Breast cancer and its treatments cause physical and physiological side effects that exercise can mitigate. However, there is little evidence on the effects and feasibility of high-intensity remote supervised training. In addition, there is no evidence of the effect of individualizing intensity prescription based on autonomic control in this population. Thus, this study aimed to compare the effects of two concurrent online exercise programs, pre-planned intensity prescription (PPI) and intensity prescription guided by autonomic control (HRV) on cardiorespiratory fitness (VO2peak), parasympathetic autonomic control, and maximum strength. Secondly, it examined programs’ compliance. This 16-week randomized controlled trial involved 54 breast cancer survivors, divided into three equal groups: PPI, HRV, and a control group. PPI and HRV participants trained remotely three times per week under real-time supervision. Both training designs included progressively increased aerobic interval and strength exercises with intensity in the HRV group based on the daily root mean square of successive differences between normal heartbeats (rMSSD). Other measurements included cardiorespiratory fitness (VO2peak), lower and upper body 1RM maximum strength, and training load. The intervention showed significant differences between groups in exercise dose (p < 0.001) and within-group intensity progression (p < 0.001). The effects showed significant interactions in VO2peak (32.94

BACKGROUND:Investment in recreational physical activity and sports participation (PAS) needs to be justified. The Social Return on Investment (SROI) is a framework that aims to quantify social value, but there is no standard on how to apply it to the PAS sector. This study uses the Delphi method to reach international consensus on (1) the definition of social value of PAS, (2) the social outcomes that should be measured, and (3) the tools to measure and value them. METHODS:The preparing phase included a systematic review, initial interviews, and 2 creative workshops. During the conducting phase, a pilot was followed by 3 iterative rounds of communication with experts. Participants indicated their level of agreement with different statements. Consensus was reached if ≥70% of the panel agreed or disagreed. Small expert meetings were used as an additional step. RESULTS:Fifty-nine experts completed the first round and consensus was reached in all statements. There was 100% of agreement that Health, Education, Subjective Well-being, and Social Capital should be outcomes of a Social Return on Investment model of PAS and 85.7% for Crime. However, the results from the small expert meetings led to the removal of Social Capital and Crime from the final model. Stability of consensus (≤10% variability) was reached. CONCLUSIONS:This study provides the initial phase for a standardized international PAS Social Return on Investment model to guide policymakers, industry, and any stakeholder interested in the evaluation of the social value generated by their activity.

IntroductionActive behavior performed in leisure centers might help reduce the negative health impacts associated with physical inactivity. The disability-adjusted life years (DALYs) is a valuation technique to quantify lifetime disease burden including both non-fatal health consequences of diseases and premature death.MethodThis study estimated the role of the largest leisure center in Spain (GO fit) in averting the burden of five diseases and premature deaths during 2017 as a consequence of the physical activity and exercise programs and services delivered. A preferred model was implemented with a static picture of the burden of disease, without including discounting rate and age-weights. Sensitivity analyses were conducted considering these two variables.ResultsThe estimation was that GO fit services could have averted a total of 1,165.74 DALYs (10.96 DALYs per 1,000 members) coming from type 2 diabetes (22.62 DALYs), colorectal cancer (81.16 DALYs), breast cancer (48.72 DALYs), stroke (206.15 DALYs), and coronary heart disease (807.10 DALYs).DiscussionThese results indicate that programs and services delivered in physical activity leisure centers could help the public health agenda aim of promoting a more active lifestyle and reducing the burden of disease associated with physical inactivity.

