ArticleLiterature Review

# Running as a Key Lifestyle Medicine for Longevity

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## Abstract

Running is a popular and convenient leisure-time physical activity (PA) with a significant impact on longevity. In general, runners have a 25-40% reduced risk of premature mortality and live approximately 3years longer than non-runners. Recently, specific questions have emerged regarding the extent of the health benefits of running versus other types of PA, and perhaps more critically, whether there are diminishing returns on health and mortality outcomes with higher amounts of running. This review details the findings surrounding the impact of running on various health outcomes and premature mortality, highlights plausible underlying mechanisms linking running with chronic disease prevention and longevity, identifies the estimated additional life expectancy among runners and other active individuals, and discusses whether there is adequate evidence to suggest that longevity benefits are attenuated with higher doses of running.

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... Running is one of the most popular sports across the globe (Hulteen et al., 2017), a fortunate situation since running alleviates some of the adverse effects of the global physical inactivity pandemic (Guthold et al., 2018). Running also promotes longevity, helps to prevent chronic disease (Daskalopoulou et al., 2017;Fields et al., 2010;Lee et al., 2017), and has the potential to improve mood and mental health (Mikkelsen et al., 2017;Oswald et al., 2020;Pereira et al., 2021;Roeh et al., 2020). The underlying mechanisms have been proposed to relate to increased fitness and healthy behaviors (Fields et al., 2010;Lee et al., 2017), as well as through neurosteroid blood level changes (Pereira et al., 2021). ...
... Running also promotes longevity, helps to prevent chronic disease (Daskalopoulou et al., 2017;Fields et al., 2010;Lee et al., 2017), and has the potential to improve mood and mental health (Mikkelsen et al., 2017;Oswald et al., 2020;Pereira et al., 2021;Roeh et al., 2020). The underlying mechanisms have been proposed to relate to increased fitness and healthy behaviors (Fields et al., 2010;Lee et al., 2017), as well as through neurosteroid blood level changes (Pereira et al., 2021). Unfortunately, running may also yield adverse health-related outcomes, such as running-related injuries and chronic fatigue (e.g., van Poppel et al., 2021). ...
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Runners have a high risk of getting injured compared to practitioners of other sports, and reducing this risk appears challenging. A possible solution may lie in the self-regulatory behavior of runners and their passion for running, which are promising predictors of runners' risk of running-related injuries (RRIs) and chronic fatigue. Therefore, in the present study, we investigated to what extent a mobile application (“app”), called REMBO, could reduce the risk of RRIs and chronic fatigue by externally supporting self-regulation in a personalized fashion. Long-distance runners (N = 425; 243 men, 182 women; Mage = 44.7 years), training for half and whole marathon distances, took part in our randomized controlled trial. Runners were randomly allocated to theintervention group with access to the app (n = 214) or to the control group with no access to the app (n = 211). We tested the effectiveness of the app according to the intention-to-treat protocol and via a dose-response analysis, finding no statistically significant effects with regard to RRIs and chronic fatigue. Furthermore, an exploratory latent risk profile subgroup analysis found no evidence that any reductions in RRIs or chronic fatigue due to the app intervention differed across low-risk, medium-risk, and high-risk psychological profiles of runners. Across our study, adherence was relatively low, reasons for which are discussed based on feedback from participants. In our discussion, we outline the implications of the app intervention not achieving its intended effect and list several recommendations that might steer toward more success in preventing RRIs and chronic fatigue in the future.
... Running is a popular and convenient physical activity that shows a significant positive impact on longevity [1]. It also affects the perception of health and wellness of practitioners [2]. ...
... The participants completed the questionnaire regarding the injuries caused while practicing trail running in the last 2 years. Based on the time that each participant dedicated to the practice of trail running and the number of occurrences, the incidence of injuries per 1000 h for each athlete was calculated [32]: Injury incidence = (number of injuries × 1000)/practice hours (1) The participants also indicated the body region of each injury: arm, hip, elbow, spine, neck, fingers, hand, toes, shoulder, intercostal, hamstring, wrist, thigh, nose, foot, lower leg, ankle, or non-specific region, together with the body size of occurrence. This information was later aggregated into body regions for analysis: lower extremities, upper extremities, trunk, or head. ...
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The aim of this study was to analyze the injury incidence in young trail runners according to the body region, type, mode of onset, and moment of occurrence, both in total and detailed by sex. Thirty-five male and sixteen female young elite trail runners, aged between 15 and 22 years, completed a questionnaire regarding the injury incidence in the last 2 years. Comparison of the proportions of the injury incidence within groups (all, male, and female runners) and between groups (male vs. female runners) was computed using z and Fisher’s exact tests. Results showed that most of the injuries in male runners occurred in ankle (54.3%; p < 0.001; ES = 0.520). New injuries were the most common type in male (60.0%; p < 0.001; ES = 0.829) and female runners (52.0%; p = 0.005; ES = 0.585). Acute sudden onset (55.7%; p = 0.002; ES = 0.722) and repetitive sudden onset injuries (48.0%; p = 0.002; ES = 0.141) were the most frequent in male and female athletes, respectively. Joint sprains (48.6%; p < 0.001; 0.464) were the most reported injuries in male runners. Comparative analysis between sexes showed that exacerbation injuries were higher in females (24.0%) than in male runners (8.6%), with p = 0.046 (ES = 0.205). However, female runners reported less incidence by acute sudden onset injuries (32.0%) than male runners (55.7%), with p = 0.042 (ES = 0.209). Young trail runners showed a specific injury profile due to the distinctive characteristics of the mountain terrain compared to the athletic modalities
... Yet, systematic academic research in this space is notably lacking (Logan 2015;Osmond and Woodcock 2015); it is an 'underexplored phenomenon' (Gimlin 2010, 280). Given that outdoor exercise is associated with a range of health and wellbeing benefits (Lee et al. 2017;Szabo and Júlia 2013) and running is considered particularly accessible since it requires little in the way of specialist equipment, skill, or experience (Hitchings and Latham 2017), examining the impact of street harassment as a potential barrier to this form of outdoor recreation is warranted. Echoing Gimlin (2010) who reported that among the various forms of problematic behaviour in society, consideration of the harassment runners experience by state and local governments is noticeably absent and, ' . . . to ignore the harassment targeted at any group is to blind ourselves to the active discrimination that we still tolerate and that all individuals, independent of age, gender, ethnicity, and sexuality, commit in public places ' (p. ...
... This study has shown that street harassment is a significant issue in London. Experiences of objectification, vulnerability, fear and shame resulting from street harassment create barriers to participation in outdoor activities (Lee et al. 2017;Wesely and Gaarder 2004). This study calls for a fundamental cultural change, moving beyond neoliberalist attitudes characterising street harassment as an individual issue, and instead finally recognising it as the serious harm that it is with a political will to address the problem. ...
Article
Street harassment is a common everyday occurrence, yet little academic attention has been paid to how it affects those engaged in outdoor recreation. This study critically explores street harassment experienced and managed by runners in London. Data was collected through an online survey and one-to-one interviews. A total of 121 runners across 26 London boroughs completed the survey, with seven women and two men taking part in follow-up interviews. Transcripts and survey responses were analysed using reflexive thematic analysis. The survey results showed that 84% of women and 50% of men have experienced some form of street harassment while running in London. Five themes were identified: Running into Trouble, I am Afraid of Men, The Cost of Safety, Silencing Myself and It’s Not Me, It’s You. These themes illustrate the complexities contained in the experience of street harassment, the impact it has on runners and how they try to manage it. This study highlights a pressing need for a shift in cultural and political attitudes towards the issue of street harassment.
... This increase in mass participation is a positive trend because of the beneficial physiological adaptations associated with or induced by distance running. For instance, frequently performed distance running is associated with overall better longevity compared to non-running (Lee et al., 2017;Pedisic et al., 2020). It should be no surprise that running as intense physical activity is part of many health care and training programs that promote a healthy lifestyle. ...
... Distance running has many known physical benefits, (Lee et al., 2017) but it does not come without risk. (Hespanhol Junior et al., 2016;Mann et al., 2015) Risk factors for running-related injuries are multifaceted at the whole-body level. ...
Thesis
... Like walking and cycling, running is a widespread alternate type of physical activity and with hundreds of millions of runners and constantly increasing all over the world (Breuer, Hallmann & Wicker, 2011;Hulteen et al., 2017;Leslie et al., 2004). It demonstrates positive impacts on both physical and mental health, including dramatical reduction of cardiovascular disease, depression, anxiety disorders (Chakravarty, Hubert, Lingala & Fries, 2008;Lavie et al., 2015;Lee et al., 2014;Lee et al., 2017;Oja et al., 2017). Thus, the sustainable street environment that is suitable for running is becoming more important for urban runners. ...
Preprint
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The running environment is found to relate to running behaviors. Prior studies focused more on the mental benefits of runners' perceived quality of the natural environment. However, how built environment factors, especially the micro-level streetscapes and corresponding perceptions affect running intensity is less addressed. This might be due to the limited availability of large-scale per-ception and running data. Additionally, the spatial interaction effects on running are also less known. We hypothesize that the physical features and the perceptions of streetscapes both can af-fect runners’ route choices, which in turn can be reflected via the running intensity. To test our hy-pothesis, we explored the associations between the number of runners on streets and six groups of environmental factors (i.e., sociodemographic factors, safety attributes, land use and built environ-ment factors, traffic-related factors, objective street environment features, and subjective street envi-ronment perceptions) in Boston. To tackle the gap of lacking runner data, we took advantage of the semi-open-source Strava Heatmap to extract running intensity information. We then applied geo-graphic information system (GIS), deep learning, and computer vision to measure the key indices for streetscape quality and perceptions. The associations between running intensity and streetscape quality and perceptions were tested, while other variables are controlled. In addition to the ordinary least squares model (OLS), the spatial autoregressive combined model (SAC) and geographically weighted regression model (GWR) were also conducted to account for the spatial dependence and heterogeneity effects. The results indicated that: 1) the objective and subjective eye-level streetscape were both significant for runners’ route choices; 2) the proximity of natural elements including nat-ural land, tree density, green open space area, vegetation, and terrains alongside the streets could encourage running; 3) other built environment factors such as the points of interests (POIs), street light density and length of the street segment had positive impacts on running amount; 4) accessi-bility to running environment and transportation facilities could increase running amount; 5) safer street conditions (perceived safer streets and less crime) had positive impacts on running and; 6) the indices hindering running are crime density, population density, motorcycles and traffic lights on streets. The proposed framework based on semi-open data sources like Strava maps is effective and can be applied to larger geospatial contexts and even comparison studies between various cities, which significantly fill the gap of missing data on running and outdoor sports. Our findings also enrich the literature on the interaction between micro-level street environment and human behavior and can be used for urban environment improvement to facilitate running and promote public health. Keywords: Street View Image; Deep Learning; Street Measures; Running; Route Choice; Boston
... Багато людей вважають, що ходьба для суглобів куди корисніша, ніж біг, аргументуючи це тим, що ударні навантаження на нижні кінцівки при ходьбі менш шкідливі і «руйнівні». Фактично ряд робіт показує[104,112], що біг благотворно впливає на здоров'я суглобів, володіючи захисним ефектом.Також дослідники виявили[91,109,110], що аматорський біг зменшує ризик розвитку остеоартриту (хронічне захворювання, що викликає пошкодження хрящів і оточуючих їх тканин) тазостегнового і колінного суглобів у порівнянні з тими, хто не захоплюється бігом. Навіть у спортсменів-мастерс з наявними остеоартритом колінного суглоба біг не приводив до посилення симптомів і запобігав прогресування хвороби. ...
