Functional tests are commonly used for chronic kidney disease (CKD) patients undergoing hemodialysis (HD). However, the relative and absolute reliability of such physical performance-outcome assessments must first be determined in specific patient cohorts. The aims of this study were to assess the relative and the absolute reliability of the Short Physical Performance Battery (SPPB), One-Legged Stance Test (OLST), and Timed Up and Go (TUG) test, as well as the minimal detectable change (MDC) scores for these tests in CKD patients receiving HD. Seventy-one end-stage CKD patients receiving HD therapy, aged between 21 and 90 years, participated in the study. The patients completed two testing sessions one to two weeks apart and performed by the same examiner, comprising the following tests: the SPPB (n = 65), OLST (n = 62), and TUG test (n = 66). High intraclass correlation coefficients (≥0.90) were found for all the tests, suggesting that their relative reliability is excellent. The MDC scores for the 90% confidence intervals were as follows: 1.7 points for the SPPB, 11.3 seconds for the OLST, and 2.9 seconds for the TUG test. The reliability of the SPPB, OLST, and TUG test for this sample were all considered to be acceptable. The MDC data generated by these tests can be used to monitor meaningful changes in the functional capacity of the daily living-related activity of CKD patients on HD.

Objective: The main objective of this investigation was to assess feasibility of conducting a future RCT with an intradialysis non‐immersive virtual reality exercise intervention. The secondary aim was to explore the impact of either conventional or VR exercise on physical function.Design: Feasibility randomized trial.Participants: Eighteen subjects who participated in a 16‐week intradialysis combined exercise program.Interventions: The program lasted four additional weeks of either combined exercise or virtual reality exercise.Main outcome measures: Physical function was measured through several reliable tests (sit‐to‐stand‐to‐sit tests 10 and 60, gait speed, one‐leg heel‐rise tests, and 6‐minute walk test) at baseline, after 16 weeks of intradialysis combined exercise and by the end of four additional weeks of exercise. Adherence to the exercise programs was registered.Results: There was a significant time effect, so that physical function improved in both groups. By the end of the 20 weeks, function improved as measured through the sit‐to‐stand‐to‐sit tests 10 and 60, gait speed, one‐leg heel‐rise left leg, and the 6‐minute walk test. Changes that did not occur due to error in the test were seen after 20 weeks were achieved in the sit‐to‐stand‐to‐sit test 60, gait speed, one‐leg heel‐rise test for the left leg, and 6‐minute walking test.Conclusion: Virtual reality was a feasible intervention. Both interventions improved physical function. Adherence was not significantly different between groups.

The aim of this study was to compare the effect of a hospital clinic group- versus home-based combined exercise-diet program for the treatment of childhood obesity. One hundred ten overweight/obese Spanish children and adolescents (6-16 years) in 2 intervention groups (hospital clinic group-based [n = 45] and home-based [n = 41]) and a sex-age-matched control group (n = 24) were randomly assigned to participate in a 6-month combined exercise (aerobic and resistance training) and Mediterranean diet program. Anthropometric values (including body weight, height, body mass index, BMI-Z score, and waist circumference) were measured pre- and postintervention for all the participants. Percentage body fat was also determined with a body fat analyzer (TANITA TBF-410 M). Our study showed a significant reduction in percentage body fat and body mass index Z-score among both intervention-group participants (4%, 0.16, hospital clinic group-based; 4.4%, 0.23, home-based; P < .0001). There was also a significant reduction in waist circumference in the home-based group (4.4 cm; P = .019). Attendance rates at intervention sessions were equivalent for both intervention groups (P = .805). The study findings indicate that a simple home-based combined exercise and Mediterranean diet program may be effective among overweight and obese children and adolescents, because it improves body composition, is feasible and can be adopted on a large scale without substantial expenses.

Background: The running segment of a triathlon produces 70% of the lower limb injuries. Previous research has shown a clear association between kinematic patterns and specific injuries during running. Methods: After completing a seven-month gait retraining program, a questionnaire was used to assess 19 triathletes for the incidence of injuries. They were also biomechanically analyzed at the beginning and end of the program while running at a speed of 90% of their maximum aerobic speed (MAS) using surface sensor dynamic electromyography and kinematic analysis. We used classification tree (random forest) techniques from the field of artificial intelligence to identify linear and non-linear relationships between different biomechanical patterns and injuries to identify which styles best prevent injuries. Results: Fewer injuries occurred after completing the program, with athletes showing less pelvic fall and greater activation in gluteus medius during the first phase of the float phase, with increased trunk extension, knee flexion, and decreased ankle dorsiflexion during the initial contact with the ground. Conclusions: The triathletes who had suffered the most injuries ran with increased pelvic drop and less activation in gluteus medius during the first phase of the float phase. Contralateral pelvic drop seems to be an important variable in the incidence of injuries in young triathletes.

Triathlon has become increasingly popular in recent years. In this discipline, maximum oxygen consumption (VO₂max) is considered the gold standard for determining competition cardiovascular capacity. However, the emergence of wearable sensors (as Stryd) has drastically changed training and races, allowing for the more precise evaluation of athletes and study of many more potential determining variables. Thus, in order to discover factors associated with improved running efficiency, we studied which variables are correlated with increased speed. We then developed a methodology to identify associated running patterns that could allow each individual athlete to improve their performance. To achieve this, we developed a correlation matrix, implemented regression models, and created a heat map using hierarchical cluster analysis. This highlighted relationships between running patterns in groups of young triathlon athletes and several different variables. Among the most important conclusions, we found that high VO₂max did not seem to be significantly correlated with faster speed. However, faster individuals did have higher power per kg, horizontal power, stride length, and running effectiveness, and lower ground contact time and form power ratio. VO₂max appeared to strongly correlate with power per kg and this seemed to indicate that to run faster, athletes must also correctly manage their power.