Publications by authors named "Tommi Vasankari"

138 Publications

Association between cardiorespiratory fitness and metabolic health in overweight and obese adults.

J Sports Med Phys Fitness 2021 Nov 10. Epub 2021 Nov 10.

Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland.

Background: Cardiorespiratory fitness (CRF) has been inversely associated with insulin resistance and clustering of cardiometabolic risk factors among overweight and obese individuals. However, most previous studies have scaled CRF by body mass (BM) possibly inflating the association between CRF and cardiometabolic health. We investigated the associations of peak oxygen uptake (V̇ O2peak) and peak power output (Wpeak) scaled either by BM-1, fat free mass (FFM-1), or by allometric methods with individual cardiometabolic risk factors and clustering of cardiometabolic risk factors in 55 overweight or obese adults with metabolic syndrome.

Methods: V̇ O2peak and Wpeak were assessed by a maximal cycle ergometer exercise test. FFM was measured by air displacement plethysmograph and glucose, insulin, HbA1c, triglycerides, and total, LDL, and HDL cholesterol from fasting blood samples. HOMA-IR and metabolic syndrome score (MetS) were computed.

Results: V̇ O2peak and Wpeak scaled by BM-1 were inversely associated with insulin (β=-0.404 to -0.372, 95% CI=-0.704 to -0.048), HOMA-IR (β=-0.442 to -0.440, 95% CI=-0.762 to -0.117), and MetS (β=-0.474 to -0.463, 95% CI's=-0.798 to -0.127). Other measures of CRF were not associated with cardiometabolic risk factors.

Conclusions: Our results suggest that using BM-1 as a scaling factor confounds the associations between CRF and cardiometabolic risk in overweight/obese adults with the metabolic syndrome.
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http://dx.doi.org/10.23736/S0022-4707.21.13234-7DOI Listing
November 2021

Standing time and daily proportion of sedentary time are associated with pain-related disability in a one month accelerometer measurement in adults with overweight or obesity.

Scand J Pain 2021 Sep 27. Epub 2021 Sep 27.

Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland.

Objectives: The association between the subjective experience of pain-related disability (PRD) and device-measured physical activity (PA) and sedentary behavior (SB) in overweight and obese adults is not well known. The aim of this study was to investigate the associations of pain markers with accelerometer-measured SB duration and different intensities of PA among physically inactive middle-aged adults with overweight or obesity.

Methods: This cross-sectional analysis included 72 subjects (27 men) with mean age of 57.9 (SD 6.7) years and mean BMI of 31.6 (SD 4.1) kg/m. SB and standing time (ST), breaks in sedentary time, light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) were measured for four consecutive weeks (mean 25 days, SD 4) with a hip-worn triaxial accelerometer. Headache, musculoskeletal pain, back pain, and PRD were assessed by visual analog scales (VAS) and using the Oswestry disability index (ODI). RAND-36 questionnaire was applied to assess health-related quality of life. The associations were studied by linear models.

Results: ST was positively and SB proportion was negatively associated with PRD when adjusted for age, sex, BMI, accelerometry duration, MVPA, pain medication use, and general health perceptions assessed by RAND-36. No associations were found between ST and back pain. SB or different PA intensities were not associated with pain experience at specific sites.

Conclusions: Longer daily ST, but not LPA or MVPA is associated with higher level of PRD. Correspondingly, higher proportion of SB is associated with lower level of PRD. This suggests that individuals with PRD prefer to stand, possibly to cope with pain. These results may highlight the importance of habitual standing behaviors in coping with experienced PRD in adults with overweight or obesity.
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http://dx.doi.org/10.1515/sjpain-2021-0108DOI Listing
September 2021

Standing is associated with insulin sensitivity in adults with metabolic syndrome.

J Sci Med Sport 2021 Dec 14;24(12):1255-1260. Epub 2021 Aug 14.

Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland; Rydberg Laboratory of Applied Sciences, University of Halmstad, Halmstad, Sweden.

Objectives: To determine how components of accelerometer-measured sedentary behavior (SB) and physical activity (PA), and fitness are associated with insulin sensitivity in adults with metabolic syndrome.

Design: Cross-sectional.

Methods: Target population was middle-aged (40-65 years) sedentary adults with metabolic syndrome. SB, breaks in SB, standing, and PA were measured for four weeks with hip-worn accelerometers. VOmax (ml/min/kg) was measured with maximal cycle ergometry. Insulin sensitivity was determined by hyperinsulinaemic-euglycaemic clamp (M-value) and fasting blood sampling (HOMA-IR, insulin). Multivariable regression was used for analyses.

Results: Sixty-four participants (37 women; 58.3 [SD 6.8] years) were included. Participants spent 10.0 (1.0) h sedentary, 1.8 (0.6) h standing, and 2.7 (0.6) h in PA and took 5149 (1825) steps and 29 (8) breaks daily. In sex-, age- and accelerometer wear time-adjusted model SB, standing, steps and VOmax were associated with M-value (β = -0.384; β = 0.400; β = 0.350; β = 0.609, respectively), HOMA-IR (β = 0.420; β = -0.548; β = -0.252; β = -0.449), and insulin (β = 0.433; β = -0.541; β = -0.252; β = -0.453); all p-values < 0.05. Breaks associated only with M-value (β = 0.277). When further adjusted for body fat %, only standing remained significantly associated with HOMA-IR (β = -0.381) and insulin (β = -0.366); significance was maintained even when further adjusted for SB, PA and fitness. Light and moderate-to-vigorous PA were not associated with insulin sensitivity.

Conclusions: Standing is associated with insulin sensitivity markers. The association with HOMA-IR and insulin is independent of adiposity, PA, SB and fitness. Further studies are warranted, but these findings encourage replacing sitting with standing for potential improvements in insulin sensitivity in adults at increased type 2 diabetes risk.
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http://dx.doi.org/10.1016/j.jsams.2021.08.009DOI Listing
December 2021

Physical activity and sedentary behaviour in secondary prevention of coronary artery disease: A review.

Am J Prev Cardiol 2021 Mar 9;5:100146. Epub 2021 Jan 9.

Heart Center, Kuopio University Hospital (KUH), Kuopio, Finland.