Book
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В магістерській роботі розкрито теоретичні засади розвитку витривалості в циклічних видах спорту. Висвітлено основи організації спортивного тренування та особливості періодизації. Досліджено обсяги дозування тренувальних навантажень у циклічних видах спорту. Проведено аналіз фізіологічних процесів витривалості організму спортсменів в бігу на довгі дистанції. Встановлено методи контролю в підготовці бігуна на довгі дистанції. Викладено матеріал щодо організації тренувального процесу в бігу на довгі дистанції. Проведено анкетні дослідження щодо побудови тренувального процесу в бігу на довгі дистанції. Визначено оптимальний рівень витривалості у бігуна на довгі дистанції. Обґрунтовано процес підготовки бігунів до старту на довгі дистанції. Відображено особливості організації тренувальних занять з бігунами на довгі дистанції вікової категорії «Мастерс».
... Esse fato pode estar relacionado ao fato de alguns praticantes de exercício utilizarem a prática de exercício para superar outro vício (e.g. Depressão, alcoolismo, tabagismo) ou como maneira de reduzir o estresse, sendo a forte dedicação transformando os praticantes em viciados pela prática do exercício (Lee et al., 2017;Warburton & Bredin, 2017). ...
Article
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... Middle-distance running was the most unpopular test item, particularly with the least motivated students comprising mostly secondary females. Considering running is convenient and provides significant health benefits for example prevention of chronic diseases (Lee et al. 2017), it is important to explore possible intervention approaches such as using novel activities (Vazou et al. 2019) to motivate these least motivated students to engage in the fitness test middle-distance running and develop their positive perceptions of the running. ...
Article
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Background: Fitness testing is frequently conducted in school-based physical education. However, researchers dispute if fitness testing should be discontinued or, when appropriately implemented, has value. In Singapore, the National Physical Fitness Award test develops students’ knowledge and skills to assess, maintain, and improve their fitness levels. Nonethless, physical activity levels have not improved, and the obesity rate has increased in schools. Improvements cannot be made judiciously due to limited research on fitness testing meaningfulness and young people’s views. Purpose: This study examined Singapore students’ fitness testing perceptions across three school stages, between gender groups, and their identified motivational profiles. Method: A survey package was administered to 549 Singapore students (328 females, 221 males) recruited from primary, secondary, and pre-university (age range 11–19 years) to comprehend their fitness testing perceptions (motivations, attitudes, and the popularity of fitness test items). Confirmatory factor analysis assessed the factorial validity of Singapore students’ responses to the adapted questionnaires on fitness testing motivations and attitudes. Between-subjects MANOVAs then examined the differences in students’ fitness testing motivations, attitudes, and test items’ popularity separately. A two-step cluster analysis categorised the students using their identified motivational profiles. Subsequently, another set of between-subjects MANOVAs verified if the fitness testing perceptions were significantly different among the clusters. Results: Findings revealed that students’ fitness testing perceptions were more positive at primary than secondary and pre-university levels; female students’ fitness testing perceptions were more negative than male students, distinctly at secondary. Middle-distance running was the least popular test item, notably with secondary females. Conversely, PE teachers had positively influenced pre-university females’ fitness testing perceptions compared to secondary females. Conclusions: Singapore students’ fitness testing perceptions were generally positive. Students’ experience of enjoyment in fitness testing was found to be a key factor for their positive perceptions of fitness testing. More pragmatic support from PE teachers would be required for the secondary female students to promote positive fitness testing perceptions.
... Considering the existent sport activities, running is one of the most widely performed sport activity, involving millions of individuals every year, both at the competitive and amateur levels. Indeed running is easily accessible because it does not require specialized equipment and the performing subject can set the level of fatigue according to his/her personal capabilities, like in the considered dataset [1,29]. This dataset is particularly proper for the validation of the presented EEMD-based algorithm because SNR is low. ...
... Physical activity is associated with a reduced risk for developing chronic disease and premature all-cause mortality. 1 Evidence further suggests that participating in outdoor physical activity improves mental well-being. 2 Trail running involves running on off-road terrains in outdoor environments and is characterized by large elevation changes. 3 Although running has numerous proven physical and mental health benefits, it is still associated with a high risk for injury. ...
Article
Introduction Trail running is characterized by elevation changes, with uneven and varying running surfaces. Risk factors that may predict gradual-onset running-related injuries (GORRIs) in short-distance trail running have not been explored. The objective was to determine risk factors that predict GORRIs in trail running race entrants who entered mass community-based trail running events. Methods In this descriptive cross-sectional study, data were collected prospectively from a prerace medical screening questionnaire over 4 trail run events held annually. Using a Poisson regression model, runner demographics, race distance, running training/racing variables, history of chronic diseases (number of chronic diseases reported as a cumulative “chronic disease composite score”), and allergies were investigated to determine factors predicting self-reported GORRI history in the previous 12 mo. Results This study included 2824 race entrants (80% of entrants). The retrospective annual incidence for GORRIs was 13%. Independent risk factors predicting GORRIs were longer race distance (P<0.0001), increasing chronic disease composite score (P=0.0012), and a history of allergies (P=0.0056). The lower limb (94%) was the main anatomic region of GORRIs, and soft tissue injuries accounted for most (83%) GORRIs. Common specific GORRIs were iliotibial band syndrome (22%), Achilles tendon injury (10%), and hamstring injury (9%). Conclusions Independent risk factors predicting GORRIs among trail running entrants included longer race distance, a higher chronic disease composite score, and a history of allergies. This study has highlighted trail running race entrants at risk for sustaining GORRIs who could be targeted for future injury prevention interventions.
... [1][2][3][4] Running is an increasingly popular way to improve physical and mental well-being. [5][6][7] In 2019, close to 2 million people (11% of the Dutch population) performed weekly running activities in the Netherlands. 8 Musculoskeletal injuries are a prominent disadvantage of running, with training errors being frequently suggested to be a major cause of injury. ...
Article
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Objectives: To evaluate the impact of running-related injuries (RRIs) on activities of daily living (ADL), work, healthcare utilization and estimated costs. Design: Prospective cohort study with data from a randomized controlled trial. Methods: Adult recreational runners who registered for a running event (distances 5 km to 42 km) were included in this study. Minimum follow-up duration was 3 months (preparation, event participation and post-race period). Injuries were registered using a standardized definition. Primary outcome measure was a standardized 5-item survey on limitations in ADL. The survey data were categorised to the number of injured runners with complete/moderate/no limitations. This outcome was expressed as the percentage of injured runners with any limitation (complete or moderate limitations amalgamated) ). Secondary outcomes were work absenteeism, the number of healthcare visits per injured runner and estimated direct medical and indirect costs per participant and per RRI. Results: 1929 runners (mean (SD) age 41 (12) years, 53% men) were included in this study and 883 runners (46%) sustained a RRI during the course of the study. Injured runners reported the highest limitations (% with any limitation) of RRIs during the first week of injury on sports and leisure activities (70%) and transportation activities (23%). 39% of the injured runners visited a health care professional. Work absenteeism due to the RRI was reported in 5% of the injured runners. The total mean estimated costs were €74 per RRI and €35 per participant. Conclusions: Injured runners are mainly limited in their transportation activities and during sports and leisure. While the estimated costs of RRIs are not high when expressed per participant, the absolute costs may be substantial due to the popularity of running.
Article
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Objective: To verify the association between sex with cardiorespiratory fitness (CF) of adolescents from public and private schools. Material and methods: study with adolescents from Curitiba (n = 349) and São José dos Pinhais (n = 418), Paraná, Brazil. Teenagers reported their sex and age. Body mass index and socioeconomic status were also considered. A 20-meter test evaluated the CF. Poisson regression tested the association between sex and CF. Results: public school students were more likely to be in the healthy zone of CF (PR: 1,769; 95% CI: 1,303-2,403; p = 0.001). Boys from private and public schools were more likely to be in the healthy zone than girls (PR: 2,926; 95% CI: 1,578-5,426; p = 0.001 and PR: 4,085; 95% CI: 2,632-6,340; p = 0.001, respectively). Conclusion: public school students were more likely to have low CF levels.
... Running is linked to numerous health benefits, both physical and psychological. Studies have suggested that runners have a 25-40% reduced risk of premature mortality, as well as significantly lower rates of cardiovascular disease and certain cancers [5][6][7][8][9]. In terms of psychological benefits, studies have shown that running can improve both mood and mental health, especially depression and anxiety disorders [10][11][12]. ...
Article
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Recreational road running is growing in popularity and has been linked to numerous mental and physical health benefits. However, we know little about what environmental preferences or concerns runners have regarding participation in the sport, and whether differences exist across age and gender. We conducted a cross-sectional survey on recreational road runners to investigate the type of built and natural environments road runners prefer, as well as the safety and health concerns that may affect runners’ choice of environment. Responses were analyzed by age and gender. A total of 1228 road runners responded to the survey; 59.6% of respondents were women and 32.1% of respondents were men. Most respondents preferred to run on asphalt or sidewalk surfaces, and preferred well-lit, tree-lined routes. Major concerns for both men and women include animals and dangerous road conditions. Men and women differed significantly in their responses to the importance of running around others and their primary concerns while running. Results of this study serve to deepen our understanding of recreational road runners’ environmental preferences and concerns, providing valuable information for public health officials and city planners alike. This information must be considered if we are to continue to encourage uptake of running as a sport and reap its health effects.
