Research in Health and Medicine (ISSN: 3066-0777) is an open access, peer-reviewed journal. The journal encourages authors to submit research in the health sciences, epidemiology, physical activity, health disparities and other health-related lines of inquiry.
Copyright, 2026 by the authors. This work is licensed under the Creative Commons Attribution 4.0 International License.
A Single Bout of Continuous Blood Flow Restriction Walking Does Not Negatively Affect Lower Limb Microvascular Function
Introduction: Diminished macrovascular vasodilatory function has been reported following one blood flow restriction (BFR) walking bout. The primary aim was to investigate the potential effect that walking exercise (control, BFR) and cool-down (supine, rolling massage [RM], walk) had on microvascular function. Methods: Fourteen participants walked for 15 minutes at a 3/10 rating of perceived exertion without (Session 1) and with (Sessions 2-4) BFR (60% limb occlusion pressure, LOP). Participants either rested supine, had RM performed on the thigh, or actively walked for the first two minutes of the cool-down. Microvascular functions of the quadriceps and calf muscles of a randomized leg were measured before and 20 minutes after each walking bout using the vascular occlusion test (VOT) via near-infrared spectroscopy. Between session intraclass correlations (ICC) and minimal detectable change (MDC) were calculated for microvascular function of each muscle. Two-way repeated measures analysis of variance was performed to assess if condition (CON+Supine, BFR+Supine, BFR+RM, BFR+Walk) and/or time (pre-exercise, post-exercise) affected microvascular function. Statistical significance was set at p<0.05. Results: Quadriceps (ICC=0.891, MDC=0.60 %/s) and calf (ICC=0.839, MDC=0.63 %/s) microvascular function demonstrated good between session reliability. Microvascular function statistically increased in the quadriceps (0.88±0.74 %/s vs 1.07±0.70 %/s) and calf (0.56±0.57 %/s vs 0.75±0.70 %/s) muscles after exercise; however, the changes (quadriceps=0.13 %/s, calf=0.19 %/s) did not exceed the MDC. No significant differences in microvascular function were observed between conditions. Conclusions: Microvascular function was maintained following fifteen minutes of continuous BFR walking with 60% LOP, regardless of the cool-down procedure.
Copyright (c) 2026 Trent Cayot, Stefanie Markwardt, Hadley Fisher, Kimberly Bowers, Tom Saint-Juvin, Noah Cantu, Nathanial Eckert https://creativecommons.org/licenses/by/4.0
Associations Between Fall Risk and Lower Limb Joint Range of Motion During Sit-to-Stand Among Community-Dwelling Older Adults
Introduction: Despite the sit-to-stand transition being an acute period of increased fall risk among older adults, it is currently unclear how lower-limb joint range-of-motion (ROM) during this task relates to fall risk. Methods: We examined 45 community-dwelling older adults (female = 32 (71.1%), age = 76.5±6.1years, BMI = 26.4±4.0kg/m2) within this cross-sectional study, assessing lower-limb mobility during 10 seconds of sit-to-stand repetitions using a single camera marker-less system. Hip and knee flexion, hip adduction, and ankle dorsiflexion were assessed for the right and left limbs, as well as asymmetry indices between sides. Fall risk was assessed using the STEADI checklist, Short Physical Performance Battery (SPPB), lower-body muscular power, postural sway, the Short Fall Efficacy Scale-International (FES-I), and 4-meter walking gait speed. Spearman’s rho (ρ) and Kruskal Wallis H-test were used due to nonnormal data distributions. Results: High fall risk participants had significantly lower muscular power (2.8±0.6W/kg, p = 0.004, ε2 = 0.187) and higher knee flexion asymmetry (4.5±2.5°; p = 0.021, ε2 = 0.121) than low fall risk participants (3.6±1.0W/kg; 2.9±2.4°). All correlations between joint movements and fall risk assessments were relatively small/weak (ρ ≤ |0.38|). Hip flexion asymmetries were significantly correlated with SPPB performance (ρ = -0.33, p = 0.03) and Short FES-I scores (i.e., fear of falling; ρ = 0.35, p = 0.02). Conclusions: Lower-limb ROM during the sit-to-stand transition may not be a strong indicator of fall risk on its own but may provide clinically relevant insight when paired with a validated fall risk assessment.
Copyright (c) 2026 Kworweinski Lafontant, Carla Stokes Leinbach, Nicolle Armas, Patria Marcano Maldonado, Jethro Raphael M. Suarez, Chitra Banarjee, Janet Lopez, Jeffrey R. Stout, David H. Fukuda, Ladda Thiamwong https://creativecommons.org/licenses/by/4.0
Cognitive Impairment and Depressive Symptoms Among Low-Income Hispanic and Non-Hispanic White Older Adults: A Cross-Sectional Analysis
Introduction: Hispanic older adults represent a rapidly growing demographic in the United States and may be disproportionately affected by cognitive impairment and depression. This study aimed to examine ethnic differences in the prevalence of cognitive impairment and depression among low-income Hispanic and non-Hispanic White older adults, and to explore the relationship between cognitive impairment and depressive symptoms within these groups. Methods: This cross-sectional study included 157 older adults (age = 76.3 ± 6.7 years, female = 133), recruited from independent living facilities and low-income community centers in Central Florida. The sample consisted of Hispanic (n = 91) and non-Hispanic White (n = 66) older adults. Cognitive impairment was assessed using the Memory Impairment Screen, and depression was measured using the Patient Health Questionnaire-9 (PHQ-9). Chi-square tests and Mann-Whitney U tests were used to analyze group differences. Results: A significant difference in cognitive impairment prevalence was found between ethnic groups (χ² = 7.528, p = .006), with Hispanic participants showing higher rates. However, depression scores did not significantly differ between Hispanic and non-Hispanic White participants (U = 2930.50, p = .79), nor between those with and without cognitive impairment within each ethnic group (Hispanic: U = 839.00, p = .71; non-Hispanic White: U = 227.50, p = .93). Conclusions: Cognitive impairment is more prevalent among low-income Hispanic older adults compared to their non-Hispanic White counterparts. These findings emphasize the need for culturally tailored interventions to improve cognitive health care access for older adults.
