The exercise-app Axia for axial spondyloarthritis enhances the home-based exercise frequency in axial spondyloarthritis patients - A cross-sectional survey.

BACKGROUND: Patients with axial spondyloarthritis (axSpA) benefit from regular home-based exercise (HbE). In spite of recommendations, a relevant proportion of German axSpA patients does not adhere to recommended HbE practices. To enhance HbE care, we developed the novel digital therapeutic (DTx) "Axia" compliant with the European medical device regulation (MDR). Axia offers a modern app-based HbE solution with patient educative content and further integrated features. OBJECTIVE: We aimed to assess Axia's efficacy, attractiveness, and functionality through a survey among axSpA-patients involved in the first user tests. METHODS: A mixed-method online questionnaire with 38 items was administered to 37 axSpA volunteers after using Axia. Numeric rating scales (NRS) and likelihood scales were primarily used. RESULTS: HbE frequency significantly increased from a median of 1 day/week to 6 days/week (p < 0.001) by using Axia. Existing HbE practitioners also increased their frequency (median of 4 days/week before, 6 days/week with Axia, p < 0.05). Axia received a median rating of 5 out of 5 stars. On NRS scales, Axia scored a median of 9 for intuitiveness and design, and a median of 8 for entertainment. 64.9% reported improved range of motion, 43.2% reported reduced pain, and 93.6% enhanced disease-specific knowledge. All users recommended Axia to other patients. CONCLUSION: Axia increases axSpA patients HbE frequency, possibly due to its good intuitiveness and design, leading to reduction in pain and subjective improvement of range of motion. This warrants further investigation in large randomized controlled interventional trials to establish its efficacy conclusively and patients adherence to HbE.

Strengths, weaknesses, opportunities, and threats associated with the application of artificial intelligence in connection with sport research, coaching, and optimization of athletic performance: a brief SWOT analysis.

Here, we performed a non-systematic analysis of the strength, weaknesses, opportunities, and threats (SWOT) associated with the application of artificial intelligence to sports research, coaching and optimization of athletic performance. The strength of AI with regards to applied sports research, coaching and athletic performance involve the automation of time-consuming tasks, processing and analysis of large amounts of data, and recognition of complex patterns and relationships. However, it is also essential to be aware of the weaknesses associated with the integration of AI into this field. For instance, it is imperative that the data employed to train the AI system be both diverse and complete, in addition to as unbiased as possible with respect to factors such as the gender, level of performance, and experience of an athlete. Other challenges include e.g., limited adaptability to novel situations and the cost and other resources required. Opportunities include the possibility to monitor athletes both long-term and in real-time, the potential discovery of novel indicators of performance, and prediction of risk for future injury. Leveraging these opportunities can transform athletic development and the practice of sports science in general. Threats include over-dependence on technology, less involvement of human expertise, risks with respect to data privacy, breaching of the integrity and manipulation of data, and resistance to adopting such new technology. Understanding and addressing these SWOT factors is essential for maximizing the benefits of AI while mitigating its risks, thereby paving the way for its successful integration into sport science research, coaching, and optimization of athletic performance.

Evaluating blood oxygen saturation measurements by popular fitness trackers in postoperative patients: A prospective clinical trial.

Blood oxygen saturation is an important clinical parameter, especially in postoperative hospitalized patients, monitored in clinical practice by arterial blood gas (ABG) and/or pulse oximetry that both are not suitable for a long-term continuous monitoring of patients during the entire hospital stay, or beyond. Technological advances developed recently for consumer-grade fitness trackers could-at least in theory-help to fill in this gap, but benchmarks on the applicability and accuracy of these technologies in hospitalized patients are currently lacking. We therefore conducted at the postanaesthesia care unit under controlled settings a prospective clinical trial with 201 patients, comparing in total >1,000 oxygen blood saturation measurements by fitness trackers of three brands with the ABG gold standard and with pulse oximetry. Our results suggest that, despite of an overall still tolerable measuring accuracy, comparatively high dropout rates severely limit the possibilities of employing fitness trackers, particularly during the immediate postoperative period of hospitalized patients.