... decreased risk of cardiovascular disease) and psychological (e.g. improved self-esteem and life satisfaction) benefits associated with regular running (Lee et al., 2017;Nezlek et al., 2018). Drawbacks are also noted, such as running being associated with many overuse injuries (Ferber et al., 2009), which may be linked to insufficient/excessive coordination variability (Cunningham et al., 2014;Hamill, 2012;Heiderscheit et al., 2002;Seay et al., 2011). ...
Article
Lay abstract: Walking and running are popular forms of physical activity that involve the whole body (pelvis/legs and arms/torso) and are coordinated by the neuromuscular system, generally without much conscious effort. However, autistic persons tend not to engage in sufficient amounts of these activities to enjoy their health benefits. Recent reports indicate that autistic individuals tend to experience altered coordination patterns and increased variability during walking tasks when compared to non-autistic controls. Greater stride-to-stride coordination variability, when the task has not changed (i.e. walking at same speed and on same surface), is likely indicative of motor control issues and is more metabolically wasteful. To date, although, research examining running is unavailable in any form for this population. This study aimed to determine if coordination variability during running differs between autistic adolescents and age, sex, and body mass index matched non-autistic controls. This study found that increased variability exists throughout the many different areas of the body (foot-leg, left/right thighs, and opposite arm-opposite thigh) for autistic adolescents compared to controls. Along with previous research, these findings indicate autistic persons exhibit motor control issues across both forms of locomotion (walking and running) and at multiple speeds. These findings highlight issues with motor control that can be addressed by therapeutic/rehabilitative programming. Reducing coordination variability, inherently lessening metabolic inefficiency, may be an important step toward encouraging autistic youth to engage in sufficient physical activity (i.e. running) to enjoy physiological and psychological benefits.
... Importantly, physical activity and running can protect and enhance physical, mental, and social components of health (Greist et al., 1979;Chan and Grossman, 1988;Penedo and Dahn, 2005;Eime et al., 2013;Xie et al., 2020). Running has been related to a 30 to 45% lower risk of mortality and a 45 to 70% lower risk of cardiovascular disease-related mortality (Lee et al., 2017). Not only can running benefit physical health but also psychological health is reported to be higher in runners and worsens when habitual runners are prevented from running (Chan and Grossman, 1988;Trost et al., 2002). ...
Article
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The primary purpose of this study was to examine how the type and magnitude of changes in running behavior, as a consequence of COVID-19 pandemic restrictions, influence running-related injuries. Secondarily, we aimed to examine how lifestyle and psychosocial well-being measures may influence running behavior change. An online survey was advertised to individuals over the age of 18 that currently run or have previously participated in running for exercise. The survey questions examined injury history and new injuries sustained during COVID-19 restrictions, as well as changes related to training behavior changes, training environment changes, social behaviors, and psychosocial well-being. Changes reflected differences in running behaviors prior to COVID-19 restrictions (1 month prior to COVID-19 restrictions being imposed) and during COVID-19 restrictions (May 5 to June 10, 2020). A total of 1,035 runners were included in the analysis. Current injuries sustained during COVID-19 occurred in 9.5% of the runners. Injured runners made a greater number of total changes ( p = 0.031) as well as training-related ( p = 0.042) and environment-related ( p = 0.017) changes compared with uninjured runners. A significant relationship was found between injury and those that reported less time to exercise to changes in work environment ( p = 0017). This study highlights the multi-dimensional nature of running-related injuries and the need to consider the interaction of multiple changes in running behavior, rather than isolating single factors. Greater understanding of the underlying causes of running-related injuries can help reduce the risk of future injury.
... Esse fato pode estar relacionado ao fato de alguns praticantes de exercício utilizarem a prática de exercício para superar outro vício (e.g. Depressão, alcoolismo, tabagismo) ou como maneira de reduzir o estresse, sendo a forte dedicação transformando os praticantes em viciados pela prática do exercício (Lee et al., 2017;Warburton & Bredin, 2017). ...
Article
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This cross-sectional study aimed to investigate the association of age, frequency of training and time of practice with the degree of dependence on exercise (DE) of recreational athletes. 159 recreational running, bodybuilding and crossfit athletes participated, with an average age of 31.59 ± 7.98 years, from the state of Pernambuco. The instruments used were a sociodemographic questionnaire to characterize the sample and the Exercise Dependence Scale-Revised to measure ED. Data analysis was conducted using Spearman's Correlation and Multiple Regression (p <0.05). The results showed a significant and positive correlation (p <0.05) of the training frequency with the dimensions of DE continuity (r = 0.16), reduction in other activities (r = 0.27), lack of control (r = 0, 24), time (r = 0.25) and general DE score (r = 0.25). The multiple regression analysis revealed that only the training frequency had a significant and positive prediction on the dimensions of ED. Specifically, the weekly training frequency explains 1% of the continuity variance, 6% of the reduction in other activities, 5% of the lack of control, 5% of the time and 57% of the general ED score. It is concluded that the weekly frequency of training seems to be an intervening factor in the degree of ED in recreational athletes.
... Moderate physical activity is an important component of health and longevity (Langhammer, Bergland, & Rydwik, 2018), and exercise training has fundamental beneficial effects on ischemic and nonischemic heart failure (Akyuz, 2020). Running is one of the most popular types of such activity, which is also a key element to achieve health and longevity (Lee, Brellenthin, Thompson, Sui, Lee, & Lavie, 2017). Thus, an important point is to determine the changes in the human organism that occur under the influence of running. ...
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Effect of 5-weeks running training on modulation of the H-reflex amplitude on soleus muscle in non-trained men was studied. It was established that modulation of the H-reflex amplitude occurs in two phases. In the course of the first 3 weeks of running training (first phase) statistically significant (p < 0.05) increase in H-reflex amplitudes and the maximum H-reflex to the maximum M-response amplitudes ratio (10%) were registered. In contrast to the first phase, decrease in investigated parameters up to initial values were observed during the next 2 weeks of the training (second phase). An increase in the of the soleus H-reflex amplitude, is probably due to the enhanced drive in descending pathways, increased motoneuron excitability and changes in presynaptic Ia afferent inhibition, whereas decrease in the amplitude of the H-reflex might occurs presumably due to motor learning. Apparently, that the repetitive task, which automatically performed and controlled on a spinal or brainstem level can be reflected in the normalization and stabilization of the H-reflexes registered after running training in later period.
... A few benefits emerge immediately after a running session, but the major part is dependent on the regularity of running (Hespanhol Junior, 2015). One of the most effective approaches for enhancing health is to keep up with running, or other similar physical activities, for the entire life (Lee, 2017). Therefore, to maintain the short-and long-term health benefits of running, it is of importance to minimise the factors forcing people to quit running. ...
... Running has a significant positive effect on the body by improving cardiorespiratory function and by preventing and treating various diseases. 1 As a result, and the number of people involved in running has increased worldwide. However, strenuous endurance exercises can cause immune system disorders and damage various tissues including muscles, as a result of metabolic and mechanical stress. ...
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Background Catecholamine is a typical index of exercise intensity, but it is difficult to detect. Plasma metanephrine (MN) and normethanephrine (NMN) levels are more stable than those of catecholamines. This study aimed to investigate plasma MN and NMN levels during acute exercise running in amateur runners. Methods Samples were collected from eight healthy male participants. They were either sedentary or running at low or high intensity for 30 min. Blood samples were collected under these conditions. Measurements taken included plasma adrenaline, noradrenaline, MN, and NMN. Results Plasma adrenaline levels increased after high-intensity exercise compared with sedentary subjects. Plasma noradrenaline, MN, and NMN levels increased after both low- and high-intensity exercise compared with sedentary subjects. In addition, these levels were also significantly higher at high intensity than at low intensity. Plasma adrenaline and noradrenaline levels were positively correlated with plasma free MN and NMN levels after acute running, respectively. Conclusion This study revealed that plasma MN and NMN levels transiently increased depending on exercise intensity in amateur runners. In addition, plasma NMN levels are better markers than plasma MN levels because of their stronger correlation with plasma catecholamine levels.
... Participation in regular physical activity decreases the risk for premature all-cause mortality, development of chronic disease and is effective in management of a current chronic disease [1][2][3]. Running is a popular mode of physical activity due to its easily accessible nature, with no need for specialised equipment or requirement of specific facilities [4,5]. Some evidence suggests that physical activity in outdoor environments has a higher positive impact on mental wellbeing compared to indoor activity [6]. ...
Article
Full-text available
Background Trail running is characterised by large elevation gains/losses and uneven varying running surfaces. Limited information is available on injury and illness among trail runners to help guide injury and illness prevention strategies.Objective The primary aim of this review was to describe the epidemiology of injury and illness among trail runners.Methods Eight electronic databases were systematically searched (MEDLINE Ovid, PubMed, Scopus, SportsDiscus, CINAHL, Health Source: Nursing/Academic, Health Source: Consumer Ed., and Cochrane) from inception to November 2020. The search was conducted according to the PRISMA statement and the study was registered on PROSPERO international prospective register of systematic reviews (CRD42019135933). Full-text English and French studies that investigated injury and/or illness among trail runners participating in training/racing were included. The main outcome measurements included: trail running injury (incidence, prevalence, anatomical site, tissue type, pathology-type/specific diagnosis, severity), and illness (incidence, prevalence, symptoms, specific diagnosis, organ system, severity). The methodological quality of the included studies was assessed using an adapted Downs and Black assessment tool.ResultsSixteen studies with 8644 participants were included. Thirteen studies investigated race-related injury and/or illness and three studies included training-related injuries. The overall incidence range was 1.6–4285.0 injuries per 1000 h of running and 65.0–6676.6 illnesses per 1000 h of running. The foot was the most common anatomical site of trail running injury followed by the knee, lower leg, thigh, and ankle. Skin lacerations/abrasions were the most common injury diagnoses followed by skin blisters, muscle strains, muscle cramping, and ligament sprains. The most common trail running illnesses reported related to the gastro-intestinal tract (GIT), followed by the metabolic, and cardiovascular systems. Symptoms of nausea and vomiting related to GIT distress and dehydration were commonly reported.Conclusion Current trail running literature consists mainly of injury and illness outcomes specifically in relation to single-day race participation events. Limited evidence is available on training-related injury and illness in trail running. Our review showed that injury and illness are common among trail runners, but certain studies included in this review only focused on dermatological injuries (e.g. large number of feet blisters) and GIT symptoms. Specific areas for future research were identified that could improve the management of trail running injury and illness.
