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The Acute and Chronic Physiological Responses to Pickleball in Middle-Aged and Older Adults
Abstract
Purpose: The purpose of this study was (a) to quantify the acute cardiovascular and metabolic responses to Pickleball, and (b) to determine the effectiveness of a 6wk Pickleball intervention at positively modifying cardiometabolic risk factors. Methods: Fifteen women and men (mean ± standard deviation: age, weight, percent body fat, and maximal oxygen uptake = 65.2 ± 8.0 years, 76.3 ± 20.5 kg, 30.3 ± 6.6 %, and 26.2 ± 5.7 mL/kg/min, respectively) completed both a maximal graded exercise test and played a doubles match of Pickleball on non-consecutive days. Cardiovascular and metabolic data were collected via a portable calorimetric measurement system. Additionally, participants completed a 6wk Pickleball intervention (~ 1/hr sessions performed 3 times/wk). Cardiometabolic risk factors and cardiorespiratory fitness were measured at baseline and post-program. Results: Overall average heart rate for Pickleball match play was 108.8 ± 16.7 beats/min, which corresponded to 50.9 ± 11.2% heart rate reserve. Exercise intensity in metabolic equivalents was 4.1 ± 1.0 which equated to 52.5 ± 11.3% oxygen uptake reserve. Total energy expenditure for Pickleball was 353.5 ± 85.0 kcal/match. After 6wk of participation in Pickleball there were significant (p < 0.05) improvements in the following outcomes: high-density lipoprotein and-low density lipoprotein cholesterol, systolic and diastolic blood pressure, and maximal oxygen uptake. Conclusions: Findings from the present study support the activity of Pickleball as a feasible alternative to traditional exercise modalities for middle-aged and older adults that elicits metabolic responses within the accepted moderate intensity domain. Moreover, regular participation in Pickleball improves cardiorespiratory fitness and positively modifies key cardiovascular disease risk factors.
... Despite the huge rise in popularity, little exists in published literature regarding the physiological demands of the sport. One study measured cardiovascular and metabolic data in 15 participants (65.2 ± 8.0 years of age) while they played doubles pickleball for 1 hr, and during a maximal graded exercise test on a treadmill (Smith et al., 2018). Mean heart rate during pickleball was 108.8 ± 16.7 beats/min, corresponding to 50.9 ± 11.2% heart rate reserve, which is categorized as moderate intensity (Riebe et al., 2018, p. 146). ...
... The mean and peak heart rate values observed in doubles participants in our study were comparable to those previously reported in smaller samples of similarly aged pickleball players (Smith et al., 2018). Mean heart rate was 111.5 beats/min, and peak heart rate was 141.0 beats/min in our doubles participants (mean age 62.8 years), whereas Smith et al. (2018) reported values of 108.8 bpm and 158.0 bpm in pickleball players with a mean age of 65.2 years. ...
... The mean and peak heart rate values observed in doubles participants in our study were comparable to those previously reported in smaller samples of similarly aged pickleball players (Smith et al., 2018). Mean heart rate was 111.5 beats/min, and peak heart rate was 141.0 beats/min in our doubles participants (mean age 62.8 years), whereas Smith et al. (2018) reported values of 108.8 bpm and 158.0 bpm in pickleball players with a mean age of 65.2 years. Data reported in younger pickleball players (mean age 48.5 years) are also consistent with mean heart rates of 117.3 beats/ min and peak heart rates of 140.5 beats/min reported . ...
The purpose of this study was to measure heart rate, activity intensity, and steps in recreational singles and doubles pickleball players. We collected data in 22 singles and 31 doubles players (62.1 ± 9.7 years of age) using Garmin Fenix 5 watches (Garmin International, Inc.) and ActiGraph GT3X+ (ActiGraph LLC) accelerometers. Mean heart rates during singles and doubles were 111.6 ± 13.5 and 111.5 ± 16.2 beats/min (70.3% and 71.2% of predicted maximum heart rate), respectively. Over 70% of singles and doubles playing time was categorized in moderate to vigorous heart rate zones whereas 80.5% of singles time and 50.4% of doubles time were moderate based on Freedson accelerometer cut-points. Steps per hour were higher in singles versus doubles (3,322 ± 493 vs. 2,791 ± 359), t (51) = 4.540, p < .001. Singles and doubles pickleball are moderate- to vigorous-intensity activities that can contribute substantially toward older adults meeting physical activity guidelines.
... To date, the authors found limited published research documenting specific physiological variables such as heart rate, lactate, and duration of points during a pickleball game. Smith et al. explored the acute and chronic physiological responses to pickleball in middle age adults to determine variables such as heart rate and intensity level achieved during a game (32). Fifteen women and men (65.2 6 8.0 years) engaged in a 6week pickleball program 3 days per week for approximately 60 minutes each session. ...