Comprehensive management of coronary artery disease (CAD) includes physical exercise as a part of daily lifestyle therapy. Still CAD patients generally have low physical activity (PA) and high sedentary behaviour (SB). This review summarizes the effect of exercise training and habitual PA and SB on physical fitness and quality of life (QoL) as well as on rehospitalizations and mortality in patients with stable CAD, recent acute coronary syndrome (ACS) or recent revascularization. A literature review of the influence of exercise, and PA and SB profiles in secondary prevention of CAD was performed using PubMed. All articles published between January 2001 and April 2019, meeting the inclusion criteria were considered. A total of 25 cross-sectional or prospective studies or randomized controlled trials (RCT) were included to this review. Exercise training was found to improve maximal oxygen consumption, QoL, and to reduce rehospitalizations and mortality among patients with established CAD. Remote PA interventions have not been as effective as the supervised exercise sessions in reducing the clinical endpoints. High SB, especially when combined to low PA, is associated with poor cardiorespiratory fitness and worse long-term prognosis among patients with ACS. In conclusion, exercise training and high PA are beneficial for patients with stable CAD, recent ACS or recent revascularization. High SB is associated with poor cardiopulmonary fitness and increased mortality in ACS patients. Novel tools using online applications and smart devices are promising means to offer remote guidance for PA among patients unable to participate in regular exercise sessions.
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http://dx.doi.org/10.1016/j.ajpc.2021.100146DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8315618PMC
March 2021

Change of Direction Biomechanics in a 180-Degree Pivot Turn and the Risk for Noncontact Knee Injuries in Youth Basketball and Floorball Players.

Am J Sports Med 2021 08 20;49(10):2651-2658. Epub 2021 Jul 20.

Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland.

Background: Studies investigating biomechanical risk factors for knee injuries in sport-specific tasks are needed.

Purpose: To investigate the association between change of direction (COD) biomechanics in a 180-degree pivot turn and knee injury risk among youth team sport players.

Study Design: Cohort study; Level of evidence, 2.

Methods: A total of 258 female and male basketball and floorball players (age range, 12-21 years) participated in the baseline COD test and follow-up. Complete data were obtained from 489 player-legs. Injuries, practice, and game exposure were registered for 12 months. The COD test consisted of a quick ball pass before and after a high-speed 180-degree pivot turn on the force plates. The following variables were analyzed: peak vertical ground-reaction force (N/kg); peak trunk lateral flexion angle (degree); peak knee flexion angle (degree); peak knee valgus angle (degree); peak knee flexion moment (N·m/kg); peak knee abduction moment (N·m/kg); and peak knee internal and external rotation moments (N·m/kg). Legs were analyzed separately and the mean of 3 trials was used in the analysis. Main outcome measure was a new acute noncontact knee injury.

Results: A total of 18 new noncontact knee injuries were registered (0.3 injuries/1000 hours of exposure). Female players sustained 14 knee injuries and male players 4. A higher rate of knee injuries was observed in female players compared with male players (incidence rate ratio, 6.2; 95% CI, 2.1-21.7). Of all knee injuries, 8 were anterior cruciate ligament (ACL) injuries, all in female players. Female players displayed significantly larger peak knee valgus angles compared with male players (mean for female and male players, respectively: 13.9°± 9.4° and 2.0°± 8.5°). No significant associations between biomechanical variables and knee injury risk were found.

Conclusion: Female players were at increased risk of knee and ACL injury compared with male players. Female players performed the 180-degree pivot turn with significantly larger knee valgus compared with male players. However, none of the investigated variables was associated with knee injury risk in youth basketball and floorball players.
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http://dx.doi.org/10.1177/03635465211026944DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8355634PMC
August 2021

Physical activity from adolescence to young adulthood: patterns of change, and their associations with activity domains and sedentary time.

Int J Behav Nutr Phys Act 2021 06 30;18(1):85. Epub 2021 Jun 30.

Faculty of Sport and Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, PL 35, FI-40014, Jyväskylä, Finland.

Background: Longitudinal studies demonstrate an average decline in physical activity (PA) from adolescence to young adulthood. However, while some subgroups of adolescents decrease activity, others increase or maintain high or low activity. Activity domains may differ between subgroups (exhibiting different PA patterns), and they offer valuable information for targeted health promotion. Hence, the aim of this study was to identify PA patterns from adolescence to young adulthood; also to explore the associations of (i) changes in PA domains and in sedentary time, (ii) sociodemographic factors, and (iii) self-rated health with diverging PA patterns.

Methods: The observational cohort study data encompassed 254 adolescents at age 15 and age 19. K-means cluster analysis for longitudinal data was performed to identify participant clusters (patterns) based on their accelerometry-measured moderate-to-vigorous PA (MVPA). Logistic regressions were applied in further analysis.

Results: Five PA patterns were identified: inactivity maintainers (n = 71), activity maintainers (n = 70), decreasers from moderate (to low) PA (n = 61), decreasers from high (to moderate) PA (n = 32), and increasers (n = 20). At age 15, participation in sports clubs (SC, 41-97%) and active commuting (AC, 47-75%) was common in all the patterns. By age 19, clear dropout from these activities was prevalent (SC participation mean 32%, AC 31-63%). Inactivity maintainers reported the lowest amount of weekly school physical education. Dropout from SC - in contrast to non-participation in SC - was associated with higher odds of being a decreaser from high PA, and with lower odds of being an inactivity maintainer. Maintained SC participation was associated with higher odds of belonging to the decreasers from high PA, and to the combined group of activity maintainers and increasers; also with lower odds of being an inactivity maintainer. Maintenance/adoption of AC was associated with decreased odds of being an inactivity maintainer. Self-reported health at age 19 was associated with the patterns of maintained activity and inactivity.

Conclusions: PA patterns diverge over the transition to adulthood. Changes in SC participation and AC show different associations with diverging PA patterns. Hence, tailored PA promotion is recommended.
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http://dx.doi.org/10.1186/s12966-021-01130-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8246658PMC
June 2021

Reliability and Validity of the ONAPS Physical Activity Questionnaire in Assessing Physical Activity and Sedentary Behavior in French Adults.

Int J Environ Res Public Health 2021 05 25;18(11). Epub 2021 May 25.

Service de Médecine du Sport et des Explorations Fonctionnelles, Centre Hospitalier Universitaire Gabriel Montpied, 63003 Clermont-Ferrand, France.

