annales kinesiologiae • 7 • 2016 • 1 81 reports and reviews/poročila in ocene, 81–88 4th international scientific conference on »exercise and quality of life« novi sad, serbia, 22nd to 23rd april, 2016. faculty of sport and physical education, university of novi sad (serbia), organized the 4th international scientific conference on exercise and quality of life, which was held from 22nd to 23rd of april, 2016. the aim of the conference was to promote and enhance communication across sub-disciplines of sports sciences, which largely contributes to the understanding of the impact of physical activity on the quality of life. this year, more than one hundred fifty scientist and researchers from fifteen countries presented their work from the fields of physical education, recreation, sport, health, sports psychology, pedagogy and sociology. the abstracts they submitted were published on the eqol 2016 abstracts cd-rom. the scientific programme included plenary sessions led by eminent international experts: sandra mandić (university of ontago, new zeland) and tuija tammelin (likesresearch centre for sport and health sciences in jyväskylä, finland) who presented the organisational aspect of the research and the promotion of physical activity from the scope of multi-sectoral approach; roger harris (uk), sergej ostojić (university of novi sad, serbia) and daniela caporossi (university of rome “foro italico”, italy) exposed new evidences in the field of biochemical processes which come to effect during training and physical performance; while rado pišot (institute of kinesiology research, university of primorska, koper, slovenia) addressed his lecture to the role of kinesiology in the contemporary society. furthermore, it should be pointed out, that the 2016 edition of eqol was also attended by eight members of institute of kinesiology research, university of primorska, who actively participated with the presentations of their scientific work. we can honestly say that our regular attendance in eqol has become a tradition which reflects good cooperation between our institute and faculty of sport and physical education in novi sad. armin paravlić 82 reports and reviews/poročila in ocene, 81–88 annales kinesiologiae • 7 • 2016 • 1 4. mednarodna znanstvena konferenca »exercise and quality of life« novi sad, srbija, 22.–23. april 2016 fakulteta za šport in športno vzgojo univerze v novem sadu (srbija) je v času od 22. do 23. aprila 2016 organizirala že 4. mednarodno konferenco z naslovom exercise and quality of life. tokratna tema konference je bila promocija povezovanja med posameznimi poddisciplinami športnih znanosti, kar znatno pripomore k razumevanju pomena gibalne/športne aktivnosti za kakovost življenja. več kot 150 znanstvenikov in raziskovalcev iz 15 držav je predstavilo svoja dela s področij športa, športne vzgoje, rekreacije, zdravja, športne psihologije, pedagogike in sociologije. prispevki so bili kot zbirka povzetkov eqol 2016 izdani v cd obliki. v plenarnem delu prvega in drugega dne konference so svoje poglede na izbrane teme tudi tokrat predstavili nekateri eminentni gostje. profesorici sandra mandić (univerza v ontagu, nova zelandija) in tuija tammelin (likes raziskovalni center za šport in vede o zdravju, jyväskylä, finska) sta predstavili organizacijski vidik raziskovanja in promocije gibalne/športne aktivnosti z uporabo večsektorskega pristopa na primerih tako odrasle populacije kot tudi šolskih otrok; profesorji roger harris (velika britanija), sergej ostojić (univerza v novem sadu) in daniela caporossi (univerza »foro italico« v rimu) pa so izpostavili nova dognanja na področju biokemičnih procesov med vadbo in gibalno aktivnostjo, medtem ko je rado pišot (inštitut za kineziološke raziskave, univerza na primorskem, koper) poudaril vlogo kineziologije v sodobni družbi. 4. konference eqol v novem sadu se je udeležilo kar osem raziskovalcev iz inštituta za kineziološke raziskave univerze na primorskem, ki so predstavili svoje raziskovalno delo. številna udeležba predstavnikov inštituta za kineziološke raziskave je že tradicionalna, kar je le še en odraz dobrega sodelovanja med našim inštitutom in fakulteto za šport in športno vzgojo iz novega sada. armin paravlić annales kinesiologiae • 7 • 2016 • 1 85 reports and reviews/poročila in ocene, 81–88 book review fadilj eminović and milivoj dopsaj (eds.): physical activity effects on the anthropological status of children, youth and adults hauppauge, ny, usa: nova science publishers, inc., 2016, 332 pages the scientific monograph titled “physical activity effects on the anthropological status of children, youth and adults” by the editors fadilj eminović and milivoj dopsaj represents an important new contribution to interdisciplinary treatment of physical activity and its effects on physical and mental health of an individual in particular. a lack of physical activity and a shift from the physically-active lifestyle are two important risk factors for the occurence of modern diseases and non-contagious chronic diseases, such as type 2 diabetes, cardiovascular diseases and obesity. regular physical activity and exercise have proven a significant positive impact on physical and mental health as well as on the overall physical performance and motor efficiency of an individual. therefore, it is extremely important that the interdisciplinary research in the fields of kinesiology, medicine, rehabilitation, anthropology and others highlight both the positive effects of physical activity as well as the negative effects of physical inactivity and sedentary lifestyle. the present monograph, in its 15 independent scientific articles, addresses the effects of physical activity on the various sub-systems of human organism and its functions. the monograph is particularly significant as it comprises articles written by various authors from around the world. through the content of articles, the monograph offers many new approaches to the treatment of physical (in)activity regarding various age groups, environments and cultures. the chapters´ content is complementary. with the research on physical development, maintenance of health, optimal physical development and ensuring the overall quality of life, the monograph will prove to be an important contribution to the knowledge treasure in the field of physical activitiy tre86 reports and reviews/poročila in ocene, 81–88 annales kinesiologiae • 7 • 2016 • 1 atment, particularly since the findings are supported by the latest scientific approaches and findings. the monograph also contains an article entitled “the effect of regular sport exercise on muscle contractile properties in children” written by slovenian authors tadeja volmut, boštjan šimunič and rado pišot, the researchers of the institute for kinesiology research, at the science and research centre of university of primorska. matej plevnik annales kinesiologiae • 7 • 2016 • 1 87 reports and reviews/poročila in ocene, 81–88 recenzija knjige fadilj eminović in milivoj dopsaj (ur.): učinki telesne aktivnosti na antropološki status otrok, mladine in odraslih hauppauge, ny, usa: založba nova science publishers, 2016, 332 strani znanstvena monografija “učinki telesne aktivnosti na antropološki status otrok, mladine in odraslih”, urednikov fadilja eminovića in milivoja dopsaja, predstavlja nov pomemben prispevek na področju interdisciplinarne obravnave telesne aktivnosti in njenih učinkov na predvsem telesno in mentalno zdravje posameznika. pomanjkanje telesne aktivnosti in odmik od gibalno aktivnega življenjskega sloga je pomemben dejavnik tveganja za prisotnost bolezni sodobnega življenjskega sloga oziroma nenalezljivih kroničnih bolezni, kot so med drugimi sladkorna bolezen tipa 2, srčno-žilne bolezni in pojav debelosti. redna telesna aktivnost in vadba ima dokazano pomemben pozitiven vpliv na telesno in mentalno zdravje, pa tudi na splošno telesno zmogljivost in gibalno učinkovitost človeka. zato je izredno pomembno, da interdisciplinarne raziskave s področij kineziologije, medicine, rehabilitacije, antropologije in drugih, vedno znova osvetljujejo tako pozitivne učinke telesne aktivnosti kot tudi negativne učinke telesne neaktivnosti in sedentarnosti. pričujoča monografija v 15 samostojnih znanstvenih sestavkih obravnava učinke gibalne aktivnosti na različne podsisteme človekovega organizma in njegovega delovanja. posebno težo monografiji daje dejstvo, da so v njej zbrani prispevki različnih avtorjev iz celega sveta. skozi vsebino prispevkov ponujajo mnoge nove pristope k obravnavi telesne (ne)aktivnosti v različnih starostnih obdobjih, življenjskih okoljih in kulturah. poglavja se vsebinsko nadgrajujejo. z vsebinami, ki posegajo na področja razvoja in ohranjanja zdravja, optimalnega telesnega razvoja in zagotavljanja splošne kakovosti življenja, bo pomemben prispevek v zakladnico znanj na področju obravnave telesne aktivnosti, še zlasti, ker so ugotovitve podprte z najnovejšimi znanstvenimi pristopi in rezultati. 88 reports and reviews/poročila in ocene, 81–88 annales kinesiologiae • 7 • 2016 • 1 v monografiji so svoj prispevek z naslovom “vpliv redne športne vadbe na kontraktilne elemente mišice pri otrocih” objavili tudi slovenski avtorji tadeja volmut, boštjan šimunič in rado pišot, raziskovalci inštituta za kineziološke raziskave, znanstveno-raziskovalnega središča univerze na primorskem. matej plevnik annales kinesiologiae • 6 • 2015 • 1 77 reports and reviews/poročila in ocene, 69–78 summer school: »a holistic approach to workplace health promotion and corporate wellness« izola, slovenia, 10th−15th september 2015 the summer school was a part of the project for the creation of a 2-year erasmus mundus joint master degree in the field of corporate wellness and active lifestyles. the same universities (university of padua, university of augsburg, university of basel and university of primorska) involved in the summer school are also the universities taking part in the mundus project, coordinated by university of padua. the general aim of the summer school was to prepare participants to develop, implement and promote physical activity and exercise in different working contexts, by adopting a holistic approach to individual and collective health and well-being. during the summer school, the following activities were scheduled: key-lectures, workshops, round tables, plenary sessions, social and physical activities. the activities took place during six consecutive days from the 10th to the 15th september 2015 in izola (simon’s bay). two whole days were dedicated to practical experiences, indoor and outdoor. participants were master and ph.d. students from slovenia, italy, germany, switzerland, serbia and croatia. the lecturers came from all four participating universities: hans peter brandl-bredenbeck, ph.d. (university of augsburg), uwe pühse, ph.d. (university of basel), carlo reggiani, ph.d., antonio paoli, ph.d., attilio carraro, ph.d., erica gobbi, ph.d., fabio sgarbossa, ph.d., and silvano zanuso, ph.d. (university of padua), boštjan šimunič, ph.d., dorjana zerbo šporin, ph.d., and shawnda morrison, ph.d. (university of primorska). tjaša dimec časar 78 reports and reviews/poročila in ocene, 69–78 annales kinesiologiae • 6 • 2015 • 1 poletna šola “a holistic approach to workplace healthpromotion and corporate wellness” izola, slovenija, 10.−15. september 2015 poletna šola je bila del projekta za oblikovanje 2-letnega erasmus mundus programa na področju wellnessa in aktivnega življenjskega sloga. iste univerze, ki so sodelovale pri izvedbi poletne šole (univerza v padovi, univerza v augsburgu, univerza v baslu in univerza na primorskem), nameravajo sodelovati tudi v projektu mundus, ki ga usklajuje univerza v padovi. glavni namen poletne šole je bil priprava udeležencev za razvoj, izvajanje in spodbujanje telesne aktivnosti in športne vadbe v različnih delovnih okoljih, s sprejetjem holističnega pristopa do individualnega in kolektivnega zdravja ter dobrega počutja. v času poletne šole so se odvijala različna predavanja, delavnice, okrogle mize, plenarna zasedanja ter družabne in telesne aktivnosti. celotna dva dneva sta bila posvečena praktičnim izkušnjam (v predavalnicah in na prostem). dejavnosti so potekale v šestih zaporednih dneh od 10. do 15. septembra 2015 v izoli (simonov zaliv). poletne šole so se udeležili podiplomski študenti iz slovenije, italije, nemčije, švice, srbije in s hrvaške. predavatelji so bili iz vseh štirih sodelujočih univerz: dr. hans peter brandl-bredenbeck (univerza v augsburgu), dr. uwe pühse (univerza v baslu), dr. carlo reggiani, dr. antonio paoli, dr. attilio carraro, dr. erica gobbi, dr. fabio sgarbossa in dr. silvano zanuso (univerza v padovi), dr. boštjan šimunič, dr. dorjana zerbo šporin in dr. shawnda morrison (univerza na primorskem). tjaša dimec časar _enref_26 _goback _goback _goback _goback bm3 _goback _goback annales kinesiologiae • 6 • 2015 • 1 73 reports and reviews/poročila in ocene, 69–78 20th annual congress of the european college of sport science malmö, sweden, 24th−27th june 2015 the 20th annual congress of the european college of sport science was held in malmö (sweden) from 24 to 27th june, 2015. this year the congress was organized by two neighbouring countries and three universities: the department of sport sciences, malmö university, the department of health sciences, lund university, and the department of nutrition, exercise and sports (nexs), university of copenhagen. in total, there were 2394 participants from 70 countries with 1587 submitted abstracts. there were 4 plenary sessions, 38 invited speakers, 113 oral sessions, and 64 mini-oral sessions. the congress participants presented their latest research from different research fields. namely, the presentations were given on the topics of physiology, training and testing, health and fitness, sports medicine and orthopedics, biomechanics and others. the ecss young investigator award 2015 contest was held again this year. martin keller (switzerland) won in the oral presentation category; tetsuhiro kidokoro (japan) was the winner in the mini-oral (poster) presentations category. the ecss 2015 was attended by a member of the institute for kinesiology research, scientific and research centre koper, university of primorska, slovenia, uroš marušič, ph.d. he gave a speech within the section of invited speakers, his presentation’s title was “mental and cognitive training: importance for skill learning, rehabilitation and sports activities – mechanisms and applications”. the 21st annual congress of the european college of sport science will be held next year from 6th to 9th july in vienna, austria. uroš marušič 74 reports and reviews/poročila in ocene, 69–78 annales kinesiologiae • 6 • 2015 • 1 20. letni znanstveni kongres »european college of sport science« malmö, švedska, 24.–27. junij 2015 20. letni znanstveni kongres »european college of sport science« je potekal v malmu (švedska) med 24. in 27. junijem 2015. letošnji kongres sta organizirali dve sosednji državi in kar tri univerze: oddelek za znanosti o športu univerze v malmu, oddelek za znanosti o zdravju univerze v lundu ter oddelek za prehrano, telesno aktivnost in šport (nexs) univerze v kopenhagnu. letošnjega ecss-kongresa se je udeležilo 2394 udeležencev iz 70 držav, oddanih pa je bilo 1587 povzetkov. odvile so se 4 plenarne sekcije, 3 ustne predstavitve in 64 predstavitev v obliki posterja, prisostvovalo pa je tudi 38 povabljenih govornikov. udeleženci kongresa so predstavili svoje najnovejše ugotovitve na različnih znanstvenoraziskovalnih področjih, kot so fiziologija, treniranje in merjenje, zdravje in zmogljivost, športna medicina in ortopedija, biomehanika in ostalo. tudi letos je potekalo tekmovanje mladih raziskovalcev (ecss young investigator award 2015 contest), kjer je v kategoriji ustnih predstavitev zmagal martin keller (švica), v kategoriji predstavitev v obliki posterja pa tetsuhiro kidokoro (japonska). letošnjega kongresa ecss 2015 sem se udeležil kot predstavnik inštituta za kineziološke raziskave znanstveno-raziskovalnega središča univerze na primorskem. v sekciji vabljenih predavateljev sem predstavil prispevek z naslovom »miselni/kognitivni trening: pomen za učenje veščin, rehabilitacije in športnih dejavnosti – mehanizmi in aplikacije«. naslednje leto bo 21. letni kongres ecss potekal med 6. in 9. julijem na dunaju v avstriji. uroš marušič _enref_26 _goback _goback _goback _goback bm3 _goback _goback annales kinesiologiae • 7 • 2016 • 1 83 reports and reviews/poročila in ocene, 81–88 foundation anniversary promotion of the olympic committee of kosovo, 27th may, 2016 on 27th may 2016, the olympic committee of kosovo (ock) organized olympic day, which was intended to promote the anniversary of the ock. the institute of kinesiology research, university of primorska, was invited to actively participate and promote the event. the main role of the institute of kinesiology research was measuring anthropometric and motor skills of the children who were actively involved in various activities. the measurements were attended by 23 children aged between the ages of 7 and 8. anthropometric analysis included measurements of height, weight and body composition (body mass index, fat mass, muscle mass, free fat mass and total body water). motor skills analysis included countermovement jump, 10-meter sprint, maximal voluntary isometric knee extension and flexion. all measurements followed each other in a logical sequence. the aim of the measurements was to compare the results of kosovar children with children from more developed countries who took part in a similar analysis. the main purposes why the institute of kinesiology research, university of primorska, participated at the olympic day in kosovo were to obtain information about locomotor status of kosovar children, to demonstrate the operating principles of the institute in a developing country and to establish new contacts together with further opportunities for future cooperation with the ock. matej kleva 84 reports and reviews/poročila in ocene, 81–88 annales kinesiologiae • 7 • 2016 • 1 promocija obletnice ustanovitve olimpijskega komiteja kosova 27. maj 2016 olimpijski komite kosova je 27. maja 2016 organiziral olimpijski dan, ki je bil namenjen obeleženju obletnice njegove ustanovitve. inštitut za kineziološke raziskave univerze na primorskem je bil povabljen k aktivni udeležbi in promociji tega dogodka. glavna vloga inštituta za kineziološke raziskave je bila izvedba meritev antropometrijskih in gibalnih sposobnosti otrok, ki so sodelovali v različnih aktivnostih. meritev se je udeležilo 23 otrok starih 7 ali 8 let. člani inštituta smo v okviru antropomterijske analize izmerili telesno maso in višino ter analizirali telesno sestavo (indeks telesne mase, maščobna masa, mišična masa, pusta maščobna masa in odstotek vode v telesu). analiza gibalnih sposobnosti je vključevala skok z nasprotnim gibanjem, leteči šprint na 10 metrov in največjo hoteno mišično kontrakcijo v smeri iztega in upogiba kolena. vse meritve so si sledile v smiselnem zaporedju. cilj meritev je bil primerjati rezultate kosovskih otrok z rezultati otrok iz bolj razvitih držav, ki so bili deležni podobnih meritev. primarni namen sodelovanja inštituta za kineziološke raziskave univerze na primorskem na omenjenem dogodku je bil pridobiti informacije o gibalnem statusu kosovskih otrok, prikazati princip delovanja inštituta državi v razvoju in vzpostaviti nove medosebne vezi ter možnosti za morebitno prihodnje sodelovanje z olimpijskim komitejem kosova. matej kleva annales kinesiologiae • 6 • 2015 • 2 153 reports and reviews/poročila in ocene, 149–156 the 22nd international scientific symposium on biometrics, biostat 2015 dubrovnik, croatia, 28th june−1st july 2015 biostat symposium 2015 was organized by croatian biometric society (hbmd), under the auspices of the university of zagreb. researchers and practitioners in the field of biometrics presented their work from the development and application of statistical and mathematical methods to data analysis in life sciences and covered the following topics: design of experiments; clinical study design; sampling methods, statistical modelling of biological systems, statistical genomics, environmental statistics, predictive and prescriptive modelling; temporal-spatial analysis, forecasting and prediction; multivariate statistics in life sciences, meta-analysis, data visualization, data mining, quantitative decision support, risk assessment, statistical learning, taxonomy and classification, research data lifecycle, management and education in biometrics. on the first day of the symposium, professor lynne billard from university of georgia (usa) conducted the 20th school of biometrics. her lecture on “multiple sets of multivariate time series” was an inspiring introduction to commence with other sections. the symposium brings together researchers from a wide range of disciplines and institutions from agriculture and forestry through biomedicine, anthropology, psychology, kinesiology to statistics and mathematics. over 30 participants from 14 countries participated at this congress with 23 presentations and two keynote lectures. the keynote speakers were prof. viswanathan ramakrishnan (medical university of south carolina, usa), who presented the lecture titled “is the adaptive paradigm shifting the perception of clinical trials?” and prof. rado pišot (up src; institute for kinesiology research), with the lecture titled »bed rest as a model for studying mechanisms of functional decline«. three presentations of methods and the latest findings from the field of kinesiology were given also by prof. franjo prot (kif, university of zagreb), uroš marušič, ph.d. (up src) and saša pišot (up src). the symposium took place in the beautiful ancient city of dubrovnik, in the centre for advanced academy studies (caas) which is located close to the main gate leading to the old city centre. a warm social atmosphere and hospitality of the organizers enabled us to share many a professional thoughts and ideas for further collaboration and to take home a pleasant memory of croatia and the dalmatian pearl – the city of dubrovnik. one of the important messages of the symposium is also that the event will be biannual from now on, therefore, the next opportunity to exchange new viewpoints will be in the summer of 2017. saša pišot 154 reports and reviews/poročila in ocene, 149–156 annales kinesiologiae • 6 • 2015 • 2 22. mednarodni znanstveni simpozij biometrije, biostat 2015 dubrovnik, hrvaška, 28. junij–1. julij 2015 simpozij biostat 2015 je pod okriljem univerze v zagrebu letos že 22. organiziralo hrvaško biometirično društvo (hbmd). raziskovalci in strokovnjaki s področja biometrije so imeli možnost predstaviti izsledke razvojnega in aplikativnega dela statističnih in matematičnih metod v okviru naslednjih tematik: design of experiments; clinical study design; sampling methods, statistical modeling of biological systems, statistical genomics, environmental statistics, predictive and prescriptive modeling; temporal-spatial analysis, forecasting and prediction; multivariate statistics in life sciences, meta-analysis, data visualization, data mining, quantitative decision support, risk assessment, statistical learning, taxonomy and classification, research data lifecycle management and education in biometrics. prvi dan simpozija je bil namenjen že 20. šoli biometrije, ki jo je tokrat izvedla priznana profesorica lynne billard iz univerze v georigiji iz zda. predavanje z naslovom »multiple sets of multivariate time series« je bil dobrodošel uvodni navdih za nadaljnje sekcije, ki so se nato zvrstile. mednarodni znanstveni simpozij je tudi tokrat združil raziskovalce iz široke palete znanstvenih disciplin in institucij; od kmetijstva in gozdarstva, biomedicine, antropologije, psihologije, kineziologije do statistike in matematike. preko 30 udeležencev iz 14 držav je sodelovalo s 23 predstavitvami in z dvema vabljenima predavanjema. predavatelja sta bila prof. viswanathan ramakrishnan (medicinska univerza v južni karolini, zda), ki je v predstavitvi poskušal odgovoriti na vprašanje: »is the adaptive paradigm shifting the perception of clinical trials?« in prof. rado pišot (up zrs, inštitut za kineziološke raziskave), ki je predstavil odmevno delo inštituta z naslovom »bed rest as a model for studying mechanisms of functional decline«. nadalje so se zvrstile poleg drugih tudi tri predstavitve, v katerih so prof. franjo prot (kineziološka fakulteta, univerza v zagrebu), dr. uroš marušič (up zrs) in saša pišot (up zrs) predstavili pomembne metode, uporabljene pri raziskovanju na področju kineziologije. simpozij se je odvijal v prijetnih prostorih centra za napredne akademske študije (caas) v bližini srednjeveškega starega mestnega jedra dubrovnika. prijetna klima in gostoljubnost organizatorjev sta omogočali izmenjavo idej in dobrih praks tudi izven predavalnic, zato nam bo simpozij ostal v prijetnem spominu. novost simpozija je tudi, da se bo simpozij sedaj organiziral na vsaki dve leti, zato bo naslednja možnost izmenjave znanstvenih misli poleti leta 2017. saša pišot _goback _goback _goback _goback _goback _goback _goback annales kinesiologiae • 7 • 2016 • 2 173 reports and reviews/poročila in ocene, 171–180 international conference “sport science and sport as a regular component of the life style“ sharm el-sheikh, egypt, 1st-3rd november 2016 faculty of physical education, university`of assiut (egypt), in cooperation with the institute of sport science, university of magdeburg (germany), organized the international conference "sport science and sport as regular component of the life style“, which took place from 1st to 3rd november, 2016. the aim of the conference was to bring together sport scientists, experts and professionals from around the world to share their knowledge and ideas in the light of new advancements in sport sciences and in the connected areas through the multidisciplinary approach raised at the conference in order to discuss the ways of development in the sports field. in addition, to support the interaction and the dialogue between different organizations and international sports bodies, thus the work on providing the inter-arab collaboration with european countries through upgrading the level of exchange to the level of coordination and knowledge integration. therefore, more than two hundred scientists and researchers from ten countries and three continents presented their work from the fields of s physical education, motor control and learning, recreation, health and aging, and also sport in general i.e. sports tourism, sports management, sports psychology and sociology. the accepted abstracts were published in the book of proceedings 2016. the scientific programme included plenary sessions by eminent international experts: rado pišot (university of primorska; slovenia) who focused his lecture on the importance of physical activity in contemporary society; elke knisel (university of magdeburg; germany) presented the model of health promotion at schools. moreover, anita hokelmann (university of magdeburg; germany) exposed the latest research in neuroscience on the scope of neural plasticity in response to physical activity, while hagen wasche (university of karlsruhe; germany) presented a new way of social network analysis in sport research. furthermore, this conference was also attended by the young researcher armin paravlić, a member of institute of kinesiology research, university of primorska, who actively participated in presenting the latest scientific research of the institute, related to the modified approach of measuring electromechanical muscle efficiency. we can say that the conference was successful not only from the scientific but also from social aspects, and it has surely accomplished its objectives. armin paravlić 174 reports and reviews/poročila in ocene, 171–180 annales kinesiologiae • 7 • 2016 • 2 mednarodna konferenca »znanost o športu in šport kot redna komponenta življenjskega sloga« sharm el-sheikh, egipt, 1.–3. november 2016 fakulteta za športno vzgojo univerze v assiuntu (egipt), je v sodelovanju z inštitutom za znanosti o športu univerze v magdenburgu (nemčija), organizirala mednarodno konferenco z naslovom znanost o športu in šport kot redna komponenta življenjskega sloga, ki je potekala od 1. do 3. novembra 2016 v sharm el-sheikhu v egiptu. namen konference je bil združiti znanstvenike, strokovnjake in profesionalce za področje športa iz celega sveta. kot vodilo je bil na konferenci postavljen multidisciplinaren pristop, udeleženci pa so izmenjavali svoje znanje in ideje na osnovi novih dognanj v športnih znanostih in sorodnih področjih ter razpravljali o možnostih razvoja na področju športa. dodaten namen konference je bil podpora interakciji in dialogu med različnimi organizacijami in mednarodnimi športnimi organi, s čimer bi zagotovili medarabsko sodelovanje z evropskimi državami in nadgradili nivo izmenjave na raven usklajevanja in povezovanja znanja. v teh okvirih je več kot dvesto znanstvenikov in raziskovalcev iz desetih držav in treh celin predstavilo svoje delo s področij športne vzgoje, motoričnih sposobnosti in učenja ter rekreacije, zdravja in staranja, pa tudi športa na splošno, tj. športnega turizma, upravljanja v športu, športne psihologije in sociologije. zbrani povzetki so predstavljeni v zborniku book of proceedings 2016. znanstveni program je vseboval plenarna predavanja uglednih mednarodnih strokovnjakov: rado pišot (univerza na primorskem, slovenija), ki je svoje predavanje namenil pomembnosti fizične aktivnosti v današnji družbi; elke knisel (univerza v magdenburgu, nemčija) je predstavila model promocije zdravja v šolah. poleg tega je anita hokelman iz univerze v magdenburgu v nemčiji predstavila najnovejše raziskave na področju nevroznanosti omejene na nevroplastičnost glede na odziv na fizično aktivnost, medtem ko je hagen wasche (univerza v karlsruhe, nemčija) predstavil nov način analiz družbenih omrežij pri športnih raziskavah. konference se je udeležil tudi mladi raziskovalec armin paravlić, član inštituta za kineziološke raziskave znanstveno-raziskovalnega središča univerze na primorskem, ki je aktivno sodeloval pri predstavitvi najnovejše znanstvene raziskave inštituta, povezane s spremenjenim pristopom k merjenju elektromehanske učinkovitosti mišic. potrdimo lahko, da je bila konferenca uspešna, ne le zaradi znanstvenih, ampak tudi zaradi socialnih vidikov, in je gotovo dosegla zastavljene cilje. armin paravlić annales kinesiologiae • 6 • 2015 • 1 75 reports and reviews/poročila in ocene, 69–78 contemporary kinesiology: 5th international scientific conference split, croatia, 28th – 30th august 2015 university of split, faculty of kinesiology in cooperation with science and research center, university of primorska (koper, slovenia), faculty of sport and physical education (sarajevo, bosna & herzegovina); faculty of sport and physical education (novi sad, serbia) organized an international scientific conference titled contemporary kinesiology for the fifth time, focusing on physical education, sport and health issues. the aim of the conference was to promote the latest methods and techniques developed by researchers involved in the application of kinesiology and sport in contemporary life. this year, nearly two hundred scientists and researchers from twenty countries presented their work on the following topics a) contemporary sport issues; b) trends in physical education; c) physical activity for health. the papers, accepted by two independent reviewers, were published in the electronic conference proceedings. the conference itself comprised keynote speeches of some eminent scientists, original scientific papers presented by the authors, as well as poster presentations. the scientific program included the lectures by the following eminent international experts: slobodan jarić, rado pišot, nic james, raul oliveira, sergej ostojić, boštjan šimunič, goran sporiš. prof. pišot, ph.d., held a lecture addressing the role of fundamental motor patterns in child´s motor development, while prof. šimunič, ph.d., introduced new knowledge and results from tmg studies and discussed perspectives in muscle physiology. the whole scientific agenda, including pleasant social interaction, took place in the split university library, which permitted the participants to network, exchange experiences and ideas with the possibility of further development of possibilities for cooperation. damir zubac 76 reports and reviews/poročila in ocene, 69–78 annales kinesiologiae • 6 • 2015 • 1 5. mednarodna znanstvena konferenca sodobna kineziologija split, hrvaška, 28.–30. avgust 2015 fakulteta za kineziologijo univerze v splitu je v sodelovanju z znanstveno-raziskovalnim središčem univerze na primorskem iz kopra (slovenija), fakulteto za šport in telesno vzgojo iz sarajeva (bosna in hercegovina) in fakulteto za šport in telesno vzgojo iz novega sada (srbija) že petič organizirala mednarodno znanstveno konferenco sodobna kineziologija, na kateri so razpravljali o telesni vzgoji, športu in zdravstvenih vprašanjih. cilj konference je bila promocija najnovejših metod in tehnik, ki so jih razvili raziskovalci na področju aplikativne kineziologije in športa v sodobnem življenju. skoraj 200 znanstvenikov in raziskovalcev iz 20 držav je letos predstavilo svoje delo na naslednjih področjih: a) vprašanja sodobnega športa; b) trendi v telesni vzgoji in c) telesna aktivnost in zdravje. prispevki, ki sta jih odobrila dva neodvisna ocenjevalca, so bili objavljeni v elektronskem zborniku konference. na konferenci so se zvrstila razna predavanja, predstavljeni so bili tudi znanstveni članki in posterji. v okviru znanstvenega programa so predavali nekateri priznani mednarodni strokovnjaki, in sicer: slobodan jarić, rado pišot, nic james, raul oliveira, sergej ostojić, boštjan šimunič in goran sporiš. dr. pišot je predaval o vlogi temeljnih motoričnih vzorcev v razvoju otroške motorike, dr. šimunič pa je predstavil nova znanja in izsledke tmg-študij ter govoril o perspektivi fiziologije mišic. celoten dogodek, vključno s prijetnim druženjem, se je odvijal v splitski univerzitetni knjižnici, kjer so sodelujoči lahko izmenjevali stike, izkušnje in zamisli ter razpravljali o možnostih kasnejšega sodelovanja. damir zubac annales kinesiologiae • 8 • 2017 • 1 59 reports and reviews/poročila in ocene, 51–60 conference report: 8th international scientific conference on kinesiology 20th anniversary opatija, croatia, 10th–14th may 2017 in the middle of may 2017, rado pišot, boštjan šimunič and saša pišot were attending the 8th international scientific conference on kinesiology in opatija, croatia. under the organisation of faculty of kinesiology at university of zagreb, they successfully hosted around 380 delegates from 31 countries and provided great intellectual and social interaction for the participants. during the conference 252 papers, written by 579 authors were presented in 10 conference sessions: adapted physical activity and kinesitherapy; biology and medicine of sport and exercise; biomechanics and motor control; physical education; kinesiological recreation; kinesiology of top-level sport; kinesiology and social sciences (sociology, psychology, history, philosophy); kinesiology in physical conditioning – management of sport and research methodology. together with three satellite symposiums: health kinesiology, new technologies in physical education and science in dance enable participants to provide a forum for the latest research, theoretical and applicative insights, findings and experiences from the vast field of kinesiology, the science of human movement and exercise. the conference gave us the expected added value and impetus to further cooperation between participants and institutions, so we are looking forward for next 9th international conference on kinesiology in 2020. saša pišot 60 reports and reviews/poročila in ocene, 51–60 annales kinesiologiae • 8 • 2017 • 1 poročilo z 8. mednarodne znanstvene konference o kineziologiji (20. obletnica) opatija, hrvaška, 10.–14. maj 2017 sredi maja 2017 smo se rado pišot, boštjan šimunič in saša pišot udeležili 8. mednarodne znanstvene konference o kineziologiji v opatiji na hrvaškem. kineziološka fakulteta univerze v zagrebu je uspešno gostila okoli 380 delegatov iz 31 držav in zagotovila prijetno intelektualno in socialno druženje udeležencev. v štirih dneh konference je bilo v desetih sekcijah predstavljeno 252 prispevkov skupno 579 avtorjev. posamezne sekcije so bile posvečene naslednjim področjem: prilagojena telesna dejavnost in kinezioterapija; biologija, medicina športa in trening; biomehanika in motorični nadzor; športna vzgoja; kineziološka rekreacija; kineziologija vrhunskega športa; kineziologija in družboslovje (sociologija, psihologija, zgodovina, filozofija); kineziologija v fizičnem okolju – upravljanje v športu in raziskovalna metodologija. skupaj s tremi satelitskimi simpoziji: kineziologija zdravja, nove tehnologije v športnem izobraževanju in znanosti v plesu, ki so potekali vzporedno s konferenco, so udeležencem omogočile vpogled v najnovejše raziskave, teoretične in aplikativne vidike, ugotovitve in izkušnje iz obsežnega področja kineziologije, znanosti o gibanju človeka in treningu. konferenca je prinesla pričakovano dodano vrednost in spodbudo za nadaljnje sodelovanje med udeleženci in institucijami, zato se veselimo naslednje 9. mednarodne konference o kineziologiji, ki bo potekala leta 2020. saša pišot _goback _goback _goback _hlk501362470 _hlk501363405 _hlk501369360 annales kinesiologiae • 6 • 2015 • 1 1 editorial the first issue of the journal annales kinesiologiae, year 6, proves that the orientation of the journal towards studying and widening of the field of kinesiology with the aim to achieve a better life quality has been the right decision and that the challenges of modern society even more intensively encourage us to address this topical issue. the problems addressed by the scientific articles herewith are interesting indicators of the professional growth of all the professionals involved in the research of exercise and training, preventive or developmental incentives of kinesiology programs and the contents of organized and unorganized physical / sports training. a wider perspective of the current problems in modern kinesiology is brought to the reader through the reviews of scientific literature and the reports from international conferences. in order to make the journal even more easily accessible to the interested professionals and the widest range of readers, while facilitating the review process, the editorial board decided to apply an open-source software for the management of peer-reviewed academic journals »open journal systems« (ojs). ojs not only facilitates the work of all the members of the editorial board, improves their communication with authors on the one hand, and the reviewers and external collaborators on the other, but it also significantly improves the transparency of the work. by adopting the ojs editorial platform we are also upgrading the »usefulness« of the published articles by adding url addresses with links to the internet accessible articles, chapters or monographs from the lists of references. finally, the ojs software is compatible with the openaire instructions and allows direct export of metadata on articles which is required for the envisaged integration of the journal in the directory of open access journals (doaj), which is in line with the »national strategy of open access to scientific publications and research data in slovenia 2015 – 2020« by the ministry of education, science and sport. we also believe that all these efforts will be largely compensated by an overall increase in recognisability both on the national as well as international level. in 2015, the editorial board (both the select board and the wider board) and the board of reviewers were expanded to 58 members, which will certainly, in its own way, contribute to the journal's wider availability. prof. rado pišot, ph.d., editor-in-chief and managing editor annales kinesiologiae • 6 • 2015 • 1 2 uvodnik tudi vsebina prve številke 6. letnika annales kinesiologiae dokazuje, da je bila usmeritev revije v proučevanje in poglabljanje področja kineziologije s ciljem doseganja boljše kakovosti življenja prava odločitev in jo izzivi sodobne družbe še bolj intenzivno vzpodbujajo k obravnavi perečih tem. problemi, ki jih obravnavajo pričujoči znanstveni članki, so zanimivi spremljevalci strokovne rasti vseh vključenih v obravnavo vadbe in treninga, preventivnih oz. razvojnih spodbud kinezioloških programov ter vsebin organizirane in neorganizirane gibalne/športne vadbe. z recenzijo strokovne literature in s poročili z mednarodnih konferenc pa lahko bralec dobi širši pogled na aktualne probleme sodobne kineziološke znanosti. da bi zainteresirani strokovni javnosti in najširšemu krogu uporabnikov revije annales kinesiologiae omogočili še lažjo dosegljivost, hkrati pa olajšali upravljanje z recenzentskimi postopki, smo se v uredniškem odboru odločili, da pristopimo k uporabi odprtokodne programske opreme za izdajanje revij »open journal systems« (ojs). ojs ne le da olajša delo vseh članov uredniškega odbora, izboljšuje njihovo komunikacijo z avtorji na eni strani ter recenzenti in drugimi zunanjimi sodelavci na drugi, ampak tudi bistveno izboljša preglednost dela. s prehodom na uredniško platformo ojs nadgrajujemo tudi »uporabnost« objavljenih člankov z dodajanjem url-naslovov do spletno dostopnih člankov, poglavij ali monografij s seznamov referenc. nenazadnje pa je programska oprema ojs kompatibilna z navodili openaire in omogoča neposreden izvoz metapodatkov o člankih za potrebe predvidenega vključevanja revije v directory of open access journals (doaj), kar je v skladu z »nacionalno strategijo odprtega dostopa do znanstvenih objav in raziskovalnih podatkov v sloveniji 2015–2020« mizš. prepričani pa smo tudi, da bodo napori v veliki meri poplačani s splošnim povečanjem prepoznavnosti tako v nacionalnem kot mednarodnem merilu. v letu 2015 smo z 58 člani dopolnili (ožji in širši) uredniški in recenzentski odbor revije, kar bo gotovo na svojstven način prispevalo tudi k njeni širši dostopnosti. prof. dr. rado pišot, glavni in odgovorni urednik _enref_26 _goback _goback _goback _goback bm3 _goback _goback annales kinesiologiae • 7 • 2016 • 2 93 editorial could these be golden days for kinesiology!? if we take a look at today's lifestyle and the time that an average person spends being completely physically inactive, we can quickly find all the reasons for both poor performance and increased rate of illness (most of all chronic non-communicable diseases) of modern society. we have indeed entered an era when health analysis and risk reasons may be accompanied by the question of whether (and to what extent) you have a sedentary lifestyle and not only whether (and how much) you smoke!? nowadays, the overall increase in physical inactivity is not only a problem of certain groups of society but of all, children and the elderly, an average recreation enthusiast or a potential professional athlete. this is something that we, kinesiologists are convinced of. the question that poses is to what extent the wider society is aware of this issue and the problems it brings along? the present editorial and the presentation of articles herein, therefore, deliberately begins at the very end, with an only seemingly less important report on the round table, titled »a kinesiologist in the labour market« which was organized by the association of kinesiologists of slovenia and was held at the scientific and research centre of the university of primorska in the beginning of november 2016. the contents of the round table can be closely linked to the above-mentioned problems considering a wide spectre of needs, however, the round table can as well be connected with the 2016/2017 competitive skiing season which brought much success to our skier from maribor, ilka štuhec. our top skier especially likes to point out that her team consists of various professionals who are crucial in order to achieve such exceptional results, and among them, there is also a kinesiologist! nevertheless, this issue starts with an article which deals with the detailed examination of all the factors that cause numerous injuries on snowy slopes. once again, an individual with his or her own characteristics is in the spotlight. besides a mine of information offered by modern information technology, individuals are still not sufficiently prepared for taking efforts, are still ignorant of the ski slopes rules and regulations and are unreasonably tolerant to deviations from the security requirements that are established by professionals. the following articles further examine the role and importance of elementary movement patterns in motor development from childhood to old age, general physical efficiency and specifically targeted and tailored intervention programs for high-quality and independent lifestyle of the elderly etc. these are just as interesting and modern topics that concern every individual much more than we know. these topics, however, may be brought to the fore of interest only when we are old and incapable of performing daily tasks, when we need help and when we would give anything to overcome ... a flight of stairs!? »in the first half of our life we sacrifice our health in order to make money, in the other half we give money to recuperate health.« this is what was written by the french writer, philosopher and humanist françoismarie arouet voltaire (1694–1778) a long ago, yet, a man has not paid any attention to such warnings for centuries. in the articles published in this issue, we can again find evidence that the change only requires a shift in our belief, a real motivation and profes94 annales kinesiologiae • 7 • 2016 • 2 sional guidance. thus, all tailor-made interventions as well as the environment in which we spend the autumn of our life can contribute significantly to more success, health, and, above all, satisfaction of an individual and the society. kinesiologists firmly believe in this. our efforts to persuade the general public are only partially successful. scientifiarticles, conferences, meetings of professionals, round tables and other public events, workshops and promotions are a regular feature of our work. we strive for even more efficiency and would like to raise awareness among large crowds. however, can only a fear of illness, powerlessness, weakness and loss be more efficient? prof. rado pišot, ph.d. editor-in-chief and managing editor annales kinesiologiae • 7 • 2016 • 2 95 uvodnik zlati časi za kineziologijo!? če se ozremo na današnji način življenja in čas, ki ga povprečni posameznik preživi popolnoma gibalno neaktiven, lahko hitro najdemo razloge za vse slabšo učinkovitost in večjo obolevnost (predvsem s kroničnimi nenalezljivimi boleznimi) sodobne družbe. resnično smo stopili v čas, ko je ob analizo zdravstvenega stanja in razloge tveganja morda potrebno že kar na prvo mesto postaviti vprašanje ali (in koliko) sedite in ne le ali (in koliko) kadite!? splošni porast gibalne neaktivnosti danes ni le problem nekaterih specifičnih skupin temveč vseh, tako otrok kot starostnikov, povprečnega rekreativca ali potencialnega vrhunskega športnika. kineziologi to vemo! koliko pa je to vprašanje in iz njega izhajajoča problematika uzaveščena v širši družbi? v tokratnem uvodniku kratko predstavitev prispevkov zato namerno začenjamo na koncu, pri le na videz manj pomembnem poročilu iz okrogle mize z naslovom »kineziolog na trgu dela«, ki je v organizaciji društva kineziologov slovenije potekala na znanstveno-raziskovalnem središču univerze na primorskem v pričetku novembra 2016. vsebino okrogle mize namreč lahko tesno povežemo z zgoraj omenjeno problematiko na širokem polju potreb, lahko pa jo še posebej z navdušenjem povežemo tudi s tekmovalno smučarsko sezono 2016/2017 in uspehi mariborske smučarke ilke štuhec. naša vrhunska športnica posebej rada izpostavi, da ima v ekipi poleg ostalih strokovnjakov, ki so nujno potrebni za doseganje tovrstnih izjemnih rezultatov, tudi kineziologinjo! sicer pa nabor tokratnih prispevkov pričenjamo ravno s podrobno obravnavo dejavnikov, ki povzročajo številne poškodbe na zasneženih pobočjih. ponovno je v ospredju posameznik s svojimi značilnostmi. ob številnih informacijah, ki mu jih nudi sodobna informacijska tehnologija, še vedno ni dovolj pripravljen na napore, je nepoučen o redu na smučišču in nerazumno toleranten do odstopanj od strokovno uveljavljenih zahtev varnosti. vloga in pomen elementarnih gibalnih vzorcev v gibalnem razvoju od otroštva do starosti, splošne gibalne učinkovitosti ter posebej usmerjenih in prilagojenih intervencijskih programov za kakovostno in neodvisno življenje starejših odraslih, kar preučujejo naslednji prispevki, so ravno tako zanimiva in sodobna tematika, ki se slehernega posameznika dotika veliko bolj kot se danes zavedamo. morda stopi v ospredje interesa šele takrat, ko nam je v starosti onemogočeno opravljanje vsakodnevnih opravil, ko smo potrebni pomoči in ko bi dali vse, da bi lahko premagali … nekaj stopnic!? »polovico življenja dajemo zdravje za denar, drugo polovico pa denar, da bi ponovno pridobili zdravje« je, že dolgo tega, zapisal francoski pisatelj, filozof in humanist françois-marie arouet voltaire (1694–1778), pa vendar na ta zgodnja opozorila človek stoletja ni reagiral. v člankih, objavljenih v tokratni številki revije, lahko ponovno najdemo dokaze, da je za spremembo potreben le premik v prepričanju, pravi motiv ter strokovna usmeritev. tako prilagojene intervencije kot okolje, v katerem preživimo jesen življenja, lahko pomembno prispevajo k uspešnejšemu, zdravemu, predvsem pa zadovoljnemu posamezniku in družbi. 96 annales kinesiologiae • 7 • 2016 • 2 kineziologi smo v to prepričani. naša prizadevanja, da bi prepričali tudi laično javnost so le delno uspešna. znanstveni prispevki, konference, strokovna srečanja, okrogle mize in drugi javni dogodki, delavnice in promocije so stalnica pri našem delu. želeli pa bi si še večjo učinkovitost in dvig zavedanja med širšimi množicami. ali so res lahko bolj učinkoviti le strah pred boleznijo, nemoč, slabost in izguba? prof. dr. rado pišot, glavni in odgovorni urednik annales kinesiologiae • 6 • 2015 • 2 155 reports and reviews/poročila in ocene, 149–156 scientific conference active healthy aging (aha 2015) magdeburg, germany, 2nd −5th september 2015 the international scientific conference active healthy aging 2015 was held between 2nd and 5th september 2015 in magdeburg (germany) and was organized by the otto von guericke university magdeburg in cooperation with the dzne magdeburg (german center for neurodegenerative diseases within helmholtz association) and the city of magdeburg. the conference included several interesting scientific topics such as “60 is the new 40” and the meaning of active aging in the 21st century, preserving cognitive functions, the potentiating effects of physical and cognitive activity, maintaining independence through assistive technology systems, nutritional interventions to promote healthy aging, etc. the aha 2015 congress participants had a great opportunity to listen and learn from several excellent scientists from different countries with special emphasis on aha 2015 keynote speakers: • prof. michael falkenstein, ph.d., (leibniz research centre for working environment and human factors, university of dortmund, germany), • prof. martin lövden, ph.d., (aging research center, department of neurobiology, care sciences and society, karolinska institute, stockholm, sweden), • prof. marco narici, ph.d., (school of graduate entry medicine and health, university of nottingham, united kingdom), • prof. sandra pais, ph.d., (center for research and development in health, university of algarve, portugal), • prof. rado pišot, ph.d., (institute of kinesiology research, university of primorska, slovenia), and • prof. claudia voelcker-rehage, ph.d., (jacobs center on lifelong learning and institutional development, jacobs university bremen, germany). the interdisciplinary approach of the congress covered several aspects of active and healthy aging phenomena, such as cognition, physical activity and nutrition. the international scientific conference active healthy aging 2015 was attended by three members of the institute for kinesiology research, scientific and research centre koper, university of primorska, slovenia. firstly, rado pišot, ph.d., was invited as the keynote speaker and presented the results of the latest bed rest campaign with detailed insights of cognitive and functional decline that occur after a period of being immobilized or hospitalized. secondly, boštjan šimunič, ph.d., was chairing the symposium titled “physical activity and nutrition for healthy aging” as well as he gave a talk regarding the use of tensiomography in the field of aging. in the same symposium, our third participant, uroš marušič, ph.d., presented a computerized cognitive training approach for mitigating physical inactivity related negative effects. uroš marušič 156 reports and reviews/poročila in ocene, 149–156 annales kinesiologiae • 6 • 2015 • 2 znanstvena konferenca aktivno zdravo staranje (aha 2015) magdeburg, nemčija, 2.–5. september 2015 mednarodna znanstvena konferenca aktivno zdravo staranje (angl: active healthy aging; aha 2015) se je odvijala med 2. in 5. septembrom 2015 v magdeburgu (nemčija). organizirana je bila v okviru magdeburške univerze otto von guericke v sodelovanju z dzne magdeburg (nemški center za nevrodegenerativne bolezni znotraj združenja helmholtz) in mestom magdeburg. znanstvena konferenca je zajemala številna znanstvena področja, kot so “60. so nova 40”. in pomen aktivnega staranja v 21. stoletju, ohranjanje kognitivnih funkcij, učinki telesne in kognitivne aktivnosti, ohranjanje neodvisnosti s pomočjo podpornih tehnoloških sistemov, prehranske intervencije za spodbujanje zdravega staranja itd. udeleženci konference aha 2015 so imeli izjemno priložnost slišati številne odlične znanstvenike iz različnih držav, s posebnim poudarkom na vabljenih osrednjih govornikih aha 2015 konference: • prof. dr. michael falkenstein (center za raziskave delovnega okolja in človeških vplivov leibniz, univerza v dortmundu, nemčija), • prof. dr. martin lövden (center za raziskave staranja, oddelek za nevrobiologijo, socialno varstvo in družbene vede, karolinski inštitut, stockholm, švedska), • prof. dr. marco narici (fakulteta za medicinske in zdravstvene vede, univerza v nottinghamu, velika britanija), • prof. dr. sandra pais (center za raziskave in razvoj v zdravstvu, univerza algarve, portugalska), • prof. dr. rado pišot (inštitut za kineziološke raziskave, znanstveno-raziskovalno središče, univerza na primorskem, koper, slovenija) in • prof. dr. claudia voelcker-rehage (center jacobs za vseživljenjsko učenje in institucionalni razvoj, univerza jacobs, bremen, nemčija). interdisciplinarni pristop kongresa je zajemal več vidikov aktivnega in zdravega staranja, kot so kognicija, telesna aktivnost in prehrana v najširšem pomenu besede. mednarodne znanstvene konference aktivno zdravo staranje 2015 smo se udeležili trije predstavniki inštituta za kineziološke raziskave znanstveno-raziskovalnega središča univerze na primorskem. prof. dr. rado pišot je bil eden izmed osrednjih govornikov. predstavil je rezultate zadnje študije večdnevnega horizontalnega ležanja s poudarkov na kognitivnem in funkcionalnem upadu, ki nastane po določenem času hospitalizacije. izr. prof. dr. boštjan šimunič je vodil vabljeni simpozij z naslovom “telesna aktivnost in prehrana za zdravo staranje” ter predstavil prispevek z naslovom “uporaba tenziomiografije na področju staranja”. na istem simpoziju sem sam predstavil pristope računalniško podprtega kognitivnega treninga za ublažitev negativnih posledic večdnevne fizične neaktivnosti. uroš marušič _goback _goback _goback _goback _goback _goback _goback annales kinesiologiae • 9 • 2018 • 1 61 reports and reviews/poročila in ocene, 57–68 15th international conference on transformation processes in sport budva, montenegro, 12th–15th april 2018 from 12th to 15th of april 2018, a selection of researchers from the institute for kinesiology research of the science and research centre koper visited and participated in the 15th international scientific conference on transformation processes in sport organised by the montenegrin sports academy (msa). the conference entitled sports performance was held in coastal town of budva. the first lecture session was reduced to two speakers. antónio figueiredo of the faculty of sport science and physical education of the university of coimbra portugal displayed his extensive experience as a football coach and sports advisor into his lecture, titled youth soccer coach’s decisions: there is a biological-related issues bias? however, this lecture slightly missed a strong impact, due to the absence of related content supposed to be provided by the first speaker dejan madić who was going to speak about promotion of exercise interventions in children: is there a critical period. concluding this session was nejc šarabon, representing the faculty of health sciences of the university of primorska, slovenia with the lecture kinesiology in ergonomics: focus on back pain, that splendidly introduced the faculty›s on-going research projects. in two days, the scientific programme was divided into three rooms with parallel sessions that each hosted oral sessions and poster sessions with varied topics. rang62 reports and reviews/poročila in ocene, 57–68 annales kinesiologiae • 9 • 2018 • 1 ing from video games influencing tennis techniques, knee arthroplasty, bed rest influencing skeletal muscle, to movement and assessment in preschool children, and from gender differences in physical activity among elderly and non-physical techniques to counteract functional decline, to the potential contribution of muscles consumption to a healthier active lifestyle. through well-moderated sessions, the contributors among which were students and young researchers, were provided with plenty of time to present their findings and – time permitting – these were followed by fruitful discussions. several following lectures were of specific interest, especially rémi radel›s of the université cote d’azur, nice france neurocognitive functions involved in the regulation of effort during endurance exercise: a dual-model perspective that provided a clear theoretical proposition of the regulatory brain network of physical effort. and the lecture of boštjan šimunič of the science and research centre, koper, slovenia, dealing with skeletal muscle mechanical contractile properties: from childhood to late adulthood, which showed that through tensiomyography, nonsymmetrical development trends in muscle wasting could be observed for subjects that maintain different levels of physical activity. further detailed information on lectures and posters can be found on msa’s listing of conferences (http://csakademija.me/publications/#book-of-abstracts), where also previous editions can be found. well worth a browse and a further orientation into developing an interest in this highly diverse and interesting regional conference on sport performance of various disciplines and the like. cécil meulenberg annales kinesiologiae • 9 • 2018 • 1 63 reports and reviews/poročila in ocene, 57–68 15. mednarodna konferenca »transformacijski procesi v športu« budva, črna gora, 12.–15. april 2018 izbrani raziskovalci inštituta za kineziološke raziskave znanstveno-raziskovalnega središča koper, so se s predstavitvijo prispevkov udeležili 15. mednarodne znanstvene konference »transformacijski procesi v športu«, ki jo je od 12. do 15. aprila 2018 organizirala športna akademija črne gore. konferenca z naslovom »športna učinkovitost« je potekala v obmorskem mestu budva. v uvodni sekciji sta bili predstavljeni samo dve od načrtovanih treh predavanj. prvo je imel prof. antónio figueiredo iz fakultete za športno znanost in telesno vzgojo, univerze v coimbri (portugalska). prikazal je dobro poznavanje področja treninga nogometa in svoje izkušnje nogometnega trenerja in športnega svetovalca predstavil v predavanju na temo odločanja nogometnih trenerjev na področju otrok in mladostnikov, z naslovom »odločitve nogometnega trenerja in upoštevanje bioloških danosti otrok in mladostnikov«. predavatelj je pustil precej odprtih vprašanj in tez, predvsem zaradi dejstva, da se konference žal ni mogel udeležiti tretji od načrtovanih uvodnih govorcev prof. dejan madić, ki naj bi predstavil komplementarno temo z naslovom »promocija gibalno/športnih intervencij med otroci in mladostniki: ali obstaja kritična obdobje?« in v njej predstavil področje športa otrok in mladostnikov. sekcijo je zaključil prof. nejc 64 reports and reviews/poročila in ocene, 57–68 annales kinesiologiae • 9 • 2018 • 1 šarabon iz fakultete za vede o zdravju univerze na primorskem, slovenija, ki je v predavanju z naslovom »kineziologija v ergonomiji: poudarek na bolečini v spodnjem delu hrbta«, ponudil dober vpogled v raziskave in projekte, ki jih izvajajo na fakulteti. dvodnevni znanstveni program je potekal v treh dvoranah s paralelnimi sekcijami, od katerih je vsaka gostila tako predavanja kot poster predstavitve. teme so bile zelo raznovrstne: vpliv video iger na tehniko tenisa, kolenska artroplastika, vpliv ležanja na skeletno mišico, gibalna aktivnost in spremljanje le-te med predšolskimi otroci, razlika med spoloma v gibalni aktivnosti v starosti, kognitivne tehnike za zmanjšanje funkcionalnega upada, potencialni vpliv uživanja školjk na aktiven življenjski slog. skozi dobro moderirane sekcije so predavatelji, tudi študentje in mladi raziskovalci, imeli dovolj časa za temeljite predstavitve njihovih ugotovitev kot tudi za pestre razprave. sekcija uvodnih predavanj drugega dne je bila izredno zanimiva. prof. rémi radel iz université cote d’azur, nica, francija je v predavanju z naslovom »neurokognitivne funkcije, vključene v regulacijo napora med vzdržljivostnim treningom. dvodelni model« predstavil teoretično ozadje regulatornih mehanizmov možganske mreže med telesnim naporom. prof. boštjan šimunič iz znanstveno-raziskovalnega središča koper, slovenija je v predavanju z naslovom »kontraktilni mehanizmi skeletne mišice: od otroštva do pozne odraslosti« predstavil metodo tenziomiografije ter pokazal, da je mogoče s to metodo opazovati nesimetrične razvojne trende propadanja mišic pri osebah, ki vzdržujejo različne stopnje telesne aktivnosti. vse informacije o predavanjih in posterjih je mogoče najti na spletni strani športne akademije črne gore (http://csakademija.me/publications/#book-of-abstracts), kjer so dostopne tudi vsebine prejšnjih konferenc. priporočam ogled vsebin izvedene konference po področjih interesa. konferenco prepoznavam kot interesantno področno srečanje na temo športne zmogljivosti in drugih sorodnih tem. cécil meulenberg (prevod v slovenščino matej plevnik) annales kinesiologiae • 7 • 2016 • 1 1 editorial on numerous occasions, the factors of positive impact of physical / sport activities on health and quality of life have been already studied, tested and proven. the objectives of new and advanced research into these factors are, among other things, the search for new opportunities, shedding light on grey areas, opening any niches ... what is extremely important, is the flexibility of these factors regarding each individual role of man in modern society, the profession, the environment and, especially, gender and age. by studying the differences and mechanisms and by the differentiation of the selected interventions of the adjusted dimensioning and the content of exercise in real time, we can seek higher performance, better management of these factors, and especially, increased efficiency. the four original scientific contributions published in issue 1, volume 7, of annales kinesiologiae, reveal the perspective of examining the young and the old, men and women, in specific situations, and also in sports where the aim is, unfortunately, not always directed only at the quality of an individual and their performance, but also at the competition and the results, here and now. the articles in this volume demonstrate the importance of longitudinal studies which are necessary in order to monitor the development of an individual from his or her earliest childhood to old age on one hand, and the development of society as a whole on the other. it is becoming increasingly evident that the development of society does not necessarily mean a quality development of an individual. these are topics covered in the article on the pre-school children's achievements on abc movement tests trends and the article on the correlation between the time of contraction of the biceps femoris skeletal muscle and the maximum running speed both in children and adults. more methodological is the article on the issue of the role of small-sided games in the modern soccer training. the methodology of small-sided games is not the focal point of the article, however, it does reach into the area of system theories as theories on achieving the most accomplished integrity of reflection and behaviour. safety in sport and recreation and planning of activities are of special importance, as discussed in the article of safety elements in paragliding. only a safe sport is a healthy, quality and entertaining activity. these days, active sports tourism is increasingly gaining in economic importance and so much more can still be done in the area of prevention. as usual, the section reviews and reports in this journal continues with a series of reports from two conferences, which usually summarize various aspects of the aforementioned factors. the journal rounds up with a brief review of the proceedings, published in 2016 by nova science. titled effects of physical activity on the anthropological status of children, youth and adults, it associates with the same red thread of the topics mentioned at the beginning of this editorial. prof. rado pišot, ph.d. editor-in-chief and managing editor 2 annales kinesiologiae • 7 • 2016 • 1 uvodnik dejavniki pozitivnega vpliva gibalne/športne aktivnosti na zdravje in kakovost življenja so bili neštetokrat preučevani, preverjeni in dokazani. vedno nove in naprednejše raziskave teh dejavnikov si za cilje med drugim postavljajo iskanje novih možnosti, osvetljevanje sivih con, odpiranje niš ... gotovo je izredno pomembna njihova prilagodljivost posamezni vlogi človeka v sodobni družbi, poklicu, okolju predvsem pa spolu in starosti. s preučevanjem razlik in mehanizmov ter diferenciacijo izbranih intervencij, prilagojenega dimenzioniranja in vsebine vadbe v realnem času, lahko iščemo večji učinek, lažje upravljanje omenjenih dejavnikov, predvsem pa njihov boljši izkoristek. v štirih izvirnih znanstvenih prispevkih, objavljenih v prvem zvezku 7. letnika revije annales kinesiologiae, nam avtorji odstirajo pogled na preučevanje mlajših in starejših, moškega in ženskega spola, v specifičnih situacijah in nenazadnje v športih, kjer cilj, žal, ni vedno usmerjen le v kakovost posameznika in njegovega učinka, temveč pogosto predvsem v tekmovalni rezultat tukaj in zdaj. v tokratnih prispevkih se ponovno izkazuje pomen longitudinalnih študij, ki so nujne za spremljanje razvoja posameznika od njegovega najzgodnejšega otroštva do pozne starosti na eni strani ter razvoja družbe kot celote na drugi. vse bolj očitno namreč postaja, da razvoj družbe ne pomeni nujno kakovostnega razvoja posameznika znotraj nje. to so tematike, o katerih govorita prispevek o dosežkih predšolskih otrok na testih abc gibanja ter prispevek o korelaciji med časom krčenja skeletne mišice biceps femoris in maksimalno hitrostjo teka pri otrocih in odraslih. na bolj metodološko področje posega prispevek o vprašanju vloge igralnih oblik pri sodobni vadbi nogometa. ne posveča se toliko sami metodologiji igralnih oblik, ampak poseže na področje sistemskih teorij kot teorij o doseganju čim večje celovitosti razmisleka in ravnanja. posebnega pomena pa je gotovo varnost v športu in rekreaciji ter s tem povezano načrtovanje aktivnosti, o čemer govori prispevek elementi varnosti v jadralnem padalstvu. le varno je lahko zdravo, kakovostno in nenazadnje razvedrilno. v časih, ko aktivni športni turizem vse bolj pridobiva na gospodarskem pomenu, odkrivamo, da je mogoče še marsikaj postoriti na področju preventive. kot običajno tudi tokratno številko v rubriki ocene in poročila nadaljujemo s poročili iz dveh konferenc, ki praviloma povzemajo različne vidike obravnave omenjenih dejavnikov. revijo pa zaključuje kratka ocena zbornika, ki je v letu 2016 izšla pri založbi nova science, in nas z naslovom učinki telesne aktivnosti na antropološki status otrok, mladine in odraslih ponovno vrne na začetek tega uvodnika. prof. dr. rado pišot, glavni in odgovorni urednik annales kinesiologiae • 6 • 2015 • 2 83 editorial three important factors that have always both characterized and separated a man from other living beings are a unique combination of cognitive abilities, social participation and extremely sophisticated physical activity. it has been repeatedly proven that physical competency is one of the most important factors of self-exploration and interaction with the environment as well as a sign of harmonious development and preservation of health. physical development that takes place in close interaction with the environment (besides genetic and environmental factors), is focused on the acquisition of vital physical competencies, which represents an upgrade of motor skills and motor abilities. in phylogeny, physical activity of a man is much more than just transport movement and has been developing along with the need for survival, communication, creativity and expressiveness, identification, even with the contents of sport as a means of socialization and integration, and also as a social norm. however, in the modern and developed world it has lost its important role. in terms of aggressiveness of the modern environment and changes in modern society, the study of development mechanisms and functioning of the human organism, the basic human habitat, needs to consider and respect the fundamental biological laws. therefore, the scope of research in the scientific papers and professional recommendations in the second issue of annales kinesiologiae, year six, is focused primarily on optimizing an individual’s and group physical movement with the aim of raising physical abilities, taking care of health and observing recommendations for safe and effective physical activity. in three review and original scientific articles, their authors represent the importance of endurance exercise in childhood, how the selected training methods can affect some specific metabolic processes and the potential and the need for treatment of specific postures and positions of musicians with the help of kinesiology. only a safe physical activity is entertaining and acceptable in a sustainable way. the topics of the abovementioned articles are complemented by a series of expert recommendations and fact sheets which are listed among the contents of the annales kinesiologiae journal for the first time, hoping that this shall become a regular practice. the applied value that science is able to offer to direct users will in this way get a new section in the journal, which, i believe, we will be able to conveniently use to good effect at our work. and last but not least, as a regular practice by now, the journal concludes with reports from international scientific conferences which are brought closer to us through the views of the authors and, which, thereby, indirectly involve us in the events and might evoke interest in us for future participation. prof. rado pišot, ph. d., editor-in-chief and managing editor 84 annales kinesiologiae • 6 • 2015 • 2 uvodnik edinstven preplet kognitivnih zmožnosti, socialne participacije ter specifične in izredno dovršene gibalne aktivnosti so trije pomembnejši dejavniki, ki so človeka že od nekdaj značilno ločili od ostalih živih bitij. dejstvo, da so gibalne kompetence eden od najpomembnejših dejavnikov spoznavanja samega sebe ter interakcije z okoljem pa tudi skladnega razvoja in ohranjanja zdravja, je bilo že večkrat dokazano. gibalni razvoj, ki poteka v tesni interakciji z okoljem (med genetskimi in okoljskimi dejavniki), je usmerjen k usvajanju življenjsko pomembnih gibalnih kompetenc, kar predstavlja nadgradnjo gibalnih znanj in gibalnih sposobnosti. gibalna aktivnost, ki je v filogenezi človeka pomenila veliko več kot zgolj transportno gibanje in se je v njegovi kompetenci razvijala s potrebo po preživetju, komunikaciji, kreativnosti in izraznosti, identifikaciji, vse do vsebin športa kot socializacijske in integracijske vsebine, ne nazadnje družbene norme, pa je danes v sodobnem in razvitem svetu izgubila svojo pomembno vlogo. obravnava mehanizmov razvoja in delovanja človeškega organizma, osnovnega prostora bivanja človeka, z vidika agresivnosti sodobnega okolja in spremenjenih okvirjev sodobne družbe nujno vključuje upoštevanje temeljnih bioloških zakonitosti. in ravno optimizacija gibanja posameznika in skupin s ciljem dviga gibalnih zmožnosti, zagotavljanja zdravja in priporočil varne in učinkovite vadbe so področja obravnave znanstvenih prispevkov in strokovnih priporočil druge številke šestega letnika annales kinesiologiae, ki je pred vami. skozi tri pregledne in izvirne znanstvene prispevke nam avtorji predstavljajo pomen vzdržljivostne vadbe v otroštvu, kako lahko izbrane vadbene metode vplivajo na specifične procese metabolizma ter možnosti in potrebo po kineziološki obravnavi specifičnih drž in položajev glasbenih umetnikov. le varna vadba je lahko zabavna in učinkovita ter trajnostno sprejemljiva za uporabnika. tematiko omenjenih prispevkov dopolnjuje prispevek strokovnih priporočil, ugotovljenih dejstev (fact sheets), ki jih tokrat prvič uvrščamo med vsebine revije annales kinesiologiae in si želimo, da bi to postala trajna praksa. uporabna vrednost, ki jo znanost lahko ponudi neposrednemu uporabniku znanja, bo v tej obliki dobila novo rubriko, za katero verjamem, da jo bomo znali s pridom izkoristiti pri našem delu. kot običajno pa zaokrožujemo tudi to številko s predstavitvami mednarodnih znanstvenih konferenc, ki nam jih avtorji približajo s svojimi pogledi in nas na ta način posredno vključijo v dogajanje ter zainteresirajo za sodelovanje v bodoče. prof. dr. rado pišot, glavni in odgovorni urednik _goback _goback _goback _goback _goback _goback _goback annales kinesiologiae • 7 • 2016 • 2 171 reports and reviews/poročila in ocene, 171–180 the 21st annual congress of the european college of sport science vienna, austria, 6th − 9th july 2016 the 21st annual scientific congress “european college of sport science (ecss)” took place in vienna (austria) between 6th and 9th july 2016. this was the second biggest ecss congress in history (after the ecss barcelona 2013) with a total of 2,783 researchers from all over the world who attended the event. the participants presented their latest discoveries in their respective scientific fields such as physiology, sports training and measurement, health and endurance, sports medicine and orthopedics, biomechanics and other. similarly, the competition for young researchers (ecss young investigator award 2016 contest) took place at ecss in vienna. in this context, two researchers from the university of primorska (slovenia) won their prizes. out of the total of 421 competitors, assistant professor uroš marušič, ph.d., and assistant professor borut fonda, ph.d., entered the finals competing with 116 best young investigators and won the fourth and the fifth place, respectively. assistant professor uroš marušič, ph.d., presented his article titled “mental simulation of locomotor tasks improves rehabilitation outcome in elderly adults after hip surgery”, which included results from a twelvemonth “pangea hip study” and presented an innovative concept of rehabilitation after hip replacement. assistant professor borut fonda, ph.d., presented his work titled “the effect of the medial-lateral force during cycling” where he underlined some practical aspects of measuring forces on pedals during cycling in order to achieve optimization of efficiency and prevention of injuries. additional information on the ecss can be found on the following links: http://sport-science.org/index.php?option=com_content&view=article&id=599 http://sport-science.org/index.php?option=com_content&view=article&id=600 the next congress is foreseen to take place in essen (germany), from 5th to 8th july 2017. uroš marušič http://sport-science.org/index.php?option=com_content&view=article&id=599 http://sport-science.org/index.php?option=com_content&view=article&id=600 172 reports and reviews/poročila in ocene, 171–180 annales kinesiologiae • 7 • 2016 • 2 21. letni znanstveni kongres »european college of sport science« dunaj, avstrija, 6.-9. julij 2016 21. letni znanstveni kongres »european college of sport science (ecss)« je potekal na dunaju (avstrija) med 6. in 9. julijem 2016. po številu udeležencev je bil to drugi največji ecss kongres do sedaj, takoj za ecss v barceloni (leta 2013), z udeležbo kar 2783 raziskovalcev iz celotnega sveta. udeleženci kongresa so predstavili svoje najnovejše ugotovitve na različnih znanstveno-raziskovalnih področjih, kot so npr. fiziologija, treniranje in merjenje, zdravje in zmogljivost, športna medicina in ortopedija, biomehanika, itd. prav tako kot pretekla leta je v okviru ecss na dunaju potekalo tekmovanje mladih raziskovalcev (ecss young investigator award 2016 contest), v okviru katerega sta nagradi osvojila tudi raziskovalca z univerze na primorskem. izmed skupno 421 tekmovalcev, sta doc. dr. uroš marušič in doc. dr. borut fonda prišla v »ožji« izbor 116-ih mladih raziskovalcev ter na koncu dosegla prestižni 4. in 5. mesto. doc. dr. uroš marušič je predstavil prispevek z naslovom »mental simulation of locomotor tasks improves rehabilitation outcome in elderly adults after hip surgery«, kjer je z rezultati enoletne študije »pangea hip study« predstavil inovativen koncept rehabilitacije po zamenjavi kolka. doc. dr. borut fonda je predstavil prispevek z naslovom »the effect of the medial-lateral force during cycling«, kjer je izpostavil praktični pomen meritev sil na pedalih med kolesarjenjem za optimizacijo učinkovitosti in preprečevanje poškodb. več informacij o kongresu in nagradah je dostopnih na spletnih naslovih: http://sport-science.org/index.php?option=com_content&view=article&id=599 http://sport-science.org/index.php?option=com_content&view=article&id=600 naslednji kongres ecss bo 22. po vrsti, potekal pa bo med 5. in 8. julijem v essnu, nemčija. uroš marušič http://sport-science.org/index.php?option=com_content&view=article&id=599 http://sport-science.org/index.php?option=com_content&view=article&id=600 annales kinesiologiae • 8 • 2017 • 1 57 reports and reviews/poročila in ocene, 51–60 36th international conference on organizational science development portorož, slovenia, 22nd−24th march 2017 faculty of organizational sciences, university of maribor organized a traditional international conference on organizational science development and this year`s theme was responsible organization. from kinesiological sciences` point of view, an important section of the conference was management in sport and within this section a special event titled “dual career of athletes and social responsibility”. the latter was organized by faculty of organizational sciences (um), ministry of education, science and sport and olympic committee of slovenia, association of sports federations. the section was divided into two parts: a presentation of views on the dual career of slovenian athletes by key stakeholders and a round table. the views on understanding and further development of dual career of slovenian athletes were presented by the representatives of regulators and decision makers (simona kustec lipicer, the member of the slovenian parliament; boro štrumbelj from the ministry of education, science and sport, directorate for sport; edvard kolar from the olympic committee of slovenia, secretary general; maja makovec brenčič, the minister of education, science and sport of slovenian government); as well as businesses and companies dealing with human resources management (rene mlekuž, the representative of the peak company in slovenia and the sponsor of olympic committee of slovenia, the association of sports federations and damir battisti from addeco slovenia) and the representatives from education sector (marko ferjan from the university of maribor). the starting point of the round table discussion was dedicated to the preliminary results of the erasmus + project “regional centre for dual career politics and advocacy” (dc4ac) which took place at the scientific and research centre koper. namely, a survey was presented, offering an insight into the situation in this field as perceived by some present and former slovenian athletes. in addition to the representatives of key stakeholders in the field of dual career, the ombudsman and the representative of the austrian organization kada all actively participated in the discussion. the latter presented the austrian model of dual career, which is often referred to by the international profession as an example of good practice. in recent years, athletes’ dual career has become an extremely topical issue at the international level, and with events like this it is becoming an important item on the national agenda. blaž lenarčič 58 reports and reviews/poročila in ocene, 51–60 annales kinesiologiae • 8 • 2017 • 1 36. mednarodna konferenca o razvoju organizacijskih znanosti portorož, slovenija, 22.–24. marec 2017 fakulteta za organizacijske vede univerze v mariboru je organizirala tradicionalno mednarodno konferenco o razvoju organizacijskih znanosti, katere osrednja tema je bila odgovorna organizacija. z vidika kinezioloških znanosti je bila pomembna sekcija management v športu, v okviru katere se je odvil poseben dogodek z naslovom »dvojna kariera športnikov in družbena odgovornost«, ki so ga organizirali fakulteta za organizacijske vede, ministrstvo za izobraževanje, znanost in šport ter olimpijski komite slovenije – združenje športnih zvez. sekcija je bila razdeljena na dva dela: predstavitev pogledov na dvojno kariero slovenskih športnikov s strani ključnih deležnikov in okroglo mizo. poglede na razumevanje in nadaljnji razvoj dvojne kariere slovenskih športnikov so predstavili predstavniki zakonodajalcev in odločevalcev (simona kustec lipicer, poslanka dz, boro štrumbelj, direktor direktorata za šport, ministrstvo za izobraževanje, znanost in šport rs, edvard kolar, generalni sekretar olimpijskega komiteja slovenije – združenja športnih zvez in maja makovec brenčič, ministrica, ministrstvo za izobraževanje, znanost in šport rs), gospodarstva in podjetja za kadrovski management (rene mlekuž, predstavnik podjetja peak v sloveniji, sponzor olimpijskega komiteja slovenije – združenja športnih zvez in damir battisti, adecco slovenija) ter izobraževalnega sektorja (marko ferjan, univerza v mariboru). izhodišče diskusije okrogle mize so bili preliminarni rezultati erasmus+ projekta regionalni center za omogočanje dvojne poklicne poti športnikov (dc4ac), ki so ga izvajali na znanstveno-raziskovalnem središču koper. predstavljena je bila raziskava, s pomočjo katere smo pridobili vpogled v stanje na tem področju, kot ga dojemajo aktualni in nekdanji slovenski športniki. poleg predstavnikov ključnih deležnikov dvojne kariere sta v diskusiji aktivno sodelovala še varuh športnikovih pravic in predstavnik avstrijske organizacije kada. slednji je skozi pogovor predstavil avstrijski model dvojne kariere, ki ga mednarodna stroka pogosto navaja kot primer dobre prakse. v zadnjih letih je postala dvojna kariera športnikov izjemno aktualna tema na mednarodnem nivoju in z dogodki, kot je bil tu predstavljeni, postaja pomembna vsebina nacionalne agende. blaž lenarčič _goback _goback _goback _hlk501362470 _hlk501363405 _hlk501369360 annales kinesiologiae • 8 • 2017 • 2 137 reports and reviews/poročila in ocene, 137–142 mediterranean health centre institute for kinesiology research of the science and research centre koper arena bonifika, koper, slovenia; december 13th, 2017 on december 13th, 2017, institute for kinesiology research of the science and research centre koper held an opening ceremony of its new mediterranean health centre. the centre was established with a strong support of the municipality of koper and will significantly add to the development of sports activities locally as well as in the wider region. with the cooperation of the team of experts from the nearby izola general hospital, the main purpose of the centre is to give support in rehabilitation after sports injuries. a solemn opening ceremony was introduced with a speech held by the head of the institute for kinesiology research of the zrs koper, assoc. prof. boštjan šimunič, ph.d., who summarized the past achievements of the institute. prof. rado pišot, ph.d., director of zrs koper, further explained the planned purposes of the new mediterranean health centre premises. he pointed out the center’s general support of active healthy living and of the widely acknowledged mediterranean lifestyle. its main focus is going to be on functional diagnostics, development and planning of modern and holistic exercise programs, rehabilitation programs designed to the specific individual needs, thus, providing safe and quick return of active sportsmen and women to their activities and designing healthy ergonomic working conditions. the municipality of koper has been a strong supporter of the centre since the beginning. as the mayor, mr. boris popovič put it, it represents an important step towards the realization of a long-time ambition of the municipality of koper to become an important destination of sports tourism. the support given to the opening of the medi138 reports and reviews/poročila in ocene, 137–142 annales kinesiologiae • 8 • 2017 • 2 annales kinesiologiae • 8 • 2017 • 2 139 reports and reviews/poročila in ocene, 137–142 terranean health centre was also expressed by the president of the slovenian olympic committee mr. bogdan gabrovec, and the head of the institute of sports medicine of the faculty of medicine of the university of maribor, assoc. prof. matjaž vogrin, m.d., ph.d. with this even, the institute for kinesiology research of the zrs koper rounded up the year 2017 that can be marked as a successful one. it was the year in which the institute obtained two important and worldwide acknowledged accreditations, namely a fifa medical centre of excellence (in collaboration with the institute of sports medicine of the faculty of medicine of the university of maribor, the brdo national football centre and maribor university medical centre) and an olympic sports medicine centre (in collaboration with izola general hospital), the latter providing sportsmen with fast and efficient injury diagnostics and first aid. the centre opening earned special acknowledgement by the president of uefa, mr. aleksander čeferin, who sent his congratulations to the entire team of the institute for kinesiology research of the zrs koper. matej kleva 140 reports and reviews/poročila in ocene, 137–142 annales kinesiologiae • 8 • 2017 • 2 mediteranski center zdravja inštitut za kineziološke raziskave, znanstveno-raziskovalno središče koper arena bonifika, koper, 13. december 2017 v koprski areni bonifika je 13. decembra 2017 inštitut za kineziološke raziskave znanstveno-raziskovalnega središča koper (zrs) slovesno odprl prostore mediteranskega centra zdravja. center, ki je zaživel ob podpori mestne občine koper, bo pomembno prispeval k razvoju športa v lokalnem okolju in širše, v prvi vrsti pa bo ob sodelovanju strokovnjakov splošne bolnišnice izola (sbi) namenjen rehabilitaciji posameznikov po športnih poškodbah. svečana otvoritev se je pričela z uvodnim pozdravom predstojnika inštituta za kineziološke raziskave, zrs koper, dr. boštjana šimuniča, ki je povzel vse dosedanje dosežke inštituta, ki ga vodi. direktor zrs koper, prof. rado pišot, je v nadaljevanju pojasnil, da bodo novi prostori mediteranskega centra zdravja namenjeni vsesplošni podpori zdravju, ki bo slonela na mediteranskem življenjskem slogu s svetovno priznanim znakom odličnosti. aktivnosti centra bodo osredotočene na funkcionalno diagnostiko, razvoj in načrtovanje sodobnih in celostnih programov vadbe in rehabilitacije po meri posameznikov, z zagotavljanjem varnega vračanja po poškodbah pa tudi načrtovanju zdravega delovnega okolja. odprtje centra je omogočila mestna občina koper, saj sodeč po besedah župana, gospoda borisa popoviča, mediteranski center zdravja predstavlja pomemben korak k uresničitvi dolgoletnih prizadevanj občine, da bi koper postal tudi športno-turistični center. podporo odprtju mediteranskega centra zdravja sta izrazila tudi predsednik olimpijskega komiteja slovenije, gospod bogdan gabrovec in predstojnik inštituta za športno medicino medicinske fakultete univerze v mariboru, dr. matjaž vogrin. annales kinesiologiae • 8 • 2017 • 2 141 reports and reviews/poročila in ocene, 137–142 142 reports and reviews/poročila in ocene, 137–142 annales kinesiologiae • 8 • 2017 • 2 inštitut za kineziološke raziskave zrs koper, je s tem dogodkom zaključil uspešno leto 2017, v katerem je pridobil dve pomembni mednarodni akreditaciji – fifa medicinski center odličnosti (v sodelovanju z inštitutom za športno medicino medicinske fakultete v mariboru, centrom nzs brdo in ukc maribor) in olimpijski referenčni športno-medicinski center (v sodelovanju s splošno bolnišnico izola), v katerem bodo športniki po diagnostiki dobili hitro pomoč. obe akreditaciji sta svoj sedež dobili v mediteranskem centru zdravja. hkrati se s tem imenovanjem zaokrožuje slovenska mreža referenčnih medicinskih centrov. ob odprtju mediteranskega centra zdravja je čestitke inštitutu za kineziološke raziskave zrs koper poslal tudi predsednik uefe, gospod aleksander čeferin. matej kleva annales kinesiologiae • 8 • 2017 • 1 51 reports and reviews/poročila in ocene, 51–60 report from the 2nd round table »a kinesiologist in the labour market« slovenian association of kinesiology, faculty of sport, ljubljana, 20th april 2017 the slovenian association of kinesiology decided to organize another round table, after the first one which was held in koper on 8th november 2016. about 50 students took part in the event at the faculty of sport on 20th of april 2017. while at the first round table the role and importance of the study of kinesiology in the society was presented and also the current situation and the possibilities for placement of the profession into the labour market were discussed, determining what obstacles we encounter, the purpose of the second round table was somewhat different. the main aim of the second round table was the presentation of young successful kinesiologists and the obstacles in the field of employment that they need to surpass in their careers. the invited kinesiologists briefly presented what they are doing, how their career started, which obstacles they encountered and how they have overcome them. they also gave their view of the future of kinesiology. official guests of the round table were: luka hren (one of the founders of kinvital d.o.o.) who presented an example of a successful independent career in the field of kinesiology; katja vodopivec (employed at the private physiotherapeutic centre remedios in maribor) who presented the connection between kinesiology and physiotherapy; matej kleva (employed at the science and research centre of koper, institute for kinesiology research) who presented an example of the application of scientific knowledge into practice; suzana pustivšek and aljaž valič (employed in health centres in the project titled “the development of personnel in sport of the ministry of education, science and sport”) who presented the work of a kinesiologist in health centres. last but not least, anja šešum (member of the ilka štuhec team) as one of the best known kinesiologists in slovenia presented her approach and work in the ilka štuhec team. at the second round table “a kinesiologist at the labour market” we were focused on the present and the future work of successful young kinesiologists. in the conclusion, once again the right direction of slovenian association of kinesiology was confirmed, despite the fact that the current situation and possibilities for placing the profession of a kinesiologist into the labour market are not in ideal position. nevertheless, the profession enables endless possibilities for working in various fields of society. matej kleva 52 reports and reviews/poročila in ocene, 51–60 annales kinesiologiae • 8 • 2017 • 1 poročilo iz 2. okrogle mize: »kineziolog na trgu dela« društvo kineziologov slovenije, fakulteta za šport, ljubljana, 20. april, 2017 po izvedeni prvi okrogli mizi 8. novembra 2016 v kopru, se je društvo kineziologov slovenije odločilo za izvedbo še druge okrogle mize na isto temo. dogodka, ki je potekal na fakulteti za šport univerze v ljubljani, se je udeležilo 50 študentov. na prvi okrogli mizi je bila predstavljena vloga in pomen študija kineziologije v družbi in izpostavljeno je bilo trenutno stanje ter možnosti za umestitev poklica na trg dela ter ovire s katerimi se pri tem srečujemo. namen tokratne okrogle mize pa je bil predstavitev mladih uspešnih kineziologov, ki so določene ovire na področju zaposlovanja že presegli. gostje so na kratko predstavili s čim se ukvarjajo in kako se je začela njihova karierna pot, s katerimi ovirami se srečujejo in kako jih premagujejo. ob tem so izpostavili tudi svoj pogled na prihodnost kineziologije. povabljeni gostje na okrogli mizi so bili: luka hren (eden od ustanoviteljev podjetja kinvital d.o.o), ki je predstavil primer uspešne samostojne poti na področju kineziologije; katja vodopivec (zaposlena v zasebnem fizioterapevtskem centru remedios v mariboru), ki je predstavila povezavo med kineziologijo in fizioterapijo, matej kleva (zaposlen na znanstveno-raziskovalnem središču koper, inštitut za kineziološke raziskave), ki je predstavil primer prenosa znanstvenih dognanj v prakso; suzana pustivšek in aljaž valič (zaposlena v zdravstvenih centrih preko razpisa razvoj kadrov v športu ministrstva za izobraževanje, znanost in šport), ki sta predstavila delo kineziologa v zdravstvenih domovih ter anja šešum (članica ekipe ilke štuhec), kot ena izmed trenutno najbolj znanih kineziologinj v sloveniji, ki je predstavila pristop in delo v ekipi vrhunske smučarke ilke štuhec. na drugi okrogli mizi so gostje izpostavili prakse dela uspešnih mladih kineziologov, udeleženci pa so prisluhnili njihovemu pogledu na stroko in željam za prihodnost. vnovič je bila potrjena vizija društva kineziologov slovenije, da kljub temu, da trenutno stanje in možnosti za umestitev poklica kineziologa na trg dela še niso takšne kot bi morale biti, stroka omogoča neskončno možnosti za delovanje na različnih področjih. matej kleva _goback _goback _goback _hlk501362470 _hlk501363405 _hlk501369360 annales kinesiologiae • 8 • 2017 • 1 1 editorial at the very beginning, during the process of formation, annales kinesiologiae has set itself the objective to answer the questions regarding kinesiological science and to reveal the issues that its distinctly interdisciplinary and integrative nature reveals on a daily basis. critical consideration of scientific research questions mirrored in the kinesiology science thus faces us with the responsibility towards science, profession and society, individuals and groups, direct users of the findings and the conclusions that we offer. on numerous occasions, the factors of the positive impact of physical / sport activities on both health and quality of life have already been studied, tested and proven. the objectives of the new and advanced research into these factors are, among other, the search for new opportunities, shedding light on grey areas, opening new niches ... what is extremely important is the flexibility of these factors regarding each individual role of man in modern society, the profession, the environment and, especially, gender and age. by studying the differences and mechanisms and by differentiation of the selected interventions of the adjusted dimensioning and the content of exercise in real time, we can seek higher performance, better management of these factors, and especially, increased efficiency. the four original and review scientific contributions published in issue 1, volume 8 of annales kinesiologiae reveal the perspective of examining the young and the old, men and women, in specific situations, also in sports where the aim is, unfortunately, not always directed only at the quality of an individual and their performance, but also at the competition and the results, here and now. the issue is introduced by a rather methodological article looking into the question is specific motor test enough to evaluate new alpine ski knowledge in ski beginners? the motor test using continuous lateral jumps in dictated tempo – skilj is being used to evaluate new alpine ski knowledge and is the focal point of the article which aims at determining whether the results of such motor tests can be used to evaluate the level of acquired knowledge of ski beginners. tensiomyography as a tool for measuring muscle contraction time and maximal radial displacement of biceps femoris is described in the following article. a division between the sedentary participants and those who were regularly engaged in recreational sports activities has been observed and recognized. two articles in this volume introduce the review studies that originate from the results of the international research project pangea (physical activity and nutrition for great ageing). it is becoming increasingly evident that both motor as well as cognitive exercise is essential for healthy ageing. these are the topics covered in the article on exercise and the ageing immune system and the article which present the benefits of motor / cognitive exercise with recommendations for third age. as usual, the section reviews and reports in this journal continues with a series of reports from various events. first with a report from the second round table »a kinesiologist in the labour market« which was organized by the association of kinesiologists of slovenia after a very successful first round table. the participants introduced some 2 annales kinesiologiae • 8 • 2017 • 1 very interesting topics that shared their vision of kinesiology and recommendations for the future. the journal rounds up with reports from three conferences, which usually summarize various aspects of research in kinesiology. prof. rado pišot, ph.d. editor-in-chief and managing editor annales kinesiologiae • 8 • 2017 • 1 3 uvodnik annales kinesiologiae si je že v sami zasnovi in procesu nastajanja zastavila nalogo odgovarjati na vprašanja kineziološke znanosti in razkrivati probleme, ki jih njen izrazito interdisciplinaren in integrativen značaj vsakodnevno odpira. kritična obravnava znanstveno raziskovalnih vprašanj, ki se zrcalijo v ogledalu kineziološke znanosti, pred nas tako postavlja odgovornost do znanosti, stroke in družbe, posameznika in skupin, neposrednih uporabnikov ugotovitev in zaključkov, ki jih ponujamo. dejavniki pozitivnega vpliva gibalne/športne aktivnosti na zdravje in kakovost življenja so bili neštetokrat preučevani, preverjeni in dokazani. vedno nove in naprednejše raziskave teh dejavnikov si za cilje med drugim postavljajo iskanje novih možnosti, osvetljevanje sivih con, odpiranje niš ... gotovo je izredno pomembna njihova prilagodljivost posamezni vlogi človeka v sodobni družbi, poklicu, okolju predvsem pa spolu in starosti. s preučevanjem razlik in mehanizmov ter diferenciacijo izbranih intervencij, prilagojenega dimenzioniranja in vsebine vadbe v realnem času, lahko iščemo večji učinek, lažje upravljanje omenjenih dejavnikov, predvsem pa njihov boljši izkoristek. v štirih izvirnih in preglednih znanstvenih prispevkih, objavljenih v prvem zvezku 8. letnika revije annales kinesiologiae, nam avtorji odstirajo pogled na preučevanje mlajših in starejših, moškega in ženskega spola, v specifičnih situacijah in nenazadnje v športih, kjer cilj, žal, ni vedno usmerjen le v dobrobit posameznika in njegovo učinkovitost, temveč pogosto predvsem v tekmovalni rezultat tukaj in zdaj. na bolj metodološko področje posega prispevek je predlagani motorični test veljaven test znanja alpskih smučarjev začetnikov? motorični test z izvajanjem zaporednih lateralnih odskokov po ritmu – skilj je osrednja tema prispevka, v njem pa avtorji preverjajo, če lahko rezultate tovrstnega testa uporabimo za preverjanje stopnje pridobljenega znanja smučarjev začetnikov. s tenzimiografsko metodo pridobljen čas kontrakcije in maksimalni odmik trebuha dvoglave stegenske mišice obravnavajo avtorji članka z metodo tenzimiografije izmerjene razlike med časom kontrakcije in odmikom mišice med različno starimi in fizično aktivnimi skupinami. avtorji so poleg nekaterih drugih opažanj med udeleženci raziskave na osnovi dobljenih rezultatov meritev opazili delitev na dve skupini glede na rednost ukvarjanja s fizično aktivnostjo, in sicer na sedeče in na tiste, ki so se redno ukvarjali z rekreativno obliko športne dejavnosti. dva članka iz tokratne številke uvajata niz preglednih študij, ki so rezultat aktivnosti mednarodnega raziskovalnega projekta pangea. vse bolj evidentno je, da imata tako motorična kot kognitivna vadba pomembne učinke na zdravo staranje. s tovrstnimi tematikami se ukvarjajo avtorji članka gibanje in imunski sistem med procesom staranja ter članka prednosti in koristi gibalne in/ali kognitivne vadbe: pregled področja s priporočili za tretje življenjsko obdobje. kot običajno, tudi tokratno številko v rubriki ocene in poročila nadaljujemo s poročili iz raznih dogodkov. najprej je to kratko poročilo iz druge okrogle mize »kineziolog na trgu dela«, ki jo je društvo kineziologov slovenije organiziralo po zelo odzivni prvi tovrstni okrogli mizi. tudi na tem srečanju so bile predstavljene številne zanimive 4 annales kinesiologiae • 8 • 2017 • 1 teme, predvsem pa so sodelovali številni zanimivi gostje, ki so udeležencem predstavili svojo vizijo kineziologije in priporočila za prihodnost. revijo pa zaključujejo poročila iz treh konferenc, ki praviloma povzemajo različne vidike obravnave kinezioloških vprašanj. prof. dr. rado pišot, glavni in odgovorni urednik annales kinesiologiae • 6 • 2015 • 2 149 reports and reviews/poročila in ocene, 149–156 a new opportunity for the enforcement of slovenian sports tourism? the 1st scientific conference “sustainable development of sports tourism’’ portorož, slovenia, 4th and 5th of june 2015 the directors of the first scientific conference entitled ‘’sustainable development of sports tourism’’, the ministry of education, science and sports (mizš), public agency of the republic of slovenia to promote entrepreneurship, innovation, development, investment and tourism (spirit slovenia), university of primorska, science and research centre institute for kinesiology research (up src ikarus), in collaboration with the university of primorska, faculty of tourism studies (turistica), the slovenian olympic committee (oks) and under the honorary patronage of the president of the republic of slovenia, borut pahor, have successfully concluded a conference which took place at the bernardin congress centre on the 4th and 5th of june 2015. the event has successfully connected almost a hundred researchers and professors from fifteen different countries (from new zealand to the united arab emirates), and encouraged them to spread scientific and professional knowledge in the field of sports tourism. most of the participants shared an opinion that particularly innovative sports and tourism programs can directly contribute both to new employment and to the overall added value of tourism. in conclusion, it contributes positively to the visibility of slovenia as a sports tourism destination. introductory plenary contributions were presented by: nigel ross hemmington, faculty of applied humanities, auckland university of technology, new zealand, jean-loup chappelet, university of lausanne, switzerland, stephan penz, deutsche sportausweis, germany, terry stevens, stevens & associates, united britain, mike weed, centre for sport, physical education & activity research, great britain and maja uran, university of primorska, faculty of tourism studies (turistica), slovenia. the presentation of scientific evidence was followed by a professional program, namely, a round table where sports and tourism professionals gathered to contribute into a meaningful dialogue which formed a basis for the design described below in the conference’s conclusion. the summary made by the organizers includes the following highlights. to begin with, scientific research achievements of kinesiology as a young science (which is also enforced in slovenia) is confirmed to contribute to the creation of quality in sports and sustainably oriented sports and tourism services. therefore, the implementation of kinesiology scientific knowledge in sustainable sports tourism is of vital importance. the enforcement of quality, both formal and non-formal lifelong learning in the field is emphasized as well. attention is paid particularly to ever faster developmental programs of sports preparations for native and foreign athletes by actively including public 150 reports and reviews/poročila in ocene, 149–156 annales kinesiologiae • 6 • 2015 • 2 sports infrastructure and sports clubs, as the preparations are integrated and interdisciplinary-based (medicine, kinesiology, nutrition, psychology, informatics, etc.). sustainably oriented major sports events are also promoted, as they have a tradition and a wide social and political support as well as they receive co-financing from public funds due to their concrete scientifically-determined and expected synergy effects. the development and integration of sports and tourism is proposed, such as spa and wellness services. what is also expected is a more effective national and local inter-ministerial coordination of interested stakeholders that have influence in shaping sports tourism in order to stimulate action in the sports tourism market, particularly by removing administrative and other systemic barriers. better marketing of slovenia’s natural features is also expected, as these can be used as carriers of unique sports and tourism services. there is also the need for even faster development of the connection between sports and tourism on the basis of the already appropriate road infrastructure. this includes the enforcement of renovation and construction of cycling lanes and sports-tourist hiking trails, as well as the improvement of effective sports and tourist infrastructure by renovation and modernisation. another recommendation includes connecting public sports infrastructure and sports grounds with the knowledge of slovenian sports experts. what needs to be used in our promotion even more is the rich slovenian sports history, tradition and heritage. a wide support was also given to the modern on-line selling and on-line promotion of slovenian tourism that would improve the visibility of slovenia as a sports tourism destination. innovative approaches and creativity in the design, marketing and organization of sustainably-oriented sports and tourism services were also presented as highly important. the conference organizers will act in accordance with the given possibilities in favour of the enforcement of the above stated guidelines, and, thus, also contribute to faster and better development of sustainable sport and tourism offer in slovenia. it was further stressed that they expect to be invited to cooperate in the preparation of the new strategy of slovenian tourism. the event was rated as a successful activity in the further development of sports tourism and the second international scientific conference is planned in 2017. iztok retar, president of the organizing committee annales kinesiologiae • 6 • 2015 • 2 151 reports and reviews/poročila in ocene, 149–156 nova priložnost za uveljavitev slovenskega športnega turizma? 1. znanstvena konferenca “trajnostni razvoj športnega turizma” portorož, slovenija, 4. in 5. junij 2015 organizatorji prve znanstvene konference z naslovom trajnostni razvoj športnega turizma, ministrstvo za izobraževanje, znanost in šport (mizš), javna agencija republike slovenije za spodbujanje podjetništva, inovativnosti, razvoja, investicij in turizma (spirit slovenija), univerza na primorskem, znanstveno-raziskovalno središče, inštitut za kineziološke raziskave (up zrs ikarus) v sodelovanju z univerzo na primorskem, fakulteto za turistične študije (up ftš turistica), olimpijskim komitejem slovenije (oks) in pod častnim pokroviteljstvom predsednika republike slovenije boruta pahorja, so uspešno sklenili konferenco, ki je bila v kongresnem centru bernardin 4. in 5. junija 2015. dogodek je uspešno povezal skoraj sto raziskovalcev in profesorjev iz 15 držav od nove zelandije pa do združenih arabskih emiratov ter jih spodbudil k širjenju znanstvenih in strokovnih spoznanj na področju športnega turizma. prevladovalo je stališče, da lahko predvsem inovativni športnoturistični programi neposredno prispevajo nova delovna mesta in so dodana vrednost turizma ter prispevajo k prepoznavnosti slovenije kot tudi športnoturistične destinacije. uvodne plenarne prispevke so predstavili: nigel ross hemmington, faculty of applied humanities, auckland university of technology, nova zelandija, jean-loup chappelet, university of lausanne, švica, stephan penz, deutsche sportausweis, nemčija, terry stevens, stevens & associates, velika britanija, mike weed, centre for sport, physical education & activity research, velika britanija in maja uran, univerza na primorskem, fakulteta za turistične študije (up ftš turistica), slovenija. znanstvenemu delu je sledil strokovni program, ki je zlasti z organizacijo okrogle mize športnim in turističnim strokovnjakom omogočil poglobljeno strokovno razpravo – podlago za oblikovanje v nadaljevanju predstavljenih zaključkov konference. organizatorji namreč ugotavljajo, da lahko znanstvenoraziskovalni dosežki kineziologije kot mlade vede, ki se uveljavlja tudi v sloveniji, prispevajo k oblikovanju kakovostnih in trajnostjo naravnanih športnoturističnih storitev, in se zato zavzemajo za implementacijo kinezioloških znanstvenih spoznanj pri oblikovanju trajnostne športnoturistične ponudbe. poudarjajo uveljavljanje kakovostnega, tako formalnega kot neformalnega in priložnostnega vseživljenjskega učenja na področju športnega turizma. posebno pozornost namenjajo še hitrejšemu razvoju programov športnih priprav domačih in tujih športnikov z vključevanjem javne športne infrastrukture in športnih klubov, ki so celostno in interdisciplinarno zasnovane (medicina, kineziologija, nutricistika, psihologija, informatika …). spodbujajo organizacijo predvsem trajnostno naravnanih velikih mednarodnih športnih dogodkov, ki imajo tradicijo in so širše 152 reports and reviews/poročila in ocene, 149–156 annales kinesiologiae • 6 • 2015 • 2 družbeno in politično podprti ter sofinancirani z javnimi sredstvi zaradi konkretno znanstveno ugotovljenih pričakovanih sinergijskih učinkov. zavzemajo se za razvoj in povezavo športnoturističnih zdraviliških in welness storitev ter pričakujejo učinkovitejše nacionalno in lokalno medresorsko usklajevanje deležnikov, ki vplivajo na oblikovanje športnega turizma, kar bi spodbudilo delovanje na športnoturističnem trgu zlasti z odpravljanjem administrativnih in drugih sistemskih ovir. pričakujejo boljše trženje naravnih danosti slovenije, ki jih lahko uporabimo kot nosilce unikatnih športnoturističnih storitev. opozarjajo na potrebno okrepitev aktivnosti za še hitrejši razvoj povezave med športom in turizmom na podlagi že primerne cestne infrastrukture, uveljavljanje prenove in gradnje kolesarskih in športnoturističnih pešpoti ter izboljšanje učinkovitost športnoturistične infrastrukture z domišljenimi prenovami in posodobitvami. priporočajo povezovanje javnih športnih infrastrukurnih objektov in površin ter znanje slovenskih športnih strokovnjakov. zavzemajo se še za bolj učinkovito trženje bogate slovenske športne zgodovine, tradicije in izročila ter predlagajo okrepitev sodobne zlasti e-prodajne poti in aktivnosti slovenskega turizma ter tako izboljšanje prepoznavnosti slovenije tudi kot športnoturistične destinacije. zavzemajo se za inovativne pristope in kreativnost pri oblikovanju, trženju in organiziranju trajnostno naravnanih športnoturističnih storitev. organizatorji konference se bodo skladno z zmožnostmi zavzeli za uveljavljanje navedenih usmeritev ter tudi tako prispevali k hitrejšemu in h kakovostnejšemu razvoju trajnostne športnoturistične ponudbe v sloveniji. poleg tega še poudarjajo, da pričakujejo povabilo pri pripravi nove strategije turizma slovenije, ocenjujejo dogodek kot uspešno aktivnost pri nadaljnjem razvijanju športnega turizma in načrtujejo 2. mednarodno znanstveno konferenco v letu 2017. iztok retar, predsednik organizacijskega odbora _goback _goback _goback _goback _goback _goback _goback annales kinesiologiae • 7 • 2016 • 2 175 reports and reviews/poročila in ocene, 171–180 report from the round table "a kinesiologist in the labour market" slovenian association of kinesiology, science and research centre of koper, institute for kinesiology research koper, 8th november, 2016 kinesiology is a young science whose main content is the study of human movement (physical activity). in a broader sense, kinesiology is the science that examines the nature principles and the management process of human movement and the effects of these processes on the human organism in relation with its living and working environment. in slovenia, the formal study of kinesiology is possible in two study programs, namely, the program of (applied) kinesiology at the university of primorska and the program of kinesiology at the university of ljubljana, faculty of sport. kinesiology as the field of study has been in the constant development since 2010. nowadays, first kinesiologists, b.sc. and m.sc. are successfully placed within the labour market. the profession of kinesiologist is one of the youngest professions in slovenia. in the description of the standard classification of professions (skp-08) the profession of kinesiologist is described as a health expert / specialist. the content of kinesiology and the occupation of kinesiologist is placed among the fields of health, sports and safety and occupational health. currently, the profession is systemically placed in the existing as well in the new draft to sports act. thus, a kinesiologist is an educated expert in the field of sport and thereby a regulated profession in slovenia. as an educated expert it is placed also in the resolution on the national program on nutrition and physical activity for health in 2015 − 2025. continuous efforts are being made to place the profession of kinesiologist also in the national system in health field and in the area of health and safety at work. in accordance with the placement of kinesiology and kinesiologists in the content of modern society, their main competencies / skills are as followed: – designing health promotion programs; – planning and implementation of preventive health programs; – planning, implementation, evaluation and analysis of programs of exercise / sport activity for health; – participating in the implementation of therapeutic and rehabilitation programs; – implementing the programs of exercise / sports activities for different age and target groups (children, adults, seniors, persons with disabilities, persons with chronic non-communicable diseases, like asthma, diabetes, ...); – implementing the preventive measures of physical characteristics, motor abilities, and their use in the preparation of the system and / or individually tailored prevention programs; – designing and implementing a basic ergonomic analysis of the workplace and preparing measures to improve the health of the selected job; 176 reports and reviews/poročila in ocene, 171–180 annales kinesiologiae • 7 • 2016 • 2 – implementing programs of condition training in elite sport; – participating in and advising on the procedure of planning physically and movement stimulating environments. with these and other specific competences and skills, kinesiologists are employable in the public sector (e.g. collaborator and referee for sport in municipalities), as operators of national projects (healthy lifestyle, human resources development in the sport, together for health, the national program of sport discipline in schools...) or independently on the labour market, employed by companies (e.g. private retirement homes, spas, hotels or sports centers ...) or as self-employed. on 8th november 2016, the slovenian association of kinesiology together with science and research centre of koper, institute for kinesiology research organized a round table titled "kinesiologist in the labour market" in the library of the scientific research centre of koper in order to open a conversation on the topic of employability of kinesiologists between the representatives of different institutions and organizations. official guests of the round table were boro štrumbelj, ph.d., director general of directorate of sport from the ministry of education, science and sport, assoc. prof. edvard kolar, ph.d., secretary general of the olympic committee of slovenia, prof. rado pišot, phd., director of the science and research centre koper and the president of slovenian association of kinesiology, prof. damir karpljuk, ph.d., vice-dean of the faculty of sport, university of ljubljana, mr. marjan plavčak, the president of the slovenian association of physical and sport teachers, vedran hadžič, phd., the kinesiology study program coordinator at the university of ljubljana, matej plevnik, ph.d., a lecturer at the study program applied kinesiology at the university of primorska, anja andrenšek, an undergraduate studentof applied kinesiology at university of primorska and maja dakskobler, univ. sc. kin., a kinesiology graduate from the university of ljubljana. kinesiology students and other guests filled the venue. annales kinesiologiae • 7 • 2016 • 2 177 reports and reviews/poročila in ocene, 171–180 the contents of the round table was divided in four topics, namely, a kinesiologist’s competences, the current employment opportunities for kinesiologists, the relationship between education programs and the training in the field of sport and an insight into the future directions and the development of kinesiology. guests noted that a kinesiologist as an educated professional is placed in the existing sports act, as well as in the draft of the new act, which will be accepted in the near future. they shared the opinion that the society needs educated professionals from the field which covers kinesiology, but that it is also necessary to make further efforts to expand the knowledge of the profession and its fields of activity, especially in the area of health and safety and health at work. as examples of good practice they mentioned some cases where kinesiologists are well-placed in the labour market, as well as the projects and financial mechanisms through which they are incorporated into the labour market (healthy lifestyle, human resources development in the sport, together for health, the national program of sport discipline and others). the event was concluded with the decision that it is necessary to strive for greater integration of the institutions that educate kinesiologists in slovenia and make further efforts for the spread of systemic arrangements in the field of employment for kinesiologists and the promotion of kinesiology as a professional field and a scientific discipline. younger colleagues expressed their hopes for their older, already graduated colleagues, to help create new employment opportunities through their good work and through setting the examples for them. matej plevnik, rado pišot 178 reports and reviews/poročila in ocene, 171–180 annales kinesiologiae • 7 • 2016 • 2 poročilo z okrogle mize »kineziolog na trgu dela« društvo kineziologov slovenije, znanstveno-raziskovalno središče koper, inštitut za kineziološke raziskave koper, 8. november 2016 kineziologija je mlada znanost, katere osrednja vsebina je preučevanje gibanja človeka. v širšem pomenu besede je kineziologija znanost, ki preučuje zakonitosti upravljanja procesov gibanja človeka in posledice delovanja teh procesov na človekov organizem, v odvisnosti in povezavi z njegovim življenjskim in delovnim okoljem. v sloveniji je študij kineziologije mogoč na dveh študijskih programih, in sicer programu aplikativne kineziologije na univerzi na primorskem ter programu kineziologije na univerzi v ljubljani. študijsko področje kineziologije je v razvoju od leta 2010 dalje, danes pa se na trg dela uspešno umeščajo prvi diplomirani kineziologi in magistri kineziologije. poklic kineziologa je v sloveniji eden mlajših. v standardni klasifikaciji opisa poklicev (skp-08) je poklic kineziologa opisan kot zdravstveni strokovnjak/strokovnjakinja. vsebinsko se polje delovanja umešča med zdravstvo, šport in varnost ter varovanje zdravja pri delu. sistemsko je trenutno umeščen v obstoječi, kot tudi novi predlog zakona o športu. tako je kineziolog tudi izobražen strokovnjak na področju športa in s tem reguliran poklic v sloveniji. kot izobražen strokovnjak je umeščen tudi v resolucijo o nacionalnem programu o prehrani in telesni dejavnosti za zdravje 2015 – 2025. ves čas potekajo prizadevanja, da bi poklic kineziologa vsebinsko primerno sistemsko umestili tudi na področju zdravstva in na področju zdravja in varnosti pri delu. skladno z umestitvijo kineziologa, so njegove glavne kompetence/veščine naslednje: – oblikovanje programov promocije zdravja, – načrtovanje in izvedba preventivnih programov zdravja, – načrtovanje, izvedba, vrednotenje in analiza programov gibalne/športne aktivnosti za zdravje, – sodelovanje pri izvajanju terapevtskih in rehabilitacijskih programov, – vodenje programov gibalne/športne aktivnosti za različne starostne in ciljne skupine (otroci, odrasli, starostniki, osebe s posebnimi potrebami, osebe s kroničnimi nenalezljivimi boleznimi – astma, sladkorna bolezen, …), – izvajanje preventivnih merjenj telesnih značilnosti in gibalnih sposobnosti ter njihova uporaba pri pripravi sistemskih in/ali individualno prilagojenih preventivnih programov, – načrtovanje in izvajanje osnovnih ergonomskih analiz delovnega mesta in priprava ukrepov za izboljšanje zdravja na izbranih delovnih mestih, – izvajanje programov kondicijske vadbe v vrhunskem športu – sodelovanje in svetovanje pri načrtovanju gibalno spodbudnega okolja. annales kinesiologiae • 7 • 2016 • 2 179 reports and reviews/poročila in ocene, 171–180 kineziologi so z omenjenimi in drugimi specifičnimi kompetencami zaposljivi v javnem sektorju (npr. kot referenti za šport na občinah), kot izvajalci nacionalnih projektov (zdrav življenjski slog, razvoj kadrov v športu, za boljše zdravje in zmanjšanje neenakopravnosti v zdravju, program športnih panožnih šol…) oziroma samostojno na trgu dela, pri podjetjih (npr. zasebni domovi starejših, zdravilišča, hotelski ali športni centri…) ali kot samozaposleni. društvo kineziologov slovenije in znanstveno-raziskovalno središče koper, inštitut za kineziološke raziskave, sta 8. novembra 2016 v knjižnici znanstveno-raziskovalnega središča up organizirala okroglo mizo z naslovom »kineziolog na trgu dela«. osnovni namen okrogle mize je bil odprt pogovor med predstavniki različnih ustanov na temo zaposljivosti kineziologa. uradni gostje okrogle mize so bili dr. boro štrumbelj, generalni direktor direktorata za šport, ministrstva za izobraževanje, znanost in šport, izr. prof. dr. edvard kolar, generalni sekretar olimpijskega komiteja slovenije, prof. dr. rado pišot, direktor znanstveno-raziskovalnega središča up, prof. dr. damir karpljuk, prodekan fakultete za šport, ul, g. marjan plavčak, predsednik zveze društev športnih pedagogov slovenije, doc. dr. vedran hadžič, koordinator študijskega programa kineziologija na fakulteti za šport, ul, doc. dr. matej plevnik, predavatelj na študijskem programu aplikativna kineziologijae up famnit, anja andrenšek, absolventka – študentka aplikativne kineziologije up famnit ter maja dakskobler, univ. dipl. kin. (ul fš). študentje kineziologije in ostali poslušalci so napolnili prostor dogodka. vsebina okrogle mize je bila strnjena v štiri vsebinske sklope: kompetence kineziologa, trenutne zaposlitvene možnosti kineziologa, razmerja med izobraževanjem in usposabljanjem na področju in pogled v prihodnost poklica kineziologa. gostje so 180 reports and reviews/poročila in ocene, 171–180 annales kinesiologiae • 7 • 2016 • 2 ugotovili, da je kineziolog, kot izobražen strokovni delavec, umeščen tako v obstoječi zakon o športu kot tudi osnutek novega zakona, ki bo predvidoma sprejet v bližnji prihodnosti. enotni so si bili, da obstaja potreba po izobraženem kadru tega profila, da pa si je potrebno tudi nadalje prizadevati za širitev prepoznavnosti poklica in njegovih področij delovanja, predvsem na področja zdravstva ter varnosti in zdravja pri delu. omenili so primere dobre prakse, iz katerih je razvidno, da se kineziologi kot strokovni sodelavci dobro umeščajo na trgu dela, kot tudi projekte in finančne mehanizme, skozi katere so vključeni na trg dela (zdrav življenjski slog, razvoj kadrov v športu, za boljše zdravje in zmanjšanje neenakosti v zdravju in drugi). dogodek so zaključili s sklepom, da si je potrebno prizadevati za večje povezovanje inštitucij, ki izobražujejo kineziologe v sloveniji ter si nadalje prizadevati za širjenje sistemske ureditve področja zaposlovanja kineziologov in promocije polja kineziologije. mlajši kolegi pa so priporočili starejšim že diplomiranim, da s svojim zgledom in dobrim delom ustvarjajo nove zaposlitvene možnosti tudi za njih. matej plevnik, rado pišot annales kinesiologiae • 8 • 2017 • 1 53 reports and reviews/poročila in ocene, 51–60 1st scientific conference spe balkan ski kopaonik ski resort, serbia, 12th−16th march 2017 the desire and willingness to cooperate in the field of winter sports has always been present in the balkan countries. various forms of cooperation have long been present, however, limited at individual or, mostly institutional level. there have always been cooperation initiatives that would systemically link the ski experts of the balkan peninsula, but somehow they have not been realised. after the slovenian team had returned from the interski congress in argentina at the end of 2015, we were able to share our impressions and experience we had gained in argentina with our serbian colleagues in kopaonik and bosnian colleagues in jahorina in the winter of 2016. this was the starting point from which the idea to organise a balkan ski congress according to the interski model arose. the main idea was to combine science, practice and education in the field of winter sports, to enhance interest in the wider scientific and professional public as well as to enrich ski companionship and to involve other professionals who have a common interest in the field of winter sports. this led to organising the spe (science, practice & education) balkan ski conference. 54 reports and reviews/poročila in ocene, 51–60 annales kinesiologiae • 8 • 2017 • 1 good previous experience was the reason for choosing the kopaonik ski resort as the venue of the first conference, and building on excellent collaboration between all the major players in the scientific and technical fields guarantees a successful organisation of the event. all the associations that unite skiing trainers and teachers in this area immediately supported the idea of the conference. international response was achieved with the presentation of the spe balkan ski conference at the icss − international conference of science and ski, in december 2016 in st. christoph, austria and its promotion was fostered through the ecss european college of sport science official site. an important added value was the excellency of the guest speakers who came from different parts of the world and, of course, the audience; ski enthusiasts, researchers, professors, trainers and ski teachers. over 120 participants from 14 countries of the balkans (bosnia and herzegovina, montenegro, croatia, macedonia, slovenia and serbia) and others (the usa, great britain, italy, czech republic, lithuania ...) registered for the conference and we are sure that the first spe balkan ski conference fulfilled the main goals that the organisers set forward − to empower, advocate, develop and promote ski professions, as well as to consider scientific and professional bases in theory and practice. besides theoretical lectures and workshops, for which our international guest lecturers contributed a special added value, practical work on the slopes was very important for the full success of the conference. workshops that were led by experts and the members of demo teams from the participating countries opened up new insights in learning and instructing how to ski. to guarantee the success of the conference and promote its vision, it was also important to develop a network of excellence by bringing together ski experts, i.e. ski instructors, coaches, scientists and other ski professionals from the balkan region, and make their integration and networking possible. at the opening session, the participants were greeted and welcomed by a ski legend and one of the best skiers of all times in the balkan region, bojan križaj, whilst the bulgarian colleagues presented the interski pamporovo 2019 meeting. mingling and setting up potential collaborations between ski instructors played an important role during the following days, culminating on wednesday, march 15 with the balkan ski demo show when all the national demo teams from the participating countries and some registered ski schools from the balkan area introduced themselves jointly as well as individually. the 2nd spe balkan ski congress will be organized from march 11th to 15th, 2018 in jahorina ski resort in bosnia and herzegovina, where the 1984 winter olympics also took place. rado pišot annales kinesiologiae • 8 • 2017 • 1 55 reports and reviews/poročila in ocene, 51–60 1. znanstvena konferenca spe balkan ski smučarsko središče kopaonik, srbija, 12.–16. marec 2017 med državami balkana je bila od nekdaj prisotna želja in pripravljenost, da bi sodelovale na področju zimskih športov. različne oblike sodelovanja so sicer prisotne že dalj časa, vendar so večinoma omejene na osebno ali največ institucionalno raven. ves čas je čutiti tudi prisotnost najrazličnejših iniciativ za sistematično povezovanje smučarskih strokovnjakov, ki pa žal v praksi nikoli niso resnično zaživele. po povratku slovenskih udeležencev iz kongresa interski v argentini ob koncu leta 2015, smo imeli možnost deliti tam pridobljene vtise in izkušnje, najprej s kolegi iz srbije na kopaoniku, kasneje pa še s kolegi iz bosne in hercegovine na jahorini. ti dve srečanji pozimi 2016 sta bili izhodiščni točki, iz katerih je izšla ideja, da bi po vzoru kongresov interski organizirali tudi balkanski smučarski kongres. osnovno vodilo pri tem je bilo, da bi združili vidike znanosti, prakse in vzgoje na področju zimskih športov. iniciatorji ideje so s tem želeli povečati zanimanje širše znanstvene in strokovne javnosti, obogatiti smučarsko druženje ter v dogajanje pritegniti širši krog strokovnjakov, ki jih druži sku56 reports and reviews/poročila in ocene, 51–60 annales kinesiologiae • 8 • 2017 • 1 pni interes na področju zimskih športov. vse to je privedlo do organizacije konference spe (science, practice & education / znanost, stroka in vzgoja) balkan ski. dobre pretekle izkušnje s tem prizoriščem so bile razlog, da je bilo za kraj izvedbe prve konference izbrano smučarsko središče kopaonik. številna predhodna izvrstna sodelovanja med vsemi glavnimi akterji tako na znanstvenih kot tudi strokovnih področjih pa so zagotavljala organizacijo na najvišjem nivoju. vse organizacije, ki na izbranem področju kakorkoli združujejo smučarske trenerje in učitelje, so idejo o konferenci nemudoma podprle. za mednarodni odziv so organizatorji poskrbeli s tem, da so spe balkan ski decembra 2016 predstavili na konferenci icss (international conference of science and ski), ki je potekala v kraju st. christoph v avstriji, ter s promocijo preko uradne spletne strani ecss (european college of sport science). pomembno dodano vrednost h konferenci so prispevali izvrstni povabljeni predavatelji iz različnih delov sveta ter seveda pričakovani udeleženci, smučarski navdušenci, raziskovalci, profesorji, trenerji in učitelji smučanja. na konferenco se je prijavilo preko 120 udeležencev iz 14 držav iz balkana (bosna in hercegovina, črna gora, hrvaška, makedonija, slovenija in srbija) ter od drugod (zda, velika britanija, italija, republika češka, litva, …). prepričani smo, da je prva konferenca spe balkan ski v celoti dosegla cilje, ki so si jih zastavili organizatorji, in sicer opolnomočiti, promovirati in razvijati smučarsko stroko ter tako v teoriji kot praksi zagotoviti znanstveno in strokovno osnovo. poleg teoretičnih predavanj in delavnic, ki so jim posebno dodano vrednost zagotovili mednarodni gostujoči predavatelji, so bile pomemben del konference tudi praktične demonstracije na zasneženih pobočjih kopaonika. delavnice, ki so jih vodili strokovnjaki, člani demonstracijskih ekip posameznih držav udeleženk, so ponudile nov vpogled v tehnike učenja smučanja. za uspeh konference in doseganje njene vizije je bila pomembna tudi vzpostavitev kvalitetne mreže, ki bi povezala strokovnjake iz različnih področij; inštruktorje smučanja, trenerje, znanstvenike in druge, ki se kakorkoli ukvarjajo s smučanjem, iz balkanskih držav. na otvoritveni slovesnosti je udeležence konference pozdravil bojan križaj, smučarska legenda in eden najboljših smučarjev vseh časov iz te regije. kolegi iz bolgarije pa so predstavili prihodnje srečanje interski pamporovo 2019. druženje in vzpostavljanje morebitnih bodočih sodelovanj med učitelji smučanja je bilo vodilo dogajanja prihodnjih dni konference. ta je svoj vrhunec nedvomno doživela v sredo, 15. marca, ko so se nacionalne demonstracijske skupine držav udeleženk in prijavljenih smučarskih šol predstavile v balkan ski demo show-u tako v skupnem nastopu kot tudi individualno. naslednja, 2. spe balkan ski konferenca, bo potekala od 11. do 15. marca 2018 v smučarskem središču jahorina v bosni in hercegovini, prizorišču zimskih olimpijskih iger leta 1984. rado pišot _goback _goback _goback _hlk501362470 _hlk501363405 _hlk501369360 annales kinesiologiae • 8 • 2017 • 2 65 editorial dear reader of the second issue of the scientific journal annales kinesiologiae volume 8. we are pleased to present five new articles that address the broad interdisciplinary field of the anthropological branch of kinesiology, as well as the importance of human movement, as the main study subject of this scientific discipline; all of them throughout different life periods and in the light of promoting healthy development and active lifestyle in both childhood and third age period. the introductory article focuses on the study of the female athlete triad and the associated negative energy balance, ovulation disorder, and osteopenia or even osteoporosis. doyle-baker, mclean and fung thus present the positive and negative effects of the menstrual cycle on sports performance and, through an empirical study, they determine the presence of the female athlete triad among elite female ice hockey players. this phenomenon is probable among athletes who are subject to high energy demands, although the authors find it difficult to confirm. let’s mention at this point that the abstract of this study was presented at the 8th international scientific conference on kinesiology in opatija, croatia, and now we are glad to publish it as a full text in the present issue of the annales kinesiologiae journal. further on, there are three review articles from the field of physical activity and exercise in the third age that have been prepared under the framework of the pangea project – physical activity and nutrition for quality aging funded by the interreg cross-border cooperation program slovenia – italy 2007–2013. they are rounded up so that capatti, dalla nora and passaro first present the problems with age-related changes in body composition and metabolism, including sarcopenia, sarcopenic obesity and bone loss with a progressive decline in aerobic capacity, muscle mass and strength as the main risk factors for reducing the mobility of older people, especially when combined with associated chronic diseases. then, through extensive literature review, they summarize some recommendations for physical activity, exercise and nutrition, which enable older adults to maintain the heart and lungs function, to increase cardiovascular fitness and endurance, as well as preserving muscle mass and strength, bone density and reducing the increment of fat. it turns out that in older adults, especially with a combination of strength and endurance training, and appropriate protein intake, we can act both preventively and curatively against sarcopenia, sarcopenic obesity, and metabolic syndrome. this is followed by a review by rejc, del torto and lazzer, which present exhaustively the effects of aging on maximal aerobic power, the effects of aerobic exercise in older adults. at the end the authors summarize current recommendations for aerobic exercise during the third age. in doing so, authors are also critical of the valid recommendations, as they draw attention to their too generic nature and give suggestions for improvements. the third part of the review papers then deals with the aspect of the impact of exercise on activation and the increase in the number (proliferation) of the skeletal muscles stem (satellite) cells, which facilitate the recovery of the “damaged” muscle tissue under various psycho-physiological loads and stimuli. jurdana thus 66 annales kinesiologiae • 8 • 2017 • 2 updates the view on the role of muscular satellite cells in regulating muscle mass in conjunction with the effectiveness of various training interventions in order to reduce the decline in muscle mass that may be present in all stages of life, and especially in old age. she notes that it is possible to stimulate the activation and proliferation of skeletal muscle satellite cells, through an appropriate diet, resistance and endurance exercise, thus improving skeletal muscle function and successfully combating against muscular atrophy and age-related sarcopenia. she emphasizes that more studies will be needed for further understanding of the role and impact of training variables on the activation of satellite cells in order to set optimal training stimuli for this purpose. the report from the opening of the mediterranean health centre (mhc) of the science and research centre koper rounds this issue of the journal. the mhc represents an important link between kinesiological science and practice as well as the socio-cultural environment and geographical location in which it was established, since the healthy mediterranean lifestyle (in particular its typical diet, simplicity of living, social inclusion and interactions of people in this area) is thus enhanced by a healthy active lifestyle, exercise and training, kinesiological diagnostics and therapies based on modern scientific knowledge. all this has now become accessible to all of us, irrespective of age, gender, health status or other differences that can occur among people. this is also one of the most effective ways of implementing the mission to man-oriented kinesiology, which has an increasingly important role and responsibility in modern society in ensuring a healthy and balanced development of an individual and the society from childhood to the late adulthood. mitja gerževič, phd guest editor annales kinesiologiae • 8 • 2017 • 2 67 uvodnik spoštovani bralec druge številke osmega letnika znanstvene revije annales kinesiologiae. z veseljem vam predstavljamo novih pet prispevkov, ki široko interdisciplinarno področje antropološke veje kineziologije in pomen gibanja človeka, kot glavnega predmeta preučevanja te znanstvene discipline, obravnavajo preko različnih življenjskih obdobij v luči spodbujanja zdravega razvoja in aktivnega življenjskega sloga, tako v otroštvu kot v tretjem življenjskem obdobju. uvodni prispevek je nekoliko ožje usmerjen, in sicer v proučevanje ženske športne triade ter s tem povezanim pomanjkanjem energije oz. negativno energijsko bilanco, motnjo ovulacije in osteopenijo ali celo osteoporozo. doyle-baker, mclean in fung tako predstavljajo pozitivne in negativne vplive menstrualnega cikla na športno uspešnost ter preko empirične študije ugotavljajo pojavnost ženske športne triade med vrhunskimi igralkami hokeja na ledu. pojav je med športnicami, ki so podvržene visokim energijskim zahtevam sicer možen, vendar avtorji ugotavljajo, da ga je težko potrditi. naj omenimo, da je bil izvleček te študije predstavljen na 8. mednarodni znanstveni konferenci o kineziologiji v opatiji na hrvaškem in ga sedaj z veseljem v celoti objavljamo v pričujoči številki revije annales kinesiologiae. sledijo trije pregledni članki s področja telesne oz. gibalne/športne aktivnosti in vadbe v tretjem življenjskem obdobju, ki so bili pripravljeni v okviru projekta pangea – telesna aktivnost in prehrana za kakovostno staranje. projekt je potekal v okviru programa čezmejnega sodelovanja interreg slovenija–italija 2007–2013. članki so zaokroženi tako, da capatti, dalla nora in passaro najprej predstavijo problematiko s staranjem povezanih sprememb v telesni sestavi in metabolizmu, vključujoč sarkopenijo, sarkopenično debelost in upad kostne mase ter trend postopnega upada aerobnih funkcij, mišične mase in moči kot glavnih dejavnikov tveganja za zmanjšanje mobilnosti starejših oseb, še posebej v povezavi s pridruženimi kroničnimi obolenji. nato preko obširnega pregleda literature podajo priporočila za telesno aktivnost, vadbo in prehrano, ki starejšim osebam omogočajo ohranjanje ustreznega delovanja srčne in dihalne funkcije, izboljšanje srčno-žilne pripravljenosti in vzdržljivosti, kakor tudi ohranjanje mišične mase in moči, kostne gostote ter zmanjšanje pridobivanja maščobne mase. izkaže se, da lahko pri starejših osebah, predvsem s kombinacijo vadbe za moč in vzdržljivost ter ustreznim vnosom beljakovin, delujemo tako preventivno kot kurativno proti sarkopeniji, sarkopenični debelosti in metabolnemu sindromu. temu sledi pregled rejca, del torta in lazzerja, ki izčrpno predstavi vplive staranja na največjo aerobno moč, učinke aerobne vadbe pri starejših osebah in povzame trenutno veljavna priporočila za aerobno vadbo za to življenjsko obdobje. pri tem se avtorji kritično opredelijo do veljavnih priporočil, saj opozorijo na njihovo preveliko generičnost in podajo predloge za izboljšanje. tretji izmed preglednih prispevkov obravnava vidik vpliva vadbe na aktivacijo in povečanje števila (proliferacijo) matičnih (satelitskih) celic skeletnih mišic, ki olajšajo obnovo »poškodovanega« mišičnega tkiva po različnih psiho-fizičnih obremenitvah. jurdana tako posodobi pogled na vlogo mišičnih satelitskih celic pri 68 annales kinesiologiae • 8 • 2017 • 2 uravnavanju mišične mase v povezavi z učinkovitostjo različnih vadbenih intervencij za zmanjšanje upada mišične mase, ki je lahko prisotno v vseh življenjskih obdobjih, predvsem pa v starosti. ugotavlja, da je tudi v starosti, preko ustrezne prehrane in vadbe proti uporu (za moč in silovitost) ter vadbe za vzdržljivost, možno spodbuditi aktivacijo in proliferacijo satelitskih celic skeletnih mišic, s tem izboljšati mišično funkcijo ter se tako uspešno boriti proti mišični atrofiji in starostno pogojeni sarkopeniji. pri tem pa poudarja, da bo potrebnih več študij, ki bodo bolje osvetlile in pojasnile vlogo in vpliv vadbenih spremenljivk na aktivacijo satelitskih celic ter podale za ta namen najoptimalnejše vadbene dražljaje. s poročilom z otvoritve mediteranskega centra zdravja (mcz) znanstveno-raziskovalnega središča koper pa zaokrožujemo celoto tokratnega izvoda revije. mcz predstavlja namreč pomembno vez med kineziološko znanostjo in prakso ter družbeno-kulturnim okoljem in geografsko lego, v kateri deluje, saj zdrav sredozemski življenjski slog (predvsem zanj značilna prehrana, enostavnost bivanja ter socialna vključenost in interakcija ljudi na tem območju) nadgrajuje z zdravim aktivnim življenjskim slogom, vadbo in treningom ter kineziološko diagnostiko in terapijami, ki temeljijo na sodobnih znanstvenih dognanjih. vse našteto je s tem centrom postalo dosegljivo prav vsem, ne glede na starost, spol, zdravstveno stanje ali druge razlike, ki se med ljudmi lahko pojavljajo. prav to je eden od najučinkovitejših načinov udejanjanja poslanstva k človeku usmerjene kineziologije, ki ima v sodobni družbi vse pomembnejšo vlogo in odgovornost pri zagotavljanju zdravega in uravnoteženega razvoja posameznika in družbe od otroštva do starosti. dr. mitja gerževič, gostujoči urednik annales kinesiologiae • 9 • 2018 • 1 35 correlation between different motor abilities and score points in the rauch cup špela bogataj¹, blaž lešnik¹ ¹university of ljubljana, faculty of sport, slovenia corresponding author: špela bogataj university of ljubljana, faculty of sport, slovenia phone: +386 40 415 766 e-mail: sspelabogataj@gmail.com abstract in alpine skiing, like in other sports, achieving good results depends on a variety of factors and the quality of planning and conducting the process of training. the purpose of the research was to determine whether there is a correlation between the selected motor tests and the number of points achieved in rauch cup. the research was conducted on a sample of 41 male competitors from different ski clubs across slovenia. the following tests were conducted on our selected group of 13to 14-year old males: taping with a dominant leg, test of stability, run from a flying start (maximum speed), ten jumps on both legs, 400-metre run, running nines, counter-movement jump and reaction time to a visual impulse (squat jump). the linear regression analysis was used to determine the relationship between the selected motor tests and performance in alpine skiing (rauch cup points). correlation was found between each individual motor test and criterion variable (rauch cup points) except test of stability and reaction time test (squat jump). multiple linear regression (mlr) showed us that the selected model, assembled of four tests that gave the highest mlr was significant (r = .727; p < .001). according to the findings, we can conclude that motor skills represent 53 % of the competitive performance variance of the alpine skier. keywords: alpine skiing, competition, motor functions, performance. original scientific article udc: 796.926:796.012.1 received: 2018-04-26 36 špela bogataj, blaž lešnik: correlation between different motor abilities and score points ..., 35–44 annales kinesiologiae • 9 • 2018 • 1 povezava različnih motoričnih sposobnosti z doseženimi točkami v rauch pokalu izvleček pri alpskem smučanju je doseganje dobrih rezultatov, enako kot tudi pri drugih športnih disciplinah, odvisno od različnih dejavnikov in kakovosti načrtovanja ter izvajanja trenažnega procesa. namen naše raziskave je ugotoviti, ali obstaja korelacija med rezultati v izbranih motoričnih testih in številom doseženih točk v rauch pokalu. v raziskavo smo vključili 41 moških tekmovalcev, starih od 13 do 14 let, iz različnih slovenskih smučarskih klubov. izvedli smo sledeče teste: taping z dominantno nogo, test stabilnosti, tek z letečim štartom (maksimalna hitrost), deseteroskok sonožno, tek na 400 metrov, osmice med devetimi keglji, skok z nasprotnim gibanjem in reakcijski čas na vizualni impulz (skok iz polčepa). s pearsonovim koeficientom smo določili linearno razmerje med motoričnimi testi in kriterijsko spremenljivko (dosežene točke v rauch pokalu). regresijska analiza je bila uporabljena za določitev hipotetičnega vpliva celotnega spektra izbranih motoričnih sposobnosti na uspešnost pri alpskem smučanju. korelacijska analiza med posameznimi testi in kriterijsko spremenljivko je pokazala, da vsi testi razen testa stabilnosti in reakcijskega časa na vizualni impulz, medsebojno korelirajo. multipla regresija nam je pokazala, da je regresijski model, sestavljen iz štirih izbranih spremenljivk, značilen (r = .727; p < .001). glede na ugotovitve lahko trdimo, da motorične sposobnosti predstavljajo velik delež tekmovalne uspešnosti v alpskem smučanju, zato bi morali redno testiranje vključiti v program treninga in evalvacije. ključne besede: alpsko smučanje, tekmovanje, motorika, tekmovalna uspešnost introduction good psychophysical preparation is one of the basic conditions for achieving good results at competitions. that is why this part requires extra attention in younger as well as in older categories of competitors. the potential of the psychosomatic status of an alpine skiing competitor depends on the development of their motor skills, which also represents a basic guideline for designing a training process with content that is as closely as possible related to the quality of movement in alpine skiing. depending on this, we need to define a method to help us monitoring positive or negative changes which result from both the content and intensity of the training process (šturm, 2012). coaches should perform regular tests of their athletes aiming to obtain valid results for efficient and healthy athlete’s development and health (ušaj, 2003). alpine skiing is a complex sport discipline which requires basic muscular power, aerobic and anaerobic abilities as well as a wide movement program of specific motor 37 annales kinesiologiae • 9 • 2018 • 1 špela bogataj, blaž lešnik: correlation between different motor abilities and score points ..., 35–44 abilities. the contribution level of each factor depends on the competition demands in which the athlete takes part. some sports, like swimming or track, are performed in a controlled environment and there the demands of competition can be quantified quite easily. on the other hand, sports like alpine skiing or football are exposed to various external influences and an athlete must often adapt to them in the middle of their performance (heikkinen, 2003). if we want to develop an appropriate battery of tests for alpine skiers, we need to understand which muscles are used during a competition and in what way (the type of contraction). during these tests, the athletes need to stimulate those muscles in the same way as they do at the competition. hintermeister et al. (1995) conducted research involving elite skiers and found out that their lower body and torso musculature was heavily activated during the alpine skiing movements. throughout a turn, adductors and some other muscles were working almost continuously at over 100 % of maximum voluntary rate of contraction. brown and wilkinson (1983) state that alpine skiers have, in comparison with untrained general population, lower body fat and that their body composition is similar to weight lifters’ and swimmers’. a study conducted by haymes & dickinson (1980) documented that alpine skiers have high ranking of isokinetic leg strength. the conclusion from these results suggests that lower body strength is an important predictor of a successful alpine ski competitor. this can help us conduct a proper battery of tests for alpine skiers. there is not a lot of research done with younger populations in alpine skiing correlating competition performance and field or laboratory tests. mladenović et al. (2015) investigated the correlation between results in ten motor ability tests and achieved level of ski knowledge during six-day alpine ski school in children aged between 7 and 8. they found that successful children have better developed agility, coordination, strength and frequency of movement. bandalo and lešnik (2011) studied a correlation, based on a model of potential and competitive performance, on a sample of 30 older boys aged from 13 to 14 who participated in the argeta cup 2009 / 2010 and showed 4 correlations of anthropometric dimensions and 13 correlations of motor dimensions. dolenec and lešnik also found an important correlation between competition success and morphology and motor abilities in young female (dolenec, 1996) and young male competitors (lešnik, 1996) in alpine skiing. based on the results they concluded that it would be reasonable to reduce the number of variables from battery of tests. according to these findings, we have put together a potentially successful battery of tests that measure those motor skills that are most associated with competitive performance. as dolenec (1996), bandalo and lešnik (2011) and lešnik (1996) suggested, we have reduced the number of motor variables from eighteen to eight variables. we set the following research questions: i.) is there a correlation between selected motor tests and points achieved in rauch cup in male u14 age class and ii) does the selected model of four variables has a correlation with points achieved in the rauch cup. 38 špela bogataj, blaž lešnik: correlation between different motor abilities and score points ..., 35–44 annales kinesiologiae • 9 • 2018 • 1 methods participants the sample consisted of 41 boys who were competing in rauch cup (slalom, giant slalom and super-g) in season 2016 / 17 in u14 age class. they came from different ski clubs across slovenia. the ethical board of the faculty of sport, university of ljubljana, approved the research experiment. all participants were informed of the study purpose and voluntarily participated in all tests. parental written agreement was also obtained for each participant. procedure measurements were assessed in autumn, before the competition season started. the whole procedure and tests were explained prior to the start of measurements. tests were conducted at the faculty of sport in ljubljana. the athletes were properly warmed-up before the start. first we assessed basic anthropometric measurements, body height and body weight. then we used the following motor tests: taping with a dominant leg (tap) this represents the rate of movements test and is performed by shifting one’s foot as quickly as possible over a 15-cm-high bar within 15 sec. the athlete sits on a chair with arms along his torso. one full cycle consists of moving the foot over the bar, touching the ground and returning the foot to its original position. the device counts only fully completed cycles and our research consisted of each athlete having two attempts, with the better of the two taken into account. test of stability (stab) the athlete had two attempts for this test, which was used to assess the overall dynamic stability and was performed in laboratory with biodex balance sd. the result is presented in the form of stability index. the athlete was positioned with both legs on the device’s platform and attempted to maintain the stable position for as long as possible. 39 annales kinesiologiae • 9 • 2018 • 1 špela bogataj, blaž lešnik: correlation between different motor abilities and score points ..., 35–44 run from the flying start – maximum speed (maxsp) the athletes had two attempts and were asked to start in the ski stance position. on starting mark athlete must in 30m develop maximum speed. the results are measured in m / s by a laser device, maximum speed achieved during running was recorded. ten jumps on both legs (mskok10) this test measured driving power of the legs, with each athlete having two attempts and the longest of the two was taken into analysis. the test involved the measurement of the distance achieved by 10 consecutive jumps with no interruption between repetitions. 400m run (mt400) speed endurance was assessed by 400 meters run test. athletes performed this test only once. running nines (ski9) the task here was to run as quickly as possible around nine pins (in the form of an eight) and represents a test of agility. this test was performed only once. counter movement jump (cmj) in this test, the athletes had to jump as high as possible using countermovement jumping technique (cmj). they had three trial jumps followed by two recorded attempts. there was a 2-minute rest between each jump, with jumps being performed on a ground-force plate. the height was calculated based on the flight time. the highest jump was taken into account. reaction time to a visual impulse (squat jump) (sjreac) reaction time to a visual impulse triggered by computer screen was measured using optojump device. on a visual signal, the athlete had to jump as quickly as possible from a squat position. they had three trial jumps followed by two recorded attempts. 40 špela bogataj, blaž lešnik: correlation between different motor abilities and score points ..., 35–44 annales kinesiologiae • 9 • 2018 • 1 criterion variable (points in rauch cup) the criterion variable represents the actual performance of all measured competitors on rauch cup in the 2016 / 2017 season. this was expressed by the total number of points, achieved in each individual competition for rauch cup. statistical analysis collected data was analysed using spss (ibm, version 22, usa) and microsoft excel 2013 and we summarized data with descriptive statistics. with pearson’s correlation coefficient we determined the linear correlation of each individual variable with competitive performance (rauch cup points). the multiple linear regression (mlr) analysis was used to determine how multiple independent variables are related to one dependent variable, in our case to competitive performance. with enter method we inserted four variables that gave the highest mlr, with that we predicted the level of effect of this model and each variable on criterion variable. the criterion variable was represented by the total number of points, achieved in the rauch cup. statistical significance was accepted at p < .05. results participant’s basic anthropometric data are presented in table 1. table 1: basic anthropometric data. am ± sd n 41 body height (cm) 158.2 ± 9.3 body mass (kg) 49.5 ± 11.7 in table 2 we determined for each variable minimum value, maximum value, range of values and arithmetic mean ± standard deviation. 41 annales kinesiologiae • 9 • 2018 • 1 špela bogataj, blaž lešnik: correlation between different motor abilities and score points ..., 35–44 table 2: descriptive statistics for each variable. range min max am ± sd taping with the dominant leg 9.0 17.0 26.0 22.0 ± 2.3 test of stability 6.6 1.3 7.9 3.9 ± 1.8 maximum speed 2.47 5.39 7.87 6.64 ± .55 ten jumps on both legs 11.1 15.2 26.3 19.6 ± 2.4 400m run 41.7 62.1 103.8 79.8 ± 9.6 running nines 11.6 28.1 39.7 33.0 ± 2.8 counter-movement jump 22.5 18.6 41.1 27.6 ± 4.8 reaction time to a visual impulse .23 .39 .62 0.47 ± .06 note: range the range between minimum and maximum value, min – minimum value, max maximum value, am±sd – arithmetic mean with standard deviation. table 3: pearson correlation coefficient values between motor variables and performance (points) in the rauch cup. test points taping with the dominant leg r .320* p .041 test of stability r .111 p .488 maximum speed r .712** p <.001 ten jumps on both legs r .678** p <.001 400m run r -.583** p <.001 running nines r -.563** p .001 counter-movement jump r .576** p .001 reaction time to a visual impulse r -.293 p .063 note: ** correlation is significant at the 0.01 level (2-tailed), * correlation is significant at the 0.05 level (2-tailed), r – pearson’s coefficient. 42 špela bogataj, blaž lešnik: correlation between different motor abilities and score points ..., 35–44 annales kinesiologiae • 9 • 2018 • 1 table 3 presents pearson’s correlation coefficients for the motor tests in relation to skiing performance. we found positive correlation between criterion variable and variables tap, mskok10, maxsp and cmj, while negative for mt400 and ski9. in the case of sjreac and stab, the correlation coefficient calculation did not show a significant correlation. multiple linear regression (mlr) analysis was performed with enter method. we included 4 predictors that gave the highest mlr for our sample of 41 participants. these were maxsp, mskok10, mt400 and cmj. results showed that the linear relationship, between four motor tests and skiing performance is high (r = .727; p < .001) and explained 53 % of skiing performance variance (table 4). table 4: model. r r2 p .727 .53 < .001 note: r – coefficient of multiple correlation; r²coefficient of determination. predictors: (constant), maxsp run from the flying start (max. speed), mskok10 – ten jumps on both legs, mt400 400m run, cmj – counter-movement jump. table 5: the multiple linear regression (mlr) analysis. b beta partial r p constant -1773.776 .033 maximum speed 199.497 .613 .342 .036 ten jumps on both legs 24.375 .325 .178 .284 400m run 2.917 .156 .113 .498 counter-movement jump -2.373 -.063 -.046 .784 note: dependent variable: pokal; predictors: (constant), maxsp run from the flying start (max. speed), mskok10 – ten jumps on both legs, mt400 400m run, cmj – counter-movement jump. in table 5 we can see that when we add four variables into mlr analysis, some of them are not significant anymore. in our case, the variable maxsp is the most important contributor (p = .036). 43 annales kinesiologiae • 9 • 2018 • 1 špela bogataj, blaž lešnik: correlation between different motor abilities and score points ..., 35–44 discussion this study was focused on the correlation between the selected motor abilities and competitive performance in u14 age group of alpine skiers. we found a correlation between competitive performance and results in six out of eight motor tests. positive correlation was found between rauch points and variables tap, mskok10, maxsp and cmj, while negative for mt400 and ski9. the same as bandalo and lešnik (2011), we also did not find a significant correlation between balance (variable stab) and criterion variable. this is interesting because the postural control in alpine skiing, in particular the management of the balance, is widely considered as one of the limiting factors of performance. for future research, we suggest that researchers use different balance tests and find out which test is best correlated with performance. in multiple linear regression, we included 4 predictors that gave the highest mlr: maxsp, cmj, mskok10 and mt400. simple linear regression showed us that each predictor variable had a significant p-value. but from the multiple regression model output, cmj, mskok10 and mt400 no longer displayed a significant p-value. we think this is an example of collinearity of the predictors. but overall, the model is still significant. in our case, the variable maxsp, which represents maximum speed, had a strongest correlation with the criterion. with our research we addressed the dilemma with using a greater or smaller battery of test. as lešnik (1996) and dolenec (1996) suggested, we used a smaller battery, which can be performed at once. based on the test results we can plan and conduct the training process, which later leads to efficient effort overcoming at training and at competitions. in future, it will be necessary to monitor the development of young athletes even more systematically. this is a sensitive period and that is why it is even more important that the battery of tests is effective and tells us those things about the athlete, which professionals needs in order to guide them in the training process. nowadays, the differences between individuals’ performance are getting smaller, that is why we need to focus on raising the level of motor and functional skills to the highest level possible. in this part, testing motor abilities plays an important role. although highly developed motor abilities are crucial for good competitive performance, we must not ignore the role of biological age, motivation and concentration for this age group. conclusion our findings show the suitability of selected motor tests in determining the potential success of young alpine skiers. we will continue with deployment of state-of-the-art measurement methods and try to connect them with the measurements of older age categories of competitors in alpine skiing. in conclusion, the test concepts presented in this study can help ski schools, clubs and skiing federations in the guidance and evaluation of young talents. in the future, we suggest that in addition to motor test, researches also include several anthropometric measures and examine cognitive and behavioural measures of motivation. 44 špela bogataj, blaž lešnik: correlation between different motor abilities and score points ..., 35–44 annales kinesiologiae • 9 • 2018 • 1 references bandalo, m. & lešnik, b. (2011). the connection between selected anthropometric and motor variables and the competitive success of young competitors in alpine skiing. kinesiologia slovenica, 17(3), 16–31. view item brown, s. l., & wilkinson, j. g. (1983). characteristics of national, divisional, and club male alpine ski racers. medicine and science in sports and exercise, l5(6), 491-495. view item dolenec, m. (1996). vrednotenje modela uspešnosti mlajših deklic v alpskem smučanju [evaluation of the model of success of young girls in alpine skiing] (unpublished master’s thesis), faculty of sport, university of ljubljana, slovenia. haymes, e. m., & dickinson, a. l. (1980). characteristics of elite male and female ski racers. medicine and science in sports and exercise, l2(3), 153-158. view item heikkinen, d. (2003). physical testing characteristics and technical event performance of junior alpine ski racers (master’s thesis). retrieved from university of maine electronic theses and dissertations. (etd 473) view item hintermeister, r. a., o’connor, d. d., dillman, c. j., suplizio, c. l., lange, g. w., & steadman, r. j. (1995). muscle activity in slalom and giant slalom skiing. medicine and science in sports and exercise, 27(3), 315-322. view item lešnik, b. (1996). vrednotenje modela uspešnosti mlajših dečkov v alpskem smučanju [evaluation of the model of success of young boys in alpine skiing]. (unpublished master’s thesis), faculty of sport, university of ljubljana, slovenia. mladenović, d., cigrovski, v., stanković, v., prlenda, n., & uljević o. (2015). success in adopting technique of alpine skiing with respect to motor abilities of the children aged 7-8 years. collegium antropologicum, 39(1), 77–82. view item šturm, r. (2012). načrt otroškega programa smučanja [plan of the children’s ski program]. retrieved from: http://www.sloski.si/resources/files/pdf/alpsko-smucanje/letni_ nart_alpskih_reprezentanc_2012-2013_vlado_makuc_popravljen_mlad_ prog.pdf ušaj, a. (2003). osnove športnega treniranja [basics of sports training]. unpublished manuscript, faculty of sport, university of ljubljana, slovenia. https://www.kinsi.si/mma/007899_223_bandalo.pdf/201805221111450002/ https://journals.lww.com/acsm-msse/abstract/1983/15060/characteristics_of_national,_divisional,_and_club.9.aspx https://journals.lww.com/acsm-msse/abstract/1980/23000/characteristics_of_elite_male_and_female_ski.5.aspx https://digitalcommons.library.umaine.edu/etd/473/ https://journals.lww.com/acsm-msse/abstract/1995/03000/muscle_activity_in_slalom_and_giant_slalom_skiing.5.aspx https://hrcak.srce.hr/file/217128 annales kinesiologiae • 8 • 2017 • 1 5 original scientific article udc: 796.926.015 received: 2017-05-30 is specific motor test enough to evaluate new alpine ski knowledge in ski beginners? vjekoslav cigrovski1, ivica franjko1, tomislav rupčić1, marijo baković1, & igor božić2 1university of zagreb, faculty of kinesiology, croatia 2university of banja luka, faculty of physical education and sport, bosnia and herzegovina corresponding author: vjekoslav cigrovski, ph.d. university of zagreb, faculty of kinesiology, horvaćanski zavoj 15, 10000 zagreb, croatia phone: +385 91 544 2202 e-mail: vjekoslav.cigrovski@kif.hr abstract the present research aims at determining whether the results of specific motor tests (continuous lateral jumps in dictated tempo − skilj) are a sufficient measure to evaluate the level of acquired alpine ski knowledge of ski beginners. twenty four alpine ski naïve male participants with comparable performance levels and no record of injuries in the preceding six months were included in the study. they were tested on skilj test microgate optojump next system prior to participating in a structured alpine ski school program. after completing the ski school program, the participants’ knowledge of short turn was tested by five judges. correlation coefficients between the five judges for the short turn element were all high and statistically significant, implying judges’ objectivity in grading alpine ski knowledge. on the other hand, there was no statistically significant correlation between lateral jumps in predefined pace and the acquired knowledge of short turn skiing technique. therefore, we conclude that the movements executed during alpine skiing with continuous connecting of short parallel turns are much more complicated than the movements needed during the performance of skilj which cannot fully depict alpine skiing. keywords: recreational level alpine skiers, motor abilities, motor skills learning efficiency. 6 vjekoslav cigrovski, ivica franjko, tomislav rupčić, marijo baković, igor božić: is specific motor test enough ..., 5–14 annales kinesiologiae • 8 • 2017 • 1 je predlagani motorični test veljaven test znanja alpskih smučarjev začetnikov? izvleček cilj raziskave je bil ugotoviti ali rezultati specifičnih motoričnih testov (zaporedni lateralni odskoki po ritmu − skilj) omogočajo vrednotenje napredka smučarjev začetnikov pri pridobivanju veščin alpskega smučanja. v raziskavo je bilo vključenih štiriindvajset moških smučarjev začetnikov s primerljivimi sposobnostmi, ki vsaj šest mesecev pred izvedbo raziskave niso bili poškodovani. preden so se preiskovanci udeležili strukturirane šole alpskega smučanja, smo jih motorično testirali s testom skilj (microgate optojump next). po zaključenem šolanju alpskega smučanja, je skupina petih sodnikov vsakemu preiskovancu ocenila smučanje v ozkem hodniku. korelacijski koeficienti med ocenami petih sodnikov so bili visoki in statistično značilni, kar nakazuje objektivnost sodnikov pri ocenjevanju. hkrati pa nismo zaznali statistično značilne povezave med lateralnimi odskoki z definiranim ritmom in pridobljenimi znanji smučanja v ozkem hodniku. ugotovili smo, da je gibanje, ki ga alpski smučar izvaja med kontinuirano in povezano izvedbo ozkega hodnika mnogo bolj zapleteno kot gibanje med izvedbo testa skilj in da slednji ne more v celoti orisati alpskega smučanja. ključne besede: alpski smučarji rekreativci, motorične sposobnosti, učinkovitost motoričnega učenja introduction most of the cyclic sports include the performance of certain rhythmical movements that are systematically repeated. the movements that are repeated in alpine skiing are turns (oreb, vlašić, cigrovski, prlenda, & radman, 2011). effective and meaningful interconnection of individual parts of a turn, as well as connecting multiple turns into a whole represents a skiing rhythm (cigrovski & matković, 2015). the rhythmic performance of multiple turns is intuitive performance without any prior thoughts on each part of the turn. the rhythm of the turns, maintaining good balance on the skis, and smooth sliding of the skis all influence our skiing technique, making it more efficient (loland, 2009; cigrovski & matković, 2015). when analyzing competitive level skiers, slalom discipline is the one in which rhythm is often commented with respect to the set course of gates series (waibel, huber, & spitzenpfell, 2009). slalom turns are short and in a narrow corridor, they are a modified version of short turn element. although the rhythm of turns is also present in the wider corridor during the technique and in other alpine skiing disciplines, according to waibel and coworkers (2009), slalom is a annales kinesiologiae • 8 • 2017 • 1 7 vjekoslav cigrovski, ivica franjko, tomislav rupčić, marijo baković, igor božić: is specific motor test enough ..., 5–14 discipline in which oscillations in the change of rhythm during a continuous connection of multiple turns are visible and recorded. from the aspect of recreational skiers, it is known that the success of alpine ski learning depends upon multiple factors, and among the most important are: learning conditions, the expertise of the ski instructor and the abilities and motivation of the ski beginners (loland, 2009). although one would expect explosive leg strength to be equally important for beginners as it is for competitive level skiers, tests for its assessment in alpine ski beginners failed to prove correlation with the success of ski learning suggesting that explosive leg strength is not critical in the beginning phases of learning (neumayr et al., 2003). on the other hand, of all the motor abilities, it is balance that probably differs those ski beginners who will acquire ski knowledge sooner from those whose adoption of ski knowledge will go slower (malliou et al., 2004; ružić, rađenović, & tudor, 2008; cigrovski, franjko, rupčić, baković, & matković, 2016). interestingly, much less is known about the correlation of coordination in the rhythm with the effectiveness of adopting ski knowledge. it can be assumed that ski beginners who have developed this ability at a higher level will adopt the elements of ski technique that are continuously linked to overcoming the ski terrain more quickly. currently, the use of simulation devices to improve the motor performances of athletes is becoming increasingly popular. ski simulators are specifically constructed to enable alpine skiers’ adequate conditioning trainings before going to the ski terrains (straub, 2013). it is expected that ski-simulator training during the off-season, when access to real slopes is limited, would benefit skiers. existing ski-simulator studies largely verify the training effect through observation of changes in the movement pattern, while only few verify the effectiveness of reality-based ski simulator (nam & woo, 2007; lee, kim, & roh, 2012). moreover, simulation devices are used at recreational level with the purpose to predict the tempo of learning new activity, suggest individual approaches to each beginner, allow people to enjoy skiing during non-winter season and practice ski-turn motor performance (panizzolo, marcolin, & petrone, 2013). with respect to the aforementioned, data on importance of specific motor abilities learned and tested by ski simulator are scarce, but according to nourrit-lucas, zelic, deschamps, hilpron, and delignières (2013), coordination variables tend to be among the most important factors for valid assessment of learning and retention of alpine skiing (nourrit-lucas et al., 2013). skiing is an activity that requires a coordination between upper and lower body, with special accent on leg muscles that need to be strengthened. during ski turns, especially short turns skiers are constantly performing lateral leg movements which are simulated by lateral jumps during training. the use of ski simulators enables lateral movements / jumps to be performed more authentically to short turns. repetition of lateral jumps or lateral leg movements on a ski simulator represents a certain rhythm that can be performed at different pace, also, the pace at which lateral jumps are performed can be adjusted to usual pace of turns during slalom skiing. therefore, in the present research we wanted to determine whether the results in specific motor test (continuous lateral jumps − skilj) are sufficient to evaluate the level of acquired alpine ski knowledge of ski beginners. 8 vjekoslav cigrovski, ivica franjko, tomislav rupčić, marijo baković, igor božić: is specific motor test enough ..., 5–14 annales kinesiologiae • 8 • 2017 • 1 methods participants overall, 24 male participants were included in the study. they were all students of school of kinesiology, university of zagreb, who exhibited comparable performance levels and had no record of injuries in the preceding 6 months (age 23.4±1.68 years). they were all ski beginners prior to inclusion in the present study, with no experience whatsoever in alpine skiing. the study was approved by ethics committee of the school of kinesiology, university of zagreb. each participant voluntarily provided written informed consent before participating and was thoroughly informed about the study aims and procedures. variables at the beginning, the participants were tested according to a specific skilj test, assessing their performance of lateral jumps in dictated tempo (fifteen jumps in a time unit) using microgate optojump next system. the system consists of two bars; transmitting and receiving which communicate by led lamps and calculate the duration of interruptions in the communication. the calculations measure the flight and contact times during the performance of a series of jumps with an accuracy of 1/1000 of a second. moreover, the use of two cameras allows recording of the images of the tests performed, synchronizing them with the measured events. the participants were then included in a structured alpine ski program in identical conditions, and were afterwards tested on the short turn alpine ski technique. short turns best represent the continuous connection of short unfinished parallel turns performed in a narrow corridor. research protocol the participants were first tested on skilj test for motor ability assessment. the test was repeated 3 times and the average result of each participant was used. two parallel lines 30 cm apart were put on the ground; suggesting a minimal width of lateral jumps. the participants were asked to perform fifteen lateral jumps in the defined space. during the jumps they could use hand swings for the stability and adjusting the tempo of jumps. intensity of the performance was tested in two variants. in variant one, participants chose their own tempo and intensity for lateral jumps, optimal take off and flight, while in variant two they had to perform 76 lateral jumps per minute (metronome). variables that were selected and measured included: average contact with ground (contact / s), average duration of flight (flight / s), average power (power w / kg), average value of pace (rsi step / s), average jump height (height / cm). annales kinesiologiae • 8 • 2017 • 1 9 vjekoslav cigrovski, ivica franjko, tomislav rupčić, marijo baković, igor božić: is specific motor test enough ..., 5–14 figure 1 participant performing lateral jumps during the testing with microgate optojump next system. after taking the test, the participants were included in a ten-day alpine ski program. during the skiing program they all had identical conditions regarding the terrains in the ski center, the quality of ski equipment, the hours of daily learning and practice, the availability of ski instructors and the information on alpine skiing. the participants were randomized in three groups of eight, and when the program of alpine skiing finished they all joined one group, demonstrating the acquired knowledge of short turn. five independent judges graded the demonstration of short turn on a scale from 1 to 5; where the grade 5 was given to participants with superb demonstration. each grade was given upon previously defined criteria and each judge had to pay attention to a specific part of a turn. judges’ objectivity and homogeneity was tested in previous studies and therefore allowed their engagement in this research (cigrovski, matković, & matković, 2008). moreover, each participant was filmed during the demonstration of short turn, and afterwards the same judges once again evaluated the video of participants’ short turn. statistical methods the results were analyzed by the statistica statistical package version 12. to test the objectivity, the correlation coefficients between grades for short turn were calculated. factor analysis was used to test judges’ homogeneity. basic descriptive parameters were calculated, assessing participants’ motor ability (skilj). pearson’s coefficients were calculated for the evaluation of degrees of the correlation between motor ability (lateral jumps) and alpine ski knowledge (on-field demonstration of short turn and video analysis of the same element). the results were considered significant if p<.05. 10 vjekoslav cigrovski, ivica franjko, tomislav rupčić, marijo baković, igor božić: is specific motor test enough ..., 5–14 annales kinesiologiae • 8 • 2017 • 1 table 1: correlation coefficients between grades given by five judges for the demonstration of short turn. judge 1 judge 2 judge 3 judge 4 judge 5 judge 1 1.00 0.75** 0.80** 0.77** 0.72** judge 2 1.00 0.79** 0.79** 0.88** judge 3 1.00 0.82** 0.82** judge 4 1.00 0.78** judge 5 1.00 * p<0.05; ** p<0.01 correlation coefficients between the five judges for the short turn element are all high and statistically significant, implying judges’ objectivity. data on judges’ homogeneity are presented in table 2. table 2: results of first components given by judges during the short turn grading. element of ski technique components (factors) eigenvalue % variance short turn 1 4.17 83.38 table 2 presents the eigenvalue of the principal component which fulfils the guttman-kaiser criterion (λ=4.17) and represents the knowledge of alpine skiing. the results suggest that all judges participating in the investigation graded the same item, i.e. alpine ski knowledge. basic descriptive parameters for the variables obtained in the skilj test and for the short turn are shown in table 3. annales kinesiologiae • 8 • 2017 • 1 11 vjekoslav cigrovski, ivica franjko, tomislav rupčić, marijo baković, igor božić: is specific motor test enough ..., 5–14 table 3: basic descriptive parameters for the variables obtained in the skilj test and for the short turn. n mean max min sd skilj 24 1.95 1.17 2.41 0.31 short turn 24 3.70 2.00 5.00 1.02 video short turn 24 1.08 0.93 1.27 0.10 skilj avg 24 1.94 1.42 2.35 0.25 skilj = continuous lateral jumps; video short turn =grade for filmed short turn; skilj avg =skilj average result; max=maximal; min=minimal correlation between skilj test and the level of acquired alpine ski knowledge in short turn is presented in table 4. table 4: correlation between the skilj test and the level of acquired alpine ski knowledge in short turn. skilj short turn video short turn skilj avg skilj 1.00 0.05 -0.01 0.94* short turn 1.00 0.11 0.11 video short turn 1.00 -0.10 skilj avg 1.00 * p<0.05; ** p<0.01 skilj = continuous lateral jumps; video short turn =grade for filmed short turn; skilj avg =skilj average result the results show no statistically significant correlation between lateral jumps in predefined pace and the acquired knowledge of short turn ski technique. discussion and conclusion alpine skiing is best characterized by repetition of ski turns, the basic motion for managing speed and direction during downhill descend (lemaster, 2009). it is expected that different exercises or tests simulating specific ski movements used during off12 vjekoslav cigrovski, ivica franjko, tomislav rupčić, marijo baković, igor božić: is specific motor test enough ..., 5–14 annales kinesiologiae • 8 • 2017 • 1 -season would benefit skiers in terms of training and maintaining their functional and strength capabilities. significant interest has been shown in the use of motion analysis of ski turns to improve performance while performance of turns affects overall performance (gwangjae et al., 2016). although for recreational skiers one would expect similar training might help in learning or mastering specific movements important for ski technique it has not been proven repeatedly. for example, explosive leg strength which is of utmost importance for the success of competitive level skiers, did not show its correlation with success of ski learning during the beginning phases (neumayr et al., 2003). on the other hand, balance is equally important for competitive skiers as it is for ski beginners, while those who have developed balance at the higher level also adopt ski knowledge more rapidly (malliou et al., 2004; ružić et al., 2008; cigrovski et al., 2016). although one would expect similar importance of coordination in the rhythm with the effectiveness of adopting ski knowledge, our results failed to demonstrate it with test lateral jumps. lateral jumps are often used during competitive skiing trainings because they are like lower body and leg motion during skiing. they play a crucial role in the control of speed and direction during turns. in this study, we found no statistical significance between the results achieved in the skilj test (testing lateral jumps) and learned level of short turn. results suggest that the movements executed during continuous connecting few short parallel turns are much more layered (complicated) than the movements needed during the performance of skilj. moreover, different ways of executing short turns and lateral jumps in the test additionally contributed to a lack of correlation between the two variables. besides the biomechanical aspects of ski turn that have been studied with different methods and simulators, the analysis of movement helps in determining patterns of injury and subsequently leads to their successful prevention (lee et al., 2012; gwangjae et al., 2016). this is where the research with ski simulators is aimed at in the recent years (lee et al., 2012). as alpine skiing is a specific motor activity primarily due to the conditions in which it is executed and the need for continuous rhythmic body movements while descending the slope in different width corridors, efforts are made in the development of specific training protocols and tests that would improve ski technique. before making final conclusions about the existence of correlation between the results in skilj test and adoption of knowledge in short turn, we need to mention the study limitations. firstly, it included a small number of participants. in succeeding studies, a larger sample of participants and participants of different age need to be included. if repeatedly one would find no correlation between skilj results and alpine ski learning, conclusion with greater certainty would be that we cannot predict success of learning short parallel turn with skilj. once again it must be accentuated that the skilj test was taken and modified from conditioning training of the competitive level alpine skiers. different lateral jumps in dictated tempo are systematically used during conditioning trainings of alpine skiers. analogy with the mentioned led to the assumption that lateral jumps in predefined tempo of performance like that of short parallel turns will be in close correlation, but as previously mentioned in similar studies, the correlations although sometimes logical, do not always prove in the praxis (neumayr et al., 2003). annales kinesiologiae • 8 • 2017 • 1 13 vjekoslav cigrovski, ivica franjko, tomislav rupčić, marijo baković, igor božić: is specific motor test enough ..., 5–14 acknowledgements the authors are grateful to the hep (croatian national electricity company) for supporting the measurements as well as to microgate and the university of zagreb for their contributions to this research. references cigrovski, v., & matković, b. (2015). skiing technique carving. zagreb (cro): university of zagreb, faculty of kinesiology. cigrovski, v., matković, b., & matković, r. b. (2008). evaluation of objectivity and homogeneity of skiing knowledge grading process. in: d. milanović, & f. prot (eds.), proceedings of 5th international scientific conference on kinesiology (pp. 513–517). zagreb: university of zagreb, faculty of kinesiology. cigrovski, v., franjko, i., rupčić, t., baković, m., & matković, b. (2016). correlation between balance, specific alpine skiing knowledge and situational efficiency in alpine skiing. acta kinesiologica, 10 suppl., (1), 66–70. view item gwangjae, y., young, j. j., jinhyeok, k., jin, hae, k., hye, y. k., kitae, k., & siddhartha, b. p. (2016). potential of imu sensors in performance analysis of professional alpine skiers. sensors, 16(4), 463. doi:10.3390/s16040463 view item lee, h. t., kim, y. j., & roh, h. l. 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(2011). relationship between rhythm and learning alpine skiing technique. in i. prskalo, & d. novak (eds.), http://bib.irb.hr/datoteka/865413.acta_kinesiologica_2016.pdf http://dx.doi.org/10.3390/s16040463 https://www.jstage.jst.go.jp/article/jpts/24/6/24_471/_article https://doi.org/10.2466/pms.99.1.149-154 http://dx.doi.org/10.5103/kjsb.2007.17.3.041 http://dx.doi.org/10.1055/s-2003-43270 http://dx.doi.org/10.1055/s-2003-43270 https://doi.org/10.1016/j.humov.2013.07.005 14 vjekoslav cigrovski, ivica franjko, tomislav rupčić, marijo baković, igor božić: is specific motor test enough ..., 5–14 annales kinesiologiae • 8 • 2017 • 1 proceedings of 6th fiep european congress “physical education in the 21st century-pupils competencies” (pp. 640–646). zagreb: hrks. panizzolo, f. a., marcolin, g., & petrone, n. (2013). comparative evaluation of two skiing simulators as functional training devices for recreational skiers. journal of sports science and medicine, 12(1), 151–158. view item ružić, l., rađenović, o., & tudor, a. (2008). the predictive power of balance board: tests for «on-the-skis» balance performance. in d. milanović, & f. prot (eds.), proceedings of 5th international scientific conference on kinesiology (pp. 196–200). zagreb: university of zagreb, faculty of kinesiology. straub, w. f. (1975). validation of a ski simulator. research quarterly for exercise and sport. american alliance for health, physical education and recreation, 46(1), 92–99. doi: 10.1080/10671315.1975.10615309 view item waibel, k., huber, a., & spitzenpfell, p. (2009). performance analyses in alpine ski racing regarding the characters of slopes and course settings. in e. műller, s. lindinger, & t. stoggl (eds.), science and skiing iv (pp. 565–572). oxford (uk): meyer & meyer sport. http://www.jssm.org/gecjssm-12-151.xml.xml http://dx.doi.org/10.1080/10671315.1975.10615309 _goback _goback _goback _hlk501362470 _hlk501363405 _hlk501369360 annales kinesiologiae • 9 • 2018 • 1 57 reports and reviews/poročila in ocene, 57–68 2nd international conference spe balkan ski mt. jahorina ski resort, bosnia and herzegovina, 11th–15th march 2018 after the 1st conference organized in 2017 at the kopaonik ski center in serbia, following the initiative of prof. rado pišot, the director of the science and research centre koper and his colleague prof. ljubomir pavlovič from the university of niš, the jahorina ski center with faculty of sports and physical education of university of sarajevo, bosnia and herzegovina, hosted the 2nd international conference spe balkan. the conference was co-organized by the science and research centre of koper (slovenia), faculty of sport and physical education, university of niš and the association of ski teachers and coaches of slovenia (zuts). as “science, practice and education” remained the leading ideas of the content and scope of the conference on alpine skiing and boarding, this year’s main theme was: “fun and safety in contemporary skiing − the new role of ski instructors / trainers in winter sports and society.” as the first conference set high scientific standards, many experts responsible for the development and progress in winter sports have been invited to participate at the second conference. the afternoon lectures held by prof. ron kipp (usa) (in the absence 58 reports and reviews/poročila in ocene, 57–68 annales kinesiologiae • 9 • 2018 • 1 of prof. erich muller, austria), prof. pete alison (scotland and usa), prof. blaž lešnik (slovenia) and many others, in over 30 scientific contributions highlighted the latest views on the sensitive areas of safety and injury, the secrets of preparing and developing the technique and tactics of the alpine skiing, and, finally, the contemporary possibilities and approaches in the methodology and didactics of teaching skiing. after the conference, the best-presented works were invited to be published in scientific journals. morning snow workshops were led by the members of the demo teams from the participating countries in the balkans (demo teams of slovenia, bulgaria, bosnia and hercegovina, serbia and montenegro) upgraded the theoretical starting points through practical work on snow. the spectacular evening demo show was outstanding event where even the most demanding supporters enjoyed in ski proficiency of demo teams. despite the warm and spring weather, the jahorina ski resort, as the only venue of the winter olympic games in the balkans invited special guests − the slovenian and bosnian ski legends, mr. bojan križaj and mr. enis bećirbegović as well as 143 participants from 10 countries who were assurance for a diverse, interesting, dynamic and unforgettable event. because the winter of 2019 is the already reserved time for interski congress in pomporovo, bulgaria, the next 3rd international conference spe balkan ski will be held in slovenia, at rogla ski resort in march 2020. saša pišot annales kinesiologiae • 9 • 2018 • 1 59 reports and reviews/poročila in ocene, 57–68 2. mednarodna konferenca spe balkan ski smučarski center jahorina, bosna in hercegovina, 11.–15. marec 2018 po lanski uspešni prvi konferenci, ki je bila organizirana v smučarskem centru kopaonik v srbiji na pobudo prof. rada pišota, direktorja znanstveno-raziskovalnega središča koper in prof. ljubomirja pavloviča iz univerze v nišu, je smučarski center jahorina s fakulteto za šport in telesno vzgojo univerze v sarajevu, bosne in hercegovine, gostil 2. mednarodno konferenco spe balkan ski. soorganizatorji konference so bili tudi letos znanstveno-raziskovalno središče koper, fakulteta za šport in telesno vzgojo univerze v nišu in zveza učiteljev in trenerjev smučanja slovenije (zuts). vodilno idejo konference “znanost, praksa in izobraževanje” je spremljala tokratna glavna tema “zabava in varnost v sodobnem smučanju nova vloga smučarskih učiteljev/trenerjev zimskih športov v družbi.” že prva konferenca je postavila visoke znanstvene standarde, zato so bili tudi letos med povabljenimi številni priznani strokovnjaki, odgovorni za razvoj in napredek alpskega smučanja in deskanja na snegu. na popoldanskem znanstvenem delu konference smo lahko prisluhnili dr. ronu kippu (zda), ki je nadomestil odsotnega prof. ericha mullerja iz avstrije, prof. petu alisonu (škotska in zda) in prof. blažu lešniku 60 reports and reviews/poročila in ocene, 57–68 annales kinesiologiae • 9 • 2018 • 1 (slovenija) ter mnogim drugim, ki so v več kot 30 znanstvenih prispevkih predstavili najnovejše poglede na občutljiva področja varnosti in poškodb, odkrivali skrivnosti priprav in razvoja smučarske tehnike ter izpostavili sodobne možnosti in pristope v metodologiji in didaktiki učenja smučanja. avtorji najboljših prispevkov so bili povabljeni, da dela objavijo v znanstvenih časopisih univerz gostiteljic. dopoldanske delavnice na snegu so vodili člani demo skupin iz sodelujočih držav na balkanu (ekipe demonstratorjev iz slovenije, bolgarije, bosne in hercegovine, srbije in črne gore), kjer so udeleženci lahko nadgradili teoretična znanja s praktičnim delom na snegu. spektakularni večer z “demo showom” je bil izjemno odmeven dogodek, kjer so lahko še tako zahtevni poznavalci uživali v popolnosti smučarskih tehnik nastopajočih ekip demonstratorjev nacionalnih smučarskih šol. kljub toplemu pomladnemu vremenu in zato slabšim snežnim pogojem, je smučišče jahorina, kot edino prizorišče zimskih olimpijskih iger na balkanu, ob prisotnosti posebnih gostov – slovenske in bosanske smučarske legende bojana križaja in enisa bećirbegovića ter 143 udeležencev iz 10 držav, pričaralo prvovrsten in nepozaben dogodek. zima 2019 je že rezervirana za pomemben interski kongres v bolgarskem smučarskem centru pomporovo, zato bo naslednjo, 3. mednarodno konferenco spe balkan ski, v marcu 2020 gostila slovenija v smučarskem centru rogla. saša pišot annales kinesiologiae • 9 • 2018 • 1 3 original scientific article udc: 796.012.1-053.2:316.454 received: 2018-02-06 influence of social interaction in a group on young girls’ physical performance kateřina strašilová1 & petr vajda1 1 masaryk university, faculty of sport studies, brno, czech republic corresponding author: kateřina strašilová, msc masaryk university, faculty of sport studies, kamenice 5, 625 00 brno, czech republic phone: 420 549 49 2000 e-mail: katka.strasilova24@gmail.com abstract it is assumed that there are many factors influencing sport performance in youth sport. this research is designed to find out whether there are any differences between individual and group physical performance. the aim of study is to report on the effect of social-comparative effect on young girls’ physical performance. the study involved young elite synchronized swimmers from a czech club with olympic tradition who compete at an international level (n = 28, age 10.12±1.20). the swimmers were required to hold a wall-seat position as long as possible in two separately measured rounds, i.e. as individuals and as a group. the girls were randomly split into two groups. they started with an individual or group try of the wall-seat position exercise. there was a week’s interval between the measured rounds. the mean performance was m = 108.82±57.10 in the individual try and m = 271.50±218.88 in the group one. the influence of social interaction in the group was evaluated by cohen’s d which showed high substantive differences (d = 1.1, large effect). the wilcoxon matched pair test was used for data analysis (results were statistically significant, p < 0.05). it showed mutual social encouragement in a group that caused improvement in performing a wall-seat position and influenced significantly their performance. however, it was also established that such social interaction / encouragement is not consistent for every child. nevertheless, there are many other important factors influencing a youth physical performance as positive verbal motivation, constructive feedback or appraisal. keywords: group cohesion, mutual encouragement, self-motivation, sport performance, synchronized swimming, youth athletes. 