background Physical exercise is seen as a promising intervention to prevent or delay cognitive decline in individuals aged 50 years and older, yet the evidence from reviews is not conclusive. Objectives To determine if physical exercise is effective in improving cognitive function in this population. Design Systematic review with multilevel meta-analysis. Data sources Electronic databases Medline (PubMed), EMBASE (Scopus), PsychINFO and CENTRAL (Cochrane) from inception to November 2016. Eligibility criteria Randomised controlled trials of physical exercise interventions in community-dwelling adults older than 50 years, with an outcome measure of cognitive function. Results The search returned 12 820 records, of which 39 studies were included in the systematic review. Analysis of 333 dependent effect sizes from 36 studies showed that physical exercise improved cognitive function (0.29; 95% CI 0.17 to 0.41; p<0.01). Interventions of aerobic exercise, resistance training, multicomponent training and tai chi, all had significant point estimates. When exercise prescription was examined, a duration of 45-60 min per session and at least moderate intensity, were associated with benefits to cognition. The results of the meta-analysis were consistent and independent of the cognitive domain tested or the cognitive status of the participants. Conclusions Physical exercise improved cognitive function in the over 50s, regardless of the cognitive status of participants. To improve cognitive function, this meta-analysis provides clinicians with evidence to recommend that patients obtain both aerobic and resistance exercise of at least moderate intensity on as many days of the week as feasible, in line with current exercise guidelines.

Lifestyle intervention programmes are efficacious in the management of obesity but often report poor attendance and adherence rates that hinder treatment effectiveness and health outcomes. The aim of this systematic review is to identify (i) barriers to behaviour change and (ii) predictors of adherence to lifestyle intervention programmes in adults with obesity. Studies were identified by systematically reviewing the literature within Medline, PsycINFO, CINAHL, SPORTDiscus and Web of Science from inception to August 2016. Barriers to behaviour change include poor motivation; environmental, societal and social pressures; lack of time; health and physical limitations; negative thoughts/moods; socioeconomic constraints; gaps in knowledge/awareness; and lack of enjoyment of exercise. The most prominent predictors of adherence include early weight loss success, lower baseline body mass index (BMI), better baseline mood, being male and older age. The findings within this review provide novel insight to clinicians working in obesity and have important implications for lifestyle intervention programme design. Barriers to behaviour change need to be addressed early in treatment, with lifestyle intervention individualized accordingly. Predictors of adherence should also be taken into careful consideration, with negative moods and unrealistic weight loss expectations discussed at the outset. If adherence is improved, treatment effectiveness, health outcomes and the ultimate burden of chronic diseases could also be improved.

Purpose: Resistance exercise has great potential to aid in the management of breast cancer-related lymphedema (BCRL); however, little is known regarding optimal exercise prescription. The pervasive view is that resistance exercise with heavy loads may be contraindicated, disregarding the dose-response relationship that exists between the load utilised in resistance exercise and the magnitude of structural and functional improvements. No previous research has examined various resistance exercise prescriptions for the management of BCRL. This study compared the effects of high load and low load resistance exercise on the extent of swelling, severity of symptoms, physical function and quality of life in women with BCRL. Methods: Sixty-two women with a clinical diagnosis of BCRL (\u3e5 % inter-limb discrepancy) were randomly assigned to a high-load resistance exercise (n = 22), low-load resistance exercise (n = 21) or usual care (n = 19) group. Participants in the experimental groups completed a 3-month moderate- to high-intensity resistance exercise program in which the load of the exercises was manipulated from 10-6 repetition maximum (75-85 % of one repetition maximum [1RM]) for the high-load group or from 20-15 repetition maximum (55-65 % 1RM) for the low-load group. Outcome measures included the extent of swelling in the affected arm, symptom severity, physical function and quality of life. Results: There were no differences between groups in the extent of affected arm swelling or severity of symptoms. The change in muscle strength, muscle endurance and quality of life-physical functioning was significantly greater in both high-load and low-load groups compared with the control group (p \u3c 0.040). Change in quality of life-physical function was significantly associated with the change in symptom severity and muscle strength. No lymphedema exacerbations or other adverse events occurred during this trial. Conclusion: Women with BCRL can safely lift heavy weights during upper body resistance exercise without fear of lymphedema exacerbation or increased symptom severity. Implications for Cancer Survivors: Women with breast cancer-related lymphedema can be informed that appropriately prescribed and supervised upper body resistance exercise is safe and can aid in the management of lymphedema through improvements in physical function and quality of life