Copyright (c) 2026 Cecil Latta, Janet Lopez, Dahee Kim, Kworweinski Lafontant, Nicole Haberland, Trucvy Nguyen, Ayse Malatyali, Ladda Thiamwong https://creativecommons.org/licenses/by/4.0
Artificial Intelligence in Long-Term Care: Benefits and Concerns
In recent days, artificial intelligence (AI) has emerged as a valuable tool to reshape the long-term care industry. Integrating AI into long-term care facilities is a revolutionary achievement in supporting the growing aging population.
AI-powered technologies, health outcomes, quality of life.
Copyright (c) 2026 Kallol Kumar Bhattacharyya https://creativecommons.org/licenses/by/4.0
Mindfulness, Depression, and Fall Risk in Low-Income Older Adults
Introduction: Mindfulness, through mind-body practices, promotes awareness and presence. Its practice, along with reduced depression, may improve balance and lower fall risk in older adults. This study examined the association between mindfulness, depression, and fall risk among low-income, community-dwelling older adults. Methods: A descriptive cross-sectional study was conducted with 103 community-dwelling, low-income older adults, including 16 males and 87 females, with a mean age = 75.70 years (95% CI ± 7.19). Mindfulness was assessed with the Mindful Attention Awareness Scale (MAAS), depression using the Patient Health Questionnaire (PHQ-9) and fall risk with the CDC’s checklist for elderly accidents and injuries. Multiple regression analysis was conducted. Results: Mindfulness was negatively correlated with fall risk (r=-.437, p<.001), while depression was positively correlated with fall risk (r=.486, p<.001). These variables explained 31.1% of the variance in fall risk (R² = .311, p < .001). Mindfulness (β = -.262, p =.006) and depression (β = .306, p =.001), respectively, were significantly associated with fall risk. Conclusions: This study demonstrates that mindfulness and depression are predictors of fall risk. Community-dwelling low-income older adults may benefit from mind-body exercises. These exercises can help them become more aware and enhance their mental health, which may lower their risk of falling.
Community-dwelling low-income older adults
Copyright (c) 2025 Aleeyah Uddeen, Janet Lopez, Renata Komalasari, Manika Petcharat, Veronica Decker , Tatiana Orozco , Ladda Thiamwong https://creativecommons.org/licenses/by/4.0
Using Ecological Momentary Assessment to Examine Predictors of Motivation for Physical Activity in Older Adults
Introduction: Ecological Momentary Assessment (EMA) involves repeated assessments of patients’ real-time experiences. Smartphone delivery of EMA can monitor healthy behaviors, including physical activity (PA). PA is critical for maintaining mobility and independence in older adults. We aimed to utilize EMA for monitoring motivation for PA, while assessing PA and physical function (PF) as predictors. Methods: We collected 179 EMA responses from 28 community-dwelling older adults (Mage = 72.67±6.55 years, 82.1% female) over one week. Motivation for PA was determined using a single question delivered by a smartphone, PA was monitored using accelerometers, and PF was assessed using dynamic balance (Timed-Up-and-Go) and lower limb power (Sit-to-Stand). Results: Motivation for PA showed weak correlations with PA (ρ=0.187), dynamic balance (ρ=-0.157) and lower limb power (ρ=0.200). However, mixed effects models revealed that only better dynamic balance (p=0.001) predicted increased motivation. Conclusions: This study revealed the feasibility of monitoring motivation through mobile delivery of EMA, validating the method for future interventions. Evaluation of motivation can assess older adults’ subjective attitudes towards interventions. Additionally, these findings have implications for intervention designs that aim to increase engagement in PA; exercises or methods designed to improve dynamic balance may provide more lasting improvements than focusing on increasing PA alone.
Copyright (c) 2025 Chitra Banarjee, Rui Xie, Chen Chen, Janet Lopez, Ladda Thiamwong https://creativecommons.org/licenses/by/4.0
Accuracy of Physical Function-based Fall Risk Assessments Among Community-Dwelling Older Adults: An ROC Analysis
Introduction: Physical function assessments, such as the Timed-Up-and-Go (TUG) and Short Physical Performance Battery (SPPB), are commonly used to evaluate fall risk among older adults, yet they may misclassify individuals. Center-of-pressure postural sway path length (PS) is a criterion for assessing fall risk, but it is unclear how TUG and SPPB compare. This study examined the sensitivity, specificity, and accuracy of these three assessments in classifying older adults as high or low fall risk. Methods: We conducted a cross-sectional study of 234 community-dwelling older adults (women=203, age=75.0±7.0 years, height=159±7.9cm, Body Mass Index=30.0±6.3kg/m²). Cut off values for SPPB (<7 out of 12), TUG (≥20 seconds), and PS (>30 cm) were used to categorize participants as high or low fall risk. McNemar tests were used to compare fall risk assessment between assessments. Results: Participants had a mean TUG time of 10.2±6.3 seconds, SPPB score of 8.7±2.3, and PS of 34.7±21.3cm. Both TUG (high risk=10, low risk=224; X²=95.9, p<0.001) and SPPB (high risk=40, low risk=194; X²=55.7, p<0.001) significantly differed in fall risk assessment compared to PS (high risk=115, low risk=119). Compared to postural sway, TUG had a sensitivity of 4.3%, specificity of 95.8%, and accuracy of 50.9%. Similarly, SPPB had a sensitivity of 23.5%, specificity of 89.1%, and accuracy of 56.8%. Conclusions: TUG and SPPB both demonstrated low sensitivity and accuracy, suggesting that they may be better as measures of physical function rather than fall risk. Clinicians may benefit from using PS or other criterion measures to screen for fall risk.