4 kateřina strašilová, petr vajda: influence of social interaction in a group on young girls’ physical ..., 3–13 annales kinesiologiae • 9 • 2018 • 1 vpliv socialnih interakcij v skupini na telesne zmogljivosti deklic izvleček na uspešnost udejstvovanja v mladinskem športu vplivajo številni dejavniki. namen pričujoče raziskave je bil ugotoviti morebitne razlike med telesnimi zmogljivostmi pri individualnem in skupinskem udejstvovanju. v raziskavo smo vključili skupino mladih vrhunskih športnic skladnostnega plavanja iz češkega kluba z olimpijsko tradicijo, ki tekmujejo na mednarodnem nivoju (n=28, starost 10,12±1,20). plavalke smo prosili, da vztrajajo v položaju »sedenje ob steni« kolikor mogoče dolgo. vajo smo ponovili dvakrat, s to razliko, da so jo udeleženke v raziskavi enkrat izvajale individualno, nato pa še skupinsko. dekleta smo naključno razdelili v dve skupini in pri eni smo najprej merili individualno izvedbo, pri drugi pa skupinsko izvedbo vaje. interval med enim in drugim merjenjem je bil en teden. povprečni izmerjeni dosežki udeleženk v raziskavi so bili m=108.82±57.10 pri individualni izvedbi vaje in m=271.50±218.88 pri skupinski. učinek socialne interakcije v skupini smo ovrednotili s pomočjo cohenovega d indeksa, ki je pokazal visoko statistično odstopanje (d=1,1, velik učinek). za analizo podatkov smo uporabili wilcoxonov test predznačenih rangov (rezultati so bili statistično pomembni, p< 0,05). izkazalo se je, da je vzajemna socialna vzpodbuda v skupini povzročila učinkovitejše izvajanje vaje sedenja ob steni in znatno vplivala na izmerjene rezultate. tekom raziskave pa smo ugotovili tudi, da tovrstna socialna interakcija/ vzpodbuda ne vpliva nujno na vsakega otroka. vsekakor obstaja še vrsta drugih pomembnih faktorjev, ki vplivajo na otrokovo samomotivacijo kot npr. pozitivno verbalno motiviranje, konstruktivne povratne informacije in pohvale. ključne besede: skupinska kohezivnost, vzajemno vzpodbujanje, samomotivacija, športna zmogljivost, skladnostno plavanje, mlade športnice introduction motivation to exercise, often referred to as a need of achievement, is described as a need to prove something difficult, be the best, overcome yourself and your rivals. the natural social aspect of motivation to exercise is an effort to compete with others (výrost & slaměník, 2008). similarly, heckhausen (1991) described the need to be the best or to do things better than before or to do them better than other people. motivation to exercise is proposed by many psychological factors. enjoyment, social influence and self-efficacy are among the most frequently mentioned (carron, hausenblas, & mack, 1996; irwin, scorniaenchi, kerr, eisenmann, & feltz, 2012; mcauley & courneya, 1993). another annales kinesiologiae • 9 • 2018 • 1 5 kateřina strašilová, petr vajda: influence of social interaction in a group on young girls’ physical ..., 3–13 factor that should not be overlooked is exercising in a group. the motivational effect of a group activity has been studied for many years, mainly in social psychology, and it was shown it could lead to higher exercise adherence than individual programs (dishman & buckworth, 1996). the motivational effect of exercising in a group was described in two different ways. the first one, the so-called motivational loss, is caused by a phenomenon of social lofting. especially more capable team members developed less effort than if they worked individually (baron & kerr, 2003). however, motivation gain is described more frequently. the kӧhler motivation effect and social compensation are two phenomena which are connected with motivation gain. in case when superior group members work hard and increase their individual effort in order to compensate the effort of less-capable group members we call it social compensation (osborn, irwin, skogsberg, & feltz, 2012). the kӧhler effect occurs when the inferior group members enhance their effort to cooperate with the superior members (baron & kerr, 2003). it was shown that the kohler effect is task-dependent (weber & hertel, 2007). for example, steiner (1972) created the task taxonomy which divided motivation tasks into three relevant categories: conjunctive, coactive, and additive. the first one, the conjunctive task, means that group performance is dependent on the inferior members´ performance. the result of the weakest member defined the overall team result. the second one, the coactive task, means that the task is performed simultaneously by all members of the group, but their individual result is not dependent on the outcome of other group members. the last one, the additive task, describes an exercise when the sum of members performance represents the result of the group. on the other hand, kerr et al. (2007) proposed two main explanations of the kӧhler effect. one explanation works with conjunctive theory. it says that group performance will always be as strong as the weakest group member. it brings motivation gain for the inferior group members who want to get closer to the stronger members because they know that the group result is dependent on their performance. the other explanation suggests an increase in motivation due to social comparison. it means that the presence of superior group members may enhance personal and performance goals of weaker group members. it was shown from previous studies that the greatest motivation gains for the weakest group members was in a conjunctive group task, when the weaker members were exercising with moderate partners, it worked especially for women. on the other hand, it has been shown that a lot of men work better in coactive tasks with a superior coworker and it does not matter if they cooperate on a task or not (weber & hertel, 2007). on the contrary, feltz, kerr and irwin (2011) found out that the increase in motivation was entirely the result of social comparison. it means that the presence of the other group member brought the main motivation gain regardless if they work on the group goal or not. it was also confirmed that the motivation gains are greatest when the inferior members are 1.4 times weaker than the stronger ones (messé, hertel, kerr, lount jr, & park, 2002). nevertheless, the differences between the most and the least capable partners should not be too large as this can cause motivation losses (hertel, niemeyer, & clauss, 2008). 6 kateřina strašilová, petr vajda: influence of social interaction in a group on young girls’ physical ..., 3–13 annales kinesiologiae • 9 • 2018 • 1 osborn et al. (2012) states that motivation is a cognitive process and it is impossible to express it in the correct way. for this reason, the motivation is inferred from the performance differences that could be weakness as well. unfortunately, many previous studies have been done in laboratory conditions only and they have not been tested on real existing sports teams. it means that we have many results which demonstrated the effects of kohler motivation gains but only a few of them aim to show effectiveness in real sport team groups. methods subject a number of thirty-three girls at the age ranging from eight to twelve (m=10.12±1.20) were randomly split into two groups (fifteen and sixteen). the girls were young elite synchronized swimmers from the czech club with olympic tradition who compete at an international level. the experimental group consisted of two smaller training groups (younger and older ones). the girls are close friends within the training group, but they do not know well the girls from the other training group. the girls from both training groups were randomly split in two experimental groups. their physical performance was measured in two separate rounds, i.e. as individuals and as a group. the first group started with individual exercises and the second one with exercising in a group. though this approach we controlled the effect of previous experience with testing session. there was a one-week interval between the rounds. five girls did not finish the research because of health reasons. therefore, only twenty-eight girls fulfilled the whole protocol. it changed the number of participants in the examined groups to 13:15. consent before the beginning of this research, all under-aged girls´ parents were thoroughly informed about the research purpose and all potential health and other risks. all parents agreed on their children´s participation and signed appropriate consensus documents. procedure all girls held a wall-seat position (isometric strength) as long as they were able to in two separate occasion. in the individual try, there was only the researcher and the tested girl, however, in the group test, there were all girls from the selected part of the sample. the group exercising was coactive, it means the girls exercised together in the same room and at the same time but we measured individual time of each girl, not a team result. both measurements took place at the same time of a day with a one-week annales kinesiologiae • 9 • 2018 • 1 7 kateřina strašilová, petr vajda: influence of social interaction in a group on young girls’ physical ..., 3–13 rest interval. all of the girls participated in both tests, in the individual as well as the group one, so we gathered the data to compare performance with or without the presence of teammates for each participant. in this way, we were able to measure the effect of the exercise on physical performance in a small social group. performance duration was recorded for each occasion and later used to interpret the findings. the girls held a wall-seat position when they leaned their back against the wall with arms held forward. they bent the ankles, knees, and hips at the right angle. it looked as if they were sitting on an imaginary chair (fig. 1 and 2). all girls received the same instructions: “girls, i would like you to hold the wall-seat position as long as you can. when it starts to hurt too much or you get too tired only then you can sit on the floor and leave the room. do you understand what to do?” the subjects were not allowed to talk during the session and were informed about their results after their second measurement. when they did not abide by the instructions, during the exercise position, they were immediately asked to adjust it. if they did not adjust the position immediately, the exercise was stopped. fig. 1 and 2: wall seat position 8 kateřina strašilová, petr vajda: influence of social interaction in a group on young girls’ physical ..., 3–13 annales kinesiologiae • 9 • 2018 • 1 research questions 1. how does social comparison affect the performance in wall-seat test of the synchronized swimmers at the age from eight to twelve? 2. does the social comparison have the same effect on inferior and superior members? results the data were tested by the kologmo-smirmov test and it was established that it did not come from a normal distribution. the data from both measurements were recorded and inserted into table 1. we can see the performance of all girls in the individual and group exercises, the differences between these two measurements and the percentage changes. the mean performance was m = 108.82±57.10 for the individual try and m = 271.50±218.88 for the group one. other average values (median, values coming from the 2nd and 3rd quartile and min / max value) you can see from figure 3. the influence of group interaction on the performance of synchronised swimmers was evaluated by the cohen’s d which showed a high substantive dependence (d=1.1, large effect). the wilcoxon matched pair test was used for the data analysis. the results showed significant differences (p < 0.05) between the performance carried out individually and the one in the group. based on the results of both tests, we can conclude that the social interaction had a positive impact on girls’ physical performance in the wall-seat test. we also evaluated the size of the motivation gain or loss for individual girls. the influence of social interaction on each girl is described in the figure 4. the graph shows percentage changes in girls’ performance between the individual and group exercises. girls were ranked in the chart from the weakest to the strongest (rated according to their performance from individual exercises). the mean percentage change in the wall-seat position test was +166.6 % (range -18.5 % to +616.3 %). we can see a slight trend in the graph, which suggests that inferior girls from individual exercises achieved a slightly higher positive change in performance. annales kinesiologiae • 9 • 2018 • 1 9 kateřina strašilová, petr vajda: influence of social interaction in a group on young girls’ physical ..., 3–13 table 1. performance result, difference and percentage change for the wall-seat test. no. time in individual exercise (sec) time in group exercise (sec) difference (sec) percent. change (%) 1 32 34 2 6.3 2 90 625 535 594.4 3 83 225 142 171.1 4 40 120 80 200.0 5 83 171 88 106.0 6 47 195 148 314.9 7 178 800 622 349.4 8 92 93 1 1.1 9 62 121 59 95.2 10 124 197 73 58.9 11 109 238 129 118.3 12 173 141 -32 -18.5 13 102 337 235 230.4 14 87 126 39 44.8 15 70 316 246 351.4 16 65 76 11 16.9 17 330 411 81 24.5 18 105 419 314 299.0 19 140 536 396 282.9 20 85 487 402 472.9 21 86 91 5 5.8 22 98 702 604 616.3 23 175 240 65 37.1 24 87 91 4 4.6 25 109 108 -1 -0.9 26 182 255 73 40.1 27 134 241 107 79.9 28 79 206 127 160.8 note: the girls were divided into two groups. the first one started with the individual and the other one with the group measurements. the group results are separated by a line in the tables. 10 kateřina strašilová, petr vajda: influence of social interaction in a group on young girls’ physical ..., 3–13 annales kinesiologiae • 9 • 2018 • 1 fig. 3: average difference in physical performance in wall-seat position. note: participants were ordered according the results in individual try from the weakest to the strongest one. fig. 4: percentage changes in performance in individual and group tries. annales kinesiologiae • 9 • 2018 • 1 11 kateřina strašilová, petr vajda: influence of social interaction in a group on young girls’ physical ..., 3–13 discussion the primary aim of the study was to find out whether the group exercise (kohler effect) could positively influence the performance of girls aged 8 to 12. the results showed significant differences between the performance of the girls in individual and group exercises. based on these results, we can conclude that the group exercise caused a positive performance increase for most girls, which is consistent with the results of many other studies. for example, hertel, kerr, and messé (2000) investigated the influence of group condition on motor persistence task. the participants held a metal bar in stretched arms for as long as possible. the exercising time was measured in an individual and in a group condition for all the participants. in the group condition, the partners held the bar over a rope. once the first partner touched the rope the timer was stopped and exercising was ended. the authors found out that less capable participants held the bar longer if they worked in the group. feltz et al. (2011) empirically tested the impact of kӧhler motivation gain. they found out that people who were exercising with superior partner in a series of five isometric exercises improved by 24 % (d=0.99) compared to a check-up sample where people were exercising individually. irwin et al. (2012) examined the impact of a coactive and a conjunctive task on an aerobic exercise. they described the performance increase up to 86 % per coactive and even to 208 % for conjunctive tasks. we also evaluated the individual performance differences of all girls in an individual and a group try. there we can see a slightly higher impact of motivation gain on the inferior member. a similar motivation gain was described by weber and hertel (2007) in the coactive task. in their research, they discovered the stronger impact of social interaction due to additive and conjunctive task in women. they also suggested that the strongest gain of the kӧhler effect occurs when: (a) all group members are involved in the team goal, (b) all team members care about the good team performance, (c) all group members perceive the group as a team. furthermore, they proposed that connecting these three points could bring a particularly large enhancement in motivation. their results showed a large effect on the physical performance due to these three points (d = 0.94). we would like to extend our research by a comparison of these three points in accordance with weber and hertel in our next study. however, the influence of the group motivation could be affected due to friendships between or among some girls. we tried to reduce the impact of friendship in the way that the experimental groups were randomly split and mixing younger and older girls. for example, the last two exercising girls in the first experimental group were from the same training group and the last two girls from the other experimental group were from different training groups. yet all of them increased their physical performance in the group try in comparison with their individual tries. so we believe that the enhancement was caused because of the group exercising and not because of the relationships in the group. nevertheless, it is possible that this effect will not be traceable or effective in other sport groups or in boys. because of this reason, we would like to extend our 12 kateřina strašilová, petr vajda: influence of social interaction in a group on young girls’ physical ..., 3–13 annales kinesiologiae • 9 • 2018 • 1 research to another different group of children, for example boys, in some individual / team disciplines, games, etc. conclusion to sum up, we established that social interaction, i.e. mutual encouragement in a group of young girls, could influence their sport performance. however, it was also found out that such social interaction / encouragement is not consistent for every girl; it was fluctuating in the sample. a small positive trend was noticed, which showed that the motivation gain was a little bit higher for the inferior group members. we believe that this effect could be important in exercises that girls do not enjoy so much and where they have to overcome a certain degree of discomfort or even pain. not only young girls but children in general often do not understand why they should do some unpleasant activities and put their effort in them. so there is surely some extra motivation gain needed. exercising in a training group could be used to increase the attractiveness of training in the individual sports and increase the training efforts of youth through competitions and fun. but it should be noted that group dynamics can influence the effectiveness of this result. nevertheless, it seems that social interaction could be beneficial for the young girls´ training as well as other factors influencing a child’s self-motivation, such as positive verbal motivation, constructive feedback or appraisal. references baron, r. s., & kerr, n. l. (2003). group process, group decision, group action (2. ed). buckingham: open univ. press. carron, a. v., hausenblas, h. a., & mack, d. (1996). social influence and exercise: a meta-analysis. journal of sport and exercise psychology, 18(1), 1–16. doi: 10.1123/ jsep.18.1.1 view item dishman, r. k., & buckworth, j. (1996). increasing physical activity: a quantitative synthesis. medicine & science in sports & exercise, 28(6), 706–719. doi: 10.1097/00005768199606000-00010 view item feltz, d. l., kerr, n. l., & irwin, b. c. (2011). buddy up: the köhler effect applied to health games. journal of sport & exercise psychology, 33(4), 506–526. doi: 10.1123/ jsep.33.4.506 view item heckhausen, h. (1991). motivation and action (tr. p. leppmann). berlín: springer. hertel, g., kerr, n. l., & messé, l. a. (2000). motivation gains in performance groups: paradigmatic and theoretical developments on the köhler effect. journal of personality and social psychology, 79(4), 580–601. doi: 10.1037/0022-3514.79.4.580 view item hertel, g., niemeyer, g., & clauss, a. (2008). social indispensability or social comparison: the why and when of motivation gains of inferior group members. journal of https://doi.org/10.1123/jsep.18.1.1 https://doi.org/10.1097/00005768-199606000-00010 https://doi.org/10.1123/jsep.33.4.506 https://doi.org/10.1037/0022-3514.79.4.580 annales kinesiologiae • 9 • 2018 • 1 13 kateřina strašilová, petr vajda: influence of social interaction in a group on young girls’ physical ..., 3–13 applied social psychology, 38(5), 1329–1363. doi: 10.1111/j.1559-1816.2008.00350.x view item irwin, b. c., scorniaenchi, j., kerr, n. l., eisenmann, j. c., & feltz, d. l. 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(2007). motivation gains of inferior group members: a meta-analytical review. journal of personality and social psychology, 93(6), 973–993. doi: 10.1037/0022-3514.93.6.973 view item https://doi.org/10.1111/j.1559-1816.2008.00350.x https://doi.org/10.1007/s12160-012-9367-4 https://doi.org/10.1177/0146167207301020 https://doi.org/10.1016/s0962-1849(05)80113-1 http://psycnet.apa.org/doi/10.1037/0022-3514.82.6.935 https://doi.org/10.1037/a0026887 https://doi.org/10.1037/0022-3514.93.6.973 annales kinesiologiae • 8 • 2017 • 2 125 exercise effects on muscle stem cells mihaela jurdana1 1university of primorska, faculty of health sciences, izola, slovenia corresponding author: mihaela jurdana, phd, university of primorska, faculty of health sciences izola, polje 42, 6310 izola, slovenia. tel.: +386 5 66 26 469 e-mail: mihaela.jurdana@fvz.upr.si abstract satellite cells are skeletal muscle stem cells that facilitate muscle repair and regeneration after “damage” which occurs after physiological stimuli: exercise, post-training micro-injuries and electrical stimulation. exercise stimuli lead to activation and proliferation of these cells from their quiescent state, therefore, increasing cell numbers having the potential to provide additional myonuclei to their parent muscle fibre or return to a quiescent state. different exercise modalities are the focus of numerous studies on satellite cells activation. an increase in muscle activity augments satellite cells proliferation as well as skeletal muscle mass and function, both in young and elderly. this review provides an updated view of the contribution of skeletal muscle satellite cells in regulating skeletal muscle mass and the efficiency of the exercise intervention to attenuate the decline in muscle mass. keywords: satellite cells, acute and chronic exercises, micro damage, muscle regeneration. učinek telesne aktivnosti na skletno-mišične staminalne celice izvleček satelitske celice so skeletno-mišične staminalne celice, ki omogočajo popravilo in regeneracijo mišičnih vlaken po mikropoškodbah, kot je telesna aktivnost, trening ali review article udc: 612.74:796.012 received: 2017-05-31 mailto:mihaela.jurdana@fvz.upr.si 126 mihaela jurdana: exercise effects on muscle stem cells ..., 125–135 annales kinesiologiae • 8 • 2017 • 2 električna stimulacija. telesna aktivnost sproži prehod satelitskih celic iz stanja mirovanja v aktivacijo in proliferacijo, kar jim omogoča, da se namnožijo in povečajo svoje število. novonastale satelitske celice se lahko vežejo na matično mišično vlakno ali preidejo v stanje mirovanja. veliko študij preučuje, kako različne oblike vadbe vplivajo na aktivacijo satelitskih celic ter njihovo število. znano je, da mišična aktivnost povečuje proliferacijo satelitskih celic, posledično tudi mišično maso in funkcijo, tako pri mladih kakor tudi pri starejših osebah. pregled literature v tem članku prikazuje posodobljen pogled na vlogo satelitskih celic pri vzdrževanju mišične mase in pomembnost vloge telesno/gibalne aktivnosti v preventivi pred izgubo le-te. ključne besede: satelitske celice, akutna in kronična vadba, mikro poškodbe, mišična regeneracija introduction skeletal muscle regeneration skeletal muscle regeneration is a highly integrated process involving the activation of various cellular and molecular responses; skeletal muscle stem cells play a pivotal role in this process. adult skeletal muscle is a stable post-mitotic tissue, small daily injury can be repaired without causing inflammatory responses and cell death. muscle injury such as extensive physical activity is related to myofibre necrosis, inflammatory responses, and activation, differentiation, and fusion of satellite cells. muscle regeneration includes the above mentioned processes with a new myofibre formation. mammalian skeletal muscles consist of different multinucleated myofibers, grouped in slow (type 1) and fast types (2a, 2x, and 2b) with different myosin heavy chain (myhc) composition. myofibres also differ in their metabolic profile, extending from slow /oxidative to fast / glycolytic (schiaffino & reggiani, 2011). the maintenance of skeletal muscle mass depends on mono nucleated muscle precursors or muscle satellite cells. in addition, pericytes, resident in small vessels of skeletal muscle, contribute to its growth and regeneration during postnatal life (dellavalle et al., 2011). satellite cells were identified over 50 years ago through electron microscopy by mauro in 1961. the satellite cell population varies by age, muscle type, and activity, and are used during muscle regeneration and repair due to their special self-renewal and multi-differentiation capabilities. at birth, satellite cells account for 15 % of the entire myofibre nuclei population (thornell, lindström, renault, mouly, & butler-browne, 2003). that proportion latter decreases to between 1 % and 6 % of total myonuclear content in mature muscle fibres (roth et al., 2000). the major function of satellite cells is contribution to the maintenance of muscle mass, regeneration, and annales kinesiologiae • 8 • 2017 • 2 127 mihaela jurdana: exercise effects on muscle stem cells ..., 125–135 hypertrophy by differentiating into myocytes during human’s lifespan. satellite cells are normally non-proliferative, mitotically quiescent and they become activated in response to stimuli such as myotrauma upon injury or muscle growth (bischoff & heintz, 1994), or when skeletal muscle tissue is heavily used during physical activities such as weight lifting or running. when skeletal muscle is injured, damaged or exercised, satellite cells are activated from their quiescent state, proliferated and fused into existing fibres to provide new myonuclei or return to quiescence (dhawan & rando, 2005). activation of those cells is not restricted to the site of muscle damage. satellite cells are activated, migrate and proliferate from different parts of myofibre. however, the number of satellite cells appears to increase in the end part of myofibres, where longitudinal elongation of the skeletal muscle occurs (yin, price, & rudnicki, 2013). importantly, satellite cells have a limited capacity of division entering a state of irreversible growth arrest after a finite number of cell division (chargé & rudnicki, 2004). the self-renewing proliferation of satellite cells maintains the stem cell population and provides abundant myogenic cells which proliferate, differentiate, and fuse to generate new myofibre formation (yin et al., 2013). with these additional nuclei, muscle fibres can synthesize more proteins and create more contractile myofilaments (actin and myosin) in skeletal muscle cells (chargé & rudnicki, 2004). it is interesting to note that high numbers of satellite cells are found associated to slow-twitch muscle fibres as compared to fast-twitch muscle fibres within the same muscle, as they are regularly going through cell maintenance repair from daily activities (martin & lewis 2012). as satellite cells are constantly replenished during lifetime and are essential for muscle fibre maintenance, a decline in number and reduced proliferative capacity of satellite cells and / or their inability to become activated and proliferate upon stimuli might contribute to muscle fibre atrophy observed in the elderly (bischoff, 1994; seale & rudnicki, 2000). many researchers are interested in new training programs and exercise for developing skeletal muscle mass. however, the mechanism(s) by which exercise induces skeletal muscle hypertrophy remain poorly understood. through exercise, the muscular work done against progressively challenging overloads leads to increases in muscle mass. individual satellite cells respond to exercise and they are influenced by such factors as training status, age, nutrition, and the intensity and volume of the exercise. duration, frequency and intensity of exercise are important contributing factors in satellite cells activation. passive stretching of contracted muscles may cause multiple micro damages, disruption of contractile elements or necrosis. for many of us, this happens after changes in the locomotor behaviour by severe onset of exercise. also after 20 minutes of stepping up and down induces a remarkable increase in muscle-derived proteins in plasma, which reflects some muscle damage (wernig, 2003). it has been shown that the intensity of the exercise is an important factor in satellite cells activation and muscle regeneration (martin & lewis, 2012). similarly, other researchers have demonstrated that an increase in satellite cell content depends on the intensity rather than the duration 128 mihaela jurdana: exercise effects on muscle stem cells ..., 125–135 annales kinesiologiae • 8 • 2017 • 2 of exercise (bazgir, fathi, rezazadeh valojerdi, mozdziak, & asgari, 2017). intensive exercise such as resistance training bout induces damage to the muscle fibres, causing activation and proliferation of satellite cells. this biological effort often leads to increasing in muscle fibre cross-section area or hypertrophy (bischoff, 1994). on the other hand, various muscle groups and types react differently to intensity and volume of exercise. during muscle hypertrophy, muscle fibre size appears to be related to the size of the myonuclear domain, defined as the amount of cytoplasm within a muscle fibre controlled by single myonuclei (hall & ralston, 1989). protein synthesis of single myonuclei is confined in myonuclear domain. the amount of cytoplasm controlled by each myonuclei in adult muscle fibre is relatively constant, thus supporting the theory that satellite cells are required for muscle hypertrophy in order to keep the myonuclear domain constant. considering the presence of other stem cells in skeletal muscle, their contribution in muscle regeneration and hypertrophic growth is possible (blaauw & reggiani, 2014). methods electronic databases medline, pubmed, and science direct including the articles published up to 2017 were used to search literature sources. different keywords were used: satellite cells (sc), sc during exercise, skeletal muscle regeneration and hypertrophy, sc during ageing. based on the keywords and review articles, satellite cells activation and proliferation during exercise was described. results satellite cell during ageing it is well known that impairments in satellite cell function during aging result in an impaired muscle fibre regenerative response (sousa & muñoz-cánoves, 2016; snijders & parise, 2017) leading to the gradual loss of muscle mass and function (sarcopenia) which diminishes muscle recovery after injury in elderly individuals. in many cases this leads to disability and the subsequent loss of independence. a lower number of satellite cell pool and the exhausted proliferative capacity of aged satellite cells may contribute to accelerated loss of skeletal muscle mass during ageing (renault, thorne, eriksson, butler-browne, & mouly, 2002; sajko et al., 2004; joanisse, nederveen, snijders, mckay, & parise, 2017). other possible reasons for impaired muscle recovery in elderly individuals relate to the reduced production of growth factors or affect the e−c (excitation−contraction) coupling mechanism (muscle-contracting mechanism), (delbono, o’rourke, & ettinger, 1995). it has also been demonstrated that inadequate muscle fibre vascularization occurring during ageing process annales kinesiologiae • 8 • 2017 • 2 129 mihaela jurdana: exercise effects on muscle stem cells ..., 125–135 may be an important cause of impaired regulation of satellite cells in older adults (snijders & parise, 2017). a certain number of satellite cells seems to be necessary for muscle regeneration during the ageing process. bengal’s recent review (bengal, perdiguero, serrano, & muñoz-cánoves, 2017) has identified the network of cell-intrinsic and cell-extrinsic factors and processes contributing to satellite cells decline during ageing. most of the studies suggest that the mentioned decline is caused by age-associated extrinsic (environmental changes) and intrinsic mechanisms (dna damage, oxidative stress). both mechanisms contribute to muscle stem cell dysfunction. based on this idea, many studies propose to rejuvenate aged satellite cells to improving muscle repair in the elderly. (rando & chang, 2012; bengal et al., 2017). other studies proposed that inadequate activation of notch signalling, necessary for cell proliferation and cell fate determination, contributes to the loss of regenerative proprieties of aged skeletal muscle (conboy, conboy, smythe, & rando, 2003; bjornson et al., 2012). satellite cells activation and proliferation after exercise resistance and endurance types of exercise training improve muscle mass and strength, and increase the performance capacity in young and elderly. satellite cells are involved in muscle maturation during postnatal development, regeneration after injury, hypertrophy, hyperplasia and atrophic post-muscle recovery (dhawan & rando, 2005; chargé & rudnicki, 2004). the increase of satellite cell proliferation and activation takes place after short-term muscle activity (darr & schultz, 1987), but the increases in satellite cell numbers only occur after a long term resistance or endurance training (martin & lewis, 2012). many studies reported the result of a number of satellite cells following exercise in human (table 1). satellite cells get activated from their quiescent state and are involved in muscle regeneration after micro-injuries that follow exercise. satellite cell content and activity after endurance training can be correlated with time and intensity, duration and frequency of exercise. it has been observed that satellite cell content increased after 30 to 155 minutes of moderate to high-intensity endurance exercises (parise, mckinnell, & rudnicki, 2008; van de vyver & myburgh, 2012; bazgir et al., 2017), while no such increase was associated after 30 minutes of low-intensity exercise (smith, maxwell, rodgers, mckee, & plyley, 2001). these data confirm the role of the intensity of exercise in satellite cell activation and their role in regeneration and muscle repair. the acute satellite cell response to exercise has been examined in humans using maximal eccentric contractions of the vastus lateralis muscle by isokinetic dynamometry, as eccentric exercise is considered to induce maximal levels of muscle damage (gibala, macdougall, tarnopolsky, stauber, & elorriaga, 1995). indeed, it appears that the satellite cell response to acute exercise in humans occurs during the first 24 hours after eccentric exercise, however, there was a significant increase in satellite cells 130 mihaela jurdana: exercise effects on muscle stem cells ..., 125–135 annales kinesiologiae • 8 • 2017 • 2 table 1: summarized studies on human satellite cell numbers following different exercise type (martin & lewis, 2012). acute/chronic training exercise type muscle analysed satellite cell number references acute exercise training rt vl increase crameri et al. 2004 rt vl increase dreyer et al. 2006 rt vl increase o’reilly et al. 2008 rt vl increase mckay et al. 2009 es vl increase mackey et al. 2012 increase mackey et al. 2009 chronic training rt vl increase roth et al. 2001 rt vl # increase petrella et al. 2008 rt vl increase mackey et al. 2010 rt vl increase kadi et al. 2004 rt vl increase mackey et al., 2007 rt vl increase verdijk et al. 2009 rt tr increase kadi and thornell, 2000 rt, et edl, vl increase verney et al. 2008 et pl * increase kurosaka et al. 2011 et vl increase charifi et al. 2003 et vl increase shefer et al. 2010 abbreviations: rt= resistance training, et= endurance training, edl= extensor digitorum longus, es= electrical stimulation, vl=vastus lateralis, pl= plantaris, tr= trapezius, * increase of sc number only with high intensity training. # increase of sc number only seen in individuals who responded most robustly to rt. annales kinesiologiae • 8 • 2017 • 2 131 mihaela jurdana: exercise effects on muscle stem cells ..., 125–135 over pre-exercise values even at later times (o’reilly et al., 2008). therefore, satellite cells get activated and proliferated in 24 hours after exercise, and increase considerably between 72 and 96 hours, thereafter they decline in number. (mckay et al., 2009; o’reilly et al. 2008). the research data on humans suggest that resistance and endurance training can increase satellite cell content and activation in response to exercise periods from 9 to 16 weeks. (kadi, charifi, denis, & lexell, 2004; petrella, kim, mayhew, cross, & bamman, 2008; shefer, rauner, yablonka-reuveni, & benayahu, 2010). however, it should be noted that the resistance type of training leads to an expansion in satellite cell pool with myonuclear addition (petrella et al., 2008). muscle fatigue seems to be a stimulus for activation, proliferation and differentiation of satellite cells. unfortunately, there is little research available that compares satellite cells quantity in response to endurance exercise and resistance exercise. verney et al. (2008) observed an increase in satellite cell content in the deltoid (resistance-trained) and vl (endurance-trained) muscles after 14 weeks in elderly individuals. interestingly, a failure in increasing the satellite cell pool after a training intervention was observed in obese, diabetic population (snijders, verdijk, hansen, dendale, & van loon, 2011). as to animal models, a study on rat soleus muscle showed no increase in satellite cell content after one week of running for 30 minutes per day on treadmill (smith et al., 2001). while a similar study on mice anterior tibialis muscle reported a significant increase in the satellite cell number and activation (parise et al., 2008), due to the different composition of muscle fibre type. the study of smith and merry (2012) described a six-week resistance type or endurance type of exercise in rats and found no difference between the proportional gains in satellite cell number of the same muscles between groups. these data suggest that endurance and resistance training enhance the satellite cell pool to a similar extent (marin & lewis 2012). in addition, a differential response in fibre-type expansion of satellite cells in response to exercise was observed. fibre-type classification demonstrates that satellite cells are not equally distributed among the various fibre types and muscles. in human studies, no difference has been detected in satellite cell numbers between fibre types in vastus lateralis untrained muscle of young healthy individuals (kadi et al., 2006; verdijk et al., 2007; snijders et al., 2012), while other studies revealed a greater number of satellite cells in type i fibres and, consequently, minor adaptive potential (martin & lewis, 2012; bazgir et al., 2017). it was demonstrated that untrained rodent muscle type i fibres contain a greater number of satellite cells in respect to type ii fibres. in response to training, the number of satellite cells in type ii fibre was increased, while the same increase was not observed in type i (verdijk et al., 2009; smith & merry, 2012). this process seems sensible as type ii fibres give a greater contribution to muscle mass (hypertrophy) and show a higher responsiveness to resistance training (martin & lewis 2012; bazgir et al., 2017). all these data underline the need of future investigation because the mechanisms of exercise-induced satellite cells activation are not completely understood. 132 mihaela jurdana: exercise effects on muscle stem cells ..., 125–135 annales kinesiologiae • 8 • 2017 • 2 conclusion the maintenance of skeletal muscle mass and regenerative capacity depends on a functional pool of muscle satellite cells. a loss of skeletal muscle satellite cells and defects in their activity are associated with a variety of neuromuscular and other disorders which lead to muscle atrophy. exercise training has been successfully applied to augment satellite cells muscle mass and improve muscle function also in elderly. it has been demonstrated that satellite cell activation after exercise together with adequate nutrition are the most effective countermeasures for ageing sarcopenia. modalities of exercise, intensity, duration and frequency are correlated with satellite cell content. they are activated and proliferate after acute exercise training, and are increased in number after resistance and endurance training. there are still some discrepancies between the role of volume and the intensity of exercise on satellite cells activation. to clarify the optimal exercise stimuli for satellite cell activation and differentiation, further research is required. references bazgir, b., fathi, r., rezazadeh valojerdi, m., mozdziak, p., & asgari, a. 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(2013). satellite cells and the muscle stem cell niche. physiological reviews, 93(1), 23-67. doi: 10.1152/physrev.00043.2011 view item https://doi.org/10.1007/s10974-012-9303-z https://doi.org/10.1093/gerona/gln050 https://doi.org/10.1152/ajpendo.00278.2006 http://onlinelibrary.wiley.com/doi/10.1002/mus.21054/full https://doi.org/10.1024/0040-5930.60.7.383 https://doi.org/10.1152/physrev.00043.2011 annales kinesiologiae • 9 • 2018 • 1 1 editorial annales kinesiologiae has published several scientific articles, adding an important value to the role and importance of regular physical / sports activities as well as for the holistic and harmonious development of every individual. focusing on an individual’s health and prevention, several articles present interesting research findings about the preventive role of physical / sports activity and its influence on the overall quality of life. our readers can also get an insight into numerous events, scientific meetings and congresses with a common straightforward effort to raise awareness of the discussed values. in this number, the topic is presented from a slightly different perspective. these articles all have a common starting point aiming to contribute to a successful sports performance and the quality of exercise. the studied factors are highlighted by both the social aspect − the role of the group and social integration, the set of appropriate nutrition strategies, as well as the functional aspect − the role of motor abilities and technical knowledge. the process of training and development of an individual involved are usually organized and guided by experts − kinesiologists and trainers in cooperation with the interdisciplinary team and, of course, parents when talking about the period of childhood. with the professionally adapted and integrated, but above all, coordinated operation of these factors, we can multiply the effects and impact of exercise and the sport results which is not only shown in sports results or ranking, but will represent an important positive experience for further and sustainable engagement in physical / sports activities. prof. rado pišot, ph.d. editor-in-chief and managing editor 2 annales kinesiologiae • 9 • 2018 • 1 uvodnik o vlogi in pomenu redne gibalne/športne aktivnosti za celosten in skladen razvoj posameznika, za njegovo zdravje, o preventivni vlogi ter vplivu na kakovost življenja, smo v annales kinesiologiae objavili že vrsto znanstvenih člankov ter ob tem našim bralcem predstavili številne dogodke, znanstvena srečanja in kongrese, ki jim je skupno ravno prizadevanje za uzaveščenje omenjenih vrednot. v številki, ki je pred vami, je ta problematika izpostavljena nekoliko drugače. prispevki imajo skupno izhodišče v doprinosu k uspešnemu športnemu nastopu in kakovosti vadbe in treninga. kot pomembne dejavnike za doseganje cilja pa izpostavljajo tako socialni vidik – vlogo skupine in socialne integracije ter nabora ustreznih strategij prehranjevanja, kot tudi funkcionalni vidik – vlogo gibalnih sposobnosti ter tehničnega znanja. sam proces vadbe in razvoja posameznika vključenega v vadbo in trening običajno vodijo in usmerjajo strokovnjaki – kineziologi in trenerji, v sodelovanju z interdisciplinarnim timom ter seveda starši ali skrbniki, ko govorimo o obdobju otroštva. s strokovno prilagojenim, celostnim, predvsem pa usklajenim delovanjem navedenih dejavnikov, lahko multipliciramo učinke in doprinos vadbe ter športnega dosežka tako, da ta ne bo izkazan le na področju športnega rezultata/uvrstitve, temveč bo predstavljal pomembno pozitivno izkušnjo ter spodbudo za nadaljnje in trajno udejstvovanje v gibalni/športni aktivnosti. prof. dr. rado pišot, glavni in odgovorni urednik annales kinesiologiae • 6 • 2015 • 2 137 fact sheets, 137–148 recommendations for achieving mediumand high-intensity physical / sport activity in physical education to improve the health and learning of children and adolescents institute for kinesiology research up src corresponding author: boštjan šimunič university of primorska, science and research centre, institute for kinesiology research, garibaldijeva 1, 6000 koper, slovenia tel.: +386 5 663 77 00, +386 5 663 77 31 e-mail: bostjan.simunic@zrs.upr.si the world faces an epidemic of general physical inactivity, impeding the achievement of a sufficient level of mediumand high-intensity physical / sport activities (p / sa). never in human history were people less physically active than they are now, both at work and in their free time. the most problematic seem to be children and adolescents whose level of p / sa decreases and is not sufficient for maintaining health. school plays an important role in ensuring sufficient and quality p / sa. physical education is a key period during school when students can be physically active. consequently, policy makers and moderators of strategies in the field of movement, health and sport should strive to develop the appropriate curriculum and strategies for increasing the volume, intensity and quality of p / sa during physical education. teachers should pay particular attention, with didactic and methodical approaches, to the achievement of mediumand high-intensity of children’s p / sa. what is mediumand high-intensity physical / sport activity? movement is defined as any bodily motion produced by skeletal muscles that results in increased energy consumption (caspersen, powell, & christenson, 1985). this includes playing, exercising, doing household chores and also practicing sport. sport is a voluntary form of the goal-oriented bodily movement, which follows certain rules in standardized circumstances, while these are regulated by an institution and thus allows competition (hosta, 2004). therefore, sport should not be equalled with movement (who, 2011). the term that connects both movement and sport is physical / sport acfact sheets udc: 37.016:796.011.1 received: 2015-12-23 mailto:bostjan.simunic@zrs.upr.si 138 fact sheets, 1–12 annales kinesiologiae • 6 • 2015 • 1 fact sheets, 137–148 annales kinesiologiae • 6 • 2015 • 2 138 tivity (p / sa). in an effort to improve levels of physically / sportily active population and thus contribute to improving their health status, general health and fitness, it is important to include and address all modes and forms of p / sa, including movement during working hours, at home and during leisure time, as well as sports (pišot, 2004). the intensity of movement is defined as the degree of effort in which certain movements are undertaken, depending on an individual’s fitness, age, sex, etc. in the light of these factors, race walking, dancing, cycling and other activities are considered as mediumintense movements. high-intensity movements are manifested with deeper and accelerated breathing and elevated heart rate that reaches at least 140 beats per minute (sallis, buono, roby, micale, & nelson, 1993). these include jogging, fast jogging / cycling, walking, jogging or cycling uphill, fast swimming, etc. there are objective and subjective methods of monitoring and measuring the intensity of the p / sa. among the objective measurements the most commonly used are the accelerometer and the heart rate monitor, meanwhile a questionnaire is used for a subjective measurement. the term inactivity, the fourth factor in global mortality (who, 2011), includes sitting, lying, standing on the spot, playing computer games or working on the computer. advantages of medium and high physical / sport activity various international and national health organizations emphasize that children and adolescents need to achieve at least 60 minutes per day of medium and high p / sa (who, 2011; resolution on the national programme of sport of the republic of slovenia 2014-2023). they also state that mediumand high-intensity p / sa increase health effects, which is primarily reflected in the reduced number of obesity rate and obesity-related diseases (type 2 diabetes, metabolic syndrome, cardiovascular diseases), better physical fitness which expands the choices for physical and sport activities, as well as better cognitive abilities (physical education matters, 2010). at the same time they emphasize the need to limit physical inactivity, which sometimes exceeds 90 per cent of the daytime (grey-thompson, huppert, keeley, & leslie, 2014). physical inactivity to such an extent may result in negative effects for an individual, regardless of their daily p / sa. how to achieve sixty minutes of mediumand highintensive physical / sport activity? children should reach the required minimum of 60 minutes of medium and high p / sa in two daily periods, which should last from 20 to 40 minutes. an appropriate time for children and young people to achieve at least one such period is during school hours, namely during physical education. in the initiative of the centre for disease control and prevention healthy people 2010, it was recommended that every child and adolescent should achieve at least 50 per cent of the mediumor high-inannales kinesiologiae • 6 • 2015 • 2 139 fact sheets, 137–148 tensity p / sa time (which equals 22.5 minutes) during physical education in school (healthy people, 2010). current situation of students’ physical / sport activities in physical education many hours of physical education do not offer an adequate amount of options for children and adolescents to achieve the recommended mediumand high-intensity p / sa. a survey conducted in the united states reports that students are mostly physically inactive during the lesson of physical education, since they reach high physical activity for only 13 per cent of the time. the authors also state that the time of high-intensity movement reduces with the number of students attending the lesson of physical education (failing fitness: physical activity and physical education in schools. policy brief, 2007). the slovenian survey discovered that the lesson of physical education of an eight-year-old and a nine-year-old only lasts 36 minutes and that children reach mediumand high-intensity for only 36 per cent of the time; they are physically inactive for 42 per cent of the time (pušnik, volmut, & šimunič, 2014). it is interesting that the lesson of physical education outdoors is 7 minutes shorter than the lesson in the gym. the duration of the lesson of physical education also decreases with the number of children attending the lesson, namely for 1.24 minutes per child. an example of good practice is certainly a dutch study, which shows that children reach 46 per cent of the time in mediumand high-intensity p / sa during the lessons of physical education in primary schools (slingerland, haerens, cardon, & borghouts, 2013), while in secondary schools, this amount is reduced to 42 per cent for male students and 37 per cent for female students. intervention programs for achieving the recommended levels of physical / sport activity during the lessons of physical education school management together with sport pedagogues and class teachers should consider the possibility of increasing the p / sa during the lessons of physical education, especially in terms of: • providing suitable knowledge of class management and teaching methods that would allow the simultaneous physical activity of more students (e.g. games in small groups, circular exercise, assuming an active role, minimized time for switching stations, counting children between warming-up and giving precise instructions (partnership for prevention, 2008); • encouraging teachers to integrate different organizational forms of exercise / sport and sport program contents, such as public, private, and public-private; 140 fact sheets, 1–12 annales kinesiologiae • 6 • 2015 • 1 fact sheets, 137–148 annales kinesiologiae • 6 • 2015 • 2 140 • orienting teachers to install students in the centre of proactive learning process with didactic approach that is adjusted to students, which follows their demand and thereby increases the effectiveness of teaching; • encouraging teachers to individual approach towards students with special needs or gifted students; • motivating teachers to contribute to a greater effectiveness, measurability and attractions, both in the field of locomotor learning as p / sa in general, with the use of multimedia demonstrations, and information and communication support; • the use of inexpensive or donated equipment (e.g. aerobic exercise with a frisbee, skipping ropes, hoops); • finding competent assistants for class teachers and / or sports pedagogues (e.g. class teachers, kinesiologists, sports trainers, other professionals), who are employed at various schools; • using the knowledge and experience of class teachers and sports pedagogues in designing curriculum that will focus on mediumand high-intensity p / sa; • seeking the opportunities for co-financing the execution of physical education lessons (e.g. collaboration with universities or other research institutes, collaboration with sports clubs, attracting insurance companies and other foundations); • encouraging teachers of other subjects to integrate physical activity during class, in cooperation with teachers of physical education (e.g. morning exercise and stretching, a minute for health, relaxation with yoga and others); • encouraging teachers of other subjects to the enriched interdisciplinary collaboration and to obtain the estimated knowledge through movement (e.g. mathematics, a foreign language, biology ...). strategies for achieving the 50 per cent of time in medium and high-intensity movement / sport activity during the lesson of physical education during the lesson of physical education, school management has the option to support p / sa through their areas of responsibility: setting goals, ensuring the efficient staffing, helping the executers, promoting the objectives of sport to the general population – mostly parents, sports clubs, potential co-financers... that is why they can: 1. raise awareness of the importance of p / sa, thus highlighting the subject of physical education between the various parties (the ministry, field experts, general public, parents, and children). in particular, they should stress the importance of the subject and p / sa for health and mental capacity; 2. adapt the objectives of the curriculum, which will allow an increase in p / sa and a reduction of physical inactivity. they should refer to scientifically proven sports programs, which have increased time in mediumand high-intensity p / sa and reduced physical inactivity (find more information on: www.csba.org/ physicalactivity.aspx); annales kinesiologiae • 6 • 2015 • 2 141 fact sheets, 137–148 3. take on initiatives to increase the time in mediumand high-intensity p / sa during the lesson of physical education, through which they should: • ensure that every student reaches at least 50 per cent of mediumand high-intensity p / sa time during the lesson of physical education which is implemented within the stipulated time range (45 or 90 minutes); • ensure an adequate number of students within the lessons of physical education to achieve the basic objective – 50 per cent of the time in mediumand high-intensity p / sa; • ensure recruitment of quality staff and allow additional training; 4. monitor the execution of the subject of physical education and establish reporting on the achievement of objectives on regular basis to school management, program partners and the general public. to this end, it is necessary to place the valuation methodology of p / sa during the lesson of physical education (e.g. the accelerometers, heart rate monitors and stopwatch). in doing so, they should make use of the established practices of research institutes in the field of kinesiology and sports; 5. accept national and international initiatives to raise mediumand highintensity p / sa during the lesson of physical education; 6. develop a good attitude towards program partners with the objective of supporting the achievement of the objectives. references caspersen, c. j., powell, k. e., & christenson, g. m. (1985). physical activity, exercise, and physical fitness. public health report, 100(2), 126–131. failing fitness: physical activity and physical education in schools. policy brief (2007). retrieved 6. 6. 2015, from http://www.californiateenhealth.org/health-topics/ nutrition-and-physical-activity/recent-research-nutrition-physical-activity/failing-fitness-physical-activity-and-physical-education-in-schools. grey-thompson, t., huppert, j., keeley, b., & leslie, c. (2014). tackling physical inactivity a coordinated approach. retrieved 5. 6. 2015, from https://parliamentarycommissiononphysicalactivity.files.wordpress.com/2014/04/apcopa-final.pdf. healthy people (2010). chapter 22 physical activity and fitness, centers for disease control and prevention and president’s council on fitness. retrieved 5. 6. 2015, from http:// www.healthypeople.gov/2010/document/pdf/volume2/22physical.pdf. hosta, m. (2004). zdravje med gibalno nujnostjo in športno izbiro. in r. pišot, v. štemberger, j. zurc, & a. obid (eds.), otrok v gibanju: zbornik prispevkov 3. mednarodnega znanstvenega posveta (pp. 88–89). koper: univerza na primorskem, znanstveno-raziskovalno središče. partnership for prevention (2008). school-based physical education: working with schools to increase physical activity among children and adolescents in physical education classes an action guide. washington, dc: partnership for prevention. retrieved 6. 6. 2015, from https://www.prevent.org/downloadstart.aspx?id=34. http://www.californiateenhealth.org/health-topics/nutrition-and-physical-activity/recent-research-nutrition-physical-activity/failing-fitness-physical-activity-and-physical-education-in-schools http://www.californiateenhealth.org/health-topics/nutrition-and-physical-activity/recent-research-nutrition-physical-activity/failing-fitness-physical-activity-and-physical-education-in-schools http://www.californiateenhealth.org/health-topics/nutrition-and-physical-activity/recent-research-nutrition-physical-activity/failing-fitness-physical-activity-and-physical-education-in-schools https://parliamentarycommissiononphysicalactivity.files.wordpress.com/2014/04/apcopa-final.pdf https://parliamentarycommissiononphysicalactivity.files.wordpress.com/2014/04/apcopa-final.pdf http://www.healthypeople.gov/2010/document/pdf/volume2/22physical.pdf http://www.healthypeople.gov/2010/document/pdf/volume2/22physical.pdf https://www.prevent.org/downloadstart.aspx?id=34 142 fact sheets, 1–12 annales kinesiologiae • 6 • 2015 • 1 fact sheets, 137–148 annales kinesiologiae • 6 • 2015 • 2 142 physical education matters (2010). retrieved 12. 5. 2015 from http://www.cityprojectca. org/blog/wp-content/uploads/2008/02/pe-matters-long-versionfinal.pdf. pišot, r. (2004). vloga in pomen gibalne/športne dejavnosti v šolskem obdobju. zdrava šola, 1, 24–27. pušnik, t., volmut, t., & šimunič, b. (2014). the quantity and intensity of physical activity during physical education in 3rd grade primary school children. annales kinesiologiae, 5(2), 196–201. view item resolucija o nacionalnem programu športa v republiki sloveniji za obdobje 2014 – 2023 [resolution on the national programme of sport of the republic of slovenia 2014– 2023] (renpš14-23). (2014). ljubljana: ministrstvo za izobraževanje, znanost in šport. retrieved 6. 6. 2015, from http://www.pisrs.si/pis.web/pregledpredpisa?id=reso99 sallis, j. f., buono, m. j., roby, j. j., micale, f. g., & nelson, j. a. (1993). seven-day recall and other physical activity self-reports in children and adolescents. medicine and science in sports and exercise, 25(1), 99–108. slingerland, m., haerens, l., cardon, g., & borghouts, l. (2013). differences in perceived competence and physical activity levels during single-gender modified basketball game play in middle school physical education. european physical education review, 20(1), 20–35. view item who (2011). global recommendations on physical activity for health. retrieved 8.6.2015, from http://www.who.int/dietphysicalactivity/leaflet-physical-activity-recommendations.pdf http://www.cityprojectca.org/blog/wp-content/uploads/2008/02/pe-matters-long-versionfinal.pdf http://www.cityprojectca.org/blog/wp-content/uploads/2008/02/pe-matters-long-versionfinal.pdf http://ojs.zrs.upr.si/index.php/ak/article/view/35/30 http://dx.doi.org/10.1177/1356336x13496000 http://www.who.int/dietphysicalactivity/leaflet-physical-activity-recommendations.pdf http://www.who.int/dietphysicalactivity/leaflet-physical-activity-recommendations.pdf annales kinesiologiae • 6 • 2015 • 2 143 fact sheets, 137–148 priporočila za doseganje srednjein visokointenzivne gibalne/športne aktivnosti pri urah športa in športne vzgoje za izboljšanje zdravja in učenja otrok in mladostnikov inštitut za kineziološke raziskave up zrs vodilni avtor: boštjan šimunič univerza na primorskem, znanstveno-raziskovalno središče, inštitut za kineziološke raziskave, garibaldijeva 1, 6000 koper, slovenija tel.: +386 5 663 77 00, +386 5 663 77 31 e-mail: bostjan.simunic@zrs.upr.si svet se sooča z epidemijo splošne gibalne neaktivnosti, še posebno z nedoseganjem zadostne stopnje srednje in visoke intenzivnosti gibalne/športne aktivnosti (g/ša). v vsej svoji zgodovini človek ni bil tako malo gibalno/športno aktiven tako na delovnem mestu kot v prostem času. največji problem predstavljajo otroci in mladostniki, katerih raven g/ša upada in ni zadostna za ohranjanje zdravja. šola ima pomembno vlogo pri zagotavljanju zadostne in kakovostne g/ša. ura športa in športne vzgoje je ključno obdobje v šoli, ko so učenci in dijaki lahko gibalno/športno aktivni. zato naj se snovalci politik in usmerjevalci strategij na področju gibanja, zdravja in športa zavzamejo za oblikovanje ustreznih učnih načrtov in strategij za zagotavljanje večje količine in intenzivnosti ter kakovosti g/ša med uro športa in športne vzgoje. učitelji in vzgojitelji naj z didaktičnimi in metodičnimi prijemi posebno pozornost posvetijo doseganju srednjein visokointenzivne g/ša otrok. kaj je srednjein visokointenzivna gibalna/športna aktivnost? gibanje je vsakršen premik telesa, ki ga proizvedejo skeletne mišice in se odraža v povečani porabi energije (caspersen, powell, & christenson, 1985). to vključuje igro, vadbo, gospodinjska opravila in tudi šport. šport je prostovoljna oblika k cilju naravnanega telesnega gibanja, ki sledi določenim pravilom v standardiziranih okoliščinah, le-te pa uravnava institucija in tako omogoča tekmovanje (hosta, 2004), zato športa ne smemo zamenjevati z gibanjem (who, 2011). termin, ki povezuje tako gibanje kot šport, je gibalna/športna aktivnost (g/ša). v želji, da se izboljša raven gibalno/športno aktivne populacije in s tem prispeva k izboljšanju njenega zdravstvenega statusa, splošnega počutja in pripravljenosti, je pomembno vključevati in obravnavati vse načine in oblike g/ša, tako gibanje med delom, doma oziroma v prostem času, kakor tudi šport (pišot, 2004). mailto:bostjan.simunic@zrs.upr.si 144 fact sheets, 1–12 annales kinesiologiae • 6 • 2015 • 1 fact sheets, 137–148 annales kinesiologiae • 6 • 2015 • 2 144 intenzivnost gibanja opredelimo kot stopnjo napora, pri kateri se določeno gibanje izvaja, in je odvisna od posameznika, njegovega stanja telesne pripravljenosti, starosti, spola itd. glede na omenjene dejavnike se za srednjeintenzivna gibanja smatra npr. hitro hojo, ples, kolesarjenje in drugo. visokointenzivna gibanja se odražajo v globljem in pospešenem dihanju ter povišani srčni frekvenci, ki dosega vsaj 140 utripov v minuti (sallis, buono, roby, micale, & nelson, 1993). med slednja uvrščamo tek, hiter tek/ kolesarjenje, hojo/tek/kolesarjenje navkreber, hitro plavanje itd. poznamo objektivne in subjektivne metode spremljanja in merjenja intenzivnosti g/ša. za objektivno merjenje se najpogosteje uporabljata merilnik pospeška in merilnik srčne frekvence, za subjektivno merjenje pa anketni vprašalnik. h gibalni neaktivnosti, četrtemu dejavniku globalne umrljivosti (who, 2011), štejemo sedenje, ležanje, stojo na mestu, igranje računalniških igric ali delo za računalnikom. prednosti srednjein visokointenzivne gibalne/športne aktivnosti različne mednarodne in nacionalne zdravstvene organizacije poudarjajo, da morajo otroci in mladostniki doseči vsaj 60 minut dnevne srednjein visokointenzivne g/ ša (who, 2011; resolucija o nacionalnem programu športa v republiki sloveniji za obdobje 2014–2023). prav tako navajajo, da daljši čas srednje in visoke intenzivnosti g/ša povečuje učinke na zdravje, ki se kažejo predvsem v manjšem deležu debelosti in pojavnosti z debelostjo povezanih bolezni (diabetes tipa 2, metabolni sindrom, srčno-žilne bolezni), boljši telesni pripravljenosti, ki se odraža v večji izbiri gibalnega in športnega udejstvovanja, pa tudi v boljših kognitivnih sposobnostih (physical education matters, 2010). obenem poudarjajo, da je potrebno omejiti gibalno neaktivnost, ki včasih presega 90 % vsega dnevnega časa (grey-thompson, huppert, keeley, & leslie, 2014). gibalna neaktivnost v takšni meri lahko za posameznika, kljub njegovi vsakodnevni g/ša, pomeni negativne učinke. kako doseči 60 minut srednje in visoke intenzivne gibalne/ športne aktivnosti? otroci naj dosežejo potrebnih minimalnih 60 minut srednjein visokointenzivne g/ ša v dveh dnevnih časovnih obdobjih, ki naj trajajo od 20 do 40 minut. med šolskim poukom je primeren čas, ko naj bi otroci in mladostniki dosegli vsaj eno tako obdobje, in sicer med uro športa in športne vzgoje. tako so v iniciativi centra za kontrolo boleznih in preventive healthy people 2010 priporočili, da bi moral vsak otrok in mladostnik med uro športa in športne vzgoje doseči vsaj 50 % časa (= 22,5 minut) v srednji in visoki intenzivnosti g/ša (healthy people, 2010). annales kinesiologiae • 6 • 2015 • 2 145 fact sheets, 137–148 trenutno stanje gibalne/športne aktivnosti učencev pri urah športa mnoge ure športa in športne vzgoje otrokom in mladostnikom ne ponudijo dovolj možnosti, da bi dosegli priporočen čas srednje in visoke intenzivnosti g/ša. raziskava, opravljena v zda, poroča, da so učenci med uro športa večinoma gibalno neaktivni, saj dosežejo zgolj 13 % časa v visoki gibalni aktivnosti. avtorji tudi navajajo, da se čas visoke intenzivnosti gibanja zmanjšuje s številom učencev pri uri športa (failing fitness: physical activity and physical education in schools. policy brief, 2007). v slovenski raziskavi je bilo ugotovljeno, da ura športa osemdo devetletnih otrok traja le 36 minut in da otroci dosežejo le 36 % časa v srednji in visoki intenzivnosti ter so kar 42 % časa gibalno neaktivni (pušnik, volmut, & šimunič, 2014). zanimivo je, da je ura športa na prostem za kar sedem minut krajša od ure v telovadnici. čas trajanja upada tudi s številom otrok pri uri športa, in sicer za 1,24 minute na otroka. primer dobre prakse je zagotovo nizozemska študija, v kateri avtorji poročajo, da so otroci med urami športa v osnovni šoli deležni kar 46 % časa v srednji in visoki intenzivnosti g/ša (slingerland, haerens, cardon, & borghouts, 2013), medtem ko se v srednjih šolah ta vrednost zmanjša na 42 % za dijake in 37 % za dijakinje. intervencijski programi za doseganje priporočene ravni gibalne/športne aktivnosti pri urah športa in športne vzgoje v šoli bi lahko vodstvo v sodelovanju s športnimi pedagogi in z razrednimi učiteljicami razmislilo o možnostih za povečanje g/ša med urami športa in športne vzgoje, zlasti v smislu: • zagotavljanja ustreznih znanj o vodenju razreda in načinih poučevanja, ki bi omogočili istočasno gibalno aktivnost več učencev/dijakov (npr. igre v manjših skupinah, krožna vadba, aktivno prevzemanje vlog, čim krajši časi menjav postaj, preštevanje otrok med ogrevanjem in posredovanje natančnih navodil (partnership for prevention, 2008)); • spodbujanja učiteljev, da vključijo različne organizacijske oblike gibalnih/športnih in športnih programskih vsebin, kot so javne, zasebne in javno-zasebne; • usmerjanja učiteljev, da umeščajo učence/dijake v središče proaktivnega učnega procesa z didaktičnim pristopom, ki je prilagojen učencem/dijakom in sledi njihovemu povpraševanju ter tako povečuje učinkovitost poučevanja; • spodbujanja učiteljev k individualnemu pristopu do učencev/dijakov s posebnimi potrebami ter nadarjenih; • motiviranja učiteljev, da z multimedijsko demonstracijo in informacijsko-komunikacijsko podporo prispevajo k večji učinkovitosti, merljivosti in zanimivosti tako na področju gibalnega učenja kot g/ša nasploh; 146 fact sheets, 1–12 annales kinesiologiae • 6 • 2015 • 1 fact sheets, 137–148 annales kinesiologiae • 6 • 2015 • 2 146 • uporabe cenovno ugodne ali podarjene opreme (npr. aerobna vadba s frizbijem, kolebnice, obroči); • iskanja kompetentnih pomočnikov razrednim učiteljicam in/ali športnim pedagogom (npr. razredni učitelji, kineziologi, športni trenerji, drugi strokovnjaki), ki so zaposleni na različnih šolah; • uporabe znanj in izkušenj razrednih učiteljic in športnih pedagogov pri snovanju učnega načrta, ki bo imel poudarek na srednji in visoki intenzivnosti g/ša; • iskanja možnosti za (so)financiranje izvedbe ure športa in športne vzgoje (npr. sodelovanje z univerzo ali drugimi raziskovalnimi inštituti, sodelovanje s športnimi klubi, pritegniti zavarovalnice in ostale fundacije); • spodbujanja učiteljev drugih šolskih predmetov k vključevanju gibalnih aktivnosti pri učnih urah v sodelovanju z učitelji športne vzgoje (npr. jutranje ogrevanje in raztezanje, minuta za zdravje, sprostitev z jogo in druge); • spodbujanja učiteljev drugih šolskih predmetov k obogatenemu medpredmetnemu sodelovanju in usvajanju predvidenega znanja s pomočjo gibanja (npr. matematika, tuji jezik, biologija …). strategije za doseganje 50 % časa srednje in visoke intenzivnosti gibalne/športne aktivnosti med uro športa in športne vzgoje vodstva šol imajo možnost podpiranja g/ša med uro športa in športne vzgoje skozi svoja področja odgovornosti: postavljanje ciljev, zagotavljanje učinkovite kadrovske strukture, pomoč izvajalcem, promocija ciljev športa širši populaciji – predvsem staršem, športnim klubom, možnim sofinancerjem. 1. ozaveščajo naj o pomembnosti g/ša in pri tem izpostavijo predmet šport in športna vzgoja med različnimi deležniki (ministrstvom, strokovnjaki področja, širšo javnostjo, starši, otroci). predvsem naj poudarjajo pomen predmeta in g/ ša za zdravje in umske sposobnosti. 2. prilagodijo naj cilje učnega načrta, ki bo omogočal povečanje g/ša in zmanjšanje gibalne neaktivnosti. pri tem naj se sklicujejo na znanstveno dokazane programe športa, ki so povečali čas v srednji in visoki intenzivnosti g/ša in zmanjšali gibalno neaktivnost (za več informacij na: www.csba.org/physicalactivity.aspx). 3. sprejmejo naj pobude za povečanje časa v srednji in visoki intenzivnosti g/ša med uro športa in športne vzgoje, preko katerih naj: • zagotovijo, da bo vsak učenec/dijak dosegel vsaj 50 % časa srednje in visoke intenzivnosti g/ša med uro športa in športne vzgoje in da se bo le-ta izvajala v predvidenem časovnem obsegu (45 ali 90 minut); • zagotovijo primerno število učencev/dijakov pri uri športa in športne vzgoje za doseganje osnovnega cilja – 50 % časa v srednji in visoki intenzivnosti g/ša; http://www.csba.org/physicalactivity.aspx http://www.csba.org/physicalactivity.aspx annales kinesiologiae • 6 • 2015 • 2 147 fact sheets, 137–148 • zagotovijo zaposlitev kakovostnega kadra in omogočajo dodatna usposabljanja. 4. spremljajo naj izvedbo predmeta šport in športna vzgoja ter vzpostavijo redno poročanje o doseganju ciljev vodstvu šole, programskim partnerjem in javnosti. v ta namen je potrebno postaviti metodologijo vrednotenja g/ša med uro športa in športne vzgoje (npr. merilniki pospeška, merilniki srčne frekvence, štoparica). pri tem naj si pomagajo z uveljavljenimi praksami raziskovalnih inštitutov s področja kineziologije in športa. 5. sprejemajo naj nacionalne in mednarodne pobude za povečanje srednje in visoke intenzivnosti g/ša med uro športa in športne vzgoje. 6. razvijajo naj dober odnos do programskih partnerjev s ciljem podpore pri doseganju ciljev. literatura caspersen, c. j., powell, k. e., & christenson, g. m. (1985). physical activity, exercise, and physical fitness. public health report, 100(2), 126–131. failing fitness: physical activity and physical education in schools. policy brief (2007). pridobljeno 6. 6. 2015, s http://www.californiateenhealth.org/health-topics/nutrition-and-physical-activity/recent-research-nutrition-physical-activity/failing-fitnessphysical-activity-and-physical-education-in-schools. grey-thompson, t., huppert, j., keeley, b., & leslie, c. (2014). tackling physical inactivity a coordinated approach. pridobljeno 5. 6. 2015, s https://parliamentarycommissiononphysicalactivity.files.wordpress.com/2014/04/apcopa-final.pdf. healthy people (2010). chapter 22 physical activity and fitness, centers for disease control and prevention and president’s council on fitness. pridobljeno 5. 6. 2015, s http:// www.healthypeople.gov/2010/document/pdf/volume2/22physical.pdf. hosta, m. (2004). zdravje med gibalno nujnostjo in športno izbiro. v r. pišot, v. štemberger, j. zurc, & a. obid (ur.), otrok v gibanju: zbornik prispevkov 3. mednarodnega znanstvenega posveta (str. 88–89). koper: univerza na primorskem, znanstvenoraziskovalno središče. partnership for prevention (2008). school-based physical education: working with schools to increase physical activity among children and adolescents in physical education classes an action guide. washington, dc: partnership for prevention. pridobljeno 6. 6. 2015, s https://www.prevent.org/downloadstart.aspx?id=34. physical education matters (2010). pridobljeno 12. 5. 2015 s http://www.cityprojectca. org/blog/wp-content/uploads/2008/02/pe-matters-long-versionfinal.pdf. pišot, r. (2004). vloga in pomen gibalne/športne dejavnosti v šolskem obdobju. zdrava šola, 1, 24–27. pušnik, t., volmut, t., & šimunič, b. (2014). the quantity and intensity of physical activity during physical education in 3rd grade primary school children. annales kinesiologiae, 5(2), 196–201. view item http://www.californiateenhealth.org/health-topics/nutrition-and-physical-activity/recent-research-nutrition-physical-activity/failing-fitness-physical-activity-and-physical-education-in-schools http://www.californiateenhealth.org/health-topics/nutrition-and-physical-activity/recent-research-nutrition-physical-activity/failing-fitness-physical-activity-and-physical-education-in-schools http://www.californiateenhealth.org/health-topics/nutrition-and-physical-activity/recent-research-nutrition-physical-activity/failing-fitness-physical-activity-and-physical-education-in-schools https://parliamentarycommissiononphysicalactivity.files.wordpress.com/2014/04/apcopa-final.pdf https://parliamentarycommissiononphysicalactivity.files.wordpress.com/2014/04/apcopa-final.pdf http://www.healthypeople.gov/2010/document/pdf/volume2/22physical.pdf http://www.healthypeople.gov/2010/document/pdf/volume2/22physical.pdf https://www.prevent.org/downloadstart.aspx?id=34 http://www.cityprojectca.org/blog/wp-content/uploads/2008/02/pe-matters-long-versionfinal.pdf http://www.cityprojectca.org/blog/wp-content/uploads/2008/02/pe-matters-long-versionfinal.pdf http://ojs.zrs.upr.si/index.php/ak/article/view/35/30 148 fact sheets, 1–12 annales kinesiologiae • 6 • 2015 • 1 fact sheets, 137–148 annales kinesiologiae • 6 • 2015 • 2 148 resolucija o nacionalnem programu športa v republiki sloveniji za obdobje 2014 – 2023 (renpš14-23). (2014). ljubljana: ministrstvo za izobraževanje, znanost in šport. pridobljeno 6. 6. 2015, s http://www.pisrs.si/pis.web/pregledpredpisa?id=reso99 sallis, j. f., buono, m. j., roby, j. j., micale, f. g., & nelson, j. a. (1993). seven-day recall and other physical activity self-reports in children and adolescents. medicine and science in sports and exercise, 25(1), 99–108. slingerland, m., haerens, l., cardon, g., & borghouts, l. (2013). differences in perceived competence and physical activity levels during single-gender modified basketball game play in middle school physical education. european physical education review, 20(1), 20–35. view item who (2011). global recommendations on physical activity for health. pridobljeno 8.6.2015, s http://www.who.int/dietphysicalactivity/leaflet-physical-activity-recommendations.pdf http://dx.doi.org/10.1177/1356336x13496000 http://www.who.int/dietphysicalactivity/leaflet-physical-activity-recommendations.pdf http://www.who.int/dietphysicalactivity/leaflet-physical-activity-recommendations.pdf _goback _goback _goback _goback _goback _goback _goback annales kinesiologiae • 10 • 2019 • 1 73 reports and reviews/poročila in ocene, 73–80 5th international scientific conference on “exercise and quality of life” novi sad, serbia, 11–13 april, 2019 a delegation from the institute for kinesiology research attended the hospitable eqol2019 in novi sad, organised by the faculty of sports and physical education of the university of novi sad. the plenary lectures of the conference covered various aspects within the subtopic ‘from active childhood to healthy aging’ in a very informative way: wlodzimierz starosta: model of children’s comprehensive movement education in a family as a fundament of healthy, physically active, successful and long life; antonino bianco: field-based tests for the assessment of physical fitness in youth practicing sports: a systematic review within the esa program; james s. skinner: exercise and quality of life in the elderly; francisco b. ortega: fitter kids for a healthier adult society; jozsef betlehem: how can health literacy influence health status?; jorunn sundgot-borgen: exercise and quality of life in healthy adolescents, women with eating disorders and female elite athletes; dejan magoc: impact of 5-2-1-0: a community-based childhood obesity prevention initiative; sanja music milanovic: physical (in)activity in early school-age: what are we doing wrong?; visnja djordjic: the post-milennials’ lifestyle and what physical education can do about it?; sanja salaj: physical activity and motor skills in preschool children; finn berggren: hepa europe – before – now – and ???. the conference allowed sufficient time for the oral presentations of both the invited speakers and work sessions, as well for poster sessions, where young and old could gather and discuss the themes. from the main lectures, it was obvious that there is a role for attendees and organisers to raise awareness of the importance of physical activity during primary school periods, to battle sedentary lifestyles, and to consider physical activity as an integrated element of obligatory academic courses. hepa europe, a network of organisations recognized by who which emphasises health-enhancing physical activity, could have an important role in this (for more on hepa europe visit: http://www.hepaeurope2019. org/). from this perspective, it seems that new field-based tests for the assessment of physical activity for young people might even be of interest for (early) detection of cognitive and physical disabilities in children. the abstracts of the conference have been published in bmc sports science, medicine and rehabilitation, volume 11, supplement 1 (https://doi.org/10.1186/s13102019-0119-7), while more details of the conference and its associated journal can be found elsewhere (http://eqol.rs and www.eqoljournal.com). the well-organised conference is highly commended for its invitation to renowned academic speakers, and for attracting several hundred participants who had the chance to share knowledge in a stimulating environment, which was especially rewarding for young researchers. cécil meulenberg http://www.hepaeurope2019.org/ http://www.hepaeurope2019.org/ https://doi.org/10.1186/s13102-019-0119-7 https://doi.org/10.1186/s13102-019-0119-7 http://eqol.rs http://www.eqoljournal.com 74 reports and reviews/poročila in ocene, 73–80 annales kinesiologiae • 10 • 2019 • 1 5. mednarodna znanstvena konferenca »exercise and quality of life« novi sad, srbija, 11.–13. april 2019 sodelavci inštituta za kineziološke raziskave zrs koper so se že tradicionalno udeležili 5. eqol2019 konference v gostoljubnem novem sadu, ki jo je organizirala fakulteta za šport in telesno vzgojo univerze v novem sadu. plenarna predavanja konference: wlodzimierz starosta: model of children’s comprehensive movement education in a family as a fundament of healthy, physically active, successful and long life; antonino bianco: field-based tests for the assessment of physical fitness in youth practicing sports: a systematic review within the esa program; james s. skinner: exercise and quality of life in the elderly; francisco b. ortega: fitter kids for a healthier adult society; jozsef betlehem: how can health literacy influence health status?; jorunn sundgot-borgen: exercise and quality of life in healthy adolescents, women with eating disorders and female elite athletes; dejan magoc: impact of 5-2-1-0: a community-based childhood obesity prevention initiative; sanja music milanovic: physical (in)activity in early school-age: what are we doing wrong?; visnja djordjic: the post-milennials’ lifestyle and what physical education can do about it?; sanja salaj: physical activity and motor skills in preschool children in finn berggren: hepa europe – before – now – and ??? so na zelo informativen način zajemala različne vidike letošnje glavne teme “od aktivnega otroštva do zdravega staranja”. konferenca je obsegala tako govorne predstavitve aktivnih udeležencev, kot tudi sekcijo poster predstavitev, kjer je bilo več časa za razpravo namenjenega predvsem tistim, ki so šele na začetku akademske poti. plenarna predavanja so tudi tokrat opozarjala na očitno vlogo, ki jo imajo udeleženci in organizatorji konference pri ozaveščanju javnosti o pomenu gibalne/športne dejavnosti v osnovnošolskem obdobju, pri boju proti sedentarnemu življenjskemu slogu in pri upoštevanju telesne dejavnosti kot integriranega elementa v učnih načrtih. pri tem bi lahko izpostavili pomembno vlogo mreže organizacij »hepa europe«, pod okriljem svetovne zdravstvene organizacije, ki promovira gibalno/športno aktivnost za krepitev zdravja populacije (več o »hepa europe« na http://www.hepaeurope2019.org/). v tej smeri lahko razumemo tudi nove terenske teste za oceno gša za mlade, ki naj bi pripomogli k (zgodnjemu) odkrivanju kognitivnih in telesnih pomanjkljivosti pri otrocih. povzetki konference so bili objavljeni v reviji bmc sports science, medicine and rehabilitation, volume 11 supplement 1 (https://doi.org/10.1186/s13102-019-0119-7), več podrobnosti o konferenci in znanstveni reviji lahko najdete tudi na (http://eqol.rs in www.eqoljournal.com). dobra organizacija konference z aktualnimi predavanji priznanih strokovnjakov ter več kot 100 predstavljenimi prispevki, zagotavlja spodbudno okolje in dobro priporočilo za vse mlade raziskovalce, ki si želijo akademske rasti. cécil meulenberg, prevod saša pišot http://www.hepaeurope2019.org/ https://doi.org/10.1186/s13102-019-0119-7 http://eqol.rs http://www.eqoljournal.com _goback _hlk3367923 _goback _goback _goback _hlk3056869 _goback _goback _hlk23766418 _goback _hlk26527070 _goback _goback annales kinesiologiae • 9 • 2018 • 1 67 reports and reviews/poročila in ocene, 57–68 international conference on healthiness and fitness across the lifespan magdeburg, germany, 12th–15th september 2018 the 2018 version of the international scientific conference on health across lifespan (hal) organised by the otto von guericke university magdeburg and the centre of neurodegenerative diseases magdeburg together with the european group for research into elderly and physical activity (egrepa) was a great success. not only because it attracted about 160 participants of 22 different nationalities from africa, asia, europe, northand south-america. but actually because it was a well-organised and very informative conference. the key note lectures comprised marcela gonzález gross’ fitness and lifestyle in middle life; kirk erickson’s effects of exercise on brain and cognition; rado pišot’s bed rest model for studying physical and cognitive decline; gerd kempermann’s the neurobiology of individualised brain aging; and matthieu lenoir’s motor competence and childhood obesity, which altogether indicate the red-line of the conference, with the speakers giving excellent updates on the current status of these topics and their work. further, the audience could attend the invited symposia motor training, mobility and cognition (two separate sessions organised by egrepa), and cognitive-motor interactions across the lifespan, and in three parallel sessions indulge in the oral presentations that ranged from the topics on healthy aging to social aspects of health and physical activity. additionally, two extensive poster sessions and workshops (e.g. shiatsu and various dances) gave a more hands-on character to the conference. further detailed information on the content of the lectures and posters can be found on (https://www.hal2018.de/index.php?id=20908). we certainly hope that the conference will be again held in 2021, thus becoming triennial; the previous version in 2015 was entitled active healthy aging (its report can be read in annales kinesiologiae 2015, vol 6 (2): 155-156), as this event is highly recommended for all the researchers or clinicians from the field of motor development, studying the effects of physical activity and cognitive-functional exercise for all ages. cécil meulenberg and uroš marušič https://www.hal2018.de/index.php?id=20908 http://ojs.zrs.upr.si/index.php/ak/article/view/104/127 68 reports and reviews/poročila in ocene, 57–68 annales kinesiologiae • 9 • 2018 • 1 mednarodna konferenca o zdravju in telesni pripravljenosti v življenjski dobi magdeburg, nemčija, 12.–15. september 2018 letošnja mednarodna znanstvena konferenca o zdravju v celotnem življenjskem obdobju ('health across lifespan' hal 2018), ki sta jo organizirala univerza otto von guericke magdeburg in center za nevrodegenerativne bolezni magdeburg skupaj z evropsko skupino za raziskave starejših in gibalno/športno aktivnost ('european group for research into elderly and physical activity' egrepa), je bila izvedena zelo uspešno. ne le zato, ker je pritegnila približno 160 udeležencev 22 različnih narodnosti iz afrike, azije, evrope ter severne in južne amerike, ampak tudi zato, ker je bila dobro organizirana in zelo informativne narave. vabljena predavanja so udeležencem predstavili predavatelji: marcela gonzález gross 'fitness and lifestyle in middle life'; kirk erickson 'effects of exercise on brain and cognition'; rado pišot 'bed rest a model for studying physical and cognitive decline'; gerd kempermann 'the neurobiology of individualised brain aging'; in matthieu lenoir 'motor competence and childhood obesity'. naslovi plenarnih predavanj nakazujejo rdečo nit konference, predavatelji pa so v njih odlično podali povzetke najnovejših ugotovitev na svojih raziskovalnih področjih. poleg plenarnih predavanj so se udeleženci konference lahko udeležili vabljenih simpozijev z naslovi: 'motor training, mobility and cognition' (dve različni sekciji organizirani s strani egrepa-e), 'cognitive-motor interactions across the lifespan', in treh vzporednih sekcij prestavitev, ki so zajemale tematike od 'zdravega staranja' do 'socialnih vidikov zdravja' in 'gibalne/športne aktivnosti'. organizirani sta bili tudi dve sekciji s predstavitvami plakatov in delavnice (npr. shiatsu in različni plesi), ki so konferenci dale bolj praktičen značaj. podrobnejše informacije o vsebini predavanj in predstavitvah plakatov so dostopne preko spletnega naslova: https://www.hal2018.de/index.php?id=20908. vsekakor upamo, da bo ta predvidoma trienalna konferenca (predzadnja, z naslovom aktivno zdravo staranje in za katero dostopno poročilo v annales kinesiologiae 2015, vol. 6 (2): 155-156, je potekala leta 2015), organizirana tudi 2021. znanstvena konferenca je namreč zelo priporočljiva za vse raziskovalce ali zdravnike/medicinske delavce, ki delajo na področjih gibalnega razvoja in/ali raziskujejo učinke gibalne/ športne aktivnosti in kognitivno-gibalne vadbe v vseh starostnih obdobjih. cécil meulenberg in uroš marušič https://www.hal2018.de/index.php?id=20908 http://ojs.zrs.upr.si/index.php/ak/article/view/104/127 http://ojs.zrs.upr.si/index.php/ak/article/view/104/127 annales kinesiologiae • 7 • 2016 • 2 139 original scientific article udc: 365-053.88:645.4(497.4ljubljana) received: 2017-02-17 healthy ageing at home: ergonomic adaptations of interior design and self-assessed quality of life of older adults of the municipality of ljubljana jasna hrovatin1, saša pišot2, matej plevnik3 1 faculty of design, associated member of university of primorska, trzin, slovenia 2 science and research centre of koper, institute for kinesiology research, koper, slovenia 3 university of primorska, faculty of health sciences, applied kinesiology, izola, slovenia corresponding author: jasna hrovatin faculty of design, associated member of university of primorska, prevale 10, 1236 trzin, slovenia tel.: +386 59 23 5008 e-mail: jasna.hrovatin@fd.si abstract population is ageing and many nations already respond by developing and promoting special strategies of healthy ageing. living environment is one of the factors that can contribute to healthy and safe ageing at home, providing that it is well adapted to the needs of older adults. on the contrary, it can cause stress, discomfort and lead to injuries, resulting in the loss of independence and autonomy. with the use of a questionnaire, conducting a survey and an analysis regarding the adaptability of living environment to the needs of older adults, we obtained an insight into the quality of living environment of the elderly. in the quality of life survey as a part of the a-qu-a questionnaire, the participants were 198 older adults with an average age of 71.5 ± 5.2 years of age. further on, 83 of them participated in the study of the “adaptation of the living environment to the needs of older people,” carried out in the homes of the participants, (with an average of 76 ± 1.2 years of age). the results showed that there is a significant difference between the subjective evaluation of the participants and the evaluation by the professionals regarding the estimation of appropriate lighting. the participants who estimated their quality of life as better are more likely to have sufficient or adequate lighting and more adaptations in the kitchen, which makes daily kitchen work easy and safe. further investigation dealt with the ergonomic adaptation of the bathrooms, where we found out that less than 15 % of the participants installed mailto:jasna.hrovatin@fd.si 140 jasna hrovatin, saša pišot, matej plevnik: healthy ageing at home ..., 139–152 annales kinesiologiae • 7 • 2016 • 2 the handrails in the shower or bath tub, which can significantly contribute to safety. additionally, physical capability as part of quality of life negatively correlates with the number of adaptations made in bathroom (r = -0.149; p = 0.039), which refers to the fact that the adaptation of accessories (handrails) were only installed when the need for them appeared. with minor changes in the living environment and taking care for maintaining psycho-physical capabilities, older adults can easily and safely perform everyday tasks, which prolongs an individual’s autonomy and independence − the fact we are still not sufficiently aware of. keywords: older adults, ergonomic furniture adaptation, self-assessed quality of life. zdravo staranje na domu: ergonomska prilagoditev notranje opreme in samozaznana ocena kakovosti življenja na primeru starejših odraslih v mestni občini ljubljana izvleček človeštvo se stara in mnoge države so se na to dejstvo že odzvale z razvijanjem in promocijo ukrepov za zdravo staranje. bivalno okolje je eden od dejavnikov, ki lahko prispevajo k zdravemu, predvsem pa k varnemu staranju na domu, če je le to urejeno in prilagojeno potrebam, ki jih imajo starejši odrasli. v nasprotnem primeru lahko neprilagojeno bivalno okolje povzroča stres, slabo počutje in izgubo samostojnosti, poleg tega pa je lahko tudi vzrok za poškodbe. v raziskavi o kvaliteti življenja je sodelovalo 198 starejših odraslih s povprečno starostjo 71 ± 5,2 let. nadalje se je 83 izmed vseh udeležilo tudi raziskave “prilagojenost bivalnega okolja potrebam starejših oseb”, ki se je izvajala na domovih uporabnikov (povprečna starost 76 ± 1,2 leti). študijo smo izvedli z uporabo dveh prilagojenih vprašalnikov ter osebnim vpogledom v bivanjski prostor udeležencev. ugotavljamo, da glede na priporočila obstajajo pomembne razlike med oceno primerne osvetlitve po mnenju starostnikov v primerjavi s strokovno oceno izmerjeno na domu. starostniki, ki so imeli primerno urejeno osvetljenost prostorov, so kvaliteto svojega življenja ocenjevali višje in so poročali tudi v več primerih prilagoditev v kuhinji, ki olajša dnevno delo v kuhinji. nadalje smo raziskali stanje ergonomske prilagojenosti kopalnic udeležencev, kjer smo ugotovili, da je manj kot 15 % sodelujočih v raziskavi že uredilo ustrezne ročke za oporo v kopalnici pod tušem ali v kopalni kadi. telesna zmogljivost teh posameznikov, kot komponenta kvalitete življenja, statistično značilno negativno korelira s številom prilagoditev v kopalnici (r = -0,149; p = 0,039). ti svojo telesno zmogljivost kot del kvalitete življenja ocenjujejo annales kinesiologiae • 7 • 2016 • 2 141 jasna hrovatin, saša pišot, matej plevnik: healthy ageing at home ..., 139–152 nižje. to vodi do ugotovitve, da prilagoditve bivalnega prostora starostniki uredijo šele, ko jih potrebujejo. z manjšimi prilagoditvami v bivalnem okolju ter z ohranjanjem psiho-fizične zmogljivosti bi starejši odrasli lahko vsakdanja opravila izvajali lažje, z manj napora in bolj varno. to bi pomenilo daljše samostojno in neodvisno bivanje starejših odraslih v domačem okolju dejstvo, ki se ga ne zavedamo dovolj. ključne besede: starejši odrasli, ergonomija, prilagoditev pohištva in opreme, samoocena kakovosti življenja. introduction being aware of the fact that population is ageing, the main focus and challenge for nations are how to increase or at least maintain the quality and years of healthy life (drewnowski et al., 2003; who, 2002). many nations have already responded by developing and implementing the policies to promote healthy ageing. according to the last data from 2011, in slovenia the older adults (65 +) represented 16.6 % of population (women 19.8 %, men 13.3 %). eropop2010 eurostat projection expects that lifespan will be prolonged, so older adults (65 +) will represent 27.5 % of population in 2040, yet in the year 2050, 30.6 % of population and in the year 2060 every third slovenian will be older than 65 years of age (statistic office rs, 2012). a lot of older citizens live in homes that are not properly adapted to the needs of older adults (colombo, vitali, molla, gioia, & milani, 1998), which can cause stress, discomfort and loss of independence. in the last decade, there has been a trend in developed countries to provide independent living conditions for older people, in a familiar home environment and for as long as possible (grdiša, 2010). in slovenia, only 7.85 % of people aged 65 and over live in the old people’s homes, therefore, it is very important that housing and equipment for older adults and disabled persons is facilitated and adapted to the safety and comfort of their use (hvalič touzery, 2009). the research performed by the school of architecture, university of sheffield, uk (2004), regarding the impact of architecture on the quality of life, with the emphasis on environmental suitability of housing for the elderly, found out that the design of buildings have both positive and negative effects on the quality of residents’ life. that is particularly important since older people spend most of their time in the building in which they reside. due to the increased susceptibility of older adults to infections and diseases, they found that the compliance with hygiene standards is of extreme importance, particularly in the parts of buildings where food preparation and dining take place (torrington, barnes, mckee, morgan, & tregenza, 2004). in the research by colombo et al. (1998), the most frequent problems faced by older adults were identified. among other things, older adults reported a safety problem in the kitchen (as many as 33 % of the dwellers) and of inadequate lighting (25 % of the dwellers). very few older adults can afford a thorough home adaptation because of financial reasons. it was found that 60 % of older 142 jasna hrovatin, saša pišot, matej plevnik: healthy ageing at home ..., 139–152 annales kinesiologiae • 7 • 2016 • 2 people live in homes that have not been renovated or ergonomically adopted or newly equipped more than 20 years, which affects lower comfort and safety of the residents. more than 14 % of older people in england live in inadequate housing condition at home that urgently needs adaptation (boyo, 2001). in addition, only 10 % of older adults decide to modify the existing equipment and adjust them to new needs (gilderbloom & markham, 1996). the studies mainly focused on furniture design for seniors, which is extremely important as most products include the elements designed for young people, so that older adults often have difficulties in using them (fabisiak & jankowska, 2016; klos, fabisiak, & kaczmarek, 2014). it should be emphasized that the designers and furniture manufacturers who wish to create products tailored to the needs of elderly people should first identify and focus on the needs arising from the old-age-related changes occurring in the human body (fabisiak & klos, 2016). however, there is also evidence that older adults have poor knowledge of the possible psycho-physical changes in the old age and about positive effect on performance of daily routines and, thereby, the possibilities to prolong the period of independence in home environment (batič et al., 2016). beside the adaptation of living environment to age-related changes in functionality of older adults, we were focused also on the potentially dangerous places in the apartment. evidence showed that most accidents in the home environment happened in the kitchen and bathroom (stevens, 2005), so we need to pay more attention to the ergonomics of the furniture to maintain the performance of daily habits easy and, most of all, safe. in addition, the lighting proves to be a common problem with the kitchen equipment. the kitchen is a workspace where we use sharp knives, home appliance and hot dishes, so it is necessary that the entire kitchen, especially the working area has proper lighting. a particular attention should be paid to the main working surface, sink and cooker hob area. when installing the lighting and choosing a single lamp, we must pay attention to disturbing shadows, glare and adequate power. for lighting which is directed towards the workplace, it is necessary to be installed from the front or from the left side and not from behind. this prevents the appearance of throwing shadows on the worktop. another potentially dangerous place in the living environment is the bathroom (carter, campbell, sanson-fisher, & redman, 1997). the handrails intended for greater security should be placed at the appropriate level and at appropriate places. our next analyses were directed to the research of handrails and other accessories (shelves, anti-slip mats) and their connection with the self-assessed quality of life, as well as the falls that occurred in a one year period. within the definition of healthy ageing (pell, mcclure, & bartlett, 2005) as “a lifelong process optimizing opportunities for improving and preserving health and physical, social and mental wellness; independence; quality of life and enhancing successful life-course transitions” we were focused on the situation of living old people’s environment. having in mind the self-assessed quality of life according to the status of ergonomics adapted in living environment and furniture, we wanted to annales kinesiologiae • 7 • 2016 • 2 143 jasna hrovatin, saša pišot, matej plevnik: healthy ageing at home ..., 139–152 examine the effect on independence and diminishing the potential injuries. that is why we examined the current status of adapted living environment when prolonging autonomy and ensuring the independence of older adults, their safety and comfort when living at home. according to the presented facts, the research questions we considered in this part of the project were the following: i.) what is the present state of ergonomic interior design of old people’s home environment in the studied sample of older population in the municipality of ljubljana and ii.) does the self-assessed quality of life of older adults correlate with the level of adapted living environment (considering the number of adaptations). methods the study was a part of the project titled a-qu-a: active and quality ageing, (project no. 4300-472/2014), supported by norway grants. the leading partner of the project was the ljubljana home care institution, department of home care ljubljana (slovenia), while the research partners of the project were the institute for kinesiology research, science and research centre, university of primorska and the faculty of design that collected all the data of the mass measurements and carried out the intervention. through a complex questionnaire and with an interview we tried to determine the status of interior adaptations to the needs of older adults living in dwellings within the municipality of ljubljana. the research protocol was conducted according to the declaration of helsinki, all the participants also signed a written consent to participate in the measurements. participants in the quality of life survey, there were 198 older adult participants (151 female, 70.35 ± 5.8 years of age and 47 male, 71.54 ± 5.3 years of age). 83 of them (58 female and 25 male), with their average age of 76 ±1.2 years, have additionally decided to participate also in the second survey – “adaptation of the living space to the needs of the elderly.” all the participants of the study are the residents of the municipality of ljubljana. measurements in the quality of life survey, 198 older adults filled out a complex a-qu-a questionnaire regarding the demographic and socio-economic data, healthy lifestyle, nutrition habits and ergonomic adaptation of interior design and furniture. they were all initially tested for physical characteristics, functional capabilities and general health status. 144 jasna hrovatin, saša pišot, matej plevnik: healthy ageing at home ..., 139–152 annales kinesiologiae • 7 • 2016 • 2 aqua questionnaire was a combination of different parts of standardized questionnaires (gpaq, qol), where part of qol was used also in the survey of quality of life of national institute for public health. it consisted of 78 questions and was sent to each participant who agreed with a signed consent to participate in the mass measurement. the participant brought their own questionnaire, filled out on the first day of measurement. after the measurement, the researchers checked the understanding and the missing answers together with the participants, to obtain more relevant data. in the second survey titled “adapt the living space to the needs of the elderly,” the questionnaire was filled out by a group of interior design experts during their visit at the participant's home. the questionnaire was divided into 7 groups according to individual residential premises and comprised a total of 121 questions. most of the questions were related to individual elements that affect the increased security and functionality processes in homes for the elderly. the adequacy of light exposure was measured using the lux-meter (cem, model dt-1301). statistical analysis all data were organized in microsoft excel and analyzed in ibm spss statistical package, version 20.0. descriptive statistics, independent samples of t-test for gender difference, the number of adaptations and spearman test for correlation between the number of living environment adaptations and quality of life (general health, physical capability, psychical condition and general quality of life) were used. p values < .05 were considered significant. results during the visit at the participant's home, we found out that only 22 % of the total of 83 respondents have appropriate task lighting. the measurements for determining the suitability was performed using the lux meter. there is a high level of those who assessed their kitchen lighting inadequate (figure 1). annales kinesiologiae • 7 • 2016 • 2 145 jasna hrovatin, saša pišot, matej plevnik: healthy ageing at home ..., 139–152 figure 1: comparison of adequate or inadequate lighting of working area by professional assessment criteria and self-assessed criteria. additionally, we have analyzed the bathroom’s equipment for safety when entering into a bath tub (a step) and the shower equipment (a chair) and additional accessories such as handrails, shelves for shampoo and anti-slip mats. the results showed that 59 % of the participants have a shower and only 33 % participants reported a bath with at least one of the listed accessories (figure 2 and figure 3 respectively). the other 8 % did not report any ergonomic accessories. the results from the questionnaire showed that only less than 15 % of the respondents installed the handrails in the shower or either in the bath tub, which significantly increases safety when using the bathroom. from the interviews, it was evident that persons who have handrails installed were already receiving benefits by physiotherapists or occupational therapists who advised them to set up such holders. similar results were found also with the presence of a seat / a chair in the shower. 146 jasna hrovatin, saša pišot, matej plevnik: healthy ageing at home ..., 139–152 annales kinesiologiae • 7 • 2016 • 2 figure 2: number of the participants who have equipment in the shower (n = 117). figure 3: number of the participants who have specially adapted equipment in the bath tub (n = 66). within the study, we additionally analyzed the self-assessed adequate living environment (no. of adaptations) and its correlation according to the self-assessed “quality of life”: general health, physical capability, psychological conditions and general quality of life. the participants assessed the quality of life on the qualitative scale, in the range annales kinesiologiae • 7 • 2016 • 2 147 jasna hrovatin, saša pišot, matej plevnik: healthy ageing at home ..., 139–152 from 1 − ”very bad,” 2 − “bad,” 3 − “fair,” 4 − “good,” and 5 − ”very good.” in the correlation analysis also the variables such as “education level” and “number of falls in the previous year” were included. since bathroom is marked as a place with the highest rate of accidents, we have gathered the data of the number of participants’ adaptations of useful accessories such as handrails, shelves and seats in the shower or steps, shelves and anti-slip mats in the bath tubs, which could prevent potential falls and slips. the number of adaptations showed us logical results in negative correlation (ρ = -.149) between the number of adaptations in the bathroom and the self-assessed physical capability, which could be argued that older adults who assessed their physical capability lower have more adaptations than those with better physical capability. additionally, we found no correlation between the number of the adaptations with the presented variables (table 1) and other life quality determinants. also, there is no gender difference referring to the number of adaptations among men and women who participated in project. table 1: spearman correlation of adaptations in the bathroom and quality of life. spearman's rho general health status physical capability general quality of life no. of adaptations in in the bathroom c o r r e l a t i o n coefficient -.036 -.149* -.089 sig. (2-tailed) .620 .039 .213 n 197 192 198 spearman's rho psychological status level of education no. of falls last year no. of adaptations in in the bathroom c o r r e l a t i o n coefficient -.084 -.078 -.021 sig. (2-tailed) .241 .272 .767 n 198 198 197 correlations were found between the characteristics of qol, especially physical status, which were estimated better by those participants who assessed general health (ρ=.490), physical capability (ρ=.339) and general quality of life (ρ=.731), which is reasonable, and also we can confirm that those with higher education level more likely estimate psychological status (ρ=.282) and general quality of life (ρ=.246) better than those with lower. on the other hand, the variable “number of falls last year” showed us significant negative correlations regarding general health (ρ= -.260), physical capa148 jasna hrovatin, saša pišot, matej plevnik: healthy ageing at home ..., 139–152 annales kinesiologiae • 7 • 2016 • 2 bility (ρ=-.213) and education (ρ=-.148), which can be argued that older adults who are less healthy have lower physical capabilities and lower educational level are more likely to fall in the previous year. additionally, we can find a larger share of those with the self-assessed quality of life as “very good” and “good” and reported more adaptations in the kitchen which simplify their daily kitchen work and provide safety (automatic shutdown of the oven; lower edge of the oven at the height of the kitchen countertop and easy cleaning of the kitchen hob), which could suggest possible correlation between qol and adaptation of furniture (figure 4). figure 4: self assessed general quality of life in relation to the characteristics of kitchen adaptation. still, a significant number of participants do not pay enough attention to the safety in the bathroom, whereas only 18 % possess the handrails, 31 % have a seat in their shower and 22 % have an anti-slip mat. for this reason, the warnings of possible accidents in the bathroom (falls, slips) should be much more highlighted. living in unadapted apartments does not allow an independent life and could even present a danger for health. annales kinesiologiae • 7 • 2016 • 2 149 jasna hrovatin, saša pišot, matej plevnik: healthy ageing at home ..., 139–152 discussion within the detailed analysis of ergonomic characteristics of participant’s homes, we focus on two main characteristics: adequate lighting in the kitchen work area and the safety of equipment and accessories in the bathrooms. for adequate lighting, 1400 lux or more for work surface and 600 lux or more for general lighting are advised. however, a general recommendation is that the lighting of between 1400 and 2000 lux is advisable for the working surface and from 600 to 900 lux for the general lighting of kitchens for people over 65 years of age (podlesnik, 2011). most of the participants had too weak lighting. our findings varied from the data in the questionnaire, where the respondents self-reported having adequate worktop lighting in their kitchen with a rather higher percentage (46 %). the results indicate that older people generally think they have sufficient lighting of their work surface, but in reality the lighting in most cases is too weak, which hinders older adults at their work and may also be a cause of accidents. due to the fact that older adults find it difficult to stand up for a long time, in particular while they wash their hair with their arms raised, it is recommended that a seat is placed in their shower. there are special self-supporting chairs which could even be attached to the wall. thus, older adults can sit while showering and washing their hair without any danger to slide on the slippery floor or to fall as they might get dizzy as well. the above presented results show that only 15 % of the participants have a seat placed in their shower despite the fact that many older people have problems with balance because of poorer movement skills. to enhance the security in the shower, shelves for storing soaps and shampoos also help as deposing and bending can cause a loss of balance and lead to a fall. here we found more promising results because almost 60 % of the participants reported having a shelf for storing cosmetics in the shower. installing the storage shelves in the shower is simple, as they can also be fixed with the help of a vacuum; that is why a majority of the respondents have shelves in the shower, however, 43 % of showers are still without shelves. tinetti (2003) and tomšič & gunčar, (2012) found out that the falls of older adults grow constantly and linearly with the increasing number of risk factors among which we also rank unadjusted living environment. that could be argued that adaptation and installing the accessories (handrails) only take place after the first fall. older adults are not aware enough of the potential problems encountered in their own homes, and of the existing possibilities in order to create living environment with minimal interventions that could significantly ease their living at home (hrovatin, 2015). older adults are often afraid of any kind of adaptation, on one hand due to the fear of high costs and on the other hand due to the fear of the organization. the fact is that even a minor adaptation, which is neither financial nor organizational problem, brings significant changes that ensure greater safety and consequently prolong an individual’s independence. with this research, we found that most of older adults from our sample do not have ergonomically adopted interior design of their home, i.e. that they live in the apartments which do not suit their actual needs. despite the fact that there are negative correlations 150 jasna hrovatin, saša pišot, matej plevnik: healthy ageing at home ..., 139–152 annales kinesiologiae • 7 • 2016 • 2 between self-assessed physical capability as one characteristic of quality of life and the adaptations of equipment or accessories in the bathrooms, such as holders, shelves, steps and seats, we found that higher-assessed quality of life is more common for people with higher education. that corresponds also to higher economic status and, thus, higher standards of living conditions. conclusion according to the research, we found that the majority of older adults in our sample live in the apartments which could prove a threat to their health and prevent successful ageing. older adults are mostly not aware enough that they could achieve a significant level of safety and independence in their living environment with only minimal interventions or adaptations. the best time to make adjustments to achieve ergonomic interior design is immediately after the retirement, when the problems are not yet present, to avoid the fact that maladjusted interior design leads to the early loss of independence. for the safe, high-quality and independent living in particular homes, it is also very important to maintain the physical and mental fitness of older adults. the need for safe, high-quality and independent living is evident so the awareness of possible small adaptations needs to be highlighted. being aware that inadequate living environment remains a problem among older population, we need to investigate and identify the proper strategies to ensure healthy ageing with prolonged living at home. conscious of the potential barriers to achieve adaptation in the old people’s living environment should present a further challenge in creating national strategies of health promotion for the older population. as mentioned, older adults should be aware that even minor changes in their living environment could allow them to perform everyday tasks faster, with less effort and more security, but above all, that this can prolong their autonomy and independence and contribute to the sufficient quality of life even in their »golden age.« acknowledgements the presented parts of study were funded by norway grants, project no. 4300472/2014 and the government office for development and cohesion policy. we are grateful to all project partners, researchers and co-workers for their contribution and especially to the participants for their willingness to take part in this study. annales kinesiologiae • 7 • 2016 • 2 151 jasna hrovatin, saša pišot, matej plevnik: healthy ageing at home ..., 139–152 references batič, l., pišot, r., tomišič, m., sedmak, m., hrovatin, j., maraž, d., & preglau, m. 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(2003). preventing falls in elderly persons. the new england journal of medicine, 348(1), 42-49. view item https://doi.org/10.1093/ageing/26.3.195 https://doi.org/10.1093/ageing/26.3.195 https://doi.org/10.1016/s0167-4943(98)80015-0 http://dx.doi.org/10.2165/00115677-200311050-00003 https://doi.org/10.1177/0013916596284005 http://www.dlib.si/stream/urn:nbn:si:doc-auqlixa9/8fb54d6d-2f7d-4b11-9d39-92259c7c5b6f/pdf http://dx.doi.org/10.5552/drind.2014.1329 http://doi.org/10.1016/j.amepre.2004.12.002 http://www.stat.si/novica_prikazi.aspx?id=4617 http://doi.org/10.1016/j.jsr.2005.08.001 http://dx.doi.org/10.1056/nejmcp020719 152 jasna hrovatin, saša pišot, matej plevnik: healthy ageing at home ..., 139–152 annales kinesiologiae • 7 • 2016 • 2 tomšič, m. & gunčar, m. (2012). tveganost za padce v domačem okolju [riskiness for falls at home environment]. in m. tomšič (ed.) delovna terapija stroka sedanjosti. zbornik prispevkov z recenzijo (pp 115-122), ljubljana: university of ljubljana: faculty of health sciences. view item torrington, j., barnes, s., mckee, k., morgan, k., & tregenza, p. (2004). the influence of building design on the quality of life of older people. architectural science review, 47(2), 193-197. view item world health organisation. (2002). world health report 2002: reducing risk to health, promoting healthy life. retrieved from http://www.who.int/whr/2002/en/. http://www2.zf.uni-lj.si/ri/publikacije/stroka2012/12.pdf http://dx.doi.org/10.1080/00038628.2004.9697043 http://www.who.int/whr/2002/en/ annales kinesiologiae • 9 • 2018 • 2 149 reports and reviews/poročila in ocene, 135–150 world food day 2018 – conference on “food, nutrition, health” koper, slovenia, 16th and 17th october 2018 under the slogan “we and our environment together” this conference celebrated different milestones along the world food day 2018, namely, 150 years since the publication of the first slovene cookbook by magdalene pleiweis, the 35th anniversary of european centre for peace and development (ecpd, established by the united nations university for peace https://www.ecpd.org.rs/), the 10th anniversary of the european declaration on food, technology and nutrition for health (eftnd, http://eftndeclaration.aaeuropae.org/), and the inauguration of the mediterranean institute for environmental studies (mies) at the science and research centre koper (zrs koper). the conference was jointly organized by ecpd, eftn and zrs koper, hosted by janez podobnik m.d. (director of ecpd ljubljana), prof. peter raspor, double ph.d. (on behalf of eftn ambassadors) and prof. rado pišot, ph.d. (director of zrs koper). the first day of the conference was focused on topics that addressed interesting views on the environmental impact on food production, the connection of food and health, and food and nutrition education in slovenian schools, as well as training of nutritionists. although one session partly covered the issue of food contamination, there was a lack of contrasting topics on underappreciated bioavailable nutritional value of food from the biochemical perspective. illustrative and central were two round-table sessions: the connection between environment, food production and health, moderated by janez podobnik, m.d. and the connection between food, physical activity and health, moderated by prof. rado pišot. both were very well prepared and informative for the public. the second day was more hands-on, intended for the presentation of medium and large enterprises showcasing their food products under the title eat and drink slovenian. the goal of the presentations was also to connect the producers directly to the consumers and political facilitators of development. at the end of the sessions, the presenters joined in a panel and addressed the received questions, which was excellently moderated by janez podobnik, m.d. prof. peter raspor, ph.d., organized an outstanding conference dealing with many aspects of slovenian food (http://danhrane.ecpd.si/). some 60 participants attended the events every day. however, the participation could have been broader since the conference was well-structured and efficiently moderated. we strongly believe that the conference covers topics that would be of interest for various experts on public health and healthy lifestyle, representatives from different ministries and students from the fields of dietetics, nutrition, food-technology and food production. cécil meulenberg 150 reports and reviews/poročila in ocene, 135–150 annales kinesiologiae • 9 • 2018 • 2 svetovni dan hrane 2018 – konferenca »hrana, prehrana, zdravje« koper, slovenija, 16. in 17. oktober 2018 pod sloganom »mi in okolje skupaj« je imela konferenca namen obeležiti svetovni dan hrane, 150 letnico izida prve slovenske kuharske knjige izpod peresa magdalene pleiweis, 35 letnico ustanovitve evropskega centra za mir in razvoj (ecpd) https://www.ecpd.org.rs/ in 10 let evropske deklaracije o hrani in prehrani (eftn) http://eftndeclaration.aaeuropae.org/. hkrati je bil ob tej priložnosti inavguriran tudi mediteranski inštitut za okoljske študije (mios), ki deluje v okviru znanstveno-raziskovalnega središča koper. konferenco so organizirali evropski center za mir in razvoj (ecpd), znanstveno-raziskovalno središče koper (zrs koper) in ambasadorji eftn, ki so jih zastopali janez podobnik, dr. med, direktor mednarodnega inštituta ecpd za trajnostni razvoj ljubljana, prof. dr. rado pišot, direktor zrs koper in prof. ddr. peter raspor, v imenu ambasadorjev eftn. prvi dan konference je bil namenjen sekcijam, ki so obravnavale zanimive poglede na vpliv okolja na pridelavo hrane, povezanost hrane in zdravja ter izobraževanje o hrani in prehrani v slovenskih šolah, pa tudi izobraževanju prehranskih strokovnjakov. vzporedno sta bili organizirani dve okrogli mizi: povezava med okoljem, pridelavo hrane in zdravjem, ki jo je moderiral dr. janez podobnik in povezava med prehranjevanjem, gibanjem in zdravjem, ki jo je moderiral prof. dr. rado pišot. obe okrogli mizi sta bili dobro vodeni in zanimivi. drugi dan konference je bil z naslovom: »jejmo in pijmo slovensko« namenjen predstavitvi manjših in srednje velikih slovenskih proizvajalcev hrane in njihovemu čim bolj neposrednemu povezovanju s potrošniki in s političnimi usmerjevalci razvoja. zadnji del je bil namenjen predstavitvi projektov vezanih na hrano, ki potekajo v sloveniji. konferenca, katere glavni organizator je bil prof. ddr. peter raspor, je predstavila mnoge zanimive in aktualne teme povezane s hrano. približno 60 udeležencev, ki so zastopali znanost, proizvajalce hrane, izobraževanje in politične usmerjevalce razvoja, je bila pravzaprav preskromna udeležba za tako dobro strukturirano in organizirano konferenco. menim, da bi se je lahko udeležilo več strokovnjakov javnega zdravja, promocije zdravja, ministrstev, pa tudi študentov študijskih programov s področja hrane, prehrane in zdravja. nadja plazar annales kinesiologiae • 10 • 2019 • 2 149 reports and reviews/poročila in ocene, 149–154 book review barbara burlingame and sandro dernini (eds): sustainable diets – linking nutrition and food systems cab international, 2019, 280 pages in the scope of the nutrition decade that started in 2016, this monograph addresses, in detail, the united nations food and agriculture organisation’s current definition of sustainable diets from the perspective that ‘those have low environmental impacts which contribute to food and nutrition security and to healthy life for present and future generations. besides, are protective and respectful of biodiversity and ecosystems, culturally acceptale, accessible, economically fair and affordable; nutritionally adequate, safe and healthy; while optimizing natural and human resources’. throughout 29 expert contributions, the current policymaking process regarding the sustainable development goals of the united nations general assembly supported by the world health organisation and their implementation are explained in length. a focus is placed on the right to high quality nutritious food, and the incorporation of safe food and food security into sustainable development. more importantly, it is outlined how to qualitatively and quantitatively approach these challenges through sustainable lifestyles, which the monograph names as diets. the mediterranean diet frequently resurfaces to illustrate a sustainable diet according to this definition. however, there are concerns about the decline of the ‘traditional’ mediterranean diet throughout the mediterranean countries due to various economic and sociocultural factors and globalization of food markets. various chapters describe how to hold on to such lifestyles, which is outlined as a multi-actor responsibility. other chapters describe how to assess lifestlye adherence, and their subsequent environmental, nutritional and sustainable impacts. next to various nutritional dimensions, an indicator concerning the prevalance of physical activity and inactivity is outlined, with the notion that the related questionnaires are difficult to compare across cultures, indicating the limitation of population-based data. it is emphasized that personal inter150 reports and reviews/poročila in ocene, 149–154 annales kinesiologiae • 10 • 2019 • 2 views related to physical activity should be included, and that country-specific sustainable food-based dietary and lifestyle guidelines are needed. in view of the sustainable development goals such as zero hunger, good health and well-being for everyone, with responsible production and consumption, the mediterranean diet is recognized as a lifestyle with a healthier dietary pattern characterized by a lower environmental impact. the international experts contributing to this monograph recognize the role of physical activity therein. but it is for kinesiology and physiotherapy practitioners to emphasize the role of it, and further develop the indicators and present the proof of effectiveness of nutrition combined with physical activity in the breadth of sustainable diets. the issues described in sustainable diets will be of major use in planning effective holistic research as they provide direct links to the existing written policies in order to further intertwine kinesiology and health-related research proposals. cécil j. w. meulenberg annales kinesiologiae • 10 • 2019 • 2 151 reports and reviews/poročila in ocene, 149–154 recenzija knjige barbara burlingame in sandro dernini (ur.): sustainable diets – linking nutrition and food systems cab international, 2019, 280 str. v duhu desetletja ukrepov na področju prehrane, ki se je začelo leta 2016, monografija podrobno predstavlja uveljavljene definicije trajnostnih načinov prehranjevanja organizacije združenih narodov za prehrano in kmetijstvo (un fao). predstavitev izhaja iz stališča, da so trajnostni tisti prehranski sistemi, »ki imajo nizek vpliv na okolje in zagotavljajo varno in kakovostno hrano, dostopno vsem sedanjim in prihodnjim generacijam. poleg tega ohranjajo biotsko raznovrstnost vseh ekosistemov, so kulturno sprejemljivi, ekonomsko pošteni ter dostopni vsem v enaki meri. morajo biti prehrambno ustrezni in s tem zagotavljati zdravje in varnost ter stremeti k optimizaciji naravnih in človeških virov.« v 29 poglavjih zbornika, strokovnjaki poglobljeno predstavijo trenutno stanje na področjih vzpostavljanja ustreznih politik za doseganje ciljev trajnostnega razvoja, ki si jih je zadala generalna skupščina združenih narodov (un ga) in jih podpira svetovna zdravstvena organizacija (who). avtorji se izrecno posvečajo problematiki pravice do ustrezne prehrane ter povezavi med varno in kakovostno prehrano in trajnostnim razvojem. posebno pozornost so posvetili kvalitativnim in kvantitativnim pristopom pri soočanju s tovrstnimi izzivi skozi trajnostni življenjski slog oz. trajnostne prehrambne navade, kot jih poimenujejo avtorji posameznih poglavij. v navezavi na navedene definicije, je kot ilustracija trajnostne prehrane pogosto omenjena sredozemska prehrana, hkrati pa je prisotna tudi zaskrbljenost zaradi postopnega opuščanja ‹tradicionalnega› sredozemskega načina prehranjevanja v sredozemlju, kot posledica različnih ekonomskih, socialnih in kulturnih faktorjev ter globalizacije prehrambnih trgov. več poglavij opisuje aktivnosti, s katerimi bi omogočili nadaljnji obstoj tradicionalnih prehrambnih slogov. avtorji trdijo, da je za doseganje tega cilja nujna aktivacija številnih različnih akterjev. spet druga poglavja opisujejo načine, s katerimi bi bilo mogoče vrednotiti privrženost izbranemu življenjskemu slogu 152 reports and reviews/poročila in ocene, 149–154 annales kinesiologiae • 10 • 2019 • 2 ter iz njega izhajajoči učinek na okolje, prehrano in trajnost. ob mnogih prehranskih indikatorjih, je kot posebej poveden izpostavljen tudi vidik telesne aktivnosti oz. neaktivnosti. ob tem pa je nujno izpostaviti pomislek glede primernosti uporabe tovrstnih vprašalnikov za medkulturne primerjave, kar nakazuje na določene omejitve pri populacijskih študijah. avtorji so opozorili še, da je za pridobivanje relevantnih informacij glede telesne aktivnosti primerna metoda osebnih intervjujev ter da je nujno potrebno zagotoviti priporočila za specifične trajnostne prehrambne in tudi sicer življenjske sloge za vsako državo posebej. v luči nekaterih od ciljev trajnostnega razvoja, kot so odprava lakote, zdravje in dobro počutje za vse ter odgovorna poraba in proizvodnja, je bil prav sredozemski življenjski slog prepoznan kot tisti z bolj zdravim vzorcem prehranjevanja, ki ga hkrati karakterizira nižji vpliv na okolje. mednarodni strokovnjaki, avtorji prispevkov v zborniku, so v vsem tem prepoznali tudi pomen telesne aktivnosti. šele kineziologi in fizioterapevti pa so tisti, ki morajo izpostaviti pravo vlogo telesne aktivnosti ter oblikovati primerne indikatorje, s pomočjo katerih bodo lahko nedvoumno dokazali pozitivne učinke ustrezne prehrane v povezavi s telesno aktivnostjo na stopnjo doseganja zastavljenih ciljev v okviru trajnostnih prehrambnih sistemov. vsebine, ki jih nagovarjajo avtorji v zborniku »sustainable diets«, so lahko v veliko pomoč pri načrtovanju učinkovitih in celostnih raziskav, vsebujejo pa tudi neposredno povezavo do številnih obstoječih priporočil za še intenzivnejši preplet kineziologije in z zdravjem povezanih raziskovalnih predlogov. cécil j.w. meulenberg _goback _goback _hlk23772821 _goback _goback _hlk27564900 _goback bbib0050 bbib0035 _hlk3367923 _goback annales kinesiologiae • 8 • 2017 • 1 15 differences of the tensiomyography-derived biceps femoris muscle contraction time and displacement between different age and fitness groups marko vidnjevič1, rumiana tasheva2, jure urbanc3, urška gašperin4 1alma mater europaea – ecm, maribor, slovenia 2national sports academy (nsa) "vasil levski", sofia, bulgaria 3university of maribor, faculty of education, maribor, slovenia, 4university of primorska, faculty of health sciences, izola, slovenia corresponding author: urška gašperin university of primorska, faculty of health sciences polje 42, 6310 izola, slovenia phone: +386 70 817 689 e-mail: urska.gasperin@gmail.com abstract introduction: the aim of this study was to compare tensiomyography-derived biceps femoris muscle (bf) contraction time (tc) and maximal radial displacement (dm). methods: ninety male participants were divided into three age groups: young adults (ya; 23.7 ± 4.3 years), middle-aged adults (ma; 46.7 ± 5.6 years), and older adults (oa; 64.2 ± 6.5 years). furthermore, the participants were divided in two physical activity groups – the sedentary and those who were regularly engaged in recreational sports activities (at least three times a week). tensiomyography (tmg) method was used to measure the bf dm and tc during isometric single-twitch maximal contraction. results: we found shorter tc in active ya than sedentary ya (p = 0.001). active ya had also shorter tc than active oa (p = 0.046). active ya had also a lower dm than sedentary ya (p = 0.031), while pooled ya showed a trend towards a lower dm than pooled ma (p = 0.073) and pooled oa (p = 0.120). discussion and conclusions: tmg data indicates a transition towards higher slow-twitch muscle fibre type with age and sedentary lifestyle. furthermore, tmg data also indicates a lower muscle tone with age and sedentary lifestyle. data obtained with tmg can be used to assess muscle imbalances in human body, which may be of clinical importance. keywords: tensiomyography, biceps femoris, lifestyle, aging, sport. original scientific article udc: 612.741 received: 2017-03-15 16 marko vidnjevič, rumiana tasheva, jure urbanc, urška gašperin: differences of the ..., 15–22 annales kinesiologiae • 8 • 2017 • 1 z metodo tenziomiografije izmerjene razlike med časom kontrakcije in odmikom mišice med različno starimi in fizično aktivnimi skupinami izvleček uvod: namen pričujoče študije je bil primerjati s tenziomiografsko metodo (tmg) pridobljen čas kontrakcije (tc) in maksimalni odmik (dm) trebuha dvoglave stegenske mišice (bf). metode: devetdeset moških udeležencev je bilo razdeljenih v 3 starostne skupine: mladi odrasli (ya; 23.7 ± 4.3 let), odrasli v srednjih letih (ma; 46.7 ± 5.6 let) in starejši odrasli (oa; 64.2 ± 6.5 let). nadalje so bili udeleženci razdeljeni v 2 skupini glede na rednost ukvarjanja s fizično aktivnostjosedeči in tisti, ki so se redno ukvarjali z rekreativno obliko športne dejavnosti (vsaj 3-krat na teden). metoda tmg je bila uporabljena za merjenje odziva parametrov dm in tc mišice bf na en maksimalni dražljaj. rezultati: ugotovili smo, da imajo aktivni ya krajši tc od sedečih ya (p = 0.001) in tudi krajši tc od aktivnih oa (p = 0.046). aktivni ya imajo nižji dm kot sedeči ya (p = 0.031). za ya je značilen trend nižjega dm v primerjavi z ma (p = 0.073) in z oa (p = 0.120). razprava in zaključki: dobljeni podatki kažejo, da mišica bf z leti in s sedečim načinom življenja postaja počasnejša in manj tonizirana. na osnovi pridobljenih tmg podatkov se lahko oceni mišična neravnovesja v človeškem telesu in rezultate se lahko interpretira tudi v okviru klinične pomembnosti. ključne besede: tenziomiografija, biceps femoris, življenjski slog, staranje, šport introduction the world's population is aging, and the proportion of elderly people keeps increasing. in 2010, the proportion of people aged over 65 years accounted for about 8 % of the world's population. the forecast for 2050 projects that the percentage will increase to 16 %, which will represent some 1.5 billion people (2010 revision of the world population prospects). according to the statistical office of the republic of slovenia (2015), which summarizes eurostat's data projections, it is expected that in the year 2060 a third of slovenians will be aged over 65 years. in 2015, the proportion of slovenians older than 65 amounted to 20 %, whereas it is estimated that this will increase to 30 % in 2060. longer life spans as well as larger proportions of elderly population will likely lead to an increase in the number of diseases that are more prevalent with age. 17 annales kinesiologiae • 8 • 2017 • 1 marko vidnjevič, rumiana tasheva, jure urbanc, urška gašperin: differences of the ..., 15–22 it is clear that physical inactivity significantly contributes to mortality, as the who (2013) reported that over 3.2 million people die each year due to physical inactivity. many non-communicable chronic health conditions, prevailing in developed and developing countries are associated with physical inactivity (blair, sallis, hutber, & archer, 2012; chodzko-zajko et al., 2009; paterson, jones, & rice, 2007). in addition to the higher incidence of these risk factors with aging, a decline in many physiological systems occurs along with the loss of muscle mass, impaired balance, reductions of muscle strength and endurance (sakuma & yamaguchi, 2012) as well as cognitive capacities, all of which impacts functional independence (salthouse, 2003). there are various guidelines for physical activity of people aged 65 years and above: (i) the who's recommends (who, 2010) at least 150 minutes of moderate-intensity aerobic physical activity per week, or at least 75 minutes of high intensity physical activity per week, or an equivalent combination of moderate and high intensity exercise; (ii) the american college of sport medicine (acsm) and the american heart association (aha) recommend 30 minutes of moderate intensity aerobic physical activity 5 times per week, or 20 minutes of high intensity physical activity 3 times per week, or an equivalent combination of moderate and high intensity exercise with a duration of at least 10 minute bouts is recommended (nelson et al., 2007). while who is not specific, the acsm and the aha emphasize that it is also necessary to incorporate strength training twice per week, which should be composed of 8 to 10 exercises with 10 to 15 repetitions and 1 to 2 sets. šimunič, pišot, & rittweger (2009) investigated the age and sport activity type on postural (vl, vastus lateralis) and non-postural (bf, biceps femoris) muscle contraction time in master athletes and non-athletes. authors performed tensiomyographic (tmg) assessment of 35+ years of control group, explosive athletes and endurance athletes. they found that the sport activity type significantly affects contraction time (tc) only in non-postural bf muscle. bf muscle deteriorates in all groups, but least in explosive athletes, which emphasizes strength and power training to maintain skeletal muscle contractile properties. they explained that postural muscles receive enough daily stimuli to be prevented from major deterioration. although they reported tc data, they failed to report maximal displacement of tmg response (dm). therefore, we decided to obtain tmg responses and calculate tc and dm of bf in 3 age groups and 2 fitness groups. we decided to measure bf as, according to valenčič & djordjevič (2002) in djordjevič, rozman, & pišot (2005), there are indications that bf muscle is one of the most sensitive to deterioration or improvement after physical inactivity or age and training, respectively. 18 marko vidnjevič, rumiana tasheva, jure urbanc, urška gašperin: differences of the ..., 15–22 annales kinesiologiae • 8 • 2017 • 1 methods participants ninety male participants were divided into 3 age groups and measured in the laboratory of the institute for kinesiology research in koper, using tmg: young adults (ya), middle-aged adults (ma), and older adults (oa). the selection of participants was based on the following criteria: 15 ya (age: 23.7 ± 4.3 years; body height: 172± 8.0 cm; body mass: 59±10.5kg), 15 ma (age: 46.6 ± 5.6years; body height: 182 ±6.7 cm; body mass: 88±7.0 kg), and 15 oa (age: 64.2 ± 6.5 years; body height: 175±2.6 cm; body mass: 87±5.0 kg). in each group, half of the participants were active 2 to 3 times in organized sport activities, while 15 were not. tensiomyography two contractile parameters, dm and tc of bf muscle were measured in ninety males by tmg (tmg − bmc, ljubljana, slovenia). the measurement point in bf muscle was defined at the midpoint of the line between the fibula head and the ischial tuberosity. positioning the sensor directly on the skin above the muscle belly makes the method sensitive to mechanical displacement of the underlying muscle tissue. the measurements were performed isometrically in relaxed predefined position with fixed joint angle at 5 degrees kneeflexion, with the participants lying on their front. selfadhesive electrodes were placed directly on the muscle belly: the cathode was placed 5 centimetres distally, while the anode was 5 centimetres proximally from the measurement point. the amplitude of the electrical stimulation was gradually increased to get maximal response. from the twitch response, thedm was analysed in mm and tc was calculated in ms as time of the response reaching from 10 % to 90 % of the maximal amplitude. statistics all data are presented with mean values (± sd). after checking for normality of distribution with visual inspection, we proceeded with 3 x 2 analysis of variance with post hoc t-tests for independent samples and using bonferroni corrections. all decisions were accepted with alpha set at 0.05. results in table 1 we found shortest tc in active ya that is increasing with age (p = 0.003) and lifestyle groups (p = 0.041). dm was found to be higher in active ya than in se19 annales kinesiologiae • 8 • 2017 • 1 marko vidnjevič, rumiana tasheva, jure urbanc, urška gašperin: differences of the ..., 15–22 dentary ya (p = 0.031). post hoc analysis revealed also shorter tc in active ya than in sedentary ya (p = 0.001). active ya had also shorter tc than active oa (p = 0.046). active ya had also lower dm than sedentary ya (p = 0.031), while pooled ya has trend towards lower dm than pooled ma (p = 0.073) and pooled oa (p = 0.120). table i: comparison between active / sedentary participants of three age groups in bf contraction time and maximal displacement. age group lifestyle group contraction time (ms) displacement (mm) young adults active 26.2 ± 10.2 5.5 ± 1.1 sedentary 49.0 ± 11.7 8.8 ± 4.3 middle-age adults active 35.2 ± 16.4 6.4 ± 2.1 sedentary 42.8 ± 17.2 6.4 ± 2.5 older adults active 33.6 ± 4.6 6.0 ± 2.5 sedentary 37.8 ± 7.1 5.9 ± 1.1 discussion it is well established that aging leads to progressive changes in the human body, which causes a loss of muscle function, weakness, disease and death. older people are also the most sedentary and physically inactive segment of society, according to certain evidence (paterson & warburton, 2010), therefore, it is hard to study the aging effect solely, independently of physical activity or fitness level. therefore, it is important to study different age groups but levelled on physical or sport activity. there are differences in skeletal muscles between physically active and inactive people, as evident in muscle composition analysis conducted with tmg. this method enables easy as well as selective measurements of contractile properties of the muscle belly and was recently shown to be a valid, repeatable and non-invasive assessment of muscle composition (šimunič et al., 2011; šimunič, 2012; šimunič, 2015). comparison of dm between active / sedentary participants the biggest differences are between active and sedentary ya. ya have expectedly lowest dm, which indicates the highest bf tone. pišot et al. (2008) provided evidence that dm reflects physical activity or inactivity and demonstrated that dm increases after acute muscle atrophy. there were no differences in dm regarding the lifestyle between 20 marko vidnjevič, rumiana tasheva, jure urbanc, urška gašperin: differences of the ..., 15–22 annales kinesiologiae • 8 • 2017 • 1 ma and oa. pišot et al. (2008) further explained that the smaller the dm value before bed rest, the larger the change induced by bed rest, which puts tmg amplitude dm as a measure of muscle belly stiffness. comparison of tc between active / sedentary participants shortest tc was in active ya and was getting higher with age and sedentary lifestyle. tc reflects muscle composition, whereas shorter tc indicates lower proportion of myosin heavy chain type 1 (šimunič et al., 2011). šimunič, pišot, rittweger, and mekjavić (2008) found that bf muscle deteriorates in much greater scale than vl with age and sport group and they evaluated this with tc calculated from mechanical response of muscle belly, using tmg. the data obtained highlighted the importance of physical / sports activity and the importance of tmg as method of evaluating muscles status and as method for monitoring the effects of pa on the physical fitness of people. based on the data obtained it would be possible to choose the most optimal training method and the means to plan and modify the physical preparation of the individual or of homogenous groups and such adjusted physical / sporting activity can improve their physical condition. it consequently improves physical health of people and especially in elderly it contributes to increased stability, autonomy, mobility, self-confidence when moving, which has a great impact on both well-being and satisfaction of older adults. it is well known that regular physical activity and exercise are beneficial for physical and mental health. hence, it is important that people consider this already in their younger age and educate themselves about the positive effects of being active, the importance of maintaining motor abilities as well as the value of quality of life in older age. without data on movement, physical, physiological and biochemical characteristics, it is difficult to accurately design, programme and model exercise, adapted to the needs of individuals of a certain age and capacity. conclusion in conclusion, tc and dm were found to be sensitive of age and fitness level in our participants. that makes tmg useful for a variety of purposes. since tmg data correlates to muscle composition and muscle atrophy, it makes tmg useful in the field of aging, preventive assessment, sport training, rehabilitation, etc. 21 annales kinesiologiae • 8 • 2017 • 1 marko vidnjevič, rumiana tasheva, jure urbanc, urška gašperin: differences of the ..., 15–22 references blair, s., sallis, r., hutber, a., & archer, e. 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(2002). maximal velocity and biceps femoris muscle contraction time dependence tensiomyographic analysis in elite sprinters. salzburg: european college of sport science (ecss). in djordjevič s., rozman, s. & pišot, r. (2005). monitoring of biceps femoris (bf) activation pattern changes between maximal and supramaximal sprints. book of abstracts of the 10th annual congress of the european college of sport science in belgrade, serbia from 13-16 july 2005. who world health organisation (2010). global recommendations on physical activity for health. isbn 978-92-4-159-997-9. retrieved from http://www.who.int/dietphysicalactivity/global-pa-recs-2010.pdf who world health organisation (2013). global strategy on diet, physical activity and health. retrieved from http://www.who.int/dietphysicalactivity/factsheet_inactivity/en/ index.html http://www.stat.si/statweb/en/news/index/5477 http://www.un.org/en/development/desa/population/publications/pdf/trends/wpp2010/wpp2010_volume-i_comprehensive-tables.pdf http://www.un.org/en/development/desa/population/publications/pdf/trends/wpp2010/wpp2010_volume-i_comprehensive-tables.pdf http://www.who.int/dietphysicalactivity/global-pa-recs-2010.pdf http://www.who.int/dietphysicalactivity/global-pa-recs-2010.pdf http://www.who.int/dietphysicalactivity/factsheet_inactivity/en/index.html http://www.who.int/dietphysicalactivity/factsheet_inactivity/en/index.html _goback _goback _goback _hlk501362470 _hlk501363405 _hlk501369360 annales kinesiologiae • 10 • 2019 • 1 79 reports and reviews/poročila in ocene, 73–80 research exchange at one of the top american institutions − university of michigan uroš marušič, ph.d. employed at the science and research centre koper and alma mater europaea-european center, maribor, visited the functional neuroimaging, cognition and mobility laboratory at one of the most prestigious and biggest higher education institutions in the usa, the university of michigan (http://pdresearch.rad.med. umich.edu/). the exchange was carried out within the framework of the operation “mobility of higher education teachers ameu-ecm 2018-2021” funded by the ministry of education, science and sport, between september 2018 and february 2019. according to shanghai ranking score, the university of michigan ranks the 20th among all universities in the world (http://www.shanghairanking.com/arwu2019.html). marušič was actively involved in the laboratory work of nicolaas bohnen, md, ph.d., and martin muller, ph.d., who are proactive in the research area of postural instability and mobility difficulties of parkinson’s disease patients. their studies successfully combine behavior with neuroimaging data, especially with positron emission tomography (pet) and cholinergic receptors. in the framework of this exchange, researchers have recently published the common research manuscript: müller, m. l., marusic, u., van emde boas, m., weiss, d., & bohnen, n. i. (2019). treatment options for postural instability and gait difficulties in parkinson’s disease. expert review of neurotherapeutics, 19(12), 1229-1251. https://doi.org/10.1080/14737175.2019.165 6067. during the exchange at the university of michigan, marušič also dived into the field of neuroergonomics, where he successfully completed the study with elderly patients with type 2 diabetes. parallel with his intensive research work, marušič delivered numerous lectures at the university of michigan medical school for undergraduate, doctoral and postdoctoral students. the exchange in the usa has brought many positive effects for both institutions. namely, in the period between april and october 2019, a joint neuroergonomic study kogis (cognitive and motor benefits of standing) was conducted at the mediterranean health centre (zrs koper), where researchers examined new possibilities for ergonomic arrangement of office workers and consequently the effects of newly developed ergonomic worktables on musculoskeletal discomfort, brain electrocortical activity, cognitive ability and work efficiency. uroš marušič http://pdresearch.rad.med.umich.edu/ http://pdresearch.rad.med.umich.edu/ http://www.shanghairanking.com/arwu2019.html https://doi.org/10.1080/14737175.2019.1656067 https://doi.org/10.1080/14737175.2019.1656067 https://www.zrs-kp.si/index.php/en/institutes-units/mhc/ https://www.zrs-kp.si/index.php/en/institutes-units/mhc/ 80 reports and reviews/poročila in ocene, 73–80 annales kinesiologiae • 10 • 2019 • 1 izmenjava na eni vodilnih ameriških univerz univerza v michigan-u raziskovalec znanstveno-raziskovalnega središča koper in alma mater europaea-e, se je v sklopu razpisa »mobilnost slovenskih visokošolskih učiteljev 2018-2021« ministrstva za izobraževanje, znanost in šport, med septembrom 2018 in februarjem 2019 mudil na eni največjih in najprestižnejših ameriških visokošolskih institucij, univerzi v michigan-u (ann arbor, michigan, zda), natančneje v laboratoriju za funkcionalno možgansko slikanje, kognicijo in mobilnost (http://pdresearch.rad.med.umich.edu/). na shanghaiski lestvici najboljših 500 univerz na svetu, je univerza v michiganu uvrščena na prestižno 20. mesto (http://www.shanghairanking.com/arwu2019.html). dr. marušič je raziskoval v laboratoriju prof. dr. nicolaas-a bohnen-a in dr. martina müller-ja, ki delujeta predvsem na področjih posturalne nestabilnosti in težav mobilnosti pri parkinsonovih bolnikih ter v svojih raziskavah uspešno primerjata vedenjske vzorce z rezultati možganskih slik, predvsem pozitronske emisijske tomografije (pet) in holinergičnih receptorjev. v sklopu izmenjave so raziskovalci objavili skupni pregledni članek: müller, m. l., marusic, u., van emde boas, m., weiss, d., & bohnen, n. i. (2019). treatment options for postural instability and gait difficulties in parkinson’s disease. expert review of neurotherapeutics, 19(12), 1229-1251. https://doi.org/1 0.1080/14737175.2019.1656067. dr. marušič se je med izmenjavo na univerzi v michiganu poglobil tudi v področje nevroergonomije, kjer je uspešno zaključil študijo na pacientih s sladkorno boleznijo tipa 2. vzporedno z intenzivnim raziskovalnim delom je dr. marušič izvedel številna predavanja za dodiplomske, doktorske in podoktorske študente v sklopu medicinske fakultete univerze v michiganu. izmenjava v zda je prinesla številne pozitivne učinke za obe inštituciji. tako je že v obdobju od aprila do oktobra 2019 potekala skupna nevroergonomska raziskava kogis (kognitivne in gibalne prednosti stoječega delovnega mesta) v mediteranskem centru zdravja zrs koper, v okviru katere smo preverjali nove možnosti ergonomske ureditve delovnih mest pisarniških delavcev in posledične učinke novo razvite ergonomske delovne mize na skeletno-mišično neugodje, možgansko elektrokortikalno aktivnost, kognitivne sposobnosti in delovno učinkovitost. uroš marušič http://pdresearch.rad.med.umich.edu/ http://www.shanghairanking.com/arwu2019.html https://doi.org/10.1080/14737175.2019.1656067 https://doi.org/10.1080/14737175.2019.1656067 https://www.zrs-kp.si/index.php/research-2/mcz/ https://www.zrs-kp.si/index.php/research-2/mcz/ _goback _hlk3367923 _goback _goback _goback _hlk3056869 _goback _goback _hlk23766418 _goback _hlk26527070 _goback _goback annales kinesiologiae • 8 • 2017 • 1 23 review article udc: 796.011:616-053.9 received: 2017-07-03 exercise and the ageing immune system ana petelin1, nina mohorko1 1university of primorska, faculty of health sciences, polje 42, si-6310 izola, slovenia corresponding author: nina mohorko university of primorska, faculty of health sciences, polje 42, 6310 izola, slovenia. tel.: +386 5 66 35 802 e-mail: nina.mohorko@fvz.upr.si abstract life expectancy in the developed world has increased exponentially over the last century. there is now a strong body of evidence demonstrating that aging is accompanied by severe alterations in the immune system, a process known as “immunosenescence”, commonly defined as the functional decline of the adaptive immune system with age. inflamm-aging, a chronic progressive increase in the inflammatory status has attracted great attention in recent years in age-related research field. this process plays an important role in the age-related diseases, such as heart disease, atherosclerosis, alzheimer’s disease, type ii diabetes, among others. exercise impacts immune function both acutely and chronically. this article describes how exercise activates the release of hormones, myokines and cytokines, as well as modulates the expression of various immune-reactive molecules, which all contribute to anti-inflammatory effects and possible attenuation of immunosenescence. keywords: immunosenescence, inflamm-aging, exercise gibanje in imunski sistem med procesom staranja izvleček v zadnjem stoletju je pričakovana življenjska doba v zahodnem svetu eksponentno narasla. staranje spremljajo velike spremembe v imunskem sistemu. ta proces, ime24 ana petelin, nina mohorko: exercise and the ageing immune system ..., 23–32 annales kinesiologiae • 8 • 2017 • 1 novan imunosenescenca, je definiran kot funkcionalni upad adaptivnega imunskega sistema s staranjem. za staranje je značilno tudi progresivno naraščanje vnetja, ki ima pomembno vlogo pri s staranjem povezanih boleznih, kot so bolezni srca, ateroskleroza, alzheimerjeva bolezen, sladkorna bolezen tipa 2 in druge. gibanje vpliva na imunski sistem tako akutno kot kronično. gibanje povzroči sproščanje hormonov, miokinov in citokinov in spremeni ekspresijo različnih z imunostjo povezanih molekul, kar vpliva na protivnetne učinke in zmanjšanje imunosenescence, kar opisuje članek. ključne besede: imunosenescenca, s staranjem povezano kronično vnetje, gibanje introduction life expectancy in the developed world has increased exponentially over the last century. there is now a strong body of evidence demonstrating that aging is accompanied by severe alterations in the immune system, a process known as “immunosenescence”, commonly defined as the functional decline of the adaptive immune system with age. indeed, according to arnold et al. (2011), the assurance of longevity and healthy aging occurs by maintaining the integrity of immunity. the worldwide increase of the proportion of people older than 65 years has led to the rising costs of age-related diseases; therefore, a better understanding of immunosenescence could help us to limit the development and progression of age-related diseases. immunosenescence results from the accumulation of molecular and cellular defects due to thymic involution (the age-related reduction in thymus size and activity), oxidative damage, and hyper stimulation of both the innate and adaptive immune system. thymic involution results in significant exhaustion of naive t cells, and the shrinkage of the t-cell repertoire (nguyen, mendelsohn, & larrick, 2017). moreover, the progressive functional b lymphocyte deficits have also been suggested as the main responsible factors for age-associated disorders (gruver, hudson, & sempowski 2007). however, in general, all immune cells are affected by aging, but the adaptive response seems to be more affected by the age-related changes in the immune system (franceschi, bonafè, & valensin, 2000). poor immune function in elderly combined with continued exposure to antigens, results in chronic activation of macrophages and other pro-inflammatory cells and contributes to chronic low-level systemic inflammation common in older age (franceschi et al., 2000). inflammation, oxidative stress and aging chronic low-grade systemic inflammation is a common manifestation of aging. while acute inflammation is normally tightly controlled and is a part of the common physiological healing processes, low-grade systemic inflammation describes a chronic, annales kinesiologiae • 8 • 2017 • 1 25 ana petelin, nina mohorko: exercise and the ageing immune system ..., 23–32 mostly asymptomatic, low-grade inflammatory state that can eventually lead to chronic illness in the elderly such as cardiovascular diseases (cvd), diabetes, osteoarthritis, obesity, physical disability, alzheimer’s disease (ad), sarcopenia, among others (singh & newman, 2011). but, as with all other physiological systems, with aging there are also significant declines in the immune function that promote inflammation (chung et al., 2009). age-related chronic inflammation is often attributed to the immune system (franceschi et al., 2000; vasto et al., 2007), because as we age, we accumulate an “antigenic burden,” the sum of all the antigenic stresses (both internal and external) that we unavoidably encounter throughout life, which causes the progressive activation of macrophages and other immune-cell types. this low-level chronic activation leads to the continuous production of inflammatory factors such as cytokines and chemokines, which raises the basal levels of these factors throughout the body. this process, termed “inflamm-aging” has been thoroughly described elsewhere and is supported by a substantial body of data (franceschi et al., 2000; singh & newman, 2011). indeed, 2-4 fold increase in the primarily serum levels of pro-inflammatory cytokines such as interleukine-7 (il-7), il-6, tumor necrosis factor-α (tnf-α) and acute phase proteins such as c-reactive protein (crp) are typical for aged individuals when compared to younger individuals, even in the absence of chronic diseases (bruunsgaard, 2006; vasto et al., 2007; xia et al., 2016). thus, circulating levels of inflammatory mediators such as il-6 and crp have been found to be useful prognostic markers in very old people (jylhä et al., 2007; singh & newman, 2011). indeed, elevated levels of il-6 and tnf-α in the serum of elderly have been found to be associated with some diseases (de martinis, franceschi, monti, & ginaldi, 2005). il-6 is a proand anti-inflammatory cytokine produced by the cells of the immune system, vascular endothelial cells, adipocytes, and skeletal muscles. another cytokine, tnf-α is produced mainly by macrophages, but also by vascular endothelial cells, adipocytes, and some others, and has been shown to increase muscle protein degradation and impair muscle protein synthesis. its elevated levels have been observed in many inflammatory diseases, such as osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, idiopathic inflammatory myopathies, metabolic syndrome, type 2 diabetes mellitus and congestive heart failure (thomas, 2013). crp is an acute phase protein produced by the liver and its levels are up-regulated in response to elevation in il-6 (singh & newman, 2011). the exact mechanism for the increase in pro-inflammatory cytokines with age is still not fully understood. accumulating evidence indicates that obesity and systemic inflammation are highly interrelated. obesity is associated with diabetes and cvd as well as growing number of other diseases with inflammatory components including dementia and cancer (knight, 2011). adipose tissue (at) acts as an endocrine organ by releasing some pro and anti-inflammatory cytokines, which originate from adipose cells and/or infiltrated macrophages (ouchi, parker, lugus, & walsh, 2011). at is infiltrated with macrophages in two separate polarization states: m1, which produce pro-inflammatory cytokines and m2, producing anti-inflammatory cytokines. therefore, it has been proposed that in at a phenotypic switch takes place toward macrophages of the m1-phenotype, promoting the inflammatory state (reviewed in müller & pawelec, 2014). 26 ana petelin, nina mohorko: exercise and the ageing immune system ..., 23–32 annales kinesiologiae • 8 • 2017 • 1 moreover, increases in oxidative stress with aging may also contribute to the development of chronic inflammation and disease (cannizzo et al., 2011). there are several potential mechanisms linking oxidative stress to inflammation (xia et al., 2016). aging is associated with increases in both tissue and circulating levels of reactive oxygen species (ros) as well as a decline in antioxidant capacity (kregel & zhang, 2007). to protect itself, organisms have developed various antioxidative defenses that include superoxide dismutase (sod), glutathione (gsh) peroxidase, and catalase, as well as non-enzymatic ros scavengers, vitamin e, vitamin c, and uric acid (lykkesfeldt, hagen, vinarsky, & ames, 1998). among all this, gsh is the most abundant and effective biological anti-oxidative reductant (cross et al., 1997). ros cause both oxidative damage and elicit release of additional “inflamm-aging-cytokines” perpetuating a vicious cycle. recently, it has been shown that ros activation of toll-like receptors on a variety of immune cells play an important role in activating the inflammatory cascade (gill, tsung, & billiar, 2010). therefore, the continual presence of circulating pro-inflammatory factors may keep the immune system in a state of chronic low-level activation and eventually this chronic immune activation causes immunosenesence. moreover, low-grade chronic inflammation has also been related to frailty, defined as an increased vulnerability to stress in old age (hubbard, o'mahony, savva, calver, & woodhouse, 2009). frailty results from the accumulation of functional declines in multiple systems that decrease overall physiological reserve leading to weight loss, especially loss of muscle, reduced strength and endurance, and overall poor physical function (fried et al., 2001). sarcopenia, one of the most noticeable changes occurring in elderly, is defined as the age-related loss of muscle mass, strength and function and is a major component of frailty and a risk factor for disability outcomes (lang et al., 2010). it has been shown by visser et al. (2002) that older people with high cytokine levels (il-6 and tnf-α) have a tendency to develop sarcopenia (visser et al., 2002). in addition, a growing body of literature indicates that inflammatory processes are also related to cognitive decline and the development of dementia, including the vascular and alzheimer’s types (yaffe et al., 2003; engelhart et al., 2004). acute effects of exercise as aging is an inevitable process, there is a lot of interest in certain strategies that would reduce age-related inflammation and may therefore improve the quality of life in older adults. as such, there has been recent interest in the manipulation of certain lifestyle factors like increasing physical activity levels, as a way of moderating the effects of aging on the immune system. regular exercise is recommended for older people for a variety of reasons including increasing muscle mass and reducing risk for chronic diseases of the heart and metabolic systems. acutely, exercise induces local and systemic cytokine responses in skeletal muscle. effects of different types of exercise and different intensities on inflammation in inflammatory conditions were reviewed by thomas (2013). eccentric exercise causes annales kinesiologiae • 8 • 2017 • 1 27 ana petelin, nina mohorko: exercise and the ageing immune system ..., 23–32 greater muscle damage than concentric and seems to be associated with higher interleukine-6 expression, higher serum creatine kinase and greater recruitment of monocytes, dendritic cells, and memory t cells to sites of infection and injury, although results vary due to differences in the participants' training status, exercise protocols and sampling times. furthermore, exercise intensity governs the amount of the inflammatory response that follows the exercise bout: while strenuous high-intensity exercise increases tnf-α level, low intensity exercise, if sustained over time, decreases tnf-α level (thomas, 2013). in a study of acute effect of walking for four consecutive days at a self-selected pace for 30 km a day in twenty octogenarians, changes in immune cell numbers and functions were observed with an emphasis on response of cd4+ t cells, rather than cd8+ t cells or nk cells (van der geest et al., 2017), with naïve cd4+ subsets dominating the cd4+ t cell compartment. impact of chronic physical activity on inflammatory and oxidative status it has been shown that lifelong physical activity is associated with increased lifespan, lower risk of functional and cognitive impairment, and lower levels of inflammatory markers in older adults (simpson & guy, 2010). exercise has also been reported to favorably impact immune function (simpson & guy, 2010). repeated bouts of exercise seem to have a protective effect on the inflammatory response in patients with inflammatory conditions, which might have an important role in skeletal muscle adaptation (thomas, 2013). therefore, reducing inflamm-aging via exercise could be an efficient therapeutic approach to either prevent or delay the onset of those chronic diseases associated with low-grade chronic inflammation and thus reduce frailty and mortality in the elderly. some cross sectional studies have shown an association between low-grade inflammation and physical inactivity in healthy older subjects (pedersen & bruusgard, 2003; colbert et al., 2004). in our study of complete inactivity, we observed increased inflammation after 14 days of bed rest (jurdana et al., 2015). the inflammatory response differed between elderly and young subjects: the elderly group responded to 14-days complete inactivity by pronounced increases in il-6 and tnf-α while for the young subjects the tnf-α levels did not change and il-6 levels decreased. moreover, regular exercise training has been shown to reduce circulating levels of tnf-α, il-6, and crp in a population of healthy older adults (colbert et al., 2004, nicklas et al., 2008; phillips, flynn, mcfarlin, stewart, & timmerman, 2010; woods, wilund, martin, & kistler, 2012). the exact mechanism for reducing the levels of inflammatory markers by physical activity is not clear, but some possible mechanisms have been proposed for the anti-inflammatory effects of exercise (gleeson et al., 2011). the anti-inflammatory effects of regular exercise may be mediated via reduction in visceral fat mass. regular exercise reduces fat mass and at inflammation, both known to contribute to systemic inflamma28 ana petelin, nina mohorko: exercise and the ageing immune system ..., 23–32 annales kinesiologiae • 8 • 2017 • 1 tion (calder et al., 2011). independently of losses of fat mass, exercise also increases muscle production of il-6. in contrast to what occurs in sepsis, contracting muscle produces il-6 independently of tnf-α (there is, in fact, no tnf-α increase during exercise), which suggests the cytokine cascades in the contracting muscle are markedly different from those during infection (pedersen & febbraio, 2008). exercise derived il-6 is considered to possess a central role in anti-inflammatory activities and to be responsible for reducing tnf-α production – and increase anti-inflammatory cytokines, as for example anti-inflammatory adiponectin (starkie, ostrowski, jauffred, febbraio, & pedersen, 2003). in addition, the anti-inflammatory effects of regular exercise may be mediated via increased production and release of anti-inflammatory cytokines, or reduced expression of toll-like receptors on monocytes and macrophages (gleeson et al., 2011; singh & newman, 2011). moreover, increases in antioxidant capabilities with regular exercise may prevent cellular dna and structural damage from attacking ros thus preventing premature biological aging of specific immune cells (mota et al., 2010). for example, it has been shown that proper physical exercise blunts the age-related decrease of gsh the body’s major anti-oxidative reductant (carter at al., 2007). as mentioned above, ad is also associated with chronic low-grade inflammation. physical activity influences inflammation, and both affect brain structure and ad. indeed, higher levels of physical activity have been associated with al lower risk of developing ad (luck et al., 2013). although the main mechanism for this reduced risk is still unclear, physical activity may be associated with lower brain amyloid levels in humans (liang et al., 2010; head et al., 2012; brown et al., 2013). further, while imaging techniques in humans showed that exercise positively correlated with brain-derived neurotrophic factor (a marker of adult neurogenesis), spatial memory, and various cognitive functions (voss, vivar, kramer, & van praag, 2013), enhanced neurogenesis due to exercise was directly shown in rodent studies (voss et al, 2013). although it is possible that exercise as part of lifestyle acts to prevent or treat immunosenescence, there is no clear answer to this question thus far. however, several interventions, including different types of exercises, have been proposed to restore immune function in elderly people. it has been shown that moderate exercise training might up-regulate monocytes and dendritic cells, thereby possibly improving t-cell mediated immunity in elderly (shimizu et al., 2008; schimizu et al., 2011). moreover, it has been shown, that regular exercise is associated with improved immune responsiveness to influenza vaccination in elderly (kohut & senchina, 2004; woods et al., 2009). thus, the accumulated data thus far suggest that exercise may be a powerful approach to restoring immune function in elderly people. conclusions taken together, we conclude that physical activity, such as regular exercise, activates the release of hormones, myokines and cytokines, as well as modulates the expression of various immune-reactive molecules, which all contribute to anti-inflammatory annales kinesiologiae • 8 • 2017 • 1 29 ana petelin, nina mohorko: exercise and the ageing immune system ..., 23–32 effects and possible the attenuation of immunosenescence. moreover, the reduction of visceral fat mass alone already leads to a decreased production and release of pro-inflammatory adipokines from fat tissue. therefore, lifestyle attitudes, particularly aerobic exercise in the elderly may provide low cost and long-term ways to limit inflammation and slow declines in the elderly. references arnold, c. r., wolf, j., brunner, s., herndler-brandstetter, d., & grubeck-loebenstein, b. 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http://dx.doi.org/10.1155/2016/8426874 _goback _goback _goback _hlk501362470 _hlk501363405 _hlk501369360 annales kinesiologiae • 11 • 2020 • 2 99 playing, then and now – differences in time and elements of play from parents’ perspective ranko rajović1, vanja ković2, dragana berić3 1 university of primorska, faculty of education, koper, slovenia 2 faculty of philosophy, department of psychology, university of belgrade, serbia 3 faculty of sport and physical education, university of niš, serbia corresponding author: ranko rajović, university of primorska, faculty of education, cankarjeva 5, 6000 koper, slovenia tel.: +386 70 576 706 e-mail: ranko.ntc@gmail.com abstract the question how the general trend toward physical inactivity and sedentary behavior affects children’s capabilities and cognitive skills is becoming increasingly important. the aim of this study was to compare children’s play time with parents’ play time at their child’s age, as well as the elements of play. a survey was conducted among parents of children aged 6 to 8 years. the results of the survey, which was based on a sample of 37 parents, showed that a child nowadays spends more time playing at home (110 minutes/day on average compared to the 96 minutes/day their parents played as children) and, conversely, with a statistically significant difference, only half the time their parents did playing outside (96 minutes/day on average compared to the 157 minutes/day on average that their parents spent at the same age). we also found a statistically significant difference in screen time in children today (93 minutes/day on average), which is three times as much as it used to be in their parents at that age. differences were also evident in activities involving elements of rotation, balance, and dynamic accommodation, with most children now spending 0-15 minutes/day compared to parents who used to spend an hour or more on similar activities. for activities based on fine motor skills, half of the children nowadays spend 15-30 minutes/day, whereas half of the parents used to spend an hour or more. the contemporary lifestyle that is highly sedentary can affect many aspects of children’s play. the paper discusses differences of play in the time dimension and possible consequences of such behavior for child development. keywords: motor skills, play, cognitive development, childhood, leisure time. original scientific article doi: https://doi.org/10.35469/ak.2020.150 received: 2017-05-31 udc: 796.11 100 ranko rajović, vanja ković, dragana berić: play then and now ..., 99–119 annales kinesiologiae • 11 • 2020 • 2 igra nekoč in danes – razlika v času in elementih igre iz perspektive staršev izvleček vprašanje trenda vpliva telesne neaktivnosti in sedentarnega življenjskega sloga otrok na njihov splošni razvoj in kognitivne sposobnosti, postaja iz dneva v dan bolj pomembno. za boljše razumevanje tega fenomena in podrobnejši vpogled v splošne trende preživljanja prostega časa pri otrocih, je bila izvedena raziskava med starši otrok, starih od 6 do 8 let. namen raziskave je bila primerjava časa, namenjenega igri in posameznim elementom igre pri otrocih, s časom, ki so ga igri namenili njihovi starši, ko so bili stari toliko, kot njihovi otroci. pri vzorcu 37 staršev otrok, starih od 6 do 8 let je bilo ugotovljeno, da otroci danes igri doma namenijo v povprečju 110 min/ dan, medtem ko so starši v njihovih letih domači igri namenili povprečno 96 min/dan, kar ni statistično pomembno. na drugi strani pa otroci danes igri na prostem namenijo v povprečju 96 min/dan, medtem ko so njihovi starši tej vrsti igre povprečno namenjali 157 min/dan, kar je skoraj dvakrat več in torej očitna, statistično pomembna razlika. otroci danes preživijo v povprečju 93 min/dan pred ekrani, kar je trikrat toliko časa, kot so ga temu namenjali starši v njihovih letih (povprečno 30 min), in je statistično pomembno. pri aktivnostih, ki vsebujejo elemente rotacijskega gibanja, ravnotežja in dinamičnega prilagajanja očesa, večina otrok danes preživi 0‒15 min, medtem ko so njihovi starši tovrstnim aktivnostim namenjali v povprečju uro ali več. aktivnostim na osnovi fine motorike polovica otrok nameni 15–30 min, medtem ko je polovica staršev tem aktivnostim namenila vsaj eno uro časa ali celo več. sodobni življenjski slog, ki na eni strani vključuje malo gibanja in telesnih aktivnosti, na drugi strani pa precej časa, preživetega pred ekrani, lahko vpliva na številne aspekte otrokovega razvoja. članek obravnava posledice tovrstnega vedenja in morebitne načine za preprečevanje tega naraščajočega trenda. ključne besede: gibalne sposobnosti, igra, kognitivni razvoj, otroštvo, prosti čas. annales kinesiologiae • 11 • 2020 • 2 101 ranko rajović, vanja ković, dragana berić: play then and now ..., 99–119 introduction currently, schoolteachers estimate children’s abilities (motor skills, attention, and concentration) to be significantly lower than those of previous generations of children (rajović, rajović, kovačić, & dajčman, 2016). one of the reasons for that could be the contemporary lifestyle that includes a lower level of physical activity (pa). an increasing number of teachers and experts share this opinion, which could be justified by numerous studies which have shown that the prevalence of certain neurodevelopmental disorders has increased over the past four decades (u.s. environmental protection agency, 2015, p. 233). in comparison to previous generations, a changing trend has been observed with regard to developmental problems, such as speech disorders, dyslexia, dysgraphia, and disorders associated with attention deficit, and behavior, emotional and impulse control. educators and paediatricians report a rise in the number of schoolchildren with behavioral and learning disorders (u.s. environmental protection agency, 2015, p. 233). several studies carried out in the past 10 years in the countries of former yugoslavia have shown that an increasing number of children have flat feet. research conducted in ljubljana, slovenia, on a sample of 127 children aged three years, showed that 72% of the respondents had fallen arches (videmšek, klopčič, štihec, & karpljuk, 2006). in novi sad, serbia, it was found that in a sample of 377 children aged six, only 31.66% of them had healthy feet (milošević & obradović, 2008). all these issues indicate a persistent and progressive problem that has not been fully understood yet. the most intense period of synaptogenesis occurs in the first few years of life and pet imaging studies reveal that overall brain metabolism rises to twice the level in adults by 4–5 years of age and remains high until 9–10 years of age. the first two years of human life are marked by rapid elaboration of neural processes and synaptogenesis, followed by a so-called “plateau” phase of development (horska, kaufmann, brant, naidu, harris, & barker, 2002). although brain size between the ages of two and five years does not change much, myelination and synaptic remodeling are particularly active during this so-called “plateau” phase of development (tau & peterson, 2010). such findings help us understand the importance of childhood and especially the first few years of life for brain development. however, it is becoming increasingly evident that one of the main issues of contemporary lifestyle is sedentary behavior, more generally lack of physical activity, and consequent deterioration of child development and health. it is often forgotten that physical activity is a necessity and not a luxury. until the age of twelve, the human brain goes through intensive developmental stages. children possess enormous energy that is biologically given to them for movement, through which important brain functions develop, structures interconnect and new neural pathways form. through complex movements like walking uphill and downhill, skipping, jumping, rolling, running, climbing, tumbling, etc., a child prepares for life by developing basic biological functions. the human organism has a very difficult task maintaining homeostasis in ages marked by rapid change. some consequences are more, and some less obvious, but it is a fact that a sedentary lifestyle is responsible for a growing num102 ranko rajović, vanja ković, dragana berić: play then and now ..., 99–119 annales kinesiologiae • 11 • 2020 • 2 ber of diseases and disorders suffered in modern society. sedentary behavior in children, and particularly increasing screen time, has been linked to inadequate cardiorespiratory fitness (sandercock & ogunleye, 2013), high bmi (ullrich-french, power, daratha, bindler, & steele 2010), diabetes type ii (henderson et al., 2012), hypertension (martinez-gomez, tucker, heelan, welk, & eisenmann, 2009), asthma (protudjer, kozyrskyj, mcgavock, ramsey, & becker, 2012), adhd (christakis, 2009), and poor executive functions (lillard, drell, richey, boguszewski, & smith, 2015). moreover, the level of aerobic fitness in children is directly correlated to the volume of certain brain structures, such as basal ganglia, as well as to children’s cognitive abilities, such as attention and cognitive control (chaddock et al., 2010). the idea that there is a connection between motor and cognitive development is not radically new. in 1953, piaget suggested the importance of sensorimotor experience for the development of cognitive abilities (piaget, 1953). if we look at a simple analogy, living beings that do not move don’t have nerve cells and a nervous system, and species that move have a nervous system, then important characteristics of the human include their upright gait and motor movement. this is particularly important for children because their brains develop rapidly until the age of five, and the reason why walking and running must be one of a child’s main activities (rajović, 2010). a growing body of research indicates a high correlation between intelligence and connectivity between lateral prefrontal regions and other brain regions (cole, yarkoni, repovš, anticevic, & braver, 2012). consistent with these findings, it is necessary to promote connectivity between sensorimotor and associative brain regions of the developing brain through specific games and activities. the aim of the study was to investigate whether leisure time of children today contains less pa and complex outdoor play in comparison to that of their parents at the same age. of particular interest were the activities or children’s play that include these elements: (a) rotation, (b) balance, (c) dynamic accommodation, (d) fine motor skills, and (e) running. complex motor movements and activities that promote aerobic fitness such as running are seen as particularly important, as their lack can contribute to cognitive dysfunction in children (sibley & etnier, 2003; chaddock et al., 2010; gomez-pinilla & hillman, 2013; buckley, cohen, kramer, mcauley & mullen, 2014; denham, marques, o’brien & charchar, 2014; erickson, hillman & kramer, 2015). there are specific games that involve rotation, balance, dynamic accommodation, fine motor skills, and running, and the very reason children should practice these activities is the prevention of many cognitive, motor, or other deficits that we can increasingly observe in them. in order to understand the importance and outreach of these elements, we will provide you with a brief overview. activities such as rotation and balance maintenance, often practiced through various spinning games, were long ago recognized as an important building block for proper child development. these activities are the source of vestibular stimulation and, as elliot (1999) states, the vestibular system is one of the earliest senses to mature. vestibular stimulation thus provides the child with a large amount of early sensory experience upon which other sensory and motor skills are built, which in turn encouannales kinesiologiae • 11 • 2020 • 2 103 ranko rajović, vanja ković, dragana berić: play then and now ..., 99–119 rage the development of higher emotional and cognitive skills (elliot, 1999, p. 154). as already mentioned, aerobic fitness, apart from maintaining physical wellbeing, has been shown to be directly correlated to children’s cognitive abilities, such as attention and cognitive control (chaddock et al., 2010). this type of fitness is mainly achieved through activities that involve walking and running. the impact of fine motor skills goes well beyond the development of dexterity, strength, and everyday skills. in the school readiness test, fine motor skills, along with attention and general knowledge, have been shown to be much stronger predictors of math, reading, and science achievements overall in elementary school than early math and reading scores alone (grissmer, grimm, aiyer, murrah, & steele, 2010). moreover, numerous studies conducted to date have shown a clear correlation between fine motor skills and reading performance (brookman, mcdonald, mcdonald, & bishop, 2013; cameron et al., 2012; grissmer et al., 2010). because of its complexity, authors consider dynamic accommodation to be particularly important for the proper development of a child. in order to explore the cross-generational trend of leisure activities at an early school age, a survey of play elements and time was conducted among parents of children aged 6 to 8. methods the research was conducted in “dečiji kulturni centar,” belgrade, on 9 june 2017. the survey with its specific questionnaire was created for the purpose of this study, as we could not find an appropriate questionnaire in the existing literature. the survey consists of four parts and is a combination of openand closed-ended questions (see appendix). the first part of the survey was structured to collect data on independent (demographic) variables such as sex, marital status, education level, etc. the next two parts, labelled a and b, focus on examining core research questions (correlation between the amount and quality of outdoor and indoor play and cognitive development of children). part a investigates this topic via a set of questions for parents about their children, while part b investigates the same topic from the perspective of parents in their childhood. the last part, c, investigates the amount of screen time in the parents when they were young and, in their children, now. the probability sampling method was used for this study in which parents who attended a lecture given by the first author of the paper were asked to complete the questionnaire after the lecture. participation in the survey was voluntary, all parents who attended the lecture were happy to take part in the research. the sample consisted of 37 parents (7 males) with an age range of 30-49 (mean 39.97 years), 32 of them were married (3 divorced, 2 single). as for their education, the majority (67.6%) had a university diploma or higher education (19 university diplomas, 4 masters and 2 phds), while one third had a college or lower education level (5 primary school, 4 secondary school and 3 college), accordingly, children can be considered a “subsample” because their experiences and habits were reported indirectly through their parents. 104 ranko rajović, vanja ković, dragana berić: play then and now ..., 99–119 annales kinesiologiae • 11 • 2020 • 2 the spss software (version 16.0, ibm, usa) was used for data analysis. the data were presented as mean and additionally frequency analysis of differences in play time between children and parents at the child’s age. chi square analysis for play elements of: (a) rotation, (b) balance, (c) dynamic accommodation, (d) fine motor skills, and (e) running, and other specific games with these elements was used to determine a statistically significant relation at p<.001. results the results section presents a parallel perspective of core research questions between parents and their children. as has been stated above, authors compare the childhoods of parents and their children at 6-8 years. at the very beginning, the amount of time spent playing indoors and outdoors is compared as well as screen time. afterwards, a more profound and segmental approach is taken, investigating both populations regarding time spent in play involving elements of: (a) rotation, (b) balance, (c) dynamic accommodation, (d) fine motor skills, and (e) running, and the specific games including these elements. the survey results have shown that a child today spends 110 min/day on average playing indoors (table 1), while their parent used to spend 96 min/day, which is not a statistically significant difference (t (1, 66)=0.9, p=.371). on the other hand, a child today spends 96 min/day on average in outdoor play, while a parent used to spend 157 min/day on average, almost twice as much as their children, with a statistically significant difference (t(1, 66)=3.93, p<.001). a child today spends 93 min/day in front of a screen on average, which is three times as much as their parents used to (30 minutes on average), which is statistically significant (t(1, 66)=4.95, p<.001). table 1. overview of the play time of children and parents at their age spent indoors, outdoors, and in front of a screen. n mean std. deviation std. error mean home child 37 110.00 70.711 11.625 parent 31 96.13 52.769 9.478 outdoors child 37 96.62 43.494 7.150 parent 32 157.97 82.773 14.632 tv, smartphone, etc. child 35 92.71 69.540 11.754 parent 33 29.39 24.487 4.263 annales kinesiologiae • 11 • 2020 • 2 105 ranko rajović, vanja ković, dragana berić: play then and now ..., 99–119 the overview of the time that children spend in various elements of play involving rotation, balance, dynamic accommodation, fine motor skills, and running, as estimated by their parents, and the amount of time the parents used to spend in the same activities when they were children is structured in the survey via likert scale with time categories. these are formed based on the minutes spent on a game (from 0, 15 min, 30 min, 45 min, 60 min, over 60 minutes). in activities that have the elements of rotation (elastics, playing with marbles1, running, hopscotch), balance (elastics, rope skipping, climbing, hopscotch) and dynamic accommodation (jumping over obstacles, catching and throwing a ball, etc.), most of the children spend 0-15 minutes, while parents used to spend an hour or more. in fine motor skills-based activities (marbles, stickers, plasticine, playing an instrument, etc.), half of the children spend 15 to 30 minutes, while half of the parents used to spend at least an hour or more. in activities that include walking and running, half of the children and 75% of the parents used to spend an hour or more (this is the activity in which parents and children spent an equal amount of time). elements of play involving rotation as can be seen from the comparative bar chart data presentation (figure 1), there is a significant difference between the results obtained for parents and their children. figure 1. play time of children and parents at children’s age spent in elements of play involving rotation. 1 a classic game of marbles, that used to be played in parks and playgrounds, is a dynamic game which involves a lot of turns and squatting. physically dynamic nature of the game requires a constant change of body position which involves both rotation and sustained balance. 106 ranko rajović, vanja ković, dragana berić: play then and now ..., 99–119 annales kinesiologiae • 11 • 2020 • 2 table 2. play time of children and parents at children’s age spent in elements of play involving rotation. daily duration of games and activities involving rotation no answer 0-15 min 16-30 min 31-45 min 46-60 min >60 min children 2.70% 48.65% 21.62% 16.22% 5.41% 5.41% parents 5.41% 2.70% 2.70% 21.62% 27.03% 40.54% chi square analysis for rotation χ²(1.5)=36.55, p<0.001 what is striking in these two representations of data is the totally opposite maximum and minimum amounts of time spent in games involving rotation activities. 40.5% of parents used to spend over 60 minutes in games involving rotation (elastics, marbles, running, hopscotch) while only 5.41% of their children spend time playing these kinds of games. elements of play involving balance data on the comparative analysis of elements of play involving balance are presented in table 3 and figure 2. table 3. play time of children and parents at children’s age spent in elements of play involving balance. daily duration of games and activities involving balance no answer none 0-15 min 16-30 min 31-45 min 46-60 min >60 min children 2.70% 2,70% 51.35% 21.65% 18.92% 2.70% 2.70% parents 5.41% / / 8.11% 10.81% 32.43% 43.24% chi square analysis for rotation χ²(1.5)=48.73, p<0.001 annales kinesiologiae • 11 • 2020 • 2 107 ranko rajović, vanja ković, dragana berić: play then and now ..., 99–119 figure 2. play time of children and parents at children’s age spent in elements of play involving balance. interestingly, the situation is similar to that reflected in table 2, as 43.24% of parents used to spend over 60 minutes in games involving balance (elastics, skipping rope, climbing, hopscotch) while only 2.7% of their children spend time playing these kinds of games now. elements of play involving dynamic accommodation activities data on the comparative analysis of games involving dynamic accommodation activities are presented in table 4. here, too, we can see that more than one third of parents (35.14 %) used to spend over 60 minutes in games involving dynamic accommodation (jumping over obstacles, catching and throwing a ball, etc.) while only 8.11% of their children spend time in these kinds of games. 