This study was conducted to assess the validity and reliability of a new questionnaire, the ONAPS-PAQ, developed to assess physical activity (PA) and sedentary behaviors (SB) in the general population. A total of 137 healthy adults aged 18 to 69 years were included. Following completion of two physical activity questionnaires (ONAPS-PAQ and GPAQ, the Global physical activity questionnaire) to study concurrent validity, participants wore an accelerometer (UKK-RM42) for 7 days to study criterion validity. A subsample ( = 36) also completed a 7-day-interval test-retest protocol to assess its reliability. Reliability was tested by the intraclass correlation coefficient (ICC) and Kappa coefficient; concurrent and criterion validity by the Spearman correlation coefficient (ρ) and Bland-Altman plot analyses. The ONAPS-PAQ showed good reliability (ICC = 0.71-0.98; Kappa = 0.61-0.99) and concurrent validity (ρ = 0.56-0.86), but only poor criterion validity (ρ = 0.26-0.41), and wide limits of agreement. Self-reported and accelerometer-measured SB were better correlated with ONAPS-PAQ than GPAQ (0.41 vs. 0.26, respectively) and medians were comparable, whereas the GPAQ underestimated SB (SB = 481 (432-566), SB = 480 (360-652), SB = 360 (240-540) min·day; (-)). The ONAPS-PAQ provides good reliability and acceptable validity for the measurement of PA and SB and seems to provide a better assessment of SB than GPAQ.
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http://dx.doi.org/10.3390/ijerph18115643DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8197457PMC
May 2021

Influence of the Duration and Timing of Data Collection on Accelerometer-Measured Physical Activity, Sedentary Time and Associated Insulin Resistance.

Int J Environ Res Public Health 2021 05 6;18(9). Epub 2021 May 6.

Turku PET Centre, University of Turku and Turku University Hospital, 20521 Turku, Finland.

Accelerometry is a commonly used method to determine physical activity in clinical studies, but the duration and timing of measurement have seldom been addressed. We aimed to evaluate possible changes in the measured outcomes and associations with insulin resistance during four weeks of accelerometry data collection. This study included 143 participants (median age of 59 (IQR9) years; mean BMI of 30.7 (SD4) kg/m; 41 men). Sedentary and standing time, breaks in sedentary time, and different intensities of physical activity were measured with hip-worn accelerometers. Differences in the accelerometer-based results between weeks 1, 2, 3 and 4 were analyzed by mixed models, differences during winter and summer by two-way ANOVA, and the associations between insulin resistance and cumulative means of accelerometer results during weeks 1 to 4 by linear models. Mean accelerometry duration was 24 (SD3) days. Sedentary time decreased after three weeks of measurement. More physical activity was measured during summer compared to winter. The associations between insulin resistance and sedentary behavior and light physical activity were non-significant after the first week of measurement, but the associations turned significant in two to three weeks. If the purpose of data collection is to reveal associations between accelerometer-measured outcomes and tenuous health outcomes, such as insulin sensitivity, data collection for at least three weeks may be needed.
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http://dx.doi.org/10.3390/ijerph18094950DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8125504PMC
May 2021

Childhood Sports Participation Is Associated With Health-Related Quality of Life in Young Men: A Retrospective Cross-Sectional Study.

Front Sports Act Living 2021 22;3:642993. Epub 2021 Apr 22.

Department of Leadership and Military Pedagogy, National Defence University, Helsinki, Finland.

The aim of the study was to examine whether sports participation (SP), engagement in competitive sports (CS), and the type of sport undertaken at the age of 12 are associated with the physical and mental components of health-related quality of life (HRQoL) in young adulthood. The data were collected using questionnaires prior to a compulsory military refresher training course in Finland. The sample consisted of 784 men (mean age 26 years). HRQoL was measured with RAND 36 and childhood SP with a series of questions. Data were analyzed with logistic regression. Higher frequency of SP, participation in district-level CS; performing team, endurance, or extreme sports; and playing yard games in childhood were after adjustments all associated with better HRQoL in early adulthood. The association was mainly found with the mental component, and to a lesser extent with the physical component, of HRQoL. Team (OR 1.43, CI 1.00-2.06) and extreme sports (OR 1.77, CI 1.19-2.63) were associated with better mental HRQoL, while playing yard games (OR 0.62, CI 0.44-0.89) reduced the likelihood for having low physical HRQoL. SP in childhood-in the forms of team or individual sports, but also as informal physical activity, such as playing yard games-is associated with HRQoL in young adulthood.
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http://dx.doi.org/10.3389/fspor.2021.642993DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8100196PMC
April 2021

Body Adiposity, But Not Elements of Objectively Measured Sedentary Behavior or Physical Activity, Is Associated With Circulating Liver Enzymes in Adults With Overweight and Obesity.

Front Endocrinol (Lausanne) 2021 20;12:655756. Epub 2021 Apr 20.

Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland.

Objective: We studied the associations between accelerometer-measured sedentary behavior (SB) and habitual physical activity (PA) as well as markers of body adiposity and other cardiometabolic risk factors with liver enzymes alanine aminotransferase (ALT), aspartate aminotransferase (AST) and γ-glutamyltransferase (GGT).

Methods: A total of 144 middle-aged adults (mean age 57 (SD 6.5) years) with overweight or obesity (mean body mass index [BMI] 31.8 [SD 3.9] kg/m) participated. Different components of SB (sitting, lying) and PA (standing, breaks in SB, daily steps, light PA, moderate-to-vigorous PA and total PA) were measured with validated hip-worn accelerometers for four consecutive weeks (mean 25 days, [SD 4]). Fasting venous blood samples were analysed using standard assays. The associations were examined with Pearson's partial correlation coefficient test and linear mixed model.

Results: Among 102 women and 42 men accelerometer measured SB or the elements of PA were not associated with circulating liver enzymes. When adjusted for age and sex, liver enzymes correlated positively with BMI and waist circumference (WC) (ALT r=0.34, p<0.0001, r=0.41, < 0.0001, AST r=0.17, p=0.049, r=0.26, p=0.002, GGT r=0.29, p=0.0005, r=0.32, p < 0.0001, respectively). SB proportion associated positively with BMI (r=0.21, p=0.008) and WC (r=0.27, p=0.001). Components of PA associated negatively with BMI (MVPA r=-0.23, p=0.005, daily steps r=-0.30, p<0.0001 and breaks in sedentary time r=-0.32, p<0.0001), as well as with WC (breaks in SB r=-0.35, p<0.0001, MVPA r=-0.26, p=0.002, daily steps r=-0.31, p<0.0001, standing time r=-0.27, p=0.001). Liver enzymes associated positively with common cardiometabolic markers such as resting heart rate (ALT; β=0.17, p=0.03, AST; β=0.25, p=0.002, GGT; β=0.23, p=0.004) and systolic/diastolic blood pressure (ALT β=0.20, p=0.01, β=0.22, p=0.005, AST (only diastolic) β=0.23, p=0.006, GGT β=0.19, p=0.02, = 0.23, p=0.004, respectively), fasting insulin (ALT β=0.41, p<0.0001, AST β=0.36, p=0.0003, GGT β=0.20, p=0.04) and insulin resistance index (ALT β=0.42, p<0.0001, AST β=0.36, p=0.0003, GGT β=0.21, p=0.03), even after adjustment with BMI.