BACKGROUND:Exercise has been shown to improve mental well-being and health-related quality of life (HRQoL) in breast cancer survivors. However, there is no evidence on the effects of online interventions tailored using heart rate variability (HRV). AIMS:This study analyzed the effects of online high-intensity interval and strength training, guided daily by autonomic modulation, compared to pre-planned moderate to high-intensity concurrent training and control, on HRQoL, pain, fatigue, anxiety, depression, life satisfaction, self-esteem, and fear of movement in breast cancer survivors. METHODS:A 16-week randomized controlled trial was conducted with 54 participants assigned to HRV-guided exercise, pre-planned exercise, or usual care. Participants trained aerobic and strength three times per week under real-time online supervision. Intensity was adjusted based on HRV for the HRV-guided group. HRQoL, anxiety, depression, life satisfaction, self-esteem and fear of movement were assessed pre- and post-intervention. RESULTS:Significant time-by-group interactions were found for HRQoL functional domains (physical p = 0.004, role p = 0.005, emotional p = 0.013, social p = 0.001) and symptoms (fatigue p < 0.001, pain p < 0.001, dyspnea p = 0.004, insomnia p = 0.012, constipation p = 0.014), as well as depression (p < 0.001), anxiety (p = 0.002), life satisfaction (p = 0.003), self-esteem (p = 0.024), and fear of movement (p = 0.015). HRV-guided exercise led to greater improvements, while the control group worsened. Moreover, the exploratory analysis suggested a higher degree of interconnected changes in the HRV-guided group, and that dyspnea and fatigue might be the variables most strongly connected with anxiety, depression, and functioning-related variables. CONCLUSION:Individualized online concurrent exercise, especially autonomic modulation-guided, improves HRQoL and mental health in breast cancer survivors, representing a promising personalized rehabilitation strategy.

BACKGROUND:Sports and physical activity are important contributors to the development of nations. International calls advocate for the creation of a system of indicators to measure the impact of physical activity and sports on the sustainable development of regions. METHODS:Twelve indicators of Sports and Development for the Ibero-American region were developed by a consortium comprised by the Ibero-American Sports Council, the United Nations Educational, Scientific and Cultural Organization, and the German Agency for International Cooperation. In Bogota, this set of indicators was implemented and informed with survey data, policy documents, and administrative data at the city level. RESULTS:Nine of the 12 indicators were informed based on the most recent available information, reaching 75% implementation. All the indicators corresponding to the economy, health, and peace and social cohesion dimensions were informed. The indicators with missing information were related to education, gender equality, and inclusion. CONCLUSIONS:The pilot implementation of the Ibero-American indicators for Sport and Development in Bogota suggests that physical activity and sport actions and investments are a priority for the district government and can contribute to sustainable development. Our results provide a baseline that should be followed up to monitor and evaluate the efforts that the city is implementing to promote active living and sustainable development.

ABSTRACT There is growing demand from policy makers and practitioners to understand and measure the social impact of physical activity and sport (PAS) driven by the needs to justify investments from funders, improve decision-making of PAS managers, and produce robust and defensible evidence to underpin international and national PAS policy. Social return on investment (SROI) has emerged as a credible framework for measuring the non-financial impact of PAS; however, there is a lack of agreement about what and how social outcomes should be measured and valued. This article presents a research project that aims to address this gap through a systematic review and three-round Delphi study. The review identified five domains of social impact, and the Delphi study achieved consensus across 29 statements relating to health, education, crime, social capital, and well-being. The next stage of the project is to establish the most appropriate valuation techniques for capturing the monetary value of social outcomes from PAS across the domains. When complete, this research should encourage a more standardized approach to social impact measurement, which will help PAS stakeholders to articulate the social value of the sector more consistently.

BACKGROUND:The Social Return on Investment (SROI) model has been applied to physical activity and sports (PAS) inconsistently in the past. In order to demonstrate that PAS creates social value for society, consistent, scientific-based tools must be developed. METHODS:In 2022, a group of interdisciplinary researchers started a project to standardize the application of SROI to global PAS activities. A Delphi study, informed by a systematic review on this topic, was used and the present commentary exposes the main conclusions. RESULTS:Six main lessons can be drawn from the process of building a global SROI applied to PAS: the methodology to measure the impact of PAS at the population level is different from the methodology applied to specific interventions; there is consensus on the impact in health; there is knowledge, but also unanswered questions on the impact of PAS in education; the impact of PAS in population well-being as a promising area; the of impact on crime and social capital requires more research; and there is controversy in the relationship between PAS, and environment, and climate change. CONCLUSIONS:A global SROI applied to PAS is a powerful tool to demonstrate how an active population can bring value to society. For this purpose, researchers and policymakers are called to action to fill in the gaps that remain open in order to build a robust model.