... Fifteen women and men (65.2 6 8.0 years) engaged in a 6week pickleball program 3 days per week for approximately 60 minutes each session. The average exercise intensity eclipsed 4.1 6 1.0 METS (metabolic equivalent), which would be classified as a moderate intensity (32). The heart rate averaged 108.8 6 16.7 beats per minute, and caloric expenditure for matches averaged 353.5 6 85.0 kcal/match. ...
... The results of this study imply pickleball could be a viable intervention for meeting intensity thresholds to obtain health benefits and potentially reduce premature mortality risks associated with cardiovascular disease in the older population (32). However, the intersubject variability and small sample size elucidate that additional research is needed regarding the physiological demands of pickleball. ...
Pickleball is one of the fastest growing racket sports in the United States because of its high social engagement and ability to facilitate physical and emotional well-being. Although participation trends indicate the sport appeals to an array of ages and abilities, the highest purported participant demographic is 55 years and older. In spite of its rising popularity, there is limited strength and conditioning research exploring training strategies for pickleball athletes. Therefore, this article details how pickleball is played, the sport's movement and physiological demands, and injury risks. An example training program targeting the older pickleball athlete is provided.
... Traditionally, both pickleball and paddleball have been reserved for aging athletes, but the rising popularity of both games has sparked interest in players of all ages [1,5]. For the 65 and older population, pickleball has especially allowed for more physical activity in a group that is rising in numbers and age, which results in many health benefits [6]. The shift in demographics in the two similar sports has modified both the amount of and the types of injuries being presented to emergency departments (EDs) and outpatient clinics throughout the past years. ...
Introduction
While pickleball and paddleball are rapidly growing as popular sports in the United States, research on the incidence of hand and upper extremity injuries and treatments in outpatient clinics are lacking. This study evaluates the incidence rates and treatment options, both surgically and nonsurgically, for patients presenting with pickleball/paddleball-related injuries.
Methods
A retrospective database search of our multispecialty, multilocation electronic medical record (EMR) system from 2015 to 2022 identified 204 patients with outpatient pickleball- and paddleball-related injuries. The data from these patients’ charts were reviewed for injury incidences, treatment trends, and demographics.
Results
The majority of patients suffered wrist fractures due to a fall/dive and were treated nonsurgically. The most common surgical treatment, when required, was open reduction and internal fixation of the distal radius. We found that pickleball and paddleball players who sustained wrist fractures required surgery at a higher rate than the general population if above the age of 65.
Conclusion
As pickleball and paddleball continue to gain popularity, hand surgeons should be aware of the types of injuries that can occur and, when possible, counsel patients accordingly to try to prevent them. Additionally, hand surgeons should recognize the common treatments and outcomes that arise from pickleball/paddleball-related injuries.
Pickleball offers sociopsychological and physical activity benefits for older adults but lacks racial diversity. The purpose of this study was to identify constraints to pickleball participation with Black older adults (65+ years) as well as examine differences based on physical activity and sex. A Qualtrics panel included Black older adults ( N = 292) who have heard of pickleball and are physically able to play but have not played. Results found Knowledge, Accessibility, Interpersonal, and Interest were the most salient constraints overall. Multivariate analysis of variance found that those who report low physical activity had significantly higher Interpersonal, Psychological, Costs, and Perceived Racism constraints. Additionally, females report significantly higher Knowledge, Psychological, and Cost constraints compared to males. The results further the theoretical application of constraints to physical activity research and provide insights into practitioner implications to grow the sport of pickleball for Black older adults.
Introduction
Pickleball is a rapidly growing leisure sport played by a range of age groups and skill levels. The physiological effects of playing pickleball, however, are relatively unexamined. Thus, the purpose of this study was to identify the physiological and activity effects (heart rate, ratings of perceived exertion, step count, caloric expenditure, and enjoyment levels) of playing 30-minutes of pickleball compared to 30-minutes of self-paced walking.
Summary of facts and results
Significant differences existed for all variables (P < 0.05). Compared to walking, playing pickleball doubles increased mean heart rates by nearly 14%, peak heart rates by nearly 19%, caloric expenditure by 36%, perceived exertion by 44%, and enjoyment levels by 150%. Walking, however, required 54% more steps when compared to playing pickleball doubles.
Conclusion
Playing pickleball doubles elicits greater physical activity demand with more enjoyment when compared to self-paced walking except for in step count. These changes indicate playing pickleball may be a suitable physical activity to improve and maintain physical fitness.
We sought to establish whether cardiorespiratory fitness had important implications for long-term cardiovascular risk among individuals classified as low risk by the Framingham Risk Score (10-year coronary heart disease risk <10%). Prognostic factors of long-term cardiovascular risk are needed for low-risk subjects who make up the largest percentage of the US population.