Accuracy and Systematic Biases of Heart Rate Measurements by Consumer-Grade Fitness Trackers in Postoperative Patients: Prospective Clinical Trial.

BACKGROUND: Over the recent years, technological advances of wrist-worn fitness trackers heralded a new era in the continuous monitoring of vital signs. So far, these devices have primarily been used for sports. OBJECTIVE: However, for using these technologies in health care, further validations of the measurement accuracy in hospitalized patients are essential but lacking to date. METHODS: We conducted a prospective validation study with 201 patients after moderate to major surgery in a controlled setting to benchmark the accuracy of heart rate measurements in 4 consumer-grade fitness trackers (Apple Watch 7, Garmin Fenix 6 Pro, Withings ScanWatch, and Fitbit Sense) against the clinical gold standard (electrocardiography). RESULTS: All devices exhibited high correlation (r≥0.95; P<.001) and concordance (rc≥0.94) coefficients, with a relative error as low as mean absolute percentage error <5% based on 1630 valid measurements. We identified confounders significantly biasing the measurement accuracy, although not at clinically relevant levels (mean absolute error<5 beats per minute). CONCLUSIONS: Consumer-grade fitness trackers appear promising in hospitalized patients for monitoring heart rate. TRIAL REGISTRATION: ClinicalTrials.gov NCT05418881; https://www.clinicaltrials.gov/ct2/show/NCT05418881.

Retrospective Analysis of Training Intensity Distribution Based on Race Pace Versus Physiological Benchmarks in Highly Trained Sprint Kayakers.

BACKGROUND: Research results on the training intensity distribution (TID) in endurance athletes are equivocal. This non-uniformity appears to be partially founded in the different quantification methods that are implemented. So far, TID research has solely focused on sports involving the lower-body muscles as prime movers (e.g. running). Sprint kayaking imposes high demands on the upper-body endurance capacity of the athlete. As there are structural and physiological differences between upper- and lower-body musculature, TID in kayaking should be different to lower-body dominant sports. Therefore, we aimed to compare the training intensity distribution during an 8-wk macrocycle in a group of highly trained sprint kayakers employing three different methods of training intensity quantification. METHODS: Heart rate (HR) and velocity during on-water training of nine highly trained German sprint kayakers were recorded during the final 8 weeks of a competition period leading to the national championships. The fractional analysis of TID was based on three zones (Z) derived from either HR (TIDBla-HR) or velocity (TIDBla-V) based on blood lactate (Bla) concentrations (Z1 ≤ 2.5 mmol L-1 Bla, Z2 = 2.5-4.0 mmol L-1 Bla, Z3 ≥ 4.0 mmol L-1 Bla) of an incremental test or the 1000-m race pace (TIDRace): Z1 ≤ 85% of race pace, Z2 = 86-95% and Z3 ≥ 95%. RESULTS: TIDBla-V (Z1: 68%, Z2: 14%, Z3: 18%) differed from TIDBla-HR (Z1: 91%, Z2: 6%, Z3: 3%) in each zone (all p < 0.01). TIDRace (Z1: 73%, Z2: 20%, Z3: 7%) differed to Z3 in TIDBla-V (p < 0.01) and all three TIDBla-HR zones (all p < 0.01). Individual analysis revealed ranges of Z1, Z2, Z3 fractions for TIDBla-HR of 85-98%, 2-11% and 0.1-6%. For TIDBla-V, the individual ranges were 41-82% (Z1), 6-30% (Z2) and 8-30% (Z3) and for TIDRace 64-81% (Z1), 14-29% (Z2) and 4-10% (Z3). CONCLUSION: The results show that the method of training intensity quantification substantially affects the fraction of TID in well-trained sprint kayakers. TIDRace determination shows low interindividual variation compared to the physiologically based TIDBla-HR and TIDBla-V. Depending on the aim of the analysis TIDRace, TIDBla-HR and TIDBla-V have advantages as well as drawbacks and may be implemented in conjunction to maximize adaptation.