BackgroundIn recognition of the potential contributions of sports and physical activity to national development and responding to international calls from organizations like UNESCO and the World Health Organization, a coalition of agencies and Ibero-American sports ministers endorsed the creation of an indicator set to assess the impact of sports participation and physical activity on sustainable development.MethodsThe Ibero-American Sports Council, UNESCO, and the German Agency for International Cooperation developed a set of twelve Sports and Development indicators and four key data points for the Ibero-American region. In 2024, the first national-level pilot implementation was completed in Chile, Costa Rica, and Ecuador, collecting data using specifically designed formulae.ResultsEach country was able to partially provide relevant data for the defined indicators, with Chile completing eight, Costa Rica four, and Ecuador seven indicators. All countries provided data for the key data points.ConclusionsThe first national pilot implementation of the proposed indicators—as part of its validation process—highlights the need for improved quality and accessibility of reliable data across the Ibero-American region. These indicators have the potential to assess, track, and compare policies related to physical activity and sports, and to identify challenges and opportunities for improvement.

Background : Leisure-time physical activity is the preferred domain by the population to follow physical activity recommendations, helping to maintain a healthy lifestyle. However, the main issue in this type of physical activity intervention is massive dropout. Methods : Using monthly data from 20,908 leisure/fitness center members (2011–2016), we estimate a discrete-time duration model to examine how membership duration influences dropout probability, addressing cross-sectional limitations. Additionally, we assess the explanatory power of different covariate groups. Results : Dropout probability follows a seasonal pattern, peaking within the first 3 months before declining and stabilizing over time. Short-term memberships and low attendance frequency significantly increase dropout risk, confirming that membership conditions and time-related variables are key predictors of retention. Additionally, macroeconomic factors particularly unemployment play a crucial role in increasing dropout probability. Conclusions : These results could help both recreational facility managers and policymakers to design strategies to reduce dropout among physical activity practitioners, in particular, in the current situation generated by the COVID-19 crisis.

BackgroundPhysical activity and sport (PAS) have been related to many health outcomes and social benefits. The main aim of this research is to build a Social Return on Investment (SROI) model of PAS based on experts’ opinion to clarify the domains of impact and how to measure and value them.Methods and analysisA Delphi method will be employed with a systematic review on the SROI framework applied to PAS and initial interviews with experts informing the design of the Delphi survey statements. Three iterative rounds of communication with the expert panel will be carried out. Participants will indicate their level of agreement with each statement on a five-point Likert scale. During the second and third iterative rounds, experts will reappraise the statements and will be provided with a summary of the group responses from the panel. A statement will have reached consensus if ≥70% of the panel agree/strongly agree or disagree/strongly disagree after round 3. Finally, group meetings (3–4 experts) will be conducted to ask about the measurement and valuation methods for each domain.DiscussionThe final goal of this project will result in the design of a toolkit for organizations, professionals, and policymakers on how to measure the social benefits of PAS.

BACKGROUND:Physical activity and sport (PAS) have been related to health and social benefits, but their monetary value remains unclear. This systematic review on the social return on investment of PAS aimed to find what are the social outcomes measured in previous PAS literature and how are these measured and valued. METHODS:A systematic search was conducted on WoS, PubMed, and EconLit. Articles in English, measuring the social value of any type of PAS in monetary terms and utilizing a social return on investment framework, were included. Risk of bias was evaluated using the Drummond checklist. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. RESULTS:Fifty-five documents (2010-2022), from all continents except America, were included; only 8 were published in peer-reviewed journals, whereas 47 were reports. Most studies evaluated the benefits of specific programs, and 6 measured the engagement in PAS at the population level based on national or community surveys. The social outcomes identified were health (94.5%), crime (50.9%), education (83.6%), subjective well-being (89.1%), social capital (60%), and other (3.6%-23.6%). The valuation methods included willingness to pay, well-being valuation, the cost of an activity that could result in the same outcome, and cost databases associating outcomes with a monetary value. CONCLUSIONS:This study updates a previous review and widens the scope by answering the question of how social outcomes are measured and valued in previous PAS literature. Given the heterogeneity found in the application of the method, this review will inform a Delphi study to reach a Global Consensus Statement on the measurement of social value and PAS.