The study population was composed of men and women, 30 to 50 years of age, who had a baseline medical exam at the Cooper Clinic, Dallas, TX, between 1970 and 1983. Eligible individuals were defined as at low risk for coronary heart disease by Framingham Risk Score at the time of study entry and had no history of diabetes (n=11 190). Cardiorespiratory fitness was determined by maximum graded exercise treadmill tests. Over an average 27±2-year period, 15% of low-fit (quintile 1) compared to 6% of high-fit (quintile 5) individuals died (P<0.001). A 1-metabolic equivalent level increase in baseline fitness was associated with an 11% reduction in all-cause deaths and an 18% reduction in deaths due to cardiovascular disease (CVD) after adjustment for age, sex, body mass index, systolic blood pressure, total cholesterol, blood glucose levels, smoking, and early family history of coronary disease. There was an incremental decrease in CVD risk with increasing fitness quintile, such that the high fit had the lowest adjusted 30-year CVD mortality rate (hazard ratio 0.29, 95% CI: 0.16-0.51) compared to the low fit.
Cardiorespiratory fitness is associated with a significant reduction in long-term CVD among individuals identified as low risk by Framingham Risk Score. These data suggest that preventive lifestyle interventions geared to optimize cardiorespiratory fitness, even among a "low-risk" subset, should be considered to improve CVD-free survival. (J Am Heart Assoc. 2012;1:e001354 doi: 10.1161/JAHA.112.001354.).
OBJECTIVE: To issue a recommendation on the types and amounts of physical activity needed to improve and maintain health in older adults. PARTICIPANTS: A panel of scientists with expertise in public health, behavioral science, epidemiology, exercise science, medicine, and gerontology. EVIDENCE: The expert panel reviewed existing consensus statements and relevant evidence from primary research articles and reviews of the literature. Process: After drafting a recommendation for the older adult population and reviewing drafts of the Updated Recommendation from the American College of Sports Medicine (ACSM) and the American Heart Association (AHA) for Adults, the panel issued a final recommendation on physical activity for older adults. SUMMARY: The recommendation for older adults is similar to the updated ACSM/AHA recommendation for adults, but has several important differences including: the recommended intensity of aerobic activity takes into account the older adult's aerobic fitness; activities that maintain or increase flexibility are recommended; and balance exercises are recommended for older adults at risk of falls. In addition, older adults should have an activity plan for achieving recommended physical activity that integrates preventive and therapeutic recommendations. The promotion of physical activity in older adults should emphasize moderate-intensity aerobic activity, muscle-strengthening activity, reducing sedentary behavior, and risk management. Language: en
In this review, we develop a blueprint for exercise biology research in the new millennium. The first part of our plan provides statistics to support the contention that there has been an epidemic emergence of modern chronic diseases in the latter part of the 20th century. The health care costs of these conditions were almost two-thirds of a trillion dollars and affected 90 million Americans in 1990. We estimate that these costs are now approaching $1 trillion and stand to further dramatically increase as the baby boom generation ages. We discuss the reaction of the biomedical establishment to this epidemic, which has primarily been to apply modern technologies to stabilize overt clinical problems (e.g., secondary and tertiary prevention). Because this approach has been largely unsuccessful in reversing the epidemic, we argue that more emphasis must be placed on novel approaches such as primary prevention, which requires attacking the environmental roots of these conditions. In this respect, a strong association exists between the increase in physical inactivity and the emergence of modern chronic diseases in 20th century industrialized societies. Approximately 250,000 deaths per year in the United States are premature due to physical inactivity. Epidemiological data have established that physical inactivity increases the incidence of at least 17 unhealthy conditions, almost all of which are chronic diseases or considered risk factors for chronic diseases. Therefore, as part of this review, we present the concept that the human genome evolved within an environment of high physical activity. Accordingly, we propose that exercise biologists do not study "the effect of physical activity" but in reality study the effect of reintroducing exercise into an unhealthy sedentary population that is genetically programmed to expect physical activity. On the basis of healthy gene function, exercise research should thus be viewed from a nontraditional perspective in that the "control" group should actually be taken from a physically active population and not from a sedentary population with its predisposition to modern chronic diseases. We provide exciting examples of exercise biology research that is elucidating the underlying mechanisms by which physical inactivity may predispose individuals to chronic disease conditions, such as mechanisms contributing to insulin resistance and decreased skeletal muscle lipoprotein lipase activity. Some findings have been surprising and remarkable in that novel signaling mechanisms have been discovered that vary with the type and level of physical activity/inactivity at multiple levels of gene expression. Because this area of research is underfunded despite its high impact, the final part of our blueprint for the next millennium calls for the National Institutes of Health (NIH) to establish a major initiative devoted to the study of the biology of the primary prevention of modern chronic diseases. We justify this in several ways, including the following estimate: if the percentage of all US morbidity and mortality statistics attributed to the combination of physical inactivity and inappropriate diet were applied as a percentage of the NIH's total operating budget, the resulting funds would equal the budgets of two full institutes at the NIH! Furthermore, the fiscal support of studies elucidating the scientific foundation(s) targeted by primary prevention strategies in other public health efforts has resulted in an increased efficacy of the overall prevention effort. We estimate that physical inactivity impacts 80-90% of the 24 integrated review group (IRG) topics proposed by the NIH's Panel on Scientific Boundaries for Review, which is currently directing a major restructuring of the NIH's scientific funding system. Unfortunately, the primary prevention of chronic disease and the investigation of physical activity/inactivity and/or exercise are not mentioned in the almost 200 total subtopics comprising t
The Compendium of Physical Activities was developed to enhance the comparability of results across studies using self-report physical activity (PA) and is used to quantify the energy cost of a wide variety of PA. We provide the second update of the Compendium, called the 2011 Compendium.