Establishing a cardiac training group for patients with heart failure: the "HIP-in-Würzburg" study.

BACKGROUND: Exercise training in heart failure (HF) is recommended but not routinely offered, because of logistic and safety-related reasons. In 2020, the German Society for Prevention&Rehabilitation and the German Society for Cardiology requested establishing dedicated "HF training groups." Here, we aimed to implement and evaluate the feasibility and safety of one of the first HF training groups in Germany. METHODS: Twelve patients (three women) with symptomatic HF (NYHA class II/III) and an ejection fraction ≤ 45% participated and were offered weekly, physician-supervised exercise training for 1 year. Patients received a wrist-worn pedometer (M430 Polar) and underwent the following assessments at baseline and after 4, 8 and 12 months: cardiopulmonary exercise test, 6-min walk test, echocardiography (blinded reading), and quality of life assessment (Kansas City Cardiomyopathy Questionnaire, KCCQ). RESULTS: All patients (median age [quartiles] 64 [49; 64] years) completed the study and participated in 76% of the offered 36 training sessions. The pedometer was worn ≥ 1000 min per day over 86% of the time. No cardiovascular events occurred during training. Across 12 months, NT-proBNP dropped from 986 pg/ml [455; 1937] to 483 pg/ml [247; 2322], and LVEF increased from 36% [29;41] to 41% [32;46]%, (p for trend = 0.01). We observed no changes in exercise capacity except for a subtle increase in peak VO2% predicted, from 66.5 [49; 77] to 67 [52; 78]; p for trend = 0.03. The physical function and social limitation domains of the KCCQ improved from 60 [54; 82] to 71 [58; 95, and from 63 [39; 83] to 78 [64; 92]; p for trend = 0.04 and = 0.01, respectively. Positive trends were further seen for the clinical and overall summary scores. CONCLUSION: This pilot study showed that the implementation of a supervised HF-exercise program is feasible, safe, and has the potential to improve both quality of life and surrogate markers of HF severity. This first exercise experiment should facilitate the design of risk-adopted training programs for patients with HF.

The integration of training and off-training activities substantially alters training volume and load analysis in elite rowers.

Training studies in elite athletes traditionally focus on the relationship between scheduled training (TRAIN) and performance. Here, we added activities outside of scheduled training i.e., off-training (OFF) contributing to total training (TOTAL) to evaluate the contribution of OFF on performance. Eight elite rowers recorded OFF and TRAIN during waking hours for one season (30-45 weeks) with multisensory smartwatches. Changes in performance were assessed via rowing ergometer testing and maximum oxygen uptake ([Formula: see text]O2max). Based on 1-Hz-sampling of heart rate data during TRAIN and OFF (> 60% maximum heart rate (HRmax), the volume, session count, intensity, training impulse (TRIMP), and training intensity distribution were calculated. OFF altered volume, TRIMP, and session count by 19 ± 13%, 13 ± 9%, and 41 ± 67% (p < 0.001). On an individual level, training intensity distribution changed in 3% of the valid weeks. Athletes exercised 31% of their weekly volume below 60% HRmax. Low to moderate intensities dominated during OFF with 87% (95% CI [79, 95]); however, in some weeks high-intensity activities > 89% HRmax during OFF amounted to 21 min·week-1 (95% CI [4, 45]). No effect of OFF on changes of performance surrogates was found (0.072 > p > 0.604). The integration of OFF substantially altered volume, TRIMP, and session count. However, no effect on performance was found.

The Relationship Between the Distribution of Training Intensity and Performance of Kayak and Canoe Sprinters: A Retrospective Observational Analysis of One Season of Competition.