... This is in line with results from published meta-analyses (4,5). Higher levels of physical activity have been shown to reduce the incidence of obesity and noncommunicable diseases (38), improve quality of life (39), and increase mean and maximum life span (40). In addition, previous studies have demonstrated that smoking is a strong independent risk factor of cardiovascular disease, diabetes mellitus, cancer, and many other diseases (41,42). ...
Article
Background To examine the relations of individual lifestyle factors and its composite score with healthy ageing among Chinese. Methods We included 14,159 participants aged 45-74 years at baseline from the Singapore Chinese Health Study, a population-based prospective cohort. A protective lifestyle score (0-5 scale) was calculated at baseline (1993-1998) and updated at the second follow-up visit (2006-2010) on the basis of optimal body mass index (18.5-22.9 kg/m2), healthy diet (upper 40% of the Alternative Healthy Eating Index score), being physically active (≥2 hours/week of moderate activity or ≥0.5 hours/week of strenuous activity), non-smoking (never smoking), and low-to-moderate alcohol drinking (>0 to ≤14 drinks/week for men and >0 to ≤7 drinks/week for women). Healthy ageing was assessed at the third follow-up visit (2014-2016), and was defined as absence of specific chronic diseases, absence of cognitive impairment and limitations in instrumental activities of daily living, good mental and overall self-perceived health, good physical functioning, and no function-limiting pain. Results About 20.0% (2,834) participants met the criteria of healthy ageing after a median follow-up of 20 years. Each one-point increase in the protective lifestyle score computed at baseline and second follow-up visits was associated with higher likelihood of healthy ageing by 25% (95% CI: 20%-30%) and 24% (18%-29%), respectively. The population-attributable risk percent of adherence to 4-5 protective lifestyle factors was 34.3% (95% CI: 25.3%-42.3%) at baseline and 31.3% (23.0%-38.7%) at second follow-up visits for healthy ageing. In addition, positive increase in lifestyle scores from baseline to second follow-up visits was also significantly associated with a higher likelihood of healthy ageing with an odds ratio of 1.18 (95% CI: 1.12-1.24) for each increment in protective lifestyle score. Conclusions Our findings confirmed that adopting healthy lifestyle factors, even after midlife, was associated with healthy ageing at old age.
... Moderate intensity exercise training has various health benefits, and is recommended for the prevention of metabolic and cardiovascular diseases [19,20]. Although much data pointed out the exercise-induced physiological adaptations, including improved blood lipid and blood pressure profiles, as well as enhanced physical performance, an increased risk of exercise-induced myocardial infarction has also been reported [21][22][23]. ...
Article
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Background: The study aimed to evaluate the effects of a 3-week ω-3 PUFA supplementation on serum adipocytokines (i.e., adiponectin, leptin), neuregulin-4 (NRG4) and erythrocyte omega-3 (ω-3) fatty acid content, as well as the blood antioxidant defense capacity in non-elite endurance runners. Methods: Twenty-four runners were randomized into two groups: the supplemented group, who received omega free fatty acids extract containing 142 mg of EPA, 267 mg of DHA, 12 mg of vitamin E and 5 µg of vitamin D, each administrated at a dose of six capsules twice a day for three weeks, or the placebo group. Venous blood samples were withdrawn at the start and at the end of the study protocols to estimate serum biochemical variables. Results: A significantly higher ω-3 index and lower AA/EPA ratio was observed after ω-3 PUFA compared to pre-supplementation levels (p < 0.001 and p < 0.001, respectively). An increase in baseline adiponectin and NRG4 levels, as well as a decrease of leptin concentration and lipid profile improvement, were observed in subjects after a ω-3 PUFA diet. The increased ω-3 index had a significant effect on TNFα levels and a serum marker of antioxidant defense. Conclusions: The ω-3 PUFA extract with added vitamin E and D supplementation may have a positive effect on the function of the adipocyte tissue, as well as the ability to prevent cardiovascular complications in athletes.
... Collegiate track and field (T&F) athletes engage in demanding aerobic and muscular-strengthening activities that can improve health and well-being. 1,2 However, as with most sports, T&F has inherent injury risks and the highly repetitive and intense nature of its activities may increase previously injured athletes' risk of sustaining a recurrent in-jury. [3][4][5] Recurrent injuries occur when an athlete experiences the same injury they have previously recovered from, either in the same season or a previous one. ...
Article
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Background As with most sports, participating in Track and Field (T&F) has inherent injury risks and a previous injury often predisposes athletes to a greater future injury risk. However, the frequency and burden of recurrent injuries in collegiate T&F have not been closely examined. Purpose The purpose of this study was to describe the frequency and burden of recurrent injuries in collegiate T&F and compare differences in the time loss associated with initial and recurrent injuries by sex and T&F discipline. Study Design Descriptive Epidemiology Study Methods Data from the NCAA Injury Surveillance Program were analyzed to describe the frequency and burden of recurrent injuries in collegiate T&F between 2009 and 2014. Comparisons of recurrent injury proportions by T&F discipline were made using Injury Proportion Ratios (IPR) and injury-associated time loss comparisons by injury type and sex were made using Negative Binomial Regression. Results Four hundred and seventy-four injuries were reported, 13.1% of which were classified as recurrent injuries. T&F athletes who competed in jumps experienced a lower proportion of recurrent injuries (6.1%) than runners (14.6%) and throwers (19.2%) (Recurrent IPR 0.40, 95% CI 0.18-0.88, p<0.05). When controlling for sex and injury diagnosis, T&F athletes experienced 50% greater time loss from sport following a recurrent injury than an initial injury (95% CI 17%-107%, p<0.01). Conclusions Recurrent injuries in T&F athletes account for greater time loss than initial injuries, despite sex or injury diagnosis. The current study indicates a need for further research to assess factors contributing to time loss. Level of Evidence Level 3
... decreased risk of cardiovascular disease) and psychological (e.g. improved self-esteem and life satisfaction) benefits associated with regular running (Lee et al., 2017;Nezlek et al., 2018). Drawbacks are also noted, such as running being associated with many overuse injuries (Ferber et al., 2009), which may be linked to insufficient/excessive coordination variability (Cunningham et al., 2014;Hamill, 2012;Heiderscheit et al., 2002;Seay et al., 2011). ...
Article
Background Autism spectrum disorder, a neurodevelopmental disorder, is difficult to characterize from a gait biomechanics perspective, possibly due to increased inter and intra-individual variability. Previous research illustrates increased gait variability in young children with autism, but assessments in older adolescents or at varying speeds are unavailable. The purpose of this study was to determine if adolescents with autism demonstrate increased intra-limb and inter-limb coordination variability during walking compared to age, sex, and body mass index matched controls. Methods Seventeen adolescents with autism (age 13–18 years) and seventeen matched controls performed walking at two matched speeds: self-selected of adolescents with autism and at 1.3 m/s. Modified vector coding was used to determine the patterns of movement for foot-shank, left/right thigh, and contralateral thigh-arm coupling. Coordination variability, a measure of cycle-to-cycle variability, was determined across the full stride. Mixed-model analyses of variance were used to determine if group by speed interactions and/or main effects existed for coordination variability. Findings A significant interaction existed for foot-shank variability (p = 0.039). Adolescents with autism had greater variability at self-selected speeds (p = 0.018), but not at 1.3 m/s (p = 0.593) compared to controls. Thigh-thigh coordination was greater for adolescents with ASD compared to controls at both speeds (p = 0.021). Variability was decreased at 1.3 m/s for both foot-shank (p = 0.016) and thigh-thigh (p = 0.021) coupling. Interpretation This study illustrates that adolescents with autism perform walking with increased coordination variability at both proximal and distal segments. Thus, it is likely intra-individual variability drives the disparity of movement patterns in this population.
... This presumption was also confirmed by the results of studies on the impact of running on the state of health. Research has suggested that running has a positive effect on the cardiovascular, metabolic, musculoskeletal, and neurocognitive system, reducing premature mortality in runners by 25-40%, and increasing their life expectancy by up to three years when compared with nonrunners [42,43]. A similar effect can be achieved by activities that put a load on large muscle groups. ...
Article
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Regular physical activity (PA) plays an important role in the prevention of several noninfectious chronic diseases, partly due to its positive effects on body composition. The relationship between the amount of weekly PA and body composition in premenopausal women, however, remains unclear. The objective of the study is to assess the relationship between body composition and the volume of PA in full-time employed premenopausal women. The study included 136 women (aged 41.07 ± 2.77 years). The women were divided into tertiles (T1–T3) according to the level of total reported weekly PA. T1 were women with the lowest volume of PA, T2 were women with a medium volume, and T3 were women with the highest PA volume. DXA was used to measure body mass (BM), body fat (BF), visceral fat (VFA), and fat-free mass (FFM). For the comparison of means, we used one-way ANOVA and a t test. Practical significance was verified with effect of size. Significant differences were found between women in T1 vs. T2 and T1 vs. T3. When compared with T2, T1 women had a higher BM (+6.10 kg), BF (+5.98 kg), BF (+5.42%), and VF (+17.49 cm2). When compared with T3, T1 women had a higher BM (+5.99 kg), BF (+6.42 kg), BF (+5.89%), and VFA (+20.71 cm2). We can conclude that a higher volume of weekly PA is associated with lower BF, but appears to have no effect on FFM.
... In the context of the U-trend [21], it is notable that there are data suggesting an increased incidence of atrial fibrillation [22], a disease associated with both heart failure and cardioembolic stroke, myocardial fibrosis [23] and, infrequently, arrhythmogenic sudden death [24] in those involved in extreme physical activities. The greatest mortality benefit was reported to be achieved for individuals who were running and engaged in some other physical activity [25]. The present study accounted for the potential impact of participating in several activities by mutually adjusting for and testing the 17 activities in the models (Table 4). ...
Article
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Background The association between leisure-time physical activity and cardiovascular mortality has been previously studied, but few studies have focused on specific activities and intensities. Methods The association between different leisure-time physical activities and cardiovascular mortality was investigated among 25,876 individuals without diabetes or cardiovascular disease from the population-based Malmö Diet and Cancer Study cohort. The individuals estimated the average duration spent on 17 physical activities at baseline in 1991–1996 and after 5 years. Cardiovascular mortality was obtained from a register during a mean of 20 years of follow-up. Results A total leisure-time physical activity of 15–25 metabolic equivalent task (MET) hours/week was associated with a decreased risk of cardiovascular mortality (HR 15–25 vs < 7.5 MET-h/week =0.80, 95% CI 0.69–0.93), with no further risk reduction at higher levels. Several high-intensity activities (i.e., lawn tennis and running) and moderate-intensity activities (i.e., golf, cycling and gardening) were associated with a reduced risk. Individuals who engaged in high-intensity physical activity for an average of 2.29 MET h/week (30 min/week) had an 18% (95% CI 0.72–0.93) reduced risk of cardiovascular mortality compared with non-participants, and no further risk reductions were observed at higher levels. Decreased risk was observed among individuals who had started (HR 0.56, 95% CI 0.32–0.97) or continued (HR 0.49, 95% CI 0.36–0.66) high-intensity activities at the five-year follow-up. Conclusions Moderate- and high-intensity leisure-time physical activities reduced the risk of cardiovascular mortality. With regard to total leisure-time physical activity, the largest risk reduction was observed for 15–25 MET-h/week (equivalent to walking for approximately 5 h/week).