BackgroundEngagement in physical activity (PA) benefits physical and mental health as well as many other areas of society. In Europe however, 1/3 adults do not meet minimum PA recommendations. Social value, and its quantification through social return on investment (SROI) evidence, may be a useful framing to enhance PA promotion. This study aimed to assess the current use of social value framing of PA in European Union (EU) policies.MethodsContent analysis of 45 EU member state policies which contain reference to PA was conducted to evaluate the presence of five social value domains and SROI evidence. Data was analysed using manual inductive coding, supported by DeepL translation and NVivo tools.ResultsSocial value framing was present to a certain extent in existing policies, with improved health being the most commonly referenced benefit of PA, followed by reference to social and community and then environmental benefits. Acknowledgement of the positive impacts of PA on wellbeing and education was the least present. Reference to SROI evidence was also limited. Generally, policies lacked holistic recognition of the social value of PA. Policies from the health sector were particularly limited in recognising the wider benefits of PA, whilst those from the environmental sector acknowledged the widest range of co-benefits.ConclusionAdopting social value framing could be a useful approach for enhancing PA promotion. Whilst it is present to a certain extent in existing policy, this could be increased in terms of comprehensiveness to increase issue salience and multisectoral policy action.

Introduction: This study examines the distribution of events and event records (EVRs) in elite judo competitions, encompassing both male and female categories. Sample: By analyzing data from the 2018, 2019, and 2021 World Championships, the study incorporates 6487 events (EVs) and 2340 contests classified by their last event (cEV). Results: The predominant occurrence of EV2 and EV3 in male (23.2% and 36.6%) and female (26.8% and 31.7%) contests suggests consistent patterns. Statistical analyses reveal non-uniform distributions of events within temporal units (TUs). Small associations were found between EVRs and TUs for EV1, EV2 and EV3 (Cramer’s V = 0.103 to 0.171; p<0.001), while moderate associations were observed for EV4 (Cramer’s V = 0.260 to 0.271; p<0.001) with no associations detected for EV5 and EV6, in both sexes. Female contests generally feature fewer events, concentrated within the same TU, indicating shorter durations compared to males. The study emphasizes the association between the occurrence of EVRs and the moment they occur, demonstrating similar patterns across sexes. Waza-ari was significantly overrepresented in the TU1 for both males and females (SR = 2.1 and 2.2, respectively). In contrast, Ippon was overrepresented in the Golden Score (TU-GS) period (SR = 3.3) for males. Notably, cEV1, cEV2, and cEV3 exhibit timing variations between male and female categories, while cEV4 share equivalent timing. Conclusion: This research provides comprehensive insights into the dynamics of elite judo contests, informing professionals on the nuanced strategies needed for male and female judo athletes. The observed tendency of athletes to adopt an offensive approach at the beginning of contests, focusing on throws or body controls in groundwork over penalizations, adds a valuable layer to understanding the competitive dynamics in judo.

The main aim of this study was to ascertain whether the victory and defeat in the different types of the judo contest, in the elite male and female divisions, are associated to the occurrence of the penalties and scores of the first three events (changes in the scoreboard -either penalty or score-) of them. 2340 contests of the 2018, 2019 and 2021 World Judo Championships were analysed. The Pearson’s chi-squared test expressed that [1] shido-1 in the first event (EV1) of the contests that end before the regular time (BRT) and of those without considering when they end (OC) is associated to defeat for both sexes and, that [2] wazari-1 in the EV1 of the BRT and in the EV2 and EV3 of the BRT, of the contests with the duration extended beyond the regular time (EXT) and of OC is associated to victory for both sexes except in the EV2 of the EXT (only for male athletes in this case). Thus, it is suggested that the victory and defeat in the different types of the judo elite contests are associated with the occurrence of the penalties and scores of the first three events of them.