Poor adherence to lifestyle intervention remains a key factor hindering treatment effectiveness and health outcomes for adults with obesity. The aim of this systematic review and meta-analysis is to determine if behavioural treatment strategies (e.g. goal setting, motivational interviewing, relapse prevention, cognitive restructuring etc.) improve adherence to lifestyle intervention programmes in adults with obesity. Randomized controlled trials that investigated the use of behavioural treatment strategies in obesity management were identified by systematically reviewing the literature within Medline, PsycINFO, CINAHL, SPORTDiscus and Web of Science from their inception to August 2016. This meta-analysis shows that behavioural treatment interventions have a significant positive effect on session attendance (percentage) and physical activity (total min/week) in adults with obesity (M = 17.63 (95% confidence interval (CI) = 10.77, 24.50), z =5.0337, P < 0.0001 and M = 105.98 (95% CI = 58.64, 153.32), z =4.3878, P < 0.0001, respectively). This meta-analysis of randomized controlled trials provides evidence that behavioural treatment strategies improve adherence to lifestyle intervention programmes in adults with obesity. These strategies should be routinely incorporated into lifestyle intervention, obesity management and weight loss programmes with the aim of improving engagement and adherence. If adherence were improved, treatment effectiveness, health outcomes and the ultimate burden of chronic disease could also be improved.

No abstract

The aim of this study was to determine the high-speed running and sprinting profiles of elite female soccer players during competitive matches using a new Optical Player Tracking system. Eight stationary video cameras were positioned at vantage points surrounding the soccer field so that when each camera view was combined, the entire field could be viewed simultaneously. After each match, an optical player tracking system detected the coordinates (x, y) of each player for every video frame. Algorithms applied to the x and y coordinates were used to determine activity variables for 12 elite female players across 7 competitive matches. Players covered 9,220-10,581 m of total distance, 1,772-2,917 m of high-speed running (3.4-5.3 m·s) distance, and 417-850 m of sprinting (>5.4 m·s) distance, with variations between positional groups (p < 0.001; partial η = 0.444-0.488). Similarly, the number of high-speed runs differed between positional groups (p = 0.002; partial η = 0.342), and a large proportion of high-speed runs (81-84%) and sprints (71-78%) were performed over distances less than 10 m. Mean time between high-speed runs (13.9 ± 4.4 seconds) and sprints (86.5 ± 38.0 seconds) varied according to playing position (p < 0.001; partial η = 0.409) and time of the match (p < 0.001; partial η = 0.113-0.310). The results of this study can be used to design match-specific conditioning drills and shows that coaches should take an individualized approach to training load monitoring according to position.

No abstract

Nursing and allied health professionals (AHPs) are in an ideal position to promote physical activity (PA) as part of their health care provision. The aim of this study was to investigate current promotion and knowledge of PA among people in these disciplines. A cross-sectional online survey of practicing Australian physiotherapists, nurses, exercise physiologists, occupational therapists, dietitians and pharmacists was conducted in 2016. A total of 433 nurses and AHPs completed the survey. All disciplines agreed that providing PA advice was part of their role, although nurses were less likely to agree. All disciplines felt they had the skills to promote PA but nurses were more likely to report a lack of time as a barrier. Physiotherapists and exercise physiologists were more confident giving PA advice to patients. Most health professionals (68%) were aware of the PA guidelines, although only 16% were accurately able to describe all relevant components. In logistic regression modelling, women and those working in public hospitals were less likely to encourage PA. Awareness of the PA guidelines doubled the odds of encouraging PA in patients (odds ratio 2.01, 95% confidence interval 1.18-3.43). Australian nurses and AHPs perceive that PA promotion is part of their role, however few have specific knowledge of the PA guidelines. To increase PA promotion by nurses and AHPs awareness of the PA guidelines appears to be essential. Nurses and AHPs are in an ideal position to promote PA, although there is limited evidence of their PA promotion and knowledge. Australian nurses and AHPs are confident and think it is feasible to promote PA to patients in several healthcare settings but many lack sufficient PA knowledge, limiting their PA promotion. Increasing PA knowledge of nurses and AHPs could generate increased levels of PA in the Australian population and improve national health and wellbeing.