... The positive aspects of nature mentioned by participants (e.g., green scenery, types of plants, and views found pleasing) is also consistent with research demonstrating a like and preference for the natural environment (Ulrich, 1983(Ulrich, , 1999Wilson, 1984;Kaplan and Kaplan, 1989). The personal benefits associated with exercise, as reported by current participants, are also congruent across diverse populations; individuals with severe mental illness experienced improved mood as a consequence of becoming more active (Firth et al., 2016), while runners can potentially increase their life expectancy by 3.2 years compared to non-runners (Lee et al., 2017). ...
Article
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Background A recent upsurge in nature-based exercise research demonstrates the potential added benefits of exercising in this context compared to more urban ones. Yet there is a lack of qualitative research investigating the lived experiences of those who participate in nature-based exercise events. Objective To explore the lived experience of individuals who were first-time participants in a nature-based running event. Method Six participants who completed the Run Forrest trail run for the first time were individually interviewed. Semi-structured interviews were devised, and participants were invited to talk about their experiences of running in the event. Interviews were analysed using interpretative phenomenological analysis. Results Following data analysis, two superordinate themes were constructed to resemble participant experiences. “Maintaining good health is vital” reflected participants’ personal theory of health and their perceived benefits of exercise. “Nature as a special place” reflected the atmospheric characteristics of the event, including the pre-event set-up and the actual running event itself. Conclusion Analysis suggests that participants considered the event and natural environment to provide unique value adding opportunities that encouraged positive experiences. These results also reaffirm the positive benefits associated with nature-based exercise, including potential benefits to individual wellbeing. Further research in this context may strengthen our collective understanding regarding individual motivation towards such events.
... Participation in regular physical activity decreases the risk for premature all-cause mortality, development of chronic disease and is effective in management of a current chronic disease [1][2][3]. Running is a popular mode of physical activity due to its easily accessible nature, with no need for specialised equipment or requirement of specific facilities [4,5]. Some evidence suggests that physical activity in outdoor environments has a higher positive impact on mental wellbeing compared to indoor activity [6]. ...
Conference Paper
Full-text available
Background Trail running (TR) is characterised by uneven varying running surfaces, with large elevation gains/losses. Therefore, the injury and illness profiles of TR may differ compared to road running. Limited information is available on injury and illness among trail runners (TRs) to help develop interventions towards injury prevention. Objective Systematically review data on TR injury and illness. Design Systematic review. Setting MEDLINE Ovid, PubMed, Scopus, SportsDiscus, CINAHL, Health Source: Nursing/Academic, Health Source: Consumer Ed. and Cochrane were searched from inception to February 2019. Methodological quality was assessed using an adapted Downs and Black assessment tool. Patients (or Participants) N/A (systematic review abstract). Interventions (or Assessment of Risk Factors) Studies were included if they investigated injury and/or illness among TRs participating in training/racing and full-text available in English/French. Studies were excluded on biomarkers of injury/illness in the absence of participants reporting injury/illness, or if no clear evidence was found of investigating TR. Main Outcome Measurements TR injury (incidence, prevalence, anatomical site, tissue type, specific diagnosis, severity) and illness (incidence, prevalence, symptoms, specific diagnosis, body system, severity). Results Fourteen studies with 3094 participants were included. Six studies investigated injuries and illnesses, 3 studies investigated only injuries and 5 studies only illnesses. Twelve studies investigated race-related injury and/or illness and 2 studies included training-related injuries. Different study designs, injury and illness definitions, race distances, and surfaces, made pooling of results difficult. The foot, knee, ankle and thigh are the most common anatomical sites of TR injury, with lacerations/abrasions, blisters, muscle strains, cramping and ankle sprains most commonly diagnosed. TR illness involved the gastrointestinal tract (GIT), metabolic and cardiovascular body systems. Symptoms of nausea and vomiting related to GIT distress and dehydration are commonly reported. Conclusions Injury and illness are common among TRs participating in TR races. Limited evidence is available on training-related injury and illness in TR specific.
... On any given day, about 12 million adults in the United States will go running for exercise (Woods 2017). These runners enjoy longer lives characterized by lower levels of chronic disease and disability compared with their sedentary peers, and those with greater training volumes reap greater health benefits (Chakravarty et al 2008, Lee et al 2017a. Runners also experience high rates of running-related overuse injury, and the risk of sustaining these injuries is likewise strongly tied to training volume (Johnston et al 2018). ...
Article
Wearable accelerometers hold great promise for physical activity epidemiology and sports biomechanists. However, identifying and extracting data from specific physical activities, such as running, remains challenging. Objective: To develop and validate an algorithm to identify bouts of running in raw, free-living accelerometer data from devices worn at the wrist or torso (waist, hip, chest). Approach: The CARL (continuous amplitude running logistic) classifier identifies acceleration data with amplitude and frequency characteristics consistent with running. The CARL classifier was trained on data from 31 adults wearing accelerometers on the waist and wrist, then validated on free-living data from 30 new, unseen subjects plus 166 subjects from previously-published datasets using different devices, wear locations, and sample frequencies. Main results: On free-living data, the CARL classifier achieved mean accuracy (F1 score) of 0.984 (95% confidence interval 0.962-0.996) for data from the waist and 0.994 (95% CI 0.991-0.996) for data from the wrist. In previously-published datasets, the CARL classifier identified running with mean accuracy (F1 score) of 0.861 (95% CI 0.836-0.884) for data from the chest, 0.911 (95% CI 0.884-0.937) for data from the hip, 0.916 (95% CI 0.877-0.948) for data from the waist, and 0.870 (95% CI 0.834-0.903) for data from the wrist. Misclassification primarily occurred during activities with similar torso acceleration profiles to running, such as rope jumping and elliptical machine use. Significance: The CARL classifier can accurately identify bouts of running as short as three seconds in free-living accelerometry data. An open-source implementation of the CARL classifier is available at < >.
... 2020 Running, 2020). Running has both physical benefits, and mental benefits, such as lowering depressive symptoms and enhancing emotional well-being (Galper et al., 2006;Hespanhol Junior et al., 2015;Lee et al., 2017). Unfortunately, musculoskeletal injuries are common in running with an estimated 17.8 injuries in novice runners and 7.7 injuries in recreational runners per 1000 h of running (Videbaek et al., 2015). ...
Article
Objective Examine injury-related psychological distress and association with perceived running ability in injured runners. Design Prospective longitudinal study. Participants Forty-three patients with a running-related injury. Main outcome measures Data collection at initial physical therapy visit and 12–16 weeks later included Optimal Screening for Prediction of Referral and Outcome - Yellow Flag (OSPRO-YF) and Athlete Fear Avoidance Questionnaire (AFAQ) for injury-related psychological distress, and University of Wisconsin Running and Recovery Index (UWRI) for perceived running ability. OSPRO-YF composite score, total yellow flags, and yellow flags in each domain (negative mood, fear-avoidance, positive affect/coping) were calculated. Results UWRI score and OSPRO-YF composite score and yellow flags significantly improved over time, while AFAQ score and yellow flags in OSPRO-YF negative mood domain did not. AFAQ scores were significantly correlated with UWRI score at baseline, follow-up and change over time, while OSPRO-YF composite score and yellow flags were not. Baseline OSPRO-YF composite score and AFAQ score were not correlated with follow-up UWRI score. Conclusions Injury-related psychological distress is elevated when injured runners start rehabilitation, and generally improves; however, negative mood and athletic fear-avoidance may persist. Higher athletic fear-avoidance is associated with lower perceived running ability at the same time point or interval.
... Given the popularity of leisure-time running and its longterm health benefits, 31 running appears to be a costeffective lifestyle medicine from a public health perspective. 14 A major drawback of running is the high risk of sustaining an injury, identified as the main reason to stop running. 10 Most running-related injuries develop gradually over time and are thought to originate from an imbalance between cumulative damage resulting from repetitive tissue loading and its remodeling capacity. ...
Article
Background Running biomechanics may play a role in running-related injury development, but to date, only a few modifiable factors have been prospectively associated with injury risk. Purpose To identify risk factors among spatiotemporal and ground-reaction force characteristics in recreational runners and to investigate whether shoe cushioning modifies the association between running biomechanics and injury risk. Study Design Case-control study; Level of evidence, 3. Methods Recreational runners (N = 848) were tested on an instrumented treadmill at their preferred running speed in randomly allocated, standardized running shoes (with either hard or soft cushioning). Typical kinetic and spatiotemporal metrics were derived from ground-reaction force recordings. Participants were subsequently followed up for 6 months regarding running activity and injury. Cox regression models for competing risk were used to investigate the association between biomechanical risk factors and injury risk, including stratified analyses by shoe version. Results In the crude analysis, greater injury risk was found for greater step length (subhazard rate ratio [SHR], 1.01; 95% CI, 1.00-1.02; P = .038), longer flight time (SHR, 1.00; 95% CI, 1.00-1.01; P = .028), shorter contact time (SHR, 0.99; 95% CI, 0.99-1.00; P = .030), and lower duty factor (defined as the ratio between contact time and stride time; SHR, 0.95; 95% CI, 0.91-0.98; P = .005). In the stratified analyses by shoe version, adjusted for previous injury and running speed, lower duty factor was associated with greater injury risk in those using the soft shoes (SHR, 0.92; 95% CI, 0.85-0.99; P = .042) but not in those using the hard shoes (SHR, 0.97; 95% CI, 0.91-1.04; P = .348). Conclusion Lower duty factor is an injury risk factor, especially for softer shoe use. Contrary to widespread beliefs, vertical impact peak, loading rate, and step rate were not injury risk factors in recreational runners. Registration NCT03115437 (ClinicalTrials.gov identifier).