Copyright (c) 2025 Estefania Zamarripa, Kworweinski Lafontant, David H. Fukuda, Jeffrey R. Stout, Ladda Thiamwong https://creativecommons.org/licenses/by/4.0
Firefighter Years: Mediating Effects of Years of Service on Physical Fitness
Introduction: Firefighters' biological age and years of service (YOS) often vary significantly, as individuals may enter the profession at any age. YOS introduces cumulative occupational stressors that may mediate age-related declines in physical fitness. While age-related reductions in physical fitness are well-documented, the mediating effect of YOS on firefighters' fitness remains unclear. Thus, the purpose of this study was to investigate the mediating role of YOS in the relationship between age and physical fitness outcomes and assess whether sex moderates the effects of YOS on these outcomes. Methods: A retrospective analysis of physical fitness testing data from 2019 to 2021 of 1,281 firefighters (1,136 males, 145 females; Age: 39.2 ± 9.3 years; YOS: 11.0 ± 7.3 years) was conducted. Fitness tests included maximum pull-ups (PL), push-ups within 60 seconds (PU), sit-ups within 60 seconds (SU), and a 3-minute step test to estimate VO2max. Pearson’s correlation tested the relationship between age and YOS, while path analysis evaluated YOS as a mediator between age and fitness outcomes. A moderation analysis examined the influence of sex on these relationships. Results: Age and YOS were moderately correlated (r = 0.66). YOS fully mediated the relationship between age and SU (p < 0.001) and partially mediated the effects of age on PL (p < 0.001) and PU (p < 0.001). No mediation effect of YOS was observed for VO2max (p > 0.05). Sex significantly moderated the relationship between age, YOS, and several physical fitness outcomes. Specifically, the relationship between age and pull-up performance was stronger for males (b = -0.152, p < 0.001) than females (b = -0.065, p < 0.05), while YOS was significantly related to pull-up performance in males (b = -0.123, p < 0.001) but not in females (b = -0.071, p > 0.05). Conclusions: YOS exacerbates declines in musculoskeletal strength and endurance, independent of age, particularly in male firefighters. Fire departments should consider YOS and sex, alongside age, when designing fitness assessments and training programs to optimize performance and safety.
Copyright (c) 2025 Joel Martin , Mike Toczko, Angela Miller, Shane Caswell https://creativecommons.org/licenses/by/4.0
Geographic Disparities in Vaccine Clinical Trial Access in the Mid-West: Impact of COVID-Era Clinical Trial Reform
Introduction: The COVID-19 pandemic prompted numerous vaccine studies. The Food and Drug Administration (FDA) also modified research regulatory guidelines, such as allowing virtual visits, in March 2020 that could make clinical research in rural areas more feasible. This study evaluates the effect of 2020 clinical trial reform on vaccine trial access in rural/underserved regions of the mid-West. Methods: Clinicaltrials.gov data was accessed from 1/1/2018-9/30/2022 for vaccination studies conducted in Kentucky, Tennessee, Illinois, Indiana, and Ohio. Trial locations were categorized by Rural-Urban Commuting Area codes (urban, suburban, small town and isolated rural) and identified as pre- vs. post-pandemic regulations. Trial locations from pre- and post-pandemic regulation dates were analyzed by paired t-test. Comparison of trial location category by state was analyzed by one-way ANOVA with pairwise multiple comparisons. Results: Pandemic-era deregulation had no impact on vaccine trial geographic availability (p=0.8637). Overall, 95% of study locations were in urban/metropolitan areas, 4% in suburban/micropolitan areas, 0.5% in small town/rural areas, and 0.1% in isolated rural areas. Results varied by state (p<0.0001) with Kentucky offering the most suburban and rural trial availability (31%). Conclusions: While modifications in the FDA’s regulatory guidelines may have increased flexibility for patients, these changes did not improve access to vaccine clinical trials at community sites in suburban, small town, and rural areas as measured by RUCA code. Increasing geographic diversity in vaccine clinical trials is critical for the development of more effective and equitable vaccines, as well as enhancing public trust in vaccination programs.
Underserved, COVID-19 pandemic, Telemedicine.
COVID-19, Underserved, Rural Health Disparity, Vaccination
Copyright (c) 2025 Dr. Elizabeth A. Gordon https://creativecommons.org/licenses/by/4.0
Fluctuations in Physical Activity over the Course of the COVID-19 Pandemic
Introduction: Several studies have indicated that physical activity (PA) declined during the restrictions associated with the onset of the COVID-19 pandemic. However, research comparing PA before the pandemic and during the pandemic-related restrictions to a more recent period when pandemic-related restrictions ended is limited. The purpose of this study was to compare PA across three timepoints: prior to the start of the pandemic (T1), the initial six-months of the pandemic (T2), and 18 – 24 months after the onset of the pandemic (T3). Methods: University students (N = 149, n = 80 female) who owned an Apple iPhone reported PA (average steps/day) using the Health app at three timepoints: T1 (9/2019-3/2020), T2 (3/2020-8/2020), and T3 (9/2021-3/2022). Results: A one-way repeated measures ANOVA demonstrated a significant main effect (F = 11.4, p < 0.001) for changes in average daily steps across timepoints. Steps were significantly lower (p £ 0.004) during T2 (5045 ± 2423 steps/day) when compared to T1 (5674 ± 2856 steps/day) and T3 (6010 ± 2616 steps/day). No significant differences (p = 0.11) were found between T1 and T3. Conclusions: During the initial six months of the pandemic participants reduced steps by 11%, which supports previous research. Subsequently, current evidence supports a novel recovery in steps in the six months prior to data collection as PA returned to baseline values. Future research is warranted to determine if other negative behaviors that may have been adopted during the pandemic have since abated.
