The psychological well-being index and quality of life after a cardiac rehabilitation program based on aerobic training and psychosocial support.

BACKGROUND: This study aimed to investigate the physical and psychological benefits of an alternative cardiac rehabilitation program based on therapeutic groups during physical exercise sessions and to compare the results with those of a conventional cardiac rehabilitation program. METHOD: The sample included 112 patients from the cardiac rehabilitation unit of a medical center, 91.1 % of whom were male. The control group consisted of 47 subjects, with a mean age of 57.89 ± 12.30 and the experimental group consisted of 65 subjects, with a mean age of M = 58.38 ± 9.86. Quality of life, psychological well-being, health-related quality of life, body mass index, blood pressure, abdominal circumference and resting heart rate were measured before starting and at the end of the cardiac rehabilitation program. RESULTS: The experimental group improved significantly more than the control group in body mass index, systolic and diastolic blood pressure, abdominal circumference, and resting heart rate (p value < 0.005). In addition, the experimental group had significantly greater improvements in quality of life, psychological well-being, and health-related quality of life than the control group (p-value < 0.001). CONCLUSIONS: A cardiac rehabilitation program based on simultaneous aerobic training and psychosocial support improved the physical function, health-related quality of life and well-being.

Test-Retest Reliability of Isokinetic Strength in Lower Limbs under Single and Dual Task Conditions in Women with Fibromyalgia.

Background: Previous research has established good test-retest reliability for isokinetic dynamometry in fibromyalgia. However, the reliability of this test under dual-task conditions has not been investigated in fibromyalgia. Methods: A total of 10 women with fibromyalgia participated in this study. Participants completed the concentric/concentric test. The dual-task condition involved subtracting two by two while performing the test. Results: Reliability analysis under the single condition showed "poor" to "excellent" values for maximum peak torque in knee extension and "moderate" to "excellent" values for average. "Poor" to "excellent" reliability values were found in knee flexion for the maximum and average. Dual-task condition in knee extension ranged from "moderate" to "excellent" for maximum and average values, and in knee flexion, it ranged from "poor" to "excellent" for maximum value and from "moderate" to "excellent" for average value. Conclusions: Isokinetic dynamometry demonstrated sufficient reliability for measuring strength in knee extension maximum and average during single-task and dual-task conditions, along with knee flexion dual-task average in fibromyalgia. For knee flexion single-task maximum and average and knee flexion dual-task maximum, we did not obtain sufficiently reliable measurements. Only the concentric/concentric test has been studied, and future studies with a larger sample size are needed in order to generalize the results.

Classification and Definitions of Compensatory Protective Step Strategies in Older Adults: A Scoping Review.

BACKGROUND: The risk for an unexpected fall can be due to increasing age, health conditions, and loss of cognitive, sensory, or musculoskeletal functions. Falls have personal and economic consequences in many countries. Different disturbances can occur during gait, such as tripping, slipping, or other unexpected circumstances that can generate a loss of balance. The strategies used to recover balance depend on many factors, but selecting a correct response strategy influences the success of balance recovery. OBJECTIVES: (1) To collect and clarify the definitions of compensatory protective step strategies to recover balance in older adults; (2) to identify the most used methods to induce loss of balance; and (3) to identify the most used spatiotemporal variables in analyzing these actions. METHODS: The present review has followed the PRISMA guideline extension for Scoping Review (PRISMA-ScR) and the phases proposed by Askery and O'Malley. The search was conducted in three databases: PubMed, Web of Science, and Scopus. RESULTS: A total of 525 articles were identified, and 53 studies were included. Forty-five articles were quasi-experimental studies, six articles were randomized controlled trials, and two studies had an observational design. In total, 12 compensatory protective step strategies have been identified. CONCLUSIONS: There are 12 compensatory protective step strategies: lowering and elevating strategy, short- and long-step strategy, backward and forward stepping for slip, single step, multiple steps, lateral sidesteps or loaded leg sidestep unloaded leg sidestep, crossover step (behind and front), and medial sidestep. To standardize the terminology applied in future studies, we recommend collecting these strategies under the term of compensatory protective step strategies. The most used methods to induce loss of balance are the tether-release, trip, waist-pull, and slip methods. The variables analyzed by articles are the number of steps, the acceleration phase and deceleration phase, COM displacement, the step initiation or step duration, stance phase time, swing phase time and double-stance duration, stride length, step length, speed step, speed gait and the type of step.