Article
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Physical fatigue is a recurrent problem in running that negatively affects performance and leads to an increased risk of being injured. Identification and management of fatigue helps reducing such negative effects, but is presently commonly based on subjective fatigue measurements. Inertial sensors can record movement data continuously, allowing recording for long durations and extensive amounts of data. Here we aimed to assess if inertial measurement units (IMUs) can be used to distinguish between fatigue levels during an outdoor run with a machine learning classification algorithm trained on IMU-derived biomechanical features, and what is the optimal configuration to do so. Eight runners ran 13 laps of 400 m on an athletic track at a constant speed with 8 IMUs attached to their body (feet, tibias, thighs, pelvis, and sternum). Three segments were extracted from the run: laps 2–4 (no fatigue condition, Rating of Perceived Exertion (RPE) = 6.0 ± 0.0); laps 8–10 (mild fatigue condition, RPE = 11.7 ± 2.0); laps 11–13 (heavy fatigue condition, RPE = 14.2 ± 3.0), run directly after a fatiguing protocol (progressive increase of speed until RPE ≥ 16) that followed lap 10. A random forest classification algorithm was trained with selected features from the 400 m moving average of the IMU-derived accelerations, angular velocities, and joint angles. A leave-one-subject-out cross validation was performed to assess the optimal combination of IMU locations to detect fatigue and selected sensor configurations were considered. The left tibia was the most recurrent sensor location, resulting in accuracies ranging between 0.761 (single left tibia location) and 0.905 (all IMU locations). These findings contribute toward a balanced choice between higher accuracy and lower intrusiveness in the development of IMU-based fatigue detection devices in running.
Chapter
Like any sport, running is affected by biological development, the body process of maturity and degeneration. Each phase of our lives, childhood, adolescence, and old age plays an essential role in this physiological development—lifetime effect. Therefore, to evaluate the development of sports skills, the sports physician must systematically assess the neurological, cognitive, somatic, and psychological functions before classifying a runner or athlete as a sports talent without considering the individual’s maturation phase. For most runners, the passion for running is born after overcoming their own physical limits for the first time. However, some of them will go beyond, dreaming of new physical challenges and, consequently, developing a trigger to adopt a non-stop behavior of faster-increasing training and running to reach their self-imposed goals—the “perfect” scenario for injuries. It may affect children, adolescents, and elderly runners indistinctly, where lower limb injuries are prevalent. The sports physician should be aware of inadequate running program regarding the volume, intensity, frequency of training, and muscle imbalances. Moreover, injuries prevention should identify runner’s biological body development, physical and psychological stress related to running or other sports practice, and its mental balance status—“Forrest Gump” runner’s behavior syndrome”.
Chapter
One of the main benefits of exercise is the impact on metabolic regulation. The substances produced during metabolism are called metabolites. These are the intermediaries of the complex metabolic mechanism of the body and can characterize metabolic health and its variation in response to exercise. The human body was designed for movement. Human locomotion is the most natural way to exercise. Our whole body is adapted for walking and running. Therefore, it is not surprising that running is strongly associated with several health benefits, both physically and mentally. In some pathologies running works as a “medication” without severe contraindications. It is well established that physical inactivity influences the development of chronic metabolic diseases. In turn, regular exercise prevents or delays the progression of a significant number of conditions, including metabolic dysfunctions. In addition, many metabolic disorders are known—cardiovascular diseases, type 2 diabetes, hypertension, obesity and dyslipidaemia. Thus, the lack of physical activity is strongly linked to the development of many chronic and metabolic disorders. Running and the resulting physiological adaptations may have a beneficial effect on disease prevention and on the individual’s health status. The purpose of this chapter is to discuss the impact of running on health, particularly in the prevention and treatment of some metabolic diseases.
Article
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Introduction: In this study, we examined the impact of government measures being imposed to slow down the spread of COVID-19 pandemic on long-distance runners’ sports habits and well-being. Material and methods: Data from a total of 323 runners (mean age 41.72 (8.78), 41.8% male) were analysed using quantitative and qualitative methods. Results: 46.9% of runners changed their running habits during the pandemic, 20.4% partly changed it. The poorest psychological well-being was found in a group that changed previous habits. Only 9 individuals reported no running activity at all, and 10 trained on a treadmill instead of a field. Overall, our respondents ran significantly more during the quarantine than before, which is partly explained by changed working conditions, reduced working hours, or lost jobs. The explanatory variables of excess running were previous mileage and distress. Conclusions: Running is suitable for relieving distress and restoring the feeling of freedom. All of these were confirmed by our subjects in the survey interview.
Article
Objectives The aim of this study was to examine the effectiveness of an enhanced online injury prevention programme on the number of running-related injuries (RRIs) in recreational runners. Methods We conducted a randomised-controlled trial in runners who registered for running events (distances: 10–42.195 km) in the Netherlands. Adult runners who provided informed consent were randomised into the intervention or control group. Participants in the intervention group received access to the online prevention programme, which included items to prevent RRIs. Participants in the control group followed their regular preparation for the running event. The primary outcome measure was the number of new RRIs from baseline to 1 month after the running event. To determine differences between injury proportions, univariate and multivariate logistic regression analyses were performed. Results This study included 4050 recreational runners (63.5% males; mean (SD) age: 42.3 (12.1) years) for analyses. During follow-up, 35.5% (95% CI: 33.5 to 37.6) of the participants in the intervention group sustained a new RRI compared with 35.4% (95% CI: 33.3 to 37.5) of the participants in the control group, with no between-group difference (OR: 1.03; 95% CI: 0.90 to 1.17). There was a positive association between the number of items followed in the injury prevention programme and the number of RRIs (OR: 1.05; 95% CI: 1.00 to 1.11). Conclusion The enhanced online injury prevention programme had no effect on the number of RRIs in recreational runners, and being compliant with the programme paradoxically was associated with a slightly higher injury rate. Future studies should focus on individual targeted prevention with emphasis on the timing and application of preventive measures. Trial registration number NL7694.
Article
Context: Injury prevention programs are effective when implemented in team sports, but many recreational runners have less access to such focused interventions or peer support and often seek other sources to learn about injury reduction strategies. Objective: This study aimed to explore runners' motivations in attending a prehabilitation (prehab) for runners workshop, establish their comprehension of prehab, and identify barriers to ongoing engagement with injury prevention. Design: Qualitative study using focus groups. Participants and setting: Twenty-two runners participating in prehab for runners workshops took part in one of 4 focus groups, each recorded, transcribed, and analyzed using Grounded Theory to create codes, subthemes, and themes. Results: Four themes emerged: (1) Participation was influenced by experience of previous injury and worry of cessation of running. As the workshop ran weekly for 4 weeks, opportunity to see someone more than once who was also a physiotherapist influenced participation. (2) Runners welcomed clarification for online exercises and advice suggested for runners. They were surprised by the difficulty of single-leg neuromuscular facilitation exercises and reported benefit from most or all information especially non-exercise-based approaches such as load management, pain monitoring, and running cues. (3) Participants were empowered by a structured, holistic, and evidence-based approach that embraced autonomy for exercise self-selection and progression. Confidence to engage in open discussion was due to small group size. (4) Barriers to prehab were personal responsibility, equipment, time, lack of supervision, and peer influence. Conclusion: A composite approach to strategies for injury risk reduction during prehab, combining progressive exercises with educational resources, can address runners' individual needs. Early discussion of motivational tools on commencement of prehab with guidance from runners on how to incorporate prehab independently into running training is recommended. Providing these tools allows runners to self-identify the approach best suited to their personal running profile at that given time.
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Background: Running carries the risk of several types of running-related injuries (RRIs), especially in the lower limbs. The variety of risk factors and the lack of strong evidence for several of these injury risks hinder the ability to draw assertive conclusions about them, hampering the implementation of effective preventive strategies. Because the etiology of RRIs seems to be multifactorial, the presence of RRI risk factors might influence the outcome of therapeutic strategies in different ways. Thus, further investigations on how risk and protective factors influence the incidence and prevention of RRIs should be conducted. Purpose: To investigate the predictive effect of well-known risk factors and 1 protective factor-foot-core training-on the incidence of lower limb RRIs in recreational runners. Study design: Cohort study; Level of evidence, 2. Methods: Middle- and long-distance recreational runners (N = 118) were assessed at baseline and randomly allocated to either an intervention group (n = 57) or a control group (n = 61). The intervention group underwent an 8-week (3 times/wk) foot-core training program. Participants were followed for a year after baseline assessment for the occurrence of RRIs. Logistic regression with backward elimination of variables was used to develop a model for prediction of RRI in recreational runners. Candidate predictor variables included age, sex, body mass index, years of running practice, number of races, training volume, training frequency, previous RRI, and the foot-core exercise training. Results: The final logistic regression model included 3 variables. As previously shown, the foot-core exercise program is a protective factor for RRIs (odds ratio, 0.40; 95% CI, 0.15-0.98). In addition, older age (odds ratio, 1.07; 95% CI, 1.00-1.14) and higher training volume (odds ratio, 1.02; 95% CI, 1.00-1.03) were risk factors for RRIs. Conclusion: The foot-core training was identified as a protective effect against lower limb RRI, which can be negatively influenced by older age and higher weekly training volume. The predictive model showed that RRIs should be considered a multivariate entity owing to the interaction among several factors. Registration: NCT02306148 (ClinicalTrials.gov identifier).
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This chapter introduces the epigenetic processes that govern how exercise affects the aging processes. We begin with an introduction to the molecular changes that occur with aging including methylation and histone and noncoding RNA modifications. We then present the evidence for changes in these processes by exercise and physical activity, Lastly, we present evidence for and against a role for exercise on changes in telomere length and aging.
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After reading this article, fitness professionals will be able to: • appreciate the relatively high injury prevalence in recreational runners and share this information with their clients; • understand and share the major risk factors for running-related injuries; • guide clients through functional balance and hip strengthening exercises to help prevent running-related injuries.
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The growing popularity of endurance sports activities is associated with a growing number of running injuries among recreational runners. The aim of this study was to assess the kinematic and kinetic variation on biomechanical parameters before and after 5km of treadmill running in female runners. Fourteen habitually shod female runners were assessed during treadmill running at their self-selected 5km running speed. A VICON motion analysis system and a Novel Pedar insole plantar pressure measurement system were used to record kinematic and plantar pressure data. Key findings from the study were that the internal and external rotation angle of the ankle, hip and knee while pre-5k running showed significant differences to those evaluated post-5k. The peak values of ground reaction forces (GRF) recorded pre-5k running were larger than the forces measured post-5k running. Combining the inversion and eversion of the ankle in the coronal plane during the pushing off phase, post-5k running showed a bigger eversion angle than pre-5k running. These subtle differences may reﬂect adaptation of motor control in female runners during long distance running of 5km.