Purpose: To evaluate retrospectively the training intensity distribution (TID) among highly trained canoe sprinters during a single season and to relate TID to changes in performance. Methods: The heart rates during on-water training by 11 German sprint kayakers (7 women, 4 men) and one male canoeist were monitored during preparation periods (PP) 1 and 2, as well as during the period of competition (CP) (total monitoring period: 37 weeks). The zones of training intensity (Z) were defined as Z1 [<80% of peak oxygen consumption (VO2peak)], Z2 (81-87% VO2peak) and Z3 (>87% VO2peak), as determined by 4 × 1,500-m incremental testing on-water. Prior to and after each period, the time required to complete the last 1,500-m stage (all-out) of the incremental test (1,500-m time-trial), velocities associated with 2 and 4 mmol·L-1 blood lactate (v2[BLa], v4[BLa]) and VO2peak were determined. Results: During each period, the mean TID for the entire group was pyramidal (PP1: 84/12/4%, PP2: 80/12/8% and CP: 91/5/4% for Z1, Z2, Z3) and total training time on-water increased from 5.0 ± 0.9 h (PP1) to 6.1 ± 0.9 h (PP2) and 6.5 ± 1.0 h (CP). The individual ranges for Z1, Z2 and Z3 were 61-96, 2-26 and 0-19%. During PP2 VO2peak (25.5 ± 11.4%) markedly increased compared to PP1 and CP and during PP1 v2[bla] (3.6 ± 3.4%) showed greater improvement compared to PP2, but not to CP. All variables related to performance improved as the season progressed, but no other effects were observed. With respect to time-trial performance, the time spent in Z1 (r = 0.66, p = 0.01) and total time in all three zones (r = 0.66, p = 0.01) showed positive correlations, while the time spent in Z2 (r = -0.57, p = 0.04) was negatively correlated. Conclusions: This seasonal analysis of the effects of training revealed extensive inter-individual variability. Overall, TID was pyramidal during the entire period of observation, with a tendency toward improvement in VO2peak, v2[bla], v4[bla] and time-trial performance. During PP2, when the COVID-19 lockdown was in place, the proportion of time spent in Z3 doubled, while that spent in Z1 was lowered; the total time spent training on water increased; these changes may have accentuated the improvement in performance during this period. A further increase in total on-water training time during CP was made possible by reductions in the proportions of time spent in Z2 and Z3, so that more fractions of time was spent in Z1.

The Impact of the German Strategy for Containment of Coronavirus SARS-CoV-2 on Training Characteristics, Physical Activity and Sleep of Highly Trained Kayakers and Canoeists: A Retrospective Observational Study.

Aim: To characterize the impact of the German strategy for containment of Coronavirus SARS-CoV-2 (social distancing and lockdown) on the training, other habitual physical activity, and sleep in highly trained kayakers and canoeists. Method: During the 4 weeks immediately prior to and following the beginning of the German government's strategy for containment of Coronavirus SARS-CoV-2 on March 23, 2020, 14 highly trained athletes (VO2peak: 3,162 ± 774 ml/min; 500-m best time: 117.9 ± 7.9 s) wore a multi-sensor smartwatch to allow continuous assessment of heart rate, physical activity, and sleep duration. Result: In comparison to before lockdown, the overall weekly training time and the average length of each session of training during the lockdown decreased by 27.6% (P = 0.02; d = 0.91) and 15.4% (P = 0.36; d = 0.36), respectively. At the same time, the number of sessions involving specific (i.e., canoeing and kayaking) and non-specific (i.e., running, cycling) training, respectively, did not change (P = 0.36-0.37; d = 0.34-0.35). The number of sessions involving strength (+17.4%; P = 0.03; d = 0.89) or other types of training (+16.7%; P = 0.06; d = 0.75) increased during the lockdown with 2.8-17.5% more training time involving a heart rate <60%, 82-88, 89-93, or 94-100% of individual peak heart rate (HRpeak) (P = 0.03-0.86; d = 0.07-1.38), and 4.3-18.7% less time with a heart rate of 60-72 or 73-83% HRpeak (P = < 0.001-0.0.26; d = 0.44-2.24). The daily duration of sleep was ~30 min (6.7%) longer during the lockdown (P < 0.001; d = 1.53) and the overall time spent lying down was 17% greater (P < 0.001; d = 2.26); whereas sitting time (-9.4%; P = 0.003; d = 1.23), the duration of light (15 min; -7.3%; P = 0.04; d = 0.83), and moderate (-18.6%; P = 0.01; d = 1.00) physical activity other than training (-9.4%; P = 0.22; d = 0.00) were all lower during lockdown. Conclusion: The present data revealed that following the German lockdown for containment of the Coronavirus SARS-CoV-2, highly trained kayakers and canoeists spent less overall time training each week (-27.6%) with, on average, shorter training sessions (-15.1%) and less light-to-moderate physical activity outside of training. Moreover, they performed more strength training sessions per week, and all engaged in more training at intensities >82 and <60% of HRpeak and spent longer periods lying down and sleeping during the lockdown.