Effects of an 11-Week Detraining, Imposed by the COVID-19 Confinement, on Handball Players' Shoulder Rotator Isokinetic Profile, Shoulder Range of Motion, and Ball Release Velocity.

Background and Objectives: The COVID-19 confinement significantly impacted the physical condition of athletes. However, the detraining impacts of this period on the shoulder rotator and range of motion in handball players have not been studied. Thus, the main aim of this study was to investigate the effect of this 11-week detraining period, imposed by the COVID-19 pandemic confinement, on the shoulder rotator isokinetic profile (peak torque, ratio, fatigue index), shoulder rotator and flexion range of motion, and ball release velocity in handball players. Materials and Methods: A total of 16 handball players, with a mean age of 22.38 (5.28) years, participated in this study. The isokinetic strength was assessed using two protocols (three repetitions at an angular velocity of 60°/s and 20 repetitions at an angular velocity of 180°/s). In addition, the range of motion and ball release (at jump and standing shots) were measured. All these measurements were assessed before and after the COVID-19 confinement. Results: The results showed a significant reduction in the peak torque of the external rotation of their dominant and non-dominant shoulders. In addition, confinement significantly increased the fatigue index of external rotation and internal rotation and reduced the range of motion of internal rotation. Additionally, the ball release velocity during standing and jump shots was significantly reduced. Conclusions: These results suggested that strengthening external and internal rotation as well as recovering the internal rotation range of motion may be necessary after a detraining period in order to prevent shoulder injuries.

Validity of On-Line Supervised Fitness Tests in People with Low Back Pain.

This study aimed to investigate the concurrent validity between online evaluations (OEs) and face-to-face evaluations (IPEs) of a Senior Fitness Test and two balance tests in people with low back pain (LBP). Forty participants of 58.48 (9.87) years were included. The 30 s chair stand-up, arm curl, 2 min step, chair-sit and reach, back scratch, 8 foot up-and-go, sharpened Romberg, and one-legged stance tests were administrated using both OE and IPE methods. The results indicated no significant differences (p > 0.05) between the two methods except in the 8-foot up-and-go test (p = 0.007). Considering the ICC values and Bland-Altman plots, excellent agreement was found for the chair-sit and reach test, moderate agreement for the arm-curl and 8-foot up-and-go tests, and good agreement for the other tests. Strong correlations (p < 0.001) were observed in all variables except for the arm-curl and 8-foot up-and-go tests, where moderate correlations were found (p < 0.05). These results support the validity of OEs and IPEs in all tests, except for the arm-curl and 8-foot up-and-go tests, where lower ICC values and moderate correlations were found. However, it is important to consider the range of fluctuation of the ICC and the significant values obtained through correlations.

The Behavior of Muscle Oxygen Saturation, Oxy and Deoxy Hemoglobin during a Fatigue Test in Fibromyalgia.