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Habitual physical activity and regular exercise training improve cardiovascular health and longevity. A physically active lifestyle is, therefore, a key aspect of primary and secondary prevention strategies. An appropriate volume and intensity are essential to maximally benefit from exercise interventions. This document summarizes available evidence on the relationship between the exercise volume and risk reductions in cardiovascular morbidity and mortality. Furthermore, the risks and benefits of moderate- versus high-intensity exercise interventions are compared. Findings are presented for the general population and cardiac patients eligible for cardiac rehabilitation. Finally, the controversy of excessive volumes of exercise in the athletic population is discussed.
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Introduction: Physical fitness is an important prognostic factor in heart failure (HF). To improve fitness, different types of exercise have been explored, with recent focus on high-intensity interval training (HIT). We comprehensively compared effects of HIT versus continuous training (CT) in HF patients NYHA II-III on physical fitness, cardiovascular function and structure, and quality of life, and hypothesize that HIT leads to superior improvements compared to CT. Methods: Twenty HF patients (male:female 19:1, 64±8 yrs, ejection fraction 38±6%) were allocated to 12-weeks of HIT (10*1-minute at 90% maximal workload-alternated by 2.5 minutes at 30% maximal workload) or CT (30 minutes at 60-75% of maximal workload). Before and after intervention, we examined physical fitness (incremental cycling test), cardiac function and structure (echocardiography), vascular function and structure (ultrasound) and quality of life (SF-36, Minnesota living with HF questionnaire (MLHFQ)). Results: Training improved maximal workload, peak oxygen uptake (VO2peak) related to the predicted VO2peak, oxygen uptake at the anaerobic threshold, and maximal oxygen pulse (all P<0.05), whilst no differences were present between HIT and CT (N.S.). We found no major changes in resting cardiovascular function and structure. SF-36 physical function score improved after training (P<0.05), whilst SF-36 total score and MLHFQ did not change after training (N.S.). Conclusion: Training induced significant improvements in parameters of physical fitness, although no evidence for superiority of HIT over CT was demonstrated. No major effect of training was found on cardiovascular structure and function or quality of life in HF patients NYHA II-III. Trial registration: Nederlands Trial Register NTR3671.
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Purpose: To compare the effects of six weeks of high intensity interval training (HIIT) vs continuous moderate intensity training (MIT) for improving body composition, insulin sensitivity (SI), blood pressure, blood lipids, and cardiovascular fitness in a cohort of sedentary overweight or obese young men. We hypothesized that HIIT would result in similar improvements in body composition, cardiovascular fitness, blood lipids, and SI as compared to the MIT group, despite requiring only one hour of activity per week compared to five hours per week for the MIT group. Methods: 28 sedentary overweight or obese men (age, 20 ± 1.5 years, body mass index 29.5 ± 3.3 kg/m2) participated in a six week exercise treatment. Participants were randomly assigned to HIIT or MIT and evaluated at baseline and post-training. DXA was used to assess body composition, graded treadmill exercise test to measure cardiovascular fitness, oral glucose tolerance to measure SI, nuclear magnetic resonance spectroscopy to assess lipoprotein particles, and automatic auscultation to measure blood pressure. Results: A greater improvement in VO2peak was observed in MIT compared to HIIT (11.1% vs 2.83%, P = 0.0185) in the complete-case analysis. No differences were seen in the intention to treat analysis, and no other group differences were observed. Both exercise conditions were associated with temporal improvements in % body fat, total cholesterol, medium VLDL, medium HDL, triglycerides, SI, and VO2peak (P < 0.05). Conclusion: Participation in HIIT or MIT exercise training displayed: 1) improved SI, 2) reduced blood lipids, 3) decreased % body fat, and 4) improved cardiovascular fitness. While both exercise groups led to similar improvements for most cardiometabolic risk factors assessed, MIT led to a greater improvement in overall cardiovascular fitness. Overall, these observations suggest that a relatively short duration of either HIIT or MIT training may improve cardiometabolic risk factors in previously sedentary overweight or obese young men, with no clear advantage between these two specific regimes (Clinical Trial Registry number NCT01935323). Trial registration: ClinicalTrials.gov NCT01935323.
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The aim of this meta-analysis was to quantify the effects of high-intensity interval training (HIIT) on markers of glucose regulation and insulin resistance compared to control conditions (CON) or continuous training (CT). Databases were searched for HIIT interventions based on the inclusion criteria: training ≥2 weeks, adult participants, and outcome measurements that included insulin resistance, fasting glucose, HbA1c or fasting insulin. Dual interventions and participants with type 1 diabetes were excluded. Fifty studies were included. There was a reduction in insulin resistance following HIIT compared to both CON & CT, (HIIT vs. CON: standardised mean difference (SMD)=-0.49, confidence intervals (CI) -0.87 to -0.12, p=0.009; CT: SMD=-0.35, -0.68 to -0.02, p=0.036). Compared to CON, HbA1c decreased by 0.19% (-0.36 to -0.03, p=0.021) and body weight decreased by 1.3kg (-1.9 to -0.7, p<0.001). There were no statistically significant differences between groups in other outcomes overall. However, participants with or at risk of Type 2 diabetes experienced reductions in fasting glucose (-0.92mmol.L-1, -1.22 to -0.62, p<0.001) compared to CON. HIIT appears effective at improving metabolic health, particularly in those at risk of or with Type 2 diabetes. Larger randomised controlled trials of longer duration than those included in this meta-analysis are required to confirm these results.
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In order to implement running to promote physical activity, it is essential to quantify the extent to which running improves health. The aim was to summarise the literature on the effects of endurance running on biomedical indices of health in physically inactive adults. Electronic searches were conducted in October 2014 on PubMed, Embase, CINAHL, SPORTDiscus, PEDro, the Cochrane Library and LILACS, with no limits of date and language of publication. Randomised controlled trials (with a minimum of 8 weeks of running training) that included physically inactive but healthy adults (18-65 years) were selected. The studies needed to compare intervention (i.e. endurance running) and control (i.e. no intervention) groups. Two authors evaluated study eligibility, extracted data, and assessed risk of bias; a third author resolved any uncertainties. Random-effects meta-analyses were performed to summarise the estimates for length of training and sex. A dose-response analysis was performed with random-effects meta-regression in order to investigate the relationship between running characteristics and effect sizes. After screening 22,380 records, 49 articles were included, of which 35 were used to combine data on ten biomedical indices of health. On average the running programs were composed of 3.7 ± 0.9 sessions/week, 2.3 ± 1.0 h/week, 14.4 ± 5.4 km/week, at 60-90 % of the maximum heart rate, and lasted 21.5 ± 16.8 weeks. After 1 year of training, running was effective in reducing body mass by 3.3 kg [95 % confidence interval (CI) 4.1-2.5], body fat by 2.7 % (95 % CI 5.1-0.2), resting heart rate by 6.7 min(-1) (95 % CI 10.3-3.0) and triglycerides by 16.9 mg dl(-1) (95 % CI 28.1-5.6). Also, running significantly increased maximal oxygen uptake (VO2max) by 7.1 ml min(-1) kg(-1) (95 % CI 5.0-9.1) and high-density lipoprotein (HDL) cholesterol by 3.3 mg dl(-1) (95 % CI 1.2-5.4). No significant effect was found for lean body mass, body mass index, total cholesterol and low-density lipoprotein cholesterol after 1 year of training. In the dose-response analysis, larger effect sizes were found for longer length of training. It was only possible to combine the data of ten out the 161 outcome measures identified. Lack of information on training characteristics precluded a multivariate model in the dose-response analysis. Endurance running was effective in providing substantial beneficial effects on body mass, body fat, resting heart rate, VO2max, triglycerides and HDL cholesterol in physically inactive adults. The longer the length of training, the larger the achieved health benefits. Clinicians and health authorities can use this information to advise individuals to run, and to support policies towards investing in running programs.
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To help public health practitioners promote physical activities with a low risk of injury, this study determined the relation among type and duration of physical activity, cardiorespiratory fitness, and musculoskeletal injury in a sample of adults enrolled in the Aerobics Center Longitudinal Study. Subjects included 4,034 men and 967 women who underwent a baseline physical examination between 1970 and 1985 and who returned a mailed follow-up survey in 1986. At baseline, a treadmill graded exercise test was used to measure cardiorespiratory fitness. At follow-up, subjects reported injuries and type and duration of physical activity in the preceding 12 months. Polytomous logistic regression was used to estimate the association among physical activity type and duration, cardiorespiratory fitness, and injury. The risk of sustaining an activity-related injury increased with higher duration of physical activity per week and cardiorespiratory fitness levels. Results suggest that cardiorespiratory fitness may be a surrogate for unmeasured components of physical activity, such as exercise intensity. Among walkers, increasing duration of activity per week was not associated with an increased risk of injury. Results suggest that, for most adults, walking is a safe form of physical activity associated with a lower risk of injury than running or sport participation.
