Predictive Validity of the Single Leg Hamstring Bridge Test in Military Settings

The hamstrings are biarticular muscle group that plays an important role in the occupational performance of military personnel. The single leg hamstring bridge test (SLHBT) could be a good test to screen military personnel performance. The aims of our study were to assess the reproducibility of the SLHBT in the military population and to use receiver operating curve (ROC) analysis to examine the ability of the SLHBT to discriminate between soldiers with poor and good baseline fitness. A cross-sectional study was performed on 201 male members of the Slovenian Armed Forces (SAF). They undertook army physical fitness testing (APFT) and functional physical fitness testing (FPFT), which included the SLHBT. The SLHBT showed acceptable reproducibility in a military setting and had moderate predictive validity to discriminate between soldiers with poor and good overall physical fitness performance using a cut-off value of 20 repetitions. In conclusion, the SLHBT could be a good candidate test for the military population as the ROC analysis showed the ability of the SLHBT to discriminate between soldiers with poor and good baseline fitness. The SLHBT represents a simple and affordable test that can be used to evaluate performance and form preventive guidelines for military personnel.

Physical fitness changes among amateur soccer players: effects of the pre-season period

Study aim: To assess changes in physical fitness of amateur soccer players after a pre-season training period and baseline fitness dependencies. Material and methods: Twenty-one amateur soccer players were assessed during the pre-season. The following physical variables were assessed before and after a two-month pre-season training period: (i) cardiorespiratory fitness, (ii) strength and power, and (iii) change of direction (COD). Results: Significant decreases were found for countermovement jump (CMJ) (p < 0.001; d = 1.161), drop jump (DJ) (p = 0.014; d = 0.958), and horizontal jump (HJ) (p = 0.042; d = 0.640), while no significant changes were found for the overall variables from the beginning to the end of pre-season. Fit players revealed significant decreases for CMJ (p = 0.002; d = –2.495), DJ (p = 0.004; d = –1.760), HJ (p = 0.028; d = –1.005), COD deficit (p = 0.034; d = 1.013), and maximal aerobic speed (MAS) (p = 0.026; d = –4.053). No significant changes were found for unfit players. Conclusions: Amateur soccer coaches should consider assessing physical qualities at the beginning of pre-season and use the free-of-charge monitoring tools such as session-rate of perceived exertion (s-RPE) during the training process.

Convergent validity and reliability of a novel repeated agility protocol in junior rugby league players

Background: Rugby league involves repeated, complex, change-of-direction movements, although there are no test protocols that specifically assesses these physical fitness profiles. Thus, the current study examined the convergent validity and reliability of a repeated Illinois Agility (RIA) protocol in adolescent Rugby League players. Methods: Twenty-two junior Rugby League players completed 4 sessions with each separated by 7 days. Initially, physical fitness characteristics at baseline (i.e., multi-stage fitness, countermovement jump, 30-m sprint, single-effort agility and repeated sprint ability [RSA]) were assessed. The second session involved a familiarisation of RIA and repeated T-agility test (RTT) protocols. During the third and fourth sessions, participants completed the RIA and RTT protocols in a randomised, counterbalanced design to examine the validity and test-retest reliability of these protocols. Results: For convergent validity, significant correlations were identified between RIA and RTT performances (r= >0.80; p<0.05). For contributors to RIA performance, significant correlations were identified between all baseline fitness characteristics and RIA (r = >0.71; p < 0.05). Reliability of the RIA protocol was near perfect with excellent intra-class correlation coefficient (0.87-0.97), good ratio limits of agreement (×/÷ 1.05-1.06) and low coefficient of variations (1.77-1.97%). Conclusions: The current study has demonstrated the RIA to be a simple, valid and reliable field test that can provide coaches with information about their athlete’s ability to sustain high intensity, multi-directional running efforts.

Regular strength training and baseline fitness in overweight infantry members of Slovenian Armed Forces

IntroductionThe prevalence of overweight subjects in military cohorts increases despite the obligatory army physical fitness test (APFT) requirements and the negative consequences of possible test failure due to the increased body mass index (BMI). Studies that have examined the association of BMI with baseline fitness in the military are showing conflicting evidence. The primary aim of the study is to examine BMI effects on baseline fitness that was measured by APFT and additional functional performance tests (FT) (vertical countermovement jump with and without load, loaded prone plank, single-leg hamstring bridge test and pull-ups). Our secondary goal is to explore if regular strength training modifies the BMI effect on baseline fitness.MethodsA cross-sectional study on a sample of 118 male infantry soldiers that have performed APFT and FT was carried out. Body mass and body height measurements were used to calculate BMI, and to categorise participants into BMI ranks. Two independent categorical variables (BMI rank and strength training) were used to evaluate their influence on dependent variables of physical performance acquired from APFT and FT.ResultsA significantly large size effect of BMI rank (F=1.69, p=0.037; effect size (ES)=0.15) and regular strength training (F=2.66, p=0.006; ES=0.21) on physical performance was found. It was shown that strength training had a medium ES on push-up and pull-up performance, as well as on the overall APFT score and loaded plank.ConclusionsThe importance of regular strength training and normal BMI for better overall baseline fitness in infantry members was highlighted. Most importantly, it was shown that performance is not affected in overweight soldiers who are performing regular strength training in addition to their daily physical training.Trial registration numberNCT03415464

SAT-575 Association Between Baseline Fitness and Changes in Physical Activity and Weight Loss in an 18-Month Behavioral Weight Loss Program