Copyright (c) 2024 Jessica Smith-Ricketts, Gretchen E. Elsey, David Kohan, Andrew Lepp, Jacob E. Barkley https://creativecommons.org/licenses/by/4.0
Effect of Properly Describing the Borg Rating of Perceived Exertion (RPE) Scale on Heart Rate Response
Introduction: The Rating of Perceived Exertion (RPE) scale is often used to guide intensity during exercise. The purpose of this study was to determine if a thorough explanation of the scale is necessary to achieve optimal heart rate during indoor group cycling. Methods: The study consisted of a familiarization visit and two 60-minute instructor-led group cycling classes. The cycling sessions were identical in procedure; the only difference was that during one session, there was no explanation of the RPE scale (RPE-NE), and in the other, it was fully described in detail (RPE-E). Heart rate (HR) was continuously monitored. Maximal and average HR were calculated for each stage of the class. Repeated measures ANOVAs (condition x stage) were used to compare the mean HR, HRmax and %HRmax between conditions. Paired-samples t-tests were used to compare session RPE between conditions. Results: There were no differences between conditions for average HR (p=.436), HRmax (p=.086), or %HRmax (p=.084). There was also no difference between conditions in session RPE (RPE-NE: 15.7±1.4; RPE-E: 16.0±1.3; p=.432) Conclusions: A detailed explanation of the RPE scale before a group cycling class elicits a HR response similar to simply having a poster of the RPE scale posted and referenced.
Copyright (c) 2024 Khari Dickey, Nicholas Hanson, Rachel Maceri https://creativecommons.org/licenses/by/4.0
The Association of Hip Strength and Range of Motion with Hip and Groin Pain in Collegiate Ice Hockey Players
Introduction: Hip and groin pain is common in male ice hockey players. The relationship between physical examination findings and hip and groin pain in collegiate male hockey players is not well established. The purpose of this study was to explore associations between hip strength and hip range of motion (ROM) and hip and groin pain in male collegiate ice hockey players. Methods: This was a cross-sectional study of 59 male ice hockey players. The Sport subscale of the Copenhagen Hip and Groin Outcome Score (HAGOS) were collected to identify those with hip and groin pain. Measurements of hip ROM and strength were obtained at the beginning of the season. Between group comparisons were made and logistic regression was used to determine the strength of the association. Results: Compared to those without, male ice hockey players with hip and groin pain (n=17) had a lower amount of hip internal rotation ROM (-6.21; 95% CI 2.29, 10.14; p<0.01) and a lower ratio of hip adductor to abductor strength (-0.16; 95% CI -0.27, -0.05; p<0.01). These two variables explained 37% of the difference between groups (R2=0.37; p<0.01). There was no significant difference in hip external rotation ROM between groups. Conclusions: Hip internal rotation ROM and the ratio of hip adductor to abductor strength were lower in male collegiate ice hockey players with hip and groin pain compared to those without. These findings may help inform secondary prevention and rehabilitation strategies in this population.
Copyright (c) 2024 William Suits, Stacie Fruth, Paul Whitehead, Kieran Fogarty https://creativecommons.org/licenses/by/4.0
A Preliminary Investigation of Turkesterone: It’s Not Deca
Introduction: It has been suggested that supplementation with turkesterone, a type of ecdysteroid, may have anabolic properties that promote improvements in body composition. Thus, the purpose of this investigation was to determine if four weeks of Turkesterone (500 mg daily dose) supplementation affected body composition in healthy males and females. Methods: Thirty-one active males (n=14) and females (n=17) volunteered for this investigation. Research participants were assessed pre and four weeks post for body composition (i.e., dual-energy X-ray absorptiometry). After pre-testing, they were randomized into a placebo (rice flour) or treatment group (i.e., 500 mg per day of turkesterone [Ajuga Extract]). Subjects were instructed to maintain the same diet and exercise habits during the study. Results: The delta scores of the treatment and placebo groups were compared using an independent samples t-test. There were no between-group differences (p>0.05) at baseline for age, height, or body mass. There were no between-group differences in the delta score between the turkesterone and placebo groups in body mass (p=0.38), lean body mass (p=0.68), fat mass (p=0.06), or percent body fat (p=0.14); (Delta score, mean±SD: body mass kg – treatment -0.4±1.8, placebo 0.1±1.8; lean body mass kg - treatment -0.6±1.4, placebo -0.3±1.7; fat mass kg - treatment 0.1±0.6, placebo 0.5±0.6, % fat treatment 0.3±0.6, placebo 0.7±0.9). Conclusions: Four weeks of supplementation with 500 mg of turkesterone did not affect body composition in active, healthy males and females
Copyright (c) 2024 Jose Antonio, Tobin Silver, Ava Lukowiak , Lia Jiannine https://creativecommons.org/licenses/by/4.0
Training, Nutrition, and Sports Supplement Strategies of an Elite Female Masters Cyclist: A Case Study
Background: The purpose of this case report was to compare the training, diet, and supplement strategies of a 54-year-old female national-class cyclist to what is typically recommended in the literature. Methods: This case study examined the training, nutrition, and supplement strategies of a 54-year-old Masters female cyclist who won the 2023 USA Cycling Time Trials. Data was acquired via a smartwatch that the athlete wore in all of her training sessions over 29 weeks, outlining the volume of training as well as macronutrient and supplement consumption. Results: Her average weekly training volume was 167.0±61.4 miles (268.8±98.8 km; mean ± standard deviation [SD]). The number of training sessions per week was 8.4±2.1. In addition, the percentage of the weekly training sessions that consisted of high-intensity interval training was 55.3±20.1 %. Her mean energy intake was 2444±101 kcal or 36.6 kcal/kg. Her macronutrient intake was 228±33 grams (g) of carbohydrate, 95±34 g of fat, and 196±25 g of protein. Expressed per unit body weight daily (kilograms or kg), her macronutrient intake was 3.3 g/kg carbohydrate, 1.4 g/kg fat, and 2.9 g/kg protein. After 29 weeks of training, the athlete won first place in the 30k USA Cycling Time Trial (Masters) with an average speed of 23.35 miles per hour (37.6 km/hr.). Conclusions: The results highlight that for this particular female athlete, consuming a high-protein diet coupled with a moderate intake of carbohydrates is a viable strategy for endurance events (e.g., cycling time trials). It should also be noted that the majority of her training sessions consisted of interval training.