Intra-individual physiological response of recreational runners to different training mesocycles: a randomized cross-over study.

PURPOSE: Pronounced differences in individual physiological adaptation may occur following various training mesocycles in runners. Here we aimed to assess the individual changes in performance and physiological adaptation of recreational runners performing mesocycles with different intensity, duration and frequency. METHODS: Employing a randomized cross-over design, the intra-individual physiological responses [i.e., peak ([Formula: see text]) and submaximal ([Formula: see text]) oxygen uptake, velocity at lactate thresholds (V2, V4)] and performance (time-to-exhaustion (TTE)) of 13 recreational runners who performed three 3-week sessions of high-intensity interval training (HIIT), high-volume low-intensity training (HVLIT) or more but shorter sessions of HVLIT (high-frequency training; HFT) were assessed. RESULTS: [Formula: see text], V2, V4 and TTE were not altered by HIIT, HVLIT or HFT (p > 0.05). [Formula: see text] improved to the same extent following HVLIT (p = 0.045) and HFT (p = 0.02). The number of moderately negative responders was higher following HIIT (15.4%); and HFT (15.4%) than HVLIT (7.6%). The number of very positive responders was higher following HVLIT (38.5%) than HFT (23%) or HIIT (7.7%). 46% of the runners responded positively to two mesocycles, while 23% did not respond to any. CONCLUSION: On a group level, none of the interventions altered [Formula: see text], V2, V4 or TTE, while HVLIT and HFT improved [Formula: see text]. The mean adaptation index indicated similar numbers of positive, negative and non-responders to HIIT, HVLIT and HFT, but more very positive responders to HVLIT than HFT or HIIT. 46% responded positively to two mesocycles, while 23% did not respond to any. These findings indicate that the magnitude of responses to HIIT, HVLIT and HFT is highly individual and no pattern was apparent.

A 4-Week Intervention Involving Mobile-Based Daily 6-Minute Micro-Sessions of Functional High-Intensity Circuit Training Improves Strength and Quality of Life, but Not Cardio-Respiratory Fitness of Young Untrained Adults.

The present study was designed to assess the psycho-physiological responses of physically untrained individuals to mobile-based multi-stimulating, circuit-like, multiple-joint conditioning (CircuitHIIT) performed either once (1xCircuitHIIT) or twice (2xCircuitHIIT) daily for 4 weeks. In this single-center, two-arm randomized, controlled study, 24 men and women (age: 25 ± 5 years) first received no training instructions for 4 weeks and then performed 4 weeks of either 1xCircuitHIIT or 2xCircuitHIIT (5 men and 7 women in each group) daily. The 1xCircuitHIIT and 2xCircuitHIIT participants carried out 90.7 and 85.7% of all planned training sessions, respectively, with average heart rates during the 6-min sessions of 74.3 and 70.8% of maximal heart rate. Body, fat and fat-free mass, and metabolic rate at rest did not differ between the groups or between time-points of measurement. Heart rate while running at 6 km⋅h-1 declined after the intervention in both groups. Submaximal and peak oxygen uptake, the respiratory exchange ratio and heart rate recovery were not altered by either intervention. The maximal numbers of push-ups, leg-levers, burpees, 45°-one-legged squats and 30-s skipping, as well as perception of general health improved in both groups. Our 1xCircuitHIIT or 2xCircuitHIIT interventions improved certain parameters of functional strength and certain dimensions of quality of life in young untrained individuals. However, they were not sufficient to enhance cardio-respiratory fitness, in particular peak oxygen uptake.