The 2011 Compendium retains the previous coding scheme to identify the major category headings and specific PA by their rate of energy expenditure in MET. Modifications in the 2011 Compendium include cataloging measured MET values and their source references, when available; addition of new codes and specific activities; an update of the Compendium tracking guide that links information in the 1993, 2000, and 2011 compendia versions; and the creation of a Web site to facilitate easy access and downloading of Compendium documents. Measured MET values were obtained from a systematic search of databases using defined key words.
The 2011 Compendium contains 821 codes for specific activities. Two hundred seventeen new codes were added, 68% (561/821) of which have measured MET values. Approximately half (317/604) of the codes from the 2000 Compendium were modified to improve the definitions and/or to consolidate specific activities and to update estimated MET values where measured values did not exist. Updated MET values accounted for 73% of all code changes.
The Compendium is used globally to quantify the energy cost of PA in adults for surveillance activities, research studies, and, in clinical settings, to write PA recommendations and to assess energy expenditure in individuals. The 2011 Compendium is an update of a system for quantifying the energy cost of adult human PA and is a living document that is moving in the direction of being 100% evidence based.
The purpose of this study was (a) to assess the cardiovascular and metabolic responses to Wii Fit video games and (b) to determine if Wii Fit video games meet the American College of Sports Medicine guidelines for improving and maintaining cardiorespiratory fitness.
Twenty men and women (mean±SD age, height, and weight: = 58.1±8.8 years, 172.1±10.5 cm, 87.1±22.8 kg, respectively) completed a 20-min Wii Fit testing session consisting of six separate aerobic and balance games. Cardiovascular and metabolic data were collected via a portable calorimetric measurement system.
Mean relative exercise intensity was 43.4±16.7% of heart rate reserve. Absolute exercise intensity in metabolic equivalents (METS) was 3.5±0.96. Total net energy expenditure for the Wii Fit video game playing session was 116.2±40.9 kcal/session.
Results indicate that playing Wii Fit video games is a feasible alternative to more traditional aerobic exercise modalities for middle-aged and older adults that fulfills the American College of Sports Medicine guidelines for improving and maintaining cardiorespiratory fitness.
To study the association between the cardiorespiratory fitness (CRF) distribution and cardiovascular disease (CVD) risk measured as continuous scores for individual and clustered CVD risk factors and to explore the potential effect modification of this association exerted by weight status among adolescents.
Cross-sectional study based on 1,247 youths aged 12-19 years in the 1999-2002 National Health and Nutrition Examination Surveys. CRF was estimated by a treadmill test and categorized into age- and sex-specific quintiles. Five established CVD risk factors - an adiposity index (sum of triceps and subscapular skinfolds), the homeostatic model assessment of insulin resistance, systolic blood pressure, triglycerides, and total cholesterol/high-density lipoprotein cholesterol - were standardized for age and gender and a clustered score calculated as their average. Regression analyses adjusted for race/ethnicity and family socioeconomic status assessed differences in CVD risk across CRF quintiles for the overall sample and after stratification by weight status.
The mean clustered risk score decreased with increasing CRF in both males and females (p for trend <.001 and .004, respectively). The most significant decline in the clustered CVD risk score across CRF quintiles was observed from the first to the second quintiles (53.6% and 37.5%, in males and females, respectively). The association remained significant in both overweight and normal weight males and in normal weight females (p < .05).
Most of the excess clustered CVD risk is found among adolescents within the lowest quintile of the CRF distribution. Among adolescents, very low fitness states should be avoided or intervened upon for purposes of primordial CVD prevention.