endurance, periodization, high protein, macronutrient, polarized training
Copyright (c) 2024 Jose Antonio, Jose Rojas, Jason Curtis, Cassandra Evans, Flavia Pereira https://creativecommons.org/licenses/by/4.0
Risk of Disordered Eating, Exercise Dependence, Body Dissatisfaction, and Fueling Habits in Masters Trail Runners
Introduction: Masters-level trail runners comprise a large percentage of trail and ultramarathon racers. Endurance training may increase the risk of developing disordered eating (DE) patterns and exercise dependence (EXD). This study investigated the risk of DE and EXD in masters-level runners, and compared the risk of EXD, body dissatisfaction, injuries, and fueling habits in runners at risk vs. not at risk for DE. Methods: In this cross-sectional study design, male (n = 457) and female (n = 564) masters trail runners (41-65 years of age) completed a Qualtrics survey comprising the Disordered Eating Screen for Athletes (DESA-6), Exercise Dependence Scale (EDS-21), and questions pertaining to fueling strategies, dietary preferences, and body image satisfaction. Results: 46% of females and 32% of males were at risk for DE based on the DESA-6. 80% of female and 79% of male runners were classified as symptomatic for EXD. For the entire population, there was a significant association between DE risk (88.2%) and symptomatic EXD (χ21 = 32.5, p < 0.001). The majority of participants (71.4%) reported being dissatisfied with their weight. Conclusion: This study demonstrated a high prevalence of DE, EXD, and body dissatisfaction in masters trail runners.
Copyright (c) 2024 Alyssum M. Reno-Smith, Dr. Kelly L. Pritchett, Keely A. Henninger https://creativecommons.org/licenses/by/4.0
Applicability of Ratings of Perceived Exertion as a Measure of Subjective Fatigue in First Responders: An Exploratory Study
Introduction: Many researchers use Ratings of Perceived Exertion (RPE) as an indicator of subjective fatigue. Recent findings suggest that energy and fatigue are two distinct unipolar moods. Methods: Eleven first responders (FR) participated in a 90-minute strenuous exercise battery where they ended the protocol by completing a graded VO2max test where they were asked to perform until volitional fatigue, measured through RPE. Subjective feelings of mental energy (ME) and fatigue (MF) and physical energy (PE) and fatigue (PF) were measured before the beginning of the protocol and right after. Data was not normally distributed and presented in median and interquartile ranges. Spearman correlation coefficients were calculated for RPE, post mood state, and changes in mood states. Results: Participants’ self-reported RPE at the conclusion of the VO2max test was 18.27 [18.00,19.00]. Post PE (r=-0.012, p=0.97), PF (r=-0.036, p=0.92), ME (r=-0.13, p=0.69), and MF (r=0.43, p=0.19) displayed insignificant correlations with RPE. Similarly, insignificant correlations were observed between changes in PE (r=0.26, p=0.44), PF (r=0.46, p=0.15), ME (r=0.35, p=0.30), MF (r=-0.43, p=0.19), and RPE. Five participants reported an increase in feelings of PE (15.00 [13.00,19.00]) and seven participants reported lower feelings of PF (-12.00 [-19.50,-8.00]) post assessment. Seven participants reported improvements in ME (22.00 [8.00,68.00]) and three reported a reduction in MF (-13.00 [-27.00, -7.00]). Conclusions: Our findings suggests that self-reported RPE may not be a reliable measure of subjective fatigue in FR populations during acute strenuous exercise. Further our findings support previous work that ME, MF, PE, and PF are four distinct unipolar moods, and researchers seeking to assess fatigue in FR should use RPE with caution as it seems to be a measure of subjective perception of exercise intensity instead of a true measure of subjective fatigue.
physical energy, mental energy, mood states
Copyright (c) 2024 Michael Toczko, Dr. Ali Boolani, Dr. Joel Martin https://creativecommons.org/licenses/by/4.0
Qualitative Description of the Exertional Symptoms of Participants with Persistent Symptoms of Lyme Disease during a Low Intensity Resistance Training Intervention
Introduction: Greater emphasis needs to be placed on approaches to improve the health-related quality of life of patients with persistent symptoms of Lyme disease (PSLD), but little information exists to inform an exercise professional’s expectations of their supervision of resistance training (RT) programs with PSLD patients. In order to build this knowledge base, a secondary qualitative analysis was performed to explore the RT exertional symptoms of PSLD patients that participated in a 4-week study investigating the feasibility of an RT intervention. Methods: Comments regarding exertional symptoms that were recorded in a daily exercise log were the main source of data for this secondary analysis. A manifest content analysis was performed in order to identify recurrent themes of exertional symptoms experienced by this sample of PSLD patients during RT. Results: The reported findings revealed that strain, discomfort, crepitus, tightness, shaking, and control loss were the major themes of exertional symptoms recorded during the RT intervention. Conclusions: These results provide insights intended to inform the expectations of supervisors of exercise (personal trainers, physical therapists, exercise researchers, etc.) when directing RT programming with patients with PSLD.