BACKGROUND: Baseline cardiovascular fitness may be a significant predictor of future success in a comprehensive behavioral weight loss program (BWLP). Yet, few studies have examined the association between baseline fitness and future weight loss. PURPOSE: To determine the association between baseline fitness and changes in body weight and device-measured levels of moderate-to-vigorous physical activity (MVPA) during a BWLP. METHODS: Adults (n=85) were enrolled in an 18-month BWLP combining a calorie-restricted diet, group-based behavioral support, and 6 months of supervised exercise (progressing to 300 min/wk of moderate-intensity) followed by 12 months of unsupervised exercise. Data from 60 completers (age 41.0±9.5 years, BMI 34.6±4.2 kg/m2, 80% female) were used in this analysis. MVPA was measured over 1 week with the Sensewear Armband at months 0, 6, 12, and 18. Fitness (VO2max) was measured on a treadmill using indirect calorimetry and categorized based on published age and sex norms (Physical Fitness Specialist Certification Manual, 1997). A linear mixed effects model with unstructured covariance was used to examine the association between baseline fitness category and changes in body weight, total MVPA, and MVPA in bouts ≥10 min at the four time points. RESULTS: Of the 60 completers, 33% (n=20) were classified as having very poor fitness, 45% (n=27) poor, 18% (n=11) fair, 3% (n=2) good, and 0% (n=0) excellent or superior. Due to the low proportion of participants categorized as having fair or better fitness, we created a binary fitness variable (very poor vs. poor or better). Baseline BMI was higher in those in the very poor category compared to those in the poor or better category (36.2±4.2 vs 33.7±4.0, p=0.03). There were no significant differences between the two fitness categories in weight change at 6 or 12 months. However, at 18 months, mean weight loss was 4.3±1.7 kg in those in the very poor category and 8.2±1.2 kg in those in the poor or better category, with a marginally significant between-group difference (p=0.07). There were no differences in changes in total or bout MVPA. However, those with very poor fitness had lower bout MVPA at baseline vs. those with poor or better fitness (16±20 vs 33±31 min/d, p=0.03). At 18 months, both groups increased bout MVPA, however bout MVPA remained lower in the very poor vs. poor or better group (24±29 vs 42±29 min/d, p=0.03). Total MVPA showed a similar pattern. CONCLUSION: Baseline fitness may moderate 18-month weight loss, as those with very poor fitness lost less weight compared to those with poor or better fitness levels. Those with poor or better fitness at baseline achieved significantly higher mean levels of MVPA at 18 months compared to those with very poor fitness. Participants with very poor fitness at baseline may require additional exercise support during a BWLP to achieve the high levels of MVPA recommended for weight loss maintenance.

Optimizing chemotherapy for frail and elderly patients (pts) with advanced gastroesophageal cancer (aGOAC): The GO2 phase III trial.

4006 Background: Many pts with aGOAC are elderly and/or frail. We previously compared epirubin/ oxaliplatin/ capecitabine (EOCap) vs OCap vs Cap in a pick-the-winner study and found OCap best. GO2 was designed to find the optimum dose of OCap and to explore the use of an objective baseline geriatric assessment to individualize doses for maximum Overall Treatment Utility (OTU), a composite of clinical benefit, tolerability, QL and patient value. Methods: Pts with aGOAC were eligible if unsuitable for full-dose EOCap due to age or frailty, but fit for OCap; GFR ≥ 30, bili <2x ULN. Baseline assessment included global QL; symptoms; functional scales; comorbidity; frailty. Randomization was 1:1:1 to dose Level A (Ox 130 mg/m2d1, Cap 625 mg/m2bd d1-21, q21d), B (80% Level A doses) or C (60% Level A doses). Pts with GFR 30-50 ml/min or bili 1.5-2.0 xULN received 75% of the allocated dose of Cap. At 9 wks, pts were scored for OTU. Continuation thereafter was based on clinical judgement. Non-inferiority (vs A) was assessed using PFS censored at 12 months, with boundary HR 1.34 (based on discussion with pts and clinicians), needing 284 PFS events per 2-way comparison. Baseline fitness was assessed as predictive of OTU, overall and by interaction with dose level. Results: 514 pts were randomised, 2014-17, at 61 UK centres. Clinical trial information: 44687907. Non-inferiority of PFS is confirmed for Level B vs A (HR 1.09, CI 0.89-1.32) and for Level C vs A (HR 1.10, CI 0.90-1.33). Level C pts had less toxicity and better OTU outcomes than A or B. When analysed by baseline age, frailty and PS, Level C produced the best OTU even in younger, less frail and better PS patients; no group was identified who benefit more from the higher dose levels. Conclusions: This is the largest RCT to date specifically investigating frail and/or elderly aGOAC pts, and should guide future treatment. The lowest dose tested was non-inferior in terms of PFS and produced less toxicity and better overall treatment utility.[Table: see text]

Variability in Individual Response to Aerobic Exercise Interventions Among Older Adults

Although a plethora of evidence supports the benefits of exercise among older adults, a majority of studies have emphasized group differences, while giving little, if any, attention to individual differences. Given the lack of data on variability in response, the present review examined how nonresponse to aerobic exercise has been defined in older adult populations and characteristics associated with nonresponse among older adults. The results of this review suggest that interindividual variability in response of maximal oxygen consumption to aerobic exercise interventions is prevalent among older adults (1.4–63.4%); age, sex, race, and body mass index may not be critical determinants of nonresponse; whereas health status, baseline fitness, and exercise dose appear important. Future intervention studies should evaluate and report the variability in individual response of older adults to exercise; investigators should develop programs that allow for modification of components to assist older adults in achieving optimal benefit from exercise programs.