Governments have restricted public life during the COVID-19 pandemic, inter alia closing sports facilities and gyms. As regular exercise is essential for health, this study examined the effect of pandemic-related confinements on physical activity (PA) levels. A multinational survey was performed in 14 countries. Times spent in moderate-to-vigorous physical activity (MVPA) as well as in vigorous physical activity only (VPA) were assessed using the Nordic Physical Activity Questionnaire (short form). Data were obtained for leisure and occupational PA pre- and during restrictions. Compliance with PA guidelines was calculated based on the recommendations of the World Health Organization (WHO). In total, n = 13,503 respondents (39 ± 15 years, 59% females) were surveyed. Compared to pre-restrictions, overall self-reported PA declined by 41% (MVPA) and 42.2% (VPA). Reductions were higher for occupational vs. leisure time, young and old vs. middle-aged persons, previously more active vs. less active individuals, but similar between men and women. Compared to pre-pandemic, compliance with WHO guidelines decreased from 80.9% (95% CI: 80.3–81.7) to 62.5% (95% CI: 61.6–63.3). Results suggest PA levels have substantially decreased globally during the COVID-19 pandemic. Key stakeholders should consider strategies to mitigate loss in PA in order to preserve health during the pandemic.

The supplementation practices of elite athletes in Singapore were studied using an anonymous questionnaire. Information was sought on not only the type of supplements used but also dosage, rationale for use, and other factors that might influence supplement use including selected demographic parameters and sources of information relating to supplements. Data was collected from 160 athletes across a spectrum of 30 sports. Use of supplements was widespread, with 77% of respondents acknowledging use of at least 1 product. Respondents ingested a total of 59 different supplements, with each athlete using on average 3.6 +/- 0.3 different products. Sports drinks, caffeine, vitamin C, multivitamin/mineral supplements, and essence of chicken were some of the most commonly ingested products, confirming that while vitamin/mineral supplements are popular, sports supplements and traditional/herbal preparations were also well accepted. Respondents preferred to source information pertaining to supplements from "significant others" and other readily accessible sources. A small number of respondents acknowledged the use of International Olympic Committee (IOC) banned or restricted substances, highlighting the need for athletes to consult sports medicine professionals with specialist knowledge of dietary supplements in advance of initiating any supplementation regime.

Introduction Obesity and inactivity are associated with erectile dysfunction and hypogonadism. Aim To compare the effects of low volume (LV) and high volume (HV) of moderate-intensity exercise on sexual function, testosterone, lower urinary tract symptoms (LUTS), endothelial function, and quality of life (QoL) in obese men. Main Outcome Measures Weight, waist circumference (WC), body composition, International Index of Erectile Function 5-item (IIEF-5), International Prostate Symptom Scale (IPSS) (for LUTS), and 36-item Short Form Survey version 2 Instrument (SF-36) (for QoL) scores, plasma testosterone, sex-hormone binding globulin, glucose, insulin and lipids, and endothelial function (by Reactive Hyperaemia Index [RHI] using finger plethysmography) were measured at baseline and 24 weeks. Methods Ninety abdominally obese (body mass index>27.5kg/m2, WC>90cm), sedentary (exercise ∼80 minutes/week) Asian men (mean age 43.6 years, range 30–60) were prescribed a diet to reduce daily intake by ∼400kcal below calculated requirement and randomized to perform moderate-intensity exercise of LV (<150 minutes/week) or HV (200–300 minutes/week) (n=45 each) for 24 weeks. Seventy-five men (83.3%) completed the study. Results Weekly exercise volume was significantly greater in the HV (236±9 minutes) than the LV (105±9 minutes) group. The HV group had significantly greater increases in IIEF-5 score (2.6±0.5 points) and testosterone (2.06±0.46nmol/L) and reductions in weight (−5.9±0.7kg, −6.2%), WC (−4.9±0.8cm, −4.9%), and fat mass (−4.7±1.0kg, −14.5%) than the LV group (−2.9±0.7kg, −3.0%; −2.7±0.7cm, −2.5%; −1.1±0.8kg, −3.2%; 0.79±0.46nmol/L; and 1.8±0.5 points). Improvements in IPSS and SF-36 scores, and RHI, were similar. Conclusions Moderate-intensity HV aerobic exercise>200 minutes/week produces greater improvements in sexual function, testosterone, weight, WC, and fat mass than smaller exercise volume.