Breast cancer is a chronic disease with a large growth in its treatments, prognosis, improvements, side effects and rehabilitation therapies research. These advances have also highlighted the need to use physical exercise as a countermeasure to reduce the cardiotoxicity of pharmacological treatments, increase patients' strength and quality of life and improve body composition, physical condition and mental health. However, new investigations show the need for a closed exercise individualisation to produce higher physiological, physical and psychological benefits in remote exercise programs. To this end, the present study will use, in a novel way in this population, heart rate variability (HRV) as a measure for prescribing high-intensity training. Thus, the primary objective of this randomised clinical trial is to analyse the effects of a high-intensity exercise program daily guided by HRV, a preplanned moderate to high-intensity exercise intervention and a usual care group, in breast cancer patients after chemotherapy and radiotherapy treatments. For this purpose, a 16-week intervention will be carried out with 90 breast cancer patients distributed in 3 groups (a control group, a moderate to high-intensity preplanned exercise group and a high-intensity exercise group guided by HRV). Both physical exercise interventions will be developed remotely and supervised including strength and cardiovascular exercises. Physiological variables, such as cardiotoxicity, biomarkers, lipid profile, glucose, heart rate and blood pressure; physical measures like cardiorespiratory capacity, strength, flexibility, agility, balance and body composition; and psychosocial variables, as health-related quality of life, fatigue, functionality, self-esteem, movement fear, physical exercise level, anxiety and depression will be measure before, after the intervention and 3 and 6 months follow up. Personalized high-intensity exercise could be a promising exercise intervention in contrast to moderate-intensity or usual care in breast cancer patients to reach higher clinical, physical and mental effects. In addition, the novelty of controlling HRV measures daily may reflect exercise effects and patients' adaptation in the preplanned exercise group and a new opportunity to adjust intensity. Moreover, findings may support the effectiveness and security of physical exercise remotely supervised, although with high-intensity exercise, to reach cardiotoxicity improvements and increase physical and psychosocial variables after breast cancer treatments. Trial registration ClinicalTrials.gov nº NCT05040867 ( https://clinicaltrials.gov/ct2/show/record/NCT05040867 ).

The main aim of this study was to analyse the relationship between how contests end (scores or penalties), the temporal units and the competition rounds regarding when the contest end in the 2018, 2019 and 2021 Judo World Championships. A total of 2340 contests involving 2244 elite judo athletes (1343 men and 901 women) were analysed. Pearson’s chi-squared (χ2) was implemented to analyse the association between variables, and the standardised residuals were used to analyse its interpretation; the strength of the associations was reported as Cramer’s V. Shapiro–Wilk and Kolmogorov–Smirnov were implemented to test the normality of the length of golden score (GS) sequences, and Kruskal–Wallis was applied for analysing GS sequences by championships. Mann–Whitney U was also implemented if a significant effect was detected. The level of significance was set at 0.05. The results were as follows: (1) Most contests ended before the accomplishment of the regular time (BRT), and they were won by ippon. (2) During BRT, the defeated accumulated more shido than the winner, while the opposite happened in contests finishing at the regular time (FRT). (3) Contests ending in the first and third minutes decreased, while contests ending in the second and fourth minutes increased; a longer length of the GS period was observed for women compared with men. (4) BRT contests were overrepresented in rounds 1 and 2, while extended time contests (EXT) in repechage, semi-final, bronze and final were overrepresented. (5) There were fewer waza-ari than expected during the preliminary rounds and more in the final rounds. The current study reveals cornerstone information that could be used to improve the training programs of elite judo athletes.