Conclusions: Liver enzymes correlate with body adiposity and appear to cluster with other common cardiometabolic risk factors, even independently of body adiposity. SB and PA appear not to be essential in modulating the levels of circulating liver enzymes.
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http://dx.doi.org/10.3389/fendo.2021.655756DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8095079PMC
April 2021

Intensity Paradox-Low-Fit People Are Physically Most Active in Terms of Their Fitness.

Sensors (Basel) 2021 Mar 15;21(6). Epub 2021 Mar 15.

UKK-Institute, 33500 Tampere, Finland.

Depending on their cardiorespiratory fitness (CRF), people may perceive the exertion of incident physical activity (PA) differently. Therefore, the use of relative intensity thresholds based on individual fitness have been proposed to evaluate the accumulation of PA at different intensity levels. A subsample of the FinFit2017-study, 1952 adults (803 men and 1149 women) aged 20-69 years, participated in this study. Their maximal oxygen uptake (VOmax) was predicted with a 6 min walk test, and they were instructed to wear a triaxial hip-worn accelerometer for one week. The participants were divided into CRF tertiles by five age groups and sex. Raw acceleration data were analyzed with the mean amplitude deviation method in 6 s epochs. Additionally, the data were smoothed with 1 min and 6 min exponential moving averages. The absolute intensity threshold for moderate activity was 3.0 metabolic equivalent (MET) and for vigorous 6.0 MET. Correspondingly, the relative thresholds were 40% and 60% of the oxygen uptake reserve. Participants in the lowest CRF tertile were the most active with relative thresholds, and participants in the highest CRF tertile were the most active with absolute thresholds. High-fit people easily reached the absolute thresholds, while people in the lowest CRF tertile had to utilize most of their aerobic capacity on a daily basis simply to keep up with their daily chores or peers.
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http://dx.doi.org/10.3390/s21062063DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8002087PMC
March 2021

Higher number of steps and breaks during sedentary behaviour are associated with better lipid profiles.

BMC Public Health 2021 03 31;21(1):629. Epub 2021 Mar 31.

The UKK Institute for Health Promotion Research, Tampere, Finland.

Background: Physical activity (PA) is known to be associated with lipid profiles and the risk of both cardiovascular diseases and cancer. The aim of this study was to evaluate the association of objectively measured PA, sedentary behaviour (SB), amount of breaks during SB and number of daily steps with serum lipids in a healthy, Finnish, middle-aged, female population.

Methods: The participants (571) were recruited at mammography screening, target group was women aged 50-60 years. A measurement of PA was done with accelerometer, blood lipid profile was assessed, and questionnaires of participants characteristics were sent to participants.

Results: The participants with the highest number of daily breaks during SB (≥ 41) had the highest mean concentration of HDL-cholesterol (high density lipoprotein cholesterol, HDL-c) (1.9 mmol/l, standard deviation (SD) 0.4) and the lowest mean concentration of triglycerides (1.0 mmol/l, SD 0.5). HDL-c level was 0.16 mmol/l higher (p < 0.001) in the group with 28-40.9 breaks/day and 0.25 mmol/l higher (p < 0.001) among participants with ≥41 breaks/day than in the group with the fewest breaks during SB (< 28). Those with the most daily steps (≥ 9100) had the highest mean HDL-c level (1.9 mmol/l). HDL-c level was 0.16 mmol/l higher (p < 0.001) among the participants with 5600-9099 steps/day and 0.26 mmol/l higher (p < 0.001) among participants with ≥9100 steps/day than those with the fewest steps (< 5600). The number of daily steps was inversely associated with the triglyceride concentration. From wake-time, participants spent 60% in SB, 18% standing, 14% in light PA, and 9% in moderate-to-vigorous PA (MVPA). PA was associated with serum total cholesterol (TC), HDL-c and triglyceride levels. The mean HDL-c level was the highest in the lowest quartile of SB and in the highest quartile of MVPA.

Conclusions: To our knowledge, this is the first study showing a high number of objectively measured breaks during SB is associated with a favourable effect on the level of serum lipids, which may later translate into cardiovascular health among middle-aged women.

Trial Registration: This study was registered and approved by the Regional Ethics Committee of Tampere University Hospital in Finland (approval code R15137 ).
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http://dx.doi.org/10.1186/s12889-021-10656-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8010961PMC
March 2021

The standing knee lift test is not a useful screening tool for time loss from low back pain in youth basketball and floorball players.

Phys Ther Sport 2021 May 27;49:141-148. Epub 2021 Feb 27.

Tampere Research Center of Sports Medicine, The UKK Institute for Health Promotion Research, Kaupinpuistonkatu 1, 33500, Tampere, Finland; Tampere University Hospital, Central Hospital, PO BOX 2000, FI-33521, Tampere, Finland.

Objectives: The aim of this study was to investigate the association between pelvic kinematics during the standing knee lift (SKL) test and low back pain (LBP) in youth floorball and basketball players.

Design: A prospective cohort study.

Setting: Finnish elite youth floorball and basketball players.

Participants: Finnish elite youth female and male floorball and basketball players (n = 258, mean age 15.7 ± 1.8).

Main Outcome Measures: LBP resulting in time loss from practice and games was recorded over a 12-month period and verified by a study physician. Associations between LBP and sagittal plane pelvic tilt and frontal plane pelvic obliquity during the SKL test as measured at baseline were investigated. Individual training and game hours were recorded, and Cox's proportional hazard models with mixed effects were used for the analysis.

Results: Cox analyses revealed that sagittal plane pelvic tilt and frontal plane pelvic obliquity were not associated with LBP in floorball and basketball players during the follow-up. The hazard ratios for pelvic tilt and pelvic obliquity ranged between 0.93 and 1.08 (95% CIs between 0.91 and 1.07 and 0.83 and 1.29), respectively.

Conclusions: Pelvic movement during the SKL test is not associated with future LBP in youth floorball and basketball players.
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http://dx.doi.org/10.1016/j.ptsp.2021.01.017DOI Listing
May 2021

A 3D motion capture analysis of a giving-way ankle episode during a 180-degree pivot turn: A case report.

J Biomech 2021 03 9;118:110318. Epub 2021 Feb 9.

Sports Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Canada; Tampere Research Centre of Sports Medicine, UKK Institute, Tampere, Finland; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada; McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Canada.

