ECSS Paris 2023: CP-MH01
INTRODUCTION: Emotional distress (ED) is known as a critical risk factor for mortality. The suicide rate in South Korea has been the highest among OECD nations, emphasizing the need for effective interventions to mitigate this risk associated with ED. Current physical activity (PA) guidelines recommend adults to engage in at least 150 min/wk of moderate to vigorous PA (MVPA) to prevent and manage health problems. However, the protective effect of PA against mortality in individuals with ED remains unclear. This study aims to investigate the impact of PA on mortality in individuals with ED. METHODS: This study included 35,059 Korean adults from the 2007-2013 Korea National Health and Nutrition Examination Survey, with their all-cause and cardiovascular disease (CVD) mortality data linked up to 2019. ED was assessed using a self-reported questionnaire that evaluated the presence of stress, depressive symptoms (DS), and suicidal thoughts (ST). MVPA levels were also determined by questionnaires and classified as inactive (0 min/week), insufficiently active (<150 min/wk), and active (>=150 min/wk). Cox proportional hazards model was applied to estimate the risks of mortality associated with ED and MVPA levels. The study also assessed the combined effect of emotional status and MVPA on the risk of mortality. In a combined analysis investigating the association between ED and mortality risk across different levels of MVPA, six groups were categorized based on the presence of ED and MVPA levels (inactive, insufficiently active, active). RESULTS: Over a mean follow-up of 9.2 years, 2,033 deaths occurred, including 439 from CVD. The hazard ratios (HR) for all-cause mortality due to stress, DS, and ST were 1.13 (95% CI: 1.02-1.26), 1.13 (1.00-1.27), and 1.34 (1.21-1.49), when compared to non-affected individuals. For those with all three ED categories, the HRs for all-cause and CVD mortality were 1.31 (1.10-1.55), and 1.72 (1.24-2.39). Adhering to PA guidelines was significantly associated with lower risk of mortality: 0.76 (0.62-0.94) for stress, 0.71 (0.55-0.92) for DS, and 0.76 (0.62-0.95) for ST. Similarly, CVD mortality risks were reduced to 0.47 (0.29-0.77), 0.43 (0.23-0.79), and 0.65 (0.41-1.02) for stress, DS, and ST, respectively. In the combined analysis, individuals with ED who engage in PA (either insufficiently active (HR =0.75 (0.57-0.98) or active (HR=0.79 (0.67-0.93)) were associated with a lower risk of all-cause mortality compared to those without ED but who were inactive (HR=0.83 (0.74-0.93)). Similar patterns of associations were observed for CVD mortality. CONCLUSION: ED and MVPA were both independent predictors for risk of mortality. The higher risk of mortality associated with ED was significantly reduced by adherence to PA guidelines. Combined analysis also indicated that PA is associated with a lower mortality risk in individuals with ED, emphasizing the importance of promoting PA as a key strategy for reducing mortality risk in public health.
Read CV Su yeon KimECSS Paris 2023: CP-MH01
INTRODUCTION: Resistance exercise is the primary therapeutic strategy to counteract age-related declines in muscle function. To individualize exercise intensity, training loads are often prescribed based on an individual’s one-repetition maximum (1-RM) [1]. Despite the excellent reliability of 1-RM measurements [2], the protocol is time-consuming and may enhance the risk of injuries, especially in older adults [3]. Consequently, various approaches for estimating 1-RM, and thus accurate training intensity, have been introduced. The load-velocity (L-v) profile has emerged as one potential method, considering that movement velocity can accurately predict relative load [4]. Therefore, the aim of this analysis was to determine how accurately the 1-RM of older men can be estimated from their individual L-v profile. METHODS: Sixty-four men (66.9 ± 5.4 years old) completed the L-v profiling protocol on a pneumatic leg press device [5]. The protocol started with a maximal isometric test, followed by explosive concentric leg extensions at five pre-fixed increasing loads. Each load was a set percentage of the maximal isometric force, and participants performed 2 to 3 attempts per load. For each of the five loads, the attempt with the highest mean velocity was selected, and the load and velocity values of that attempt were used to create each participant’s individualized linear regression equation. Following the five sub-maximal contractions, all