108 ranko rajović, vanja ković, dragana berić: play then and now ..., 99–119 annales kinesiologiae • 11 • 2020 • 2 table 4. play time of children and parents at children’s age spent in elements of play involving dynamic accommodation. daily duration of games and activities involving dynamic accommodation no answer none 0-15 min 16-30 min 31-45 min 46-60 min >60 min children 2.70% 8.11% 27.03 43.24% 10.81% 8.11% / parents 5.41% / 2.70% 13.51% 13.51% 29.7% 35.14% chi square analysis for rotation χ²(1,5)=34.14, p<0.001 figure 3. play time of children and parents at children’s age spent in element of play involving dynamic accommodation. annales kinesiologiae • 11 • 2020 • 2 109 ranko rajović, vanja ković, dragana berić: play then and now ..., 99–119 elements of play involving fine motor skills data on the comparative analysis of the games involving fine motor skills activities are presented in table 5. table 5. play time of children and parents at children’s age spent in element of play involving fine motor skills. daily duration of games and activities involving fine motor skills no answer none 0-15 min 16-30 min 31-45 min 46-60 min >60 min children / 8,11% 21,62% 32,43% 10,81% 21,62% 5,41% parents 5,41% / 10,81% 16,22% 16,22% 16,22% 35,14% chi square analysis for rotation χ²(1,5)=17.09, p<0.01 figure 4. play time of children and parents at children’s age spent in elements of play involving fine motor skills. 110 ranko rajović, vanja ković, dragana berić: play then and now ..., 99–119 annales kinesiologiae • 11 • 2020 • 2 as with most elements, that of play involving fine motor skills shows a big difference as 35.14% of parents compared to 8.11% of their children spent over 60 minutes in games involving fine motor skills-based activities (marbles, stickers, plasticine, playing an instrument etc.). elements of play involving running data on the comparative analysis of games involving running activities are presented in table 6. table 6. play time of children and parents at children’s age used in elements of play involving running. daily duration of games and activities involving running no answer 0-15 min 16-30 min 31-45 min 46-60 min >60 min children / 5,41% 29,73% 13,51% 21,62% 29,73% parents 5,41% 2,70% 5,41% 13,51% 21,62% 51,35% chi square analysis for rotation χ²(1,5)=10.69, p=0.058 figure 5. play time of children and parents at children’s age spent in element of play involving running. annales kinesiologiae • 11 • 2020 • 2 111 ranko rajović, vanja ković, dragana berić: play then and now ..., 99–119 results for elements of play involving running are similar to previous tables, showing that more than half of parents (51.35%) used to spend over 60 minutes in games involving running activities while only 5.41% of their children are spending time on such games now. chi square analysis for rotation, balance, dynamic accommodation and fine motor skills were significantly different, whereas running was at the borderline of significance. discussion and conclusion from the parent’s perspective and from our own experience we found no difficulties making the estimation of the past time spent outdoors when we were young. the recall came with ease, because apart from school and other activities, meals and sleep, most of the leisure time was spent outdoors. with nostalgia, generations from the late 1970s to the late 1980s remembered how hard our parents had to try to get us to come inside for meals or sleep. free play as well as the contact with nature that seems to be scarce in today’s generations of children were among the motivations for this study. hence, we created a questionnaire which would capture this common knowledge or insight (at least in this region of the world) to enable us to point to the problems and potential consequences of such dramatic change concerning leisure time play behaviors taking place over only two to three decades. since the aim of the study was to compare the domains of pa or play elements and the quantity of children’s play time with the respective values for their parents at the same age, we managed to analyze not only the overall time spent in indoor and outdoor play, but also more specific aspects of play elements involving rotation, balance, dynamic accommodation, fine motor skill-based activities, and activities involving walking and running. we observed and reported a significant difference in both the domains (elements of play) and the quantity of play time between contemporary children and their parents at their age. while children today spend about the same amount of time playing at home as their parents did during childhood (about two hours), they spend an average of one and a half hours playing outdoors, as opposed to their parents who used to spend almost twice that amount of time outdoors. in contrast, children today spend three times as much time in front of a screen (tv, computer, mobile phone, etc.) as their parents did in their childhood (one and a half hours vs.half an hour). these findings strongly suggest that the contemporary lifestyle of children involves less physical activity (pa) and much more screen time, which must have a strong impact on their development. play is of intrinsic motivation for every child and a natural way of learning. to stimulate the overall biological potential of children it is important to integrate complex motor skills and mental processes into play. particularly, fine motor skills, dynamic accommodation, balance, and rotation have been found to be important play elements. 112 ranko rajović, vanja ković, dragana berić: play then and now ..., 99–119 annales kinesiologiae • 11 • 2020 • 2 moreover, speech, which underlies many areas of child development, is naturally fostered by the play process, as it is a common element of the classic children’s games listed in the questionnaire. if we take into consideration that there is a clear correlation between motor, cognitive, and emotional development that decreases with age, it becomes clear that early childhood age plays a key-role in regard to overall child development. when there is a clear decrease of aerobic and motor activities in children, and with the consequences of such behavior well known, it becomes a priority to educate parents and especially those who work with young children to prevent or at least reduce the effects of this trend. limitations first, the use of a non-validated set of questions in the questionnaire survey to measure the generations’ differences in elements and quantity of play may limit the strength of the study. second, the self-reported data and structure of the survey (recall bias) may represent another potential source of bias and third, the use of the chisquare test is less reliable for small sample frequencies (< 5). acknowledgements we would like to thank all the participants who took part in this study. references brookman, a., mcdonald, s., mcdonald, d., & bishop, d. v. m. 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(2006). the analysis of the arch of the foot in three-year-old children – a case of ljubljana. kinesiology 38(1), 78-85. retrieved from https://hrcak.srce.hr/4190. https://doi.org/10.1038/pr.2013.37 https://doi.org/10.1123/pes.15.3.243 https://doi.org/10.1123/pes.15.3.243 https://doi.org/10.1038/npp.2009.115 https://doi.org/10.1080/02640414.2010.487070 https://hrcak.srce.hr/4190 annales kinesiologiae • 11 • 2020 • 2 115 ranko rajović, vanja ković, dragana berić: play then and now ..., 99–119 appendix questionnaire playing, then and now dear parents, please provide your answers on the given lines or by circling the intended answer and putting an “x” in the appropriate table boxes. there are no right or wrong answers in this questionnaire, so we are kindly asking you to answer the questions as truthfully as possible. 1. gender: f m age: ________________ 2. education level (please circle the correct answer): a) primary school b) secondary school c) college d) university e) ma/msc f) phd 3. you are (please circle the correct answer): a) married b) in a common law marriage c) widow/widower d) divorced e) remarried 4. how many children do you have? ________. what is the birth order of the child referred to in the questionnaire? ________. 5. what is your birth order in your family? _____, out of how many children? ________. 6. do you wear glasses? yes no if yes, what is your eye prescription? _________ (put + or in front of the number) a. questions about your child child’s age ______ (6 to 8 yrs.) 1. does the child wear glasses? yes no if yes, please write the child’s eye prescription. ________ (put + or in front of the number) 2. does your child play any sport? yes no if yes, please specify the sport. _______________ how often does your child practice per week? _____________ when did your child start practicing that sport? _____________ 116 ranko rajović, vanja ković, dragana berić: play then and now ..., 99–119 annales kinesiologiae • 11 • 2020 • 2 3. how much time does your child usually spend playing (not including video games and similar activities): outdoors: _________ minutes indoors: ___________ minutes 4. how much time per day does your child spend playing games containing the elements listed below (put an x in the appropriate box for each type of activity, that is, 10 x signs in total: 5 for working days, 5 for weekends). it may seem to you that your child does not play the same games you played as a child, but please try to specify the number of games your child engages in per day that contain the specified elements while playing in the park, playroom, on a playground, etc. remark: please put an x in the appropriate box: working day (wd the grey column box) and weekend (w the white box). duration games none. 0-15 minutes 15-30 minutes 30-45 minutes 45-60 minutes over 60 minutes. wd w wd w wd w wd w wd w wd w rotation (e.g., elastics, marbles, running, hopscotch, etc.) balance (elastics, marbles, climbing, hopscotch, rope jumping ...) dynamic accommodation (e.g., running over obstacles, ball catching and throwing, etc.) fine motor skills, making sure the child uses all ten fingers (marbles, napkins, stickers, making flower wreaths, playing instruments, playing with clay and other modeling materials. walking, running. annales kinesiologiae • 11 • 2020 • 2 117 ranko rajović, vanja ković, dragana berić: play then and now ..., 99–119 5. what is your child’s favorite game? __________________________________ 6. what is your child’s least favorite game? _______________________________ 7. if your child spends more than 60 minutes outdoors per day, please specify how much time: on working days: a) 60-120 minutes b) 120-180 minutes c) more than 180 minutes on weekends: a) 60-120 minutes b) 120-180 minutes c) more than 180 minutes b. questions about your own childhood 1. try to remember your childhood and how much time per day you (aged 6 to 8) played games that contained the elements listed below (put an x in the appropriate box for each type of activity, that is, 10 x signs in total:5 for working days, 5 for weekends). remark: please fill in the appropriate box: working day (wd the grey column box) and weekend (w the white box). duration games none. 0-15 minutes 15-30 minutes 30-45 minutes 45-60 minutes over 60 minutes. wd w wd w wd w wd w wd w wd w rotation (e.g., elastics, marbles, running, hopscotch, etc.) balance (elastics, marbles, climbing, hopscotch, rope jumping ...) dynamic accommodation (e.g., running over obstacles, ball catching and throwing etc.) fine motor skills, making sure the child uses all ten fingers (marbles, napkins, stickers, making flower wreaths, playing instruments, playing with clay and other modeling materials. 118 ranko rajović, vanja ković, dragana berić: play then and now ..., 99–119 annales kinesiologiae • 11 • 2020 • 2 walking, running. 2. what was your favorite game? ______________________________________ 3. what was your least favorite game? __________________________________ 4. how much time did you spend playing? outdoors: _________ minutes indoors:____________ minutes 5. if you spent more than 60 minutes outdoors, please specify how much time? on working days: a) 60-120 minutes b) 120-180 minutes c) more than 180 minutes on weekends: a) 60-120 minutes b) 120-180 minutes c) more than 180 minutes c. screen time 1. how much time does your child spend in front of screens (tv, computer, smart phone etc.) on working days (wd), and how much on weekends (w)? 2. how much time did you spend in front of screens (tv, computer) at that age on working days (wd), and how much on weekends (w)? d. questions related to sleep habits 1. what time does your child usually go to bed? on working days: ___________ on weekends: _____________ 2. what time does your child usually get up in the morning? on working days: ___________ on weekends: _____________ 3. does your child nap during the day? if yes, how much time does your child spend napping during the day? answer: _________________ 4. are there any activities or routines your child usually engages in before going to bed (reading a book, watching tv, etc.)? please specify these activities: _________________________________________ minutes wd w minutes wd w annales kinesiologiae • 11 • 2020 • 2 119 ranko rajović, vanja ković, dragana berić: play then and now ..., 99–119 how long do these activities usually take? ________________________________ 5. is your child a restless sleeper, frequently rolling over during sleep? a) no b) sometimes c) yes, frequently. 6. does your child wake up at night? a) no b) sometimes c) yes, frequently. 7. is your child often tired during the day? a) no b) sometimes c) yes, frequently. 8. does your child fall asleep doing certain activities during the day? a) no b) sometimes c) yes, frequently. thank you for your cooperation _goback _hlk40898474 _hlk34144101 _hlk40871331 _hlk53505499 _hlk33786872 _hlk25864445 _hlk38187602 annales kinesiologiae • 9 • 2018 • 1 65 reports and reviews/poročila in ocene, 57–68 the 23rd annual congress of the european college of sport science dublin, ireland, 4th−7th july 2018 the 23rd annual congress of the european college of sport science was held in dublin (ireland) between 4th and 7th july 2018. it was organized by two universities: university college dublin (ucd) and ulster university. in total, there were 2900 participants from 71 countries with 2002 presented abstracts. we had 4 plenary sessions, 41 invited sessions, 161 oral sessions, and 43 minioral sessions. the congress participants presented their latest research from different research fields. namely, presentations were given in the topics of physiology, training and testing, health and fitness, sports medicine and orthopedics, biomechanics and others. this year, the ecss young investigator award 2018 contest was held again, where the oral presentation winner was alessandro del vecchio (of the imperial college london, united kingdom with the title of his presentation: populations of longitudinally tracked motor neurons increase their discharge rate following four weeks of isometric strength training) and the mini-oral (poster) presentation winner was henri tilga (of the university of tartu, estonia with the title of his presentation: the effects of web-based intervention program on physical education teachers’ autonomy-supportive and controlling behaviour). the ecss 2018 was attended by one member of the institute for kinesiology research, scientific and research centre koper, slovenia. uroš marušič, ph.d. presented the recent discoveries from the gibkop project in which he cooperates with two coauthors (prof. rado pisot and dr. jeannette mahoney). he gave a lecture as part of the “motor development and motor control” section with the title: “the influence of improved cognitive control after non-physical training on mobility-related outcomes in healthy and physically active elderly: a randomized controlled trial”. next year’s 24th annual congress of the european college of sport science will be held from 3rd to 6th july in prague, czech republic. uroš marušič 66 reports and reviews/poročila in ocene, 57–68 annales kinesiologiae • 9 • 2018 • 1 23. letni znanstveni kongres »european college of sport science« dublin, irska, 4.–7. julij 2018 23. letni znanstveni kongres »european college of sport science« (ecss) je potekal v dublinu (irska) med 4. in 7. julijem 2018. letošnji kongres sta v sodelovanju organizirali dve univerzi in sicer »university college dublin« (ucd) in »ulster university«. letošnjega kongresa ecss se je udeležilo 2900 udeležencev iz 71 držav z 2002 predstavljenima povzetkoma. kongres je bil razdeljen na štiri plenarne sekcije, 41 vabljenih, 161 ustnih predstavitev in 43 kratkih ustnih predstavitev. udeleženci kongresa so predstavili svoje najnovejše ugotovitve na različnih znanstveno-raziskovalnih področjih kot so fiziologija, treniranje in merjenje, zdravje in zmogljivost, športna medicina in ortopedija, biomehanika, če izpostavimo le nekatere. tudi letos je potekalo tekmovanje mladih raziskovalcev (ecss young investigator award 2018 contest), kjer je v kategoriji ustnih predstavitev zmagal alessandro del vecchio iz imperial college-a iz londona, velika britanija (populations of longitudinally tracked motor neurons increase their discharge rate following four weeks of isometric strength training). v kategoriji predstavitev v obliki posterja pa je slavil henri tilga iz univerze tartu, estonija (the effects of web-based intervention program on physical education teachers’ autonomy-supportive and controlling behaviour). letošnjega kongresa ecss 2018 se je udeležil en predstavnik inštituta za kineziološke raziskave znanstveno-raziskovalnega središča koper. doc. dr. uroš marušič je v soavtorsvu prof. dr. rada pišota in dr. jeannette mahoney predstavil izsledke svoje zadnje raziskave gibkop. predaval je v sekciji gibalno učenje in kontrola in predstavil prispevek z naslovom »vpliv izboljšane kognitivne kontrole po kognitivnem treningu na parametre mobilnosti pri zdravih in gibalno aktivnih starostnikih: randomizirana kontrolirana raziskava«. naslednje leto bo 24. letni znanstveni kongres ecss potekal med 3. in 6. julijem v pragi, češka republika. uroš marušič annales kinesiologiae • 10 • 2019 • 1 75 reports and reviews/poročila in ocene, 73–80 report on the first belt and road physical education forum zagreb, croatia, 16–18 april 2019 the first belt and road1 physical education forum was organised by the faculty of kinesiology, university of zagreb with the aim that the institutions of higher education from countries included in the initiative discuss the coordinated development of sports and sport education. in this two-day event, each institution was presented, pointing out the important facts as well as giving an overview of their activities and projects. they also proposed the possibilities of further collaboration within the 16+1 initiative. the science and research centre, institute for kinesiology research was presented by the director prof. rado pišot, phd. additionally, the meeting with the representatives of beijing sport university was organised where also prof. boštjan šimunič, phd and saša pišot, phd presented the possibilities of mutual collaboration on common institute’s research fields. based on the premise of respecting the diversity of sports sciences there were 32 institutions from 16 countries that signed the consensus of promotion the development of physical education research, namely: beijing sport university, beijing normal university, capital university of physical education and sports (cupes), charles university, chulalongkorn university, comenius university in bratislava, gdansk university of physical education and sport, german sport university cologne, josef pilsudski university of physical education warshaw, latvian academy of sport education, lithuanian sports university, masaryk university, national sports academy “vassil levski”, palacky university olomouc, russian state university of physical education, sport, youth and tourism, science and research centre koper, sports university of tirana, ss. cyril and methodius university in skopje; transylvania university of brasov, university of alberta, university of belgrade, university of ljubljana, university of montenegro, university of niš, university of primorska, university of sarajevo, university of split, university of tartu, university of worcester, university of zagreb, the university “vasile alecsandri” of bacau and western university. in this way they enabled sports to make its due contribution in promoting human health and changing human limits. 1 the belt and road initiative (bri) is a global development strategy adopted by the chinese government involving infrastructure development and investments in 152 countries and international organizations in asia, europe, africa, the middle east, and the americas. the leader of the people’s republic of china, xi jinping, originally announced the strategy during official visits to indonesia and kazakhstan in 2013. the “belt” refers to the overland routes for road and rail transportation, called “the silk road economic belt”; whereas the “road” refers to the sea routes, or the 21st century maritime silk road. (available on https:// en.wikipedia.org/wiki/belt_and_road_initiative). https://en.wikipedia.org/wiki/belt_and_road_initiative https://en.wikipedia.org/wiki/belt_and_road_initiative 76 reports and reviews/poročila in ocene, 73–80 annales kinesiologiae • 10 • 2019 • 1 according to the consensus, the institutions are willing to jointly build a platform for collaborative research and academic exchanges, strive to improve the level of sports scientific research, and consolidate and enhance the competence of the countries along the belt and road in physical education research. the first forum is certainly a welcome opportunity to open up the scientific and research potential of the institute for kinesiology research of the science and research centre koper, but we will need to wait for the response from the future potential partners, so in the meanwhile we can look for similar initiatives. saša pišot annales kinesiologiae • 10 • 2019 • 1 77 reports and reviews/poročila in ocene, 73–80 poročilo prvega foruma “belt and road” za izobraževanje v športu zagreb, hrvaška, 16.–18. april 2019 prvi forum “belt and road”2 za izobraževanje v športu je organizirala kineziološka fakulteta univerze v zagrebu z namenom, da visokošolskim ustanovam držav, vključenih v iniciativo, ponudi prostor za razpravo o usklajenem razvoju športa in izobraževanja v športu. ta dvodnevni dogodek je bil namenjen predstavitvi ustanov in podrobnejšemu pregledu njihovih dejavnosti in projektov ter prikazu možnosti nadaljnjega sodelovanja v okviru pobude 16 + 1. znanstveno-raziskovalno središče koper, inštitut za kineziološke raziskave je predstavil direktor prof. rado pišot. ob tem je bilo organizirano samostojno srečanje s predstavniki pekinške univerze za šport, kjer sta možnosti za razvoj sodelovanja na skupnih področjih predstavila prof. boštjan šimunič in dr. saša pišot. skladno s spoštovanjem raznolikosti znanosti o športih je 32 ustanov iz 16 držav (pekinška univerza za šport, pekinška normal univerza, kapital univerza za telesno vzgojo in šport (cupes), karlova univerza v pragi, univerza chulalongkorn, univerza comenius v bratislavi, univerza za telesno vzgojo in šport v gdansku, nemška univerza za šport v kölnu, univerza “josefa pilsudskega“ za telesno vzgojo v varšavi, latvijska akademija za športno vzgojo, litovska univerza za šport, masarykova univerza v brnu, nacionalna športna akademija „vassil levski“ v sofiji, univerza palacky olomouc, ruska državna univerza za telesno vzgojo, šport, mladino in turizem, znanstveno-raziskovalno središče koper, univerza za šport v tirani, uuniverza cirila in metoda v skopju, transilvanska univerza v brasovu, univerza v alberti, univerza v beogradu, univerza v ljubljani, univerza v črni gori, univerza v nišu, univerza na primorskem, univerza v sarajevu, univerza v splitu, univerza tartu, univerza iz worcestra, univerza v zagrebu, univerza „vasile alecsandri“ v bacauu in univerza western) podpisalo soglasno izjavo za promocijo razvoja raziskovanja športa in telesne vzgoje, s katero želijo omogočiti, da šport v svoji vlogi še nadalje ustrezno prispeva k promociji zdravja ljudi in premikanju človeških omejitev. glede na podpisano izjavo so institucije podpisnice pripravljene graditi platformo za skupne raziskave in akademske izmenjave, si prizadevati za izboljšanje ravni znanstvenih raziskav s področja športa ter utrditi in povečati usposobljenost držav ob »belt and road« pri raziskovanju telesne vzgoje. 2 pobuda belt and road (bri) je globalna razvojna strategija, ki jo je sprejela kitajska vlada in vključuje razvoj infrastrukture in naložbe v 152 držav in mednarodnih organizacij v aziji, evropi, afriki, na bližnjem vzhodu in v ameriki. vodja ljudske republike kitajske xi jinping je strategijo prvotno napovedal med uradnimi obiski indonezije in kazahstana leta 2013. „the silk road economic belt“ se nanaša na kopenske poti (cestni in železniški promet) „belt“, medtem ko se „road“ nanaša na morske poti ali pomorsko svileno pot 21. stoletja. (dostopno na https://en.wikipedia.org/wiki/belt_and_road_initiative). https://en.wikipedia.org/wiki/belt_and_road_initiative 78 reports and reviews/poročila in ocene, 73–80 annales kinesiologiae • 10 • 2019 • 1 prvi forum je bil zagotovo dobrodošla možnost in odskočna deska za nadaljnje odpiranje raziskovalnih potencialov inštituta za kineziološke raziskave zrs koper, seveda pa bo potrebno počakati na odziv bodočih potencialnih partnerjev in hkrati iskati podobne pobude. saša pišot _goback _hlk3367923 _goback _goback _goback _hlk3056869 _goback _goback _hlk23766418 _goback _hlk26527070 _goback _goback annales kinesiologiae • 7 • 2016 • 2 153 vertical jump height in young children − a longitudinal study in 4to 6-year-old children katja koren1, rado pišot1, boštjan šimunič1 1 science and research centre koper, institute for kinesiology research, garibaldijeva 1, 6000 koper, slovenia corresponding author: boštjan šimunič science and research centre koper, institute for kinesiology research, garibaldijeva 1, 6000 koper, slovenia tel.: +386 5 66 37 700 e-mail: bostjan.simunic@zrs-kp.si abstract preschool children are intensively involved in the process of developing fundamental movement skills such as walking, running, jumping, climbing, crawling and other simple movements. we aimed to compare ageand genderrelated trends in countermovement vertical jump (cmj) performance (jumping height) measured with a means of ground force plate during a longitudinal study of 4to 6-year old children (n=79; 43% boys). furthermore, we classified children cmj arm-leg coordination into poor, average, or excellent on the grounds of high speed video footage. we found that cmj height progresses significantly with age when arms are used (p<.001; η2=.632) and without the use of arms (p<.001; η2=.620). there were no sex effects. after classification of cmj arm − leg coordination we found that children with excellent cmj coordination progress more intensively than those with average coordination, whereas poorly coordinated jumpers do not progress at all. after extrapolating our data with the data of others we found logarithmic cmj height trends until the age of 16 in both sexes, athlete boys jumping higher than the non-athletes after the ages of 14 or 15. it seems that the initial movement patterns level, in this case the observed jumping technic, develops and refines in 4to 6-year old children at that age. we conclude that jumping coordination is a very important factor of cmj performance in the studied age span. keywords: countermovement jump; ground force plate; coordination, explosive power, pre-school children. original scientific article udc: 796.012.414.2-053.4(497.4) received: 2016-12-06 154 katja koren, rado pišot, boštjan šimunič: vertical jump height in young children a longitudinal study ..., 153–170 annales kinesiologiae • 7 • 2016 • 2 razvoj navpičnega skoka otrok longitudinalna študija 4do 6-letnih otrok izvleček predšolski otroci so intenzivno vključeni v proces razvoja elementarnih gibalnih vzorcev, kot so hoja, tek, skok, plezanje, plazenje in drugih enostavnih gibanj. naš namen je longitudinalno primerjati uspešnost skoka z nasprotnim gibanjem cmj (višina skoka) merjeno s tenziometrijsko ploščo 4 do 6 let starih otrok (n=79; 43% dečkov) glede na starost in spol. poleg tega smo otroke razvrstili glede na cmj koordinacijo med rokami in nogami v slabše, povprečne ali odlične na podlagi visokofrekvenčnih video bočnih posnetkov. ugotovili smo, da cmj višina narašča z leti, pri skokih z uporabo rok (p<,001; η2=,632) in brez uporabe rok (p<,001; η2=,620). med spoloma ni bilo razlik. po klasifikaciji koordinacije cmj smo ugotovili, da otroci z odlično koordinacijo cmj napredujejo intenzivneje kot tisti s povprečno koordinacijo cmj, medtem ko otroci s slabšo koordinacijo cmj sploh niso napredovali. po ekstrapolaciji naših podatkov z drugimi, smo ugotovili logaritemski trend višine cmj do starosti 16 let pri obeh spolih, kjer po starosti 14-15 let fantje športniki skočijo višje kot fantje, ki niso športniki. ugotavljamo intenziven trend razvoja cmj v tem starostnem obdobju, kjer je koordinacija cmj zelo pomemben dejavnik uspešnosti izvedbe cmj. ključne besede: skok z nasprotnim gibanjem, tenziometrijska plošča, koordinacija, eksplozivna moč, predšolski otroci introduction the reported children sedentary behavior (carson, leblanc, moreau, & tremblay, 2013; colley et al. 2011; participaction 2015, 2016) and obesity (gotay et al. 2013; ng et al. 2014) are among the major health problems. the epidemic of physical inactivity and the associated epidemic of obesity are being driven by multiple factors: societal, technologic, industrial, commercial, financial (council on sports medicine and fitness and council on school health, 2006). obesity among children in slovenia is increasing. the data collected in the context of the european initiative show that the slovenian children are among the most endangered of obesity among the eu countries (oecd/eu, 2016). this global trend of prolonged sitting and obesity is likely to continue due to the growing availability and popularity of computer, mobile phones, video games and television (lepp, barkley, sanders, rebold, and gates, 2013; public health england, 2013) and due to less favorable food availability (raychaudhuri & sanyal 2012; skidmore & yarnell, 2004). moreover, we must be aware that health behaviors and obesity is transferred into adulthood. 155 annales kinesiologiae • 7 • 2016 • 2 katja koren, rado pišot, boštjan šimunič: vertical jump height in young children a longitudinal study ..., 153–170 on the other hand, physical activity and exercise helps preventing chronic diseases such as cardiovascular disease (kruk, 2007; warburton, nicol, & bredin, 2006), diabetes (kruk, 2007; warburton, nicol, & bredin, 2006), cancer (kruk, 2007; warburton, nicol, & bredin, 2006), hypertension, obesity (kruk, 2007; warburton, nicol, & bredin, 2006), osteoporosis (kruk, 2007; warburton, nicol, & bredin, 2006), fall-related injuries (kruk, 2007), depression (kruk, 2007; warburton, nicol, & bredin, 2006) and emotional stress (kruk, 2007). therefore, it is essential to encourage preschool children to engage healthy lifestyle as early as possible, to develop motor abilities satisfactory and develop fundamental movement skill (fms) such as walking, running, jumping, crawling, climbing, hopping, catching, kicking, throwing and hitting a ball. if sufficiently developed, fms plays an important role in establishing physical confidence and competence (gallahue and ozmun, 1998). fms development has been classified into stages, progressing from a beginner level to a mature level (hynes-dusel, 2002). the beginner level generally depicts the minimal standard of children ages 4 to 7 (gabbard, 1992). by the completed age of 8, with practice and maturity, most children will have achieved mature level (gabbard, 1992). the experts believe that motor delays negatively influence future motor and cognitive development (gallahue, 1996). therefore, mastering fms is linked also to cognitive development (diamond, 2000; krombholz, 1997). most of the studies reports fms data obtained in adult male subjects (laffaye and choukou, 2010; harman, rosenstein, frykman, & rosenstein,1990; marković, dizdar, jukić, & cardinale, 2004; marković, 2007; runge, rittweger, russo, schiessl, & felsenberg, 2004) and there are few longitudinal data about children development trends of both sexes where the most frequent fmss observed are walking and the vertical jump (focke et al., 2013). different researchers defined the factors affecting vertical jump ability: a) composition of skeletal muscles (kaneko, fuchimoto, toji, & suei, 1983; wilson, newton, murphy, & humphries, 1993), b) well-developed alactic or anaerobic power capacity (in comparison with the athletes with high aerobic power capacity) (shorten, 1987; conlee, mcgown, fisher, dalsky, & robinson, 1982), c) neural adaptation (motor unit activation, motor unit synchronization and the specificity of the movement pattern (wilson et al., 1993; sale, 1988), d) initial levels of strength of the person and the ability to make use of a stretch shortening cycle (adams, o'shea, o'shea, & climstein, 1992; duke & beneliayhu, 1992; wilson, newton, murphy, & humphries, 1993), e) the use of elastic and contractile energy for producing dynamic muscle contractions (adams et al., 1992; duke & beneliayhu, 1992), f) effective use of the arms for increased vertical velocity (harman et al., 1990), g) trunk extension, head movements and utilization of a countermovement to initiate the stretch shortening cycle (young, 1995; van soest, roebroeck, bobbert, huijing, & van ingen schenau, 1985; harman et al., 1990), h) upper body and abdominal (trunk) strength has also shown to be a contributing factor to vertical jump performance (shorten, 1987; cisar & corbelli, 1989; bobbert & van soest, 1994), and i) development of a motor pattern for vertical jump − arm swing (young, 1995). all the above-mentioned factors develop through childhood and, thus, this development must affect vertical jump development as well as other fms. 156 katja koren, rado pišot, boštjan šimunič: vertical jump height in young children a longitudinal study ..., 153–170 annales kinesiologiae • 7 • 2016 • 2 there have been numerous studies which have investigated jumping in adult athletes from various sports, and the most commonly reported parameter is jumping height. however, it is difficult to compare the results of various studies as they all vary greatly in the experimental design, in the duration of research, in the testing procedures utilized and in the application of training techniques. although vertical jumping is often used in physical performance tests for both children and adults, normative data for children are lacking in the literature. only few studies focused on jumping performance in primary and secondary school children (klausen, schibye, & rasnussen, 1989; temfemo, hugues, chardon, mandengue, & ahmaidi, 2009; focke et al., 2013) and some in pre-school children (neelly & zebas, 2003; harrison & moroney, 2007; focke et al., 2013). neelly and zebas (2003) where a research was performed on a 4.5 year-old children, while focke et al. (2013) measured 1835 children aged from 4 to 17 years of age. they specified that boys jump higher than girls and reported cross-sectional developmental trends for both sexes. therefore, we aimed to develop longitudinal cmj height trends in 4to 6 year-old children for both sexes. additionally, our goal is to detect the jumping technique used by children. when comparing cmj height in children classified with different jumping coordination score (1 − poor; 2 − average; 3 − excellent) we hypothesized that the percentage of excellent jumpers would increase and excellent jumpers would progress in cmj height more intensively with their age. we also plan to extrapolate cmj height age trends with the data of others. methods participants four-year-old children were recruited in 2009 from three randomly selected slovenian kindergartens, all in the coastal region: koper, škofije and semedela. all tests and procedures were explained to the parents on organized meetings in kindergartens prior to the obtainment of their written consent. none of the children had any history of neuromuscular disorders or muscle diseases. in regard to the recruitment process, 160 children in total were selected (only those who had their 4th birthday in 2009), of which 79 children (34 boys, 45 girls) completed all three longitudinal jumping measurements and were selected for the analysis. moreover, all procedures conformed to the 1964 declaration of helsinki and were approved by the national medical ethics committee of the republic of slovenia. procedures the organizational settings of the conducted longitudinal study were the same for all three assessments. the assessments were conducted in autumn of 2009, 2010, and 157 annales kinesiologiae • 7 • 2016 • 2 katja koren, rado pišot, boštjan šimunič: vertical jump height in young children a longitudinal study ..., 153–170 2011. a week before the assessment we notified the teachers to follow a specific protocol prior to the measurement, namely, that all major physical or sport activities were discouraged two days before the assessment. daily, from 2 to 5 children arrived in the laboratory and performed a series of tests (body composition, muscle architecture, posture analysis, and five fms analysis) from where only basic anthropometrical data and vertical jumping is presented in this report. measurements of anthropometrical characteristics all children had their standing height and weight measured. participants’ body mass and height were measured by a means of standard tools. their body mass was measured to an accuracy of .1 kilograms, while the body height was measured to an accuracy of .5 centimeters. all participants were barefoot and wearing their sportswear during the measurements. the body composition was measured with bioimpedance (bioscan 916s, maltron, uk), where children lied on a bed for 30 minutes before the assessment. countermovement jumping height assessment each child performed a 15 minutes of standardized warm-up before the fms assessment. after the walking and running analysis we analysed jumping performance. the instruction was to jump as high as possible, using their arms and countermovement jumping (cmj) technique. each child performed between 3 and 5 trial jumps followed by three maximal cmjs with the use of their arms and three maximal jumps without the use of their arms on a ground force plate system (amti sampling at 1000 hz.). they were also simultaneously videotaped with high-frequency camera (fujifilm finepix hs10) for qualitative analysis of arm-leg coordination and synchronization of movement. during each jump, there was at least one minute of rest. cmj height was calculated based on the flight time. the highest jumps from both techniques (with and without the use of the arms) were taken for further analysis. we used several motivational methods to achieve a maximal performance (wall stickers), similarly as in some previous studies where they used balloons (clark, phillips, & petersen, 1989; jensen, phillips, & clark, 1994). countermovement jumping coordination assessment for the jumping coordination assessment, we used a scale developed by plevnik (2014) adapted from the technique for the evaluation of the implementation of motor tasks (vies, kroes & feron, 2004), where jumping coordination was qualitatively (based on high-speed video footage, see figure 1) classified as: 158 katja koren, rado pišot, boštjan šimunič: vertical jump height in young children a longitudinal study ..., 153–170 annales kinesiologiae • 7 • 2016 • 2 poor (score 1): hands do not follow the body movement. they move backwards, or not at all. average (score 2): hands are somewhat included in jumping performance, but less intensively or with less amplitude. excellent (score 3): hands follow the vertical jump in all phases, correct timing, intensity and amplitude. figure 1: coordinated vertical jump classified as excellent (left) and non-coordinated vertical jump classified as poor (right). data analysis the data were analyzed using spss (version 22, ibm, usa) and microsoft excel (version 2013, microsoft, usa) programs. data are presented as means with standard deviation. there was no major deviation from normal distribution. sex and age effects were tested with two-way analysis of variance (anova) with sex (2) as between factor and age (3) as within factor. longitudinal changes were analyzed with repeated measures anova, where improvement in jump performance of coordinated and non-coordinated jumpers was analyzed with repeated measures anova and one fixed factor (jump coordination). the pooled longitudinal trends (our data and the data of others) were fitted by mathematical modelling using logarithmic curve to establish best fit. the pearson correlation was used to analyze the correlation between fat mass and cmj height. the level of significance for all tests was set at p<.05. if significance was confirmed, we reported also the η2 effect size. 159 annales kinesiologiae • 7 • 2016 • 2 katja koren, rado pišot, boštjan šimunič: vertical jump height in young children a longitudinal study ..., 153–170 results in all three-measurement points in total, 79 participants being included; their average body height, body mass, fat mass, muscle mass, cmj height without arms, cmj height with arms and percent of coordinated jumpers is shown in table 1. ta bl e 1: l on gi tu di na l a nt hr op om et ri c an d ju m p pe rf or m an ce d at a fo r bo th s ex es . p ar am et er se x 4 ye ar s 5 ye ar s 6 ye ar s p se x ( η2 ) p ag e ( η2 ) p ag e x se x ( η2 ) b od y he ig ht / cm b oy s 10 8± 4. 8 11 5± 5. 3 12 1± 5. 6 .0 73 <. 00 1 (.9 43 ) .3 39 g ir ls 10 8± 4. 4 11 6± 5. 0 12 3± 5. 8 b od y m as s / k g b oy s 18 .2 ±2 .5 20 .5 ±3 .0 23 .6 ±3 .7 .4 94 <. 00 1 (.8 77 ) .3 64 g ir ls 18 .5 ±2 .8 21 .3 ±3 .6 24 .0 ±4 .2 f at m as s / % b oy s 14 .2 ±2 .4 14 .6 ±3 .3 17 .2 ±4 .7 .0 01 (. 13 3) <. 00 1 (.2 93 ) .7 01 g ir ls 16 .7 ±2 .5 17 .1 ±3 .8 19 .2 ±4 .2 m us cl e m as s / k g b oy s 5. 7± 0. 9 6. 6± 1. 0 7. 7± 1. 2 .0 02 (. 11 6) <. 00 1 (.8 81 ) .1 94 g ir ls 5. 1± 0. 8 6. 0± 0. 9 6. 9± 1. 1 c m j he ig ht w it ho ut a rm s / c m b oy s 9. 1± 3. 1 11 .8 ±3 .3 13 .2 ±3 .4 .3 37 <. 00 1 (.6 20 ) .0 72 g ir ls 8. 9± 2. 9 12 .8 ±3 .1 14 .3 ±2 .9 c m j he ig ht w it h ar m s / c m b oy s 9. 9± 3. 3 12 .6 ±3 .2 14 .7 ±3 .3 .1 40 <. 00 1 (.6 32 ) .0 95 g ir ls 8. 9± 2. 9 14 .2 ±3 .7 15 .8 ±3 .2 c oo rd in at ed ju m pe rs / % b oy s 35 53 79 <. 00 1 (.8 81 ) g ir ls 33 76 87 c m j – co un te rm ov em en t j um p c oo rd in at ed ju m pe rs su bj ec ts w ith e xc el le nt ju m pi ng c oo rd in at io n η2 – p ar tia l e ta -s qu ar ed 160 katja koren, rado pišot, boštjan šimunič: vertical jump height in young children a longitudinal study ..., 153–170 annales kinesiologiae • 7 • 2016 • 2 body height (p<.001; η2=.943) and body mass (p<.001; η2=.877) increased with age, similarly in both sexes. post hoc analysis revealed that body height in boys increased for 7 % at the age of 5 (p=.001) and for 5 % at the age of 6 (p=.001) and in girls for 7 % at the age of 5 (p=.001) and for 5.5 % at the age of 6 (p=.001). body mass increased in boys for 13 % at the age of 5 (p=.001) and for 15 % at the age of 6 (p=.001) and in girls for 15 % at the age of 5 (p=.001) and for 13 % at the age of 6 (p=.001). fat mass was higher in girls than in boys (p=.001; η2=.133) and increased with age (p<.001; η2=.293). post hoc analysis revealed an increase only at the age of 6 in boys for 2.6 % (p=.001) and in girls for 2.1 % (p=.001). there was no correlation between cmj height and fat mass at any age. on the other hand, muscle mass was higher in boys than in girls (p=.002; η2=.116) and increased with age (p<.001; η2=.881). post hoc analysis revealed an increase in muscle mass in boys for 16 % at the age of 5 (p=.001) and for 17 % at the age of 6 (p=.001) and in girls for 18 % at the age of 5 (p=.001) and for 15 % at the age of 6 (p=.001). cmj with (p<.001; η2=.632) and without the use of arms (p<.001; η2=.620) increased with age, similarly in both sexes. post hoc analysis revealed an increase in cmj without arms in boys for 23 % at the age of 5 (p=.001) and for 11 % at the age of 6 (p=.001) and in girls for 30 % at the age of 5 (p=.001) and for 10 % at the age of 6 (p=.001). cmj with arms increased in boys for 16 % at the age of 5 (p=.001) and for 17 % at the age of 6 (p=.001) and in girls for 18 % at the age of 5 (p=.001) and for 15 % at the age of 6 (p=.001). after putting together our data of cmj with arms with the data of focke et al. (2013), we modelled developmental trends of jumping performance (figure 2). it is evident that the trends are logarithmic, where boys exceed jumping performance of girls after the age of 7. figure 2: comparison of countermovement jumping height (with arms) analysed by the means of force plate in relation to age and gender from the literature. 161 annales kinesiologiae • 7 • 2016 • 2 katja koren, rado pišot, boštjan šimunič: vertical jump height in young children a longitudinal study ..., 153–170 in the next analysis we compared cmj height performance (with arms) in children classified with different jumping coordination score (1 − poor; 2 − average; 3 − excellent). table 2 presents the percentage of children performing excellent, average and poor jumping coordination for each age. we found that the percentage of average jumpers decreases with age by about half each year. on the contrary, we see that the percentage of excellent jumpers increased. the percentage on poor jumpers is diminishing, however at the age of 6 there are still 4.4 to 5.9 % of jumpers with poor coordination. table 2: percentages of poor, average, and excellent jumping coordination classifications in relation to age and sex. arm coordination 4 years 5 years 6 years poor boys 11,8 % 14,7 % 5,9 % girls 8,9 % 2,2 % 4,4 % average boys 73,5 % 35,3 % 14,7 % girls 68,9 % 24,4 % 8,9 % excellent boys 14,7 % 50,0 % 79,4 % girls 22,2 % 73,3 % 86,7 % after the classification of cmj coordination we compared average cmj height (with arms) of children in each jumping coordination group, pooled for both sexes (figure 3). obviously, the children with excellent cmj coordination progress more intensively than others, the average coordination jumpers still show progress, whereas the children with poor coordination do not progress at all. 162 katja koren, rado pišot, boštjan šimunič: vertical jump height in young children a longitudinal study ..., 153–170 annales kinesiologiae • 7 • 2016 • 2 figure 3: age progress in countermovement jumping height (with arms) of children from each jumping coordination (poor, average, excellent), pooled for both sexes. discussion our longitudinal study contributed to new insights into children’s fms, focusing on vertical jumping. we developed a developmental trend for cmj performance increase considering the arms use. we also extrapolated our data with the data of others (non-athletes, focke et al., 2013) and modelled a logarithmic trend in jumping performance from the age of 3 to 16. furthermore, we presented a strong dependence of jumping performance progress with jumping coordination. the cmj is a commonly used method to measure leg or whole body explosive power (richter, jekauc, woll, & schwameder, 2010). muscle composition, muscle mass and strength, body height, and jumping coordination are the most important factors of maximal jumping performance. however, at the age span of 4 to 6 we did not find any significant correlation between fat mass and cmj height; however, we observed increasing fat mass when a child progresses from 4 to 6 years of age that is in accordance with the data of other studies (weber, leonard, & zemel, 2012). it seems that increasing fat mass decreases the ability of anaerobic performance in adult population (inacio, dipietro, visek, miller, 2011), especially in adult athletes (abidin & adam, 2013). from the observed cmj height developmental trends we found significant year-to-year progress in both sexes for about 10 to 30 % per year, comparing the age of 5 (16 to 30 %) to age of 6 (10 to 17 %). the percentages of jumping progress strongly depen163 annales kinesiologiae • 7 • 2016 • 2 katja koren, rado pišot, boštjan šimunič: vertical jump height in young children a longitudinal study ..., 153–170 ding on lower average values at lower ages therefore might be misleading. however, later on the jumping performance increases in both sexes even more steeply after the age of 11, the boys preceding the girls at the age of 16 for about 8 to 10 %. the steeper progress at the age of 11s was found also in sprinting velocity of slovenian children (volmut, pišot, & šimunič, 2016), where girls show little improvement with age while boys continue to improve their sprinting velocity. the authors explained a vast portion of sprinting velocity improvement variance with regular organized sport exercise and contractile properties of skeletal muscles, in particular of biceps femoris, detected by tensiomyography (šimunič et al., 2011). završnik et al. (2016) found significant sex differences in sprinting velocity after the age of 13 years, where boys have about 10 to 15 % higher sprinting velocity than girls. završnik et al. (2016) also confirmed the importance of skeletal muscle contractile parameters for sprinting performance. focke et al. (2013) analyzed cmj in 4to 17-year-old children. their data are inserted in figure 2. they specified that boys jumped higher than girls and the difference was present in all age spans, being 12.5 % at the age of 4 to 5, 5 % at the age of 6 to 7, 9.1 % at the age of 8 to 9 years, 6.4 % at the age of 10 to 11, 14.6 % at the age of 12 to 14, and 42 % at the age of 15 to 17. the higher jump performance in boys is in line with the previously reported studies and can be explained by different gender-related physical conditions (temfemo et al., 2009; harrison & gaffney, 2001). although boys develop lower rate of force development than girls, boys jump higher than girls. it seems that the explosiveness obviously is not sufficient to guarantee better performance. however, boys are able to produce forces over a longer period of time leading to enhanced jumping height (focke et al., 2013). there have been numerous studies which have investigated jumping in athletes from various sports (nikolaidis, ingebrigtsen, póvoas, moss, & torres-luque, 2015; yanci & camara, 2016; wisløff, castagna, helgerud, jones, & hoff, 2004; cilli, gelen, yildiz, saglam, & camur, 2014; sánchez-muñoz et al., 2011). apparently, at certain age they progress in jumping performance more steeply than non-athletes (figure 4). from figure 4 it is evident that the athletes older than 11 precedes non-athletes in the performance. before that age there are actually no differences. 164 katja koren, rado pišot, boštjan šimunič: vertical jump height in young children a longitudinal study ..., 153–170 annales kinesiologiae • 7 • 2016 • 2 figure 4: comparison of countermovement jumping height (with arms) of boys in relation to age and sport participation. we have also presented the effect of arm swings coordination on jump performance. this has been also a focus of other studies, but in adult population (payne, slater, & telford, 1968; miller, 1976; shetty & etnyre, 1989; harman et al., 1990). in the vertical jump, as well as in many other sports skills, the arms are swung vigorously upwards during the take-off to enhance performance (lees, vanrenterghem, & clercq, 2004). the arm swing can increase the ground reaction force in the latter half of the propulsive phase, leading to enhanced net ground reaction impulse. consequently, the center of mass position and vertical velocity at the take-off can also be raised, which increases the jump height (cheng, 2008). feltner, bishop and perez (2004) showed that the arm swing decreases extensor joint torques early in the propulsive phase but augments these same extensor torques later in the propulsive phase. the increased jump height consists of increased center of mass height (54 %) and vertical velocity (46 %) at the take-off, while a different percentage distribution (28 % and 72 %, respectively) was found by lees et al. (2004). hara, shibayama, takeshita and fukashiro (2006) studied the effect of the arm swing on lower extremities in vertical jumping. they concluded that an increased jump height is mainly due to increased work done by the lower extremities, which also comes as a result of the additional load on the lower extremities because of the arm swing. although an increased take-off velocity is reported consistently when a − nikolaidis et al. (2015); b − sánchez-muñoz et al. (2011); c − pagaduan, pojskić, užičanin, and babajić (2012); d − cilli et al. (2014); e − yanci and camara (2016); f − wisløff et al. (2004). 165 annales kinesiologiae • 7 • 2016 • 2 katja koren, rado pišot, boštjan šimunič: vertical jump height in young children a longitudinal study ..., 153–170 arms are swung, the mechanisms by which arm swing leads to an increase in the take-off velocity have not been fully established (lees et al., 2004; harman et al., 1990; shetty & etnyre, 1989). proper use of the arms assures the optimal use of stretch shortening cycle, where harrison and gaffney (2001) found that 6 year-old children could utilize the ssc in vertical jumping equally well compared to adults. harrison and moroney (2007) found also that girls at age 6.6 ± .5 years) appear to be equally effective to adult woman aged 22.1±1.2 years in using the arms to improve jumping performance. moreover, results indicated that the arm action significantly improved performance in both adults (woman) and children (girls) and adults jumped significantly higher than children irrespective of whether arm action was used. improvements in performance of the jump may be due more to differences in body stature and muscle strength and power rather than coordination and control (harrison & moroney, 2007). study limitations the limitations of the study are in the selection of the research environment, namely only one slovenian region was selected for performing this study. furthermore, there are no objective data of their physical status or habits available for the whole group of participants. conclusion this research focused on studying 4 to 6 year-old children's fms, vertical jump. we found no sex differences, but confirmed age-related cmj height increase as well as strong dependence of cmj height increase with engaged jumping coordination. we conclude that jumping coordination is the most important factor of jumping performance in the studied age span. acknowledgement the authors would like to thank all other colleagues, researchers and students who have significantly contributed to this study. thanks also to all the children and parents who gave so willingly of their time to participate in our study of such magnitude. without their collaboration, there would be no scientific advances. finally, this study was financed by the slovenian research agency in the research project “analysis of fundamental motor pattern, skeletal and muscle adaptation on specific sedentary lifestyle factors amongst 4to 7 year-old children”. 166 katja koren, rado pišot, boštjan šimunič: vertical jump height in young children a longitudinal study ..., 153–170 annales kinesiologiae • 7 • 2016 • 2 funding the presented longitudinal research study was part of the national project financed by the slovenian research agency: the research project with the title “analysis of fundamental motor pattern, skeletal and muscle adaptation on specific sedentary lifestyle factors amongst 4 to 7 year-old children” performed by the institute for kinesiology research, science and research centre of koper, university of primorska. references abidin, n. z., & adam, m. b. 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(2016). lower correlation between biceps femoris contraction time and maximal running speed in children than in adults: a longitudinal study in 9to 14year old children. annales kinesiologiae, 7(1), 21-42. view item http://dx.doi.org/10.1503/cmaj.051351 http://dx.doi.org/10.1503/cmaj.051351 http://pdfs.journals.lww.com/acsm-msse/1993/11000/the_optimal_training_load_for_the_development_of.13.pdf http://dx.doi.org/10.1136/bjsm.2002.002071 http://dx.doi.org/10.5604/20831862.1198638 annales kinesiologiae • 10 • 2019 • 2 153 reports and reviews/poročila in ocene, 149–154 report on a visit to the russian state university of physical education, sport, youth and tourism moscow, russian federation, 14th–18th may 2019 within the framework of the bilateral cooperation between slovenia and russian federation, a few colleagues from the institute for kinesiology research of src koper paid a visit to the russian state university of physical education, sport, youth and tourism was held between 14th and 18th may 2019. our kind hosts were elena komova, phd, and prof. sergei levuskhin, phd, who showed us the university and the laboratory of the research institute for sports and sports medicine, where we got acquainted with the research associates, equipment, different measurements and researches as well as how the institute functions. at the same time, our research work and scientific capacities were presented to our russian partners in bilateral cooperation. on 16th may 2019, we were invited to lecture at introductory session at xiii. “contemporary university sport science”, a conference dedicated to graduate students and their international experiences. prof. boštjan šimunič, phd, participated with the lecture “the use of methods of tensiomyography in the study of atrophies” while saša pišot, phd with the lecture titled: “basic motor patterns and physical (embodied) capital of the child.” the following day, on 17th may 2019, we also participated in a roundtable discussion held at the conference entitled: world sports development systems and elite athletes’ access to education. the topic of the round table was about the current good practices and shortcomings of the systems in russia, egypt and slovenia, where prof. rado pišot, phd, presented the results of the project “double career (2d4c)”, while prof. smolianov presented his research of elite sports development systems around the world, currently in the us, uk, senegal and qatar. in the afternoon we had a meeting with prof. valentin sonkin, phd, who explained us their work in detail. we all recognised several common interests in further research, above all in the fields of muscle physiology. the first visit can be considered a success since we have had an important insight into the work of our partner institutions and have made a new acquaintance for a successful cooperation in research on the field of motor status components of children and adolescents with an emphasis on their assessment and measurement. the next step we are going to pursue is to formulate concrete suggestions of common research or data comparison in the field of children’s motor status. our russian colleagues visited us in october 2019, when they visited our premises and laboratories as well as participated at the 10th international scientific and professional conference “child in motion” in portorož, slovenia. this way we continue our collaboration. saša pišot 154 reports and reviews/poročila in ocene, 149–154 annales kinesiologiae • 10 • 2019 • 2 poročilu o obisku ruske državne univerze za telesno vzgojo, šport, mlade in turizem moskva, ruska federacija, 14.–18. maj 2019 v okviru sodelovanja bileterala slovenija rusija je od 14. do 18. maja 2019 manjša skupina sodelavcev inštituta za kineziološke raziskave zrs koper obiskala russian state university of physical education, sport, youth and tourism, kjer smo bili gostje prof. sergeja levuskhinga in dr. elene komove. ogledali smo si univerzo ter laboratorij raziskovalnega inštituta za šport in medicino športa, kjer smo se seznanili z raziskovalnimi sodelavci, opremo, meritvami, raziskavami in delovanjem inštituta. ruskim partnerjem v bilateralnem sodelovanju smo ob tem predstavili tudi svoje raziskovalne in znanstvene zmogljivosti. 16. maja 2019 smo sodelovali z uvodnimi predavanji na konferenci xiii. modern university sport science, namenjeni podiplomskih študentom. prof. dr. boštjan šimunič je sodeloval s predavanjem the use of tensiomiography in athrophy study /uporaba metode tenziomiografije v študijah atrofij in dr. saša pišot s predavanjem fundamental motor patterns and physical (embodied) capital of a child /elementarni gibalni vzorci in utelešen gibalni kapital otroka. 17. maja 2019 smo sodelovali na okrogli mizi, ki je potekala v okviru konference worldwide sport development systems and elite athlete’s access to education /sistemi za razvoj športa in dostop elitnega športnika do izobraževanja. pogovarjali smo se o trenutnih dobrih praksah in pomanjkljivostih sistemov v rusiji, egiptu in sloveniji. prof. dr. rado pišot je predstavil izsledke projekta dual career (2d4c), prof. smolianov pa raziskavo, ki proučuje različne elitne sisteme za razvoj športa po svetu, trenutno v zda, veliki britaniji, senegalu in katarju. v popoldanskem času smo imeli še sestanek s prof. dr. valentinom sonkinom, v okviru katerega smo podrobneje spoznali njihovo delo in opredelili precej skupnih interesov pri raziskovanju, predvsem na področju motoričnega razvoja in fiziologije mišice. prvi tovrsten obisk je bil uspešen, saj smo dobili pomemben vpogled v delo partnerske institucije ter sklenili nova poznanstva za uspešno prihodnje sodelovanje in raziskovanje na področju komponent gibalnega stanja otrok in mladostnikov s poudarkom na njihovem spremljanju in merjenju. naslednji korak je namenjen oblikovanju konkretnih predlogov za sodelovanje v raziskavah in morebitno primerjavo podatkov raziskav na področju gibalnega statusa otrok. obisk ruskih kolegov je potekal oktobra 2019, ko so obiskali naše prostore in laboratorije in se udeležili 10. mednarodne znanstvene in strokovne konference otrok v gibanju v portorožu. saša pišot _goback _goback _hlk23772821 _goback _goback _hlk27564900 _goback bbib0050 bbib0035 _hlk3367923 _goback annales kinesiologiae • 9 • 2018 • 2 73 editorial how to take advantage of information technology in favour of the exercise / sports activity is a challenge, addressed not only by the manufacturers of sports equipment and technologies but also all the sports professionals who strive to move the curve of the decline in locomotor activity in a positive direction. the questions of how to exploit actively the benefits of tennis video games for the young tennis players are also posed by the authors of the first article that have found positive effects especially in the improvement of visual attention, which, however, cannot replace the real training techniques. the following article reminds us of how important regular physical / sports activity in college years is, which also demonstrates a positive connection between longer and more intense physical exercising and academic achievement. at the same time, the article indicates that a quarter of students in slovenia still do not reach the recommended levels of sports activities. in a conference at the 70th anniversary of prof. carlo reggiani, ph.d., we together celebrated the treasure trove of his contributions. the lecturers introduced many new findings and facts, and again highlighted the importance of expertise in the field of skeletal muscles physiology. the next contribution with a similar topic presents the positive effects of electrical stimulation on muscle contraction and, consequently, different adaptations that derive from the procedure. the following article discusses regular physical activity which has become the guarantee for a healthy life and maintaining functional ability in old age. the article highlights the positive effects of an active lifestyle in order to prevent and reduce the problems of the decreasing mental health of the elderly as the most vulnerable groups. the red thread of scientific and expert conference »motor skills of children« and the first international summer school »healthy and active lifestyle« was the importance of acquiring and mastering movement skills in childhood which seems to be one’s physical capital, leading to an active and healthy life style in all life periods. the conference marking the world food day 2018 reminded of healthy diet guidelines and confirmed that both movement and healthy nutrition are integral parts of a healthy life style and they simply cannot and should not be treated separately. prof. rado pišot, ph.d. editor-in-chief and managing editor 74 annales kinesiologiae • 9 • 2018 • 2 uvodnik kako izkoristiti informacijsko tehnologijo v prid gibalni/športni aktivnosti je izziv, ki si ga postavljajo ne samo proizvajalci športne opreme in tehnologij, temveč tudi vsi tisti športni strokovnjaki, ki stremijo za ciljem premakniti krivuljo upada gibalne aktivnosti v pozitivno smer. vprašanje, kako izkoristiti aktivno video igro tenisa pri mlajših teniških igralcih, so si tako zastavili tudi avtorji prvega članka in ugotovili pozitivne učinke predvsem v izboljšanju vizualne pozornosti, ki pa ne more nadomestiti realnega treninga tehnike. kako pomembna je redna gibalna/športna aktivnost v študentskih letih, nas opozarja naslednji članek, ki ravno tako dokazuje pozitivno povezanost daljše in intenzivnejše vadbe s telesnim fitnesom in študijskim uspehom, obenem pa opozarja na to, da še vedno četrtina študentov v sloveniji ne dosega priporočljive stopnje gibalne/športne aktivnosti. bogata je zakladnica znanja, ki smo jo udeleženci obeležili na konferenci ob 70-letnici prof. dr. carla reggianija na univerzi v padovi. prisotni referenti in ostali so predstavili številna nova znanja in dejstva ter znova opozorili, kako pomembna so temeljna poznavanja področja fiziologije skeletnih mišic. podobno tematiko obravnava tudi prispevek, v katerem avtorji predstavijo pozitivne učinke električne stimulacije na mišično kontrakcijo in posledično njene adaptacije. da je redna gibalna aktivnost postala garancija zdravega življenja in ohranjanja funkcionalnih sposobnosti tudi v starosti, govori naslednji pregledni članek, v katerem so poudarjeni pozitivni učinki aktivnega življenjskega sloga v preventivi in zmanjševanju problemov upadanja mentalnega zdravja starostnikov kot najbolj ranljive skupine. pomen pridobivanja in usvajanja gibalnih kompetenc v otroštvu kot gibalnega kapitala, ki vodi v aktiven in zdrav življenjski slog skozi vsa obdobja, pa je predstavljal rdečo nit znanstvene in strokovne konference »motorička znanja djece« ter prve mednarodne poletne šole »healthy and active lifestyle«. poleg smernic zdrave prehrane, ki so bile predstavljene na konferenci ob svetovnem dnevu hrane 2018, so udeleženci konference ponovno potrdili, da sta gibanje in zdrava prehrana neločljiv tandem zdravega življenjske sloga in ju enostavno ne moremo in ne smemo obravnavati ločeno! prof. dr. rado pišot, glavni in odgovorni urednik annales kinesiologiae • 6 • 2015 • 2 119 playing-related health risks among students and teachers of music department at the koper art school matej plevnik1, ines bažon, rado pišot1 1 university of primorska, science and research centre, institute of kinesiology research corresponding author: matej plevnik university of primorska, science and research centre, institute of kinesiology research garibaldijeva 1, 6000 koper, slovenia e-mail: matej.plevnik@zrs.upr.si abstract the study of a musical instrument demands several hours of practicing on a daily basis as well as playing and performing. consequently, the musician can be subjected to various health risks during his or her study process but also afterwards. health problems depend on the individual physical and mental fitness, but also on the features and structure of the instrument as well as on the playing technique, which consists of repeated movements and mainly of static body position. because of the possibility of chronic injuries, especially neuromuscular disorders but also others, it is important for the musician to regularly maintain his or her physical and mental fitness and movement performance by preventive and compensating activities and immediate action in case of pain or when noticing the first signs of medical problems or limitations. the study included 43 students (16.7 ± 1.5 year; 31 females and 12 males) and 15 teachers (36.9 ± 8.8 years; 7 females and 8 males) that attend and teach at the music department of the koper art school, which is a part of the koper high school. the aim of the study was to recognize the risk factors in health status that occur as a consequence of playing a music instrument. a questionnaire consisting of 26 questions was used in the research. the results of the study showed that a half of the interviewed students practices every day but teachers practice less (p = 0.04). therefore, teachers value the importance of physical (p = 0.013) and mental (p = 0.000) fitness more than students. teachers also estimate their current physical and mental fitness to be higher (p = 0.003). 89.7 % of the respondents feel pain of discomfort during or after playing, out of these 95.3 % are students, and 73.3 % are teachers. these musicians state that they most frequently feel pain in the back and neck area and in the shoulders and wrists. 36.2 % of the musicians, original scientific article udc: 616-001:78.071 received: 2016-01-27 120 matej plevnik, ines bažon, rado pišot: playing-related health risks among students and teachers ..., 119–135 annales kinesiologiae • 6 • 2015 • 2 41.9 % of students and 20 % of teachers, affirmed to have had strains or pain, both of physical and psychological nature. it is indispensable for both students and teachers to be aware of suitable preventive, practicing and therapeutic measures. preventive activities and control over risk factors can contribute significantly to the motivation for playing, to the quality of producing and reproducing musical works and to the absence of pain, discomfort and injury occurrences among musicians. keywords: musician, health, pain, prevention, education. zdravstvena tveganja igranja na glasbeni inštrument dijakov in učiteljev umetniške gimnazije koper izvleček študij glasbenega inštrumenta in petja zahteva vsakodnevno in večurno vadbo, igranje ter nastopanje. posledično je glasbenik v procesu študija, pa tudi kasneje, tako lahko izpostavljen različnim zdravstvenim tveganjem. pojav zdravstvenih težav je odvisen od psihofizičnih predispozicij posameznika, hkrati pa tudi od značilnosti in zgradbe inštrumenta ter tehnike igranja na inštrument, ki je sestavljena iz ponavljajočih se gibov in pretežno statičnega položaja telesa. zaradi možnosti pojava kroničnih poškodb, predvsem živčno-mišične narave in drugih zdravstvenih tveganj, je pomembno, da glasbenik redno skrbi za svoj psihofizični status in gibalno zmogljivost tako s preventivnimi aktivnostmi kot tudi s takojšnim ukrepanjem v primeru pojava bolečine oziroma opažanju prvih zdravstvenih zapletov in omejitev. v študiji je sodelovalo 43 dijakov (16.7 ± 1.5 let; 31 žensk in 12 moških) in 15 učiteljev (36.9 ± 8.8 let; 7 žensk in 8 moških), ki se izobražujejo oziroma poučujejo na umetniški gimnaziji koper. cilj študije je bil prepoznati dejavnike tveganja za zdravstveni status kot posledico igranja na glasbeni inštrument. v raziskavi smo uporabili avtorski vprašalnik s 26 vprašanji. rezultati raziskave so pokazali, da polovica anketiranih dijakov vadi vsak dan, učitelji manj (p = 0.04). učitelji tako pomen telesne pripravljenosti (p = 0.013) kot tudi pomen psihične pripravljenosti (p = 0.000) vrednotijo višje kot dijaki. učitelji prav tako višje ocenjujejo tako svojo trenutno telesno kot tudi psihično pripravljenost (p = 0.003). bolečine oziroma neugodje v telesu med igranjem in po njem čuti 89.7 % vseh v raziskavo vključenih glasbenikov, med njimi 95.3 % dijakov in 73.3 % učiteljev. glasbeniki navajajo najpogostejše bolečine v predelu hrbta, vratu, ramenskega obroča in zapestij. o obremenitvah in poškodbah, bodisi telesne ali psihične narave, je poročalo 36.2 % glasbenikov, med temi 41.9 % dijakov in 20 % učiteljev. ozaveščenost glasbenikov, tako dijakov kot tudi njihovih učiteljev, o ustreznih preventivnih, vadbenih kot tudi teraannales kinesiologiae • 6 • 2015 • 2 121 matej plevnik, ines bažon, rado pišot: playing-related health risks among students and teachers ..., 119–135 pevtskih, ukrepih je nujna. preventivne aktivnosti in nadzor nad dejavniki tveganja pomembno prispevajo k motivaciji za igranje, h kakovosti ustvarjanja in poustvarjanja glasbenih del ter k odsotnosti bolečin, neugodja in pojavu poškodb glasbenikov. ključne besede: glasbenik, zdravje, bolečina, preventiva, izobraževanje introduction music and society have always been closely related. in ancient societies, music was a means for connecting with the spiritual world. at first, humans did not have instruments so they created music with clapping and stomping. instruments spread widely during the development of the first civilizations. the newly acquired musical profession was highly regarded in society. the egyptians and ancient greeks, as well as other nations, appreciated music very much. not only did it have an important role in everyday life, professional concert playing was diffused, too. music developed greatly through history. since the second half of the 20th century technological progress reflected also in the musical sphere. mass media, such as radio, television and internet spread music and contribute to its importance in economy (blažič primožič & čerič, 2004; čerič & šramel vučina, 2008). amateur and professional musicians usually begin their education in elementary music school, most of them by the age between 6 and 8. education in music schools is part of the public education system in slovenia. each year around 25.500 children and youths enrol in music educational programmes (european music union, 2010). some of the children decide to continue their music education in high school or at university; many of them upgrade their knowledge in music institutions abroad. the study of a musical instrument demands several hours of practicing on a daily basis which can lead to various health risks. musicians are top athletes who execute, dominate and control tiny movement skills and can undergo tremendous physical, functional and cognitive strain while studying and playing musical instruments both during their performance or other artistic production. in order to produce music with a musical instrument, many years of studying and playing are necessary. it is by playing that we can achieve temporal and spatial precision, moreover, also exceptional control over the execution of fine movements (plevnik & gerževič, 2015). playing a musical instrument demands the execution of fine movements, including movements of the hands and fingers, arms, legs and torso. however, it can also involve locomotor movement, such as walking in place or around which is common in wind orchestras or choruses. playing a musical instrument is therefore a physical activity that puts strain primarily on small muscle groups of fingers and arms, but also on large muscle groups that are responsible for maintaining an optimal body posture, often in forced and non-physiological positions. pearce and rohrmeier (2012) talk about a wide range of links between playing music and listening to it on one hand and human cognition on the other. they describe music as a “complex cogni122 matej plevnik, ines bažon, rado pišot: playing-related health risks among students and teachers ..., 119–135 annales kinesiologiae • 6 • 2015 • 2 tive system”. listening, performing and interacting with music require a wide range of cognitive functions and processes from the musician, including auditory analysis, perception of the musical structure (voice, intonation, rhythm, tempo, volume etc.), attention, learning and memorizing (a composition and its features), shaping expectations, emotions, social cognition etc. a musical performance on a professional level is one of the most demanding tasks for the human nervous system. if we combine this all, we can assume that a musical performance is made at least of the cognitive and motor aspects. the cognitive aspect, along with the general cognitive functions, regards the understanding of the musical structure (harmonies, tonalities, phrasing, auditory perception), whereas the motor aspect concerns the actualisation of a movement within its spatial and timely characteristics (precision, speed, punctuality, rhythm, softness) (plevnik & gerževič, 2015). health problems are common among musicians; their occurrence depends on several factors, namely: the individual psychophysical predisposition, the characteristics of the instrument and the playing technique (gaserzer & neugebauer, 2011). the most common health problems among musicians are musculoskeletal, neurological, auditory, skin and psychological conditions (heinan, 2008). the listed conditions can hinder a musician from producing and reproducing music effectively and can even prevent him or her from playing the instrument completely due to pain and injuries (gambichler, boms, & freitag, 2004; gasenzer & parncutt, 2006; hansen & reed, 2006; hojs & bilban, 2010; carli & bilban, 2012; lee et al., 2013). črnivec (2004) conducted a study among the musicians of the slovene philharmonic orchestra and describes that 50 to 76 % of the musicians suffer from musculoskeletal conditions, mostly because excessive strain on tendons, tendon sheaths and tendon and muscular insertions. also common are back conditions due to regular strains in non-physiological positions which are the result of the static nature of the task, neurological damage due to excessive pressure and occupational hearing impairment. musicians of the slovene philharmonic orchestra claim that the symptoms start occurring after 60 to 93 minutes of playing the instrument. pain and discomfort usually first occur in the shoulder girdle, followed by the lumbar and lower back area, backline, wrists, elbows, thoracic spine, fingers, lower limbs and forearms (črnivec, 2004). leaver, harris, and palmer (2010) conducted a study that included professional musicians from the top orchestras in great britain and the results showed that 86 % of the musicians experienced pain in the 12 months prior to the research, mainly in the neck, lower back and shoulder area. the study also showed that pain problems occur more often with female musicians and musicians with a general feeling of being unwell; the occurrence of pain also depends on the instrument category. different studies have shown that approximately one half of professional musicians and music students face musculoskeletal injuries, women more often than men and violinists and pianists more often than other musicians (robinson & zander, 2002; paarup, baelum, holm, mannuche, & wedderkopp, 2011). robinson and zander (2002) state that playing a musical instrument is the second most frequent form of risk exposure for bone and muscle injuries, right after using the computer. a study (chan, driscoll, & ackermann, 2013) conducted among australian professional musicians in annales kinesiologiae • 6 • 2015 • 2 123 matej plevnik, ines bažon, rado pišot: playing-related health risks among students and teachers ..., 119–135 orchestras, showed that the most common conditions occur in the shoulders, neck and backline, followed by tingling sensation, loss of muscle control and force production (robinson & zander, 2002; norris, 2011). overuse injuries can be defined as acute or chronical. acute overuse injuries occur when a musician overuses the tissue to the extent of feeling the consequences the following day, which can occur in form of muscle pain and rigidity in the areas that were subjected to overuse (e.g. arm, hand). chronical overuse injuries develop during a longer period of time and in a less obvious manner (shafer-crane, 2006). they begin as slightly unpleasant sensations that can advance to severe pain over the period of weeks and months (norris, 2011). table 1 shows the most common musculoskeletal injuries linked to playing a specific musical instrument. table 1: musculoskeletal injuries associated with specific instruments (adapted from robinson & zander, 2002). violin / viola neck pain thoracic outlet syndrome (left) carpal tunnel syndrome (left) cubital tunnel syndrome (left) rotator cuff tendinitis (right) extensor carpi radialis tendinitis (right) temporomandibular joint dysfunction flute thoracic outlet syndrome (left and right) ulnar nerve entrapment (left) extensor carpi radialis tendinitis (left) back and neck pain de quervain’s syndrome (left and right) focal dystonia of ring and little fingers (left) bassoon back and neck pain temporomandibular joint dysfunction dental problems strain of the teres major muscle and the pectoralis major muscle (right) de quervain’s syndrome keyboards (piano / organ / accordion) thoracic outlet syndrome medial and lateral epicondylitis tendinitis of wrist flexors and extensors carpal tunnel syndrome de quervain’s syndrome dorsal wrist ganglion focal dystonia of thumb, finger, hand, and foot muscles percussion lateral and medial epicondylitis flexor carpi ulnaris tendinitis extensor carpi radialis tendinitis de quervain’s syndrome carpal tunnel syndrome achilles tendinitis guitar triceps tendinitis (right) focal dystonia of index and middle fingers and thumb (right) thoracic outlet syndrome (left) carpal tunnel syndrome (left) flexor carpi ulnaris tendinitis (left) strain of dorsal interosseous (left 124 matej plevnik, ines bažon, rado pišot: playing-related health risks among students and teachers ..., 119–135 annales kinesiologiae • 6 • 2015 • 2 clarinet carpometacarpal joint strain (right) carpal tunnel syndrome de quervain´s syndrome (right) lateral epicondylitis (right and left) temporomandibular joint dysfunction cello / string bass neck pain ulnar nerve entrapment (left) flexor carpi ulnaris tendinitis (left) rotator cuff tendinitis (right) extensor radialis tendinitis (right) oboe extensor carpi radialis tendinitis (right) lateral epicondylitis (right) ulnar nerve entrapment (right) posterior interosseous nerve entrapment (right) back and neck pain de quervain’s syndrome trumpet maxillofacial and lip trauma pharyngeal dilatation saxophone back and neck pain extensor carpi radialis tendinitis (right and left) temporomandibular joint dysfunction vocals vocal cord strain facial and neck muscle strain focal dystonia of vocal cord muscles trombone focal dystonia of lip lateral epicondylitis (right) strain of the orbicularis oris muscle the reasons for the emergence of pain are mainly long-term playing in a non-physiological position of the body, the presence of stress and psychological pressure, insufficient breaks, the lack of warming up before playing, bad posture while playing the instrument, repetitive movements, muscle tension, too much power used in the body movements and the wrong playing technique. poor general physical condition of the musician and consequently fatigue also significantly contribute to the occurrence of pain and injuries (robinson & zander, 2002; dragulin, 2011). playing an instrument of an unsuitable size or one that is ergonomically unsuitable also accelerates the occurrence of pain and injuries (gasenzer & parncutt, 2006). the aims of this study were to use the questionnaire to identify: 1) the occurrence of early health problems of students and 2) the difference between students and teachers in health status and their approach to playing and practicing the musical instrument. methods subjects the sample consisted of 43 students (16.7 ± 1.5 years; 31 females and 12 males) who were enrolled in the academic year 2014 / 15 in the first, second, third or fourth year of music department of the koper art school, a part of the koper high school, annales kinesiologiae • 6 • 2015 • 2 125 matej plevnik, ines bažon, rado pišot: playing-related health risks among students and teachers ..., 119–135 and their 15 teachers (36.9 ± 8.8 years; 7 females and 8 males). the participation in the survey was voluntary. 75 % of the respondents were students and 52 % were teachers. the study included all groups of instruments, namely string instruments (n = 8), wind instruments (n = 16), brass instruments (n = 11), percussions (n = 1), plucked string instruments (n = 5) and keyboard instruments (n = 16). project procedure for the purpose of this research we developed a questionnaire with 29 questions. the questions were divided in several parts, namely a) main characteristics about the subject and his / her playing habits and musical traditions, b) questions about lifestyle, c) questions about anxiety, fatigue and injuries and d) approaches to playing a musical instrument and medical particularities of the musician. questionnaires were distributed in printed form to students and teachers. data analysis the data was analysed and edited in microsoft office excel 2013. we used the method of descriptive statistics, spearman’s rank correlation coefficient and the t-test for independent samples for calculating the analysis of the mean differences. the data is presented as an arithmetic mean ± standard deviation (am±sd). results and discussion the study results show many differences in the answers to the research questions between students and their teachers. the answers significantly identify the causes underlying the health problems as well as differences in the approach to playing and practicing musical instruments between the students and their teachers. at the time of the study, the students had practiced their musical instrument on average 9.3 ± 2.1 years, while their teachers 27.7 ± 9.9 years (p = 0.000). among the students, the shortest period of playing is 2 years and the longest is 15 years, whereas among the teachers, the shortest period is 15 years and the longest period is 45 years. among students, the beginning of formal musical education by enrolling in the music school is on average at the age of 7.4 ± 2.1 years and among teachers 9.3 ± 2.2 years. the students play on average 6.1 ± 1.2 days per week, whereas the teachers 5.5 ± 0.8 days (p = 0.04). a half (49 %) of the students practice every day, meanwhile, only 2 teachers practice regularly every day. the students practice an average of 3.1 ± 1.2 hours per day; on the other hand, the teachers practice 2.8 ± 1 hour per day. most students and teachers take a break while playing and practicing the musical instrument. students’ breaks are slightly longer (15 ± 10.3 min; 11.9 ± 6.6 min), all of them usually take 2 126 matej plevnik, ines bažon, rado pišot: playing-related health risks among students and teachers ..., 119–135 annales kinesiologiae • 6 • 2015 • 2 breaks. statistically, there are no significant differences in the duration and frequency of breaks between the students and the teachers. musicians, participating in the survey, evaluated the importance of physical and mental fitness for their work on a scale from 1 (“not important”) to 6 (“very important”). musicians also assessed their physical and mental fitness and state of health on a scale from 1 (“low”) to 6 (“extraordinary”). there is no statistically significant difference in evaluating the health status among students and teachers (4.3 ± 1.2; 4.5 ± 0.9). table 2: assessment of the importance of physical fitness and current physical fitness. assessment of the importance of physical fitness assessment of current physical fitness students 4.7 ± 1.3 2.9 ± 1.1 teachers 5.4 ± 0.8 3.5 ± 1.3 total 4.8 ± 1.2 3.1 ± 1.2 p = 0.013 teachers evaluate the importance of good physical fitness higher; their own assessment of their physical fitness was also better (table 2). teachers also give a higher value to the importance of good mental fitness; their assessment of their own current mental fitness is also higher (table 3). both, students and teachers, evaluated the importance of physical and mental fitness higher in comparison to their assessment of their actual physical and mental fitness. a distinct decrease in physical (movement and functional) capacity can be seen in this period, due to the consequences of many individuals’ lifestyles in the modern society (world health organization, 2014). table 3: assessment of the importance of mental fitness and current mental fitness. assessment of the importance of mental fitness assessment of current mental fitness students 5.2 ± 1.0 3.8 ± 1.3 teachers 5.9 ± 0.4 4.8 ± 0.9 total 5.4 ± 0.9 4.1 ± 1.3 p = 0.000 p = 0.003 annales kinesiologiae • 6 • 2015 • 2 127 matej plevnik, ines bažon, rado pišot: playing-related health risks among students and teachers ..., 119–135 36 % of the musicians participating in the survey, namely 17 students and 4 teachers, believe that they exaggerate when practicing the musical instrument. the most common reason for exaggeration are upcoming concerts, followed by their own high expectations and an increase in the repertoire (figure 1). what is interesting is that 12 % of the students state that the reasons for their exaggeration are the demands of others, parents or teachers. figure 1: reasons for exaggerations in playing. students and teachers experience fatigue after playing an instrument. both, students and teachers assessed it with the average value of 3.7 ± 1.1, on a scale from 1 (“not tired at all”) to 6 (“very tired”). the musicians who express a higher degree of fatigue after playing also assessed their general health status to be worse (r = -537, p = 0.000, n=58). statistically, the link between the assessment of fatigue after playing and the evaluation of their own physical capability is not expressed. the phenomenon of stage anxiety before performances is present with both students and teachers. the students, on a scale from 1 (“never”) to 6 (“always”), evaluate the frequency of the presence of stage anxiety with the assessment of 4.9 ± 1.4, meanwhile the teachers evaluate it with the assessment 3.3 ± 1.5 (p = 0.003). on the scale from 1 (“not present”) to 6 (“very strong”), the students evaluate the intensity of the stage anxiety with the assessment of 4.4 ± 1.3, meanwhile the teachers assessed it lower 3.3 ± 1.5 (p = 0.02). students are engaged in physical activity in an average of 2 ± 1.8 days a week, the teachers on the other hand in an average of 3.1 ± 2.8 days a week. among all the participating musicians, 26.7 % of them is not engaged in any kind of physical activity – 13 students and 3 teachers. figure 2 shows the most common forms of physical activity among students and teachers. 128 matej plevnik, ines bažon, rado pišot: playing-related health risks among students and teachers ..., 119–135 annales kinesiologiae • 6 • 2015 • 2 figure 2: students´ and teachers´ engaging in physical activity or sport. 89.7 % of all the participating musicians feel musculoskeletal discomfort, among them 95.3 % of the students and 73.3 % of the teachers. the average time of reporting pain in the locomotor system after the starting point of playing on an instrument among the interviewed musicians is 64 ± 47 minutes, wherein the beginning of the occurrence of problems with the students is on average 61 ± 41 minutes (onset between 5 and 180 minutes), with the teachers on average of 75 ± 64 minutes (between 20 and 240 minutes). there are no statistically typical differences in the time of occurrence of pain among the students and the teachers. the musicians cite the most common pain in the back, neck, shoulder girdle and wrists (figure 3). back pain occurs with mostly all instruments, flutists, violinists and pianists are the ones who most frequently feel neck pain and pain in the shoulder girdle, violinists and pianists also sense pain in the lower back, pianists can also feel pain in the upper arm, forearm and wrists, finger pain occurs with mostly keyboard instrument players, violinists and guitarists, lip pain with the players of wind instruments and finger skin pain with violinists and guitarists. annales kinesiologiae • 6 • 2015 • 2 129 matej plevnik, ines bažon, rado pišot: playing-related health risks among students and teachers ..., 119–135 figure 3: occurrence of pain or discomfort while playing the instrument. when the pain occurs, 67.3 % of musicians immediately take measures, namely 61 % of the students and 90.9 % of the teachers (p = 0.001). most often, the musicians take a break when the pain occurs; some of them stretch and take exercise, massage themselves or correct their posture. 36.2 % of musicians, among them 41.9 % of the students and 20 % of the teachers, report load and injuries, either of physical or psychological nature. the most common load reported by musicians is stress, followed by tendinitis and tendon sheath (figure 4). figure 4: loads and injuries reported by the participating musicians. 130 matej plevnik, ines bažon, rado pišot: playing-related health risks among students and teachers ..., 119–135 annales kinesiologiae • 6 • 2015 • 2 demands for excellence and the highest level of professionalism among both the young as well as older academic musicians are increasingly exceeding the limit of loads that men are capable of withstanding without negative effects on their body. in the last decade, this shows as a significant increase in injuries as a result of overloading due to playing the instruments and is reflected in the most demanding forms of chronic injuries of world-class musicians (črnivec, 2004; elliott, 2012). an increasing number of typical injuries, particularly those of muscle-skeletal apparatus, which are typical for top musicians, could be detected already among the youngest musicians at the beginning of their artistic career (ranelli, 2012). both the students and the teachers evaluated the importance of preventive measures on a scale from 1 (“not important”) to 6 (“very important”). these are, according to both, the teachers and the students, arranged according to their importance, from the most important to the least important: optimal technique of playing, adjustment of the length of playing according to an individual’s abilities, adequate breaks, warming-up before playing, gradual increase in the amount of playing or avoidance of sudden increase in the amount of playing, implementation of mobility exercises during breaks and the use of ergonomic devices (figure 5). statistically, there are no differences in the assessments of the teachers and the students. figure 5: assessments of the importance of preventive measures, according to the students and the teachers. regular physical exercise oriented either towards prevention or therapy helps improving health conditions, general well-being and physical condition (bejjani, glenn, & benham, 1996; ackermann, 2013; world health organization, 2010). physical exercise also affects cognitive processes (gasenzer & parncutt, 2006), which are of great importance for creating and performing music. in her study, ackerman (2013) demonannales kinesiologiae • 6 • 2015 • 2 131 matej plevnik, ines bažon, rado pišot: playing-related health risks among students and teachers ..., 119–135 strated that if one engages in physical activity at least 2 times a week, this already has a positive effect when playing the instrument. adequate physical activity and exercises is the first preventive measure, which should be taken into account by every musician (norris, 2011). a special attention must be paid to the exercises of hands and fingers, which are distinctively strained while playing, but are usually the least taken care of (ackermann, 2013). to prevent pain and injuries it is important to shift between the strain periods, i.e. playing the instrument, and suitably long and active breaks (moharić, 2014). good mental fitness and stability are important for optimal musical performance and keeping to the chosen strategy of practicing (lockwood, 1989). professional instrument playing causes a considerably increased heart rate (beats / min), which is also connected to body mass index, tempo of music and characteristics of the instrument (vellers, irwin, & lightfoot, 2015). iñesta, terrados and garcia (2008) report that while playing an instrument the heart rate rises on average up to 72 % of the highest heart rate (the highest measured heart rate 85 %). the achieved heart rate depends on the playing characteristics, the complexity of the music and the psychophysical abilities of the musician. injury prevention includes awareness and control over risk factors that cause pain and influence the emergence of injuries. prevention also includes identifying and taking appropriate action when first symptoms and signs of injury occur (robinson & zander, 2002; zupan, 2007). it is very important that musicians know their psychophysical abilities and they do not exceed them to the disadvantage of their own health. to avoid illness and injuries they have to control and maintain their health, physical condition and appropriate diet (bragge, bialocerkowski, & mcmeeken, 2006). the most important preventive measures include maintaining good health and good physical condition, properly organised practicing and playing the instrument, the choice of appropriate ergonomic tools and instruments, proper lifting, holding and carrying the instrument and good awareness of the body (robinson & zander, 2002; norris, 2011). according to plevnik and gerževič (2015), preventive actions also include implementing complementary tasks using a variety of training therapeutic devices while playing the instrument. one of the major causes of injuries is also a sudden increase of the amount of playing. when planning the instrument playing and practicing we need to take into account if a concert date is approaching in order to rearrange the quantity and the intensity of practice and preparation. it is very important that the amount of practice gradually increases before concerts and competitions and that we do not exaggerate with playing the instrument. a gradual change in the intensity of activity allows the body to adapt to it and enables musicians to recognise when their limits are exceeded and identify the signs and symptoms of injuries (robinson & zander, 2002; roset-llobet, rosines-cubells, & salo-orfila, 2000). in case of a sudden increase of the repertoire we divide practice into several shorter practice sessions; they will be more effective than one long practice. fatigue is the indicator of excessive practise. we may also experience pain when fatigue occurs, therefore, we must be very attentive to posture, frequency and length of breaks and playing time. nevertheless, the environment in which we play also 132 matej plevnik, ines bažon, rado pišot: playing-related health risks among students and teachers ..., 119–135 annales kinesiologiae • 6 • 2015 • 2 plays a significant role in successful instrument playing (temperature, brightness of the room etc.) as well as a quality of sleep, a healthy diet, a healthy lifestyle, avoiding stress and adequate hydration (robinson & zander, 2002). due to a high occurrence of injuries, it is very important that the musicians are aware of the possibility of injuries or diseases that may arise as a result of playing (parncutt, 2007; potter & jones, 1995). it is also very important to know the preventive measures that can prevent injuries and to know how to take action when the pain already arises. rising awareness about the consequences of playing the instrument should be carried out from the first contact with a musical instrument, as this would significantly contribute to the acquisition of the optimal technique of playing a musical instrument in the early years and would, thereby, reduce the occurrence of injuries and health problems in the later years of the musical career. conclusion the purpose of the study was to deter–ferences between approaches in the strategies of practicing musical instruments of students and teachers of music department the koper art school. there is a statistical difference in the quantity of instrument playing time between the students who practice more and their teachers. (p = 0.04). no statistically significant differences in the duration and frequency of breaks between the students and the teachers were detected. an important finding in the study concerns the assessment of the importance of physical and mental preparation in relation to the demands and needs of playing the music instrument. the teachers value the importance of physical and mental fitness higher (p = 0.013; p = 0.000), and at the same time they estimate the level of their own physical and mental fitness to be higher as well. according to the surveyed musicians, the assessment of their own health condition is significantly associated with a greater degree of fatigue during and after the completion of playing (r = -537, p = 0.000). 89.7 % of all surveyed musicians feel pain or discomfort in their body, among them 95.3 % of students and 73.3 % of teachers. the musicians state that the most common pain occurs in the back, neck, shoulder and wrists. 36.2 % of musicians, among them 41.9 % of the students and 20 % of the teachers reported about strains and injuries, either of physical or psychological nature. however, the reported injuries were not confirmed by a medical doctor. the most common strain reported by the musicians is stress, followed by tendinitis and tendon sheaths inflammation. stress is connected to the occurrence of stage anxiety, the musicians report. the students reported a higher frequency and greater intensity of stage anxiety before performances compared to their teachers (p = 0.003; p = 0.02). as the most important preventive measures, musicians expose the acquired optimal technique of playing the instrument, adjusting the length of the individual playing abilities and adequate long breaks during practice. regular physical exercise oriented either towards prevention or therapy helps improving medical health, general well-being and physical fitness (bejjani, glenn, & benham, 1996; ackermann, 2013; world health organization, 2010). among all the annales kinesiologiae • 6 • 2015 • 2 133 matej plevnik, ines bažon, rado pišot: playing-related health risks among students and teachers ..., 119–135 musicians involved in the study, 27.6 % of them engage in physical activity less than once a week. based on the study results, we find significant differences between the strategies for instrument playing approaches between the students and their teachers. the teachers are more aware, not only of the technicality and specificity of the music, but also of the importance of and adequate physical and mental fitness. they are also more physically active and they express significantly lower frequency and intensity of stage anxiety of performances. also, the teachers report a lower rate of pain and discomfort occurrences, as well as damage occurrences as a result of playing a musical instrument. based on the mentioned study, we recommend that teachers include raising the awareness about risk factors of injuries in the learning process and that they teach students the basics of preventive action in the event of the occurrence of pain, discomfort and injury while playing. acknowledgement the authors would like to thank the management of the music department of the koper art school for their support and help with study realisation, as well as all musicians, students and teachers who participated in the study. references ackermann, b. 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(2015). heart rate response of professional musicians when playing music. medical problems of performing artists, 30(2), 100. view item world health organization (2014). data and analysis on prevalence of insufficient physical activity. geneva: world health organization. retrieved 12. 2. 2016, from http:// www.who.int/entity/gho/ncd/risk_factors/physical_activity/en/index.html. world health organization. (2010). global recommendations on physical activity for health. geneva: world health organization. view item zupan, d. (2007). preventiva pred zdravstvenimi okvarami poklicnih glasbenikov [prevention of occupational disorders in musicians]. slovenian journal of public health, 46(4), 157–164. view item http://www.ncbi.nlm.nih.gov/pmc/articles/pmc2146452/ http://espace.library.curtin.edu.au/r?func=dbin-jump-full&local_base=gen01-era02&object_id=188300 http://matrixwww.co-bw.com/health%20pdf/preventing_injury_musicians_dnacers.pdf https://www.sciandmed.com/mppa/journalviewer.aspx?issue=1090&article=997 http://dx.doi.org/10.1016/j.pmr.2006.07.005 https://www.sciandmed.com/mppa/journalviewer.aspx?issue=1209&article=2098 http://apps.who.int/iris/bitstream/10665/44399/1/9789241599979_eng.pdf http://www.dlib.si/details/urn:nbn:si:doc-248avfy1 _goback _goback _goback _goback _goback _goback _goback annales kinesiologiae • 10 • 2019 • 1 1 editorial numerous mechanisms of the impact of exercise/sports activity on our health and quality of life have been addressed several times in previous studies, and their direct and indirect impact on an individual and the wider society has been proven many times. nevertheless, the field of study of individual motor, cognitive, and nutritional intervention remains one of the most interesting and effective, as well as economically acceptable, approaches within the framework of public health solutions. at times, it may seem that only the desire for the ultimate performance of movement with the goal of a good sporting result receives an in-depth individual treatment, but this is not the case. it is true that with today’s approaches to diagnostics and finding the background of a good result, we can get closer to an individual and, on the basis of scientific findings, direct further training regimes, as presented by the author of the first article in this issue. however, the following three articles bring us closer to the importance of individualizing the approach to each user according to their specific needs, dietary regimes and exercise incentives. certain environments are particularly encouraging, and the mediterranean environment is certainly one of the most suitable ones, be it a specific natural or social environment. in the final articles and the researchers’ reports, we receive further confirmation of how researchers from different corners of the world, with different interests, orientations and aims, are jointly oriented towards, more or less, the same goal. how to ensure a healthy and quality life for modern people, entangled in many (virtual) communication networks, supported by innovative technologies of the digitalized world, which, due to their own development, has fallen into more or less planned, and, unfortunately, unsolicited and unwanted anthropological and ecological transformations? often we think we know several solutions; however, either with a quick glance around us or following research on these indicators, the opposite is confirmed. never in the familiar history of mankind have we communicated so poorly, never have we been so unsociable, or so mentally and functionally labile and incapable. therefore, there is still a lot of room for research and the work of kinesiologists and many other professionals who strive in similar directions. prof. rado pišot, phd editor in chief 2 annales kinesiologiae • 10 • 2019 • 1 uvodnik številni mehanizmi vpliva gibalne/športne dejavnosti na zdravje in kakovost življenja so bili v predhodnih študijah že večkrat obravnavani, njihov neposreden in posreden vpliv na posameznika in širšo družbo pa tudi že večkrat dokazan. kljub temu je področje proučevanja posameznih gibalnih, kognitivnih in prehranskih intervencij še vedno eden najzanimivejših in najučinkovitejših ter ne nazadnje tudi ekonomično najsprejemljivejših pristopov v okviru javnozdravstvenih rešitev. včasih se zdi, da je le želja vrhunske izvedbe gibanja zaradi športnega rezultata deležna poglobljene individualne obravnave, vendar ni tako. res je sicer, da se z današnjimi pristopi v diagnostiki in iskanju ozadij dobrega rezultata posamezniku lahko popolnoma približamo in na osnovi znanstvenih ugotovitev usmerjamo nadaljnje trenažne pristope, kot so predstavili avtorji prvega prispevka v izdaji revije, ki je pred vami. vendar pa nam naslednji trije prispevki zelo nazorno približajo pomen individualizacije pristopa za vsakega uporabnika glede na njegove specifične potrebe, prehranske režime in gibalne spodbude. pri tem so določena okolja še posebej spodbudna in sredozemsko je z vsem, kar mu nudita posebno naravno in družbeno okolje, prav gotovo eno najprimernejših. v končnih prispevkih, poročilih raziskovalcev, pa lahko dobimo le še dodatne potrditve, kako so raziskovalci na različnih koncih sveta, z različnimi interesi, usmeritvami in cilji, ne glede na to, od kod prihajajo, skupaj usmerjeni k bolj ali manj enakemu cilju. kako sodobnemu človeku, zapletenemu v številne (virtualne) komunikacijske mreže, podprte z inovativnimi tehnologijami digitaliziranega sveta, ki je zaradi svojega razvoja padel v bolj ali manj načrtovane, večkrat pa žal tudi neslutene in neželene antropološke in ekološke transformacije, zagotoviti zdravo in kakovostno življenje? večkrat menimo, da poznamo ogromno rešitev, že bežen pogled okoli sebe in še toliko bolj raziskani kazalniki pa kažejo prav nasprotno. nikoli v nam znani zgodovini človeštva nismo tako slabo komunicirali, se družili, bili duševno in funkcionalno tako labilni in nezmožni. torej je prostora za raziskave in delo kineziologov in številnih drugih strokovnjakov, ki si prizadevajo za to, še veliko. prof. dr. rado pišot, glavni in odgovorni urednik annales kinesiologiae • 9 • 2018 • 2 75 original scientific article udc: 796.342:796.015.1 received: 2018-05-13 playing active video games while in a tennis training process: a new training tool or a handicap for children? luka šlosar 2, matej plevnik 1, uroš marušič 3,4 1 university of primorska, faculty of health sciences, department of kinesiology and physiotherapy, izola, slovenia 2 oš vincenzo e diego de castro, piran, slovenia 3 institute for kinesiology research, science and research centre koper, slovenia 4 department of health sciences, alma mater europaea – ecm, maribor, slovenia corresponding author: uroš marušič institute for kinesiology research, science and research centre koper, garibaldijeva 1, 6000 koper, slovenia phone: +386 5 663 77 00 e-mail: uros.marusic@zrs-kp.si and umarusic@outlook.com orcid id: https://orcid.org/0000-0002-7420-2137 abstract aim: the purpose of this pilot study was to quantify the effect of a continued active video games (avg) playing on the tennis forehand and backhand technique development. methods: altogether 24 tennis players (7 – 9 year olds) were randomly divided in two different groups, both involved in a 12-week tennis training program (twice a week for an hour). the participants in the experimental group received an additional twice a week (20-minute) avg virtua tennis 4 game intervention at the end of each regular tennis training hour, while the participants in the control group received no additional intervention. preand post-avg intervention, the tennis rating score for children scale (trsc) was applied to detect tennis training-related changes that occur in each specific stroke. results: our results at the post-test show that participants in the experimental group did not significantly improved in one element (trsc12; p = 0,317) in the forehand stroke and two (trsc10; p = 0,157 and trsc12 p = 0,157) in the backhand. the control group significantly improved in all the fifteen evaluated elements in both the forehand and backhand stroke. the experimental group had a higher effect size in 76 luka šlosar, matej plevnik, uros marušič: playing active video games while in a tennis training process ..., 75–88 annales kinesiologiae • 9 • 2018 • 2 all the kinetic chain section in both the forehand and backhand stroke compared to the control. the same happens for the trsc7 (point of contact – height). conclusion: prolonged avg playing seems to improve visual attentions skills (perception of a moving object) in young tennis players, giving them the opportunity to be able to prepare themselves for the oncoming ball sooner as compared to their control counterparts. from the other perspective, avg were shown to negatively affect correct players positioning, especially at the beginning and at the end of a stroke. keywords: exergames, tennis technique, visual attention skills. igranje aktivnih video iger v procesu učenja tenisa otrok: novo vadbeno orodje ali ovira? izvleček cilj: namen pilotske študije je bil preučiti vpliv dolgotrajnega igranja aktivnih video iger (avg) na proces usvojitve tehnike teniških udarcev bekend in forhend. metode: v študiji je sodelovalo 24 teniških igralcev starih 7 do 9 let, ki so bili naključno razdeljeni v dve skupini. obe skupini sta bili vključeni v 12-tedenski teniški program usposabljanja (dvakrat na teden po eno uro). v prvi, t. i. eksperimentalni skupini, so igralci poleg rednega procesa treninga, bili deležni 20 minutnega igranja avg virtua tennis 4 neposredno po treningu. kontrolna skupina se je udeleževala le rednega procesa treninga. za oceno izvedbe tehnike udarcev smo uporabili lestvico teniškega napredka (trsc). rezultati: po 12-tedenski intervenciji eksperimentalna skupina ni pomembno napredovala v enem elementu (trsc12; p=0,317) pri forhend udarcu in dveh (trsc10; p=0,157 in trsc12; p=0,157) pri bekend. kontrolna skupina je pomembno napredovala v vseh petnajstih elementih tako pri forhend kot bekend udarcu. eksperimentalna skupina je imela višjo vrednost učinka pri vseh elementih kinetične verige tako pri bekend kot forhend udarcu v primerjavi s kontrolno skupino. enako velja za element trsc7 (višina točke udarca). zaključek: dolgotrajno igranje avg naj bi izboljšalo vidno zaznavne sposobnosti mladih teniških igralcev in s tem omogočilo hitrejšo postavitev na udarec. po drugi strani negativno vpliva na pravilno tehnično postavitev in zamah pri forhend in bekend udarcih. rezultati predstavljajo koristne informacije tako za starše kot trenerje o vplivu avg na teniški razvoj mladih igralcev. ključne besede: aktivne video igre, tehnika udarcev, vidno prostorske sposobnosti. annales kinesiologiae • 9 • 2018 • 2 77 luka šlosar, matej plevnik, uros marušič: playing active video games while in a tennis training process ..., 75–88 introduction active video games (hereinafter avg) represent a new video games generation that introduced controllers and motion sensing input devices, for which a whole body physical interaction is required while playing (mears & hansen, 2009). compared to the traditional sedentary video games, the new virtual reality experience allowed its users to see, hear and feel the environment as being part of it. avg are able to track full-body movements in three dimensions, can measure reaction times, accelerations and detect the speed of a player’s movement (staiano & calvert, 2011). while playing, the users need to simulate the basic movements and features that represent the key elements and specificities of each sport, hence they are able to express the most authentic replication of a real sport experience. the most popular avg devices are the commercially available xbox, wii, and playstation consoles. according to fulton et al. (2012), 40 % of adolescents play video games at least once a week, 83 % of americans aged between 8 and 18 have at least one avg console at home while 56 % have two or more (rideout, foehr & roberts, 2010). the fast growing interest in avg made them a significant research area. studies were mainly focused on the contribution they can offer as a weapon against sedentary lifestyle and a way to promote wellness. review articles and meta-analysis for observational studies (peng, lin & crouse, 2011; peng, crouse & lin, 2013) proved that playing avg compared to inactivity, increase heart rate, oxygen consumption (vo2) and energy expenditure. even more recent studies (newel, 2013; mills et al. 2013) demonstrate that a critical threshold of 3 mets (metabolic equivalents), representing moderate activities (3.5 to 7 kcal / min), can be achieved while playing avg. according to the above-mentioned studies, playing avg increases physiological body responses. the unexplained field remains the influence of those games on the development of motor abilities and fundamental movement skills (barnett, hinkley, okely, hesketh & salmon, 2012), which provide the basis for a more successful performance of sport-specific movement skills (lubans, morgan, cliff, barnett & okely, 2010). furthermore, few studies have been conducted on children using avg and none on tennis. since 2007, the physical activity council (2016) reports a 6 % increase in tennis players, which is the highest increment among all analyzed sports. currently, nearly 4000 young professional tennis players (< 19 years old) are listed in the international tennis federation (itf). due to the fast growing number of professional tennis players across the world and the subsequent increasing competitiveness, the intensity and volume of training programs have been led to a higher level in early ages, intended to reach superior results (reid, crespo & santilli, 2009). in accordance with the international tennis federation coaches’ education program (crespo & reid, 2009), 6 to 12-year-old children represent the introduction / foundation stage in a tennis world class players’ development guidelines, with the main goal of fully mastering the technique of basic strokes (forehand, backhand, serve). all the distinct phases of a player development are inextricably linked together (saviano, 2001) and without successfully acquired fundamentals (technique of basic strokes), the increasing intensity 78 luka šlosar, matej plevnik, uros marušič: playing active video games while in a tennis training process ..., 75–88 annales kinesiologiae • 9 • 2018 • 2 and volume of training sessions, which are enhanced in the second phase, may lead to injuries. as avg are mainly used among adolescents, when the development of motor skills is in full swing, determining their positive and negative effects may offer the prospect of a possible application using them in favor of improving physical performance by their influence on motor efficiency and learning. on the other side, repetitive performance of irregular movement patterns may destroy the correct execution of the strokes that were previously learned during the training sessions. therefore, the aim of our study was to evaluate the impact of a continued avg playing on the tennis technique development during the training process in 7to 9-year-old children. methods participants this research was conducted on 24 tennis players (7 females, 17 males, average age 7.95 ± 0.92 years, range 7 – 9 year olds) recruited from the local tennis club (tennis club portorož, slovenia, eu). after a detailed presentation of the study, its purpose, and study design to the participants and parents, we obtained a written parental consent for each child. the inclusion criterion was no more than two years of regular participation in a tennis training process; players with injuries or long-term body impairments that prevented them from performing shots as they are usually instructed were excluded. the study was approved by the republic of slovenia national medical ethics committee, number 0120-631/2017/2. study design the participants were randomly allocated into experimental (tennis training + avg; 11 participants; female: 3; male: 7) and control (only tennis training; 13 participants; female: 1; male: 12) group. both groups attended a 12-week tennis training program (twice a week for an hour), where the experimental group had an additional avg intervention which lasted 20 min per session and was administred after each “physical” tennis training. for avg, the virtua tennis 4 game on xbox 360 console was chosen. we used the kinect device that allowed the participants to play using merely the movements of their body. the children were involved in a novice tennis training program where each training session lasted for one hour, with an emphasis on tennis strokes technique execution and motor skills development (agility, balance, coordination, power, reaction time and speed). the avg intervention program was implemented to be able to gradually increase the difficulty of the game. the game itself provides different levels of difficulty for “human player vs. computer option”, as well as an option to play with “multiple annales kinesiologiae • 9 • 2018 • 2 79 luka šlosar, matej plevnik, uros marušič: playing active video games while in a tennis training process ..., 75–88 human players”. for our intervention, both options were chosen depending on the number of children involved and mixed troughout the whole interventional period. the participants with an absence percentage up to 15 (more than 3 times) were eliminated from the investigation. outcome measures our participants are novice tennis players, therefore, as stated in the introduction, their main goal is to fully master the technique of main strokes. for assessing the progress made in the game of tennis, we used the trsc that evaluates the improvement made in technique of both the forehand and backhand stroke. we decided not to assess the serve stroke, as the children up to 9 years of age who have not yet developed enough power for such a complex movement play the stroke only in its most basic version. the scale divides each stroke in fifteen different elements that need to be evaluated to reach the final score. we followed the protocol which had previously been validated in šlosar, šimunic, pišot & marusic, (2018). the trsc is divided into fifteen different elements (figure 1) that need to be evaluated to reach the final score, i.e. the current technical knowledge in a specific stroke. the elements correspond to different postitions end motions starting from the stroke preparation to a follow-through and the kinetic chain, that all evaluate the coordinated activation of all body segments involved (for details see šlosar, šimunic, pišot & marusic, 2018). the evaluation needs to be performed while reviewing the execution previously recorded on a video tape with the possibility of viewing it in slow motion and pausing the recording at the desired player position. video clips were made using high quality video facilities on mobile phones and free computer applications for editing. all the evaluated elements were rated on 5-point grading likert scale. 80 luka šlosar, matej plevnik, uros marušič: playing active video games while in a tennis training process ..., 75–88 annales kinesiologiae • 9 • 2018 • 2 ta bl e 1. t en ni s ra tin g sc or e fo r ch ild re n ev al ua tio n cr ite ri a. sh o t p r e pa r a t io n a r m p o si t io n b a c k sw in g st a n c e fo r e h a n d t he n on -h itt in g ha nd le ad s th e ra ck et he ad to th e ba ck s w in g an d go in g to ex te nd o ut to th e si de o f t he c ou rt in a pa ra lle l p os iti on to th e gr ou nd . t he h ittin g ha nd s ho ul d be s lig ht ly b en t a t t he ba ck w hi le h ol di ng th e ra ck et v er tic al ly w ith th e bu ttca p fa ci ng th e co ur t. sh ou ld er ro ta tio n un til th ey a re pe rp en di cu la r t o th e ne t w ith h ip s "l oc ke d" a t t he p el vi c jo in t. w ei gh t i s on th e re ar le g w ith k ne es be nt a nd fo ot p oi nt in g ou t. fr on t l eg in th e ga m e di re ct io n. b a c k h a n d b ot h ha nd s ar e at th e ba ck o f t he b od y w ith th e hi tti ng a rm s tr ai gh t a nd th e ot he r s lig ht ly b en t. a n "l " sh ap e m us t be c re at ed w ith th e ar m a nd ra cq ue t po si tio n. sh ou ld er ro ta tio n un til th ey a re p er pe nd ic ul ar to th e ne t w ith h ip s "l oc ke d" a t t he p el vi c jo in t. w ei gh t i s on th e re ar le g w ith k ne es be nt a nd fo ot p oi nt in g ou t. fr on t l eg in th e ga m e di re ct io n. a c c e l e r a t io n w e ig h t t r a n sf e r h it t in g m o t io n r a c q u e t p a t h fo r e h a n d sh ot p re pa ra tio n: 8 0 % re ar le g; 2 0 % fr on t l eg . c on ta ct p oi nt : 5 0 % re ar le g; 50 % fr on t l eg . t he c en te r o f g ra vi ty is ra is ed w ith in th e tr un k, b y tr an sf er ri ng th e bo dy w ei gh t f or w ar d. h ip s an d sh ou ld er s ro ta te fo rw ar d an d op en u p to w ar ds th e co ur t. l ea ni ng fo rw ar d at th e bo tto m o f t he sw in g. t he b ut tca p is p oi nt in g to th e ne t w ith th e w ri st ta ke n ba ck c re at in g pr est re tc h. t he ra cq ue t t he n ac ce le ra te s up w ar d an d fo rw ar d. b a c k h a n d sh ot p re pa ra tio n: 8 0 % re ar le g; 2 0 % fr on t l eg . c on ta ct p oi nt : 5 0 % re ar le g; 50 % fr on t l eg . t he c en te r o f g ra vi ty is ra is ed w ith in th e tr un k, b y tr an sf er ri ng th e bo dy w ei gh t f or w ar d. h ip s an d sh ou ld er s ro ta te fo rw ar d an d op en u p to w ar ds th e co ur t. l ea ni ng fo rw ar d in th e bo tto m o f t he sw in g. t he b ut tca p is p oi nt in g to th e ne t w ith th e w ri st s ta ke n ba ck c re at in g pr est re tc h. t he ra cq ue t t he n ac ce le ra te s up w ar d an d fo rw ar d. annales kinesiologiae • 9 • 2018 • 2 81 luka šlosar, matej plevnik, uros marušič: playing active video games while in a tennis training process ..., 75–88 p o in t o f c o n ta c t h e ig h t b o d y p o si t io n sw e e t s p o t fo r e h a n d in fr on t o f t he b od y at th e hi p le ve l. l ow c en te r o f g ra vi ty w ith le gs a t le as t s ho ul de rw id th a pa rt . s ho ul de rs m us t b e pa ra lle l t o th e ne t w ith a n up ri gh t a nd s til l h ea d po si tio n. c lo se to th e ce nt er o f t he ra ck et . b a c k h a n d in fr on t o f t he b od y at th e hi p le ve l. l ow c en te r o f g ra vi ty w ith le gs a t le as t s ho ul de rw id th a pa rt . s ho ul de rs m us t b e pa ra lle l t o th e ne t w ith a n up ri gh t a nd s til l h ea d po si tio n. c lo se to th e ce nt er o f t he ra ck et . f o l l o w t h r o u g h e n d p o si t io n r a c q u e t p o si t io n n o n -d o m in a n t a r m p o si t io n fo r e h a n d a bo ve th e no nhi tti ng a rm s ho ul de r. t he ra cq ue t f ac es h or iz on ta lly a t co m pl et io n. tu ck ed a t t he s id e of th e bo dy o r us ed to c at ch th e ra ck et a t t he fi na l po si tio n. b a c k h a n d a bo ve th e sh ou ld er o f t he h an d pl ac ed at th e bo tto m o f t he g ri p. t he ra cq ue t f ac es h or iz on ta lly a t co m pl et io n. b en t t o an " l " sh ap e, k ee pi ng th e el bo w u p be fo re fi ni sh in g th e fo llo w -t hr ou gh (r ig ht a rm − fo r r ig ht -h an de rs ). k in e t ic c h a in se q u e n c e o f a c t iv a t e d b o d y se g m e n t s f l u id it y t im in g fo r e h a n d l eg s (e xt en si on th ro ug h an kl es , k ne es , an d hi ps ), hi ps (r ot at io n) , t ru nk (r ot at ion ), sh ou ld er (h or iz on ta l a dd uc tio n an d in te rn al ro ta tio n) , f or ea rm (p ro na tio n) , w ri st (fl ex io n) . a s of t, si m pl e an d rh yt hm ic s w in g th at fl ow s th ro ug h th e st ro ke , w ith ou t be in g af fe ct ed b y th e ba ll’ s pr es en ce . m ak e m ot io ns a nd p ut th em se lv es in ri gh t b od y po si tio ns a t t he ri gh t m om en t t o m at ch p ar ts o f t he s tr ok e th at b el on g to ge th er . b a c k h a n d l eg s (e xt en si on t hr ou gh a nk le s, k ne es , an d hi ps ), hi ps ( ro ta tio n) , tr un k (r ot at ion ), sh ou ld er ( ho ri zo nt al a bd uc tio n an d ex te rn al r ot at io n) , fo re ar m ( su pi na tio n) , w ri st (e xt en si on ). a s of t, si m pl e an d rh yt hm ic s w in g th at fl ow s th ro ug h th e st ro ke , w ith ou t be in g af fe ct ed b y th e ba ll’ s pr es en ce . m ak e m ot io ns a nd p ut t he m se lv es i n ri gh t bo dy p os iti on s at t he r ig ht m om en t t o m at ch p ar ts o f th e st ro ke th at be lo ng to ge th er . 82 luka šlosar, matej plevnik, uros marušič: playing active video games while in a tennis training process ..., 75–88 annales kinesiologiae • 9 • 2018 • 2 procedure the evaluation was performed by the participants’ tennis coach. all the participants were evaluated on a forehand and backhand stroke on day 1 and day 84 (preand post-intervention). to better understand the influence of a continued avg playing on a tennis technique, only the results corresponding to fifteen evaluated elements were considered, while the final trsc score is primarly used to make the data analysis more comprehensible, especially for the players’ parents. statistical analysis the distribution of each evaluated element (trsc scale) was examined on a normal quantile (q-q) plot as well as a histogram to determine whether the data were well approximated by a normal (gaussian) distribution. non-normally distributed data were summarized with means and standard deviations. the results between the control and experimental group at the pre-test were compared using the mann whitney u-test. differences between preand post-test for the control and experimental group were evaluated with a wilcoxon test. the intervention effect size was estimated and interpreted by cohen (1988) as follows: > 0.1 small; > 0.3 medium; > 0.5 large effect. a p value ˂ 0.05 was considered statistically significant. results all the participants from the initially included 24 were taken into statistical analyses. the data from all fifteen elements of the trsc were non-normally distributed (p < 0.05). mann whitney test showed no significant differences for both the forehand and backhand stroke between the experimental and control group at the pre-test. table 1 shows the baseline characteristics of the children included. table 2. characteristics of included children. experimental group control group m sd m sd experience (months) 15 0.72 17 0.71 age 7.43 0.82 8.38 0.96 height 130.73 9.43 141.00 9.16 weight 27.18 4.6 35.85 6.28 annales kinesiologiae • 9 • 2018 • 2 83 luka šlosar, matej plevnik, uros marušič: playing active video games while in a tennis training process ..., 75–88 forehand a wilcoxon test revealed a significant improvement at the post-test for all the fifteen evaluated elements in the control group. a moderate effect size was shown in trsc7 (0.42) and trsc9 (0.46). in all the other elements, the effect was large and greater than 0.52. at the post-test, the experimental group did not significantly improve in trsc12 (p = 0.317). the same element revealed a low effect size (0.21). a moderate effect size was shown in trsc1 (0.43) and trsc10 (0.48). in all the other elements, the effect size was large and greater than 0.52. table 3. wilcoxon test between the pre and post-test for the experimental and control group for the forehand stroke. control group experimental group trsc pre-test post-test p (es) pre-test post-test p (es) 1 2.69 ± 0.48 3.54 ± 0.66 0,001 (0,64) 2.09 ± 0.70 2.27 ± 0.47 0,046 (0,43) 2 2.54 ± 0.97 2.85 ± 0.55 0,001 (0,66) 2.27 ± 0.79 2.82 ± 0.40 0,011 (0,54) 3 2.31 ± 0.86 2.92 ± 1.25 ˂ 0,001 (0,69) 2.00 ± 0.63 2.45 ± 1.03 0,002 (0,67) 4 2.38 ± 0.77 2.38 ± 0.77 ˂ 0,001 (0,71) 2.09 ± 0.70 2.09 ± 0.70 0,003 (0,64) 5 2.23 ± 0.83 2.77 ± 0.56 0,002 (0,60) 2.18 ± 0.75 2.73 ± 0.47 0,003 (0,64) 6 2.00 ± 0.70 2.62 ± 0.65 0,004 (0,57) 1.82 ± 0.40 2.27 ± 0.78 0,002 (0,65) 7 2.54 ± 0.78 2.85 ± 0.69 0,034 (0,42) 2.27 ± 0.79 3.45 ± 0.52 0,002 (0,64) 8 2.31 ± 0.75 2.31 ± 0.75 0,005 (0,55) 2.09 ± 0.70 2.09 ± 0.70 0,005 (0,60) 9 3.00 ± 1.08 3.31 ± 0.75 0,020 (0,46) 2.45 ± 1.03 3.00 ± 0.63 0,011 (0,54) 10 2.85 ± 0.99 3.08 ± 0.86 0,004 (0,57) 2.82 ± 0.98 3.18 ± 0.75 0,025 (0,48) 11 2.38 ± 0.77 3.08 ± 0.64 0,001 (0,64) 1.91 ± 0.83 2.45 ± 0.69 0,014 (0,52) 12 2.85 ± 0.55 3.38 ± 0.77 0,005 (0,55) 2.82 ± 0.40 2.82 ± 0.40 0,317 (0,21)* 13 2.54 ± 0.78 2.62 ± 0.65 0,008 (0,52) 2.27 ± 0.79 2.45 ± 0.52 0,003 (0,63) 14 2.23 ± 0.73 2.69 ± 0.48 0,001 (0,65) 2.00 ± 0.63 3.00 ± 0.63 0,002 (0,67) 15 2.00 ± 0.58 2.31 ± 0.75 0,003 (0,59) 1.82 ± 0.40 3.00 ± 0.48 0,002 (0,67) notes: es = effect size; * p > 0,05 84 luka šlosar, matej plevnik, uros marušič: playing active video games while in a tennis training process ..., 75–88 annales kinesiologiae • 9 • 2018 • 2 backhand a wilcoxon test revealed a significant improvement at the post-test for all the fifteen evaluated elements in the control group. a moderate effect size was shown in trsc7 (0.44). in all the other elements, the effect was large and greater than 0.53. at the post-test the experimental group did not significantly improve in trsc10 (0.157) and trsc12 (p = 0.157). the same elements revealed a moderate effect size (0.30), as it is for trsc1 (0.48), trsc8 (0.30) and trsc9 (0.43). in all the other elements, the effect size was large and greater than 0.58. table 4. wilcoxon test between the pre and post-test for the experimental and control group for the backhand stroke. control group experimental group trsc pre-test post-test p (es) pre-test post-test p (es) 1 2.38 ± 0.77 3.08 ± 0.64 0,001 (0,65) 2.18 ± 0.60 2.36 ± 0.67 0,025 (0,48) 2 2.00 ± 0.82 2.31 ± 0.63 0,001 (0,63) 2.18 ± 0.75 2.45 ± 0.52 0,005 (0,60) 3 1.85 ± 0.69 2.62 ± 0.87 0,001 (0,64) 1.45 ± 0.52 2.27 ± 0.79 0,001 (0,68) 4 2.23 ± 0.83 2.31 ± 0.75 0,001 (0,64) 2.00 ± 0.63 2.00 ± 0.63 0,007 (0,58) 5 1.85 ± 0.55 2.62 ± 0.51 0,001 (0,63) 1.91 ± 0.54 2.91 ± 0.54 0,002 (0,67) 6 1.85 ± 0.69 2.08 ± 0.64 0,001 (0,65) 2.00 ± 0.63 2.00 ± 0.63 0,008 (0,64) 7 2.46 ± 0.78 2.62 ± 0.51 0,025 (0,44) 2.36 ± 0.67 3.45 ± 0.52 0,002 (0,58) 8 2.00 ± 0.82 2.15 ± 0.89 0,001 (0,63) 2.00 ± 0.63 2.00 ± 0.63 0,003 (0,30) 9 2.54 ± 0.78 3.08 ± 0.64 0,003 (0,58) 2.27 ± 0.78 2.82 ± 0.40 0,007 (0,43) 10 2.54 ± 0.78 2.77 ± 0.44 0,001 (0,67) 2.64 ± 0.80 2.82 ± 0.40 0,157 (0,30)* 11 2.31 ± 0.75 2.92 ± 1.04 0,001 (0,64) 1.73 ± 0.78 1.82 ± 0.75 0,046 (0,63) 12 2.54 ± 0.78 2.92 ± 0.49 0,001 (0,63) 2.64 ± 0.80 2.64 ± 0.81 0,157 (0,30)* 13 2.31 ± 0.75 2.46 ± 0.52 0,007 (0,53) 2.18 ±0.75 2.36 ± 0.50 0,003 (0,63) 14 1.77 ± 0.44 2.38 ± 0.76 ˂ 0,001 (0,69) 1.82 ± 0.40 2.82 ± 0.40 0,001 (0,71) 15 1.92 ± 0.49 2.15 ± 0.68 0,002 (0,62) 1.82 ± 0.40 3.00 ± 0.48 0,001 (0,68) notes: es = effect size; * p > 0,05 annales kinesiologiae • 9 • 2018 • 2 85 luka šlosar, matej plevnik, uros marušič: playing active video games while in a tennis training process ..., 75–88 discussion the aim of the present pilot study was to evaluate the impact of a prolonged avg playing on the tennis technique of two main strokes while being in a tennis training process. our results show similar intervention effects among both the forehand and backhand stroke. the evaluated trsc12element has not been improved by the experimental group in both the forehand and backhand stroke. the same stands for the trsc10 element only in the backhand stroke. as part of the follow-through sections, prolonged avg playing seems to negatively affect a proper player positioning at the end of the stroke. a poorer attention at the correct tennis positions is also noted comparing the effect size among groups at the trsc1, which stands for the arm position at the shot preparation. in both the backhand and forehand stroke, the stroke is large in the control group and moderate in the experimental. the results may find explanation upon the model of control the user had over the actions of the avatar in avg, which are more prominent on simple reaction times and timing of the hand swing. if the hand does not swing at the right time, the avatar would fail to shoot the ball, which is not considered to be a successful stroke in this model. the whole kinetic chain section (the sequence of activated body segments; fluidity; timing), is the only one among both strokes where the experimental group had a higher effect size. the trsc13 element (the sequence of activated body segments) had a large effect size in the experimental group compared to the moderate in the control. the same happens with the trsc7 element (point of contact – height) in both strokes. the results may suggest that avg might increase a player’s reaction time and attention towards the ball arriving from the other side of the court. the results seem to confirm the ones concluded by green and bavelier (2003; 2006) which demonstrate higher visual attention skills in video game players compared to non-players. improved visual attention skills represent the ability to track objects moving at a higher speed, track multiple items at the same time, eliminate irrelevant visible information, increase focusing and concentration capabilities. the constant technology development managed to create natural user interfaces and gesture recognition video game consoles which are able to track full-body movements in three dimensions, thus offering the opportunity to play virtual sports as being in a real environment. the results of the present study support wiemeyer & kliem (2012) theories, asserting that, due to the way of playing some motor control competencies may be enhanced, such as: reaction time, balance, endurance, strength and rhythmic abilities. furthermore, wiemeyer & hardy (2013) in accordance with our results, confirmed that a possible transfer of motor learning settings between the real and virtual environment may be possible while using avg. to our knowledge, this is the first study that evaluates the effects of prolonged avg playing on specific sport technique execution and not performance. several limitations are however acknowledged in the study, starting from the lack of a third group playing just avg without any real tennis practice and the small sample size used. furthermore, a combination of technical and precision skills (suitable for beginners) would extend 86 luka šlosar, matej plevnik, uros marušič: playing active video games while in a tennis training process ..., 75–88 annales kinesiologiae • 9 • 2018 • 2 the range of knowledge about avg. finally, we cannot generalize results among the entire middle age population, as they are related to participants with a specific status, like children from wealthy families, or those with high expectations of accomplishment. although the findings of this pilot study do suggest that a possible transfer of motor learning settings between the real and virtual environment may be possible, this still needs to be addressed on larger samples. conclusion on the basis of the above, as many avg like the virtua tennis 4 require rapid movements, they may improve general visual attention skills. on the other side, they can negatively affect correct technique positioning. the results of our study suggest a specific adaptation of playing avg while being in the tennis process. namely, 7to 9-year-old children who play avg (virtua tennis 4) twice a week for three months (24 x avg + tennis trainings) are more progressive in cognitive domain, while having negative adaptation from the perspective of tennis technique acquisition (the first and the last part of a stroke motion). the present study shows the effect of playing / not playing avg in children while being in the early process of tennis training program, and better understand the impact of avg games on players’ physical skills. finally, the results of our pilot study, the first of its kind, could serve as – a scientific evidence noting to which extent playing avg influences the tennis technique. acknowledgements we thank all the coaches who provided an insight and expertise that greatly assisted the research. we are also immensely grateful to the local tennis club (tennis club portorož, slovenia, eu) and all the players who dedicated their time for this project, since this research would not have been possible without them. references barnett, l. m., hinkley, t., hesketh, k., okely, a. d. & salmon, j. 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(2013). serious games and motor learning concepts, evidence, technology. in k. bredl & w. bösche (eds.), serious games and virtual worlds in education, professional development, and healthcare, (pp 197-220). heshey, pa: igi global. wiemeyer, j. & kliem, a. (2012). serious games in prevention and rehabilitation – a new panacea for elderly people? european review of aging and physical activity, 9(1), 4150. doi: 10.1007/s11556-011-0093-x view item https://link.springer.com/article/10.1007%2fs11556-011-0093-x 144 reports and reviews/poročila in ocene, 135–150 annales kinesiologiae • 9 • 2018 • 2 confference report “skeletal muscle: from molecules to function” padua, italy, 1st october 2018 it was a handful of students, almost eight centuries ago, who founded one of the first universities in europe: 1222 marked the birth of the university of padua, destined to welcome teachers such as galileo galilei and andreas vesalius (from: http:// www.unipd.it). prof. carlo reggiani began his academic journey at the university of pavia back in 1974. after spending 5-years learning in the laboratory of prof. paul edman at the university of lund, he was appointed as an associate professor at the university of pavia in 1984 and in november 1999 he joined the medical school staff as a full professor at the university of padua, one of the oldest universities. october 1st 2018 marked another great day in the life of the university of padua and carlo’s friends and colleagues. carlo celebrated his 70th birthday and announced his retirement. along with attending the conference devoted to his achievements, we had an opportunity to envisage his great achievements and anecdotes during the presentations by his friends, students and colleagues. the conference was organised by his colleague and friend, prof. marco narici, in aula magna of palazzo bo, a historical mecca of physicians. saving the best for the last, carlo’s talk began with a story of scheherazade. the king shahryar found out that his first wife was unfaithful to him. he thus resolved to marry a new virgin each day as well as behead the previous day’s wife, so that she would have no chance to be unfaithful to him. he had killed 1,001 such women by the time he was introduced to scheherazade. once in the king’s chambers, scheherazade’s sister asked her to tell a story during the long night. the king lay awake and listened to scheherazade told her first story. the night passed by and scheherazade stopped in the middle. the king asked her to finish, but scheherazade said there was no time, as dawn was breaking. so, the king spared her life for one day to finish the story the next night. the following night, scheherazade finished the story and then began a second, even more exciting tale, which she again stopped halfway through at dawn. again, the king spared her life for one more day, so she could finish the second story. and so, the king kept scheherazade alive day by day, and at the end of 1,001 nights, and 1,000 stories, the king had fallen in love with scheherazade (summarised from: scheherazade). and similarly to the stories of scheherazade, carlo experimented in thousands of muscle fibres from animals, humans, young, old, athletic, sedentary, himself, etc. preannales kinesiologiae • 9 • 2018 • 2 145 reports and reviews/poročila in ocene, 135–150 paring each intact fibre under the microscope for 30-60 minutes to investigate its contractile properties. and finally, allowing time for one more. and another. his work was enormous (more than 220 scientific articles, and more than 8000 citations) and we are proud to share bits of his academic career. we have collaborated in six scientific articles since 2008, reporting data from the studies where we listened, learned, discussed, and had fun. we compared the responses of older and young men to 14 days of bed rest and subsequent rehabilitation. the effect of inactivity on muscle mass and function was greater in older men, whereas metabolic alterations were greater in young men. recovery of preinactivity conditions occurred more slowly in older men. the results emphasize the importance of avoiding or minimizing the periods of inactivity in old age (pišot, reggiani, šimunič, et al. j appl physiol, 2016). as we jointly discovered, it is important to know that we need to compensate for old age and to avoid periods of inactivity. dear carlo, since your thirties, you have lost 6 kilos of muscle fibres. that is the exact amount found in this prosciutto. most of muscle loss is due to decrease of 146 reports and reviews/poročila in ocene, 135–150 annales kinesiologiae • 9 • 2018 • 2 daily physical activity, therefore you will need to increase it for what you will need this exercise t-shirt. to support your exercise, you will need to increase intake of certain carotenes, minerals and vitamins. you will find them in this bottle of olive oil; however, for the vitamin d you will need to expose yourself to the sun. which we believe you will have no trouble during your retirement. blood will distribute your nutrition to your new working muscle and for that purpose you will need to compensate for the lost blood. to compensate for plasma and erythrocyte volume you will need to ingest these two bottles of malvasia and refosco wine, respectively. (from the presentation of rado pišot and boštjan šimunič) it was a great pleasure that our institute for kinesiology research took part at this conference and that you also cooperated with our institute. thank you, carlo! boštjan šimunič, rado pišot and other members of the institute for kinesiology research annales kinesiologiae • 9 • 2018 • 2 147 reports and reviews/poročila in ocene, 135–150 poročilo iz konference »skeletne mišice: od molekule do funkcije« padova, italija, 1. oktober 2018 bila je le peščica študentov, ki je pred skoraj osmimi stoletji ustanovila eno prvih univerz v evropi. leto 1222 predstavlja rojstvo univerze v padovi, ki bo kasneje gostila tako pomembne učitelje, kot sta bila galileo galilei in andreas vesalius (povzeto po: http://www.unipd.it). prof. carlo reggiani je začel svoje akademsko pot na univerzi v pavii v italiji leta 1974. kasneje se je pet let izpopolnjeval v laboratoriju prof. paula edmana na univerzi v lundu na švedskem, leta 1984 pa je bil imenovan za izrednega profesorja na univerzi v pavii. novembra leta 1999 se je kot redni profesor pridružil osebju ene najstarejših univerz na fakulteti za medicino in kirurgijo univerze v padovi. 1. oktober 2018 označuje še en pomemben dan za univerzo v padovi in za vse prijatelje in kolege carla reggianija. ta dan je namreč hkrati praznoval 70. rojstni dan in odhod v pokoj. ob konferenci, posvečeni njemu v čast, smo imeli priložnost podoživeti nekaj utrinkov iz njegove bogate kariere skozi predstavitve njegovih znanstvenih dosežkov pa tudi anekdot iz življenja, skozi oči njegovih prijateljev, študentov in kolegov. konferenco je organiziral njegov prijatelj in znanstveni kolega prof. marco narici v t. i. veliki predavalnici (aula magna) v znameniti univerzitetni palači bo, ki je še danes neke vrste zgodovinska meka vseh zdravnikov. carlo je svoj nagovor na kongresu pričel z znano zgodbo o šeherezadi: sultan šahrijar je ugotovil, da mu je bila njegova prva žena nezvesta. odločil se je, da se bo vsak dan poročil z novo devico, hkrati pa bo vsak dan dal obglaviti svojo ženo iz prejšnjega dne. prepričan je bil, da bo lahko le tako preprečil svoji ženi nezvestobo. do tistega dne, ko so mu kot novo nevesto predstavili šeherezado je ubil že tisoč in eno dekle. ko je bila šeherezada v sultanovih sobanah, je svojega moža prosila, če se lahko pred usmrtitvijo še poslovi od svoje sestre in on ji je to dovolil. sestra je šeherezado prosila, naj pove kakšno zgodbo, da bo dolga noč hitreje minila. tudi sultan, ki je ležal poleg, je poslušal šeherezadino prvo zgodbo. noč je minila in šeherezada je nehala pripovedovati, čeprav zgodba še ni bila končana. sultan jo je prosil, naj zgodbo dokonča, vendar ga je ona zavrnila, da ni dovolj časa, saj se zunaj že dani. sultan je sklenil, da jo bo pustil pri življenju še en dan, da bi lahko dokončala zgodbo naslednjo noč. toda naslednjo noč, ko je šeherezada prvo zgodbo končala, je takoj pričela pripovedovati drugo, še bolj zanimivo. pripovedovanje te druge zgodbe je prav tako prekinila na sredini ob zori naslednjega dne. šahrijar jo je ponovno pomilostil za en dan, da bi lahko ponoči dokončala pripoved druge zgodbe. tako si je šeherezada noč za nočjo podaljševala življenje z vedno novimi zgodbami. ko je minila tisoč in ena noč in mu je povedala tisoč zgodb, 148 reports and reviews/poročila in ocene, 135–150 annales kinesiologiae • 9 • 2018 • 2 se je sultan šahrijar zaljubil v šeherezado in jo dokončno pomilostil. (povzeto po: tisoč in ena noč) podobno kot je šeherezada prepletala svoje zgodbe, je carlo eksperimentiral z na tisoče mišičnimi vlakni živali, ljudi, mladih in starih, športnikov in ostalih in ne nazadnje samega sebe. vsako vlakno posebej je pod mikroskopom pripravljal 30-60 minut, da bi lahko nato preveril njegove kontraktilne lastnosti. in vedno je našel čas za še eno … in še eno … njegovo znanstveno delo je ogromno (več kot 220 znanstvenih člankov, preko 8000 citatov) in ponosni smo, da smo lahko delček njegove akademske kariere. od leta 2008 dalje smo sodelovali pri pripravi šestih znanstvenih člankov, v katerih smo poročali o rezultatih znanstvenih raziskav pri katerih smo poslušali, se učili, diskutirali in se tudi zabavali. primerjali smo učinke 14-dnevne popolne gibalne neaktivnosti v študiji »bed rest« med starejšimi in mlajšimi moškimi in rehabilitacije, ki je temu sledila. učinek neaktivnosti na mišično maso in funkcionalnost je bil večji pri starejših, medtem ko so bile pri mlajših ugotovljene večje metabolne spremembe. rehabilitacija po neaktivnosti je bila počasnejša pri starejših moških. rezultati kažejo na velik klinični pomen skrajševanja period neaktivnosti pri starejših (pišot, reggiani, šimunič, et al. j appl physiol, 2016) kot smo skupaj dognali, se moramo zavedati, da je potrebno starost kompenzirati in se izogibati obdobjem neaktivnosti. dragi carlo, od tvojih tridesetih let si izgubil 6 kilogramov mišičnih vlaken. natanko toliko jih je v pršutu, ki ti ga podarjamo. izguba mišičnih vlaken je večinoma posledica upada dnevne gibalne aktivnosti, kar boš moral nadomestiti in pri tem naj ti bo v pomoč ta športna majica. za boljšo vadbo boš moral povečati vnos nekaterih karotenov, mineralov in vitaminov, ki so vsi prisotni v tej steklenici oljčnega olja. kljub temu pa boš moral poskrbeti še za zadostno količino vitamina d in se za to dovolj izpostavljati sončnim žarkom, kar sedaj, ko si v pokoju, ne bi smel biti problem. kri bo hranila prenašala do tvojih na novo pridobljenih mišičnih vlaken in potrebno bo nekako dopolniti zalogo krvi. da boš imel v prihodnje dovolj plazme in eritrocitov, boš moral zaužiti ti dve steklenici malvazije in refoška. (iz predstavitve rada pišota in boštjana šimuniča) v veliko zadovoljstvo nam je bilo, da je lahko inštitut za kineziološke raziskave zrs koper sodeloval na tej konferenci in hkrati, da si tudi ti del našega inštituta. hvala carlo! boštjan šimunič, rado pišot in ostali člani inštituta za kineziološke raziskave zrs koper annales kinesiologiae • 9 • 2018 • 2 135 reports and reviews/poročila in ocene, 135–150 final scientific and professional conference “motor skills of preschool children” zagreb, croatia, august 31st, 2018 at the end of the summer, the 4th scientific-professional conference “motor skills of preschool children” was held in zagreb. it was organized by the faculty of kinesiology, and the education and rehabilitation faculty, university of zagreb, under the patronage of the president of the republic of croatia, the ministry of science and education, and the agency for education of the republic of croatia. it was attended by over 200 participants. the purpose of the conference was to present the results of the uip-2014-09-5428 project titled ”motor skills of preschool children” funded by the croatian science foundation and was carried out under the guidance of assist. prof. sanja šalaj, ph.d. the objectives of the project were as follows: a) evaluating preschool children’s motor skills in the republic of croatia, b) determining differences in the motor skills of children with different levels of physical activity and involvement in the implementation programs, c) defining the connections between motor development and other areas of childhood development (socioeconomic and linguistic development), d) establishing the impact of parental support on children’s physical activity and the degree of their physical activity at the level of children’s motor abilities and e) determining the impact of different training programs on motor skills and abilities of pre-school children. the project included 1,500 girls and boys aged 3 to 7 from various parts of croatia. the measurements were carried out in two parts, in the first part the parents were requested to fill out a questionnaire, while in the second part the children’s motor skills were assessed with two sets of tests to determine their motor status. in the third year of the project implementation, certain effects of exercise programs on the children’s motor skills were also analysed. the problems of inadequate motor competencies and overweight children from the kinesiological, medical, health, sociological and psychological point of view, were presented by plenary lecturers from croatia (rea fulgosi-masnjak, ph.d., giovan armano, saša krstulović, ph.d., biljana trajkovski, ph.d., sara cobal, frane žuvela, ph.d.), from slovenia (gregor jurak, ph.d. and saša pišot, ph.d.) and from serbia (boris popović, ph.d.) in order to present important findings from the field of child’s development. a wider selection of motor skills that are already included in the project, such as intervention training and exercises, will enable children to choose from the sports activities that they master and enjoy. acquiring motor competencies and one’s own satisfaction with physical activity is not given enough emphasis, however, it should be recognized as an important factor for the child’s healthy / unhealthy behaviour and physical activity / inactivity. 136 reports and reviews/poročila in ocene, 135–150 annales kinesiologiae • 9 • 2018 • 2 the results of the project undoubtedly provide important information for educators, teachers, pedagogues, kinesiologists, health workers and parents advising how to encourage children›s motor development in order to achieve multiple benefits and healthy active lifestyle. therefore, projects like this are always welcome for professional public. saša pišot annales kinesiologiae • 9 • 2018 • 2 137 reports and reviews/poročila in ocene, 135–150 zaključna znanstveno-strokovna konferenca »motorička znanja djece predškolske dobi« zagreb, hrvaška, 31. avgust 2018 ob koncu poletja se je v zagrebu odvijala 4. znanstveno-strokovna konferenca »motorička znanja djece predškolske dobi«, ki je v organizaciji kineziološke fakultete in pedagoško-rehabilitacijske fakultete univerze v zagrebu ter pod pokroviteljstvom predsednice republike hrvaške, ministrstva za znanost in izobraževanje ter agencije za vzgojo in izobraževanje republike hrvaške, gostila preko 200 udeležencev. namen konference je bil predstaviti zaključne rezultate projekta uip-2014-09-5428 »motorička znanja djece predškolske dobi«, ki ga je financirala hrvaška fundacija za znanost in je v obdobju od 2015-2018 potekal pod vodstvom doc. dr. sanje šalaj. cilji projekta so bili: a) vrednotenje motoričnih sposobnosti predšolskih otrok v republiki hrvaški, b) prepoznavanje razlik v motoričnih spretnostih otrok z različnimi stopnjami telesne aktivnosti in vključenosti v vadbene programe gibalne/športne aktivnosti, c) opredelitev povezav razvoja motorike z drugimi področji razvoja v otroštvu (socialnoekonomski in jezikovni razvoj), č) ugotoviti vpliv starševske podpore na gibalno/športno aktivnost otrok in stopnjo njihove telesne aktivnosti na ravni motoričnih sposobnosti otrok in d) prepoznavanje vpliva različnih programov usposabljanja na motorične spretnosti in gibalne sposobnosti predšolskih otrok. projekt je vključeval 1500 deklic in dečkov v starosti od 3 do 7 let iz različnih delov hrvaške. meritve so v okviru projekta potekale v dveh delih. v prvem delu so starši otrok izpolnjevali vprašalnik, v drugem delu pa so bili otroci deležni testiranja motoričnih spretnosti z dvema sklopoma testov za oceno njihovega motoričnega statusa. v tretjem letu izvajanja projekta so bili preizkušeni nekateri učinki programov vadbe na motorične spretnosti predšolskih otrok. problem nezadovoljivih gibalnih kompetenc in prekomerne telesne mase otrok, so plenarni predavatelji iz hrvaške (dr. rea fulgosi-masnjak, giovana armano, dr. med., dr. saša krstulović, dr. biljana trajkovski, sara cobal, mag., dr. frane žuvela), slovenije (dr. gregor jurak in dr. saša pišot) in srbije (dr. boris popović) izpostavili iz kineziološkega, medicinsko-zdravstvenega, sociološkega in psihološkega vidika ter predstavili pomembna dognanja iz področja otrokovega razvoja, v povezavi z gibalno/ športno aktivnostjo in okoljem. širši nabor motoričnih znanj, ki so jih raziskovalci v obliki intervencijske vadbe v projektu že vključili, bo otrokom med drugim omogočil, da izberejo tiste gibalne/ športne aktivnosti, ki jih dobro obvladujejo in v njih uživajo. vzročnemu momentu pridobivanja gibalnih kompetenc in lastnega zadovoljstva v gibanju, se kot pomembnemu dejavniku za nadaljnje zdravo/nezdravo vedenje in gibalno aktivnost/neaktivnost, vse prepogosto ne daje dovolj poudarka. 138 reports and reviews/poročila in ocene, 135–150 annales kinesiologiae • 9 • 2018 • 2 rezultati projekta nedvomno podajajo pomembne informacije za vzgojitelje, učitelje, pedagoge, kineziologe, zdravstvene delavce in starše o tem, kako spodbujati otrokov motorični razvoj, za doseganje koristi na številnih področjih in zdravega aktivnega življenja, zato so tovrstni projekti za strokovno javnosti vedno dobrodošli. saša pišot annales kinesiologiae • 10 • 2019 • 2 85 editorial through the contributions of the authors of the next volume of the annales kinesiologiae, we continue the study of kinesiology − the science of human movement. a septagram of kinesiology in all its fields, from considering the developmental and expressive abilities that movement grants to the individual, to the role in learning about the world − learning or finding balance − health, its treatment in the everyday work environment, relaxation − recreation or with the aim of competing − in sports, it connects the whole of human activity and being from morning to evening, from birth to death. the articles in this issue present the authors’ results, findings and confirmed facts, together with their supplements and elaborations of their content. the physical and social environment surrounding the individual, and indisputably influencing them, is further discussed in two contributions. the results of the original scientific articles thus provide us with guidance and solutions which should be considered by decision-makers in the professional and political public. knowledge is a quality product of science and plays a role of an added value for the individual and the wider society. through research and development, over the last 50 years, we have become the best version of human, but at times some decisions of modern people seem to be backed up by just as much ignorance. something has gone wrong along the way, and only listening to and understanding knowledge can help us find a way forward. knowledge should be centred around the person and seek solutions for their own good. if we could put the welfare of the wider society at the centre of this process, and not only our own interests, we would win in any event. in this journal, the authors offer a number of interesting facts and findings, and they summarize the findings of other experts written in the monograph or presented at the conference. with the ability to connect the presented research issues, we can create a comprehensive picture and make contact with all the areas that kinesiology wants to address. prof. rado pišot, phd editor in chief 86 annales kinesiologiae • 10 • 2019 • 2 uvodnik s prispevki avtorjev drugega zvezka annales kinesiologiae v letu 2019 nadaljujemo obravnavo pojava kineziologije – znanosti o gibanju človeka. septagram kineziologije s svojimi področji, od obravnave razvojnih in ekspresivnih zmožnosti, ki jih posamezniku omogoča gibanje, prek njegove vloge v spoznavanju sveta – učenju ali iskanju ravnovesja – zdravja, obravnave v vsakdanjem delovnem okolju, sprostitvi – rekreaciji ali zaradi dokazovanja – v športu, povezuje celotno človekovo dejavnost in bivanje od jutra do večera, od rojstva do smrti. prispevki avtorjev člankov s predstavljenimi rezultati, ugotovitvami in potrjenimi dejstvi nadgrajujejo in dopolnjujejo omenjene vsebine. fizično in družbeno okolje, ki obdaja posameznika in nanj nedvomno vpliva, pa je v dveh prispevkih še dodatno poglobljeno obravnavano. rezultati izvirnih znanstvenih člankov nam tako ponujajo usmeritve in predloge rešitev, o katerih bi morala razmišljati strokovna in politična javnost odločevalcev. znanje, ki je lahko kakovosten produkt znanosti, se šele v rokah teh udejanji kot dodana vrednost za posameznika in širšo družbo. z raziskavami in razvojem smo v zadnjih 50 letih postali najboljša izvedba človeka, samega sebe, vendar se včasih zdi, da so nekatere odločitve sodobnega človeka utemeljene z neizmerno ignoranco. nekaj se nam je na tej poti zalomilo ter le posluh in dojemljivost za znanje nam lahko pomagata najti tudi pot naprej. znanje, ki je osredinjeno na človeka in njemu v dobro, išče rešitve. če bi zmogli v tem procesu v središče postaviti še blagor širše družbe in ne le lastnega, bi zmagali v vseh pogledih. v reviji, ki je pred vami, avtorji ponujajo številna zanimiva dejstva in ugotovitve ter povzemajo ugotovitve drugih strokovnjakov, zapisane v monografiji oz. predstavljene na konferenci. z zmožnostjo povezovanja predstavljene raziskovalne problematike si lahko ustvarimo celovito sliko in najdemo stik z vsemi področji, ki jih želi obravnavati kineziologija. prof. dr. rado pišot, glavni in odgovorni urednik _goback _goback _hlk23772821 _goback _goback _hlk27564900 _goback bbib0050 bbib0035 _hlk3367923 _goback annales kinesiologiae • 9 • 2018 • 2 139 reports and reviews/poročila in ocene, 135–150 summer school on healthy and active lifestyle “hals − healthy and active lifestyle 2018” piran, slovenia, 3rd ̶ 9th september 2018 the successful summer school hals2018, held between 3 and 9 september 2018, was organized by the science and research centre koper and the euro-mediterranean university (emuni). the summer school saw the participation of numerous renowned lecturers from slovenia, italy, austria and germany. the first day opened with the presentation of boštjan šimunič, ph.d., focusing on positive aspects and limitations of the technology for measuring quantity and intensity of movement / sports activity. the participants received actigraph accelerometers and wore them until the last day of the summer school when they analysed and showed the data in the final report. the second day was focused around theories and lectures delivered by rado pišot, ph.d., marco narici, ph.d., pietro di prampero, ph.d., and tadej debevec, ph.d. the topics presented included kinesiology as a science in the field of a healthy and active lifestyle, transfer of knowledge from space research to earth research, research models in aging and motor inactivity, as well as cardiovascular adaptations in extreme living environments such as hypoxia and long-term horizontal bed rest / physical inactivity. in the afternoon, the participants visited the mediterranean health centre where the content of sports diagnostics and rehabilitation was introduced. the participants were able to check their motor skills and receive an interpretation of their results. the afternoon activities included the visit to bonifika sports park and the pangea active park for the elderly and the new construction of sandy volleyball courts along the grand canal. this allowed the students to learn about the spatial possibilities of urban environment for active population in the municipality of koper. the third day of the summer school was marked by our host lecturers carlo reggiani, ph.d., marco narici, ph.d., and nandu goswami, ph.d. they presented the latest findings of their research in the areas of muscular adaptations from the point of view of muscle fibres and neuromuscular connections and mechanisms of cardiovascular decline in old age. boštjan šimunič, ph.d. showed muscular contractile properties in practice and presented the latest guidelines for muscular potentiation, peripheral and central fatigue, and the muscular adaptations that occur in the process of normal and pathological aging. in the afternoon, the participants were invited to rowing in a multi-seat canoe. gianni biolo, ph.d., started the fourth day with his lecture on the meaning of a healthy diet during all periods of life. the lecture was followed by milena bučar, ph.d., and bojan butinar, ph.d. who highlighted the importance of mediterranean diet and micronutrients for a healthy and active lifestyle. this was followed by a workshop on preparation of a healthy mediterranean meal and some other sports activities. the afternoon activity included a cycling trip to sečovlje salt pans, combining sports and nutrition in practice. 140 reports and reviews/poročila in ocene, 135–150 annales kinesiologiae • 9 • 2018 • 2 annales kinesiologiae • 9 • 2018 • 2 141 reports and reviews/poročila in ocene, 135–150 the fifth day of the summer school focused on neuroscience. anita hokelmann, ph.d., and kathrine rehfeld, ph.d., lectured on neuro-plasticity of the brain in cyclic and acyclic movements. later on, uroš marušič, ph.d. presented the findings of his research in the field of motion-cognitive interventions aiming to improve functional and cognitive abilities of older population. in the afternoon, anita hokelmann, ph.d., and kathrine rehfeld, ph.d. presented the practical content of motion learning and new guidelines for dance to promote neuro-plasticity of the brain. the day wrapped up with nordic walking workshop. through the activity, the participants were discovering fiesa and the slopes of pacug with stunning views of the strunjan bay. the sixth day of the summer school included theoretical presentations on the treatment of patients after a stroke. pietro paolo battaglini, ph.d., presented the latest applications of neuro-feedback methods for bci: brain-computer interfaces. the lecture was followed by enrico tongiorgi ph.d. who introduced the memori-net project where new guidelines for the treatment of patients after stroke are being formulated. the theoretical part was concluded by paolo manganotti, ph.d. with an outline of treatments for patient after a stroke. afternoon workshops were carried out by uroš marušič, ph.d. and boštjan šimunič, ph.d. the former presented the importance of measuring brain activity while simultaneously measuring equilibrium and walking for the needs of rehabilitation, while the latter focused on handling functional abilities with the help of simple and advanced measuring equipment. the last evening brought the participants to a final gathering, collecting impressions and establishing new friendships in the pleasant ambient of summertime piran. on the last day of the hals2018 summer school, participants presented the results of the whole-day measurement of motion / sports activity and passed a written and oral exam. given the encouraging feedback from the participants and the very successful organization of the first hals2018 summer school, the organizers suggested the date for the second hals2019 summer school, which is to be organized between 15th and 21st july, 2019. we look forward to your participation. uroš marušič and saša pišot 142 reports and reviews/poročila in ocene, 135–150 annales kinesiologiae • 9 • 2018 • 2 poletna šola o zdravem in aktivnem življenjskem slogu »hals – healthy and active lifestyle 2018« piran, slovenija, 3. ̶ 9. september 2018 poletna šola hals2018 je potekala v tednu od 3. do 9. septembra 2018 in bila zelo uspešno organizirana s strani znanstveno-raziskovalnega središča koper in evro-sredozemske univerze emuni. na poletni šoli so sodelovali številni priznani predavatelji iz slovenije, italije, avstrije in nemčije. prvi dan je dr. boštjan šimunič predstavil pozitivne aspekte in hkrati omejitve tehnologije merjenja količine in intenzivnosti gibalne/športne aktivnosti. udeleženci poletne šole so prejeli actigraph pospeškometre in jih nosili vse do zadnjega dne poletne šole, ko so podatke analizirali in prikazali v končnem poročilu. v drugem dnevu poletne šole hals2018 so se v teoretičnem delu zvrstili predavatelji dr. rado pišot, dr. marco narici, dr. pietro di prampero in dr. tadej debevec. predstavili so tematike umestitve kineziologije kot vede v področje zdravega in aktivnega življenjskega sloga, prenosa znanj iz vesoljskih raziskav na raziskave na zemlji, raziskovalnih modelov pohitrenega staranja in gibalne neaktivnosti ter srčno-žilnih adaptacij v ekstremnih življenjskih okoljih, kot so hipoksija in dolgotrajno horizontalno ležanje/gibalna neaktivnost. v popoldanskem času so udeleženci obiskali mediteranski center zdravja, kjer jim je bila predstavljena vsebina športne diagnostike in rehabilitacije. na najnovejših napravah so udeleženci lahko preverili svoje gibalne sposobnosti in prejeli ustrezna poročila ter interpretacijo rezultatov. v sklopu popoldanskih aktivnosti pa so si ogledali še športni park bonifika z aktivni gibalnim parkom pangea za starejše ter novogradnjo peščenih igrišč za odbojko ob kanalu grande ter ob tem spoznavali prostorske možnosti urbanega okolja za aktivno prebivalstvo v mestni občini koper. poletna šola je v tretjem dnevu gostila dr. carla reggianija, dr. marca naricija in dr. nanduja goswamija. predavatelji so podali najnovejše ugotovitve svojega raziskovalnega področja in s tem udeležencem predstavili področja mišičnih adaptacij z vidika mišičnih vlaken in živčno-mišičnih povezav ter mehanizme srčno-žilnega upada v starosti. s praktičnega vidika je dr. boštjan šimunič prikazal meritve mišičnih kontraktilnih lastnosti in podal zadnje smernice mišične potenciacije, perifernega in centralnega utrujanja ter nasploh mišičnih adaptacij, ki se zgodijo v procesu normalnega in patološkega staranja. popoldansko aktivnost pa so popestrili z veslanjem v večsedežnem kanuju. dr. gianni biolo je pričel s predavanjem četrtega dneva, v katerem je podal pomen zdrave prehrane v vseh obdobjih življenja. sledili sta predavanji dr. milene bučar in dr. bojana butinarja, ki sta izpostavila pomen mediteranske prehrane in mikronutrientov za zdrav in aktivni življenjski slog. sledila je delavnica priprave zdravega mediteranskega obroka in gibalne/športne aktivnosti. popoldansko aktivnost pa smo začinili še s kolesarskim izletom v sečoveljske soline in tako združili gibalno aktivnost in prehrano. annales kinesiologiae • 9 • 2018 • 2 143 reports and reviews/poročila in ocene, 135–150 peti dan poletne šole je bil osredotočen na nevroznanstvene vsebine. dr. anita hokelmann in dr. kathrine rehfeld sta predavali o nevro-plastičnosti možganov pri cikličnih in acikličnih gibanjih. nadaljeval je dr. uroš marušič, ki je predstavil ugotovitve raziskav na področju gibalno-kognitivnih intervencij za izboljšanje funkcionalnih in kognitivnih sposobnosti starejše populacije. v popoldanskem času sta dr. anita hokelmann in dr. kathrine rehfeld predstavili praktične vsebine gibalnega učenja in nove smernice učenja plesa za spodbujanje nevro-plastičnosti možganov. aktiven dan se je zaključil z delavnico nordijske hoje, kjer smo poleg tehnike nordijske hoje spoznavali še fieso in klifnata pobočja pacuga s čudovitimi pogledi na strunjanski zaliv. šesti dan poletne šole je bil namenjen teoretičnim predstavitvam obravnave pacientov po možganski kapi. dr. pietro paolo battaglini je prikazal najnovejše aplikacije nevro-feedback metod za potrebe komunikacij med človekom in robotom (»bci: brain-computer interfaces«). nadaljeval je dr. enrico tongiorgi, ki je predstavil projekt memori-net, kjer se oblikujejo nove smernice obravnave pacientov po možganski kapi. teoretični del je zaključil dr. paolo manganotti z orisom problematike obravnave pacienta po možganski kapi. popoldanske delavnice sta vodila dr. uroš marušič in dr. boštjan šimunič. dr. marušič je prikazal pomen merjenja možganske aktivnosti med sočasnim merjenjem ravnotežja in hoje za potrebe rehabilitacije, dr. šimunič pa je predstavil obravnavo funkcionalnih sposobnosti s pomočjo enostavne in napredne merilne opreme. zadnji večer pred zaključkom so se udeleženci srečali na zaključnem druženju, ker so ob zakuski in prijetnem glasbenem ambientu poletnega pirana zbirali vtise in spletali nova prijateljstva. zadnji (sedmi) dan poletne šole hals2018 so udeleženci predstavili rezultate celotedenskega merjenja gibalne/športne aktivnosti ter opravili pisni in ustni izpit. zaradi spodbudnih povratnih informacij udeležencev in nasploh zelo uspešno organizirane prve poletne šole hals2018, so organizatorji predstavili datum druge poletne šole hals2019, ki bo organizirana v tednu od 15.do 21. julija 2019. vljudno vabljeni. uroš marušič in saša pišot annales kinesiologiae • 6 • 2015 • 1 27 changes in mental health and satisfaction with life during physical inactivity induced by bed rest experiment tjaša dimec časar1, matej tušak2, petra dolenc1,3 1 university of primorska, science and research centre, institute for kinesiology research, garibaldijeva 1, 6000 koper, slovenia 2 university of ljubljana, faculty of sport, gortanova 22, 1000 ljubljana, slovenia 3 university of primorska, faculty of education, cankarjeva 5, 6000 koper, slovenia corresponding author: tjaša dimec časar university of primorska, science and research centre, institute for kinesiology research, garibaldijeva 1, 6000 koper, slovenia e-mail: tjasa.dimeccasar@zrs.upr.si abstract simulated weightlessness in the case of bed rest model represents an important method to study the consequences of physical inactivity and sedentarism on the human body. the purpose of the study was to examine the effects of prolonged physical inactivity on psychological distress, depressive symptoms and satisfaction with life of healthy male adults. the volunteers who took part in the study were aged between 21 and 28 and were subjected to a 35-day head-down bed rest. the psychological state of the participants was measured with the general health questionnaire (ghq-12), the center for epidemiological studies depression scale (ces-d), and the satisfaction with life scale (swls). the participants completed psychological inventories before, during and after the experiment. the results revealed no significant differences in mental health and satisfaction with life of the participants following the head-down bed rest, however, there was a tendency towards an increase in neurotic and depressive symptoms at the end of the experiment. the obtained results are interpreted in the light of stimulative living conditions in which the experiment was carried out, as well as the amount and the quality of social interactions during the period of extended physical inactivity. keywords: prolonged physical inactivity, bed rest studies, mental health. original scientific article udc: 159.91.07:796.012 received: 2015-10-23 28 tjaša dimec časar, matej tušak, petra dolenc: changes in mental health and satisfaction with life ..., 27–38 annales kinesiologiae • 6 • 2015 • 1 spremembe v psihičnem zdravju in zadovoljstvu z življenjem v obdobju gibalne neaktivnosti v okviru bed rest raziskave izvleček bed rest model, ki predpostavlja daljše obdobje ležanja v vodoravnem položaju, predstavlja pomembno metodo za spremljanje učinkov popolne gibalne neaktivnosti na človekov organizem. cilj raziskave je bil proučiti spremembe v mentalnem zdravju, depresivni simptomatiki in zadovoljstvu z življenjem po obdobju daljše gibalne neaktivnosti pri zdravih odraslih moških. v raziskavi je sodelovalo deset odraslih oseb moškega spola, starih od 21 do 28 let, ki so bili izpostavljeni 35-dnevnemu neprekinjenemu ležanju s 6-odstotnim naklonom glave. psihološki status udeležencev smo ugotavljali s splošnim vprašalnikom o zdravju (ghq-12), z lestvico depresivnosti (ces-d) in lestvico zadovoljstva z življenjem (swls). preiskovanci so bili z izbranimi merskimi pripomočki testirani pred in med eksperimentom ter ob koncu eksperimenta. rezultati so pokazali, da ni prišlo do pomembnih sprememb v mentalnem zdravju in zadovoljstvu z življenjem udeležencev po obdobju daljše neaktivnosti v ležečem položaju. primerjava začetnega in končnega stanja pa je nakazala tendenco povečanja nevrotičnih znakov in depresivne simptomatike pri udeležencih. razloge za dobljene rezultate smo poskušali pojasniti zlasti v luči ugodnih bivanjskih pogojev ter v količini in kvaliteti socialnih interakcij v obdobju daljše gibalne neaktivnosti. ključne besede: popolna gibalna neaktivnost, bed rest raziskave, duševno zdravje introduction the benefits of physical activity on health and psychological well-being are well documented (warburton, nicol, & bredin, 2006). positive effects of physical activity have been found in both healthy individuals and individuals with various emotional disorders, regardless of their age, gender or abilities (guszkowska, 2004). there has been a rather vast body of research examining the effects of physical / sports activities in the past. studies have shown that physical activity (i.e. aerobic exercise) helps lower anxiety levels and leads to positive changes in emotional states (berger & motl, 2000; biddle, 1995; ekkekakis, hall, & petruzzello, 1999; o’connor, raglin, & martinsen, 2000). moderate intensity and regular physical activity helps alleviate psychological problems, such as depression and anxiety (blinc & bresjanac, 2005; peluso & de andrade, 2005), leads to an improvement in subjective well-being (fox, 1999) and positive psychological effects, including higher general satisfaction with life (fontaine, 2000; penedo & dahn, 2005). annales kinesiologiae • 6 • 2015 • 1 29 tjaša dimec časar, matej tušak, petra dolenc: changes in mental health and satisfaction with life ..., 27–38 complete physical inactivity is rather hard to enact in everyday life and the effects are fairly difficult to monitor. therefore, the effects of complete physical inactivity are frequently examined by experimental situations of simulated weightlessness, known as bed rest (br) studies. prolonged exposure to strict lying position is the most frequently used ground-based method for monitoring the effects of adaptation to microgravity in space flights on the human body. also, br studies are important for assessing the effects of long-term physical inactivity on individuals (rittweger, felsenberg, maganaris, & ferretti, 2007). literature that examine psychological aspects of adjustment to longer periods of bed rest also feature horizontal bed rest (hbr) experiments and headdown bed rest experiments (hdbr). studies examining long-duration br tackle both hbr and hbdr, involve limitations of body movements and generate various changes in physical and mental states (hirayanagi et al., 2009). compared to hbr, the hdbr method, mainly a 6 degrees head-down bed rest is considered to be more suitable as it speeds up physiological processes in the human body (e.g. redistribution of bodily fluids to the upper part of the body) and represents conditions being similar to zero gravity in space (hyeteok et al., 2003; styf, hutchinson, carlsson, & hargens, 2001). psychological factors (i.e. personality variables and psychosocial variables) have a significant role in the processes of adaptation to conditions of extreme limitation and isolation, such as experienced in the state of (simulated) weightlessness. the adjustment to new circumstances undoubtedly represents a significant source of stress. japanese scientists conducted br experiments motivated by the fact that a growing body of population can no longer stand in an upright position either due to a disease or an accident. thus, japanese researchers conducted five long-term studies in the period from 1990 to 1994. the aim of the latter was to explore the main effects of physical inactivity on individuals’ health. the obtained results were to be used to encourage people to awaken from inactivity and regain an active lifestyle. the results pertaining to the participants’ mental status have shown a significant decrease in their mental health and a significant increase in depression symptoms after a prolonged period of physical inactivity induced by horizontal bed rest (gunji, 1997). ishizaki and colleagues conducted a number of br studies (ishizaki et al., 1994; ishizaki et al., 1997; ishizaki et al., 2000) and reported a tendency for subjects to develop depressive and neurotic symptoms during a prolonged period of complete physical inactivity. in another study, changes in mood as well as the rate of depressive and neurotic signs during a 20-day bed rest on a sample young healthy males were examined (ishizaki et al., 2002). authors reported increased rates of depressive and neurotic symptoms after the completion of the study. slovenian researchers examined different psychological variables in two 35-day horizontal bed rest studies. according to the first study, performed in 2006, no significant decrease in anxiety level, emotion regulation and control and concentration ability was established after the period of strict physical immobility in young male participants (dolenc, tušak, dimec časar, & pišot, 2008). in the study carried out in 2007, the level of psychological distress was enhanced during the br period, whereas self-perceptions were relatively stable during the experiment. however, even after the period of physical 30 tjaša dimec časar, matej tušak, petra dolenc: changes in mental health and satisfaction with life ..., 27–38 annales kinesiologiae • 6 • 2015 • 1 inactivity, the expression of these symptoms remained relatively low and did not represent a risk to the mental health of participants. also, the results indicated a tendency toward an increase of emotion-focused coping and a decrease of problem-focused coping strategies (dolenc, tušak, dimec časar, & pišot, 2009). nicolas and weiss (2009) examined the psychological effects of a 60-day -6° headdown bed rest as well as the influence of exercise on the psychological state. the experiment consisted of three stages: a 20-day pre-experimental period, a 60-day head-down bed rest and a 20-day period of rehabilitation. the participants’ psychological state was measured with the recovery-stress questionnaire for athletes consisting of items related to stress and recovery after stress. as the results revealed, the experimental group reported a higher level of stress when compared to the control group. after the period of rehabilitation, the experimental group continued to score higher on the scale lack of energy, while reaching lower values on scales general well-being and personal accomplishments. furthermore, the most recent studies in china focused primarily on examining emotions during shortand long-duration -6° hdbr involving complete physical inactivity. qin et al. (2010) conducted a 60-day study with measurements performed on a sample of 21 subjects on nine different occasions (on the 3rd, 10th, 17th, 24th, 31st, 38th, 45th, 52nd and 59th day) and found a 4-phase fluctuating trend of negative emotions (high – low – high – low). the measurements also revealed significant differences in the rate of fatigue or exhaustion (a dimension of the poms questionnaire) and the cortisol levels, while the rate of depression significantly increased between the 38th and the 52nd day of bed rest. conversely, chen, zhao, zhou, wang and tan (2011) found no significant changes in anxiety, depression and positive / negative emotions in their 15-day study of hdbr. further, two chinese studies conducted over a longer time period (45 days of hdbr) also found no significant increase in symptoms of anxiety and depression (liu, zhou, chen, & tan, 2012; zhao, wang, zhou, wang & tan, 2011). based on the above-mentioned research, it can be concluded that complete physical inactivity induced by bed rest model may lead to negative changes in the mental status of individuals. our study aimed to examine the psychological effects of a 6 degrees head-down tilt bed rest in healthy male volunteers. in the year 2008, this type of bed rest was carried out for the first time in slovenia. we assumed that 35 days’ absence of physical activity will lead to poorer mental health, an increase in the level of depressive symptoms and a decline of the general satisfaction with life. method participants the study was conducted on 10 healthy males with a mean age of 23.36 years (sd = 2.17) who volunteered to participate in the project “valdoltra bed rest study”. annales kinesiologiae • 6 • 2015 • 1 31 tjaša dimec časar, matej tušak, petra dolenc: changes in mental health and satisfaction with life ..., 27–38 previously, the participants were explained about the objectives and the procedure of the study. the participants’ selection was based on an in-depth structured interview and a thorough medical examination to exclude neuromuscular, cardiovascular diseases and psychiatric disorders. the selected participants signed a written consent for participating in the research. a personality questionnaire (bfq – big five questionnaire; caprara et al., 2002) was assessed to check the subjects’ emotional stability and there were indeed no significant deviations in their personality profiles, hence rendering them suitable participants. the experiment was approved by the national medical ethics committee of the republic of slovenia and was conducted in accordance with the principles of the helsinki-tokyo declaration. experimental protocol the study was conducted at the valdoltra orthopaedic hospital, slovenia. the 35day bed rest was carried out in a strictly 6-degree head-down tilt position. the participants performed all daily activities lying down. physical activity was strictly forbidden. during the entire bed rest, the participants received medical care and were monitored by video-cameras. they were allowed to watch television, listen to music, use computers with the internet connection, read and have visits. participants completed the psychological questionnaires in the forenoon, at three different test time points – a day before bed rest, on the 17th day of bed rest (during br) and on the 35th day of bed rest (after br). instruments general health questionnaire – ghq-12 (goldberg, 1972) is a questionnaire used to assess general mental health at the time of measurement. it is a screening instrument used to discover neurotic disorders in the framework of general medical practice and primary care. the questionnaire consists of 12 items referring to general well-being and individuals’ phenomenological experience. for the purpose of the present study, participants were asked to report the intensity of their feelings over the past week on a 4-point scale (0 – much more than usual, 1 – more than usual, 2 – same as usual, 3 – much less than usual). the final score obtained is the sum of all figures. six answers are reverse scored. scores range from 0 to 36 – a high result indicates poor health (individuals have trouble sleeping, find it hard to concentrate on their work, feel under pressure, feel unable to conquer problems, are unhappy, irritable and depressed, have been losing confidence in themselves and their abilities etc.). a low score, conversely, indicates absence of health problems. the questionnaire has high coefficients of internal consistency (0.82 < α < 0.90) and reliability in time (rtest-retest = 0.73) (goldberg & williams, 1988). 32 tjaša dimec časar, matej tušak, petra dolenc: changes in mental health and satisfaction with life ..., 27–38 annales kinesiologiae • 6 • 2015 • 1 center for epidemiologic studies depression scale – ces-d (radloff, 1977) is a 20item self-report scale designed to measure depression symptoms with an emphasis on the affective component, i.e. depressed mood. the scale measures symptoms that constitute the criteria for clinical depression: depressed mood, feelings of guilt and worthlessness, feelings of helplessness and despair, psychomotor inhibition, loss of appetite and sleeping problems. it consists of 20 statements focusing on individuals’ feelings. respondents use a 4-point scale (0 – rarely or none of the time, 1 – some or a little of the time, 2 – occasionally or a moderate amount of the time, 3 – most or all of the time) in answering how often they have experienced the described emotional content recently. total score is the sum of all items. four items are reverse scored. scores range from 0 to 60, a high result indicating a higher level of depression symptoms. a total score above 16 indicates the presence of clinically significant level of depression symptoms. values between 16 and 21 indicate slight to moderate level of depression symptoms, while scores above 21 indicate a probable major depressive episode. the scale has high coefficients of internal consistency (0.84 < α < 0.90) and reliability in time (rtest-retest = from 0.45 to 0.70). satisfaction with life scale – swls (diener, emmons, larsen, & griffin 1985) measures general satisfaction with life. among various components of the subjective well-being, this scale focuses on the cognitive aspect of satisfaction with life. the score obtained by the scale can be seen as an individuals’ global assessment of the quality of their life based on their own criteria (the feeling that life was and is good, that life at the moment or life in general is full, meaningful and pleasant). the scale consists of five items and the participants answer on a 7-item scale (1 – strongly disagree, 2 – disagree, 3 – slightly disagree, 4 – neither agree nor disagree, 5 – slightly agree, 6 – agree, 7 – strongly agree). the final score is a sum of answers on all five items. results range from 5 points (low satisfaction with life) to 35 points (high satisfaction with life). authors report a high coefficient of internal consistency (α = 0.87) and reliability in time (rtest-retest = 0.82). statistical analysis ibm spss statistics 20 was used to calculate the relevant parameters. differences in psychological variables before, during and after br were tested using wilcoxon signed rank test. in addition to statistical significance, practical relevance of the obtained results was reported using pearson’s r as effect size measure (field, 2005). cohen’s guidelines for interpreting effect size were followed, with r = 0.10 indicating small, r = 0.30 medium, and r = 0.50 large effect size (field, 2005). results results in table 1 show no significant decrease in the mental health (ghq-12) of participants following the br period however, there was a medium to high effect size in the direction of health deterioration. the analysis of depressive symptoms assessed by annales kinesiologiae • 6 • 2015 • 1 33 tjaša dimec časar, matej tušak, petra dolenc: changes in mental health and satisfaction with life ..., 27–38 the ces-d revealed no significant changes after the br period although the effect size measure indicates a medium to high effect, indicating a tendency toward an increase of depressive symptoms. furthermore, no significant differences were found in satisfaction with life assessed by swls during the 35-day bed rest. the effect size coefficient revealed a medium effect. table 1: differences in mental health, depressive symptoms and satisfaction with life before and after 35-day bed rest (br). before br after br variables me min max me min max t z p r mental health (ghq-12) 16.50 7 18 18.00 15 32 5.00 –1.83 0.07 –0.41 depressive symptoms (ces-d) 3.50 1 18 5.00 0 44 6.50 –1.83 0.07 –0.41 satisfaction with life (swls) 25.00 12 31 24.50 9 34 9.00 –1.27 0.21 –0.28 legend: br – bed rest, me – median, min – minimum value, max – maximum value, t – test statistics, z – standardized value of t, p – significance of differences: * p < .05, r –effect size coefficient. data collected during the experiment (on the 17th day of br) revealed that the participants’ health deteriorated in the first half of the experiment, the participants’ scores were significantly lower before br than during br (meduring = 18.00; t = 4.00; z = –1.97; p < 0.05; r = –0.44). the biggest rise in depressive symptoms, however, was in the first part of the experiment and results also reveal a tendency towards a statistically significant difference (meduring = 7.00; t = 10.00; z = –1.80; p = 0.07; r = –0.40). depressive symptoms continued to increase slightly in the second half of the experiment, however, the increase was no longer as pronounced as in the first part. in the first half of br, satisfaction with life gradually decreased. during br, participants reported the lowest rate of satisfaction with life, although their scores were still relatively high, while a slight enhancement in satisfaction with life occurred in the second half of br. however, there were no significant differences in the measured variable before and during br. discussion at the time of the first measurement, participants’ scores on the mental health questionnaire (ghq-12) and depression scale (ces-d) were low and indicated an absence 34 tjaša dimec časar, matej tušak, petra dolenc: changes in mental health and satisfaction with life ..., 27–38 annales kinesiologiae • 6 • 2015 • 1 of health problems, neurotic signs and depressive symptoms. comparison of results collected at the beginning and at the end of the experiment revealed that after 35 days of br, there were no significant differences in mental health and depression, however, there was a tendency towards a decrease in both parameters. similar results were obtained in several studies (ishizaki et al., 1994; ishizaki et al., 1997; ishizaki et al., 2000), but are in contrast with some studies reporting a significant increase in psychological distress of participants after horizontal br (dolenc et al., 2009). a 35-day head-down bed rest had a medium to high effect (field, 2005) leading to a decrease in the participants’ psychological health, however, due to generally low scores, it can be concluded that the mental health of the participants was good immediately before, during, as well as at the end of the experiment. despite the slight trends towards an increase in depressive symptoms and a deterioration of mental health, the latter was not in serious danger at any point during the experiment. the obtained results are similar to the findings of most recent head-down bed rest studies that similarly found no increase in depressive symptoms due to physical inactivity (chen et al., 2011; liu et al., 2012; zhao et al., 2011) and contradict the findings of some older studies (ishizaki et al., 2002). measurements performed during bed rest, on the other hand, revealed a significant difference in health in the first half of the experiment. ishizaki et al. (1994) in their study examining the influence of complete physical inactivity on mental health similarly found a significant increase in raw values for all participants on the 19th day of br, however, these values decreased until the end of bed rest. possible reasons for the deterioration of health in the first part of the experiment can perhaps be found in the processes of basic physical and psychological adaptation caused by physical inactivity and spending days in a restricted environment. in this initial stage, problems may arise due to fatigue and disturbances in the vestibular and sensorimotor system caused by weightlessness. participants also experienced some secondary effects of the simulated weightlessness state (e.g. headaches, sleep disturbances, etc.) (gushin, kholin, & ivanovsky, 1993). based on a closer overview of the obtained results, we can thus come to the conclusion that the first half of the experiment had a somewhat negative influence on participants’ health, while their health only slightly deteriorated in the second half of the experiment. the obtained findings could be a result of the healthy and fit participants’ bodies adapting to inactivity after the initial “shock”. additionally, they opted to participate in the experiment including inactivity voluntarily and were highly motivated for participation. the largest increase in depressive symptoms occurred in the first part of the experiment. the difference was not significant, however, there was a tendency towards statistical significance and a medium to high effect size. kanas and manzey (2003) similarly report an increase in the depressive mood following a decrease in physical / sports activity − in our study, the biggest effect of physical inactivity was found in the first part of the experiment. manzey, lorenz and poljakov (1998) further report a stabilization of mood after a successful adaptation to the new environment, which is similar to our findings as the depressive mood continued to increase only slightly until annales kinesiologiae • 6 • 2015 • 1 35 tjaša dimec časar, matej tušak, petra dolenc: changes in mental health and satisfaction with life ..., 27–38 the end of our experiment. styf et al. (2001) examined differences in depression in br and hdbr and reported similar findings. after a 35-day period of complete physical inactivity, satisfaction with life did not significantly decrease. examining the effect size, however, it can be seen that the longduration complete physical inactivity had a medium effect leading to deterioration in an individuals’ satisfaction with life. measurements conducted during the experiment revealed that participants reported the lowest satisfaction with life at that time compared to their initial results and results at the end of the experiment, however, their satisfaction with life scores were still in the range of average satisfaction with life. the participants thus reported an average level of satisfaction with life throughout the experiment. when discussing the main sources of satisfaction with life, diener (2000) mentions individuals’ satisfaction with oneself, faith or spiritual life, process of learning and development as well as free time as main sources of satisfaction and perhaps this is also the reason for the participants’ relatively stable level of satisfaction with life. the experimental situation did not touch any of those areas, quite the contrary, participants were able to learn something new about themselves and dedicate time to themselves and their own personal growth. our study revealed no prominent decrease in the mental state and well-being of the participants after a long-lasting physical inactivity induced by head-down bed rest. the results can perhaps be explained in the light of various factors: stimulating living conditions during the experiment (participants had access to computers and the internet connection as well as television, music, books, newspapers etc.); good initial mental state of the participants; the fact that participants could have contacts with family and friends every day and were consequently satisfied with the amount of social contacts; absence of conflicts between the participants; the possibility of communication with various staff members at all times and the satisfaction of the participants with the quality of interaction with staff members; participants feeling safe and trusting the research and healthcare staff; the awareness that intervention is possible at any moment and they will get immediate help if any problems should arise: predictability of events at the time of bed rest (participants knew what to expect from the next step, saw the experiment as something positive or as a challenge, they decided to participate in the experiment voluntarily, the absence of or lack of any real danger (e.g. to their own physical or mental health) as well as the awareness of the participants that their state is only temporary and that they will be able to continue with their active lifestyle after the experiment. the above-mentioned findings could also be used for suggestions for psychological interventions aimed at lowering stress and improving individuals’ quality of life in conditions of long-lasting physical inactivity. to conclude, better psychological outcomes and fewer problems in psychological adjustment can be expected if mentally stable young individuals exposed to a longer period of physical inactivity (e.g. in the initial stage of rehabilitation or following a surgery) are provided with positive and stimulating living conditions, the possibility for frequent social interactions and a feeling of safety as well as being cared for by trust-worthy health staff. we can further predict that in cases of slightly poorer initial 36 tjaša dimec časar, matej tušak, petra dolenc: changes in mental health and satisfaction with life ..., 27–38 annales kinesiologiae • 6 • 2015 • 1 mental health, favourable living conditions and social interactions could bear an even more significant role in maintaining a favourable mental status. conclusions the study of psychological aspects of acute physical inactivity, induced by bed rest model deserves special attention and consideration in the future. bed rest studies could further be enriched by examining the effects of various psychological interventions, such as relaxation and visualisation techniques on participants’ mental status. the results of the present study could be applied with the aim of providing adequate psychological support and assistance in the cases of prolonged planned physical inactivity in otherwise healthy individuals, in particular in the field of sport and exercise, e.g. after orthopaedic surgeries that require long-term recovery and other medical indication which presume prolonged physical inactivity. acknowledgments the study is a part of the wider international research project “bed rest valdoltra 2008 – the effects of simulated weightlessness on the human organism” led and coordinated by the institute for kinesiology research, science and research centre, university of primorska in collaboration with the jozef-stefan institute, ljubljana and karolinska institutet, stockholm. the project was co-financed by asi (italian space agency). we would like to express our gratitude to all participants taking part in the study, to the project leader prof. rado pišot, ph. d., and to the medical staff of the valdoltra orthopaedic hospital. references berger, b. g., & motl, r. w. 