Lateral ankle sprains are highly prevalent during sporting activities, as it accounts for approximately 60% of all athletic injuries. There is currently a paucity of research which provides kinetic and kinematic assessments of sprains and giving-way episodes of the ankle joint. The aim of this case study was to examine the kinetics and kinematics of the ankle and knee during a giving-way episode in a female ice hockey player during a 180-degree pivot turn, which was conducted in a 3D motion capture laboratory. Three trials were conducted on this participant (one accident trial, two control trials). Kinetic and kinematic analysis was conducted on the outside leg during a left 180-degree pivot turn (right leg). The plantarflexion angle of the giving-way trial was larger than the control trials from the point of initial contact until the end of the trial. Inversion was also 27-degrees greater 150 ms after initial contact in the giving-way trial and 26-degrees greater compared to control trials 1 and 2. Substantially greater plantarflexion, inversion and internal rotation angles of the ankle were observed during the giving-way trial compared to control trials. The maximum vertical and horizontal ground reaction forces, as well as ankle inversion and internal rotation moments, were lower for the giving-way trial in comparison to the control trials. Further research is needed to understand the influence of plantarflexion angle with a giving-way episode of the ankle. This study provides valuable kinetic and kinematic information regarding a giving-way episode of the ankle.
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http://dx.doi.org/10.1016/j.jbiomech.2021.110318DOI Listing
March 2021

Device-Based Measures of Sedentary Time and Physical Activity Are Associated With Physical Fitness and Body Fat Content.

Front Sports Act Living 2020 18;2:587789. Epub 2020 Dec 18.

Department of Leadership and Military Pedagogy, National Defence University, Helsinki, Finland.

Physical activity and sedentary time may associate with physical fitness and body composition. Yet, there exists some observational studies that have investigated the associations of device-based measures of sedentary time and physical activity (PA) with cardiorespiratory fitness (CRF) and body composition but associations with muscular fitness (MF) are less studied. Objective sedentary time and physical activity was measured by a hip worn accelerometer from 415 young adult men (age: mean 26, standard deviation 7 years). Cardiorespiratory fitness (VOmax) (CRF) was determined using a graded cycle ergometer test until exhaustion. Maximal force of lower extremities was measured isometrically and lower body power was assessed using standing long jump (MF). Body composition was determined with bioimpedance method. Single and compositional approach was used in regression analysis. Mean sedentary time was 707 (standard deviation 133) minutes per day (77 ± 8% of the wear time). Volumes of all PA intensities were positively associated with CRF and associations showed linearly increasing magnitudes with higher intensities in single regression models adjusted for age and smoking ( < 0.001). Similarly, PA intensities were positively associated with lower body MF, however, with weaker associations ( < 0.005). After further adjustment for resistance training, the associations remained significant. The associations of the relative distribution of time within sedentary behavior (SB), light intensity PA (LPA) and moderate-to-vigorous PA (MVPA) behaviors as a whole with using compositional analysis further revealed that within the composition MVPA and SB were positively associated with CRF and MF ( < 0.001), while LPA was not. In addition, within the composition, accumulated PA bouts lasting more than 3 min were consistently associated with CRF and MF, and with all body composition variables ( < 0.001), while sedentary time was associated with body fat percentage ( < 0.001). Promoting physical activity and reducing sedentary time may have positive influence on physical fitness and body fat content, and thereby may offer positive health effects. Physical activity of higher intensities may offer greater benefits.
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http://dx.doi.org/10.3389/fspor.2020.587789DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7750877PMC
December 2020

Opinion paper: Exercise for healthy aging.

Maturitas 2021 Feb 4;144:45-52. Epub 2020 Nov 4.

Department of Obstetrics and Gynecology, South Karelia Central Hospital. Lappeenranta, Finland.

The physical demands of daily life in developed countries have decreased remarkably during the last two centuries. General leisure time has increased and the age at retirement has decreased. General health has improved and life expectancy has increased. Most people can expect to live 20-30 years after retirement. By 2050, one in four people in Europe and North America will be aged 65 or over. Furthermore, women live longer than men. Generally, the physical demands on older women will be low. Thus, their physical fitness will decline, which in turn will affect a variety of organ systems and functions, and so impact on mental health, quality of life and independent living. This opinion paper explores exercise strategies for healthy ageing.
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http://dx.doi.org/10.1016/j.maturitas.2020.10.012DOI Listing
February 2021

Both sedentary time and physical activity are associated with cardiometabolic health in overweight adults in a 1 month accelerometer measurement.

Sci Rep 2020 11 25;10(1):20578. Epub 2020 Nov 25.

Turku PET Centre, University of Turku and Turku University Hospital, P.O. box 52, 20521, Turku, Finland.

The aim of this study was to examine the associations of cardiometabolic health markers with device-measured sedentary behavior (SB) duration and different intensities of physical activity (PA) among overweight working-aged adults with low self-reported PA levels. This cross-sectional analysis included 144 subjects (42 men) with mean age of 57 (SD 6.5) years and mean BMI of 31.7 (SD 4) kg/m. SB and standing time, breaks in sedentary time, light PA (LPA) and moderate-to-vigorous PA (MVPA) were measured for 4 consecutive weeks (mean 25 days, SD 4) with hip-worn accelerometers. Fasting plasma glucose, insulin, HbA, triglycerides and total cholesterol, HDL and LDL were measured from venous blood samples. HOMA-IR index was calculated as a surrogate of insulin resistance. The associations were examined using linear models. LPA, MVPA, and daily steps associated with better insulin sensitivity and favorable plasma lipid profile, when adjusted for age, sex and BMI, whereas greater proportion of SB associated with insulin resistance and unfavorable lipid profile. As all PA intensities associated with better cardiometabolic health, the total daily duration of PA may be more relevant than intensity in maintaining metabolic health in overweight adults, if the current guidelines for PA are not met.Trial Registration: ClinicalTrials.gov NCT03101228, registered 05/04/2017, https://clinicaltrials.gov/show/NCT03101228 .
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http://dx.doi.org/10.1038/s41598-020-77637-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7688927PMC
November 2020

Resting Electrocardiogram and Blood Pressure in Young Endurance and Nonendurance Athletes and Nonathletes.

J Athl Train 2021 May;56(5):484-490

Kuopio Research Institute of Exercise Medicine, Finland.

Context: Much information is available on electrocardiogram (ECG) and blood pressure (BP) changes in senior athletes. However, corresponding data on adolescent athletes are scarce.

Objective: To study the differences in resting ECG and BP values among adolescent endurance athletes, nonendurance athletes, and nonathletes.

Design: Cross-sectional study.

Setting: A total of 154 youth sports clubs in Finland and 100 secondary schools for comparison data.

Patients Or Other Participants: We recruited young athletes (n = 410) aged 14 to 16 years in 10 popular sport disciplines, including winter and summer as well as team and individual sports, and categorized them as endurance or nonendurance sports. Comparison data for age-matched, non-sports club participants (n = 164) were collected via secondary schools.

Main Outcome Measure(s): Resting ECG, including heart rate, PR interval, QRS duration, QRS axis, QRS amplitude, T axis, and QT interval as well as systolic and diastolic BPs.