participants performed additional single repetitions until reaching 1-RM. Each individual’s velocity at 1-RM was recorded and used to calculate the group’s mean velocity at 1-RM. This value (0.10 ± 0.07 m/s) was used as an input in the individualized L-v equations to finally obtain each individual’s estimated 1-RM. RESULTS: Estimated 1-RM was slightly higher than measured 1-RM, but the difference was not significant (-0.5 ± 6.4 kg, p=0.525). In addition, the methods showed excellent absolute agreement (ICC=0.92, p<0.001). Despite the strong relationship at a group level, there was substantial inter-individual variability in the agreement between the two methods. The large difference between the estimated and measured 1-RM in some individuals was reflected in the Bland-Altman plot, as well as in the linear regression analysis that yielded a standard error of estimate of 6.3 kg. CONCLUSION: Estimating 1-RM from L-v profiling provides a low risk, time-efficient alternative for prescribing resistance training load. The results are promising at a group level but may not be generalizable to all individuals and should therefore be interpreted with caution. REFERENCES: 1. Thompson, S.W., et al. Sports Med, 2020. 50(5): p. 919-938. 2. McMaster, D.T., et al. Sports Med, 2014. 44(5): p. 603-23. 3. Niewiadomski, W., et al. J Hum Kinet, 2008. 19(1): p. 109-120. 4. González-Badillo, J.J. and L. Sánchez-Medina. Int J Sports Med, 2010. 31(5): p. 347-52. 5. Poffé, C., et al. J Sports Sci Med, 2023. 22(2): p. 345-357.
Read CV Jolien DeboutteECSS Paris 2023: CP-MH01
INTRODUCTION: Registered Clinical Exercise Physiologists (CEPs) are recognised healthcare professionals in the United Kingdom (UK) and are registered through the Academy of Healthcare Science (AHCS). Their practice is guided by the Clinical Exercise Physiology UK (CEP-UK) standards outlined in the scope of practice [1] and the accompanying curriculum framework [2]. This study aimed to identify and reach consensus on the key knowledge and skills of a UK CEP. METHODS: Two phases, (i) a scoping review, (ii) a modified, 1-round Delphi survey were utilised. Key requirements were identified from analysis of 24 studies in the scoping review, and the current UK CEP standards and training documents. The survey contained CEP knowledge and skills (n=58), health conditions that a CEP should be able to work with (n=15), and healthcare professions that a CEP should understand the roles and expertise of (n=9). Academics (n=26), healthcare professionals (n=25), CEPs (n=10), service managers (n=6), and researchers (n=4) were identified through purposive sampling (university websites, and databases of exercise rehabilitation services), public advertisement through social media, and snowball sampling. A 1-to-5 rating Likert scale was completed by participants based on the importance of each component for a CEP to practice effectively in the UK. RESULTS: n=58 of the 71 participants identified (82%) completed the survey. All knowledge and skills identified from the scoping review and the CEP-UK and AHCS standards and training documents (n=58) were accepted, with those in clinical practice (99.7%) deemed the most important and those in behaviour change and communication (82.7%) the least important. n=12 of the 15 health conditions identified (80%) were accepted, with cardiovascular and respiratory diseases (100%) being the most important and eating disorders (54%) the least important. All healthcare professions (n=9) were accepted, with specialist exercise instructors (100%) being the most important and podiatrists (73%) the least important. CONCLUSION: The final consensus list contains 58 key knowledge and skills, 12 health conditions and 9 healthcare professions that are important for CEPs to work effectively in UK healthcare. This list shows that the current CEP-UK curriculum framework is fit for purpose. Further, this could contribute to future iterations of the framework, and form the bedrock of a growing workforce in the UK. 1. Clinical Exercise Physiology UK (2022a) The Scope of Practice for a UK Clinical Exercise Physiologist [online] Available at: https://www.clinicalexercisephysiology.org.uk/application-resources [Accessed: 22nd January 2024] 2. Clinical Exercise Physiology UK (2022b) Clinical Exercise Physiology Curriculum Framework Statement [online] Available at: https://www.clinicalexercisephysiology.org.uk/msc-degree-accreditation [Accessed: 22nd January 2024]
Read CV Connor OsinECSS Paris 2023: CP-MH01