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http://www.cmaj.ca/content/174/6/801.short http://dx.doi.org/10.1016/j.actaastro.2011.07.003 _enref_26 _goback _goback _goback _goback bm3 _goback _goback annales kinesiologiae • 7 • 2016 • 1 3 preschool children’s results in movement abc tests: differences between girls and boys in movement deficit giuliana jelovčan1, joca zurc2 1 university of primorska, faculty of education, koper, slovenia 2 alma mater europaea ecm graduate health sciences program, maribor, slovenia corresponding author: giuliana jelovčan university of primorska, faculty of education cankarjeva 5, 6000 koper, slovenia phone: +386 5 663 12 66 e-mail: giuliana.jelovcan@pef.upr.si abstract the aim of our study was to assess the children’s motor skills on a sample of preschool children between the age of 4 and 5 (x = 4.44 ̅, so = 0.46), using a checklist questionnaire and movement assessment battery for children. we wanted to know whether the examined sample shows any deficits in movement or any physical difficulties, as well as what are the differences in gender. the study included 100 children from three kindergartens on the slovenian coastal region. we used the percentile norms for common evaluation of movement problems. the total score below 15 percentile which indicates movement problems, was determined in 27 % of children, of which 66.7% in girls and 33.3% in boys. statistically significant gender difference was found in the skipping rope test (p = 0.005), where boys performed better (x ̅ = 0.21) than girls (̅ x = 1.08). the findings show a high incidence of movement difficulties in preschool children, as a quarter of children do not reach the expected level of motor development, thus, this indicates the suspected occurrence of developmental coordination disorder. further research is needed in the field of movement abc tests application and in the incidence of movement deficites on a representative sample. it ia also advisable to identify the factors that are associated with movement deviations in preschool children. in encouraging a child’s motor developement a greater attention should be given to girls in particular. the results of the movement abc tests needs to be considered from the perspective of the child’s holistic development and their motivation to perform. keywords: preschool children, motor development, clumsy child, developmental coordination disorder, movement abc – movement assessment battery for children. original scientific article udc: 796.012-053.4 received: 2015-07-06 4 giuliana jelovčan, joca zurc: preschool children’s results in movement abc tests ..., 3–19 annales kinesiologiae • 7 • 2016 • 1 dosežki predšolskih otrok na testih abc gibanja: razlike med deklicami in dečki v primanjkljajih na gibalnem področju izvleček namen naše raziskave je bil s pomočjo vprašalnika in baterije testnih nalog abc oceniti otrokovo gibanje na vzorcu predšolskih otrok v starosti med 4. in 5. letom (=4,44, so=0,46). zanimalo nas je, ali se na proučevanem vzorcu pojavljajo primanjkljaji na gibalnem področju oziroma gibalne težave ter kakšne so na tem področju razlike med spoloma. v raziskavi je sodelovalo 100 otrok iz treh obalnih vrtcev. uporabili smo percentilne norme za skupno oceno gibalnih težav. skupna ocena pod 15 percentili, ki nakazuje prisotnost gibalnih težav, se je pokazala pri 27 % otrok, od tega pri 66,7 % deklicah in 33,3 % dečkih. statistično značilna razlika med spoloma se je pokazala v testu preskakovanje vrvi (p=0,005), v katerem so se bolje izkazali dečki (=0,21) kot deklice (=1,08). ugotovitve raziskave kažejo visoko pojavnost gibalnih težav pri predšolskih otrocih, saj jih četrtina ne dosega pričakovane stopnje gibalnega razvoja in kaže na sum pojava razvojne motnje koordinacije. potrebne so nadaljnje raziskave na področju uporabe baterije testov abc in pojavnosti primanjkljajev na gibalnem področju na reprezentativnem vzorcu ter ugotavljanje dejavnikov, ki so povezani s pojavom gibalnih odstopanj pri predšolskem otroku. pri spodbujanju otrokovega gibalnega razvoja je potrebno večji poudarek posvetiti zlasti deklicam. rezultate na testih abc gibanja je potrebno obravnavati iz perspektive otrokovega celostnega razvoja in motivacije za izvedbo. ključne besede: predšolski otrok, gibalni razvoj, neroden otrok, razvojna motnja koordinacije, abc gibanja – baterija za oceno otrokovega gibanja theoretical grounds preschool period is the period of fundamental motor development. the child’s body is most receptive for environmental influences in early childhood, moreover, this affects the development of the child’s personality as well. in this period of the child’s development, the individual areas, such as movement, physical, cognitive, emotional and social development, are closely linked. therefore, it is important not to miss the most suitable period, when the child’s development is the most sensitive for the various effects that can be achieved with physical / sports activities (pišot & planinšec, 2005). the development of motor skills and abilities is connected to the chronological age, but not dependent on it, so it does not take place in all children equally fast (videmšek & annales kinesiologiae • 7 • 2016 • 1 5 giuliana jelovčan, joca zurc: preschool children’s results in movement abc tests ..., 3–19 pišot, 2007). gallahue and ozmun (2006) point out that motor development continues through different periods, which are called development stages, in which certain types of conduct can be detected, which apply to the majority of children at each stage of development. due to individual differences, individual stages of development may occur in different age groups, although the order of their occurrence is generally the same (videmšek & pišot, 2007). as every child has his or her own biological clock (gallahue & ozmun, 2006), it is possible to notice among the children of the same age that some children are more adept than others, but some children stand out as being more clumsy than the others. the most common reason to this is a delayed motor development, which can be recognized also from the child’s late development of the ability to sit and / or to walk (kalar, videmšek, & karpljuk, 2005). delayed development of motor skills and abilities of a child represents a developmental coordination disorder, or the so-called clumsiness. clumsiness in motor skills may give the impression that the child is also lagging behind in his or her intellectual development. however, it has been proven that clumsy children are without any localized brain damage and are intellectually on the level of their physically more developed peers (kalar et al., 2005). gubbay (1975, in hamilton, 2002), called this clumsiness “a clumsy child syndrome”, which used to be considered a description of a child of adequate intelligence, who had no diagnosed medical or neurological problems. the term described the child’s difficulties in movement, without a recognized medical or neurological condition. difficulties were encountered in the child’s daily operations and, in particular, in socialization. in recent years, the term “a clumsy child syndrome” has been replaced with the term “developmental coordination disorder” (hereinafter dcd) or “dyspraxia”. hamilton (2002) points out that the clumsiness is not that insignificant a problem as it may seem, so it is advisable to consistently monitor a child and the possibility of the occurrence of any movement problems. any evolving physical discrepancy in a child needs to be professionally addressed, as clumsiness may be the potential indicator of dcd. dcd indicators vary depending on the age and the stage of development. younger children may also show signs of clumsiness and developmental delays and do not reach the milestones in motor development in basic motor activities such as walking, crawling, sitting, tying shoes, opening and closing buttons or zippers (gubbay, 1975, in hamilton, 2002; kirby & drew 2003; terčon, 2013). children have difficulties planning their own movement, describing it or changing it (clark, getchell, smiley-oyen, & whitall, 2005; filipčič, 2006). dcd causes problems with movement, coordination, organization and processing of sensory information and low self-esteem, which can also lead to a variety of learning and socialization problems (losse et al., 1991; kremžar & petelin, 2001; terčon, 2013). in the preschool age, children suffering from dcd (clark et al., 2005; filipčič, 2006; kirby & peters, 2007; harris, mickelson, & zwicker, 2015) often have difficulty with orientation in space. problems and slower development are also reflected in crawling and creeping, seating, activities in standing position, walking, climbing stairs (upstairs and downstairs), running, jumping, catching and throwing the ball. they are noted for being slower at dressing and feeding, their 6 giuliana jelovčan, joca zurc: preschool children’s results in movement abc tests ..., 3–19 annales kinesiologiae • 7 • 2016 • 1 drawing is less developed in comparison with their peers and they have more difficulties in establishing social contacts. however, losse et al. (1991) note that there are individual differences among children regarding how they can cope with the continuous difficulties for a long period. developmentally conditioned clumsiness typically occurs in the earliest years of life and can continue well into adulthood (kremžar & petelin, 2001). problems can occur in adult with continuing effect on their lives. physically impaired adults refuse to perform physically demanding tasks, which excludes them from the important activities of daily life (cousins & smyth, 2003). early detection of children with dcd in the earliest years of life is therefore crucial for offering professional support to both children and their parents before the child starts attending school (jongmans, 2005, in the van waelvelde, peersman, lenoir, smits engelsmand, & henderson, 2008). according to some estimates (kirby, 2005; harris et al., 2015), the dcd occurs in one of twelve individuals (5% 6%) in the population, and is three times more common in boys than in girls. the dysfunction is often disguised as children do not have visible physical signs and, they have great difficulty in motor activities at home and at school. children with such problems are perceived as clumsy, sometimes even as lazy. aim of the study, objectives and hypotheses the aim of the research was to assess the children’s motor skills on a sample of preschool children, aged between 4 and 5, with the help of a checklist questionnaire and movement abc tests. the objectives of the research: – to identify the presence of impairments in motor skills or deficits in movement when testing a group of preschool children; – to identify differences in performance on movement abc tests between girls and boys, – to identify statistically significant correlations between the movement abc tests. in this study, we surveyed the following hypotheses: – h1: there are significant differences between girls and boys in the results of the movement abc tests: – h1.1: we assume that boys perform better in the tests of gross motor skills. – h1.2: we assume that girls perform better in the tests of fine motor skills. – h2: there is a statistically significant relationship between all movement abc tests: – h2.1: there is a statistically significant relationship between movement abc tests that assess hand skills and the tests that assess statistical-dynamic balance. annales kinesiologiae • 7 • 2016 • 1 7 giuliana jelovčan, joca zurc: preschool children’s results in movement abc tests ..., 3–19 – h2.2: there is a statistically significant relationship between movement abc tests that assess ball skills and the tests that evaluate the static-dynamic balance. – h2.3: there is a statistically significant relationship between movement abc tests that assess hand skills and the tests that assess ball skills. work methods sample three kindergartens from the coastal slovenian region were invited to participate in the survey, 570 children all together. the prior consent to participate in the survey was given by 107 children, of which 52 boys and 55 girls. in fact, 100 children from 10 departments from the selected kindergartens participated in the survey, of which 47 (47%) boys and 53 (53%) girls. the realization of the sample was 17.54%. our sample was represented by the children in these kindergartens, the average age of 4.44 ± 0.46. tools data were collected with movement abc tests (henderson & sugden, 1992). we chose single test tasks for all children, namely, eight test tasks for the first age group of 4 to 6 year olds, which include hand skills tasks (inserting coins, stringing blocks, following cycling track) ball skills (catching a bag of beans, rolling a ball into a goal) and the skills of the static and dynamic balance (balancing on one foot, skipping the rope, tiptoeing). movement abc tests were designed to identify and describe the less efficient movement of children of the ages between four and twelve. movement abc tests (henderson & sugden, 1992) are considered to be commonly used in children for the detection of deficits in the development of coordination. test results, their conversions and interpretation in each individual movement abc test, the child could have a different number of attempts to perform the required physical task successfully and, thus, reach the score of 0, which means very good. in hand skills tasks two attempts were allowed and in ball skills ten attempts. in the task of balancing on one leg, two attempts were allowed for each leg, and in the tasks of dynamic balance (skipping the rope and tiptoeing), two attempts were allowed. (henderson & sugden, 1992). in each task, the number of seconds needed for the child to successfully complete the task was noted down. if the child did not carry the task out, the test performer marked whether it was an unsuccessful attempt, an inappropriate task that the child 8 giuliana jelovčan, joca zurc: preschool children’s results in movement abc tests ..., 3–19 annales kinesiologiae • 7 • 2016 • 1 could not perform due to their physical characteristics, or whether the child refused to participate. the first score of each test, expressed in seconds, was converted to the rating on a scale from 0 to 5. in converting the results, we used the table by henderson and sugden (1992), attached the summary sheet, where we looked for the value of a child’s result in relation to the his or her age group. the converted result was then entered into the box titled “total task results” (figure 1). if the child received an assessment rate higher than 0, namely, any other assessment (i.e. from 1 to 5), and the instructions for each test allow so, the task was repeated until the child reached his or her highest result. if the child still has not reached the rate 0, we considered the best result which we converted into the corresponding rating from 1 to 5, according to the table of henderson and sugden (1992). a higher score indicates higher difficulties. if the child did not carry out a task in any of the attempts, he or she got the score 5. in the case of functions test, where the activity of both hands or feet was assessed, we got the overall result by adding up all the results for each arm or leg and then halving the sum. motor impairment of children on the movement abc tests was interpreted by using the percentile norm where higher results means lower motor skills and efficiency (henderson & sugden, 1992). the percentile refers to the placement of the child in the rank of the standardization sample according to the identified motor efficacy in the overall population of children of a certain age. in interpreting the percentiles, according to henderson and sugden (1992), we used the norms in three intervals: 1) the results under the fifth percentile, pointing to a sign of undoubted movement difficulties; 2) the results between the 5th and 15th percentiles, pointing to borderline level of difficulty; 3) the results above the 15th percentile, pointing to appropriate motor skills of the child. a suspicion of dcd was identified in children whose results were below the 15th percentile (henderson & sugden, 1992). data collection method testing has been subject to prior written consent of the parents and the management of the kindergarten and was conducted on the premises of the three kindergartens on the slovenian coastal area that were included in the study. the tests were performed in april and may 2010, following a previously confirmed schedule. in performing all tests, we took care of equivalent test conditions (in the morning, in ventilated area with adequate light, the same test material, the same evaluators). on the day of the testing, the children were healthy and wore appropriate sports clothing (short-sleeved t-shirts and shorts). in one testing, normally in the morning, from 3 to 4 children were tested. the testing was conducted in two stages, at each stage two children were jointly tested by two test performers. children had met their test performers in january 2010, when they were tested for elementary movement patterns. the child, who was waiting for testing, could draw or play with soft toys while waiting. the playground area was on the other side of the waiting room, so that the tested children were not distracted by the annales kinesiologiae • 7 • 2016 • 1 9 giuliana jelovčan, joca zurc: preschool children’s results in movement abc tests ..., 3–19 children waiting for the test and playing. the test performers also had different roles and assignments. one was directly with the child, demonstrating and explaining the tests. other test performer was recording, photographing and writing down important notes during the completion of each test. the testing time for one child was 20-25 minutes. data analysis methods the collected data were initially analyzed using descriptive statistics (frequency, percentage, average value, median, mode, minimum and maximum values, standard deviation). gender differences in the results of the movement abc tests in children were analyzed using nonparametric mann whitney u test. the correlations between the measured tests were determined by spearman’s correlation (newell, aitchison, & grant, 2014). in order to achieve statistical significance, the differences by gender were considered, as well as the correlations between the tests at the level p ≤ 0.05. all data analyzes were performed in the spss statistical program, version 20.0. results the results show the distribution of children according to the percentile rank following the movement abc tests results that indicate the presence of interference in the motor skills or deficits in movement in the studied group of preschool children. below we present the results of the studied sample of children on movement abc tests, with respect to the performance resulting on a scale of 0 to 5 (0-best score, 5-worst result), which was used to determine the presence of statistically significant differences between the achievements of boys and girls and statistically significant correlations between individual movement abc tests. 10 giuliana jelovčan, joca zurc: preschool children’s results in movement abc tests ..., 3–19 annales kinesiologiae • 7 • 2016 • 1 table 1: percentage of children according to the percentile rank in movement abc tests results. girls n (% rank, % gender) boys n (% rank, % gender) age () ≤ 5: sign of undoubted motor difficulties (n=4) n 3 1 4.32 % rank 5.7 2.1 % gender 75.0 25.0 5 – 15: borderline level of difficulties (n=23) n 15 8 4.45 % rank 28.3 17.0 % gender 65.2 34.8 ≥ 15: no difficulties (n=73) n 35 38 4.45 % rank 66.0 80.9 % gender 47.9 52.1 total (n=100) n 53 47 / % rank 100.0 100.0 % gender 53 47 note: n=number of children, %=percentage of children regarding the percentile rank and gender, =average value. table 1 shows that the results ranking below 15th percentile, which draws attention to the suspicion of deficit in motor skills development, showed in 27% of the studied preschool children, the average age of 4.4, of which 66.7% in girls and 33.3% in boys (table 1). the assessment results of undoubted movement problems were found in four of the children included in the study, namely, in three girls and one boy. three-quarters of the tested children (75 %) reached the percentile rank above 15, which indicates proper physical functioning. the average age of children from the 5th percentile rank upwards and does not change (x ̅ = 4.45), but is somewhat lower in children who were ranked in the interval below the 5th percentile rank (x ̅ = 4.32). annales kinesiologiae • 7 • 2016 • 1 11 giuliana jelovčan, joca zurc: preschool children’s results in movement abc tests ..., 3–19 table 2: children’s results in individual movement abc tests. minimum maximum  sd inserting coins 0.0 4.0 0.99 1.027 stringing blocks 0.0 5.0 1.41 1.634 following a cycling track 0.0 0.0 0.00 0.000 catching a bag 0.0 3.0 0.16 0.564 rolling a ball into a goal 0.0 5.0 0.59 1.181 balancing on one leg 0.0 4.5 1.06 1.278 skipping the rope 0.0 5.0 0.67 1.602 tiptoeing 0.0 5.0 2.48 1.956 note: =average value, sd=standard deviation. table 2 shows that the tested 4 to 5-year old preschoolers performed best in the task of following the cycling track, which was carried out without any observed errors. second most successfully performed tests were catching a bag (̅ x = 0.16), rolling a ball into a goal (x ̅ = 0.59) and skipping the rope (x ̅ = 0.67). less successful they were in performing tiptoeing test (x ̅ = 2.48). standard deviations point to considerable differences between the tested children in the results of movement abc tests, ranging from 1 to 2 points. deviations are the largest in the results of the test of tiptoeing (sd = 1.96). the exceptions were the tests of following a cycling track (sd = 0.00) and catching a bag (sd = 0.56), which both show the the homogeneity in motor development of the tested children, which is required in the conduct of such tests. 12 giuliana jelovčan, joca zurc: preschool children’s results in movement abc tests ..., 3–19 annales kinesiologiae • 7 • 2016 • 1 table 3: differences between boys and girls in the results of individual movement abc tests. gender  sd mann whitney u test (p) inserting coins boy 0.93 1.073 0.405 girl 1.05 0.992 stringing blocks boy 1.57 1.791 0.407 girl 1.26 1.483 catching a bag boy 0.15 0.510 0.656 girl 0.17 0.612 rolling a ball into a goal boy 0.57 1.281 0.524 girl 0.60 1.098 balancing on one leg boy 1.21 1.322 0.237 girl 0.93 1.234 skipping the rope boy 0.21 1.020 0.002 girl 1.08 1.900 tiptoeing boy 2.49 1.988 0.977 girl 2.47 1.947 note: =average value, sd=standard deviation, t=coefficient of the t-test for independent samples, p=level of statistical significance. mann whitney u test showed a statistically significant difference in the test of skipping rope (p = 0.002), in which boys proved to be better (x ̅ = 0.21) than girls (x ̅ = 1.08) (table 3). girls (sd = 1.90) in this test were more non-uniform as compared with boys (sd = 1.02). in other tests, statistically significant differences between the genders did not occur. the first hypothesis, which anticipated that there are statistically significant differences between girls and boys in the results of the movement abc tests measurement, where boys achieve better results in the tests of gross motor skills (h1.1 hypothesis) and girls in tests of fine motor skills (h1. 2 hypothesis) can be confirmed in h1.1 and rejected in h1.2. boys showed statistically significant, better results in the tests of gross motor skills, whereas girls did not show significantly better results in any of the measured motor skills tests. correlation between individual movement abc tests shows statistically significant correlations between the tests of inserting coins and stringing blocks (p <0.001), between the tests of stringing blocks and skipping the rope (p <0.001) and between the test of balancing on one leg and walking on tiptoe (p = 0.023), catching a bag (p = 0.053) and annales kinesiologiae • 7 • 2016 • 1 13 giuliana jelovčan, joca zurc: preschool children’s results in movement abc tests ..., 3–19 skipping the rope (p = 0.055) (table 4). the correlations between the test of stringing the blocks and inserting coins (rho = 0.428) and skipping the rope (rho = 0.345) have a medium intensity, the rest of the statistically significant correlations have a low intensity. all statistically significant correlations are positive regarding the integration direction, which means that the scores on the correated tests rise or fall in the same direction. table 4: spearman’s correlation in movement abc tests. in se rt in g co in s st ri ng in g bl oc ks c at ch in g a ba g r ol lin g a ba ll in to a g oa l b al an ci ng o n on e le g ju m pi ng th e ro pe t ip -t oe in g inserting coins* rho (p) 1 stringing blocks* rho (p) 0.428 (<0.001) 1 catching a bag** rho (p) 0.116 (0.252) 0.053 (0.601) 1 rolling a ball into a goal ** rho (p) -0.050 (0.620) -0.010 (0.924) -0.028 (0.781) 1 balancing on one leg*** rho (p) 0.064 (0.527) 0.095 (0.348) 0.194 (0.053) 0.042 (0.679) 1 jumping the rope*** rho (p) 0.181 (0.072) 0.345 (<0.001) 0.141 (0.163) 0.084 (0.403) 0.193 (0.055) 1 tiptoeing*** rho (p) 0.101 (0.319) -0.051 (0.611) 0.056 (0.579) 0.112 (0.265) 0.227 (0.023) 0.185 (0.065) 1 note: rho = spearman’s correlation coefficient , p=level of statistical significance, *=hand skill tests, **=ball skill tests, *** = static-dynamic balance tests. the second hypothesis, in which we anticipated that there are statistically significant correlations between the movement abc tests that assess hand skills and the tests that assess a statistical-dynamic balance (h2.1 hypothesis), between the tests that assess ball skills and the tests that assess statistical and dynamic balance (h2.2 hypothesis), and the tests that assess hand skills and the tests that assess ball skills (h2.3 hypothesis), can be confirmed in h2.1 and h2.2 and rejected in h2 .3. the results of spearman’s correlation showed statistically significant correlations between the movement abc tests, assessing hand skills (putting cubes on a string task), and the tests that assess a statistical-dynamic balance (skipping the rope task), and the tests that assess ball skills (catching a bag task) and tests that assess the statistical-dynamic balance (balancing on one leg task), but did not show any statistically significant correlations between the tests that assess ball skills and the tests that assess hand skills. 14 giuliana jelovčan, joca zurc: preschool children’s results in movement abc tests ..., 3–19 annales kinesiologiae • 7 • 2016 • 1 discussion our study, which was conducted with movement abc tests on the sample of 4and 5-year-old preschool children on the slovenian coast, showed that three quarters of the tested children have adequate motor skills without any problems occurring. an overall rating below 15 percentile rank, which indicates the presence of deficits in movement or difficulties in motor development, however, was shown in a quarter of the tested children. a high risk degree with the results under the 5 percentile rank was shown in 4% of the tested children, in which case it is possible to conclude that motor difficulties are already present. the results of the present research regarding the proportion of children with motor difficulties is slightly lower compared to the australian study, which showed that 6% of the children included in the tests were placed in the group with a high degree of dcr risk (pridham, hillier, & estermann, 2011 in terčon, 2013). the deviations of the related research findings from ours could be attributed to the non-randomized sample of preschool children who participated in our study. henderson and sugden (1992) point out that it is, nevertheless, necessary to be cautious when finalizing the findings of the child’s status on the basis of the movement abc tests achievements. lower achievements can be expressed as “physical problems”, “motor difficulties”, “a deficit in movement”, “delay in motor skills development” or “developmental coordination disorder”. in any case, on the basis of the movement abc tests achievements it is not possible to establish any medical diagnoses. before we in any way connect the movement abc tests results with physical or motor deficit, a precise diagnostic medical treatment needs to be applied. due to misdiagnosis or labeling a child can suffer irreparable damage, that is why the researcher is supposed to know well the characteristics of the child’s age group in order to avoid technical errors and thereby the negative effects on the child’s development. diagnostic assessment of dcd in children is recommended only after the child is five years old (blank, smits-engelsman, polatajko, & wilson, 2012), before that we can talk only about the higher risk for dcd occurrence (pridham, hillier, & esterman, 2011; in terčon, 2013). the preschool children included in the study were more successful in the following movement abc tests: following a cycling track, catching a bag, rolling a ball into the goal and skipping ropes, however, they were less successful in tiptoeing. explaining the results obtained should be based on the theoretical knowledge of the characteristics of the child’s motor development, which is characterized by a a sequence of development from mastering coarse to fine motor skills. in the period between four and five years of age, children become increasingly adept in dressing and buttoning visible buttons (papalia, olds, & feldman, 2001; vander zanden, 1993; in marjanovič umek, zupančič, kavčič, & fekonja, 2009). the latter was also shown with a correlation analysis in our study, which showed statistically significant correlations between the tests of fine motorics or hand skills, such as inserting coins and putting play cubes on a string and gross motor skills tests, such as catching a bag and balancing on one leg. the correlation analysis also showed statistically significant connections between the tests of static-dynamic equilibrium (skipping ropes, balancing on one leg) and the annales kinesiologiae • 7 • 2016 • 1 15 giuliana jelovčan, joca zurc: preschool children’s results in movement abc tests ..., 3–19 tests that require hand skills (stringing blocks) and ball skills (catching a bag). when catching, a child must assess the speed or the force of the approaching object. power control is also an important factor, or the effort that is put in the task, which is also characteristic of the motor exercises in static-dynamic balance. the way in which a child throws and catches things varies systematically with the child’s age. targeting and catching require fairly accurate skills of mastering space. with the former, the movement plan needs to contain the correct targeting of the ball, while at the latter, the child needs to find the appropriate body and hands postures (henderson & sugden, 1992). static and dynamic balance are the most common tasks in the neurological development test instruments (in clinical practice and in research). in compliance with the definition of balance, which is the ability of quick formation of compensatory movements, necessary for returning the body in a balanced position when it is destroyed, the functions of the dynamic balance require the movement of the body from one point to another and various means for monitoring the movement (antolović, 2014). pišot and videmšek (2004) emphasize that the child’s coordination of movement and balance are crucial in the realization of motor tasks. in particular, balance is the filter that allows or prevents (hinders) the realization of most motor tasks. similar to our study, in the study performed by van waelvelde et al. (2008), 4-year-old flemish children showed few errors in the task of following the cycling track. in contrast to the tested children in our study, flemish children were significantly less successful in the task of rolling a ball into the goal and they also needed more attempts in the task of jumping over the rope. the children included in our study reached similar good results as the chinese children aged 4 to 6, in the tests of dynamic balance (e.g. the task of following a cycling track and skipping the rope) and similar to the american preschoolers in the tasks of accepting / catching items (e.g. the task of catching a bag, rolling a ball into the goal) (chow, henderson, & barnett, 2001). clarification of the movement abc test results in preschool children could be also found in looking into the socio-demographic differences among children. the engel-yeger, rosenblum and josman (2010) survey results, which included 249 israeli children, have shown that the performance of motor tasks in preschool children are affected by age, gender, the level of the mother’s education, and socio-economic status of the family. pridham, hillier and esterman (2011; in terčon, 2013) performed a research in 4-year-old australian children which showed as much as 3.6 times greater incidence of high risk of dcd in boys. other authors (kadesjö & gillberg, 1998; pridham, hillier, & esterman, 2011 in terčon, 2013) also indicate an increased incidence of dcd in boys. in contrast to the survey mentioned, our study showed that the boys reached statistically significantly better results in the skipping rope task, even more, a greater deficit in motor skills was shown in girls. malina (2004) stresses that when considering the differences between the genders as regards the movement competences, it is necessary to take into account the opportunities for acquiring and consolidating certain motor skills, the adequacy of approaches and the instructions given. many stereotypical attitudes to girls make it impossible for them to be as physically adept as boys in certain activities such as jumping, running and ball games (malina, 2004; venetsanou & kambas, 2010). in completing and generalis16 giuliana jelovčan, joca zurc: preschool children’s results in movement abc tests ..., 3–19 annales kinesiologiae • 7 • 2016 • 1 ing the results obtained, it is necessary to take into account also certain limitations of our study, such as a deliberately selected sample of children from three kindergartens on the slovenian coastal region, the age of the children in the study (4-5 year olds) and the sample size. the findings therefore predominantly apply to the studied sample of children and should be re-tested on a representative sample of slovenian preschool children for any further or broader generalizations. the study looked at differences in motor development with regard to the gender of the children. according to the obtained findings and the findings of other studies, in future it would be necessary to examine the correlations with other socio-demographic and behavioral factors that the analysis of our study did not include. nevertheless, we need to consider that in younger children, the test results depend primarily on how the children are motivated and prepared to perform the tasks. supposedly, though, different test performers had a different impact on motivation and preparation of children, which may be reflected in the findings showing differences between the genders. any testing of preschool children is undoubtedly an extremely demanding task, as it is to be adapted to the characteristics of the early developmental period (pišot & planinšec, 2005; videmšek & pišot, 2007; zajec, videmšek, karpljuk, & štihec, 2009). henderson and sugden (1992) similarly consider that the assessment of preschool children can be very difficult and brings a lot of unpredictability. therefore, working methods, approach and attitude in working with children play a key role (pišot & planinšec, 2005). conclusion our study showed that a quarter of children aged 4 to 5 years, does not reach the expected level of motor skills and suspected occurrence of developmental coordination disorder (dcd) is thus indicated. girls under-perform compared to boys in the skipping rope test. further research is needed in the field of movement abc tests application and in the incidence of movement deficites on a representative sample. the factors that are associated with the occurrence of dcd in a preschool child also need to be further identified. in promoting the child’s motor development, a greater emphasis ought to be given to girls in particular. it is recommended to be cautious in establishing the findings regarding the child’s status on the basis of the test achievements in order to avoid technical errors and negative effects on the child’s development. annales kinesiologiae • 7 • 2016 • 1 17 giuliana jelovčan, joca zurc: preschool children’s results in movement abc tests ..., 3–19 acknowledgements the study is based on empirical quantitative methods. data from the study were collected within the j5-2397 national key project titled “analysis of elementary body movement patterns and adaptation of skeletal-muscular system to certain modern lifestyle factors in children between the age of 4 and 7”, which was held from 1 may 2009 to 30 april 2011. the project was financed by the public agency for research of the republic of slovenia (arrs) and was authorized by the commission for medical ethics of the republic of slovenia (no. 153/07/09). the project was implemented by the institute for kinesiology research (ikarus), which operates within the university of primorska, science and research centre (up src). the principal and accountable project leader was prof. rado pišot, ph.d. we would like to thank all the associates at the institute for kinesiology research – icarus, up src, who contributed to the study and enabled it being carried out smoothly and completed successfully. our thanks go also to public agency for research of the republic of slovenia which supported the research financially and to the participating institutions valdoltra orthopaedic hospital, the university rehabilitation institute soča and the medical faculty of the university of trieste. we appreciate the help of the management and the members of staff in kindergartens in koper, semedela and škofije who helped in the organization and execution of the survey. last but not least, we are grateful to all the children and their parents for their cooperation, which was key for the success of the study. references antolović, a. 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(2009). značilnosti gibalnih/športnih dejavnosti in specifičnosti v spodbujanju gibanja predšolskih otrok [the characteristics of locomotor / sport activities and specifities in encouraging movement of pre-school children]. sodobna pedagogika, 60(3), 112-125. view item http://link.springer.com/article/10.1007/s10643-009-0350-z http://www.dlib.si/details/urn:nbn:si:doc-ffdoy5ey annales kinesiologiae • 7 • 2016 • 2 97 original scientific article udc: 796.926.02:614.8(497.4) received: 2016-11-23 factors affecting accidents on ski hills (slovenian case) janez mekinc1, lea grom1, tomislav omejec2, saša planinc1 1faculty of tourism studies, obala 11a, 6320 portorož, slovenia 2general police directorate, uniformed police directorate, litostrojska 54, 1000 ljubljana, slovenia corresponding author: lea grom university of primorska, faculty of tourism studies, obala 11a, 6320 portorož, slovenia tel.: +386 70 910 472 e-mail: lea.grom1@gmail.com abstract safety on the licensed ski slopes in slovenia, like in many other winter countries, is a complex notion involving, in addition to ski slope owners and operators, several governmental agencies and functionaries, such as inspectors, supervisors, police, medical staff, and others. we cannot assign blame for accidents to them. our research, in agreement with the inspectorate of the republic of slovenia responsible for internal affairs and the police academy, focuses on the causes for skiing accidents. we found out that a skier plays an important role in safe-guarding his/her own safety as well as that of fellow skiers on the ski slopes. obligations of the skier using a licensed ski slope are described in 10 internationally endorsed fis rules of skiing. we obtained data on ski accidents for three consecutive ski seasons between december 2012 and april 2015. we studied whether or not the skiers followed fis regulations and whether or not they adequately safeguarded their own safety. we also studied who is most often responsible for ski accidents. key words: safety on ski slopes, causes of accidents, skier, skier’s fault. 98 janez mekinc, lea grom, tomislav omejec, saša planinc: factors affecting accidents on ski hills ..., 97–116 annales kinesiologiae • 7 • 2016 • 2 vplivni dejavniki nesreč na smučišču izvleček varnost na smučiščih je zelo kompleksen pojem. zanj so pristojni številni organinadzorniki, upravljavci, policija in drugi. vendar pa krivde za nastanek nesreč ne smemo pripisati njim. izsledki dosedanjih raziskav in našega raziskovanja, ki smo ga opravili s soglasjem inšpektorata rs, pristojnim za notranje zadeve in policijsko akademijo kažejo, da nesrečo v večini primerov povzroči smučar s svojim ravnanjem. največjo odgovornost za lastno varnost in varnost ostalih smučarjev na smučišču nosi smučar sam, njegove dolžnosti pa so opisane v 10 mednarodno sprejetih smučarskih fis pravilih. podatke o nesrečah smo zbrali in obdelali za obdobje smučarskih sezon v letih 2012/2013, 2013/2014 in 2014/2015. zanimalo nas je, če smučarji upoštevajo predpise in dovolj dobro poskrbijo za svojo varnost. preverili smo tudi, kdo je najpogosteje odgovoren za nastanek nesreč na smučišču. ključne besede: varnost na smučišču, vzroki za nesrečo, smučar, krivda smučarja introduction safety on ski slopes is a complex and difficult-to-define term. it does not depend only on the ski slope’s operations, safety supervisors, and technical conditions that a ski slope is required by law to satisfy; it is also strongly affected by the behaviour of the ski slope’s clients, i.e., the skiers themselves. all these factors represent risks for potential skiing accidents to occur (burton, brown & fischer, 1984; haegeli, gunn, & haider, 2012). scott and steiger (2013) studied in detail the external factors that influence the development of skiing destinations in europe as well as north america, and concluded that the environment depends on climate change. artificial snow is one of the possible solutions to ever-decreasing snow fall; however, a low client base, i.e., low attendance on ski slopes or difficulties in obtaining funding for the purchase and installation of artificial snow equipment often preclude this solution. furthermore, simpson, gössling, scott, and hall in gladin (2008) state that the production of artificial snow is relatively costly, since it requires a significant amount of energy, the production of which causes an increase in global warming and accelerates the melting of glaciers. jahn (2005) mentions an interesting technological advance introduced to several glaciers in austria where these were covered with special white-coloured plastic covers that keep the snow at a constant temperature thereby slowing down the melting of glaciers. kipp (2012) describes skiing as a unique activity that requires a certain level of body equilibrium and skill for a proper execution. joubert (1978), the pioneer of alpine 99 annales kinesiologiae • 7 • 2016 • 2 janez mekinc, lea grom, tomislav omejec, saša planinc: factors affecting accidents on ski hills ..., 97–116 skiing in france, explains that a skier is the central element in the execution of a ski turn. according to him, skiers executing a ski turn must remain in steady equilibrium while seeking support from the surface material on which they ski. according to zvsmuč (2016, page 2), ''a ski run/piste is a section of a ski slope that is dedicated to skiing and is adequately equipped with signage, secured, as well as maintained with regard to its purpose and separated from other areas''. a ski run/piste must be equipped with cautionary and informative notices as well signs on prohibitions and obligations. ski runs/pistes are classified with various colours for a designation of the level of difficulty. the green colour represents ski runs/pistes for beginners with lateral and downhill slopes not exceeding 25% and the red colour represents intermediate ski runs/ pistes with lateral and downhill slopes not exceeding 40%. the steepest and the most demanding ski runs/pistes for which the largest lateral and directional slopes exceed 40% are identified in black (deutscher skiverband, 2016). ''it is the responsibility of all skiers themselves to evaluate their own skiing ability and choose ski runs/pistes that are appropriate for their skills'' (guček et al., 2011). kipp (2012) is of the opinion that it is the responsibility of individual skiers to evaluate the available information on the ski runs/pistes of a given ski area before they actually embark on them. similarly, köhne, kusche, schaller, and gutsfeld (2007) concluded that the majority of injured skiers during a six-year period at the german ski resort garmisch-partenkirchen used the new model of skis with accentuated side curve (carving skis) and that the type of injury has changed significantly since the introduction of the new ski model. they compared two groups of skiers: a group that used carving skis and a group that skied with traditional ski models. of specific interest were the differences in the number of injuries to individual body parts between the two groups and they found that the carving skis group suffered a significantly higher number of injuries on the trunk as well as upper and lower extremities than the group that skied on traditional skis. mechelen, hlobil, and kemper (2012) stress that the classification of sports’ injuries depends on the definition of a given sport injury as well as the participation in a given sport. in their opinion the statistical data on sport injuries should be normalized to one hour of a given sport activity. the authors also introduced a model that allows the determination of the causes of sport’s injuries and proposed that the level of a given injury should be categorized on the basis of the following seven categories: (i) type of injury; (ii) length of medical care; (iii) type of medical care; (iv) amount of time prevented from practising a given sport activity because of the injury; (v) loss of time from work; (vi) long-term bodily injury; and (vii) financial cost related to medical care. in addition, one needs to define all the causes and mechanisms that influence and act as source of injuries. the last part of the model deals with solutions that may in the future diminish the risk of injuries. hu, baker, and baker (2009) confirm that the causes of minor and serious injuries are difficult to determine, because they are influenced by various factors, such as the number of skiers on the ski slope, level of difficulty of the ski run/piste, the number of skiing days, and other factors. they note that their investigation of conditions on north 100 janez mekinc, lea grom, tomislav omejec, saša planinc: factors affecting accidents on ski hills ..., 97–116 annales kinesiologiae • 7 • 2016 • 2 american ski slopes showed that the number of accidents increased during the period from the years 2000 to 2005, despite a decrease in the number of skiers during the same period. moreover, they also note that hospitals providing data on the number of injuries in various sports’ categories do not give a sufficiently large emphasis on skiing. caine and maffulli (2005) and onik, szopa, domagalska-szopa, knapik, and sieroń-stołtny (2014) have divided accident risks into two categories: non-material and material. non-material risks of ski accidents include the skier’s age, gender, and level of skill, while material risks are influenced by the quality of the skiing equipment, the use or non-use of helmets, and the special characteristics of the ski run/piste. the authors postulate that these two risk categories can lead to ski injuries. the seriousness of the ski injury is evaluated according to the model introduced above. onik et al. (2014) arrived at the conclusion that the largest number of injured skiers with regard to their age fell within the group of children and youngsters below the age of 16, while the majority of accidents, according to these authors as well as to caine and maffulli (2005), can be attributed to falls of skiers that are the fault of the skiers themselves. mcbeth, ball, mulloy, and kirkpatrick (2009) carried out an interesting study of ski injuries that occurred on canadian ski areas during ten successive ski seasons from 1996 to 2006. they note that a significantly higher number of accidents occurred to skiers who used newer ski equipment. they also surmised that environmental factors play a large role in the number of accidents and proclaim that the afternoon skiing period is the most critical daily period on ski slopes because during that period of the day the quality of snow is the lowest and, on top of this, the skiers, after several hours of skiing, are physically and mentally tired and do not react to danger with the habitual alertness and speed with which they would react in the morning. goulet et al. (1999) studied children whose age was below 12 who were skiing at the canadian ski resort quebec city during the 1995/96 ski season. they noted that at that time, despite its popularity among the population and the use of traditional ski models, skiing in terms of bodily injuries ranked immediately after hockey. furthermore, they found that the main causes of ski accidents resulting in bodily injuries were: inappropriate equipment; inadequate knowledge of skiing; low skiing skill level; and use of rented equipment. they also identified the high risks that skiers who rent ski equipment were faced with because of lack of experience with the rented equipment. they established that continuing instruction as well as skill improvement are the key components in the quest to decrease the risk of accidents in skiing and they recommended that beginners in skiing be thoroughly informed on how to deal with ski equipment and on the general rules of, and appropriate behaviour on, ski slopes. we gave special consideration to serious ski accidents resulting in death. according to an article the protective effects of helmets in skiers and snowboarders, these types of accidents are relatively rare in the ski world (ruedl, kopp & burtscher, 2011) and neither recreational nor professional skiers are generally aware of the risks for this type of accident to happen (williams, 2016). unfortunately, the awareness of skiing etiquette as well as the appropriate behaviour on ski slopes are on a disappointingly low level among skiers. 101 annales kinesiologiae • 7 • 2016 • 2 janez mekinc, lea grom, tomislav omejec, saša planinc: factors affecting accidents on ski hills ..., 97–116 based on a study carried out on the austrian ski slopes during the ski season 2009/10 and presented in the article impact of ski helmet mandatory on helmet use on austrian ski slopes by ruedl, brunner, kopp & burtscher (2011) a conclusion can be reached that fatal ski accidents are rare and that the main cause of these accidents is head trauma, self-inflicted by the skier’s irresponsible behaviour, such as not wearing a ski helmet while skiing. as mentioned above, the causes of ski accidents can be attributed to a variety of factors. williams et al. (2007) and hildebrandt et al. (2011) place great emphasis on the behaviour of skiers as well as on honouring international ski regulations. several organizations have been active in this area. among them, it is worth mentioning the american organization called the pennsylvania safekids coalition that makes children aware of the importance of ski equipment. in this regard, the biggest impression on children was made by comparing a human head with a coconut that was smashed to pieces in a heavy blow representing a ski accident when no safety equipment such as a ski helmet was used. after seeing the coconut experiment, all the children committed to wear a ski helmet while skiing. alexander and raub (2003) praised this programme pointing out that the knowledge and the understanding which the children acquire during theoretical and practical ski instruction are of great importance. based on this finding, hildebrandt et al. (2011) opined that schools as well as other educational institutions based in countries promoting skiing should put more emphasis on discussing safety issues on the ski slopes. we wholeheartedly agree with these authors, since children as well as beginners in skiing, similarly to skilled adult skiers, are all at risk of injury on ski slopes. we believe that an introduction of better schooling in skiing techniques as well as the obligations of all participants on ski slopes would diminish the number of ski accidents and serve to curtail situations that increase the risk of accidents. of course, the prevention of skiing accidents does not end with teaching the skiers the rules and the etiquette of good behaviour on ski slopes. for example, tuli et al. (2010) have shown that facial injuries resulted primarily in adult skiers who fell accidentally or collided with another skier on the ski run/piste. they strongly recommended a sensible solution that would prevent or at least alleviate facial injuries, namely the use of a ski helmet during skiing. williams et al. (2007) have reported on the importance of using a ski helmet in relationship to brain trauma. a helmet can to a certain degree alleviate the consequences of a ski accident; however, they do not see a ski helmet as the ultimate solution. rather, they suggest that the best approach to accident prevention is an unconditional honouring of the fis rules in conjunction with a controlled speed limit on ski slopes. to prevent the most serious bodily injuries onik et al. (2014) recommend to all skiers the wearing of ski helmets irrespective of their skill level. caine and maffulli (2005) also suggest the use of ski helmets for reducing the number of ski injuries and, in addition, recommend the use of wrist shields, appropriate behaviour, and a skiing speed adjusted to the skill level of individual skiers. all the authors quoted the good reasons presented above for strengthening and improving safety conditions on ski slopes. we believe that the learning process of children 102 janez mekinc, lea grom, tomislav omejec, saša planinc: factors affecting accidents on ski hills ..., 97–116 annales kinesiologiae • 7 • 2016 • 2 at a young age is very important, because the knowledge that they gain at that time will serve them well throughout their lifetime. therefore, we strongly support the activities of organizations and projects in slovenia, such as “schoolchildren on skis” that are focused on educating youngsters regarding the rules and codes of behaviour on the ski slopes. it should be noted, however, that the knowledge of rules and regulations is a necessary but not sufficient safety guarantee for an individual skier on ski slopes. in our opinion, adequate ski equipment as well as a tuned and well-conditioned body that is ready for vigorous sport activity are also of significant importance. this point was of interest to whelan, gass, and moran (1999) who studied the influence of warming-up before skiing on decreasing the risk of skiing accidents. they concluded that a series of stretching exercises has a very beneficial effect, not only on the skiing ability itself but also on the reaction time in situations in which a body that is not properly warmed up would respond sluggishly and this could potentially lead to an accident. skiers using slovenian ski slopes must: (i) follow the so-called zvsmuč law (zakon o varnosti na smučiščih, 2016 – ski safety act, 2016); (ii) honour the international fis regulations; and (iii) behave following the principle of mutual respect and understanding between themselves and other skiers. they may use the ski slopes in a manner that does not threaten or injure themselves and other skiers, or damage the equipment on the ski slope. in addition, they must adjust their speed as well as the direction of skiing to the ski slope conditions, and they must overtake other skiers allowing sufficient separation between themselves and the skier they are passing. it should also be noted that the amount of alcohol in a skiers’ blood is by law limited to 0.24 milligram per litre of exhaled air and that the use of ski helmets is mandatory for all skiers below the age of 14 years. a skiing accident is defined as an incident that occurs as a result of skiing or some other sport activity on the ski slope and involves at least one skier who either dies, is injured, or causes material damage to the ski slope equipment (zvsmuč, 2016, page 2). skiing accidents are divided into the following four categories: (i) accidents without bodily injuries that may involve damage to the ski slopes’ equipment, and will not be discussed in this paper; (ii) accidents with minor bodily injuries; (iii) accidents with serious bodily injuries; and (iv) fatal accidents. a wide variety of skiing accidents are possible. for example, the responsibility for the accident may lie with the operator of the ski slope and equipment or with the skier who did not follow the international fis regulations; the accident may have been caused by a malfunction of the ski lift; or the cause for the accident may be something else, for example the weather conditions. the operator of the ski slope must keep records of skiing accidents, enforce safety standards, maintain the ski slope equipment, and organize the manpower as well as the operation of the ski slope. 103 annales kinesiologiae • 7 • 2016 • 2 janez mekinc, lea grom, tomislav omejec, saša planinc: factors affecting accidents on ski hills ..., 97–116 research question the safety considerations for ski slopes have several components. some authors conclude that the new style “carving skis” has had an effect on the number of ski accidents (burtscher et al., 2008; dingerkus & mang, 2002; hörterer, 2004; köhne et al., 2007; sabeti, 2013). others (caine & maffulli, 2005; goulet, régnier, grimard, valois, & villeneuve, 1999; hu et al., 2009; mcbeth et al., 2009; onik et al., 2014) have tried and some of these have succeeded in proving that accidents can also be caused by other factors, such as the condition of the ski run, environmental factors, ski equipment, skills and the physical condition of the skier, warming up before skiing, etc. furthermore, several researchers, when studying the causes of an accident, place great importance on the skiers’ knowledge and understanding of the international fis regulations (williams et al., 2007; hildebrandt et al., 2011). we now get to the important question on the cause of the steady increase in the number of accidents on the ski slopes. are skiers only innocent victims of circumstances or are they themselves responsible for the increase as a result of a lack of understanding of the risks of skiing and their ignorance of the international fis regulations applicable to ski slopes? a discussion about these questions will serve as a general overview of the accidents on slovenian ski slopes during the ski seasons 2012/13, 2013/14, and 2014/15. we analysed our data for the three ski seasons and compared our conclusions with those of previous studies by other authors. our study has contributed to an understanding of the safety and security conditions on slovenian ski slopes and highlighted possible concrete improvements. because we had a somewhat incomplete access to data regarding the circumstances surrounding the skiing accidents, we propose that a record is kept over the skier’s equipment (ski model and manufacturer, presence of a helmet and its manufacturer) as well as other pertinent characteristics of the accident, such as weather conditions and snow quality, in order to get a more thorough overview of skiing accidents in the future ski seasons. moreover, to date, we have not noted any study on slovenian ski slopes that would evaluate the skiers’ knowledge of fis regulations. the following questions were addressed in our evaluation of the safety standards on slovenian ski slopes: – are there any statistical differences among the causes of ski accidents with minor bodily injuries? – what is the age of the skiers involved in skiing accidents to determine which age group of skiers contributes to the largest number of accidents? – what is the age of skiers with respect to the causes of accidents with minor bodily injuries? – what is the influence of the age of the skiers on the severity of the accidents? – are there any statistical differences between the age of foreign skiers and local skiers in accidents with minor bodily injuries? 104 janez mekinc, lea grom, tomislav omejec, saša planinc: factors affecting accidents on ski hills ..., 97–116 annales kinesiologiae • 7 • 2016 • 2 – is there a correlation between the number of days of ski slope operation and the number of ski accidents? – how do weather conditions affect the number of ski accidents? – is there a correlation between the number of accidents with minor bodily injuries and the causes of the accident? methods in our study we used a descriptive method based on local and international literature. in agreement with the general police office we analysed their statistical data on ski slope accidents and we also acquired some data from the inspectorate of the inspectorate for internal affairs of the republic of slovenia. we used the methodology of an explanatory case study that is based on a thorough description and study of the available data for each individual situation. we determined and explained the cause – effect relationship among the accidents occurring on slovenian ski slopes. for our study we chose an analytic method in which we show the acquired data in a tabular or graphic format. we collected our data from the evidence gathered from accidents with minor bodily injuries by the inspectorate for internal affairs of the republic of slovenia and for accidents with severe bodily injuries, as well as for fatal accidents recorded by the slovenian police. the statistical results were verified with the statistical package for social sciences (spss), namely, with the statistical methods, the chi-square goodness of fit test, the mann-whitney u test, and the kruskal-wallis h test. skiers, included in the research our data sample consisted of skiers who were involved in skiing accidents on slovenian ski slopes during three successive ski seasons: 2012/2013, 2013/2014, and 2014/2015, i.e., for a period from december 2012 to april 2015. the accidents are split into three categories: minor accidents, resulting in light bodily injuries; serious accidents, resulting in serious bodily injuries; and fatal skiing accidents. as shown in table 1, the total number of injured skiers on the 47 slovenian ski slopes during the three seasons was 2,804. of these, 2,683 suffered minor bodily injuries and 121 severe bodily injuries, of which 4 were fatal. 105 annales kinesiologiae • 7 • 2016 • 2 janez mekinc, lea grom, tomislav omejec, saša planinc: factors affecting accidents on ski hills ..., 97–116 table 1. number of accidents ski season type of accident 2012 / 2013 2013 / 2014 2014 / 2015 total number of accidents for three seasons minor accidents 1,070 648 965 2,683 serious accidents 40 28 49 117 fatal accidents 2 1 1 4 total # of accidents per ski season 1,112 677 1,015 2,804 source: authors, based on the data obtained from the inspectorate of the republic of slovenia for internal affairs and from the police academy. in the cohort of 2,683 minor injuries, 2,349 injured skiers were the residents of slovenia, while 334 were from abroad (177 from croatia, 69 from hungary, 61 from the uk, and 27 from various other countries). the ages of the injured skiers ranged from 2 years to 87 years. for greater clarity we split the age range into 8 age groups, as indicated in fig. 1. figure 1. number of accidents by age (source: authors, based on the data obtained from the inspectorate of the republic of slovenia for internal affairs and from the police academy). 106 janez mekinc, lea grom, tomislav omejec, saša planinc: factors affecting accidents on ski hills ..., 97–116 annales kinesiologiae • 7 • 2016 • 2 the highest accident rate occurred in the 15 to 24 age group of skiers (721 of 2,804 skiers or 25.9% of the total). children in the 8 to 14 age group also form a relatively large accident rate of 550 (19.8%) of injured skiers. next in size are two age groups (25 to 34 and 35 to 44) that represent 365 (13.1%) injured skiers each. the age groups of (45 to 54) and (55 to 64) consist of 344 (12.4 %) and 204 (7.3%) injured skiers, respectively. skiers in the over 65-year age group were involved in 194 (7.0%) accidents, while children in the 2 to 7 age group had the lowest accident rate with 41 (1.5%) injured skiers. the total number of accidents for all age groups listed above adds up to 2,784, noting that we could not get the age data for 20 skiers injured in 20 ski accidents. results official reports, in addition to the skiing injuries caused by the skiers to themselves (self-inflicted injuries), list 24 other causes of accidents. based on the reports recorded for ski accidents with minor bodily injuries, we conclude that by far the largest component of these accidents falls into the category of self-inflicted injury. as evident from table 2, the self-inflicted injuries amounted to about 50% of all minor injuries that happened during each of the three seasons analysed in our study. table 2. number of minor accidents ski season accidents 2012 / 2013 2013 / 2014 2014 / 2015 total for three seasons all minor accidents irrespective of fault 1,070 (100%) 648 (100%) 965 (100%) 2,683 (100%) minor accidents 588 (55%) 320 (49,4%) 520 (53,9%) 1,428 (53,2%) source: authors, based on the data obtained from the inspectorate of the republic of slovenia for internal affairs. thus, during the three seasons (from december 2012 to april 2015), of the 2,683 skiers with minor injuries 1,428 (or 53.2%) of them had injurious falls that they caused themselves and the injuries were categorized as self-inflicted and minor. we summarize that a study of the 121 serious accidents (including the 4 fatal ones) would result in a similar conclusion; however, we cannot state this categorically because the data on the causes of serious accidents were not available to us. we recommend that this question be investigated to establish whether or not the probability for serious ski accidents as a result of skier error and lack of skill appropriate for a particular ski run is roughly the 107 annales kinesiologiae • 7 • 2016 • 2 janez mekinc, lea grom, tomislav omejec, saša planinc: factors affecting accidents on ski hills ..., 97–116 same as the sum of the probabilities of serious accidents caused by all other possible causes. a closer look into the data for the three ski seasons reveals, as summarized in table 3, that the number of days of operation from december 2012 to april 2015 was highest during the 2012/13 ski season, amounting on the average to 47.1 days per ski slope or a total of 2,215 days for all 47 ski slopes. the 2013/14 ski season was the shortest of the three seasons studied with on average 26.2 ski days per ski slope and a total of 1,230 days for all 47 ski slopes. the following 2014/15 ski season showed some improvement over the second one with an average of 35.4 days per ski slope and a total of 1,665 days. table 3. number of average operational days and total number of skiing accidents per operational day ski season average number of operation days per season number of skiing accidents per operational day 2012 / 2013 47.13 23.59 2013 / 2014 26.17 25.87 2014 / 2015 35.43 28.65 source: authors, based on the data obtained from the association of ski lift operators of slovenia (gtz) and the inspectorate of the republic of slovenia for internal affairs. further study reveals on average a total (combined minor plus serious) of 23.6 accidents per day of operation on all slovenian ski slopes combined during the first season studied, 25.9 accidents per day during the second season, and 28.7 accidents per day during the last season. these data clearly indicate a steady increase in the total average daily number of accidents from one season to the next. as shown in table 1, during the three seasons from december 2012 to april 2015 under our study we counted 2,683 accidents on slovenian ski slopes that resulted in minor bodily injuries (minor accidents). in table 4 we present for each individual season a comparison of the number of self-inflicted minor accidents with the number of accidents attributed to all other causes for each full day of the ski slope’s operation. 108 janez mekinc, lea grom, tomislav omejec, saša planinc: factors affecting accidents on ski hills ..., 97–116 annales kinesiologiae • 7 • 2016 • 2 table 4. number of minor injuries per operational day ski season cause of accident 2012 / 2013 2013 / 2014 2014 / 2015 skier’s own fault 12.48 12.23 14.68 other causes 10.22 13.64 13.97 total number of accidents 22.70 25.87 28.65 source: authors, based on the data obtained from the association of ski lift operators of slovenia (gtz) and the inspectorate of the republic of slovenia for internal affairs. irrespective of the accident causes, the total number of minor accidents during the 2012/13 season amounted to 22.7 per day of operation, during the 2013/14 season to 24.8 per day of operation, and during 2014/15 season to 27.2 per day of operation. it is clear that the highest total number of accidents occurred during the 2014/15 season, the last season in our study. we verified our study using the chi-square test (p = 0.196; χ2 = 5.99; df = 2) whether or not from season 2012/13 to season 2014/15, the number of self-inflicted accidents in comparison to the accidents attributed to all other possible causes combined is increasing through the three seasons. since the differences from season to season were not statistically significant and the connectivity of the variables is weak, we conclude that minor ski accidents from one season to the next cannot be characterized by a constant ratio between the number of self-inflicted accidents and accidents attributed to other causes. of special interest is the question focusing on the effects of the weather conditions on the number of skiing accidents. to investigate this issue, we concentrated on two time periods during which the ski slopes have the highest occupancy rate, namely during the winter school holidays (10 days) and christmas – new year holidays (10 days). the weather service of slovenia summarized for us the weather conditions prevalent on the major slovenian ski slopes during the two 10-day holiday periods for the three ski seasons included in our study. under the heading of weather conditions, we studied the wind speed, degree of clouding, height of new snow, presence of fog, and presence of rain. data presented in table 5 describe the number of minor accidents that occurred on the ski slopes of slovenia during the period of christmas – new year 10-day holidays and winter 10day school holidays for three ski seasons (2012/2013; 2013/2014; and 2014/2015) for a period from december 2012 to april 2015. 109 annales kinesiologiae • 7 • 2016 • 2 janez mekinc, lea grom, tomislav omejec, saša planinc: factors affecting accidents on ski hills ..., 97–116 table 5. number of minor accidents for two ski periods ski season ski period 2012 / 2013 2013 / 2014 2014 / 2015 christmas – new year holidays (10 days) 142 26 19 winter school holidays (10 days) 134 158 314 total number of accidents during the complete season 1070 648 965 source: authors, based on the data obtained from the inspectorate of the republic of slovenia for internal affairs. it is shown that in the second (2013/2014) and third (2014/2015) season discussed in our study, the number of accidents during the 10-day school holidays exceeded those that happened during the 10-day christmas – new year holidays. moreover, during the 10-day school holidays of the third season (2014/2015), the number of accidents amounted to almost a third of all accidents that occurred during the total season (i.e., 314 out of 965). a comparison of the weather conditions for the two holiday periods for a given ski season did not show any significant deviations. during the first ski season we noticed a difference in the average temperature of the ambient air (christmas-new year holiday: 0.1oc; winter holidays: -5.8oc); however, we cannot surmise that the higher air temperature during christmas – new year holiday caused a higher number of accidents. even though we found a difference in the number of accidents between the second and the third ski season (table 5), there were no large deviations in the weather conditions between the two seasons. since there were no appreciable deviations in the weather conditions in the three ski seasons, we cannot postulate that weather conditions had an appreciable effect on the number of accidents for the individual seasons. a more thorough analysis of the seasons in which there are significant deviations in the weather conditions should be carried out and the conclusions should account for the number of skiers present on the ski slopes. of the total number of 2,683 minor accidents during the three ski seasons from december 2012 to april 2015 we obtained data on the causes for 2,314 accidents. the average age of the accident victims was 30.25 years. in table 6 we display the distribution of the accidents with regard to their cause based on the data available from the official records on ski accidents compiled on the sites of the accidents by the ski slope’s supervisors and the police. accident causes that appeared at least five times in the official records are specified in table 6 as follows: (1) the skier fell because of his/ her own fault; (2) represents the fall only; (3) the skier was stationary; (4) the skier had just started to move; (7) the skier skied at the tail end (of a group of skiers); (8) the skier 110 janez mekinc, lea grom, tomislav omejec, saša planinc: factors affecting accidents on ski hills ..., 97–116 annales kinesiologiae • 7 • 2016 • 2 crashed (into a barrier); (10) the skier was stopping with a left turn or right turn; (12) the skier jumped; (15) the skier skied on a run marked with posts; (22) the skier collided with another skier; and (25) the skier was involved in an accident not listed above. for example, accident category (25) typically includes a stationary skier; merging from the right or left; shadow skiing; rear skiing from the left or right side; passing; skiing in the reverse direction; lingering in a blind spot; sitting under a break-point; crossing the ski slope; skiing with an disconnected safety harness; skiing with unsuitable equipment; skiing with disconnected bindings; walking on the ski run without ski equipment; skiing on a closed ski run; sledding on a ski run; skiing on a ski run under the influence of alcohol or any other psychoactive substance; as well as any other cause of accident that has not yet appeared in the official documents. table 6. number and percentage of light accidents designation cause of accident number of accidents percentage of total number rank average (1) skier fell because of his/her own fault 1,440 62.2 1,127.28 (2) skier fell by no fault of his/her own 492 21.3 1,158.28 (3) skier was stationary 18 0.8 750.06 (4) skier had just taken off 29 1.3 1,139.53 (7) skier skied in the rear 16 0.7 1,431.53 (8) skier crashed 48 2.1 1,431.53 (10) skier was slowing down 50 2.2 1,432.30 (12) skier made a jump 33 1.4 1,157.99 (15) skier skied on a run marked with posts 49 2.1 982.83 (22) skier collided with another skier 28 1.2 1208.23 (25) other infrequent accident causes 111 4.8 1,250.18 total number n/a 2,314 100.0 1,463.31 source: authors, based on the data obtained from the inspectorate of the republic of slovenia for internal affairs. we found a significant deviation for accidents caused by skiers who either were stationary or jumped resulting in ranks that were significantly lower than in other groups. this suggests that there are significant differences among the average age ranks for various causes of accidents (p = 0.000; χ2= 46.83; df = 10). next, we focus on the average age of the accident victims who in their accidents suffered minor or serious (including fatal) bodily injuries and show results in table 7 111 annales kinesiologiae • 7 • 2016 • 2 janez mekinc, lea grom, tomislav omejec, saša planinc: factors affecting accidents on ski hills ..., 97–116 during the three consecutive winter seasons (2012/2013; 2013/2014; and 2014/2015) during the period from december 2012 to april 2015. we acquired age data for 2,779 skiers: data for serious accidents were available for all the age groups and we used the average value age values for each group. for the oldest group (age above 64 years) we did not have the maximum age, so we do not know the real median age. based on our data for minor injuries, we assumed that in the severe injury category the average age for the highest age group was also 69 years. table 7. number of accidents and age rank averages bodily injury number of accidents rank average sum of rank averages minor 2,658 1,386.43 3,685 142.50 serious (incl. fatal) 121 1,468.33 177 667.50 source: authors, based on the data obtained from the inspectorate of the republic of slovenia for internal affairs and from the police academy. we then used the mann-whitney u test to determine whether or not the seriously injured skiers were on average older than the skiers in the minor injury category. for minor accidents the rank average is 1,386.43, while for serious (including fatal) injuries it is 1,468.33). our calculations show that differences among various ranks exist; however, we cannot claim that they are statistically significant (p = 0.272; u = 151,331.5). this means that the average ages of the accident victims with respect to the type of injury (minor versus serious including fatal) are essentially the same. since foreigners skiing on slovenian ski slopes during the three winter seasons from december 2012 to april 2015 represented 12.45% of the total population that was included in the category of minor accidents, we now touch upon foreign skiers in table 8. the average age of all skiers (local and foreign) was 30.37 years. table 8. number of accidents and age rank averages injured skiers number of accidents rank average sum of rank averages local 2,069 1,291.40 2 671 910.00 foreign 582 1,449.00 843 316.00 source: authors, based on data obtained from the inspectorate of the republic of slovenia for internal affairs. 112 janez mekinc, lea grom, tomislav omejec, saša planinc: factors affecting accidents on ski hills ..., 97–116 annales kinesiologiae • 7 • 2016 • 2 the mann-whitney u test was used to investigate whether or not there were any statistically significant differences in the ages of foreign skiers and domestic skiers involved in minor accidents on slovenian ski slopes. the investigation results in a rank average of 1,291.40 for local skiers and 1,449.00 for foreign skiers. this result is based on almost null risk suggesting a statistically significant difference in rank averages between local and foreign skiers (p = 0.000; u = 530495) and we conclude that the foreign skiers injured on slovenian ski slopes during the past three ski seasons were, on average, older than the local skiers. discussion as stated above, goulet et al. (1999) showed that two of the possible factors affecting the risk of a skiing accident are insufficient knowledge of and the fitness needed for skiing. in slovenia, the responsible functionaries are not mandated to deal with these issues; however, despite this drawback, our study shows that in more than a half of all minor ski accidents the injuries suffered by the skier are self-inflicted, i.e., are the skier’s own fault and caused by the skier’s own error. our finding that the average number of accidents per day of ski slope operation is increasing from one season to the next is comparable to the situation on north-american ski slopes, as shown by hu et al. (2009). both studies showed a steady increase in the accident rates for minor and severe (including fatal) bodily injuries from one season to the next and suggest that for the benefit of tourism and recreational skiing, strong measures will be required to stop this disturbing trend on ski slopes around the world. based on our finding that the largest proportion of injuries is attributed to the age group of youngsters and young adults between the ages of 15 and 24 years, we propose an educational innovation: a ski examination that would likely improve the general knowledge of skiing rules and regulations. educational institutions could introduce this project into special education curricula in a similar manner that they already use with cycling examinations in which slovenian school-attending children must exhibit a certain knowledge of traffic rules to make their cycling safer. the ski examination would consist of two components. the theoretical component would focus on the fis regulations on skiing and the practical component would be part of the already existing programme under the auspices of winter schools in nature or special school days concentrating on various sport activities. thus, ski examinations would promote skiing as a slovenian national sport and would also decrease the number of ski accidents that are on ski slopes often caused by the skier’s own fault. several years ago, one of the slovenian elementary schools (osnovna šola rovte) already introduced a pilot programme on formal ski education based on theoretical and practical examinations as part of winter school in nature. the programme was very successful and greatly improved children’s knowledge of the international fis rules and understanding of the consequences that can arise from carelessness and ignorance of the rules while skiing (grom, 2009). 113 annales kinesiologiae • 7 • 2016 • 2 janez mekinc, lea grom, tomislav omejec, saša planinc: factors affecting accidents on ski hills ..., 97–116 we also investigated the age of skiers for a given minor accident and found that more than one age group fell into a rank average that differed from the other ones. based on these deviations it has become clear that there are statistically significant differences in rank averages and that age affects the cause of minor accidents. the effect of the age of injured skiers on the type of injury was also of interest to us and we found that both categories of injury (minor and serious including fatal) were roughly the same average age. we need to mention foreign skiers who visit slovenian ski slopes and represented 12.45% of the total cohort of skiers with minor injuries. despite our findings that there are differences between the average age of foreign and local skiers, we believe that it would make sense to modernize the pictograms on ski trails as well as post information on ski slopes in the major foreign languages to decrease accident risks for foreign skiers. following the statements above, we believe that our research can contribute to the overall safety on slovenian ski slopes. regarding the findings, slopes should promote and ensure that all skiers understand the possible consequences that may result from crazy and irresponsible skiing. it would be advisable to modernize the pictograms that exhibit the fis rules on slovenian ski hills, since this move would definitely be attractive to local and foreign skiers, and a larger exposure of skiers to modern pictograms would eventually bring the international fis rules into the skiers’ sub-consciousness. conclusions based on the available literature and our results we cannot unequivocally state whether or not skiers on slovenian ski slopes follow the international fis ski regulations and the unwritten etiquette of skiing adequately. however, we can safely state that in the majority of ski accidents the skiers are responsible for causing their own injury as well as putting other skiers in danger. in concrete terms, the self-inflicted injuries during the last three seasons on slovenian ski slopes accounted for 1,428 minor accidents out of a total of 2,683 minor accidents. safety on ski slopes is strongly affected by various educational activities for children attending elementary schools during the winter months. research has shown that children and youngsters are often injured in accidents on ski slopes. therefore, increasing the awareness of safety issues on ski slopes with a ski examination would clearly result in an improved level of understanding of the fis rules. special programmes on ski instruction in elementary schools would also improve the work of commercial ski schools and ski associations, thereby, contributing to an elevated level of knowledge of skiing, understanding the fis rules, as well as appropriate behaviour on the ski slopes. this would result in increased safety on ski slopes and a concurrent decrease in the occurrence of skiing accidents. to follow the safety situation on slovenian ski slopes as well as skiing accidents trends, it would make sense to continue collecting accident statistics in future ski sea114 janez mekinc, lea grom, tomislav omejec, saša planinc: factors affecting accidents on ski hills ..., 97–116 annales kinesiologiae • 7 • 2016 • 2 sons. this would allow us to verify whether or not the number of skiing accidents continues to increase; however, the various governmental agencies involved in the collection of accident data must unify their accident investigation processes and data keeping. this would give a more efficient supervision over the causes of skiing accidents and enable the same data analysis for both minor and serious (including) fatal accidents. as regular users of ski slopes, we believe that ski slope safety is of great importance for the promotion of skiing as a component of the tourism industry. based on the modest opportunities for the development of the skiing industry in slovenia, we cannot expect that 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(2016). uradni list republike slovenije, (44/16) [official gazette of rs, no. 44/16], 21. retrieved december 9th from http://www.uradni-list.si/1/objava.jsp?sop=2016-01-1922 http://dx.doi.org/10.1016/j.wem.2015.10.003 http://dx.doi.org/10.1580/06-weme-or-037r1.1 http://www.uradni-list.si/1/objava.jsp?sop=2016-01-1922 annales kinesiologiae • 8 • 2017 • 2 111 review article udc: 796.012:613.2 received: 2017-06-16 benefits of aerobic exercise training with recommendations for healthy aging enrico rejc1,2, alessio del torto1,3, stefano lazzer1,3 1 department of medicine, university of udine, italy. 2 university of louisville, department of neurological surgery, louisville, usa. 3 school of sport sciences, university of udine, italy. corresponding author: prof. stefano lazzer university of udine department of medicine p.le kolbe 4 33100 udine, italy. phone: +39 0432 494333 fax: +39 0432 494301 e-mail: stefano.lazzer@uniud.it abstract the purpose of this articlet is to provide an overview of the importance of aerobic exercise and its characteristics for healthy aging. the first section briefly reviews the effects of aging on maximal aerobic power; section 2 considers the effects of aerobic exercise training, and section 3 summarizes the recommendations and some limitations of the current guidelines for aerobic exercise training. physical activity cannot stop the biological processes; however, there is evidence that regular aerobic exercise can minimize the physiological effects of an otherwise sedentary lifestyle and increase active life expectancy by limiting the development and progression of chronic disease and disability conditions. the use of moderately standardized guidelines for exercise prescription resulted in safe and effective impact on health-related outcomes. keywords: aerobic exercise; physical activity; training. 112 enrico rejc, alessio del torto, stefano lazzer: benefits of aerobic exercise training with recommendations ..., 111–124 annales kinesiologiae • 8 • 2017 • 2 pozitivni učinki aerobne vadbe s priporočili za zdravo staranje izvleček namen tega članka je podati pregled razpoložljivih informacij o pomenu aerobne vadbe in njenih lastnosti za zdravo staranje. v prvem delu so na kratko predstavljeni učinki staranja na maksimalno aerobno moč. drugi del obravnava učinke aerobne vadbe, medtem ko so v tretjem delu povzeta priporočila ter nekatere omejitve trenutno veljavnih smernic za aerobno vadbo. telesna aktivnost ne more ustaviti bioloških procesov. kljub temu pa je na voljo precej dokazov, da redna aerobna vadba zmanjšuje fiziološke učinke sicer sedentarnega življenjskega sloga ter obenem podaljšuje pričakovano življenjsko dobo s tem, ko omejuje nastanek in razvoj kroničnih bolezni ter pogojev invalidnosti. uporaba zmernih standardiziranih smernic pri predpisovanju telesne vadbe, se odraža neposredno v varnih in učinkovitih vplivih na zdravje in z zdravjem povezana pričakovanja. ključne besede: aerobna vadba, telesna aktivnost, vadba. introduction the most widely used terms of maximal aerobic functional power are peak and maximum oxygen uptake (v’o2peak and v’o2max). both terms are often used as though they are synonymous, but there are important distinctions to be made between them (whipp, davis, torres, & wasserman, 1981). while the v’o2peak is easier to define and determine, its relevance to physiological and patho-physiological functioning is less secure. it is, simply, the highest value of v’o2 attained on the particular test, most commonly an incremental or other high-intensity test designed to bring the subject to the limit of tolerance – neglecting considerations of what time, or breath-number, frame of reference is chosen for the determination. unfortunately, it is the highest value achieved regardless of the subject’s effort. and so while it defines the highest v’o2 that was attained during the test it does not necessarily define the highest value attainable by the subject. this value is the v’o2max: a term introduced by hill and lupton in 1923 (hill & lupton, 1923) as ‘‘the oxygen intake during an exercise intensity at which actual oxygen intake reaches a maximum beyond which no increase in effort can raise it”; its rigorous determination depends on a particular criterion having been met. considering this, the demonstration v’o2 does not continue to increase, or only to increase by a trivially-small amount, despite further increases in work rate “involving a large proportion of muscle mass” i.e., a v’o2 “plateau” shows results when v’o2 is plotted as a function of work rate. annales kinesiologiae • 8 • 2017 • 2 113 enrico rejc, alessio del torto, stefano lazzer: benefits of aerobic exercise training with recommendations ..., 111–124 cross-sectional studies show that v’o2peak typically declines 6 − 10 % per age decade in healthy men and women (talbot, metter, & fleg, 2000; wilson & tanaka, 2000; aspenes et al., 2011). however, the older individuals included in these studies conceivably presented favourable genetics as well as lifestyle differences, thus limiting the generalization of findings for their age peers. in a longitudinal study, a decline in peak v’o2 of 20 − 25 % per decade was shown in 70+ healthy elderly subjects (fig. 1) (fleg et al., 2005). hawkins et al. (hawkins, marcell, victoria jaque, & wiswell, 2001) also subdivided the sample of master athletes by age group and found that loss rates in maximal oxygen uptake (v’o2max) increased with age, from rates similar to those reported for sedentary subjects in the younger master athletes to rates four times greater than sedentary subjects in the older master athletes (figure 1). the declines of 20 − 30 % per decade most likely reflect the periods of rapid decline associated with reductions in physical activity and exercise. these findings suggest that either accelerates the reduction in v’o2max or increases the difficulty of maintaining training. decline in v’o2max can be attributed to age-related reductions in both maximal cardiac output (q’max) and maximal arteriovenous oxygen (a-v o2) difference in sedentary subjects, while in older endurance-trained individuals only the reduction of q’max might explain the age-induced decline in maximal aerobic power (ogawa et al., 1992). maximal heart rate decreases about six to ten beats per minute per decade, and is responsible for much of the age-associated decrease in q’max (hawkins et al., 2001). however, a reduction in stroke volume during maximal exercise in older adults also contributes to the decline in cardiac output (hagberg et al., 1985). in addition, left ventricular ejection fraction appears to be reduced in older adults during maximal exercise compared to young adults (taylor & groeller, 2008; thomas, paterson, cunningham, mclellan, & kostuk, 1993). decreases in vascular capacity and local blood flow regulation, along with a decline in muscle oxidative capacity contribute to the overall reduction in maximal a-v o2 difference observed with age (sagiv, goldhammer, ben-sira, & amir, 2010; toda, 2012). coupled with poor oxygen delivery mechanisms, mitochondrial alterations also lead to a reduction in maximal capacity to utilize oxygen at the level of active skeletal muscle. for a submaximal exercise bout, cardiac output is lower in older adults, while a-v o2 difference may tend to increase as a compensatory response to maintain v’o2. a reduction in stroke volume appears to be the major factor responsible for the lower cardiac output observed during submaximal exercise (ogawa et al., 1992). blood pressure is also higher in absolute as well as relative work rates in older adults as compared to younger adults. in addition, total peripheral resistance is generally higher in older adults for a given exercise intensity (ogawa et al., 1992). although reduced physical activity with age contributes to decrease the maximal aerobic power, similar rates of decline are observed with age even among highly active individuals. however, the v’o2peak of such athletic persons is substantially higher than that of their age peers (fleg et al., 1994). moreover, the cardiovascular (cv) system remains fully adaptable to training at any age (kohrt et al., 1991) with relative increases in v’o2max in adults of any age equivalent to those seen in young individuals. given the effect of cardio vascular exercise training and greater fitness on cv disease 114 enrico rejc, alessio del torto, stefano lazzer: benefits of aerobic exercise training with recommendations ..., 111–124 annales kinesiologiae • 8 • 2017 • 2 figure 1: cross-sectional versus longitudinal comparison of loss rates in maximal oxygen consumption (v’o2max) [ml/kg/min] in men and women master athletes (adapted from hawkins & wiswell, 2003). **: significantly different rate of loss compared with cross-sectional. annales kinesiologiae • 8 • 2017 • 2 115 enrico rejc, alessio del torto, stefano lazzer: benefits of aerobic exercise training with recommendations ..., 111–124 risk factors (kelley & sharpe kelley, 2001), mortality, and all-cause mortality (myers et al., 2002), recommending aerobic activity to adults of all ages would seem prudent (balady, 2002). effects of aerobic exercise training the ability to maintain high aerobic power is a major determinant of an older adult’s functional independence. several observational studies have demonstrated that endurance athletes, even those in their 60s and beyond, maintain a v’o2peak considerably higher than the one of less active age peers. for example, the v’o2peak in distance runners aged 60 − 80 years was 30 − 40 % higher than active non-trained age peers in the baltimore longitudinal study of (blsa). in fact, their aerobic capacity was similar to that of blsa participants 2 or 3 decades younger (fleg et al., 1994). as well, data from the heritage family study suggest that genetics explains 47 % of the v’o2peak response to 20 weeks of aerobic exercise training after adjustment for age, sex, baseline v’o2peak, and baseline body mass and composition (bouchard, 2012). additionally, multiple studies have documented training-induced increases of 10 − 25 % in v’o2peak among adults in their 60s to 80s, and these increases are similar to those in younger adults (vaitkevicius et al., 2002). a meta-analysis of training studies in persons aged 60 and older found a mean increase in v’o2peak of 16% (huang, gibson, tran, & osness, 2005). in general, higher intensity training and longer exercise duration elicited greater improvement. in addition to its beneficial effects on aerobic capacity, exercise training produces multiple benefits that reduce risk factors for cv disease. hypertension hypertension is defined by a systolic blood pressure (bp) ≥140 mmhg and / or diastolic bp ≥90 mmhg, and it represents the leading risk factor for global burden of disease and mortality (roger et al., 2012). high blood pressure contributes to 7.0 % of disability-adjusted life-years and 9.4 million deaths. also, the estimated number of adults with hypertension will be increased to 1.56 billion by 2025 (hu et al., 2016). the prevalence of hypertension increases with age and it represents a risk factor for the most common causes of morbidity and mortality in older age such as stroke, ischemic heart disease, heart failure and coronary events (lloyd-sherlock, beard, minicuci, ebrahim, & chatterji, 2014). in both younger and older persons with hypertension, regular aerobic exercise reduces bp. important mechanisms contributing to exercise-related bp reduction include a decrease in aortic stiffness and enhanced flow-mediated arterial dilation due to increased nitric oxide release from endothelial cells lining these blood vessels (desouza et al., 2000). the reductions in bp from aerobic exercise are often similar to those induced 116 enrico rejc, alessio del torto, stefano lazzer: benefits of aerobic exercise training with recommendations ..., 111–124 annales kinesiologiae • 8 • 2017 • 2 by a single antihypertensive drug. mean bp reduction in a large meta-analysis averaged 3.8-2.6 mmhg (whelton, chin, xin, & he, 2002). it is important to point out that lower intensity exercise equivalent to brisk walking demonstrated bp reductions similar to that of more intensive training in older hypertensive adults (hagberg, montain, martin, & ehsani, 1989). dyslipidemia abnormal blood lipids are powerful risk factors for cv events in older adults. aerobic exercise training has beneficial effects on these abnormal lipid levels, irrespective of age. in a meta-analysis of aerobic exercise training trials in older adults, significant increases in high density lipoprotein (hdl) or “good” cholesterol averaged 2.5 mg/ dl, and reduced total cholesterol / hdl cholesterol ratio were observed, independent of changes in body composition; improvements in blood lipids correlated with increases in v’o2peak (kelley, kelley, & tran, 2005). weight loss, which is often observed during prolonged training programs, may further improve lipid profile (katzel et al., 1995). glucose tolerance aging is accompanied by reduced insulin sensitivity, which impairs glucose tolerance. this adaptation often results in type 2 diabetes mellitus, which itself is a potent risk factor for atherosclerotic cv disease. both age-associated increase in body fat and reduced physical activity appear to contribute to the impairment of insulin sensitivity and glucose tolerance in older adults. thus, it is not surprising that both weight reduction and aerobic exercise training ameliorate these impairments. a 9-month aerobic exercise intervention in 71 obese older men (61 ± 1 years, bmi 30.4 ± 0.4 [mean ± sd] ) increased v’o2peak by a mean of 17 % (p < 0.001) and reduced area (under the glycaemic curve) of an oral glucose tolerance test by an equal amount (katzel et al., 1995). bone density reduction in bone density associated with aging occurs in both sexes but accelerates in women after menopause, increasing risk for osteoporotic-related fractures, thus, worsening the quality of life. bonaiuti et al. (2002) reported an increase in bone mineral density of hips and spine by 1.3 % and 0.9 %, respectively (p= 0.055 and p = 0.011, respectively), following walking activity. (hatori et al., 1993) also showed an increase of bone mineral density of 1.1 ± 2.9 % (p < 0.05) in postmenopausal healthy women (45 to 67 years) following a 7-month training protocol that consisted of 30 minutes of high-intensity walking performed three times per week. although estrogen replaceannales kinesiologiae • 8 • 2017 • 2 117 enrico rejc, alessio del torto, stefano lazzer: benefits of aerobic exercise training with recommendations ..., 111–124 ment therapy reduces post-menopausal bone loss, the negative cardio vascular effects of estrogen have markedly curtailed its use. it seems worth noting that reduced bone mineral density can represent a potential threat for the health status of an individual. in fact, as mentioned above, reduced bone mineral density can increase the risk of fractures, which affects quality of life and leads to physical inactivity. fortunately, weight bearing aerobic as well as resistance exercise can increase bone density in older adults by increasing the loading force on bone and stimulating osteoblast activity. depression in a case-control study, the inerheart study, it was found that psychological factors (e.g. depression, perceived stress and life events) were strong risk factors for myocardial infarction. also, depression was officially recognized as a cv risk factor following the 2010 global burden of disease study and other studies (yusuf et al., 2004; elderon & whooley, 2013). while it seems important to reiterate that modifiable health behaviour (e.g. physical inactivity, poor diet, smoking, dyslipidemia and medication non-adherence) are conceivably the most critical mediators for cv disease, the role of depression on cv diseases and physical (in)activity should be considered (pan, sun, okereke, rexrode, & hu, 2011; hamer, 2012). in fact, some studies reported associations between physical inactivity, depression and cv mortality also in the aged population (win et al., 2011). in particular, the primary finding of win and colleagues (2011) was that physical inactivity accounted for approximately 25 % of the increased risk of cv mortality due to depression in community-dwelling aged adults. furthermore, whooley et al. (2008) showed that, in a batch of outpatients with stable coronary heart disease, physical inactivity explained almost half of the association between depressive symptoms and cv events. interestingly, in addition to the beneficial effects of cognitive behavioural therapy and antidepressant medication, regular exercise has been shown to reduce depressive symptoms. for example, lavie and milani (1995) have shown lower depression scores, reduced anxiety, and improved total quality of life (qol) after cardiac rehabilitation (cr) in 85+ coronary patients. the program lasted 12 weeks in which 36 exercise and educational sessions were performed. each session included: i) around 10 minutes of warm-up stretching and calisthenics; ii) 30 to 40 minutes of continuous upright aerobic and dynamic exercise (various combinations of walking, bicycling, jogging, rowing, etc.), along with light isometric exercises (e.g. hand weights); iii) around 10-minute cool-down period of stretching. the exercise intensity was prescribed with the aim of making patients attain approximately 75 % to 85 % of their maximal heart rate, or 10 to 15 beats per minute below the level of any exercise induced myocardial ischemia. the exercise prescriptions were periodically adjusted to guarantee a gradual increase in exercise performance. moreover, all patients were oftentimes supported by physicians, dieticians, nurses, and exercise physiologists to comply with the exercise program (lavie & milani, 1995). 118 enrico rejc, alessio del torto, stefano lazzer: benefits of aerobic exercise training with recommendations ..., 111–124 annales kinesiologiae • 8 • 2017 • 2 long-term benefits of exercise in older adults despite the study results on physiological benefits of exercise in older adults reviewed above, elderly people are more concerned about their functional independence and qol than laboratory measurements. as noted earlier, the ability to perform daily activities generally requires an aerobic power > 20 ml/kg/min (cress & meyer, 2003). ehsani et al. (2003) reported a v’o2peak of 15.6 ± 2.7 ml/kg/min in frail octogenarians women; similarly, (ades, ballor, ashikaga, utton, & nair, 1996) found a peak aerobic power equal to 21.5 ± 1.1 ml / kg / min in old women (70.4±4 years). these findings highlight the fact that older individuals are extremely close to the threshold for loss of independence (cress & meyer, 2003). in this population, regular aerobic training may prevent or significantly delay the crossing of “independence threshold”; furthermore ongoing clinical trials are rigorously examining the effects of regular exercise in preserving independence and reducing morbidity and mortality (mazzeo & tanaka, 2001). older adults are conceivably more concerned about their qol than their longevity per se. thus, improving and maintaining high qol assumes great importance in the aged population. because qol is adversely impacted by illness and disability, improved physical function might be expected to cause parallel increases in qol. in hf-action, a trial of supervised aerobic exercise training followed by home exercise in adults with moderate-to-severe chf, qol improved significantly with training (flynn et al., 2009). similarly austin, williams, ross, moseley, & hutchison (2005) observed improved qol in 200 patients 60 − 89 years old (mean 72 years) after a 24-week program of aerobic exercise plus low-resistance strength training. aging is accompanied by an accelerating reduction of functional capacity, best quantified by v’o2max and / or v’o2peak; the degradation of maximal aerobic power is also induced by many comorbidities common to the older individuals (huggett, connelly, & overend, 2005). however, numerous observational and interventional studies have demonstrated the beneficial effects of exercise training in older adults, both in healthy and diseased individuals (mazzeo & tanaka, 2001). a major challenge confronting the medical community and society is to increase significantly the participation of the aged population in such activities. recommendations for aerobic exercise training current recommendations for improving cv fitness and reducing disease risks are certainly effective (chodzko-zajko et al., 2009), even though further research is needed to identify the minimum effective dosage for intensity and volume to improve v’o2max and reduce disease and mortality outcomes. these recommendations call for 15 – 60 minutes of aerobic activities that include large muscles, rhythmic movement, 3 – 5 days per week, at an intensity equivalent to 40 – 85 % of v’o2max (55-90% hrmax). this means that practicing exercise at high intensity and volume, just like athletes would, annales kinesiologiae • 8 • 2017 • 2 119 enrico rejc, alessio del torto, stefano lazzer: benefits of aerobic exercise training with recommendations ..., 111–124 is not a prerequisite for significant improvements in cv performance and health status in general. the practice of lightto moderate-intensity physical activity on a more frequent basis, on the other hand, is identified as a requirement to optimize health by the recent guidelines issued by the centers for disease control and prevention / american college of sports medicine (acsm) (pate et al., 1995). this should be the main focus of aerobic exercise prescription for adults of all ages (balady, 2002). therefore, the acsm guidelines should provide the basis for exercise prescription for most adults (chodzko-zajko et al., 2009). the current consensus recommendations of the acsm and american heart association (aha) with respect to the frequency, intensity, and duration of exercise and physical activity for older adults are summarized below. the acsm / aha physical activity recommendations are generally consistent with the 2008 physical activity guidelines for americans by the department of health and human services (dhhs) (physical activities guidelines advisory committee, 2008), which also recommend 150 minutes / week of physical activity for health benefits. however, the dhhs guidelines note that additional benefits occur as the amount of physical activity increases through higher intensity, greater frequency, and / or longer duration. the dhhs physical activity guidelines point out that if older adults cannot perform 150 min of moderate-intensity aerobic activity per week because of chronic conditions, they should be as physically active as their abilities and conditions allow. main recommendations for aerobic exercise training frequency: for moderate-intensity activities, accumulate at least 30 or up to 60 (for greater benefit) minutes / day in bouts of at least 10 min each to total 150 – 300 minutes / week, at least 20 – 30 minutes / day or more of vigorous-intensity activities to total 75 – 150 minutes / week, an equivalent combination of moderate and vigorous activity. intensity: on a scale of 0 to 10 for level of physical exertion, 5 to 6 for moderate-intensity and 7 to 8 for vigorous intensity. duration: for moderate-intensity activities, accumulate at least 30 minutes / day in bouts of at least 10 min each or at least 20 minutes / day of continuous activity for vigorous-intensity activities. type: any modality that does not impose excessive orthopaedic stress; walking is the most common type of activity. aquatic exercise and stationary cycle exercise may be advantageous for those with limited tolerance for weight bearing activity. despite the extremely favourable health outcomes promoted by the above described physical activity, it may be argued that the proposed exercise guidelines are too generic. the adoption of a common prescription approach may not allow to achieve the full therapeutic potential of physical exercise treatment. in fact, these guidelines do not take into account some crucial aspects of exercise prescription, such as the recovery period among each training session (especially between the ones carried out at high intensity and / or high volume) as well as training periodization and the individualization of 120 enrico rejc, alessio del torto, stefano lazzer: benefits of aerobic exercise training with recommendations ..., 111–124 annales kinesiologiae • 8 • 2017 • 2 training variables (volume, intensity and frequency) based on the individual needs of the older individuals. in particular, it is known that periodized training promotes better physical improvements compared to non-periodized training programs in the healthy population, and this may conceivably be the case also for non-healthy individuals (issurin, 2010). another positive aspect of periodization is the reduced risk of overtraining and its side effects (fry, morton, & keast, 1992). acsm guidelines also reported that exercise and physical activity progression for older adults should be individualized, also using exercise tolerance as an additional criteria (chodzko-zajko et al., 2009). conclusions a body of evidence clearly indicates that involvement in exercise programs induces several benefits for older individuals. these favourable ameliorations involve noteworthy health-related issues including cv disease, metabolic syndrome, diabetes mellitus and osteoporosis. however, not only the cardio-metabolic profile is improved in response to exercise program, indeed, it is reported that physical activity positively affects also more functional benefits that allow for continued independence and the ability to perform daily life activities and reduced cognitive symptoms (e.g. depression and anxiety). as a matter of fact, all these exercise-induced benefits are vanished if the aged population is not involved in a regular physical activity regime. nowadays, extreme importance is placed on the development of new strategies and educational programs with the aim to inform the older population about the meaningful benefits of regular exercise and increase their involvement, adherence and compliance to such programs. references ades, p. a., ballor, d. l., ashikaga, t., utton, j. l., & nair, k. s. 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and preserve this value. proceeding from the basic definition of health as a holistic and long-term dimension, it was certainly necessary to treat it as such. ensuring health, however, is far from being the responsibility of the public health sector alone, rather of many other agents which may directly or indirectly affect people’s wellbeing. the measures adopted to contain the spread of coronavirus thus included the closure of schools and gyms, as well as bans on organized sports training, use of sports playgrounds, and gatherings in public spaces. in addition to already implemented restrictions of movement in general, these further impeded exercise and sports training, including their supervised and organized forms. when discussing and professionally analyzing the measures adopted, it is important to recognize that in the desire to contain the infection (a clear threat to health) through such measures, unfortunately, we are indirectly establishing other circumstances that pose a direct threat to human health. during the ten years of its existence, annales kinesiologiae has published many articles which scientifically substantiate the role and importance of physical/sports activity, exercise and training for the preservation of a balanced functioning of the human organism, of one’s health, motor competence, and of the quality of life in one’s different roles and activities. the authors of the scientific articles in this issue continue this important mission by scientifically corroborating the role of physical activity and sports training as a lever for a healthy development and maintenance of balance under the impacts of social and physical environments. once again, we can follow relevant contributions to the science of kinesiology and its profession complemented by presentations of new research projects, publications, and conferences from this field. on the 10th anniversary of the annales kinesiologiae journal and of scientific publication within the annales zrs scientific publishing house i wish to congratulate the authors, past and present, and particularly the core of the editorial board and all editorial collaborators, as well as numerous reviewers. without their effort and extensive volunteer work we could not have come this far and the science of kinesiology would have been denied many interesting publications and presentations of research achievements. i am convinced that our journey and hard work will one day be rewarded by annales kinesiologiae being admitted among journals with appropriate scientific indexing. prof. dr. rado pišot editor-in-chief and managing editor 2 annales kinesiologiae • 11 • 2020 • 1 uvodnik zaradi hude grožnje zdravju in ohranjanja golega življenja se je naša družba v kratkem času morala odpovedati številnim dejavnostim in s tem tudi razlogom, ki življenju dajejo smisel. v položaju, v katerem smo se znašli, je bila naloga odgovorne države poiskati smiselne, znanstveno in strokovno podprte ukrepe, ki bodo vsakemu posamezniku zagotovili doseganje in ohranjanje te vrednote. ker je zdravje, že izhajajoč iz temeljne opredelitve zelo celostna in dolgoročno opredeljena dimenzija, ga je bilo vsekakor treba tako tudi obravnavati. pri tem pa to še zdaleč ni le v pristojnosti zdravstvenega sektorja, temveč tudi številnih drugih, ki nanj vplivajo neposredno ali posredno. med ukrepi za zajezitev okužbe s koronavirusno boleznijo so bili sprejeti tudi ukrepi, kot so zaprtje šol in telovadnic, prepoved organizirane športne vadbe, treningov, prepoved uporabe igrišč in druženja na javnih prostorih. ukrepi, ki ob omejevanju gibanja na splošno, dodatno onemogočajo gibanje in športno vadbo – tudi nadzirano in organizirano. ob obravnavi in strokovni analizi sprejetih ukrepov se je treba zavedati, da v želji po zajezitvi okužbe (grožnje zdravju) s takimi ukrepi posredno žal poudarjamo prav vzvode, ki neposredno ogrožajo zdravje?! annales kinesiologiae je v desetih letih obstoja izdala številne prispevke, ki znanstveno utemeljujejo vlogo in pomen gibalne/športne aktivnosti, vadbe in treninga za ohranjanje ravnovesja delovanja organizma človeka, za njegovo zdravje, gibalne kompetence in kakovost življenja v različnih vlogah in dejavnostih. tudi avtorji znanstvenih prispevkov v tej reviji nadaljujejo to pomembno poslanstvo z znanstveno utemeljitvijo vloge gibalne aktivnosti in športne vadbe kot vzvodov za zdrav razvoj in ohranjanje ravnovesja pod vplivom družbenega in fizičnega okolja. tudi tokrat lahko sledimo pomembnim prispevkom kineziološki znanosti in stroki, ki jih dopolnjujejo predstavitve novih raziskovalnih projektov, publikacij in konferenc s področja. ob deseti obletnici revije annales kinesiologiae in znanstvenega objavljanja v okviru znanstvene založbe annales zrs želim čestitati vsem dosedanjim avtorjem, še posebej pa ožjemu in širšemu uredniškemu odboru in številnim recenzentom. zavedati se moramo, da brez njihovih prizadevanj in obsežnega prostovoljnega dela te poti ne bi prehodili, kineziološka znanost pa bi bila prikrajšana za številne zanimive objave in predstavitve raziskovalnih dosežkov. verjamem, da bosta ta pot in prizadevno delo nekoč nagrajena tudi z umestitvijo revije annales kinesiologiae med revije z ustreznim indeksom. prof. dr. rado pišot, glavni in odgovorni urednik annales kinesiologiae • 11 • 2020 • 2 155 reports and reviews/poročila in ocene, 147–158 living with smart technology development opportunities and dangers koper, slovenia, 25 november 2020 the event “living with smart technology development opportunities and dangers” took place on wednesday, 25 november 2020, in the large hall of koper theater. it was organized by the science and research centre koper (zrs koper) in cooperation with koper theater, and broadcast live via the websites and facebook pages of zrs koper, koper theater, and the regional portal. the conversation was chaired by rado pišot, phd (director of zrs koper), and among the invited speakers were gorazd andrejč, phd (institute for philosophical studies zrs koper and university of groningen, the netherlands), gašper hrastelj (deputy general secretary of the slovenian national commission for unesco), uroš marušič, phd (institute for kinesiology research, zrs koper) and matej mertik, phd (alma mater europaea ecm, maribor). the 1.5-hour talk focused on rapidly developing technology, the penetration of artificial intelligence into many areas of applied sciences, medicine, engineering, and related fields. the speakers agreed that in many ways, intelligent technologies can facilitate human work and life efforts, provide immense help in treatment and rehabilitation; but at the same time represent a decisive departure from evolutionary patterns and life practices, appropriating and isolating humans. the mo156 reports and reviews/poročila in ocene, 147–158 annales kinesiologiae • 11 • 2020 • 2 derator encouraged the speakers with burning ethical issues of technology use; the speakers also touched on content related to the evolution of the web, the importance of critical reflection on the impact of smart technologies, and the artificial intelligence revolution that is becoming part of everyday life. the entire event is available via the youtube link: https://www.youtube.com/watch?v=o4cj4jl9h9q&ab_channel=zrskoper. uroš marušič https://www.youtube.com/watch?v=o4cj4jl9h9q&ab_channel=zrskoper annales kinesiologiae • 11 • 2020 • 2 157 reports and reviews/poročila in ocene, 147–158 življenje s pametno tehnologijo – razvojne možnosti in nevarnosti koper, slovenia, 25. november 2020 dogodek življenje s pametno tehnologijo – razvojne možnosti in nevarnosti je potekal v sredo, 25. novembra 2020, v veliki dvorani gledališča koper. znanstveno-raziskovalno središče koper (zrs koper) je v sodelovanju z gledališčem koper organiziralo dogodek, ki se je prenašal v živo prek spletnih in facebook strani zrs koper, gledališča koper in portala regional. pogovor je vodil dr. rado pišot (direktor zrs koper), med povabljenimi govorci pa so bili dr. gorazd andrejč (inštitut za filozofske študije zrs koper in univerza v groningenu, nizozemska), gašper hrastelj (generalni sekretar slovenske nacionalne komisije za unesco), dr. uroš marušič (inštitut za kineziološke raziskave zrs koper) in dr. matej mertik (alma mater europaea ecm, maribor). v enoinpolurnem pogovoru so udeleženci govorili o hitro razvijajoči se tehnologiji, pronicanju umetne inteligence na številna področja aplikativnih znanosti, medicine, inženiringa in podobnih področij. govorci so se strinjali z dejstvom, da lahko pametne tehnologije v številnih pogledih olajšajo delovne in življenjske napore človeka, neizmerno pomagajo pri zdravljenju in rehabilitaciji, hkrati pa pomenijo odločen odklon od evolucijskih vzorcev in življenjskih praks ter človeka posedejo in osamijo. moderator je govorce spodbujal z odpiranjem perečih 158 reports and reviews/poročila in ocene, 147–158 annales kinesiologiae • 11 • 2020 • 2 etičnih vprašanj uporabe tehnologije, udeleženci so obravnavali tudi vsebine, vezane na razvoj spleta, pomembnost kritičnega premisleka o vplivu pametnih tehnologij in revolucije umetne inteligence, ki postaja del vsakdana. dogodek je dosegljiv na povezavi: https://www.youtube.com/watch?v=o4cj4jl9h9q&ab_channel=zrskoper. uroš marušič https://www.youtube.com/watch?v=o4cj4jl9h9q&ab_channel=zrskoper _goback _hlk40898474 _hlk34144101 _hlk40871331 _hlk53505499 _hlk33786872 _hlk25864445 _hlk38187602 _hlk71096081 annales kinesiologiae • 11 • 2020 • 2 81 editorial this issue of annales kinesiologiae clearly highlights the parents’ perspective and the importance of the entire family in the harmonious motor development of the child. studies examining the family environment as one of the factors in child development consistently confirm the extraordinary importance of early experiences in the formation of future habits and patterns of behavior in the individual. the challenge of balancing professional obligations and active time with the family is particularly great for parents today. reasons such as lack of time and bad weather are always convenient excuses, as evidenced by the research findings in the first article in this issue. the generational shift to predominantly negative influences and exercise patterns is fierce and can no longer be denied. the behavioral patterns of today’s children are rapidly changing from those of their parents, unfortunately toward an increase in physical inactivity and screen time. playtime in the same children’s natural environment is being reduced. as a result, children are losing the opportunity for important experiences that the natural environment and play in it provide. this issue is explored in the final article. numerous studies have found that regular moderate-intensity physical activity has a significant impact on health, physical performance, and overall well-being. the other two articles in this issue describe the relationships between body composition and motor skills in children, and moderate-intensity physical activity as a factor in behavioral prevention and improvement of diabetes. it is the task of experts in the interdisciplinary field of kinesiology to continually promote and provide evidence of the importance of regular physical activity, active lifestyles, and active recreation for the quality of life and health of individuals as well as society as a whole. it is also necessary to draw attention to the responsibility of each of us to contribute, within our means, to the awareness and co-creation of a physically stimulating space and environment. only with intense effort will we be able to overcome the intergenerational decline in physical activity. adults and even adolescents have a responsibility to young children to encourage through example an active lifestyle. matej plevnik, phd, assist. prof. editor 82 annales kinesiologiae • 11 • 2020 • 2 uvodnik tokratna številka revije pomembno osvetljuje pogled staršev in pomen celotne družine za skladen gibalni razvoj otroka. študije, ki proučujejo okolje družine kot enega izmed dejavnikov otrokovega razvoja, vedno znova potrjujejo izjemen pomen prvih izkušenj za oblikovanje prihodnjih navad in vedenjskih vzorcev posameznika. v današnjem času je izziv usklajevanja službenih obveznosti in aktivno preživetega časa z družino za starše še posebej velik. razlogi, kot so pomanjkanje časa in slabo vreme, so vedno znova priročen izgovor, kar z raziskovalnimi ugotovitvami podpira tudi prvi objavljen prispevek v tokratni številki. generacijske spremembe predvsem negativnih vplivov in vzorcev gibalne neaktivnosti so silovite in jih ni več mogoče zanikati. vzorci vedenja današnjih otrok se v primerjavi z vzorci njihovih staršev hitro spreminjajo, žal v smeri povečevanja časa gibalne neaktivnosti in zaslonskega časa. hkrati pa se čas igre v zunanjem naravnem okolju pri istih otrocih zmanjšuje. s tem izgubljajo priložnost za pomembne izkušnje, ki jih nudi naravno okolje in igra v njem. to problematiko proučuje zadnji prispevek tokratne številke. da redna zmerno intenzivna gibalna aktivnost pomembno vpliva na zdravje, gibalno učinkovitost in splošno počutje, sicer ugotavljajo številne raziskave. preostala prispevka te številke opisujeta povezave med telesno sestavo in gibalnimi sposobnostmi pri otrocih ter zmerno intenzivno gibalno aktivnostjo kot dejavniki preventivnega vedenja in izboljšanja stanja sladkorne bolezni. naloga strokovnjakov interdisciplinarnega področja kineziologije je, da vedno znova spodbujajo in dokazujejo pomen redne gibalne aktivnosti, aktivnega življenjskega sloga in aktivno preživetega prostega časa za kakovost življenja in zdravja posameznika in tudi celotne družbe. pri tem je treba opozoriti tudi na odgovornost vsakega izmed nas, da po svojih zmožnostih prispeva k ozaveščanju in soustvarjanju gibalno spodbudnega prostora in izkušenjsko bogatega okolja. medgeneracijski upad gibalnih aktivnosti bomo lahko premagali le s prizadevnostjo vsakega izmed nas. starši otrok in mladostnikov imajo v svoji vlogi pomembno nalogo, da z zgledom in stalno motivacijo svoje najmlajše navdušujejo za redno gibalno udejstvovanje. prav je, da jim pri tem pomagamo. doc. dr. matej plevnik, urednik _hlk40898474 _hlk34144101 _hlk40871331 _hlk53505499 _hlk33786872 _hlk25864445 _hlk38187602 _hlk71096081 annales kinesiologiae • 9 • 2018 • 1 45 original scientific article udc: 796.926.034.6 received: 2018-09-03 the relationship between dimensions of technical knowledge of young alpine skiing competitors and competitive performance stojan puhalj1, blaž lešnik2 1 faculty of education, department for sports training, university of maribor, slovenia, 2 faculty of sport, university of ljubljana & ski instructors and trainers association of slovenia corresponding author: blaž lešnik university of ljubljana, faculty of sport, gortanova ul. 22, 1000 ljubljana, slovenia phone: +386 41 79 55 36 e-mail: blaz.lesnik@fsp.uni-lj,si abstract in the research, the relationship between individual variables of technical assessment of free and competitive style alpine skiing and the criterion variable (competitive performance) are addressed. the criterion variable is the total number of points that was achieved in the rauch ski cup in the season 2013/2014. twenty selected alpine skiers between the ages of 12 and 14were included in the research. technical knowledge and tactics of alpine skiing were assessed in the free skiing (tfs) during two giant slalom races for the rauch ski cup (tcs). in order to determine bivariate correlations between the tfs and tfc variables and the competitive performance, the pearson correlation coefficient method was used. for this particular section of the study, it was confirmed that all the variables used were significantly related to the criterion variable. in the successive test, using the calculation of multiple regression coefficients, we confirmed the high percentage of the explained variance of the two sets of measurements (tfs and tcs). in this research, the influence of technical knowledge of skiing in the free (tfs) and competitive skiing (tcs) on the competitive performance of alpine skiing in slovenia was studied for the first time. based on the results of the research, the foundation for both an improved concept of psychophysical and technical training and for the modernization of the selection criteria for the young competitors in alpine skiing will be proposed. keywords: alpine skiing, young categories, competitive successfulness, technique in free skiing, technique in competitive skiing. mailto:blaz.lesnik@fsp.uni-lj,si 46 stojan puhalj, blaž lešnik: the relationship between dimensions of technical knowledge ..., 45–55 annales kinesiologiae • 9 • 2018 • 1 povezanost dimenzij tehničnega znanja mladih tekmovalcev v alpskem smučanju s tekmovalno uspešnostjo izvleček v raziskavi smo ugotavljali povezavo med posameznimi spremenljivkami pri oceni tehnike alpskega smučanja v prostem in tekmovalnem smučanju s kriterijsko spremenljivko (tekmovalna uspešnost). slednjo je predstavljal seštevek točk v smučarskem pokalu rauch v sezoni 2013/14. v raziskavo je bilo vključenih 40 izbranih tekmovalcev alpskega smučanja starih od 12 do 14 let. področje tehnike in taktike alpskega smučanja je bilo ocenjeno v prostem smučanju (tfs) in na dveh tekmovanjih v veleslalomu za pokal rauch (tcs). za določitev bivariatnih povezanosti posameznih spremenljivk tfs in tcs s tekmovalno uspešnostjo smo uporabili metodo izračuna pearsonovih koeficientov korelacije. v tem delu smo potrdili, da so s kriterijsko spremenljivko statistično značilno povezane vse uporabljene spremenljivke. v nadaljevanju smo s pomočjo izračuna multiplih regresijskih koeficientov potrdili visok odstotek pojasnjene variance obeh sklopov meritev (tfs in tcs). v tej raziskavi je bil v slovenskem prostoru prvič raziskan vpliv tehničnega znanja smučanja v prostem (tfs) in tekmovalnem smučanju (tcs) na uspešnost v tekmovalnem alpskem smučanju. na osnovi rezultatov raziskave bodo predlagana izhodišča za izboljšan koncept psihofizične in tehnične priprave ter za posodobitev kriterijev za selekcioniranje mladih tekmovalcev in tekmovalk v alpskem smučanju. ključne besede: alpsko smučanje, mlajše kategorije, tekmovalna uspešnost, tehnika v prostem smučanju, tekmovalna tehnika introduction alpine skiing as an athletic and recreational activity is a small part of global sports. however, in snowy and mountainous regions it is an integral part of the lifestyle of both the young and the old (krautgasser et al., 2012). this research interest follows the concept of scientific approach in alpine skiing for children in late childhood and in adolescence, exploring some of the factors that influence success in this sport. alpine skiing is a sport in which success in competitions depends on various internal and external factors that are related to each other (lešnik & žvan, 2003). with the development of skiing disciplines, alpine skiing has reached the level where top results are very hard to reach (hébert-losier, supej, & holmberg, 2014). in the process of training, there is a set of different and special elements that are more effective for each discipline in alpine annales kinesiologiae • 9 • 2018 • 1 47 stojan puhalj, blaž lešnik: the relationship between dimensions of technical knowledge ..., 45–55 skiing (lešnik et al., 2017). in a multitude of factors that influence the performance of young alpine skiers, technical knowledge of skiing is certainly one of the most important. based on observations in practice, we find that the skiing technique of young athletes is not on the level that is needed to achieve top results in competitions. the reasons for this, on one hand, are the modes and contents of training that include a lot of skiing between the gates. this, on the other hand, leaves too little time to train the elements of skiing techniques that are outside the ski course setting. as a consequence, many young competitors have a relatively narrow base of skiing skills, and there are many with incorrectly learned movement patterns. the movements executed during alpine skiing, which involve continuous connecting of short parallel turns, are much more complicated than the movements needed during performance and experimental conditions (cigrovski et al., 2017). each skiing turn consists of three phases. the first phase is the beginning of a turn. the second phase is the pivoting phase of a turn, and the third phase is the completion phase (lešnik & žvan, 2010). the most common deficiencies in technical knowledge in younger categories are the imbalance of the body, excessive slipping of the skis throughout the turn, choosing a slower skiing line, and uncoordinated excessive movements during the performances of racing, skiing turns and other technical elements of skiing. all this is becoming one of the main reasons for achieving poorer results in competitions, especially in competitions with more demanding course settings (lešnik & žvan, 2007; puhalj, 2018). special elements of alpine skiing sports techniques correlate highly with the successes and accomplishments in competitive alpine skiing (loland & haugen, 2000). it is important that the development of sporting techniques, psychological potentials and motoric abilities take place simultaneously (weineck, 2009). technical elements can be carried out in a series of small partial services or movement patterns which can be connected into a well-functioning technical execution that present quality skiing (lemaster, 1999). one of the main goals of the ski training technique is stable skiing on the ski edges even in the most difficult conditions. in terms of mastering the technique of skiing, this means constant fine adjustments of body angles, particularly in the hips, knees and ankles, as well as tilting of the body to the side. distribution of the appropriate strength to complete a turn especially across the fall-line refers to when an increasing gravitational force and resistance develop through extreme inclination of the skis in order to maintain the line of a turn (wörndle, 2007). in practice, we talk about slipping in turns, which often reflects inadequate or poor technique and pivoting turns on the edges with a good ski grip on a snowy surface (lemaster, 1999) or, according to jouberts (1978), for finding quality support on a snowy surface. development of effective control over the skiing speed and direction can be achieved through a turn on the edges where the front and the rear of the ski slide along the same line of the turn. the skis should only move forward, preferably with zero side slipping and with minimum energy loss (loland, 2009). the basic aim of the training of the technique is therefore a balanced, fluid, light and controlled pivoting of skis with appropriate patterns of movement and without 48 stojan puhalj, blaž lešnik: the relationship between dimensions of technical knowledge ..., 45–55 annales kinesiologiae • 9 • 2018 • 1 excessive pressure on the surface. quality ski training should include both skiing between the gates and skiing outside course settings. it is generally known that a high level of technical knowledge can be achieved primarily through training in a variety of conditions (hard surface, poor visibility, powder skiing and mogul skiing, to name a few). this was also the main starting point for setting up the criteria for the quality technical knowledge of young competitors in alpine skiing (puhalj, 2018). the so-called technical skills knowledge model of young competitors consists of the variables of the free skiing technique (tfs) and the variables of the technique in competitive skiing between the gates (tcs). therefore, the main aim of this research is to find out the correlation between the selected variables of skiing technique knowledge and the competitive performance of young athletes in alpine skiing. methods the study included 20 young boys (year of birth 2000 and 2001; height 158.97 cm, +/9.11 cm; weight 50.18 kg, +/9.42 kg) , all of whom were selected athletes in alpine skiing. the factors of technique in freeride skiing (tfs) that were studied are balance in free skiing (fsbl), coordination in free skiing (fsco) and phase of completing the turn in free skiing (fsct). the factors of technique in competitive skiing (tcs) that were studied are technique in competitive skiing (csbl), balance in competitive skiing (csbl), phase of completing the turn in competitive skiing (csct) and lines of skiing in competitive skiing (csls). the evaluation of ski variables of the competition technique for younger boys was carried out during two giant slalom competitions, which also counted for the rauch cup. the first competition took place on soriška planina (march 21, 2014), and the second one in krvavec (march 29, 2014). in the 30-second starting intervals, the evaluators recorded grades from 1 to 3 on the pre-prepared scoreboards (grade 1 = poor, 2 = medium, 3 = good). both competitions were carried out in ideal snow conditions, which ensured equivalent competitive conditions for all competitors. the grades of the variables were obtained from 7 members of the national examination committee for alpine skiing from the ski instructors and trainers association of slovenia (sitas). the grades of the balance assessment (1 to 3) for frequent loss of balance in all four operating directions were marked with the lowest score; the cases of stable balance positions were marked with the highest score. the same evaluation was used in both the competitive and free skiing. assessment of the pivoting of skis in turns took place under the same criteria in the competitive giant slalom as well as in the giant slalom turns in free skiing with special tasks. turns with more slipping of the edges were marked with the score 1 and the turns without slipping of the edges were marked with the score 3. the skiing lines on the medium steep racing tracks, which were carried out with a longer pre-preparation over the gate with a turn above the gate or with a turn below the gate, were rated with the score 1. turns with a more direct beginning and completion were rated with the score 3. turns a little over and a little below the annales kinesiologiae • 9 • 2018 • 1 49 stojan puhalj, blaž lešnik: the relationship between dimensions of technical knowledge ..., 45–55 gates (configuration, preparation and ski course setting all considered) were marked with the score 2. the co-ordination of movements was assessed only in free skiing and was based on harmonic, timely and spatially coordinated uninterrupted movements from one turn to another. the moving phases followed each other slower downwards and faster upwards. special attention was also paid to the coordinated pole planting, which also marked the beginning of the vertical movement. this was absolutely necessary when passing from one turn to another on the lower ski with a lifted upper ski. a score of 3 was assigned for a well-coordinated movement from one turn to another and a score of 1 for uncoordinated movement (puhalj, 2018). the pearson correlation coefficient method was used to calculate the correlation between individual variables and the criterion variable (achieved points in the rauch ski cup for the season 2013/14). on the basis of certain components, consisting of free skiing (tfs) and competitive skiing between the gates variables (tcs), we also calculated the percentage of the explained variance. the criterion variable represents competitive performance at the highest degree of children’s competitions in alpine skiing organized under sas. ranking level at competitions (criterion variable) for each competitor is calculated on the basis of the sum of official results (sas, 2010). results and discussion the analysis of the correlation between variables of the technique in free skiing (tfs) and the variables of the technique in competitive skiing (tcs) shows a statistically significant correlation with the criterion variable (success in the rauch cup). as a rule, the participants of the study who received higher scores for their skiing technique also achieved a higher ranking in the competitions for the rauch cup. table 1 shows the association of all three variables of the free skiing technique skills and the performance in competitions at the level of a 1 % risk. the coordination in free skiing variable runs the highest level of association with the performance in competitions (rfsco=0.762**). an almost as high correlation was calculated for the variables of balance in free skiing (rfsbl=0.728**) and for the variable quality completing the turn in free skiing (rfsct=0.601**). the three variables considered together account for as much as 83 % of the variance area of the component of the technique in free skiing (tfs), which means that the selected criteria for determining and checking the technique of young competitors in free skiing is appropriate. statistically high significant correlations between the components of the technique in free skiing indicate that the training elements of free skiing techniques are a very important part of training for young competitors. therefore, in the future, during snow training, trainers will have to spend more time conducting training for balance, coordination and skiing turns in freeride skiing. all these elements of skiing techniques are closely interconnected and, as such, provide a quality performance of skiing turns, which form the basis of the competition skiing style. an important reason for increasing the amount of the skiing 50 stojan puhalj, blaž lešnik: the relationship between dimensions of technical knowledge ..., 45–55 annales kinesiologiae • 9 • 2018 • 1 technique training in free skiing is that it also allows for the diversification of training on snow. special exercises based on atypical motor structures can be a good variation of training on snow, which in turn can have a positive impact on the technical knowledge of skiing (lešnik & žvan, 2010). the acquisition of technical skills for young athletes, along with quality physical conditioning, is very important because over the years all the missing technical knowledge becomes increasingly difficult to correct and the imbalances more difficult to adjust (raschner, müller, & hildebrandt, 2015). among the 3 variables of the competition technique of skiing between the gates (tcs), the completing the turn variable (rcsct=0.743**) is strongly associated with the competition performance, while the balance variable is slightly less associated with it (rcsbl=0.613**). both connections are statistically significant at the level of a 1 % risk. the third considered variable, which determines the quality of the selected turning line, is the least connected with success in competitions, but is still statistically significant at the level of a 5 % risk (rcsls=0.506*). the three variables presented in total explain table 1: calculation of pearson‘s coefficients between individual variables of the technique in free skiing (tfs) and technique in competitive skiing (tcs), and criterion variable, and percentage of explained variance of main component in free skiing (fsev %) and in competition skiing (csev %). tfs n av sd r h2 λ % ev fsbl 20 6.55 1.669 .728** 0.745 ( f s e v %) fsco 20 7.10 1.518 .762** 0.928 2.494 83.140 fsct 20 7.05 1.731 .601** 0.821 tcs n av sd r h2 λ % ev csbl 20 10.75 1.803 .613** 0.683 ( c s e v %) csct 20 13.05 2.328 .743** 0.814 2.188 72.940 csls 20 11.75 2.337 .506* 0.691 legend: tfs-technique in free skiing; fsbl-balance in free skiing; fsco-coordination in free skiing; fsctphase of completing the turn in free skiing; tcstechnique in competitive skiing; csbltechnique in competitive skiing; csctphase of completing the turn in competitive skiing; csls-lines of skiing in competitive skiing; n-number of competitors; av-average result; sd-standard deviation; r-person’s coefficient of correlation with criterion variable; *statistical significance of r on 5% risk level; **statistical significance of r on 1% of risk level; h2main component comunality; λ – main component value; %ev% of explained variance; fsev%% of explained variance of main component in free skiing; csev%% of explained variance of main component in competition skiing. annales kinesiologiae • 9 • 2018 • 1 51 stojan puhalj, blaž lešnik: the relationship between dimensions of technical knowledge ..., 45–55 73 % of the space variance of the competition technique of skiing between the gates component (tcs), which means that the selected criteria for identifying and assessing the technique of young competitors in the competition ski course setting are appropriate. stable skiing on the edges means constant fine-tuning of body angles in the hips, knees and ankles, as well as tilting of the body to the side. all the measured parameters of the technique are considered to be crucial for the competition results in alpine skiing (wörndle, 2007; loland, 2009). in accordance with the results, the competitors with a better balance on the skis, a cleaner turn performance and a better selected and a faster line of the turn were ranked higher in the competitions for the rauch cup 2014/15. therefore, these segments of competitive skiing techniques will require even more attention in the future. at such training, the use of various didactic tools, such as markers, cones and other aids (pišot & videmšek, 2004) is crucial in helping athletes balance the position of the body, as well as limit the time and length of a turn and the line throughout an entire turn (lešnik & žvan, 2010). the main finding of this research is that all the selected variables for checking and determining the quality of the technique of young, skiing competitors in alpine skiing are significantly related to the criterion variable (competition performance). particularly interesting is the fact that the highest degree of association with the criterion is displayed by the variables that are manifested as the most important ones in practice too. although all the variables used proved to be statistically significant at the highest level of integration, we must, in particular, point out the variable of the coordination of movement in free skiing (rfsco=0.762**), completing the turn between the gates variable (rcsct=0.743**) and the balance in free skiing variable (rfsbl=0.728**). in competitive alpine skiing there can be many reasons for losing time; however, from the point of view of skiing technique, one of the main reasons for losing time during the course setting is a poor performance of turns. a good skier performs in a balanced, smooth and effortless manner, ensuring that they have the situation under control through adequate pivoting of skis. additionally, a good skier’s switching between moving patterns is rolling and without excessive pressure on the surface (loland & haugen, 2000). this means that the competitor can lose too much time in the beginning phase of a turn, the pivoting phase as well as in the completion phase of a turn. slipping of skis, the wrong body position and other unnecessary manoeuvres on the track may also contribute to loss of time. (sandbakk et al., 2014). in order to keep turns on the edges and optimum arcs of turns, one must use the pressure on the ground very rationally (loland, 2009). in this respect, the most illustrative is the high correlation between completing the turn between the gates variable (rcsct=0.743**) and the performance. since only the smallest details distinguish the best competitors from the finest, there are still many reserves in the phase of completing a turn, which must be used with a well-targeted ski training technique. 52 stojan puhalj, blaž lešnik: the relationship between dimensions of technical knowledge ..., 45–55 annales kinesiologiae • 9 • 2018 • 1 conclusion the research showed a high degree of correlation between the selected elements of the technique in free and competitive skiing and competitive performance. the latter is especially important when working with younger categories of competitors. however, we must realize that good technical knowledge is only the basis for good tactics in skiing. in different settings of the gates and competition slopes, the straightest route between the two ski gate poles with a short radius of a turn is not always the fastest. therefore, at competitions, the fastest skiers do not always win. instead, it is the skiers who lose the least time on the track who are successful (madura, lufkin & brown, 2012). researchers recommend an early start of skiing along the fall-line and thus immediate speeding at the beginning of the turning trajectory. the primary force of acceleration is gravitation (müller & schwameder, 2003). using the 3d kinematical system of measuring and evaluating technical and tactical elements of 16 elite competitors, supej (2008) also notes that the most direct and the shortest lines in turns are not always the most effective ones. it has been proven that the amplitude of the reaction of the radial force, radii of turns, speed and acceleration are not the only parameters for assessing the quality of skiing, although all these parameters are essential for the competitive alpine skiing. the high speed of the skier at the point of observation does not necessarily mean that the skier is successful because he could slow down the skiing by inappropriate trajectory of turns (supej, kugovnik, & nemec, 2005). there are turns with a very direct beginning with pivoting and turns with at least 1/3 of the line of a turn performed above the gate. in line with the research of the lines of turns, we can divide them into turns with lines of 50 % above and 50 % below the gate, and on turns with lines of 60 % above and 40 % below the gate. the choice of the most optimal manner of skiing between the gates depends on different factors, especially on weather conditions, treatments of the snow, layout of the racing tracks, disciplines of alpine skiing, configuration of the racing tracks and, of course, physical and technical condition of the competitors. mainly in the technical disciplines of alpine skiing on steep, configurable demanding fields and with difficult course settings which are dominated by turns with large radii, better racers perform skiing lines with early ski edging and transfer weight on the outside ski. they also have more turn performance above the gates than beneath them (brodie, 2009). on the way to achieving good results in alpine skiing, strengthening of the psychomotor base and development of motor control processes are largely linked to ski coordination. in previous research, it has been repeatedly found that general and special co-ordination have the greatest influence on the efficiency of the movement of young competitors (bandalo, 2016; pišot, kipp, & supej, 2010). malina and bouchard (1991) also find high association between the biological age (bone age) and motor abilities and skills in conjunction with high muscular force. in the process of acquiring ski knowledge, this is especially reflected in practice. acquisition of basic ski skills begins through practice of the basics of the free skiing technique (mildner et al., 2012). only later are the acquired knowledge and skills gradually upgraded on the set-up ski courses. annales kinesiologiae • 9 • 2018 • 1 53 stojan puhalj, blaž lešnik: the relationship between dimensions of technical knowledge ..., 45–55 weineck (2009) also defines a theory of gradualism in acquiring motor skills (which include also technical knowledge) over a 4-tier scale. therefore, we gradually approach the situation in competitions where measured time is the only performance parameter. in the age group covered by the sample, the efficiency of movement is also associated with developmental changes (grosser, starischka & zimmermann, 2004). accelerated growth can greatly aggravate movement and the entire training process needs to be adapted to it (pernitsch & staudacher, 1998). in the study, there were many cases where competitors were unable to achieve top-level results because of a poorly developed co-ordination capability. due to high demands for development of special motor skills (pišot, kipp & supej, 2010), mechanical movement analysis is followed by the qualities, where the human body is seen as a system of internal mechanical forces and skiing is seen as the interaction between these forces and the external forces connected with the environment (supej et al., 2005). according to the findings, the physical self-concept is more closely connected with body composition and morphologic features in boys than in girls, whereas the body fat proportion is the strongest predictor of physical self-concept in boys. the findings show that, particularly in boys, the physical self-concept is also largely based on the morphologic features and body composition (puhalj, matejek, & planinšec, 2013). in the research, the influence of technical knowledge of skiing in free and competitive skiing in comparison to the competitive performance in alpine skiing has been explored and it has shown a high degree of integration. research findings of this study are an important confirmation for systematic integration of the training of skiing techniques into the training process of younger categories in alpine skiing. based on the research results, the necessary conditions for devising exercise, the establishment of new criteria for selecting children, and the prediction of the likelihood of sports results in alpine skiing for the selected sample of children will be suggested with orientations for a more friendly and athletic-focused approach. references bandalo, m. 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(2015). talent detection and development in alpine skiing. in e. müller, s. lindinger, & t. stöggl (eds.), science and skiing iv, (pp. 65 – 75). oxford: meyer & meyer. sandbakk, ø., bucher sandbakk, s., supej, m., & holmberg, h.-c., (2014). the velocity and energy profiles of elite cross-country skiers executing downhill turns with different radii. international journal of sports physiology & performance, 9(1), 41-47. doi: 10.1123/ijspp.2013-0383 view item supej, m., (2008). differential specific mechanical energy as a quality parameter in racing alpine skiing. journal of applied biomechanics, 24(2), 121-129. doi: 10.1123/ jab.24.2.121 viev item supej, m., kugovnik, o., & nemec, b. (2005). advanced analysis of skiing based on 3d kinematic measurements. in e. müller, d. bacharach, r. klika, s. lindinger, & h. schwameder, (eds.) science and skiing iii. (pp. 216-227). oxford: meyer & meyer sport (uk). sas – ski association of slovenia (2010). competitions in alpine skiing. retrived from http://www.sloski.si/resources/files/pdf/alpsko-smucanje/10-11/slo/alp-sdipok.htm weineck, j. (2009). optimales training. 16. aufl. balingen: spitta-verlag gmbh & co. wörndle, w. (2007). snowsport austria. purkersdorf: verlags brüder hollinek. http://ojs.zrs.upr.si/index.php/ak/article/view/18 http://journals.humankinetics.com/doi/pdf/10.1123/ijspp.2013-0383 https://doi.org/10.1123/jab.24.2.121 http://www.sloski.si/resources/files/pdf/alpsko-smucanje/10-11/slo/alp-sdipok.htm annales kinesiologiae • 10 • 2019 • 1 3 original scientific article doi: https://doi.org/10.35469/ak.2019.195 received: 2019-11-11 udc: 796.853.23.063 the impact of the 2013 rule changes on gripping configuration in high-level judo athletes nemanja stanković1, nikola milošević1, mladen živković1 1 university of niš, faculty of sport and physical education, niš, serbia corresponding author: nemanja stanković university of niš, faculty of sport and physical education, čarnojevićeva 10a, 18000 niš, serbia phone: +381 69 18 29 073 e-mail: nemanjastankovic84@hotmail.com orcid id: https://orcid.org/0000-0001-5723-1481 abstract purpose: international judo federation introduced a set of new rules in a short time period (2009 − 2013). the aim of this research is to determine how the rule modification influences the gripping configurations used by elite male judo athletes. methods: the sample contained 280 combats from the 2011 and 2014 world championships. all the effective and ineffective throw attempts with related gripping configurations were registered. the chi-square test was used to determine the difference between frequencies, along with z-test for calculating the partial difference. results: a total of 1707 actions and gripping configurations were registered. the chi-square test showed that there is a significant difference in the usage of gripping configurations between the two championships (χ2=32,8; sig<0,001). the z-test showed a significant increase in the usage of kenka-yotsu and ai-yotsu, and a significant decrease in the usage of central grip, cross grip and situations where only tori has established a grip. the difference in the usage of the same side grip was not detected. conclusion: the recommendation for coaches is to reduce the use of all other gripping configurations except kenka-yotsu and ai-yotsu when practicing techniques, especially unorthodox gripping like the cross grip and the same side grip. keywords: kumikata, technical-tactical analysis, performance analysis, combat sports mailto:nemanjastankovic84@hotmail.com https://orcid.org/0000-0001-5723-1481 4 nemanja stanković, nikola milošević, mladen živković: the impact of the 2013 rule changes on gripping ..., 3–13 annales kinesiologiae • 10 • 2019 • 1 vpliv leta 2013 uvedenih sprememb pravil na izvajanje tehnik prijema pri vrhunskih moških judoistih izvleček cilj: mednarodna judo federacija (ijf) je v sorazmerno kratkem obdobju med leti 2009 in 2013 uvedla vrsto novih pravil. cilj te raziskave je ugotoviti, kako so te spremembe vplivale na izvajanja tehnik prijema pri vrhunskih moških judoistih. metode: v raziskavo je bilo vključenih 280 borb iz svetovnih prvenstev v letih 2011 in 2014 in registrirani so bili vsi uspešno, kot tudi neuspešno zaključeni prijemi. hi-kvadrat test je bil uporabljen za ugotavljanje razlik v porazdelitvi frekvenc in z-test za izračun razlik. rezultati: skupno je bilo registriranih 1707 akcij in tehnik prijema. hi-kvadrat test je pokazal, da obstaja pri izvajanju tehnik prijema med obema prvenstvoma pomembna razlika (χ2=32,8; sig<0,001). rezultati z-testa so pokazali, da je prišlo do povečanja frekvence uporabe prijemov kenka-yotsu in ai-yotsu, in značilno zmanjšanje frekvenc uporabe sredinskega prijema, nasprotnega (križnega) prijema in akcij, kjer je prijem izvedel le izvajalec prijema. ni bilo razlik med uporabo levega in desnega prijema. zaključek: rezultati raziskave navajajo priporočilo trenerjem, da se pri treningu tehnike prijema čim manj poslužujejo vseh konfiguracij prijema razen kenka-yotsu in ai-yotsu. še zlasti to velja za neortodoksne vrste prijemov, kot so nasprotni prijem in levi oz. desni prijem. ključne besede: kumi kata, tehnično-taktična analiza, izvedbena analiza, borilni športi introduction a continuous search for improvement made a significant change in judo rules in the last decade. aiming to promote more attacking style and improve audience understanding of the fight, international judo federation introduced a set of new rules in a short time period (boguszewski, 2011; franchini, takito, & calmet, 2013; ito et al., 2013; calmet, pierantozzi, sterkowicz, challis, & franchini, 2017). including blue and white judogi, excluding the smallest point koka, adding and changing the rules of the fight in the situation of an equal score at the end of the regular time of the fight – it was all a prelude to the most significant rule change in the history of the sport. in 2009, ijf limited direct contact of the attacker’s hand below the belt of the opponent (allowed only in counter-attack or as a second part of the combination of techniques). first in 2013, all techniques that include leg grab were completely banned (franchini, takito & calmet, 2013). this is highly important because the execution of some of the most 5 annales kinesiologiae • 10 • 2019 • 1 nemanja stanković, nikola milošević, mladen živković: the impact of the 2013 rule changes on gripping ..., 3–13 efficient techniques (te guruma, kata guruma, kuchiki taoshi, morote gari) include grabbing the leg of the opponent (miarka, ferreira julio, del vecchio, calmet, & franchini, 2010). secondly, they reduced the importance of penalties in favor of attacking scores. thirdly, kumikata fighting (grip fighting) was totally altered by forbidding the competitors to break grip with both hands simultaneously. also, they demand from the judokas to attack “immediately” in the situations where they are having any other grip that is different from the classic judo grip. for both of the above-mentioned infringements, judokas will be penalized with shido (international judo federation ‒ ijf, 2013). these are sport-changing modifications since grip fighting phase makes up a large part of the total combat time (barreto et al., 2019) and having a dominant grip is one of the most important factors for the positive outcome of the combat (kajmovic, rađo, mekic, crnogorac & colakhodzic, 2014). the players who are able to establish their grip during the fight have more chances to apply their throwing technique or to enforce a penalty to their opponent by making them passive. grip fighting is also an important factor that distinguishes elite judokas from average and it is documented that it is different in relation to sex, age, weight and judokas’ proficiency (calmet, miarka & franchini, 2010; miarka et al., 2012, miarka et al., 2014; miarka, sterkowicz-przybycien & fukuda, 2017; barreto et al., 2019; dal bello, aedo-muñoz, brito, & miarka, 2019). ijf assumed that changing the kumikata rules will shorten the grip fight and force the judokas to spend more time in firm contact, which is necessary to perform a throw. influence of the rule modifications was investigated in the terms of scores and penalties, match duration and the efficiency of judo techniques (adam et al., 2012; franchini, takito & calmet, 2013; calmet et al., 2017; calmet, pierantozzi, sterkowicz, takito, & franchini, 2017). there is scarce evidence about the impact made to gripping strategy used in combat. therefore, the aim of this research is to determine how the rule modification influences the gripping configurations used by elite male judo athletes. we hypothesised that the rule modification will influence gripping configurations in elite male judo athletes. methods sample the sample contained 280 fights from two world championships (2011 paris world championships and 2014 chelyabinsk world championships). to ensure the elite characteristic of the sample, preliminary rounds of the tournament were excluded. final, bronze medal matches, semi-finals, repechages, 1/4 and 1/8 finals from each of the seven men weight divisions were analyzed. for a more detailed analysis, the categories were classified as light (-60kg and -66kg), middle (73kg, -81kg and -90kg) and heavy (-100kg and +100kg) according to a previous classification made elsewhere (escobarmolina, courel, franchini, femia, & stankovic, 2014; stankovic, cuk, milosevic, & stamenkovic, 2015). 6 nemanja stanković, nikola milošević, mladen živković: the impact of the 2013 rule changes on gripping ..., 3–13 annales kinesiologiae • 10 • 2019 • 1 variable data effective actions that ended with a score announced by the referee and ineffective actions in which a contestant clearly unbalanced his adversary were included in the analysis. the observers’ task was to associate the appropriate grip configuration with every action that was registered. gripping variables were as follows: a) ai-yotsu (both athletes used the same grip – right or left); b) central grip (both athletes were gripping the sleeves or lapels at the same time); c) same side grip (the athlete attacking was using a classic lapel grip, but instead of holding the opposite sleeve, he was holding the sleeve on the same side of lapel grip); d) kenka-yotsu (each athlete was holding the opposite grip compared to the opponents grip (i.e., right versus left)); e) cross grip (the athlete attacking was having a classic sleeve grip, but instead of holding opposite lapel, he was holding the lapel on the same side of sleeve grip) and f) only one athlete (tori) was having a grip (the athlete attacking performed the grip and applied the technique before the opponent establishes his grip) (courel, franchini, femia, stankovic, & escobar-molina, 2014; stankovic et al., 2015). these grip configurations take into consideration the interaction between the fighters, instead of analyzing only the fighter who is performing the throw attempt. the ai-yotsu and kenka-yotsu grip explain clearly the relations between the judokas. cross grip, same side grip, and central grip are unorthodox gripping configurations that favor one of the athletes and the referee is obliged to stop the fight and award a penalty to an athlete that was holding this kind of grip for more than five seconds without initiating an attack. there were also situations where the attack was initiated before the opponent was able to establish his grip. procedures all videos included were provided by the international judo federation via their official dartfish.tv – channel. landscape view of the entire competition area and video quality (standard definition 480/60i) provided the necessary ecological validity of the sample. the free computer version of lince 1.2.1 software, flexible digital recording software that enables data exportation, was used to collect data (gabin, camerino, anguera & castañer, 2012). reliability testing two experts with more than 25 years of judo experience, at least 4th dan-degree black belt and phd in sports science conducted the analysis. the reliability measures were assessed through intra-observer and inter-observer testing procedures. the following kappa values and strength of agreement classifications were used: 0.0 to 0.2, poor; 0.21 to 0.40, fair; 0.41 to 0.60, moderate; 0.61 to 0.80, substantial; 0.81 to 1.00, almost perfect (hopkins, 2000). the index and classification of kappa values for inter-expert 7 annales kinesiologiae • 10 • 2019 • 1 nemanja stanković, nikola milošević, mladen živković: the impact of the 2013 rule changes on gripping ..., 3–13 (0.74) and intra-expert (0.88 and 0.91) measurements were classified as “strong” and “almost perfect”. statistical analysis to determine the difference between the two world championships, the chi-square test at the level of statistical significance of 0,05% with contingency tables to determine the difference between frequencies was used, along with the z-test for calculating the partial difference between each variable that was analyzed. data were analyzed using the ibm spss 20.0. results a total of 280 matches were analyzed, from which 1707 actions were extracted (6.1 per match). number of actions per match increased from 5.4 in 2011 to 6.8 in 2014. the difference in the gripping configurations applied between the two world championships was determined by the χ2 test (table 1). a test result of sig <0.001 indicates that there are statistically significant differences in the gripping configurations used. table 1. chi-square test for gripping configurations observed at two championships. a iy o t su c e n t r a l g r ip sa m e s id e g ir p k e n k a -y o t su c r o ss g r ip t o r i g r ip s total 2011 183 (24,11%) 78 (10,28%) 37 (4,87%) 288 (37,94%) 85 (11,2%) 88 (11,59%) 759 2014 257 (27,11%) 81 (8,54%) 47 (4,96%) 436 (45,99%) 51 (5,38%) 76 (8,02%) 948 total 440 159 84 724 136 164 1707 χ2=32,8; sig<0,001 8 nemanja stanković, nikola milošević, mladen živković: the impact of the 2013 rule changes on gripping ..., 3–13 annales kinesiologiae • 10 • 2019 • 1 to determine which gripping configurations contributed to the differences between the two samples, a z-test was performed for the proportions of the two independent samples. based on the results obtained, it can be concluded that the ai yotsu and kenka-yotsu configurations were more prevalent in 2014, and the central grip, cross grip and tori grips were more used in 2011. table 2. z-test for gripping configurations observed at two championships. 2011 2014 z sig ai-yotsu 183 (24,11%) 257 (27,11%) -2.77 0,006 central grip 78 (10,28%) 81 (8,54%) 4.01 <0.001 same side grip 37 (4,87%) 47 (4,96%) -0.35 0.723 kenka-yotsu 288 (37,94%) 436 (45,99%) -5.11 <0.001 cross grip 85 (11,2%) 51 (5,38%) 15.63 <0.001 tori grips 88 (11,59%) 76 (8,02%) 8.04 <0.001 by using the χ2 test we found a statistically significant difference when comparing two championships separately by each weight category (p<0.05%). to determine which gripping configurations contributed to the differences between the two samples, the z-test was performed. in table 3 the difference between the two championships by weight category was presented. 9 annales kinesiologiae • 10 • 2019 • 1 nemanja stanković, nikola milošević, mladen živković: the impact of the 2013 rule changes on gripping ..., 3–13 table 3. z-test for gripping configurations observed at two championships by weight division. l ig h t w e ig h t (60 ,66 ) m id d l e w e ig h t (73 ,81 , 90 ) h e av y w e ig h t (10 0, + 10 0) 2011-2014 (total) ai-yotsu ↔ (p=0,682) ↑ (p<0.001) ↑ (p=0.003) ↑ central grip ↔ (p=0,922) ↓ (p<0.001) ↔ (p=0.633) ↓ same side grip ↑ (p=0.036) ↑ (p=0.003) ↓ (p<0.001) ↔ kenka-yotsu ↑ (p<0.001) ↔ (p=0,112) ↑ (p=0.017) ↑ cross grip ↓ (p<0.001) ↓ (p<0.001) ↓ (p<0.001) ↓ tori grips ↓ (p<0.001) ↔ (p=0.335) ↓ (p<0.001) ↓ ↔ there is no statistical difference between the two championships; ↑ there is a statistically significant increase in the usage of kumikata; ↓ there is a statistically significant decrease in the usage of kumikata. discussion the aim of the present study is was to determine how the rule modification influences the gripping configurations used by elite male judo athletes. a total of 1707 gripping configurations connected to the throwing attempt were registered in a sample of 280 fights, with 6.1 throwing attempts per match on average. a similar number of fights (242) and throwing attempts (1462) were analyzed in studies conducted by courel et al. (2014) and escobar-molina et al. (2014), noting that their sample consisted of both male and female combats. on average, in these two studies, there was the same number of throw attempts per match (6.0 vs. 6.1). a similar result (7.0) was reported on the sample of international championship matches held during 2011 and 2012, while there were significantly more throwing attempts per combat (9.0) registered at the 2012 olympics (miarka et al., 2016). the dominant configurations in both championships 10 nemanja stanković, nikola milošević, mladen živković: the impact of the 2013 rule changes on gripping ..., 3–13 annales kinesiologiae • 10 • 2019 • 1 were kenka yotsu, followed by ai yotsu. while using kenka-yotsu, athletes are typically in an asymmetrical position which increases their chance to score (mayo, dopico-calvo, & iglesias-soler, 2019) while not compromising the defense (courel et al., 2014). in seniors, the same conclusion was reached by courel et al. (2014), while in two other studies ai yotsu was the dominant gripping configuration (kajmovic & radjo, 2014; kajmovic, et al., 2014). a possible explanation is a different sample used in the terms of the level of competition (national vs. elite) and different age categories (cadet vs. senior) when compared to our sample. as expected, new gripping rules have increased the difficulty of breaking the grip, leading to a significant increase of grip configurations where tori and uke have a strong connection (kenka-yotsu and ai-yotsu). consequently, a shorter time period judokas spent separated led to a significant decrease in the situations where only one judoka (tori) had a grip. these trends were clearly visible even when the sample was divided by weight category on light, middle and heavyweight. international judo federation wanted to discourage the use of any unorthodox gripping that will give a clear attacking or defensive advantage to one of the contestants. to avoid a potential penalty, they demand from the judokas to attack “immediately” in the situations where they are having any other grip than the classic judo grip. the result is a significant decrease in the usage of cross grip. the decrease is observed in the whole sample, but also when analyzing by weight category. the use of the central grip decreased significantly. since central grip configuration is a defensive grip, used to block the opponent’s attacks rather than to produce our own, the registered decrease can be characterized as a positive outcome of the rule changes. we hypothesize that the absence of significant differences in the usage of same side grip was due to a modification of one of the most utilized judo techniques − kata guruma (miarka et al., 2010; witkowski, maśliński, & kotwica, 2012). the classic kata guruma is performed by grabbing the opponent’s leg, which was previously allowed. now, judokas avoid breaking new rules while applying kata guruma by grabbing the sleeve instead of the leg of the opponent (ito et al. 2013). the significant increase of the same side grip was observed in light and middleweight categories, while there was a decrease in heavyweight. kata guruma is rarely used by heavyweights since for executing the technique one needs to hold complete weight of the opponent on the shoulders. the present results demonstrated the differences in the usage of gripping configurations before and after the rule change. the fact that ai yotsu and kenka yotsu combined for 73% of all grip configurations used in 2014 (vs. 62% in 2011) further highlights the importance of the firm connection between the judokas during the execution of the throw. by shortening the allowed time to use unorthodox grips, the usage of these grips during the attacking actions was reduced significantly (from 16% in 2011 to 10% in 2014). 11 annales kinesiologiae • 10 • 2019 • 1 nemanja stanković, nikola milošević, mladen živković: the impact of the 2013 rule changes on gripping ..., 3–13 conclusion the current research aimed to compare gripping configurations used in two world championships. summarizing the results it can be stated that the aimed outcomes of the gripping rule modification have been achieved. by making it harder to break the grip of the opponent, judokas were forced to use the gripping configurations that include a firm relationship with their adversary, thus providing more attacking attempts per combat. the recommendation for coaches is to significantly reduce the use of all other gripping configurations when practicing techniques, especially unorthodox gripping like cross grip and same side grip. these findings will help coaches build adequate training regimes in order to improve their competitors’ technical and tactical skills that are necessary for competing at the highest level of competition. references adam, m., tabakov, s., klimowicz, p., paczoska, b., laskowski, r., & smaruj, m. 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(2016). time-motion and tactical analysis of olympic judo fighters. international journal of performance analysis in sport, 16(1), 133–142. https://doi.org/10.1080/247486 68.2016.11868876. https://doi.org/10.1080/24748668.2014.11868770 https://doi.org/10.1080/24748668.2013.11868663 https://doi.org/10.1080/24748668.2013.11868663 https://doi.org/10.1016/j.sbspro.2012.06.320 https://doi.org/10.2165/00007256-200030010-00001 http://www.ijf.org/ http://archbudo.com/view/abstract/id/10557 http://archbudo.com/view/abstract/id/10509 https://doi.org/10.1080/24748668.2014.11868747 https://doi.org/10.3390/sports7020042 https://doi.org/10.18002/rama.v5i1.139 https://doi.org/10.1080/02640414.2012.679675 https://doi.org/10.1080/02640414.2012.679675 https://doi.org/10.1080/02640414.2014.903335 https://doi.org/10.1080/02640414.2014.903335 https://doi.org/10.1080/24748668.2016.11868876 https://doi.org/10.1080/24748668.2016.11868876 13 annales kinesiologiae • 10 • 2019 • 1 nemanja stanković, nikola milošević, mladen živković: the impact of the 2013 rule changes on gripping ..., 3–13 miarka, b., sterkowicz-przybycien, k., & fukuda, d. h. (2017). evaluation of sexspecific movement patterns in judo using probabilistic neural networks. motor control, 21(4), 390-412. https://doi.org/10.1123/mc.2016-0007. stanković, n., cuk, s., milosevic, n., & stamenkovic, s. (2015). the course of the judo fight at the 2011 world championship. facta universitatis-series: physical education and sport, 13(1), 107-113. retrieved from http://casopisi.junis.ni.ac.rs/index.php/fuphysedsport/article/view/838. witkowski, k., maśliński, j., & kotwica, t. (2012). analysis of fighting actions of judo competitors on the basis of the men’s tournament during the 2008 olympic games in bejing. journal of combat sports and martial arts, 2(2), 121-129. https://doi. org/10.5604/20815735.1047659. https://doi.org/10.1123/mc.2016-0007 http://casopisi.junis.ni.ac.rs/index.php/fuphysedsport/article/view/838 http://casopisi.junis.ni.ac.rs/index.php/fuphysedsport/article/view/838 _goback _hlk3367923 _goback _goback _goback _hlk3056869 _goback _goback _hlk23766418 _goback _hlk26527070 _goback _goback annales kinesiologiae • 7 • 2016 • 1 21 original scientific article udc: 612.741:796.012.13 received: 2016-04-18 lower correlation between biceps femoris contraction time and maximal running speed in children than in adults: a longitudinal study in 9to 14-year old children* jernej završnik1, rado pišot2, tadeja volmut2, katja koren2, helena blažun vošner3, peter kokol4, janez vošner4, boštjan šimunič2 1dr. adolf drolc healthcare center, maribor, slovenia 2university of primorska, science and research centre, institute for kinesiology research, koper, slovenia 3university of maribor, faculty of health sciences, center for international cooperation, maribor, slovenia 4university of maribor, faculty of electrical engineering and computer sciences, maribor slovenia corresponding author: boštjan šimunič university of primorska, science and research centre, institute for kinesiology research garibaldijeva 1, 6000 koper, slovenia phone: +386 31 832 016 e-mail: bostjan.simunic@zrs.upr.si abstract biceps femoris is a major propulsor muscle in sprinting and its contraction time negatively correlates to the running speeds of adults. our aim was to compare ageand gender-related correlations between vastus lateralis and biceps femoris contraction times and running speeds during a longitudinal study of 9to 14-year old children. on a yearly basis, we conducted vastus lateralis and biceps femoris tensiomyographic measurements of muscle contraction time and maximal running speeds measured during 7-metre sprints with flying starts using photocells in 107 children (of which 53 boys). vastus lateralis contraction time was not correlated with the running speed. however, biceps femoris contraction time was negatively correlated with the running speed only in boys after the age of 12.9 years (pearson r ranges from -0.391 to -0.426; p < * the paper has been previously published in the hijacked journal wulfenia (vol. 22(1): pp. 233–252, january 2015). the editor has been notified and he fully agrees with the publication in annales kinesiologiae. the paper has been modified, double-blind peer reviewed and only then accepted for publication. 22 jernej završnik, rado pišot, tadeja volmut, katja koren, helena blažun vošner, peter kokol, janez vošner, boštjan šimunič, 21–42 annales kinesiologiae • 7 • 2016 • 1 0.002). it was concluded that biceps femoris contraction time is far less correlated with running speed than in adult athletes (pearson r = -0.60); however, the correlation is genderand age-specific. it seems that the knee flexor and hip extensor, biceps femoris, is not as yet the major determinant of running speed in 9to 14-year old children at that age. keywords: skeletal muscle, biceps femoris, vastus lateralis, tensiomyography, pediatrics. korelacija med časom krčenja mišice biceps femoris in hitrostjo šprinta je pri otrocih nižja kot pri odraslih: longitudinalna študija 9do 14-letnih otrok izvleček skeletna mišica biceps femoris je pomembna za propulzijo v fazi odriva med tekom in vemo, da je njen čas krčenja negativno povezan z maksimalno hitrostjo teka pri odraslih moških. zato smo si za cilj zastavili, da preverimo povezavo med časom krčenja mišic vastus lateralis in biceps femoris pri otrocih, glede na spol in starost. v longitudinalni 5-letni študiji smo spremljali 107 otrok (53 dečkov) s periodično letnimi meritvami telesnih značilnosti, maksimalne hitrosti teka in kontraktilnih lastnosti omenjenih mišic z uporabo tenziomiografije. otroci so bili na začetku stari 9 let in na koncu 14 let. ugotovili smo, da čas krčenja mišice vastus lateralis ni povezan z maksimalno hitrostjo teka. medtem, ko je bil čas krčenja mišice biceps femoris negativno povezan z maksimalno hitrostjo teka, a le pri dečkih po 12.9 letu starosti (pearsonov r med -0.391 in -0.426; p < 0.002). zaključimo lahko, da je čas krčenja mišice biceps femoris bistveno manj povezan z maksimalno hitrostjo teka pri otrocih, kot pri odraslih (pearsonov r = -0.60). sklepamo lahko, da mišica biceps femoris pri tej starosti otrok še ni poglaviten dejavnik maksimalne hitrosti teka. ključne besede: skeletna mišica, biceps femoris, vastus lateralis, tenziomiografija, pediatrija annales kinesiologiae • 7 • 2016 • 1 23 jernej završnik, rado pišot, tadeja volmut, katja koren, helena blažun vošner, peter kokol, janez vošner, boštjan šimunič, 21–42 introduction nowadays, we are faced with fast lifestyle as a society, which influences individuals’ health, social, cultural, and physical statuses. children are one of the more vulnerable groups within a society. therefore, we should pay special attention to their development. childhood is a very sensitive period and is, in general, characterized by various dynamic changes in physiological and psychological development, as well as the establishment of healthy or unhealthy behaviour (faigenbaum & myer, 2012). as a result of global health trends, there is a growing interest in children’s physical exercise; and, thus, consequently in their body growth and development. tensiomyography (tmg) is a non-invasive tool for the assessment of skeletal muscle contractile properties (valenčič & knez, 1997) which are related to muscle composition (dahmane, valenčič, knez, & eržen, 2001; šimunič et al., 2011). rodríguez ruiz, et al. (2011) performed a study amongst 84 males who were divided into four age groups; teenagers, undergraduate students, adults and the elderly, and discovered a decline in vm (tensiomyographicaly determined normalized muscle twitch response velocity, contraction time / amplitude of radial displacement) in the vastus lateralis in relation to age. in contrast, vm values in biceps femoris (bf) did not change between age groups; although, the value was slightly reduced in the older age group. furthermore, the researchers noted that changes in muscle composition are associated with the physical activity levels of individuals and, therefore, the changes in muscle response may not only depend on age but also on the amounts and types of physical activity (rodríguez ruiz et al. 2011). there is great interest in muscle composition; however, it is more than evident that the invasiveness of the approach used in this research field is the main drawback for obtaining data on muscle composition as a representative sample. further, the more common muscle to be observed by its composition is the vastus lateralis. additionally, there is also a huge interest in other muscles that are even more important in childhood for children’s health, posture, and motor development. however, sample sizes are rather small and longitudinal studies are very rare. valenčič and knez (1997) proposed a non-invasive and selective tmg where several tmg contractile parameters were defined (valenčič & knez, 1997), and where contraction time was later correlated to a proportion of slow-twitch muscle fibers within skeletal muscle (dahmane et al., 2001; dahmane, djordjević, šimunič, & valenčič, 2005; šimunič et al. 2011). the tmg contractile parameters were found to be highly reliable (icc r > 0.85; šimunič, 2012). oliver, lloyd, and rumpf (2013) claimed that sprinting speed is one of the distinguishing indicators of successful motor performance in children and is developed throughout childhood and adolescence, as children grow and mature. indeed, a failure to master sprinting may be an enormous barrier preventing children from gaining more complex physical activity skills. these authors also suggest that speed during this period is developed in a nonlinear manner due to the large maturational influence associated with increases in limb lengths, increased muscle mass, and changes in intrinsic muscle-tendon properties. additionally, gender differences in speed development become 24 jernej završnik, rado pišot, tadeja volmut, katja koren, helena blažun vošner, peter kokol, janez vošner, boštjan šimunič, 21–42 annales kinesiologiae • 7 • 2016 • 1 apparent at the onset of puberty, with girls making limited gains in speed throughout adolescence, contrary to boys for whom large gains in speed could be observed. these authors also noted paucity of research studies on speed and muscle development for the above pediatric population (oliver et al., 2013). therefore, we aimed at analysing the correlation between vastus lateralis and biceps femoris contraction time with maximal running speed and, furthermore, at establishing how contraction times of both abovementioned muscles are related to standard anthropometric measures (body height and mass, rohr index) at different ages and sexes. methods participants recruitment of participants started in september 2001 in three different slovenian regions: ljubljana region, maribor region, and the primorska region. primary schools in these regions were randomly selected. therefore, the participants come from five different slovenian towns (table 1), two of which are major cities covering central and northeast slovenia, and three small towns covering the coastal region. in this way, we ensured that the sample covered the whole of slovenia. table 1. selection of regions, primary schools and towns included in the 5-year longitudinal study. city primary school town ljubljana region tone čufar ljubljana valentin vodnik ljubljana dr. vito kraigher ljubljana maribor region prežihov voranc maribor slava klavora maribor tone čufar maribor primorska region anton ukmar koper vojka šmuc izola ciril kosmač piran annales kinesiologiae • 7 • 2016 • 1 25 jernej završnik, rado pišot, tadeja volmut, katja koren, helena blažun vošner, peter kokol, janez vošner, boštjan šimunič, 21–42 researchers organized short workshops for the school head teachers, physical education teachers, the children, and their parents, with the aim of presenting the purpose and the aims of the research study, the research design, to present the measurement protocols and tools, and to invite potential participants. throughout the workshop execution, the researchers were available for answering any questions which might occur during the session in order to clarify any dilemmas regarding the study. in regard to the recruitment process, 300 children in total were selected (100 children from each region), of which 265 children participated in the baseline study (138 boys, 127 girls). in the first follow-up study, 263 children (125 boys, 138 girls) participated, in the second follow-up study 252 children (127 boys, 125 girls), in the third follow-up study 179 children (98 boys, 81 girls), in the fourth follow-up study 175 children (98 boys, 77 girls), and in the last, the fifth follow-up study, there were 176 children (96 boys, 80 girls). to summarize, 107 children (53 boys, 54 girls) (initial measurement average age 9.1 ± 0.5 years) who had completed all six longitudinal measurements were selected for the analysis. at the baseline, the study participants attended the third grade of primary school and at the last follow-up study they attended the eighth grade. the selection process was performed by researchers with the support of teachers in a manner which prevented any possible bias (i.e. gender, geographical distribution, anthropometrical characteristics). however, children eligible to participate in this study had to be in good health. none of the children had had any history of neuromuscular disorders or muscle diseases. during the recruitment process and before carrying out any research study at the baseline or follow-ups, the participants and their parents were informed that any participation in the study was strictly on voluntary basis. additionally, they were informed that the participants could withdraw from the study at any time and for any reason, and that the collected data would only be used for the research purposes. therefore, the parents of the children gave their written consent for them to participate in the study. moreover, all procedures conformed to the 1964 declaration of helsinki and were approved by the national medical ethics committee of the republic of slovenia. the organizational settings of the conducted longitudinal study were the same within all three regions. procedures the 5-year-long research was conducted once per school year from 2001 till 2006, and it included single-point quantitative research studies and the following measurements of: – anthropometrical characteristics; – contractile properties of skeletal muscles; and – running speed. 