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Treatment of plantar fasciitis with ACP or ESWT plus conventional treatments resulted in improved pain and functional outcomes compared with conventional treatment alone. There was no significant difference between ACP and ESWT in terms of VAS and AOFAS ankle-hindfoot scale improvements, although the ACP group demonstrated greater reductions in plantar fascia thickness.

Most countries affected by the COVID-19 pandemic have repeatedly restricted public life to control the contagion. However, the health impact of confinement measures is hitherto unclear. We performed a multinational survey investigating changes in mental and physical well-being (MWB/PWB) during the first wave of the pandemic. A total of 14,975 individuals from 14 countries provided valid responses. Compared to pre-restrictions, MWB, as measured by the WHO-5 questionnaire, decreased considerably during restrictions (68.1 ± 16.9 to 51.9 ± 21.0 points). Whereas 14.2% of the participants met the cutoff for depression screening pre-restrictions, this share tripled to 45.2% during restrictions. Factors associated with clinically relevant decreases in MWB were female sex (odds ratio/OR = 1.20, 95% CI: 1.11–1.29), high physical activity levels pre-restrictions (OR = 1.29, 95% CI 1.16–1.42), decreased vigorous physical activity during restrictions (OR = 1.14, 95% CI: 1.05–1.23), and working (partially) outside the home vs. working remotely (OR = 1.29, 95% CI: 1.16–1.44/OR = 1.35, 95% CI: 1.23–1.47). Reductions, although smaller, were also seen for PWB. Scores in the SF-36 bodily pain subscale decreased from 85.8 ± 18.7% pre-restrictions to 81.3 ± 21.9% during restrictions. Clinically relevant decrements of PWB were associated with female sex (OR = 1.62, 95% CI: 1.50–1.75), high levels of public life restrictions (OR = 1.26, 95% CI: 1.18–1.36), and young age (OR = 1.10, 95% CI: 1.03–1.19). Study findings suggest lockdowns instituted during the COVID-19 pandemic may have had substantial adverse public health effects. The development of interventions mitigating losses in MWB and PWB is, thus, paramount when preparing for forthcoming waves of COVID-19 or future public life restrictions.

The outbreak of COVID‐19 has precipitated international lockdown measures to curb disease transmissions. The closure of public activity spaces as well as changes in pandemic workload may disrupt healthcare workers' physical activity and self‐care routines. We sought to examine the association between physical activity levels and mental health burden of healthcare workers during the COVID‐19 lockdown in Singapore. This cross‐sectional study comprised of an multidomain survey that was administered digitally to 707 healthcare workers between 17 May and 18 June 2020. Exercise frequency, duration and intensity of these healthcare workers had reduced significantly during the lockdown compared to pre‐lockdown. 25.3%, 37.2%, and 11.9% had screened positive for moderate‐to‐extremely‐severe depression, anxiety and stress respectively. Reductions in exercise duration was a significant risk factor for mild stress and moderate‐to‐severe depression while increase in exercise frequency was found to be a protective factor against depressed mood. Our study revealed that a short‐term reduction in physical activity levels during lockdown was associated with poorer psychological outcomes. Given the protection that exercise confers on depression, physical activity should be promoted at the workplace and at home to support healthcare workers to cope through this protracted health crisis.

Laser class sailors have to hike out, i.e. hook their feet under the toe straps near the centreline of the boat and hold their upper bodies over the edge of the boat, to counteract the heeling forces generated by the sails. To identify the parameters that are associated with maximal hiking performance, this cross-sectional observational study measures various knee extensor and hip flexor muscle performance characteristics in 55 Laser sailors and correlates each with the area-under-the-curve hiking moment over 3 min of hiking on a hiking dynamometer (HM180). Our results showed that higher body mass and HM180 were significantly associated with better race scores (Spearman's rho = - 0.69 and - 0.62, respectively, both P < 0.01) in male sailors who participated in the National Inter-School Laser competition. Body mass (Pearson's correlation coefficient, r > or = 0.95, P < 0.01 in both males and females), maximum voluntary isometric strength of the quadriceps (r > or = 0.80, P < 0.01 in both males and females), and 3-RM knee extension strength (r > or = 0.80, P < 0.01 in both males and females) were associated with a higher HM180. The correlations between height, abdominal muscle endurance (crunches), explosive lower body strength (vertical jumps), cycling time-to-exhaustion, quadriceps strength endurance, or isometric quadriceps endurance with incremental loads (bucket test), and HM180 were weaker (r < 0.60). HM180 may be a useful performance indicator for Laser racing. Since strength measures correlated well with HM180, greater emphasis should be placed on developing maximum strength in the quadriceps to improve maximal hiking performance.