Despite progress made in recent decades, gender bias is still present in scientific publication authorship. The underrepresentation of women and overrepresentation of men has already been reported in the medical fields but little is known in the fields of exercise sciences and rehabilitation. This study examines trends in authorship by gender in this field in the last 5 years. All randomized controlled trials published in indexed journals from April 2017 to March 2022 through the widely inclusive Medline dataset using the MeSH term “exercise therapy” were collected, and the gender of the first and last authors was identified through names, pronouns and photographs. Year of publication, country of affiliation of the first author, and ranking of the journal were also collected. A chi-squared test for trends and logistic regression models were performed to analyze the odds of a woman being a first or last author. The analysis was performed on a total of 5259 articles. Overall, 47% had a woman as the first author and 33% had a woman as the last author, with a similar trend over five years. The trend in women’s authorship varied by geographical area, with the higher representation of women authors in Oceania (first: 53.1%; last: 38.8%), North-Central America (first: 45.3%; last: 37.2%), and Europe (first: 47.2%; last: 33.3%). The logistic regression models (p < 0.001) indicated that women have lower odds of being authors in prominent authorship positions in higher-ranked journals. In conclusion, over the last five years, in the field of exercise and rehabilitation research, women and men are almost equally represented as first authors, in contrast with other medical areas. However, gender bias, unfavoring women, still exists, especially in the last authorship position, regardless of geographical area and journal ranking.

Background/Objectives: We aimed to test whether home-based low-intensity interval training (LIIT) could be equally or more effective than traditional continuous walking advice (TWA) in a population hospitalized and healed from severe COVID-19. Methods: This pragmatic nonrandomized controlled trial (NCT04615390) enrolled patients admitted to intensive care units due to COVID-19 who at discharge from the hospital were given a choice between either a home-based LIIT program or TWA. The former received a structured LIIT walking (1:1 walk:rest ratio per 10 times) to be performed at a prescribed progressively increasing speed maintained with a metronome. The latter received TWA according to the guidelines (30 min or moderate intensity activity, 5 days/week). Outcome measures, collected at baseline, at the end of the 3-month training and at the 6-month follow-up, included 6 min walking distance (primary), lower limb strength, quality of life, depression and cognitive status. Results: From a total of 85 enrolled patients, 69 of them (LIIT n = 32; TWA n = 37) completed the study. Home exercise was safely executed with an 82% adherence for the LIIT group and 64% adherence for TWA. After the 3-month program, both groups significantly improved the 6MWD (LIIT: +87 m vs. TWA +42 m; p < 0.001) with a significant difference that was also maintained at follow-up (LIIT: +138 m vs. TWA +69 m; p < 0.001). No other significant between-group differences were noted. However, patients in the LIIT group significantly improved in the majority of the outcomes, while patients of TWA improved in only the primary outcome and the physical component of quality of life. Conclusions: Compared with TWA, LIIT walking was feasible, safe and associated with more favorable multidimensional recovery in COVID-19 survivors after hospitalization for severe pneumonitis.

Exercise is a recognized tool to improve or maintain physical functioning and quality of life in chronic diseases, particularly in the presence of disability. Patients affected with vascular and neurological motor disabilities, such as people with multiple sclerosis (PwMS) or peripheral arterial disease (PAD), are daily limited by fatigue. This symptom, which can occur in a variety of forms, could interfere with exercise execution and the rate of adherence to rehabilitative programs. The early detection of objective biomarkers of peripheral fatigue and their integration into specific training programs could increase the long-term engagement of these patients in exercise. In this light, the study aims to analyze the association between muscle oxygenation, cardiovascular response and perceived exertion during a treadmill incremental walking test in healthy and chronically ill subjects. After eligibility assessment, a total of 53 subjects were divided into three subgroups: 17 patients diagnosed with PAD (mean age: 71 $\pm 9$ years), 26 with MS (mean age: $45\pm 12$ years), and 10 healthy subjects (mean age: 23 $\pm 1$ years). Parameters of muscle metabolism at the gastrocnemius were collected by near-infrared spectroscopy (NIRS) during an incremental treadmill test and quantified as area-under curve for oxygenated $(\mathrm{O}_{2}\text{Hb}_{\text{AUC}})$ and deoxygenated $(\text{HHb}_{\text{AUC}})$ hemoglobin traces. Heart rate values during the test and the rate of perceived exertion by the Borg scale 0–10 were also collected. $\mathrm{O}_{2}\text{Hb}_{\text{AUC}}$ was significantly lower in the PAD group with an opposite trend for $\text{HHb}_{\text{AUC}}$ , whereas MS subjects showed heterogeneous trends in both $\mathrm{O}_{2}\text{HHb}_{\text{AUC}}$ and $\text{HHb}_{\text{AUC}}$ , suggesting a different but abnormal pattern associated with the perception of peripheral fatigue in the two diseases. Significant and negative correlations were indeed observed between changes in $\mathrm{O}_{2}\text{Hb}$ , heart rate and perceived exertion in the whole population. At this stage of the research, the dynamic and objective measurement of oxygenation in the fatiguing muscle enabled the discrimination of different abnormal responses to exercise in different diseases and among subjects. These results in a second phase of the study will be analyzed with the purpose of identifying early objective markers of fatigue that could possibly be integrated into semiautomatic technology-assisted ergo meters to personalize training programs.

Background/Objectives: This multicenter nonrandomized pragmatic trial (NCT04282616), offering different options for active support by an exercise facilitator (EF) in the dialysis unit, aims to explore the attitudes and preferences of end-stage kidney disease (ESKD) patients in relation to their characteristics, capabilities and barriers. Methods: In six European dialysis units, an EF was set to offer to each ESKD patient able to walk four simple low-cost three-month interventions: (i) advised physical activity increase (U-PA-I); (ii) structured home-based walking exercise (S-HB-LI); (iii) in-hospital (pre/postdialysis) supervised walking and resistance low-intensity training (S-SU-LI); and (iv) performance assessment only (PPA). After collecting attitudes and perceptions of patients, the EF was available for counseling about the choice. Outcome measures were the percentage of engaged patients among the total population, the percentage of active interventions versus PPA and their distribution among the available options, as well as the factors related to patients’ choices (anthropometry, clinical, exercise capacity, and others). Results: Of the 297 eligible patients, 221 met the inclusion criteria, 176 (59%) of whom chose to participate (males, n = 113; aged 68 ± 10 years). The patients’ choices were as follows: S-SU-LI, (n = 80), S-HB-LI (n = 66), PPA (n = 25) and U-PA-I (n = 5). Patients in the LI group were significantly older (p < 0.001) and had a lower exercise capacity, as measured by the 6 min walking distance (p < 0.001). No significant differences in sex, distance from the dialysis center, dialysis duration, or recruiting site were recorded. The main reasons for nonparticipation were not being interested (67%) or already active (22%). Conclusions: In this exploratory research, patients exhibited positive attitudes toward exercise training and abandoning a sedentary lifestyle when counseled by an EF and when offered the possibility to choose. As the patient profile becomes more comorbid and frail, supervised and/or lower-intensity programs are preferred.