26 jernej završnik, rado pišot, tadeja volmut, katja koren, helena blažun vošner, peter kokol, janez vošner, boštjan šimunič, 21–42 annales kinesiologiae • 7 • 2016 • 1 measurements of anthropometrical characteristics participants’ body masses and heights were measured by using standard tools. the body mass was measured to an accuracy of 0.1 kilograms, while the height was measured to an accuracy of 0.5 centimetres. all participants were barefoot and wearing their sportswear during the measurements. on the basis of the measured variables, each body mass index (rohr’s index) was calculated. rohr’s anthropometric index is a statistical data, which combines a participant’s height and mass into a metrical form. actually, both rohr’s as well as the body mass index (bmi), serve the purpose of classifying individuals into categories of underweight, normal, and obese. bmi measurement projects a two-dimensional square state by measuring the mass per square unit of surface area, while rohr’s index assumes that the body is a three-dimensional cube and, therefore, measures the mass per cubic unit of volume. rohr’s index takes into account both the width and circumference, unlike bmi which projects that the breadth and scope of an individual is proportional to his / her height. rohr’s index was, therefore, chosen as a better indicator of the children’s and adolescents’ nutritional statuses (foster, voors, webber, frerichs, & berenson, 1977; kokol et al., 1992; omura, zinno, harada, & inoue, 1993; freedman & perry, 2000). the measurements of anthropometrical characteristics were performed on three sport science students. measurements of contractile properties of skeletal muscles the contractile properties of their skeletal muscles were measured using the tmg method. tmg detects radial displacement of the skeletal muscle belly during maximal isometric twitch contraction (valenčič, 1990), and has been developed in the laboratory for skeletal muscles and biomedical imaging (lbm) at the faculty of electrical engineering, university of ljubljana, slovenia. measurements were performed on two muscles vastus lateralis and biceps femoris of leg-dominant sites. measurements on the vastus lateralis were performed in supine positions at knee angles set at 30° knee flexion, where 0° represents the extended joint. measurements on the biceps femoris were performed in prone positions at a knee angles set at 5° knee flexion. a measured muscle was in a relaxed predefined position and muscle contraction was evoked by brief electrical stimulus. to this end, we used a pair of self-adhesive stimulation electrodes (axelgaard, pals) within this study with a diameter of 50 millimetres. the muscle was measured in a bipolar way in that we installed the negative electrode (cathode) 5 cm distal, and the positive electrode (anode) 5 cm proximal to the measurement point. the measuring point was selected at a place where the belly muscle was the largest and additionally ensured that the selected place was between the two electrodes. in doing so, we used the experimental measurements, palpation and re-installing the electrodes and sensors if needed. due to the fact that each muscle has its own specific anatomic structure, we had to make adjustments according to the locations of the measuring equipment. the sensor was set perpendicular to the skin overlying the muscle belly: in vastus lateralis at 30 % of the femur length above the patella on the lateral side; in biceps femoris at the midpoint of the line between the fibula head and the ischial annales kinesiologiae • 7 • 2016 • 1 27 jernej završnik, rado pišot, tadeja volmut, katja koren, helena blažun vošner, peter kokol, janez vošner, boštjan šimunič, 21–42 tuberosity. in order to elicit twitch contraction, we used a single one-millisecond pulse applied through the cathode and the anode. the stimulation current at the start was just above the contraction threshold and then it was gradually increased until the response amplitude did not increase any further. two maximal twitch responses were recorded and saved. the maximal displacement amplitude and the contraction times were calculated from each twitch response, as proposed by valenčič (1990) and valenčič and knez (1997). maximal displacement amplitude (dm, in millimeters) was defined as the peak amplitude on the displacement-time curve of the tmg twitch response. the contraction time (tc, in milliseconds) was the time from 10 % to 90 % of dm being reached. the average value of these parameters, extracted from two twitch responses, was used for further analysis. tmg measurements were performed by an expert from the field of electrical engineering and computer science, four physical education teachers, and five undergraduate sport sciences students. the measurements were supervised by a medical doctor. measurement of the running speed prior to testing the maximal running speed, all the children were appropriately warmed up, which lasted approximately 20 minutes. the warm-up process was composed of running (5 minutes), stretching (5 minutes), and warm-up running practices (10 minutes). the children’s warming-up process was always conducted by the same person and by using the same procedure. each participant had the opportunity of two experimental sprints. maximal running speed was measured at a distance of 7 meters from a flying start. during the measurement process, the participants performed preliminary runs, then followed the first photocell checkpoint, and after 7 meters the second photocell checkpoint. we divided up the running distance of 7 meters to include a sprint time from which we calculated the sprint speed. each participant repeated the sprint twice and the better result was used in the further analysis. maximum running speed was measured by using a wireless brower measurement system (brower timing systems ltd., usa). design and measures detailed description of all study procedures and design are presented in figure 1. we performed six repeated measurements of the children’s progress from the third to the eighth grade of their primary schools. every measurement was performed using the same procedure. a week before the study, each school was notified to follow a specific protocol prior to the measurement, namely, that all major physical or sport activities were discouraged two days before the measurement. all the recruited participants were invited to participate at each study / measurement. a detailed description of the recruitment and data collection is presented in figure 1. 28 jernej završnik, rado pišot, tadeja volmut, katja koren, helena blažun vošner, peter kokol, janez vošner, boštjan šimunič, 21–42 annales kinesiologiae • 7 • 2016 • 1 figure 1. flowchart of recruitment and data collection procedure annales kinesiologiae • 7 • 2016 • 1 29 jernej završnik, rado pišot, tadeja volmut, katja koren, helena blažun vošner, peter kokol, janez vošner, boštjan šimunič, 21–42 data analysis all data are expressed as means ± standard deviations. for all variables, the hypothesis of a normal distribution was tested and confirmed using visual inspection supported by d’agostino’s normality procedure and kolmogorov-smirnov test. morphologic growth was analyzed by 2-way rm anova, with age as a repeated measure and gender as a fixed group. for correlating vastus lateralis and biceps femoris tc with running speed, a pearson correlation coefficient was calculated. statistical significance was accepted at p<0.05 level. results background of the participants in all six-measurement points in total, 107 participants being included; their average age, body height and body mass is shown in table 2. table 2. longitudinal descriptive anthropometrical data of 53 boys and 54 girls at different age. age / years body height / cm p body mass / kg p rohr’s index / kg / m3 p boys girls boys girls boys girls 9.1±0.5 139.6±6.5 139.5±7.2 0.905 34.9±7.2 32.7±6.8 0.110 12.7±1.78 12.0±1.66 0.025 9.9±0.5 143.4±6.9 143.5±7.5 0.962 37.8±8.2 36.1±7.5 0.257 12.7±1.96 12.1±1.70 0.097 10.6±0.5 147.6±7.2 148.4±7.6 0.602 39.5±8.8 37.4±7.8 0.188 12.2±1.88 11.3±1.54 0.015 12.0±0.5 156.5±7.9 158.4±7.5 0.215 48.5±10.8 45.8±9.0 0.160 12.5±1.92 11.4±1.59 0.002 12.9±0.5 162.6±8.1 162.4±6.9 0.883 53.5±11.6 50.7±9.3 0.166 12.4±2.12 11.8±1.68 0.109 13.6±0.5 167.2±8.0 164.5±6.5 0.058 56.8±11.7 54.3±8.7 0.016 12.1±1.96 11.6±1.49 0.162 child anthropometrical growth could be classified as normal, following general trends. there was a significant age effect on body height (p<0.001), body mass (p<0.001) and rohr’s index (p<0.001) with a significant age × gender interaction effect on body height (p<0.001), body mass (p=0.028), and rohr’s index (p=0.026). 30 jernej završnik, rado pišot, tadeja volmut, katja koren, helena blažun vošner, peter kokol, janez vošner, boštjan šimunič, 21–42 annales kinesiologiae • 7 • 2016 • 1 vastus lateralis and biceps femoris tc and running speed correlation analysis in figure 2, a descriptive data for vastus lateralis and biceps femoris tc is presented, as well as for maximal running speed for both muscles and genders. in tables 3 and 4, a correlation analysis is presented for both muscles and genders. we found sex-related differences only after the age of 12.9 years in all three presented variables. furthermore, a longitudinal trend reveals that there was no significant correlation between running speed and vastus lateralis tc; however, significant negative correlation for biceps femoris tc and running speed could be confirmed in boys after the age of 12.9 years (figure 3). * p<0.05 between sexes figure 2: longitudinal descriptive analysis for vastus lateralis and biceps femoris contraction time (tc) and maximal running speed. annales kinesiologiae • 7 • 2016 • 1 31 jernej završnik, rado pišot, tadeja volmut, katja koren, helena blažun vošner, peter kokol, janez vošner, boštjan šimunič, 21–42 table 3. pearson correlation between vastus lateralis contraction time and running speed. boys girls age / years pearson r p pearson r p 9.1 ± 0.5 -0.048 0.367 -0.033 0.408 9.9 ± 0.5 -0.062 0.331 -0.053 0.352 10.6 ± 0.5 -0.118 0.201 -0.070 0.309 12.0 ± 0.5 -0.167 0.115 0.037 0.396 12.9 ± 0.5 -0.170 0.112 0.351 0.399 13.6 ± 0.5 -0.172 0.109 0.043 0.380 table 4. pearson correlation between biceps femoris contraction time and running speed. boys girls age / years pearson r p pearson r p 9.1 ± 0.5 0.118 0.200 0.130 0.175 9.9 ± 0.5 -0.021 0.441 -0.020 0.390 10.6 ± 0.5 -0.195 0.081 0.085 0.270 12.0 ± 0.5 -0.177 0.097 0.128 0.178 12.9 ± 0.5 -0.426 0.001 0.117 0.200 13.6 ± 0.5 -0.391 0.002 0.125 0.182 32 jernej završnik, rado pišot, tadeja volmut, katja koren, helena blažun vošner, peter kokol, janez vošner, boštjan šimunič, 21–42 annales kinesiologiae • 7 • 2016 • 1 figure 3: pearson correlation for biceps femoris contraction time (tc) and maximal running speed at age 12.9 (left) and 13.6 (right) years. correlation between body mass, height, rohr index, and tc of vastus lateralis and biceps femoris while the tmg measurement tool or running speed measurement equipment are not readily available to parents, average school sports teachers or sport club trainers, we decided to analyse how simple anthropometrical measures like mass, height and rohr’s index are correlated to tc of vastus lateralis and biceps femoris muscles to enable them to have some indicators for predicting the muscle developments and sport talents of young adolescents. table 5 presents the correlations between body mass, height, and the rohr index and the tc of biceps femoris and vastus lateralis muscles for all six measurement points (baseline and 5 follow-up studies). it is evident, that the correlations between the contraction times of the vastus lateralis muscle and the anthropometrical measurements is more frequent than for the bl muscle. to be precise, at least one anthropometrical measurement correlated with the contraction time of the vastus lateralis muscle for the 4th till 6th measurement points. on the contrary, the biceps femoris muscles contraction times are more correlated with anthropometrical measures annales kinesiologiae • 7 • 2016 • 1 33 jernej završnik, rado pišot, tadeja volmut, katja koren, helena blažun vošner, peter kokol, janez vošner, boštjan šimunič, 21–42 at the baseline and the first and the second follow-up compared to the third, the fourth and the fifth follow-up studies. table 5. significant correlations between body mass, height, rohr index, and contraction time of biceps femoris (bf) and vastus lateralis (vl) muscles. a v e r a g e age / years 9.1 ± 0.5 9.9 ± 0.5 10.6 ± 0.5 12.0 ± 0.5 12.9 ± 0.5 13.6 ± 0.5 anthropometrical measurements 9.1 ± 0.5 body mass -bf +vl +vl +vl body height +vl +vl +vl rohr index -bf -bf 9.9 ± 0.5 body mass +vl +vl +vl body height +vl +vl +vl rohr index -bf -bf -bf 10.6 ± 0.5 body mass +vl +vl +vl body height +vl +vl +vl +vl rohr index -bf -bf -bf 12.0 ± 0.5 body mass +vl +vl +vl body height +vl +vl +vl rohr index -bf -bf 12.9 ± 0.5 body mass -bf -bf +vl -bf, +vl body height +vl +vl +vl +vl rohr index -bf -bf 13.6 ± 0.5 body mass -bf +vl +vl +vl -bf, +vl body height +vl +vl +vl +vl +vl rohr index -bf -bf -bf 34 jernej završnik, rado pišot, tadeja volmut, katja koren, helena blažun vošner, peter kokol, janez vošner, boštjan šimunič, 21–42 annales kinesiologiae • 7 • 2016 • 1 interestingly, the rohr’s index is obviously a better predictor of contraction times for biceps femoris muscles compared to mass and height, indeed, it only correlates with biceps femoris muscles and not in any instance to vastus lateralis muscles. on the other hand, the height is a better predictor for the vastus lateralis muscle contraction time than the mass. discussion our longitudinal study contributed with an insight into children’s skeletal muscle development, focusing on skeletal muscle composition. using a non-invasive tmg, we assessed muscle composition related to the contractile parameter (tc) in two skeletal muscles. although there were initially 263 children included in the study, representative subsamples of 107 children (42 %) were present in all six measurements. tmg assessment requires electrical stimulus to evoke muscle contraction and some of the children found this as being less appropriate for them and so they were not forced to cooperate during the measurement. this was also the main reason for not performing the tmg assessment. other reasons were illness or injury, absence from school, changing schools, etc. skeletal muscle composition is very difficult, if not even ethically impossible, to measure in healthy children. therefore, using a non-invasive approach we presented ageand gender-related longitudinal trends in tc in the two skeletal muscles. there are numerous data about vastus lateralis composition in adults but only few in children (bell, macdougal, billeter, & howald, 1980) and in adolescents (glenmark, hedberg, & jansson, 1992). johnson, polgar, weightman, and appleton (1973) reported 37.8 % and 46.9 % at muscle surface and deep site, respectively. in a longitudinal study, glenmark et al. (1992) found different developments of fibre type composition with increased age from 16 to 27 in women and men: the type i percentage tended to increase in the women from 51 % to 55 % and decrease significantly in the men from 55 % to 48 %. fibre cross-sectional areas remained unchanged in both genders. they suggested gender-related fibre type 1 adapted during increased age. in children, bell et al. (1980) found 58.8 % type1 fibers and concluded that the distribution patterns and ultra-structures of skeletal muscles in six-year-old children was not different from normal adult tissues. however, this study showed no correlation between vastus lateralis contraction time and running speed in both sexes at any age, which is rather logical since the fact that vastus lateralis muscle is not the most important muscle for maximal running speed (praprotnik, valenčič, čoh, & šimunič, 2002). however, from this study we also found positive proportional correlations between the contraction time of the vastus lateralis muscle and anthropometrical measurements (i.e. body mass, body height) in children older than 12.0 ± 0.5 years; meaning that heavier and taller participants have shorter contraction times for the vastus lateralis muscle. annales kinesiologiae • 7 • 2016 • 1 35 jernej završnik, rado pišot, tadeja volmut, katja koren, helena blažun vošner, peter kokol, janez vošner, boštjan šimunič, 21–42 vastus lateralis muscle in the lateral muscle of the knee extensors on the dominant side, we found that the contraction time changes with age, in boys faster than in girls. in boys, according to the third grade results (at the baseline) we found significantly lower contraction times in the fourth and the fifth grades, while in girls we measured significantly lower contraction times in the sixth and the seventh grades. a short contraction time means that the muscle is faster in younger boys than in girls. differences between correlations according to sex showed significant deviations; meaning that the girls in the seventh and eighth grade had shorter contraction times, due to the fact that their outer knee extensor muscles on the dominant side were faster during this period of time. vastus lateralis muscle is an anti-gravitational muscle and as such receives a lot of mechanical stimuli for its adaptation − hypertrophy. shorter contraction times in the fourth and the fifth grades were witnesses to increasing in physiological cross-section of the rapid muscle fibres, which may be the answer to the intense movement triggered by muscles in the legs. however, the subsequent extension of tc does not confirm the long age-range. one of the possible causes for an extension of the period tc in the 6th grade can be with age and physical habits associated with an increase of the pennation angle of the muscle fibres and, thus, less effective transfer of forces to the tendons or bone. in the more pennant muscles, the forces are transferred slower to the attachment of the bone. we assume also that the cause of the extension of tc in the period from the 6th to 8th grades could be a less active lifestyle at this age. differences in girls during this period of age could be explained by developmental delay, which is also identified in the speed of sprint. biceps femoris muscle analysis of the biceps femoris muscles on the dominant side of the body showed that the times of contractions varied with the ages of the children. however, post hoc analysis did not show significant variations in the boys belonging to the third grade. the girls belonging to the third grade did have significant longer contraction times in the fifth, sixth, seventh and eighth grades. analysis by sex showed significant deviations, namely that the girls had longer contraction times in the seventh and eighth grades, which means that girls compared with boys have slower biceps femoris during the second half of elementary school. biceps femoris is not an anti-gravitational muscle and, therefore, there has little everyday mechanical stimuli. this alone can explain the longer tc versus vastus lateralis muscle. it is interesting that the tc observed in girls extends through this period, while in boys only to the sixth grade and then it decreases again. this finding coincides with the kind of changes in muscle biceps femoris, which can be confirmed by the characteristics of the life-style, since boys use their legs more from a certain age, while the girls use their hands more. the biceps femoris muscle is used mainly 36 jernej završnik, rado pišot, tadeja volmut, katja koren, helena blažun vošner, peter kokol, janez vošner, boštjan šimunič, 21–42 annales kinesiologiae • 7 • 2016 • 1 during various high-speed runs, changing directions, jumps, the trends of which are more typical of boys. the relation between the contractile properties of the vastus lateralis and biceps femoris skeletal muscles and the maximum running speed in order to see the connection between the contractile properties of the skeletal muscle and the maximal running speed, we first present the development of the maximal running speeds and the contraction times of the vastus lateralis and the biceps femoris, by age: – maximal running speed of the boys over the whole measurement period grew, while for the girls it only grew up to the seventh grade; – the contraction times of the vastus lateralis first declined to the fourth grade and later went upwards, significantly more in boys than in girls; – the contraction times of the biceps femoral increased over the whole measurement period. analysis of the results showed that there was a significant negative correlation between the maximal running speeds and the contraction times of the biceps femoris in boys. this relationship was characterized only from the sixth to the eighth grade and amounted to between -0.21 and -0.29. regression analysis of the variance showed that the correlation was relatively low, as it was represented by only 8.4 % of the explained variance. as for the girls, the correlation was not determined during any of the measurement period. there was also no evidence found of any correlation between the maximal running speeds and the contraction times of the vastus lateralis, neither in boys nor in girls. a negative correlation was found confirming that there was a significant correlation between the biceps femoris and the maximum running speed. it is known that the period between the ages 6 to 11 years, or the early school period, as we like to call it, is the most suitable period for the development of children’s motor potentials and the learning of movement patterns. the child learns new movement techniques very quickly and without much effort (shaffer & kipp, 2009; koffka, 2002). when children develop coordination, they also change their ways of running. it seems that boys run technically more correctly and they do include a biceps femoris during the running process. the correlation though was only -0.29 but this was the result of poor technique just at the start of a proper running process. in the study (praprotnik et al., 2002), the correlation between the femoral biceps muscle and the maximum speeds of the adult athletes was studied, specifically male sprinters. they found a correlation of -0.60. a greater coherence was the result of optimal running using a proper technique and by taking advantage of the biceps femoris muscle. in the girls, we did not detect correlations, which can be attributed to their later motor development. dolenec and pistotnik (2001) found that in most tests of coordination boys perform better than girls. at the age of 8 or 9, the only statistically significant differences between sexes occur in their capacities to annales kinesiologiae • 7 • 2016 • 1 37 jernej završnik, rado pišot, tadeja volmut, katja koren, helena blažun vošner, peter kokol, janez vošner, boštjan šimunič, 21–42 carry out rhythmic structures, namely, in the benefit of girls, meaning that during this period the girls are not using the biceps femoris as much as boys. it is also true that to date there is no known correlation with adult female sprinting events. gender differences in the contraction times of vastus lateralis and biceps femoris skeletal muscles and the maximal running speeds after identifying the impact of regular sporting activity on the maximal running speed and to the biceps femoris, we checked if the contraction time of the skeletal muscle and maximal running speed differed between the sexes. we found that: – contraction times of the skeletal muscle were significantly different between the sexes. throughout the period of the measurements, the following were discovered: vastus lateralis contraction time is shorter in girls, while contraction time of the biceps femoris is shorter in boys; – maximum running speed differs between sexes where boys reach a higher maximum speed of running than girls. significant differences were not confirmed only at the age of 10 to 12 year olds. the vastus lateralis muscle has shorter contraction time in girls during the period of the seventh and eighth grade. in reviewing the periods in which the muscles in girls are faster than in boys, the question appears as to the impact of growth and maturing of the nervous system. it is known that the myelination of the nervous system is crucial for the responsiveness of the muscles, significant differences in the speed of muscle coincides with the so-called blast growth in the middle and late childhood and adolescence (tomazo-ravnik, 2004). the period of late childhood, which is from the age of 7 to 10 for girls and from the age of 7 to 12 for boys, is characterized by rapid linear growth of the limbs. the following growth surge occurs during adolescence, beginning with pre-puberty and lasts for about two years, from 11 to 13 years of age in girls and from 12 to 14 years of age in boys. at this stage, a rapid increase occurs in some of the dimensions of the body. faster growing and maturing of girls could have an impact on their faster muscle responses. boys had higher maximal running speed, significantly in the seventh and eighth grade. the exception was in the fifth and sixth grades, where girls were faster but it was not significant. the previous study (praprotnik et al., 2002) that was also confirmed by our findings, reported that the biceps femoris muscle was correlated to the maximal running speed (r = -0.60). furthermore, they reported also significant correlation for gastrocnemius lateralis tc with a maximal running speed (r = -0,39) and even bigger correlation was found between half relaxation time of biceps femoris with a maximal running speed (r = -0.66). it seems that time-based contractile parameters assessed using tmg are negatively related to maximal running speed. the study of praprotnik et al. (2002) was conducted on twenty-seven slovenian adult sprinters and confirmed the primary 38 jernej završnik, rado pišot, tadeja volmut, katja koren, helena blažun vošner, peter kokol, janez vošner, boštjan šimunič, 21–42 annales kinesiologiae • 7 • 2016 • 1 importance of the biceps femoris muscle when implementing the propulsive phase of sprint running. in the analysis of the results, several questions were raised, why the biceps femoris muscle contraction time appears equal for both sexes, and why boys experience higher maximum running speeds than the girls. the answer could be sought in the differences in the muscle masses of children. it is well known that the key biomechanical parameter that affects the speed of running is muscle power, which is the product of force and speed. using the contraction times of muscles, we measured the rate of shortening, however, this did not cover the muscle mass which affects the maximum force. šimunič, volmut, and pišot (2010) presented that overall muscle mass in boys is higher than in girls by 13 % to 17 % between the ages of 8 to 13. this may explain the higher running speed of boys, although the contraction times of the biceps femoris are the same. it is known that the biceps femoris can be trained to a greater extent, because it contains the largest number of fibers of type iic or satellite-based fibers which can be, depending on the functional requirements of the body, transformed into fibers of type i or ii. djordjević, et al. (2000) measured biceps femoris contraction time in two groups: in non-athletes and sprinters. the difference in the biceps femoris contraction time between both groups was 35.5 %, which confirms the correlation between muscle contractile property and maximum running speed. differences between athletes and non-athletes were also found by šimunič, pišot, and rittweger (2009), who measured the contractile properties of biceps femoris and vastus lateralis in master athletes and comparable controls. these findings suggest that regular exercise affects muscle properties and were also confirmed by our results. undoubtedly, the maximum running speed is affected by the development of the child and, consequently, in the correct technique of running the maximum running speed is also affected by the proper integration of the biceps femoris muscles during the process of running. among other determinants of the maximal running speed (body dimensions, muscle power, stiffness, etc.) described by åstrand et al. (2003), schepens et al. (1998) found also significant increase in step frequency after the age of 12 years, where strengthening of the muscles has a decisive impact on the run, however, differs by gender. in a number of conducted studies, a difference was found in the choice of discipline. men are more often involved in team sports, while girls prefer to engage in individual sports disciplines (pears dawes, vest, & simpkins, 2013). when choosing a discipline, it is also important considering their popularity. boys are often involved in football, basketball, and athletics, while the girls engage in gymnastics, swimming, and athletics (volmut, pišot, & šimunič, 2013). a possible answer would be different muscle compositions by gender but research to date does not support such a hypothesis. significant differences in the percentage of fibre types between the sexes do not exist (drinkwater, 1984; staron et al., 2000). although women have a smaller cross-section of muscle fibres than men (always, grumbt, gonyea, & stray-gundersen, 1989), a possible explanation of shorter contraction time in women can also be in a smaller weight of the body in which the muscles work. annales kinesiologiae • 7 • 2016 • 1 39 jernej završnik, rado pišot, tadeja volmut, katja koren, helena blažun vošner, peter kokol, janez vošner, boštjan šimunič, 21–42 study limitations the limitations of the study are in the selection of the research environment, namely, only three of twelve slovenian regions were selected for performing this study. although instructions and test sprinting trials were clearly stated, we did not check for achievement of maximal sprinting speed using redundant photocells setup. conclusion the research focuses on studying children’s motor development, specifically the biomechanical properties of skeletal muscles in relation to the physical development and growth (anthropometrical characteristics). after the age of 12.9, girls have shorter tc in vastus lateralis but boys have shorter tc in biceps femoris. furthermore, shorter tc in biceps femoris was found to correlate with higher running speed; however, the correlation was much lower than in adults. non-invasive and selective assessment of muscle’s contractile parameters in two skeletal muscles contributed to some important understanding of children’s skeletal muscle development. acknowledgement this study was funded by the slovenian research agency through two three-year projects and performed by the institute for kinesiology research, science and research centre, university of primorska in cooperation with dr. adolf drolc healthcare center maribor. the authors would like to thank the research group of the tmg-bmc company and the research group of the department of muscle biomechanics at the faculty of electrical engineering, university of ljubljana. finally, we are thankful to school head teachers, their physical education teachers, all the participants in the study, and the parents for their willingness to participate in a study of such magnitude. funding the presented longitudinal research study was a part of two national projects financed by the ministry of education, science and sport of the republic of slovenia: the applicative project with the title “the role of the biomechanical skeletal muscle properties in children’s motor development” and the basic project with the title “monitoring the biomechanical properties of skeletal muscles in childhood and adolescence” performed by the institute for kinesiology research, science and research centre, university of primorska in cooperation with dr. adolf drolc healthcare centre maribor. 40 jernej završnik, rado pišot, tadeja volmut, katja koren, helena blažun vošner, peter kokol, janez vošner, boštjan šimunič, 21–42 annales kinesiologiae • 7 • 2016 • 1 references always, s. e., grumbt, w. h., gonyea, w. j., & stray-gundersen, j. 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(2013). objectively measured physical activity in children aged from 5 to 8 years. journal of public health, 52(1), 9–18. view item http://dx.doi.org/10.1111/j.1525-1594.1997.tb04658.x http://dx.doi.org/10.2478/sjph-2013-0002 annales kinesiologiae • 11 • 2020 • 1 69 reports and reviews/poročila in ocene, 65–76 2nd euro-pak international conference on sports sciences & physical education “a way forward towards healthy life” islamabad, pakistan, 11–13 october 2019 in the middle of october 2019, sharad university of science and information technology, peshawar, in cooperation with the following institutions: university of the punjab, lahore; abdul wali khan university, mardan; otto von guericke university magdeburg, germany; university of sargodha, sargodha; gomal university, di khan; pakistan sports board, islamabad; higher education department, kp; pakistan council of sports science (pcoss); international network of sport and health science (inshs); higher education commission islamabad, pakistan, organised the 2nd euro-pak international conference on sports sciences & physical education with the promising title: “a way forward towards healthy life.” in a three-day program, nine international keynote and guest speakers presented a wide scope of sports, other physical activity domain, and health related topics. additionally, in three different parallel sessions, another 65 presentations pointed out the important topics regarding the trends observed in pakistan’s population. 70 reports and reviews/poročila in ocene, 65–76 annales kinesiologiae • 11 • 2020 • 1 prof. rado pišot, phd, as keynote speaker with the lecture “effective prevention, diagnostic and rehabilitation of sports injuries,” and saša pišot, phd, as guest speaker with the lecture “elementary motor patterns and the creation of physical (incorporated) capital of a child,” represented the institute for kinesiology research of the science and research centre koper and its recent research outcomes. this conference, the second annual, aimed to bring together a large scope of scientists, scholars, researchers, experts and leaders not only from pakistan but from around the world to share and discuss the current sports and health related issues that the pakistani community is confronted with, and served for the preparation of much needed national recommendations and public health strategies. saša pišot annales kinesiologiae • 11 • 2020 • 1 71 reports and reviews/poročila in ocene, 65–76 druga mednarodna konferenca euro-pak o znanosti in izobraževanju v športu »pot do zdravega življenja« islamabad, pakistan, 11.–13. oktober 2019 v sredini oktobra 2019 je univerza za znanosti in informacijsko tehnologijo sharad v pešavarju v sodelovanju z univerzo v pandžabu, lahore; univerzo abdul wali khan, mardan; univerzo otto von guericke magdeburg, nemčija; univerzo v sargodhi, sargodha; univerzo gomal, di khan; pakistanskim odborom za šport iz islamabada; ministrstvom za visoko šolstvo v pakistanu, pakistanskim svetom za znanost (pcoss); mednarodno zvezo za znanosti o športu in zdravju (inshs) in komisijo za visoko šolstvo islamabad, pakistan, organizirala drugo europak mednarodno konferenco o znanosti in izobraževanju v športu z obetavnim naslovom “pot proti zdravemu življenju”. v tridnevnem programu je devet mednarodnih vabljenih in gostujočih predavateljev predstavilo širok nabor športnih tematik in novosti s področja gibalne aktivnosti oz. telesnih aktivnosti in zagotavljanja zdravja. v treh različnih vzporednih sekcijah so bile v kar 65 predstavitvah obravnavane pomembne teme, ki zadevajo trende zdravja pakistanske populacije. 72 reports and reviews/poročila in ocene, 65–76 annales kinesiologiae • 11 • 2020 • 1 konference sta se kot vabljena in gostujoča predavatelja udeležila tudi prof. dr. rado pišot in dr. saša pišot, ki sta v predavanjih “effective prevention, diagnostic and rehabilitation of sports injuries” in “elementary motor patterns and the creation of physical (incorporated) capital of a child” predstavila novejše delo inštituta za kineziološke raziskave, zrs koper. konferenca, že druga po vrsti, je želela združiti strokovnjake, znanstvenike, raziskovalce in vodilne ne samo iz pakistana, ampak tudi iz širšega mednarodnega okolja, ter je dosegla namen, da se razpravlja o trenutnih vprašanjih, povezanih s športom, gibalno aktivnostjo in zdravjem, s katerimi se sooča pakistanska skupnost. obravnavana problematika in nova znanja bodo dobrodošli za pripravo prepotrebnih nacionalnih priporočil in strategij za javno zdravje pakistanske populacije. saša pišot _hlk35418826 _goback _hlk35971111 _hlk35511489 _hlk35972306 _hlk35451145 _hlk35511425 _hlk35973495 _hlk35973574 _hlk35973830 _hlk35975249 _hlk35975104 _gjdgxs 30j0zll 1fob9te _goback _3znysh7 _goback _goback _goback _hlk54274488 _goback annales kinesiologiae • 8 • 2017 • 1 33 review article udc: 796.012:612.67 received: 2017-07-13 benefits of motor and/or cognitive exercise: a review with recommendations for the third age mitja gerževič1, matej plevnik2, uroš marušič3,4 1 euro-mediterranean university, kidričevo nabrežje 2, 6330 piran, slovenia 2 university of primorska, faculty of health sciences, polje 42, 6310 izola, slovenia 3 science and research centre koper, institute for kinesiology research, garibaldijeva 1, 6000 koper, slovenia 4 alma mater europaea – ecm, department of health sciences, slovenska ul. 17, 2000 maribor, slovenia corresponding author: mitja gerževič euro-mediterranean university, kidričevo nabrežje 2, 6330 piran, slovenia tel.: +386 59 25 00 51 e-mail: mitja.gerzevic@emuni.si abstract physical activity in the form of aerobic and resistance exercise, leading to a high level of cardio-respiratory fitness, represents a strong non-pharmacological preventive tool against cognitive decline and thus the occurrence of neuro-degenerative diseases in the third age. however, the effects are even greater if such exercise is performed on regular basis in the form of simultaneous combination of a motor and additional cognitive task, dancing or interactive video dancing or as a body-mind meditative exercise like tai ji quan. the aim of this article is a review of benefits of motor / cognitive exercise with recommendations for older adults. in the first part, the benefits and effects of physical activity and exercise on cognitive functions are reviewed. physical activity and exercise have an important role in mitigating age-related structural and behavioural changes within the brain, they increase bdnf levels in the hippocampus, enhance learning and neurogenesis in the hippocampal regions and optimize spatial abilities. the second part is expanded onto the benefits and effects of combined motor and / or cognitive exercise on cognitive functions with recommendations. this combination of motor and / or cognitive exercise could be achieved so that both activities are performed separately, one after another, named “motor and cognitive exercise” or simultaneously, named 34 mitja gerževič, matej plevnik, uroš marušič: benefits of motor and/or cognitive exercise ..., 33–49 annales kinesiologiae • 8 • 2017 • 1 “motor-cognitive exercise.” based on this premise, we divided the second part into three sub-topics: i) the effects of physical exercise / training followed by computerized and other forms of cognitive training, ii) the effects of simultaneously performed motor and cognitive exercise / training and iii) the effects of dancing, interactive video dancing and ancient body-mind meditative techniques. studies suggest that a combination of mental and physical training may result in greater cognitive gains, namely, in larger improvements in the executive control task and in the paired-associates task. keywords: ageing, neurogenesis, motor learning, computerized cognitive training, dancing, body-mind meditative techniques. prednosti in koristi gibalne in/ali kognitivne vadbe: pregled področja s priporočili za tretje življenjsko obdobje izvleček telesna aktivnost v obliki aerobne vadbe in vadbe proti uporu, ki omogočata visoko stopnjo kardio-respiratorne pripravljenosti, predstavlja močno nefarmakološko preventivno orodje proti upadu kognitivnih funkcij in s tem pojavljanju nevrodegenerativnih bolezni v tretjem življenjskem obdobju. učinki vadbe pa so lahko še večji, če se ta izvaja redno v obliki sočasne kombinacije gibalne in dodatne kognitivne naloge, plesa ali interaktivne plesne videoigre ali v obliki meditativne vadbe za telo in um, kot je npr. tai ji quan. namen prispevka je pregled prednosti in koristi, ki jih ima gibalna/kognitivna vadba, s priporočili za starejše odrasle osebe. v prvem delu so predstavljene prednosti in koristi ter vplivi telesne aktivnosti in vadbe na kognitivne funkcije. telesna aktivnost in vadba imata pomembno vlogo pri zmanjševanju s starostjo povezanih strukturnih in vedenjskih sprememb v možganih, hkrati pa vplivata na povečanje bdnf vrednosti v hipokampusu, spodbujata procesa učenja in nevrogeneze in izboljšujeta sposobnosti prostorske predstave. drugi del prispevka je razširjen na prednosti in koristi ter učinke kombinirane gibalne in/ali kognitivne vadbe na kognitivne funkcije starejših oseb, s priporočili. kombinacijo gibalne in/ali kognitivne vadbe je mogoče doseči tako, da obe dejavnosti opravljamo ločeno, eno za drugo, kar imenujemo "gibalna in kognitivna vadba/trening" ali pa sočasno, kar smo imenovali "gibalno-kognitivna vadba/ trening". na tej osnovi smo razdelili drugi del na tri podteme: i) učinki telesne vadbe/ treninga, ki mu sledijo računalniško podprte in druge oblike kognitivne vadbe/treninga, ii) učinki sočasno opravljene gibalne in kognitivne vadbe/treninga in iii) učinki plesa, interaktivnih plesnih videoiger in meditativnih tehnik na telo in um. študije poročajo, 35 annales kinesiologiae • 8 • 2017 • 1 mitja gerževič, matej plevnik, uroš marušič: benefits of motor and/or cognitive exercise ..., 33–49 da se kombinacija gibalne in kognitivne vadbe odraža v povečanih kognitivnih učinkih, posebno v večjem izboljšanju izvršilnih funkcij. ključne besede: staranje, nevrogeneza, hipokampus, računalniško podprta kognitivna vadba, ples, meditativne tehnike za um in telo introduction motor abilities, physical, functional and cognitive capacities decrease with ageing. however, with regular and adequate physical and cognitive exercise and training it is possible to reduce or even prevent such declines (bherer, erickson & liu-ambrose, 2013; erickson, gildengers & butters, 2013; erickson et al., 2014; pišot et al., 2016). health guidelines emphasize that all adults should avoid physical inactivity. according to the guidelines, one’s lifestyle should include at least some physical activity in order to obtain health benefits. physical activity for adults and seniors should include strength, balance and flexibility training, as well as aerobic exercise. the general aim of exercise in late adulthood should be improving the stability and responsiveness of the body, with reduction of the risk of falls as one of the first effects. an appropriate approach in the context of “risk of falls” prevention is the combination of different contents of exercise programs (strength, stability, responsiveness, flexibility etc.). studies confirm that regular physical activity and high fitness level in the adulthood reduces the risk of negative effects of (primary) ageing as well as those, such as chronic diseases, related to the modern, sedentary lifestyle and environment pollution (secondary ageing) (bherer, erickson & liu-ambrose, 2013; chodzko-zajko et al., 2009; erickson, gildengers & butters, 2013). the risk of falls increases with age and the falls are the main cause of death associated with injury in the age over 65 years (rubenstein, 2006). the falls are generally connected with serious consequences such as bone fractures and other injuries. the most common causes of falls are problems with walking and balance (masud & morris, 2001). these problems are often associated with neurological and skeletal muscle disorders, impaired ability of thinking, memory and vision as well as different risks in the environment (richardson & ashton-miller, 1996). a sedentary lifestyle and / or lack of physical activity is a common cause, which provoke older people to lose muscle tone and bone mass, reduce their muscle strength and flexibility, which further contributes to increasing the risk of falling. the problem is complex, which can be combined by physiological, biological, behavioural, physical and socio-economic factors (sattin, 1992). with ageing, we are also facing difficulties in cognitive functioning, which increases the risk of falls. of course, being active and exercising regularly cannot stop the biological aging process; however, with proper training we can mitigate or even prevent the age-related cognitive decline. epidemiological studies suggest that a well36 mitja gerževič, matej plevnik, uroš marušič: benefits of motor and/or cognitive exercise ..., 33–49 annales kinesiologiae • 8 • 2017 • 1 -functioning cardiovascular system and a high level of physical activity reduce the risk of cognitive decline and dementia in the old age (gregory, parker & thompson, 2012). aerobic exercise and strength training, but mostly a combination of both, have been shown to improve some cognitive performance measures among previously sedentary older adults. the effects of such exercises on fitness status are largest for the tasks that require complex processing requiring executive control (chodzko-zajko et al., 2009). motor-cognitive exercise, which is characterized by an additional cognitive (mental) work during the execution of various motor exercises and tasks, can also represent the missing content, and perhaps even more effective upgrade of the usual forms of motor exercise. it has been shown that such exercise contributes to improving the mobility and may prevent falls in older adults (shatil, 2013). however, the stability and focus of the movement is disrupted in the presence of additional cognitive demand. the aim of this paper is to describe what are the benefits and effects of motor and / or cognitive exercises on the cognitive function in older adults. physical activity has favourable effects across numerous physical and mental-health outcomes. it enhances cognitive functioning and it delays age-related cognitive decline which, therefore, results in a better quality of life and health outcomes. the fast developing area of brain-imaging techniques will continue revealing new insides into multiple neural mechanisms that occur at the corticospinal levels and beyond while being physically active per se. however, a growing body of literature in the recent years suggests that the combination of mental and physical training seems to have an additive effect on neurogenesis and it results in even greater increase in neurogenesis than either physical or mental activity alone. benefits of physical activity and exercise on cognitive function in older adults extensive evidence suggests that physical activity can maintain functional abilities, well-being, and independence in the older person, and it is an essential component of everyday life, and therefore, it is beneficial also for healthy ageing (netz, wu, becker & tenenbaum, 2005; penedo & dahn, 2005; rejeski & mihalko, 2001; gradari, palle, mcgreevy, fontan-lozano, & trejo, 2016). positive effects of physical activity on cognitive functioning are well reported as well, and are usually presented in two types of studies. the first are (longitudinal) randomized controlled trials that involve intervention and control group(s), and the second are cross-sectional studies that correlate physical activity and exercise levels with cognitive function outcomes and brain structures. the literature overview is summarized in the forthcoming paragraphs with the discussion of possible mechanisms that are most likely to occur. ageing process in humans is accompanied by stereotypical structural as well as neurophysiological changes that happen within the brain and variable rates of cognitive decline (bishop, lu, & yankner, 2010). however, this degenerative process was shown to be operational in the older age (dinse, 2006) and studies showed that physical ac37 annales kinesiologiae • 8 • 2017 • 1 mitja gerževič, matej plevnik, uroš marušič: benefits of motor and/or cognitive exercise ..., 33–49 tivity and exercise could be one of the lifestyle factors that can successfully moderate age-related cognitive and neurophysiological declines (hillman, erickson, & kramer, 2008; kramer & erickson, 2007; weuve et al., 2004). kempermann et al. (2010) suggest that there is a need for a proper combination of physical activity and enriched environment for neurogenesis in adult brain. physical activity and locomotion are believed to stimulate the proliferation of precursor cells in the hippocampus, while enriched environment and learning are needed to promote the survival of immature neurons (kempermann et al., 2010). in the animal studies it was shown that physical exercise enhances angiogenesis, synaptogenesis and neurogenesis, and that it regulates several neurotrophic factors (carro, nuñez, busiguina, & torres-aleman, 2000; cotman, berchtold, & christie, 2007; van praag, shubert, zhao, & gage, 2005). namely, it was shown that exercising increases bdnf (brain derived neurotrophic factor) levels in the hippocampus (cotman & berchtold, 2002), enhances learning and neurogenesis in the hippocampal regions (van praag et al., 2005) and optimizes spatial abilities (creer, romberg, saksida, van praag, & bussey, 2010). the underlying protecting mechanism of physical activity and exercise on cognitive functioning in older age might be related to reduced inflammation and, therefore, not-impaired growth factor signalling in the brain and periphery (cotman et al., 2007). studies in humans that have used brain-imaging techniques have revealed that physical activity and exercise have an important role in mitigating age-related structural and behavioural changes within the brain. in a study conducted by colcombe et al. (2006) it was shown that a 6-month aerobic training resulted in significant increases of grey and white matter primarily located in prefrontal and temporal cortices. furthermore, exercise was shown to increase hippocampal volumes, which were related to increased serum bdnf levels and improved memory as well (erickson et al., 2011). studies have also shown that aerobic exercise improves general cognitive functions (weuve et al., 2004), and more specifically, aerobic exercise was shown to enhance visuospatial memory (stroth, hille, spitzer, & reinhardt, 2009) and executive control (kramer et al., 1999). further, some studies reported the effects and benefits of computerized cognitive training on executive functioning in older adults (marusic et al., 2018), as well as its benefits on motor functions (marusic et al., 2015), plasma level of the bdnf (passaro et al., 2017) or even on vascular function (goswami et al., 2015) after prolonged physical inactivity. finally, the participants who exercised regularly had faster reaction times, better attention and cognitive flexibility (masley, roetzheim & gualtieri, 2009; smith et al., 2010). together with the above reported positive effects of physical activity on cognitive functioning in humans and animals, physical activity was shown also to have a protective effect against cognitive decline in the older age, as well as in some neurodegenerative diseases. a recent meta-analysis showed that greater amounts of physical activity earlier in life are associated with a 38% reduced risk of developing cognitive impairment later in life (erickson et al., 2014). in a large-scale prospective cohort study that was carried out on canadian older adult population, laurin and colleagues (2001) 38 mitja gerževič, matej plevnik, uroš marušič: benefits of motor and/or cognitive exercise ..., 33–49 annales kinesiologiae • 8 • 2017 • 1 showed a positive relation between physical activity and lower risk of cognitive impairment, alzheimer disease, and all types of dementia in the later life (laurin, verreault, lindsay, macpherson, & rockwood, 2001). in a randomized controlled trial with 24week physical activity intervention, older adults with memory problems (but without diagnosed dementia) showed a modest improvement in cognition (lautenschlager et al., 2008). positive effects of aerobic activity on medial temporal brain structures have been also registered in patients with alzheimer’s disease (erickson et al., 2011; yuede et al., 2009) and schizophrenia patients (pajonk et al., 2010). benefits of combined motor and / or cognitive exercise on cognitive function in older adults with recommendations physical activity and high levels of cardiorespiratory / cardiovascular fitness, achieved with regular aerobic and resistance exercise / training as well as motor learning and coordinative exercise, have been shown to enhance cognitive function and decrease the risk of cognitive decline and dementia (alzheimer’s disease) in older population (bherer, erickson & liu-ambrose, 2013; erickson, gildengers & butters, 2013; erickson et al., 2014). new evidences emerge showing that the effects are even greater when physical activity and exercise are combined with (additional) cognitive tasks. this combination could be achieved so that both activities are performed separately, one after another (here we introduce the expression “motor and cognitive exercise / training”) or simultaneously (for this we will use the expression “motor-cognitive exercise / training”). however, when there will be no emphasis on one of the above mentioned options, the term “motor / cognitive exercise/training” will be used. through the process of neurogenesis, many of new neuron cells are produced every day in the adult brain in the hippocampal formation, a brain structure necessary for many types of new learning, and one that is highly responsive to the effects of mental and physical training. these new neurons in the hippocampus are extremely responsive to the external environment, since physical activity and exercise have been shown to increase the number of cells that are produced, even after just one day of exercise (curlik & shors, 2011). physical activity and exercise take advantage of neuroplasticity also in later life, which promotes neural, regional, and, possibly, total brain growth. the term neuroplasticity is usually used in reference to positive or adaptive (rather than maladaptive) changes to brain architecture that is above and beyond its current functioning limits (erickson et al., 2014). as already described, the most well characterized physical activities for slowing the rate of cognitive decline and preventing dementia are the aerobic as well as resistance exercise / training, motor learning and coordinative exercise (bherer, erickson & liu-ambrose, 2013; erickson et al., 2014). however, besides physical activity and exercise, fratiglioni, paillard-borg and winblad (2004) report that also a socially integrated network and cognitive leisure activities can play a significant role. 39 annales kinesiologiae • 8 • 2017 • 1 mitja gerževič, matej plevnik, uroš marušič: benefits of motor and/or cognitive exercise ..., 33–49 on the other hand, curlik and shors (2013) emphasize that physical training by itself is not enough to rescue new neurons from death, but learning must occur during the training process. even more, learning has to be difficult to master in order to rescue these cells. this could be, for example, learning to associate two stimuli that overlap, but are separated by long temporal window or learning to associate two stimuli that do not occur together in time with sufficiently long temporal gap between them or learning to find the platform using only spatial cues outside the maze (curlik & shors, 2013). since individual animals and humans tend to learn at different rate, it is also important how many trials are necessary to learn. thus, it has been repeatedly shown that there are strong positive correlations between the number of trials necessary to learn the task or skill and the number of surviving cells in the animals’ dentate gyrus (curlik & shors, 2013) – a part of the hippocampus thought to contribute to the formation of new episodic memories (amaral, scharfman, & lavenex, 2007; saab et al., 2009) – the spontaneous exploration of novel environments (saab et al., 2009) and other functions (scharfman, 2007), being one of a selected few brain structures currently known to have high rates of neurogenesis in adult rats (cameron & mckay, 2001). this means that animals that need more trials of training in order to learn the skill tend to retain more cells than those that learn it with less effort. on the whole, these results show that learning has the greatest impact on neurogenesis when training task itself is challenging, and when many trials and / or days of training are required to master the skill (curlik & shors, 2011; curlik & shors, 2013). therefore, the authors suggest that a combination of mental and physical training may result in greater cognitive gains and can have additive effects on the structure of the adult brain than either form alone, which may help to keep the brain fit for future learning. if we go a little further, greater cognitive gains could be achieved by using training regimens that combine physical and mental skill training, which in practice means motor learning. for example, learning to perform a new dance routine or when engaged in any new sports activities. these activities influence many learning processes, including working memory and require some significant degree of cognitive effort, suggesting that the mental effort intrinsic to many athletic and sporting endeavours can produce long-lasting effects in the structure of the adult brain (curlik & shors, 2013). in the last 10–15 years, numerous studies (randomized exercise interventions, cross-sectional, prospective longitudinal and epidemiological studies) have been conducted to evaluate how physical activity and exercise (in the form of aerobic or resistance training, motor learning and coordinative exercise) in the adulthood and in the old age influences cognitive functions and brain structures in older adult population. however, only recently more emphasis has been given to motor / cognitive exercise strategies to maximize the effects on neural adaptations (neurogenesis) and cognitive function, in order to alleviate or prevent dementia and other neurodegenerative processes in the third age. all of them definitely require both mental and physical effort and are, thus, potentially useful to preserve or improve cognitive function in midand especially in late adulthood. such strategies could include: 40 mitja gerževič, matej plevnik, uroš marušič: benefits of motor and/or cognitive exercise ..., 33–49 annales kinesiologiae • 8 • 2017 • 1 1. any kind of physical exercise / training followed by computerized and other forms of cognitive training, 2. simultaneously performed motor and cognitive exercise / training, 3. dancing and interactive video dancing or even 4. the ancient techniques such as tai ji quan (tai-chi). effects of physical exercise / training followed by computerized and other forms of cognitive training shatil (2013) performed a four-condition randomized controlled trial among healthy older adults in order to evaluate if a 4-month mild aerobic and / or cognitive training enhance cognitive abilities more than either alone. one hundred twenty-two community dwelling and healthy older adults (65 – 93 year olds) were divided into four groups: the first group was engaged in cognitive training, the second in mild aerobic training, the third in the combination of both, and the fourth, as a control, in book-reading and discussion activities. the cognitive training intervention was performed in 48 fortyminute sessions three times per week for 16 consecutive weeks using a previously validated cognifit® program. the mild aerobic training intervention consisted of 10 minutes of aerobic warm-up, 15 minutes of cardiovascular workout seated and standing, 5 minutes of aerobic cool-down, 10 minutes of strength training and 5 minutes of flexibility training, followed by brief relaxation; a total of 45 minutes, three times per week for 16 consecutive weeks. the combined intervention consisted of both the above mentioned interventions, receiving twice as many training sessions as the previous two groups. the control group needed to read the book “active living everyday: twenty weeks to lifelong vitality” at home and held one 60-minute weekly meeting for discussion about it. the results indicate that, compared to older adults who did not engage in cognitive training (the mild aerobic and control groups), those who did (separate or combined training group) showed significant improvement in cognitive performance, especially in hand-eye coordination, global visual memory (working memory and longterm memory), speed of information processing, visual scanning, and naming words. these results and results of a similar study performed by oswald, gunzelmann, ruprecht and hagen (2006) suggest that it is the cognitive training (not mild aerobic training (shatil, 2013) or physical training (oswald et al., 2006)) which is driving the improvement in the combined condition (performed on separate sessions) and somehow contradict a research consensus that aerobic activity is a main mechanism in the enhancement of cognitive ability (shatil, 2013). however, it is possible that the intensity and duration (four months only) of the interventions in the shatil’s (2013) study were insufficiently high and long to induce cognitive gains or too broad-based (not sufficiently specific and intense) in the oswald et al.’s (2006) study. on the other hand, positive effects of the combined interventions on cognitive function, independence of living, and some measures of health and emotional status (especially depression) could be observed up to five years after the intervention (oswald et al., 2006). future studies should aim to 41 annales kinesiologiae • 8 • 2017 • 1 mitja gerževič, matej plevnik, uroš marušič: benefits of motor and/or cognitive exercise ..., 33–49 investigate also the combination of different non-physical ways of training, such as action observation and motor imagery with physical exercise (eaves, riach, holmes, & wright, 2016). effects of simultaneously performed motor and cognitive exercise / training further, if the effects of a simultaneously performed, motor-cognitive training intervention is compared to a single cognitive training intervention or to passive controls the motor-cognitive intervention results in larger cognitive and motor-cognitive (dual-task) improvements. in fact, theill, schumacher, adelsberger, martin and jäncke (2013) looked at the effects of 10 weeks of simultaneously performed cognitive and physical training in 63 healthy older adults (65 – 84 year olds), who were divided in three groups. the first group simultaneously performed a verbal working memory and a cardiovascular training, while the second group performed only verbal working memory training, both for 20 training sessions two times weekly. the third group attended no training at all and served as a control. the cognitive training session contained 15 minutes of computer-based n-back training (continuous responses to a series of letters appearing all for three seconds, always comparing the subsequent letters with the letter in a given sequence n-times before) and 15 minutes of serial position training (learning a sequence of words in the correct order, presented for three seconds and followed by a distraction phase) – see theill et al. (2013) for more details. on the other hand, the motor-cognitive training session consisted of 40-minute treadmill walking (including warm-up at a self-selected speed) at the intensity (walking speed) between 60 % and 80 % of the individual’s age related maximum heart rate value (hrmax = 220 – age), while simultaneously performing the same cognitive training as described earlier. the results indicate similar training progress and larger improvements in the executive control task for both experimental groups compared to the passive control group. however, the simultaneous, motor-cognitive training group showed larger improvements in the paired-associates task compared to the single cognitive training group and was able to reduce the step-to-step variability during the motor-cognitive dual-task condition compared to the single cognitive training group and passive controls. thus, the authors (theill et al., 2013) conclude that the simultaneous training of cognitive and physical abilities presents a promising concept to improve cognitive and motor-cognitive dual-task performance, offering greater potential on daily life functioning, which usually involves the recruitment of multiple abilities and resources rather than a single one. 42 mitja gerževič, matej plevnik, uroš marušič: benefits of motor and/or cognitive exercise ..., 33–49 annales kinesiologiae • 8 • 2017 • 1 effects of dancing, interactive video dancing and ancient body-mind meditative techniques based on this premise it can be realized that even dancing and the ancient body-mind meditative exercise, such as tai ji quan (tai-chi) is a form of motor-cognitive exercise, which requires substantial simultaneous mental and physical effort in order to be (adequately) performed. their positive effects on physical and especially cognitive functions in older adults have recently been confirmed by several studies (olsson, 2012). for example, jovancevic, rosano, perera, erickson and studenski (2012) (a study protocol report) examined the effects of a 6-month interactive video dancing game intervention (using a commercially available dance dance revolution system) in comparison to brisk walking (at least twice a week for 30 minutes, with a target of 150 minutes per week) and passive controls on physical and mental health, balance, attention and visual spatial skills in 168 overweight or obese, sedentary post-menopausal women (50 – 65 year olds). similarly, pichierri, murer and de bruin (2012) examined the effects of 12 weeks of additional dance video gaming to progressive strength and balance exercise on gait performance under singleand dual-task conditions (at normal and fast speed), foot placement accuracy (fpa), and falls efficacy (fear of falling questionnaire and gaze behaviour during fpa) in 31 community dwelling older adults (86.2 ± 4.6 years). pilot findings of jovancevic et al. (2012) suggest that interactive video dance is associated with increased fronto-parietal attention network activation and a trend towards improved reaction times, while the results of pichierri et al. (2012) support previous findings that strength and balance exercise may lead to better walking performance in older untrained subjects. in addition, integrating a cognitive training (video dance gaming) to strength and balance exercise results in further improvements in walking performance under dual-task conditions (higher gait velocity and shorter single support time during fast dual-task walking), most likely due to functional or even structural changes in the brain (pichierri et al., 2012). furthermore, both interventions in the pichierri’s study reduced the concerns about falling and only the dance group improved foot placement accuracy (in the medio-lateral direction) without significant differences between the two groups after 12 weeks. why is this so? interactive video dance games are a form of action video games that also require physical activity besides constant monitoring of the periphery for frequent unpredictable events that require quick and accurate responses, thus, influencing positively physical and cognitive skills, abilities and functions such as hand-eye coordination, processing in the periphery, mental rotation, divided attention and reaction times (jovancevic et al., 2012). in fact, monitoring of the periphery places heavy demands on visual-attentional systems, as players need to keep track of many moving objects while ignoring distracters. these games also require precise visual-motor control in order to aim steps in space and time according to the sequence of moving targets (jovancevic et al., 2012). what about usual dancing exercise / training? kattenstroth, kalisch, holt, tegenthoff and dinse, (2013) performed a study where 35 healthy older adults (60 – 94 43 annales kinesiologiae • 8 • 2017 • 1 mitja gerževič, matej plevnik, uroš marušič: benefits of motor and/or cognitive exercise ..., 33–49 year olds) were engaged in a 6-month dance intervention group one hour per week (agilandotm dance program – it can be performed without a partner) or in a control group. cognition, fluid intelligence, attention, reaction time, motor, tactile and postural performance, as well as subjective well-being and cardio-respiratory performance were assessed. similarly, hamacher, hamacher, rehfeld, hökelmann and schega (2015) examined the effects of a 6-month dancing program on motor-cognitive dual-task performance, where cognitive performance, stride-to-stride variability of minimum foot clearance, stride time and stride length while walking were measured in 35 older adults (years), who were assigned to a dancing group or a health-related exercise group. the results of kattenstroth et al. (2013) indicate no changes or further degradation of performance after six months in the control group. on the other hand, beneficial effects were found in the dance group for dance related parameters such as posture and reaction times, cognitive, tactile and motor performance, and subjective well-being, without alterations in cardio-respiratory performance (kattenstroth et al., 2013). furthermore, dancing also lowers gait variability and improves cognitive performance in dual-task conditions in a greater extent than conventional health-related exercise (hamacher et al., 2015). thus, it could be concluded that the lack of changes of cardio-respiratory function found by kattenstroth et al. (2013) indicate that even moderate levels of physical activity in combination with rich sensorimotor, cognitive, social, and emotional challenges can act to ameliorate a wide spectrum of age-related decline. this shows that dancing could be a powerful tool to improve motor / cognitive (dual-task) performance and it can play an important role in the maintenance of perceptual and cognitive abilities, contributing also to a reduced risk of falls in older adult population. in fact, learning new dance steps requires three-dimensional and geometric thinking, which has been associated with improved learning capabilities (kattenstroth et al., 2013), thus, stimulating neurogenesis and preservation of new neurons as noted by curlik and shors (2013). similarly, even the ancient body-mind meditative techniques like tai ji quan (tai-chi) represent an efficient exercise mode to preserve or improve motor / cognitive functions and performance. recent studies demonstrate that it improves cognitive and physical function (bherer, erickson & liu-ambrose, 2013; sun et al., 2015), coordination (qiu & zhu, 2003), visual span (bherer, erickson & liu-ambrose, 2013) and through improved balance (qiu & zhu, 2003) also the efficiency of postural control (zhou et al., 2015). it relieves stress, reduces pain and muscle stiffness (qiu & zhu, 2003) and it is effective in reducing blood pressure and body mass index, maintaining normal renal function, and improving physical health of health-related quality of life (sun & buys, 2015). furthermore, long-term tai ji quan (tai-chi) exercising can also improve vagal modulations, it tends to reduce sympathetic modulations (guo, 2015) and has shown to be the cost most effective strategy (compared to resistance training or stretching) for optimizing fall prevention in parkinson disease patients (li & harmer, 2015). all of this is the scientific confirmation why our ancestors’ knowledge should not be forgotten and why we should stand on their shoulders to further improve our knowledge, ourselves as human beings and to direct our actions into helping each other 44 mitja gerževič, matej plevnik, uroš marušič: benefits of motor and/or cognitive exercise ..., 33–49 annales kinesiologiae • 8 • 2017 • 1 as well as generations that still have to come to live a better, healthier and, thus, more contended and successful life. conclusion physical activity in the form of aerobic and resistance exercise leading to a high level of cardio-respiratory fitness represents a strong non-pharmacological preventive tool in the third age (bherer, erickson & liu-ambrose, 2013; hökelmann et al., 2015). the effects are even greater if any type in this paper mentioned motor-cognitive exercise / training are performed on regular basis. it could be performed either as a simultaneous combination of a motor task (movements) with an additional cognitive task (gerževič & dobnik, 2014; gerževič, dobnik, & pišot, 2014; theill et al., 2013), as dancing or video dancing (hamacher et al., 2015; hökelmann et al., 2015; jovancevic et al., 2012; kattenstroth et al., 2013; pichierri et al., 2012) or as a body-mind meditative exercise like tai ji quan (bherer, erickson & liu-ambrose, 2013; guo, 2015; li & harmer, 2015; qiu & zhu, 2003; sun & buys, 2015; sun et al., 2015; zhou et al., 2015). despite an increasing number of studies indicate a strong connection between physical activity and brain health and plasticity in late adulthood, many questions remain still open for future research. although positive effects were found with moderate intensity exercise for several months, bherer, erickson and liu-ambrose (2013), erickson, gildengers & butters (2013) and erickson et al. (2014) noted, that the exact dose-response relationship between physical activity and mood, cognitive or brain health in older adults remains unknown. this means there is a very poor understanding of the types (aerobic exercise alone like walking, tennis, swimming or cycling; anaerobic alone like resistance exercise; combined motor and cognitive exercise, such as (simultaneous) motor-cognitive exercise, dancing or tai ji quan etc.; competitive or non-competitive sports), intensity (low, moderate, high) and duration of exercise that might be most useful to promote a healthier brain. there is also a very poor understanding of what age is optimal to start exercising, as well as a poor understanding of the retention of the effects, since individuals stop exercising for a variety of different reasons including injuries, illnesses, and personal issues (e.g., mourning). it is still unknown whether the increased grey matter volume or improved white matter integrity persists after the completion of the exercise intervention or after some period of inactivity (follow-up assessments of the effects). and finally, the effects still need to be fully understood in cognitively impaired populations including persons with alzheimer’s disease, depression, and parkinson’s disease (de dreu, kwakkel, & van wegen, 2015). in the end, it could be concluded that physical activity and exercise hold great potential as inexpensive and effective methods of elevating cognitive function, improving brain health, and restoring brain function after atrophy or disease (erickson et al., 2014). 45 annales kinesiologiae • 8 • 2017 • 1 mitja gerževič, matej plevnik, uroš marušič: benefits of motor and/or cognitive exercise ..., 33–49 references amaral, d., scharfman, h. & lavenex, p. 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(2009). effects of voluntary and forced exercise on plaque deposition, hippocampal volume, and behavior in the tg2576 mouse model of alzheimer's disease. neurobiology of disease, 35(3), 426–432. doi: 10.1016/j.nbd.2009.06.002 view item zhou, j., chang, s., cong, y., qin, m., sun, w., lian, j., et al. (2015). effects of 24 weeks of tai chi exercise on postural control among elderly women. research in sports medicine, 23(3): 302–314. doi: 10.1080/15438627.2015.1040918 view item https://doi.org/10.1097/psy.0b013e3181d14633 https://doi.org/10.1080/09602010802091183 https://doi.org/10.1016/j.amjcard.2015.07.012 https://doi.org/10.1589/jpts.27.1467 https://doi.org/10.1186/1471-2202-14-103 https://doi.org/10.1523/jneurosci.1731-05.2005 https://jamanetwork.com/journals/jama/fullarticle/199487 https://doi.org/10.1016/j.nbd.2009.06.002 https://doi.org/10.1080/15438627.2015.1040918 _goback _goback _goback _hlk501362470 _hlk501363405 _hlk501369360 annales kinesiologiae • 11 • 2020 • 1 73 reports and reviews/poročila in ocene, 65–76 conference report: 10th jubilee international scientific and professional congress a child in motion 2019 piran, slovenia, 7–9 november 2019 the international scientific and professional congress “a child in motion” celebrates 20 years. i sincerely congratulate the institute for kinesiology research of the science and research centre koper, which in cooperation with many partners managed to set the symposium at such a high level. not only for this event, but especially because twenty years of professional and scientific meetings and socializing demonstrate the sustainable orientation of your work and promise thoughtful effects of your professional work and research. in the days when experts in portorož will deal with demanding issues of child development, we are celebrating children’s week. this framework adds to your work a special awareness of the importance and role of the child, his or her healthy development, and commits everyone to the responsibilities imposed on us by future generations. president of the republic of slovenia borut pahor, honorary patron of the congress “a child in motion” the tenth jubilee scientific and professional congress “a child in motion” was, as before, organized by the science and research centre koper, institute for kinesiology research. the congress, which focuses on children and adolescents and their healthy physical and holistic development, is becoming an international reference conference in this part of europe. the partners in the organization of the congress are the faculties of education in koper, ljubljana and maribor, the dr. adolf drolc healthcare center, the faculty of sports and the biotechnical faculty of the university of ljubljana, as well as the slovenian kindergarten association and the slovenian paediatric association. once again, the congress was attended by many important foreign guests. the vision of the 10th congress was ”to provide an active environment for children and adolescents”. the conference was attended by 231 active participants from 11 countries, and included three invited lecturers, 14 plenary scientific lecturers, 46 scientific papers and 168 professional presentations, five of which were professional workshops. the emphasis can be summed up in the meaning of daily physical / sports activities of children in school or kindergarten and outside. in school children, physical / sports activity is encouraged not only in the course of physical education, but also in other school subjects. only in this way can we provide the child with enough physical stimuli and sufficient amounts of physical / sports activity important for the development of resilience and health, motor and cognitive competencies, creativity, and thereby contri74 reports and reviews/poročila in ocene, 65–76 annales kinesiologiae • 11 • 2020 • 1 bute to emotional and social maturation. unfortunately, today’s lifestyle, which society shapes and offers to young people, does not allow this and will require a holistic effort on the part of many stakeholders. in parallel with the congress, we hosted important guests of the international project “knowledge hub on the euro-mediterranean region med-hub”, led by the euro-mediterranean university in partnership with the organizers of the congress, which linked the professional and scientific pool of our mediterranean region to seek solutions and enrich study programs within the whole european region. boštjan šimunič, rado pišot, tadeja volmut annales kinesiologiae • 11 • 2020 • 1 75 reports and reviews/poročila in ocene, 65–76 poročilo s kongresa: 10. jubilejni mednarodni znanstveni in strokovni kongres – otrok v gibanju 2019 piran, slovenija, 7.–9. november 2019 mednarodna znanstvena in strokovna konferenca “otrok v gibanju” praznuje 20 let. inštitutu za kineziološke raziskave znanstveno-raziskovalnega središča koper, ki mu je v sodelovanju s številnimi partnerji simpozij uspelo postaviti na tako visoko raven, iskreno čestitam. ne le za tokratno prireditev, predvsem za to, ker 20 let strokovnega in znanstvenega sestajanja in druženja kaže na trajnostno naravnanost vašega dela ter obeta premišljene učinke vašega strokovnega dela in raziskovanja. v dneh, ko se boste v portorožu strokovnjaki ukvarjali z zahtevnimi vprašanji otrokovega razvoja, obeležujemo teden otroka. ta okvir dodaja vašemu delu posebno zavedanje o pomenu in vlogi otroka ter pomembnosti njegovega zdravega razvoja, zavezuje pa tudi k odgovornosti, ki nam jo nalagajo prihajajoče generacije. predsednik republike slovenije borut pahor, častni pokrovitelj konference otrok v gibanju deseto jubilejno znanstveno in strokovno konferenco otrok v gibanju je kot vse do zdaj organiziral inštitut za kineziološke raziskave znanstveno-raziskovalnega središča koper. konferenca, ki daje v ospredje otroka in mladostnika ter njun zdravi telesni in celostni razvoj, postaja mednarodna referenčna konferenca v tem delu evrope. kot partnerji pri njeni organizaciji sodelujejo pedagoške fakultete v kopru, ljubljani in mariboru, zdravstveni dom dr. adolfa drolca, fakulteta za šport in biotehnična fakulteta univerze v ljubljani, skupnost vrtcev slovenije in združenje pediatrov slovenije. tudi tokrat so se konference udeležili številni pomembni tuji gosti. vizija 10. konference je bila »zagotovimo otroku in mladostniku aktivno okolje«. konference se je udeležilo 231 aktivnih udeležencev iz 11 držav, ki so se predstavili s tremi vabljenimi referati, 14 uvodnimi znanstvenimi predavanji, 46 znanstvenimi prispevki in 168 strokovnimi referati, od katerih jih je bilo pet predstavljenih v strokovni delavnici. poudarke lahko strnemo v pomenu vsakodnevne gibalne/športne aktivnosti otrok v šoli in vrtcu in zunaj teh. pri šolskih otrocih gibalno/športno aktivnost ne spodbujamo le pri predmetu šport, temveč tudi pri drugih šolskih predmetih. le tako lahko otroku zagotovimo dovolj gibalnih spodbud in zadostno količino gibalne/športne aktivnosti, pomembne za razvoj odpornosti in zdravja, njegovih gibalnih in kognitivnih kompetenc in ustvarjalnosti, ter prispevamo k čustvenemu in družbenemu dozorevanju. žal današnji življenjski slog, ki ga družba oblikuje in ponuja mladim, tega ne omogoča, zato bo potrebno celostno prizadevanje. 76 reports and reviews/poročila in ocene, 65–76 annales kinesiologiae • 11 • 2020 • 1 hkrati s kongresom smo gostili tudi pomembne goste mednarodnega projekta »knowledge hub on the euro-mediterranean region – med-hub«, ki ga vodi evro-sredozemska univerza v partnerstvu z organizatorji kongresa, ki je povezal stroko in znanost naše sredozemske regije v prioritete razvoja novih rešitev in študijskih programov celotne evropske regije. boštjan šimunič, rado pišot, tadeja volmut _hlk35418826 _goback _hlk35971111 _hlk35511489 _hlk35972306 _hlk35451145 _hlk35511425 _hlk35973495 _hlk35973574 _hlk35973830 _hlk35975249 _hlk35975104 _gjdgxs 30j0zll 1fob9te _goback _3znysh7 _goback _goback _goback _hlk54274488 _goback annales kinesiologiae • 7 • 2016 • 2 117 original scientific article udc: 796.012.61-053.9 received: 2016-12-26 the effects of different exercise-based interventions on functional fitness of older adults armin paravlić1, uroš marušič1,2, mitja gerževič2, felicita urzi3, boštjan šimunič1 1 science and research centre koper, institute for kinesiology research, garibaldijeva 1, 6000 koper, slovenia 2 university of primorska, faculty of health sciences, polje 42, 6310 izola, slovenia 3 university of primorska, faculty of mathematics, natural sciences and information technologies, department of biodiversity, glagoljaška 8, 6000 koper, slovenia corresponding author: boštjan šimunič science and research centre koper, institute for kinesiology research, garibaldijeva 1, 6000 koper, slovenia tel.: +386 5 66 37 700 e-mail: bostjan.simunic@zrs-kp.si abstract ageing is a multifactorial process associated with several irreversible functional and cognitive alterations of human body and determined by genetic and environmental factors. we aimed to investigate the effects of three physical activity interventions of 40 independently living older adults before and after a 3-month training period. thirty female (69.6 ± 5.3 years) and ten male (70.6 ± 5.4 years) participants were randomly assigned into a physical exercise group (peg; n = 9), a concurrent physical and cognitive exercise group (peg + cog; n = 10), a physical exercise with additional 10 g of bcaa daily supplementation group (peg+bcaa; n = 11), and a control group (cg; n = 10). all three groups performed the same physical exercise program for 12 weeks, three days a week for 45 − 60 minutes per session. preand post-measurements were performed using a standardized functional fitness assessment tool for older adults i.e. senior fitness test battery, upgraded with the four square step test (fsst) and grip strength test (gst). when intervention groups were pooled, we found moderate to low improvements in the chair stand up, timed up and go, fsst and six-minute walk tests (all p < .001). however, those improvements were intervention-specific with highest improvements found in the peg for the fsst (p = .004) and six-minute walk test (p = .004); in the peg + cog for the timed up and go test (p < .001); and in 118 armin paravlić, uroš marušič, mitja gerževič, felicita urzi, rado pišot, boštjan šimunič: the effects of different ..., 117–137 annales kinesiologiae • 7 • 2016 • 2 the peg+bcaa for body mass (p = .012) and the chair stand up test (p < .001). although the sample size was low, our study provides further evidence of different interventional exercise-based programs that can benefit the population of independently living older adults. keywords: ageing, senior fitness test, frailty, cognition, diet, interventions. učinek različnih intervencijskih programov na funkcionalno telesno pripravljenost zdravih starejših odraslih izvleček staranje je pogojeno z več dejavniki, ki vodijo v funkcionalne in kognitivne spremembe, v močni soodvisnosti od genetskih in okolijskih dejavnikov. cilj raziskave je bil preučiti učinkovitost treh 3-mesečnih gibalnih intervencij na 40 funkcionalno neodvisnih starejših preiskovancih, 30 žensk (69,6 ± 5,3 let) in 10 moških (70,6 ± 5,4 let). preiskovanci so bili naključno razdeljeni v štiri skupine: gibalna intervencija (peg; n = 9), gibalno-kognitivna intervencija (peg+cog; n = 10), gibalno-prehranska intervencija z 10 gramov dodatkov bcaa dnevno (peg+bcaa; n = 11) in kontrolna skupina (cg; n = 10). vse tri intervencijske skupine so 12 tednov izvajale enako gibalno vadbo, tri vadbe na teden v trajanju posamezne vadbe 45-60 minut. meritve smo opravili pred in po koncu intervencij z uporabo standardiziranega testa telesne pripravljenosti za starejše (senior fitness test battery) in dodatno še testa štirih kvadratov (four square step test – fsst) ter testa silovitosti stiska pesti (grip strength test – gst). ko smo vse tri intervencijske skupine združili, smo ugotovili nizko do srednje napredovanje v testih vstajanja s stola, vstani in pojdi, fsst in hoje na 6 minut (vsi p < 0,001). kljub temu pa smo ugotovili, da so bili napredki odvisni od specifične intervencije, saj so preiskovanci v skupini peg najbolj napredovali v fsst (p = 0,004) in hoji na 6 minut (p = 0,004); v skupini peg+cog v vstani in pojdi (p < 0,001); in v skupini peg+bcaa v telesni masi (p = 0,012) in vstajanju s stola (p < 0,001). navkljub nizkemu številu preiskovancev, smo dokazali vpliv različnih gibalnih intervencij, ki lahko pomembno prispevajo populaciji starejših, funkcionalno neodvisnih preiskovancev. ključne besede: staranje, test telesne pripravljenosti za starejše, krhkost, dieta, intervencija annales kinesiologiae • 7 • 2016 • 2 119 armin paravlić, uroš marušič, mitja gerževič, felicita urzi, rado pišot, boštjan šimunič: the effects of different ..., 117–137 introduction ageing is a complex, multidimensional physiological process associated with a significant changes in the structure and function of an organism that occur as a result of time flow (grimby & saltin, 1983; salthouse, 2009; vandervoort, 2002; verhaeghen, steitz, sliwinski, & cerella, 2003; wertz & dronkers, 1990). these age-related changes negatively affect a broad range of tissues, major organ systems and functions (harman, 1981; weinert & timiras, 2003). more specifically, aging process triggers alterations in body composition (i.e. gradual accumulation of body fat and its redistribution to central and visceral depots), the loss of muscle mass or function (sarcopenia) and muscle weakness (dynapenia) along with other alterations in metabolic, cardiovascular or skeletal (osteopenia) systems (baumgartner, 2000; clark & manini, 2008; goodpaster et al., 2006; haramizu, ota, hase, & murase, 2011; milanovic et al., 2013). with advancing age, these alterations become more pronounced, leading to physical and cognitive functions deterioration, which eventually increase prevalence of disability and mortality risk (atkinson hh, 2007; kallman, plato, & tobin, 1990; kokkinos, 2012; onder et al., 2002; power, dalton, & rice, 2013; salthouse, 2009; topinková, 2008). it is also known that functional (and cognitive) loss can be preventable and even reversible through timely detection of physical weakness and appropriate intervention (fried, ferrucci, darer, williamson, & anderson, 2004). physical inactivity, a main risk factor for overall mortality, leads to severe acute deterioration of muscle mass and function that could be also irreversible if not recognized and contrasted (pisot et al., 2016). as both lifespan and aged population are increasing (klenk, rapp, büchele, keil, & weiland, 2007), the emerging problem should represent identification of optimal and timely pharmacological, surgical, dietary, exercise and cognitive interventions that can mitigate ageing-related changes on a number of levels (rowe & kahn, 1997). the effects of medical interventions are often centered and specific (i.e. affecting only the targeted health-related issues) and often cause serious side effects (meador, 1994; turjanski & lloyd, 2005). also, along with the high costs (i.e. lifelong drug usage) they might not represent the most desirable and effective strategies. in contrast, various exercise / physical activity interventions, when individually and professionally programed, have been proven to produce beneficial effects on physical and cognitive functions as well (hallage et al., 2010; hanson et al., 2009; karavirta et al., 2011); even for population at-risk and / or patients (flansbjer, miller, downham, & lexell, 2008; heyn, abreu, & ottenbacher, 2004; morris, dodd, & morris, 2004). accordingly, it is well established that regular physical activity is an efficient strategy for successful ageing (kokkinos, 2012; nelson et al., 2007; taylor et al., 2004). physical activity (pa) engagement increases life expectancy and improves the quality of life (blair et al., 1989; nelson et al., 2007; paffenbarger, hyde, wing, & hsieh, 1986). further, it has been shown that pa reduces all-cause mortality (blair et al., 1989; kampert, blair, barlow, & kohl, 1996; nelson et al., 2007; paffenbarger et al., 1986) by 22% even if practiced with a low dose (< 150 min/week) of moderate-to-vigorous intensity (hupin 120 armin paravlić, uroš marušič, mitja gerževič, felicita urzi, rado pišot, boštjan šimunič: the effects of different ..., 117–137 annales kinesiologiae • 7 • 2016 • 2 et al., 2015). however, additional benefits might be expected when the amount of pa progressively increases regarding both the intensity and the volume of exercise (chodzko-zajko et al., 2009). moreover, pa effects are positively correlated with a higher level of individual fitness (kampert et al., 1996), where the percentage of functional fitness decline (e.g. lower and upper body muscle strength, lower and upper body flexibility, aerobic endurance, and motor agility / dynamic balance) is generally consistent with age-related declines in physical performance (rikli & jones, 1999). therefore, interventions including both endurance and strength activities (nelson et al., 2007) alone or along with dietary manipulation and / or cognitive interventions might be plausible strategies that might counteract the aforementioned negative changes and risks, making older adults’ life more comfortable (ball, berch, & helmers, 2002; buchman et al., 2012; harman, 1981; marusic et al., 2016; pišot et al., 2015). accordingly, there is ample evidence suggesting that the combination of proper dieting (fiatarone et al., 1994; kim et al., 2012; messier et al., 2004) and pa could show greater benefits on functional fitness than either intervention alone. the current recommended dietary allowance for the minimum protein intake for adults, including older adults population, is 0.8 g protein / kg bm / day (who, 2007). however, recent research results suggest that the recommended protein intake does not promote optimal health or protect older adults from age-related body changes (morley et al., 2010; paddon-jones & van loon, 2012; volpi et al., 2003). based on new evidence, the prot-age study group recommends an average daily intake in the range of 1.0 to 1.2 g / kg bm / d for healthy older adults, 1.2 to 1.5 g / kg bm / d for those who have acute or chronic diseases and 2.0 g / kg bm / d for people with severe illness or injury or with recognizable malnutrition (bauer et al., 2013). the consumption of higher protein diet, at least 1.2 to 1.6 g / kg bm / day of high-quality protein with concentrated source of essential amino acids, including branched amino acids (bcaa) leucine, could prevent age-related sarcopenia, the loss of muscle mass and strength. including ~30 g of protein per meal seems a successful strategy to achieve optimal health outcomes in adults (phillips, chevalier & leidy, 2016). exercise greatly increases energy expenditure and promotes oxidation of bcaas (rennie, 1996). bcaas are regulators of protein metabolism and are key metabolic precursors for glutamine and alanine synthesis (choudry, karinch & souba, 2006). these properties have suggested that bcaas may have interesting and clinically-relevant metabolic effects. the effects of bcaa supplementation before and after exercise has beneficial effects for decreasing exercise-induced muscle damage and are responsible for the direct stimulation of muscle protein synthesis and the suppression of exercise-induced protein breakdown (coombes & mcnaughton 2000; fujita & volpi, 2006; maclean, graham & saltin, 1994; nosaka, 2003). in addition, amino acids, particularly bcaas, may be used clinically to attenuate diet-induced muscle atrophy (layman, 2003) and prevent sarcopenia in older adults (koopman et al., 2006; volpi et al., 2003; volpi et al., 2007). various cognitive training approaches revealed considerable beneficial effects in improving specifically targeted cognitive abilities (i.e. memory, reasoning and procesannales kinesiologiae • 7 • 2016 • 2 121 armin paravlić, uroš marušič, mitja gerževič, felicita urzi, rado pišot, boštjan šimunič: the effects of different ..., 117–137 sing speed) (ball et al., 2002; edwards et al., 2005; saczynski, willis, & schaie, 2002), with some evidence of positive transfer to non-specifically trained cognitive functions and activities of daily living (ball et al., 2002; marušič et al., 2016; willis, tennstedt, marsiske, & et al., 2006). for example, the study by edwards et al. (2005) provides evidence that speed processing training has the potential to enhance everyday functions that help to maintain independence and quality of life, particularly when the training is targeted toward individuals who most need it. in a five-year study, willis et al. (2006) showed that cognitive training resulted in lower functional decline in self-reported instrumental activities of daily living, which was evident up to 5 years after the initiation of the intervention. furthermore, a multidimensional intervention which combined diet, exercise, cognitive training and vascular risk monitoring, showed 25 % better results in cognitive functions as compared to the controls (ngandu et al., 2015). regarding the aforementioned positive influence of cognitive and pa interventions and their training specificity, their combined effects might have greater effects on instrumental activities of daily living or even functional fitness. moreover, theill et al. (2013) investigated the effects of a simultaneously performed motor-cognitive training compared to a single cognitive training and to controls. they concluded that the combined motor-cognitive training presents a promising concept to improve cognitive and motor-cognitive dual-task performance, offering greater potential on daily functioning, which usually involves the recruitment of multiple abilities and resources rather than a single one. thus, the effects of physical training alone or in combination with dietary interventions, as well as cognitive training, on physical and cognitive functions are well documented, while there are almost no experimental studies that directly compare the effects of these interventions or its combination between each other and / or controls. furthermore, the aforementioned studies mainly include community-dwelling older adults where outcome measures were specific cognitive abilities and daily activities assessed by participants’ self-reports and / or with only a few physical performance tests. thus, the influences of combined interventions in healthy, independent older adults in respect to functional fitness are unknown. in addition, according to our knowledge, this type of interventional study is one of the first performed among slovenian older adults. therefore, the aim of this study was to compare the effects of three different 3-month interventions on functional fitness of healthy older adults chosen among the population of independently living slovenians. we hypothesized that all three intervention groups (physical exercise only; combined physical and cognitive exercise; combined physical exercise and diet supplement) will have significant effects on physical fitness in comparison to the control group (cg). 122 armin paravlić, uroš marušič, mitja gerževič, felicita urzi, rado pišot, boštjan šimunič: the effects of different ..., 117–137 annales kinesiologiae • 7 • 2016 • 2 methods participants after the initial screening of 195 older adults, we recruited 40 individuals of which 30 were females (69.2 ± 5.3 years) and ten males (70.6 ± 5.4 years). the participants were randomly assigned to one of three intervention groups: i) a physical exercise group (peg), ii) a concurrent physical and cognitive exercise group (peg+cog), iii) a physical exercise with additional branched-chain amino acids (bcaa) daily supplementation group (peg+bcaa) or iv) in a control group (cg). the final sample of the study included nine participants in peg (age: 68.7 ± 5.3 years, height: 165.5 ± 6.9 cm, body mass: 71.5 ± 13.7 kg), ten in peg+cog (age: 70.6 ± 5.4 years, height: 162.3 ± 6.7 cm, body mass: 68.8 ± 15.1 kg), eleven in peg+bcaa (age: 69.9 ± 6.8 years, height: 166.2 ± 8.1 cm, body mass: 73.2 ± 9.1 kg) and ten in cg (age: 68.9 ± 3.4 years, height: 161.8 ± 5.1 cm, body mass: 64.4 ± 8.4 kg). the participants were healthy volunteers without serious cardiovascular or musculoskeletal diseases. the inclusion criteria were: i) at least 65 years old, ii) independently living at home (i.e. performing everyday activities without mobility aids), iii) residents of the city of ljubljana (where the measurements were performed) and iv) feeling healthy and able to walk 2 km without stopping and using walking aids. all the participants provided a written informed consent to participate in the study according to helsinki − tokyo declaration. the study obtained ethical approval from the national medical ethics committee of the republic of slovenia. interventions each intervention lasted for 12 weeks, 3 times per week (altogether 34 sessions), with individual sessions’ duration of 45 to 60 minutes. each training session was performed at the same time of the day (starting at 10 a. m.). thus, the training sessions consisted of three parts explained in details in table 1 (on the left side). the volume and intensity in the second (main) part of the session was controlled by the ratio of the working and resting training time. at the beginning of the intervention (weeks 1 to 3) the working time for each exercise was 20 seconds with 40 seconds rest (work / rest ratio was 1:2); from week 4 to week 8 the ratio was 1:1 (30 s : 30 s) and at the end of the intervention (from week 9 to week 12) the ratio was 2:1 favouring the working time. peg and peg+bcaa intervention consisted of the same physical activity program. the participants in the peg+bcaa group were receiving orally 10 g of bcaa supplement immediately after each training session, three times per week and at the same time on the days without training. annales kinesiologiae • 7 • 2016 • 2 123 armin paravlić, uroš marušič, mitja gerževič, felicita urzi, rado pišot, boštjan šimunič: the effects of different ..., 117–137 ta bl e 1: a pp ro xi m at e du ra tio n an d ex am pl es o f p hy si ca l a nd c og ni tiv e ex er ci se s an d di et ar y su pp le m en ts . p e g p e g + c o g p e g + b c a a pa rt i (1 0 − 15 m in ): d yn am ic w ar m u p: a c om bi na tio n of st ep pi ng o n si te o r w al ki ng f or w ar d / si de w ay s w ith (a dd iti on al ) a ct iv e fle xi bi lit y st re tc hi ng a nd r hy th m ic e xe rc ise s w er e us ed ( e. g. m ar ch in g w ith r isi ng a nd lo w er in g th e ar m s, h ig h kn ee w al ki ng , si de w al ki ng w ith c ro ss ov er st ep s on c la pp in g et c. ). ph ys ic al e xe rc is es : t he s am e as in p e g ; co gn iti ve e xe rc is es p er fo rm ed c on cu rr en tly w ith p hy si ca l e xe rc is es : e. g. : lis t o f w or ds to re m em be r “ w ha t t o br in g fr om th e su pe rm ar ke t” : eg gs , m ilk , c he es e, b ut te r, cr ea m , t om at oe s, b re ad or “ w hi ch in gr ed ie nt s ar e ne ed ed fo r t he s av or y g ar lic m ar in at ed s te ak s” : ba ls am ic v in eg ar , s oy s au ce , g ar lic , h on ey , o liv e oi l, bl ac k pe pp er e tc . ph ys ic al e xe rc is es : th e sa m e as in p e g ; pa rt ii (3 0 − 40 m in ): e ig ht st re ng th an d po w er ex er ci se s (m ai n pa rt ) ba se d on c ir cu it tr ai ni ng pr in ci pl e fo r tr un k, u pp er an d lo w er -b od y m us cl es (e .g . sq ua ts , lu ng es , ca lf r is es , pu sh -u ps a nd p la nk s on a ch ai r, cr un ch es a nd s id e cr un ch es ). ph ys ic al e xe rc is es : t he s am e as in p e g ; co gn iti ve e xe rc is es p er fo rm ed c on cu rr en tly w ith p hy si ca l e xe rc is es : e. g. : na m in g ci tie s, s ta rt in g w ith th e la st le tte r o f t he p re vi ou s ci ty : l ju bl ja na , a nc ar a , a th en s, s yd ne y e tc .; co un tin g ba ck w ar ds fr om 1 00 : in a s te p of 1 (9 9, 9 8, 9 7 et c. ); in a s te p of 1 7 (8 3, 6 6, 4 9 et c. ). ph ys ic al e xe rc is es : th e sa m e as in p e g . pa rt ii i ( 10 -1 5m in ): fl ex ib ili ty an d re la xa tio n ex er ci se , w ith f oc us o n br ea th in g te ch ni qu e in or de r to r es to re b od y fu nc tio ns o n its in iti al le ve l w as u se d. ph ys ic al e xe rc is es : t he s am e as in p e g ; c og ni tiv e ex er ci se s pe rf or m ed c on cu rr en tly w ith p hy si ca l e xe rc is es : l is t a ll th e w or ds fr om th e pa rt i. ph ys ic al e xe rc is es : th e sa m e as in p e g . po st e xe rc is e / / 10 g b c a a 124 armin paravlić, uroš marušič, mitja gerževič, felicita urzi, rado pišot, boštjan šimunič: the effects of different ..., 117–137 annales kinesiologiae • 7 • 2016 • 2 comparing with peg and peg+bcaa intervention program, peg+cog intervention consisted of similar physical exercises, while cognitive tasks were added. during the warm up exercises, each participant in peg+cog received a list of words that he / she needed to remember and report at the end of each session, see table 1. (mid-side). the lists of words were different for each participant and were changing each session. the main part consisted of the same physical exercises as for the peg with additional cognitive tasks targeting on working and short-term memory, attention, mental rotation and visual-spatial perception. examples of cognitive tasks were naming animals on a certain letter, counting backwards, listing all flavours that remind you of summer etc. while performing physical exercises. finally, during the flexibility and relaxation exercises, the participants in peg+cog were asked to disclose previously delivered list of words. participants in the cg had only preand post-measurement screening with no specific interventions in-between and were asked to maintain their usual daily activities. measurements all groups were tested before (pre) and after (post) the interventions. on the testing day, the participants completed all senior fitness test items (rikli & jones, 1999; 2001) in order to determine subjects’ lower and upper body strength, flexibility, agility, aerobic endurance and dynamic standing balance. the senior fitness test consists of six assessment items (i.e. the chair stand test, arm curl test, chair sit and reach test, back scratch test, timed up and go test and six-minute walk test). the chair stand test assesses lower body strength. each subject completed two practice repetitions and one 30-second test trial. the recorded score was the total number of stands executed correctly within 30 seconds. the arm curl test assesses upper body strength. each subject completed two practice repetitions and one 30-second test trial sitting on a chair. women used 2.5 kg, while men 3.5 kg barbells. the score was the total number of arm flexions and extensions through the full range of motion in 30-seconds. the chair sit and reach test assesses lower body flexibility. each subject completed two practice trials and two test trials. the score was the longest distance achieved between the extended fingers and the tip of the toe. the back scratch test assesses upper body flexibility. each subject completed two practice trials and two test trials. the score was the shortest distance achieved between the extended middle fingers. the timed up and go test assesses agility and dynamic balance. each subject completed one practice trial and two test trials. the score was the shortest time to rise from a seated position, walk 8 feet, turn around the cone, and return to the seated position. the six-minute walk test assesses aerobic endurance. the score was the total distance walked in six minutes around the two cones 15 m apart. additional to the senior fitness test battery, participants also performed the four square step test / fsst (dite & temple, 2002) and the grip strength test. the fsst involves stepping over 4 canes that are laid on the ground at 90° angles to each other annales kinesiologiae • 7 • 2016 • 2 125 armin paravlić, uroš marušič, mitja gerževič, felicita urzi, rado pišot, boštjan šimunič: the effects of different ..., 117–137 (like a “plus” sign). the canes were 90 cm in length as first described by dite and temple (2002). subjects were asked to stand in 1 square facing forward with their shoes on. they then rotated clockwise around the “plus sign” by moving forward, to the right, backward, to the left. the patients then reversed their path and moved in a counterclockwise direction. the instructions were as follows: “try to complete the sequence as fast as possible without touching the sticks. both feet must make contact with the floor in each square. if possible, face forward during the entire sequence.” (dite & temple, 2002). each subject had 1 practice trial and 2 timed trials; with all subjects completing the testing within 5 minutes. if a patient touched the cane, lost his / her balance, or did not place both feet in the square, he / she was asked to repeat the trial. the best score achieved was used for further analysis. maximal grip strength was measured bilaterally with a portable jamar hydraulic hand dynamometer (sammons preston, rolyan, bolingbrook, il, usa). in accordance with american society of hand therapy recommendations, subjects were seated with their shoulders in 0° abduction and neutral rotation, their elbows in 90° of flexion, and their forearms in neutral pronation / supination. the average of three and two maximal repetitions was used for further analysis. habitual dietary intake was assessed by three-day food record and the participants were asked to continue habitual diet during the study adding 10 g of bcaa each day at 11 am. statistical analysis all data are presented as means ± standard deviations. data were analysed using spss software (version 20.0). after confirming normality and homogeneity of distribution using shapiro-wilk and leven test, a 1-way analysis of variance (anova) was used to compare baseline values between the groups. a two-way, repeated measures anova was performed to determine changes within groups over time (pre to post) and between groups. firstly, we compared the pooled interventions group (peg) vs. cg (2x2 repeated measure anova), and also each intervention group separately vs. cg (2x4 repeated measures anova). individual group changes from preto post period were assessed using the paired-sample student’s t-test (two-tailed). the level of significance was set at 0.05. when significant changes were confirmed, the effect size was calculated as the mean change found in a variable divided by the standard deviation at baseline of that variable; an effect size of 0.10 – 0.19 was considered very small, 0.20 – 0.49 small, 0.50 – 0.79 moderate, 0.80 – 1.19 large, 1.20 – 1.99 very large and 2.00 or greater was considered a huge effect (sawilowsky, 2009). 126 armin paravlić, uroš marušič, mitja gerževič, felicita urzi, rado pišot, boštjan šimunič: the effects of different ..., 117–137 annales kinesiologiae • 7 • 2016 • 2 results initially, 67 participants were randomly divided in 4 groups; however, 40 of them passed > 90 % of sessions adherence with both preand post-testing. a vast majority of drop-out was a consequence of holidays, trips and large daily travel distances to admit sessions. there was no injury occurrence during this study. the average adherence to interventions was more than 80 %. the participants followed their habitual diet and the estimated dietary intake was not different between the beginning and the end of the study. the mean daily protein intake was 0.92 ± 0.3 g / kg bm / day. there were no significant differences in pre-tests between peg and cg, neither in all four groups nor individually. the results from the 2 x 2 repeated measures anova indicated a significant main effect of time for chair stand (f[1,38] = 17.4; p < .001; η2 = .31), the timed up and go (f[1,38] = 8.49; p = .006; η2 = .183), and the six-minute walk (f[1,38] = 11.46; p = .002; η2 = 0.232) tests, while the arm curl (f[1,38] = 4.07; p = .051; η2 = .090) and the four square step test (f[1,38] = 3.55; p = .067; η2 = .085) were near-significant. there were significant time x group interaction effects for the timed up and go (f[1,38] = 6.93; p = .012; η2 = .154) and the four square step test (f[1,38] = 5.76; p = .021; η2 = .132). furthermore, in table 2, paired sample t-tests indicated that participants in peg performed better at the post-test compared to the pre-test in lower body strength, agility, dynamic standing balance, and aerobic endurance, while the cg did not improve in any test performed. results of the 4x2 repeated measures anova confirmed main time effect for body mass (f[3,38] = 5.06; p = .031; η2 = .123), the chair stand (f[3,38] = 34.34; p < .001; η2 = .488), the arm curl (f[3,38] = 7.64; p = .009; η2 = .177), the timed up and go (f[3,38] = 23.24; p < .001, η2 = .392), the four square step (f[3,38] = 12.0; p < .001; η2 = .251) and the 6-minute walk (f[3,38] = 20.1; p < 0.001; η2 = .359), while the back stretch (f[3,38] = 3.30; p = .078; η2 = .084) and the grip strength (f[3,38] = 3.36; p = .075; η2 = .085) were near-significant. there were significant time x group interaction effects for the timed up and go (f [3,38] = 3.36;, p = .029; η2 = .219), while in the four square test (f[3,38] = 2.31; p = .093; η2 = .161) was almost significant. the paired sample t-tests indicated that the participants in peg improved in back stretch for 100 % (p = .005), the timed up and go for 8.3 % (p = .022), the four square step for 13 % (p = .004), and the 6-minute walk for 9.6 % (p = .004), while for the chair stand up the improvement was near-significant (p = .052). the peg+cog improved in chair stand up for 26.1 % (p = .017), the timed up and go for 15.6 % (p < .001) and the four square step for 8.8 % (p = .014). moreover, peg+bcaa improved significantly in almost all functional tests performed; the chair stand up for 35.3 % (p < .001), the arm curl for 16.6 % (p = .023), timed up and go for 15.8 % (p = .028), the four square step for 16.6 % (p = .043), the 6-minute walk for 10.9 % (p = .004), and had lower body mass for 1.8 % (p = .012) at post-test (table 3). annales kinesiologiae • 7 • 2016 • 2 127 armin paravlić, uroš marušič, mitja gerževič, felicita urzi, rado pišot, boštjan šimunič: the effects of different ..., 117–137 ta bl e 2: p re t o po st -c om pa ri so n be tw ee n th e po ol ed in te rv en tio ns g ro up s (p e g ) a nd c on tr ol g ro up (c g ). pe g (n =3 0) c g (n =1 0) te st s pr e po st p (d ) pr e po st p (d ) b od y m as s (k g) 71 .1 ±1 2. 5 69 .8 ±1 2. 1 n a () 64 .4 ±8 .4 1 64 .1 ±1 2. 5 n a () b od y m as s in de x (k g/ m 2 ) 26 .1 7 ± 3. 83 25 .6 5 ± 3. 63 n a () 24 .6 4 ± 3. 45 23 .9 5 ± 4. 07 n a () c ha ir s ta nd u p (r ep s) 17 .2 ±4 .5 2 21 .7 ±4 .9 4 <0 .0 01 (. 99 ) 18 .1 ±3 .4 4 19 .6 ±4 .7 8 .1 10 () a rm c ur l ( re ps ) 19 .1 ±3 .9 1 20 .9 ±4 .1 9 n a ( -) 18 .9 ±3 .8 4 19 .7 ±3 .1 9 n a () si t a nd r ea ch (c m ) 3. 11 ±1 0. 8 1. 16 ±1 0. 4 n a () 7. 31 ±1 5. 1 6. 31 ±1 1. 9 n a () b ac k st re tc h (c m ) -4 .3 1± 9. 64 -2 .9 1± 10 .7 n a () .5 11 ±7 .7 1 1. 71 ±8 .2 1 n a () ti m ed u p an d g o (s ) 5. 02 ±1 .2 2 4. 33 ±0 .7 0 <. 00 1 (.5 7) 4. 65 ±0 .5 3 4. 62 ±0 .4 6 .7 90 () g ri p st re ng th (k g) 31 .8 ±8 .8 4 30 .9 ±8 .8 7 n a () 30 .1 ±4 .9 4 29 .1 ±4 .7 9 n a () 4sq ua re s te p (s ) 6. 66 ±1 .9 3 5. 81 ±1 .3 4 <. 00 1 (.4 5) 6. 41 ±1 .5 4 6. 51 ±1 .3 8 .7 78 () 6m in w al k (m ) 53 7± 67 .8 57 8± 66 .1 <. 00 1 (.6 1) 59 5± 81 .8 62 1± 75 .3 .2 86 () n a – n ot a pp lic ab le a s tim e or ti m e x gr ou p in te ra ct io n ef fe ct s w er e no t c on fir m ed . p – si gn ifi ca nc e le ve l o f p ai re dsa m pl e tte st . d – e ff ec t s iz e. 128 armin paravlić, uroš marušič, mitja gerževič, felicita urzi, rado pišot, boštjan šimunič: the effects of different ..., 117–137 annales kinesiologiae • 7 • 2016 • 2 table 3: preto post-comparison between physical group (peg), physical-cognitive group (peg+cog), physical-dietary group (peg+bcaa), and control group (cg). peg (n=9) peg+cog (n=10) peg+bcaa (n=11) cg (n=11) p (d) p (d) p (d) p (d) body mass (kg) pre 71.6±13.7 68.8 ±15.1 73.2 ±9.17 64.4 ±8.41 post 69.6±13.5 .068 (.14) 67.7 ±13.8 .109 (-) 71.9 ±9.79 .012 (.14) 64.0 ±12.5 .831 (-) body mass index pre 25.98±3.65 26.01 ±5.14 26.48 ±2.79 24.64 ±3.46 post 25.24±3.41 na 25.61 ±4.63 na 26.02 ±3.06 na 23.95 ±4.07 na chair stand up (reps) pre 20.0±4.12 17.2 ±2.48 14.9 ±5.24 18.1 ±3.44 post 23.6±5.38 .052 (.86) 21.7 ±4.49 .017 (1.81) 20.2 ±4.89 <.001 (1.01) 19.6 ±4.78 .110 (.21) arm curl (reps) pre 20.7±3.35 19.2 ±3.52 17.4 ±4.36 18.9 ±3.84 post 22.9±4.85 .126 (.66) 19.7 ±2.83 .740 (.14) 20.4 ±4.43 .023 (.67) 19.7 ±3.19 .235 (-) sit and reach (cm) pre 9.11±13.12 1.60 ±9.43 -0.45 ±8.75 7.30 ±15.1 post 6.44±8.80 na 0.90 ±12.0 na -2.90 ±9.13 na 6.30 ±11.9 na back stretch (cm) pre -3.11±9.14 -4.00 ±10.5 -5.55 ±9.99 0.50 ±7.70 post .00±8.06 na -4.40 ±13.8 na -3.90 ±10.0 na 1.70 ±8.20 na timed up and go (s) pre 4.42±0.24 5.17 ±0.64 5.38 ±1.85 4.65 ±0.52 post 4.05±0.40 .022 (1.48) 4.36 ±0.41 <.001 (1.26) 4.53 ±1.00 .028 (.46) 4.62 ±0.46 .790 (-) grip strength (kg) pre 34.6±8.58 32.7 ±10.2 28.7 ±7.53 30.0 ±4.94 post 33.88±8.78 na 32.1 ±8.22 na 27.5 ±9.15 na 29.1 ±4.79 na 4 square step (s) pre 6.23±1.13 6.80 ± 1.01 6.90 ±2.93 6.41 ±1.54 post 5.41±1.08 .004 (.72) 6.20 ±0.78 .014 (.59) 5.75 ±1.86 .043 (.39) 6.51 ±1.38 .778 (-) 6 min walk (m) pre 557±55.3 542 ±53.6 517 ±86.6 596 ±81.8 post 611±57.0 .004 (.97) 555 ±58.8 .343 (.25) 574 ±73.6 .004 (.66) 621 ±75.4 .286 (.31) na – not applicable as time or time x group interaction effects were not confirmed. p – significance level of paired-sample t-test. d – effect size. annales kinesiologiae • 7 • 2016 • 2 129 armin paravlić, uroš marušič, mitja gerževič, felicita urzi, rado pišot, boštjan šimunič: the effects of different ..., 117–137 disscussion individual intervention groups have small sample sizes, therefore, we compared cumulative effects of all three interventions, by pairing all intervention groups together and contrasting vs. the cg. thus, the results showed significant time effects for chair stand up, the timed up and go, and the six-minute walk tests in interventions group, while the cg did not improve in any test. furthermore, certain meaningful interactions were seen in respect to the timed up and go as well for the four square test, suggesting that the applied physical training program influenced mostly agility and dynamic standing balance, which was expected in relation to physical intervention program design. the effects were large (the chair stand up), moderate (the timed up and go and the 6 min walk) and small (the 4 square step). when all groups were compared between each other individually, there was significant improvement observed in physical fitness tests after three months of interventions compared to the baseline in all intervention groups, except in cg, where body mass decreased only in peg+bcaa. our findings are consistent with findings from the literature (chang et al., 2004). although we cannot compare our interventions directly regarding the training design, their results are similar with ours, which suggests that older people could benefit from various supervised physical exercise programs. however, the intensity and the volume of exercise is important as demonstrated by cyarto et al. (2008) when comparing the effects of home-based resistance training, group-based resistance training, and group-based walking on functional ability in older adults. after 20 weeks of training with only two weekly sessions, they showed that both groups of resistance training experienced improvements in strength, lower-body flexibility, and agility / dynamic balance while there were no observed improvements in the walking group. therefore, frequency of two sessions per week used in the aforementioned study was far below those generally suggested (i.e. 30 minutes in duration and up to five weekly sessions) in order to promote and maintain health (nelson, et al., 2007, haskell, et al., 2007). taken together, the results of some systematic reviews and meta-analysis (cermak, de groot, saris, & van loon, 2012; cruz-jentoft et al., 2014; finger et al., 2015; nowson & o'connell, 2015) which assessed the effect of combined intervention with protein supplementation and resistance exercise on muscle mass and the function in aged population, show the inconsistency of studies to prove the effectiveness of protein supplementation. overall, the studies show the capacity of such intervention for electing gains in fat-free mass, a limited evidence for improvement in muscle strength, but no significant improvement to increase muscle function in older adults. the variation among studies regarding the supplementation protocols, protein sources, and amounts used are making it difficult to reach firm conclusions on this question. it was proposed that older adults need higher levels of protein intake due to their lower responsiveness to the anabolic stimulus (baum, kim, & wolfe, 2016). in fact, larger experiments that have demonstrated a significant functional benefit from combined intervention with resistance exercise and protein intake exceeded the range from inadequate intakes to 130 armin paravlić, uroš marušič, mitja gerževič, felicita urzi, rado pišot, boštjan šimunič: the effects of different ..., 117–137 annales kinesiologiae • 7 • 2016 • 2 optimal protein intakes (≥1.2 g/kg bm/day) and lasting for few months (chalé et al., 2012; tieland et al., 2012). although protein supplementation failed to point out consistent results, new evidence shows that branched chain amino acids (bcaa), such as leucine, at a daily amount of either 2.5 g or 2.8 g in combination with resistance exercise may affect muscle protein synthesis, muscle recovery following illness, and muscle mass (bauer et al., 2013). katsanos et al. (2006) demonstrate that the attenuated response of muscle protein synthesis in older adults, following the ingestion of small amounts of amino acids, can be reversed by the ingestion of additional amount of leucine. these data may explain the role of bcaa, especially leucine in reversing the lack of response following the protein-based supplementation. in our study, the peg+bcaa group was supplemented with 10g bcaa immediately after the exercise. however, even not significantly different, this intervention group experienced greater improvements in leg strength compered to others. for example, leg strength improved most (35.3 %) in the peg+bcaa group, while the peg and peg+cog groups improved less i.e. 26.1 % and 17.7 %, respectively, which is consistent with previous findings (verdijk et al., 2009). in the study by verdijk et al. (2009), 26 healthy older man, aged between 70 and 74 years were randomly assigned to a progressive, 12-week resistance-type exercise training program with (protein group) or without (placebo group) protein provided before and immediately after each exercise session (3 sessions per week, 20 g protein per session). although they trained with the resistance intensity of 65 % to 75 %, both training groups showed improvements of 25 % to 30 %, similar to our results. it is difficult to compare our results to other studies due to different exercise protocols and supplementation used. a few studies that show improvement in functional outcome in older adults included the participants who generally have an inadequate protein intake of 0.8 g / kg bm / day (kim et al., 2012; tieland et al., 2012). similarly, our participants had lower dietary protein intake (0.92 g / kg bm / day) than recommended (who, 2007) and, therefore, may benefit from the combined intervention. regarding aerobic endurance, only the peg and peg+bcaa improved for 9.6 % and 10.9 %, respectively. bearing in mind that the peg+cog had a more demanding cognitive aspect of exercise rather than physical, our results suggest that more than 30 minutes of moderate intensity pa is needed to induce positive alterations in aerobic endurance in older population; and / or two exercise models should be performed separately (i.e. not combined in the same task). furthermore, future studies should include measurements of various cognitive-motor tasks. in 375 elderly community residents, oswald and colleagues (2006) found significant training-related effects after five years of combined interventions. in detail, they showed that when compared with a non-treatment group, both physical and cognitive status can be preserved on a higher level, as well as emotional status of involved participants (as reflected through fewer depressive symptoms). our peg+cog group was included in the so-called broad approach that targets multiple domains of cognitive processes, which might be more effective than a specific one that includes only a sole or limited-set targeted cognitive functions (holannales kinesiologiae • 7 • 2016 • 2 131 armin paravlić, uroš marušič, mitja gerževič, felicita urzi, rado pišot, boštjan šimunič: the effects of different ..., 117–137 tzer et al., 2006). recent studies revealed that cognitive-based protocols can positively influence mobility-related outcomes in different population of older adults, namely, community-dwelling older adults (smith-ray et al., 2014), patients with parkinson’s disease (milman et al., 2014) and older adults during a prolonged bed rest (marusic et al., 2015; marusic et al., in press). therefore, we can further speculate that lack of improvements in the peg+cog group could also originate from inadequate measurement tests which were not sensitive enough to detect cognitive-motor related improvements. conclusion our research findings indicate that physical activity, alone or combined with cognitive and nutritional interventions could enhance functional fitness in older adults. more than 30 minutes of moderate-intensity physical activity, three times per week is needed for an improvement in aerobic endurance, while same volume of specific training program is enough to induce positive alterations in dynamic balance and agility. thus, when nutritional supplementation is added to physical exercise, results regarding functional strength task and body mass were more pronounced. acknowledgements this study was part of the project active and quality ageing in home environment (a-qu-a) financially supported by the norwegian financial mechanism and the republic of slovenia government office for development and european cohesion policy. we would like to thank the research coordinator prof. rado pišot, ph.d., all project partners and other researchers involved in the data collection process, students, participants, and everyone who helped. references atkinson h. h., et al. 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(2002). aging of the human neuromuscular system. muscle and nerve, 25(1), 17–25. view item verdijk, l. b., jonkers, r. a, gleeson, b. g., beelen, m., meijer, k., savelberg, h. h., et al. (2009). protein supplementation before and after exercise does not further augment skeletal muscle hypertrophy after resistance training in elderly men. the american journal of clinical nutrition, 89(2), 608–616. view item verhaeghen, p., steitz, d. w., sliwinski, m. j., & cerella, j. (2003). aging and dual-task performance: a meta-analysis. psychology and aging, 18(3), 443–460. view item volpi, e., ferrando, a. a., yeckel, c. w., tipton, k. d., & wolfe, r. r. (1998). exogenous amino acids stimulate net muscle protein synthesis in the elderly. journal of clinical investigation, 101(9), 2000-2007. view item volpi, e., kobayashi, h., sheffield-moore, m., mittendorfer, b., & wolfe, r. r. (2003). essential amino acids are primarily responsible for the amino acid stimulation of muscle protein anabolism in healthy elderly adults. the american journal of clinical nutrition, 78(2), 250-258. view item weinert, b. t., & timiras, p. s. (2003). physiology of aging. invited review: theories of aging. journal of applied physiology, 95(4), 1706–1716. view item wertz, r. t., & dronkers, n. f. (1990). effects of age on aphasia. in e. cherow (ed.), proceedings of the research symposium on communication sciences and disorders of aging (pp. 88–98). rockville, md: asha. who. (2007). protein and amino acid requirements in human nutrition: report of a joint fao/who/unu expert consultation. geneva: who press, report 935, 284. view item willis, s. l., tennstedt, s. l., marsiske, m., & et al. (2006). long-term effects of cognitive training on everyday functional outcomes in older adults. jama : journal of the american medical association, 296(23), 2805–2814. view item https://doi.org/10.1002/mus.1215 https://doi.org/10.3945/ajcn.2008.26626 https://doi.org/10.1037/0882-7974.18.3.443 https://dx.doi.org/10.1172%2fjci939 http://ajcn.nutrition.org/content/78/2/250.full https://doi.org/10.1152/japplphysiol.00288.2003 http://www.who.int/iris/handle/10665/43411 http://www.who.int/iris/handle/10665/43411 https://doi.org/10.1001/jama.296.23.2805 annales kinesiologiae • 11 • 2020 • 1 65 reports and reviews/poročila in ocene, 65–76 twinning the brain with machine learning for neuro-muscular efficiency (twinbrain) the project “twinning the brain with machine learning for neuro-muscular efficiency (twinbrain)1”, will be implemented between 1 november 2020 and 31 october 2023. the project is a part of the call “horizon 2020 twinning widespread-05-2020”. the twinbrain project was successfully designed and obtained within the institute for kinesiology research, science and research centre koper (zrs koper), under the leadership of dr. uroš marušič. the project partners with prestigious universities from germany (technische universität berlin; tub) and switzerland (université de genève; unige) and the neurology department of cattinara hospital (università degli studi di trieste; units, italy). the € 0.9m project, which will last for three years, aims to establish a research and diagnostic centre in the field of neuromuscular efficiency and to understand the functioning and control of the central nervous system during movement. one specific goal of the twinbrain project is to increase the scientific and technological capacities of related institutions with an emphasis on the institution of the applicant country zrs koper. the activities of the twinbrain project are aimed at establishing and raising the quality of the research group in the country with a lower r&i index (zrs koper), with the help of partner institutions with a higher r&i index (tub, unige and units). the ultimate goal of the project is to set up the slomobil: slovenian mobile brain/ body imaging laboratory, which will be established through the transfer of knowledge and technology from bemobil: berlin mobile brain/body imaging laboratory 2. in order to fully understand brain dynamics in actively moving people, we need to analyse brain dynamics in relation to coincident behaviour. this combination makes it possible to assess the complex interrelationships between brain and behavioural dynamics and is captured in the mobile brain/body imaging (mobi) system. the mobi system aligns real-time eeg signals with concurrent recordings of eye movements, body movements, and autonomic responses. the result is the simultaneous capture of large amounts of data that require advanced methods to process. to this end, the twinbrain project plans to implement machine learning methods that can statistically “learn” nonlinear relationships between brain dynamics and behaviour. a central aim of these analyses is to identify a limited number of functionally different large-brain networks that represents different aspects of the performed and recorded behavioural information. in that way, it would not only be possible to statically image brain activities related to the given task, but to characterise specific large-scale network dynamics and describe their time-resolved properties in relation to behaviour. 1 https://cordis.europa.eu/project/id/952401. 2 https://blogs.tu-berlin.de/bpn_bemobil/. https://cordis.europa.eu/project/id/952401 https://blogs.tu-berlin.de/bpn_bemobil/ 66 reports and reviews/poročila in ocene, 65–76 annales kinesiologiae • 11 • 2020 • 1 finally, with successful coupling of brain dynamics, motion kinematics, advanced brain imaging techniques, and machine learning, this project aims at transferring technology and knowledge among the included partners and beyond. as a result, the consortium will have enhanced scientific and technological capacity as well as networking activities. the institution from slovenia (zrs koper) will raise its research profile and the research profile of its staff. taking the broader perspective, through all proposed activities, a new and dynamic network will be established, enabling the involved partners to continue their scientific and professional collaboration, including in the framework of new eu-funded research projects, with the view of addressing wider challenges related to demographics and health. uroš marušič annales kinesiologiae • 11 • 2020 • 1 67 reports and reviews/poročila in ocene, 65–76 twinning the brain with machine learning for neuro-muscular efficiency (twinbrain) med 1. novembrom 2020 in 31. oktobrom 2023 bodo potekale dejavnosti projekta »twinning the brain with machine learning for neuro-muscular efficiency (twinbrain)3«, ki je bil pridobljen na razpisu »horizont 2020 twinning widespread-05-2020«. projekt twinbrain je bil v okviru inštituta za kineziološke raziskave znanstveno-raziskovalnega središča koper (zrs koper) uspešno zasnovan in prijavljen pod vodstvom dr. uroša marušiča. ob zrs koper sodelujejo v projektu kot partnerji prestižni univerzi iz nemčije (technische universität berlin; tub) in švice (université de genève; unige) ter nevrološki oddelek bolnišnice cattinara (università degli studi di trieste; units, italija). projekt v vrednosti 0,9 milijona evrov, ki bo trajal tri leta, si za cilj postavlja vzpostavitev raziskovalno-diagnostičnega centra na področju živčno-mišične učinkovitosti ter razumevanja delovanja in nadzora centralnega živčnega sistema med gibanjem. poseben cilj projekta twinbrain je tudi povečanje znanstvene in tehnološke zmogljivosti povezanih inštitucij, pri čemer je poudarek na inštituciji države prijaviteljice zrs koper. dejavnosti projekta twinbrain so usmerjene v vzpostavitev in dvig kakovosti raziskovalne skupine v državi z nižjim kazalnikom raziskav in inovacij (r&i; zrs koper) s pomočjo partnerskih inštitucij z višjim kazalnikom r&i (tub, unige in units). končni cilj projekta je postavitev laboratorija slomobil: slovenian mobile brain/body imaging laboratory, ki bo vzpostavljen prek prenosa znanj in tehnologije iz bemobil: berlin mobile brain/body imaging laboratory4. da bi lahko v celoti razumeli možgansko dinamiko pri aktivno premikajočih se ljudeh, moramo analizirati možgansko dinamiko v povezavi s sočasnim vedenjem. ta kombinacija omogoča oceno zapletenih medsebojnih odnosov med možgansko in vedenjsko dinamiko in je zajeta v sistemu mobile brain/body imaging (mobi). ta sistem v realnem času usklajuje eegsignale s hkratnimi posnetki gibov oči, gibov telesa in avtonomnih odzivov. posledično gre za hkratno zajemanje velike količine podatkov, ki zahtevajo napredne metode obdelave. v ta namen v projektu twinbrain načrtujemo uporabo metod strojnega učenja, ki se lahko statistično »naučijo« nelinearnih razmerij med možgansko dinamiko in vedenjem. osrednji cilj teh analiz je prepoznati omejeno število funkcionalno različnih obsežnih možganskih omrežij, ki predstavljajo različne vidike izvedenih in zabeleženih vedenjskih informacij. tako ne bi bilo mogoče le statično prikazati možganskih dejavnosti, povezanih z dano nalogo, temveč tudi opredeliti specifično dinamiko obsežnega možganskega omrežja in opisati njihove časovne lastnosti glede na vedenje. nazadnje je cilj tega projekta ob uspešnem povezovanju možganske dinamike, kinematike gibanja, naprednih tehnik slikanja možganov in strojnega učenja prenesti teh3 https://cordis.europa.eu/project/id/952401. 4 https://blogs.tu-berlin.de/bpn_bemobil/. 68 reports and reviews/poročila in ocene, 65–76 annales kinesiologiae • 11 • 2020 • 1 nologije in znanja med vključene partnerje in širše. rezultat tega bodo okrepljene znanstvene in tehnološke zmogljivosti in dejavnosti mreženja konzorcija. vodilni partner projekta iz slovenije (zrs koper) bo povečal svoj raziskovalni profil in raziskovalni profil svojega osebja. na podlagi širše perspektive se bo z vsemi predlaganimi dejavnostmi vzpostavila nova dinamična mreža, ki bo vključenim partnerjem omogočila nadaljevanje znanstvenega in strokovnega sodelovanja tudi v okviru novih raziskovalnih projektov, ki jih financira eu, s pogledom na obravnavanje širših izzivov, povezanih z demografijo in zdravjem. uroš marušič _hlk35418826 _goback _hlk35971111 _hlk35511489 _hlk35972306 _hlk35451145 _hlk35511425 _hlk35973495 _hlk35973574 _hlk35973830 _hlk35975249 _hlk35975104 _gjdgxs 30j0zll 1fob9te _goback _3znysh7 _goback _goback _goback _hlk54274488 _goback annales kinesiologiae • 8 • 2017 • 2 93 review article udc: 796.012:613.98 received: 2017-07-04 physical activity and exercise as a key factor in successful aging eleonora capatti, edoardo dalla nora, angelina passaro university of ferrara, department of medical sciences, section of internal medicine and cardio-respiratory, via aldo moro n°8, cona 44121 ferrara, italy corresponding author: angelina passaro, md, phd. university of ferrara, department of medical sciences, section of internal medicine and cardio-respiratory, via aldo moro n°8, cona 44121 ferrara, italy tel +039 0532 239012 e-mail: psn@unife.it abstract aging is associated with several changes in body composition and metabolism, including sarcopenia, sarcopenic obesity and decrease in bone mass; aerobic capacity, muscle mass and strength tend to decline progressively. these changes have considerable impact on the ability to perform daily activities, especially when associated with chronic diseases, such as type 2 diabetes, cardio-vascular disease and dyslipidemia, as well as geriatric syndromes, like mobility impairment, falls and frailty. scientific research has shown that physical activity and exercise can slow the physiological aging clock. particularly, active elderly people seem to age “successfully” compared to sedentary ones. the aim of our work is to review evidence-based recommendations for physical activity, exercise and diet that would help to preserve muscle mass and strength, and to reduce the gain of fat mass in older adults. increasing levels of physical activity, in particular resistance training mixed with aerobic exercise, and adequate protein nutrition intake should be an integral component in the prevention and treatment of sarcopenia, sarcopenic obesity and metabolic syndrome in elderly subjects. key words: sarcopenia, physical activity, body composition, energy consumption, nutrition, aging. mailto:psn@unife.it 94 eleonora capatti, edoardo dalla nora, angelina passaro: physical activity and exercise ..., 93–109 annales kinesiologiae • 8 • 2017 • 2 gibalna aktivnost in vadba kot ključna faktorja pri uspešnem staranju izvleček staranje je povezano s številnimi spremembami v telesni zgradbi in metabolizmu kot so npr. sarkopenija, sarkopenična debelost in zmanjševanje kostne gostote. posledično se progresivno zmanjšujejo aerobna kapaciteta ter mišična masa in moč. te spremembe odločilno vplivajo na sposobnost opravljanja vsakdanjih aktivnosti, še zlasti v povezavi z morebitnimi kroničnimi boleznimi kot so npr. sladkorna bolezen tipa 2, kardio-vaskularne bolezni in dislipidemija pa tudi raznimi geriatričnimi sindromi kot so motnje v gibanju, padci in krhkost. znanstvene raziskave so pokazale, da gibalna aktivnost in vadba lahko upočasnita fiziološko uro staranja. predvsem se zdi, da se aktivni starostniki starajo »bolj uspešno«, kot pa sedentarni. namen članka je pregled priporočil, pridobljenih na osnovi raziskav in dokazov, za gibalno aktivnost, vadbo in prehrano, ki bi pomagali starejšim odraslim ohraniti mišično moč in maso ter hkrati zmanjševati maščobno maso. povečevanje stopnje gibalne aktivnosti, predvsem vadbe za moč v povezavi z aerobno vadbo, ter ustrezna prehrana bogata s proteini, bi morale biti integralne komponente pri preprečevanju in obravnavi primerov sarkopenije, sarkopenične debelosti ter metaboličnih sindromov pri starejših osebah. ključne besede: sarkopenija, gibalna aktivnost, telesna zgradba, poraba energije, prehrana, staranje introduction aging is associated with major changes in body composition, including an increase and redistribution of adipose tissue and a decrease in skeletal muscle mass (sarcopenia) and bone mass, events that begin generally around the fourth decade of life (fiatarone singh, 2002). recent population trends (swinburn et al., 2011) indicate an alarming rise in the prevalence of obesity among older adults, potentially adding a complementary condition that compounds the risk of poor health outcomes. the interplay between sarcopenia and rising trends in obesity in aging population emerged more than 20 years ago as an important public health concern in geriatrics (evans & campbell, 1993). the prevalence of sarcopenia and sarcopenic obesity increases with age, thus, muscle mass and strength lead to a progressive decline (zamboni, mazzali, fantin, rossi, & di francesco, 2008). these changes have considerable impact on the ability of performing daily activities (batsis, mackenzie, lopez-jimenez, & bartels, 2015; baumgartner et al., 2004) and have also significant consequences in health and functioning of the 95 annales kinesiologiae • 8 • 2017 • 2 eleonora capatti, edoardo dalla nora, angelina passaro: physical activity and exercise ..., 93–109 individual, because of their association with chronic disease’s expression and severity, as well as with mobility impairment, risk of falls and frailty. changes in muscle, fat and bone surely relate to an excess / incorrect energy consumption, decreased energy expenditure in physical activity, or both factors in combination. however, in elderly subjects, other mechanisms are involved, such as changes in hormones regulating metabolism, like growth and sex hormones (sakuma & yamaguchi, 2012). this declining need for energy due to a reduction in the amount of lean body mass and a more sedentary lifestyle, together with an inappropriate dietary intake, is the first step in the development of malnutrition in the elderly. the main age-related changes in body composition and physiologic function which appear to influence nutrient requirements in older adults are listed in table 1 (blumberg, 1997). dietary intervention has to be considered a key part of the demographic challenge of an aging population and should be a fundamental part of the public health policy necessary to reduce chronic diseases and compress morbidity (bendich & decktable 1. examples of age-related changes in body composition and physiologic function that influence nutrient requirements (modified from blumberg, 1997). changes in body composition or physiological function impact on nutrient requirements decreased muscle mass decreased need for energy decreased bone density increased need for calcium and vitamin d decreased immune function increased need for vitamin b6, vitamin e and zinc increased gastric ph and decreased gastric motility increased need for vitamin b6, folic acid, calcium, iron, zinc, fiber and water decreased skin capacity for cholecalciferol synthesis increased need for vitamin d increased wintertime parathyroid hormone production increased need for vitamin d decrease calcium bioavailability increased need for calcium and vitamin d decreased efficiency in metabolic use of vitamin b6 increased need for vitamin b increased oxidative stress and homocysteine levels increased need for beta-carotene, vitamin c, vitamin e, folate, vitamin b12 and b6 decreased vitamin absorption increased need for food choices with high nutrient density 96 eleonora capatti, edoardo dalla nora, angelina passaro: physical activity and exercise ..., 93–109 annales kinesiologiae • 8 • 2017 • 2 elbaum, 2015), as well as physical activity and exercise, capable of slowing down the physiological aging clock (taylor et al., 2004). methods relevant medical literature was identified from searches of pubmed and references cited in appropriate articles identified. search terms used included sarcopenia, aging, physical activity, elderly, exercise, body composition, aging metabolism, nutrition. more detailed search terms were used following the identification of relevant mechanisms and to identify epidemiological studies. selection of articles was based on peer review, journal and relevance. age-related changes in body composition and body metabolism sarcopenia, commonly associated with fat infiltration into muscles (sarcopenic obesity), is very common, with a prevalence of ∼5 % in persons aged 65 years and as high as 50 % over the age of 80 (janssen, 2010). it leads to a decline in muscle strength and power, supported also by altered muscle energetics, changes in tendon insertion, altered muscle coordination and decreased blood flow in the capillary bed of the muscle. fat infiltration into muscle (myosteatosis) is associated with decreased strength and an increase in the prevalence of disability (rolland et al., 2009). as an adequate nutrient intake is essential to maintain muscle mass, the decline in food intake with aging plays a role in the development of sarcopenia. in particular, maintenance of muscle mass requires adequate protein intake; it is postulated that older persons require at least 1.2 g / kg of protein a day (morley et al., 2010). from a metabolic point of view, the most important consequence of sarcopenia is the decrease in energy expenditure (in particular for physical activity) and basal metabolic decline; moreover, the ability to increase or decrease energy expenditure to counterbalance overeating or undereating is impaired with an increased susceptibility to energy imbalance (both positive and negative) (roberts & rosenberg, 2006). a decline in basal metabolic rate (bmr) with aging is well recognized (poehlman, 1992), associated to a loss of fat free mass (ffm) and a gain of fat (fm), a less metabolically active tissue. a longitudinal study by keys, taylor, and grande (1973) documented a decline in bmr with age of 1 – 2 % per decade. other studies examining the role of aging on resting metabolic rate (rmr) and substrate oxidation (frisard et al., 2007; krems, lührmann, straßburg, hartmann, & neuhäuser-berthold, 2005) indicate a reduction in rmr with age greater than what would be predicted from the observed modification of fm and ffm, suggesting that the lower rmr of older adults may be due in part to slowed organ metabolic rates (st-onge & gallagher, 2010). 97 annales kinesiologiae • 8 • 2017 • 2 eleonora capatti, edoardo dalla nora, angelina passaro: physical activity and exercise ..., 93–109 the lowering of ffm and the increase of fm, in particular of visceral adipose tissue (vat), is related to an increased risk of cardiovascular disease, type 2 diabetes, hyperlipidemia, hypertension and malignancy (donohoe, doyle, & reynolds, 2011). the association of central adiposity to poor health is related to vat accumulation and associated with hyperinsulinemia and insulin resistance. vat secretes a number of adipokines and inflammatory cytokines (tnfα, il-6, il-1β) that can up-regulate nuclear factor-κb (nfκb), which leads to an increase in nitric oxide (no), a substrate for reactive oxygen species (ros) (sonnenberg, krakower, & kissebah, 2004). moreover, excess adiposity is associated with a state of low-grade chronic inflammation, which interfere with adipose cell differentiation and adipokines pattern secretion, resulting in dysfunctional adipose tissue (paniagua, 2016). increased vat is associated with elevated free fatty acids, impaired hepatic insulin clearance, resulting in hyperinsulinemia, increased gluconeogenesis, and elevation of very-low-density lipoprotein secretion (matsuzawa et al., 1995). in this state the subject presents a pro-inflammatory, pro-coagulant and insulin resistant state typical of the metabolic syndrome (despres & lemieux, 2006). physical activity and aerobic / anaerobic exercise regular physical activity is one of the most important protective factors against the development of chronic diseases (harridge & lazarus, 2017): sedentary individuals show an higher incidence of cardiovascular disease, diabetes mellitus, obesity as well as different malignancy. on the contrary, physical activity is inversely related to allcause mortality in older adults (brown et al., 2012). besides being active or un-active, also the total amount and intensity of physical activity is important. the physiologic adaptations to aerobic and resistance exercise are different: aerobic exercise improves cardiovascular function, that increase peak oxygen consumption without significantly changing strength, whereas resistance exercise improves neuromuscular adaptations, leading to an increase in strength, without significantly changing peak oxygen consumption. despite lower baseline values, the available data suggest that older individuals have the same relative improvement in maximal strength and maximal aerobic capacity to resistance training and aerobic training regimens, respectively (lambert & evans, 2005). these physiologic adaptations may integrate with each other when the two types of training are performed together (wilson et al., 2012). in a recent clinical trial (villareal et al., 2017), the effectiveness of aerobic exercise has been compared with resistance exercise and combined exercise in reversing frailty and preserving muscle and bone mass, during weight loss in obese older adults. the authors show that combined aerobic and resistance training seems to provide the greatest benefits with respect to physical function (pf) and relative preservation of lean mass. in particular, the most effective exercise protocol for frail older adults seem to be a multi-component training, performed three times per week, with shorter-duration sessions (30 – 45 min), in order to prevent adverse health consequences (theou et al., 2011). 98 eleonora capatti, edoardo dalla nora, angelina passaro: physical activity and exercise ..., 93–109 annales kinesiologiae • 8 • 2017 • 2 physical exercise and changes in body composition human body is composed of water, protein, minerals, and fat. the total amount of body fat consists of essential fat (detectable in bone marrow, heart, lungs, liver, spleen, kidneys, muscles, and central nervous system) and storage fat, that accumulates in adipose tissue. lean body mass (lbm), comprehensive of muscles, bones, ligaments, tendons, and internal organs, differences from ffm for the content of a small percentage of essential fat (bone marrow and organs). regular physical activity has an overall positive effect on body composition, modifying both ffm and fm, muscle volume, muscle strength, and physical mobility in older people, including overweight and obese individuals (liao et al., 2017). many studies describe a non-significant change, reliable to exercise, in ffm (toth, beckett, & poehlman, 1999), even if exercise leads to an increase in skeletal muscle mass, especially if anaerobic one, with a related increase in strength. according to different studies on elderly people, an aerobic exercise of moderate intensity (vo2max> 60 %), is generally associated to a lowering in total body fat (fm), even in the absence of changes in dietary regime, proportional to the amount of training sessions. in particular, aerobic exercise can induce significant results on the loss of adipose tissue in the abdominal region (vat) (kay & fiatarone singh, 2006). in order to estimate vo2max and fitness index, a two-km walking test was developed by the ukk institute in finland (laukkanen, oja, ojala, pasanen, & vuori, 1992). this test, relatively simple to administer, is a feasible and accurate alternative for determination of cardio-respiratory fitness in adults with both normal body weight as well as in overweight individuals. in ferrara’s population of pangea study (a mass population study we conducted with slovenian colleagues, aiming at identifying the main elements involved in successful aging), applying the ukk-test, we found that fitness index is inversely correlated to waist circumference. in this population, applying a linear regression model, fitness index, independently of gender and age, predicts waist circumference, explaining the 32 % of its variability (r2 square 0,322, standardized β-coefficient -0,477, p < 0,001) (figure 1, data not published). physical exercise and changes in body metabolism even if not associated with a specific dietary regime, aerobic exercise and resistance training may be responsible for different and positive changes in body metabolism: – improvement in glycemic control (sigal et al., 2007), due to increases in muscle glut4 number and function (holten et al., 2004), – improvements in insulin sensitivity (winnick et al., 2008), – stimulation of lipid oxidation, – improvement in lipid profile with increased clearance of atherogenic lipids, specially triglycerides (katsanos, 2006), reduced levels of total cholesterol and apolipoprotein b (holme, høstmark, & anderssen, 2007), changes in ldl par99 annales kinesiologiae • 8 • 2017 • 2 eleonora capatti, edoardo dalla nora, angelina passaro: physical activity and exercise ..., 93–109 ticle size (more than lower levels) and higher hdl concentration (kraus et al., 2002), – decrease of vat in relation to an increased sympathetic tonus and consequential increased lipolysis (ismail, keating, baker, & johnson, 2012), – decrease of vat and pro-inflammatory state may contribute to improve glucose uptake (fisher et al., 2011), – decrease in biomarkers of inflammation like c-reactive protein (crp) (strasser, arvandi, & siebert, 2012), – improvement in adiponectin and leptin profile (simpson & singh, 2008). the impact of aerobic exercise on body metabolism is better and more significant if it is characterized by high intensity; strength training can provide up to a 15 % increase in metabolic rate, which is very helpful in terms of weight loss and long-term weight control. a review published by strasser provides strong support for the recommendation that physical activity, in particular resistance training mixed with aerobic exercise, should be an integral component in the prevention and treatment of obesity and metabolic syndrome risk factors (strasser, 2013). resistance training is an effective way to increase energy requirements, decrease body fm, and maintain metabolically active figure 1. pearson correlation between fitness index and waist circumference (pangea’s ferrara population): men r=-0,62, p<0.001; women r=-0,401, p=0,001. 100 eleonora capatti, edoardo dalla nora, angelina passaro: physical activity and exercise ..., 93–109 annales kinesiologiae • 8 • 2017 • 2 tissue mass. a consequent improvement in insulin sensitivity and in the lipid profile could reduce the risk of metabolic syndrome and type 2 diabetes and attenuate the development of cardiovascular disease in an elderly population (ferrara, goldberg, ortmeyer, & ryan, 2006). physical activity and related benefits it is well established that with increasing age, individuals are more likely to experience functional declines, mobility limitations, and physical disability (holmes, powellgriner, lethbridge-cejku, & heyman, 2009). a large body of literature has supported the interrelationships among various factors affecting physical function (pf) in older adults (villareal et al., 2011), like physical activity, body composition (fat mass and skeletal muscle mass), muscle capacity (leg strength and leg power), and muscle quality, whose aging-related changes tend to promote a decline in maximal aerobic power and skeletal muscle force production. although the likelihood of physical limitations and disability increases with age, multiple studies have demonstrated that exercise is an effective intervention strategy for improving pf in older adults (brady, straight, & evans, 2014). several intervention trials have reported improvements in pf after a resistance training program in relatively healthy older (avila, gutierres, sheehy, lofgren, & delmonico, 2010; henwood & taaffe, 2005), as well as older adults with chronic health conditions (yang, wang, lin, chu, & chan, 2006). in addition, aerobic training, often a cornerstone of an exercise program, has also been found to be beneficial at improving pf in older adults (davidson et al., 2009). the evidence suggests how the pillars of an effective exercise program should be both aerobic and resistance exercise (chodzko-zajko et al., 2009) and it is well known that both endurance exercise and resistance training can substantially improve physical fitness and health-related factors in older individuals (conceição et al., 2014). this helps to maintain and increase skeletal muscle mass and respiratory fitness, with increase in resting metabolic rate and enhanced capacity for lipid oxidation during rest and exercise. endurance training in particular is purported to be more effective for decreasing fm, resting heart rate and blood pressure, while resistance training has been shown to be more effective for increasing basal metabolism, bone mineral density (bmd) and muscle strength and power (romero-arenas, martínez-pascual, et al. 2013). regular physical activity can have a positive effect on disorders and diseases that affect muscles and bones (such as osteoarthritis, back pain and osteoporosis). walking provides a modest increase in the loads on the skeleton above gravity and, therefore, this type of exercise has proved to be less effective in osteoporosis prevention. strength exercises instead, seems to be a powerful stimulus to improve and maintain bone mass during the aging process (gomez-cabello, ara, gonzález-agüero, casajús, & vicenterodríguez, 2012). 101 annales kinesiologiae • 8 • 2017 • 2 eleonora capatti, edoardo dalla nora, angelina passaro: physical activity and exercise ..., 93–109 many evidences show that physical activity programs aimed at strengthening muscles help the elderly to maintain balance, which decrease the likelihood and severity of falls and fractures, one of major health concerns for many older adults (howe, rochester, neil, skelton, & ballinger, 2011). compared to sedentary people, older athletes enjoy a wide range of physiological benefits on health: – a better profile in body composition including a lower accumulation of total and especially abdominal fat; greater volume muscle mass in upper and lower limbs, – higher bone mineral density (bmd), especially in case of strength training with high-load low repetitions (romero-arenas, blazevich, et al., 2013), – articulation muscle more resistant to oxidative processes and fatigue, – a better cardiac output during maximum exercise and improved cardiovascular fitness (gibala, little, macdonald, & hawley, 2012), – less cardiovascular and metabolic stress during sub-maximal exercise (lanza et al., 2008), – significantly reduced coronary risk profile in relation to lowering of blood pressure (whelton, chin, xin, & he, 2002), improvement in endothelium function (maiorana, o’driscoll, taylor, & green, 2003); low systemic inflammatory index; improved insulin sensitivity and glucose homeostasis; better lipid profile and lower waist circumference, – slowed development of disability in old age. twenty to forty minutes a day of aerobic training leads to a lower probability to develop metabolic and cardiovascular diseases. moreover, several studies have shown the beneficial effects of circuit weight training in individuals with chd. volaklis et al. combined resistance circuit and aerobic exercise program in patients with coronary artery disease. subjects improved cardiovascular fitness (vo2 peak 15.4 %) and muscular strength significantly in all exercises by an average of 28 % (volaklis, douda, kokkinos, & tokmakidis, 2006). a cochrane review of 121 randomized controlled trials of progressive resistance training (prt) in older people showed that doing prt 2–3 times per week improved physical function, gait speed, timed get-up-and-go, climbing stairs, and balance, and, more importantly, had a significant effect on muscle strength, especially in the highintensity training groups (crocker et al., 2013). in order to optimize body composition, muscle strength gains and to develop cardiovascular function, romero-arenas, martínez-pascual, et al. (2013) recommended a circuit weight training with a minimum frequency of 2 sessions per week (with a volume ranging from 30 to 50 minutes) that could be implemented with endurance training. 102 eleonora capatti, edoardo dalla nora, angelina passaro: physical activity and exercise ..., 93–109 annales kinesiologiae • 8 • 2017 • 2 diet combined with physical activity and body composition aging is related with the loss of skeletal muscle and bone mass along with progressive increase of adipose tissue. recent investigations have attempted to modify these processes with various combinations of dietary and exercise intervention (iglay, thyfault, apolzan, & campbell, 2007; kukuljan, nowson, sanders, & daly, 2009). increasing the quantity and quality (essential amino acids, specifically leucine) of dietary protein stimulates muscle protein synthesis in the elderly (børsheim et al., 2008), while protein supplementation at twice the recommended dietary allowance (rda) does not improve skeletal muscle function or increase muscle mass in healthy elderly weight lifters compared to those on a normal diet (campbell & leidy, 2007). therefore, regular resistance exercises and the habitual ingestion of adequate amounts of dietary protein from high-quality sources are two important ways to slow the progression and treat sarcopenia. assuming three meals are consumed each day, a relative protein dose of 0.4 – 0.5 g / kg / meal is consistent with recent expert opinions concerning the optimal daily protein intake (1.2 – 1.5 g / kg / day) for healthy older adults (deutz et al., 2014). this amount of protein markedly exceeds the rda for protein (at present set at 0.8 g / kg ideal body mass / day for healthy adults, regardless of sex and age), but it is supported by several larger-scale longitudinal studies (bartali et al., 2012; gray-donald et al., 2014). several studies have also reported a positive relationship between protein intake and peak bone mass in older adults (hannan et al., 2000; sahni et al., 2014). increased intake of vitamin d stimulates gene expression and boosts muscle protein synthesis, facilitates neuromuscular function and enhances strength and balance (muir & montero-odasso, 2011). in a recent clinical trial, rondanelli et al. found a significant beneficial effect of supplementation with whey protein, essential amino acids, and vitamin d compared with placebo in elderly sarcopenic adults participating in controlled resistance training, with a gain of 1.7 kg in ffm. supplementation attenuated the inflammatory state, as seen by the significant drops in crp concentrations and leads to a reduced prevalence of malnutrition, assessed with the mini nutritional assessment (mna) (rondanelli et al., 2016). in all individuals older than 70 years of age, vitamin d intakes of at least 600 iu per day (up to 1000 iu / day) are recommended, in addition to the calcium requirement of 1200 mg per day (american geriatrics society workgroup on vitamin d supplementation for older adults, 2014). for those individuals in whom there is inadequate calcium and vitamin d intake from diet, supplements and/or multivitamins can be used. a recent review suggests that calcium and vitamin d supplementation, with or without osteoporosis therapy, may decrease the risk of fractures (tricco et al., 2017). anyway, the u.s. preventive services task force (uspstf) concluded that the current evidence is insufficient to assess the balance of benefits and harms of combined vitamin d and calcium supplementation to prevent bone fractures in premenopausal women or in men (moyer & u.s. preventive services task force*, 2013). 103 annales kinesiologiae • 8 • 2017 • 2 eleonora capatti, edoardo dalla nora, angelina passaro: physical activity and exercise ..., 93–109 conclusions an inevitable consequence of advancing age is the gradual loss of muscle mass and strength, termed sarcopenia, frequently associated with a parallel increase in fat mass. this geriatric condition has known negative impacts on metabolic health, and in later life, the ability to perform everyday activities (witard, mcglory, hamilton, & phillips, 2016). this review highlights the major benefits of physical activity in the elderly in terms of body composition and metabolism. active elderly subjects show a slower “aging clock” and a lighter burden of chronic morbidity. aerobic exercises help to raise heart and lung efficiency and to increase cardiovascular fitness and endurance, while resistance training promotes an increase in muscle mass and bone density. achieving these goals represents the first step of a realistic strategy for maintaining functional status and independence. international guideline recommendations suggest that older people should perform at least 150 minutes of moderate physical activity per week and should be less sedentary in order to achieve health benefits (world health organization, 2010). active elderly in particular, seems to develop a “successful aging” compared to sedentary ones. developing simple lifestyle interventions and safe, effective and sustainable ways to promote physical activity, aimed to preserve muscle mass and strength with advancing age, is crucial for the care of patients in mid-life and beyond. references american geriatrics society workgroup on vitamin d supplementation for older adults (2014). recommendations abstracted from the american geriatrics society consensus statement on vitamin d for prevention of falls and their consequences. journal of the american geriatrics society, 62(1), 147–152. doi: 10.1111/jgs.12631 view item avila, j. j., gutierres, j. a., sheehy, m. e., lofgren, i. e., & delmonico, m. j. 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since our previous conference, we overcame a period of lockdowns when it was at times difficult to follow and adapt to all the new rules of work and communication, but despite the new “reality,” science and practice met at the 11th international scientific and professional conference “a child in motion.” this time the working title of the conference, “the lockdown aftermath,” suggested what we had experienced missed and learned during this period. we analyzed topics engendered by this situation in scientific and professional language, again enjoying the hospitality of the grand hotel bernardin and the towns of portorož and piran. the two-day program offered 3 plenary lectures and 11 keynote speakers who presented current research from the educational, paediatric, kinesiology, physiological, 138 reports and reviews/poročila in ocene, 137–144 annales kinesiologiae • 12 • 2021 • 2 socio-psychological, and nutritional fields on the impact of the covid-19 pandemic on children. prominent speakers highlighted current evidence on child well-being in the aftermath of the pandemic. the “book of proceedings” contains 35 scientific and 121 professional papers by more than 200 authors and co-authors from over a dozen european countries. the papers present current research findings as well as examples of best practices by teachers and educators in addressing the challenges of physical inactivity, eating habits, social contact, and more, that had arisen as a result of the pandemic and consequent home schooling. the success of this conference would not have been possible without all of our partner organizations and our sponsors. we are proud to have the patronage of the human rights ombudsman of the republic of slovenia, mr. peter svetina included among them. the positive feedback from participants confirms that the added value of on-site conferences is not only the in vivo presentations, but also the excellent opportunity to network, share best practices, and meet new people during the coffee breaks and social events. saša pišot and kaja teraž annales kinesiologiae • 12 • 2021 • 2 139 reports and reviews/poročila in ocene, 137–144 11. mednarodna znanstvena in strokovna konferenca otrok v gibanju portorož, slovenija, 4.–6. oktober 2021 v dveh letih, ki so minila od naše zadnje konference, v času restriktivnih ukrepov, ki jim je bilo včasih težko slediti, še težje pa novim pravilom prilagajati delo in sporazumevanje, nam je uspelo, da se ponovno srečamo na 11. mednarodni znanstveni in strokovni konferenci otrok v gibanju 2021 in uživamo gostoljubje grand hotela bernardin ter obalnih mest portorož in piran. tokratni delovni naslov konference premagajmo posledice ukrepov omejitve gibanja je izražal, analiziral in nagovarjal teme tega časa, v znanstvenem in strokovnem jeziku. 140 reports and reviews/poročila in ocene, 137–144 annales kinesiologiae • 12 • 2021 • 2 dvodnevni program je ponudil tri plenarna in 11 uvodnih predavanj, v katerih so predavatelji predstavili aktualna dognanja, povezana s posledicami pandemije covida-19 na otroke. zbornik prispevkov vsebuje 35 znanstvenih in 121 strokovnih prispevkov več kot 200 avtorjev in soavtorjev iz ducata evropskih držav. v prispevkih so predstavljene aktualne ugotovitve raziskav in primeri dobre prakse učiteljev, vzgojiteljev, pediatrov, kineziologov, dietetikov, fiziologov, psihologov, sociologov itd. pri reševanju izzivov na področju telesne (ne)aktivnosti, prehranjevalnih navad, socialnih stikov in drugega, ki so se pojavili kot posledica pandemije in šolanja na domu. uspeh te konference ne bi bil mogoč brez vseh naših partnerskih organizacij in sponzorjev. v posebno čast pa si štejemo tudi tokratno častno pokroviteljstvo varuha človekovih pravic republike slovenije petra svetine. pozitivni odzivi udeležencev konference potrjujejo, da dodana vrednost konferenc »v živo« niso le predavanja, temveč da so te tudi odlična priložnost za mreženje, izmenjavo dobrih praks in spoznavanje novih ljudi med odmori za kavo in družabnimi dogodki. saša pišot in kaja teraž _hlk89942516 _hlk103676616 _hlk111804760 _hlk111802738 _hlk30149664 _hlk111710665 annales kinesiologiae • 11 • 2020 • 2 151 reports and reviews/poročila in ocene, 147–158 new dimension and new challenge: the presentation of erasmus + sport “ski easy project” we are pleased to announce that the institute for kinesiology research of the science and research centre koper (zrs koper) has successfully obtained european funding as coordinator of an erasmus + sport cooperation partner project “easy (educational, accessible, simple, youthful) approach to skills acquisition in skiing ski easy.” the dramatic changes in alpine skiing in terms of technique and equipment, as well as the decrease in motor and functional skills of skiers, have led to the need to adapt (in light of the recent experience of the covid-19 pandemic) and improve procedures, tools, and teaching methods. the consortium consists of nine partners – besides zrs koper as coordinator – ivss (the international association of snowsports in schools and universities, austria), sitas (ski instructors /trainers association of slovenia within the ski association of slovenia, slovenia), cfvg (collegio regionale maestri sci fvg / ski instructors college of friuli-venezia giulia, italy), unisal (university of salzburg, department of sport science, austria), unizg (university of zagreb, faculty of kinesiology, croatia), bss (bulgarian ski schools, bulgaria), atus (ski trainers and instructors association in b&h, bosnia and herzegovina), and uninis (university of niš, faculty of sport and physical education, serbia), who will pursue the main objectives of the project behind the initials of the acronym easy: e promotion of education in and through sport with special focus on development of skills and competencies of ski instructors and learners; enrichment of (self-)employment opportunities for professional and dual career development; teaching module ski easy certificate. a-accessible learning and stimulating participation in outdoor sports; snowsports days to reach the population of deprived children and let them experience snow sports with the help of local communities and volunteers. s-simple communication: implement a pedagogical model of ski teaching (ski alphabet, dictionaries, and animation) for ski beginners of all partners’ linguistic groups to simplify the ski teaching process. y-youthful: a state-of-the-art it-driven approach to teaching (interactive games, gadgets, and ict applications [cartoon movies], mobile platforms and multimedia technologies to overcome language and cultural barriers). in the three-year project period (1 january 2021–31 december 2023) with a total budget of 385,198.00 €, the ski easy activities and outcomes are as follows: – ski easy teaching model adapted to linguistic and cultural diversity; free module for ski instructors to obtain a ski easy certificate; – ski easy educational materials (manuals and ict application for smartphones); 152 reports and reviews/poročila in ocene, 147–158 annales kinesiologiae • 11 • 2020 • 2 – ski easy snowsports days with innovative kids u-flex technology ski equipment for children. the kick-off meeting will be held in a hybrid version on 4–5 february 2021 in italian tarvisio, where slovenian, italian, and croatian members can participate and conduct a snow workshop, with an online meeting with other participants continuing in the afternoon. saša pišot annales kinesiologiae • 11 • 2020 • 2 153 reports and reviews/poročila in ocene, 147–158 nove dimenzije in nov izziv: predstavitev projekta erasmus+ sport – »ski easy« inštitut za kineziološke raziskave znanstveno-raziskovalnega središča koper (zrs koper) je uspešno pridobil koordinatorstvo projekta erasmus + sport – collaborative partnership »easy (izobraževalen, dostopen, preprost, mladosten) pristop k usvajanju veščin pri učenju smučanja – ski easy«. dramatične spremembe smučarske tehnike in opreme ter hkratno zmanjšanje motoričnih in funkcionalnih sposobnosti smučarjev prinaša potrebo po prilagoditvi (tudi zaradi novejših izkušenj s pandemijo covida-19) in posodobitvi postopkov, orodij in metod poučevanja alpskega smučanja. projektni konzorcij sestavlja devet partnerjev – poleg zrs koper še ivss (mednarodno združenje športov na snegu v šolah in univerzah, avstrija), sitas (združenje učiteljev/trenerjev smučanja slovenije pri smučarski zvezi slovenije), cfvg (collegio regionale maestri sci fvg / šola učiteljev smučanja v furlaniji julijski krajini, italija), unisal (univerza v salzburgu, oddelek za športne znanosti, avstrija), unizg (univerza v zagrebu, kineziološka fakulteta, hrvaška), bss (združenje bolgarskih smučarskih šol, bolgarija), atus (združenje trenerjev in učiteljev smučanja v bosni in hercegovini) in uninis (univerza v nišu, fakulteta za šport in telesno vzgojo, srbija) –, ki bodo poskušali uresničiti glavne cilje projekta, skrite v začetnicah kratice easy: e – (education): spodbujanje izobraževanja v športu in s športom s posebnim poudarkom na razvoju spretnosti in kompetenc učiteljev in učencev smučanja; obogatitev (samo)zaposlitvenih možnosti za poklicni in dvojni karierni razvoj; učni modul – potrdilo ski easy. a – (accessible): dostopno učenje in spodbujanje udeležbe v športu na prostem; dnevi športa na snegu, na katerih bi s pomočjo lokalnih skupnosti in prostovoljcev dosegli populacijo ogroženih otrok in jim omogočili, da se seznanijo s športom na snegu (smučanje) in ga doživijo. s – (simple): preprosta komunikacija: uvedba pedagoškega modela poučevanja smučanja (smučarska abeceda, slovarji in animacija) za začetnike smučanja v jezikih vseh partnerjev zaradi poenostavitve procesa poučevanja smučanja. y – (young): mladosten, sodobnejši pristop k poučevanju, ki temelji na informacijski tehnologiji (interaktivne igre, pripomočki in aplikacije ikt (risani filmi), mobilne platforme in multimedijske tehnologije za premagovanje jezikovnih in kulturnih ovir). v triletnem projektnem obdobju (1. 1. 2021–31. 12. 2023) s skupnim proračunom 385.198,00 eur so dejavnosti in cilji programa ski easy: – postaviti model poučevanja ski easy, ki bo prilagojen jezikovni in kulturni raznolikosti; izvesti brezplačen modul za učitelje smučanja za pridobitev certifikata ski easy; – izobraževalna gradiva ski easy (priročniki in ikt-aplikacije za pametne telefone); 154 reports and reviews/poročila in ocene, 147–158 annales kinesiologiae • 11 • 2020 • 2 – ski easy dnevi športa na snegu z inovativno otroško smučarsko opremo u-flex. prvi uvodni sestanek bo potekal v hibridni različici 4. in 5. februarja 2021 v italijanskem trbižu, kjer bodo sodelovali slovenski, italijanski in hrvaški člani projekta, ki bodo izvedli tudi delavnico na snegu. skupno srečanje z drugimi udeleženci, ki se sestanka zaradi okoliščin, povezanih s covidom-19, ne bodo uspeli udeležiti, se bo nadaljevalo na daljavo. saša pišot _hlk40898474 _hlk34144101 _hlk40871331 _hlk53505499 _hlk33786872 _hlk25864445 _hlk38187602 _hlk71096081 annales kinesiologiae • 11 • 2020 • 1 17 original scientific article doi: https://doi.org/10.35469/ak.2020.225 received: 2020-05-27 udc: 796.72:612.015 lactacidemia during track day motorcycle racing competitions marcelo conte1,2,3, joão vitor de souza andrade1, gustavo azevedo1, victor augusto ramos fernandes1,4,5 1group of studies in motor sports and physical performance school of physical education of jundiaí, são paulo, brazil 2conte fit sports science, brazil 3federal university of são paulo, brazil 4jundiaí medical school, são paulo, brazil 5 nossa senhora do patrocínio university cruzeiro do sul university, itu, são paulo, brazil corresponding author: victor augusto ramos fernandes, ph.d. group of studies in motor sports and physical performance school of physical education of jundiaí, rua dr. rodrigo soares de oliveira s/nº anhangabaú – jundiaí, são paulo, brazil phone: +55 11 4805-7955 e-mail: dr.victoraugustofernandes@gmail.com abstract introduction: motorbike racing is one of the most dangerous sports due to high speeds, and it is highly demanding on racers both mentally and physically. objective: to verify the lactacidemia in motorbike racers before and after the track day race. method: nine non-professional male riders (33 + 10.39 years) who practiced track day race were studied. plasma lactate was obtained twice: 30 minutes before and 5 minutes immediately after the track day race. results: there was a significant increase in lactacidemia (87.5%) after the 30-minute race (3.77 + 1.38 vs. 7.07 + 1.85 mmol). conclusion: lactacidemia in amateur motorbike racers increased significantly after the track day race. these data reinforce the results of other studies, which consider motorcycling as a sport high in terms of anaerobic metabolism. thus, physical trainers and motorcycle racers should adopt strategies to stimulate this metabolic pathway in specific training. keywords: motorcycle, lactate, anaerobic threshold, exercise. 18 marcelo conte, joão vitor de souza andrade, gustavo azevedo, victor augusto ramos fernandes: lactacidemia during ..., 17–27 annales kinesiologiae • 11 • 2020 • 1 laktacidemija na motociklistični dirki na odprt dirkaški dan izvleček uvod: motociklistične dirke so zaradi visokih hitrosti ena od najnevarnejših športnih disciplin, za tekmovalce pa so tudi fizično in psihično zelo obremenjujoče. cilj: preveriti raven laktacidemije pri udeležencih motociklistične dirke na odprt dirkaški dan (t. i. ‚track day‘) pred tekmovanjem in po njem. metoda: preučevali smo devet nepoklicnih dirkačev (starih 33 + 10.39 let), ki so se udeležili motociklističnega tekmovanja na dirkališču. plazemski laktat smo jim odvzeli dvakrat: 30 minut pred dirko in 5 minut po njej. rezultati: zabeležili smo znatno povečanje laktacidemije (87.5%) po 30-minutni dirki (3,77 + 1,38 mmol oz. 7,07 + 1,85 mmol). zaključek: laktacidemija pri amaterskih motociklističnih dirkačih je po tekmi na dirkališču močno narasla. ti podatki potrjujejo rezultate drugih študij, ki motociklizem uvrščajo med športe z visokim deležem anaerobnega metabolizma. trenerji in motociklistični dirkači bi tako morali izdelati strategije za spodbujanje te metabolične poti z namensko zasnovanimi treningi. ključne besede: motocikli, laktat, anaerobni prag, trening. 19 annales kinesiologiae • 11 • 2020 • 1 marcelo conte, joão vitor de souza andrade, gustavo azevedo, victor augusto ramos fernandes: lactacidemia during ..., 17–27 introduction motorcycling, also known as motorbiking, is a very popular sport worldwide. intrinsic factors of the category, such as the high speeds of motorcycles, the imminent risk of fatal accidents, and a very high level of competitiveness among riders, characterize the sport as imposing great physical and psychological demands on the participants. the verification of the physical and psychological conditions of practitioners of this modality is made necessary as a result of the understanding established in the prescription of training that can mitigate the risk of accidents and improve the performance of this population (d’artibale, laursen & cronin, 2018). in this sense, the use of easily obtained markers, such as glucose, lactacidemia, heart rate, and temperature can help the trainers adapt the training cycles to the needs of each athlete (potkanowicz & mendel, 2013; conte, 2018; barthel et al., 2020). lactacidemia (concentration of lactate in the bloodstream) is one of the most commonly used parameters to quantify physical effort and the predominant metabolism characteristic for energy supply during exercise (manchado, gobatto, contarteza, papoti, & mello, 2006). lactate is a metabolite, a final product of anaerobic metabolism that results from glycolysis. the lactate production/clearance ratio is directly related to the type and intensity of physical exercise. associated with this, lactate is part of a series of physiological mechanisms that protect the intracellular environment against changes in ph and consequently fatigue (cathcart et al., 2008). the method of measuring lactate concentration after sports car races has been used to compare the physiological responses between professional and amateur drivers, identifying direct relationships between competitiveness and the physical condition of the practitioner, which reinforces the need for specific training for that population (barthel et al., 2020). d’artibale, tessitore, tiberi, capranica (2007), investigated 26 female drivers during free practice, qualifying sessions, and official races and observed a significant increase in lactacidemia 2.2 + 0.5 mmol/l vs. 4.8 + 2.6 mmol/l, regardless of the competition phase. on the other hand, sperlich, osman-reinkens, zinner, krueger, and holmberg (2014) followed 10 kart drivers and observed a significant increase in lactate concentrations immediately after the 30-minute race. however, the physiological changes occurring during the practice of motorsports are still little known, especially in motorcycling. studies to observe changes in lactacidemia in motorbike racers with the aim to improve the training strategies of the respective sport are required. thus, the objective of the present study is to verify the lactacidemia of riders before and after a motorbike race. 20 marcelo conte, joão vitor de souza andrade, gustavo azevedo, victor augusto ramos fernandes: lactacidemia during ..., 17–27 annales kinesiologiae • 11 • 2020 • 1 material and method sample characteristics the nine amateur motorbike racers participating in this study and constituting a sample for accessibility, with an average age of 33 + 10.4 years, were participants of the track day race, an event open to professional racers and/or amateurs and held in a professional race track. five of the riders (aged 25.8 + 7.88 years) participated in the race with current “speed” motorcycles, namely, kawasaki ninja 250cc, kawasaki zx6 600 (manufactured between 2000 and 2009), suzuki gsx-r750 (manufactured between 2000 and 2008), while the remaining four riders (aged 42 + 3.2 years) with classic motorcycles (all thruxton 900cc manufactured in the year 1965). the research followed the ethical recommendations, obtaining the free and informed consent forms signed by the volunteers and the approval of the ethics committee of the escola superior de educação física de jundiaí (protocol number: 2,848,416). the starting grid of the race was composed of 22 drivers; our sample was 9 drivers. in this sense, adopting a 95% confidence level, we obtain a 25.7% confidence interval for the sample of this study. inclusion criteria motorbike riders participating in the track day race. male. age over 18 years. signature of the free and informed consent form (icf). exclusion criteria: presence of any injury limiting the performance of movements during the tests; refusal of consent to participate in the research. experimental procedures plasma lactate was obtained on two occasions: a) 30 minutes before and b) 5 minutes after the motorbike track day race, which consisted of 30 minutes of racing at the haras tuiuti circuit, a 2,000-meter paved track circuit (figure 1). blood was collected from the digital pulp, using disposable lancets (accu-chek softclix® pro); a drop of blood was applied to a specific area of the bm-lactate reactive strip and the samples were measured on the accutrend® lactate lactometer. 21 annales kinesiologiae • 11 • 2020 • 1 marcelo conte, joão vitor de souza andrade, gustavo azevedo, victor augusto ramos fernandes: lactacidemia during ..., 17–27 figure 1: main circuit haras tuiuti data analysis for comparison between moments, a student’s t-test paired with variables with normal distribution was used, with a bonferroni’s post-test, adopting a 5% significance level, for all analyses. results results are shown in table 1 and graphs 1 to 3. you can see that there was a significant increase in the lactacidemia of the motorcyclists, in the age and categories, after the track day races. 22 marcelo conte, joão vitor de souza andrade, gustavo azevedo, victor augusto ramos fernandes: lactacidemia during ..., 17–27 annales kinesiologiae • 11 • 2020 • 1 table 1: comparison of the mean and standard deviation of lactacidemia before and after racing between riders of vintage and current motorcycles. category time before (mmol/l) after (mmol/l) current bikes 3.36 + 0.67 6.06 + 1.95* vintage bikes 4.30 + 1.95 7.67 + 1.78* total 3.77 + 1.38 7.07 + 1.85* *p < 0,05 graph 1: comparison of blood lactate levels before and after motorcycle racing. the significant increase in lactate concentrations after track day suggests that motorbiking is a sport of high anaerobic demand (graph 1). descriptively, it is observed that the blood lactate concentration of vintage motorcycle riders, both before and after the race, was higher than that of the newer motorcycle riders (graph 2). it can be seen that there was a statistically significant difference concerning the average age of the motorbike racers (p = 0.0066). the riders of the newer motorcycles were younger than those of the vintage ones (graph 3). 23 annales kinesiologiae • 11 • 2020 • 1 marcelo conte, joão vitor de souza andrade, gustavo azevedo, victor augusto ramos fernandes: lactacidemia during ..., 17–27 graph 2: comparison of blood lactate levels before and after racing with vintage and current motorcycles. graph 3: comparison of motorbike racers’ age (average) in relation to the categories evaluated. 24 marcelo conte, joão vitor de souza andrade, gustavo azevedo, victor augusto ramos fernandes: lactacidemia during ..., 17–27 annales kinesiologiae • 11 • 2020 • 1 discussion we observed in the present study that the motorcycle racers’ lactacidemia increased significantly (87.77%) after the track day race. at the same time, in different categories of motor sports, there is an increase in lactate concentrations after competitions and/or training. we can cite as an example, the studies of del rosso, abreu, webb, zouhal, & boullosa (2016), reporting an increase of 395% in rally drivers; a case study of gobatto, mendonça, & matsushigue (2000), with 950% in kart, and 53% in f-corsa racers, as well as simões, crisp, verlengia, & pellegrinotti (2016) with a 209% increase in motocross riders. in the present study, a significant increase in lactacidemia was also observed right after the race on the track day, average of 7.07 + 1.87 mmol/l, similar to the average found by d’artibale et al. (2018) in a study with 34 riders of the european motorbike championship categories 125 gp, 250 gp and 600 ccs, where the lactate concentrations after the respective runs were 6.0 + 2.1 mmol/l. and similar to filaire, filaire, & le scanff (2007), that observed a significant increase in lactacidemia after the motorbike race (5.6 + 2.1 mmol/l); on the other hand, gobbi, francisco, tuy, and kvitne (2005) observed that motocross riders recorded lactacidemia of 5.3 + 2.1 mmol at the end of the race. however, in racing drivers, schwaberger (1987) also observed a significant increase in lactacidemia after racing and pointed out that lactate is an important metabolic marker of physical stress. it is suggested that motorcycle racers have a high demand for static muscle contraction, this means that the muscles, mainly in the abdominopelvic region, lower limbs and forearms of the riders, presented important isometric activation as well as possible reduction of peripheral blood flow during riding, conditions that exacerbate the requirement for lactic anaerobic metabolism. both current and vintage motorcycle racers showed an increase in lactacidemia, although descriptively vintage motorcycle racers showed higher lactate concentrations, both at rest and after the race. two factors may have influenced this result, the age group (riders in the vintage motorcycle class had a significantly higher average age) and the characteristics of the motorcycles. we recognize that several factors can influence lactacidemia, such as the characteristics of the circuit, power and characteristics of the racing motorcycle, physical fitness of the motorcycle racers. however, data from the present study indicate that even amateurs racing on unofficial motorcycles, in events such as track day, are subjected to a high-performance and physically demanding practice, suggesting the need for special attention regarding physical preparation. again, all drivers showed an increase in lactate concentrations after the race. febbraio et al. (1994) show that during extreme exercise, the individual’s temperature causes changes in lactate concentration; the higher the body temperature, the greater the use of muscle glycogen, increasing lactate levels, which may be one of the reasons for increased lactacidemia after the race. in this sense, the driver’s clothing and the high temperature on the track (36º c) on the day of the race, associated with high emotional 25 annales kinesiologiae • 11 • 2020 • 1 marcelo conte, joão vitor de souza andrade, gustavo azevedo, victor augusto ramos fernandes: lactacidemia during ..., 17–27 stress and the great muscular demand, both dynamic and static, for riding (potkanowicz & mendel, 2013) can explain the elevation of lactate, which is considered an important marker of exercise intensity (goodwin, harris, hernández, & gladden, 2007). the progressive increase in the intensity of effort promotes the recruitment of motor units of the fr (fatigue resistance) type and later on those of the ff (fast fatigue) type. therefore, the production of lactate by muscle fibers increases in the same order as the recruitment pattern. regardless of the type of contraction, muscle fibers of type iia and iib are recruited in high-intensity exercises, these same fibers being the most likely to produce lactate. however, although the increase in lactacidemia is an indicator of increased intensity of effort, protective effects of lactate exposure or acidosis induced in muscle contractions with potassium depression in isolated rodent muscles are reported. besides, exposure to sodium lactate can alleviate severe muscle fatigue, and sodium lactate intake can increase exhaustion time during running in humans. together, these latest findings led to the idea that lactate/h + may have an ergogenic effect during exercise (cairns, 2006). conclusion the present study found that lactacidemia increased significantly after the track day race in amateur motorbike racers. these data reinforce the results of other studies, which consider motorcycling as a sport with elevated anaerobic metabolism. thus, physical trainers and motorcycle racers should adopt strategies to stimulate this metabolic pathway in specific training. study limitations classificatory training and free training performed during the day of the competition, as well as physical activities that may have been performed during the 48 hours before data collection, may have influenced the lactacidemia values. on the other hand, it was not possible to evaluate and know the drivers’ iat, for a possible comparison between the lactate concentration obtained in the anaerobic threshold and the lactacidemia after the race. references barthel, s. c., buckingham, t. m., haft, c. e., bechtolsheimer, j. e., bechtolsheimer, t. a., & ferguson, d. p. 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(2014). cardiorespiratory, metabolic and hormonal responses during open-wheel indoor kart racing. journal of sports medicine and physical fitness. 54(4), 475-480. retrieved from: https://www.minervamedica.it/en/journals/sports-med-physical-fitness/article. php?cod=r40y2014n04a0475. https://doi.org/10.5812/asjsm.23805 https://www.minervamedica.it/en/journals/sports-med-physical-fitness/article.php?cod=r40y2014n04a0475 https://www.minervamedica.it/en/journals/sports-med-physical-fitness/article.php?cod=r40y2014n04a0475 _hlk35418826 _goback _hlk35971111 _hlk35511489 _hlk35972306 _hlk35451145 _hlk35511425 _hlk35973495 _hlk35973574 _hlk35973830 _hlk35975249 _hlk35975104 _gjdgxs 30j0zll 1fob9te _goback _3znysh7 _goback _goback _goback _hlk54274488 _goback annales kinesiologiae • 11 • 2020 • 2 145 reports and reviews/poročila in ocene, 65–76 keep active the manual rado pišot, matej kleva, kaja teraž, armin paravlić, uroš marušič, saša pišot, boštjan šimunič: ostanite doma (p)ostanite aktivni annales zrs, 2020, 56 pages we live in unfriendly times, with the covid-19 epidemic and the measures to contain it severely affecting our quotidian, most of all our freedom to move. the measures and the search for new solutions to contain the spread of infection are changing on what sometimes seems a daily basis. unfortunately, this search gives precedence to enabling all other activities over providing for the basic human need of physical activity. but even in these circumstances in which the threat of infection has put us it is necessary to stay active. in fact, besides enhanced hygiene measures, the most efficient protection is provided by our body’s natural defense, built and boosted primarily through physical activity. over millions of years, the human body shaped and evolved by resisting gravity; the adoption of the upright posture and daily movement allowed our ancestors to develop an extraordinary skeletal-muscular system, as well as nervous, cardiovascular, and respiratory systems, and subordinated the functioning of the entire human body to tasks directed by an unparalleled mind. the evolution of the human species led to the emergence of a unique pattern of developed cognitive, social, and motor abilities. and particularly unique was (or is) the capacity to connect and intertwine the three abilities within varied activities and environments. however, in recent decades (particularly since 1993, when the internet became commercially accessible), this very capacity has been challenged particularly by the rapid expansion of information (smart) technology and the digitalization of society, which neglect the motor abilities of the individual and thereby threaten their functional ability as well. we used to be able to partially compen146 reports and reviews/poročila in ocene, 65–76 annales kinesiologiae • 11 • 2020 • 2 sate for the reduced daily movement by engaging in recreation and sports – but what now, in circumstances when movement and exercise is restricted? shortly after the emergence of the first wave of the epidemic, the team of the institute for kinesiology research of zrs koper, supported by the generali insurance company, started composing a booklet with advice for everyone interested in meeting their urgent need for exercise, including the most vulnerable among the senior population and all those further at risk due to chronic illnesses. a year has passed since the beginning of the epidemics and the content of the booklet is continuing to remain very topical. all we wish to add is encouragement to carry out as many of the activities proposed as possible in fresh air and in nature. our advice is preceded by prologues by medical experts from the izola general hospital and the university medical centre maribor and by the slovenian ombudsman, which bestow on the booklet further gravitas. copies of the booklet have been distributed among numerous day care centers, senior citizen homes, health centers, and hospitals. its content is also available free of charge at https://www.zrs-kp.si or, more specifically, https://www.zrs-kp.si/wp-content/ uploads/2020/04/postanite-aktivni_spletna-izdaja.pdf. the 56-page booklet ostanite doma (p)ostanite aktivni [stay home, keep active] is a collection of advice rising to the challenge of enhancing our immunity through exercise and remaining healthy. it provides the basics for healthy and individualized exercise: a definition of fitness levels; organization of exercises, from warming up to rounding off; principle content emphases in individual parts of the exercise; exercise suggestions with pictorial instructions; nutrition advice for individual population groups. we invite you to test our advice and wish you all the best in 2021. or, in the words of greeting by one of our introductory speakers: “stay healthy, use your body as a tool and as medicine.” https://www.zrs-kp.si https://www.zrs-kp.si/wp-content/uploads/2020/04/postanite-aktivni_spletna-izdaja.pdf https://www.zrs-kp.si/wp-content/uploads/2020/04/postanite-aktivni_spletna-izdaja.pdf annales kinesiologiae • 11 • 2020 • 2 147 reports and reviews/poročila in ocene, 65–76 (p)ostanite aktivni priročnik rado pišot, matej kleva, kaja teraž, armin paravlić, uroš marušič, saša pišot, boštjan šimunič: ostanite doma (p)ostanite aktivni annales zrs, 2020, 56 str. časi, ki jih živimo niso prijazni, epidemija covid-19 in ukrepi za njeno zajezitev so krepko posegli v naš vsakdan, kjer najbolj pogrešamo gibanje. spremembam ukrepov in iskanju novih rešitev za zajezitev prenosa okužbe smo priča tako rekoč na dnevni ravni. žal pa so v ospredju tega iskanja vse druge dejavnosti, bolj malo pa se posvečamo zagotavljanju človekove osnovne potrebe – gibalne aktivnosti. tudi v današnjih okoliščinah, v katerih smo se znašli zaradi nevarnosti pred okužbo, moramo ostati dovolj gibalno aktivni! poleg higienskih ukrepov je najpomembnejša zaščita prav odpornost našega organizma, ki jo lahko dosežemo predvsem z gibanjem. človekov organizem se je v milijonih let oblikoval in razvijal z zoperstavljanjem težnosti, naši predniki so z razvojem pokončne drže in vsakodnevnim gibanjem razvili edinstven skeletnomišični sistem, živčni, srčno-žilni in dihalni sistem in delovanje celotnega organizma podredil svojim opravilom, ki jih je vodil edinstven um. razvoju človeške vrste je tako sledil edinstven vzorec razvitosti kognitivnih (spoznavnih), družbenih in gibalnih sposobnosti. predvsem pa je (bila) edinstvena zmožnost povezovanja in prepletanja vseh treh dimenzij v različnih dejavnostih in okoljih. prav ta pa je v zadnjih desetletjih (še posebej po letu 1993, odkar je medmrežje komercialno dosegljivo?!), predvsem s hitrim in velikim razmahom informacijskih (pametnih) tehnologij in digitalizacije družbe, že bila postavljena pred izziv. še posebej so postale ogrožene gibalne sposobnosti posameznika in s tem njegova funkcionalna zmožnost. pomanjkanje gibanja smo lahko delno nadoknadili z rekreacijo in športom – kaj pa zdaj, v času takih omejitev gibanja kot jih živimo danes? 