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People who are physically active have at least a 30% lower risk of death during follow-up compared with those who are inactive. However, the ideal dose of exercise for improving longevity is uncertain. The aim of this study was to investigate the association between jogging and long-term, all-cause mortality by focusing specifically on the effects of pace, quantity, and frequency of jogging. As part of the Copenhagen City Heart Study, 1,098 healthy joggers and 3,950 healthy nonjoggers have been prospectively followed up since 2001. Cox proportional hazards regression analysis was performed with age as the underlying time scale and delayed entry. Compared with sedentary nonjoggers, 1 to 2.4 h of jogging per week was associated with the lowest mortality (multivariable hazard ratio [HR]: 0.29; 95% confidence interval [CI]: 0.11 to 0.80). The optimal frequency of jogging was 2 to 3 times per week (HR: 0.32; 95% CI: 0.15 to 0.69) or ≤1 time per week (HR: 0.29; 95% CI: 0.12 to 0.72). The optimal pace was slow (HR: 0.51; 95% CI: 0.24 to 1.10) or average (HR: 0.38; 95% CI: 0.22 to 0.66). The joggers were divided into light, moderate, and strenuous joggers. The lowest HR for mortality was found in light joggers (HR: 0.22; 95% CI: 0.10 to 0.47), followed by moderate joggers (HR: 0.66; 95% CI: 0.32 to 1.38) and strenuous joggers (HR: 1.97; 95% CI: 0.48 to 8.14). The findings suggest a U-shaped association between all-cause mortality and dose of jogging as calibrated by pace, quantity, and frequency of jogging. Light and moderate joggers have lower mortality than sedentary nonjoggers, whereas strenuous joggers have a mortality rate not statistically different from that of the sedentary group. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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Background Limited data exist directly comparing the relative benefits of moderate‐ and vigorous‐intensity activities with all‐cause and cardiovascular (CV) disease mortality rates when controlling for physical activity volume. Methods and Results We followed 7979 men (Harvard Alumni Health Study, 1988–2008) and 38 671 women (Women's Health Study, 1992–2012), assessing their physical activity and health habits through repeated questionnaires. Over a mean follow‐up of 17.3 years in men and 16.4 years in women, there were 3551 deaths (1077 from CV disease) among men and 3170 deaths (620 from CV disease) among women. Those who met or exceeded an equivalent of the federal guidelines recommendation of at least 150 minutes of moderate‐intensity activity, 75 minutes of vigorous‐intensity activity, or a combination of the 2 that expended similar energy experienced significantly lower all‐cause and CV disease–related mortality rates (men, 28% to 36% and 31% to 34%, respectively; women: 38% to 55% and 22% to 44%, respectively). When comparing different combinations of moderate‐ and vigorous‐intensity activity and all‐cause mortality rates, we observed sex‐related differences. Holding constant the volume of moderate‐ to vigorous‐intensity physical activity, men experienced a modest additional benefit when expending a greater proportion of moderate‐ to vigorous‐intensity physical activity in vigorous‐intensity activities (Ptrend=0.04), but women did not (Ptrend<0.001). Moderate‐ to vigorous‐intensity physical activity composition was not associated with further cardiovascular mortality rate reductions in either men or women. Conclusions The present data support guidelines recommending 150 minutes of moderate‐intensity activity per week, 75 minutes of vigorous‐intensity activity per week, or an equivalent combination for mortality benefits. Among men, but not women, additional modest reductions in all‐cause mortality rates are associated with a greater proportion of moderate‐ to vigorous‐intensity physical activity performed at a vigorous intensity.
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In this review, we explore the association among physical activity, cardiorespiratory fitness, and exercise on gray matter volume in older adults. We conclude that higher cardiorespiratory fitness levels are routinely associated with greater gray matter volume in the prefrontal cortex and hippocampus and less consistently in other regions. We also conclude that physical activity is associated with greater gray matter volume in the same regions that are associated with cardiorespiratory fitness including the prefrontal cortex and hippocampus. Some heterogeneity in the literature may be explained by effect moderation by age, stress, or other factors. Finally, we report promising results from randomized exercise interventions that suggest that the volume of the hippocampus and prefrontal cortex remain pliable and responsive to moderate intensity exercise for 6 months-1 year. Physical activity appears to be a propitious method for influencing gray matter volume in late adulthood, but additional well-controlled studies are necessary to inform public policies about the potential protective or therapeutic effects of exercise on brain volume.
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AimsWe aimed to investigate the association of number of completed races and finishing time with risk of arrhythmias among participants of Vasaloppet, a 90 km cross-country skiing event.Methods and resultsAll the participants without cardiovascular disease who completed Vasaloppet during 1989-98 were followed through national registries until December 2005. Primary outcome was hospitalization for any arrhythmia and secondary outcomes were atrial fibrillation/flutter (AF), bradyarrhythmias, other supraventricular tachycardias (SVT), and ventricular tachycardia/ventricular fibrillation/cardiac arrest (VT/VF/CA). Among 52 755 participants, 919 experienced arrhythmia during follow-up. Adjusting for age, education, and occupational status, those who completed the highest number of races during the period had higher risk of any arrhythmias [hazard ratio (HR)1.30; 95% CI 1.08-1.58; for ≥5 vs. 1 completed race], AF (HR 1.29; 95% CI 1.04-1.61), and bradyarrhythmias (HR 2.10; 95% CI 1.28-3.47). Those who had the fastest relative finishing time also had higher risk of any arrhythmias (HR 1.30; 95% CI 1.04-1.62; for 100-160% vs. >240% of winning time), AF (1.20; 95% CI 0.93-1.55), and bradyarrhythmias (HR 1.85; 95% CI 0.97-3.54). SVT or VT/VF/CA was not associated with finishing time or number of completed races.Conclusions Among male participants of a 90 km cross-country skiing event, a faster finishing time and a high number of completed races were associated with higher risk of arrhythmias. This was mainly driven by a higher incidence of AF and bradyarrhythmias. No association with SVT or VT/VF/CA was found.
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Leisure time physical activity reduces the risk of premature mortality, but the years of life expectancy gained at different levels remains unclear. Our objective was to determine the years of life gained after age 40 associated with various levels of physical activity, both overall and according to body mass index (BMI) groups, in a large pooled analysis. We examined the association of leisure time physical activity with mortality during follow-up in pooled data from six prospective cohort studies in the National Cancer Institute Cohort Consortium, comprising 654,827 individuals, 21-90 y of age. Physical activity was categorized by metabolic equivalent hours per week (MET-h/wk). Life expectancies and years of life gained/lost were calculated using direct adjusted survival curves (for participants 40+ years of age), with 95% confidence intervals (CIs) derived by bootstrap. The study includes a median 10 y of follow-up and 82,465 deaths. A physical activity level of 0.1-3.74 MET-h/wk, equivalent to brisk walking for up to 75 min/wk, was associated with a gain of 1.8 (95% CI: 1.6-2.0) y in life expectancy relative to no leisure time activity (0 MET-h/wk). Higher levels of physical activity were associated with greater gains in life expectancy, with a gain of 4.5 (95% CI: 4.3-4.7) y at the highest level (22.5+ MET-h/wk, equivalent to brisk walking for 450+ min/wk). Substantial gains were also observed in each BMI group. In joint analyses, being active (7.5+ MET-h/wk) and normal weight (BMI 18.5-24.9) was associated with a gain of 7.2 (95% CI: 6.5-7.9) y of life compared to being inactive (0 MET-h/wk) and obese (BMI 35.0+). A limitation was that physical activity and BMI were ascertained by self report. More leisure time physical activity was associated with longer life expectancy across a range of activity levels and BMI groups. Please see later in the article for the Editors' Summary.
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Purpose: Current physical activity recommendations assume that different activities can be exchanged to produce the same weight-control benefits so long as total energy expended remains the same (exchangeability premise). To this end, they recommend calculating energy expenditure as the product of the time spent performing each activity and the activity's metabolic equivalents (MET), which may be summed to achieve target levels. The validity of the exchangeability premise was assessed using data from the National Runners' Health Study. Methods: Physical activity dose was compared to body mass index (BMI) and body circumferences in 33,374 runners who reported usual distance run and pace, and usual times spent running and other exercises per week. MET hours per day (METhr/d) from running was computed from: a) time and intensity, and b) reported distance run (1.02 MET • hours per km). Results: When computed from time and intensity, the declines (slope±SE) per METhr/d were significantly greater (P<10(-15)) for running than non-running exercise for BMI (slopes±SE, male: -0.12 ± 0.00 vs. 0.00±0.00; female: -0.12 ± 0.00 vs. -0.01 ± 0.01 kg/m(2) per METhr/d) and waist circumference (male: -0.28 ± 0.01 vs. -0.07±0.01; female: -0. 31±0.01 vs. -0.05 ± 0.01 cm per METhr/d). Reported METhr/d of running was 38% to 43% greater when calculated from time and intensity than distance. Moreover, the declines per METhr/d run were significantly greater when estimated from reported distance for BMI (males: -0.29 ± 0.01; females: -0.27 ± 0.01 kg/m(2) per METhr/d) and waist circumference (males: -0.67 ± 0.02; females: -0.69 ± 0.02 cm per METhr/d) than when computed from time and intensity (cited above). Conclusion: The exchangeability premise was not supported for running vs. non-running exercise. Moreover, distance-based running prescriptions may provide better weight control than time-based prescriptions for running or other activities. Additional longitudinal studies and randomized clinical trials are required to verify these results prospectively.
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Endurance training may be associated with arrhythmogenic cardiac remodelling of the right ventricle (RV). We examined whether myocardial dysfunction following intense endurance exercise affects the RV more than the left ventricle (LV) and whether cumulative exposure to endurance competition influences cardiac remodelling (including fibrosis) in well-trained athletes. Forty athletes were studied at baseline, immediately following an endurance race (3-11 h duration) and 1-week post-race. Evaluation included cardiac troponin (cTnI), B-type natriuretic peptide, and echocardiography [including three-dimensional volumes, ejection fraction (EF), and systolic strain rate]. Delayed gadolinium enhancement (DGE) on cardiac magnetic resonance imaging (CMR) was assessed as a marker of myocardial fibrosis. Relative to baseline, RV volumes increased and all functional measures decreased post-race, whereas LV volumes reduced and function was preserved. B-type natriuretic peptide (13.1 ± 14.0 vs. 25.4 ± 21.4 ng/L, P = 0.003) and cTnI (0.01 ± .03 vs. 0.14 ± .17 μg/L, P < 0.0001) increased post-race and correlated with reductions in RVEF (r = 0.52, P = 0.001 and r = 0.49, P = 0.002, respectively), but not LVEF. Right ventricular ejection fraction decreased with increasing race duration (r = -0.501, P < 0.0001) and VO(2)max (r = -0.359, P = 0.011). Right ventricular function mostly recovered by 1 week. On CMR, DGE localized to the interventricular septum was identified in 5 of 39 athletes who had greater cumulative exercise exposure and lower RVEF (47.1 ± 5.9 vs. 51.1 ± 3.7%, P = 0.042) than those with normal CMR. Intense endurance exercise causes acute dysfunction of the RV, but not the LV. Although short-term recovery appears complete, chronic structural changes and reduced RV function are evident in some of the most practiced athletes, the long-term clinical significance of which warrants further study.
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Considerable evidence has established the link between high levels of physical activity (PA) and all-cause and cardiovascular disease (CVD)-specific mortality. Running is a popular form of vigorous PA that has been associated with better overall survival, but there is debate about the dose-response relationship between running and CVD and all-cause survival. In this review, we specifically reviewed studies published in PubMed since 2000 that included at least 500 runners and 5-year follow-up so as to analyze the relationship between vigorous aerobic PA, specifically running, and major health consequences, especially CVD and all-cause mortality. We also made recommendations on the optimal dose of running associated with protection against CVD and premature mortality, as well as briefly discuss the potential cardiotoxicity of a high dose of aerobic exercise, including running (eg, marathons).
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