Results: No differences in any ECG variable of interest were found between the endurance and nonendurance athletes. The PR interval was longer in endurance athletes than in nonathletes (P = .05). The QRS amplitude (P = .03) was higher among nonendurance athletes than among nonathletes. Diastolic BP was lower among endurance (P = .002) and nonendurance (P = .02) athletes than among nonathletes. Endurance athletes (odds ratio [OR] = 2.85; 95% CI = 1.81, 4.50) and nonendurance athletes (OR = 2.19; 95% CI = 1.43, 3.35) were more likely to have sinus bradycardia than were nonathletes. Nonendurance athletes were more likely to have elevated systolic BP than were endurance athletes (OR = 1.70; 95% CI = 1.07, 2.72) and nonathletes (OR = 1.73; 95% CI = 1.04, 2.87).

Conclusions: Young athletes had similar ECG and BP findings independent of their sports. Physiological adaptations including sinus bradycardia, higher QRS amplitude, and lower diastolic BP, which are commonly seen in adult athletes, were also present in adolescent athletes.
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http://dx.doi.org/10.4085/78-20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8130770PMC
May 2021

The associations of oxidized lipoprotein lipids with lipoprotein subclass particle concentrations and their lipid compositions. The Cardiovascular Risk in Young Finns Study.

Free Radic Biol Med 2021 01 21;162:225-232. Epub 2020 Oct 21.

From Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Finland; Departments of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Finland.

Objective: Oxidation of low-density lipoprotein (LDL) may promote atherosclerosis, whereas the reverse transport of oxidized lipids by high-density lipoprotein (HDL) may contribute to atheroprotection. To provide insights into the associations of lipoprotein lipid oxidation markers with lipoprotein subclasses at the population level, we investigated the associations of oxidized HDL lipids (oxHDL) and oxidized LDL lipids (oxLDL) with lipoprotein subclasses in a population-based cross-sectional study of 1395 Finnish adults ages 24-39 years.

Methods: The analysis of oxidized lipids was based on the determination of the baseline level of conjugated dienes in lipoprotein lipids. A high-throughput nuclear magnetic resonance (NMR) platform was used to quantify circulating lipoprotein subclass concentrations and analyze their lipid compositions.

Results: OxHDL were mainly not associated with lipoprotein subclass lipid concentrations and lipid composition after adjustment for Apolipoprotein-A1 (Apo-A1), waist circumference and age. OxLDL were associated with several markers of lipoprotein subclass lipid concentrations and composition after adjustment for Apolipoprotein-B (Apo-B), age and waist circumference. Several measures of HDL and LDL subclasses, including phospholipid and triglyceride composition, associated directly with oxLDL Cholesterol ester and free cholesterol composition in HDL and LDL associated inversely with oxLDL.

Conclusion: We conclude that these results do not support the idea that HDL's particle size or composition would reflect its functional capacity in the reverse transport of oxidized lipids. On the contrary, oxLDL were associated with the entire lipoprotein subclass profile, including numerous associations with the compositional descriptors of the particles. This is in line with the suggested role of LDL oxidation in atherogenesis.
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http://dx.doi.org/10.1016/j.freeradbiomed.2020.10.020DOI Listing
January 2021

Haemoglobin, iron status and lung function of adolescents participating in organised sports in the Finnish Health Promoting Sports Club Study.

BMJ Open Sport Exerc Med 2020 3;6(1):e000804. Epub 2020 Sep 3.

Tampere Research Center of Sports Medicine, Ukk Institute, Tampere, Finland.

Objectives: To compare laboratory test results and lung function of adolescent organised sports participants (SP) with non-participants (NP).

Methods: In this cross-sectional study, laboratory tests (haemoglobin, iron status), and flow-volume spirometry were performed on SP youths (199 boys, 203 girls) and their NP peers (62 boys, 114 girls) aged 14-17.

Results: Haemoglobin concentration <120/130 g/L was found in 5.8% of SP and 5.1% NP (OR 1.20, 95% CI 0.54 to 2.68). Ferritin concentration below 15 µg/L was found in 22.7% of both SP and NP girls. Among boys ferritin <30 µg/L was found in 26.5% of SP and 30.2% of NP (OR 0.76, 95% CI 0.40 to 1.47). Among SP iron supplement use was reported by 3.5% of girls and 1.5% of boys. In flow-volume spirometry with bronchodilation test, 7.0% of SP and 6.4% of NP had asthma-like findings (OR 1.17, 95% CI 0.54 to 2.54); those using asthma medication, that is, 9.8% of SP and 5.2% of NP were excluded from the analysis.

Conclusions: Screening for iron deficiency is recommended for symptomatic persons and persons engaging in sports. Lung function testing is recommended for symptomatic persons and persons participating in sports in which asthma is more prevalent.
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http://dx.doi.org/10.1136/bmjsem-2020-000804DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7520547PMC
September 2020

Menstrual dysfunction and body weight dissatisfaction among Finnish young athletes and non-athletes.

Scand J Med Sci Sports 2021 Feb 8;31(2):405-417. Epub 2020 Oct 8.

Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.

To determine the prevalence of menstrual dysfunction (MD; ie, oligomenorrhea or amenorrhea) and attitudes toward body weight among athletes and non-athletes, we studied a cohort of athletes and non-athletes, in adolescence (14-16 years) and subsequently in young adulthood (18-20 years). We further studied the differences between athletes reporting MD and eumenorrheic athletes at both time periods and identified physical and behavioral characteristics that might predict MD in young adulthood. Data were collected using questionnaires, accelerometers, and a pre-participation screening. In adolescence, the athletes reported current primary amenorrhea more often than the non-athletes (4.7% vs 0%, P = .03). In young adulthood, athletes reported MD more frequently than non-athletes (38.7% vs 5.6%, P < .001). Athletes had less desire than non-athletes to lose weight at both time points, and in adolescence, athletes were more satisfied with their weight. However, about one fifth of the athletes and about 40% of the non-athletes experienced body weight dissatisfaction at both time points. In adolescence, athletes reporting MD had lower BMI than eumenorrheic athletes. In young adulthood, athletes with MD were more physically active than eumenorrheic athletes. The only longitudinal predictor of MD in young adulthood was MD in adolescence. Our findings indicate that MD is relatively frequent among young Finnish athletes. However, athletes appear to have a smaller tendency to experience body weight dissatisfaction than their non-athletic peers. MD seems to track from adolescence to adulthood, suggesting that there is a need to focus on possible causes at the earliest feasible phase of an athlete's career.
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http://dx.doi.org/10.1111/sms.13838DOI Listing
February 2021

New Machine Learning Approach for Detection of Injury Risk Factors in Young Team Sport Athletes.