148 reports and reviews/poročila in ocene, 65–76 annales kinesiologiae • 11 • 2020 • 2 sodelavci inštituta za kineziološke raziskave zrs koper smo se s podporo zavarovalnice generali že ob pojavu prvega vala odločili, da svoje nasvete ponudimo vsem, ki bi želeli v nadoknaditi nujno potrebo po gibanju. pri tem nismo pozabili tudi na najranljivejše v populaciji starejše in vse tiste, ki so še dodatno ogroženi zaradi drugih kroničnih bolezni. sedaj mineva že slabo leto od pojava epidemije in vsebina knjižice je še vedno zelo aktualna. dodamo lahko le pomembno spodbudo, da čim več vsebin izvedemo na svežem zraku v naravi. knjižico so s predgovori pospremili strokovnjaki iz zdravniških vrst iz splošne bolnišnice izola in univerzitetnega kliničnega centra maribor ter varuh človekovih pravic kar ji daje dodatno razsežnost. podarili smo jo številnim centrom dnevnih aktivnosti, domovom ostarelih, zdravstvenim domovom in bolnicam. vsem, ki si jo želijo pa je dosegljiva brezplačno na spletnem naslovu https:// www.zrs-kp.si ali neposredno https://www.zrs-kp.si/wp-content/uploads/2020/04/postanite-aktivni_spletna-izdaja.pdf . knjižica z naslovom ostanite doma (p)ostanite aktivni podaja učinkovit odgovor na izziv, kako povečati odpornost z vadbo in kako ostati zdrav. v njej boste na 56 straneh našli osnove za zdravo in posamezniku prilagojeno gibalno vadbo: opredelitev ravni pripravljenosti; razporeditev vadbe od ogrevanja do zaključnega dela; glavne poudarke vsebine posameznih delov vadbe; nekaj predlogov posameznih vaj s slikovnim materialom in tudi prehranske nasvete za posamezno skupino. vabljeni k uporabi nasvetov, vam s pozdravom enega izmed uvodničarjev želimo vse dobro v 2021 ter da “ostanete zdravi, svoje telo pa uporabite kot orodje in zdravilo”. https://www.zrs-kp.si https://www.zrs-kp.si https://www.zrs-kp.si/wp-content/uploads/2020/04/postanite-aktivni_spletna-izdaja.pdf https://www.zrs-kp.si/wp-content/uploads/2020/04/postanite-aktivni_spletna-izdaja.pdf _goback _goback _hlk40898474 _hlk34144101 _hlk40871331 _hlk53505499 _hlk33786872 _hlk25864445 annales kinesiologiae • 9 • 2018 • 2 121 review article udc: 796.011.1:159.922.63 received: 2018-09-14 psychological benefits of exercise and physical activity in older adults petra dolenc 1& mojca petrič 2 1 university of primorska, faculty of education, koper, slovenia 2 psychiatric hospital begunje, slovenia corresponding author: petra dolenc university of primorska, faculty of education, cankarjeva 5, 6000 koper, slovenia phone: +386 5 663 12 52 e-mail: petra.dolenc@pef.upr.si abstract while regular physical activity has been shown to positively impact health and physical functioning across all age groups an active lifestyle may in particular have beneficial effects in advanced age. the objective of this article is to provide a brief overview of a contemporary research on the benefits of physical activity for psychological health and quality of life in the elderly. older adults are more vulnerable than other age groups regarding mental health problems, such as depression and anxiety. many cross-sectional and experimental studies discussed in the article confirm the importance of a physically active lifestyle for preventing or reducing mental health problems and improving the quality of life among elderly people. keywords: mental health, physical activity, quality of life, late adulthood. pozitivni psihološki učinki gibalne/športne aktivnosti pri starejših odraslih izvleček redna gibalna/športna aktivnost pozitivno vpliva na gibalne zmogljivosti in zdravje posameznikov v vseh starostnih skupinah, predvsem pa ima aktivni življenjski slog lahko ugodne učinke v obdobju starosti. namen prispevka je predstaviti pregled literature 122 petra dolenc, mojca petrič: psychological benefits of exercise and physical activity in older adults, 121–134 annales kinesiologiae • 9 • 2018 • 2 s področja preučevanja koristi gibalne aktivnosti za psihološko zdravje in kakovost življenja pri starejših odraslih. slednji so v primerjavi z drugimi posamezniki bolj dovzetni za različne težave v duševnem zdravju, kot sta depresija in anksioznost. številne presečne in eksperimentalne študije, o katerih razpravljamo v prispevku, ugotavljajo, da je aktivni življenjski slog ključen za preprečevanje ali zmanjšanje težav v duševnem zdravju ter izboljšanje kakovosti življenja pri starejši populaciji. ključne besede: duševno zdravje, gibalna aktivnost, kakovost življenja, pozna odraslost introduction it is becoming increasingly apparent that successful aging is possible if people maintain certain healthy lifestyle habits throughout their lives (mora, 2013). among these habits, we also include physical activity (pa). according to the world health organization (who, 2015), a regular pa among older people is highly recommended for the promotion of an active lifestyle: older adults should participate in at least 50 minutes of moderate intensity and 75 minutes of vigorous intensity level pa per week. in a number of recent studies, pa has been identified as a key factor for improving health and quality of life in older adults (daskalopoulou et al., 2017; gill et al., 2013; murtagh et al., 2014). as population aging is progressing rapidly in many industrialized countries, it is important to understand the relationship between pa and the physical and mental well-being of older people (king & king, 2010). the health benefits of pa in older adults have been well established in the scientific literature (musich, wang, hawkins, & greame, 2017). regular pa can reduce the morbidity and mortality from many chronic diseases, postpone disability and prolong independent living (kokkinos, 2012; warburton & bredin, 2017). there is good evidence that being physically active reduces the risk of developing cardiovascular and metabolic disease through better control of blood pressure, cholesterol and waist circumference (earnest et al., 2013). physical activities and exercise programmes are important for building and maintaining bone density; they also improve neuromuscular capacity, increasing strength and muscle mass, which in turn may reduce the risk of falls (meléndez-ortega, 2007). pa is also associated with a reduction in age-related diseases such as dementia and alzheimer’s disease (reiner, niermann, jekauc, & woll, 2013). conversely, prolonged sedentary behaviour is associated with deleterious health outcomes, including cardiovascular disease incidence and mortality, type ii diabetes and cancer incidence (biswas et al., 2015). in addition to all the positive effects on physical health, there is growing evidence that pa is beneficial for mental health, well-being (mochcovitch, deslandes, freire, garcia, & nardi, 2016; netz, wu, becker, & tenenbaum, 2005) and even cognitive functioning (colcombe & kramer, 2003; gajewski & falkenstein, 2016) in older 123 annales kinesiologiae • 9 • 2018 • 2 petra dolenc, mojca petrič: psychological benefits of exercise and physical activity in older adults, 121–134 adults. multiple studies have found a positive association between exercise and pa and the alleviation of symptoms of anxiety and depression (lee et al., 2014; lindwall, rennemark, halling, berglund, & hassmén, 2007). objectives the purpose of this contribution is to present an overview of empirical literature regarding the benefits of pa on mental health and well-being, the possible mechanisms explaining pa effects on mental health and the association between pa and quality of life in the elderly. electronic databases pubmed, psycinfo, scopus, and sportdiscus were searched for literature sources in may 2018 for the last two decades (between 1997 and 2017 inclusive). different keywords were used: physical activity, exercise, mental health, quality of life, psychological well-being, older adults. physical activity effects on mental health and well-being in older adults the aging process is associated with an increased prevalence of both physical and mental health concerns (wrosch, schult, miller, lupien, & dunne, 2007). poor mental health is an important consideration for older adults, since it seems to be a substantial component of the perceived quality of life and can also affect health status (cho, martin, margrett, macdonald, & poon, 2011). depression is the most common mental disorder in this age group, which affects approximately 5 % and 7 % of the world’s older population (who, 2016) although significant depressive symptoms (which do not meet the diagnostic criteria for major depression) are much more prevalent among community-dwelling old adults. mental health problems in later life are under-identified by health professionals and by older people themselves; therefore, to promote well-being in later life, it seems crucial to prevent or adequately address mental health problems. given the high cost of health care and prescription medication, it is important to consider the relationships between the modifiable behaviours and lifestyles that might affect the mental health, such as pa (parker, strath, & swartz, 2008). penninx and colleagues (2002) examined the exercise effects on emotional function in 438 older participants with high and low depressive symptomatology. after an 18-month walking program, a significant reduction of depressive symptoms (assessed by the centre for epidemiologic studies depression scale – ces-d; radloff, 1977) was reported for both persons with initially high and low depressive symptomatology, hinting at the possible antidepressant effect of pa. these findings illustrate that aerobic exercise may have significant beneficial emotional effects among the general older population. in a similar study conducted by blumenthal et al. (1999), a 16-week 124 petra dolenc, mojca petrič: psychological benefits of exercise and physical activity in older adults, 121–134 annales kinesiologiae • 9 • 2018 • 2 randomized controlled trial was performed to assess the effectiveness of an aerobic exercise program compared with standard medication for treatment of older patients with major depressive disorder. one hundred fifty-six men and women were assigned randomly to a program of aerobic exercise, antidepressants, or combined exercise and medication. anxiety was assessed using the hamilton rating scale for depression (ham-d; linden, borchelt, barnow, & geiselman, 1995) and the beck depression inventory (bdi; beck, steer, & garbin, 1988). the investigators demonstrated that exercise training program including supervised sessions of walking and jogging are equally as effective as a standard antidepressant therapy in reducing depression symptoms among older clinically depressed persons (blumenthal et al., 1999). some authors also emphasize that traditional treatments for depression such as psychotherapy and antidepressant medications are not effective for all patients, therefore, alternative approaches are recommended, especially the use of aerobic exercise (blumenthal, smith, & hoffman, 2012). in a recent meta-analytic study, silveira and colleagues (2013) evaluated the effect of aerobic training and strength training as a treatment for depression in patients diagnosed with major depressive disorder. the meta-analysis concluded that physical exercise, mainly aerobic training, improves the response to depression treatment. however, the efficacy of exercise in the treatment of depression was influenced by age and severity of symptoms. mummery and colleagues (2004) examined the dose-response relationship between pa and mental health, comparing different levels of pa involvement. the study included 337 independent living older adults ranging from 55 to 89 years of age. activity status was assessed using the active australia questionnaire, whereas health status was assessed using the 12-item short form health survey (sf-12; jenkinson, chandola, coulter, & bruster, 2001). participants in the moderately active group (150-420 minutes of pa per week) and highly active group (>420 minutes of pa per week) displayed significantly higher mental health status than those who were classified as inactive (< 150 minutes of pa per week) when controlling for physical health status. a meta-analytic study conducted by conn (2010) synthesized depressive symptom outcomes of 38 supervised and 22 unsupervised pa interventions among healthy adults. the obtained findings showed that both supervised and unsupervised pa interventions are effective in reducing depressive symptoms among adults without clinical depression. in a recent longitudinal study, the relationship between the quantity and type of pa and subsequent depression in 3,497 adults aged between 65 and 75 was examined. total pa was measured using the physical activity scale for the elderly (pase; washburn, mcauley, katula, mihalko, & boileau, 1999), while depressive symptoms were measured by the patient health questionnaire (phq-9; martin, rief, klaiberg, & braehler, 2006). the participants who practised the highest levels of pa and whose activity profile included athletic activity were at lower risk for depression in older age (joshi et al., 2016). given the prevalence of depressive symptoms and the low rate of diagnosis among older adults, the promotion and maintenance of moderate-intensity aerobic pa could be 125 annales kinesiologiae • 9 • 2018 • 2 petra dolenc, mojca petrič: psychological benefits of exercise and physical activity in older adults, 121–134 a recommended way for improving psychological well-being for all older people (bridle, spanjers, patel, atherton, & lamb, 2012; lee et al., 2014; mummery, schofield, & caperchione, 2004). watanabe and colleagues (2000) examined the effect of an acute pa program of different exercise conditions on the level of anxiety among older adults. seventy-three healthy participants were randomly assigned to either water exercise group or land exercise group. the state of anxiety was assessed before and after the exercise. the obtained results showed that both exercise groups scored lower on anxiety after exercise, suggesting that the participation in these types of exercise can help to reduce anxiety levels in older persons. moreover, in a meta-analytic review of cross-sectional studies, a greater amount of physical exercise was associated with preferable levels of both positive and negative effects (arent, landers, & etnier, 2000). stubbe and colleagues have found that accumulating more pa is correlated with higher satisfaction with life (stubbe et al., 2007). the effects of regular pa on the person’s mood have mainly been studied using aerobic exercise but evidence indicates that other types of exercise, such as strength or flexibility training, can also reduce depressive symptoms, while less consensus exists with respect to anxiety symptoms (peluso & andrade, 2005). chodzko-zajko and colleagues (2009) reported that both aerobic exercise training and resistance exercise training produce clinically meaningful improvements in depression in clinical patients, with response rates ranging from 25 % to 88 %, whereas the findings are less consistent among the seniors without clinical depression. in a recent systematic review, mochcovitch and colleagues (2016) evaluated the efficacy of regular pa on anxiety symptoms in older adults without anxiety disorders. all analysed studies have shown that regular and supervised pa was directly related to decreased anxiety symptoms in older individuals. the authors concluded that regular pa may be effective for reducing anxiety levels in older adults, however, more studies are needed to identify the ideal pa modality, frequency, duration and intensity for optimizing the positive effects of exercise on anxiety in this population. although research consistently points to an inverse correlation between exercise and mental health, some authors indicated conflicting results it this relationship, emphasizing the importance of instrumentation used to measure pa (parker et al., 2008). due to lower complexity and relative low cost, most studies use subjective techniques, such as questionnaires, to assess pa. in general, subjective methods are accurate for measuring structured exercise but tend to overestimate moderate and vigorous pa and underestimate sedentary behaviour (dyrstad, hansen, holme, & anderssen, 2014). on the other hand, objective pa measures (i.e., pedometers, accelerometers) are increasingly used to evaluate the relationship between pa and mental health in older adults (fox, mckenna, & davis, 2007; loprinzi, 2013). parker and colleagues (2008) examined the relationship between one week of pa and mental health among 84 adults aged 55 to 87 as measured by pedometers, accelerometers and the pase questionnaire. objective pa assessment instruments were more sensitive in detecting the small but significant relationship between pa and mental health (in terms of positive affect, negative affect, 126 petra dolenc, mojca petrič: psychological benefits of exercise and physical activity in older adults, 121–134 annales kinesiologiae • 9 • 2018 • 2 and satisfaction with life) relative to the subjective pa measurement technique. these results suggest that objective instruments may be preferable for assessing pa patterns among older adults. a study conducted by loprinzi (2013) examined the association between accelerometer-assessed pa and depression symptoms among 708 older adults (65+ years). they wore an accelerometer for at least four days, and completed data on the study covariates along with depression, as assessed by the phq-9. after controlling for age, gender, race-ethnicity, body mass index, marital status, education, comorbidity index, and physical functioning, both light, and moderate-to-vigorous intensity pa was associated with lower depression levels. mechanisms underlying the relationship between physical activity and mental health the relationship between pa and mental health has been widely investigated and several hypotheses including neurobiological, psychological and social mechanisms have been proposed to explain this relationship (deslandes et al., 2009; lubans et al., 2016). physiological mechanisms that are often discussed involve monoamine, endorphin and thermogenic hypothesis (mikkelsen et al., 2017). exercise is associated with the increased synthesis and release of both neurotransmitters and neurotrophic factors, and these increases may be associated with neurogenesis, angiogenesis and neuroplasticity (matta mello portugal et al., 2013). the monoamine hypothesis proposes that exercises lead to balanced levels of neurotransmitters (such as dopamine, serotonin, and norepinephrine) which are usually imbalanced in people suffering from depression. therefore, this hypothesis suggests that pa can work in a similar way as anti-depressants, medications that can help relieve symptoms of depression (toups et al., 2011). the thermogenic hypothesis states that pa facilitates an increase in body temperature. consequently, the increased temperature in specific brain region can lead to a more relaxed state, and, consequently, mood enhancement (deboer, powers, utschig, otto, & smits, 2012). the endorphin hypothesis originated from runners experiencing a feeling of euphoria or high after long distances. it states that the release of β-endorphins in the brain following exercise produces a morphine-like effect which reduces the sensation of pain and provides a state of positive mood and an overall enhanced sense of wellbeing (dishman & o’connor, 2009). alternatively, psychological mechanisms for positive changes in mood and effect as a result of pa include the distraction hypothesis and the self-efficacy hypothesis (peluso & andrade, 2005; shaw, gorely, & corban, 2005). the distraction hypothesis suggests that exercise distracts people from depressive worries and negative thoughts. participating in pa or other distracting activities (e.g. relaxation, social contacts) gives people a break from daily hassles and stressors and provide the opportunity to relax and perhaps put things in perspective. (peluso & andrade, 2005). the self-efficacy hypothesis is centred on the notion that exercise brings better physical competence which results in positive feelings of achievement, increased sense of ability and self-confidence. while 127 annales kinesiologiae • 9 • 2018 • 2 petra dolenc, mojca petrič: psychological benefits of exercise and physical activity in older adults, 121–134 these feelings are associated specifically to the exercise domain, it is hypothesized that they may generalize to other areas of life, resulting in an increase of psychological well-being (shaw et al., 2005). the social interaction hypothesis proposes that social interaction and support from other people in an exercise setting provides a significant proportion of the pa effect on mental health (crone, smith, & gough, 2009). research confirmed the relationship between social network ties and positive mental state in the older population, showing that people who are more socially connected tend to report greater emotional wellbeing compared to those who have fewer social ties (litwin & shiovitz-ezra, 2011). especially for some excluded groups, such as older people or people with depression, the opportunity for social interaction may be particularly important for their psychological health. physical activity and quality of life in older adults an important component in determining the health status of an individual, particularly during the process of aging, is quality of life (qol). qol is a global, multidimensional construct representing overall relative satisfaction with life. the concept of qol includes different domains such as functional ability, psychological well-being, social relationships, socioeconomic status, living environment, daily activities, health, cultural and ethical values (bowling, 2005). older adults are often more concerned with their qol than their longevity per se, so improving and maintaining a high qol assumes great importance among the elderly. because qol is adversely impacted by illness and disability, an improved physical function might be expected to cause a parallel increase in qol (fleg, 2012). pa has been consistently associated with enhanced well-being and qol in later life (netz et al., 2005). different studies conducted on older adults from the general population have found that physical exercise may improve social interactions, self-esteem and global qol. furthermore, it may also contribute to increased independence in activities of daily living in older adults (taylor et al., 2004; warburton & bredin, 2017). flynn et al. (2009) have investigated the effects of exercise training on health status and qol (assessed by the kansas city cardiomyopathy questionnaire – kccq; green, porter, bresnahan, & spertus, 2000) in 2,331 older adults with heart failure. the intervention included usual care plus aerobic exercise training, consisting of 36 supervised sessions followed by home-based training, compared to usual care alone. the results demonstrate that the participation in an exercise training program provides a modest but statistically significant improvement in patient-reported health status and qol compared with usual care. similarly, austin and colleagues (2005) aimed to determine whether a cardiac rehabilitation programme improved health-related quality of life of 200 patients with heart failure aged 60 to 89. patients were randomised to one of two interventions, outpatient clinic based care (standard care) or clinic based care plus cardiac rehabilitation, including a 24-week of low resistance training. health-related 128 petra dolenc, mojca petrič: psychological benefits of exercise and physical activity in older adults, 121–134 annales kinesiologiae • 9 • 2018 • 2 quality of life was measured with the minnesota living with heart failure questionnaire (mlhf; rector, kubo, & cohn, 1993) and the euroqol questionnaire (brooks & de charro, 1996) at baseline and 24 weeks. patients attending cardiac rehabilitation attained a significant improvement in health-related qol compared to the patients in standard care. to establish the association between pa and qol in older adults, vagetti and colleagues (2014) conducted a systematic review of the literature in the period between 2000 and 2012. in general, the studies included in this review showed a positive association between pa and many but not all domains of qol. results indicated that pa was often associated with the following qol domains: functional capacity; general life autonomy; past, present and future activities; intimacy and mental health. these associations suggest that pa may promote physical independence as well as essential mental health aspects of qol. although the results of recent literature suggest a positive and consistent influence on the relationship between pa and qol in older adults, the mechanisms underlying these effects are still unclear. self-efficacy – commonly defined as the belief in one’s capabilities to achieve a goal or an outcome, appears to be an important variable that mediates the relationship between pa and qol (vagetti et al., 2014). researchers have consistently shown that when pa is associated with significant increases in self-efficacy, improvements in health-related qol are most likely to occur (mudrak, stochl, slepicka, & elavsky, 2016). efficacy beliefs also predict the behaviour and performance of older adults with mobility problems, balance difficulties, and are therefore at risk for falls (rejski & mihalko, 2001; mcauley et al., 2011). furthermore, exercise and pa have been proposed to impact the qol and well-being through their moderating and mediating effects on constructs such as self-concept and self-esteem. in particular, physical self-esteem has repeatedly been shown to be an important mental health status indicator in the context of pa and qol relationship (phillips, wójcicki, & mcauley, 2013). pa and qol play an important role in enhancing successful aging (choi, lee, lee, & jung, 2017). according to vagetti et al. (2014), evidence on the impact of pa frequency and intensity on qol domains is still limited. therefore, further longitudinal and intervention studies are needed to better understand this influence. conclusion growth in the elderly population means an increased risk for poor mental health outcomes such as depression, anxiety, and serious constraints on the qol among older people. in recent years, a substantial body of literature has tried to explain the mental health benefits of pa in older adults. although most of the studies discussed in this article report an inverse, dose-dependent relationship between pa participation and mental health outcomes, some questions remain unanswered, such as the right amount of exercise (e.g. frequency and intensity) to improve this protective response. also, further 129 annales kinesiologiae • 9 • 2018 • 2 petra dolenc, mojca petrič: psychological benefits of exercise and physical activity in older adults, 121–134 studies using objective pa measures can contribute significantly to establish clear links between the amount of exercise and specific mental health benefits in older adults. regular pa and exercise are important for healthy aging and are beneficial for chronic disease management. however, there is evidence that as people age, they tend to exercise progressively less and most of them do not meet the recommended pa levels, particularly those living in less affluent areas (mcphee et al., 2016). greater consideration of all psychological benefits of physical exercise is needed among health and exercise professionals working with the elderly. the main challenge is to find effective ways to encourage older adults to increase pa and reduce sedentary behaviour. it is therefore important to develop strategies to overcome barriers to exercise and stimulate participation in such activities that will be adapted to the needs and interests of older individuals. references ainsworth, b. e., bassett, d. r., strath, s. j., swartz, a. m., o’brien, w. l., thompson, r., … kimsey, c. d. 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(2007). physical health problems, depressive mood, and cortisol secretion in old age: buffer effects of health engagement control strategies. health psychology, 26(3), 341-349. doi: 10.1037/02786133.26.3.341 view item https://doi.org/10.2466/pms.2000.91.1.97 http://www.who.int/dietphysicalactivity/factsheet_olderadults/en/ http://www.who.int/dietphysicalactivity/factsheet_olderadults/en/ http://www.who.int/en/news-room/fact-sheets/detail/mental-health-of-older-adults https://doi.org/10.1037/0278-6133.26.3.341 annales kinesiologiae • 9 • 2018 • 1 15 original scientific article udc: 797.21.034.6:613.2 received: 2018-04-19 nutritional strategies of slovenian national junior swimming team vesna simič1, nina mohorko1 1university of primorska, faculty of health sciences, slovenia corresponding author: nina mohorko university of primorska, faculty of health sciences, polje 42, 6310 izola, slovenia. phone: +386 5 66 35 801 e-mail: nina.mohorko@fvz.upr.si abstract purpose: the purpose of our study was to assess the nutritional strategies of slovenian national junior swimming team and compare them with recommendations of clinical sports nutrition. competitive young swimmers, namely, have increased energy and nutrient needs compared to general adolescents due to frequent and intense training. despite some physiological differences if compared with adults, adult sports nutrition recommendations for macronutrients apply to them. further, literature reports iron, calcium, and vitamin d intake as frequently inadequate. methods: nutritional strategies of 19 members of slovenian national junior swimming team were assessed retrospectively through 3-day food and activity diaries, questionnaires, anthropometric data including bioimpedance analysis. energy availability (ea), macronutrient intake and timing, iron, calcium and vitamin d intakes, hydration, consumption of sports food and dietary supplement use were evaluated. results: ea in some of male swimmers and in the majority of female swimmers was lower than recommended. carbohydrate intake was adequate in male swimmers and two thirds of female swimmers. although average protein intake exceeded the upper recommended limit, some female swimmers did not meet the lower recommended intake limit. total fat intake was lower than recommended, with saturated fat intake on the upper recommended level. calcium and iron intake in male swimmers exceeded recommended values, while female swimmers had lower calcium intake than recommended and some had lower iron intake, too. vitamin d intake was low in all swimmers. meal timing was adequate in the majority of swimmers, who often reached for dietary supplements, mostly omega 3 fatty acids, multivitamins and magnesium. conclusions: low ea in young competitive swimmers is of concern. more successful, personalised nutrition strategies for young competitive swimmers, focusing on hi16 vesna simič, nina mohorko: nutritional strategies of slovenian national junior swimming team, 15–34 annales kinesiologiae • 9 • 2018 • 1 gher energy intake and healthy food choices, would contribute to the preservation of their health and further development into top performers. keywords: nutrition, young athletes, sport nutrition recommendation, health, performance. prehranske strategije plavalcev slovenske kadetske in mladinske reprezentance izvleček namen: namen naše raziskave je bil ugotoviti ustreznost uporabljenih prehranskih strategij plavalcev slovenske kadetske in mladinske reprezentance v primerjavi z veljavnimi priporočili klinične športne prehrane. mladi plavalci, ki tekmujejo, imajo v primerjavi z ostalimi najstniki zaradi pogostih in intenzivnih treningov povečane energijske in prehranske potrebe. kljub očitnim fiziološkim razlikam, ki jih ločijo od odraslih, veljajo zanje priporočila za vnos makrohranil za odrasle športnike. med mikrohranili literatura navaja, da so vnosi železa, kalcija in vitamina d pogosto nezadostni. metode: prehranske strategije 19 plavalcev slovenske kadetske in mladinske reprezentance smo retrospektivno ocenili na osnovi 3-dnevnih prehranskih in aktivnostnih dnevnikov, vprašalnika ter podatkov antropometričnih meritev, vključno z bioimpedančno analizo. ugotavljali smo energijsko razpoložljivost (er), vnos in časovno razporejanje makrohranil, vnose železa, kalcija in vitamina d, hidracijo, uporabo športne prehrane in prehranskih dopolnil. rezultati: er je bila pri nekaterih moških plavalcih in pri večini plavalk prenizka. vnosi ogljikovih hidratov so bili primerni pri plavalcih in dveh tretjinah plavalk. kljub temu, da je ugotovljeni povprečni vnos beljakovin presegal zgornjo priporočeno mejo, nekatere plavalke niso dosegale spodnje priporočene meje. celokupni vnosi maščob so bili nižji od priporočenih, vnosi nasičenih maščob pa na zgornji meji. vnos kalcija in železa je pri plavalcih presegal priporočene vrednosti, pri plavalkah pa je bil vnos kalcija in pri nekaterih tudi vnos železa pod priporočeno mejo. ritem obrokov je bil pri večini ustrezen. plavalci in plavalke so pogosto uživali prehranska dopolnila, najpogosteje maščobne kisline omega-3, multivitamine in magnezij. zaključek: nizka er pri mladih plavalcih, ki tekmujejo, je zaskrbljujoča. bolj uspešne individualne prehranske strategije za mlade plavalce, ki bi se osredotočale na višji energijski vnos in zdravo prehrano, bi prispevale k varovanju njihovega zdravja in razvoju v vrhunske športnike. ključne besede: prehrana, mladi športnik, priporočila, zdravje, zmogljivost 17 annales kinesiologiae • 9 • 2018 • 1 vesna simič, nina mohorko: nutritional strategies of slovenian national junior swimming team, 15–34 introduction young athletes who participate in high intensity sports programs have higher nutritional and energy needs than the general who recommendations stated for children and adolescents (desbrow & leveritt, 2015). competitive young swimmers belong to a group of athletes with increased energy and nutrient needs due to frequent and intense training (petrie, stover, & horswill, 2004). at the metabolic level, all three energy systems (the high energy phosphagen system, anaerobic glycolysis and aerobic metabolism) are involved in all swimming competition disciplines, ranging by duration between 20 seconds (50 m) and 14.5 minutes (1,500 m) in junior elite swimmers (federation internationale de natation, 2018). although adolescents have specific nutritional needs because they differ from adults in energy consumption, substrate consumption during exercise, thermoregulation, sweat mechanism and maintenance of fluid balance as well as other physiological components (desbrow & leveritt, 2015), the sports nutrition principles are similar to those for adults. for long-term health protection of athletes, adequate energy availability (ea), 45 kcal/kg of fat-free mas (ffm) or more, must be provided (desbrow & leveritt, 2015). sufficient energy and nutrient intake in adolescence is critical for normal growth and development, maintaining health and injury prevention. an adequate nutrition intake also enables optimization of the training process and successful recovery. adolescence is a crucial period, comprised of intense growth and development, involving the alteration of body composition, metabolic and hormonal fluctuations, maturation of organ systems and formation of nutrient storage, all of which has a potential impact on the individual’s health in the future (sawyer et al., 2012). long-term suboptimal ea, in the range between 30 and 45 kcal/kg ffm, or too low ea, under 30 kcal/kg ffm, leads to relative energy deficiency in sport (red-s) (mountjoy et al., 2014). the latter leads to disrupted physiological functions caused by the relative lack of energy, which include lowered metabolic rate, disrupted menstrual function, and compromised bone health, immunity, protein synthesis and cardiovascular health. despite the fact that there are potential differences in the ability to store carbohydrates (cho) and to use substrates during physical activity between adults and children, literature reports that the cho needs of young athletes do not differ greatly from the needs of adults (desbrow et al., 2014). in moderate to high-intensity endurance training, which lasts from 1 to 3 hours per day, cho intake of 6 to 10 g/kg of body weight (bw) is recommended and in moderate to high intensity exercise, which lasts 4 to 5 hours per day, 8 to 12 g cho/kg bw/ day is recommended (burke, hawley, wong, & jeukendrup, 2011). the recommendations must be individual, dynamic and in accordance with the requirements and goals (thomas, erdman, & burke, 2016). due to the lack of specific research into the protein requirements of adolescent athletes, it is suggested to follow the recommendations for adult athletes (1.3 – 1.8 g protein/kg bw). some athletes have increased protein requirements during adolescence compared to the recommended quantities for their age group, especially if they have well-developed muscle mass or if they participate in high intensity exercise programs 18 vesna simič, nina mohorko: nutritional strategies of slovenian national junior swimming team, 15–34 annales kinesiologiae • 9 • 2018 • 1 (boisseau, vermorel, & rance, 2007; aerenhouts, deriemaeker, hebbelinck, & clarys, 2011; aerenhouts, van cauwenberg, poortmans, hauspie, & clarys, 2013). dietary fat intake of adolescent athletes should follow general recommendations (desbrow et al., 2014). according to the national institute for public health (2016) this means that in the 10to 14-year old age group, fat should represent between 30 and 35% of total energy intake (ei), while in the 15to 18-year old age group, fat intake should contribute up to 30% ei, with the note that in physically active individuals this share could be increased to up to 35% ei. saturated fat should not exceed 10% ei (national institute for public health, 2016). micronutrient deficiencies have negative impact on health and performance because micronutrients participate in a number of functions in the body. in young athletes, special attention must be paid to iron, calcium and vitamin d intakes (desbrow & leveritt, 2015). recommendations for iron intake in young athletes do not differ from recommendations for the general population, despite the fact that exercise can cause additional iron loss through sweating or bleeding into the gastrointestinal system or also due to the decomposition of erythrocytes during a long run (peeling et al., 2009; koehler et al., 2012). slovenian adolescent males aged 13 to 18 should therefore consume 12 mg of iron per day and females 15 mg per day (national institute for public health, 2016). the only exception are vegetarian athletes who require higher intakes due to the reduced bioavailability of non-heme iron (desbrow & leveritt, 2015). calcium and vitamin d are key nutrients for the development and maintenance of bone mass. due to intense bone growth during adolescence, calcium needs are increased in both males and females. for 13to 18-year olds, the recommended daily intake of calcium is 1200 mg (national institute for public health, 2016), which applies to adolescent athletes, too, until there is more research available (desbrow & leveritt, 2015). vitamin d plays an important role in calcium and phosphate metabolism and calcium integration into bones and teeth, and in the operation of the immune and muscle systems (desbrow & leveritt, 2015). approximately 90% of our daily vitamin d requirements are covered by internal synthesis in the skin after exposure to ultraviolet rays; dietary intake contributing only 10% of the requirements (koundourakis, avgoustinaki, malliaraki, & margioris, 2016). in slovenia, typical nutritional vitamin d intakes (2–4 µg daily) in adolescents in the absence of internal synthesis do not suffice to achieve recommended serum concentrations. the difference between the intake and the recommended value of 20 µg must be reached through frequent exposure to the sun and/or taking a vitamin d formulation (national institute for public health, 2016). in latitudes above 35° north, which applies to slovenia, the sun rays angle in winter are too oblique for efficient skin vitamin d synthesis (holick, 2008), apart from that, competitive young swimmers spend long hours practicing indoor also in autumn and spring, which poses them at risk for vitamin d deficiency. geiker et al. (2017) reported that 45% of the 29 swimmers (16−24 years old) residing at latitude 55−56° north had 25-hydroxycholecalciferol below 50 nmol/l in march and april. it is known that adolescent athletes have a higher height to body mass ratio (petrie et al., 2004) and a lower sweating rate (shibasaki, inoue, kondo & iwata, 1997) than 19 annales kinesiologiae • 9 • 2018 • 1 vesna simič, nina mohorko: nutritional strategies of slovenian national junior swimming team, 15–34 adults. a decreased sweating rate is an advantage in maintaining hydration status and at the same time decreases the success of thermoregulation. sawka et al. (2007) propose fluid replacement during exercise to such a degree that hypohydration exceeding 2% is prevented. desbrow et al. (2014) and smith, holmes & mcallister (2015), who deal with adolescent athletes, recommend the same. water or milk should not be replaced by sports drinks that contain electrolytes and cho because sodium losses through sweating are smaller than in adults (meyer, volterman, timmons, & boguslaw, 2012). sports drinks are recommended only in long-term intense physical activity. drinking caffeinated energy drinks is advised against in young athletes (desbrow & leveritt, 2015). the use of sports food (sports drinks, sports bars, sports confectionery, sports gels, liquid meal supplements, …) is justified in adolescents in cases of long and intensive training (desbrow et al., 2014). replacing nutrients with dietary supplements, such as calcium, iron and vitamin d, is also justified when a deficiency is confirmed (international olympic committee (ioc), 2011). the use of ergogenics is advised against because it is inappropriate and unnecessary, and in addition their safe use in all age groups has not been confirmed (international olympic committee (ioc), 2011). to fulfil their increased energy requirements, young athletes are recommended three main meals and two snacks (desbrow & leveritt, 2015). a meal rich in cho (1–4 g cho/kg bw) is recommended 1–4 hours before activity. during exercise lasting 1–2.5 hours, 30–60 g cho/h should be consumed. the post exercise meal should contain 1.0–1.2 g cho/kg bw and 20 g of protein (smith et al., 2015). such a meal, consumed directly or as soon as possible after exercise, enables the refilling of glycogen stores, muscle repair and replaces lost fluid. this is especially important in athletes who compete several days in a row (e.g. in a tournaments) or train more than once per day (desbrow & leveritt, 2015). the aim of our study was to assess the nutritional strategies of slovenian national junior swimming team and compare them with recommendations. methods data collection all members of slovenian national junior swimming team were invited to participate in the study. the eligibility criteria for the national team are determined by the slovenian swimming federation, which also provided us with the list of swimmers (27 competitive young swimmers). out of 21 swimmers for whom written consents for personal data processing were obtained, 2 were excluded from analysis due to inadequate food diaries, confining the final sample to 19 competitive young swimmers (figure 1, table 1). the data was collected from october to december 2016 and analysed in february 2017. 20 vesna simič, nina mohorko: nutritional strategies of slovenian national junior swimming team, 15–34 annales kinesiologiae • 9 • 2018 • 1 anthropometric measurements we collected weight and height data from anthropometric measurements regularly performed during preparation training cycles. swimmers were weighed to the nearest 10 g (m 304641-01, aed) and height was measured to the nearest 0.5 cm (stadiometer, m 304641-01 (ade). whole body bia (bia 101 anniversary akern, florence, italy, medically approved: en iso 13485 − iso 9001) was performed using an alternating sinusoidal electric current of 400 µa at an operating frequency of 50 khz according to recommendations (kyle et al., 2004) for ffm assessment, that was needed for ea calculation. dietary assessment and energy consumption evaluation data were collected from food and activity diaries. swimmers were asked to keep 3-day weighted food and activity diaries for three consecutive days (including one weekend day). swimmers were fully briefed on how to complete the diary and asked to continue their normal diet and physical activity. they were asked to include food labels and recipes for mixed dishes in their record. for each day, they had to record the kind, duration and intensity of the physical activity. the dietary intake was assessed using open platform for clinical nutrition (open), that is an online, freely accessible, dietary assessment and planning tool for the analysis of food diary (http://www.opkp.si/en_gb/cms/vstopna-stran). open food composition data was taken from the slovenian food composition database (golob et al., 2006); or if not available there, from the souci, fachmann & kraut food composition and nutrition tables (2008) and/or from the usda national nutrient database for standard referenfigure 1: swimmers flow diagram. http://www.opkp.si/en_gb/cms/vstopna-stran 21 annales kinesiologiae • 9 • 2018 • 1 vesna simič, nina mohorko: nutritional strategies of slovenian national junior swimming team, 15–34 ce (http://www.ars.usda.gov/services/docs.htm?docid=8964). food composition data applied by the open meet the european standard for food data cen/tc 387, available at http://www.cen.eu/. ei, macronutrient intake and calcium, iron and vitamin d intakes were evaluated. to examine the suitability of energy consumption, ea was calculated. ea represents the energy that is available for body function, growth and development taking in consideration exercise energy expenditure (eee) during planned physical activity (desbrow et al., 2014). metabolic equivalent of task (met) was used for eee evaluation, as suggested by open. questionnaire data from a questionnaire that was developed by nutrition expert in charge of nutrition support of national swimming team, were analysed. swimmers were asked to answer the questionnaire on health parameters (number of infections, menstrual cycle, growth), nutritional habits, timing of meal intake, use of dietary supplements and sports food, as well as type, intensity and the duration of exercise. statistical analysis answers from the questionnaire that refer to sports nutrition recommendations and dietary intake compared to recommended values were processed in microsoft excel (ibm corp. released 2011), while anthropometric data and dietary intakes were processed with spss 20.0 (ibm spss statistics for windows, version 20.0. armonk, ny: ibm corp.). the descriptive statistics was used to determine averages, standard deviations and minimum and maximum values. the shapiro-wilk test was used for assessing the normality in the distribution of variables, one sample t-test and independent samples t-test were used to evaluate the difference from recommended values and difference between genders. statistical significance was set at p < 0,05. spearman and eta correlations were performed to detect different associations between dietary intakes and frequency of infection as well as regularity of menstrual cycle. (1) http://www.ars.usda.gov/services/docs.htm?docid=8964 http://www.cen.eu/ 22 vesna simič, nina mohorko: nutritional strategies of slovenian national junior swimming team, 15–34 annales kinesiologiae • 9 • 2018 • 1 results characteristics of swimmers grouped by gender are presented in table 1. ta bl e 1: c ha ra ct er is tic s of s w im m er s di vi de d by g en de r a ve ra ge (± s d ) t* p (2 -t ai le d) * a ll (n = 19 ) m al e sw im m er s (n = 6) f em al e sw im m er s (n =1 3) a ge (y ea rs ) 14 ,9 5 ± 1, 22 16 ,1 7 ± 0, 75 14 ,3 8 ± 0, 96 3, 99 0, 00 1 b od y he ig ht (c m ) 17 3, 97 ± 7 ,7 0 18 1, 92 ± 4 ,3 2 17 0, 31 ± 5 ,9 1 4, 28 0, 00 1 b od y w ei gh t ( kg ) 62 ,3 5 ± 10 ,0 7 73 ,3 3 ± 4, 88 57 ,2 8 ± 7, 35 4, 84 0, 00 0 b m r (k ca l/d ay ) (k j/ da y) 16 08 ,5 0 ± 18 0, 30 (6 72 9, 96 ± 7 45 ,3 8 18 27 ,8 8 ± 91 ,5 5 (7 64 7, 85 ± 3 83 ,0 4) 15 07 ,2 5 ± 10 0, 50 (6 30 6, 33 ± 42 0, 49 ) 6, 63 0, 00 0 f f m (k g) 51 ,5 8 ± 9, 39 62 ,9 7 ± 3, 80 46 ,3 3 ± 5, 62 6, 54 0, 00 0 f at m as s (% ) 17 ,4 4 ±3 ,7 7 14 ,0 8 ± 1, 75 18 ,9 9 ± 3, 43 3, 28 0, 00 4 tr ai ni ng lo ad (h /w ee k) 20 ,7 8 ± 2, 59 21 ,4 2 ± 3, 52 20 ,4 8 ± 2, 15 0, 72 0, 48 0 e ne rg y av ai la bi lit y (k ca l/k g f f m ) (k j/ kg f f m ) 37 ,0 1 ± 12 ,9 9 (1 55 ,2 3 ± 54 ,3 5) 43 ,4 8 ± 9, 16 (1 81 ,9 2 ± 38 ,3 2) 34 ,0 2 ± 13 ,6 9 (1 43 ,0 9 ± 57 ,2 8) 1, 53 0, 14 4 b m r – b as al m et ab ol ic ra te , f fm – fa t f re e m as s * d iff er en ce b et w ee n m al e an d fe m al e sw im m er s 23 annales kinesiologiae • 9 • 2018 • 1 vesna simič, nina mohorko: nutritional strategies of slovenian national junior swimming team, 15–34 nutritional data is presented in table 2 and graphically for each swimmer (figure 2), coded based on the calculated ea. female swimmers were assigned codes from 1 to 13 and male swimmers codes from 14 to 19. each individual’s code applies to all displays. ta bl e 2: n ut ri tio na l i nt ak es o f s w im m er s di vi de d by g en de r a ve ra ge (± s d ) t* p (2 -t ai le d) * a ll (n = 19 ) m al e sw im m er s (n = 6) f em al e sw im m er s (n =1 3) c h o in ta ke /k g b w (g /k g) 7, 24 ± 1 ,9 2 8, 08 ± 1 ,3 2 6, 85 ± 2 ,0 7 1, 33 0, 20 1 p ro te in in ta ke /k g b w (g /k g) 2. 03 ± 0 .7 6 2, 70 ± 0 ,9 0 1, 72 ± 0 ,4 4 3, 21 0, 00 5 f at (% e i) 25 ,0 6 ± 25 ,9 8 23 ,0 7 ± 4, 54 25 ,9 8 ± 7, 10 -0 ,9 16 0, 37 3 sa tu ra te d fa t ( % e i) 8, 67 ± 9 ,0 0 8, 67 ± 2 ,9 4 9, 00 ± 2 ,4 8 -0 ,2 57 0, 80 0 ir on it ak e (m g) 19 ,4 7 ± 7, 18 25 ,7 5 ± 6, 89 16 ,5 7 ± 5, 35 3, 18 0 0, 00 5 c al ci um in ta ke (m g) 11 56 ,9 9 ± 51 6, 64 17 15 ,5 7 ± 35 2, 75 89 9, 19 ± 3 47 ,1 7 4, 74 2 0, 00 0 v it am in d in ta ke (µ g) 4, 84 ± 4 ,7 6 9, 20 ± 6 ,3 1 2, 83 ± 1 ,8 8 2, 42 4 0, 05 6 e i – e ne rg y in ta ke , c h o – ca rb oh yd ra te , b w – b od y w ei gh t * d if fe re nc e be tw ee n m al e an d fe m al e sw im m er s 24 vesna simič, nina mohorko: nutritional strategies of slovenian national junior swimming team, 15–34 annales kinesiologiae • 9 • 2018 • 1 figure 2a: nutritional intake of slovenian junior national swimming team compared to recommendations. a ea. b cho intake. c protein intake. d fat intake. a b c d le ge nd : m al e sw im m er s in ta ke – b la ck b ar s; f em al e sw im m er s in ta ke – g ra y ba rs ; r ec om m en da tio n – fu ll lin e. w he re a pp lic ab le : da rk li ne – lo w er li m it; li gh t l in e – up pe r lim it 25 annales kinesiologiae • 9 • 2018 • 1 vesna simič, nina mohorko: nutritional strategies of slovenian national junior swimming team, 15–34 figure 2b: nutritional intake of slovenian junior national swimming team compared to recommendations. e saturated fat intake. f iron intake. g calcium intake. h vitamin d intake. h g f e le ge nd : m al e sw im m er s in ta ke – b la ck b ar s; f em al e sw im m er s in ta ke – g ra y ba rs ; r ec om m en da tio n – fu ll lin e. w he re a pp lic ab le : da rk li ne – lo w er li m it; li gh t l in e – up pe r lim it 26 vesna simič, nina mohorko: nutritional strategies of slovenian national junior swimming team, 15–34 annales kinesiologiae • 9 • 2018 • 1 ea of the majority of swimmers was between 30 and 45 kcal/kg ffm, little less than of one third under 30 and only 5 above 45 (figure 2a). 4 female swimmers with low ea also had a low cho intake (figure 2b). all male swimmers exceeded the upper limit for protein intake, while 3 female swimmers did not reach the lower limit of the recommendations, 4 were within the recommended values, and 6 exceeded the upper limit of the recommendations (figure 2c). the intake of fat was below the recommended limit for all male swimmers and for 8 female swimmers (figure 2d), while the intake of saturated fat was in accordance with the recommendations in 13 swimmers, whereas 5 female swimmers and 1 male swimmer had intakes that were higher than recommended (figure 2e). 5 female swimmers had inadequate iron intake (figure 2f). all male swimmers and 2 female swimmers exceeded the recommended calcium intake, while the remaining 11 female swimmers were under the recommended limit (figure 2g). vitamin d intake was below the recommended limit in all swimmers (figure 2h). 4 female swimmers drank less than 1.5 l of fluid per day, while the majority of male swimmers (n = 5) and one female swimmer drank more than 3 l of fluid. the rest drank 1.5 − 2.5 l of fluid per day (n = 6) or 2.5 − 3 l (n = 3) on days when they were training. most of the swimmers drank 0.3 − 0.8 l of fluid in one hour of training (n = 9). 6 swimmers consumed less than that, 3 swimmers drank 0.8 − 1 l, and 1 swimmer drank 1 − 1.5 l of fluid in an hour. the questionnaire gave us the insight in swimmers’ nutritional habits. 17 swimmers (6 male swimmers and 11 female swimmers) regularly consumed fluid during their training, one female swimmer rarely and one never. all swimmers consumed an isotonic beverage with electrolytes during the exercise, while 17 of them never consumed caffeinated energy drinks, and 2 swimmers rarely took them. all swimmers consumed sports food (energy bars, gels, …), 15 also took dietary supplements, 3 of which took one dietary supplement, 3 took two dietary supplements, 4 took 3 dietary supplements, while 2 took 4 dietary supplements. the most consumed dietary supplement were omega 3 fatty acids (n = 8 swimmers), followed by multivitamins (n = 6) and magnesium (n = 5), 4 took iron, glutamine or vitamin c and 3 took vitamin d. vitamin b, creatine, q10 or branched amino acids were taken by 1 swimmer each. the majority (n = 15) consumed five meals or more per day. others consumed four (n = 2) or three (n = 2) meals per day, but none less than that. the majority of swimmers (n = 14) also always consumed a balanced meal 2 – 3 hours before training, 4 rarely and 1 never. the majority (n = 12) consumed a cho rich meal one hour before training. almost all (n = 18) regularly consumed a meal rich in cho and protein within an hour after training, while one swimmer rarely did so. to the question “do you consume a protein supplement within an hour after training?” 6 swimmers answered “always”, 5 answered that they “rarely consumed protein in the form of a supplement” and 8 answered “never”. we also determined the frequency of infections in competitive young swimmers. the majority (n = 13) fell ill 1 – 2 times per year, 4 more frequently and 2 never. only 3 female swimmers had a regular menstrual cycle. 2 females in the group who had never had a period (n= 6) were over 15 years old. 4 female swimmers had an irregular menstrual cycle. the frequency of infection was not statistically significantly associated 27 annales kinesiologiae • 9 • 2018 • 1 vesna simič, nina mohorko: nutritional strategies of slovenian national junior swimming team, 15–34 with energy availability (ρ = -0.223, p = 0.360), cho (ρ = 0.099, p = 0.686), protein (ρ = -0.066, p = 0.787) nor fat (ρ = -0.354, p = 0.138) intake. the regularity of menstrual cycles in females was not statistically significantly associated with energy availability (η = 0.186, η2 = 0.340, p = 0.839), cho (η = 0.264, η2 = 0.070, p = 0.696), protein (η = 0.543, η2 = 0.295, p = 0.175) nor fat intake (η = 0.444, η2 = 0.197, p = 0.333), either. discussion the first systematic insight into the nutrition status of young competitive athletes in slovenia showed some inadequate intake of nutrients that may influence the performance and health of young athletes. some exceptionally low ea values (min. = 15.1 kcal/kg ffm) and the fact that almost three quarters of the swimmers did not achieve the recommended ea values indicated that the ei in some young male swimmers and mostly in female swimmers were too low and needed improvement, because long-lasting low relative ea influences a number of organic systems and may in the short and long-term compromise health and performance (mountjoy et al., 2014). the calculated low ea may also be due to methodological causes. it is known that in determining dietary intake with the use of a food diary, inaccuracies may occur that may be the consequence of a changed diet due to recording into the food diary itself, incorrectly recording foods that are or are not desired in order to improve the impression on what was eaten, or actual errors that occur in the weighing or description of consumed quantities (burke, 2001). it is also known that as many as 80 % of participants report too low quantities of food intake, with reported quantity being up to 20 % lower than actual intake (black et al., 1993). another problem could be the eee, because it was not measured but calculated based on reported time and type of exercise, using met. the small sample of swimmers and unequal representation of genders also represented an additional restriction. based on reported training load, 18 swimmers required cho intake of 6 to 10 g /kg bw, while one swimmer had higher requirements due to a higher exercise load (8 – 12 g/kg bw). while all male swimmers had adequate cho intake, 4 female swimmers did not reach the lower recommended intake limit. inadequate intake leads to inadequate glycogen stores and the onset of fatigue, which, in connection with low ea that was identified in all of them, has a negative effect on health and performance (loucks, kiens, & wright, 2011). an adequate intake of cho also prevents protein catabolism. burke et al. (2011) define cho availability as a dynamic measure of suitable cho intake, both on daily basis and on strategic time points around important exercise sessions as high cho availability provides cho for muscle and nervous system and has thus the potential to enhance performance and recovery at key times. we examined the adequacy of meal timing and composition around training with a questionnaire. 14 swimmers followed the recommendations and always consumed a balanced meal, including cho, 2 – 3 hours prior to training. in addition, 12 consumed one more meal rich in cho within one hour prior to exercise, which is an effective strategy for ensuring an additional 28 vesna simič, nina mohorko: nutritional strategies of slovenian national junior swimming team, 15–34 annales kinesiologiae • 9 • 2018 • 1 energy source for working muscles and the central nervous system (jeukendrup & cronin, 2011). during their exercise, all swimmers replaced fluids, cho and electrolytes. as many as 18 swimmers consumed a cho and protein rich meal after training. all the above shows that top young slovenian swimmers mainly use nutrition strategies in accordance with recommendations before, during and after training. however, since cho availability covers both, daily intake and meals around exercise, inadequate daily cho intake in 4 female swimmers means low cho availability, which means their glycogen stores are not optimally replenished which can affect performance, both on training and competition (burke et al., 2011). more emphasis should therefore be placed on adequate daily cho intake in female young swimmers. this would enable them to reach adequate cho availability and ea and consequently adequate glycogen stores and prevent them from fatigue and muscle catabolism. the protein intake of all male swimmers and 6 female swimmers exceeded the upper recommended limit, 1.8 g/kg bw/day, despite ea being too low in 4 male swimmers and 3 female swimmers. the literature reports that young athletes who have adequate ea reach or exceed protein intake recommendations (petrie et al., 2004; heanley, o’connor, giifford, & naughton, 2010; gibson, stuart-hill, martin, & gaul, 2011). after training, 3 male swimmers and 3 female swimmers always consumed protein in the form of a supplement, 1 male and 4 female swimmers did so occasionally, while the others did not consume protein in the form of supplements. the use of protein supplement in young athletes could be justified merely due to their practicality, however, food sources of protein would be a better choice, especially because protein needs can be fulfilled within normal ea. on the other hand, 3 female swimmers (all 3 with low ea) did not reach the lower recommended protein intake, 1.3 g/kg bw/day. an inadequate protein intake or a low ea, where part of the protein is used as a substrate in the process of energy acquisition, could potentially lower the amino acid availability for basic physiological functions (petrie et al., 2004; campbell et al., 2007). therefore, low protein intake is problematic, and even (too) high intake in the context of low ea does not guarantee appropriate protein availability. the average ea in female swimmers was lower than the recommended limit, and therefore they were more prone to protein deficiency in our sample than male swimmers. to prevent protein and energy deficiency, we would suggest to fulfil protein needs by increasing ei through normal food. no guidelines or recommendations mention the absolute fat content in an individual‘s diet, the values refer to the percentage of ei provided by fat. our swimmers had low fat intake, contrary to literature reports (croll et al., 2006; juzwiak, amancio, vitalle, pinheiro, & szejnfeld, 2008), which state that the fat intake in young athletes usually exceeds 30 % of ei. this lack of fat may be the cause of the low ea that was noticed mainly in female swimmers, which is why we, in line with other authors, recommend that young athletes be encouraged to eat fish and unsaturated fats from plant sources and to avoid the consumption of saturated fats from fried foods and baked goods as well as fats of animal origin (desbrow et al., 2014) which contribute to higher saturated fat intake. indeed, the intake of saturated fat in some swimmers was above the upper recommended value. 29 annales kinesiologiae • 9 • 2018 • 1 vesna simič, nina mohorko: nutritional strategies of slovenian national junior swimming team, 15–34 three key micronutrients for young athletes can be identified from the literature: iron, calcium and vitamin d (desbrow et al., 2014; smith et al., 2015). the average iron intake in female swimmers was sufficient, but individual intake was insufficient in 5 female swimmers. the findings partially correspond to the findings of other authors who state that the dietary intake of iron in young male athletes exceeds the recommendations, while in females they are within the recommended limits (juzwiak et al., 2008; heanley, et al., 2010; gibson et al., 2011; martinez et al., 2011). since low iron stores are usually observed in female swimmers, regular supervision of iron status is necessary as well as early detection of low iron stores and appropriate intervention in order to increase iron intake or to increase the iron bioavailability. taking iron as a dietary supplement is justified only in cases of proven deficiency (desbrow et al., 2014). the literature states that young athletes achieve only one half of the recommended calcium intake (gibson et al., 2011; juzwiak et al., 2008), which was not the case in our study. calcium intake was above the recommended values in male swimmers, but under the recommended limit in female swimmers, which is in line with martinez et al. (2011). encouraging milk and dairy consumption would not only improve calcium intake, but also fat and protein intake and ea (fayet, ridges, wright, & petocz, 2013). the estimated dietary intake of vitamin d was lower in female swimmers than in male swimmers. a comparison with recommendations was not possible as they define vitamin d requirements that may be met through dietary intake as well as through internal synthesis. serum concentrations of 25-hydroxycholecalciferol would give us a better insight into vitamin d status, however considering our latitude (above 35th parallel north), long hours spent indoors due to training and the low dietary intake of vitamin d in female swimmers, we can suspect that this group is at risk of vitamin d deficiency. due to the high physical load we are concerned that the current nutrition strategies of some competitive female swimmers together with calcium deficiency and low ea may have a negative impact on bone health, which is further exacerbated by the physical activity in water which lowers the workload against gravity (gomez-bruton et al., 2017). regular monitoring of vitamin d status is necessary in athletes at increased risk of deficiency and suitable supplementation should be advised in case of discovered inadequacy (desbrow et al., 2014). fluid intake was assessed using a questionnaire as we were not able to assess it based on the food diary due to insufficient data. the problem with sufficient fluid intake is that there are noticeable individual differences between athletes, due to which there are no concrete fluid intake recommendations. reference values for nutrient intake (german nutrition society (dge), 2004) state that moderately active 15-year-old adolescents or younger should consume 1330 ml of fluid daily, while those over 15 years old should consume 1530 ml. from the questionnaire, we discovered that 4 female swimmers drank less than 1.5 l of fluid per day on training days, which we can certainly assess as inadequate as that is the recommended intake for non-active individuals. adams et al. (2016) discovered that as many as 67 – 78 % (depending on the method) of swimmers aged 8 to 17 came to morning training in a hypohydrated state. due to significant differences between individuals and physical activities, australian dieticians 30 vesna simič, nina mohorko: nutritional strategies of slovenian national junior swimming team, 15–34 annales kinesiologiae • 9 • 2018 • 1 and sports nutrition specialists (desbrow et al., 2014) recommend regular monitoring of fluid intake needs by weighing before and after training. we do not have the data on individual weight losses during exercise and cannot estimate the quantitative adequacy of fluid replacement. drinking energy drinks containing caffeine is not recommended in this age group (desbrow & leveritt, 2015). only 2 young swimmers (10.5 %) reported consuming energy drinks, which is a good result, as o’dea (2003) found that in the age group between 11 and 18 years old as many as 42.3 % of otherwise moderately active children consumed energy drinks. all the competitive young swimmers in the sample consumed sports food, which is justified considering their heavy training load. they also often used dietary supplements (78.8 %), possibly including more than one supplement (up to four), which is a little more than reported by mcdowall (2007), who found the prevalence between 22 % and 71 %. the competitive young swimmers most commonly took omega-3 fatty acids, multivitamins and magnesium. the supplementation of nutrients is considered justified when a deficiency is discovered or if needs cannot be met through nutrition. based on our results, competitive young swimmers should consider supplementing vitamin d. even though the use of ergogenic aids for better performance is inappropriate and unnecessary and their safe use has not been confirmed in this age group, we discovered that 1 swimmer used creatine. competitive young swimmers should be familiarized with the risks of using dietary supplements because they may not be safe, may be disallowed or ineffective or even contaminated with banned substances (desbrow et al., 2014). they should be encouraged to meet their nutritional requirements through the correct choice of foods and not through supplements. it is known that low ea is a risk factor for low immune function and increased susceptibility to infection (montenero, lopez-varela, nova, & marcos, 2002). despite the fact that there was the possibility that the reported intake was too low, the low ea that we noticed in 14 of the competitive young swimmers indicated an increased risk of infection that we did not manage to prove in our sample of 19 swimmers. we also did not manage to determine a correlation between the frequency of infection and the intake of other macronutrients that are connected with immune system function. low ea influences the regularity of the menstrual cycle and causes functional hypothalamic menstrual dysfunction, which has a negative impact on bone health as it leads to decreased formation of new bone tissue and increased resorption of existing bone tissue, which represents the second largest protein store after muscles (loucks et al., 2011). low ea in our female swimmers is of concern, as only 3 female swimmers had reported regular menstrual cycle. in the group of 6 female swimmers that had never had their period, there were 2 swimmers over the age of 15, thus expressing primary amenorrhea. for those with irregular menstrual cycles (n = 4), we did not manage to acquire the information on the length of the absence of their period, so we cannot discuss secondary amenorrhea in our swimmers. we did not find a statistically significant correlation between ea, intakes of cho, protein and fat and menstrual cycle regularity. nevertheless, we find alarming to identify 4 young female swimmers (nearly 1/3 of female swimmers) with low ea, low cho intake (one also with low protein intake) 31 annales kinesiologiae • 9 • 2018 • 1 vesna simič, nina mohorko: nutritional strategies of slovenian national junior swimming team, 15–34 as well as low calcium and vitamin d intake. only one of them stated that she had a regular menstrual cycle. since female swimmers, due to their high training load, belong in the group with a high risk of red-s, and consequently of functional hypothalamic menstrual dysfunction, which may also have long-term negative effects on health, we believe that the menstrual cycle must be monitored in competitive young swimmers and measures be taken in cases where a dysfunction is discovered. measures include an increase in ei, a decrease in eee or both (mountjoy et al., 2014; de souza et al., 2014). hereby, it is important to emphasize the necessity of adaptation of strategies to specific individual, for they have to be aligned with their individual goals, their ability to execute and potential intolerance for certain specific nutrients. those strategies must take into consideration the athlete‘s favourite foods as well as individual responses to strategies themselves (thomas et al., 2016). conclusions comparison of applied nutrition strategies with the current recommendations of clinical sports nutrition in young slovenian competitive swimmers enabled us to identify dietary deficits, especially among female swimmers, where too low ei leads to insufficient macronutrient and micronutrient intake and too low ea, which can lead to a decline in performance and even seriously compromise their health. the acquired information can enable dietitians to prepare more successful, personalised nutrition strategies for young competitive swimmers, hence contribute to the preservation of their health and their development into top athletes. acknowledgement the authors thank slovenian swimming federation, coaches, swimmers and their parents for showing a high level of support for the research. references adams, j. d., kavouras, s. a., robillard, j. i., bardis, c. n., johnson, e. c., ganio, m. s., … white, m. a. 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https://doi.org/10.1016/j.nut.2004.04.002 https://journals.lww.com/acsm-msse/fulltext/2007/02000/exercise_and_fluid_replacement.22.aspx https://doi.org/10.1016/s0140-6736(12)60072-5 https://doi.org/10.1007/s004210050150 http://dx.doi.org/10.1155/2015/734649 http://dx.doi.org/10.1155/2015/734649 http://dx.doi.org/10.1155/2015/734649 https://doi.org/10.1016/j.jand.2015.12.006 annales kinesiologiae • 10 • 2019 • 2 87 characteristics of adolescents’ active lifestyle in the city of ljubljana marta bon1 1 university of ljubljana, faculty of sports, slovenia corresponding author: marta bon, ph.d. university of ljubljana, faculty of sports, gortanova 22, ljubljana, slovenia phone: +386 51 670 581 e-mail: marta.bon@fsp.uni-lj.si abstract purpose: the aim of our study was to analyse the characteristics of the adolescents’ active lifestyle and their relationship to some environmental correlates in the city of ljubljana. methods: the characteristics of active lifestyle on the sample of 269 students of secondary school of nursing ljubljana (206 females, 63 males), aged 16−18 years) via an online questionnaire were evaluated. descriptive statistics and fisher’s exact test were used (at p < 0.05 5 %. level). in the second part, we used half-structured interviews with former students of the same school (no. 6); to evaluate their attitude to physical education lessons, their general active lifestyle and their evaluation of the environmental correlates: physical (facilities, equipment), social (social support and social norms) or institutional (policies). results: results show that the majority of students (44.96 %) was physically active at least two to three times per week. the students partly agree (3.7/5) that sports activities play an essential role in their general lifestyle. furthermore, they care about leading a healthy lifestyle (3.7/5) and eating healthy food (3.7/5). students evaluated both physical factors (at the municipality level 76.15%, at the state level 71.49%), and social (parents) support as appropriate. the former students believe that physical environmental factors around their school (facilities, equipment) are optimal, but they regret that they did not use them enough; neither during pe lessons nor in their leisure time. conclusion: based on our results, we propose better cooperation between all the included factors, which can result in the improvement of adolescents’ active lifestyle. keywords: lifestyle, sport, adolescents, ljubljana, environmental correlates. original scientific article doi: https://doi.org/10.35469/ak.2019.202 received: 2019-12-02 udc: 796.01:316.728(497.4ljubljana) 88 marta bon: characteristics of adolescents' active lifestyle in the city of ljubljana, 87–98 annales kinesiologiae • 10 • 2019 • 2 značilnosti aktivnega življenjskega sloga mladostnikov v mestni občini ljubljana izvleček namen: namen naše raziskave je bil analizirati značilnosti aktivnega življenjskega sloga mladostnikov in odnos do nekaterih okolijskih dejavnikov v mestu ljubljana. metode: s pomočjo spletnega vprašalnika so bile ovrednotene značilnosti aktivnega življenjskega sloga na vzorcu 269 dijakov srednje zdravstvene šole ljubljana (206 žensk, 63 moških, starih 16-18 let). uporabljeni so bili opisni statistični podatki in fisherjev natančni test (pri p <0,05 5% stopnja). v drugem delu so bili izvedeni polstrukturirani intervjuji z nekdanjimi dijaki te šole (6), s katerimi so bila opredeljena njihova stališča do aktivnega življenjskega sloga sploh ter posebej odnosa do športne vzgoje in je bil ovrednoten njihov odnos do okolijskih dejavnikov: fizičnih (objekti, pogoji, oprema), socialnih (socialna podpora in socialne norme) ali institucionalnih (predvsem lokalne politike). rezultati: rezultati kažejo, da je bila večina dijakov (44,96%) vsaj dva do trikrat na teden telesno dejavnih. dijaki se delno strinjajo (3.7/5), da imajo športne aktivnosti bistveno vlogo v njihovem življenjskem slogu. poleg tega dijaki navajajo, da skrbijo za zdrav življenjski slog (3,7/5), uživajo zdravo hrano (3,7/5). dijaki so okolijske (fizične) dejavnike ocenili kot ustrezne (na ravni občine 76,15%, na državni ravni 71,49%) in socialno oporo (starši), kot primerno. nekdanji dijaki tudi ocenjujejo fizične oz. prostorske možnosti v okolici šole kot optimalne, vendar obžalujejo, da jih niso uporabljali v večji meri tako med poukom, kot v prostem času. zaključek: na podlagi rezultatov predlagamo boljše sodelovanje med vsemi navedenimi dejavniki, kar lahko pripomore k izboljšanju aktivnega življenjskega sloga mladostnikov. ključne besede: življenjski slog, šport, mladostniki, ljubljana, dejavniki okolja. 89 annales kinesiologiae • 10 • 2019 • 2 marta bon: characteristics of adolescents' active lifestyle in the city of ljubljana, 87–98 introduction physical activity (pa) is one of the key health determinants in life (fletcher et al., 1996; gunter, almstedt, & janz, 2012; janssen & leblanc, 2010). it is one of the sources of total energy expenditure, which incorporates active energy expenditure, metabolism in resting state, the thermal effects of food digestion and body growth in children and adolescents (armstrong & welsman, 2006). the existing evidence shows that pa has positive effects on psychosocial health, and the functional capacity and wellbeing of people (brettschneider & roland, 2004; lima et al., 2017; powell & pratt, 1996)inc. background: the current study evaluated the reciprocal longitudinal relationship between physical activity (pa, whereas physical inactivity increases health risks (hallal et al., 2012). despite these established benefits, a substantial proportion of children are not meeting (aubert et al., 2018) pa recommendations of 60 min moderate to vigorous pa (mvpa) daily (world health organization, 2010). moreover, participation declines during the transition from childhood to adolescence (dalene et al., 2018; farooq et al., 2018; kimm et al., 2002), with pa increasingly replaced with sedentary activities (brodersen, steptoe, boniface, & wardle, 2007; volmut, pišot, & šimunič, 2013)ethnicity and socioeconomic status (ses. given that young people spend approximately half of their waking day at school, schools represent an essential setting for promoting physical activity and reducing sedentary behaviours (morton, atkin, corder, suhrcke, & van sluijs, 2016). pa interventions tend to focus on increasing knowledge through health education and implementing curriculum to increase the number of time students are engaged in pa (morton et al., 2016) during the school day. generally speaking, these interventions have not been successful for adolescent populations (dobbins, husson, decorby, & larocca, 2013). a general criticism directed at many school‐based interventions is the lack of attention paid to the role of the wider environment (doak, visscher, renders, & seidell, 2006). pa behaviour is not driven only by consideration of knowledge, attitudes and beliefs; but can also be automatically enriched by environmental stimuli (dunton, cousineau, & reynolds, 2010; marteau, hollands, & fletcher, 2012). these factors may be physical (facilities, equipment), social (social support and social norms) or institutional (policies) (morton et al., 2016). sport is an increasingly important human activity and part of the general culture, which considerably enriches the life of an individual and is a significant element in quality of life. in the literature review of the correlates of sports activity, some differences emerge. first, the empirical analyses use different measures of sport participation. a large number of studies analyse whether or not individuals perform sports activities (e.g. bauman et al., 2012). the second set of studies also analyses the frequency of participation or duration of the activity and expenditures (e.g., farooq et al., 2018, bon, lavrič, gradišar-saifet, & kambic, 2019). one of the environmental correlates are state and city policies. sport in the municipality of ljubljana is based on the sports act (2017) and other municipality regulations. 90 marta bon: characteristics of adolescents' active lifestyle in the city of ljubljana, 87–98 annales kinesiologiae • 10 • 2019 • 2 sports policy in the city of ljubljana is one of the health-enhancing acts of the city council of ljubljana (ccl), which is the supreme body that determines all matters within the framework of the rights and obligations of the city of ljubljana. the most important strategic goals in the document titled “strategy for the development of sport in the city of ljubljana 2008-2012” (bon, kolenc, peršolja, & tomc, 2008) were mostly connected with sport facilities: to improve and increase the number of outdoor facilities (outdoor fitness, recreational areas near the sava river, skate parks, etc.) and to build new indoor facilities such as the sports centre stožice, gymnastic centre ljubljana, kolezija swimming pool, etc. (bon et al., 2008). our study aimed to examine some characteristics of adolescents’ lifestyle and evaluate the perception of environmental correlates, especially all settings and conditions around the secondary school of nursing ljubljana (r=2 km). methods our study combined qualitative and quantitative methods. in the first part, we analysed the data about lifestyle and conditions (bon et al., 2019) obtained via e-survey (no. 269). the second part included structured interviews (no. 6) to evaluate the characteristics of physical education (pe) in school and school surroundings in the city of ljubljana. a total number of 269 adolescents (206 females), aged 16−18, students of the secondary school of nursing ljubljana participated in the study. each participant was informed about the purpose of the study and a written informed consent was obtained from all adolescents. the participation was anonymous, and participants were free to withdraw from the study at any time and for any reason. all respondents’ answers were rated on a 5-point likert scale. responses on the subscale ranged on a scale 1−5, where one represents not satisfied or very unimportant and five very satisfied or very important. the validity of the used questionnaire (alpha 0.78) is sufficient. apart from the descriptive statistics, fisher’s exact test was used (at p < 0.05 5 %. level). data were collected on the “1ka” platform (faculty for social sciences, university of ljubljana) and analysed in the program ibm spss 19 (spss inc., chicago, usa). additionally, in the qualitative part six semi-structured interviews were conducted with an aim to shed further light on the results with three female and three male students all finishing school within three years (born 1998 or younger). at the end an overview of sports facilities around the school (2 km) was made by analysing available documentation about sports facilities in the city of ljubljana. the transcription of the semi-structured interviews and data organization was followed by the descriptive encoding and the data validation process. the first validation phase was about the accuracy of the design/methods, and the second about the reliability of the procedures to produce consistent and dependable results. finally, the data analysis stating the findings and research outcomes based on the research objectives 91 annales kinesiologiae • 10 • 2019 • 2 marta bon: characteristics of adolescents' active lifestyle in the city of ljubljana, 87–98 were concluded. our goal was to find a valid link between the analysed data and the research questions. in the first part of the study, the invitation for voluntary participation was sent to all students of the secondary school of nursing ljubljana of the year 2018/19, followed by life face-to-face or phone conversation to explain the purpose of the study. after a positive response from the students, participants completed an online survey on the “1ka” platform. after a descriptive analysis of the answers from all students, the interview process was organized. it included six students of the secondary school of nursing (3 females, 3 males), aged 16−18, who have already finished the first two years of school. the individuals who agreed to participate in interviews, signed an informed consent after a detailed description of the purpose of the study and their participant’s rights. the interviews lasted 30 to 40 minutes and were conducted by one person (first author). all steps in the testing procedure were conducted in accordance with the ethical standards of a responsible local human experimentation committee and with the helsinki declaration as revised in 2013. results results of the questionnaire the results of the questionnaire are presented in table 1. the students partly agree (3.7/5) that sports activities play an important role in their lifestyle. furthermore, they care about leading a healthy lifestyle (3.7/5) and eating healthy food (3.7/5). more than half of adolescents occasionally (69. 42%) consume alcohol, and some of them even take drugs. only 44.9 % of the included students reaches the recommendations for pa of 150 min pa/week. 31 students (12.0%) are physically active only once per week and 21 (8.14%) even less than once per month. results show that there is no significant difference between gender (p=0,159) and age (p=0.753) regarding pa. the majority of respondents (84.40%) see the social and emotional support of their parents as appropriate, and the results are similar for those within the school (69.26 %). most of them also perceive the environmental correlates − physical (conditions, facilities) and social support (parents, teachers) as appropriate (in municipality 76.15%, at the state level 71.49%). on average, they spend 123.6 eur (from 6 to 1000 eur) per month for sports activities. according to official data, students have many possibilities for indoor sports (in ljubljana around 130,000m2) and outdoor sports (outdoor fitness, trim trails, and especially golovec hill and kodeljevo sports park), which create a near-optimal environment for an active lifestyle. we asked them about social support (family, school). out of all, 86.4% announced that they have appropriate social support from parents, and 73.6 % are happy with the support in school. 92 marta bon: characteristics of adolescents' active lifestyle in the city of ljubljana, 87–98 annales kinesiologiae • 10 • 2019 • 2 ta bl e 1: r es ul ts o f t he q ue st io nn ai re . q ue st io n/ va ri ab le s 1. st ro ng ly di sa gr ee 2. d is ag re e 3. n ei th er ag re e no r di sa gr ee 4. a gr ee 5. st ro ng ly ag re e su m m sd sp or ts a ct iv it y is o f g re at va lu e to m e. 20 23 45 90 73 25 1 3. 7 1. 21 7. 97 % 9. 16 % 17 .9 3% 35 .8 6% 29 .0 8% 10 0. 00 % i le ad a h ea lt hy li fe st yl e. 6 11 78 11 1 40 24 6 3. 7 0. 88 2. 44 % 4. 47 % 31 .7 1% 45 .1 2% 16 .2 6% 10 0. 00 % i ea t h ea lt hi ly . 8 33 11 7 71 15 24 4 3. 2 0. 87 3. 28 % 13 .5 2% 47 .9 5% 29 .1 0% 6. 15 % 10 0. 00 % i co ns um e al co ho l. 74 36 53 62 17 24 2 2. 6 1. 34 30 .5 8% 14 .8 8% 21 .9 0% 25 .6 2% 7. 02 % 10 0. 00 % i sm ok e. 16 6 34 18 15 10 24 3 1. 6 1. 12 68 .3 1% 13 .9 9% 7. 41 % 6. 17 % 4. 12 % 10 0. 00 % i us e so ft d ru gs . 19 2 27 12 6 5 24 2 1. 4 0. 86 79 .3 4% 11 .1 6% 4. 96 % 2. 48 % 2. 07 % 10 0. 00 % i ta ke h ar d dr ug s. 20 9 23 6 2 1 24 1 1. 2 0. 55 su m s um o f q ue st io ns a ns w er ed , m m ea n, s d s ta nd ar d de vi at io n. 93 annales kinesiologiae • 10 • 2019 • 2 marta bon: characteristics of adolescents' active lifestyle in the city of ljubljana, 87–98 qualitative results an evaluation of the survey results clearly shows that there were different opinions about the degree to which (living/physical) environment affected pa level of adolescents of ljubljana. students are of the opinion that pe teachers could ask more from them during physical education lessons. – student w 1: “we never go to golovec, a hill near the school, or to any facility around the school. we once used kodeljevo sports park, only for a 2400m run test.“ students also agree that they were not motivated enough for sports activities, they tended to avoid sports activities and rest during pe lessons; – student w 2: “we were happy when our pe teacher allowed us to sit and talk… and we were gossiping …. i must admit that it was only in the first class when we had one old teacher.” it was also pointed out that especially the participation of female students in pe classes was additionally limited due to personal and hygiene reasons. – student w3: “i like sport, but i did not participate much in pe classes, because i really hated to sweat, i hate to be wet and to stink after a pe class… for all of us, the “sweating situation” was the biggest problem.” it is difficult to determine if these are excuses, or these hygiene reasons are a legitimate influencing factor, and it is necessary to find an organisational solution (bathrooms, showers, time-space for showering…). student w3 also admitted: “from today’s perspective, i am sorry that i wasn’t more active during pe classes: but we really did not have time to take a shower afterwards.” students also honestly admitted that they were trying to avoid pe classes to study for other tests and exams. – student w1: “many of us were studying for a test (in one of the next periods) during our pe classes. “ – student w2: “i‘m really not quite sure what the main reason that girls didn‘t do much sport in pe classes was. it was a sort of combination of girls‘ laziness, conditions (only half of the sports hall) and teachers’ insufficient motivation, which all resulted in sport not having any real value in our school. “ it is evident that male students have an entirely different perception. they did not mention hygiene reasons (sweating) and showed ambition to be even more active (m1, m2, m3) – student m1: “i liked that we could suggest to our pe teacher what we wanted to do mostly it was football “. – student m2: “mostly we were in the school sports hall. only once we were on golovec hill and once at the kodeljevo stadium. i liked it very much, and i’m still sorry that we didn’t use these possibilities more.” – student m 3: “i would have liked our lessons to be more intensive and that we would have had pe every day.” 94 marta bon: characteristics of adolescents' active lifestyle in the city of ljubljana, 87–98 annales kinesiologiae • 10 • 2019 • 2 from these results, we can conclude that for female students the hygiene concern is a significant barrier to participating more in pe and leading a more active lifestyle, while male students would like to participate in more activities and dedicate more time to pe. male students are aware of the wide range of possibilities in the school surroundings, and they would have liked to use those facilities around school more. female students, on the other hand, are not so aware of these facilities and possibilities, their answers were mainly “i’m not quite sure”, “i didn’t care”. it seems that during pa, their focus was more on body aesthetics and ‘good looks’. sports facilities around the school in connection with city sports policies sports policy in the city is of vital importance, as the majority of sports facilities are in the domain of the city of ljubljana. the basic goals in the field of sports in the city of ljubljana are sustainability, accessibility, the competence of professional staff and fairness. more than 11% of the city budget is intended for sport, for the implementation of the sports strategy – to manage sports facilities, in one of the first priority. sports facilities and natural environment correlates, within 2 km radius around the school: – golovec hill (250m–2,5km), – kodeljevo park (football, tennis, swimming pool) – (200m), – outdoor fitness (in front of the school) (10m) and – ljubljana caste hill (300m). those are physical factors which are of free of charge, available for all people. in this circle of 2 km there are, besides the sports hall at the secondary school of nursing ljubljana, also: sports hall kodeljevo, sports hall poljane, facilities at the faculty of sport and some with private owners. discussion and conclusion regular pa during adolescence provides numerous benefits; that why it is important to organize and implement the environmental correlates in the supportive way − to improve the level of adolescents’ active lifestyle. in general, our results show insufficient level of sports activity, according to the recommendation of the world health organization (who), which states that youngsters, from 5 to 17 years of age, should engage in moderate to vigorous physical activity (mvpa) daily for at least 60 min, and in vigorous physical activity (vpa) at least three times a week. as in many countries all over the world, where there is an increasing academic and policy interest (e.g. van hecke et al., 2016; farooq et al., 2018) in interventions aiming to promote young people’s health by ensuring that the school environment supports healthy and active (sports) behaviours, we can see similar strategies also in slovenia, particularly in ljubljana, where the city of ljubljana has more than 103 indoor and 83 95 annales kinesiologiae • 10 • 2019 • 2 marta bon: characteristics of adolescents' active lifestyle in the city of ljubljana, 87–98 outdoor facilities, which can all be used to promote active lifestyle for adolescents. regarding environmental correlates, the majority of our respondents perceive conditions in ljubljana as appropriate. our adolescents are aware that sport and physical education are an important part of their lifestyle, but it is evident that adolescents, as well as teachers of pe, are not motivated enough to make full use of the facilities available to them. many factors influence the complex behaviour of adolescents pa (bauman et al., 2012; gustafson & rhodes 2006; telama, nupponen, & laakso, 2007). support from peers, socio-economic status, parental education, school policies and environmental correlates emerged as potential determinants of pa (ferreira et al., 2007). the results show that students, as well as teachers, lack a higher level of motivation for more dedicated work in active sports life. it seems that adolescents are not aware that being active is first and foremost their responsibility. the institutional environmental correlates (teachers, officials, sports policies) have to find a suitable model to makes adolescents more motivated and committed to leading an active lifestyle. in general, sport communication strategies might play a prominent role in persuading potential participants of the benefits of sports activity and frequency for adolescents. identifying and understanding factors that can improve childhood and adolescent physical activity is necessary to design and implement effective interventions. recent years have witnessed a growing interest in environmental factors that influence physical activity: physical (e.g. physical structures and facilities), social (e.g. support and norms) and institutional (e.g. school rules and policies). in addition to sports activities, one major contribution to childhood physical activity lies in free active play and unstructured physical activities taking place outdoors during their free time. this type of play provides numerous benefits in terms of cognitive, social and physical development (van hecke et al., 2016; farooq et al., 2018; dobbins et al., 2013; bauman et al., 2012). the adolescents in our study are of the opinion that physical environmental factors (facilities, equipment) are not used enough, but they are happy with social support and institutional (city, state) factors. based on our results, we propose better cooperation between all the factors involved, which can improve the active lifestyle of adolescents. the specifics of active lifestyle on one hand and connection with structured (school, sport clubs, etc.) and unstructured (outdoor) correlates 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(2013). objectively measured physical activity in children aged from 5 to 8 years. slovenian journal of public health, 52(1), 9-18. https:// doi.org/10.2478/sjph-2013-0002. world health organization (2010). global recommendations on physical activity for health. retrieved from http://whqlibdoc.who.int/publications/2010/9789241599979_eng. pdf. https://doi.org/10.1186/s12966-016-0396-4 https://doi.org/10.2478/sjph-2013-0002 https://doi.org/10.2478/sjph-2013-0002 http://whqlibdoc.who.int/publications/2010/9789241599979_eng.pdf http://whqlibdoc.who.int/publications/2010/9789241599979_eng.pdf _goback _goback _hlk23772821 _goback _goback _hlk27564900 _goback bbib0050 bbib0035 _hlk3367923 _goback annales kinesiologiae • 10 • 2019 • 1 15 health benefits induced by adherence to the mediterranean lifestyle components diet and physical activity cécil j. w. meulenberg science and research centre koper, institute for kinesiology research, slovenia corresponding author: cécil j. w. meulenberg science and research centre koper, institute for kinesiology research garibaldijeva 1, si-6000 koper, slovenia phone: +386 31 424 233 e-mail: cecil.meulenberg@zrs-kp.si abstract the purpose of this overview is to present the evidence that adherence to mediterranean lifestyle components is beneficial for functional and cognitive health. although mediterranean diet is the principal component of this lifestyle, other components, like physical activity and socializing, form complex interactions and together they complete into the mediterranean lifestyle. individual components and their interactions have not been studied thoroughly, however, there is an increasing attention for these matters through scientific literature in original research, reviews and meta-analysis. this paper considers the recent knowledge and trends related to defining the indicators concerning these lifestyle components, as well as summarizes the health benefits induced by adherence to them and explains why mediterranean lifestyle components are important for health. keywords: lifestyle, mediterranean diet, physical activity, health benefit, interactions. review article doi: https://doi.org/10.35469/ak.2019.175 received: 2018-12-04 udc: 613.2+613.7 16 cécil j. w. meulenberg: health benefits induced by adherence to the mediterranean lifestyle ..., 15–30 annales kinesiologiae • 10 • 2019 • 1 prehrana in gibalna aktivnost kot zdravju koristni sestavini sredozemskega življenjskega sloga izvleček namen preglednega članka je predstaviti dosedanja dognanja o tem, kako lahko ima upoštevanje sredozemskega načina življenja dobrodejne učinke na funkcionalno in kognitivno zdravje posameznika. medtem ko številni avtorji trdijo, da je sredozemska prehrana poglavitna sestavina zdravega načina življenja, le ta z drugimi dejavniki, kot so gibalna aktivnost in bogato socialno življenje, tvori zapletene interakcije in skupaj z njimi dopolnjuje sredozemski način življenja. posamezne komponente in njihov medsebojni vpliv še niso popolnoma raziskane, vendar pa jim raziskovalci v izvirnih znanstvenih raziskavah, preglednih člankih in meta-analizah, posvečajo vedno več pozornosti. prispevek obravnava najnovejša dognanja in trende v zvezi z opredelitvijo kazalcev omenjenih komponent sredozemskega življenjskega sloga, poleg tega pa pojasnjuje tudi, zakaj so sredozemske sestavine življenjskega sloga tako pomembne za zdravje. ključne besede: življenjski slog, sredozemska prehrana, telesna dejavnost, zdravje, interakcije introduction the attention to the possible benefit for health of the diet and the lifestyle typical of mediterranean countries came from the “seven countries study”. started in 1947 by ancel keys and co-workers the study compared diet and lifestyles in the usa, finland, yugoslavia, japan, the netherlands, italy and greece, and led to the discovery that italy, greece and yugoslavia (particularly the coastal region of croatia) had a much lower incidence of non-communicable degenerative diseases (keys, fidanza, karvonen, kimura & taylor, 1972). later on, ancel keys and his co-workers settled in italy in the small village of pioppi, south of naples, and deeply analysed the lifestyle and the food choice not only in italy but also in greece (particularly on the island of crete), spain, portugal and croatia. from their work, the foundation of the concept of mediterranean diet and lifestyles were set (keys et al., 1986). unfortunately, in those countries, 60 years later, the traditional way of eating and the healthy lifestyles have been cancelled, to a great extent due to homogenization of dietary choices and living habits typical of the global economy (bach-faig et al., 2011; martinez-lacoba, pardo-garcia, amo-saus & escribano-sotos, 2018). 17 annales kinesiologiae • 10 • 2019 • 1 cécil j. w. meulenberg: health benefits induced by adherence to the mediterranean lifestyle ..., 15–30 characteristics of mediterranean diet mediterranean diet within the scientific fields of dietetics, nutrition and food technology is predominantly handled as a traditional dietary pattern with a focus on its constituents (e.g., bach et al., 2006; katz & meller, 2014; davis, bryan, hogson & murphy, 2015). it is plant-based with freshly-harvested vegetables, fruits, nuts and seeds, beans and legumes, many herbs and spices, and whole grains. with frequent consumption of fish and other sea foods, selective dairy intake and quite limited consumption of meat, eggs and sweets, but emphasizing the use and consumption of healthful fats like extra virgin olive oils and fishy fats, and moderate amounts of (red) wine. the mediterranean diet is not an homogeneous model globally nor within the mediterranean area, as it is highly dependent on the region, and influenced by socio-cultural, religious and economic factors (bach et al., 2006). despite these regional variations, the average nutrient content of the diet is relatively consistent among various studies (davis et al., 2015). for eight studies the percentage of total daily energy (9.3 mjoule) was as follows: 37% as fat of which 5% polyunsaturated, 19% monounsaturated, and 9% saturated (note the ratio of 2 for unsaturated to saturated); 15% protein; 43% carbohydrate; with for some constituents: fibre 33 g/day, vitamin c 225 mg/day and folate 508 µg/day. thus, the diet promotes high intake of fibre, results in a favourable ratio of omega-6 and omega-3 essential fatty acids (trichopoulou et al., 2014; davis et al., 2015), and especially increases the non-enzymatic antioxidant capacity through the consumption of antioxidants and polyphenols from extra virgin olive oil (zamora-ros et al., 2013). mediterranean diet-induced health effects the combination of foods and the content of nutrient constituents made the mediterranean diet a subject of many scientific studies, that investigated the potential health effect during the intervention by mediterranean eating (reviewed by sofi, macchi, abbate, gensini & casini, 2014; martinez-lacoba et al., 2018). an early systematic review by serra-majem, roman and estruch (2006) investigated 35 experimental studies referring to the mediterranean diet as an intervention and showed favourable effects on lipoprotein levels, endothelium-dependent vasodilatation, insulin resistance, metabolic syndrome, antioxidant capacity, myocardial and cardiovascular mortality, and cancer incidence. moreover, sofi et al. showed by analysing 18 cohort prospective studies that adherence to the mediterranean diet for three to 18 years reduced the risk of overall mortality, with a clear reduction of the incidence for cardiovascular, cancer, and neurodegenerative diseases and stroke (sofi, cesari, abbate, gensini & casini, 2008; sofi, abbate, gensini & casini, 2010). in recent years, these beneficial health effects have been confirmed, namely in the form of improved insulin sensitivity (ryan et al., 2013), reduced cancer risk (giacosa et al., 2013), and particularly well-demonstrated the reduced risk of cardiovascular diseases (de lorgeril & salen, 2006; 2011; ibarrola18 cécil j. w. meulenberg: health benefits induced by adherence to the mediterranean lifestyle ..., 15–30 annales kinesiologiae • 10 • 2019 • 1 jurado et al., 2011; nordmann et al., 2011; bonaccio et al., 2018; estruch et al., 2018). lower prevalence of general obesity and metabolic syndrome has been shown (ibarrola-jurado et al., 2011), and also the improvement of quality of life and diminished pulmonary inflammation in asthmatic patients (sexton et al., 2013; papamichael, itsiopoulos, susanto & erbas, 2017; papamichael et al., 2018). finally, higher adherence to a mediterranean diet was associated with a reduction in mortality (trichopoulou, bamia & trichopoulos, 2009; bonaccio et al., 2018). thus, in conclusion, adherence to the mediterranean diet, the plant-based diet as described above, seems to provide longevity with a reduced risk for chronic non-communicable diseases. diet as part of mediterranean lifestyle long and healthy (functional and cognitive) ageing is of importance to humans as a species, and perhaps these health benefits attributed to the diet, in combination with where, and in which cultural environmental settings the diet is embedded, were the reasons that in 2010 the mediterranean diet got inscribed in the unesco representative list of intangible cultural heritage of humanity (unesco, 2010). on unesco’s webpages, one can find the following description: ‘the mediterranean diet involves a set of skills, knowledge, and traditions concerning crops, harvesting, fishing, animal husbandry, conservation, processing, cooking, and particularly the sharing and consumption of food. eating together is the foundation of the cultural identity and continuity of communities throughout the mediterranean basin. it is a moment of social exchange and communication, an affirmation and renewal of family, group or community identity. the mediterranean diet emphasizes values of hospitality, neighbourliness, intercultural dialogue and creativity, and a way of life guided by respect for diversity.’ these writings clearly emphasize a particular social ensemble of traits that centres around food production, harvesting and consumption, guided by the mediterranean climate and region. an update by the mediterranean diet foundation expert group (bach-faig et al., 2011), additionally adds to emphasize sobriety and moderation, with inclusion of cultural and lifestyle components that are based on the mediterranean diet pyramid, such as conviviality, culinary activities, adequate rest, and physical activity. mediterranean diet, when used in dietetics or nutritional sciences, often refers to the plant-based and micronutrient-balanced diet, while often, in the wider scientific fields like the social sciences, or in specific fields like kinesiology, this unesco-recognized mediterranean intangible heritage as such, should be, more appropriately, referred to as mediterranean lifestyle. unesco, the scientific committee of the international foundation of mediterranean diet and others acknowledge the specific lifestyle characteristics (sotos-prieto et al., 2015; yannakoulia, kontogianni, & scarmeas, 2015; dernini et al., 2017). they indicate that such lifestyle components are worth being identified (bach et al., 2006), as they might be valuable to human health and heritage. 19 annales kinesiologiae • 10 • 2019 • 1 cécil j. w. meulenberg: health benefits induced by adherence to the mediterranean lifestyle ..., 15–30 brain health influenced by mediterranean lifestyle components brain function, overwhelmingly studied, is a good example to demonstrate its dependence on lifestyle components. in relation to mediterranean lifestyle components beneficial to cognitive health, next to adherence to the diet, yannakoulia et al. (2015) particularly mention the participation in leisure activities, social interaction, physical activity and the quality of sleep. each of these factors have been individually demonstrated to effectively maintain better cognitive performance, promote healthy cognitive ageing, reduce depressive symptoms, and delay neurodegeneration (e.g., polidori, nelles & pientka, 2010; schreiber et al., 2016; clare et al., 2017; kivipelto, mangialasche & ngandu, 2018; zhao et al., 2018). sofi et al. came to the conclusion (sofi et al., 2008; 2010) that the adherence to the mediterranean diet reduced mild cognitive impairment and the risk to undergo parkinson’s and alzheimer’s diseases. more recent studies confirm that higher adherence to the mediterranean diet is associated with improved cognition (féart et al., 2009; martínez-lapiscina et al., 2013; ye et al., 2013), assessed through, amongst others, mini mental state examinations and the clock drawing tests. adherence to the mediterranean diet thus establishes lower risk of cognitive impairment (ye et al., 2013; gardener et al., 2015), it reduces the risk of alzheimer’s disease (scarmeas et al., 2006), and induces better performance in the executive function domain (gardener et al., 2015). the positive impact of the mediterranean diet on brain health is detectable also at morphological level. among 672 cognitively normal participants from the u.s.a., with an average of 79.8 years of age, higher adherence to the mediterranean diet was associated with larger frontal, parietal, occipital, and average cortical thickness (staubo et al., 2017). in line with this, among 400 scottish elderly persons, a low adherence to the mediterranean diet predicted brain atrophy (luciano et al., 2017). a study with 4447 participants in the netherlands showed that a higher diet quality, especially the one that abode by the mediterranean diet, was associated with larger overall and hippocampal brain tissue volumes (croll et al., 2018). similarly, among 459 participants in the united kingdom, a higher and prolonged adherence (over 11 years) to guidelines for healthy diet was associated with larger hippocampal volume (akbaraly et al., 2018). these studies clearly indicate that diet itself affects brain volume and structure. further, higher adherence to the mediterranean diet has been shown to reduce the incidence of depression from a meta-analysis among 20 longitudinal and 21 crosssectional studies (lassale et al., 2018), and in addition, a diet with a low potential to induce inflammation, was associated with lower depression incidence in four longitudinal studies (lassale et al., 2018). a recent randomized controlled trial showed that a 12-week intervention with mediterranean diet significantly reduced the symptoms of major depression (jacka et al., 2017). thus, as for functionality of the brain, a condition as behaviour in the form of depression, is clearly influenced by diet as well. presumably, it is influenced in both directions, depending on the quality of diet. 20 cécil j. w. meulenberg: health benefits induced by adherence to the mediterranean lifestyle ..., 15–30 annales kinesiologiae • 10 • 2019 • 1 moreover, a healthy diet maintains a healthy balanced intestinal microbiota (cryan & dinan, 2012; dash, clarke, berk & jacka, 2015; johnson & foster, 2018), and research indicates that this symbiosis establishes an intestines-brain axis, and is of major support to the health of the brain, by influencing the development of the brain, as well as behaviour and mood. interestingly, in the intestines, the microbial fermentation of host-indigestible dietary fibres produces short-chain fatty acids that act as signals in the host (kelly, minuto, cryan, clarke & dinan, 2017; johnson & foster, 2018). supplementation of such fatty acids to mice has been shown to alleviate selective and enduring alterations induced by repeated psychosocial stress (van de wouw et al., 2018). such fatty acids are not the only products from the presence of microbiota that can influence the host’s endocrine signalling. not even closely do we have proper understanding of the microbiota-intestines-brain axis. continuing to reason along this axis, which means drawing associations between the consumption of specific foods and brain health might seem far-fetched. the examples of depression studies mentioned in the previous paragraph make it very plausible for food (the microbiota-intestine-brain axis) to affect our mood and behaviour. besides, the following examples emphasize this importance. there is established evidence that altered microbiota populations exist in human patients with autism spectrum disorders, schizophrenia, depression and obesity, compared to unaffected patients and can contribute to (brain) inflammation as well (cryan & dinan, 2012; dash et al., 2015; kelly et al., 2017; johnson & foster, 2018). another accent comes from a recent large cohort, in which removal of the vermiform appendix − that hosts microbiota, pathogens and immune cells − decades before the onset of parkinson’s disease, lowers the risk of obtaining parkinson’s disease (killinger et al., 2018). even more interesting is the fact that bacteria are presumed to live in our brains during our life (roberts, farmer & walker, 2018). altogether, food consumption not only determines the quantity and quality of the micronutrients available to the host, but influences the contamination of the host with microorganisms and potential symbioses as well, consequently having effect on the host by the microorganism’s metabolism and the production of endocrine signals. brain health is a complex matter and dependent on various lifestyle factors. the same can be claimed about human health in general. finding the palette for optimal living requires identifying the details, relations and synergies of lifestyle components. how to measure adherence to the mediterranean lifestyle to measure adherence to the mediterranean diet, questionnaires on food consumption frequency have been used. in general, when conducting population-based prospective investigations, the participants are invited to complete extensive, validated, food or physical-activity frequency questionnaires at baseline. during the follow-up, adherence is assessed by multiple-items scales that incorporate salient characteristics of both eating habits and/or physical activity patterns. usually, the populations’ range 21 annales kinesiologiae • 10 • 2019 • 1 cécil j. w. meulenberg: health benefits induced by adherence to the mediterranean lifestyle ..., 15–30 of the scores and the higher scores, describe the population’s greater adherence to the topic or lifestyles of interest. more recently, in order to assess adherence to lifestyle-habits, sotos-prieto et al. (2015) designed the 28-indicator mediterranean lifestyle (medlife) index that additionally included physical activity patterns, adequate rest, social interactions and conviviality. expanding on the medlife index, and beyond the obvious category (1) health and nutritional benefits, dernini et al. (2017) characterized the multiple dimensions and benefits of the mediterranean lifestyle through a methodological framework (med diet 4.0). it identifies and recognizes country-specific and culturally appropriate variations, i.e., regional food diversity, making a future-derived scale internationally applicable. additionally, the framework introduces several sustainability categories and proposes to assess specific indicators for benefits in additional areas: (2) richness in biodiversity and low environmental impact; (3) high social and cultural food values; and (4) positive local economic returns. the framework is described by the scientific committee of the international foundation of mediterranean diet (dernini et al., 2017) and would be of special interest as it describes a wider lifestyle with various components, but up till now a practical index has not been tested. the 24-hour dietary recall (thompson & byers, 1994), the questionnaires on food consumption frequency (sampson, 1985), together with the recent scales and frameworks like medlife (sotos-prieto et al., 2015) and the med diet 4.0 (dernini et al., 2017) are easily implemented. especially the latter two would facilitate the comparison of studies that investigate adherence to the mediterranean lifestyle and the contributing interrelated lifestyle components (bach et al., 2006). such comparison is important for understanding the quality of human life (both in health and of footprint), and the identification of common and/or cultural-specific lifestyle components, that could gain attention and thus might find a way of becoming tangible heritage. mediterranean lifestyle interventions the state of health across the lifespan − during childhood, adolescence and old age − is a product of the cumulative factors experienced (calder et al., 2018). in general, a healthy diet with the specific distribution and prevalence of physical and sedentary activities influence physiological and metabolic functions that altogether determine disease, cognition and functionality (calder et al., 2018; martin et al., 2018). however, the interactions of such components are poorly studied. therefore, the following sections of this paper will recapitulate the details of various systematic reviews that include meta-analysis of randomized controlled trials (or cohorts), where adherence to the components 1) physical activity and 2) mediterranean diet, were addressed as an intervention, either separately or in combination. 22 cécil j. w. meulenberg: health benefits induced by adherence to the mediterranean lifestyle ..., 15–30 annales kinesiologiae • 10 • 2019 • 1 mediterranean diet as an intervention in relation to health benefits induced by mediterranean diet as an intervention, kastorini et al. (2011) reviewed 35 clinical trials and garcia et al. (2016) reviewed 29 randomized controlled trials. both reviews showed that waist circumference was significantly reduced, while also systolic and diastolic blood pressures, blood glucose and triglycerides levels were significantly reduced with adherence to the mediterranean diet. high-density lipoprotein cholesterol levels were increased as reported by kastorini et al. (2011), although no change was observed by garcia et al. (2016). both reviews showed that adherence to the mediterranean diet positively effects the biomarkers linked to the metabolic syndrome, especially for interventions longer than 3 months in duration. interestingly, it was mentioned that adherence to the mediterranean diet was significantly beneficial when the study was of high quality and the intervention was longer in duration (kastorini et al., 2011; garcia et al., 2016), besides, it was conducted in europe (garcia et al., 2016). esposito, kastorini, panagiotakos and giugliano (2011) reviewed 16 randomized controlled trials, 1 to 24 months in duration, were mediterranean diet was used as an intervention compared to a control diet. the mediterranean diet groups showed greater reductions in body weight and body mass index for trials longer than 6 months in duration, while the effect was larger in association with increased physical activity or energy restriction. thus, typically none of the studies reported weight gain with adherence to a mediterranean diet more than 6 months in length, which made the authors conclude that mediterranean diet is useful as an intervention targeted to lose weight (esposito et al., 2011), despite the diet being high in fat of predominantly extra virgin olive oils origin. physical activity as an intervention despite the fact that plenty of intervention studies based on physical activity are available in the scientific literature, the current discussion restricts itself to the most relevant systematic reviews and meta-analysis of randomized controlled trials. physical activity as an intervention during randomized controlled trials was reviewed by kodama et al. (2007) who identified 25 intervention studies with an average length of about 7 months. aerobic training resulted in increases of high-density lipoprotein cholesterol levels (kodama et al., 2007), with no association between exercise frequency or intensity. strasser, siebert and schobersberger (2010) identified 13 randomized controlled trials, in which the effect of physical resistance training on average 3 times a week for 1.5 to 12 months, was compared between a control group and patients with abnormal glucose regulation. the physical activity reduced the fat mass and systolic blood pressure (strasser et al., 2010), while no statistically significant effects on total cholesterol, highand low-density lipoprotein cholesterol, triglycerides and diastolic blood pressure were observed. further, cornelissen and smart (2013) identified 93 trials and showed that physical activity as endurance, dynamic resistance, 23 annales kinesiologiae • 10 • 2019 • 1 cécil j. w. meulenberg: health benefits induced by adherence to the mediterranean lifestyle ..., 15–30 and isometric resistance training lowered both systolic and diastolic blood pressures for interventions smaller than 6 months. whereas interventions longer than 6 months induced smaller reductions in blood pressures, and the combination of these types of physical training lowered only diastolic blood pressure (cornelissen & smart, 2013). lin et al. (2015) identified 29 randomized controlled trials with physical activity as an intervention with a medium duration of 3 months. it was shown that exercise significantly improved cardiorespiratory fitness and lowered the levels of fasting insulin, triglycerides and leptin, while increasing the levels of both high-density lipoprotein cholesterol and apolipoprotein a1, and interleukin-18. the effects of physical activity were more pronounced in persons over 50 years of age, men, and persons suffering from type 2 diabetes, hypertension and metabolic syndrome. physical activity improves the blood pressure regardless of the type of exercise, and, just like diet, positively influences the indicators of metabolic syndrome. concurrent physical activity and mediterranean diet as an intervention recently, the randomized controlled trials assessing overall health resulting from the combined intervention, physical activity and adherence to mediterranean diet, were systematically reviewed (malakou et al., 2018). this meta-analysis identified 11 randomized controlled trials executed between 2003 and 2017, of which the intervention duration lasted from 2 months to 6 years. the combined intervention reduced body weight, body mass index, waist circumference, both systolic and diastolic blood pressures, while as well reducing the levels of blood glucose, triglycerides and total cholesterol, and increasing the high-density lipoprotein cholesterol levels. no evidence of an effect on insulin concentrations was found. although the authors mention the high degree of heterogeneity between the results from the trials, and the need for welldesigned and thoroughly executed randomized controlled trials, the combination of mediterranean diet and physical activity as an intervention clearly provides a reduction in weight (especially with interventions shorter than 12 months in duration), and a reduced metabolic syndrome risk. interestingly, malakou et al. (2018) mention that none of the randomized controlled trials compare the combined effect against control groups receiving only physical activity, mediterranean diet or no treatment respectively. only two studies compared the combined intervention results with usual control group (droste et al., 2013; dunn, siu, freund & boutcher, 2014) and found a reduced metabolic syndrome risk for the combined intervention. still, it is not clear whether a synergistic effect of the concurrent interventions exists. in addition, the results of recent studies seem to suggest that there are synergistic effects. in the u.s.a., out of 170.672 women and men aged 51 to 71 years at baseline in 1996/1997 and followed-up in 2009, adhering to high physical activity levels and mediterranean diet, was associated with lower risk of mortality than groups only ad24 cécil j. w. meulenberg: health benefits induced by adherence to the mediterranean lifestyle ..., 15–30 annales kinesiologiae • 10 • 2019 • 1 hering to physical activity recommendations or only following the mediterranean diet (behrens et al., 2013). in a study in spain, among 19.467 female and male university graduates aged 27 to 46 years of age at baseline in 1999 and followed-up in 2016, similar results were found (alvarez-alvarez et al., 2018a). more specifically, the combination of interventions showed a reduced risk for cardiovascular disease as compared to the physical activity or mediterranean diet separately (alvarez-alvarez et al., 2018b). in combination with these epidemiological studies, it is concluded that adherence to a mediterranean lifestyle, and most likely the individual mediterranean lifestyle components, high physical activity and richly consuming the plant-based mediterranean diet, will provide better health perspectives. this seems additionally true for living out of the geographical region from which the mediterranean diet is originating. conclusions mediterranean lifestyle seems to be the palette we should strive to adhere to. it incorporates diet, physical activity and other lifestyle components, all worth promoting publicly for all ages. health benefits, only induced by its components of diet and physical activity, seem numerous: increasing general and cognitive health with a reduced risk for non-communicable diseases, especially metabolic syndrome. however, further studies are needed that will investigate the synergy effects of combined components that determine the essential, effect-inducing, interactions between the mediterranean lifestyle components. this can be done by thoroughly planned randomized controlled trials, using the established scales to assess the adherence, and the proper inclusion of multiple control groups. for adults, the world health organisation recommends a minimum of 150 minutes of moderate-intense physical activity throughout the week. the international society for nutritional psychiatry research, recognizes diet and nutrition as central determinants of both physical and mental health, referred to as nutritional or orthomolecular medicine (zell & grundmann, 2012; sarris et al., 2015), with a recent success story that concerns the reversing of cognitive decline (bredensen, 2017). the mediterranean lifestyle embraces these recommendations. besides, it promotes outdoor physical activities, organic food consumption, and sustainable novel food production. thus, the adherence to the mediterranean lifestyle can nowadays be geographically applicable anywhere, and it gives the opportunity for practitioners, care givers and the public to create and adopt to more personalized nutritional and functional therapy, resulting in a better general health. 25 annales kinesiologiae • 10 • 2019 • 1 cécil j. w. meulenberg: health benefits induced by adherence to the mediterranean lifestyle ..., 15–30 acknowledgement this manuscript was prepared as part of the research programme kinesiology for quality of life (p5-0381) funded by the slovenian research agency. references akbaraly, t., sexton, c., zsoldos, e., mahmood, a., filippini, n., kerleau, c., ... kivimaki, m. 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(2018). dietary patterns, physical activity, sleep, and risk for dementia and cognitive decline. current nutrition reports, 7(4), 335-345. https://doi.org/10.1007/s13668-018-0247-9. https://doi.org/10.1016/j.jalz.2016.06.2359 https://doi.org/10.1016/j.jalz.2016.06.2359 https://doi.org/10.2165/11531380-000000000-00000 https://doi.org/10.2165/11531380-000000000-00000 https://doi.org/10.1136/bmj.b2337 https://doi.org/10.1136/bmj.b2337 https://doi.org/10.1186/1741-7015-12-112 https://doi.org/10.1113/jp276431 https://doi.org/10.1113/jp276431 https://doi.org/10.1016/j.arr.2014.10.003 https://doi.org/10.1016/j.arr.2014.10.003 https://doi.org/10.1016/j.jand.2012.10.014 https://doi.org/10.1016/j.numecd.2012.12.008 https://doi.org/10.1007/s13668-018-0247-9 _goback _hlk3367923 _goback _goback _goback _hlk3056869 _goback _goback _hlk23766418 _goback _hlk26527070 _goback _goback annales kinesiologiae • 8 • 2017 • 2 69 original scientific article udc: 796.966-055.2:612.662 received: 2018-01-24 female athlete triad − probable but difficult to confirm in female ice hockey players patricia k. doyle-baker1,2, leanne mclean1, tak fung3 1 university of calgary, faculty of kinesiology, human performance lab 2 university of calgary, faculty of environmental design 3 university of calgary, research computing services, information technologies corresponding author: patricia k. doyle-baker human performance lab, faculty of kinesiology university of calgary, calgary, alberta, canada t2n1n4 tel.: 011 403 2207034 email: pdoyleba@ucalgary.ca abstract female hockey players have high energy expenditure and may enter a negative energy balance (eb) without noticeable body composition changes. menstrual cycle (mc) and luteal phase (lp) length, eb, and bone mineral density (bmd) were tracked over nine months (mean, sd (±) in 12 ice hockey players (hp; age 21.1 ± 3.4 yrs; height (ht) 165.9 ± 4.6 cm; weight (wt) 64.7 ± 8.1 kg; body fat percent (bf %) 2.8 ± 3.8 %) and 12 non-athlete controls (c; age 21.4 ± 2.8 yrs; ht 169.5 ± 5.5 cm; wt 65.4 ± 5.4 kg; bf % 20.0 ± 3.1 %). hp mc (35.8 ± 11.2 days) was longer than c (29.8 ± 4.3 days) and hp lp (10.1 ± 2.1 days) was also longer than c (9.6 ± 2.8 days). anovulation occurred in 50.0 % of hp versus 39.2 % of c. no group bmd differences were observed in lumbar spine (p = 0.9), hip (p = 0.5), and radial (p = 0.7) sites. a negative eb was identified (hp = -1026.52 ± 450.1; c = -780.00 ± 310.19 kcal / day), yet no significant within-group differences in wt (hp p = 0.7; c p = 0.8), bf % (hp p = 0.97; c p = 0.6), or fat free mass (hp p = 0.6; c p = 0.98) were found over the study duration. rigorous hockey schedule likely contributed to 28 % completion of the basal body temperature and mc recordings in hp compared to 70 % in c. both groups entered a state of negative eb, but did not exhibit a bf % change associated with the female athlete triad. keywords: menstrual cycle, female ice hockey players, bone mineral density. 70 patricia k. doyle-baker, leanne mclean, tak fung: female athlete triad − probable but difficult to confirm ..., 69–92 annales kinesiologiae • 8 • 2017 • 2 ženska športna triada – verjetna, a jo je pri hokejistkah težko dokazati izvleček za hokejistke je značilna visoka poraba energije, ki lahko vodi do negativnega energijskega ravnovesja (eb) brez opaznih sprememb v telesni sestavi. v obdobju 9 mesecev smo spremljali menstrualni ciklus (mc) in dolžino lutealne faze (lp), eb in mineralno gostoto kosti (bmd) pri 12 hokejistkah (hp; starost 21,1 ± 3,4 let; telesna višina (ht) 165,9 ± 4,6 cm; telesna masa (wt) 64,7± 8,1 kg; %telesnih maščob (bf %) 22,8 ± 3,8 %) in pri 12 kontrolnih ne-športnikih (c; starost 21,4 ± 2,8 let; ht 169,5 ± 5,5 cm; wt 65,4 ± 5,4 kg, bf % 20,0 ± 3,1 %). pri skupini hp je bil zabeležen daljši mc (35,8 ± 11,2 dni) kot pri c (29,8 ± 4,3 dni) in pri hp je bil lp prav tako daljši (10,1 ± 2,1 dni) kot pri c (9,6 ± 2,8 dni). pri 50,0 % hp je prišlo do anovulacije, medtem ko pri c le pri 39,2 %. nismo ugotovili razlik v bmd na lumbarnih vretencih (p=0,9), medenici (p=0,5) in koželjnici (p=0,5). v času izvajanja študije smo zaznali negativno eb (hp =-1026,52 ± 450,1 kcal / dan; c = -780,00 ± 310,19 kcal / dan), ne pa tudi pomembnih razlik znotraj skupine pri wt (hp p = 0,7; c p = 0,8), bf % (hp p = 0,97; c p = 0,6), ali pusti masi (hp p = 0,6; c p = 0,98). strog urnik hokejistk je najbrž razlog za zgolj 28 % popolnost njihovih zapisov bazalne temperature in mc, za razliko od 70 % poročanja pri c. obe skupini sta dosegli negativno eb, ni pa bila vidna sprememba bf % v povezavi z žensko športno triado. ključne besede: menstruacijski ciklus, hokejistke, mineralna gostota kosti introduction there has been a dramatic increase in female athletic participation and intense physical activity (pa) in the past 30 years (chen & bryzyski, 1999; highet, 1989; nattiv, agostini, drinkwater, & yeager, 1994; prior, vigna, & mckay, 1992). a growing concern among health care clinicians and practitioners is the potential detrimental effect of long term training on bone mineral density (bmd), which may be preceded by low energy availability (ea) (olympic charter, 2011). ea is defined as energy obtained through oral nutrition minus energy expended during exercise. it is reasonable to conclude that low energy may result because of increased energy expenditure (ee), decreased oral intake (either intentional or unintentional), or both (kishner, 2016). subsequently, musculoskeletal and reproductive dysfunction from this prolonged energy deficit may occur, inducing the amenorrhoeic condition (international olympic committee, 2005; mountjoy et al., 2014; nattiv et al., 1994; otis, drinkwater, johnson, & wilmore, 1997). bmd decreases with the number of missed menstrual cycles (mc) accumulated over months and years. more specifically, a regular mc with either anovu71 annales kinesiologiae • 8 • 2017 • 2 patricia k. doyle-baker, leanne mclean, tak fung: female athlete triad − probable but difficult to confirm ..., 69–92 lation (absence of ovulation) or short luteal phase length (slp) may pose also a risk for bone remodeling, imbalance and bone loss (seifert-klauss & prior 2010). the female athlete triad (triad) and/or its individual components (decreased ea, menstrual dysfunction, and low bmd) have previously been identified in athletic women (egan, reilly, whyte, giacomoni, & cable, 2003; koehler, achtzehn, braun, mester, & schaenzer, 2013; reed, de souza, & williams, 2013). all female athletes in any sport regardless of the competition level are at potential risk to develop the triad. however, those females participating in endurance sports, such as track and field, swimming, and rowing, or in those events requiring subjective judging, such as gymnastics and figure skating, are most at risk (martinsen & sundgotborgen, 2013). the current risk profile of the triad includes very little information on female athletes having ‘average body weights and lean body mass’ (lbm), who participate in predominantly team oriented, weight-bearing sports (e.g. ice hockey, field hockey, soccer, basketball, and volleyball). female athletes in weight bearing sports may also be energy deficit without knowing it and have ovulatory disturbances leading to future bone loss (osteoporosis) or bone weakening (osteopenia). the sport of ice hockey requires a long-term commitment to skill development and physical fitness which may impact a player’s ee levels. it is possible that over time players may enter a state of negative eb without noticeable body weight change. the prevalence of inadvertent low ea is unknown in female ice hockey players. therefore, the primary purpose of this study was to describe menstrual disturbances using basal body temperature (bbt) analysis to determine luteal phase (lp) length, and occurrence of anovulatory cycles in a group of female ice hockey players (hp) (17-25 years of age) participating in the olympic oval high performance training program (hptp). our control (c) group were non-athlete students recruited from the university of calgary community. we hypothesized that hp would: (ho1) exhibit longer mc, shortened lp (<10 days), with a greater number of anovulatory cycles as indicated by the mc diary and bbt measurements when compared with c; (ho2) be in a state of negative eb in the absence of any change in body composition; and (ho3) have greater baseline bmd values at the spine, hip, and radial site compared to c and the population reference standards. methods our study took place over 9-months and encompassed the fall and winter university semesters (october to june). recruitment occurred at the start of the fall semester (september 1999) and the data collection period had a staggered study start; october for hp and november for c. the staggered start was necessary because of scheduling issues and conflicts with booking the dual energy x-ray absorptiometry (dxa) machine. volunteers were invited to participate:1) if hp had a five-year history of hockey specific training and if they committed to four or more 75 minute training sessions per week at the olympic oval in calgary, alberta, 2) following completion of the 72 patricia k. doyle-baker, leanne mclean, tak fung: female athlete triad − probable but difficult to confirm ..., 69–92 annales kinesiologiae • 8 • 2017 • 2 baecke questionnaire of habitual physical activity (baecke, burema & frijters, 1982), used to evaluate their physical activity level, and 3) following completion of the eating disorder inventory (edi-2) questionnaire and screening tool (edi-sc) to identify predisposition towards disordered eating (garner, 1991). volunteers were excluded if they: (1) had used oral contraceptives during the preceding six months, (2) were smokers, (3) showed predispositions to disordered eating tendencies based on the edi-2 and edi-sc results, or (4) were involved in shift work (e.g. night shifts) as this would interfere with the accuracy of bbt methods (prior, vigna, schulzer, hall, & bonen, 1990). of the 38 volunteers, 4 hp and 5 c were excluded due to their use of oral contraceptives, and one hp scored positively for disordered eating tendencies and was referred to counseling. data collection procedures and measurement participants attended a 2-hour information / education session during their study start week where demographic information, menstrual history and current menstrual status data were collected. a registered dietician provided education on how to correctly complete the 7-day dietary record including accurate recording of dietary intake, serving sizes, calories per serving, and how to read food labels and recall techniques. the participants were given similar detailed information on how to correctly complete the 7-day activity record, mc diary, and bbt measurements. during the study, multiple reminders (e.g. follow-up telephone contacts and emails) and assurances of confidentiality were incorporated into the data collection methods to increase response rate and decrease non-sampling errors (ransdell, 1996). menstrual cycle length mc was tracked on a calendar and participants were asked to identify the first day with a phone call to the research coordinator (rc). mc start was defined as the first day of menstrual flow and the final day was defined as the day before the onset of the next menstrual flow. mc length was calculated as the difference between the day before the onset of menstrual flow and the first day of the previous cycle and was calculated as the mean length of each recorded cycle from month 1 through to month 6 of the data collection period. basal body temperature participants were instructed to measure their oral bbt immediately upon waking and before standing using a low-reading digital thermometer read to the nearest 0.05°c. these measurements were recorded in the mc diary and in addition participants re73 annales kinesiologiae • 8 • 2017 • 2 patricia k. doyle-baker, leanne mclean, tak fung: female athlete triad − probable but difficult to confirm ..., 69–92 corded their subjective observations about late rising, illness, amount of menstrual flow, emotions, and disturbed sleep. participants also commented on subjective markers of ovulation such as mucous secretion and breast tenderness (prior et al., 1990; prior, 1996). luteal phase length we chose the mean temperature method (mtm) to predict the onset of lp using pre-established criteria from vollman (1977). according to prior et al., (1990) the lp length determined by mtm is comparable to directly measured serum mid-cycle luteinizing hormone (lh) on the peak day (r = 0.891). the temperatures of a given mc were averaged and a corresponding mean line drawn across the graph of the data. the start of the lp was defined as the first temperature to rise above the mean line and remain above for three consecutive days. the end of the lp was defined as the day before the onset of the next menstrual flow (prior et al., 1990). temperatures of more than 0.5°c above the mean were discarded as febrile values (vollman, 1977). slp was defined as those cycles having lp length < 10 days within a cycle of normal length (prior et al., 1990). anovulation can be determined by a lack of thermal shift in bbt (vollman, 1977). we designated anovulatory mcs as those cycles having irregular temperature patterns and the absence of a definite lp when a normal mc length of 21 to 36 days was maintained (personal communication, j. c. prior, october 1999). the number of anovulatory cycles was expressed as a percentage of the total number of eligible cycles recorded for the study period. total energy expenditure (tee) ee includes the components of resting energy expenditure (ree), the thermic effect of food (tef) and the energy expended through pa (epa). ree is the largest single source of ee and accounts for approximately 50 to 75 % of an individual’s tee (mahan & escott-stump, 1996; van zant, 1992). tee is defined as the energy expended due to resting physiological functions (e.g. ventilation, cardiovascular activity, protein, glycogen, and triglyceride synthesis, and electrical activity within the cells) (thompson & manore, 1996). we employed the cunningham equation (1980) because of the ability to include fat free mass (ffm) in the calculation for estimated ree: (kcal / day) = 500 + 22 (ffm) (mcardle, katch, & katch, 1991). thompson and manore (1996) compared this equation against directly measured ree and to several predictive ree equations. the ree estimate derived from the cunningham equation was the only estimate that was not significantly different than the directly measured ree in a study of 24 male and 13 female endurance athletes. 74 patricia k. doyle-baker, leanne mclean, tak fung: female athlete triad − probable but difficult to confirm ..., 69–92 annales kinesiologiae • 8 • 2017 • 2 tee was determined using estimated ree plus epa and tef (7 % of ree + eap) (personal communication, k.a. carter-erdman, january 2000; mahan & escottstump, 1996). an estimate of the epa was derived using the participants’ 7-day activity records from three time points over the study collection period (october to june). time 1 for the 7-day activity record started on the first day of menstrual flow during the month of october for hp and november for c. records two and three were collected in similar fashion at two-month intervals. participants were given instruction on recording daily activity into four 6-hour periods which included: (1) a general description of the activity (e.g. reclining, sitting, standing, walking, running, skating etc.); (2) an estimation of the effort involved (e.g. light, moderate, or vigorous effort); (3) a specific description of the activity performed (e.g. sitting-reading, standing-talking, walking to school etc.); (4) duration in minutes performing each activity; and (5) a check mark designating those activities that were sport-specific. sport-specific activity was defined in this study as the performance of hockey related training. verbal instructions with working examples were given regarding the accurate measurement and recording of activity type, intensity, duration and exercising radial pulse counts. the mean heart rate (hr) during exercise was calculated using hr taken at time 1, 2, and 3 as indicated on the activity records. participants were also asked to record their weight each monday during the study period. each activity record was collected and evaluated at the end of the 7-day period and illegible and/or questionable entries were confirmed via telephone contact or personal interview. the accuracy of using activity records to estimate tee is variable, with errors of various methods ranging from 6 to 30 % of actual energy need (campbell, 1999). to establish the accuracy of several commonly employed methods of determining activity level, miller, freedson, and kline (1994) tested five recording questionnaires against direct measurement of pa using a caltrac accelerometer. the 7-day pa recall and the caltrac were the only method that resulted in a significant spearman rank order correlation coefficient (r = 0.79). epa was also estimated based on each groups’ habitual physical activity patterns and calculated as a percentage of ree: epa = 75 % of ree for hp and 45 % of ree for c (heyward, 1997; mahalko & johnson, 1980). this method is based on the factorial approach to calculating energy requirements of individuals (world health organization, 1985). energy intake ei was collected at the onset of the first day of menstrual flow from the 7-day dietary record. diet records, three in total, were also collected at two-month intervals simultaneously with the collection of the 7-day activity records. to avoid recall bias, participants were instructed to record dietary intake within 30 minutes of ingestion and they were contacted via phone (rc) to fact-check their intake. a nutrition intern categorized data for entry into “nutritionist 5.0 – version 1.6” software package (first 75 annales kinesiologiae • 8 • 2017 • 2 patricia k. doyle-baker, leanne mclean, tak fung: female athlete triad − probable but difficult to confirm ..., 69–92 data bank, san bruno, ca). data were analysed to yield daily caloric intake, daily percentages for individual nutrients, and macro and micronutrient intakes. energy balance eb was calculated as the difference between the mean ei from the 7-day diet record and mean tee calculated using ree, tef, and epa estimated by heyward’s (1997) approach, as stated above. bone mineral density baseline bmd testing of the lumbar spine (l1-l4), femoral neck, and distal radius occurred in week 1 for each group. dxa measurements were completed by a nuclear medicine technician (hologic qdr2000– rectilinear scanner; hologic, inc.). scan time was approximately 2 to 4 minutes and the coefficient of variation (cv) was better than 1.0 % for spinal measurements and approximately 2 to 3 % for femoral neck measurements (hologic manufacturers inc., [on-line] august 1999; personal communication, dr. r. kloiber, april 2000). individual bmd measurements in g/cm2 were compared to hologic qdr 2000 reference standards of mean young adult bmd (t-score: standard deviation from the peak bone mass or young normal values of a female reference population) as well as across the groups (kanis, melton, christiansen, johnston & khaltaev, 1994; maggi, 1993). all reporting of the bmd values (bmd three decimal places; t-scores and z-scores one decimal place) follow the recommendations for bone mineral density reporting in canada (siminoski, et al., 2005). body composition a sport anthropometrist measured participant’s height (ht), weight (wt), girths (10 sites), limb dimensions (8 sites), and skinfold thickness (15 sites) at start and end of the study, using a medical scale, harpenden skinfold caliper, an anthropometer, and steel tape. the equations of parizkova (1978) and matiegka (1921) were used to estimate bf %, ffm (kg), and muscle mass percent (lmm %). body composition in this study included: wt, bf, and ffm. 76 patricia k. doyle-baker, leanne mclean, tak fung: female athlete triad − probable but difficult to confirm ..., 69–92 annales kinesiologiae • 8 • 2017 • 2 data analysis the main outcome was the identification of menstrual disturbances related to mc length (> 36 days oligomenorrhea vs < 21 days polymenorrhea), and slp (< 10 days), as indicated by the mc diary and bbt measurements. the independent variables were: ei, tee, eb, body composition, and bmd. sample size sample size was calculated from the results of a one-year prospective study investigating the proportion of menstrual disturbances in runners, as no available literature on female ice hockey players was found. thirteen subjects (n = 66) were identified as experiencing menstrual disturbances based on their slp (≤ 10 days) (prior et al. 1990). therefore, a conservative estimate of 20 participants was required to achieve a power of 80 % and an alpha of 0.05 for this study (brant sample size calculator [on-line], august 1998). statistics statistical analyses were not performed because of the descriptive nature of the study; partly due to low compliance from hp. we report means (sd (±)) and box plots with median values, 25th and 75th percentiles, ranges, and outliers for percent change in wt, bf, ffm, bmd, t-scores, z-scores, ei, tee, eb, mc length and lp length. percent change in wt, bf, and ffm were calculated to describe the pre (t1)-post (t2) body composition change (percent change = [(time 2 – time 1)/ time 2]x100). results three hps were excluded because they did not provide mc diary data and one hp was excluded from the bmd analysis due to multiple missed appointments. twelve hockey players (mean, sd (±): age = 21.1 ± 3.4 years; ht = 165.9 ± 4.6 cm; wt = 64.7 ± 8.1 kg; bf % 22.8 ± 3.8) and 12 non-athletes (age = 21.4 ± 2.8 years; ht = 169.5 ± 5.5 cm; wt = 65.4 ± 6.4 kg; bf % 20.0 ± 3.1) were enrolled in all testing sessions (n = 24). anthropometric characteristics and exercise patterns for hp and c are listed in table 1. no differences were observed between groups in anthropometric characteristics at the study start. the hp participated in l0.3 ± 4.1 as compared to the c 4.4 ± 1.8 number of exercise sessions per week. the calculated mean hr per exercise session was 151.1 ± 17.5 bpm and 137.2 ± 9.7 bpm in the hp and c, respectively. (see table 1). 77 annales kinesiologiae • 8 • 2017 • 2 patricia k. doyle-baker, leanne mclean, tak fung: female athlete triad − probable but difficult to confirm ..., 69–92 table 1: mean and standard deviations (sd (±)) of hockey player and control group’s anthropometric and exercise characteristics. mean, sd min max hp (n = 12) fat free mass (kg) 49.80 ± 5. l0 41.30 57.40 muscle mass (kg) 23.70 ± 4.30 16.70 31.80 fat mass (kg) 14.90 ± 3.90 10.50 21.60 body fat (%) 22.80 ± 3.80 17.00 29.20 volume of thigh (cm3) 9217.90 ± 1336.70 7477.80 12130.20 number of exercise / week 10.30 ± 4.10 5.00 21.00 exercise duration / session (min.) 73.80 ± 14.90 60.00 90.00 heart rate / session (bpm) 151.10 ± 17.50 125.00 175.00 c (n = 12) fat free mass (kg) 52.20 ± 4.00 47.00 59.20 muscle mass (kg) 25.60 ± 3.10 21.40 32.90 fat mass (kg) 13.20 ± 3.10 8.50 18.80 body fat (%) 20.00 ± 3.10 14.90 25.40 volume of thigh (cm3) 9185.90 ± 1011.20 7281.80 10392.80 number of exercise / week 4.40 ± l.80 2.00 9.00 exercise duration / session (min.) 56.70 ± 27.80 30.00 120.00 heart rate / session (bpm) 137.18 ± 9.70 123.00 154.00 the median (25th and 75th percentile) wt percent change over the study duration for the hp and c was: -1.43 % (-2.45 % and 6.38 %) and 0.30 % (0.13 % and 2.53 %), respectively. the median (25th and 75th percentile) bf % percent change for the hp and c was: -4.42 % (-9.18 % and 0.34 %) and 4.73 % (-3.44 % and 9.28 %), respectively. no significant within group mean differences were observed for wt (hp p = 0.7; c p = 0.8), bf % (hp p = 0.97; c p = 0.6), and ffm (hp p = 0.6; c p = 0.98). 78 patricia k. doyle-baker, leanne mclean, tak fung: female athlete triad − probable but difficult to confirm ..., 69–92 annales kinesiologiae • 8 • 2017 • 2 bone mineral density median values, 25th and 75th percentiles, ranges of the baseline bmd values (g / cm2) t-scores and z-scores at the lumbar spine (l1-l4), total hip, and distal radius are presented in table 2. median lumbar spine and hip bmd were greater in the c (1.059 and 1.07 g / cm2) than in the hp (1.047 and 1.064 g / cm2). hp had one bmd measurement at the hip (1.357 g / cm2) that presented as an outlier (see figure 1). there were no significant differences in mean lumbar spine, hip, or radial bmd values between the hp and c. however, the maximum value for all bmd measurement sites was greater in the hp. median lumbar spine and hip t-scores were similar for hp and c. however median distal radius t-score was much larger for the hp (1.1) than c (0.5). the hip t-scores in the hp ranged from 0.1 to 3.4 as compared to a range of –0.9 to 2.6 in the c. the minimum lumbar spine (-0.7) and radial t-score (-0.9) in the hp and minimum t-score values at all sites in the c approached the who definition of osteopenia (-1.0 to -2.5). figure 1 shows a comparison of hp and c t-scores values. table 2: bone mineral baseline values by site and group median percentile range median percentile range 25th 75th 25th 75th hockey (n = 11) control (n = 12) lumbar spine l1-l4 bmd g/cm2 1.047 0.993 1.149 0.968 1.273 1.059 1.001 1.112 0.948 1.25l t-score 0.0 -0.5 0.1 -0.7 2.3 0.1 -0.4 0.7 -0.9 l.9 z-score 0.2 -0.4 1.1 -0.5 2.4 0.2 -0.2 0.9 -0.9 2.1 total hip bmd g/cm2 1.064 1.007 1.116 0.956 1.357 1.07 0.982 1.12 0.838 1.257 t-score 1.0 0.5 1.8 0.1 3.4 1.0 0.3 1.5 -0.9 2.6 z-score 1.1 0.5 2.6 0.1 3.4 1.2 0.5 l.4 -0.9 2.6 distal radius bmd g/cm2 0.639 0.602 0.651 0.529 0.691 0.606 0.602 0.651 0.545 0.686 t-score 1.1 0.4 1.3 -0.9 2.0 0.5 0.5 1.3 -0.6 1.9 z-score 1.3 0.7 1.4 0.5 2.0 0.3 0.7 1.4 -0.5 1.9 note: outlier total hip hp 1.357 g/cm2 79 annales kinesiologiae • 8 • 2017 • 2 patricia k. doyle-baker, leanne mclean, tak fung: female athlete triad − probable but difficult to confirm ..., 69–92 figure 1: baseline bmd t-scores at three sites for control and hockey players. energy expenditure table 3 lists the mean group values of epa, ree, tef and tee for the hp and c. the mean hp-tee was greater than c-tee due to the varying contributions of epa, tef, and ree. epa and tef were greater in the hp than the c. the mean ree was greater for c. values of epa, ree, and tef for both hp and c were verified to be within recommended theoretical percentages of tee. the median ei (25th and 75th percentile) values for the hp and c were: 1880.3 (1714.6 and 2080.85) and 1799.2 (1509.1 and 2038.5) kcal / day, respectively (see table 4). one hp had an average daily energy intake of 1065.6 kcal / day and was represented as an outlier. the median (25th and 75th percentile) tee for the hp and c groups were 2854.2 (2802.8 and 3080.28) and 2544.01 (2440.08 and 2659.55) kcal / day, respectively. the frequency distribution for hp-tee is left skewed. daily mean caloric intakes for the hp and c were 11 % (hp -1026.52 ± 450.1 kcal / day) and 15 80 patricia k. doyle-baker, leanne mclean, tak fung: female athlete triad − probable but difficult to confirm ..., 69–92 annales kinesiologiae • 8 • 2017 • 2 % (c -780.00 ± 310.19 kcal / day) less than that recommended by health and welfare canada (1990) for females aged 16 to 49 years (2100 kcal / day). there was a small difference of 105.5 kcal / day in daily ei between the hp and c but the number of exercise sessions per week and calculated mean hr per exercise session were also different. thus, tee between the hp and c was different and may have contributed to the difference in eb between the groups. both groups maintained a state of negative eb for the study period as indicated by the mean tee which exceeded daily caloric intake for both hp and c (see table 4). the frequency distribution of hp-eb was symmetrical about the median and the median (25th and 75th percentile) was 984.71 (1223.8 and 767.7) kcal / day. the frequency distribution for c-eb table 4. hp and c mean daily energy balance (calculated) mean ± sd kcal / day hockey n = 12 control n = 12 daily energy intake 1882.89 ± 366.37 1777.3 l ± 328.62 range 1065 to 2419 1212 to 2219 total energy expenditure 2901.26 ± 206.1 2557.38 ± 136.06 mean energy balance -1018.37 ± 464.9 -780.07 ± 310.62 note: mean eb per day calculated as the difference between mean daily caloric intake (ei) and estimated total daily energy expenditure (tee). table 3: components of mean (sd (±)) total daily energy expenditure by group hp n = 12 c n = 12 kcal / day mean, sd min max mean, sd min max epa 1116.48 ± 79.30 985.71 1234.42 741.75 ± 39.50 690.10 810.68 ree 1594.98 ± 113.30 1408.16 1763.46 1648.33 ± 87.80 1533.56 180l.52 tef 189.80 ± 13.50 167.57 209.85 167.30 ± 8.90 155.66 182.85 tee 2901.26 ± 206.10 2561.44 3207.73 2557.38 ± 136.1 2379.32 2795.06 note: estimated energy of physical activity (epa), resting energy expenditure (ree), thermic effect of food (tef) and derived total daily energy expenditure (tee) 81 annales kinesiologiae • 8 • 2017 • 2 patricia k. doyle-baker, leanne mclean, tak fung: female athlete triad − probable but difficult to confirm ..., 69–92 was right skewed and the median (25th and 75th percentile) was 681.72 (1046.57 and 595.25) kcal / day. energy balance remained in a negative state despite corrections for errors (self-report corrected factor ~30 %) in estimating daily ei such that mean corrected eb for the hp and c was –641.8 and –424.6 kcal / day, respectively. menstrual cycle characteristics out of a possible 78 cycles for the hp and 72 cycles for the c, only 22 hp and 51 c cycles were included in the analysis due to incomplete data. the hp and c median (25th and 75th percentile) lp lengths were 9.0 (9 and 11) and 9.4 (8.3 and 10.5) days, respectively. mean lp length for the c (9.4 ± l.9) was slightly less than the hp (9.9 ± 1 .7) days. both groups were classified as having slp (<l0 days). table 5 indicates that three hp and three c had less than 25 % of eligible cycles defined as anovulatory. five c and two hp had 25 to 50 % of eligible cycles designated as anovulatory. two hp and two c had 51 to 75 % of eligible cycles considered anovutable 5. anovulatory cycle comparison between hockey players and controls hp id cycle tally cycles % anovulatory c id cycle tally cycles % anovulatory 1 1 1 100 13 0 5 0 2 2 5 40 14 3 6 50 3 3 4 75 15 0 5 0 4 2 3 67 16 1 3 33 5 missing missing missing 17 4 6 67 6 missing missing missing 18 1 3 33 7 0 2 0 19 4 6 67 8 1 3 33 20 2 4 50 9 0 2 0 21 3 3 100 10 missing missing missing 22 1 1 100 11 1 1 0 23 1 5 25 12 2 2 100 24 0 5 0 total 11 22 50% total 22 51 43.1% note: id = subject number; cycle tally = number of anovulatory cycles out of total eligible cycles per subject; cycles = total number of eligible cycles; anovulatory = total anovulatory cycles; percent = total percent of anovulatory cycles per group. 82 patricia k. doyle-baker, leanne mclean, tak fung: female athlete triad − probable but difficult to confirm ..., 69–92 annales kinesiologiae • 8 • 2017 • 2 latory. finally, 75 to 100 % of eligible cycles were defined as anovulatory in two c and two hp. thus, 11 out of 22 or 50 % of the hp eligible cycles were defined as anovulatory. similarly, 43.1 % or 22 out of 51 c eligible cycles were defined as anovulatory. discussion in this paper, we describe menstrual disturbances across two groups: athletes (hp) and young university aged women (c) through the determination of mc and lp length, and occurrence of anovulatory cycles. baseline bmd measurements were collected for comparison by group and with population based diagnostic reference standards (tscores). descriptive data on ei, tee, eb and body composition percent change over a 9-month study period were calculated and summarized. bone mineral density measurements bmd is an important component of bone strength and is considered the best method for diagnosis of osteopenia and osteoporosis. the maximum value for all bmd sites measured was greater in the hp, however, the median lumbar spine and hip values were slighter greater in the c. the median hip t-score may have been larger for the c because of the wider range in hip t-scores (0.1 to 3.4) in hp when compared to c (–0.9 to 2.6). surprisingly, the minimum values in hp’s lumbar spine and radial t-score and c’s lumbar spine, hip and radial t-score all approached the who definition of osteopenia. these results contrast with our hypothesis stating baseline bmd values at the spine, hip, and radial site in the hp would be greater than bmd values for population reference standards. these bmd results are supported by henderson, price, cole, gutheridge, & bhagat (1995) who reported normal values for mean bmd at the spine and proximal femur (caucasian women, 20 to 50 years of age) to be 1.03 ± 0.113 g / cm2 and 1.00 ± 0.114 g / cm2, respectively. mean bmd at the radius (0.69 ± 0.13 g / cm2) reported by faulkner et al. (1996) and warren et al. (1991) is higher than mean radial bmd value for the hp and c in the current study. in studies of bmd in female runners, drinkwater et al. (1984) and rencken, chesnut, and drinkwater (1996) observed a significant difference in bmd at the lumbar spine for amenorrheic athletes (1.12 g / cm2) when compared with matched eumenorrheic controls (1.30 g / cm2). hp and c bmd at the lumbar spine were less than those reported in the drinkwater et al. (1984) and rencken et al. (1996) studies (hp = 1.066 ± 0.098 g/cm2; c = 1.069 ± 0.086 g / cm2). these comparisons are made with caution as measurement techniques may have been different and there was an mean age difference between our group (hp, 21.1 ± 3.4; c, 21.4 ± 2.8 years) and drinkwater et al. (1984) (amenorrheic athletes 24.9 ± 1.3 years; eumenorrheic athletes 25.5 ± 1.4 years). it is possible that our hp and c may not be at their peak bmd for the lumbar spine due to their younger age (recker et al., 1992). 83 annales kinesiologiae • 8 • 2017 • 2 patricia k. doyle-baker, leanne mclean, tak fung: female athlete triad − probable but difficult to confirm ..., 69–92 increased bmd in female athletes is reported to be dependent on the pattern of weight bearing activity and this effect is specific to the skeletal region stimulated by the activity. specifically, increased bmd at the lumbar spine and lower body has been reported in male and female runners and weight lifters whereas increases at the distal radius have been reported for gymnasts and tennis players when compared to sedentary controls (dalsky, 1990; kannus, haapasalo, & sankelo, 1995; petit, prior, & barr, 1999). ice hockey players are assumed to experience constant skeletal loading at the hip during the motion of skating and loading of the upper body through the hands and wrists during stick handling. thus, the research of dalsky (1990), kannus, haapasalo, & sankelo (1995), and petit et al. (1999) into the activity specific accrual of bone mineral content would support increased mean bmd at these sites when compared to c. in this study, weight bearing sites specific to ice hockey did not manifest bone mass accrual specific to the activity pattern in the hp group when compared with the c. however, hp1 (25.2 years old) and hp9 (20.3 years old) did have t-scores at the hip that were greater than 2.5 sd above the mean peak bone mass or young normal values for population reference standards. hp9 also had a radial t-score greater than 2 sd above the peak bone mass or young normal values for population reference standards. evidence of low bone mass (negative t-score values) was present in both groups: hp (5 lumbar spine -0.4 to -0.7 sd; 2 radial -0.4 and –0.9 sd); and c (6 lumbar spine -0.1 to -1.0; 2 hip -0.2 and –0.9 sd; and 3 radial -0.1 to –0.6 sd). these results raise specific concerns as johnston and slemenda (1991) estimate that the risk of fracture increases by 50-100 % for each decrease of 1 sd in bmd. in addition, riggs et al. (1981) report the 90th percentile for vertebral bmd for patients with nontraumatic vertebral fractures to be 0.965 g / cm2. hp3 (18.1 yrs old) and hp4 (20.9 yrs old) had mean lumbar spine bmd values of 0.968 g / cm2 and 0.972 g / cm2, respectively. c23 (29.6 yrs old) had a mean spinal bmd of 0.948 g / cm2 which is less than the threshold below which the risk for non-traumatic vertebral fractures increases. thus, each of these individuals with spinal bmd values nearing the fracture threshold and those having t-score values approaching –1 sd may be at risk for future fracture, indicating the potential need for monitoring and preventative education. several contributing variables have been emphasized in studies investigating osteoporosis or low bmd in female athletes. henderson et al. (1995) suggest that bmd in young women is associated with their weight and muscle strength but not dietary intakes. rencken et al. (1996) suggests amenorrhea and weight have a significant impact on bmd at the lumbar spine, trochanter, intertrochanteric region, and tibial shaft in amenorrheic, aerobically trained athletes. further, these researchers recognize age of menarche as a significant predictor of lumbar spine bmd, suggesting that the later the age of menarche, the lower the lumbar spine bmd. low calcium intakes (< 1000 mg / day), prolonged hypoestrogenism, occurrence of menstrual disturbances (specifically amenorrhea, slp, and anovulatory cycles), have been recognized to differentially impact skeletal sites leading to low bmd values in female athletes (drinkwater et al., 1984; drinkwater, bruemner, & chesnut, 1990; heaney, 84 patricia k. doyle-baker, leanne mclean, tak fung: female athlete triad − probable but difficult to confirm ..., 69–92 annales kinesiologiae • 8 • 2017 • 2 1982; prior et al., 1990; warren et al., 1991). although the current study neither attempted to measure circulating estrogen levels nor determine age of menarche, mean reported calcium levels were less than 1000 mg/day in both the hp (870.53 ± 250.99 mg / day) and c (785.33 ± 217.15 mg / day) and may partially contribute to the lack of bone-trophic effect for weight bearing activity (heaney, 1982). nutritional status, energy balance and body composition changes the identification of caloric restriction or lack of nutrition is important in all athletes because of the effect, both positive and negative, this may have on sport performance and subsequent health. the general perception is that female athletes involved in aesthetic or weight dependent sports, restrict caloric intake and become energy deficient. although female hockey players do not fit the typical risk profile for the triad with respect to body composition (e.g. low body weight and low fat mass), they are involved in intense physical training. median ei values for the hp and c were 1882.89 ± 366.37and 1777.3l ± 328.62 kcal / day, respectively. these values are less than our previous ei research with varsity soccer (1850.70 ± 417.40 kcal/day), basketball (2639.50 ± 586.21 kcal/day) and volleyball players (2134.80 ± 286.00 kcal/day) (doyle-baker, macdonald, hewitt, & harris, 2000). they are also less than the 2100 kcal / day rni (required nutrient intake) by health and welfare canada (1990). jones, martin, wanfang, and boyd (1997) suggest that health canada’s rni values for women aged 25 to 49 years (2100 kcal / day) are substantially below the true requirement level of the population age based subgroup. thus, if the reported daily ei for the hp and c are below the current recommendations by 11 % and 15 %, respectively, this may be the first indication of the inadequacy of dietary caloric intake occurring. despite the indications of low caloric intake, it is important to consider that underreporting due to day to day variation in energy status, the disturbance of normal dietary practices, food recall problems, and errors related to analysing ei or calculating ee using activity records or generalized equations, contributes to a decrease in the accuracy of determining the energy requirement for a population. specifically, when 7day diet records were compared to the “gold standard” dlw method of determining ei and ee, errors in estimating ei of up to ± 30 % of actual need have been reported (devries, zock, mensink, & katan, 1994; mahalko & johnson, 1980; sawaya, tucker, & tsay, 1996; todd, herdes, & calloway, 1983). we calculated an error estimate of 20 % of actual energy need reported to determine a closer approximation of the daily caloric intake considering all possible sources of error. the mean corrected daily caloric intake (hp 2259.47; c 2132.77 kcal / day) would increase their totals to the current age specific rni. 85 annales kinesiologiae • 8 • 2017 • 2 patricia k. doyle-baker, leanne mclean, tak fung: female athlete triad − probable but difficult to confirm ..., 69–92 energy balance long term negative eb (ee exceeds ei) leads to a decrease in utilizable metabolic fuels, disrupted lh pulsatility, and subsequent alterations to thyroid metabolism and basal metabolic rate (loucks & heath, 1994; loucks & verdun, 1998; loucks, verdun, & heath et al., 1998; wade, schneider, & li, 1996). the “energy availability hypothesis” suggests that the gnrh pulse generator is disrupted by an unidentified signal that dietary intake is inadequate for the energy cost of reproduction and locomotion (loucks et al., 1998). on average, hp and c maintained a state of negative eb as indicated by their mean tee exceeded their daily caloric intake. these results are comparable to those reported by drinkwater et al. (1984), who reported that eb in a group of amenorrheic athletes was significantly lower than in an eumenorrheic group. in the drinkwater, et al. (1984) study, ei were not different, but training was significantly more rigorous in the amenorrheic group. in our study, the hp and c were divided by exercise and not based on their menstrual status. there was a small difference of 105.5 kcal / day in daily ei between the groups and the hp had more rigorous training based on the number of exercise sessions per week and calculated mean hrs per exercise session which were different. thus, tee between hp and c was different and should have contributed to higher ei in hp and a difference in eb. however, both groups experienced a negative state despite corrections for errors in estimating daily ei; mean corrected eb for the hp and c was –641.80 and –424.60 kcal / day, respectively. the eb findings are practically important in consideration of the research of loucks (1996) who suggests that exercise contributes to menstrual disturbances only when the ee is not adequately replenished. this is supported in our study as although the exercise sessions per week and exercise intensity differed between hp and c both experienced similar mc aberrations, possibly because of negative eb. in a series of well controlled studies loucks and coworkers (loucks & heath, 1994; loucks & verdun, 1998; loucks, verdun & heath, 1998), suggest energy deficits are associated with significant suppression of triiodothyronine (a regulator of metabolic rate) and disruption of lh pulsatile secretion (a strong indicator of reproductive performance). further, they suggest that the degree of disruption in lh pulse amplitude and frequency is in direct relation to the duration of energy depletion. since successful reproductive function requires appropriate hormonal stimulation, individuals experiencing disruptions in lh pulsatility may experience a range of menstrual disturbances including amenorrhea, oligoamenorrhea, slp, and anovulation. our results may be suggestive of this phenomena since a state of negative eb was consistently maintained throughout the study and menstrual disturbances in the form of slp, oligoamenorrhea, and anovulation did occur in both the hp and c. 86 patricia k. doyle-baker, leanne mclean, tak fung: female athlete triad − probable but difficult to confirm ..., 69–92 annales kinesiologiae • 8 • 2017 • 2 body composition even though both the hp and c maintained a state of negative eb for the study period, percent changes in wt, bf, and ffm were very small (hp –1.43 %, –4.42 %, 0.82 %; c 0.30 %; 4.73 %; –0.15 %) respectively. this finding supports the hypothesis that hp would be in a state of negative energy balance in the absence of any change in body composition. menstrual disturbances can occur with or without weight loss (yen, 1998). the general perception that changes in weight or body composition, specifically bf %, are an impetus to the onset of menstrual disturbances in female athletes has been challenged by several studies that have failed to correlate reproductive function and body composition (decree, 1998; i’anson, foster, & foxcroft, 1991; sanborn, albrecht, & wagner, 1987; sinning & little, 1987). specifically, reproductive function has been linked to general availability of metabolic fuels (loucks & callister, 1993; loucks & heath, 1994; loucks, verdun, & heath, 1998; wade & schneider, 1992). the results of the current study may lend support to the work of several researchers investigating the role that ea plays in regulating metabolism and producing a “hypometabolic state” in which available energy is stored or partitioned to only essential functions (laughlin & yen, 1996). decree (1998) documented alterations to the thyroid axis in individuals experiencing energy deficits linked to menstrual disturbances. such alterations lead to reduced bbt and reduced metabolic rate. the athletes in this current study did experience asymptomatic menstrual disturbances in the absence of significant changes in wt, ffm, and bf %. although, thyroid levels were not measured, these results potentially lend support to future research directed at determining the possible mechanism behind menstrual disturbances, specifically slp, oligo amenorrhea, and anovulation, and a reduction in metabolic rate leading to maintenance of body composition. further, the lack of body composition change in this study supports the need to expand the present triad model (its association with amenorrhea, eating disorders, and loss of weight) to adopt the understanding that menstrual disturbances do occur in active individuals who do not experience the symptomatic changes in body composition associated with amenorrhea in anorexia nervosa. menstrual disturbances hp and c mean menstrual cycle lengths were similar and were within the defined normal menstrual cycle length of 21-36 days. maximum mc lengths are suggestive of the occurrence of oligomenorrhea (cycles greater than 36 days) in both groups (abraham, 1978). similarly, the minimum mc length are indicative of polymenorrhea (cycles length of less than 21 days) occurring in hp (abraham, 1978). mean lp length in days for the c was slightly less than that of the hp, yet both groups are classified as having slp (< 10 days). these results support the hypothesis that the hp group would 87 annales kinesiologiae • 8 • 2017 • 2 patricia k. doyle-baker, leanne mclean, tak fung: female athlete triad − probable but difficult to confirm ..., 69–92 exhibit a longer mc length when compared with c. however, the data do not support the hypotheses that the hp group would exhibit slp (< 10 days) and a greater number of anovulatory cycles when compared with c. luteal function was disturbed in 55 of 150 eligible cycles (sum of all slp and anovulatory cycles) or in 36.70 % of recorded cycles in the hp and c combined. specifically, anovulation occurred in 50.00 % of hp and 43.10 % of c cycles. similar to the study by prior et al., (1990) disruptions to the lp occurred in both highly active hp (10.30 ± 4.10 sessions / week) and in the recreationally active c (4.40 ± 1.80 sessions / week). although, prior et al (1990) did not mention energy status, the hp and c in this study were in a state of negative eb and this may be impacting gnrh responsiveness and lh pulsatility possibly leading to altered menstrual function. the results of this study may support the work of loucks et al. (1998) who concluded that low ea, not stress of exercise or athletic involvement, alters lh pulsatility in exercising women. thus, there is a potential that these “apparently healthy” hp and c may be exposed to the detrimental effects of low reproductive hormones without their knowledge. limitations we realize that this study had a large participant burden as our original recruitment at the outset of the study exceeded the sample size calculation. however, the bbt method coupled with keeping a mc diary was time intensive for the hp with only a 28 % completion rate versus 70 % with the c. in addition, differences may be present but obscured due to errors inherent in the estimation of eb and / or because the c were university students and thus not a true “sedentary” control group. while ea did change, the effects on mc may not occur for months, and an effect on bmd may not occur for years (drinkwater, nilson, ott, & chesnut 1986; hanley, 1996). conclusions in conclusion, the prospective, descriptive nature of our study was designed to increase awareness regarding the presence of menstrual disturbances in a select population of female ice hockey players and to potentially highlight the need for intervention in this sub-population of female athletes related to future bmd loss. despite the errors inherent in indirect measurement of energy status and menstrual cyclicity, the results of our study do add to the literature which now identifies a strong relationship between reproductive endocrinology, eb and bmd. we hypothesized that neither intensity of exercise nor body composition independently would disrupt menstrual function; rather, inadequate dietary replenishing of expended energy leading to long term negative eb would explain the occurrence of menstrual disturbances. of course, this is well known today, but we did due diligence at the time of the study and contacted several research88 patricia k. doyle-baker, leanne mclean, tak fung: female athlete triad − probable but difficult to confirm ..., 69–92 annales kinesiologiae • 8 • 2017 • 2 ers to ensure that we were identifying a plausible trend (personal communication, d. a., haney; a. b. loucks; v. harber; and j. c. prior, october 2000). in 2014, the ioc published a consensus statement: beyond the female athlete triad and introduced a more comprehensive term that employs a multi-disciplinary approach across all athletes. this reframing resulted in a new model renamed, relative energy deficiency in sport (red-s), which is caused by energy deficiency relative to the balance between dietary ei and ee (mountjoy et al., 2014). references abraham, g. e. 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(1998). effects of lifestyle and body composition on the ovary. endocrinology and metabolism clinics of north america, 27(4), 915-926. doi: 10.1016/s08898529(05)70047-5 view item https://doi.org/10.1016/s0002-8223(96)00010-7 https://doi.org/10.1093/ajcn/37.1.139 https://doi.org/10.1123/ijsn.2.1.1 https://doi.org/10.1152/ajpendo.1996.270.1.e1 https://doi.org/10.1210/jcem-72-4-847 https://doi.org/10.1016/s0889-8529(05)70047-5 annales kinesiologiae • 7 • 2016 • 1 43 original scientific article udc: 796.015.1.332:001.8 received: 2016-08-18 the role of small-sided games in modern soccer and the issue of their holism miloš tul1, zdenko verdenik2, matija maršič3, matjaž mulej4 1znanstveni licej f. prešeren, trst 2fakulteta za šport, univerza v ljubljani 3fakulteta za matematiko, naravoslovje in informacijske tehnologije, aplikativna kineziologija, univerza na primorskem 4ekonomsko-poslovna fakulteta, univerza v mariboru corresponding author: miloš tul znanstveni licej france prešeren, vrdelska cesta, 13/1, 34100 trst, italy e-mail: tul.milos@gmail.com abstract in the modern soccer, small-sided games (ssg) present a significant proportion of the whole training process. ssg are introduced regularly and with different emphases, depending on the players' basic technical skills and on the training objectives, but also according to different (sports) cultural contexts. ssg immersed into the wider soccer area at different speeds and with different emphases, often with rather modified designs. due to their extraordinary adaptability and efficiency, ssg as a working method have undergone a great expansion. their design and (possible) versatility are explained in this paper from a somewhat unusual perspective of the systemic theories as the theories of achieving the greatest possible holism of our reflections and actions. in the foreground of this paper there is the question of ssg integrity (as the prevailing practical methods of work in modern football practice), through the analysis of the conditions required in order to classify the use and further development of ssg in practice as an innovation, taking into account the laws of requisite holism and innovation. keywords: soccer, small-sided games, requisite holism, innovation, innovative working. 44 miloš tul, zdenko verdenik, matija maršič, matjaž mulej: the role of small-sided games in modern soccer ..., 43–65 annales kinesiologiae • 7 • 2016 • 1 vloga igralnih oblik v sodobnem nogometu in vprašanje njihove celovitosti izvleček igralne oblike (io) tvorijo v sodobnem nogometu precejšen delež celotnega procesa vadbe. vanj se io vnašajo redno in z različnimi poudarki, glede na osnovno tehnično znanje igralcev in na cilje treninga, vendar tudi glede na različne (športno)kulturne kontekste. igralne oblike so se z različno hitrostjo in z različnimi poudarki vsidrale v širši nogometni prostor, pogostokrat tudi s precej spremenjeno zasnovo. zaradi izjemne prilagodljivosti in učinkovitosti so igralne oblike, kot metoda dela, doživele velik razmah. njihova zasnova in (možna) vsestranskost bo v tem prispevku pojasnjena z nekoliko bolj neobičajnega vidika, to je z vidika sistemskih teorij kot teorij o doseganju čim večje celovitosti razmisleka in ravnanja. v prispevku je v ospredju vprašanje celovitosti igralnih oblik (kot prevladujoče praktične metode dela v sodobni nogometni praksi), preko analize pogojev, ki so potrebni zato, da uvrščamo uporabo in nadaljnji razvoj igralnih oblik v praksi kot inovacijo, ob upoštevanju zakonov o potrebni in zadostni celovitosti ter inovativnosti. ključne besede: nogomet, igralne oblike, potrebna in zadostna celovitost, inovativnost, inovativno poslovanje. introduction ssg as a special segment of the practical methods of work and methods of the game (elsner, 1997) are an extremely widespread and efficient method of work in modern football. this methodical approach appears regularly in all football-developed countries in the world. although with different emphases and repeatedly revised baselines and at different time sequences, they were successfully anchored almost anywhere. in europe, the beginnings of ssg occur in the late sixties and early seventies in germany where this approach was apparently established thanks to horst wein (http://www.ydsocceracademy.com/index.php/articles/35history-of-the-small-sided games). a brief description of the developmental path of ssg in europe the beginnings of ssg, for instance, appeared slightly later in italy, only in the late 1980s. of great importance at that time was the article of the frenchman christian bourrel, who, in cooperation with the italian federal coach maurizio seno (1989), wrote allenare i dilettanti (amateur footballers training) and defined the general theoannales kinesiologiae • 7 • 2016 • 1 45 miloš tul, zdenko verdenik, matija maršič, matjaž mulej: the role of small-sided games in modern soccer ..., 43–65 retical and methodological bases. the visible effects of the then-prevailing pedagogical thinking are notable, in particular the famous french pedagogue bernard aucouturier. “active pedagogy”, as a basis of teachning the sports elements, therefore entered the italian soccer space, that mostly still did not know this approach at the time (costantini, personal communication, 08 may 2015; seno, personal communication, 05 may 2015). the italian version of ssg was literaly called the thematic game, games on the (selected) theme (it. giochi / partitelle a tema). in slovenia, in fact, in the former yugoslavia, they got to know the ssg as a result of the academic exchanges that were maintained by some of the professors from the faculty of sport, university of ljubljana, in particular with the major european football/ soccer centers in germany. the slovenian pioneers in the field were branko elsner, ph.d., and then zdenko verdenik, ph.d. their simultaneous engagement in the academia of the former college of physical education (later the faculty of sport), university of ljubljana, and in the circles of the former football association of yugoslavia facilitated the transition of this new methodical basis into the learning process of the soccer courses at the college and into the content of compulsory licensing of soccer coaches at the football association of yugoslavia. at the same time, the “new” approach to training covered all republican soccer centers in yugoslavia, where it immersed very specificly. the belgrade soccer profession, for example, probably accepted the professional challenge without the necessary systematization and contextualization; so, the already established school of teaching the soccer elements without this innovation ultimately prevailed there. the reason for this was mainly in the fact that, at the time, the “balkan soccer school” was a widely acknowledged superpower in world soccer area; the yugoslav coaches were greatly appreciated in the world; the yugoslav national team did not lag behind the best ones in its results. therefore, they felt that changes in the training process are not needed. ssg were in this area implemented only because of personal beliefs of individual coaches (especially ivica osim and tomislav ivić), and not as a specific feature of the local soccer school, which, in the design of the game, was still based on teaching the techniques and situational methods. the slovenian “path” to the enforcement of ssg was based on a more consistent and coherent development of ssg's initial methodological and substantive assumptions within the soccer study course at the mentioned college. transfer of the acquired knowledge and experience in the field of ssg in the program of teaching contents for the licensing of trainers was natural; that was also one of the reasons for the creation of the substantively and methodologically regulated basis to confirm the slovenian route to the licensing of trainers that was approved by uefa (in the first years after the independence of slovenia) as an independent school for the education of coaches. it is worth mentioning that the method of the game was studied; in addition to the aforementioned elsner and verdenik, ssg's actual benefit/performance was somewhat later also studied by pišot (1994). the then-magazine trener, in which the two authors actually introduced the whole concept of work, also made a big contribution to raising the awareness and promoting the knowledge about ssg. 46 miloš tul, zdenko verdenik, matija maršič, matjaž mulej: the role of small-sided games in modern soccer ..., 43–65 annales kinesiologiae • 7 • 2016 • 1 the fc barcelona takes great credit for the overall implementation of ssg (also in terms of promotion) in the modern soccer. the incipients of ssg in spain (catalonia) are said to have been established already by laureano ruiz (balague, 2013), who, as the first person in charge of barcelona`s youth groups in the early 1970s, introduced the most elementary forms of “tora” (the version we know in slovenia as “pepček”) in the training process in spanish soccer; he argues that he has not yet known such exercises. barcelona's modern ssg undoubtedly present a step forward to an even greater “coming closer” of the ssg to the universal demands of the game. the so-called “positional playing” appeared in consolidating the legality of the game of this team, this time even at the level of the team tactics, which currently presents the highest level of complexity of the traditional ssg. multilateral purpose of ssg ssg are means of socialization of soccer in society that needs orderly and cultural soccer player`s personality; the socialization in the game is achieved indeed only through the most appropriate collective/team-effect, with discipline in the game, liability and psychological balance of the players (verdenik, 1983, 2003). ssg that have actually replaced the so-called “ancillary games” ensure “(...) the joy, relaxation, emotional experience; motivation is greater, individuality is sufficiently emphasized, the diversity of solving the game situations is abundant and the like” (elsner, 1997). it is also important to take into account the consequences of the potential dominance of that working method. elsner (1997) notes, for example, that there may be “(...) excessive individuality, automation of faulty execution of technical elements and indirectly an improper development of specific footbal/soccer motor elements, improper design of mutual communication and structural situations and the like.” because of clear freedom in the design (creating, structuring) that is allowed by ssg in the pursuit of the objectives, in the period from 1980 to 1990 in italy, the application of ssg prevailed more for the development of motor abilities than for the development of technical/tactical skills of the players. games on the theme, therefore became, in the modified form, the games “under pressure” (it. “giochi a pressione”). their main objective was to develop particular energy components (endurance and strength). the application of ssg in this direction marked a whole decade of italian soccer reality, while in principle, the situational method of work dominated as the basic method of work in the designing of the game (costantini, personal communication, 08 may 2015). the use of ssg with the purpose of development of motor skills was specially exposed by several researchers across europe and the world. they published the first prominent surveys (bangsbo, 1998), which substantiate the use of ssg for the development of motor abilities as functional abilities of soccer players. it should be mentioned that the authors agree that a properly adjusted ssg has a very large fitness potential (aguiar, botelho, lago, macas, & sampaio, 2012; athanasios & eleftherios, 2009; annales kinesiologiae • 7 • 2016 • 1 47 miloš tul, zdenko verdenik, matija maršič, matjaž mulej: the role of small-sided games in modern soccer ..., 43–65 bangsbo & lindquist, 1992; d'ottavio, colli, bosco, & tranquilli, 1997; rampinini et al., 2007). the aim of this paper is, inter alia, to explain the dilemma of the approach to ssg depending on a too narrow or as wide as possible (holistic?) definition, given the constant presence of dualism, which stems from practice: on the one hand, the prevailing reductionist theories and conservative and analytical approach to the training process and, consequently, also to the use of ssg, on the other hand, a more systemic approach (cano, 2012, 2015). at the same time, the purpose of contribution to the analysis of the conditions that are necessary for the adoption of any new potential novelties in the working practices of innovation, which include, in particular, the law of the requisite holism and innovativeness. method when examining the characteristics of ssg and their developmental path, the historical method and a case study was used. the findings of the qualitative approach to research have been complemented by views of two football experts with extensive experience in coaching from italy (m. seno and m. costantini) and renowned italian researcher in the field of conditioning (r. colli). when examining the conditions for the adoption of ssg as an innovation in football practice, the method of dialectical systems theory was used, which includes the law of requisite (i.e. appropriate) holism and the law of hierarchy of sequence and interdependence (mulej, 1979; mulej et al., 2013). in the treatment of the chosen theme, the law of entropy was incorporated (mulej, 1979; mulej et al., 2013). using usomid (methodology for creative collaboration of many for innovative work) as applied methods for innovation in the work, we have studied the possibilities of success, which depend on the guidelines for appropriate comprehensive definition of objectives and guidelines for appropriate overall achievement (mulej, 1979; mulej et al., 2013). discussion the coach`s experience and competence, the consideration of the local dynamics (including the social ones) and the general requirements permit the construction of more specific ssg, which are, according to the organization, selected topics and emphases specific to a given environment and (sport) context. the pronounced flexibility of ssg allows the manipulation of basic exercise parameters (number of players, size of the field, tasks in the game, the auxiliary players, etc.); therefore, it indirectly requires the coach's creativity, which can be indicated by the introduction of new, different organizational and substantive legalities, but also completely different ways of integration of these factors with the purpose of achieving the biggest effect possible. 