Previous studies have reported that people with fibromyalgia (FM) could suffer from mitochondrial dysfunction. However, the consumption of muscle oxygen during physical exercise has been poorly studied. Therefore, this study aimed to explore the response of muscle oxygen during a fatigue protocol in people with FM and healthy controls (HC). In addition, the peak torque and the total work were assessed. A total of 31 participants (eighteen were people with fibromyalgia and thirteen were healthy controls) were enrolled in this cross-sectional study. All the participants underwent a fatigue protocol consisting of 20 repetitions at 180°·s−1 of quadriceps flexions and extensions using a Biodex System 3. The muscle oxygen saturation (SmO2), total hemoglobin (THb), deoxygenated hemoglobin (HHb) and oxygenated hemoglobin (O2Hb) values were measured using a portable near-infrared spectroscopy (NIRS) device. Significant differences between people with FM and healthy controls were found at baseline: SmO2 (FM: 56.03 ± 21.36; HC: 77.41 ± 10.82; p = 0.036), O2Hb (FM: 6.69 ± 2.59; HC: 9.37 ± 1.31; p = 0.030) and HHb (FM: 5.20 ± 2.51; HC: 2.73 ± 1.32; p = 0.039); during the fatigue protocol: SmO2 (FM: 48.54 ± 19.96; HC: 58.87 ± 19.72; p = 0.038), O2Hb (FM: 5.70 ± 2.34; HC: 7.06 ± 2.09; p = 0.027) and HHb (FM: 5.69 ± 2.65; HC: 4.81 ± 2.39; p = 0.048); and in the recovery at three min and six min for SmO2, O2Hb and HHb (p < 0.005). Furthermore, healthy control values of SmO2, O2Hb and HHb have been significantly altered by the fatigue protocol (p < 0.005). In contrast, people with FM did not show any significant alteration in these values. Moreover, significant differences were found in the peak torque at extension (FM: 62.48 ± 24.45; HC: 88.31 ± 23.51; p = 0.033) and flexion (FM: 24.16 ± 11.58; HC: 42.05 ± 9.85; p = 0.010), and the total work performed at leg extension (FM: 1039.78 ± 434.51; HC: 1535.61 ± 474.22; p = 0.007) and flexion (FM: 423.79 ± 239.89; HC: 797.16 ± 194.37; p = 0.005).

Neurophysiological Response of Adults with Cerebral Palsy during Inclusive Dance with Wheelchair.

A total of 16 adults with cerebral palsy (age = 37.50 (7.78)) participated in this cross-sectional study. The electroencephalographic (EEG) data were recorded under three conditions: (1) baseline; (2) while listening to music; (3) while performing inclusive dance choreography with wheelchair. EEG data was banded into theta (4-7 Hz), alpha (8-12 Hz), and beta (13-30 Hz). Significantly higher values of theta, alpha, and beta bands were found in dance conditions than in the baseline. Significant differences between baseline and listening to music conditions were not found in any of the power spectrum bands. Differences between listening to music conditions and inclusive dance with wheelchair were observed in theta and beta power spectrum band studies in the F4 electrode. Inclusive dance with wheelchair increases theta, alpha, and beta power spectra when compared to baseline. In addition, the beta power spectrum is greater only during inclusive dance conditions, which could be modulated by emotions. However, future studies should corroborate this hypothesis.

Comparison between the Impacts of Memory and Arithmetic-Based Dual Tasks on Physical Performance in Women with Fibromyalgia.

BACKGROUND: Fibromyalgia symptoms have a significant impact on the ability to perform activities of daily living. These activities require the ability to perform two or more tasks at the same time, which is known as a dual task. PURPOSE: To analyze physical and cognitive performance differences between memory and arithmetic dual tasks. METHODS: Twenty-five women with fibromyalgia participated in this study. Participants performed three physical tests (back scratch, arm curl, and 10-step stair) as a single task and under two types of dual task (memory and arithmetic). RESULTS: Differences between the single and dual tasks were observed in the back scratch and the 10-step stair tests using the arithmetic dual-task. Significant differences were only observed for the memory dual-task in the 10-step stair test. In addition, the performance in the back scratch and in the 10-step stair was significantly lower under the arithmetic compared to the memory-based dual task. Furthermore, a significant difference between these two types of dual task was obtained in the dual-task cost of 10-step stair. Regarding cognitive performance, a significantly lower percentage of correct responses was found in the AbDT compared to the MbDT in the 10-step stair test. CONCLUSIONS: the AbDT could have a higher impact on physical performance than the MbDT during the back scratch and the 10-step stair tests. The characteristics of the sample, environment, complexity of the motor task, and difficulty of the simultaneous cognitive task may also be relevant for understanding the differences in dual-task interference.

Creativity in Recreational Figure Roller-Skating: A Pilot Study on the Psychological Benefits in School-Age Girls.