Int J Sports Med 2021 Feb 13;42(2):175-182. Epub 2020 Sep 13.

Faculty of Information Technology, University of Jyväskylä, Jyväskylä, Finland.

The purpose of this article is to present how predictive machine learning methods can be utilized for detecting sport injury risk factors in a data-driven manner. The approach can be used for finding new hypotheses for risk factors and confirming the predictive power of previously recognized ones. We used three-dimensional motion analysis and physical data from 314 young basketball and floorball players (48.4% males, 15.72±1.79 yr, 173.34±9.14 cm, 64.65±10.4 kg). Both linear (L1-regularized logistic regression) and non-linear methods (random forest) were used to predict moderate and severe knee and ankle injuries (N=57) during three-year follow-up. Results were confirmed with permutation tests and predictive risk factors detected with Wilcoxon signed-rank-test (p<0.01). Random forest suggested twelve consistent injury predictors and logistic regression twenty. Ten of these were suggested in both models; sex, body mass index, hamstring flexibility, knee joint laxity, medial knee displacement, height, ankle plantar flexion at initial contact, leg press one-repetition max, and knee valgus at initial contact. Cross-validated areas under receiver operating characteristic curve were 0.65 (logistic regression) and 0.63 (random forest). The results highlight the difficulty of predicting future injuries, but also show that even with models having relatively low predictive power, certain predictive injury risk factors can be consistently detected.
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http://dx.doi.org/10.1055/a-1231-5304DOI Listing
February 2021

Estimating global injuries morbidity and mortality: methods and data used in the Global Burden of Disease 2017 study.

Inj Prev 2020 10 24;26(Supp 1):i125-i153. Epub 2020 Aug 24.

Department of Pharmacy, Adigrat University, Adigrat, Ethiopia.

Background: While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria.

Methods: In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced.

Results: GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes.

Conclusions: GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future.
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http://dx.doi.org/10.1136/injuryprev-2019-043531DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7571362PMC
October 2020

Females Sustain more Ankle Injuries than Males in Youth Football.

Int J Sports Med 2020 Dec 20;41(14):1017-1023. Epub 2020 Jul 20.

Sport Injury Prevention Research Centre Faculty of Kinesiology Alberta Children's Hospital Research Institute, McCaig Institute for Bone and Joint Health, Calgary, Canada.

This prospective study evaluated the incidence and pattern of acute injuries in youth (9- to 14-year- old) football players. Ten football clubs [n=730 players (567 males, 163 females)] participated in the 20-week follow-up study (January-June 2015). Data was collected by sending a standardized weekly SMS to players' parents/guardians with follow-up interviews for injured players. During the study period, 278 players (38%) sustained 410 acute injuries. The overall injury incidence for males and females was 6.47 (95% CI, 5.84-7.09) injuries per 1000 h of football exposure. Most injuries (40%) caused minimal absence from sports. Eighty-four percent of the injuries affected the lower extremities, with the ankle (30%), knee (17%), and thigh (16%) being the most commonly injured body sites. Females had significantly higher ankle injury rate (IRR) 1.85 (95% CI, 1.18-2.91, p=0.007) and non-contact ankle injury rate IRR 2.78 (95% CI, 1.91-4.02, p<0.001) than males. In conclusion, our results showed that the acute injury incidence among youth football is moderately high, and females are at higher risk for ankle injuries. Injury prevention programs aimed at preventing ankle injuries should be considered in the future.
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http://dx.doi.org/10.1055/a-1192-5399DOI Listing
December 2020

Relationship between different domains of physical activity and positive mental health among young adult men.

BMC Public Health 2020 Jul 16;20(1):1116. Epub 2020 Jul 16.

The Department of Leadership and Military Pedagogy, National Defence University, Helsinki, Finland.

Background: There is growing evidence on positive effects of physical activity (PA) on mental health. However, the focus of previous research on this relationship has typically been on mental health from the perspective of mental health problems rather than from the perspective of mental wellbeing. Further, previous research has commonly focused rather on leisure time PA without evidence on the role of other domains of PA. The aim of the present cross-sectional study was to investigate the relationship between positive mental health (PMH) and different domains of PA in young Finnish men. The secondary aim was to examine the reasons for physical inactivity among individuals with a low level of PMH.

Methods: Positive mental health (measured with Short Warwick-Edinburgh Mental Wellbeing Scale, SWEMWBS), self-reported leisure time, occupational and commuting PA as well as reasons for physical inactivity were measured using questionnaires (n = 456, mean age 29 years) among young Finnish males. Logistic regression modelling was used to generate odds for low and high levels of positive mental health for different levels of PA and sociodemographic variables.

Results: A weak positive association between leisure time PA and PMH was found in men with a low level of PMH (OR = 0.33, 95% CI 0.13-0.86). No association was found in the domains of commuting and occupational PA. Multivariate logistic regression analysis showed lower level of leisure time PA, unemployment and being single independently predicting low level of PMH. No associations were found between any domains of PA and high level of PMH. The most common reasons for physical inactivity among men with a low level of PMH were lack of interest (28%) and unwillingness to practise sports alone (27%).

Conclusions: The relationship between physical activity and positive mental health seems to vary between different domains of physical activity. The findings highlight the important role of leisure time physical activity, particularly in men with a low level of positive mental health. Strategies aimed at increasing physical activity for mental health benefits should focus particularly on providing opportunities for leisure time physical activity involving social interactions for men with lower mental wellbeing.
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http://dx.doi.org/10.1186/s12889-020-09175-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7364501PMC
July 2020

Individual- and environmental-related correlates of moderate-to-vigorous physical activity in 11-, 13-, and 15-year-old Finnish children.

PLoS One 2020 18;15(6):e0234686. Epub 2020 Jun 18.

Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.

The objective of this study was to analyze the associations of various individual- and environmental-related factors with subgroups of daily, frequent, moderate and low moderate-to-vigorous physical activity (MVPA) among children and adolescents. Data were obtained from the Finnish School-age Physical Activity (FSPA) study 2016 from 4677 national representative 11-, 13-, and 15-year-old children and adolescents. MVPA and individual- and environmental-related factors were assessed by a questionnaire and analyzed by two-level logistic regression. Seventeen of the twenty-one variables were statistically significantly associated with MVPA. However, only three variables were statistically significant in all MVPA subgroups, whereby self-directed PA at least twice a week, fewer perceived barriers, and higher peer support increased the odds of participating in more MVPA. The results from this study showed essential differences among the MVPA subgroups, also supporting previous findings, whereby various individual- and environmental-based factors are associated with children and adolescents' levels of MVPA. Challenges to designing and implementing effective interventions are based on the need to account for individual differences within the population, as well as the varied connections between PA with different social and physical environments where children and adolescents' PA takes place. PA interventions with various actions at multiple levels are warranted.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0234686PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7302665PMC
August 2020

Muscular and cardiorespiratory fitness are associated with health-related quality of life among young adult men.