Resistance training intervention for persistent symptoms of Lyme disease, exertional symptom management during resistance training
Copyright (c) 2024 Charlie McMillin, PhD, Dr. Bridget Melton, CSCS*D, TSAC-F*D, EP-C, Nicholas Murray, PhD, Chris D'Adamo, PhD https://creativecommons.org/licenses/by/4.0
Impact of Firefighting Equipment on Aerobic Performance in the Forestry Step Test in New Firefighter Cadets: A Pilot Study
Introduction: Firefighting is a physically demanding occupation, which involves tasks such as rescuing victims, pulling a hose, and carrying a ladder. Thus, firefighters must have excellent cardiovascular fitness (CF). However, the cumbersome movement and added mass of firefighting personal protective equipment (PPE) can place additional stress on the cardiovascular system, not accounted for through traditional CF testing. Purpose: Determine the effect of wearing PPE on predicted CF compared to athletic attire (AT) in firefighter (FF) cadets completing the Forestry Step Test (FST). Methods: Male and female (N = 17) FFs performed two trials of the FST, one trial completed in PPE and one in AT. Recovery heart rate was measured at the end of each trial and predicted VO2max was calculated. Paired samples t-tests compared heart rate and predicted VO2max values between the PPE and AT conditions. Results: Predicted VO2max (p < 0.001) was lower in the PPE (37.53 + 3.20 ml.kg.min-1) compared to the AT condition (46.35 + 7.63 ml.kg.min-1). Conclusion: Predicted aerobic capacity is lower when wearing PPE compared to AT using the FST as the aerobic capacity assessment method. The effect of PPE on CF effort of firefighting should be considered when developing assessments.
athletic attire, predicted VO2max, recovery heart rate
Copyright (c) 2024 Ryan Conners, Robert Cochrum, Cristina Northcutt, Haley Radden, Dakota Powell, MaryAnn Wiethop https://creativecommons.org/licenses/by/4.0
Health Science Approaches for Fall and Injury Prevention
According to the National Electronic Injury Surveillance System (NEISS) Injury Program operated by the Consumer Product Safety Commission, falls represent the number one cause of nonfatal injuries, increasing overtime from 2017-2021 (31.89%)1. Indeed, falls and fall-related injuries appear to be a growing concern, especially for an aging population and those with disabilities (e.g., mobility deficits, visual impairments). One challenge is that falls are multi-faceted, with the likelihood of a fall depending on various factors (e.g., visual, hearing, and muscular strength deficits) that affect balance and increase in prevalence with age. The projected number of individuals aged 40 and above with blindness or low vision will double between 2015 and 2050. Additionally, approximately 27.8% of adults 71 years and older have vision impairment, with 10% having contrast sensitivity impairment2. For those 85 years and older, contrast sensitivity worsens to 22.6%, which affects one’s ability to perceive sharp and clear outcomes of objects. Indeed, low vision negatively impacts one’s ability to do everyday activities, and challenges in identifying key objects compound the risk of falls3-5. Unfortunately, fall risk for individuals with visual impairment is as much as two to three times more than those without visual impairment6, with falls resulting in injury, decreased mobility, and loss of independence7. Given the preventative lenses of the health science field, future research should leverage preventative approaches to reduce fall risks and related injuries.
Copyright (c) 2024 Sara Harper https://creativecommons.org/licenses/by/4.0
Exploring the Use of Mindfulness-Based Meditation and Physical Activity to Reduce Stress in College Students
Introduction: With the prevalence of stress increasing among college students, stress reduction interventions are essential. This study explored the use of brief mindfulness meditation (BMM) and current physical activity on college students’ perceived stress. Methods: A single-cohort pre-test/posttest design was used to evaluate the effects of an 8-week classroom-based BMM. Current exercise levels and perceived stress, using the Perceived Stress Scale-10 (PSS-10), were measured in a convenience sample of college students (N = 42). Results: Brief mindfulness meditations were more effective in reducing stress for those who self-identified as “less than moderate” exercisers, SMD = 3.33 (t = 2.801, p = .023) than “moderate,” SMD = -.24 (t = -.162, p = .873) or “vigorous” exercisers, SMD = 2.56 (t = 1.577, p = .136). Discussion: The intervention was more beneficial for those who did not participate in regular physical activity. Thus, BMM sessions held during class served as a helpful means of stress reduction for these students.
Copyright (c) 2023 Phrosini Samis-Smith Samis-Smith, Nola Schmidt https://creativecommons.org/licenses/by/4.0
Implementation of a Triathlon Program for Primary School Students as part of Health and Physical Education
Introduction: The significance of triathlon is reflected in the teaching and development of motor, social and emotional skills. Because triathlon has great educational potential, this case study sought to explore whether a modified Physical Activity Enjoyment Scale (PACES) survey can be used as a suitable measure of enjoyment of physical activity in elementary school children when applied to a sports-specific task such as triathlon. Methods: The sample consisted of 12 female elementary school students (10.3 ± 1.3 years) from an inner-city high school. A modified triathlon program was delivered for one hour per week over a four-week duration with a modified PACES survey distributed each week. Survey responses were coded and then averaged over the four-week duration with the children’s responses subsequently analyzed using a Wilcoxon Signed Ranks Test to examine differences in the coded characteristic response scores of the survey. Further comparisons were made using a Student’s t-test and a coefficient of variation (CV). Results: A greater sense of pleasure and fun was reported by the participants at the conclusion of the four-week triathlon program while there was no change in the children’s sense of excitement (p < 0.5). Characteristic responses to ‘neutral’ decreased with a simultaneous increase in the ‘slightly enjoyed’ response when viewed over the four-week duration of the program (p <0.001) Conclusions: This PACES case study was designed as a feasible, simple, and innovative approach to monitor enjoyment levels in elementary school children who participated in a triathlon program. Overall, the positive enjoyment reported from this simple, low-cost intervention could be used to inform the development of future sport-specific elementary school programs.
Education. Health Education. Health and Physical Edcucation
Copyright (c) 2023 Stuart Evans https://creativecommons.org/licenses/by/4.0
The Effect of Acute Aerobic Exercise on Measures of Stress and Inflammation in Healthy Young Adults
Introduction: While the effects of long-term measures of inflammation and stress are well studied, less is known about the effects of an acute exercise challenge on exercise in young healthy individuals. Methods: This was a randomized crossover design (mean age = 19.25, SD = 1.45) that measured biomarkers of stress (cortisol and salivary alpha amylase, sAA) and inflammation (IL-1β, CRP) in an exercise and control condition. In the exercise condition, participants walked or ran on a treadmill at 75-85% of their maximum heart rate for 40 minutes. Under the control condition, participants stood for 40 minutes to control for orthostatic effects. Biomarkers were quantified from saliva collected before, 1 minute after, and 45 minutes after the exercise and control condition. Results: The change in biomarkers from baseline values (+1 min and + 45 min) between exercise and control conditions showed that compared to the control condition, the acute exercise bout significantly increased sAA CRP at +1min at +45 min and in IL-1β +45 min. Cortisol levels significantly decreased at both time points in the control condition Conclusions: Ultimately, the results of this study show how small and realistically achievable amounts of exercise can acutely strengthen the body’s physiological responses to immune challenges.