Creative strategies allow students to feel ownership of their learning, fostering interest and motivation towards sports and educational contexts. This study aimed to compare different psychological variables after applying creative and traditional sessions of recreational figure roller-skating. Twelve school-age female skaters (9.00 ± 1.09 years old) participated in this pilot study. They performed two sessions: (1) a creative session (where participants created their own choreography) and (2) a traditional session (where participants followed the choreography created by the sports professional). In the creative session, participants created their choreographies without instructions. The basic psychological needs scale, the measure of intentionality to be physically active (sports adherence) and the games and emotions scale were administered after each session. The creative intervention led to a higher satisfaction of the needs of perceived competence (p-value = 0.04; effect size = 0.59), social relationships (p-value = 0.03; effect size = 0.62) and adherence to figure roller-skating (p-value = 0.02; effect size = 0.69), compared to the traditional intervention in female skaters. Participants showed significantly more humor and less surprise in the creative session than in the traditional session. This greater satisfaction with perceived competence and social relationships could translate into greater adherence to sports.

Heart Rate Variability and Salivary Biomarkers Differences between Fibromyalgia and Healthy Participants after an Exercise Fatigue Protocol: An Experimental Study.

Previous studies showed that people with Fibromyalgia (FM) suffer from dysautonomia. Dysautonomia consists of persistent autonomic nervous system hyperactivity at rest and hyporeactivity during stressful situations. There is evidence that parameters reflecting the complex interplay between the autonomic nervous system and the cardiovascular system during exercise can provide significant prognostic information. Therefore, this study aimed to investigate the differences between people with FM and healthy controls on heart rate variability (HRV) and salivary parameters (such as flow, protein concentration, enzymatic activities of amylase, catalase and glutathione peroxidase) in two moments: (1) at baseline, and (2) after an exercise fatigue protocol. A total of 37 participants, twenty-one were people with fibromyalgia and sixteen were healthy controls, participated in this cross-sectional study. HRV and salivary samples were collected before and after an exercise fatigue protocol. The fatigue protocol consisted of 20 repetitions of knee extensions and flexions of the dominant leg at 180 °·s-1 (degrees per second). Significant differences were found in the HRV (stress index, LF and HF variables) and salivary biomarkers (with a higher concentration of salivary amylase in people with FM compared to healthy controls). Exercise acute effects on HRV showed that people with FM did not significantly react to exercise. However, significant differences between baseline and post-exercise on HRV significantly induce alteration on the HRV of healthy controls. Catalase significantly increased after exercise in healthy controls whereas salivary flow significantly increased in women with FM after an exercise fatigue protocol. Our study suggests that a higher α-amylase activity and an impaired HRV can be used as possible biomarkers of fibromyalgia, associated with a reduction in salivary flow without changes in HRV and catalase activity after a fatigue exercise protocol. More studies should be carried out in the future to evaluate this hypothesis, in order to find diagnostic biomarkers in fibromyalgia.

Relationship between Kinesiophobia and Mobility, Impact of the Disease, and Fear of Falling in Women with and without Fibromyalgia: A Cross-Sectional Study.

BACKGROUND: Kinesiophobia is defined as fear of movement due to the painful experience of it. The main symptom of fibromyalgia is persistent and widespread pain associated with other symptoms. This study analyzes the kinesiophobia between women with fibromyalgia and apparently healthy women and investigates the relationship between kinesiophobia and physical fitness tests, fear of falling, and the impact of the fibromyalgia. METHODS: Fifty-one women participated in this study were divided into two groups: (1) women with fibromyalgia and (2) apparently healthy women. Participants completed questionnaires to assess kinesiophobia, fear of falling, and the impact of fibromyalgia. Subsequently, participants completed the physical tests Timed Up and Go, 10-step stair ascent, and handgrip strength. RESULTS: Women with fibromyalgia had significant differences in kinesiophobia and fear of falling compared to apparently healthy women. Similarly, performance in the physical tests was lower, except for the handgrip strength, which maintained similar values to the apparently healthy women. Significant relationships were found only in the fibromyalgia group between kinesiophobia, the impact of the disease, fear of falling, and the Timed Up and Go and 10-step stair ascent tests. CONCLUSIONS: Women with fibromyalgia showed higher kinesiophobia scores, worse performance in mobility tests, and higher fear of falling than apparently healthy women. Kinesiophobia score is related to Timed Up and Go performance, the 10-step stair ascent, the fear of falling, and the impact of the disease in women with fibromyalgia.

The Effect of Expertise during Simulated Flight Emergencies on the Autonomic Response and Operative Performance in Military Pilots.