PurposeThe current study aimed to analyze the changes in heart rate variability (HRV) 24h, 48h and 72h after exercise sessions in breast cancer survivors. MethodsSixteen survivors who had undergone chemotherapy and radiotherapy were included. Participants trained resistance and cardiovascular components 3 times per week. The intervention was supervised and delivered online for 4 weeks. In this period, patients measured their HRV daily obtaining the lnrMSSD and lnSDNN values of: day 0 (the morning of the training sessions), 24h, 48h and 72h after exercise. ResultsSignificant changes in lnrMSSD (p=0.015) and lnSDNN (p=0.031) during recovery times and lnSDNN during the weeks were found (p=0.015). The most prominent differences were identified between the baseline measurement taken on day 0 and 24h after exercise (p=0.007 and p=0.048, respectively) and between measurements obtained 24h and 48h after the training session (p=0.019 and p=0.026, respectively). ConclusionOur study suggests that patients may decrease their lnrMSSD and lnSDNN values 24h after exercise and they were close to recover 48h after the sessions. In this regard, HRV may be an useful tool to monitor their recovery and exercise tolerance.

Background: Protein-based multi-ingredient (MTN) supplements have been suggested as a safe and effective way of enhancing exercise outcomes. However, their effectiveness remains controversial when compared to isocaloric and single-nutrient supplements. This review aims to systematically summarise the current knowledge of multi -ingredient supplementation to optimise body composition and physical performance in middle-aged and older adults.Material and methods: A systematic review with meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search of the literature was conducted using PubMed, EBSCOhost, Google Scholar, Web of Science, and SPORTDiscus from June to October 2021. Every publication identified from the outset to October 2021 was considered. The main inclusion criteria comprised randomized controlled trial (RCT) studies conducted in adults (>= 45 years old), following resistance-or endurance-based training programmes for a period of 6 weeks or longer, combined with MTN supplementation and a calorie equivalent comparator (COMP) supplement (e.g., carbohydrates). Continuous data on body composition [fat-free mass (FFM) or lean body mass], strength, and functional capacity as markers of physical performance were pooled using a random-effects model.Results: Initially, 3329 publications were identified. Data from nine RCTs were ultimately included, involving 476 participants. The overall quality of the included studies was high, demonstrating a low risk of bias. Compared to COMP, no significant further benefits of ingesting MTN were identified for FFM (kg) (g = 0.044, 95 % CI-0.14 to 0.22), upper-body strength (kg) (g = 0.046, 95 % CI-0.24 to 0.33), lower-body strength, leg press exercise (kg) (g = 0.025, 95 % CI-0.26 to 0.31), leg extension exercise (kg) (g = 0.106, 95 % CI-0.15 to 0.36) and functional capacity (time in seconds) (g = 0.079, 95 % CI-0.12 to 0.27).Conclusions: No additional benefits of ingesting MTN vs. COMP to maximise exercise-induced outcomes on body composition and physical performance in healthy physically active middle-aged and older adults have been identified.

Sport and Physical Activity (PA) Special Eurobarometer surveys may inform of the physical inactivity (PIA) levels in the European Union (EU). This study aimed to analyse the PIA levels of EU adolescents (15–17 years) in four time points, according to gender. The data were from 2002, 2005, 20013, and 2017 Special Eurobarometers. Adolescents were categorised as “Inactive” when performing less than 60 min/day of moderate to vigorous PA on average. A χ2 test was used to compare the levels of PIA between survey years. PIA levels between gender were analysed using a Z-score test for two population proportions. PIA levels ranged from 67.2% for boys (59.4% to 71.5%;) to 76.8% for girls (76.0% to 83.4) across the time points. Adjusted standardised residuals revealed a decrease in the observed levels versus the expected for 2005 (whole sample: −4.2; boys: −3.3) and an increase for 2013 (whole sample: +2.9; boys: +2.5). Boys presented lower PIA levels than girls in all years (p ≤ 0.003), but descriptively, the difference progressively decreased (from 18.4% to 11.8%). No significant reductions in PIA levels were observed between 2002 and 2017, and girls reported consistently higher levels of PIA than boys.