROSPERO (CRD42021254572). Date of registration on PROSPERO: 19 May 2021. TWEETABLE ABSTRACT: Does occupational physical activity adversely affect the cardiovascular health of healthcare workers in comparison to leisure-time physical activity?

Effects of cognitive-motor dual task training on cognitive and physical performance in healthy children and adolescents: A scoping review.

Simultaneous dual- or multitasking training has been used in manifold ways to improve cognitive-motor performance in different age groups. Dual task (DT) training is assumed to improve both, single task (ST) motor and cognitive performance, but particularly, performance under dual tasking conditions. Further, DT interventions have been shown to be beneficial for motor skill learning and cognitive performance as well as academic achievements in children and adolescents. The aim of this scoping review was to summarize current evidence on different cognitive-motor interventions that practice motor and cognitive performance simultaneously in children and adolescents and to identify training regimes that are most effective to improve cognitive or motor performance in this target group. METHODS: Four electronic databases were searched (Pubmed, MEDLINE, Web of Science and APA Psycinfo) until May 2021. Following the PRISMA guidelines, title, abstract, and full-text screening as well as quality assessment was done by two independent reviewers. Studies were eligible if they (1) were published in English or German language, (2) accessible as a full-text version, (3) included at least one group of children or adolescents with a mean age of 4 to 21 years, (4) used dual-tasks as part of the intervention, (5) conducted one or more training sessions, and (6) reported at least one cognitive or motor outcome. The main outcome measures were cognitive and motor as well as cognitive-motor DT performance. Due to the heterogeneity in the characteristics of the included studies, we designed this review as a scoping review. RESULTS: Seven studies met the inclusion criteria (n = 543, age four to 14 years, 47.1% female). One study reported two intervention experiments. Studies differed in sample size (20-189) as well as in type of training (specific or general DT training) and dose (frequency: one session/week to 110 sessions within 22 weeks). Overall, task-specific improvements in physical and cognitive functions were found, but not consistently across all interventions. Two interventions out of five interventions that measured motor performance demonstrated improvement in that domain, especially in balance. Three out of five interventions that measured cognitive functions found improved cognition. Only one study examined DT performance post training but failed to gain significant improvements in comparison to a control group. Studies only occasionally integrated training principles like individualization or progression in the design of their intervention. DISCUSSION: The results indicate that DT training interventions may improve physical and/or cognitive functions in children and adolescents. Best practice recommendations for training regimes cannot be derived as outcomes differed a lot and were not systematically assessed across studies. Future studies should integrate more principles of training monitoring and aspects like individualization and progression to provide ideal training control and achieve better DT training results. Further, more high-quality trials are needed that adhere to the previous concepts. PSYCINFO CLASSIFICATION: 2340 Cognitive Processes 2820 Cognitive & Perceptual Development. 3720 Sports.

Predicting Competition Performance in Short Trail Running Races with Lactate Thresholds.

Trail running is a popular sport, yet factors related to performance are still not fully understood. Lactate thresholds have been thoroughly investigated in road running and correlate strongly with race performance, but to date few data are available about the value in trail running performance prediction. We examined 25 trail runners (age 31.2 ± 5.1 years, BMI 22.2 ± 1.82 kg/m2) with an initial graded exercise test for measurement of VO2max (59.5 ± 5.2 ml.kg-1.min- 1) and lactate thresholds (LT): LTAET (LT aerobic) 1.03 ± 0.59 mmol/l; 11.2 ± 1.1 km/h), IAT (individual lactate threshold) (2.53 ± 0.59 mmol/l; 15.4 ± 1.6 km/h) and LT4 (lactate threshold at 4 mmol/l) (16.2 ± 1.9 km/h). All runners subsequently participated in a 31.1 km XS trail race and 9 runners in a 21 km XXS trail race. Race performance times correlated negatively with the XS trail run (LTAET: r = -0.65, p < 0.01; LT4: r = -0.87, p < 0.01; IAT: r = -0.84, p < 0.01) and regression analysis showed that race performance could be predicted by: LT4: -324.15×LT4+13195.23 (R2 = .753, F1,23 = 70.02, p < 0.01). A subgroup analysis showed higher correlations with race performance for slower than faster runners. No correlations were found with the XXS race. Lactate thresholds can be of value in predicting trail race performance and help in designing training plans.

Predicting Trail-Running Performance With Laboratory Exercise Tests and Field-Based Results.

PURPOSE: Trail running is a complex sport, and performance prediction is challenging. The aim was to evaluate 3 standard laboratory exercise tests in trail runners and correlate measurements to the race time of a trail competition evaluating its predictive power. METHODS: Nine competitive male trail runners (mean age: 31 [5.8] y) completed 3 different laboratory exercise tests (step, ramp, and trail tests) for determination of maximal oxygen uptake (VO2max), vVO2max, ventilatory (VT) and lactate thresholds (LT), mechanical power output, and running economy (RE), followed by a 31-km trail race. Runners had previously participated in the same race (previous year) and finished in the top 2%. Finishing times (dependent value) were tested in multiple-regression analysis with different independent value combinations. RESULTS: Linear-regression analysis revealed that variables measured during step and ramp tests significantly predicted performance. Step-test variables (speed at individual anaerobic threshold 16.4 [1.7] km/h and RE 12 km/h in %VO2max 65.6% [5.4%]) showed the highest performance prediction (R2 = .651, F2,6 = 5.60, P = .043), followed by the ramp test (vVO2max 20.3 [1.3] km/h; R2 = .477, F1,7 = 6.39, P = .04) and trail test (maximal power 3.9 [0.5] W/kg, VO2max 63.0 [4.8] mL O2·kg-1·min-1, vVT1 11.9 [0.7] km/h; R2 = .68, F3,5 = 3.52, P = .11). Adding race time from the preceding year to the step test improved the predictive power of the model (R2 = .988, F3,5 = 66.51, P < .001). CONCLUSIONS: The graded exercise test (VO2max, individual anaerobic threshold, and RE) most accurately predicted a 31.1-km trail-running performance. Combining submaximal intensities (individual anaerobic threshold and RE) with the previous year's race time of that specific event increased the predictive power of the model to 99%.