Copyright (c) 2023 Julien Tartar , Anthony Ricci, Jonathan Banks , Hannah Murphy, Cassandra Evans , Jose Antonio, Jaime Tartar https://creativecommons.org/licenses/by/4.0
Measuring Energy Expenditure and Heart Rate during Maximum Aerobic Testing with the Apple Watch Series 7
Introduction: Wrist-worn devices such as the Apple Watch have emerged as technology for tracking physical activity. The aim of this research study is to analyze the Apple Watch Series 7 (AW7) with measurements of the maximum heart rate (MHR) and maximum energy expenditure (MEE) during a maximal aerobic capacity test on the treadmill. AW7 measurements will be compared to the Polar Heart Rate Monitor (Polar) and the PARVO Metabolic Cart (PARVO). Methods: 22 healthy and active subjects (mean ± SD: age 23.8 ± 4.0 years; BMI 23.0 ± 5.9 kg/m2) volunteered for the study. The subjects confirmed their activity, health status, and were measured for body composition and aerobic capacity. Results: No significant difference was found in MEE between PARVO (109.6 ± 41.7 kcal) and AW7 (98.7 ± 24.3 kcal) conditions; t(21)=1.5, p = 0.153. In addition, there was no significant difference in MHR between PARVO (186.2 ± 16.2 BPM) and AW7 (189.3 ± 8.5 BPM) conditions; t(21)=-0.9, p = 0.379. Conclusions: The main findings of this study show that the MEE as well as the MHR between the AW7 compared to the PARVO are not different.
Copyright (c) 2023 Flavia Rusterholz, Andrew Rodriguez, Victoria Ortiz, Corey Peacock https://creativecommons.org/licenses/by/4.0
A Preliminary Assessment of The Relationship Between Cellphone Use and Physical Activity, Sedentary Behavior, Anxiety, and Academic Performance in High School Students.
Introduction: Prior research has examined the relationships between cellphone use and physical activity and sedentary behavior as well as measures of psychological well-being and academic performance. This work largely focuses on adults. However, there is an inverse relationship between cellphone use and age. Because their cellphone use may be different from adults, understanding these relationships in younger individuals is warranted. Methods: High school students (N = 17) completed an online survey consisting of validated items assessing self-reported cellphone use, physical activity, sedentary behavior, anxiety, and grade point average. Correlation analyses were then performed assessing the relationships between cell phone use to all other variables. Results: There were large, significant effect sizes (r ≥ -0.58, p ≤ 0.04) for negative correlations between cellphone use and vigorous and total physical activity. There was also a moderate effect size (r = -0.39; r = 0.46) for a negative relationship between cellphone use and mild physical activity and a positive correlation between cellphone use and anxiety, respectively. Cellphone use was not related to the remaining variables. Conclusions: In this preliminary study of high school students, greater cellphone use was associated with greater anxiety, which supports prior research in adults. However, unlike research reporting a lack of a relationship in adults, greater cellphone use was associated with lower physical activity in high schoolers.
Copyright (c) 2023 Ryan Wiet, Andrew Lepp, Jacob Barkley https://creativecommons.org/licenses/by/4.0
Blood Pressure in Normotensive Young Adults Is Not Influenced by Resistance Training Rest Interval Duration
Introduction: We aimed to examine the effect of resistance training rest interval length on chronic changes of systolic (SBP) and diastolic blood pressure (DBP). Methods: 27 normotensive young adults were randomly assigned to one of three rest interval length groups: 30-sec, 90-sec, or 150-sec. Baseline and posttest SBP and DBP measurements were obtained. Participants resistance trained and logged their sessions in a smartphone application three times per week for 8 weeks. They also measured their blood pressure weekly with a home kit. Changes in SBP and DBP between the three groups were tested using a mixed model 3 x 2 ANOVA analysis with follow-up post-hocs as necessary. Results: There was no significant interaction between rest interval group and time for SBP or DBP. For SBP, there was a significant main effect for time, p<0.001 (pre: 115 mmHg vs. post: 108 mmHg). Conclusions: SBP and DBP were not significantly influenced by rest interval length over time. The resistance training program had no effect on DBP but significantly decreased SBP regardless of rest interval. These results indicate that young normotensive adults may use short, moderate, or long duration rest intervals to elicit reductions in SBP.
Copyright (c) 2023 Jason Coles, G. Monique Mokha, W. Alex Edmonds, Lia Jiannine https://creativecommons.org/licenses/by/4.0
Elementary School Teachers Development of a Sense of Community in the Workplace through the Participation in a Fitness and Mindfulness Program
Introduction: Stress and burnout continue to have negative impacts on teachers. Wellness programs have reported to help improve teachers’ quality of life, social life, reduce stress, and increase awareness of healthy choices. The purpose of this paper is to explore teachers’ perceptions and experiences of a fitness and mindfulness program. Methods: Semi-structured interview guides were used in the three separate focus groups that were conducted following each of the three 9-week fitness and mindfulness programs serving as an intervention for elementary school teachers to reduce stress. Focus groups included all female participants between the ages of 22-64 years old with one to 21 years of experience in the classroom. The data were analyzed using thematic analysis. Results: Two themes and subsequent themes were found: (1) work-life balance (subthemes: Implementing mindfulness techniques; Feeling ok leaving work; Self-care) and (2) building community (subthemes: Developed community; Accountability; and Level of comfort). Conclusions: The finding revealed that teachers improved their work-life balance through self-care, implementation of mindfulness techniques, accountability, and comfort with co-workers. The participants reported developing a workplace community. Overall, the results support that elementary teachers perceived a 9-week fitness and mindfulness program to have a positive impact on workplace wellbeing.