Heart rate variability (HRV) and performance response during emergency flight maneuvers were analyzed. Two expert pilots (ages 35 and 33) and two rookie pilots (ages 25) from the Portuguese Air Force participated in this case-control report study. Participants had to complete the following emergency protocols in a flight simulator: (1) take-off engine failure, (2) flight engine failure close to the base, (3) flight engine failure far away from the base, and (4) alternator failure. The HRV was collected during all these maneuvers, as well as the performance data (the time it took to go through the emergency protocol and the subjective information from the flight simulator operator). Results regarding autonomic modulation showed a higher sympathetic response during the emergency maneuvers when compared to baseline. In some cases, there was also a higher sympathetic response during the emergency maneuvers when compared with the take-off protocol. Regarding performance data, the expert pilots accomplished the missions in less time than the rookie pilots. Autonomic modulation measured from HRV through portable devices can easily relay important information. This information is relevant since characterizing these maneuvers can provide helpful information to design training strategies to improve those psychophysiological responses.

Impact of Basketball Match on the Pre-Competitive Anxiety and HRV of Youth Female Players.

The present study aimed to investigate the impact of a basketball competition on the pre-competitive anxiety and Heart Rate Variability (HRV) of young female basketball players. A total of 12 female basketball players participated in this cross-sectional study. Girls had a mean age of 14 (1.41) years old and a mean experience of 4 (0.85) years practicing basketball. The pre-competitive anxiety and the HRV was assessed the week before and immediately before and after the match. Results showed a significant reduction (p-value < 0.05) of the several HRV variables after the match compared to baseline and pre-competition measures. However, differences between baseline and pre-competition were not found. Furthermore, a significant increase in somatic anxiety after the competition was reported. Taking into account HRV, somatic anxiety, and cognitive anxiety results, young female basketball players did not exhibit an increase in pre-competition anxiety. HRV measurements before competition can help coaches and physical trainers to identify female players with higher pre-competitive anxiety and propose intervention to manage it. Future studies should investigate the impact of coaches and parents on the pre-competitive anxiety of female and male basketball players.

Are there neurophysiological differences behind the play of different chess modalities?: An international grandmaster case study.

The study of mental load is an emerging research topic in the field of sport sciences. In the sport of chess, there is a need to understand the mental demands of the sport of chess in order to manage training loads. The present study aimed to analyze the electrical brain pattern of an elite chess player during different chess games: 15 + 10, blindfold 15 + 10, lightning game, and problem-solving chess tasks. The participant was a male 33-year-old chess player with 2562 points of ELO and more than 26 years of chess experience, training between 3 and 4 h a day. The 15 + 10 game consisted of 15 min + 10 s increment per move. In the blindfold game, the participant cannot see the positions of the pieces and does not touch them. In the lightning game, the participant played four consecutive one minute game. In addition, two high-level, two low-level, and two medium-level chess problems were performed. Electroencephalographic (EEG) and heart rate variability (HRV) responses were measured to assess the electrical brain pattern and autonomic modulation respectively. The participant won both games at 15 + 10 (normal and blindfold), lost three and drew one of the four lightning games, solved the two low-level and the two medium-level problems and solved one of the two high-level problems. Although in both games the player achieved victory the average player move quality measured with both pure analysis and analysis with additional limitations were lower in 15 + 10 blindfold game than in 15 + 10 game. Increments in theta and alpha power spectrums can be observed during the most demanding chess games (blindfold chess, lightning game, and the chess problem at difficult- level). Furthermore, the highest alpha power spectrum values can be observed during blindfold chess. In conclusion, this is the first study investigating the EEG pattern of a International Chess Grandmaster during a blindfold chess game. We found that in the chess games where lower performance is exhibited, theta and alpha power spectrums increased.

Impact of being physically active on the brain electrocortical activity, brain volumetry and performance in the Stroop color and word test in women with fibromyalgia.