48 miloš tul, zdenko verdenik, matija maršič, matjaž mulej: the role of small-sided games in modern soccer ..., 43–65 annales kinesiologiae • 7 • 2016 • 1 the first condition: the requisite holism of ssg the noted findings show that even in ssg one-sidedness is possible, but in reality − in order to utilize the most of their potential – the biggest possible holism is necessary. holism as a word is easy to use, but difficult to precisely define. different authors have different definitions (detailed in mulej et al., 2013), either explicitly or implicitly. literally speaking, it contains everything: all the components and all their relationships (links, relations) and caused synergistic properties that characterize this phenomenon. but: what is − all? experience has shown that people − due to natural causes − cannot and do not want to think and act with such a width to cover absolutely everything, as required by the concept and demanded by bertalanffy (1979), when he created his “general systems theory” “against over-specialization”, i.e. against the common and dangerous one-sidedness of specialists. it turns out that, in fact, everyone feels entitled to define what counts as a whole, according to their own criteria. this also happens in soccer practice. the mathematically generalized basis for the definition of a whole, with which the first authors of the systems theory have helped themselves (and achieved the overall impact), said that the whole (= a system, network) is everything that is composed of a set of components and a set of connections, relationships between them. in a strict soccer sense, this would mean that the whole covers all players with their abilities (also their opponents), the relationships between them (both in the defense and attack), results, strategy and chosen tactics, playing conditions, the spectators, coaches, other collaborators etc. it is generally a valid isomorphism (= similarity), which serves us well enough as long as the substantive aspect is less important than the mathematical basis for the description of the phenomenon on a general level. when we are interested in substantive aspect, we notice that the same reality, the same phenomenon can be described with many different systems, i.e. as a variety of wholes, because we look from various angles and, therefore, we observe and consider essential the different parts (!) of the actual characteristics of the phenomenon. according to the chosen problem (the importance and role of ssg in soccer training), we can easily figure out already from everyday practices that the direction of using ssg can be very different in the forefront. it can be the methodical aspect (learning/ teaching the soccer elements), economic aspects (certain game tasks performed by all the lower energy input, rationality), aspects of productivity (the actual usefulness of the selected ssg), organizational, aesthetic aspect, etc. last but not least, we must also put the question of the relationship and interaction between these aspects and their integration into emergent synergies, for example, in working or in a match as the new system. in soccer, this means to take into account the interactions e.g. of a selected organization of ssg to actually teach the game element, i.e. the actual usefulness of the selected ssg, and vice versa, for example, the impact of the learning/teaching process on the selection of the organization, etc. due to the interaction with the selected aspects, the game design appears quite specific (emergent synergies) and typicall for it at a given training process. annales kinesiologiae • 7 • 2016 • 1 49 miloš tul, zdenko verdenik, matija maršič, matjaž mulej: the role of small-sided games in modern soccer ..., 43–65 so, if the so-called wholes can be so numerous and so different in their actual contents, when is the dealing holistic, attaing wholeness, systemicity and when it is one-sided? and also: if bertalanffy`s idea has not taken root into the practice of modern humanity, which one has, while the specialization is necessary and dangerous at the same time? conferences about systems theory show that in fact no definition of holism was accepted as a completely general. specialization is too important and powerful, making the vast majority to not restrict the use of system concepts, holism etc. within their individual disciplines. they are not willing to give priority to holism; and push (their own!) specialization aside. however, the experience shows that specialization, even if necessary, is not enough, because it causes too many oversights until it poorly cooperates with others. therefore, the will and the ability to work interdisciplinarily are necessary and one must take this as a starting point: “whoever disagrees with me, is useful, because it helps me to strengthen the holism; we share our differences, by linking them we create synergies, therefore i listen, but think about it, not only obey nor reject in advance, in order to hear more of the meaningful ideas.” (see e.g. mulej et al., 2013). the consequence of the dilemma between specialization (focus on a selected aspect, e.g. ssg only for the development of special endurance) and holism (focus on several aspects at the same time and in sinergy, e.g. some technical/tactical elements of the game and special endurance) is therefore a dilemma, because of which we choose whether we will have a complex or a simple approach. a complex approach requires a lot of work to gain a fairly holistic insight and action. the approach is difficult, but the outcome are the results, that are probably holistic enough, so that at the end there will be no unpleasant surprise waiting for us as side-effects. in short: a complex and complicated work leads away from oversights and therefore to simple (more manageable) consequences. another option is to choose a simple approach that requires little work, but gives no real holistic insight and action. it is pleasant, causing less burden, but the results can easily happen to be not requisitely holistic: unpleasant surprises are 'secondary' effects. in short: over-simplified work leads to oversights and, therefore, to complicated consequences. but a complete (=total) holism is not feasible, and certainly not in the work and thinking of people as individuals without (interdisciplinary) cooperation; at the same time this causes an excessive burden. apparently, at the first this requires a decision of what level of holism is requisite, i.e. sufficient and necessary at the same time and, therefore, good enough or adequate ('just right') for the present case. therefore, it is about an intermediate path between the two extremes. with total (= full, comprising everything) holism we would try to cover absolutely everything with every aspect and connection between them, and to connect all into the total system, without any selection and elimination. the outcome would eliminate any focus on anything and would not allow any response to the question which insights and actions are essential, or resulting fictitious (= one-sided, limited to a specific selected aspect) holism; it would be too narrow, too 50 miloš tul, zdenko verdenik, matija maršič, matjaž mulej: the role of small-sided games in modern soccer ..., 43–65 annales kinesiologiae • 7 • 2016 • 1 selective, otherwise well focused, but giving a way for information and knowledge only about a fragement of reality. this is enough and important for the individual stages of work or individual specialists in an interdisciplinary group of participants, but not to manage the entire life reality! the intermediate path between the two extremes must be sufficiently close to reality, both in terms of the needs and of the options/possibilities. such a choice of holism was named requisite holism (mulej & kajzer, 1998). successful people live more in accordance with it the law of requisite holism, than the others do (of course, probably silently, unconsciously, naturally simply under the influence of specialization and life circumstances). the decision on the level of requisite holism is thus in hands of a human: what to consider and what to omit. therefore, it also requires human responsibility and complete clarity of definition, which system (network, not a mental picture) of aspects/ viewpoints one chooses in a given case. it is a dilemma, whether we choose a complex treatment and achieve simple consequences, because nothing substantial is omitted, or select a simple treatment and achieve complex consequences, because something essential is omitted and therefore we experience some possible side-effects in addition to anticipated ones, too. holism includes reflection, decision or action that at the same time includes four concepts that are exposed below (figure 1) and the phenomenon is considered as a system, i.e. a network, covering all at the same time and intertwined, interdependent and with interactions. therefore, we do consider, that the specialization is inevitable, and holism too. indeed, to specialists (e.g. the coach, fitness coach, physiotherapist, etc.) systematicity (2 in figure 1) is closer than sistemicity (1 in figure 1). cooperation between mutually different specialists who deal with the same subject from different perspectives and are therefore interdependent, (3 in figure 1) provides, that on the basis of relations interactions result that allow sistemicity (1 in figure 1). if in this case they succeed to propperly take into consideration the law of requisite holism to get to know the essence, not to get lost in irrelevant details and do not even reduce the whole to over-simplified image, they also reach the realism (4 in figure 1). therefore, it is about the question, how capable are the members of the expert team to be holistic in their thinking, decision-making and functioning, especially in the design stage of the training process, but also in its practical implementation, so that the plan would not remain a dead letter. therefore, the term “neighboring knowledge” is getting more important than “space”, where the communication between the members of the expert team is implemented. here the opinion of the renowned italian training researcher is signifficant (colli, personal communication, 20 may 2015), who believes that e.g. the fitness coach is needed, but even more necessary is that the head coach is able to grasp the meaning and purpose of the exercise, suggested by the fitness coach, and transfer it into more “soccer-type frames” or vice versa. annales kinesiologiae • 7 • 2016 • 1 51 miloš tul, zdenko verdenik, matija maršič, matjaž mulej: the role of small-sided games in modern soccer ..., 43–65 figure 1: definition of holism in the dialectical systems theory.the cases from fotball/ soccer practice are selected purely indicatively. ssg=small sided games. (1) the whole (sistemicity) in thinking at the same time we capture the synergy of all the elements that make up the game (match) in its widest sense: e.g. the number of players, the game tasks, individual, group and team tactics, the result, conditions etc. legality of the game is reflected correctly in the time, spacel and energy. the individual elements are not the central theme. ssg involve simultaneously e.g. developing all possible essential technical/tactical elements at the level of team tactics in the phase of attack and defense, and fulfill the respective energy requirements. (2) parts (systematicity) each part of the game is treated separately (match, the training process ...): e.g. defensive line, midfield, attack , individual tecnical/tactical behavior of the player, physical fitness, individual tactical choices, etc. as separate topics. ssg cover, for example, essential tecnical/tactical elements of group tactics in both phases of the game (e.g. defensive line with or without ball possession). (3) relationships (correlation, dialecticness, interdependence) we are dealing with connections that are formed between the individual parts of the whole; e.g. relations between the goalkeeper and the defensive line, the relationship between the defense and the midfield, relationships that are developed according to the opponent, in both phases of the game in the interaction between them. ssg has at the forefront for example the aspect of cooperation between players (individual, group and team tactics). (4) realism (reality proximity, materialism) we consider how the selected content is actually realized in practice and whether the ssg in its appearent shape is sufficiently similar to reality from the technical/tactical and energetical point of view. ssg consistently illustrate the legality of the game in the temporalspatial and energetical sense. it is therefore essential to move from a one-profession (e.g. only the aspect of the coach is dominating) to inter-professional creative cooperation (e.g. the coach and fitness coach), whenever it appears that the individual profession probably does not provide the requisite holism and the wider definition of holism is needed; therefore, a trans-disciplinary approach becomes one of the values, because it is preparing them for the starting point: “my specialization does matter, but not as the only one. it makes me needed by the others, and i need them. we are therefore interdependent, not independent, nor unidirectionally /one-way dependent.” (mulej & kajzer, 1998). 52 miloš tul, zdenko verdenik, matija maršič, matjaž mulej: the role of small-sided games in modern soccer ..., 43–65 annales kinesiologiae • 7 • 2016 • 1 figure 2: a summary of the basic characteristics of systemic thinking. cases are selected purely indicatively. systemic / holistic way of thinking non-systemic / unilateral thinking interdependence/s, the relationship/s, opennes, dialectical system of aspects independence, dependence , closed-in behavior, individual aspect. the thinking covers all the essential aspects of the soccer game at the same time (e.g . technical/tactical aspect, aspect of physical preparation, importance of the result, economics, aesthetics, etc .). analysis of the performance of a player is limited e.g. only to the aspect of his physical fitness. the complexity (and also complication) simplicity, the complication, the parts alone the game includes many technical/tactical elements that form a meaningful and coherent complex of technical/tactical knowledge from the complex of technical/tactical knowledge we expose only some specific knowledge (e.g. individual can properly recieve the ball) attractors , influential forces (à relations) isolation, no influential forces (à no relations) between the different parts of the team (e.g. defence and midfield) there are relationships that contribute to the teams' functioning like coherency, coordination and maintaining the balance of the game. the relationship between e.g. defence and midfield are not considered, we do not perceive them; parts of the team are considered separately; e.g. goalie coach is the only one for them. emergence , emerging (à synergy) no processes that create new properties mentioned relationships between the parts of the team create new features of the game. new opportunities are offered for their development in a more efficient and creative game. many coaches observe some “solutions” of the players and trying to fit them into the concept of the game. because they do not perceive or do not take into account the relationships, there are no ways to new features, e.g. team did not kick in. synergy, system, a hierarchy of systems no new features based on relationships team is well-coordinated, functioning as a whole, without misunderstandings. no cooperation of players in the game instead of individualism. whole and holism, the interdisciplinary approach only parts and characteristics of components, single-professionalism team is well-coordinated, functions as a whole without misunderstandings, the players are in fitness, technical and tactical training , which also takes health into account, etc., the specificities of the opponent and conditions in the next match, etc. in consideration we cover only one aspect that is prevailing (e.g. aspect of physical fitness) and on the match we look only from this perspective. we interpret problems exclusively from this aspect. annales kinesiologiae • 7 • 2016 • 1 53 miloš tul, zdenko verdenik, matija maršič, matjaž mulej: the role of small-sided games in modern soccer ..., 43–65 network, interactions (of professions , ..) no interactions (of professions , ..) team is well-coordinated, it functions as a whole, without misunderstandings, because the coaches/trainers interact with each other and with doctors and others; they also listen to the players, not only themselves, etc. trainer's analysis of the game does not take into account (or does not detect) other aspects (e.g. the aspect of physical fitness, psychological aspect, ambitions, etc. are excluded from the analysis). the final thought on the question of which approach to the search for holism is correct, is: this is crucially dependent from the subjective positions/starting points, that means, from the human personality – values, emotions, talents, knowledge and skills, from the bases of thinking, decision-making, functioning and behavior. on the way from the coach of individual shot to strategy coach of the team, the individual must therefore increasingly phase out the focus on (only) many details. it must be the characteristic of a narrowly specialized trainer/coach who is interested only in individual segment of the topic. threfore, high on the scale of complexity, the coaches' look at the work must be wider, work less detailed and more cohesive, width of the requisite holism larger and less deepened in details and currently important features, more into the long-term essence. input and output information are less detailed, more global, less tactical and operational, more strategic, political, visionary. selection of dialectical system of aspects (dsa) has to be adapted to reality and tasks. it depends on dsa which style of thinking is used by who. consideration of the reality, not only of ideas and dreams (what often occurs in novice trainers/coaches), is an essential base of the coach`s work. therefore, the formal education process of trainers/ coaches has an important role to draw attention to these facts. separate treatment of the segments of trainer's expertise (competence areas) namely exists due to requests for simplification and in a single phase of qualification. 54 miloš tul, zdenko verdenik, matija maršič, matjaž mulej: the role of small-sided games in modern soccer ..., 43–65 annales kinesiologiae • 7 • 2016 • 1 figure 3: the difference between (1) apparent, (2) requisite and (3) total holism. ------------------------------------------------------------------------------------ one-sidedness with limitation to a single chosen aspect the mental image dialectical system (= network), which combines all of essential and only essential aspects in a mental and/or emotional picture of this phenomenon, which corresponds to the law of requisite holism and therefore sufficiently reduces reductionism, so that it allows enough realistic hearing. total holism with the network of completely all aspects mental images ssg with a focus on a single aspect chosen. example: ssg focusing exclusively on the development of special endurance ssg, which include neither one individual selected aspect, except for the individual exercise phase, nor all of them at the same time, but on the basis of requisitely holistic analysis; it covers what we consider the most essential aspects and their interactions; it could also differ for every exercising individual separetly according to his/ her advantages and weaknesses as an individual and as a team member. ssg which simultaneously cover technical/tactical aspects of the game (at the level of the individual, group and team) and enable concurrent development (maintenance) of all aspects of the game in synergy. the second condition: innovativeness, not only routine, nor only creativity. previously it has been shown that some specially organized forms of ssg in some cases and at any given moment have become innovations (e.g. “positional games” of barcelona), but not in others, because there they did not give new benefits to users. “the position game” therefore presents an upgrade of traditional ssg since in a more complex form of playing the team aspect of the tactic, which presents a special, in practice useful (!) feature. in general, we can say that especially at the lower levels of competition, in principle the old established routine is prevailing, although it is of course necessary to consider the legality of the planning of exercise process, the general requirements of the period of training, etc. certain ssg are therefore deliberately “impoverished” in order to pursue a single, priority, specific goal (e.g. ssg with an emphasis on aerobic endurance components are often the content in the preparatory period) in a given stage. it raises the question about trainer's creativity, which shows the will and the ability to create something new; by definition it is different from innovation, which also contains the will and ability to change a created novelty in the new benefit, achieved in practice of the users of novelties. what is shown in figures 4 and 5, has prevailed considerably more in the innovative environment, than in environments, over-addicted to routines. annales kinesiologiae • 7 • 2016 • 1 55 miloš tul, zdenko verdenik, matija maršič, matjaž mulej: the role of small-sided games in modern soccer ..., 43–65 the new idea, which was for example the idea of ssg succeeded, where the conditions for the formation of innovation from the ‘figure 4’ were fulfilled. in soccer clubs mentioned in the introductory part, the ability and willingness to innovate is likely significantly higher than in others; probably the similar assessment applies to their social environment (the netherlands is better known for their support of innovation than serbia, e.g.). but, this capacity is the biggest in clubs, able to give additional content to ssg (e.g. some time ago “the pace games” in germany, ssg at the level of team tactics in barcelona etc.); thus, they carried out most consistently the invention-innovation-diffusion process, summarized in the figure 5. at the same time, more than others, they fulfilled the conditions for innovative business.1 1 general characterization of the features of innovative business covers several aspects and assumptions, and no longer refers only to the manufacturing part of the organization, but to all activities and all parts of life in all organizations, including the football clubs. the definition includes the knowledge about the costs, mistakes and failures (in principle are unnecessary), and that any product, process or organization sooner or later becomes obsolete. survival, and therefore good (or bad) business concerns everyone, and so we should purposely search for possible innovations everywhere (within ourselves and elsewhere) and continuously. the definition also covers the attitude about work (let us work as smart, not like crazy) and the attainment of requisite holism with the practice and ethics of interdependence (e.g. by use of iso 26000, the international counselling standard on social responsibility). because of the constant pressure from competitors, the innovationing must cover everything and constantly, and the quality of competitive ability must be systemic, which includes proper price for customers, quality, flexibility, uniqueness, care for the natural environment and social responsibility, all interrelated. this is a condition for (business) excellence. therefore, from the assesment that the present product/process/service is perfect, the order necessarily follows: “let's innovate it immediately, because it is perfect under the existing criteria, which may be changed at any moment by the customers and competitors and, therefore, they may withdraw their money away from us.” (cf.: mulej et al., 2013). 56 miloš tul, zdenko verdenik, matija maršič, matjaž mulej: the role of small-sided games in modern soccer ..., 43–65 annales kinesiologiae • 7 • 2016 • 1 figure 4: the equation of the conditions for the emergence of innovation = in practice of the users of beneficial novelties. legend: x = factor relationship; all the conditions are necessary for success. invention suggestion a new idea on ssg, new organization, a new process of learning or designing the game, new methods in the development of motor skills, etc. x enterprise and entrepreneurship how present is the entreprise/entrepreneurial approach in the way of thinking and functioning in the club management? how much risks are the coaches and players willing to take? how do they overcome their fear and exaggerated respect for the opponent? how do they overcome their conceit, which is stifling their imagination? how bravely and wisely at the same time the trainers compose and enforce their long-term views on the development of the team and the effort for its achievement? x management how do coaches compose short-term programs and enforce them into learning-training process (trainings, matches)? x holism how and how much do coaches attain sufficient holismfor the players to come to practice with pleasure and work extremely hard and ambitiously, because there is no boredom, workload and demands are placed slightly above capacity, which consequently rise? x coleagues how much is the experts team receptive to learning, the development and introduction of novelties into practice? how much are they willing and able to take into account each other due to mutual differences, making them complementarity? x culture sports culture is associated with the characteristics of the society. question: would a soccer environment where the skipping of midfield with long passing “traditionaly” dominates, allow the development of ssg that are based on ball posession (e.g. position games) and on a continuous form of attack at all? x suppliers are the members of the professional staff (sports leader, the leader of the youth groups, coaches, fitness trainers, physiotherapists, ..., caretakers of the soccer field and equipment) receptive to implementation of innovations in the working practice? from whom do they learn? x annales kinesiologiae • 7 • 2016 • 1 57 miloš tul, zdenko verdenik, matija maršič, matjaž mulej: the role of small-sided games in modern soccer ..., 43–65 customers spectators, sponsors, donors, parents of young players, their schools, clubs in higher leagues, to which the players of adequate quality could be sold to help maintaining the favorable conditions for the growth of new ones. and the like. x competitors more successful clubs are generally more receptive to innovations that bring benefits at all levels of functioning (vision, organizational level, content selection, procedures of trainers selection) ... competitors are also all the other contents of leisure time and all other ambitions and habits of the players and professional staff outside their own competition process. x natural environment how healthy is the playing surface maintained (environment, changing rooms, immediate surroundings) so that the participants do not inhale anything dangerous for health, in terms of the location of the playing field, on traffic and climate, seasons, etc. x broader social conditions the city conditions, opportunities to get support from citizens, schools, other organizations and the local management to the team/club, 'viole' and similar fan clubs and their harmful behavior (večer, 19 dec. 2015, reported that the penalty that was prescribed by the nzs in 2015, due to the behavior of only “viole” amounts over 33,000 euros.) x random influences happiness effect of referee`s mistakes, poor game conditions, injuries, shots in the post, etc. 58 miloš tul, zdenko verdenik, matija maršič, matjaž mulej: the role of small-sided games in modern soccer ..., 43–65 annales kinesiologiae • 7 • 2016 • 1 f ig ur e 5: l ik el y pr ov id er s (e .g . t he f ac ul ty a nd in st itu te o f s po rt ) a nd c us to m er s (e .g . s oc ce r cl ub s) b y th e fo ot st ep s of p er fe ct io n of in no va tio ns , s im ul ta ne ou sl y pr ob ab le u se rs . t he d eg re e of pe rf ec tio n of (p os si bl e) n ov el ty l ik el y of fe re rs (i n ge ne ra l) l ik el y of fe re rs (i n so cc er ) l ik el y cu st om er s (i n ge ne ra l) l ik el y cu st om er s (i n so cc er ) t he n ew id ea (a ny ) an yo ne e. g. th e au th or s of th e id ea o f s sg w ho s en se s pr om is in g id ea s e. g. w ho a pp re ci at es th e id ea o f a n ew s sg t he in ve nt io n (= a pr om is in g ne w id ea ) an yo ne w ho s us pe ct s th at th e ne w id ea is p ro m is in g e. g. a ut ho rs w ho s us pe ct th at th e id ea o f a n ew ss g is p ro m is in g no o ne u nl es s it be co m es a su gg es tio n, b ec au se it di sa pp ea rs in to o bl iv io n an d it is n ot in th e of fe r e. g. c lu b th at is w ill in g to su pp or t t he id ea o f a n ew ss g b ec au se it is c on si der in g it pr om is si ng su gg es tio n (= re co rd ed p ro m is in g ne w id ea ) in ve nt or s an d (r es ea rc h) or ga ni za tio ns w ith ou t a lo t o f w ill a nd k no w le dg e fo r t he te ch ni ca l d ev el op m en t, pr od uc tio n, m ar ke tin g an d tr ad in g of th e in ve nt io n e. g. a ut ho rs w ho k no w ju st h ow to re co rd a nd sh ow th e id ea o f a n ew ss g to th e ot he rs en tr ep re ne ur s, p re pa re d to ta ke h ig h ri sk a nd lo w c om pe ns at io n to th e ow ne r – in ve nt or o r t he or ga ni za tio n of th e in ve ntio n e. g. c lu b th at g et s en ou gh co nv in ce d by th e re co rd of th e id ea o n a ne w s sg , so it b eg in s to e xp lo re an d de ve lo p th e po te nt ia l in no va tio n po te nt ia l i nn ov at io n (= u sa bl e bu t n ot ye t b en efi ci al ly u se d no ve lty ) in ve nt or s an d re se ar ch an d de ve lo pm en ta l o rg ani za tio ns w ith th e kn ow led ge a nd w ill fo r t ec hn ica l d ev el op m en t, le ss s o fo r p ro du ct io n, m ar ke tin g an d tr ad in g of th e in ve ntio n, re se ar ch ed ti ll th e po te nt ia l i nn ov at io n e. g. a ut ho rs w ho a re a bl e an d w an t t o de ve lo p th e id ea o f a n ew s sg ti ll th e pr ac tic al u se fu ln es s, b ut no t t o tr ad e it or p ra ct ica ly u se it o th er w is e en tr ep re ne ur s re ad y fo r pr od uc tio n an d m ar ke tin g, b ut le ss s o fo r t ec hn ica l te ch no lo gi ca l a nd ot he r e xp lo ra to ry a nd de ve lo pm en ta l r is ks e. g. c lu b w hi ch s up po rt s th e de ve lo pm en t o f t he id ea o f a n ew s sg ti ll pr ac tic al u se , b ut is n ot us in g it ye t i n pr ac tic e or m ar ke tin g annales kinesiologiae • 7 • 2016 • 1 59 miloš tul, zdenko verdenik, matija maršič, matjaž mulej: the role of small-sided games in modern soccer ..., 43–65 in no va tio n (= p ro ve n us ef ul n ov el ty ; t hi s is de ci de d by c us to m er s, no t t he o w ne rs ) de ve lo pm en t a nd m an ufa ct ur in g or ga ni za tio ns w ith a d es ir e of re nt al be ne fit s an d in di re ct sp re ad o f i ts m ar ke t ( ra re ly in di vi du al in ve nt or s) e. g. re se ar ch o rg an iz at io n or c lu b th at d ev el op ed th e id ea o f a n ew s sg , i t i s us in g it w ith n ew b en efi t an d/ or tr ad es it en tr ep re ne ur s an d m an ag er s le ss w ill in g to ta ke pr od uc tio n an d m ar ke t ri sk th an to ta ke th e ri sk of o bs ol es ce nc e an d de pe nd en ce e. g. c lu b w hi ch h as u se d th e id ea o f a n ew s sg fo r its el f w ith b en efi t fo rm er in no va tio n no w b en efi ci al ro ut in e pr ac tit io ne rs w ho u se th e es ta bl is he d no ve lty in ev er yd ay p ra ct ic e an d ar e th e ro le m od el s e. g. c lu b w hi ch u se s th e es ta bl is he d id ea o f a n ew ss g a nd is a ro le m od el pr ac tit io ne rs w ho im ita te th e es ta bl is he d no ve lty e. g. c lu b w hi ch im ita te s th e es ta bl is he d id ea o f a ne w s sg fo rm er in no va tio n no w a ba nd on ed au th or s of s ub st itu tio na l ne w id ea s e. g. a ut ho rs o f a n ew ss g th at p ro m is es m or e th an th e ex is tin g on e su pp or te rs o f a lte rn at iv e ne w id ea s e. g. c lu bs w ho s up po rt th e id ea s of a n ew s sg , th at p ro m is es m or e th an th e ex is tin g on e 60 miloš tul, zdenko verdenik, matija maršič, matjaž mulej: the role of small-sided games in modern soccer ..., 43–65 annales kinesiologiae • 7 • 2016 • 1 f ig ur e 6: in ve nt io nin no va tio ndi ffu si on p ro ce ss (i id p ). st ag e of i id p t he m ai n in pu ts t he u su al o ut co m es t he u su al c re at or s of th e ou tc om es t he u su al e co no m ic st at us g en er at in g id ea s, e sp ec ia lly in ve nt io ns c re at iv e th ou gh t, tim e an d re so ur ce s fo r r ese ar ch pr om is in g br ai nc hi ld fr om a p ie ce o f r ese ar ch , h id de n in fo rm atio n/ kn ow le dg e im ag in at iv e, p ro fe ss io nal p eo pl e an d gr ou ps r es ea rc he rs , p ro fe ssi on al a nd /o r a m at eu rs l ab or c os ts a nd re se ar ch fu nd s, n o re ven ue /p ro fit fr om th e m ar ke t c re at in g su gg es tio ns fr om in ve nt io ns w ri tte n et c. e xp re ss io n of in ve nt io n r ec or de d pr om is in g br ai nc hi ld /id ea t he a ut ho rs o f t he in ve nt io ns a nd c on su lta nt s fo r t he re co rd in g pr oc es s t he c os ts o f p re pa ri ng th e re co rd , n o re ve nu e/ pr ofi t a po te nt ia l d iff us io n of su gg es tio ns o ff er o n th e m ar ke t o f in ve nt io ns / s ug ge st io ns w ith in a nd /o r o ut si de or ga ni za tio ns pa rt ia l s al e, p ar tia l om m is io n, p ar tia l tr an si tio n to o ne 's ow n de ve lo pm en t o f t he s ug ge st io n o w ne rs o f t he s ug ge stio ns (a ut ho rs a nd /o r ot he r) w ith c ow or ke rs o ff er c os ts , r ev en ue / pr ofi t f ro m s ol d su gg es tio ns c re at in g po te nt ia l in no va tio ns fr om su gg es tio ns c re at iv e th ou gh t, tim e an d re so ur ce s fo r d eve lo pm en t o f t he s ug ge st io n in to a p ot en tia l in no va tio n u til iz in g ne w p ro du ct / m et ho d/ p ro ce du re / m an ag em en t s ty le / po te nt ia l m ar ke t/ or ga ni za tio n/ bu si ne ss o bj ec t im ag in at iv e, p ro fe ss io nal p eo pl e an d gr ou ps de ve lo pe rs , p ro fe ss io na l an d/ or a m at eu r t he c os t o f l ab or a nd re so ur ce s fo r d ev el op in g, n o re ve nu e/ pr ofi t a po te nt ia l d iff us io n of po te nt ia l i nn ov at io n o ff er o n th e m ar ke t o f po te nt ia l i nn ov at io ns w ith in a nd /o r o ut si de th e or ga ni za tio n pa rt ia l s al e, p ar tia l o m m is io n, p ar tia l t ra ns itio n to o ne 's ow n us e of th e po te nt ia l i nn ov at io n o w ne rs o f t he p ot en tia l in no va tio ns (a ut ho rs an d/ or o th er s) a nd th ei r (m ar ke tin g) c ow or ke rs o ff er c os ts , r ev en ue / pr ofi t f ro m s ol d po te ntia l i nn ov at io ns annales kinesiologiae • 7 • 2016 • 1 61 miloš tul, zdenko verdenik, matija maršič, matjaž mulej: the role of small-sided games in modern soccer ..., 43–65 c re at in g in no va tio ns fr om po te nt ia l i nn ov at io ns c re at iv e th ou gh ts , t im e an d re so ur ce s fo r t he de ve lo pm en t o f p ot en tia l i nn ov at io n in to th e in no va tio n, in cl ud in g al l o pe ra tio ns b en efi ca lly a pp lie d ne w m ar ke t/p ro du ct / m et hod /p ro ce du re / m an ag em en t s ty le / p ot en tia l m ar ke t/ or ga ni za tio n in u se rs ' o rg an iz at io ns im ag in at iv e, p ro fe ssi on al p eo pl e an d gr ou ps de ve lo pe rs o f no ve lti es a nd m ar ke t f or th em , p ro fe ss io na ls a nd / or a m at eu rs , i nc lu di ng al l o pe ra tio ns o ff er c os ts , r ev en ue / pr ofi t f ro m s ol d in no va tio n (i ns id e an d/ or o ut si de th e or ga ni za tio n) a ny p ot en tia l d iff us io n of in no va tio ns o ff er o n th e m ar ke t o f in no va tio ns w ith in a nd / or o ut si de th e or ga ni za tio n, in p ar tic ul ar to th e ex tr a cu st om er s/ cl ie nt s (a ft er th e fir st o ne s) in w id er c ir cl es u se fu lly ap pl ie d ne w m ar ke t/ pr od uc t/m et ho d/ p ro ce du re / m an ag em en t st yl e/ p ot en tia l m ar ke t/ or ga ni za tio n o w ne rs o f t he in no va tio n (a ut ho rs a nd /o r o th er s) a nd th ei r m ar ke tin g co -w or ke rs o ff er c os ts , r ev en ue / pr ofi t f ro m a dd iti on al y so ld in no va tio ns (i ns id e an d/ or o ut si de th e or ga ni za tio n) 62 miloš tul, zdenko verdenik, matija maršič, matjaž mulej: the role of small-sided games in modern soccer ..., 43–65 annales kinesiologiae • 7 • 2016 • 1 where the innovative business is practiced – also in the soccer clubs, because the top-quality soccer is a big, expensive and profitable business process, not just a sport − usually a process summarized in figure 6 takes place. under their influence, the novelties also spread to other clubs. thus, the entire sports discipline is progressing in which such a process is happening. of course, this does not take place automatically, because the human brain is designed for routine and people are − completely naturally − resisting to innovations, particularly the intrusive ones. in order to accept the novelties, they have to be either coauthors of the innovation or have great trust in their authors. but both should be capable of requisite holism of their conduct, not only of thinking, but of the entire practice. limitations and suggestions the analysis included only the football realities of the countries in which the authors of the article have multiannual work experience. reliably, with the analysis of other football realities (e.g. northern european, south american, north american, central asian, etc.) we would get a more detailed description of the developmental path of ssg and their versatile use, but that was not the core purpose of the article, while considering ssg only in terms of the learning potential and usefulness offered by this practical work methods in terms of holism. an important factor is also the contribution of foreign coaches, who, by entering the various elements and sporting habits and vision, contributed to the development of the profession in each country. this aspect is very difficult to assess at the systemic level, despite the known examples of historically successful connections like e.g. between the dutch and spanish/catalan football and the like. in terms of increasing the learning potential of ssg, we find, that each federation should already on the systemic level take care of a greater emphasis on pedagogical and particularly on narrower didactical competences of football coaches, and particularly on the harmonization of standards of knowledge (uefa 2015), especially for coaches on youth level and of encouraging a more creative approach. despite the efforts at the institutional level (uefa 2015), the quality of education in the individual members of uefa remains very different (sedej, 2016). a particularly important factor is also the way of transmission of knowledge in courses for licensing. higher quality methods of transmission of knowledge are going more towards practical knowledge, project and problem learning and the need to create relevant learning situations during education and the concomitant need for contextualization of the acquired knowledge (pavlin, 2012; vannini & mantovani, 2007; zecca, 2014). in general, one should avoid increasing the accumulation of isolated information and promote a holistic, systemic approach, sample thinking, with greater emphasis on the processes and connections and less on data and state (marentič požarnik, 1995). precisely this aspect is, at the licensing procedures, very different from federation to federation (sedej, 2016). also, the above-mentioned creation of relevant learning situannales kinesiologiae • 7 • 2016 • 1 63 miloš tul, zdenko verdenik, matija maršič, matjaž mulej: the role of small-sided games in modern soccer ..., 43–65 ations (hosting traineeship, internships, etc.), as a necessary precondition for the quality of qualification of coaches (uefa 2015), presents a significant problem for individual coaches, since the visit of elite sports centers and the exchange of detailed information on the characteristics of the training process in fact, is difficult to achieve. conclusion ssg are very common methods in the process of soccer training and are used for very different purposes. despite the irrefutable prevalence and effectiveness of this approach, there are still very large reserves for their upgrade in the direction to even greater holism. in this sense, the coach`s methodical/didactical ability is shown as a very important competence, which should be further developed within the process of education of coaches, which is unfortunately not unified in european area. greater emphasis should therefore take place not only on creativity but also on the actual will to innovate the existing football practices. in this paper, we have tried to present the possible developmental guidelines, in particular, for overcoming of the typical dualism that prevails in the modern soccer world, i.e. fight between highly specialized/analytical and the routine-addicted approach and those broader, more holistic approaches. this aspect is also directly connected with the (sports) cultural stereotypes, which are typical for every football reality and are its most important component at the same time. in the foreground there is e the question of the approach to ssg, which would avoid one-sidedness and routine in favor of increasingly interdisciplinary and holistic approach. one should encourage the introduction of the new ideas (innovations) beside the need for increasingly innovative operations of the soccer clubs. with the use of usomid method, the conditions for the admission of ssg were analysed in football practice as a real innovation at work. references athanasios, k., & eleftherios, k. 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(2007). i giovani insegnanti laureati in scienze della formazione primaria. un’indagine empirica tra gli abilitati del corso di laurea di bologna [young teachers graduating from the education department of bologna university. an empirical study of graduates]. ricerche di pedagogia e didattica, 2, 1-55. view item verdenik, z. (1983). igralne oblike kot sredstvo socializacije igre [small sided games as means of the play socialization]. teze za predavanje visokošolskim učiteljem (osebno gradivo). ljubljana: visoka šola za telesno kulturo. verdenik, z. (2003). z jefom navzgor skupaj do zmage (“win by all”): značilnosti procesa treniranja in tekmovanja nogometnega moštva jef united ičihara v j-ligi 2001 [climbing with jeftogether towards success (win by all): training and competition process caracteristics of the jef united ichihara football team in j-league, year 2001]. ljubljana: fakulteta za šport, inštitut za šport. ydsa, (2016). history of small sided games. retrieved from: http://www.ydsocceracademy.com/index.php/articles/35-history-of-small-sided-games. zecca, l. (2014). tra “teorie” e “pratiche”: studio di caso sui laboratori di scienza della formazione primaria all'università di milano bicocca [between theories and practices: study case about on-campus laboratories (lpd pedagogical-didactical laboratories) in primary teacher education program at milano – bicocca university]. giornale italiano di ricerca educativa, 7(13), 215-229. view item colli roberto, personal communication, may 20th 2015 costantini maurizio, personal communication, may 8th 2015 seno maurizio, personal communication, may 5th 2015 https://rpd.unibo.it/article/view/1493/869 http://www.ydsocceracademy.com/index.php/articles/35-history-of-small-sided-games http://www.ydsocceracademy.com/index.php/articles/35-history-of-small-sided-games http://ojs.pensamultimedia.it/index.php/sird/article/view/1104/1070 annales kinesiologiae • 12 • 2021 • 2 141 reports and reviews/poročila in ocene, 137–144 workshop report: physical activity-related injuries prevention in adolescents. what do we know? piran, slovenia, october 6, 2021 the institute for kinesiology research at zrs koper participates in the international project prevention of physical activity injuries in adolescents (paripre), led by the university of prešov, slovakia. a total of eight partners, of which on the slovenian side the slovenian sports union and the national institute of public health are also collaborators, are investigating risk factors and prevention programs to reduce injuries in 12-to-18-year-olds. at the workshop we presented scientific background on the importance of preventive measures for different stakeholders. altogether 79 participants from seven countries joined the workshop. the program started with opening remarks from prof. dr. rado pišot and prof. dr. boštjan šimunič from science and research centre koper, organizers of the workshop. this was followed by remarks from vesna marinko (ministry of health rs) who underlined the importance of the topic of physical activity-related injuries prevention in adolescence. then a project presentation was given by peter bakalár from the university of prešov (slovakia). 142 reports and reviews/poročila in ocene, 137–144 annales kinesiologiae • 12 • 2021 • 2 regular physical activity and sport is one of the most recognized determinants of health protection, particularly for the prevention of major chronic non-communicable diseases. in adolescents, physical activity and sport contribute to healthy musculoskeletal, cardiovascular, respiratory, immune, and metabolic development and help maintain physical fitness and healthy body mass. it is also associated with several psychological and social benefits. appropriate physical and sporting activity have no harmful effects, but there is an increased risk of injury during exercise, especially in high-intensity sports, but also in low-intensity physical activity if we are poorly prepared for it. therefore, the prevention of physical activity and sportrelated injuries and the identification of risk factors must be an integral part of the promotion of physical activity and sport. an increased risk of injury is also posed by the physical inactivity that is now prevalent in the modern sedentary lifestyle, which has been exacerbated during this covid-19 era. this talk was followed with the presentation of sport injuries epidemiology by prof. dr. jari parkkari from ukk institute (finland). no less than 47% of children are injured at least once in a year, with 50% of injuries occurring in sports clubs, 30% in recreational activities and 20% at school. boys are more prone to injury than girls. sports club membership is an underlying risk factor for hospitalization of children after injury, which must be considered as a logical cause-effect relationship. if we disregard the current situation with covid-19 (where we can see a sharp decrease in participation in sports clubs), we have observed an increase in the number of people involved in sports clubs (in finland from 46% in 2010 to 62% in 2016 and in slovenia even 82% in 2019). on the other hand, the physical inactivity of children and young people (at school, at home, during leisure time) is also increasing at an extreme rate, which also affects the increase in the number of injuries during physical and sporting activity and represents a major public health problem. afterwards, dr. mari leppänen from ukk institute (finland) presented sport injury prevention strategies and measures and a draft of recommendations for the prevention of physical activity-related injuries in adolescents. the latter were discussed among various stakeholders and their comments were considered and incorporated in the final version of the recommendations that was prepared following the workshop. the recommendations were later published in a scientific journal, sent to stakeholders and are available at the webpage: https://www.paripre.eu/wp-content/uploads/2022/02/2021_ paripre_recommendations.pdf. boštjan šimunič https://www.paripre.eu/wp-content/uploads/2022/02/2021_paripre_recommendations.pdf https://www.paripre.eu/wp-content/uploads/2022/02/2021_paripre_recommendations.pdf annales kinesiologiae • 12 • 2021 • 2 143 reports and reviews/poročila in ocene, 137–144 poročilo delavnice: physical activity-related injuries prevention in adolescents. what do we know? piran, slovenija, 6. oktober 2021 inštitut za kineziološke raziskave zrs koper sodeluje v mednarodnem projektu physical activity-related injury prevention in adolescents (paripre), ki ga vodi univerza v prešovu, slovaška. osem partnerjev, od katerih na slovenski strani sodelujeta še športna unija slovenije in nacionalni inštitut za javno zdravje, proučuje dejavnike tveganja in preventivne programe zmanjševanja poškodb pri mladostnikih, starih od 12 do 18 let. na delavnici smo predstavili znanstvena izhodišča preventivnih ukrepov za različne deležnike preventive športnih poškodb. delavnice se je udeležilo 79 udeležencev iz sedmih držav. po uvodnih nagovorih prof. dr. rada pišota in prof. dr. boštjana šimuniča iz znanstveno-raziskovalnega središča koper je pomembnost teme poudarila vesna marinko z ministrstva za zdravje. sledila je predstavitev projekta s strani vodje izr. prof. dr. petra bakalárja iz univerze v prešovu (slovaška). redna gibalna/športna aktivnost je med najbolj prepoznanimi dejavniki varovanja zdravja, predvsem za preprečevanje vodilnih kroničnih nenalezljivih bolezni. v mladosti gibalna/športna aktivnost prispeva k zdravemu razvoju skeletno-mišičnega, srčno-žilnega, dihalnega, imunskega in presnovnega sistema, pomaga vzdrževati telesno pripravljenost in primerno tele144 reports and reviews/poročila in ocene, 137–144 annales kinesiologiae • 12 • 2021 • 2 sno maso. povezana je tudi s številnimi psihološkimi in socialnimi koristmi. ustrezna gibalna/športna aktivnost nima škodljivih učinkov, pri ukvarjanju z njo pa se pojavi povečano tveganje za poškodbe, predvsem med visoko intenzivnimi športi in tudi med nižje intenzivnimi gibalnimi aktivnostmi, če smo slabo pripravljeni nanje. zato morata biti preprečevanje poškodb pri gibanju in športu in prepoznavanje dejavnikov tveganja sestavna dela spodbujanja gibalne/športne aktivnosti. povečano tveganje za poškodbe pomeni tudi gibalna neaktivnost, ki je značilna za današnji prevladujoči sedentarni življenjski slog, ki se v času covida-19 še krepi. aktualne podatke o športnih poškodbah pri mladih je predstavil prof. dr. jari parkkari z inštituta ukk (finska). kar 47 % otrok se poškoduje vsaj enkrat v letu dni, pri čemer se 50 % poškodb zgodi v športnih klubih, 30 % med prostim časom in 20 % med šolskim časom. dečki so poškodbam bolj podvrženi kot deklice. članstvo v športnih klubih je temeljni dejavnik tveganja za hospitalizacijo otrok po poškodbi, kar pa je treba jemati kot logično vzročno-posledično razmerje. če odmislimo trenutne okoliščine s covidom-19 (ko beležimo velik upad vključenosti v športne klube), smo bili v zadnjih letih priča povečevanju števila vključenih v športne klube (na finskem s 46 % v letu 2010 na 62 % v letu 2016 in v sloveniji celo na 82 % v letu 2019), hkrati pa se izjemno povečuje tudi gibalna neaktivnost otrok in mladostnikov (v šolah, doma, v prostem času), kar tudi vpliva na povečevanje števila poškodb med gibalno/športno aktivnostjo in je velik javnozdravstveni problem. v glavnem delu je dr. mari leppanen z inštituta ukk predstavila osnutek strategij in priporočil sport injury prevention strategies and measures in recommendations for the prevention of physical activity-related injuries in adolescents. med interaktivno delavnico smo natančno pregledali vse ukrepe priporočil in jih posodobili. po končani delavnici smo projektni partnerji naredili čistopis priporočil, jih objavili v znanstveni reviji in z njimi seznanili vse deležnike športnih poškodb. priporočila so na voljo na spletni strani: https://www.paripre.eu/wp-content/uploads/2022/02/2021_paripre_ recommendations.pdf. boštjan šimunič https://www.paripre.eu/wp-content/uploads/2022/02/2021_paripre_recommendations.pdf https://www.paripre.eu/wp-content/uploads/2022/02/2021_paripre_recommendations.pdf _hlk89942516 _hlk103676616 _hlk111804760 _hlk111802738 _hlk30149664 _hlk111710665 annales kinesiologiae • 10 • 2019 • 2 115 can exercise make our children smarter? nenad stojiljković1, petar mitić1, goran sporiš2 1 university of niš, faculty of sport and physical education, niš, serbia 2 university of zagreb, faculty of kinesiology, zagreb, croatia corresponding author: nenad stojiljković, phd university of niš, faculty of sport and physical education, čarnojevića 10a, 18000 niš, serbia phone: +381 638084961 e-mail: snesadif@yahoo.com abstract purpose. the aim of this study is to reveal the effects of exercise on the brain structure and function in children, and to analyze methodological approach applied in the researches of this topic. methods. this literature review provides an overview of important findings in this fast-growing research domain. results from cross-sectional, longitudinal, and interventional studies of the influence of exercise on the brain structure and function of healthy children are reviewed and discussed. results. the majority of researches are done as cross-sectional studies based on the exploring correlation between the level of physical activity and characteristics of brain structure and function. results of the studies indicate that exercise has positive correlation with improved cognition and beneficial changes to brain function in children. physically active children have greater white matter integrity in several white matter tracts (corpus callosum, corona radiata, and superior longitudinal fasciculus), have greater volume of gray matter in the hippocampus and basal ganglia than their physically inactive counterparts. the longitudinal/interventional studies also showed that exercise (mainly aerobic) improve cognitive performance of children and causes changes observed on functional magnetic resonance imaging scans (fmri) located in prefrontal and parietal regions. conclusion. previous researches undoubtable proved that exercise can make positive changes of the brain structures in children, specifically the volume of the hippocampus which is the center of learning and memory. finally, the researchers agree that review article doi: https://doi.org/10.35469/ak.2019.211 received: 2019-12-17 udc: 796.011.1+612.821 mailto:snesadif@yahoo.com 116 nenad stojiljković, petar mitić, goran sporiš: can exercise make our children smarter? ..., 115–127 annales kinesiologiae • 10 • 2019 • 2 the most influential type of exercise on changes of brain structure and functions are the aerobic exercises. keywords: physical activity, cognition, brain, children. lahko otroci z vadbo postanejo pametnejši? izvleček namen: namen te študije je razkriti učinke telesne vadbe na možgansko strukturo in delovanje pri otrocih ter analizirati metodološki pristop, uporabljen v raziskavah s tega področja. metode: s pregledom literature smo izpostavili pomembne ugotovitve na tem hitro rastočem področju raziskav. obravnavali smo rezultate intersekcionalnih, longitudinalnih in intervencijskih študij vpliva vadbe na možgansko strukturo in delovanje zdravih otrok. rezultati: večina raziskav je izvedenih kot intersekcionalne študije, ki temeljijo na raziskovanju povezanosti med telesno aktivnostjo in značilnostmi možganske strukture in funkcije. rezultati študij kažejo, da je telesna vadba pozitivno povezana z izboljšano kognicijo in koristno vpliva na spremembe delovanja možganov pri otrocih. fizično aktivni otroci imajo povečano aktivnost bele snovi v več traktih bele snovi (corpus callosum, corona radiata in zgornji vzdolžni fascikul), imajo tudi več sive snovi v hipokampusu in bazalnih ganglijih kot otroci, ki so fizično neaktivni. longitudinalne / intervencijske študije so pokazale tudi, da vadba (predvsem aerobna) izboljša kognitivno delovanje otrok in povzroči spremembe v prefrontalnem in parietalnem področju, ki se jih opazi pri slikanju z magnetno resonanco (fmri). zaključki: predhodne raziskave so nesporno dokazale, da lahko telesna vadba pozitivno spremeni možganske strukture pri otrocih, zlasti volumen hipokampusa, ki je središče učenja in spomina. raziskovalci se strinjajo, da imajo aerobne vaje največji vpliv na spremembe možganskih struktur in funkcij. ključne besede: gibalna/športna aktivnost, kognicija, možgani, otroci annales kinesiologiae • 10 • 2019 • 2 117 nenad stojiljković, petar mitić, goran sporiš: can exercise make our children smarter? ..., 115–127 introduction physical activity of children has benefits not only to physical health and fitness but to cognitive and brain health as well. many studies suggest that exercise can increase the brain volume of the children, make positive changes in structure and function of brain, improve their cognitive abilities and academic achievements (hillman et al., 2009). further research of relation between physical activity and brain is a very prospective area that could give one a new dimension in the studies of exercise and training. having acquired strong scientific evidences of the influences of exercise and physical activities on the brain of children we can envisage a new approach in creating physical education curriculums aimed to develop not only physical abilities but also their cognitive side. the greatest influence of physical exercise has been observed in the domain of executive functions, which are of the great importance for performing daily activities, for the ability to adapt behavior in children, their intellectual functioning and success in performing tasks at school (tomporowski, mccullick, pendleton, & pesce, 2015). exercise has beneficial effects for the mind, it increases attention and cognitive control, it improves emotional responsivity, it enhances short and long-term memory (chaddock, pontifex, hillman, & kramer, 2011; hillman, erickson, & kramer, 2008). these functional improvements have a strong neurophysiological foundation based on the process of neuronal growth or neurogenesis (kobilo et al., 2011). it is obvious that the brain is not a static but a very dynamic organ designed to change in response to experience. this ability of the brain to change his structure and function across the lifespan is known as neuroplasticity. neuroplasticity of brain as the characteristic of adaptation and modification of brain structures in accordance to requirements of environment and some physical activities is very important (myer et al., 2015). brain cortex is especially susceptible to such requirements and responsible for the neuroplastic adaptations. the process of neuroplasticity can be explained by the rule that “neurons that fire together wire together” which means that frequent joined firing of neighboring neural cells leads to strengthening and preserving the synapses (mundkur, 2005). the major effects of exercise occur within two regions of brain: subventricular zone of the lateral ventricle and dentate gyrus in the hippocampus, but also some research suggest that exercise can affect prefrontal cortex (verburgh, königs, scherder, & oosterlaan, 2014). the subventricular zone is one of two regions where neurogenesis persists in the postnatal brain. the subventricular zone, located along the lateral ventricle, is the largest neurogenic zone in the brain that contains multiple cell populations including astrocyte-like cells and neuroblasts (lacar, young, platel, & bordey, 2010). hippocampal dentate gyrus is another location where neurogenesis induced by physical exercise can occur. studies carried out on animals shown that exercise causes specific granule cells in the dentate gyrus with longer and more complex dendritic arborizations in comparison to control animals which were not subject to exercise (arida, scorza, da silva, scorza, & cavalheiro, 2004). the third part of the brain that can be affected by exercising is the prefrontal cortex. prefrontal 118 nenad stojiljković, petar mitić, goran sporiš: can exercise make our children smarter? ..., 115–127 annales kinesiologiae • 10 • 2019 • 2 cortex is the part of the brain located in the most frontal part of the brain lobe and makes about 10 percent of the total brain volume (murray, wise, & graham, 2017). the functions of the prefrontal cortex are numerous, but the executive function of this part is the most dominant (koechlin, basso, pietrini, panzer, & grafman, 1999; wharton, & grafman, 1998). different authors define executive function in a different way but generally all definitions emphasize control of short-sighted, reflexive behaviors in decision making, planning, solving some problems, dealing with some long-term aims, self-control, and attributes this functions to the region of prefrontal cortex (koechlin, basso, pietrini, panzer, & grafman, 1999). prefrontal cortex is considered as the part of the brain important for the ability to learn. each new input will be processed in prefrontal cortex before making the final decision (spitzer, & hollmann, 2013). the first studies of changes in brain structure and its function were performed on animals, mainly rodents, but in the last decade there have been plenty of researches carried out on humans proving the positive effects of exercise on the human brain too. the interest of scientists about the relation of exercise and brain functions date back to the second half of 20th century but the application of contemporary diagnostic methods of structural and functional changes in brain gave new quality to the research of this relationship. the pioneer researches were inspired by a strong desire to preserve the brain functions of elderly, aiming to find the most effective tool in fight against the brain diseases related to the loss of memory such as alzheimer and sclerosis (radak et al., 2010). their findings confirm that exercise can reduce the risk of various neurological diseases and protect the brain from detrimental factors of aging and cognitive decline (bherer, 2015). studies that compare the cognitive performance between younger and older participants observed reduced cognitive capacities in older, but the difference were lesser if the older participants were fitter, especially if they possess higher level of cardiorespiratory fitness (hillman, weiss, hagberg, & hatfield, 2002; renaud, bherer, & maquestiaux, 2010). longitudinal studies carried out on the older participants reported that persons who participated in any type of regular exercise showed less cognitive decline especially when they exercise vigorously more than once a week (barnes, yaffe, satariano, & tager, 2003; aichberger et al., 2010). the aim of this study is to reveal the effects of exercise on the brain structure and function in children, and to analyze methodological approach applied in the researches of this topic. there is an increasing number of researches that prove positive effects of exercise on the cognition of children and their academic achievements and a need for a comprehensive review of published scientific literature is necessary to support this relatively new line of studies. annales kinesiologiae • 10 • 2019 • 2 119 nenad stojiljković, petar mitić, goran sporiš: can exercise make our children smarter? ..., 115–127 discussion exercise and white matter the majority of researches are performed as cross-sectional studies based on the exploring correlation between the level of physical activity and the characteristics of brain structure and function. the study results indicate that exercise has positive correlation with improved cognition and beneficial changes to brain function in children (lees & hopkins, 2013). physically active children have greater white matter integrity in several white matter tracts (corpus callosum, corona radiata, and superior longitudinal fasciculus), they have greater volume of gray matter in the hippocampus and basal ganglia than their physically inactive counterparts (erickson, hillman, & kramer, 2015; chaddock et al., 2010b). corpus callosum is the primary connection between the hemispheres and with more than 190 million axons is the largest white matter tract (muetzel et al., 2008). the role of corpus callosum is integration of sensory, motor and cognitive processes between hemispheres (hinkley et al., 2012). underdeveloped corpus callosum is related to low cognitive function and intelligence, processing speed and problem-solving abilities, even to autism and similar syndromes (van eimeren, niogi, mccandliss, holloway, & ansari, 2008). physical activity and exercise lead to increased white matter microstructure of corpus callosum in children (chaddock-heyman et al., 2018). scientists explain that this increase is caused by the exercise which causes more tightly bundled and structurally compact fibers, and increased myelination (chaddock-heyman et al., 2018). these results have been obtained from a study including 7 to 9-year-old children who were involved in after-school physical activity programme based on moderate to vigorous physical activities 5 days per week for 9 months. importance of duration and intensity of exercise for changes in brain structure and function the longitudinal/interventional studies also showed that exercise, mainly aerobic, improves cognitive performance of children and causes changes observed on functional magnetic resonance imaging scans (fmri) located in prefrontal and parietal regions (li et al., 2014). positive changes in brain structure and function are highly dependent on the intensity and duration of exercise. some studies support the fact that cognitive functioning can be improved with short periods of physical exercise (hancock & mcnaughton, 1986) but many other studies did not find such effects (cian, barraud, melin, & raphel, 2001; isaacs & pohlman, 1991). short and very intensive exercise with duration not longer than 10 minutes cannot initiate any change in perception, sensory integration or visual discrimination (fleury, bard, jobin, & carrière, 1981), but physical exercise of moderate intensity and duration can improve significantly brain functions of children. the recommendations of researchers for exercise that can have the highest positive effects on the structure and function of brain are 20 to 40 minutes 120 nenad stojiljković, petar mitić, goran sporiš: can exercise make our children smarter? ..., 115–127 annales kinesiologiae • 10 • 2019 • 2 with sub-maximal intensity i.e. heart rate of about 60 to 70 % of maximum (ellemberg & st-louis-deschênes, 2010). a study from 1979 (gabbard & barton, 1979) found that children improved their mathematical skills on test only after 50 minutes of physical activity and not after 20, 30 or 40 minutes. however, one of the newer studies shows benefits of cognitive functions even after 30 minutes of activities (ellemberg & stlouis-deschênes, 2010). influence of exercise on brain blood supply and angiogenesis some of the oldest explanations regarding the improvement of brain functions and structure as a consequence of exercise were based on the improvement of brain blood supply through improved blood circulation. exercise stimulates the process of angiogenesis and the development of vascular network within the brain. this development leads to a significant improvement of oxygen concentration and a better supply of other important neurochemical substances that improve cognition. physical activity increases perfusion, and angiogenesis directly increases the perfusion of the brain which is a good foundation for facilitating neuroplasticity and branching neural networks and synaptic connections (konopka, 2015). this completely rational explanation is based on augmentation of the level of serotonin, dopamine and norepinephrine after the exercise (querido & sheel, 2007; vaynman & gomez-pinilla, 2005). serotonin is associated with memory storage and retrieval, and dopamine and norepinephrine with attention. the stated increase of the level of the cathecholamines that improve cognitive performances can be initiated by exercise. influence of age and maturity on the brain changes caused by exercise researches considering the difference of effects of exercise on brain structure and function dependent on the age and maturity of children show that the greatest influence can be achieved in the age ranges of 4-7 and 11-13 years, compared with the age ranges of 8-10 and 14-18 years (sibley & etnier, 2003). those are the periods of the intensive growth and development of children and are considered as sensitive periods that “open the gates” for a greater influence of exercise on brain, even the possibility of positive effects of exercise across the whole lifespan are absolutely confirmed (hillman et al., 2008). development of the brain imaging techniques (electroencephalography – eeg, positron emission tomography – pet, magnetic resonance imaging – mri, functional magnetic resonance imaging – fmri) ensured the possibility to determine the changes caused by exercise within the specific regions of the brain and to locate the most intensive changes. researches that follow a positive deflection in a stimulus-locked event-related potential (erp) that reflects the changes in the neural representation of the stimulus environment and to the amount of attention that is required to encode a given annales kinesiologiae • 10 • 2019 • 2 121 nenad stojiljković, petar mitić, goran sporiš: can exercise make our children smarter? ..., 115–127 stimulus (amplitude) as well as the speed of stimulus evaluation (latency) has shown changes generated by a network of neural structures in frontal lobe, the anterior cingulate cortex, infero-temporal lobe and the parietal cortex (hillman et al., 2008). these regions of brain are highly activated in cognitive operations and processing stimulus, as well as in memorizing. physical activity has a strong influence on spectral frequency activation, especially on p3 component of the event-related potential (erp). the registered changes in p3 component of erp could be explained by the changes in network of neural structures within the frontal lobe, anterior cingulate cortex, infero-temporal lobe and the parietal cortex. larger amplitude and shorter latency of positive deflection in a p3 stimulus-locked event-related potential (erp) are observed across a variety of intellectual tasks in participants with higher aerobic performances (li et al., 2014). this research proves the positive relationship between higher level of physical activity or aerobic fitness and cognitive processing (polich, 2004).greater amount of physical activity directed towards the aerobic fitness development is beneficial for faster cognitive processing. these evidences could be important for raising smarter children. researhes that involve mri as a technique of tracking the changes of brain structures by imaging showed that higher levels of fitness and fitness improvement are related to larger volumes of prefrontal and temporal grey matter, as well as anterior white matter, which are the structures highly related to the intelectual performances (chaddock-heyman et al., 2018). exercise and neurogenesis for decades it has been thought that nerve cells can be produced exclusively during the embryonic period and early childhood, however, it is still unclear whether this is true, even more so, numerous researches have been performed in recent decades that support the hypothesis that neurogenesis is possible even in the adulthood (cameron & mckay, 2001). the process of neurogenesis produces thousands of new neurons every day (cameron & mckay, 2001). most of these new neural cells are produced in the hippocampal formation which is highly responsive to the physical training and exercise (curlik & shors, 2013; chaddock et al., 2010a; khan & hillman, 2014). one of the most influential external factors is aerobic exercise because it causes a large increase in the number of cells that are produced. this effect was revealed in the research dating from 1999 (van praag, kempermann, & gage, 1999) when the authors applied two weeks of daily voluntary exercise which caused an increase in the number of new cells by fifty percent with the greater increase in the dentate gyrus. steiner, murphy, mcclellan, carmichael, and davis (2011) reported that just one day of exercise can lead to a significant increase of the number of cells produced. meta-analysis of mcmorris & hale (2012) explained the influence of different exercise intensities (low, moderate, heavy) on cognitive performance. the authors of this study also monitored three moderator variables such as the timing of testing (during vs. post exercise), task complexity (central executive task vs. recall and attention/alertness 122 nenad stojiljković, petar mitić, goran sporiš: can exercise make our children smarter? ..., 115–127 annales kinesiologiae • 10 • 2019 • 2 tasks), and protocol issue, the use of counterbalancing/randomization of testing (counterbalanced/random testing vs. pre-exercise testing followed by during or post-exercise testing). the need for monitoring the time of testing is drawn from the hypothesis of catecholamines realization which occurs during, and even immediately before the exercise when hypothalamus and brainstem initiate the reaction of the sympathoadrenal system. this reaction realizes the catecholamines at the postganglionic cells of those neurons that require activating or inhibiting. with an increase of the intensity of exercise there is also epinephrine and norepinephrine are released in lesser quantity. the realized hormones catecholamines, dopamine and norepinephrine have an important role in brain functioning activating primary motor cortex, premotor cortex and supplementary motor area during exercise (mcmorris & hale, 2012). the increases of brain concentrations of catecholamines during and following a moderate intensity exercise should facilitate cognition. with increases of intensity of exercise, the quantity of the realized catecholamines increase and lead to neural noise which could inhibit performance (arnsten & goldman-rakic, 1985). exercise and brain growth factors another possible influence of exercise on brain is related to the increased concentrations of the brain-derived neurotrophic factor (bdnf) (ferris, williams, & shen, 2007; goekint et al., 2008; tang, chu, hui, helmeste, & law, 2008), insulin-like growth factor 1 (igf-1) and vascular endothelial-derived growth factor (vegf). these three growth factors belong to the group of neurotrophins that are important for the development and maintenance of neural cells in the brain. bdnf is the major mediator of the impact of aerobic exercise on hippocampal neuroplasticity and functioning (cotman, berchtold, & christie, 2007). effects of exercise on learning is mostly regulated by igf-1 and bdnf. the stimulation of angiogenesis and hippocampal neurogenesis caused by exercise is regulated by igf-1 and vegf (cotman et al., 2007). one of the recent studies shows that bdnf is crucial for hippocampal function, synaptic plasticity, learning and modulation of depression (kuipers & bramham, 2006). the level of bdnf in different regions of brain can increase by exercise. the greatest increase of bdnf occurs in the hippocampus, and after a few days of regular exercise bdnf production is increased in all hippocampal subfields. this increase of bdnf can be maintained for weeks with regular exercising (berchtold, chinn, chou, kesslak, & cotman, 2005). similar to the increase of bdnf, exercise can influence the increase of igf-1 in hippocampal neurons and this level can last several days after the exercise. exercise induces a rapid increase of peripheral circulating levels of igf-1 which is the key factor of exercise-induced neurogenesis and improved memory (trejo, carro, & torres-aleman, 2001; ding, vaynman, akhavan, ying, & gomez-pinilla, 2006). some studies consider bdnf and igf-1 as exercise-induced mediator that has the main impact on behavioral improvements, while the exercise-induced neurogenesis and angiogenesis are regulated predominantly by mutual influence of igf-1 and vascular endothelial-deannales kinesiologiae • 10 • 2019 • 2 123 nenad stojiljković, petar mitić, goran sporiš: can exercise make our children smarter? ..., 115–127 rived growth factor (vegf). these two growth factors increase their levels by exercise in the periphery and cross the blood-brain barrier to enter the brain (trejo et al., 2001; fabel et al., 2003; lopez-lopez, leroith, & torres-aleman, 2004). conclusion the examined researches undoubtedly proved that exercise can make positive changes of the brain structures in children, specifically the volume of the hippocampus which is the center of learning and memory. changes are also associated with greater dorsal striatum volumes and these changes lead to a better cognitive control. comprehensively observed, the influence of exercise on brain can be described on molecular, cellular, behavioral and systems level. the researches conducted to date do not give a completely clear picture of the necessary volume and intensity of exercise, as well as the type of exercise that can induce the greatest effect on the brain in children. the researchers could agree that the most influential type of exercise on the changes of brain structure and functions are aerobic exercises, especially if performing they require some cognitive deliberation and a higher level of attention. such exercises can lead to a greater volume of parts of the brain responsible for memory and process of thinking in children which all together leads to a successful raising of smarter children. also, the recommended duration of such aerobic exercise is between 20 and 40 minutes. further randomized control studies are necessary to discover the influences of different types of exercise and different intensities and volumes of exercise on brain structure and function. references aichberger, m. c., busch, m. a., reischies, f. m., ströhle, a., heinz, a., & rapp, m. a. 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(2011). exercise training increases mitochondrial biogenesis in the brain. journal of applied physiology, 111(4), 1066-1071. https://doi.org/10.1152/japplphysiol.00343.2011. tang, s. w., chu, e., hui, t., helmeste, d., & law, c. (2008). influence of exercise on serum brain-derived neurotrophic factor concentrations in healthy human subjects. neuroscience letters, 431(1), 62-65. https://doi.org/10.1016/j.neulet.2007.11.019. tomporowski, p. d., mccullick, b., pendleton, d. m., & pesce, c. (2015). exercise and children’s cognition: the role of exercise characteristics and a place for metacognition. journal of sport and health science, 4(1), 47-55. https://doi.org/10.1016/j. jshs.2014.09.003. trejo, j. l., carro, e., & torres-aleman, i. (2001). circulating insulin-like growth factor i mediates exercise-induced increases in the number of new neurons in the adult hippocampus. journal of neuroscience, 21(5), 1628-1634. https://doi.org/10.1523/jneurosci.21-05-01628.2001. van eimeren, l., niogi, s. n., mccandliss, b. d., holloway, i. d., & ansari, d. (2008). white matter microstructures underlying mathematical abilities in children. neuroreport, 19(11), 1117-1121. https://doi.org/10.1097/wnr.0b013e328307f5c1. van praag, h., kempermann, g., gage, f. h., (1999). running increases cell proliferation and neurogenesis in the adult mouse dentate gyrus. nature neuroscience, 2(3), 266-270. https://doi.org/10.1038/6368. vaynman, s., & gomez-pinilla, f. (2005). license to run: exercise impacts functional plasticity in the intact and injured central nervous system by using neurotrophins. neurorehabilitation and neural repair, 19(4), 283-295. https://doi.org/10.1177/1545968305280753. verburgh, l., königs, m., scherder, e. j., & oosterlaan, j. (2014). physical exercise and executive functions in preadolescent children, adolescents and young adults: a meta-analysis. british journal of sports medicine, 48(12), 973-979. https://doi.org/10.1136/ bjsports-2012-091441. wharton, c. & grafman, j. (1998). reasoning and the human brain. trends in cognitive sciences, 2(2), 54–59. https://doi.org/10.1016/s1364-6613(98)01122-x. https://doi.org/10.1152/japplphysiol.00343.2011 https://doi.org/10.1016/j.neulet.2007.11.019 https://doi.org/10.1016/j.jshs.2014.09.003 https://doi.org/10.1016/j.jshs.2014.09.003 https://doi.org/10.1523/jneurosci.21-05-01628.2001 https://doi.org/10.1523/jneurosci.21-05-01628.2001 https://doi.org/10.1097/wnr.0b013e328307f5c1 https://doi.org/10.1038/6368 https://doi.org/10.1177/1545968305280753 https://doi.org/10.1136/bjsports-2012-091441 https://doi.org/10.1136/bjsports-2012-091441 https://doi.org/10.1016/s1364-6613(98)01122-x _goback _goback _hlk23772821 _goback _goback _hlk27564900 _goback bbib0050 bbib0035 _hlk3367923 _goback annales kinesiologiae • 12 • 2021 • 1 63 reports and reviews/poročila in ocene, 59–66 slovenian mobile brain/body imaging laboratory (slomobil) on 8 july 2021, the institute for kinesiology research of the science and research centre koper (zrs koper) acquired a new laboratory. slovenian brain/body imaging laboratory (slomobil), is equipped with the latest technology for investigating neuromuscular efficiency, which will significantly help in conducting research aimed at in-depth understanding of our brains during movement. slomobil laboratory is one of the few laboratories in the world to use such technology and approaches to investigate brain processes during movement and in connection with the movement information yielded. a comprehensive understanding of the brain dynamics associated with real-life in non-static conditions, will provide insight into the complex processes of embodied cognition. the establishment of the slomobil laboratory represents one of the key milestones of the international project “twinbrain: twinning the brain with machine learning for neuro-muscular efficiency (id 952401),” which will be implemented between 2020 and 2023. in addition to zrs koper, the lead partner of the twinbrain project, the consortium consists of the technical university berlin (tehnische universität berlin), the university of geneva (université de genève) and the neurology department of the cattinara hospital in trieste (università degli studi di trieste). as a key element of the partnerships, the members of slomobil made the first transfer of knowledge at 64 reports and reviews/poročila in ocene, 59–66 annales kinesiologiae • 12 • 2021 • 1 the technical university of berlin, and in the future, a visit to geneva and a study on parkinson’s patients in trieste are also expected. at the opening ceremony speeches were delivered by prof. dr. rado pišot, director of zrs koper, prof. dr. boštjan šimunič, head of the institute for kinesiology research zrs koper, assoc. prof. dr. uroš marušič, head and principal investigator of the twinbrain project, prof. dr. klaus gramann, twinbrain project partner, and keynote speaker, prof. dr. jadran lenarčič. accompanied by musician david kocmur, dancer urša rupnik presented part of the newly acquired equipment of the slomobil, the full body kinematics, which detects body movements via high-frequency cameras and inertial sensors positioned around the limbs, torso, and head, and projects the dancer’s avatar in real time on the screen. after the ceremony, slomobil laboratory opened its doors. within, the working groups prepared interactive presentations of electroencephalography (eeg) and its application in the field of neurofeedback, the use of virtual environments (vr) for rehabilitation after unilateral upper limb injury, and investigation of motor unit activation by electromyography (emg) on the example of balance training. the tour of the laboratory was followed by socializing and refreshments. in addition to the above-mentioned people, we would like to thank maja maša šömen, daša gorjan, nina omejc, luka šlosar, miloš kalc, aleksandar miladinović, teja ličen, nika štravs and the entire zrs koper team, as well as matej sukič, david nik lipovac and draško golubar. the video of the opening ceremony is available at the following link: https://www.regionalobala.si/novica/spremljali-smo-v-zivo-otvoritev-novega-laboratorija-slomobil-video. uroš marušič and manca peskar https://www.regionalobala.si/novica/spremljali-smo-v-zivo-otvoritev-novega-laboratorija-slomobil-video https://www.regionalobala.si/novica/spremljali-smo-v-zivo-otvoritev-novega-laboratorija-slomobil-video annales kinesiologiae • 12 • 2021 • 1 65 reports and reviews/poročila in ocene, 59–66 slovenian mobile brain/body imaging laboratory (slomobil) 8. julija 2021 je inštitut za kineziološke raziskave znanstveno-raziskovalnega središča koper (zrs koper) pridobil nov laboratorij. slomobil, akronim za slovenian brain/body imaging laboratory, je opremljen z najnovejšo tehnologijo za raziskovanje živčno-mišične učinkovitosti, ki bo pomembno pripomogla k izvajanju raziskav za poglobljeno razumevanje naših možganov med gibanjem. laboratorij slomobil je eden redkih laboratorijev na svetu, ki uporablja tako tehnologijo in pristope za raziskovanje možganskih procesov med gibanjem in v povezavi z gibalnimi informacijami. približevanje oz. posnemanje okoliščin iz resničnega življenja omogoča celovito razumevanje možganske dinamike v nestatičnih pogojih in daje vpogled v kompleksne procese utelešene kognicije. vzpostavitev laboratorija slomobil je eden glavnih mejnikov mednarodnega projekta twinbrain: twinning the brain with machine learning for neuro-muscular efficiency (id 952401), ki se izvaja med letoma 2020 in 2023. ob zrs koper so projektni partnerji še tehniška univerza v berlinu (tehnische universität berlin), univerza v ženevi (université de genève) in nevrološki oddelek bolnišnice katinara v trstu (università degli studi di trieste). v sklopu partnerstev so člani slomobil-a opravili prvi prenos znanja na tehniški univerzi v berlinu, v prihodnosti pa se obeta tudi obisk v ženevi in izvedba raziskave na bolnikih s parkinsonovo boleznijo v trstu. 66 reports and reviews/poročila in ocene, 59–66 annales kinesiologiae • 12 • 2021 • 1 na slavnostni otvoritvi so sodelovali prof. dr. rado pišot, direktor zrs koper, prof. dr. boštjan šimunič, predstojnik inštituta za kineziološke raziskave zrs koper, izr. prof. dr. uroš marušič, vodja projekta twinbrain, prof. dr. klaus gramann, partner projekta twinbrain, in slavnostni govorec prof. dr. jadran lenarčič. na otvoritvi je plesalka urša rupnik ob glasbeni spremljavi davida kocmurja predstavila del novopridobljene opreme slomobil-a, natančneje full body kinematics, ki z visokofrekvenčnimi kamerami ter inercialnimi senzorji okoli okončin, trupa in glave zaznava premike telesa in v realnem času projicira na zaslon plesalkin avatar. po slavnostni otvoritvi je laboratorij slomobil odprt svoja vrata. v njem so delovne skupine pripravile interaktivne predstavitve elektroencefalografije (eeg) na primeru nevrofeedbacka, uporabe virtualnih okolij (vr) za rehabilitacijo po unilateralni poškodbi zgornje okončine in raziskovanje aktivacije motoričnih enot z elektromiografijo (emg) na primeru treninga ravnotežja. po ogledu laboratorija sta sledila druženje in pogostitev. za izvedbo dogodka se ob zgoraj omenjenih osebah zahvaljujemo še maji maši šömen, daši gorjan, nini omejc, luki šlosarju, milošu kalcu, aleksandru miladinoviću, teji ličen, niki štravs in celotni ekipi zrs koper ter mateju sukiču, davidu niku lipovacu in drašku golubarju. videoposnetek z otvoritve je dostopen na spletni povezavi https://www.regionalobala.si/novica/spremljali-smo-v-zivo-otvoritev-novega-laboratorija-slomobil-video. uroš marušič in manca peskar https://www.regionalobala.si/novica/spremljali-smo-v-zivo-otvoritev-novega-laboratorija-slomobil-video https://www.regionalobala.si/novica/spremljali-smo-v-zivo-otvoritev-novega-laboratorija-slomobil-video _goback _hlk98923763 _hlk98755967 _hlk79606686 _hlk99786836 _hlk98147084 _hlk99787368 _hlk88552317 _hlk17057094 annales kinesiologiae • 12 • 2021 • 1 59 reports and reviews/poročila in ocene, 59–66 diego celin, rado pišot: safe and with joy on a motorbike. psychophysical preparation for recreational motorcyclists annales zrs, 2021, 152 pages. many recreational motorcyclists are lured onto the roads by warmer days, but often forgetting the importance of psychophysical preparation after the winter break. this can lead to dissatisfaction, fatigue and feeling unwell after the first trips, and can also contribute to unforeseen incidents, accidents and injuries. the importance of psychophysical fitness for the safety and enjoyment of recreational motorcycling is discussed in the handbook safe and with joy on a motorbike by diego celin and rado pišot, both experts in the field of sports and kinesiology and both motorcycling enthusiasts in spirit and experience. the handbook is published by annales zrs, the scientific publishing house of zrs koper. while the first, theoretical, part of the manual summarizes important information on the movements and stresses of motorcycling and the importance of motorcyclists’ motor skills, the second part is purely practical and designed to help every motorcyclist physically prepare themselves before the season. we cannot ignore the fact that the good physical fitness of the rider is paramount to master riding and thus to ensure greater safety on the roads and racetracks. the first part of the book analyzes the movement and psychophysical stresses placed on the body while riding a motorcycle and provides guidance on how to properly prepare for the road, including in terms of diet and fluid replacement and their influence on the physiological responses of the body while riding. the second part is devoted to general and specific sports training for recreational riders of all types of road motorcycles. these guidelines will also be useful for young motorcycle riders. “we start from the fact that recreational motorcyclists usually take to the roads with long gaps between rides, forgetting the importance of psychophysical preparation for such a demanding task. this manual fills a gap in the comprehensive treatment of psychophysical preparation of motorcyclists, on which there is a lack of adequate slovenian literature,” said rado pišot. https://www.zrs-kp.si/index.php/product/predprodaja-diego-celin-in-rado-pisot-varno-in-z-veseljem-na-motor/ https://www.zrs-kp.si/index.php/product/predprodaja-diego-celin-in-rado-pisot-varno-in-z-veseljem-na-motor/ 60 reports and reviews/poročila in ocene, 59–66 annales kinesiologiae • 12 • 2021 • 1 the book was accompanied by experts from the world of motorcycling: – brane legan, safe riding course instructor at the slovene national automobile association (amzs) “when i became actively involved in motorcycle safety more than 20 years ago, i was also learning about this important element, good psychophysical condition to control and operate a motorcycle. at some points, it was the only thing that allowed me to be able to work with a motorcycle or just ride without any problems or dangers...” – andrej jereb, multiple rally champion: “i notice that drivers in general do not put enough emphasis on this important area, which not only helps us to be safer, but above all to achieve better control and therefore more driving satisfaction...” – miran stanovnik, multiple dakar rally participant: “it is necessary to take the first step and realize that we can only enjoy driving if we are psychophysically fit for it and have at least the basic skills necessary, which we can build on with proper practice... my sporting career might also have been more successful if i had been introduced to the contents of this book some three decades ago...” – miodrag (mišo) kralj, a long-time recreational motorcyclist: “i would definitely have been spared a lot of trouble if i had taken some time to prepare for the new season. i’m sure the first and all the following kilometers would have been much more relaxed...” – niko peroša, professional motorbike tour guide: “even when riding touring motorbikes, you need to know your body’s reactions, take them into account, prepare for them and then maintain the condition you’ve acquired. that’s why i think this book is the ideal winter read for anyone who considers themselves a serious motorcyclist. finally, one practical book for motorcyclists in slovenian.” nika štravs annales kinesiologiae • 12 • 2021 • 1 61 reports and reviews/poročila in ocene, 59–66 diego celin, rado pišot: varno in z veseljem na motor. psiho-fizična priprava rekreativnih motoristov annales zrs, 2021, 152 str. toplejši dnevi zvabijo na ceste številne rekreativne motoriste, ki pa velikokrat pozabijo na pomembnost psiho-fizične priprave po zimskem premoru. zadnje v najboljšem primeru vodi v nezadovoljstvo, utrujenost in slabo počutje po prvih izletih, lahko pa tudi pripomore k neželenim dogodkom, nesrečam in poškodbam. o pomenu psiho-fizične pripravljenosti za varnost in užitke v rekreativnem motociklizmu sta v priročniku varno in z veseljem na motor spregovorila avtorja, strokovnjaka s področja športnih in kinezioloških ved, diego celin in rado pišot, ki sta po duhu in izkušnjah tudi sama velika ljubitelja motociklizma. priročnik je izšel pri annales zrs, znanstveni založbi zrs koper. v prvem delu priročnika so povzete pomembne informacije o gibanju in obremenitvah motorista med vožnjo ter pomenu gibalnih sposobnosti motorista, drugi del pa je praktične narave in je nastal za to, da se lahko motoristi pred sezono samostojno ustrezno pripravijo. ne moremo namreč prezreti dejstva, da je predvsem dobra fizična priprava voznika nepogrešljiva za obvladovanje vožnje ter s tem za večjo varnost na cestah in dirkališčih. knjiga se tako v prvem delu posveča analizi gibanja in psiho-fizičnih obremenitev na telo med vožnjo motocikla ter daje napotke za dobro pripravo na potovanja tudi z vidika prehrane in nadomeščanja tekočin ter njunega vpliva na fiziološke odzive telesa med vožnjo. drugi del je namenjen vsebini o splošni in posebni športni vadbi za rekreativne voznike vseh vrst cestnih motorjev. napotki bodo uporabni tudi za mlade voznike koles z motorjem. »izhajamo iz dejstva, da se rekreativni motoristi običajno podajo na ceste z velikimi časovnimi razmiki med vožnjami in pozabljajo na pomen psiho-fizične priprave na tako zahtevno nalogo. priročnik zapolnjuje vrzel na področju celostne obravnave psiho-fizične priprave motoristov, o kateri primanjkuje primerne slovenske literature,« je povedal rado pišot. https://www.zrs-kp.si/index.php/product/predprodaja-diego-celin-in-rado-pisot-varno-in-z-veseljem-na-motor/ https://www.zrs-kp.si/index.php/product/predprodaja-diego-celin-in-rado-pisot-varno-in-z-veseljem-na-motor/ 62 reports and reviews/poročila in ocene, 59–66 annales kinesiologiae • 12 • 2021 • 1 knjigo so na pot pospremili tudi strokovnjaki iz motorističnega sveta: – brane legan, inštruktor varne vožnje amzs: »ko sem se pred dobrimi 20 leti začel aktivno ukvarjati z varnostjo motoristov, sem spoznaval tudi ta pomembni element, dobro psiho-fizično pripravljenost za obvladovanje in upravljanje motorja. v nekaterih trenutkih je bilo le to tisto, kar mi je omogočalo, da sem lahko opravljal delo z motorjem ali pa le vožnjo brez težav in nevarnosti …« – andrej jereb, večkratni prvak relija: »opažam, da vozniki na splošno dajemo premalo poudarka temu pomembnemu področju, ki nam ne pomaga samo pri večji varnosti, ampak predvsem pri doseganju boljšega obvladovanja in s tem večjega zadovoljstva v vožnji …« – miran stanovnik, večkratni udeleženec relija dakar: »treba je storiti prvi korak in se zavedati, da lahko uživamo le tedaj, ko smo za vožnjo psiho-fizično primerno pripravljeni in obvladamo vsaj osnovne veščine, ki so za to potrebne in jih lahko s primerno vadbo nadgradimo … tudi moja športna kariera bi mogoče lahko bila uspešnejša, če bi se z vsebino knjige seznanil pred kakšnimi tremi desetletji …« – miodrag (mišo) kralj, dolgoletni rekreativni motorist: »veliko tegob bi mi bilo vsekakor prihranjenih, če bi si vzel nekaj časa za pripravo na novo sezono. prepričan sem, da bi bili prvi in vsi nadaljnji kilometri veliko bolj sproščeni …« – niko peroša, profesionalni turistični vodnik na motorju: »tudi pri vožnji potovalnih motorjev je treba poznati odzive telesa, jih upoštevati, se nanje pripraviti in pozneje pridobljeno stanje vzdrževati. prav zato mislim, da je ta knjiga idealno zimsko branje za vsakogar, ki se ima za resnega motorista. končno ena praktična knjiga za motoriste v slovenščini.« nika štravs _goback _hlk98923763 _hlk98755967 _hlk79606686 _hlk99786836 _hlk98147084 _hlk99787368 _hlk88552317 _hlk17057094 annales kinesiologiae • 10 • 2019 • 1 31 review article doi: https://doi.org/10.35469/ak.2019.162 received: 2018-07-29 udc: 613.24:796.011 how does exercise support dietary approaches to weight loss and better health? katarina tomljenović borer school of kinesiology, the university of michigan, ann arbor, usa corresponding author: katarina t. borer school of kinesiology, the university of michigan, 1402 washington heights, ann arbor, mi 48109-2013, usa tel. +1 734 249-8809 e-mail: katarina@umich.edu abstract the rapid global rise of obesity incurs a heavy personal and healthcare burden due to obesity-associated morbidities and shortening of life. the purpose of this review is to provide evidence-based strategies for prevention, reversal, and mitigation of obesity and its sequelae. to that end, this review highlights the features of human physiology that favor fat accretion and interfere with fat loss. strategies for prevention of obesity include understanding the basis for the strong motivating properties of palatable food, for human inability to consciously detect calories eaten or calories expended through exercise, for metabolic and hormonal adaptations to negative energy balance that drive weight regain, and for evolutionary natural selection which likely led to high human capacity for fat storage. reversal of obesity is difficult primarily due to metabolic, hormonal, and behavioral reactions to body fat loss. reduced resting metabolic rate presents a physiological challenge whether the weight loss is achieved through dietary restriction or energy expenditure of exercise. increased insulin sensitivity after body fat loss drives resynthesis of storage substrates including triglycerides in the adipose tissue, muscle glycogen, and proteins, thus contributing to weight regain. reduced basal plasma leptin concentration elicits a strong hunger drive. mitigation of obesity-associated morbidities involves adding exercise energy expenditure to deliberate control of the quantity of food eaten, reducing postprandial hyperinsulinemia by lowering the carbohydrate load of the diet, and exercising after, rather than before, the meals to facilitate improved glucose tolerance. keywords: obesity morbidities exercise insulin leptin body weight 32 katarina tomljenović borer: how does exercise support dietary approaches to weight loss ..., 31–58 annales kinesiologiae • 10 • 2019 • 1 kako gibalna vadba deluje kot podpora dieti pri zniževanju telesne mase in izboljševanju zdravja? izvleček hiter globalni razmah debelosti in prekomerne telesne mase zaradi številnih z njim povezanih bolezni in posledično krajšanja življenjske dobe, predstavlja vedno večje breme tako za posameznike kot tudi za zdravstvene sisteme. namen preglednega članka je predstaviti na dokazih temelječe strategije za preprečevanje in ublažitev posledic prekomerne telesne mase. izpostavili bomo fiziološka ozadja, ki imajo odločilno vlogo pri kopičenju maščobnega tkiva, ter tista, ki preprečujejo izgubo maščobe. strategije za preprečevanje prekomerne telesne mase vključujejo tako razumevanje osnovnih vzvodov, ki vodijo do močne navezanosti človeka na okusno hrano, kot tudi razumevanje osnov človekove nezmožnosti, da bi zavestno prepoznal količino kalorij, ki jih je prejel z zaužito hrano ali tistih, ki jih je s telesno aktivnostjo porabil. izpostavili bomo presnovne in hormonalne adaptacije na negativno energijsko bilanco, ki vodijo v pridobivanje telesne mase in evolucijsko naravno selekcijo, ki je verjetno vodila do visoke sposobnosti človeka, da v telesu kopiči zaloge maščobe. spreminjanje trenda naraščanja prekomerne telesne mase je težavno predvsem zaradi presnovnih, hormonalnih in vedenjskih odzivov na izgubo telesnih maščob. pri zmanjšani stopnji presnove v mirovanju predstavlja poseben fiziološki izziv vprašanje ali gre v teh primerih za zmanjšanje telesne mase zaradi restriktivne prehrane ali zaradi povečanja porabe energije, kot posledico gibalne aktivnosti. povišana stopnja inzulinske rezistence po izgubi telesnih maščob vodi v resintezo skladiščenih substratov, vključno trigliceridov v maščobnem tkivu, mišični glikogen in proteine, kar prispeva k ponovnemu pridobivanju telesne mase. zmanjšane koncentracije bazalnega leptina v plazmi sprožijo občutek lakote. zmanjšanje posledic s prekomerno telesno maso povezanih bolezni, ob zavestnem nadzorovanju količine zaužite hrane, vključuje tudi dodatno porabo energije s pomočjo gibalne vadbe, zniževanje postprandialne hiperinzulinemije z nižanjem količine ogljikovih hidratov v prehrani ter z izvajanjem gibalne/športne aktivnosti po zaužitem obroku, raje kot pred njim, saj to izboljšuje toleranco za glukozo. ključne besede: debelost, slabotnost, gibalna vadba, inzulin, leptin, telesna masa annales kinesiologiae • 10 • 2019 • 1 33 katarina tomljenović borer: how does exercise support dietary approaches to weight loss ..., 31–58 introduction obesity has risen rapidly over the past half a century in all of 200 sample countries of the world (ncd risk factor collaboration, 2017). it increased from 3.2% in men and 6.4% in women in 1975 to 10.8% and 14.9%, respectively, in 2014. in 2014, 2.3% of world’s men and 5% of women were severely obese, and 0.64% men and 1.6% women were morbidly obese. by 2025, global obesity is projected to reach 18% in men and 21% in women, and 6 and 9% are, respectively, likely to become severely obese. in the us, 32.2% of men and 35.5% of women were obese in 2016 (hales, carrol, fryar & ogden, 2017). their health care burdened the economy with 147 billion usd (finkelstein, trogdon, cohen & dietz, 2009). the corresponding health care costs of obesity in europe in 2008 were 10.4 billion euros (muller-riemenschneider, reinhold, berghofer, & willich, 2008). obesity-associated morbidities include hypertension (vaněčková et al., 2014), atherosclerosis (lovren, teoh, & verma, 2015), hypercoagulability of blood (samad & ruf, 2013), endothelial dysfunction (iantorno et al., 2014), coronary vascular (rankinen, sarzynski, ghosh, & bouchard, 2015), kidney (ritz, rychlik, locatelli, & halimi, 1999), and heart disease (després et al., 1996), stroke (field et al., 2001), and particularly type 2 diabetes (t2d). these obesity-linked morbidities increase the risk of mortality by two to three fold (adams et al., 2006). the close association between obesity, peripheral tissue resistance to insulin action, and t2d is reflected in the frequently used descriptive term “diabesity” (farag & gaballa, 2011). since the driver of recent rapid increases in obesity is the interaction between behavioral choices and human physiological barriers, the purpose of this review is to describe behavioral strategies that could prevent or reduce obesity and mitigate its associated morbidities. methods the data for this review are based, in part, on pubmed search for the scientific reports on the behavioral and physiological controls of food intake and on the physiological, psychological, and hormonal barriers to weight loss, as well as, in part, on the author’s research findings and views on the regulation of energy balance in humans (borer, 2005; 2008; 2010; 2014; 2019; borer, wuorinen, chao, & burant, 2005; borer, wuorinen, ku & burant, 2009; wuorinen & borer, 2013; and lin & borer, 2016). five points will be interpreted from the evidence-based research: (1) the endocrine basis of obesity-associated morbidities; (2) physiological features that facilitate overeating, (3) evolutionary burden of high human capacity for obesity, (4) failure of spontaneous physical activity to compensate for obesity; and (5) dietary and exercise solutions to some obesity-associated morbidities. integration of these points will guide the recommendation for behavioral strategies toward prevention, reversal, or mitigation of obesity and its associated morbidities. 34 katarina tomljenović borer: how does exercise support dietary approaches to weight loss ..., 31–58 annales kinesiologiae • 10 • 2019 • 1 results 1. the endocrine basis of obesity-associated morbidities obesity leads to a disturbance in the endocrine regulation of body energy storage and its mobilization by reducing the effectiveness of its chief endocrine agent insulin. circulating glucose and amino acids elicit insulin secretion, and activate its four chief actions, to increase uptake of these nutrients by muscle and other energy-depleted tissues, to reduce the concentration of circulating glucose by increasing its metabolism, to further reduce circulating nutrients by promoting their storage in the form of muscle and liver glycogen, adipocyte triglyceride, and tissue protein, and finally, to block the breakdown, release, and metabolism of metabolic fuels from their inert storage form. it is less well-recognized that a second hormone, leptin, also plays a key role in the mealassociated regulation of energy balance. while its release from the white adipose tissue (wat) is universally recognized, it is less well known that leptin gets also released from the stomach during meal eating (sobhani et al., 2000). its secretion and actions are linked to that of insulin in a counter-regulatory fashion. insulin stimulates leptin release during meal-eating, and leptin then restrains all four of the insulin’s actions as well as insulin release. it indirectly counter-regulates the energy storage actions of insulin by promoting lipolysis and stimulation of lipid metabolism (borer, 2014). this endocrine counter-regulation of short-term energy balance is disrupted in obesity by the resistance of peripheral tissues to the actions of both insulin and leptin. increased insulin and leptin resistance in obesity (samuel, petersen, & shulman, 2010; shulman, 2014a) is reflected in the proportional rise in fasted, basal and stimulated concentration of both hormones as a function of increased body fat (figure 1). the effect of obesity on the basal insulin concentration is expressed in a disposition index (di) (lorenzo et al., 2010). di is a product of insulin sensitivity and the amount of insulin secreted in response to blood glucose level. plotted as insulin response as a function of insulin sensitivity, the parabolic curve shows that little insulin is needed to stimulate the glucose uptake when insulin sensitivity is high, but a high insulin concentration is required when the peripheral tissues are insulin-resistant and when insulin sensitivity is low. insulin-resistant peripheral tissues in obesity thus require high basal and stimulated insulin concentrations. the rise in the basal or fasted concentrations of insulin and leptin are a consequence of a fundamental relationship between prevailing hormone concentration and the number of specific hormone receptors on the cell membrane. the number of receptors on energy-storing cells (like wat, liver, or muscle) varies with the state of energy depletion or repletion. energy depleted adipocytes are smaller and have a higher density of insulin receptors on their membranes than lipid-packed adipocytes in over-fed or obese state (olefsky & reaven, 1975). this relationship is explained in figure 2 (mendelson, 1996). in this hypothetical example, a biological response is possible when insulin binds to 5000 receptors. any time the cell has in excess of 5000 insulin receptors (called “spare receptors”), the cell sensitivity to insulin, and the affinity of the hormone annales kinesiologiae • 10 • 2019 • 1 35 katarina tomljenović borer: how does exercise support dietary approaches to weight loss ..., 31–58 figure 1. the positive correlation between fasting serum insulin (top) and fasting serum leptin (bottom) as a function of percentage body weight or body fat. data for insulin from bagdade, 1968 and for leptin from considine et al., 1996. 36 katarina tomljenović borer: how does exercise support dietary approaches to weight loss ..., 31–58 annales kinesiologiae • 10 • 2019 • 1 figure 2. the sensitivity of peripheral tissues to fasting concentration of a hormone declines in parallel with the number of receptors on the target cell surface and the repletion of target cells with storage fuels. as the amount of storage fuel and the cell size increase, the number of receptors on the surface membrane declines. at the same km (a), tissue sensitivity to a hormone increases in proportion to the number of “spare receptors above the threshold number required to elicit a biological response (5000 receptors in this example). with the smaller number of receptors in energy-replete cells, resistance to a hormone manifests in the form of a higher hormone concentration required to elicit the biological response (b). from mendelson, 1996. annales kinesiologiae • 10 • 2019 • 1 37 katarina tomljenović borer: how does exercise support dietary approaches to weight loss ..., 31–58 for the cell are increased, and the biological effect is achieved with lower insulin concentration (figure 2a). the figure also shows the way to express hormone-receptor affinity or hormone sensitivity as half-maximal concentration of the hormone producing the biological effect (kd or dissociation constant). when the cell is more energy replete and has fewer (about 5,000 to 10,000) membrane receptors, hormone concentration required to produce full (100%) biological response will have to be higher (figure 2 b). this fundamental rule of hormone interaction with the number of its receptors in the context of cellular energy depletion or repletion explains why obese tissues become more resistant to insulin and why the basal concentration of insulin and leptin rise with obesity. so, postprandial hyperglycemia and hyperinsulinemia are the consequence, respectively, of reduced effectiveness of insulin to stimulate glucose uptake by peripheral tissues and to inhibit glucose mobilization from the liver and free fatty acid mobilization from wat because of insulin resistance. hyperglycemia and compensatory hyperinsulinemia (taylor, 2013) lead to glycation of circulating proteins and the formation of advanced glycation products associated with pathological oxidative stress (nowotny, jung, höhn, weber & grune, 2015). high fasting concentrations of ffas resulting from diminished insulin suppression of their mobilization from storage fat (yazıcı & sezer, 2017) directly interfere with insulin signaling in the muscle (schenk & horowitz, 2007). obesity-associated pathologies also result from excess fat deposition in ectopic sites when the capacity of adipocytes to hypertrophy exceeds the capacity of fat storage in the wat. excess fat storage in the liver (van der zijl et al., 2011; taira et al., 2013; shulman, 2014b), the pancreas (van der zijl et al., 2011), the muscle (taira et al., 2013), and the kidney (guebre-egziabher et al., 2013) cause lipotoxicity in addition to insulin resistance. non-alcoholic fatty liver disease (than & newsome, 2015) and steatohepatitis (neuman et al., 2014) result from lipotoxic fat accumulation in the liver. obesity drives the progression from insulin resistance, reduced glucose tolerance, and pre-diabetes to t2d. the incidence of t2d has increased from 4.4 million or 2.4% of us population in 1970s (fox et al. 2006) to 29.1 million or 9.3% of the population in 2014 (national diabetes statistics report, 2017). globally, in 2010, there were 284 million diabetics representing 6.4% of the world population. if the increases continue, there will be 490 billion of diabetics in 2030 (farag & gaballa, 2011). 2. physiological features that facilitate overeating overwhelming evidence indicates that excessive food intake, rather than insufficient physical activity, is the primary cause of weight gain and obesity. why is this behavior not subject to negative feedback to counteract the excessive energy gain? this question is often either overlooked or incorrectly attributed. the incorrect attribution is due to the hypothesis which posits that changes in the quantity of body fat control hunger, meal eating, and motivation for physical activity in a way that maintains healthy 38 katarina tomljenović borer: how does exercise support dietary approaches to weight loss ..., 31–58 annales kinesiologiae • 10 • 2019 • 1 figure 3. energy content of diets (35-30% fat open circles, 20-25% fat solid circles) did not affect the amount of food eaten over 11 weeks (top). instead, a similar volume of food was eaten over 11 weeks unaffected by dietary energy density (bottom). from kendall, levitsky, strupp, & lissner, 1991. annales kinesiologiae • 10 • 2019 • 1 39 katarina tomljenović borer: how does exercise support dietary approaches to weight loss ..., 31–58 body fat content (schwartz, woods, porte, seeley, & baskin, 2000). this hypothesis is not supported by facts. the simple and convincing answer to the feedback question is that humans (and probably most animals) cannot directly detect calories eaten in meals or calories expended in physical activity. this flaw in our physiological design, compounded by the strong motivating properties of palatable food, allow environmental influences such as portion size, easy availability of meals, and social facilitation, to drive food overconsumption. how good is the evidence that humans cannot track mealassociated intake of calories and exercise-associated expenditure of calories? that the volume of food eaten rather than the nutrient energy is the critical determinant of nutrient intake was demonstrated almost 30 years ago (kendall, levitsky, strupp, & lissner, 1991). lower energy low-fat (20-25% fat) or higher energy high-fat diets (35-40% fat diet) were available for 11 weeks. the volunteers spontaneously ate a constant volume of food per day regardless of the 1.1 kj daily energy difference in the two diets (figure 3) and ended up with a different weight change. a more relevant demonstration of human inability to track calories eaten in a meal or expended in exercise was done 18 years later in a study demonstrating that only a variable quantity of food taken by mouth and processed by gastrointestinal tract affected the sensation of hunger and fullness, while intravenous infusion of nutrients and substantial pre-meal exercise expenditure had no such effect (borer, wuorinen, ku, & burant, 2009, figure 4). furthermore, changes in plasma concentrations of both insulin and leptin correctly tracked calories gained or lost, but exerted no influence on the perception of hunger or satiation in contradiction to the homeostatic hypothesis of schwartz et al. (2000). (figure 5). these data show that our perception of satiation is based on gastrointestinal fullness, a signal that can easily be overlooked, and that insulin and leptin, postulated to affect appetite in response to changes in the size of wat (schwartz et al., 2000), do not operate during regular meal-to meal eating as such meal-associated changes in body fat are exceedingly small. the second flaw in our physiological design is that food provides a powerful positive motivation to eat whether or not we are experiencing energy deprivation (berridge, 2009). food activates the same brain centers of reward as the various pleasurable events like sex, stimulating drugs, and direct electrical or pharmacological stimulation by neurotransmitters such as dopamine (berridge, 2009), morphine-like endogenous opiates, and endocannabinoids (kirkham & williams, 2001). that palatable food alone and in the absence of deprivation can powerfully increase weight gain and obesity was demonstrated four decades ago with the cafeteria-diet experiment by sclafani and springer (1976, figure 6). just by making highly palatable fatty and sweet food items available in addition to the less palatable standard diet, the authors observed sustained increase in weight gain and adiposity of laboratory rats. it is certain that some of human overeating is a consequence of easy and convenient availability of fast foods commercially designed for high palatability. 40 katarina tomljenović borer: how does exercise support dietary approaches to weight loss ..., 31–58 annales kinesiologiae • 10 • 2019 • 1 figure 4. hunger (top left) and fullness (bottom left) are affected only by variable-size meals that transit through the mouth and gastrointestinal tract (2,090 kj meals=sedal, 418 kj meals=sed-r) but not by 1521 kj of parenteral nutrition (sed-r-tpn) infused intravenously or by 2 hours of mid-morning moderate-intensity exercise expending 2315kj (top and bottom, right). from borer, wuorinen, ku, & burant, 2009. annales kinesiologiae • 10 • 2019 • 1 41 katarina tomljenović borer: how does exercise support dietary approaches to weight loss ..., 31–58 figure 5. accurate quantitative responses of circulating insulin (top) and leptin (bottom) concentrations to the changes in energy as a function of variable meal size (sedal, sed-r), intravenous infusion of total parenteral nutrition (sed-r-tpn) or energy expenditure of exercise (ex-al, ex-tpn). from borer, wuorinen, ku, & burant, 2009. 42 katarina tomljenović borer: how does exercise support dietary approaches to weight loss ..., 31–58 annales kinesiologiae • 10 • 2019 • 1 figure 6. cafeteria-diet phenomenon. rapid weight gain in rats during 65 days of free access to a variety of supermarket palatable foods in addition to laboratory chow in groups i-s (solid circles) and e-s (solid triangles), compared to lower weight trajectories in rats given lab chow (groups i-p, open circle, a-p,open rectangles, and e-p, open triangles). the same fast-food dietary access with activity wheel present led to slower fat accretion during 65 days but attained the same level of obesity as e-s group after the wheel access was removed (group a-s, solid rectangles). introduction of activity wheels on day 65 to group e-s stopped weight gain on the fast-food diet. annales kinesiologiae • 10 • 2019 • 1 43 katarina tomljenović borer: how does exercise support dietary approaches to weight loss ..., 31–58 3. evolutionary burden of high human capacity for obesity given that humans are unable to directly track calories in meals or calories expended in exercise, easy access to palatable food, and reduced opportunity for physical exertion in the modern societies lead inexorably to obesity and its metabolic pathologies. so, how did humans end up with the largest capacity to become obese among the primates (stini, 1981)? natural selection toward increased brain size and the capacity of the woman to bear numerous offspring may have driven the evolution of increased capacity to store body fat in humans. evolution of larger brains in human ancestors became exponential over the past two million years (figure 7, top) and resulted in about three-fold greater brain mass compared to that in higher primates (ruff, trinkaus & holliday, 1997, figure 7, bottom.). as human brain consumes between 20 and 25% of resting energy metabolism, natural selection toward bigger brains required larger energy stores. non-arboreal existence in human ancestors has favored the evolution of unusually large brains and fat depots but not in the arboreal primates (heldstab, van schaik, & isler, 2016). similarly, the natural selection for increased fat storage capacity has provided human ancestral females with the advantage of being able to support the energy cost of pregnancy (about 18,828 kj/day) and, with about 1,255 to 1,674 kj/day, to feed additional children. it is therefore useful to be mindful of our large capacity for fat storage and of the fact that natural selection does not operate on post-reproductive portion of the life span when most metabolic pathologies develop. 4. failure of spontaneous physical activity to compensate for obesity voluntary physical activity declines in both humans (rising et al., 1994; schulz & schoeller, 1994, figure 8) and animals as the body fat mass increases. this indicates that behavioral energy expenditure does not serve as a component of energy regulatory feedback to maintain stable healthy body weight. instead of increasing as the body fat rises, spontaneous physical activity is non-homeostatic in that, the fatter the humans and animals become, the less motivated they are to be physically active (borer, 2010). the decline in voluntary running in experimental obesity is due to reduced motivation rather than a physical difficulty to move a larger body mass. in support of this conclusion are data showing no performance deficit in obese animals if running is enforced with a negative reinforcement (borer, potter & fileccia, 1983, figure 9). similarly, obese humans seeking publicity and financial incentives to lose weight in the televised “the biggest looser” program, clearly demonstrate that increased motivation can produce large increases in physical activity and decreases in food consumption in obese individuals (fothergill et al., 2016; knuth et al., 2014) that they do not show spontaneously (as shown in figure 8). this unfortunate non-homeostatic design for energy intake and motivation to move (borer, 2010) may have been the result of evolutionary pressures to take advantage of https://www-ncbi-nlm-nih-gov.proxy.lib.umich.edu/pubmed/?term=van%20schaik%20cp%5bauthor%5d&cauthor=true&cauthor_uid=27765147 https://www-ncbi-nlm-nih-gov.proxy.lib.umich.edu/pubmed/?term=isler%20k%5bauthor%5d&cauthor=true&cauthor_uid=27765147 44 katarina tomljenović borer: how does exercise support dietary approaches to weight loss ..., 31–58 annales kinesiologiae • 10 • 2019 • 1 figure 7. exponential evolution of human brain volume during the last three millennia (top) producing about 4-fold difference between human and primate brains (bottom). data from ruff, trinkaus & holliday, 1997, illustration from lieberman, 2013, pages 101 and 107. annales kinesiologiae • 10 • 2019 • 1 45 katarina tomljenović borer: how does exercise support dietary approaches to weight loss ..., 31–58 figure 9. obesifying septal lesions in golden hamsters (mesocricetus auratus) produced 82% reduction in the level of spontaneous wheel running. however, when forced to run on a treadmill with electrified off-ramp grid as a negative reinforcement, obese hamsters showed no deficit in duration of running (left) or power production (right) compared to lean non-lesioned animals throughout the range of tested treadmill speeds. figure 8. inverse relationship between non-basal daily energy expenditure as a function of human percent body fat. from rising et al., 1994 and schulz & schoeller, 1994. 46 katarina tomljenović borer: how does exercise support dietary approaches to weight loss ..., 31–58 annales kinesiologiae • 10 • 2019 • 1 uncertain food availability in human past by increasing the search for it when the food is scarce (chakravarthy & booth, 2004). beyond the lower quantity of spontaneous physical activity with the rise in obesity, staying inactive or sedentary over several hours reduces cardiovascular health and increases risk of the morbidities associated with obesity (després, 2016). the volumes of prescribed physical activity usually fall short of compensating for the ease with which excessive calories can be ingested and stored (borer, 2008). unless physical work is required for the procurement of food or some other life necessity, as was evident in cuba during early 1990s when food embargo led to food scarcity and population weight declines (rodríguez-ojea, jiménez, berdasco & esquivel, 2002), human ingenuity to make voluntary physical work unnecessary is likely to persist and obesity is likely to continue to rise. 5. dietary and exercise solutions to some obesity-associated morbidities obesity, and particularly t2d, are characterized with hyperglycemia, not only immediately after the meals, but over postprandial periods spanning substantial periods of wakefulness (van dijk et al., 2011). persistent hyperglycemia, as reflected in elevated hemoglobin a1c, has been associated with coronary heart disease and increased mortality (després et al., 1996). the association of hyperglycemia and hyperinsulinemia in t2d with obesity is firmly established as both can be reduced with weight loss (taylor, 2013). it is probable that the rapid rise in obesity and t2d in the us population since 1970’s (national diabetes statistics report, 2017) may have been facilitated by a 30.5% increase in daily carbohydrate consumption from 213 g per day in 1965 to 278 g per day or 51% of daily calories in 2011 (cohen et al., 2015). the currently high carbohydrate consumption in the us falls within the 45 to 65% of daily calorie range recommended in 2010 by us departments of agriculture and health and human services (dietary guidelines for americans, 2010). to test the hypothesis that the postprandial hyperglycemia is largely driven by the high insulin response to a high-carbohydrate diet, carbohydrate content of the isocaloric meals was reduced in a recent study (lin & borer, 2016) from 60% to 30% over a 24-hour period. the remarkable outcome of the study was that the postprandial insulin area under the curve was reduced by 39% by the third low-carbohydrate meal, after a 24-hour exposure to the changed diet, but not after the high-carbohydrate meal (figure 10). this reduced a homeostatic measure of insulin resistance by 37% (figure 11). another insight provided by the study was that exercising for 2 hours at moderate intensity before the meals aggravated carbohydrate intolerance rather than reducing plasma glucose as exercise is expected to do (figure 12). the study provides helpful information that a simple dietary intervention consisting of a decrease in dietary carbohydrate and increase in healthy dietary fat and protein could restrain hyperinsulinemia that may drive fat synthesis in wat and ectopic sites. also, that exercise before the meals, but not after the meals (heden et al., 2015), exacerbates postprandial glucose intolerance. annales kinesiologiae • 10 • 2019 • 1 47 katarina tomljenović borer: how does exercise support dietary approaches to weight loss ..., 31–58 figure 10. reduction in postprandial insulin responses after the third low-carbohydrate meal in either (a) sedentary (lcs) or (b) exercise trials (lcx) but not in, respectively, high-carbohydrate sedentary (hcs) or exercise (hcx) trials. from lin & borer, 2016. 48 katarina tomljenović borer: how does exercise support dietary approaches to weight loss ..., 31–58 annales kinesiologiae • 10 • 2019 • 1 figure 11. reduction in homa-ir measure of insulin resistance after the third lowcarbohydrate meal in either (a) sedentary (lcs) or (b) exercise trials (lcx) but not in, respectively, high-carbohydrate sedentary (hcs) or exercise (hcx) trials. from lin & borer, 2016. it would be remiss not to emphasize the advantage of combining exercise with the recommended caution in selection of quantities and quality of food. this emphasis should mitigate the problems of the two already-mentioned weaknesses of physical activity in preventing or reversing obesity, its non-homeostatic nature, and its low power to overcome the ease of ingesting palatable food calories. the benefits of exercise are so impressive that since at least 2009 (salis, 2009), the term “exercise is medicine” has been applied to the american college of sports medicine position stand on the benefits of exercise (garber et al., 2011) and to the standing category of scientific presentations at the annual meeting of the american college of sports medicine. these sources document strong scientific evidence that regular exercise contributes to primary and secondary prevention of diabetes, hypertension, cancer (particularly breast and colon cancer), depression, osteoporosis and dementia, and while it is not very effective in weight loss, it helps maintain healthy body weight, and reduces all-cause mortality. furthermore, it benefits human health regardless of ethnicity or age. finally, exercise also assists weight control through temporary suppression of hunger (king, burley & blundell, 1994). annales kinesiologiae • 10 • 2019 • 1 49 katarina tomljenović borer: how does exercise support dietary approaches to weight loss ..., 31–58 figure 12. exacerbation of postprandial glucose intolerance in exercise trials (bottom) but not in sedentary trials (top) after the third low-carbohydrate as well as highcarbohydrate meals high-carbohydrate meals. from lin & borer, 2016. 50 katarina tomljenović borer: how does exercise support dietary approaches to weight loss ..., 31–58 annales kinesiologiae • 10 • 2019 • 1 discussion the reviewed data were selected to help formulate some inferences, and provide guidance, regarding behavioral prevention, reversal, or mitigation of obesity and its associated morbidities. prevention of obesity should entail the awareness that humans are unable to track calories eaten or calories expended in exercise, elaborated in the second section on the physiological features that facilitate overeating. this fact and the evidence for the powerful motivational draw to eat palatable food, discussed in the same section, should provide a cautionary note to individuals with healthy weight to exercise vigilance and restraint about quantities of food eaten and monitor and respond to their gastrointestinal signals of fullness. preferential selection of naturally nutritious food rather than “fast food” that is commercially manipulated for maximal palatability should help counteract our innate motivation to seek palatability. selecting a diet that is rich in healthy fats and protein and avoiding over-indulging in high-carbohydrate diet should control postprandial insulin response and the property of the high circulating concentrations of this hormone to engage in excessive energy storage. conscious avoidance of long sedentary periods and introducing opportunities for physical work should, along with prudent eating pattern, help establish a stable and healthy body weight level. reversal of obesity presents a more formidable challenge. three powerful obstacles to maintenance of weight loss include physiological defense responses to any weight reduction, be it from obese level or a healthy level. the first one is a persistent reduction in resting metabolism, the second is increased hunger, and the third is heightened efficiency of energy storage. for this reason, most of the deliberately lost weight through food restriction, with or without additional exercise, is regained in the matter or months or years (wing et al., 2016, figure 13). the effect of deliberate weight loss on resting metabolic rate (rmr) was studied by kevin hall in individuals responding to the challenge of large weight losses seeking to win “the biggest loser” televised competition and compared to weight loss produced by roux-en-y gastric bypass surgery (knuth et al., 2014). both approaches produced between 40 and 49 kg weight loss with a smaller lean body mass loss in the television competition (16%) than in gastric-surgery patients (30%). however, in both groups, the reduction in rmr (characterized as the metabolic adaptation) was similarly proportional to, and associated with, a reduction in plasma leptin (knuth et al., 2016). this metabolic adaptation in the form of reduced metabolic rate occurs in response to negative energy balance caused either by fasting or by energy expenditure of exercise. it is currently viewed as an evolutionary defense response against deviations in total daily energy expenditure (pontzer, 2015). in this view, higher energy expenditure due to increased body mass is sustained with high energy intake, but any reduction in intake and exercise energy expenditure is compensated by a reduction in resting metabolism. this therefore means that once the increased body mass is acquired, attempts to reduce its lipid component will trigger downward adjustments in rmr. it also appears that a lack of change in gastro-intestinal scaling during weight loss does not affect the outcome, as https://www-ncbi-nlm-nih-gov.proxy.lib.umich.edu/pubmed/?term=wing%20rr%5bauthor%5d&cauthor=true&cauthor_uid=27271190 annales kinesiologiae • 10 • 2019 • 1 51 katarina tomljenović borer: how does exercise support dietary approaches to weight loss ..., 31–58 voluntary-effort and gastrectomy weight losers displayed similar metabolic adaptation (knuth et al., 2014; 2016). while this metabolic adaptation was shown to persist for up to 30 weeks post weight loss, it is not yet known whether moderate food restriction and at least 1 hour of exercise that are practiced by successful weight-loss maintainers (mcguire, wing, klem, seagle, & hill, 1998) can, over much longer periods of time, lead to reduced total energy expenditure setpoint through proportional reductions in all components of body mass, as well as in gastrointestinal remodeling. this is suggested by a study in which an individual totally abstained from eating for 382 days and lost 125 kg or 60.4% of initial weight. five years after returning to ad-libitum eating, his weight increased to only 89 kg from the post-fasting level of 82 kg (stewart & fleming, 1973). the other two variables that interfere with weight-loss maintenance and promote weight regain are a significant increase in insulin sensitivity as a result of weight loss which powerfully drives fat and glycogen re-synthesis and blocks triglyceride breakdown, and reduction of fasted plasma leptin to very low concentration (figure 1). as most of leptin is released from the subcutaneous wat, its role in weight-reduced state is to reduce satiation and increase hunger. this was demonstrated in powerful suppression of hunger by leptin administration to individuals who were experimentally undergoing a 10% weight loss (rosenbaum & leibel, 2014) and in persons with genetic inability to produce leptin in whom hormone administration suppressed both the hunger and reduced obesity (farooqi & o’rahilly, 2014). the appetite-suppressing effects of increases in basal leptin act on the previously-mentioned brain substrates of reward (berridge, 2009). figure 13. patterns of weight loss and regain as percent difference from the start during 4 years of an intensive lifestyle diet-and-exercise intervention in the look ahead clinical trial. from wing et al., 2016. 52 katarina tomljenović borer: how does exercise support dietary approaches to weight loss ..., 31–58 annales kinesiologiae • 10 • 2019 • 1 while there are no highly effective behavioral strategies for rapid weight loss, it is possible to sustain weight loss through deliberate control over the quantity of food eaten, daily exercise, and frequent monitoring of the weight balance (mcguire, et al., 1998). in 750 individuals tracked by the national weight control registry, a 13.5-kg weight loss was maintained for about 6 years by eating a low-calorie diet (5,792.3 kj/d and 25% of daily calories from fat) and by engaging in high levels of physical activity (11,847.3 kj/week). the strategies for the mitigation of morbidities associated with obesity include reducing the carbohydrate content of the diet to lower postprandial insulinemia and glycemia (lin & borer, 2016), exercising shortly after eating a meal (heden et al, 2015) rather than before the meals (lin & borer, 2016) because the former reduces postprandial glycemia while the latter exacerbates it. in addition, controlling the quantity of food eaten and changes in body weight with daily or at least weekly weighing provides helpful feedback for adjustments in energy balance, and engaging in about an hour of moderate daily physical activity contributes to a negative energy balance. increased exercise energy expenditure and negative energy balance may, due to reduction in total metabolic rate, be responsible for the many health benefits of exercise including lower inflammatory responses leading to reduced cardiovascular disease risk, and lower stress levels contributing to endocrine and psychological health as a consequence of the reduction in non-exercise energy expenditure (pontzer, 2015). conclusions the rapid global rise of obesity incurs a heavy personal and healthcare burden due to obesity-associated morbidities and shortening of life. we explain the features of human physiology that favor fat accretion and interfere with fat loss for the benefit of individuals who use this survey of evidence on strategies for prevention, reversal, and mitigation of obesity and its sequelae. obesifying features of human physiology include strong motivating properties of palatable food, inability to consciously detect calories eaten or expended through exercise, and hormonal and metabolic adaptations to negative energy balance that drive weight regain. we also point to the evolutionary burdens of high human capacity for fat storage and absence of a compensatory role for spontaneous physical exertion in counteracting the weight gain. adding exercise energy expenditure to deliberate control of the quantity of food eaten will reduce the incidence of some obesity-linked risk factors that lead to cardiovascular disease despite the metabolic adaptation of reduced resting metabolism. deleterious concomitants of obesity can also be mitigated by reducing postprandial hyperinsulinemia, namely by lowering the carbohydrate load of the diet and by exercising after, rather than before, the meals to facilitate greater glucose tolerance. https://www.ncbi.nlm.nih.gov/pubmed/?term=mcguire%20mt%5bauthor%5d&cauthor=true&cauthor_uid=9665679 annales 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(2013). circadian and ultradian components of hunger in human non-homeostatic meal-to-meal eating. physiology and behavior, 122, 8-16. https://doi.org/10.1016/j.physbeh.2013.08.001. yazıcı, d. & sezer, h. (2017). insulin resistance, obesity and lipotoxicity. advances in experimental medicine and biology, 960, 277-304. https://doi.org/10.1007/978-3-31948382-5_12. https://doi.org/10.2337/dc16-0509 https://doi.org/10.2337/dc16-0509 https://doi.org/10.1016/j.physbeh.2013.08.001 https://doi.org/10.1007/978-3-319-48382-5_12 https://doi.org/10.1007/978-3-319-48382-5_12 _goback _hlk3367923 _goback _goback _goback _hlk3056869 _goback _goback _hlk23766418 _goback _hlk26527070 _goback _goback annales kinesiologiae • 9 • 2018 • 2 89 original scientific article udc: 796.011.1:378.011.3-052 received: 2018-11-07 physical activity of university students and its relation to physical fitness and academic success silvester lipošek 1, jurij planinšec 2, bojan leskošek 3, aleksander pajtler 4 1university of maribor, faculty of mechanical engineering, slovenia 2university of maribor, faculty of education, slovenia 3university of ljubljana, faculty of sport, slovenia 4university of maribor, faculty of civil engineering, transportation engineering and architecture, slovenia corresponding author: silvester lipošek university of maribor, faculty of mechanical engineering smetanova ulica 17, 2000 maribor, slovenia phone: +386 31 651 868 e-mail: silvester.liposek@um.si abstract introduction: the purpose of this study was to determine the physical activity performed by students, its frequency and intensity and how this physical activity may relate to their physical fitness and academic success. methods: the sample consisted of 297 undergraduate students from 20 to 22 years of age (mean 20.5 ± 0.7) from the university of maribor. the type and frequency of physical activity in which they engaged were measured using the ipaq. academic performance was defined as regular admission to the second year of study. students’ physical fitness was determined using eurofit and fitnessgram tests. results: analysis of the ipaq questionnaire shows that the majority of students reported being physically active in the afternoon. nevertheless, according to the who’s guidelines, 79.8 % of students were insufficiently physically active. the results show that males performed better than females in nearly all of the physical fitness tests. periods of two to three hours of weekly physical activity were positively associated with academic success, while four hours or more resulted in no contribution. conclusion: correlations between physical activity and physical fitness were primarily found in higher duration physical activity and in higher frequency of vigorous exercise. the results of this study are similar to those of other countries regarding the 90 silvester lipošek, jurij planinšec, bojan leskošek, aleksander pajtler: physical activity of university students ..., 89–104 annales kinesiologiae • 9 • 2018 • 2 insufficient physical activity of young people. the influence of physical activity on academic success was analyzed by binary logistic regression. the majority of students were academically successful and regularly admitted to the second year of study (86.5 %). keywords: physical activity, physical fitness, academic achievement, university students. telesna dejavnost študentov in njena povezava s telesnim fitnesom in študijskim uspehom izvleček namen: cilj raziskave je bil ugotoviti pogostost in intenzivnost izvedene telesne aktivnosti študentov ter kako ta telesna aktivnost vpliva na njihovo telesno kondicijo in študijski uspeh. metode: v vzorec merjencev je bilo zajetih 297 dodiplomskih študentov in študentk starih od 20 do 22 let (as 20.5±0.7) univerze v mariboru. vrste in pogostost telesne aktivnosti smo merili z ipaq vprašalnikom. akademska uspešnost študentov je bila ocenjena z rednim napredovanjem v drugi letnik študija. telesna pripravljenost študentov je bila ocenjevana z uporabo eurofit in fitnessgram baterijo testov. rezultati: rezultati analize ipaq vprašalnika kažejo na to, da so študentje telesno aktivni večinoma v popoldanskih urah. v skladu s smernicami svetovne zdravstvene organizacije (who) je kar 79,8% študentov neaktivnih ali premalo telesno aktivnih. rezultati nam kažejo, da moški v skoraj vseh testih telesne pripravljenosti dosegajo boljše rezultate kot ženske. dve do tri ure telesne aktivnosti na teden kaže pozitiven učinek na študijski uspeh, medtem ko pri štirih urah in več tedenske aktivnosti, tega učinka ni zaznati. zaključek: korelacija med telesno aktivnostjo in telesno kondicijo je bila ugotovljena predvsem ob daljšem trajanju telesne aktivnosti ter pogostosti naporne vadbe. rezultati te študije so bili podobni študijam v drugih državah, kjer so ugotovili premajhno telesno aktivnost mladih. vpliv telesne aktivnosti na študijski uspeh je bil analiziran z binarno logistično regresijo. večina študentov je bila akademsko uspešnih (86,5%) in je redno napredovala v drugi letnik študija. ključne besede: športna aktivnost, telesna pripravljenost, študijski uspeh, študenti. annales kinesiologiae • 9 • 2018 • 2 91 silvester lipošek, jurij planinšec, bojan leskošek, aleksander pajtler: physical activity of university students ..., 89–104 introduction past research studies confirm that regular physical activity performed by children, adolescents and adults has a positive effect on health (boreham & roddoch, 2001; pori et al., 2013) and reduces the risk of developing various diseases (hallal, victora, azevedo & wells, 2006; warburton, nicol & bredin, 2006). generally, physical fitness and physical activity excerpt a positive impact on perception and concentration (centers for disease control and prevention, 2010; trudeau & shephard, 2008). additionally, consistent physical activity has a positive influence on self-esteem (crocker, sabiston, kowalski, mcdonough & kowalski, 2006; dunton, jamner & cooper, 2003; moreno, cervelló & moreno, 2008; weiss & williams, 2004), while lowering anxiety and stress (dolenc, 2015; flook, repetti & ullman, 2005). however, it must be taken into account that vigorous physical activity is time-consuming, requires recovery and therefore might reduce learning and studying time. the extended use of the internet and computer games (i.e., screen-time) poses a huge threat to a healthy lifestyle; therefore, only a small proportion of adolescents regularly participate in physical activity (aslan & arslan cansever, 2012; madell & muncer, 2004). many studies have attempted to identify a relationship between physical activity and academic achievement. however, these studies have had diverse and even contradictory conclusions: a significant positive correlation between the duration of physical activity and academic success (coe, pivarnik, womack, reeves & malina, 2006; kim et al., 2003), small correlation between them (daley & ryan, 2000; sallis et al., 1999) and a negative correlation (tremblay, inman & williams, 2000). research has also established that physical activity itself has many positive effects (better self-image, self-esteem, behavioural changes, better motivation in other areas, etc.), all of which influence academic success (trudeau & shephard, 2008). in the literature, the fitnessgram assessment was primarily used in the usa (renfrow, caputo, otto, farley & eveland-sayers, 2011; shriver et al., 2011). in europe, for example, fitness tests were usually combined with fitnessgram and eurofit items alongside some national recommendations (aires et al., 2010). recent results of health-related fitness tests on children show that results are progressively worsening and are accompanied by growing obesity and low physical activity (shriver et al., 2011). a comparison between obesity and health-related fitness is easier to conduct because the measures are well-defined, whereas physical activity can be measured by various means, for example, by weekly duration, frequency, intensity or variety. the study of physical activity of the university student population is especially interesting, as in slovenia and several other countries (cardinal, sorensen & cardinal, 2012; hardman, 2008), physical education is no longer a mandatory subject at tertiary level, as it is in secondary schools. therefore, it is important to establish if one of the most important objectives of mandatory physical education, i.e., educating students to accept physical activity as one of their regular life-long habits, has actually been fulfilled and if the decision to drop physical education from university curricula, a decision 92 silvester lipošek, jurij planinšec, bojan leskošek, aleksander pajtler: physical activity of university students ..., 89–104 annales kinesiologiae • 9 • 2018 • 2 made several years ago, has resulted in a large proportion of students becoming insufficiently active or even inactive. the aim of our study was twofold: 1) to explore the current state of physical activity and the physical fitness of university students and their anthropometric data and 2) to explore the relationship between physical activity, physical fitness and the academic success of university students. there has been little research on the effect of physical activity on academic performance in slovenia. on the basis of research results elsewhere, we assume that our study will demonstrate the positive effects of physical activity on academic performance. methods sample the sample consisted of second-year undergraduate students from fourteen faculties of the university of maribor. approximately 10 % of all full-time second-year undergraduate students, between 20 and 22 (mean 20.5 ± 0.7) years of age, agreed to participate in the study (n = 297, 114 or 38.4 % males and 183 or 61.6 % females). data collection procedure to collect information about students’ physical activities in the week before fitness testing, we used the ipaq questionnaire (bailey, mckay, mirwald, crocker & faulkner, 1999) with certain modifications (questions about the time of day and the type of physical activities were added). the time aspect of physical activity execution is divided as follows: pre-noon physical activities happen before 12 o’clock, afternoon physical activities are performed between 12 and 6 pm, while evening physical activities are executed after 6 pm and later. physical fitness testing took place at the university sports centre and was carried out by staff trained in measurement procedures. the two-day testing was open to all second-year students at the university of maribor. participation was voluntary; all of the participants gave written consent. individual fitness tests were carried out at stations set up as a polygon. the order of fitness tests and conducted measurements were the same for all participants. we administered the following twelve physical fitness test items to measure motor performance fitnessgram (meredith & welk, 2010), eurofit (topend sports, 2016) and national recommendations slofit (strel et al., 1996): plate tapping test (20”), polygon backwards, the wall toss test, standing forward bend and reach flexibility test, sit and reach flexibility test, standing shoulder rotation flexibility test, standing long jump test, sit-ups in 60” test, flexed arm hang test, the flamingo balance test, 20-meter sprint and the 20-meter shuttle run. the 20-meter shuttle run results were converted to vo2 max volumes according to the instructions set out by ramsbottom et al. (1988). the following anthropometric measures annales kinesiologiae • 9 • 2018 • 2 93 silvester lipošek, jurij planinšec, bojan leskošek, aleksander pajtler: physical activity of university students ..., 89–104 were taken (topend sports, 2016): body height, body weight, upper arm circumference, thigh circumference and abdominal circumference. to estimate the amount of subcutaneous fat, we measured each participant’s upper arm (triceps) skinfold, thigh skinfold (suprapatellar), abdomen skinfold (abdominal and suprailiac skinfold) and back skinfold. the weekly duration of physical activity (number of hours of physical activity in the previous week), frequency of vigorous physical activity (number of sessions of vigorous physical activity lasting at least 15 minutes in the previous week), frequency of moderate physical activity (number of sessions of moderate physical activity lasting at least 15 minutes in the previous week), frequency of low effort physical activity (number of sessions of low effort physical activity lasting at least 15 minutes in the previous week) and sports club membership were used as indicators of physical activity. criteria suggested by janssen (2001) were employed to measure the intensity of physical activity (vigorous, moderate, low effort). the dependent variable of academic success was defined as the regular admission to the second year of study (coded as 1 if a student was regularly admitted from the first to the second year of study and 0 otherwise). data analysis the collected data were analyzed using ibm spss 20.0 software (ibm corp., armonk, ny). physical fitness test results were compared by gender using an independent samples t-test or mann-whitney u test in case the shapiro–wilks test did not confirm the normal distribution of data. to determine the relationship between physical activity and physical fitness tests, spearman’s correlation coefficient was used. the influence of physical activity on academic success was calculated by a binary logistic regression. the odds ratio, 95 % confidence interval and p value were calculated for each variable included in the logistic model. a p < 0.05 was considered statistically significant. results analysis of the ipaq questionnaire results shows that the majority of students reported being physically active in the afternoon (from 12 to 6 pm), as 161 (54.2 %) reported being active 2 to 3 times a week or more; in the evening (after 6 pm), this figure was 94 (31.6 %), and in the morning (before noon), 43 (14.5 %) reported being physically active. eleven (3.7 %) students were completely inactive during the previous week. figure 1 also shows that males and females reported a similar physical activity pattern during the week. 94 silvester lipošek, jurij planinšec, bojan leskošek, aleksander pajtler: physical activity of university students ..., 89–104 annales kinesiologiae • 9 • 2018 • 2 figure 1. weekly frequency of physical activity of students by gender and time of day. for vigorous exercise of at least 15 minutes, 79 (26.6 %) students reported no engagement, and 82 (27.6 %) students exercised vigorously only once a week. for moderate exercise of at least 15 minutes, 106 (35.7 %) students reported exercising once a week, while 62 (20.9 %) reported never exercising at this intensity level. 78 (26.3%) students engaged in exercises requiring low effort once a week, while 94 (31.6 %) students reported no engagement (figure 2). based on the criteria set forth in the who’s guidelines (who, 2004), 237 (79.8 %) students were inactive or insufficiently active because they were not physically active for at least 150 minutes of moderate-intensity, or at least 75 minutes of vigorous-intensity, exercise throughout the week. among these students, approximately half expressed a lack of free time and being overburdened with study as the reasons for their inactivity. figure 2. frequency of weekly physical activity (pa) lasting longer than 15 minutes. annales kinesiologiae • 9 • 2018 • 2 95 silvester lipošek, jurij planinšec, bojan leskošek, aleksander pajtler: physical activity of university students ..., 89–104 the anthropometric data results in table 1 show that male students were higher, heavier and had a higher body mass index. males also had larger circumferences and lower skinfolds with the exception of the abdominal skinfold. there were also no differences in age between the groups. table 1. anthropometric data arranged by gender of students. males n=114 females n=183 p-value* mean sd mean sd age (years) 20.4 0.7 20.5 0.7 ns body height (cm) 180.7 6.7 166.2 5.9 <0.001 body weight (kg) 80.0 10.5 64.0 12.3 <0.001 body mass index (kg/m2) 24.5 3.0 23.1 4.3 <0.001 upper arm circumference (mm) 305.1 27.7 272.8 34.5 <0.001 thigh circumference (mm) 576.1 44.8 558.9 60.5 0.006 abdominal circumference (mm) 871.7 83.7 824.5 119.4 <0.001 upper arm skinfold (mm) 10.5 4.9 17.0 8.0 <0.001# back skinfold (mm) 13.9 5.8 16.3 8.9 0.006# thigh skinfold (mm) 18.0 9.0 24.3 8.7 <0.001# abdominal skinfold (mm) 18.7 8.5 19.2 8.4 ns# suprailiac skinfold (mm) 17.4 8.2 20.4 7.9 0.002# * independent samples t-test; # mann-whitney u test; ns = not significant the results in table 2 show that males performed statistically significantly better than females in most of the twelve physical fitness tests, except in three flexibility tests (standing forward bend and reach, sit and reach, shoulder rotation), where female students performed better than males and in flamingo balance test where the difference is not significant. 96 silvester lipošek, jurij planinšec, bojan leskošek, aleksander pajtler: physical activity of university students ..., 89–104 annales kinesiologiae • 9 • 2018 • 2 table 2. physical fitness test results arranged by gender. males n=114 females n=183 p-value* m s m s plate tapping 20« (count) 48.9 4.9 46.2 4.7 <0.001 polygon backwards (seconds) 9.0 1.6 11.9 2.2 <0.001 wall toss test (count) 22.9 4.9 15.9 4.7 <0.001 standing forward bend and reach (cm) 46.6 7.8 49.7 7.3 0.001 sit and reach (cm) 22.6 7.9 26.6 7.3 <0.001 shoulder rotation (cm) 109.4 15.5 88.5 16.7 <0.001 standing long jump (cm) 225.9 24.1 161.8 22.5 <0.001 sit-ups 60” (count) 49.8 9.2 41.1 9.1 <0.001 flexed arm hang test (seconds) 24.6 17.0 11.5 13.6 <0.001# flamingo balance test (count) 9.3 5.0 9.7 4.7 ns # 20-m sprint (seconds) 3.2 0.2 4.1 0.4 <0.001 20-m shuttle run (vo2 max, ml/kg/min) 38.2 6.4 27.4 1.4 <0.001 m = mean; sd = standard deviation; * independent samples t-test; # mann-whitney u test; ns = not significant to find out how physical activity correlates with physical fitness, we analyzed three different parameters describing the extent of physical activity: a) weekly duration of physical activity; b) the weekly frequency of vigorous exercise lasting at least 15 minutes and c) weekly frequency of moderate exercise lasting at least 15 minutes. as the significant differences between males and females in physical fitness were found, we decided to analyze this relation separately, by gender. the results in table 3 provided several significant relationships between the duration and intensity of physical activity and fitness with primarily weak correlation coefficients. annales kinesiologiae • 9 • 2018 • 2 97 silvester lipošek, jurij planinšec, bojan leskošek, aleksander pajtler: physical activity of university students ..., 89–104 table 3. correlation between physical activity and physical fitness test results, arranged by gender. weekly duration of physical activity in hours weekly frequency of vigorous exercise lasting at least 15 min weekly frequency of moderate exercise lasting at least 15 min males n=114 r** females n=183 r** males n=114 r** females n=183 r** males n=114 r** females n=183 r** plate tapping 0.20# 0.11 0.26* 0.13 -0.12 -0.03 polygon backwards -0.14 -0.15# -0.19# -0.18# 0.08 0.04 wall toss test 0.36* 0.17# 0.28* 0.12 0.18 -0.09 standing forward bend and reach 0.11 0.15# 0.02 0.14 0.00 0.04 sit and reach 0.13 0.13 -0.04 0.04 0.11 0.06 shoulder rotation -0.03 0.00 0.00 -0.10 0.13 -0.10 standing long jump 0.21# 0.14 0.26* 0.19* -0.03 -0.01 pull-up 60” 0.24* 0.17# 0.32* 0.21* -0.05 0.11 flexed arm hang test 0.25* 0.30* 0.25* 0.23* 0.11 0.21* flamingo balance test -0.20# -0.10 -0.14 -0.19* 0.05 0.02 20-m sprint -0.06 -0.22* -0.14 -0.22* 0.02 -0.08 20-m shuttle run 0.29* 0.23* 0.37* 0.28* -0.01 0.00 r** = spearman’s correlation coefficient; * = p < 0.001; # = p < 0.05 the influence of physical activity on academic success was analyzed by binary logistic regression (table 4). the majority of students were academically successful and regularly admitted to the second year of study (86.5n%). two or three hours of weekly physical activity had a positive influence on regular admission to the second year of study (or = 3.37, 95 %, ci = 1.18–9.62, p = 0.024 and or = 4.37, 95 % ci = 1.44–13.24, p = 0.009, respectively). neither vigorous physical activity nor sports club membership had any influence on academic success (or = 0.55, 95 % ci = 0.21–1.43, p = 0.220 and or = 0.81, 95 % ci = 0.30–2.18, p = 0.674, respectively). regarding the anthropome98 silvester lipošek, jurij planinšec, bojan leskošek, aleksander pajtler: physical activity of university students ..., 89–104 annales kinesiologiae • 9 • 2018 • 2 tric data, being overweight (as indicated by body mass index) also had no influence on academic success (or = 0.72, 95 % ci = 0.31–1.69, p = 0.452). table 4. binary logistic regression for the prediction of academic success. regular admission to the 2nd year of study or (95% ci) p-value no n=40 (%) yes n=257 (%) weekly pa 1 hour or less 11 (27.5) 30 (11.7) 1.00 (reference) 2 hours 8 (20.0) 64 (24.9) 3.37 (1.18 – 9.62) 0.024 3 hours 7 (17.5) 75 (29.2) 4.37 (1.44 – 13.24) 0.009 4 hours 5 (12.5) 37 (14.4) 3.54 (0.99 – 12.59) 0.051 5 hours or more 9 (22.5) 51 (19.8) 3.26 (0.86 – 12.45) 0.083 vigorous pa 2x weekly or less 28 (70.0) 199 (77.4) 1.00 (reference) 3x weekly or more 12 (30.0) 58 (22.6) 0.55 (0.21 – 1.43) 0.220 moderate pa 2x weekly or less 34 (85.0) 208 (80.9) 1.00 (reference) 3x weekly or more 6 (15.0) 49 (19.1) 1.09 (0.38 – 3.11) 0.875 low effort pa 2x weekly or less 31 (77.5) 179 (69.6) 1.00 (reference) 3x weekly or more 9 (22.5) 78 (30.4) 1.18 (0.51 – 2.76) 0.700 sports club membership no 30 (75.0) 206 (80.2) 1.00 (reference) yes 10 (25.0) 51 (19.8) 0.81 (0.30 – 2.18) 0.674 body mass index <25 (normal) 27 (67.5) 187 (72.8) 1.00 (reference) ≥ 25 (overweight) 9 (22.5) 51 (19.8) 0.72 (0.31 – 1.69) 0.452 ≥ 30 (obese) 4 (10.0) 19 (7.4) 0.56 (0.17 – 1.88) 0.349 gender male 16 (40.0) 98 (38.1) 1.00 (reference) female 24 (60.0) 159 (61.9) 0.94 (0.43 – 2.03) 0.868 or = odds ratio, 95%ci = 95% confidence interval, pa = physical activity annales kinesiologiae • 9 • 2018 • 2 99 silvester lipošek, jurij planinšec, bojan leskošek, aleksander pajtler: physical activity of university students ..., 89–104 discussion international studies have shown that the percentage of physically inactive students varies from country to country: 23 % in western europe and the u.s., 30 % in central and eastern europe, 39 % in mediterranean countries, 42 % in the countries of the asia-pacific region and 44 % in developing countries (haase, steptoe, sallis & wardle, 2004). guthold published data on levels of physical inactivity in 51 countries, most of which were low or middle income, and observed several trends (guthold, ono, strong, chatterji, & morabia, 2008). globally, with the exception of several eastern european countries, women were more likely to be physically inactive than men. few studies have explored the reasons for decreasing levels of physical activity in developing countries. ng et al. (2009) estimate that between 1991 and 2006, average weekly physical activity fell by 32 per cent. globally, around 23 % of adults aged 18 and over were not active enough in 2010 (men 20 % and women 27 %). in high-income countries, 26 % of men and 35 % of women were insufficiently physically active, as compared to 12 % of men and 24 % of women in low-income countries (world health organization, 2016). the results of our study showed a more positive picture as only 7.4 % of students reported not being involved in vigorous or moderate exercise; however, 26.6 % of students reported not performing any vigorous exercise. the results of our study on the physical activity of students may therefore be considered similar to previous studies. with respect to the who recommendations (world health organization, 2004), with the time component of adequate physical activity included (150 minutes of moderate-intensity, or at least 75 minutes of vigorous-intensity throughout the week), our results are worse, showing that only 20.2 % of students reported adequate physical activity. for example, this percentage was similar to a national survey conducted by caspersen, fereira, and curran (2000), who found that only 25 % of americans reach the recommended level of physical activity. regarding organized physical activity, our study showed that only 20.5 % of the students were active in a sports club. the percentage of students active in sports clubs is close to the figure in croatia (23 %) (andrijašević, paušić, bavčević & ciliga, 2005), although another study has suggested that only 16 % of slovene students are actually active in sports clubs (golja & robič, 2014). in sweden, however, it was reported that the percentage of young people engaged in sport clubs is increasing, as 66 % of boys and 53 % of girls were active in them (westerståhl, barnekow-berkvist, hedberg & jansson, 2003), a percentage that is considerably higher than the levels in slovenia or croatia. our results showed that students were under-active, considering that a healthy adult requires a minimum physical activity time of at least 150 minutes of moderate exercise per week (such as fast walking, cycling on flat terrain, or even mowing the lawn) or 75 minutes of vigorous exercise (running, swimming, rough terrain biking, playing basketball or tennis) (janssen, 2001), where only approximately 20.2 % of students reported sufficiently frequent engagement. since the results of the physical fitness tests indicated significant differences between males and females, we decided to calculate the correlation between physical activity and fitness tests results by gender. the results show that in this gender comparison, 100 silvester lipošek, jurij planinšec, bojan leskošek, aleksander pajtler: physical activity of university students ..., 89–104 annales kinesiologiae • 9 • 2018 • 2 there is on average a smaller share of women who take part in no physical activity, but a higher percentage who take part in physical activity once or two to three times per week. the study demonstrates that male students outperformed their female counterparts in almost all motor tests except the flamingo, which measures balance, where no significant difference was found and in flexibility, where female students performed better than male. the second purpose of the study was to explore the relationship between the reported extent of weekly physical activity and physical fitness. in most cases, especially in overall weekly duration of physical activity and weekly frequency of vigorous exercise lasting at least 15 minutes, physical activity is positively correlated to physical fitness, however most correlation coefficients were low and, in some cases, also not statistically significant. even weaker correlation was found between weekly frequency of moderate exercise lasting at least 15 minutes and physical fitness. the only coefficients exceeding 0.3 were those between overall duration of physical activity and the frequency of vigorous exercise with the wall toss test, pull-up 60” and 20-m shuttle run among male students. similarly, renfrow et al. (2011) found that males who played more sports achieved significantly better fitnessgram overall scores. in a longitudinal study, aires et al. (2010) found that an increased physical activity index contributed to improved physical fitness. associations between physical activity and physical fitness tests, as documented in available studies such as martinez-vizcaino & sanchez-lopez, (2008), fang et al. (2017) show the positive effects of increased physical activity for improved health-related physical fitness in children and young people (martínez-vizcaíno & sánchez-lópez, 2008; malina, bouchard & bar-or, 2004). our last research aim was to explore whether the extent of physical activity influences academic success, which was defined as regular admission from the first to the second year of study. in previous researches, physical activity has not clearly been associated with academic performance (daley & ryan, 2000; sallis et al., 1999; tremblay et al., 2000). our results provided some evidence that higher duration of physical activity may positively influence academic performance, which was similar to coe et al. (2006), kim et al. (2003) california department of education (2001), sibley & eitner (2003), castelli, hillman, buck & erwin (2007) and trost (2016). on the other hand, our results regarding comprehensive vigorous physical activity or sports club membership provided no proof of their positive influence on academic success. this might suggest that two to three hour weekly recreational physical activity is positive for one’s academic success, while sporting physical activity is probably too exhausting and timeconsuming. study limitations measuring weekly physical activity among the population is difficult because its duration, intensity, frequency, and type of exercise performed are seldom recorded. physical activity is usually performed with less consistency, more often in some weeks, in others less, sometimes physical activity is performed on weekends, sometimes annales kinesiologiae • 9 • 2018 • 2 101 silvester lipošek, jurij planinšec, bojan leskošek, aleksander pajtler: physical activity of university students ..., 89–104 during the week, etc. therefore, participants face difficulties in reliability and reporting every detail of their weekly physical activity. to reduce bias, we gathered data about physical activity with several measures: weekly duration in hours, frequency by intensity of exercise (vigorous and moderate), larger sample, the greater number of faculties and different level of exercise (low effort pa, moderate pa, vigorous pa). conclusions this study indicates that the duration of physical activity has only a limited influence on the academic performance of undergraduate students. two to three hour weekly recreational physical activity proved beneficial, while comprehensive vigorous exercise and sports club participation did not. according to the literature, we expected stronger correlations between the reported extent of weekly physical activity and fitness test performance. similarly, we did not expect such negative / bad results about the extent of physical activity among students, as they in general reported physical activity below international recommendations. in slovenia, the number of physically active students would most certainly increase if each faculty had adequate sports facilities and equipment which students could use in their leisure time free of charge. both society in general and individuals can take action to increase physical activity. in 2013, who member states agreed to a target of reducing insufficient physical activity by 10 % by 2025 and included strategies to achieve this goal in the „global action plan for the prevention and control of non-communicable diseases 2013-2020“. slovenia should also adhere to this action plan. funding the study had no accessional financial support. ethical approval written informed consent was obtained from all tested students references andrijašević, a., paušić, j., bavčević, t., & ciliga, d. 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https://ijbnpa.biomedcentral.com/articles/10.1186/1479-5868-5-10 https://doi.org/10.1503/cmaj.051351 https://doi.org/10.1503/cmaj.051351 https://doi.org/10.1503/cmaj.051351 https://doi.org/10.1111/j.1651-2227.2003.tb02514.x https://doi.org/10.1111/j.1651-2227.2003.tb02514.x https://www.who.int/dietphysicalactivity/strategy/eb11344/strategy_english_web.pdf https://www.who.int/dietphysicalactivity/strategy/eb11344/strategy_english_web.pdf http://www.who.int/mediacentre/factsheets/fs385/en/ annales kinesiologiae • 12 • 2021 • 1 1 editorial motor activity is, next to cognitive and social, the activity that has accompanied humans through the evolution in a special way, defining man throughout as a unique earthly living being. through the interaction of these three factors, an incredibly efficient and unrivaled system developed which perfectly meets the human need for work (imagine the work of a vascular surgeon, a neurosurgeon, a conservator, a pilot …), art and culture (picture a violin virtuoso, a painter or a sculptor, a dancer or an actor …), and sports (think of a gymnast’s or a track and field athlete’s command of their body; a skier’s, or a tennis, basketball or soccer player’s mastery of the necessary sports equipment …). however, the rapid development and diffusion of online technologies, communication via social media, and digitalization of society, the need for motor activity or, indeed, any kind of physical exertion has all but disappeared from daily life. the enormous increase in sedentary jobs (by no less than 83 percent since 1950) coupled with growing screen time (in children, adolescents and adults alike, which presently amounts to over 7.5 hours per day) is reflected in an ever more sedentary society (10 +/2h of sitting time per day) and seriously threatening human health. a sociology of sedentarism is dramatically on the rise and represents the new reality. it is safe to assume that the generations of children and adolescents who perceive this way of living as completely natural will be at even greater risk. the human organism may be uniquely flexible and plastic, but it is unrealistic to expect the physiological mechanisms established over millions of years to be able to change and adapt in such a short time. in ways unnoticeable and probably incomprehensible to most, physical inactivity is becoming public health enemy number one. from the results of numerous studies based on these facts, we can conclude that we display safe and responsible health-related behavior when we engage daily in suitably intense physical activity for a sufficient amount of time, while allowing ourselves to be sedentary or physically inactive infrequently and for the shortest amounts of time possible. the ever emerging and progressively advanced studies in this field are aimed at discovering new possibilities and systemic solutions, shedding light on the grey areas, and proposing effective and systemic interventions, also by including the digitized world and modern technology. their adaptability to an individual’s role in modern society, one’s profession, environment, and especially gender and age, is of the utmost importance. by studying the differences and mechanisms, as well as through a differentiation of selected interventions, and determination of the right intensity, length and content of exercise in real time, we can achieve better results, manage these factors better, and, above all, maximize their potential. the first volume of this year’s annales kinesiologiae journal provides fascinating views and new scientific facts that demonstrate the various aspects of the impact of motor activity, physical exercise and sports, both during childhood and adulthood, also highlighting the role of gender and, ultimately, the importance of defining the goal of the entire process. the latter can be achieving a target result in sports, enhancing the quality of a teaching process, or the reestablishment of functional balance ‒ rehabilita2 annales kinesiologiae • 12 • 2021 • 1 tion. as always, the volume is rounded off by two reports: one introducing the slovenian mobile brain/body imaging laboratory (slomobil), a new unit of the laboratory of the institute for kinesiology studies of the science and research centre koper, and the other presenting a recently published book: safe and with joy on a motorbike. even in these we can perceive the new horizons and fields where quality physical/ sports activities can be a guarantee of health and success and, even more so, of safety and quality of life. rado pišot, phd, editor-in-chief annales kinesiologiae • 12 • 2021 • 1 3 uvodnik gibalna aktivnost je bila ob kognitivni in socialni tista, ki je človeka spremljala skozi evolucijo na prav poseben način in ga ves čas opredeljevala kot edinstveno zemeljsko živo bitje. v prepletu teh treh dejavnikov je človek razvil neverjetno učinkovit in edinstven sistem, ki je zadovoljeval njegove življenjske potrebe do dela (predstavljajmo si delo žilnega kirurga, nevrokirurga ali restavratorja, pilota …), umetnosti in kulture (virtuoz na violini, slikar ali kipar, plesalec, igralec …) ter športa (upravljanje z lastnim telesom telovadca ali atleta; z rekviziti smučarja, igralca tenisa; z žogo – nogometaša ali košarkarja …). s hitrim razvojem in razmahom spletnih tehnologij, komunikacije po socialnih omrežjih in digitalizacije družbe je potreba po gibalni aktivnosti in kakršnemkoli fizičnem naporu skorajda izginila iz vsakdanjega življenja. enormen porast sedečih poklicev (kar za 83 % od leta 1950), ki se skupaj s povečanjem zaslonskega časa (otrok, mladostnikov in odrasle populacije – danes že več kot 7,5 ure dnevno) odraža v vedno bolj sedentrani družbi (čas sedenja okrog 10 ur), predstavlja resno grožnjo našemu zdravju. sociologija sedentarizma je v grozljivem vzponu in predstavlja novo življenjsko realnost. predvidevamo lahko, da bodo generacije otrok in mladostnikov, ki tak način življenja sprejemajo kot povsem naraven pojav, posledično še veliko bolj ogrožene. človeški organizem je sicer edinstveno prilagodljiv in plastičen, vendar pa ni mogoče pričakovati, da bi se fiziološki mehanizmi, ki smo jih vzpostavljali milijone let, zmogli prilagoditi in spremeniti v tako kratkem času. nezavedno in gotovo večini še nerazumljivo postaja tako gibalna neaktivnost prvi in največji sovražnik zdravja današnje družbe. upoštevajoč številne raziskave lahko na navedenih dejstvih zaključimo, da je varno in do našega zdravja odgovorno obnašanje takrat, ko skrbimo, da smo na dnevni ravni dovolj časa in ustrezno intenzivno aktivni, vendar moramo hkrati poskrbeti, da smo tudi čim manj časa in v čim krajših obdobjih sedeči oz. gibalno neaktivni. vedno nove in naprednejše raziskave področja si za cilj med drugim postavljajo iskanje novih možnosti in sistemskih rešitev, osvetljevanje sivih con, odpiranje učinkovitih in sistemskih intervencij tudi z vključevanjem digitaliziranega sveta in sodobnih tehnologij. gotovo je izredno pomembna prilagodljivost posamezni vlogi človeka v sodobni družbi, poklicu, okolju, predvsem pa spolu in starosti. s preučevanjem razlik in mehanizmov ter diferenciacijo izbranih intervencij, prilagojenega dimenzioniranja in vsebine vadbe v realnem času lahko iščemo večji učinek, lažje upravljanje omenjenih dejavnikov, predvsem pa njihov boljši izkoristek. v prvem zvezku letošnje revije annales kinesiologiae nam avtorji ponujajo zanimive poglede in nova znanstvena dejstva, ki dokazujejo različne dimenzije vpliva gibalne aktivnosti, vadbe in športa tako v obdobju otroštva kot odraslosti, s pomembno vlogo spola in ne nazadnje opredeljenosti cilja samega procesa. slednji je lahko podrejen športnemu rezultatu, kakovosti učnega procesa ali vzpostavljanju funkcionalnega ravnovesja – rehabilitaciji. tudi tokratni zvezek zaključujemo z dvema poročiloma, in sicer predstavitvijo nove enote laboratorija inštituta za kineziološke raziskave zrs koper – slovenian mobile brain/body imaging laboratory (slomobil) ter predstavitvijo 4 annales kinesiologiae • 12 • 2021 • 1 nove knjige varno in z veseljem na motor. tudi v slednjih lahko zaznamo nove širine in področja, na katerih kakovostna gibalna/športna aktivnost predstavlja zagotovilo za zdravje in uspeh, predvsem pa varnost in kakovostno življenje. prof. dr. rado pišot, odgovorni urednik _goback _hlk98923763 _hlk98755967 _hlk79606686 _hlk99786836 _hlk98147084 _hlk99787368 _hlk88552317 _hlk17057094 annales kinesiologiae • 13 • 2022 • 1 79 reports and reviews/poročila in ocene, 77–84 having fun while learning ski easy snow day 1st ski easy multiplier sport event, pamporovo, bulgaria, 14–16 march 2022 despite the difficult situation caused by covid19 measures, the project erasmus + sport cooperation “ski easy easy (educational, accessible, simple, youthful) approach to skills acquisition in skiing” has successfully pursued the implementation of its objectives. one of the important outcomes is the implementation of multiplier sport events known as the ski easy snow day. the main idea of the ski easy snow day is to promote the ski easy teaching module and to enable children – ski beginners from 6–9 years old, especially those coming from deprived social and economic environments – to experience an exciting snow day and try to take their first steps on ski. for that purpose, the elan ski manufacturer prepared and adapted special skis (using u-flex technology) and ski boots for children that enable easier turns on slopes and more fun when learning how to ski. in short, the ski easy snow day enables deprived children from lower socioeconomic environments who do not have the opportunity to experience skiing to get a 80 reports and reviews/poročila in ocene, 77–84 annales kinesiologiae • 13 • 2022 • 1 taste of this beautiful experience with professional ski instructors with the help of the ski easy mobapp application. the 2022 ski easy snow day pamporovo was the first of three planned multiplier sport events and was organized by a bulgarian ski school. it took place at the pamporovo ski resort which offers suitable conditions for the event and was divided in two parts. on the first day, a workshop was held by ski easy project partners with bulgarian ski school instructors to get acquainted with the ski easy teaching model. the following two days were devoted to ski lessons for beginners. despite the problems of viral illnesses and the covid-19 pandemic, we managed to have two very nice and unforgettable days with the children. there was a very good response from the ski instructors, coaches and other snow sport experts, participants of the 3rd spe balkan ski conference, who were invited to observe the implementation of the ski easy teaching model. the ski easy project also addresses the aspect of sustainability, as the 300 pairs of skis will remain with the eight project partners in order to be able to organize further ski days and ski teaching courses after the end of the project according to the developed unified ski easy teaching model. in 2023 another two ski easy snow days will be held in kopaonik, serbia and innsbruck, austria. saša pišot, project coordinator annales kinesiologiae • 13 • 2022 • 1 81 reports and reviews/poročila in ocene, 77–84 zabavno učenje smučanja – dnevi na snegu ski easy 1. interaktivni športni dogodek ski easy, pamporovo, bolgarija, 14.–16. marec 2022 projekt erasmus + šport „easy (izobraževalen, dostopen, preprost, mladosten) pristop k usvajanju veščin pri učenju smučanja«)“ je kljub težkim razmeram zaradi ukrepov covida-19 uspešno uresničil zastavljene cilje. eden od pomembnih rezultatov je izvedba interaktivnih športnih dogodkov, imenovanih dan na snegu ski easy. glavni zamisli dneva na snegu ski easy sta promocija učnega modula ski easy in omogočanje otrokom začetnikom, starim od 6 do 9 let, zlasti tistim, ki prihajajo iz socialno in ekonomsko šibkih družin, da doživijo razburljiv dan na snegu in poskusijo 82 reports and reviews/poročila in ocene, 77–84 annales kinesiologiae • 13 • 2022 • 1 narediti prve korake na smučeh. v ta namen je proizvajalec smuči elan pripravil posebne smuči s tehnologijo u-flex in smučarske čevlje, ki omogočajo lažje zavoje in več zabave pri učenju smučanja. dan na snegu ski easy omogoča otrokom, ki nimajo priložnosti, da s pomočjo dostopne opreme, profesionalnih učiteljev in zabavne mobilne aplikacije ski easy doživijo čudovito izkušnjo usvajanja smučarskega znanja. dan na snegu ski easy, ki ga je organizirala bolgarska šola smučanja, je bil prvi od treh načrtovanih interaktivnih športnih dogodkov, saj smučarsko središče pamporovo ponuja primerne pogoje za dogodek, ki je bil razdeljen na dva dela. prvi dan so partnerji projekta ski easy organizirali delavnico za učitelje bolgarske nacionalne smučarske šole, na kateri so se ti seznanili z modelom ski easy. preostala dneva sta bila namenjena učenju smučanja otrok začetnikov. kljub težavam z virusnimi obolenji in epidemijo covida-19 nam je uspelo pripraviti lepa in nepozabna dneva za otroke iz bližnjega mesta. lahko se pohvalimo tudi z dobrim odzivom učiteljev smučanja – udeležencev 3. spe konference balkan ski, ki so bili povabljeni, da si ogledajo izvajanje modela poučevanja ski easy. s projektom ski easy zagotavljamo tudi trajnost, saj bo 300 parov smučarske opreme pri osmih projektnih partnerjih namenjenih za organizacijo smučarskih dni in tečajev smučanja po enotnem učnem modelu ski easy tudi po končanem projektu. leta 2023 bosta izvedena še dva smučarska dogodka – dneva na snegu ski easy na kopaoniku v srbiji in v innsbrucku v avstriji. saša pišot, koordinatorica projekta _hlk119322918 _hlk110178216 _hlk38187602 _hlk120196417 _hlk120196458 _hlk117871780 _hlk117865098 _hlk118123043 _hlk118137344 _hlk70951511 annales kinesiologiae • 11 • 2020 • 1 3 original scientific article doi: https://doi.org/10.35469/ak.2020.242 received: 2020-09-14 udc: 796.071.2-055.2:613.2 eating attitudes and body image concerns among female athletes from aesthetic sports aleksandra aleksić veljković1, dušanka đurović2, filip biro3, katarina stojanović4, predrag ilić1 1 faculty of sport and physical education, university of niš, niš, serbia 2 faculty of sport and tourism, educons university, novi sad, serbia 3 faculty of philosophy, university of novi sad, novi sad, serbia 4 faculty of philosophy, university of niš, niš, serbia corresponding author: aleksandra aleksić veljković faculty of sport and physical education, university of niš, čarnojevića 10a, niš, serbia phone: +381 63 443 294 e-mail: aleksic.veljkovic@gmail.com abstract purpose: research has suggested that in female athletes from aesthetic sports the prevalence of disordered eating attitudes is higher than in female athletes from other sports, mainly due to sport related factors like extreme training and practicing sports associated with high pressure and the idea that “being thin leads to success”. the study was conducted to examine the prevalence of disturbed eating attitudes and their relationship with body image concerns in aesthetic and non-aesthetic female athletes. methods: 54 female athletes from aesthetic sports (synchronized swimming, artistic and rhythmic gymnastics, and dance), as well as 66 female athletes from non-aesthetic sports (volleyball, track and field, and soccer), completed the eating attitudes test, the body shape questionnaire, and the figure rating scale (a visual scale used to assess body image dissatisfaction and body image dissatisfaction in relation to sport). results: the results indicated that aesthetic athletes scored significantly higher than those involved in non-aesthetic sports in dieting, and in body image dissatisfaction. moreover, aesthetic athletes demonstrated significantly lower bmi mean scores. significant correlations were found between body mass index and oral control, body image dissatisfaction and body image dissatisfaction in relation to sport, and between eating attitudes test and the body shape questionnaire results in aesthetic athletes. furthermore, significant associations were found between body mass index and body shape questionnaire, body image dissatisfaction and body image dissatisfaction in relation to sport, and eating attitudes test and body shape questionnaire in non-aesthetic athletes. 4 aleksandra aleksić veljković, dušanka đurović, filip biro, katarina stojanović, predrag ilić: eating attitudes ..., 3–16 annales kinesiologiae • 11 • 2020 • 1 conclusion: the study confirmed the relationship between body image concerns and pathological eating attitudes among female aesthetic sport athletes. keywords: aesthetic sports, body shape questionnaire, eating attitudes test, eating disorders, figure rating scale prehranjevalni vzorci in obremenjenost s telesno podobo pri športnicah iz estetskih športov izvleček cilj: raziskave kažejo, da so moteni vzorci prehranjevanja bolj razširjeni pri športnicah iz estetskih športov kot pri športnicah iz drugih panog, predvsem zaradi dejavnikov, povezanih s samim športom, kot sta pretirana vadba ter ukvarjanje s športnimi zvrstmi, povezanimi z velikimi pritiski in prepričanjem, da »vitkost vodi do uspeha«. pričujočo raziskavo smo izvedli, da bi preučili razširjenost motenih vzorcev prehranjevanja in njihovo povezanost z obremenjenostjo s telesno podobo pri športnicah iz estetskih športov in športnicah iz ostalih športnih panog. metode: 54 športnic iz estetskih športov (sinhronega plavanja, športne in ritmične gimnastike ter športnega plesa) in 66 športnic iz ostalih športnih zvrsti (odbojke, atletike in nogometa), je reševalo test o prehranjevalnih vzorcih, vprašalnik o postavi in vprašalnik z ocenjevalno lestvico shematskih postav (vizualno lestvico za ocenjevanje nezadovoljstva s telesno podobo in nezadovoljstva s telesno podobo v povezavi s športom). rezultati: pri športnicah, ki tekmujejo v estetskih športih, so bile dosežene vrednosti pri hujšanju in nezadovoljstvu s telesno podobo bistveno višje kot pri športnicah iz panog brez estetske komponente. še več, športnice iz estetskih športnih panog so izkazovale bistveno nižje povprečne vrednosti itm. pri športnicah iz estetskih športov smo ugotovili pomembne korelacije med indeksom telesne mase in kontroliranjem vnosa hrane, med nezadovoljstvom s telesno podobo in nezadovoljstvom s telesno podobo v povezavi s športom ter med rezultati testa o prehranjevalnih vzorcih in vprašalnika o postavi. pri športnicah iz športnih zvrsti, neodvisnih od estetske komponente, pa smo ugotovili pomembne povezave med indeksom telesne mase in rezultati vprašalnika o postavi, med nezadovoljstvom s telesno podobo in nezadovoljstvom s telesno podobo v povezavi s športom ter med rezultati testa o prehranjevalnih vzorcih in vprašalnika o postavi. zaključek: raziskava je potrdila povezavo med obremenjenostjo s telesno podobo in patološkimi vzorci prehranjevanja pri športnicah iz estetskih športnih zvrsti. ključne besede: estetski športi, vprašalnik o postavi, test o prehranjevalnih vzorcih, motnje hranjenja, ocenjevalna lestvica shematskih postav annales kinesiologiae • 11 • 2020 • 1 5 aleksandra aleksić veljković, dušanka đurović, filip biro, katarina stojanović, predrag ilić: eating attitudes ..., 3–16 introduction eating disorders are generally characterized by severe disturbances in eating behavior and are associated with distorted body image (chizawsky & newton, 2006). these disorders are characterized by preoccupation with food, body weight, and shape that are associated with behaviors such as starvation, fasting, binge eating, purging, and excessive exercise (flament, bissada, & spettigue, 2012). the core features of eating disorders include disturbances of body image (e.g., overvaluation of thinness, weight or shape concerns), overor under-control of eating (e.g., severe dietary restriction, binge eating), and extreme behaviors to control weight or shape (e.g., compulsive exercise, purging) (ahrberg, trojca, nasrawi, & vocks, 2011). body image is central to self-concept and has important implications for multiple areas of psychological functioning and quality of life (sarwer, thompson, & cash, 2005). authors define body image as a multifaceted construct that refers to individuals’ perceptions of, and attitudes toward, their own body, especially its appearance. body dissatisfaction involves negative thoughts and feelings about one’s body and a perceived discrepancy between current and “ideal” body size (sarwer et al., 2005). individuals with a negative body image often worry about their weight, are afraid to gain weight, and therefore diet more often than persons who have fewer weight concerns (de bruin, woertman, bakker, & oudejans, 2009). participation in sports that require low body weight and overestimate aesthetics, using it as a criterion for obtaining good results in competitions – such as artistic gymnastics, synchronized swimming, running, and dance – is associated with a high incidence of eating disorders (arcelus, witcomb, & mitchell, 2014; arthur-cameselle, sossin, & quatromoni, 2017; doughty & hausenblas, 2005; maya & moria, 2018; petrie, 1993). for example, female collegiate athletes symptomatic for an eating disorder reported more perceived pressure to be thin than their asymptomatic peers (greenleaf, petrie, carter, & reel, 2009). there are multiple reasons why eating disorders are more frequent in certain sports. most often, it is not a single element that causes eating disorders, but a series of specific factors. those factors are mutually related, and they can be specific feelings or pressures to which a person is exposed. some of the factors that can influence the development of eating problems are pressure to achieve success, a false conviction that the loss of weight will result in better performance, or a desire to impress fellow athletes, parents, and coaches (bratland-sanda & sundgot-borgen, 2013). characteristics of umpiring in aesthetic sports i.e., the importance of the subjective opinion of the umpire about the virtuosity and the appearance of the athlete can contribute to the pressure to reach and maintain an ideal weight (ziegler et al., 1998). ziegler et al. (1998) concluded that the dieting behaviors of figure skaters were not associated with perceptions of being overweight nor with a negative body image, contrary to the general belief that a negative body image and dieting are causally linked. rather than believing that “thin is beautiful”, gymnasts seemed convinced or persuaded that “thin is going to win” (debruin, 2010). specific risk factors about eating disorders in aesthetic sports involve 6 aleksandra aleksić veljković, dušanka đurović, filip biro, katarina stojanović, predrag ilić: eating attitudes ..., 3–16 annales kinesiologiae • 11 • 2020 • 1 the subjectivity of the judging, the advantages of small body mass, dominant aesthetic patterns, the young age of female athletes due to early specialization, and the outfits used in competitions (francisco, narciso, & alarcão, 2013). body dissatisfaction is often regarded as an essential factor typically associated with eating disorders (torstveit & sundgot-borgen, 2005). the higher probability that one will undertake attempts to lose weight, and dieting itself has been identified as another contributor to disordered eating (zullig, matthews-ewald, & valois, 2016). several studies have reported that elite female athletes from some sports dieted frequently and used pathogenic weight control methods despite being relatively satisfied with their bodies (giel et al., 2016; sundgot-borgen & torstveit, 2010). research investigating eating disorder occurrence in sport has shown an increased prevalence in elite female athletes in comparison with non-elite athletes or non-athletes. it was suggested that future studies develop and examine multi-factorial risk factor models for eating disorders in athletes (bratland-sanda & sundgot-borgen, 2013). the authors are trying to create a universal model that represents and explains the structure of eating attitudes. factors like body image dissatisfaction, weight concerns, and actual dieting behavior are almost always part of these models and a negative body image is found to be a very potent, well-supported risk factor (perini et al., 2009; ravaldi et al., 2003). our study aims to explore the relationship between body image concerns and eating disorders among female aesthetic sport athletes. the relationship between these two constructs can place body image concerns as a potential tool for the prediction of eating disorders. method sample the study group included 54 female athletes (aged 19 ± 3 years), affiliated to clubs of different aesthetic sports in serbia (23 from artistic and rhythmic gymnastics, 20 from dance, and 11 from synchronized swimming). they reported an average training period of 7.40 ± 7.41 years, a total of 8.25 ± 3.30 hours of practice a week, and the start of the sport career at 6.33 ± 2.45 years. the control group was formed by 66 female athletes from non-aesthetic sports (aged 20 ± 3 years), consisting of 20 athletes from volleyball, 22 from soccer and 24 from basketball. they reported a training period of 6.8 ± 4.5 years, and a total of 7 ± 3.50 hours of practice a week, and the start of the sport career at 8 ± 3.5 years. all the participants filled in the informed consent form and the study was conducted according to the declaration of helsinki and approved by the ethics committee of the faculty of sports and physical education, university of niš (number 05-2115). annales kinesiologiae • 11 • 2020 • 1 7 aleksandra aleksić veljković, dušanka đurović, filip biro, katarina stojanović, predrag ilić: eating attitudes ..., 3–16 anthropometric characteristics all athletes completed a questionnaire that included age, weight, and height information, as well as training and competition details. participants’ body mass index (bmi) was calculated as the ratio of body weight to the squared standing height (kg/ m2). underweight, normal weight, overweight, and obesity were identified through age and gender-specific national and international cut-off points, which correspond with bmi values of less than 18 kg⁄m2 (underweight), 18-25kg⁄m2 (normal), 25-30 kg⁄m2 (overweight), and more than 30 kg/m2 (obesity). instruments eating attitudes test-26 (eat-26) eat-26 is a self-report questionnaire used internationally to identify and assess disturbances in eating attitudes and behaviors and is also useful for following up the progression of clinical cases. the questionnaire consists of 26 items with three sub-scales: dieting, bulimia and food preoccupation, and oral control. if the total score is higher than 20, eat-26 is considered to be positive, thus confirming the presence of abnormal dietary attitudes, and the risk of developing an eating disorder (garner & garfinkel, 1997). the inventory uses a 6-point, likert-type scale (1= always, 2 = very often, 3 = often, 4 = sometimes, 5 = seldom, and 6= never). body shape questionnaire (bsq) to assess the degree of dissatisfaction with body image, the body shape questionnaire – bsq was used, which measures the concern one has with his⁄her own body shape, self-depreciation due to physical aspects and to the feeling of being fat. the questionnaire differentiates two aspects of body image: the accuracy of body size estimates, and the feelings towards the body (dissatisfaction or depreciation of one’s fitness). the questionnaire includes 34 items, and uses a 6-point, likert-type scale (1 = never, 2 = seldom, 3 = sometimes, 4 = often, 5 = very often, and 6 = always). the items’ scores are summed, and a total score is calculated for each individual. a total score lower than or equal to 80 is considered normal; i.e., no distortion of body image. a score between 81 and 110 means mild body image distortion; scores between 111 and 140 indicate moderate distortion; and over 140 severe body image distortion (cordás & castilho, 1994). 