Copyright (c) 2023 Christina Gipson, Jessica Mutchler, Arshpreet Kaur Mallhi https://creativecommons.org/licenses/by/4.0
The Validity of a Novel Low-Cost, Wearable Physical Activity Monitor in a Laboratory Setting
Introduction: Wearable physical activity monitors are popular and may provide a more accurate data than subjective methods. The present study assessed the validity of a novel, low-cost wearable physical activity monitor (Movband 3) relative to established measures. Methods: Participants (N = 19) completed four treadmill stages (1.5, 3.0, 4.0, 6.0 MPH) while wearing the Movband 3 and the validated Actigraph GT1M monitor. Oxygen consumption (VO2 ml/kg/min) and heart rate (beats/min) were recorded. The relationship between Movband data and established measures was assessed via Pearson’s correlations. Tests of agreement were performed for actual and Movband miles traveled. Results: There were large, positive, significant (p < 0.001) effect sizes for the associations between Movband counts and Actigraph counts (r = 0.72), VO2 (r = 0.59), and heart rate (r = 0.63). There was also a large, positive, significant (p < 0.001) association between actual and Movband miles (r = 0.97). However, the difference (Δ) between Movband and actual miles was greater than a null hypothesis of zero (∆ = 0.77 ± 0.45 miles or 31.8%, t = 7.4, p < 0.001). Conclusion: While there was evidence to support the validity of the Movband 3 for the assessment of physical activity intensity this device did not provide an accurate measure of miles traveled.
Copyright (c) 2023 Jacob Barkley, Andrew Newton, Ellen Glickman https://creativecommons.org/licenses/by/4.0
Faulty Hip and Pelvis Biomechanics Do Not Differentiate Between 5k Performance in NCAA Division II Cross-Country Runners
Introduction: Excessive hip adduction (HADD) and contralateral pelvis drop (CPD) angles during running are associated with running-related injuries. Their influence on performance is less known. Therefore, we aimed to determine if HADD and CPD could differentiate between high and low race performers, and if there were relationships between CPD, HADD and race performance. Methods: Twenty-six healthy male and female NCAA Division II cross-country runners participated in this prospective study. They underwent 3D motion analysis of their HADD and CPD during pre-participation physical examinations. Times from the first race of the season were converted to International Association of Athletics Federation (IAAF) points and high and low performance groups were created. Pearson correlation coefficients were used to examine the associations between HADD, CPD and IAAF points, and Independent Samples T-tests were used to determine differences in HADD and CPD between high and low performance groups. Results: There were no significant relationships between IAAF points and left HADD (r=0.11, p=0.59), right HADD (r=0.19, p=0.35), left CPD (r=-0.06, p=0.79), or right CPD (r=-0.06, p=0.76). There were no significant differences between high and low performance groups in left HADD (t(24)=0.48, p=0.64), right HADD (t(24)=0.45, p=0.33), left CPD (t(24)=0.62, p=0.27), or right CPD (t(24)=0.53, p=0.30). Conclusions: The RRI biomechanics of excessive CPD and HADD do not influence 5k race performance in collegiate distance runners.
Copyright (c) 2023 Monique Mokha, Shandon Marshall, Maya Varghese, Isabella Rivero https://creativecommons.org/licenses/by/4.0
Recent Perspectives on the Role of Dietary Protein in Physically Active Individuals
Introduction: Whether it is the athletic population or the general population, it is essential to understand considerations regarding the amount of protein consumed daily. Protein, often referred to as the body's building blocks, is an integral part of the diet. This macronutrient plays a vital role in developing and maintaining skeletal muscle mass. This paper aims to discuss protein intake at low (<1.2 g/kg/day), medium (1.2-2.2 g/kg), and high (>2.2 g/kg/day) levels that should be consumed with consideration of physically active populations and potential benefits or detrimental effects on body composition and performance. Methods: Searches of electronic databases PubMed and Google Scholar were undertaken to identify peer-reviewed journal articles that reported on dietary protein intake on body composition, and performance/strength. Discussion: Low protein intakes may not meet the needs of all physically active individuals. Medium and high protein intakes positively influenced body composition. Medium protein intakes can benefit strength and performance; however, these effects are not consistently reported with higher intakes. Conclusions: The minimum protein requirement for active individuals is 1.2 g/kg, and higher intakes are safe and effective for healthy, physically active individuals.
Copyright (c) 2023 Cassandra Evans, Jose Rojas, Jason Curtis, Jose Antonio https://creativecommons.org/licenses/by/4.0
Evaluation of Pairing Mobile Health with Simulation Technology to Assist Sickle Cell Caregivers
Introduction: Sickle Cell disease (SCD) affects approximately 100,00 Americans and occurs in about one in every 365 black or African American births. SCD caregivers could utilize health technology such as mHealth to assist them with appointment reminders, medication management, education, and pain management as it relates to better managing this disease process. Methods: A mixed-methods approach was utilized to explore the perceived influential factors that impact the caregivers’ ability to care for the children with SCD and utilize mHealth and simulation. A 33-question survey was administered which included questions on: demographics, SCD, mHealth and simulation, General Self-Efficacy, Adult Hope, and four opened-ended questions. Results: In total, 36 SCD caregivers completed the survey and three of them provided an additional interview. Sixty nine percent of the caregivers were mothers (n = 25) of the children with SCD and all the caregivers were African American. Self-Efficacy (p=.568) and Adult Hope scores (p=.762) were not a predictor for willingness to use mHealth or simulation. Conclusions: SCD caregivers are using some forms of technology to help them however an all-inclusive (one-stop location) mHealth app along with simulation training would allow these caregivers to better manage their patient’s/loved ones SCD.
Copyright (c) 2022 Scott Sittig, Tierney Beebe, Jessica Landry, Helen Hurst https://creativecommons.org/licenses/by/4.0