Physical exercise is one of the treatment approaches with the most robust evidence against fibromyalgia (FM) symptoms. This study aimed to investigate the impact of being physically active on the Stroop Color and Word Test (SCWT) performance as well as to investigate and compare the brain electrocortical activity during SCWT. A total of 31 women completed the SCWT while EEG was recorded. People with FM were divided into two groups (physically and non-physically active) according to the WHO guidelines. Furthermore, magnetic resonance imaging was acquired and health-related quality of life, the impact of the disease, and the six-minute walking test were administered. Physically active group showed better performance in the SCWT, exhibiting less error in name different color patches condition (C), more correct responses in named color-word condition (CW) and higher interference score than non-physically active group. Moreover, a significantly higher theta power spectrum in the Fp1 during the condition C in the SCWT and a higher volume in the right rostral middle frontal gyrus have been found in the physically active group. Furthermore, physically active women with FM showed positively correlations between correct responses in names of colors printed in black condition (W) in the SCWT and theta power in the F3, Fz, Fp2 and F4 scalp positions. Regarding non-physically active women with FM, errors in condition CW negatively correlated with the volume of left superior frontal gyrus, left rostral middle frontal gyrus, right rostral middle frontal gyrus, left caudal middle frontal gyrus and right caudal middle frontal gyrus. Furthermore, physically active group showed increased performance in the 6 min walking test and lower disease impact. Fulfil the physical activity recommendation seems to protect brain health since better SCWT performance, greater frontal theta power and higher volume in the right rostral middle frontal gyrus have been found in physically active women with FM.

Effects of a Physical Literacy Breaks (PLBreaks) Program on Physical Literacy and Body Composition in Portuguese Schoolchildren: A Study Protocol.

(1) Background: Several studies have shown that active breaks have led to different improvements in their participants. However, no studies have assessed how they affect physical literacy (PL). (2) Aims: Therefore, this study will examine the effect of the PLBreaks programme on school children's PL and body composition. (3) Methods: A parallel-group randomised controlled trial will be conducted with assessments of PL (Canadian Assessment of Physical Literacy Development) and body composition (height, bodyweight, fat mass and fat-free mass) before and after an active breaks programme. PLBreak programme will run for 3 months and will be carried out 3 days a week for 20 min each day. The PLBreaks programme will consist of two blocks of 10 min of different physical activities (PA). The first block will be focused on the acquisition of knowledge and healthy life habits that will contribute to the development of the domains of knowledge and understanding and daily activity. The second block will be focused on physical competence and motivation throughout games. (4) Conclusions: The present study will investigate the efficacy of PLBreaks in schoolchildren in improving their PL and body composition. If the efficacy of the program is demonstrated, including the programme in public education programmes can be possible. This could be a scientific breakthrough in terms of health-related PA improvement and adherence, as well as the prevention of diseases associated with inactivity.

Fibromyalgia impact in the prefrontal cortex subfields: An assessment with MRI.

INTRODUCTION: Previous studies have associated brain abnormalities in people with fibromyalgia with accelerated brain ageing. The prefrontal cortex is located in the anterior pole of the mammalian brain. It is defined as the part of the cerebral cortex that receives projections from the mediodorsal nucleus of the thalamus. AIM: This study aimed to evaluate the volumetric differences in the prefrontal cortex subfields between healthy women and women with fibromyalgia using magnetic resonance imaging (MRI) and controlling for age, estimated intracranial volume, depression, and cognitive impairment. MATERIAL AND METHODS: A total of 47 women with fibromyalgia (recruited from a fibromyalgia local association) and 43 healthy women (retrieved from the Open Access Series of Imaging Studies database) participated in this cross-sectional study. Multiple linear regressions were used to predict the value of the prefrontal cortex subfields as well as to determine if there were volumetric differences between the groups. RESULTS: Volume of all prefrontal cortex regions decreased with each year of age. Healthy women showed higher volume in all the prefrontal cortex subfields than women with fibromyalgia. Regarding partial correlations performed, no significant relation were found between the fibromyalgia impact and the brain volumes analyzed, controlling for depression. CONCLUSIONS: Women with fibromyalgia showed reduced volume in the right caudal middle frontal gyrus, rostral middle frontal gyrus, left inferior frontal gyrus pars opercularis, inferior frontal gyrus pars triangularis, inferior frontal gyrus pars orbitalis, lateral orbitofrontal cortex, right medial orbitofrontal cortex, right rostral anterior cingulate gyrus subfields of the prefrontal cortex and total gray matter compared to healthy women. Furthermore, through an analysis of multiple linear regressions, the left rostral middle frontal gyrus and left lateral orbitofrontal cortex showed significantly volumetric decreases related to depression levels. The total gray matter also shows a significant decrease related to age observed through the analysis of multiple linear regressions. No significant relation were found between the impact of the disease and the brain volumes analyzed, controlling for depression in women with fibromyalgia.