BMC Public Health 2020 Jun 3;20(1):842. Epub 2020 Jun 3.

The Department of Leadership and Military Pedagogy, National Defence University, Helsinki, Finland.

Background: Despite numerous studies providing evidence for positive effects of physical activity and physical fitness, evidence for association between physical fitness and health-related quality of life (HRQoL) in young adults is limited. The aim of the present cross-sectional study was to investigate the association of cardiorespiratory and muscular fitness with HRQoL from the perspective of its physical and mental components among young adult Finnish males.

Methods: The sample consisted of 754 men, with the mean age of 26 years (SD 6.7 years), who participated in the military refresher training. HRQoL was measured using the Finnish RAND 36-item health survey. Cardiorespiratory fitness was determined by a bicycle ergometer test, and muscular fitness by various tests measuring maximal strength and muscular endurance. Logistic regression modelling was used to compare low, moderate and high physical and mental component of HRQoL scores to the respective levels of muscular and cardiorespiratory fitness.

Results: The findings of the adjusted (age, educational level, marital status, employment status, smoking, use of alcohol and BMI) analysis showed that cardiorespiratory and muscular fitness are positively associated with both physical and mental components of HRQoL. In terms of the physical component of HRQoL, even a moderate fitness level was positively associated with better HRQoL. In terms of the mental component of HRQoL, the impact was seen only in the group with the highest fitness level.

Conclusions: The findings suggest a positive contribution of physical fitness to mental health and highlight the importance of both muscular and cardiorespiratory fitness in the promotion of HRQoL. Even lighter forms of physical activity that result in moderate physical fitness could contribute to the physical component of HRQoL. In terms of the mental component of HRQoL, higher levels of physical fitness may be needed to gain higher levels of HRQoL among young males.
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http://dx.doi.org/10.1186/s12889-020-08969-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7268218PMC
June 2020

Global injury morbidity and mortality from 1990 to 2017: results from the Global Burden of Disease Study 2017.

Inj Prev 2020 10 24;26(Supp 1):i96-i114. Epub 2020 Apr 24.

Faculty of Health Sciences - Health Management and Policy, American University of Beirut, Beirut, Lebanon.

Background: Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries.

Methods: We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs).

Findings: In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505).

Interpretation: Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.
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http://dx.doi.org/10.1136/injuryprev-2019-043494DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7571366PMC
October 2020

There Is No Relationship Between Lower Extremity Alignment During Unilateral and Bilateral Drop Jumps and the Risk of Knee or Ankle Injury: A Prospective Study.

J Orthop Sports Phys Ther 2020 May 9;50(5):267-274. Epub 2020 Apr 9.

Objective: To investigate the association between lower extremity alignment during unilateral and bilateral drop jump tests and the risk of acute noncontact knee or ankle injuries in young team sport athletes.

Design: Prospective cohort study.

Methods: A 2-dimensional video analysis was used to measure the frontal plane knee projection angle in the single-leg vertical drop jump (VDJ) and the bilateral VDJ in young team sport athletes. Out of the 364 athletes (187 male, 177 female), 189 played basketball and 175 played floorball.

Results: Six male athletes sustained knee injuries and 23 sustained ankle injuries. Frontal plane knee projection angle in the single-leg VDJ or the bilateral VDJ was not associated with ankle injuries among male athletes. No statistical analysis was performed for the knee injuries. Among female athletes, 28 sustained knee and 41 sustained ankle injuries. Frontal plane knee projection angle during the single-leg VDJ or the bilateral VDJ was not a risk factor for knee or ankle injuries.

Conclusion: Lower extremity alignment during unilateral and bilateral drop jump tests was not associated with future noncontact knee or ankle injuries among young team sport athletes. The findings should be interpreted cautiously due to the small number of injuries. .
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http://dx.doi.org/10.2519/jospt.2020.9247DOI Listing
May 2020

Global, Regional, and National Burden of Calcific Aortic Valve and Degenerative Mitral Valve Diseases, 1990-2017.

Circulation 2020 05 29;141(21):1670-1680. Epub 2020 Mar 29.

Institute of Family Medicine and Public Health, University of Tartu, Tartumaa, Estonia (M.J.).

Background: Nonrheumatic valvular diseases are common; however, no studies have estimated their global or national burden. As part of the Global Burden of Disease Study 2017, mortality, prevalence, and disability-adjusted life-years (DALYs) for calcific aortic valve disease (CAVD), degenerative mitral valve disease, and other nonrheumatic valvular diseases were estimated for 195 countries and territories from 1990 to 2017.

Methods: Vital registration data, epidemiologic survey data, and administrative hospital data were used to estimate disease burden using the Global Burden of Disease Study modeling framework, which ensures comparability across locations. Geospatial statistical methods were used to estimate disease for all countries, because data on nonrheumatic valvular diseases are extremely limited for some regions of the world, such as Sub-Saharan Africa and South Asia. Results accounted for estimated level of disease severity as well as the estimated availability of valve repair or replacement procedures. DALYs and other measures of health-related burden were generated for both sexes and each 5-year age group, location, and year from 1990 to 2017.

Results: Globally, CAVD and degenerative mitral valve disease caused 102 700 (95% uncertainty interval [UI], 82 700-107 900) and 35 700 (95% UI, 30 500-42 500) deaths, and 12.6 million (95% UI, 11.4 million-13.8 million) and 18.1 million (95% UI, 17.6 million-18.6 million) prevalent cases existed in 2017, respectively. A total of 2.5 million (95% UI, 2.3 million-2.8 million) DALYs were estimated as caused by nonrheumatic valvular diseases globally, representing 0.10% (95% UI, 0.09%-0.11%) of total lost health from all diseases in 2017. The number of DALYs increased for CAVD and degenerative mitral valve disease between 1990 and 2017 by 101% (95% UI, 79%-117%) and 35% (95% UI, 23%-47%), respectively. There is significant geographic variation in the prevalence, mortality rate, and overall burden of these diseases, with highest age-standardized DALY rates of CAVD estimated for high-income countries.

Conclusions: These global and national estimates demonstrate that CAVD and degenerative mitral valve disease are important causes of disease burden among older adults. Efforts to clarify modifiable risk factors and improve access to valve interventions are necessary if progress is to be made toward reducing, and eventually eliminating, the burden of these highly treatable diseases.
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http://dx.doi.org/10.1161/CIRCULATIONAHA.119.043391DOI Listing
May 2020
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