What Mathematical Models Are Accurate for Prescribing Aerobic Exercise in Women with Fibromyalgia?

OBJECTIVES: This article aims to verify the agreement between the standard method to determine the heart rate achieved in the ventilatory threshold 1 in the cardiopulmonary exercise testing (VT1) and the mathematical models with exercise intensities suggested by the literature in order to check the most precise for fibromyalgia (FM) patients. METHODS: Seventeen women with FM were included in this study. The VT1 was used as the standard method to compare four mathematical models applied in the literature to calculate the exercise intensity in FM patients: the well-known "220 - age" at 76%, Tanaka predictive equation "208 - 0.7 × age" at 76%, the FM model HRMax "209 - 0.85 × age" at 76%, and Karvonen Formula at 60%. Bland-Altman analysis and correlation analyses were used to explore agreement and correlation between the standard method and the mathematical models. RESULTS: Significant correlations between the heart rate at the VT1 and the four mathematical estimation models were observed. However, the Bland-Altman analysis only showed agreement between VT1 and "220 - age" (bias = -114.83 + 0.868 × x; 95% LOA = -114.83 + 0.868 × x + 1.96 × 7.46 to -114.83 + 0.868 × x - 1.96 × 7.46, where x is the average between the heart rate obtained in the CPET at VT1 and "220 - age", in this case 129.15; p = 0.519) and "209 - 0.85 × age"(bias = -129.58 + 1.024 × x; 95% LOA = -129.58 + 1.024 × x + 1.96 × 6.619 to -129.58 + 1.024 × x - 1.96 × 6.619, where x is the average between the heart rate obtained in the CPET at VT1 and "209 - 0.85 × age", in this case 127.30; p = 0.403). CONCLUSIONS: The well-known predictive equation "220 - age" and the FM model HRMax ("209 - 0.85 × age") showed agreement with the standard method (VT1), revealing that it is a precise model to calculate the exercise intensity in sedentary FM patients. However, proportional bias has been detected in all the mathematical models, with a higher heart rate obtained in CPET than obtained in the mathematical model. The chronotropic incompetence observed in people with FM (inability to increase heart rate with increasing exercise intensities) could explain why methods that tend to underestimate the HRmax in the general population fit better in this population.

Benefits of Equine-Assisted Therapies in People with Multiple Sclerosis: A Systematic Review.

This systematic review aimed to provide an up-to-date analysis of the effects of equine-assisted therapies (EAT) in people with multiple sclerosis (PwMS). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed to conduct this systematic review. PubMed and Web of Science databases were employed in the search, which ended in February 2022. The risk of bias analysis was performed using the Evidence Project tool. After removing duplicates, thirty-nine studies were identified. However, only ten fulfilled the inclusion criteria and were included in this systematic review. Therefore, a total of 195 PwMS, aged between 40.3 and 51.3, were included in this systematic review. EAT-based interventions had a mean length of 13.6 weeks with a session´s frequency ranging from ten to once a week. All sessions involved real horses and lasted a mean of 34.4 min. Among the included articles, four were randomized controlled trials (RCT), four did not perform randomization, and two employed a prepost design without a control group. RCTs showed positive effects on quality of life, fatigue, balance, spasticity, and gait speed. Furthermore, non-RCT showed improvements in balance, spasticity, and postural control (postural control was not assessed in RCT studies). Importantly, significant effects were only observed when the comparison group was inactive or followed usual care. Therefore, EAT is a promising and effective therapy to improve quality of life, fatigue, balance, spasticity, and gait speed in PwMS. However, since comparison groups are heterogeneous, results could vary depending on the research design. Moreover, the inclusion of noncontrolled studies (in order to have a wide perspective of the state of art) could increase the risk of bias and make the results be taken with caution.