8 aleksandra aleksić veljković, dušanka đurović, filip biro, katarina stojanović, predrag ilić: eating attitudes ..., 3–16 annales kinesiologiae • 11 • 2020 • 1 figure rating scale a figure rating scale, developed by stunkard, sørensen, and schulsinger (1983) was used to assess body image. gender-specific drawing consisted of 9 schematic figures ranging from 1 (very underweight) to 9 (very overweight). the results are presented as the difference between the current and the desired size perceptions (current body size score minus desired body size score); and also, between athletes’ actual and perceived ideal body for their sport. a discrepancy score is interpreted as a measure of body image dissatisfaction (bid) and body image dissatisfaction in relation to sport (bids). statistical analysis descriptive statistics and t-test for small independent samples were used to examine differences in the variables recorded for the athletes involved in both aesthetic and non-aesthetic sports. pearson correlation coefficient was calculated to examine the relationship between the variables, and the kruskal-wallis test to compare three groups of participants, according to the criteria of bmi. calculation of parameters and applied statistics were performed with the use of software spss 20, with a significance level of p ≤ 0.05. results table 1 presents descriptive statistics for the groups and the whole sample, as well as the statistical significance (p) of t-test, showing differences between our two groups. the results show that the group of aesthetic sports had a significantly lower mean score of bmi, and a significantly higher mean score of eat-dieting, and bid (table 1). the difference between the mean scores of bsq was on the border of significance. consequently, we can conclude that girls from the group of aesthetic sports were significantly more dissatisfied with their body image and tended to apply dieting. furthermore, it is important to stress that in the aesthetic sport group we found 12 underweight girls (none in the control group), and 7 with bmi <17 kg⁄m2 – which is one of the dsm-5 criteria for the diagnosis of anorexia nervosa. annales kinesiologiae • 11 • 2020 • 1 9 aleksandra aleksić veljković, dušanka đurović, filip biro, katarina stojanović, predrag ilić: eating attitudes ..., 3–16 table 1. descriptive statistics and t-test between groups variables sp or t n m in im um m ax im um m ea n sd p bmi aesthetic 54 14.72 28.00 20.54 2.97 0.007 non-aesthetic 66 18.19 28.69 21.84 2.23 total sample 120 14.72 28.69 21.25 2.66 eat-26 aesthetic 54 .00 52.00 10.52 8.79 0.106 non-aesthetic 66 .00 38.00 8.23 6.63 total sample 120 .00 52.00 9.26 7.73 eat-dieting aesthetic 54 .00 30.00 6.13 5.92 0.021 non-aesthetic 66 .00 23.00 3.89 4.52 total sample 120 .00 30.00 4.90 5.29 eat-bulimia and food preoccupation aesthetic 54 .00 9.00 1.26 2.23 0.116 non-aesthetic 66 .00 12.00 1.97 2.61 total sample 120 .00 12.00 1.65 2.46 eat-oral control aesthetic 54 .00 13.00 3.13 3.06 0.119 non-aesthetic 66 .00 11.00 2.36 2.28 total sample 120 .00 13.00 2.71 2.67 body shape questionnaire (bsq) aesthetic 54 51.00 132.00 79.52 18.25 0.071 non-aesthetic 66 52.00 120.00 74.29 13.19 total sample 120 51.00 132.00 76.64 15.82 body image dissatisfaction (bid) aesthetic 54 .00 3.00 1.06 .83 0.002 non-aesthetic 66 .00 3.00 .62 .70 total sample 120 .00 3.00 .82 .79 body image dissatisfaction in relation to sport (bids) aesthetic 54 .00 3.00 .87 .95 0.372 non-aesthetic 66 .00 3.00 .73 .79 total sample 120 .00 3.00 .79 .87 10 aleksandra aleksić veljković, dušanka đurović, filip biro, katarina stojanović, predrag ilić: eating attitudes ..., 3–16 annales kinesiologiae • 11 • 2020 • 1 table 2. correlation matrix for aesthetic sports variables bmi eat-26 dieting bulimia oral control bsq bid bmi eat-26 -.077 eat-dieting .100 .927** eat-bulimia .081 .507** .320* eat-oral control -.472** .708** .494** .108 bsq .106 .489** .513** .116 .326* bid .342** .181 .239 .164 -.062 .297* bids .287* .125 .174 .238 -.150 .309* .437** ** correlation is significant at the 0.01 level (2-tailed). * correlation is significant at the 0.05 level (2-tailed). table 3. correlation matrix for non-aesthetic sports variables bmi eat-26 dieting bulimia oral control bsq bid bmi eat-26 .041 eat-dieting .125 .899** eat-bulimia .056 .757** .597** e a t o r a l control -.193 .260* -.050 -.125 bsq .267* .490** .492** .341** .059 bid .371** -.021 .016 .011 -.106 .307* bids .263* .134 .253* .335** -.182 .122 .505** ** correlation is significant at the 0.01 level (2-tailed). * correlation is significant at the 0.05 level (2-tailed). annales kinesiologiae • 11 • 2020 • 1 11 aleksandra aleksić veljković, dušanka đurović, filip biro, katarina stojanović, predrag ilić: eating attitudes ..., 3–16 by considering the results of correlation analysis in the sample of aesthetic sports (table 2), we can conclude that a low bmi highly correlates with the tendency toward oral (food) control (examples of items in eat-oral control: “i avoid eating when i’m hungry.”; “i can control myself well with food.”); the higher the bmi, the more body image dissatisfaction exists. interestingly, the correlation between bmi and body shape concerns (bsq) is low (0.106), but the correlation between body shape concerns and dieting is highly significant and positive. girls with low bmi are satisfied with their body shape and tend to keep it through strong feeding control; but, on the other hand, when they are worried about their body shape, they apply diets. the results of correlation analysis in the sample of non-aesthetic sports (table 3) show high correlation between bmi and body shape concerns (bsq), as well as between bmi and body image dissatisfaction. interestingly, body image dissatisfaction in connection with sport is most related to the bulimic type of controlling eating behavior (examples of items in eat-bulimia and food preoccupation: “i vomit after eating.”; “thinking about food preoccupies me.”). to further analyze the behavior of our subjects depending on the bmi category, we also performed a kruskal-wallis test for three groups: 1 underweight, 2 normal, and 3 overweight (see table 4). the results of the kruskal-wallis test also confirmed the underweight girls’ readiness for extreme nutritional control (to maintain their low body weight), as well as body image dissatisfaction in relation to sport found in overweight girls. table 4. kruskal-wallis test e a t26 o ra l c on tr ol d ie ti ng b ul im ia b sq b id b id s kruskal-wallis h 2.549 9.829 .528 3.879 3.118 3.701 7.970 df 2 2 2 2 2 2 2 asymp. sig. .280 .007 .768 .144 .210 .157 .019 12 aleksandra aleksić veljković, dušanka đurović, filip biro, katarina stojanović, predrag ilić: eating attitudes ..., 3–16 annales kinesiologiae • 11 • 2020 • 1 ranks group n mean rank eat-26 1 12 75.67 2 95 58.77 3 13 59.15 total 120 oral control 1 12 85.83 2 95 59.64 3 13 43.42 total 120 dieting 1 12 65.92 2 95 59.35 3 13 63.92 total 120 bulimia 1 12 43.29 2 95 62.04 3 13 65.12 total 120 bsq 1 12 66.46 2 95 57.79 3 13 74.77 total 120 bid 1 12 58.33 2 95 58.54 3 13 76.81 total 120 bids 1 12 58.33 2 95 58.54 3 13 76.81 total 120 annales kinesiologiae • 11 • 2020 • 1 13 aleksandra aleksić veljković, dušanka đurović, filip biro, katarina stojanović, predrag ilić: eating attitudes ..., 3–16 discussion this study confirmed the relationship between body image dissatisfaction and pathological eating attitudes among female aesthetic sport athletes. results show that athletes in both groups with a higher bmi are concerned about their appearance, dissatisfied with their body in connection with sport, and are inclined to use dieting or compensatory behavior to reduce their weight, but the concern is more prevalent in the group of aesthetic sports leading to pathogenic eating habits. athletes in the group of aesthetic sports have significantly lower bmi than athletes from non-aesthetic sports – some of them even fit the low body weight dsm-5 criterion for anorexia nervosa. paradoxically, underweight girls are satisfied with their body shape, and use extreme diet control to keep their bodies thin. using such pathological eating habits, those girls are at high risk for developing an eating disorder. due to the seriousness of eating disorders, and their frequent occurrence in sports, it is important to examine and understand why athletes seem to be more at risk compared to non-athletes (bratland-sanda & sundgot-borgen, 2013), especially in aesthetic sports, where the risk is even higher, because of the aesthetic component in performance. besides the aesthetic component, risk factors might also be weight regulation, dieting, and pressure to lose weight, personality traits, early start of sport-specific training, injuries, symptoms of overtraining, impression motivation, threat perception, and the impact of coaching behavior (bratland-sanda & sundgot-borgen, 2013). for all these sports, especially gymnastics, it is important to start a sport-specific career very early. the athletes in this investigation reported the start of their sport career at the age of 6.33 ± 2.45 years. the problem with the early start of sport-specific training is the risk of choosing a sport inappropriate for the athlete’s body type (sundgot-borgen, 1994). pubertal changes can affect the performance, so the earlier studies reported the importance to start primary prevention as early as 9-11 years, in order to protect athletes from different factors that can predispose them to develop eating disorders and bad eating habits (coelho et al., 2014). furthermore, engaging in sports associated with high levels of body preoccupation at an early and vulnerable age is also suggested as a factor for increasing the risk of eating disorders (bratland-sanda & sundgot-borgen, 2013; currie, 2010). the regulation of body mass is a critical issue for the athletes and attention must be paid to their strategies for weight control. for this reason, educating athletes, as well as coaches and sport functionaries, regarding the causes and consequences of eating disorders seems to be a necessary form of prevention of these. limitations in the present study include a small sample size from only one country where participants reported their height and weight and were at different levels of competition, from three different aesthetic sports. 14 aleksandra aleksić veljković, dušanka đurović, filip biro, katarina stojanović, predrag ilić: eating attitudes ..., 3–16 annales kinesiologiae • 11 • 2020 • 1 conclusion the results of our study show that girls from aesthetic sports fight hard to make their bodies thin. if they are unsuccessful in that endeavor, they show dissatisfaction with their own bodies and use rigorous forms of dieting. this puts them at a greater risk of developing eating disorders, some of them already meeting the low weight criterion for anorexia nervosa. references ahrberg, m., trojca, d., nasrawi, n., & vocks, s. 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(1998). body image and dieting behaviors among elite figure skaters. international journal of eating disorders, 24(4), 421–427. https://doi.org/10.1002/(sici)1098-108x(199812)24:4<421::aid-eat9>3.0.co;2-h. zullig, k. j., matthews-ewald, m. r., & valois, r. f. (2016). weight perceptions, disordered eating behaviors, and emotional self-efficacy among high school adolescents. eating behaviors, 21, 1–6. https://doi.org/10.1016/j.eatbeh.2015.11.007. https://doi.org/10.1002/(sici)1098-108x(199812)24:4<421::aid-eat9>3.0.co;2-h https://doi.org/10.1002/(sici)1098-108x(199812)24:4<421::aid-eat9>3.0.co;2-h https://doi.org/10.1016/j.eatbeh.2015.11.007 _hlk35418826 _goback _hlk35971111 _hlk35511489 _hlk35972306 _hlk35451145 _hlk35511425 _hlk35973495 _hlk35973574 _hlk35973830 _hlk35975249 _hlk35975104 _gjdgxs 30j0zll 1fob9te _goback _3znysh7 _goback _goback _goback _hlk54274488 _goback annales kinesiologiae • 11 • 2020 • 2 121 correlation of body composition with speed and agility of children aged 9-10 mima stanković1, dušan đorđević1, milan zelenović1,2, danijel božić1,2 1faculty of sports and physical education, doctoral academic studies, university of niš, niš, republic of serbia. 2faculty of physical education and sport, university of east sarajevo, east sarajevo, bosnia and herzegovina. corresponding author: milan zelenović faculty of physical education and sport, university of east sarajevo, aleksa šantić 3, east sarajevo 71123, bosnia and herzegovina. phone: +387 66 513 469 e-mail: milan.zelenovic@ffvis.ues.rs.ba, milanzeleni13@gmail.com abstract purpose: physical growth of children is measured by changes in body size and/or body composition, as well as by changes in motor skills. motor skills can be affected by many factors, such as genetic predisposition, body composition, socio-economic conditions, and the like. accordingly, the aim of the research is to determine the correlation between body composition with speed and agility of children aged 9 to 10 years. methods: the sample included 40 participants (29 boys and 11 girls, 9.47 ± 0.5 years). body height (bh), body weight (bw), body mass index (bmi) and body fat (bf), and basal metabolism (bmr) were determined to assess body composition. the bot2 subtest was used to assess speed and agility, which includes: shuttle run (1saa), stepping sideways over a balance beam (2saa), one-legged stationary hop (3saa), one-legged side hop (4saa), two-legged side hop (5saa), and total speed and agility (tsaa). results: the results of correlation statistics indicated the existence of negative correlations between: height and 3saa (r = -.353, p = .026); weight and 3saa (r = -.422, p = .007); weight and tsaa (r = -.359, p = .023); bmi and 3saa (r = -.342, p = . 031); bmi and tsaa (r = -.333, p = .036); bmr and 3saa (r = -.369, p = .019); bmr and tsaa (r = -.363, p = .021). conclusion: based on the results obtained in this study, it can be concluded that there is a correlation between body composition and speed and agility. in addition to body composition, a correlation was found between body height and performance of original scientific article doi: https://doi.org/10.35469/ak.2020.257 received: 2020-11-30 udc: 612.65:796.012.1 122 mima stanković, dušan đorđević, milan zelenović, danijel božić: correlation of body composition ..., 121–130 annales kinesiologiae • 11 • 2020 • 2 one-legged stationary hop, as well as between basal metabolism, the one-legged stationary hop test and the overall results achieved in motor skill tests. keywords: fat, basal metabolism, motor abilities, omron korelacija med telesno zgradbo in hitrostjo oziroma gibčnostjo pri otrocih, starih od 9 do 10 let izvleček cilj: telesna rast otrok se meri s spremembami v telesni velikosti in/ali konstituciji ter s spremembami v motoričnih spretnostih. na slednje lahko vpliva več dejavnikov, od genetske predispozicije in telesne zgradbe, do socialno-ekonomskih razmer in podobno. v skladu s tem je bil cilj naše raziskave ugotoviti, v kakšni korelaciji sta telesna zgradba in hitrost oziroma gibčnost pri otrocih, starih od 9 do 10 let. metode: vzorec je zajemal 40 udeležencev (29 dečkov in 11 deklic, starih 9.47 ± 0.5 let). pri določanju tipa konstitucije smo upoštevali telesno višino (tv), telesno težo (tt), indeks telesne mase (itm) in telesno maščobo (tm) ter bazalni metabolizem (bm). hitrost in gibčnost smo ocenjevali s podtestom bot-2, ki je vključeval: trajajoči tek sem-tja (1saa), bočno prestopanje ravnotežnostne gredi (2saa), enonožne poskoke na mestu (3saa), enonožne poskoke vstran (4saa), sonožne poskoke vstran (5saa) in skupni testni dosežek (tsaa). rezultati: rezultati so nakazali prisotnost negativnih korelacij med: višino in 3saa (r=-.353, p=.026); težo in 3saa (r=-.422, p=. 007); težo in tsaa (r=-.359, p=.023); itm in 3saa (r=-.342, p=. 031); itm in tsaa (r=-.333, p=.036); bm in 3saa (r=.369, p=. 019); bm in tsaa (r=-.363, p=.021). zaključek: na podlagi rezultatov študije lahko sklenemo, da obstaja korelacija med telesno zgradbo ter hitrostjo in gibčnostjo. poleg tega smo zaznali tudi korelacije med telesno višino in izvedbo enonožnih poskokov na mestu ter med bazalnim metabolizmom, izvedbo enonožnih poskokov na mestu in skupnim rezultatom, doseženim na testih motoričnih spretnosti. ključne besede: maščoba, bazalni metabolizem, motorične sposobnosti, omron 123 annales kinesiologiae • 11 • 2020 • 2 mima stanković, dušan đorđević, milan zelenović, danijel božić: correlation of body composition ..., 121–130 introduction physical growth of children is measured by changes in body size and/or body composition as well as changes in motor skills. physical activity is considered a key factor in the healthy physical and mental development of children (dencker & andersen, 2008; ortega, ruiz, castillo, & sjöström, 2008). regardless of the fact that motor skills during the younger school age (from 7 to 10 years) are not completely differentiated yet, this period is very important in the development of especially basic (general) motor skills. motor abilities are those anthropological dimensions that are manifested in movement in a way that depends on the type of movement, human potential, and its development in the current moment and conditions (bala, 2010). basic motor skills are those that most people possess, and specific ones are those that are created or developed over time, which is most evident in athletes (nićin, 2000). motor abilities can be affected by many factors, such as genetic predisposition, body composition, socio-economic conditions, and the like. by body composition we refer to the composition of the human organism represented by the size and grouping of the existing measurable segments of which it consists (ugarković, 2001). different batteries of tests are used to assess motor abilities, adjusted to the age of the respondents, as well as the level of motor abilities assessed. the standardized battery of tests, most commonly used to assess motor abilities in children, is the bot-2 (bruininks-oseretsky test) (bruininks & bruininks, 2005). research has shown that overweight and obese children have impaired motor skills compared to healthy-weight children, especially in the domain of strength (đokić & međedović, 2013). when the body mass index (bmi) is taken into account, studies unequivocally indicate an association between increased bmi and decreased motor skills in children of different ages (graf et al., 2004; d’hondt, deforche, de bourdeaudhuij, & lenoir, 2009; đokić & međedović, 2013). kemp & pienaar (2013) conducted research to determine the association between body composition and motor abilities of children in south africa. motor abilities were measured using the bruiniks-oseretsky test of motor proficiency-2 sf (bot 2-sf). the obtained results showed a negative correlation between running speed and agility and an increased percentage of fat in children. gentier et al., (2013) analyzed the differences between fine and gross motor skills in children of normal weight and obese children, aged 7 to 13 years. the bot-2 test was used to analyze motor abilities. the results showed that obesity is detrimental to performance in all subtests that assess motor speed, which means that obesity also has a bad effect on test results for running speed and agility. marmeleira, veiga, cansado, and raimundo (2017) conducted research with the aim of determining the association of motor abilities with the body composition of children aged 6 to 10 years. the results showed that children with normal weight achieved better results in all tests compared to their overweight or obese peers. larsen et al. (2017) conducted an analysis in children from denmark, ages 8 to 10, to establish differences in body composition and motor abilities in child athletes and 124 mima stanković, dušan đorđević, milan zelenović, danijel božić: correlation of body composition ..., 121–130 annales kinesiologiae • 11 • 2020 • 2 non-athletes. the results obtained with this test indicated that boys and girls who scored better in speed tests also had better results in relation to body composition. the aim of this research is to examine the relationship between body composition, speed and agility in children aged 9 to 10 years. methods sample of participants in accordance with the set goal, a sample of respondents consisting of third grade pupils of the “miroslav antić” elementary school from niš was selected for this research. the sample included 40 participants (29 boys and 11 girls), aged 9.42 ± 0.5 years, with all the respondents being clinically healthy and at the time of measurement displaying no obstructions of the locomotors apparatus that would limit or interfere with the performance. parents gave their consent for the testing to be performed, and all the examinees voluntarily participated in the testing. sample of measuring instruments measuring instruments were used in the research to assess body composition, speed and agility. the characteristics of the sample were assessed: height was measured with a ruler with an accuracy of 0.1 cm; weight, body mass index (bmi), body fat (bf) and basal metabolism (bmr) were measured with the body composition monitor bf511 (omron). to assess speed and agility, the bot-2 test subtest “running speed and agility bot-2 test” for motor efficiency of children was applied, which includes the following tests: shuttle run (1saa), stepping sideways over a balance beam (2saa), one-legged stationary hop (3saa), one-legged side hop (4saa), two-legged side hop (5saa) and total speed and agility (tsaa). shuttle run (1saa) the test is performed by the examinee standing at the starting line in the high start position, running 7.62 meters to pick up a ball off the floor and returning to the start. the test is performed twice, the time is measured with an accuracy of 0.1 seconds. stepping sideways over a balance beam (2saa) the test is performed by the examinee standing next to the obstacle with hands on hips, then stepping sideways over the obstacle with one foot and then the other, and 125 annales kinesiologiae • 11 • 2020 • 2 mima stanković, dušan đorđević, milan zelenović, danijel božić: correlation of body composition ..., 121–130 returning over the obstacle to the starting position in the same way. the procedure is repeated for 15 seconds. the obtained result is expressed in the number of individual sidesteps. one-legged stationary hop (3saa) the test is performed by the examinee standing with feet together, hands on hips, bending the weaker leg at the knee so that the lower leg is parallel to the floor. from this starting position, the examinee hops up and down on one leg. the test lasts 15 seconds, and the result is expressed in the number of correctly performed hops. one-legged side hop (4saa) the test is performed by the examinee standing with both feet together, next to and parallel to the line, with hands on hips, bending the weaker leg at the knee so that the lower leg is parallel to the floor. from this starting position, the examinee hops back and forth over the line. the test lasts 15 seconds, and the result is expressed in the number of correctly performed hops. two-legged side hop (5saa) the test is performed by the examinee standing with feet together, next to and parallel to the line, hands on hips, hopping back and forth over the line keeping proper posture with each hop. the test lasts 15 seconds, and the result is expressed in the number of correctly performed hops. total speed and agility (tsaa) total speed and agility is defined as the sum of points scored in each test. the testing of the children’s sample was performed in a gym. the internal temperature in the standardly equipped school hall for physical education was 18-22 °c. all the respondents were tested under the same conditions and reported for measurement and testing in the same order under the guidance of a professor. during the examination, the respondents were in physical education kits. 126 mima stanković, dušan đorđević, milan zelenović, danijel božić: correlation of body composition ..., 121–130 annales kinesiologiae • 11 • 2020 • 2 data processing the processing of data obtained by this research was performed using the statistical program spss version 20. for all data obtained by the measurement, the basic central and distribution parameters of descriptive statistics were calculated. correlation analysis (pearson’s degree of correlation) was used to determine whether there was a relationship between body composition parameters and speed and agility of children aged 9 to 10 years. results table 1. descriptive statistic n minimum maximum mean std. deviation age 40 9 10 9.47 .506 height 40 125.0 154.0 140.23 5.94 weight 40 27.20 57.00 38.65 8.23 bmi 40 14.40 28.50 19.58 3.50 bf 40 9.20 43.20 24.55 8.68 bmr 40 1087 1476 1244.23 100.57 1ass 40 12 12 12.00 .000 2ass 40 8 10 9.47 .560 3ass 40 7 10 8.61 .728 4ass 40 1 8 4.94 1.970 5ass 40 5 9 7.14 .867 tsaa 40 33 47 42.17 2.962 n sample size, bmi body mass index, bf body fat, bmr basal metabolism, 1saa shuttle run, 2saa stepping sideways over a balance beam, 3saa one-legged stationary hop, 4saa onelegged side hop, 5saa two-legged side hop, tsaa total speed and agility table 1 shows basic descriptive parameters: sample size (n), minimal result, maximum result, arithmetic mean (mean), and standard deviation (std. deviation) for each variable separately. on the 1ass test each respondent achieved maximum result, that is, they scored the highest number of points (mean 12; std. deviation .000) possible. consequently, the correlation analysis wasn’t performed. 127 annales kinesiologiae • 11 • 2020 • 2 mima stanković, dušan đorđević, milan zelenović, danijel božić: correlation of body composition ..., 121–130 table 2. correlation analysis (pearson’s correlation coefficient) 2saa 3saa 4saa 5saa tsaa height -0.143 -.353* -0.115 -0.217 -0.271 weight -0.254 -.422** -0.223 -0.136 -.359* bmi -0.227 -.342* -0.247 -0.087 -.333* bf -0.207 -0.304 -0.199 -0.065 -0.279 bmr -0.17 -.369* -0.272 -0.143 -.363* bmi body mass index, bf body fat, bmr basal metabolism, 2saa stepping sideways over a balance beam, 3saa one-legged stationary hop, 4saa one-legged side hop, 5saa twolegged side hop, tsaa total speed and agility * p<0.05 based on the results of the correlation analysis shown in table 2, between the parameters of body composition and motor abilities of children aged 9 to 10 years, the existence of statistically significant correlations was determined. the results of correlation statistics indicated the existence of the following correlations: – negative correlation (r = -.353) between height and 3saa parameters, with statistical significance p = .026; – negative correlation (r = -.422) between weight and 3saa parameters, with statistical significance p = .007; – negative correlation (r = -.359) between weight and tsaa parameters, with statistical significance p = .023; – negative correlation (r = -.342) between bmi and 3saa parameters, with statistical significance p = .031; – negative correlation (r = -.333) between bmi and tsaa parameters, with statistical significance p = .036; – negative correlation (r = -.369) between bmr and 3saa parameters, with statistical significance p = .019; – negative correlation (r = -.363) between the parameters of basal metabolism bmr and tsaa, with statistical significance p=.021. discussion research studies analyzed for the purposes of this paper (kemp & pienaar, 2013; gentier et al., 2013; marmeleira et al., 2017) did not relate the height of the respondents with the success in performing motor skill tests used to determine running speed and agility. this negative correlation obtained in this study can be explained by the fact that while children of that age very often grow abruptly, the muscular strength and body 128 mima stanković, dušan đorđević, milan zelenović, danijel božić: correlation of body composition ..., 121–130 annales kinesiologiae • 11 • 2020 • 2 growth may not develop at similar rates, and, as it is already known, explosive strength is one of the essential parameters of agility and running speed. previous research has shown a negative correlation between body weight of the respondents, regardless of gender, and success in performing motor tests for speed running and agility. research conducted in africa showed a negative association in children with an average age of 6.84 years (kemp & pienaar, 2013), who were slightly younger than the respondents in this study where there were statistically significant negative correlations between the body weight of the respondents and motor skill tests results, as well as between bmi and motor skill tests results. specifically, the one-legged stationary hop test and the overall motor skills test results were negatively correlated with bmi values and weight of the respondents. previous research analyzed in this paper (baine, gorman, kern, hunt, denny, & farry, 2009; gentier et al., 2013; chowdhury, wrotniak, & ghosh, 2016; marmeleira et al., 2017) investigated the influence of increased body weight and bmi on the performance of motor skill tests for running speed and agility, which were part of the bot-2 test. such a correlation between agility and increased body weight may result from the fact that most children with increased body weight are less physically active, so their muscles are less developed. as previously explained, muscle development is directly related to muscle strength, which affects the speed of running and the speed of change of direction. moreover, the results obtained in this study show that bmi and weight are negatively correlated with the overall results of motor skill tests, which coincides with the results of research that confirmed that obese children achieve poorer results on motor tests (baine et al., 2009; đokić & međedović, 2013; chowdhury et al., 2016). such results assume that children with increased body weight and body mass index (bmi) are motor weaker than their peers with normal body weight. obesity in children at that age usually results from insufficient physical activity. in addition to the analysis of body composition, the correlation of bmr with tests of motor abilities for agility and running speed was analyzed. the study showed that bmr is negatively correlated with 3saa and tsaa. the dominant factors that affect the value of basal metabolism are the size of the organism, age and sex. as we have seen, bmr directly depends on body surface area and cell mass. obese people have a larger body surface area and a higher cell mass compared to children of normal weight, so the rate of metabolism in obese people is higher. based on the above, we can conclude that bmr is directly proportional to weight and bmi, thus explaining the negative correlation between bmr and the one-legged side hop test (3saa) and the overall results achieved (tsaa) on the motor skill test. the fact that there is no correlation between the body composition and other tests used to assess running speed and agility, excepting the one-legged stationary hop tests can be explained by the small number of examinees as well as by the motivation the examinees themselves had during the testing. 129 annales kinesiologiae • 11 • 2020 • 2 mima stanković, dušan đorđević, milan zelenović, danijel božić: correlation of body composition ..., 121–130 conclusion based on the results obtained in this study it can be concluded that there is a correlation between body composition and speed and agility. in addition to the physical composition, a correlation was also found between body height and the performance of the one-legged stationary hop tests, as well as between basal metabolism, one-legged stationary hop tests, and the overall results achieved on motor skill tests. the limitation of this study is the small number of participants, so we suggest a larger sample for future research and a separate treatment of boys and girls. the obtained results are important for further work, because they proved a correlation between body composition, speed and agility; 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(2008). physical fitness in childhood and adolescence: a powerful marker of health. international journal of obesity, 32, 1-11. https://doi.org/10.1038/sj.ijo.0803774 ugarković, d. (2001). osnovi sportske medicine [the basics of sports medicine]. beograd, srbija: viša škola za sportske trenere. https://doi.org/10.1038/sj.ijo.0802428 https://doi.org/10.1038/sj.ijo.0802428 https://doi.org/10.1519/jsc.0000000000001952 https://doi.org/10.1111/jpc.13446 https://doi.org/10.1038/sj.ijo.0803774 _hlk40898474 _hlk34144101 _hlk40871331 _hlk53505499 _hlk33786872 _hlk25864445 _hlk38187602 _hlk71096081 annales kinesiologiae • 12 • 2021 • 2 71 editorial this issue is again marked by the impact of the covid-19 pandemic and the related restrictive measures, which is why the authors examine the possibility of curative exercise with aids that can ease the effort of exercise, especially for lung patients. unfortunately, research often does not provide immediate answers and it takes time, new measurement protocols, new subjects, etc. to translate scientific findings into practice. it is this new, unexpected experience with the coronavirus disease that continues to raise new questions in all fields. due to its preventive, rehabilitative and curative aspects, kinesiology is one of the applied sciences, alongside medicine, that needs to find answers as quickly as possible. competitive sport is also no exception. the knowledge that certain physiological parameters of the athlete can be influenced by non-invasive procedures, personalised training and specific dietary regimes is very useful for coaches and athletes. in this journal, the authors discuss how body mass manipulation and a specific high-intensity training routine in wrestling can influence grip strength, and how certain anthropometric and motor parameters are related to the competitive performance of young alpine skiers. as an aid to training routines and general monitoring of an athlete’s development, applied knowledge once again demonstrates that it can significantly contribute to peak performance, in addition to talent and external factors. that knowledge becomes latent in one’s own behaviour and that habits of an active and healthy lifestyle remain lifelong companions if they are introduced early enough in the form of regular and organised physical/sporting activity in childhood is the finding of a longitudinal study that concludes the scientific contributions of this issue. we are also pleased to present some of the activities of the institute for kinesiology research of the science and research centre koper. the live workshop on sports injuries in young athletes and the international scientific and specialist conference child in motion, which both saw a high attendance, confirm their relevance in the professional and scientific arena. in conclusion, we pledge to continue our efforts in future editions to pursue the journal’s mission and to present answers to current issues. clearly, the impact of the pandemic will continue to accompany and fuel research momentum, and the need to raise awareness of the syndemic effects of the covid-19 pandemic among the professional community is already becoming apparent. the effects of the pandemic will continue to be present in all aspects of our lives for quite some time, and kinesiologists and experts in related disciplines will continue to be forced to play an important role in the “battle” to stay healthy. saša pišot, phd, editor 72 annales kinesiologiae • 12 • 2021 • 2 uvodnik tudi tokratno številko zaznamujejo izkušnje omejitvenih ukrepov in posledic pandemije covida-19, zato se avtorji sprašujejo o mogoči kurativni vadbi s pripomočki, ki bi predvsem pljučnim bolnikom olajšali napor pri vadbi. raziskave žal velikokrat ne prinašajo takojšnih odgovorov in potreben je dodaten čas, nov merski protokol, novi subjekti ipd., da se znanstveni izsledki lahko prenesejo v prakso. prav ta nova, nepričakovana izkušnja s koronavirusno boleznijo še vedno odpira nova vprašanja na vseh področjih. kineziologija je zaradi svojega zdravstvenega preventivnega, rehabilitacijskega in kurativnega vidika poleg medicine med tistimi uporabnimi vedami, ki morajo kar najhitreje poiskati odgovore. tudi vrhunski šport ni izjema. zavedanje, da je na določene fiziološke parametre športnika mogoče vplivati z neinvazivnimi posegi, prilagojeno vadbo in določenimi prehranskimi režimi, je dobrodošla podpora trenerjem in športnikom. kako lahko manipulacija telesne mase in poseben visoko intenziven vadbeni režim pri rokoborcih vplivata na moč stiska ter kako so določeni antropometrični in motorični parametri povezani s tekmovalno uspešnostjo mlajših alpskih smučarjev, odkrivajo avtorji v reviji, ki je pred vami. uporabno znanje kot pripomoček pri vadbenih režimih in splošnem spremljanju športnikovega razvoja ponovno kaže, da lahko poleg talenta in zunanjih dejavnikov pomembno prispeva k vrhunskemu rezultatu. da postane znanje latentno v lastnem vedênju, da navade aktivnega in zdravega življenjskega sloga ostanejo vseživljenjske spremljevalke, če so »sprožene« dovolj zgodaj v obliki redne in organizirane gibalne/športne aktivnosti v otroštvu, je ugotovljeno v longitudinalni raziskavi, ki končuje znanstvene prispevke te številke. veseli nas, da lahko predstavimo tudi nekaj dejavnosti inštituta za kineziološke raziskave zrs koper. v živo izpeljani delavnici o športnih poškodbah mladih športnikov ter mednarodni znanstveni in strokovni konferenci otrok v gibanju, obe z zavidljivim odzivom, potrjujeta svojo pomembnost v strokovnem in znanstvenem prostoru. ob koncu še zaveza, da si bomo tudi v prihodnjih letnikih prizadevali slediti ciljem poslanstva revije in predstavljali odgovore na aktualne probleme. očitno bodo izkušnje in posledice pandemije še naprej spremljevalke in vzvod za dodaten raziskovalni zagon, ob tem pa se že kaže nuja po ozaveščanju strokovne javnosti o t. i. sindemičnih učinkih pandemije covida-19. ti bodo še lep čas prisotni na vseh področjih našega življenja, strokovnjaki kineziologije in sorodnih ved pa bodo še naprej prisiljeni imeti pomembno vlogo v »boju« za ohranjanje zdravja. dr. saša pišot, urednica _hlk89942516 _hlk103676616 _hlk111804760 _hlk111802738 _hlk30149664 _hlk111710665 annales kinesiologiae • 13 • 2022 • 1 83 reports and reviews/poročila in ocene, 77–84 report on the eass & issa 2022 world congress of sport sociology tübingen, germany, 7–10 june 2022 after two years of online conferences and uncertain times, the eass (european association of sociology of sports) and issa (international sociology of sport association) have joined forces to organise a joint world congress of sociology of sport with the working title: why sociology matters? the role of sociology of sport in interdisciplinary research. scholars from around the world pondered the question of why sociology and its very special relationship to society is hardly noticed. sociology seems to have a reputation problem, not only in the public and political contexts, but also in scientific research networks. the aim of this congress was therefore to provide a clearer insight into the complex descriptions of reality and to reveal the contradictions and inconsistencies in the common sense and everyday constructions that target the field of sport. the organiser of the congress was the university of tübingen, together with the institute of sports science of the university of tübingen. at the three-day event, 230 papers were presented by over 350 authors in 10 sessions. among the papers, the topics of depression and the deviant behaviour of elite athletes and coaches, and the impact of covid-19 measures on sport participation and sport policy issues were the main topics of interest. the main key lectures: 1. addressed the novelties in european football and its organisation in lectures presented by prof. mark turner, phd (against the european super league: reading this critical juncture for english and european football) and prof. david webber phd (rewriting the future: alternatives to ‘the present’ (and presence of) capitalist realism in elite european football) 2. opened up new questions in the field of sport impact on the local community with the lectures: (re)configuring for sport, volunteerism and the civil society landscape: toward sustainable communities and capacity building in a post-olympic metropolis by prof. niki koutrou and prof. geoffrey kohe, reciprocation and responsibility – “giving back” to children and youth in community organizations by prof. christine dallaire and steph mackay. the conference gave the expected impetus for further cooperation between researchers and their institutions, so we are looking forward to the next, 19th eass conference in 2023 with the working title: transitioning sport, transitioning european societies to be held in budapest, hungary on 30 may––2 june 2023. saša pišot 84 reports and reviews/poročila in ocene, 77–84 annales kinesiologiae • 13 • 2022 • 1 poročilo s svetovnega kongresa sociologije športa eass in issa 2022 tübingen, nemčija, 7.–10. junij 2022 po dveh letih spletnih konferenc in negotovih razmerah v času covida-19 sta eass (evropsko združenje za sociologijo športa) in issa (mednarodno združenje za sociologijo športa) združila moči in organizirala skupni svetovni kongres sociologije športa z delovnim naslovom zakaj je sociologija pomembna? vloga sociologije športa v interdisciplinarnem raziskovanju. udeleženci z vsega sveta so razmišljali, zakaj sta sociologija in njen posebni odnos do družbe premalo opazna, saj se zdi, da ima sociologija težave z ugledom, ne le v javnem in političnem kontekstu, temveč tudi v znanstveno-raziskovalnih mrežah. glavni namen tega kongresa je bil zato spodbuditi jasnejši vpogled v opise resničnosti, protislovij in morebitnih nedoslednosti, ki se kažejo v »zdravo razumskih« in vsakdanjih konstrukcijah na področju športa. organizator kongresa je bila univerza v tübingenu skupaj z inštitutom za znanosti o športu univerze v tübingenu. na tridnevnem dogodku je več kot 350 avtorjev v desetih sekcijah predstavilo več kot 230 prispevkov. med referati so bile v ospredju predvsem teme depresije, deviantnega vedenja vrhunskih športnikov in trenerjev in vpliv ukrepov za zajezitev covida-19 na participacijo v športu in pereča politična vprašanja s področja športa. glavna vabljena predavanja so: 1. obravnavala novosti v evropskem nogometu in njegovi organizaciji, ki sta jih predstavila prof. dr. mark turner – proti evropski superligi: (kritičen trenutek za angleški in evropski nogomet) – in prof. david webber – rewriting the future: alternativa »sedanjosti« (in prisotnosti) kapitalističnega realizma v elitnem evropskem nogometu; 2. odpirala nova vprašanja na področju vpliva športa in politik na lokalno skupnost s predavanji prof. niki koutroua in prof. geoffreya koheja – (re)configuring for sport, volunteerism and the civil society landscape: na poti k trajnostnim skupnostim in krepitvi zmogljivosti v post-olimpijski metropoli – ter predavanjem reciprocation and responsibility – »giving back« to children and youth in community organizations, ki sta ga pripravila prof. christine dallaire in steph mackay. konferenca je pričakovano spodbudila nadaljnje sodelovanje med raziskovalci in njihovimi institucijami, zato se že veselimo naslednje, 19. konference eass 2023 z delovnim naslovom transitioning sport, transitioning european societies, ki bo od 30. maja do 2. junija 2023 potekala v budimpešti. saša pišot _hlk119322918 _hlk110178216 _hlk38187602 _hlk120196417 _hlk120196458 _hlk117871780 _hlk117865098 _hlk118123043 _hlk118137344 _hlk70951511 annales kinesiologiae • 11 • 2020 • 2 83 original scientific article doi: https://doi.org/10.35469/ak.2020.223 received: 2020-03-05 udc:379.8-053.4:796.011.1 mother’s perspective of maintaining an active outdoor leisure time for a preschool child saša pišot1 1 science and research centre, koper, slovenia corresponding author: saša pišot science and research centre, koper, institute for kinesiology research, garibaldijeva 1, si-6000 koper, slovenia phone: +386 663 77 31 e-mail: sasa.pisot@zrs-kp.si abstract in the contemporary life of a family, mothers are often faced with a conflict between work and family in order to assure a healthy childhood for their children. how to provide active leisure time for a child in accordance with healthy lifestyle guidelines, and what factors affecting the quantity and quality of a child’s physical activity, have been researched from the perspective of mothers. the qualitative and quantitative methods of questionnaires and semi-structured interviews (n=54) with mothers were executed with the aim to study important factors which distract mothers and their children from ensuring physically active leisure time. additionally, the possible correlation of children’s motor efficiency and family characteristics were studied. from the mother’s perspective we found that “lack of time” along with “weather conditions” were two major obstacles. mothers also indicated “the access to recreational facilities” and “health of a child” as common impetuses for active outdoor leisure time. additionally, comparison of family characteristics showed that active family leisure behavior is influenced by i) demographic and personal factors of the family (family size, ses , sports history), ii) social factors (employment and schedule of employment, financial status of the family, social networks support), and iii) environmental factors (weather, accessibility, and safe conditions for physical activity, as well as living conditions). because environmental factors are harder to change, we need to pay attention to demographic, personal, and social factors of mothers (families) with reduced possibilities and enable them to ensure conditions for healthy child development. keywords: physical activity, family’s leisure time behavior, personal and social factors of pa, motor efficiency. 84 saša pišot: mother’s perspective of maintaining an active outdoor leisure time for a preschool child, 83–97 annales kinesiologiae • 11 • 2020 • 2 usklajevanje aktivnega preživljanja prostega časa predšolskih otrok iz perspektive mater izvleček sodobno življenje družine s predšolskimi otroki postavlja predvsem pred matere dnevne izzive. zagotoviti otrokom kvalitetno preživljanje prostega časa v obliki gibalnih/športnih aktivnosti na prostem, ob delovnih obveznosti nemalokrat privede do konflikta med delom in družino. kako skladno s smernicami zdravega življenjskega sloga nuditi otroku dovolj gibanja in aktivno preživljanje prostega časa, predvsem kateri so najpogostejši dejavniki, ki vplivajo na količino in kvaliteto gibalne aktivnosti, smo proučevali na primeru mater predšolskih otrok, ki še vedno ohranjajo primarno vlogo nosilk skrbi za otroke. izvedli smo vprašalnike ter polstrurkturirane intervjuje (n=54) ter preko sinteze kvalitativnih in kvantitativnih metod nadalje ugotavljali povezanost med otrokovo motorično učinkovitostjo, značilnostmi preživljanja prostega časa ter socio-demografskimi značilnostmi družine. ugotovili smo, da je pomanjkanje časa, poleg slabih vremenskih razmer ena izmed glavnih ovir za vsakodnevno gibalno aktivno preživljanje časa na prostem. matere so kot vzrok navedle tudi slabši dostop do površin in navadno slabše zdravstveno stanje otroka. v nadaljnji primerjavi gibalne učinkovitostjo otroka in aktivnega preživljanja časa na prostem ugotavljamo tudi vpliv i) demografskih in osebnih dejavnikov družine (število družinskih članov, zdravstveni status, športna zgodovina staršev), socio-ekonomskim dejavnikov (zaposlitveni status staršev in delovna obremenitev, finančni status ter socialna mreža pomoči) ter okoljski dejavniki (vremenski pogoji, dostopne in varne zunanje površine, bivanjski pogoji), ki pa se spreminjajo v času. na določene fizične in okoljske dejavnike je težje vplivati, zato je učinkoviteje, da pri reševanju pozornost namenimo demografskim, osebnim in socio-ekonomskim dejavnikom ogroženih mater oz. družin (nizki dohodki, enostarševske družine) in omogočimo boljše pogoje za aktivno preživljanje prostega časa. ključne besede: gibalna/športna aktivnost, družinski vzorci preživljanja prostega časa; osebni, socialni in okoljski dejavniki gša, motorična učinkovitost. annales kinesiologiae • 11 • 2020 • 2 85 saša pišot: mother’s perspective of maintaining an active outdoor leisure time for a preschool child, 83–97 introduction today’s contemporary family is facing the problem of time management, balancing between work and leisure time with family members. the labor market, especially since the late 1970s, has provided more and more employed women. even though this development can be characterized as a major success of emancipation and many economies derived great benefits from the additional labor supply and the contribution of women (oecd, 2001), this advance toward equality in the labor market paradoxically means that women become active in two domains of life: their traditional domain of care of the family members, along with that of work (bettio et al., 2014). this new status often ends in work-family conflict (wfc), (lewis & lewis, 1996) which is primarily a matter of limited time available (remery & schippers, 2019). sometimes the total work and family tasks may exceed the available time budget (24 hours/day) and work and family tasks require parents to be in different places at the same time, so wfc may develop from intertemporal problems. alongside the contemporary phenomena of “intensive” parenting, “child centricity” and “protective” childhood still indicate an emphasis on intense maternity as an exclusive, fully child-centric, emotional and long-term mandate (pišot, 2018; arunel et al., 2019). despite “active” fatherhood, we are also witnessing in gender-work related equality in slovenia, that the father’s role is treated more as parental support in the play and engaging in sports with children (rener et al., 2008), while the household remains in the domain of mothers (rener, 2006). contrary to the evident wfc, resent research has pointed out the problem that children are not physically active enough; i.e., becoming more sedentary, especially in their adolescence. the increase of screen time clearly reduces time spent physically active, and results in altered development of motor patterns, which have changed remarkably in recent decades, especially free outdoor play, as traditional games are replaced by several indoor more sedentary games (computer games). this pandemic of sitting (andersen, mota & di pietro, 2016) exists along with the widely spread paradigm of positive health benefits of physically active lifestyles that can diminish health risk factors (cholesterol, depression, injury, bone density, blood pressure, obesity, metabolic syndrome) (janssen & leblanc, 2010). regular physical activity (pa) in childhood is necessary to establish elementary motor patterns needed for children’s physiological, motor, and psychological development (owen et al., 2010; dietz, 1998; biddle & asare, 2011; mutrie & parfitt, 1998). particularly for children and adolescents, early physical activity experiences are important for influencing active lifestyles in their adulthood (thompson, humbert, & mirwald, 2003). furthermore, childhood is considered the best time for the socialization of children into physically active leisure time because of the development of motor competence (physical activity skills), attitudes, values, and behaviors (telama, yang, laakso, & viikari, 1997). unfortunately, being active in leisure time with all its benefits is becoming a challenge for the contemporary family. arising from the age and contexts of preschool children, busy daily schedules no longer favor families depending on many factors, including the socioeconomic status 86 saša pišot: mother’s perspective of maintaining an active outdoor leisure time for a preschool child, 83–97 annales kinesiologiae • 11 • 2020 • 2 of the family and their “time free from economic necessity”1 (bourdieu in kamin & tivadar, 2011). when family leisure time is shrinking, additional efforts should be made to encourage and enable physically active leisure time of families. previous longitudinal studies (bouchard, 1996) showed that parents had a significant role in support (e.g., financial, practical, and emotional) and were role models for physically active leisure. in fact, one study noted that children of active parents were 5.8 times more likely to be active in their adulthood than children of inactive parents (bouchard, 1996). lack of parental support, on the other hand, negatively influenced attitudes and behaviors towards physically active leisure during childhood and adolescence with a lasting effect in adult years. in general, the parental support showed facilitated involvement and the more support was perceived, the more the level of physically active leisure increased either directly or indirectly through its influence on a child’s efficacy (trost et al., 2003). the determinants of a physically active lifestyle are complex and are mostly socio-demographic (sex, age, socioeconomic status, ethnicity, presence of mother/ father in household, work status) and environmental correlates of physical activity (urban residence, use of community recreation facilities, crime in neighborhood, region) (gordon-larsen, mcmurray, & popkin, 2000). while socio-cultural factors are most often associated with physical activity, socio-demographic factors relate more to sedentary leisure time. environmental (physical) factors such as living environment of a family (home, neighborhood, facilities for pa) and the living conditions from the point of view of accessibility and safety significantly influence families (dowda et al., 2011; kerr et al., 2006; saelens, sallis, black, & chen, 2003). despite the important role of environmental and socio-cultural factors where parents are key to primary socialization, little is known about the mothers’ perspective and strategies regarding their children’s pa in leisure time. little research has particularly been undertaken to understand the choices and opportunities of mothers to ensure children’s healthy lifestyle regarding active outdoor leisure time, particularly from their perspective and in a format that allows them to reflect on their individual experiences (thompson et al., 2003). our research question refers to mothers facing the wfc in enhancing healthy family lifestyle and outdoor physical activity of children in leisure time. the study includes mothers of preschool children in regard to perceived barriers which enable or inhibit them to go out and ensure their children are physically active in their leisure time. additional research referred to other factors that influence family active leisure behavior: i) demographic and personal factors of the family (family size, health status, sports history), ii) social factors (employment and work shift, financial status of the family, social networks support), and iii) environmental factors (weather, accessibility, availability and safe conditions for physical activity, or family living conditions) impacting the motor efficiency (me) of a child (measured as elementary motor patterns assignments and summed as motor efficiency). 1 “time free from economic necessity” refers to time free of work or activity that enables provision for necessary means for living (bourdieu, 1986). annales kinesiologiae • 11 • 2020 • 2 87 saša pišot: mother’s perspective of maintaining an active outdoor leisure time for a preschool child, 83–97 methods a mixed method approach was used including the qualitative (a part of semi-structured interview concerning family lifestyle) and quantitative approach (questionnaires’ data and quantitative grouping of children according to their motor efficiency test results). that kind of method enabled us to study the problems of enhancing a healthy family lifestyle from the mother’s perspective: a. from the scope of the extent of perceived barriers which enable or inhibit outdoor physical activity of children during leisure time; b. from the qualitative view of the factors influencing a mother’s parenting in the domain of active outdoor leisure time; c. from the perspective of qualitative comparison of links between demographic, socio-economic, and environmental factors of the family and the child’s motor performance (efficiency). the research sample: the research was conducted in the frame of the national applied project “analyses of elementary motor pattern, skeletal and muscular adaptation on specific sedentary lifestyle factors amongst 4 to 7 year old children.” the semi-structured interviews (n=60) and questionnaires (n=87) investigating a family’s everyday life were carried out with mothers of four-year-old children involved in the project (n=107). for the study we obtained data from a specific sample involving mothers who carried out the interview (n=54), filled in the questionnaires (n=54), and allowed the participation of their four-year-old children in the motor efficiency measurements (n=54, boys=26). the interviews were executed from april to august 2010, along with questionnaires, which asked mothers to list the most significant factors enabling them and other family members to be physically active outdoors during their leisure time. questionnaires regarding demographic and family lifestyle characteristics were conducted as a part of the introduction to the semi-structured interview (written consent of participation by parents). specific questions in the questionnaire referred to the insights about perceived factors influencing pa or active outdoor leisure time of a child in the domains of i) time management (lack of time for pa because of other, more important, tasks); ii) personal factors (mother’s and child’s health status or well-being), iii) social factors (low financial or material status), and iv) physical and environmental factors (limited accessibility to sports facilities, low physical-environmental possibilities to execute pa and disadvantageous weather conditions). the interviews mostly took places in families’ homes or favorite places (quiet cafés, coffee shops and patisseries with gardens, etc.) and were transcribed from the recordings. the average time of the interview was 20.3 minutes (±6.22 minutes). topics of the semi-structured interviews were related to: i) family everyday life and the spending of leisure time together, including on weekends and during holidays (description of the typical day during the week, weekend and holidays); ii) implementation of the health-oriented practices in the family (nutrition, physical activity, hygiene) as an insight into the replication of the imperatives of “intensive maternity”; 88 saša pišot: mother’s perspective of maintaining an active outdoor leisure time for a preschool child, 83–97 annales kinesiologiae • 11 • 2020 • 2 iii) parental support (information on the support that parents provide their children in physical activity); iv) retrospective of parents’ childhood with focus on pa as determinants of a healthy lifestyle. data were thematically coded to identify convergences according to the research topic. for the purpose of the research question, we analyzed only the first topic regarding the families’ everyday lives in the domain of leisure time (afternoon, weekends and holidays). data analysis quantitative data from the questionnaire were analyzed with the statistical program imb spss, version 24, and descriptive analysis were carried out. additionally, the frequency analyses and means (z-values) of elementary motor patterns assignments2 was added as motor efficiency (me) and the sample of children was divided into four groups: the group of the most motor efficient children – group 1 (g1), two groups of children with average motor efficiency – group 2 (g2) and 3 (g3), and the group of children with lowest motor efficiency – group 4 (g4). the analysis of mean values and frequency distributions of individual variables within groups (using the descriptive method), the one-way anova test, and an additional post hoc test were performed for all four groups separately. table 1 groups: children divided regarding the level of motor efficiency. n % group 1 (g1) % group 2 (g2) % group 3 (g3) % group 4 (g4) % boys 26 48.1 7 70 5 45.5 5 33.3 9 50 girls 28 51.9 3 30 6 54.5 10 66.7 9 50 total 54 100 10 100 11 100.0 15 100.0 18 100 2 for the monitoring of elemental movement patterns (egvs) and motor skills several test batteries are used (movement assessment battery for children (sugden & henderson et al., 2007); gross motor development test (ulrich, 2000); bruininks-oseretsky motor proficiency test (bruininks & bruininks, 2005) and others. due to the specific and complex objectives in the project the institute for kinesiology research prepared its own battery of motion tests and validated the scale of the conformity assessment of the egv implementation. this was based on qualitative and quantitative analysis and performance evaluation and consisted of 9 different tests: quantitative and qualitative parameters of walking and running, climbing and crawling, and a counter movement jump on a tensiometer plate. annales kinesiologiae • 11 • 2020 • 2 89 saša pišot: mother’s perspective of maintaining an active outdoor leisure time for a preschool child, 83–97 results results from the questionnaire showed reasons for the distraction or inhibition on the part of mothers from spending active leisure outdoor time with their children were: weather conditions (27.8 %) and lack of time (27.8 %), followed by spatial conditions (16.7 %) and limited accessibility to sports facilities (16.7 %); and less frequently cited were the mother’s and child’s current well-being (13.0 %). finances and general mother’s health status (7.4 %) were not shown as a limiting factor, while general child’s health status (5.6 %) had the lowest impact from the mother’s perspective (see figure 1). figure 1: factors of distracting mothers from spending active outdoor leisure with a child. the “lack of time” as one of the most common reasons was mentioned in mothers’ statements from the semi-structured interviews and reflected the perception of lack of time as an imperative of the work-family conflict. 90 saša pišot: mother’s perspective of maintaining an active outdoor leisure time for a preschool child, 83–97 annales kinesiologiae • 11 • 2020 • 2 “… / even in the afternoons, the days are so short … there’s no time; there’s no ‘me time,’ of course, but there’s not even enough time to be spent with the child.” (mother of a boy from g4, 29 years, secondary education) “weekends are the worst, as there are various household chores breaking up the day … like tidying up, cleaning, other things /… / i’d like to go on a day trip to see something. you know, to have sundays to ourselves and spend them actively, now that they (children – author’s note) are bigger, by bike or maybe to go on a hike.” (mother of a boy from g4, 37 years, higher education diploma) there was an interesting answer that one mother gave to the question what she would do if she could: “ … if i could make a choice, i would be a homemaker, take my child to kindergarten, then clean the house and make lunch and pick him (the child – author’s note) up from the kindergarten. then i would smile all afternoon. yes, if i could make that choice, i would be like that /.../ if i had two hours in the afternoon, i would go with my child for a walk with no hurry. /…/ my ‘dream’ weekend, yes (laughs), a housekeeper who cleaned everything for me … it would be nice to find everything cleaned when you return home from a trip or outdoor activities.” (mother of a boy from g4, 43 years, secondary education). additionally, questionnaire data were compared with children’s motor efficiency by dividing the sample into four groups (g1, g2, g3, g4) and additional frequency analyses. assuming that the differences of distracting factors will be shown between most motor efficient and less motor efficient children, we compared answers of mothers of children in groups g1 (n=10) and g4 (n=18). the analysis was made despite the differences in the number of children, since families’ characteristics showed no statistical differences between both groups. data showed that “lack of time” was higher in g4 (38.9 %, i.e., 7 mothers) than in g1 (20 %, i.e., only 2 mothers). “spatial conditions for active outdoor pa” was also a higher factor in g4 (22.2 %, i.e., 4 mothers) in comparison to g1 (10 %, i.e., only 1 mother), while “weather conditions” were comparable in both groups g1 (30 %, i.e., 3 mothers) and g4 (22 %, i.e., 4 mothers). interestingly, mothers of the most efficient children reported higher percentages of mothers and children momentarily feeling unwell (g1 20 % vs. g4 5.6 %, and g1 30 % vs. g4 5.6 %) as a factor for not spending active outdoor leisure time. despite the fact that finances were not the main factor, 11.2 % or 3 mothers from g4 still named financial means as a reason why they were not active outdoors, while in g1 this was not mentioned (see figure 2). further analyses of questionnaire data in the domain of family characteristics confirmed that living conditions of families could have an impact on spending active outdoor leisure time. environmental factors are cited as important determinants of the amount of pa (sallis et al., 2000; hayley et al., 2017); therefore the living condiannales kinesiologiae • 11 • 2020 • 2 91 saša pišot: mother’s perspective of maintaining an active outdoor leisure time for a preschool child, 83–97 figure 2: factors of active outdoor leisure of children from g1 and g4. 92 saša pišot: mother’s perspective of maintaining an active outdoor leisure time for a preschool child, 83–97 annales kinesiologiae • 11 • 2020 • 2 tions of the families were investigated. we found some important differences where more motor efficient children mostly lived in a house with a yard (2/3 of children of g1) in suburbs or villages, while 50 % of less motor efficient children (g4) lived in a block of flats in towns, where free outdoor play is limited. “… in the afternoons, i pick her (daughter – author’s note) up from the kindergarten and then it depends: if the weather is nice, we stay a little longer in the kindergarten courtyard, where the girl swings, climbs the houses, or we wait for another friend to go home together. i prepare lunch at home while my daughter stays outside in the yard or plays in the house. when dad comes from work, we eat lunch together and then decide what we will do in the afternoon, whether we will go out or just stay at home, depending on the day.” (mother of a girl from g1, 31 years, secondary education) however, mothers of children from g4 reported fewer outdoor possibilities as “the place where a child mostly spent his/her leisure time” in 44.4 % was the garden or house yard (vs. g1 80 %) and playground (g4 22.2 % vs. g1 20 %). additionally, children from g4 also combined playground or house yard with indoor play in apartment or room (22.2 %), with the exception of a boy from g4 who mostly spent his leisure time in his room. an additional look at family socio-demographic characteristics could explain the possible impact of spending family leisure in connection to the level of child motor efficiency. the gender difference among the group g1 and g4 was in favor of boys in the most motor efficient (g1 60 %) and the less motor efficient group (g4) to girls (57 %), which could be explained by physiological characteristics of the child’s development. besides that, it also confirmed the role sport plays in a society where boys are more encouraged to engage in sports and other physical activities. the mean body mass index (bmi) of children from g1 and g4, as well as in other groups (g2 and g3) did not differ (p = 0.202). interestingly, from the point of family characteristics, in a group of the most efficient children (g1) there were more children coming from “small” families with one or two children, or only children (40 %). further, 2/3rds of them were first-borns, while a greater share of second-born children from families with more children (55 %) were found in g4. this could be explained as caused by the impact of increased parental attention given to the single or first-born child due to the phenomenon of “intensive parenting.” we compared demographic and ses characteristics of parents of children from g1 and g4 to assess their possible influence on spending leisure time. there were no significant differences in age between the groups: fathers’ mean age was 33.8 ± 4.6 years, while the average mothers’ age was 35.7±5.18 years. secondary education and vocational education were dominant in all groups, also reflected in the parent’s classification of their family in the middle class (g4 75 % vs. g1 46 %) and in the upper middle class (g4 15 % vs. g1 45 %). from the aspect of family income (per family member) we also found lower income for families of children from g4 (33%) annales kinesiologiae • 11 • 2020 • 2 93 saša pišot: mother’s perspective of maintaining an active outdoor leisure time for a preschool child, 83–97 with less than € 500 /member/month, while all other groups reported income between € 801 and € 1,500 per member, indicating a lower economic status for g4. that could be explained by a higher proportion of unemployed parents in g4 (15 %) leading to fewer resources and possibilities for more active leisure time. low financial and material status as an obstacle to not spending active weekends and holidays were also reported. “winter and summer holidays are practically like weekends, we stay at home, well, sometimes we go somewhere for a day. in the summer, though, yes, my daughter and i are going to the beach alone. since our daughter was born we haven’t been on holidays yet. yes, it would be ideal for me to go on holidays, now this is primarily impossible because of finances and my husband’s work.” (mother of a girl from g4, 41 years, secondary education) from the point of family support to child’s pa, interviews showed that mothers are the main motivators (2/3) for a child to learn a new sport (rollerblading, cycling, skiing, swimming), but in most cases, especially when they do not have their own sports history, they leave the teaching of new sports to the fathers (60 %) or professionals. “… otherwise, the initiative comes from me because i spend more time with the children, usually the father comes along and also the older sister, and then we agree on how we will carry it out […], e.g., when skiing, we both tried to do it and then we saw that it was best if experts do it and we enrolled him in ski school […]. it went faster. (mother of a boy from g1, 37 years, college degree) discussion mothers’ spending active outdoor leisure time with children is closely connected with family characteristics and possibilities (personal, social, and environmental factors) to overcome the most commonly noted barriers that distract them from engaging in active outdoor leisure time with a child. qualitative and quantitative data analysis of the presented sample showed that being a girl, coming from a family with more siblings, living in a flat in the city, occasionally feeling unwell or tired, with a mother who works two shifts, a father who is working late and sometimes on weekends, with parents without a sports history, a weak social network (relatives support), and low financial status, all are more likely to be at risk of lower motor efficiency beginning in childhood. on the other hand, our limited study suggests that lower levels of motor efficiency (g4) generally correspond to less time spent on leisure activities. in addition, parental work commitments (seasonal work or self-employment) are mostly reflected as “lack of time” for outdoor leisure, which in turn reflects in the wfc. also, the study showed that social network (kinship) plays an important role as children 94 saša pišot: mother’s perspective of maintaining an active outdoor leisure time for a preschool child, 83–97 annales kinesiologiae • 11 • 2020 • 2 can spend their afternoons, weekends, and even holidays more actively with grandparents or other relatives when parents have to work. the results have proved that spending time outdoor pa depends on parental time (mostly provided by mothers) as time “free from economic necessity.” at the same time, we would like to point out the problem of mothers’ perceived lower sport competence, which was indicated as “not trusting themselves to teach the child a new sport,” which was not only a result of the mother’s sport history but was more evident also in g4 children. conclusion to conclude, families with children of the highest motor scores (g1) most likely spend afternoons and weekends more actively (trips, hikes, walks) than families with lower motor effective children (g4), who more often practice visits, shopping and rest as leisure time activities. regarding the work-family conflict (wfc) issue we perceived higher maternal work engagement (double-shift or nightshift work) in families with lower motor efficiency children (g4) and a higher number of “working late fathers” (40 %). in such cases, childcare is not equally divided between the mother and the father, with fathers also more frequently relying on the involvement of relatives (grandmothers, mothers-in-law, sisters and other female relatives) in the care of the children. this confirms the slovenian example of the transfer of family work (assistance in the care of children) into the sphere of unpaid work (kinship and friendship networks) and paid work (cleaning women and nannies). on the other hand, the study pointed out that children in the most motor effective group more often spent outdoor leisure time with both parents, had active winter and summer holidays and lived in a house with a yard. additionally, the problem of mothers juggling work and family is clear (bettio et al., 2014). the problem mirrored in this research is that insufficient and inactive spending of family leisure time is mostly the result of family-work conflict (resulting in “lack of time for outdoor activities”) where mothers often ended up in dissatisfaction, fatigue, suffering stress. we could also point to other important factors that can help solve that problem by providing socio-environmental factors in the local community (kinship networks, safe and suitable areas for children to play independently). environmental factors (weather, facilities and accessibility for pa) play an important role regarding the active leisure behavior of a family. because it is hard to change, for example, facilities in a short time without local support, we need to pay attention to other personal and social factors and help underprivileged families (mothers, low income, single parents) to be able to live more active outdoor leisure time. due to the several positive aspects of active leisure time behavior, the goal of state and local policy should not only be to provide physical and environmental facilities for pa, but also to enhance initiatives promoting and living physically active leisure as incorporated daily “family” behavior. annales kinesiologiae • 11 • 2020 • 2 95 saša pišot: mother’s perspective of maintaining an active outdoor leisure time for a preschool child, 83–97 figure 3: the determinants of family active outdoor leisure time (pišot, 2018). acknowledgement thanks to the colleagues of the institute for kinesiology research at science and research centre, partner institutions for their contribution to the project. we are especially grateful to the parents and children who participated in the study. 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(2003). evaluating a model of parental influence on youth physical activity. american journal of preventive medicine, 25(4), 277–282. https://doi.org/10.1016/s07493797(03)00217-4. https://doi.org/10.3390/ijerph16224419 https://doi.org/10.2105/ajph.93.9.1552 https://doi.org/10.1016/s0749-3797(18)30182-x https://doi.org/10.1016/s0749-3797(18)30182-x https://doi.org/10.1080/01490400500227324 https://doi.org/10.1016/s0749-3797(03)00217-4 https://doi.org/10.1016/s0749-3797(03)00217-4 _hlk40898474 _hlk34144101 _hlk40871331 _hlk53505499 _hlk33786872 _hlk25864445 _hlk38187602 _hlk71096081 annales kinesiologiae • 10 • 2019 • 2 129 original scientific article doi: https://doi.org/10.35469/ak.2019.201 received: 2019-11-27 udc: 796.322:613.24(497.4) nutritional intake of slovenian semi-professional handball players kaja teraž1 & cécil j. w. meulenberg1 1science and research centre koper, institute for kinesiology research, slovenia corresponding author: kaja teraž science and research centre koper, institute for kinesiology research garibaldijeva 1, si-6000 koper, slovenia phone: +386 31 424 233 e-mail: kaja.teraz@zrs-kp.si abstract aim: handball is a highly popular team sport, both in slovenia and globally. the performance during team sport matches is influenced by numerous factors, amongst others there is nutrition whose influence is lesser known, particularly since diet is often uncontrolled. the purpose of this paper is to investigate whether slovenian handball players, on basis of their anthropometric data and nutritional recommendations, have adequate nutritional intakes of energy and macronutrients. methods: two slovenian handball teams with male and female players (17 males and 9 females) who are part of the 1a national league, were assessed through a 7-day food diary to define their nutritional intake in three different conditions for males (on their training days, match days and days off) and in two conditions for females (on their training days and days off). basal anthropometric data were measured by standard methods and the body composition by a bioelectrical impedance scale. the results were statistically analysed with ibm spss programme, using the repeated measures anova model. results: both female and male handball players show insufficient amounts of energy intake, based on the most recent nutritional intake recommendations for team sports. moreover, the intake of carbohydrates is too low for both female and male handball players, and the intake of fat is too high. conclusion: the analysis of the initial nutritional intake and the comparison with the recommendation shows that the male handball players do not have an optimal diet with proper intake of both energy and macronutrients. the energy intake is insufficient 130 kaja teraž, cécil j. w. meulenberg: nutritional intake of slovenian semi-professional handball players, 129–147 annales kinesiologiae • 10 • 2019 • 2 also in female players. adjusting the nutritional intake in a way to make it more balanced and tuned to the training schedule, would support a better health and performance. keywords: energy intake, macronutrients, nutrition, body composition, handball, team sport. prehranski vnos energije pri slovenskih polprofesionalnih rokometaših in rokometašicah izvleček namen: rokomet je eden od bolj razširjenih ekipnih športov v sloveniji in svetu. tako kot na vse druge športe, tudi na rokomet vplivajo številni dejavniki. eden izmed njih je tudi prehrana. namen raziskave je ugotoviti ali imajo slovenski rokometaši ustrezen vnos energije in makrohranil. metode: v raziskavi sta sodelovali 2 rokometni ekipi 1.a slovenske lige, sodelovalo je 26 rokometašev in rokometašic (17 moških in 9 žensk). podatke o prehranskem vnosu pri rokometaših in rokometašicah smo v treh različnih okoliščinah (na dan treninga, na dan tekme in na prost dan) zbirali 1 teden. prehranski vnos smo ocenili z metodo prehranskega dnevnika, telesno sestavo smo izmerili z bioimpedančno tehtnico. podatke smo obdelali v računalniškem programu ibm spss, uporabili smo model anova. rezultati: tako rokometaši kot tudi rokometašice nimajo zadostnega energijskega vnosa. nadalje, oboji imajo prenizek vnos ogljikovih hidratov ter previsok vnos maščob. zaključki: ugotovili smo, da rokometaši, ki so sodelovali v raziskavi, nimajo optimalne prehrane z ustreznim vnosom energije in makrohranil, ki bi podpirala njihovo zdravje in zmogljivost. tudi energijski vnos pri rokometašicah je prenizek. s prilagoditvijo prehrane svojim potrebam, bi lahko rokometaši dosegali boljše rezultate na treningu in tekmah. ključne besede: energijski vnos, makrohranila, prehrana, telesna sestava, rokomet, moštveni šport. annales kinesiologiae • 10 • 2019 • 2 131 kaja teraž, cécil j. w. meulenberg: nutritional intake of slovenian semi-professional handball players, 129–147 introduction an athlete’s performance is dependent on many different factors, one of them is nutrition (thomas, erdman, & burke, 2016). nutritional habits are not permanent and athletes generally adapt their intake to the training periodization (thomas et al., 2016), with specific athletes adopting specific nutritional strategies. the benefits of adequate nutrition are multiple and lead to better training and performance and quicker recovery, while having lower risk of illness or injury (international olympic committee, 2011; kreider et al., 2010; rodriquez, dimarco, & langley, 2009). on the other hand, athletes might adhere to diets that do not always meet their energy and nutrient requirements (spronk, heaney, prvan, & o’connor, 2015). a recent systematic literature review, showed that especially team sport athletes do not meet the dietary recommendations (jenner, buckley, belski, devlin, & forsyth, 2019). this review emphasizes the need for sport-specific dietary recommendations for both professional and semi-professional players. further, it was observed that the recommendations were fulfilled or exceeded for protein and or fat intake, but that the recommendations for both energy and carbohydrates, generally, were not met (jenner et al., 2019). handball is a highly popular team sport in slovenia and widely practiced on both professional and semi-professional levels, but it is not known whether slovenian handball players meet the recommendations for nutritional intake. the aim of this paper was to evaluate whether the nutritional intakes in slovenian handball players meet the recommendations. thus, we did a literature search to establish the current sport-specific recommendations, and to make a comparison with the actual food intake, we measured the anthropometric and body index parameters and recorded the food intakes for one week of two semi-professional handball teams, both males and females. methods participants the survey was conducted in koper, slovenia among two semi-professional national handball clubs (a male team of the rokometno društvo koper 2013, and a female team of the žensko rokometno društvo koper), which included 26 players in total (17 males and 9 females). 132 kaja teraž, cécil j. w. meulenberg: nutritional intake of slovenian semi-professional handball players, 129–147 annales kinesiologiae • 10 • 2019 • 2 data collection the anthropometric properties of the handball players were measured through standard methods at the university kinesiology centre in koper. body weight and body composition were measured with a tanita mc-980 bioimpedance scale (tanita corporation co., usa) and body height with a standardized meter. all anthropometric measurements were made in the morning. after receiving the ethical committee approval, the subjects recorded their food and fluid intake for 7 days, one microcycle (a week of training). the food intake data were collected for both male (on training days, match days and days off) and female (training, days off) handball players from march 29 to april 4, 2016. the individual dietary logs provided detailed information on food intake. for male players we collected information on food intake for 4 days of training, 1 match day and 2 days off. for female players we collected information on food intake for 5 days of training and 2 days off. for all specific days (training, match or days off) we calculated average values (where that was possible). food diaries were processed using the online tool for monitoring eating habits: open platform for clinical nutrition (abbreviated as opkp in slovenia). at the training and preparatory match days, the researchers were present to ask the participants to promptly submit their written diaries. the trainers of the teams provided the training schedule. hence, it was possible for the researcher to record the time of active participation during the match and also during the training. this information was used to accurately estimate the energy requirements of each individual player. the total energy expenditure requirements (tees) were calculated as the sum of the energy needs arising from the resting metabolism, the energy requirements for offtraining physical activity level (pal), and the energy training requirements. the resting energy expenditure (ree) was calculated by the predictive equation given by cunningham et al. (1980): rmr = 500 + (22 x fat free mass in kg), based on the individual’s fat free mass (ffm). recommendations for individual’s daily energy intake, the recommended daily energy intakes (rdeis) were calculated from the following formulas (both in kcal): rdei for training days and match days = ree × 1.4 + (met × body mass × h); rdei for days off = ree × 1.6, using the pal of 1.4 for training days and match days (which covers all daily activities outside the training or match (debeljak, debeljak, hlastan-ribič, salobir, & pokorn, 2004), and 1.6 for days off (debeljak et al., 2004). on the day of training and match, the value was multiplied by the metabolic equivalent (met, defined as the metabolic energy expenditure for sitting quietly, ainsworth et al. 2011), with a value of 8 for training days and 12 for match days, to capture the energy need for 90 minutes of training or match, respectively (ainsworth et al., 2011). annales kinesiologiae • 10 • 2019 • 2 133 kaja teraž, cécil j. w. meulenberg: nutritional intake of slovenian semi-professional handball players, 129–147 statistical analysis the food diaries data were statistically processed in microsoft office excel 2013 and ibm spss statistics for windows, version 22.0 software (ibm corp, armonk, new york, usa, 2013). basic statistical methods (i.e., descriptive statistics) were used to compare the group characteristics. for independent samples, the statistical analysis of variance (anova) for repeated measurements and post-hoc tests (tukey lsd post-hoc comparison) were used. a p value less than 0.025 was considered statistically significant. results characteristics of the subjects tables 1 and 2 show the anthropometric values of male and female handball players respectively. the tables show the average data and standard deviations of age, height, body mass (bm), body mass index (bmi), estimated percentage of body fat, fat free mass (ffm), and visceral fat level for both genders, as well as specified for the handball players’ playing position. for men, the left and right backs are the tallest players with an average height of 191.0 centimeters, followed by the line players with an average height of 187.8 centimeters, then goalkeepers with an average height of 187.0 centimeters, centre-back players with an average height of 183.5 cm. while the smallest in height are the wing players with an average of 177.5 cm. the line players have the highest percentage of fat among the male handball players (18.6%), followed by left and right backs (16.9%), then centre-back players (16.7%), followed by goalkeepers (14.4%), while the left and right wings have the lowest fat percentages (12.4%). in the present male handball players, the largest fmm was observed in the backs (78.2 kg), followed by the line players (76.4 kg). goalkeepers and wings had similar amounts of ffm (71.6 kg). the centre-back players had the smallest amount of ffm (70.7 kg). regarding the height of the female players, the line player was the tallest (178.3 cm), followed by the back players (177.7 cm), then the goalkeepers (174.1 cm), the wing player (167.8 cm), and the shortest was the centre-back player (165.0 cm). further, the female players reported the largest percentage of body fat among the wing players (32.3 %), followed by the goalkeepers (29.3%), then the line player (23.5%), and the back players (23.1%), while the centre-back player had the lowest percentage of body fat (22.7%). 134 kaja teraž, cécil j. w. meulenberg: nutritional intake of slovenian semi-professional handball players, 129–147 annales kinesiologiae • 10 • 2019 • 2 ta bl e 1: a nt hr op om et ri c pr op er tie s of m al e pl ay er s by p la yi ng p os iti on . v ar ia bl e g oa lk ee pe r (n = 4 ) w in g le ft /r ig ht (n = 2 ) b ac k le ft /r ig ht (n = 5 ) c en tr e ba ck (n = 2 ) l in e pl ay er (n = 4 ) to ta l (n = 1 7) a ge (y ea rs ) 20 .8 ± 3 .6 25 .5 ± 7 .8 21 .6 ± 5 .5 24 .0 ± 1 .4 21 .3 ± 3 .3 22 .1 ± 4 .3 h ei gh t ( cm ) 18 7. 0 ± 6. 7 17 7. 5 ± 0. 7 19 1. 0 ± 5. 0 18 3. 5 ± 2. 1 18 7. 8 ± 5. 1 18 6. 8 ± 6. 1 b od y m as s (k g) 84 .8 ± 6 .4 89 .0 ± 6 .0 96 .4 ± 5 .8 84 .4 ± 5 .9 92 .2 ± 3 .5 90 .4 ± 6 .9 b m i (k g/ cm 2) 25 .4 ± 3 .4 28 .2 ± 1 .7 26 .5 ± 2 .0 25 .1 ± 2 .3 26 .2 ± 0 .7 25 .9 ± 2 .3 b od y fa t ( % ) 14 .4 ± 5 .7 12 .4 ± 2 .6 16 .9 ± 1 .4 16 .7 ± 0 .8 18 .6 ± 1 .8 16 .2 ± 3 .5 f at fr ee m as s (k g) 71 .6 ± 1 .0 71 .6 ± 1 .3 78 .2 ± 4 .9 70 .7 ± 5 .1 76 .4 ± 5 .8 74 .9 ± 5 .1 v is ce ra l f at (% ) 2. 5 ± 3. 0 2. 0 ± 1. 4 3. 00 ± 1 .6 4. 0 ± 0. 0 3. 8 ± 1. 3 3. 1 ± 1. 8 d at a ar e m ea ns w ith th ei r s ta nd ar d de vi at io n. annales kinesiologiae • 10 • 2019 • 2 135 kaja teraž, cécil j. w. meulenberg: nutritional intake of slovenian semi-professional handball players, 129–147 ta bl e 2: a nt hr op om et ri c pr op er tie s of fe m al e pl ay er s by p la yi ng p os iti on . v ar ia bl e g oa lk ee pe r (n = 3 ) w in g le ft /r ig ht (n = 1 ) b ac k le ft /r ig ht (n = 3 ) c en tr e ba ck (n = 1 ) l in e (n = 1 ) to ta l (n = 9 ) a ge (y ea rs ) 20 .0 ± 1 .0 23 22 .0 ± 1 20 28 21 .9 ± 2 .7 h ei gh t ( cm ) 17 4. 1 ± 8. 3 16 7. 8 17 7. 7 ± 7. 3 16 5. 0 17 8. 3 17 4. 1 ± 7. 2 b od y m as s (k g) 75 .1 ± 4 .6 80 .1 68 .9 ± 9 .3 62 .5 68 .4 71 .5 ± 7 ,.4 b m i (k g/ cm 2 ) 24 .9 ± 2 .6 28 .4 21 .8 ± 2 .9 22 .7 21 .6 23 .7 ± 3 .0 b od y fa t ( % ) 29 .3 ± 2 .5 32 .3 23 .1 ± 5 .4 22 .7 23 .5 26 .2 ± 4 .8 f at fr ee m as s (k g) 53 .1 ± 3 .9 54 .2 52 .7 ± 3 .4 48 .3 52 .3 52 .5 ± 3 .1 v is ce ra l f at (% ) 2. 0 ± 1 4. 0 1. 3 ± 0. 6 1. 0 1. 0 1. 8 ± 1. 1 d at a ar e m ea ns w ith th ei r s ta nd ar d de vi at io n. 136 kaja teraž, cécil j. w. meulenberg: nutritional intake of slovenian semi-professional handball players, 129–147 annales kinesiologiae • 10 • 2019 • 2 energy and macronutrient intakes recommended energy and macronutrient intakes for handball players, there are no specific recommendations for energy and macronutrient intake available from the literature. however, we calculated the average rdeis for training days, match days and days off from the individual ffm of each male player. these amounted to: 4054 ± 248 kcal; 4587 ± 289 kcal; 3413 ± 193 kcal for training days, match days and days off, respectively. these calculated rdeis showed significant differences between the days (f=1703,75; p <0,025). for the female handball players included in this study, the rdei for training days was 3173 ± 176 kcal and for days off 2646 ± 108 kcal, respectively. for match days we calculated: 3602 ± 218 kcal. the calculated rdeis showed significant differences between training days, match days and days off (f=539,97; p <0,025). in general, the recommendations for nutrient intake are not specifically listed for various sports activities, and, with the exception of specific micronutrients, do not mention any specific distinctions between the genders (burke, hawley, wong, & jeukendrup, 2011; campbell et al., 2007; rodriquez et al., 2009; thomas et al., 2016). thus, the nutritional recommendations for handball stated here, are presumed to be in a similar range as the recommendations that are mentioned for similar team sports activities like football, basketball, volleyball, and others. the fat intake is recommended to amount to 20−35% of the daily energy intake (american dietetic association et al., 2009; rodriquez et al., 2009). for carbohydrates, it is recommended to consume 6-10 g/kg bm/day (burke et al., 2011; american dietetic association et al., 2009; rodriquez et al., 2009), while for proteins 1.4-1.6 g/kg bm/day (campbell et al., 2007). energy and macronutrient intakes in male handball players figure 1 shows the average energy and macronutrient intakes for the participating male handball players on the training day, match day and day off, respectively. fat intake is expressed in percentage of the individual daily energy intake, while the carbohydrates and protein intakes are expressed in gram per kilogram of body mass. figure 1a shows the actual recorded and the recommend energy intakes for three days. from the food diaries in this study, it was shown that on average (white bars of figure 1a), the male handball players had the highest energy intake on a match day (3290 kcal), a somewhat lower on training day (2871 kcal) and the least on a day off (2557 kcal). repeated anova measures on these actual recorded energy intakes, did not find significant differences between the three days for the included male handball players (f=2.44, p=0.118). however, the theoretical rdeis show statistical differences between the three days of the training cycle, as explained in section recommended energy and macronutrient annales kinesiologiae • 10 • 2019 • 2 137 kaja teraž, cécil j. w. meulenberg: nutritional intake of slovenian semi-professional handball players, 129–147 f ig ur e 1: a ve ra ge d ai ly e ne rg y an d m ac ro nu tr ie nt in ta ke s fo r m al e ha nd ba ll pl ay er s. a . e ne rg y in ta ke , w ith w hi te b ar s re co rd ed , gr ay b ar s re co m m en de d. b . f at in ta ke a s pe rc en ta ge o f d ai ly e ne rg y in ta ke . c . c ar bo hy dr at es in ta ke . d . p ro te in in ta ke . t hi ck gr ay h at ch ed li ne s: u pp er a nd lo w er li m it of th e ra ng e of r ec om m en de d in ta ke s. b m , b od y m as s. * d en ot es s ig ni fic an t d iff er en ce be tw ee n re co rd ed a nd r ec om m en de d. 138 kaja teraž, cécil j. w. meulenberg: nutritional intake of slovenian semi-professional handball players, 129–147 annales kinesiologiae • 10 • 2019 • 2 intakes. consequently, the actual energy intake (from the food diary) met the theoretical energy recommendation by 72.4 %, 78.7 % and 74.7 %, respectively on a training day, a match day and a day off. for each of the three days separately, the recorded average daily energy intake differed statistically from the rdei (denoted by the * in figure 1a). while the recommendations for the intake of fat were generally fulfilled (figure 1b), the carbohydrate intake was generally lower than the recommended range (figure 1c), and the recorded protein intake for male players on the training and match days were within the recommended range, while it was out of the recommended range on a day off (figure 1d). for the male handball players, we calculated more in detail the percentage of players that reached the minimal recommendations of energy and macronutrient intakes on the specific days. this is illustrated in figure 2. only 38.3% fulfilled the theoretical rdei on a match day, 18.8 % for the training day, and only 28,6% of the male players obtained enough energy during the day off. in general, carbohydrates and proteins figure 2: percentage of male players reaching the recommended energy and macronutrient levels. white bars: energy, calculated from rdei as in section 4.2.1; gray bars: carbohydrates, calculated from lower recommended limit; hatched bars: protein, calculated from lower recommended limit; black bars: fat, calculated from upper recommended limit. annales kinesiologiae • 10 • 2019 • 2 139 kaja teraž, cécil j. w. meulenberg: nutritional intake of slovenian semi-professional handball players, 129–147 recommendations were met poorly for a training day (6.3%; 12.5%, respectively). for days off none of the players fulfilled the recommendations for both carbohydrates and proteins. while on a match day, only 31% of the male players reached the recommended amount of proteins. the percentage of players reaching the minimal recommendation for fat intake was more than 25% during all three days (about 50% was within the recommended range for all days). moreover, in fact, it was observed that the percentage of players overconsuming fat was more than 38% (based on the upper recommendation limit). energy and macronutrient intakes in female handball players during the observational week of this study, the recorded daily energy intakes for the 9 female players on average were 1690 ± 750 kcal for a training day, and 1284 ± 500 for a day off (figure 3a). as already mentioned in section 4.2.1, the calculated rdeis showed significant differences between a training day, and a day off (f=539.97; p <0.025), which can also be observed in figure 3a (gray bars). consequently, on a training day, 52.3 % of the energy recommendation was met, while on a day off it reached only 47.7 %. to find out whether the differences in the rdeis and the actual recorded food intake for the female participants were present, a repeated measures analysis was conducted. no significant difference in energy intake between the different days was found (f=1.78, p=0.224). however, for each day separately a statistically significant difference between rdei and actual recorded energy intake was established (denoted by the asterisks in figure 3a). in general, the recommended fat intake for both days was reached (figure 3b). while the actual intakes of both carbohydrates and protein were below the recommendations (figures 3c and d). figure 4 shows the fulfillment of energy and macronutrient recommendations in more detail. the percentage of players that reached the daily energy intake was low (14.3% for both days), while none reached the carbohydrate recommendations, and only 11.1% and 14.3% of the players fulfilled the protein intake on training and resting days respectively. strikingly, the consumption of fat was high, and reached the upper limit of recommendation among more than 55% of female players (77.8% consume an adequate amount of fat on the training day and 57.1% on the day off). 140 kaja teraž, cécil j. w. meulenberg: nutritional intake of slovenian semi-professional handball players, 129–147 annales kinesiologiae • 10 • 2019 • 2 f ig ur e 3: a ve ra ge d ai ly e ne rg y an d m ac ro nu tr ie nt in ta ke s fo r fe m al e ha nd ba ll pl ay er s. a . e ne rg y in ta ke , w ith w hi te b ar s re co rd ed , g ra y ba rs re co m m en de d. b . f at in ta ke a s pe rc en ta ge o f d ai ly e ne rg y in ta ke . c . c ar bo hy dr at es in ta ke . d . p ro te in in ta ke . t hi ck gr ay h at ch ed li ne s: u pp er a nd lo w er li m it of th e ra ng e of r ec om m en de d in ta ke s. b m , b od y m as s. * d en ot es s ig ni fic an t d iff er en ce be tw ee n re co rd ed a nd r ec om m en de d. annales kinesiologiae • 10 • 2019 • 2 141 kaja teraž, cécil j. w. meulenberg: nutritional intake of slovenian semi-professional handball players, 129–147 discussion the aim of the study was to assess the anthropometric and body composition data in the players of two semi-professional handball teams from the slovenian national league and to evaluate whether they meet the recommended nutritional intakes of energy and macronutrients. therefore, players were asked to record, in a detailed way, their daily food intake for the 7 days of a training microcycle. the heights of the male players, shown in table 1, are comparable to the heights as previously reported (chaouachi et al., 2009; ghobadi, rajabi, farzad, bayati, & jeffreys, 2013; molina-lópez et al., 2013; massuca, branco, miarka, & fragoso, 2015; šibila & pori, 2009; sporiš, vuleta, vuleta, & milovanović, 2010). in relation to the field position, the current players’ heights follow the recent reports from large sets of professional players (n = 406, ghobadi et al., 2013; n = 161, massuca et al., 2015). furthermore, the average of 90.4 kg of body mass falls within the range of 82.2 to 96 kg as reported by previous studies in male handball players (chaouachi et al., 2009; ghobadi et al., 2013; massuca et al., 2015; molina-lópez et al., 2013; šibila & pori, 2009; sporiš et al., 2010). figure 4: percentage of female players reaching the recommended energy and macronutrient levels. white bars: energy, calculated from rdei as in section 4.2.1; gray bars: carbohydrates, calculated from lower recommended limit; hatched bars: protein, calculated from lower recommended limit; black bars: fat, calculated from upper recommended limit. 142 kaja teraž, cécil j. w. meulenberg: nutritional intake of slovenian semi-professional handball players, 129–147 annales kinesiologiae • 10 • 2019 • 2 several studies reported body fat, but only a few specifically related to the field position for male handball players, not differentiating between left, right or centrebacks (n = 21, chaouachi et al., 2009; n = 78, šibila & pori, 2009; n = 92, sporiš et al., 2010). the averaged percentages of body fat ranged from 11.2 to 15.4% (chaouachi et al., 2009; molina-lópez et al., 2013; šibila & pori, 2009; sporiš et al., 2010), while the male players from the present study have a slightly higher averaged percentage of body fat, amounting to 16.2%. in addition, the average level of visceral fat for the male handball players in the present study was of level 3.1. unfortunately, other studies do not report the measurement of visceral fat, though up to 12 is considered to be in a healthy physiological range (tanita corporation of america inc., 2013), with athletes most likely falling into the lower levels. concerning muscle mass, most studies report a detailed recording of muscle mass from body weight measurements (chaouachi et al., 2009; ghobadi et al., 2013; massuca et al., 2015; šibila & pori, 2009; sporiš et al., 2010). the muscle mass in the present study is obtained as the percentage of fat-free mass (ffm), that includes bone mass. hence, a detailed comparison is not possible. on the other hand, the averaged body mass index for the current sample of players amounts to 25.9 ± 2.3 kg/m2, that is identical to the large set reported by ghobadi and co-workers (25.5 ± 2.1 kg/m2), as well as to a small sample of 14 spanish professional male handball players (24.7 ± 1.1 kg/m2, (molina-lópez et al., 2013). only a few studies report anthropometric data for female handball players (n = 24, michalsik, madsen, & aagaard, 2013; n = 16, weber, kehl, & fonseca moreira, 2012). the presently reported average values for height and weight (table 2, 174.1 ± 7.2 cm; 71.5 ± 7.4 kg) are comparable with the danish data (174.2 cm and 70.3 kg, (michalsik et al., 2013). while for brazilian players both height and weight are smaller (164.2 cm and 56.8 kg) with a percentage of body fat of 23.2% (weber et al., 2012). in contrast, the present sample of female players displayed 26.2% of body fat. in addition, the brazilian ffm was lower and amounted to 47.9 kg, as compared to 52.5 kg in our study. thus, overall, the brazilian female handball players seem to be somewhat smaller and leaner. additionally, we report average visceral fat amounting to level 1.8 that is within the normal physiological range (tanita corporation of america inc., 2013). although the literature is limited in providing the anthropometric and body composition data for professional male and female handball players, we can assume that the data presented in tables 1 and 2 are representative of semi-professional slovenian national league handball players, and besides are within the normal range for handball players in general. the daily energy intake for team sports athletes has recently been found structurally too low (jenner et al., 2019). in the present study, an energy deficient of about 800 to 1100 kcal per day in males, and even 1500 kcal in females, has been found during the current microcycle. however, the studies specifically focused on the nutritional intake of handball players are limited. among 6 portuguese professionals, an average energy intake of 4652 kcal was found (silva et al., 2017), which is fairly high, but seems to be adequate. on the other hand, a study among 14 professional spanish male handball annales kinesiologiae • 10 • 2019 • 2 143 kaja teraž, cécil j. w. meulenberg: nutritional intake of slovenian semi-professional handball players, 129–147 players measured 2975 kcal per day (molina-lópez et al., 2013), which is comparable to our training day data (2871 kcal/day). 16 brazilian female players had an energy intake of 1883 per day (comparable with the 1690 kcal per day found here), which was mentioned to be at least 220−440 kcal less than the recommended range (weber et al., 2012). interestingly, when the spanish study introduced a nutritional education programme, after 8 weeks the intake increased with an additional 380 kcal per day (molina-lópez et al., 2013). after finishing the education, a new assessment after 8 weeks showed that the intake remained at 3329 kcal per day. while these studies do not mention the amount of players that meet the recommendations, it seems plausible that specific nutritional training and education, especially with the involvement of an expert sports dietitian, would yield higher percentages of players fulfilling the recommendations. just like the recent systematic literature review by jenner et al., (2019), we emphasize the need to prepare and include, sport-specific and player-position nutritional recommendations/education, to enhance performance. next to these generally low energy intakes, it became increasingly important to known whether our participants reached the recommended levels of macronutrients. as we suspected, the intake of macronutrients was not adequately assorted. the actual intake of carbohydrates was statistically different from the recommendations on all days, both for males and females. such a poor carbohydrates intake for team sport athletes has been reported before (holway & spriet, 2011), while on the other hand, sufficient carbohydrate intake in male soccer teams is reported in predominantly older literature (hickson, johnson, schrader, & stockton, 1987; jacobs, westlin, karlaaon, rasmusson, & houghton, 1982; rico-sanz, 1998). for women, the highest recorded carbohydrates intake was 5.2 g/kg bm/day (clark, reed, crouse, & armstrong, 2003). this does not reach the most recent minimal recommendation level of 6 g/kg bm/day that is based on soccer players (burke et al., 2011; american dietetic association et al., 2009; rodriquez et al., 2009). despite that metabolic demands between football and handball might differ, it is also suggested that recommendations for the intake of carbohydrates in team sports are set too high. based on football, recommendations have been issued ranging from 5-7 g/kg bm/day (consensus statement, 2006; holway & spriet, 2011). the protein intake of the male players was insufficient only on the day off (1,0 ± 0,4 g/kg bm/day), while for female athletes, protein intake was insufficient on training days and days off. it is important to notice that the official recommendations issued by the establish sports institutes (international society of sports nutrition – issn; american academy of sports medicine – acsm; and medical commission of the international olympic committee ioc), are of a very general character. usually recommending a range in the high amounts, facilitating for each individual (handball) player to adjust the intake, according to their personal wishes. regarding the fat intake, for all players, both males and females, no statistical significant differences with the literature recommendations were observed. however, while for females the fat intake was within the recommended range, for males an excessive intake was noticed for all days. 144 kaja teraž, cécil j. w. meulenberg: nutritional intake of slovenian semi-professional handball players, 129–147 annales kinesiologiae • 10 • 2019 • 2 high fat intake and inadequate carbohydrate intake (and on certain days, inadequate protein intake), can be linked to the anthropometric characteristics of handball players. a relatively high percentage of body fat may be due to the excess of fat intake. inadequate macronutrient ratios in combination with low energy intake, can also be interpreted as an excess of body fat, and consequently, a lower percentage of muscle mass. appropriate food choices, especially less fatty foods or foods rich in monounsaturated and polyunsaturated fatty acids, improve the anthropometric values of both males and females, optimizing their physical performance (burke & cox, 2010; fink & mikesky, 2015). for both the male and female athletes of this study, the proportion of macronutrients (carbohydrates, proteins and fats) is not in line with the recommendations of global sports institutions (burke et al., 2011; campbell et al., 2007; american dietetic association et al., 2009; rodriquez et al., 2009; thomas et al., 2016). the present study shows that the participating handball players, of both genders, adhere to a high fat intake, and, above all, low carbohydrates and protein intakes. the present study comes with several limitations. food diaries do not always reflect the actual food intake, as self-report is subject to recall errors and reporting bias, both general limitations of this method. some individuals have reported very low energy intake in relation to their actual body composition. knowing that a high percentage of body fat is due to inadequate nutrition, we assume that their reporting was not reliable. here we see an opportunity to further explore and verify the reporting of data in athletes who have weight problems. the reporting was only performed during one week. for a more accurate information and a reliable account of the nutritional status of handball players on match days, their nutrition should be recorded preferably over a whole season, especially during multiple matches. despite the fact that this study reports on a limited number (9 females and 17 males), it adds to previous energy intake studies. the anthropometric data of our study were in fact comparable with those from previous studies. thus, despite the limitations within the current study, the results bring a relevant addition to the published literature on hand ball players’ nutritional intake. conclusion in conclusion, the slovenian male and female handball players evaluated in the current study are not adequately nourished considering the current nutritional recommendations. they do not have optimally distributed macronutrient intake during their whole-day energy intake, and these inadequate macronutrient values could affect their energy metabolism and performance. both male and female athletes consume especially too little carbohydrates and too much fat. although the intake of protein for male players is within the recommended limits, the macronutrients introduced are not in the optimal ratio. handball, and other team sports, demand different exposure to the efforts in terms of playing positions, and thus, individual consultations. however, the number of scientific studies regarding nutrition and team sports are limited, and often include only a small annales kinesiologiae • 10 • 2019 • 2 145 kaja teraž, cécil j. w. meulenberg: nutritional intake of slovenian semi-professional handball players, 129–147 number of players. thus, little comparable research is available. it is for these reasons that it is difficult to formulate recommendations that would suit all players and thus optimize their performance. nevertheless, introducing nutritional instructions and interventions could improve the players’ eating habits and thus their psychophysical fitness. conflicts of interest the authors declare that no conflicts of interest exist. funding this manuscript was prepared as part of the research programme kinesiology for quality of life (p5-0381) funded by the slovenian research agency. ethical aproval the approval for this study by the ethics committee of the republic of slovenia is located under 0120-132 / 2016 kme 55/03/16. references ainsworth, b. e., haskell, w. l., herrmann, s. d., meckes, n., bassett, d. r., tudorlocke, c., … leon, a. s. 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(2012). comparison of the dietetic and anthropometric profile of handball athletes during a training period. fiep bulletin, 82, 209–212. https://doi.org/10.3305/nh.2013.28.4.6600 https://doi.org/10.3305/nh.2013.28.4.6600 https://doi.org/10.1123/ijsn.8.2.113 https://doi.org/10.1016/j.jada.2009.01.005 https://doi.org/10.1249/mss.0000000000001216 https://doi.org/10.1249/mss.0000000000001216 https://hrcak.srce.hr/59364 https://doi.org/10.1123/ijsnem.2014-0034 https://doi.org/10.1123/ijsnem.2014-0034 https://hrcak.srce.hr/51458 https://www.tanita.com/data/file/additionalresearch/visceralfatmeasurmentp1.pdf?rev=72de https://www.tanita.com/data/file/additionalresearch/visceralfatmeasurmentp1.pdf?rev=72de https://doi.org/10.1249/mss.0000000000000852 _goback _goback _hlk23772821 _goback _goback _hlk27564900 _goback bbib0050 bbib0035 _hlk3367923 _goback annales kinesiologiae • 10 • 2019 • 1 59 review article doi: https://doi.org/10.35469/ak.2019.182 received: 2019-03-12 udc: 796.012:612.67 the benefits of physical activity and exercise on physical, cognitive and daily life activities in aging adults dorjana zerbo-šporin university of primorska, faculty of health science, izola, slovenia corresponding author: dorjana zerbo-šporin university of primorska, faculty of health science, polje 42, 6310 izola, slovenia phone: +386 5 663 54 63 e-mail: dorjana.zerbosporin@fvz.upr.si abstract due to increased longevity, degenerative diseases and disabilities have become one of the largest health care problem. the state of well-being with a low risk of premature health problems is important for successful aging. even if the impact of physical activity and exercise on performance of daily life activities is still poorly understood, it seems that regular training has important benefits on physical and cognitive functioning in healthy elderly population. combined training including strength, balance, flexibility exercises and activities that improve cardiorespiratory fitness, are important to ensure the independency of elderly people. keywords: physical activity, exercise, physical functioning, daily life activities, older adults 60 dorjana zerbo-šporin: the benefits of physical activity and exercise on physical, cognitive and daily life ..., 59–71 annales kinesiologiae • 10 • 2019 • 1 vpliv gibanja na telesne in umske sposobnosti za izvajanje vsakodnevnih opravil v starosti izvleček ena izmed posledic podaljševanja povprečne življenjske dobe so tudi različne telesne omejitve in številne degenerativne bolezni, ki postajajo vse večji zdravstveni problem. kvalitetno staranje je povezano z dobrim počutjem posameznika in nizkim tveganjem za zgodnji pojav bolezni. vpliv redne telesne aktivnosti in vadbe na sposobnost izvajanja vsakodnevnih opravil v starosti še ni povsem pojasnjen, je pa vadba dokazano povezana z boljšimi telesnimi in kognitivnimi sposobnostmi starejše osebe. kombinirani trening, ki vključuje vaje za moč, ravnotežje in gibljivost, v povezavi z rednimi vzdržljivostnimi telesnimi aktivnostmi, pomembno prispeva k ohranjanju samostojnosti starostnika. ključne besede: telesna aktivnost, telesna vadba, vsakodnevne telesne aktivnosti, starejše osebe introduction european today can expect to live longer. according to eurostat (2019) in 2017, one fifth (19%) of the europeans population was aged 65 and over. the share of elderly people tends to increase. especially for those aged 80 + years it will be more than double by 2080 to reach 13% of the whole population. the consequence of this increased longevity is that degenerative diseases and disabilities have become one of the largest health care problems. the negative impact of a longer life span is a potential for suffering physical frailty and it could become questionable whether life can be enjoyed fully under physical conditions that constrain daily activities (spiduso, francis, & macrea, 2005). the degree to which participation in physical activity (pa) and exercise translates into improved physical functioning and enhanced performance of daily life activities (adl) is not yet clear. there is not a simple linear relationship between being active and being independent on others, but at least no increase in disabilities after being regular physically active was found (chodzko-zajko et al., 2009). during aging structural and functional attenuation occurs in most physiological systems, even in the absence of diseases. these age-related changes can influence daily life activities through reduction in functional capacity. advancing primary aging is mainly associated with the decline in pa volume and intensity, higher prevalence of degenerative conditions, body composition changes, and the decrease in maximal aerobic power. aging is also characterized by the reduction in muscle strength and power and by the decline in flexibility, balance and cognitive functions (shephard, 1997; hunter, annales kinesiologiae • 10 • 2019 • 1 61 dorjana zerbo-šporin: the benefits of physical activity and exercise on physical, cognitive and daily life ..., 59–71 mccarthy & bamman, 2004; chodzko-zajko et al., 2009). at present, aging including loss of abilities is an inevitable process. there is, however, evidence that regular exercise has anti-aging effects. target strength and aerobic training can attenuate a cardio-respiratory decline, muscle wasting and improve resistance to the development of disability with aging. most common age-associated chronic conditions cause alteration in physiological functions and thus physiological interventions, of which physical exercise is a good example, can be a remedy (tseng, 1995; garatachea et al., 2015). regular aerobic exercise improves endothelial function with increasing nitric oxide production and thus regulate vascular tonus. in addition, aerobic exercise stimulates angiogenesis and the reverse cholesterol transport. it increases heart rate variability, reduces activity of angiotensin ii and inhibits blood coagulation. resistance exercise improves muscle mass and strength in elderly. the molecular mechanisms involved are calcium flux, atp/adp ratio, intracellular ph redox balance. post-exercise gene transcription mostly involves myogenic regulators. exercise also attenuates neurodegeneration due to aging, by maintaining the hippocampal structure and upregulating neurotrophic factors, such as bdnf (brain derived neurotrophic factor) important for synaptic plasticity and cognitive performance (garatachea, et al., 2015; slutsky & etnier, 2016). the primary goal of care for the elderly is to ensure their independent life as long as possible. there is evidence of an association among habitual pa in later life and the maintenance of effective functions (wanderley et al., 2011). objectives the aim of this article is to present a short overview of the literature regarding the benefits of pa and exercise on physical functioning and daily life activities in an adult, aging population. for this purpose, databases pubmed and scopus were searched in february 2019 for literature sources published from 1995 to 2018 using research strategy: (physical activity or exercise) and physical functioning and daily life activities and older adults. a literature search was conducted including articles based on the following criteria: (1) clinical trials and reviews (2) published in english language. the research strategy generated 168 articles which were analyzed using the algorithm: review the titles, for the remaining review the abstracts and for the last remaining review the full text. finally, 22 articles were selected to address the objective of the study: impact of physical activity and exercise on the ability to perform everyday task and independency in the elderly. other relevant literature from the field was included. successful aging successful aging (rowe & kahn, 1997) is determined by three main components: low probability of disease and disease-related disability, high cognitive and physical functional capacity, and active engagement with life. subjects are considered to suc62 dorjana zerbo-šporin: the benefits of physical activity and exercise on physical, cognitive and daily life ..., 59–71 annales kinesiologiae • 10 • 2019 • 1 cessfully age if they can perform physical activities expected from an adult with no or little difficulties. their ability to perform basic physical daily activities such: walking, stair climbing, bathing, dressing, doing housework, gardening etc. is usually valued through questionnaires (strawbridge, cohen, shema, & kaplan, 1997). physical reserve in old age is of a great significance and can be define as the distance from physical frailty: musculoskeletal function, aerobic capacity, and motor coordination decline. individuals that still have sufficient physical reserve can continue to live in their homes and to carry out regular daily activities (spiduso, francis, & macrea, 2005). cognitive reserve, the capacity to maintain healthy brain functions, is an important issue in successful aging. identified components of cognitive reserve are childhood intelligence, higher mental ability, better management of stressful experiences, better use of health services, implementation of health education in lifestyle and a choice of cognitively more stimulating leisure activities. managing the components that influence on cognitive aging and cognitive reserve is an important issue to maintain brain functions in old age (whalley, deary, appleton, & starr, 2004). especially hippocampus is important for cognitive performance. studies have shown that maintaining a normal body weight and being physically active are beneficial for hippocampal structure and function (slutsky & etnier, 2016). the state of well-being with a low risk of premature health problems is important for successful aging (rowe & kahn, 1997). main conditions that influence daily life abilities in older adults decrease in bone and muscle mass, including faster decline in type ii muscle fibers, decrease in tensile strength of tendons and ligaments, increase in muscle and related structure stiffness and the articular cartilage weakness are some of the most important aging conditions that influence daily life abilities in older adults (shephard, 1997; anish, 2009). impairments in leg muscle power as well age – related decline in sensory capabilities, are important factors underlying mobility limitations in older adult daily life (bean et al., 2004). using bed rest as an aging model to study degenerative physiology of human systems we can follow physiological alterations at different ages. for example, the negative effect of bed rest on muscle mass and function was greater in older men, whereas metabolic disturbance was greater in younger adult men (pišot et al., 2016). the available evidence suggests that bone mass reduction in the case of extreme physical inactivity represents an acceleration of the normal ageing of the bone and underlines the importance of being active to maintain tissue balance (bilancio, lombardi, cirillo, pišot, rittweger, & de santo, 2012). there was no significant impairment in cognitive performance, mental health and satisfaction with life after the 14-day bed rest, except in the delayed recall of older adults (dolenc & petrič, 2013). the obtained results provide evidence that favourable living, as well the quality of social interactions can protect against cognitive decline during physical inactivity (dolenc & petrič, 2013; dimec časar, tušak, & dolenc, 2015). when computerized cognitive training is being annales kinesiologiae • 10 • 2019 • 1 63 dorjana zerbo-šporin: the benefits of physical activity and exercise on physical, cognitive and daily life ..., 59–71 implemented during the bed rest study the improved in cognitive performance was evident and can successfully moderate detrimental bed rest effects in healthy older adults (marušič et al., 2015; marušič et al., 2017). physical activity to improve physical functioning in daily life activities of elderly healthy older adults who are able to engage in exercise can develop positive adaptations to the training. when compared to older adults (60–74 years), 73% of the reduction in total energy expenditure in nonagenarians is attributed to a reduction in pa level. the reduced physical activity in nonagenarians is associated with less physical functionality (frisard et al., 2007). nevertheless, multicomponent exercises including muscle power training enhance muscle mass, power output, and functional outcomes also in nonagenarians (cadore et al., 2014). exercise, even at moderate level, in particular avoiding sedentary behavior, may delay disabilities and improve survival in older age. types of activities that bring joy and are in the same time easy to include in daily life are suitable. for example, regular practice of daily life activities will allow their maintenance. positive association was found among house/garden work and physical/mental well being in older women (peeters, van gellecum, van uffelen, burton, & brown, 2014). simple interventions like pet ownership are important in maintaining daily life abilities levels of older people (raina, waltner-toews, bonnett, woodward, & abernathy, 1999). even regular walking induces benefits for health, in addition is simple, safe and free of charge. we can walk anytime and anywhere: at home, up the stairs, in the nature in shopping malls (drev, 2010). dance, especially challenging dance programs are an effective countermeasure of aging on the brain. dancing has a superior potential to induce more positive effects on brain volumes in elderly people to peperitive physical exercises (rehfeld et. al., 2018). an important message is that exercises in old age are not beneficial only for physical functioning, but they also are neuro-protective (herold, törpel, schega, & müeler, 2019). but for most health outcomes, additional benefits occur as the amount of pa increases through longer duration, greater frequency and finally, higher intensity. ideally, exercise programs for successful aging should include endurance training, resistance training and exercise for flexibility and balance (simonsick, guralnik, volpato, balfour, & fried, 2005; chodzko-zajko et al., 2009). in this case gradually increasing regular pa is extremely important. when preparing the training program, we must consider any health restrictions of the elderly subject (gerževič & plevnik, 2014). the who guidelines are relevant to all healthy adults aged 65 years and over unless specific medical conditions: older adults should do at least 150 minutes (for additional benefits 300 min) of moderate-intensity aerobic pa or do at least 75 minutes (for additional benefits 150 min) of vigorous intensity aerobic pa throughout the week. aerobic activity should be performed in bouts of at least 10 minutes duration. older adults should perform pa to 64 dorjana zerbo-šporin: the benefits of physical activity and exercise on physical, cognitive and daily life ..., 59–71 annales kinesiologiae • 10 • 2019 • 1 enhance balance and prevent falls on 3 or more days per week. muscle-strengthening exercise should be done on 2 or more days a week. when older adults cannot do the recommended amounts of pa due to health conditions, they should be as physically active as conditions allow (global recommendations on physical activity for health 65 years and above, 2011). endurance activities for elderly improvements in daily life abilities are often achieved by endurance training. endurance exercises for elderly usually include brisk walking or jogging, swimming, yard work and dancing. endurance training is an effective tool against the cardiorespiratory decline observed during aging. after an 8-year follow-up of older adults, paterson, govindasamy, vidmar, cunningham, and koval (2004) report that a lower cardiorespiratory fitness is a significant determinant of becoming dependent. authors suggest that initiatives to encourage physical activity in older adults should emphasize exercise to maintain or improve cardiorespiratory fitness. thais de lima, corrêa kanan, augustin schwanke, and mânica da cruz (2013) suggest that 3 months aerobic training program by treadmill walking result in significant increases in step length and self-selected walking speeds in healthy, independent, elderly women. frequent, especially brisk pace walking is a relatively safe and easy activity also for hip fracture prevention (feskanich, flint, & willett, 2014). aerobic exercise can improve physical performance but even a number of aspects of cognition and brain function (hillman, erickson, & kramer, 2008). heart rate is commonly used as a guide to exercise intensity. the american heart association suggest the target ranges for moderate-intensity exercise as 50% to 75% of average maximum heart rate. exercise sessions should maintain target heart rate for 20 to 60 minutes (continuous or intermittent), with a minimum of 3 x 10-minute bouts collected throughout the day. according to american college of sports medicine, to achieve cardiorespiratory fitness aerobic exercise 3 to 5 days per week should be performed (mcdermott & mernitz, 2004). strength training for elderly physical activity maintains muscular strength and endurance, flexibility and balance, all factors important for independent living of an elderly person. generally, a progressive resistance training protocol can produce substantial increases in muscle strength and power of aging people (skelton, young, greig, & malbut, 1995; hanson et al., 2009). leg strength and endurance are necessary for housekeeping, food preparation, shopping etc. neuromuscular activation deficits precede changes in muscle size and strength, and this may be the initial mechanism that influences leg muscle power loss (reid et al., 2014). a progressive resistance training program is effective in improving leg power in elderly men and women (earles, judge, & gunnarsson, 2001; bean et al., 2004; holviala et al., 2014). furthermore, for improvement daily life activities of elhttps://go4life.nia.nih.gov/exercise-type/endurance/ annales kinesiologiae • 10 • 2019 • 1 65 dorjana zerbo-šporin: the benefits of physical activity and exercise on physical, cognitive and daily life ..., 59–71 derly, a functional muscle power training program based on higher velocity movements that mimic daily life activities should be prescribed (cress, conley, balding, hansensmith, & konczak, 1996; miszko et al., 2003; bean et al., 2004; henwood & taaffe, 2005). to combine, a progressive resistance training that incorporates rapid rate-offorce development movements may be safely undertaken in healthy older adults and results in significant gains in muscle strength, muscle power, and physical performance (henwood & taaffe, 2005). resistance exercises are powerful physical interventions to induce functional brain changes, especially by improvements in executive functions. resistance exercises lead to mantain white matter and to smaller white matter lesions (herold, törpel, schega, & müeler, 2019). incorporating the elastic resistance training in nursing homes could be an effective strategy against functional decline during aging (urzi, marušič, ličen, & bužan, 2019). resistance training should be performed at least twice per week and exercises should target the major muscle groups. patients can exercise all muscle groups at each session or divided the series into shorter sessions of 3 to 4 muscle groups that are worked on alternation, so 4–6 sessions per week. each set should consist of 8 to 12 repetitions at a somewhat hard to harder intensity level using the borg rating of perceived exertion scale. sessions should be no longer than an hour, with 48 hours between sessions (mcdermott & mernitz, 2004). balance and flexibility training for elderly combined exercises including strength, balance and flexibility exercises are effective in reducing the risk of falls (campbell et al., 1997) and consequent limitations in daily life activity in old age. flexibility is the range of motion around a joint and is associated with injury prevention. of particular importance in aging is the maintenance of posterior thigh and ankle flexibility and of lower back flexibility. appropriate flexibility can protect against chronic lower back pain and maintain the ability to perform daily life activities. activities that improve flexibility include exercises that lengthen the muscles such as tai-chi, yoga, and stretching. a static stretching program including all major muscle groups performed a minimum of 2 to 3 times per week can improve agility and balance. stretching exercises can be involved in warm-up and cool-down phases of an aerobic or resistance training (mcdermott & mernitz, 2004). a fitness program that includes exercises to improve flexibility, and strength, with an emphasis on balance (for safety external support must be provided) involving the lower body muscles would be a good choice for elderly patient (mcdermott & mernitz, 2004). physical activity programs including cognitive tasks physical activity and exercise alone are neuro – protective (guadagni et. al, 2018; northey, cherbuin, pumpa, smee, & rattray, 2018; tyndall et. al., 2018; herold, törpel, schega, & müeler, 2019), but less is known how to combine physical and cognitive 66 dorjana zerbo-šporin: the benefits of physical activity and exercise on physical, cognitive and daily life ..., 59–71 annales kinesiologiae • 10 • 2019 • 1 training for greater effects on cognitive functions and how brain training alone influence mobility in older adults. cognitive training itself can improve mobility-relatated outcomes in older adult, especially for challenging walking conditions (marušič, verghese, & mahoney, 2018). physical activity programs for older adults can bring greater benefits when cognitive tasks are integrated. for example, challenging dance programs that combine aerobic fitness, sensorimotor skills and cognitive demands are promising in counteracting the decline in physical and cognitive abilities during aging (müller et. al., 2017; rehfeld et. al., 2018). older adults should be made aware of the plasticity of the brain and the potential to maintain or improve their cognitive functioning when engage in mentally challenging physical activity (e.g. activities that combine physical and cognitive tasks as dance, tai-chi) (gheysen et al., 2018). a systematic review of the effect of aerobic exercise on cognition in older adults showed an improving in auditory attention and cognitive processing speed (angevaren et al., 2008). physical activity, alone or combined with cognitive and nutritional interventions could enhance functional fitness in older adults (paravlić, marušič, gerževič, urzi, & šimunič, 2016). simultaneous training of cognitive and physical abilities presents an important technique to improve cognitive and motor-cognitive performance, so offering a better basis on daily life functioning (gerževič, plevnik, & marušič, 2017). even exercise at moderate level reduces the risk of developing cognitive impairment in older adults (paterson, jones, & rice, 2007). it seems that brain derived neurotrophic factors as metabotrophin mediate the effects of exercise on cognition (gomez pinilla, vaynman, & ying, 2008). although the effects of exercise on cognition are promising, information about the specific dose and type of exercise are still missing (taylor, 2014). daily life abilities can be also impaired because of sleep disorders, which are common in elderly population. regular physical exercise has been found as beneficial to initiating and maintaining sleep (montgomery & dennis, 2002). conclusions state of well-being with a low risk of premature health problems is crucial for successful aging. even still poorly understood relationship between physical activity and performance of daily life abilities, it seems that regular training has important benefits on physical functioning and daily life abilities in healthy elderly population. in particular, a variety of resistance exercise trainings favorably impact walking and balance activities, through maintaining muscle strength, power and neuromuscular capability of aging people. an additional beneficial effect on physical functioning is achieved if rapid movements that mimic daily life abilities are incorporated in the training programs. combined training including strength, balance and flexibility exercises are effective in reducing the risk of falls the consequences of which can very limited performance of daily life abilities in the old age. old adults should be also encouraged to emphasize exercise, such as brisk walking, to maintain cardiorespiratory fitness, a significant deannales kinesiologiae • 10 • 2019 • 1 67 dorjana zerbo-šporin: the benefits of physical activity and exercise on physical, cognitive and daily life ..., 59–71 terminant of healthy aging. importantly, in the preparation of the training program is necessary to consider any health restrictions of the subject. references angevaren, m., aufdemkampe, g., verhaar, h. j. j., aleman, a., & vanhees, l. 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(2011). associations between objectively assessed physical activity levels and fitness and selfreported health-related quality of life in community-dwelling older adults. quality of life research, 20(9), 1371–1378. https://doi.org/10.1007/s11136-011-9875-x. whalley, l. j., deary, i. j., appelton, c. l., & starr, j. m. (2004). cognitive reserve and the neurobiology of cognitive aging. aging research review, 3(4), 369-382. https://doi. org/10.1016/j.arr.2004.05.001. https://doi.org/10.1093/oxfordjournals.aje.a008900 https://doi.org/10.1136/postgradmedj-2012-131366 http://revistaseletronicas.pucrs.br/ojs/index.php/pajar/article/view/13287 http://revistaseletronicas.pucrs.br/ojs/index.php/pajar/article/view/13287 https://doi.org/10.1093/gerona/50a.special_issue.113 https://doi.org/10.1093/gerona/50a.special_issue.113 https://doi.org/10.1007/s11136-011-9875-x _goback _hlk3367923 _goback _goback _goback _hlk3056869 _goback _goback _hlk23766418 _goback _hlk26527070 _goback _goback annales kinesiologiae • 13 • 2022 • 2 189 reports and reviews/poročila in ocene, 185–195 conference report – 4th international conference on technology innovations for healthcare (icdht) magdeburg, germany, 14th‒16th september 2022 the otto von guericke university hosted the 4th icdht conference in magdeburg, germany. lectures were held in the lukas klause building and in the main building of the college. the two-day conference featured a comprehensive scientific program addressing the latest developments in research and technology for digital health with clinical and technical perspectives. the conference focused on future p4 medicine (predictive, preventive, personalized and participatory) and on supporting performance in all sports through information technology tools. the program featured 8 keynote speakers and 27 oral presentations. among the participants, colleagues from the institute for kinesiology research zrs koper presented their work; prof dr rado pišot (digital technology – from an obstacle to an incentive for a healthy and active lifestyle), prof dr boštjan šimunič (the decomposition of tensiomyography using advanced mathematics) and prof dr uroš marušič (wearables and wireless technology for training and tele-rehabilitation services) were the keynote speakers and dr saša pišot and kaja teraž gave their oral presentation. the issued “book of abstracts” contains 27 abstracts of scientific papers with current research results in the field of digital health technology. the rich historical background of the city of magdeburg, the hospitality of the organizers and the interesting social program allowed us to exchange professional thoughts and ideas related to this field, which will experience many innovations in the future. kaja teraž 190 reports and reviews/poročila in ocene, 185–195 annales kinesiologiae • 13 • 2022 • 2 poročilo s 4. mednarodne konference o tehnoloških novostih v zdravstvu (icdht) magdeburg, nemčija, 14.‒16. september 2022 univerza otto von guericke je gostila 4. konferenco icdht, ki je potekala v magdeburgu v nemčiji. predavanja so potekala v stavbi lukas klause in glavni stavbi univerze. dvodnevna konferenca je vključevala obsežen znanstveni program, v okviru katerega so bili obravnavani najnovejši dosežki na področju raziskav in tehnologije za digitalno zdravje z njegovimi kliničnimi in tehničnimi vidiki. konferenca se je osredinila na obetavno p4 medicino (prediktivna, preventivna, personalizirana in participativna medicina) in podporo športnim dosežkom v vseh športih s pomočjo orodij informacijske tehnologije. v okviru programa je sodelovalo osem vabljenih govornikov, predstavljenih pa je bilo 27 povzetkov prispevkov. med vsemi udeleženci so svoje delo predstavili tudi kolegi z inštituta za kineziološke raziskave zrs koper, in sicer prof. dr. rado pišot (digitalna tehnologija – od ovire do spodbude za zdrav in aktiven življenjski slog), prof. dr. boštjan šimunič (dekompozicija tenziomiografije z uporabo napredne matematike) in prof. dr. uroš marušič (nosljiva in brezžična tehnologija za usposabljanje in storitve rehabilitacije na daljavo) kot osrednji govorci, dr. saša pišot in kaja teraž pa sta predstavili svoj povzetek prispeveka. izdan zbornik vsebuje 27 povzetkov znanstvenih prispevkov z aktualnimi rezultati raziskav na področju digitalne zdravstvene tehnologije bogato zgodovinsko ozadje mesta magdeburg, gostoljubnost organizatorjev in zanimiv družabni program so nam omogočili izmenjavo številnih strokovnih misli in idej o omenjenem področju, ki bo v prihodnosti doživelo številne novosti. kaja teraž _hlk122510532 _hlk121925715 _hlk121925783 _hlk117671776 _hlk117676890 _hlk117676830 _hlk122521710 _hlk123029474 _hlk51764713 _hlk51617947 _hlk51764685 _hlk51616945 _hlk51676200 _hlk51710755 _hlk124939594 _hlk124939408 _hlk125008249 _hlk125008423 _hlk125010166 _hlk124768186 _hlk129167818 _hlk129168885 _hlk129939779 _ref116207795 annales kinesiologiae • 12 • 2021 • 1 5 short scientific article doi: https://doi.org/10.35469/ak.2021.306 received: 2021-12-20 udc: 796.322 teaching feints to handball beginners preliminary results david henigman1, katarina ohnjec2 1rk team klaksvik, faroe islands 2university of zagreb, faculty of kinesiology, zagreb, croatia corresponding author: katarina ohnjec university of zagreb, faculty of kinesiology, horvaćanski zavoj 15, 10000 zagreb, croatia phone: +385 1 365 86 66 e-mail: katarina.ohnjec@kif.hr abstract the aim of this preliminary research was the evaluation of a two-month program for improvement of the single forward feint to the left with passage to the right, and single forward feint to the right with passage to the left by “shifting” the opponent’s hand. sixteen young male handball players aged 9.64 ± 0.87 years participated in this study. the program was implemented over two months, during which 18 training sessions (35%) were conducted for the improvement of feint skills, from 52 training sessions overall. an initial video recording was made at the beginning of the period, and a final one at the end. videos were analyzed by three experts, using a grading list and detailed grading criteria. the basic parameters of descriptive statistics were determined for both variables. the metric characteristics of the expert estimation contribution were analyzed through measures of reliability (cronbach’s α) and homogeneity (average item inter-correlation). the non-parametric (wilcoxon t-test) method was used to analyze changes in the levels of feint performance at different times. the results indicate satisfactory reliability and homogeneity of the tests (α1=0.90; r1=0.80; α2 =0.86; r2=0.87). through insight into the results, a significant difference was spotted between the initial and final states of both motor skills acquisitions (t1 = 114.5, p= 0.01; t2 =7.00; p= 0.01). the limiting factors of the study may be the sample size, as well as the absence of a control group and of a validated evaluation of the instrument. keywords: motor skills, teaching methods, single feint, work program 6 david henigman, katarina ohnjec: teaching feints to handball beginners preliminary results ..., 5–13 annales kinesiologiae • 12 • 2021 • 1 učenje »fint« pri rokometaših začetnikih – preliminarni rezultati izvleček cilj te začetne raziskave je bila ocena dvomesečnega programa za izboljšanje izvajanja enojnega lažnega koraka v levo s prehodom po desni ter enojnega lažnega koraka v desno s prehodom po levi in »odmikom« nasprotnikove roke. v raziskavi je sodelovalo šestnajst mladih rokometašev v starosti 9.64 ± 0.87 let. program je trajal dva meseca, v tem času je bilo 18 od skupno 52 treningov (35 %) posvečenih izboljšanju izvajanja lažnih akcij oziroma t. i. fintiranja. ob začetku izvajanja programa je bil posnet video, prav tako tudi ob koncu programa. videoposnetka so analizirali trije strokovnjaki, ki so si pri ocenjevanju pomagali s podrobnim ocenjevalnim seznamom in kriteriji. za obe spremenljivki smo določili osnovne parametre opisne statistike. metrične vrednosti strokovnih ocen smo analizirali z vidika zanesljivosti (cronbachov alfa) in skladnosti (povprečne interkorelacije med postavkami). spremembe na ravni izvajanja lažnih akcij na različnih časovnih točkah smo analizirali z neparametrično metodo (wilcoxonov test z rangi). rezultati so pokazali zadovoljivo zanesljivost in skladnost preizkusov (α1=0.90; r1=0.80; α2 =0.86; r2=0.87). pregled rezultatov je pokazal pomembno razliko med začetnim in končnim stanjem pri usvajanju obeh motoričnih sposobnosti (t1 = 114.5, p= 0.01; t2 =7.00; p= 0.01). omejitve raziskave so velikost vzorca ter odsotnost kontrolne skupine in validacije instrumenta. ključne besede: motorične spretnosti, učne metode, enojni lažni korak, delovni program 7 annales kinesiologiae • 12 • 2021 • 1 david henigman, katarina ohnjec: teaching feints to handball beginners preliminary results ..., 5–13 introduction since knowledge and skills can be taught and acquired in different ways, it is the task of a trainer, coach, or teacher to find the best one to achieve the defined goals. the modern handball game shows progress in this respect, as obligatory improvement of coaching competencies is being introduced in all aspects of teaching. despite the diversity of children’s training programs, the role and the importance of playing the game is still a top priority in children’s handball training sessions (foretić, burger, rogulj, 2011). a game-focused approach could be an effective method when teaching team sports in which tactical solutions and decision-making periods on the court or in the field are rather short, as well as the periods of scoring in offensive and defensive games (chatzipanteli, digelidis, karatzoglidis, & dean, 2016; hrynchenko, tykhonova, karpunets, & chupryna, 2021). younger schoolchildren (6‒10 years) take their first steps in organized handball training playing mini handball in handball schools. mini handball is adapted for younger schoolchildren in many aspects: reduced playing field, soft small ball, a lower number of players on the team (4 plus the goalkeeper), shorter duration, the way of playing through individual tactical action in offences and defense, etc... for children included in this type of training activity, it is very important that their needs for security, belonging, and affection are met, as addressed by milanović (2013), as well as their self-respect and self-actualization, which might be even more important than gaining motor knowledge and developing skills. the coach has a key role in creating such an environment. often, a problem occurs because trainers treat children as if they are older than their actual age. numerous authors have explained that the development of children has its principles and dynamics related to the specific developmental stages, which then, in turn, determine the pursued objectives (balyi, way & higgs, 2013; côté & vierimaa, 2014; lloyd et al., 2015). in this sense, creating and implementing a syllabus that is appropriate for a child’s age and will, at the same time, foster high quality sports development, is a challenging task for handball coaches and teachers of beginners. a shift from mini handball to team handball is not a simple process since the activity in question is complex. the game in the attack according to the playing positions in handball differs significantly from the free play throughout the field in mini handball. after playing defense individually in mini handball, it is necessary to learn how to function in an organized defending system. focus on ball handling is more prominent than focusing on game stops due to body contact (‘a foul’). to be more successful in the long run when playing defense, young handball players should begin learning new moving structures such as defense configurations 3:3 (zone formation) or 3+3 (combined formation) (kanjugović, ohnjec, žnidarec čučković, 2013). malić and dvoršek (2011) suggest that young players at that age should develop some basic elements of handball technique such as catching and passing, different shooting methods, as well as landing and using feints, whereas very detailed specialization is not yet desirable. the emphasis is on learning mostly technical, rather than tactical elements, so learning 8 david henigman, katarina ohnjec: teaching feints to handball beginners preliminary results ..., 5–13 annales kinesiologiae • 12 • 2021 • 1 feints and acquiring a habit of moving without the ball into an open area is extremely important to be able to deal with the situations in the game. to teach methods of physical education and sport (pes) in classes, a teacher or a coach traditionally demonstrates certain elements and instructs the students on how to execute movements. this methodology has the theoretical basis in the cognitive approach, where the mind is the center of learning an activity (raiola, 2017). the behaviorist and cognitivist theories suggest an exact and single solution model of a motor problem, and therefore are prescriptive in their nature (raiola, 2017). papić and papić. (2014) mention the importance of adapting teaching methods to the children’s needs and abilities by creating situations that enable a child to learn independently, without imitating a coach, and consequently without the need to be constantly corrected. the aim of this study was the evaluation of a two-month program for improvement of a single forward feint to the left with passage to the right, and of a single forward feint to the right with passage to the left by “shifting” the opponent’s hand. methods sample the sample consisted of 16 young handball players aged 8 to 11. all study participants were in their first year of actively competing in the national league for boys of their age. the parents of all the participants signed the program participation approval forms. the study used two variables for the evaluation of specific motoric skills: 1. a single forward feint to the left with passage to the right (fl), and 2. a single forward feint to the right with passage to the left by “shifting” the opponent’s hand (fr). training program the program was part of a regular training process (a total of 52 trainings) for two months. 18 sessions (35%) were focused on teaching feinting and structured exercises focused on repeating the new pattern of movement in the set conditions, then in situational exercises and during games of handball. the features of the feint teaching program included (henigman & ohnjec, 2021): 1. the learning of the two technical elements in a 50:50 ratio, 2. the use of the kidgrid sports equipment, a version of agility ladder (papić & papić, 2014) – a set for an independent learning of a movement, 3. repetition of a movement pattern in a real situation – after performing a moving structure by running through the kidgrid agility ladder; and after passing a passive hurdle immediately afterwards, a player was asked to implement this new 9 annales kinesiologiae • 12 • 2021 • 1 david henigman, katarina ohnjec: teaching feints to handball beginners preliminary results ..., 5–13 motor skill in the actual court situation by confronting an opponent in an attempt to score. 4. speed of performance – by adding a defending player who chased the attacker, the exercise was performed at almost maximum speed. 5. development of creativity – when confronting the opponent, the player had to perform a feint. however, this did not have to be the exact one performed on the agility grid since the player had to adapt to the real situation on the court. it is important to add that after the application of the exercise, in every training session a game of handball was played. an initial video recording was made at the beginning of the program, and a final one at the end. four videos were analyzed by three experts using a grading list and detailed grading criteria. (grade 1 inability to perform a feint, the player cannot catch the passed ball; grade 2 the player breaks game rules when performing a feint – by walking, double dribbling or fouling the defending player; grade 3 performing a feint in accordance with the game rules but with no accentuated change in movement direction; grade 4 – technically well but too slowly performed faint; grade 5 – technically well and swiftly enough performed feint). the criteria for the evaluation by the experts were formed according to a study conducted on students (gruić, 2011) and adapted to the population of beginning handball players. the experts were coaches who had completed professional and university studies in kinesiology, licensed handball coaches, and coaches who have experience working with younger age athletes. statistical analysis the basic parameters of the descriptive statistics were determined for both variables. the metric characteristics of the expert estimation contribution were analyzed by using measures of reliability (cronbach’s α) and homogeneity (average item intercorrelation). the non-parametric wilcoxon t test was used to analyze changes in the levels of feint performance at different times. results table 1 shows the basic metric characteristics of the expert estimation contribution when applying measures of reliability (cronbach’s α) and homogeneity (average item inter-correlation). 10 david henigman, katarina ohnjec: teaching feints to handball beginners preliminary results ..., 5–13 annales kinesiologiae • 12 • 2021 • 1 table 1. measures of internal agreement of expert evaluation criteria i f xα xr fl cronbach’s α 0.93 0.87 0.90 average item inter-correlation r 0.85 0.75 0.80 fr cronbach’s α 0.88 0.84 0.86 average item inter-correlation r 0.99 0.75 0.87 the results indicate a satisfactory reliability and homogeneity of the tests (α1=0.90; r1=0.80; α2 =0.86; r2=0.87). a somewhat lower reliability of the single forward feint to the right with passage to the left by “shifting” the opponent’s hand tests (0.86) could be accounted for by a higher complexity of the feint, which subsequently caused more disagreement among the assessors. the average values and standard deviations of the skill levels graph (figure 1) demonstrate a total average improvement of both motor structures. an average grade of the basic feint rose from 2.88 to 3.52, and from 1.84 to 2 in the case of the more complex structure. figure 1. average values and standard deviations of the level of knowledge in the initial and final states. 11 annales kinesiologiae • 12 • 2021 • 1 david henigman, katarina ohnjec: teaching feints to handball beginners preliminary results ..., 5–13 the table of wilcoxon t-test results (table 2) indicates a significant difference between the initial and final states of learning for both motor skills. table 2. wilcoxon t-test pair of variables t z p-value fl_in & fl_f 114.50 3.28 0.00 fr_in & fr_f 7.00 4.46 0.00 * fl_in a single forward feint to the left with passage to the right initial measurement fl_f a single forward feint to the left with passage to the right final measurement fr_in a single forward feint to the right with passage to the left by “shifting” the opponent’s hand initial measurement fr_f a single forward feint to the right with passage to the left by “shifting” the opponent’s hand initial measurement discussion this preliminary study presents the effects of a two-month training program of teaching the two types of feints to handball beginners. initial grading values, for the simple feint to the left with a passage to the right – basic feint (2.88), are slightly higher than for the feint to the right (1.84). an explanation for this could be in the “natural” way of performing the basic feint and its more frequent spontaneous application in the training process. the maximum grade in initial testing of the basic feint was 5, and minimum 1. after the training program was applied, the number of maximum grades increased, and the lowest grade was 2. lower grades in the single forward feint to the right with passage to the left by “shifting” the opponent’s hand assessment tests at both time points might be due to the more complex structure of this feint in comparison with the basic one. the level of coordination may be responsible for the success of this feint. in team-handball, optimal movement coordination is a main determinant of success in throwing performance (proximal-to-distal sequencing, upper body rotation, adaptations to different situations), jumping performance (block, jump throw, with one leg or both legs, with or without run-up) and specific agility (in offense and defense, short accelerations, changes in direction) (wagner, finkenzeller, würth & von duvillard, 2014). when comparing the initial and final assessment results, the average grade for the simple feint with the passage to the right basic feint, increased by 0.64 (from 2.88 to 3.52), while the difference between the average grade in the initial (1.84) and final tests (2.84) of the second feint passage was 1.00. because of the young age and inexperience, the subjects made many technical mistakes that included dropping the ball, untimely run-up, or taking too many steps when performing the elements. in the initial measurement, the rate of performance with technical errors was 33% for the first 12 david henigman, katarina ohnjec: teaching feints to handball beginners preliminary results ..., 5–13 annales kinesiologiae • 12 • 2021 • 1 feint and 91% for the second. in the final measurement, the rate for performance with technical errors observed dropped to 17% for the first feint and 38% for the second. although this resulted in relatively lower average grades, the program implemented on the given sample, nevertheless, confirmed that the ball feinting motor skills can be significantly improved in two months. t“he increase of the average grade in both skills (fl 2.88‒3.52, fr 1.84‒2.84), as well as statistically significant differences established between the initial and final performance of both body feints demonstrate the progress in the subjects’ performance of the feints after the implementation of the training program. fasold, houseman, noel, and klatt (2020) presented similar results when researching specific handball skill acquisition using different instruction methods (step-by-step and analogy instructions). they concluded that both coaching strategies improved the young athletes’ performances of the task at which they were relatively unexperienced (i.e., body feint). conclusion based on the results of this preliminary study, the conclusion is that the subjects improved their knowledge and skills after the applied training program. the limiting factors of the study might be the small sample size used, the absence of a control group, and the lack of a validated evaluation of the instrument. due to the complexity of the assessment of technical elements in handball, it is not easy to include the whole of the application possibilities of these skills in situational conditions. therefore, one of the recommendations for some future research is to find a way to establish a statistically relevant connection between the program for acquiring or improving a certain element, and its situational application in the game. the results of this preliminary study might also be encouraging, and inspire the coaches of young athletes, to both create new programs as well as to evaluate their efficiency. references balyi, i., way, r., & higgs, c. (2013). long-term athlete development. human kinetics. chatzipanteli, a., digelidis, n., karatzoglidis, c., & dean, r. (2016). a tactical-game approach and enhancement of metacognitive behaviour in elementary school students. physical education and sport pedagogy, 21(2), 169–184. https://doi.org/10.1080/1740 8989.2014.931366. côté, j., & vierimaa, m. (2014). the developmental model of sport participation: 15 years after its first conceptualization. science & sports, 29, s63-s69. https://doi.org/10.1016/j. scispo.2014.08.133. fasold, f., houseman, l., noel, b., & klatt, s. (2020). handball-specific skill acquisition by use of different instruction methods. human movement, 22(3), 45–53. https://doi. org/10.5114/hm.2021.100323. https://doi.org/10.1080/17408989.2014.931366 https://doi.org/10.1080/17408989.2014.931366 https://doi.org/10.1016/j.scispo.2014.08.133 https://doi.org/10.1016/j.scispo.2014.08.133 https://doi.org/10.5114/hm.2021.100323 https://doi.org/10.5114/hm.2021.100323 13 annales kinesiologiae • 12 • 2021 • 1 david henigman, katarina ohnjec: teaching feints to handball beginners preliminary results ..., 5–13 foretić, n., burger, a., & rogulj, n. (2011). primjena mini rukometa u nastavi tzk-a i školskom sportu [application of mini handball in teaching pe and school sports]. in i. prskalo & d. novak (ed.) 6. kongres fiep-a europe, zbornik radova “tjelesna i zdravstvena kultura u 21.stoljeću kompetencije učenika”, poreč, 18. – 21. lipnja 2011. (pp. 164–168). zagreb: hrvatski kineziološki savez. gruić, i. (2011). evaluation of methods of teaching team handball techniques. (unpublished doctoral dissertation). zagreb: faculty of kinesiology, university of zagreb. henigman, d. & ohnjec, k. (2021). natjecateljski mezociklus kod rukometaša početnika s naglaskom na poučavanje fintiranja [competitive mesocycle in beginner handball players with an emphasis on teaching feinting]. in l. milanović, v. wertheimer, i. jukić & i. krakan, (eds.) zbornik radova 19. godišnje međunarodne konferencije “kondicijska priprema sportaša 2021”, 282–286. zagreb: kineziološki fakultet sveučilišta u zagrebu. retrieved from http://www.ukth.hr/media/files/kps-zbornik-2021-final.pdf. hrynchenko, i., tykhonova, a., karpunets, t., & chupryna, o. (2021). use of active games in physical and tactical training of young handball players at the initial stage. educational challenges, 26(2), 63–74. https://doi.org/10.34142/2709-7986.2021.26.2.06. kanjugović, i., ohnjec, k. & žnidarec čučković, a. (2013). organizacijski oblici rada na prijelazu iz mini rukometa u rukomet [the organizational forms of work on the transition from mini handball to handball]. in v. findak (ed.), zbornik radova 22. ljetne škole kineziologa republike hrvatske “organizacijski oblici rada u područjima edukacije, sporta, sportske rekreacije i kineziterapije”, 340–344. hrvatski kineziološki savez, poreč. retrieved from https://www.bib.irb.hr/636067/download/636067.24-33-prskalobabin-2103.pdf. lloyd, r. s., oliver, j. l., faigenbaum, a. d., howard, r., croix, m. b. d. s., williams, c. a., ... & myer, g. d. (2015). long-term athletic development-part 1: a pathway for all youth. the journal of strength & conditioning research, 29(5), 1439–1450. https:// doi.org/10.1519/jsc.0000000000000756. malić, z., & dvoršek, b. (2011). rukomet – pogled s klupe [handball – a view from the bench] (2nd extended ed.), hrvatska olimpijska akademija. milanović, d. (2013). teorija treninga [theory of training]. zagreb: kineziološki fakultet sveučilišta u zagrebu. papić, r., papić, m. (2014). kreativno učenje u sportu [creative learning in sports]. zagreb, vlastita naklada. raiola, g. (2017). motor learning and teaching method. journal of physical education and sport, 17(supp. 5), 2239–2243. https://doi.org/10.7752/jpes.2017.s5236. wagner, h., finkenzeller, t., würth, s., & von duvillard, s. p. (2014). individual and team performance in team-handball: a review. journal of sports science & medicine, 13(4), 808–816. http://www.ukth.hr/media/files/kps-zbornik-2021-final.pdf https://doi.org/10.34142/2709-7986.2021.26.2.06 https://www.bib.irb.hr/636067/download/636067.24-33-prskalo-babin-2103.pdf https://www.bib.irb.hr/636067/download/636067.24-33-prskalo-babin-2103.pdf https://doi.org/10.1519/jsc.0000000000000756 https://doi.org/10.1519/jsc.0000000000000756 https://doi.org/10.7752/jpes.2017.s5236 _goback _hlk98923763 _hlk98755967 _hlk79606686 _hlk99786836 _hlk98147084 _hlk99787368 _hlk88552317 _hlk17057094 annales kinesiologiae • 9 • 2018 • 2 105 original scientific article udc: 612.74:615.84 received: 2018-11-08 effects of 8-week electrical muscle stimulation on the muscle contractile properties in adolescent girls sara pregelj, boštjan šimunič 1,2 1university of primorska, koper, slovenia 2science and research centre koper, institute for kinesiology research, slovenia corresponding author: boštjan šimunič science and research centre koper, institute for kinesiology research, garibaldijeva 1, 6000 koper, slovenia phone: +386 5 663 77 00 e-mail: bostjan.simunic@zrs-kp.si abstract the study aimed to determine the effect of 8-week unilateral electrical muscle stimulation (ems) training of leg muscles: vastus lateralis, vastus medialis and biceps femoris with the same number of muscle contractions in comparison to controls. contractile properties were monitored by measuring the maximal voluntary isometric contraction (mvc) and the rate of force development in first 50 ms (rfd50) of knee extensors and flexors and tensiomyography of stimulated muscles. in addition, we also investigated the retained effect after 8 weeks without ems training. nineteen healthy young female athletes aged 15 to 18 years (average 16.4 ± .9 years) were randomly divided in a control group (cg; n=8) and an experimental group (eg; n=11). cg performed maximal unilateral voluntary contractions while the eg performed also ems training of the same leg by stimulating both vasti muscles and biceps femoris. there were no changes in cg after 8 weeks of maximal unilateral voluntary training; however, eg improved mvc in knee extensors (12.6 %; p = .085) and rfd50 (142.1 %; p = .049) where rfd50 retained increased also 8 weeks after ems training (73 %; p = .090). tensiomyography revealed decreased amplitude (13.2 %; p = .011) only in eg, representing higher muscle tone after 8 weeks of ems in comparison to cg. our findings indicate that ems training has a positive effect on muscle contractile properties in young female athletes even after comparing to matched controls by the number of contractions. keywords: ems, muscle strength, tensiomiography, rate of force development. 106 sara pregelj, boštjan šimunič: effects of 8-week electrical muscle stimulation ..., 105–120 annales kinesiologiae • 9 • 2018 • 2 vpliv 8-tedenske elektro mišične stimulacije na kontraktilne lastnosti mišic mladih športnic izvleček cilj študije je bil raziskati vpliv 8 – tedenskega unilateralnega ems treninga na lastnosti m. vastus medialis, m. vastus lateralis in m. biceps femoris v primerjavi s kontrolno skupino z enakim številom mišičnih kontrakcij. kontraktilne lastnosti mišic smo spremljali z merjenjem največje izometrične mišične silovitosti (mvc) in hitrosti prirastka sile v prvih 50 ms (rfd50) mišic iztegovalk in upogibalk kolena ter tenziomiografskega odziva mišic. poleg začetnih meritev in meritev po 8 tednih nas je zanimal še zadržan učinek po 8 tednih brez ems. devetnajst zdravih mladih športnic, starih od 15 do 18 let (v povprečju 16.4 ± .9 let), smo naključno razdelili v kontrolno (cg; n = 8) in eksperimentalno skupino (eg; n = 11). cg je izvajala enonožne maksimalne hotene kontrakcije, medtem, ko je eg izvajala tudi trening ems iste noge s stimulacijo srednje in stranske mogočne mišice ter dvoglave stegenske mišice. po 8 tednih vadbe nismo našli razlik v cg, medtem, ko sta se v eg povečali mvc iztegovalk kolena (12.6%; p =.085) in rfd50 iztegovalk kolena (142.1%; p =.049), ki je ostala povečana tudi 8 tednov po zaključku ems treninga (73%, p =.090). tenziomiografija je pokazala na zmanjšano amplitudo le pri eg (13.2%; p =.011), ki je po 8 tednih ems v primerjavi s cg predstavljala višji mišični tonus. slednje ugotovitve kažejo na to, da ems pozitivno vpliva na kontraktilne lastnosti mišic mladih športnic, tudi po primerjavi s kontrolno skupino z istim številom kontrakcij. ključne besede: ems, mišična silovitost, hitrost prirastka sile, tenziomiografija. introduction electrical muscle stimulation (ems) includes involuntary muscle contractions as a response to the electrical currents produced by the electrical device and applied through electrodes on muscles (seyri & maffiuletti, 2011; đokić & međedović, 2013). the stimulation impulse or pulses could be applied directly on muscles or peripheral nerve (benito-martinez, martinez-amat, lara-sanchez, berdejo-del-fresno, & martinezlopez, 2013; enoka, 1988). initially, ems was used only for therapies; however, in the last two decades, there was an increment in the ems usage for conditioning purposes (pichon, martin, & cometti,1995; malatesta, cattaneo, dugnani, & maffiuletti, 2003; brocherie, babault, cometti, maffiuletti, & chatard. 2005; babault, cometti, pousson, & chatard, 2007; maffiuletti, et al., 2009; deley, cometti, fatnassi, paizis, & babault, 2011; benito-martinez, sanchez-lara, berdejo del fresno, & martinez-lopez, 2011; martinez–lopez, benito-martinez, hita-contreras, lara-sanchez, & martinez-am107 annales kinesiologiae • 9 • 2018 • 2 sara pregelj, boštjan šimunič: effects of 8-week electrical muscle stimulation ..., 105–120 at, 2012). investigators reported positive improvements in isometric muscle strength (maffiuletti, pensini, & martin, 2002; singer, 1986; zhou, oakman, & davie, 2002; sariyildiz, rezvani, & karacan, 2011), isokinetic strength ( deley, et al., 2011; lategan, crafford, suliman, & govender, 2014), vertical jumping height (malatesta, et al., 2003; babault, et al., 2007; martinez-lopez, benito-martinez, hita-contreras, larasanchez, & martinez-amat, 2012), skating and sprinting speed performance (brocherie, et al., 2005; benito martinez, et al., 2011) and motor tests ( deley, et. al., 2011; benito martinez, et. al., 2011). most of the studies were carried out on stimulating muscle quadriceps femoris (maffiuletti, et al., 2000; malatesta, et al., 2003; gondin, guette, & martin, 2005; babault, et al., 2007), muscle triceps surae (babault, et al., 2007; malatesta, et al., 2003), while just two studies performed ems on muscle biceps femoris (bf) (lategan, et. al., 2014; marqueste, et. al, 2010). only five studies examined the effect of ems on adolescent athletes (martinez– lopez, et al., 2012; benito–martinez, et al., 2013; benito-martinez, et al., 2011; malatesta, et al., 2003; deley, et al., 2011) and just one was done on girls only (deley, et.al., 2011). among them, martinez – lopez, et. al. (2012) reported that the combination of 8 weeks of plyometric and ems training improve squat jump height for 28 %, countermovement jump for 13.7 % and drop jump height for 4.1 %. benito–martinez, et. al. (2013) found that the combination of 8-week ems and plyometric training improved 30-meters sprint time for 6.8 % and the triple jump distance for 5.2 % but only in a group that practiced plyometric training before the ems was applied. interestingly, the study of benito–martinez, et. al. (2011) showed that countermovement vertical jump height improved for 13.5 % in a group that applied ems before they practiced. effects of ems were found also after shorter exposures, where malatesta, et. al. (2003) observed improvements in jumping mechanical power during 15 seconds of consecutive jumps (3.8 %) after only 4 weeks of ems training. interestingly, after ten days of follow-up the improvements in squat jump (6.5 %), counter movement jump height (5.4 %), 15-second consecutive jump height (5.3 %) and jumping mechanical power (5.9 %) were still present. deley, et. al. (2011) were the only ones investigating ems effects in adolescent girls (12.4 ± 1.2 years) and found that 6-week combined ems and gymnastic training improved maximal voluntary torque at three different angular velocities already after 3 weeks (38.8 ± 29.0% at -60˚s-1, 25.9 ± 28.0% at 60˚s-1, 40.2 ± 22.0% at 240˚ s-1) and interestingly not after 6 weeks. after 3 weeks of training, they found also improvements in squat jump height (20.9 ± 8.3 %), reactivity test (20.4 ± 26.2 %) and specific jump performance tests (14.9 ± 17.2 %). squat jump height was also improved after 6 weeks of training while other tests were not. the improvements in counter movement jump height were present only after 6 weeks of training (10.1 ± 10.0 %). after 4 weeks of follow-up, only squat jump height remained improved. obviously, there are discrepancies in data of the presented maximal voluntary tests that warrants more objective measures of muscle contractility improvements after ems. the most important physiological aspect which differs between ems and voluntary contraction is recruitment of motor units. ems recruit motor points randomly and non108 sara pregelj, boštjan šimunič: effects of 8-week electrical muscle stimulation ..., 105–120 annales kinesiologiae • 9 • 2018 • 2 selective (gregory & bickel, 2005), while in voluntary contraction recruitment follows the henneman size principle (henneman, somjen, & carpenter, 1965). this indicates that the ems can recruit more fast motor units and we would expect increase in overall skeletal muscle contraction velocity. although skeletal muscle contraction velocity could not be determined by dynamometry, non-invasive tensiomyography (tmg) was developed to detect mechanical properties of the skeletal muscles where contraction time alone or pooled with delay time and half-relaxation time correlates with myosin heavy chain i proportion (šimunič et al., 2011). tmg was previously used in adults in an 8-week plyometric study, where zubac and šimunič (2016) demonstrated shorter contraction time of 4 (out of 5) lower limb muscles and lower tmg response amplitude in all muscles. however, tmg was not used after ems training study. therefore, the aim of our study was to determine the effect of 8-week ems training of non-dominant leg on the tmg and mvc-derived contractile properties of vastus lateralis (vl), vastus medialis (vm) and bf muscle in young female athletes. in addition, we also investigated the retained effect after 8 weeks of follow-up. methods participants twenty young female athletes (average age: 16.4 ± .9 years, table 1) voluntarily decided to participate in the study. the girls have practiced regularly various sports such as artistic roller skating, athletics, handball, gymnastics, dancing, cheerleading and twirling for at least last 5 years. their sport training was carried out 3 – 6 times per week, in average 5 times per week. most of the girls competed at international level, nine of them also at european and world championships, other at national level. the study was presented to the parents and girls together with the purpose of the study and its intended course and the procedures that will be carried out in the framework of the research. the parents of the girls signed an informed-consent prior to the study. the study was approved by institutional ethics board at science and research centre koper. study design the research lasted for almost five months and was consisted of three testings. after the familiarization in the first week, the initial testing (bdc) was carried out, followed by 8-week interventions in both groups. the second testing (end) was performed after the interventions. furthermore, the third testing (fu) was carried out after 8 weeks of follow-up period. after the bdc, one girl was excluded from the study due to many diseases yielding 19 participants for data analysis. the girls were randomly divided into two groups: the control group (cg; n = 8) and the experimental group (eg; n = 11), see table 1. 109 annales kinesiologiae • 9 • 2018 • 2 sara pregelj, boštjan šimunič: effects of 8-week electrical muscle stimulation ..., 105–120 table 1: anthropometric data of our sample of participants. all control group experimental group p n 19 8 11 age / years 16.4 ± .9 16.1 ± .8 16.6 ± .9 .326 body height / cm 163.7 ± 4.6 166.6 ± 2.3 161.6 ±4.8 .014* body mass / kg 57.9 ± 6.9 58.0 ± 6.3 57.4 ± 7.6 .735 body mass index / m/kg2 21.6 ± 2.3 21.1 ± 2.2 22.0 ± 2.4 .427 fat mass / % 25.5 ± 5.5 23.9 ± 5.4 26.6 ± 5.5 .313 muscle mass / kg 19.0 ± 1.3 19.6 ± .8 18.6 ± 1.5 .116 * = significant differences between cg and eg at p <. 05. exercise intervention in cg after bdc, the active cg performed 8 weeks of supervised physical exercise 3 times per week. the participants warmed up with 6 minutes of jogging and 4 minutes of whole-body stretching. after the warm up, participants performed one leg (non-dominant) hip raise when lying on the floor for exercising bf. the subjects were lying on the back, while non-dominant leg was in knee flexion at angle of about 30 degrees with heel placed on the floor. the dominant leg was suspended in the air. the upper legs were parallel in the width of the hips. the arms were crossed on the chest. hip raise was performed until the line shoulder-hip-knee was aligned for 3 seconds. then they lowered their hip to the original position in which they waited and relaxed for 17 s. the participants performed 36 repetitions, with the intention to equalize the number of the contractions with eg. the exercise progressiveness was achieved with lifting heel support and with additional loads placed on the hips. they started exercising with body weight and a foot on the ground. then we increased the support of the heel for 35 cm. after that we added 2.5 kg, then 5 kg, followed by 7.5 kg and at the end 10 kg on the hips. out of all cg, only two girls increased the loading up to 10 kg, others got up to 7.5 kg. ems intervention in eg the girls in eg conducted one ems training session a week before the bdc for familiarization. after the bdc, they performed ems training for 8 weeks, 3 times per week. the ems session consisted of 13 minutes of isometric ems of knee extensors 110 sara pregelj, boštjan šimunič: effects of 8-week electrical muscle stimulation ..., 105–120 annales kinesiologiae • 9 • 2018 • 2 (vasti muscles at the same time) and 13 minutes of isometric ems of knee flexors (bf). for ems, we used two cefar rehab x2 electrical stimulators (cefarcompex, scandinavia ab). before the ems, the participants warmed up with 6 minutes of jogging and 4 minutes of stretching the whole body. then we placed 6 self-adhesive electrodes on subject’s thighs. four positive electrodes, one-wire, were in the size of 5 x 5 cm while two negative electrodes, two-wire, were in the size of 5 x 10 cm. all electrodes were from dura-stick plus, cefar compex, djo brands. in the case of bf, the negative electrode was placed on the posterior side of the thigh just below the muscle gluteus maximus (gm) while the positive electrodes were placed as close as possible to the motor point of m. semimembranosus and bf. on the front side of the thigh, we positioned the positive electrodes as close as possible to the motor points of vl and vm or on their muscular belly. the negative electrode was placed on the femoral triangle or 1-3 cm below the inguinal ligament. during the stimulation of vl and vm, the participants were sitting on a machine for knee extension or on the chair. during the knee extension, the stimulated leg was fixed in isometric position. among the ems session of bf, the subjects were lying on the abdomen and had a non-dominant leg stretched out, again rested and fixed in isometric position. all the exercises were carried out isometrically. ems parameters were: a biphasic electric impulse with a pulse length of 400 μs and a frequency of 100 hz, 1s of rise up, 3 s of muscle contraction, 5 s of fall time and 17 s of pause with 8 hz pulse currents. during the ems session, each subject performed 36 repetitions of knee extension and 36 repetitions of knee flexion. the intensity level of the ems was for each session the highest, according to the pain threshold and as a maximum tolerated level of each individual. measurements firstly, we measured the participants’ body height and weight with standard tools from which we calculated body mass index. for determination of body composition, we performed bioelectric impedance analysis (maltron bioscan 916s, uk). before measurement, the participants had to lay down on the measuring table for 30 minutes and then we placed two self-adhesive electrodes on the palm and two on the foot. we collected fat mass (fm, %) and muscle mass (mm, kg) data for further analysis. tensiomyography we measured maximal tmg response in all observed muscles. firstly, we examined vl and vm where the participants were lying supine with knee flexed at 30 degrees (0 degrees represents fully extended joint. afterwards, we measured bf where the participants were prone. for each muscle two surface self-adhesive electrodes were placed on the measured muscle at a distance of 5 cm proximally and distally from the sensor (digital–optical comparator, tmg-bmc ltd, slovenia). the electrodes were 111 annales kinesiologiae • 9 • 2018 • 2 sara pregelj, boštjan šimunič: effects of 8-week electrical muscle stimulation ..., 105–120 connected to an electric stimulator (tmg-bmc ltd., slovenia). the sensor was positioned perpendicularly to the tangential plane of the measuring point. measuring point was determined by a skilled expert, where the response reaches largest response. the stimulation impulse (monophasic rectangular electrical stimulus of 1 millisecond) was gradually increased from threshold to maximal amplitude. in each muscle we recorded two maximal twitch responses. from both, contraction time (tc) and maximal amplitude (dm) were extracted. tc was defined as the time when muscle contracted from 10 % dm to 90 % dm. an average of was taken for further analysis. isometric dynamometry we measured unilateral maximal voluntary isometric contraction (mvc) and rate of force development (rfd) of knee flexors and extensors. the order of mvc and rfd measurement was as follows: mvc of right knee extensors, right knee flexors, left knee extensors and left knee flexors. firstly, we placed the participants sited in knee dynamometer (s2p, science to practice, ltd., slovenia). the participant’s femur epicondyle was in line with the dynamometer axis of rotation. the participants were firmly attached through the chest and hip with a belt. distal part of the tibia was attached firmly to strength gauge. for measuring mvc and rfd, the knee angle was set at 60° and 30° for knee extensors and flexors, respectively. when measuring knee flexor, we added another belt to fix the upper leg. prior to each measurement, a special warming-up was carried out. warming-up included two submaximal isometric contractions at 50 % and 70 % of mvc and one at 100% mvc. the pause between repetitions was 60 s. each isometric contraction lasted 5 s, so that participants could escalate force in 2 s and retain force at 50 %, 70 % or 100 % mvc for 3 s. afterwards, we performed the main measurements. even in the main measurements, the contraction time lasted 5 s as in the case of warming up (“1,2,3, hold, hold, hold, release”: total 5 s). the pause between the individual measurements was 60 s. after the mvc measurements, we continued with rfd measurements in the same order. in this measurement, special warming included just one measurement in which the participants on the sign “now” had to develop greatest maximal force in the shortest possible time and hold the force for 2 – 3 s and then release the muscle. the main measurement was followed by three measurements of maximal rfd in each position. the procedure was the same as in the warming up. the pause between individual measurements was 60 s. the signals were captured and stored using a dynamometric ars program “analysis and reporting software for dynamometers” (s2p, science to practice, ltd., slovenia). we took maximal mvc amplitude (nm) and rfd50 in first 50 ms (nm/s) for further analysis. 112 sara pregelj, boštjan šimunič: effects of 8-week electrical muscle stimulation ..., 105–120 annales kinesiologiae • 9 • 2018 • 2 statistical analysis mean values and standard deviations (±sd) were calculated for all dependant variables. all variables pass normality and homogeneity tests (shapiro-wilk, q-q plot, visual inspection, leven test). a repeated measures general linear model was used to assess the interaction between eg and cg with time in each dependent variable. if significant interactions were confirmed, we performed one-way anova using bonferroni correction to identify specific effects. when reporting specific effect, we presented partial eta squared for presenting effect size. the level of significance was established at p < .10 for all decisions. statistical analyses were performed using statistical product and service solutions (ibm spss statistics 22, usa). results the participants have done 22 to 24 trainings (average 23.4± .7 trainings), yielding 97.5 % adherence to the training programme. there were no differences between the two groups at the beginning of the study in the dependant variables except participants’ body height. we did not observe and report any discomfort or injuries during and after the training program. the study protocol was carried out with no modifications. in table 2 we reported time effects in mvc of knee extensors (p=.019; η2=.213) and knee flexors (p=.019; η2=.209) as well as in rfd50 of knee extensors (p=.023; η2=.200). time x group interactions were found in mvc (p=.044; η2=.172) and rfd50 (p=.046; η2=.166) of knee extensors. post hoc revealed increases in mvc of knee extensors in eg but not in cg at end (p = .085). similarly, rfd50 of knee extensors increased in eg, not in cg, at end (p = .049) and remained increased at fu (p = .090). 113 annales kinesiologiae • 9 • 2018 • 2 sara pregelj, boštjan šimunič: effects of 8-week electrical muscle stimulation ..., 105–120 ta bl e 2: r es ul ts o f m ax im al v ol un ta ry is om et ri c co nt ra ct io n (m v c ) a nd r at e of fo rc e de ve lo pm en t i n fir st 5 0 m ill is ec on ds (r f d 50 ) of k ne e fle xo rs a nd k ne e ex te ns or s of n on -d om in an t l eg . v ar ia bl es e xp er im en ta l g ro up c on tr ol g ro up b d c e n d f u b d c e n d f u p t im e ( η2 ) p t im e x g ro up (η 2 ) m v c – k ne e ex te ns or s / n m 16 1. 6± 37 .0 18 2. 0± 35 .1 * 17 2. 5± 31 .2 15 1. 4± 21 .6 15 2. 7± 33 .6 15 2. 3± 31 .5 .0 19 # ( .2 1) .0 44 # ( .1 7) m v c – k ne e fle xo rs / n m 81 .4 ±1 3. 8 89 .2 ±1 7. 8 89 .1 ±1 3. 0 72 .6 ±1 1. 1 81 .3 ±1 3. 4 79 .0 ±1 4. 5 .0 19 # ( .2 1) .9 30 r f d 50 – k ne e ex te ns or s (n m /s ) 61 .0 ±3 8. 5 14 7. 7± 49 .4 # 10 5. 5± 71 .7 * 85 .7 ±5 9. 7 91 .9 ±6 5. 4 58 .0 ±2 1. 9 .0 23 # ( .2 0) .0 46 # ( .1 7) r f d 50 – k ne e fle xo rs (n m /s ) 70 .3 ±3 0. 5 10 6. 7± 62 .3 63 .3 ±3 3. 2 62 .6 ±3 7. 4 74 .3 ±4 9. 5 76 .8 ±4 2. 7 .1 16 .1 79 b d c = b as el in e as se ss m en t; e n d = a ss es sm en t a ft er 8 -w ee k in te rv en tio n; f u = 8 -w ee k fo llo w -u p as se ss m en t; * an d # = si gn ifi ca nt d if fe re nc es fr om b d c a t p <0 .1 a nd p <. 05 , r es pe ct iv el y. 114 sara pregelj, boštjan šimunič: effects of 8-week electrical muscle stimulation ..., 105–120 annales kinesiologiae • 9 • 2018 • 2 table 3 reports the results obtained with tensiomyography, namely contraction time and maximal amplitude of biceps femoris and vasti muscles. we found time x group interaction effect only in vm dm (p=.040; η2=.185) and post-hoc analysis of individual relative changes revealed lower dm in eg for 13.2% (p=.011) at end. ta bl e 3: t en si om yo gr ap hy r es ul ts o f bi ce ps f em or is ( b f ), va st us l at er al is ( v l) a nd v as tu s m ed ia lis ( v m ) co nt ra ct io n tim e (t c) a nd m ax im al a m pl itu de (d m ) i n no ndo m in an t l eg . v ar ia bl es e xp er im en ta l g ro up c on tr ol g ro up b d c e n d f u b d c e n d f u p t im e (η 2 ) p t im e x g ro up (η 2 ) b f tc 38 .5 ±8 .3 42 .8 ±1 1. 4 42 .5 ±8 .5 36 .8 ±1 0. 2 39 .1 ±9 .1 36 .3 ±4 .8 .2 57 .4 69 d m 6. 7± 1. 7 7. 0± 1. 9 7. 6± 2. 2 7. 5± 2. 0 8. 8± 1. 8 8. 6± 1. 6 .0 62 .4 26 v l tc 20 .5 ±2 .4 20 .9 ±2 .2 21 .5 ±2 .1 20 .8 ±1 .7 21 .3 ±2 .2 21 .4 ±1 .6 .1 15 .7 18 d m 5. 6± 1. 7 4. 9± 1. 2 5. 5± 1. 1 5. 9± 2. 0 5. 7± 1. 5 6. 3± 1. 6 .0 87 .6 90 v m tc 21 .9 ±2 .4 20 .3 ±2 .0 21 .2 ±1 .9 20 .8 ±1 .2 20 .3 ±2 .0 21 .0 ±2 .0 .7 29 .2 99 d m 7. 6± 1. 4 6. 6± 1. 1* 7. 1± 1. 3 6. 7± 1. 8 6. 9± 1. 5 7. 4± 1. 7 .1 21 .0 40 * (.1 8) b d c = b as el in e as se ss m en t; e n d = a ss es sm en t a ft er 8 -w ee k in te rv en tio n; f u = 8 -w ee k fo llo w -u p as se ss m en t; * = si gn ifi ca nt d if fe re nc es fr om b d c a t p < .0 5. 115 annales kinesiologiae • 9 • 2018 • 2 sara pregelj, boštjan šimunič: effects of 8-week electrical muscle stimulation ..., 105–120 discussion we found increased mvc strength (12.6 %) and rfd50 (142.1 %) of knee extensors after 8 week of ems training in eg but not in an active cg. furthermore, we noticed increased rfd50 of knee extensors also after 8-week follow-up (73 %). increased isometric strength was also determined in previous studies; however, increments were higher due to passive cg and even shorter ems training periods. selkowitz (1985) reported 44 % increased mvc strength in quadriceps after only 4 weeks of ems, stefanovska and vodovnik (1985) reported 13.2 to 25.3 % increased mvc strength of knee extensors by 25.3 % after 3 weeks of ems training, lai, de domenico, and strauss, (1988) reported 48.5 % and 24.2 % increments in mvc strength of quadriceps after 3 weeks of high intensity and low intensity ems training, respectively, with decreased but sustained (24.8 and 12.8 %, respectively) effects after the 3-week follow-up period. the study of maffiuletti, dugnani, folz, di pierno, and mauro, (2002) performed in athletes (volleyball players) reported comparable mvc strength gains after 4 weeks of combination of plyometric and ems training (28.5 %). however, herrero, izquierdo, maffiuletti, and garcia-lopez (2005) demonstrated in athletes that the combination of 4-week plyometric and ems training demonstrated superior effects on quadriceps mvc strength (16.3 %) vs. ems training (9.1 %) and that is comparable to the findings of our study. similar results were demonstrated also by billot, martin, paizis, cometti, and babault, (2010) that showed a 16.3 % increase in mvc strength of quadriceps in footballers after 3 weeks of ems training. our study implemented a longer ems training period, being 8 weeks, in young female athletes and with an active control group making direct comparison to other studies impossible. gains of 12.6 % from baseline and 19.2 % from active cg at the end of the training period are somehow lower that those reported by others. surely this must be attributed to the population studied and an active cg that was equalised to eg by the number of muscle contractions. the mechanisms of mvc improvements after ems were found on nervous and muscle levels. gondin et al. (2005) reported increased muscular activation, anatomical cross-sectional area and pennation angle after 8-week ems. in addition, they also reported nerve adaptations to occur within the first four weeks of ems, while changes in muscle cross sectional area and pennation angle after 8-weeks of ems. it seems that changes at the muscle level (e.g. hypertrophy, architecture) occur after 5 weeks of intense ems training (herrero et al., 2005; maffiuletti, dugnani, folz, di pierno, & mauro, 2002). therefore, the mvc gains obtained after ems training could be attributed to muscular and neural adaptations, at least for monoarticular muscles (gondin et al., 2005). based on the results of tmg, an indirect measure of myosin heavy chain composition (šimunič et al., 2011) and atrophy (pišot et al., 2008), we could conclude that there were no changes found in muscle composition (tc remained unaltered) but there was smaller dm found in vm without sustained effects at the follow-up. since increases of dm were already correlated to muscle atrophy after 35 days of bed rest (pišot et al., 2008; šimunič et al., 2008), the opposite, decreases of dm were found after high-inten116 sara pregelj, boštjan šimunič: effects of 8-week electrical muscle stimulation ..., 105–120 annales kinesiologiae • 9 • 2018 • 2 sity plyometric exercise (zubac & šimunič, 2016). both aforementioned bed rest studies (pišot et al., 2008; šimunič et al., 2008) also investigated hypertrophy after bed rest, and during the recovery period that followed bed rest when dm returned to baseline values. decreases in dm after plyometric training were paralleled to increases of muscle stiffness (spurrs, murphy, & watsford, 2003), which has a marginal effect on the capacity of skeletal muscle to effectively utilize elastic energy (avela & komi, 1998) and movement efficacy (pellegrino, ruby, & dumke, 2016). there are many possible mechanisms that could affect dm, a measure of muscle belly stiffness. presumably, alterations in muscle stiffness could be modulated via changes in the visco-elastic properties of intramuscular and tendon connective tissue (pišot et al., 2008). alterations of pennation angle following bed rest, training, etc. might impact dm either way, depending on the new initial sarcomere length, due to an increase in the fascicle length and / or more direct muscle fibre thickening and oscillation transfer in the transversal plane (to the tmg sensor) of muscle contraction. on the other hand, fouré, nordez, mcnair, and cornu (2011) demonstrated no change in muscle architecture in response to 14 weeks of plyometric training; however, they did note an increase in the passive series elastic component and a decrease in the active series elastic component. a decrease in the active sec (mainly in the intrinsic mechanical properties of the muscle fibres) could occur due to a fibre-type transition phenomenon (potteiger et al., 1999); however, this was not found in our study. therefore, the dm decrease must be linked to the passive series elastic component, which increases after high-intensity training (burgess, connick, graham-smith, & pearson, 2007; fouré et al., 2011) and as well after the ems (da-haeng, jae-keun, & joon-hee, 2015). only two studies reported the rfd after ems (schmithusen, 2008; speicher & kleinoder, 2009). after 4 weeks of ems isometric training for the upper part of the body, schmithusen (2008) reported 58 % increase of rfd and a 20 % increase in the force impulse (< 200 ms). speicher and kleinoder (2009), reported a similar, 16 % increase of force impulse (<200 ms) after 4 weeks of ems in lower part of the body, without finding changes in the rfd. our study was in line with findings of schmithusen (2008) and we demonstrated increased rfd (<50 ms) for 60.7 % with sustained effects after the follow-up period. shorter time interval of rfd makes these three studies difficult to compare. most likely, the order of motor unit recruitment, that occurs after ems training (maffiuletti, 2010; seyri & maffiuletti, 2011; jubeau, gondin, sartorio, & maffiuletti, 2007), plays an important role in increasing the rfd. during ems, training motor units are recruited non-selectively and randomly in terms of size, and not according to henneman’s size principle in voluntary contractions. jubeau et al. (2007) and maffiuletti (2010) have demonstrated that during electrically elicited contractions the contraction time is stable when muscle is recruited between 20 and 80 % of contraction intensity. in addition, during ems training / contractions, fast motor units are easier and more activated compared to voluntary training / contractions at submaximal intensity (billot et al., 2010). therefore, we suggest that ems training caused alterations in recruitment order during short maximal contractions (rfd50) that is reflected in higher rfd50 due to activation of fast motor units. 117 annales kinesiologiae • 9 • 2018 • 2 sara pregelj, boštjan šimunič: effects of 8-week electrical muscle stimulation ..., 105–120 conclusion the study confirmed the effectiveness of ems on skeletal muscle contractile properties in young female athletes. after controlling with an active control group we have demonstrated higher mvc and rfd50 of knee extensors, with higher muscle tone in vm. while the effects returned to baseline values in rfd50, remained significant also after eight weeks of follow-up. references avela, j., & komi, p. v. 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(2008). odziv sestave telesa, mišične togosti in ravnotežja po 35-dnevni odsotnosti gibanja pri mladih in zdravih preiskovancih [changes in body composition, muscle stiffness and postural stability occurring in healthy young men submitted to a 35-day bed rest]. zdravstveno varstvo, 47(2), 60-71. zubac, d. & šimunič, b. (2016). skeletal muscle contraction time and tone decrease after 8 weeks of plyometric training. journal of strength and conditioning research, 31(6), 1610-1619. doi: 10.1519/jsc.0000000000001626 view item zhou, s., oakman, a., & davie a., j. (2002). effects of unilateral voluntary and electromyostimulation training on muscular strength on the contralateral limb. hong kong journal of sports medicine and sports science, xiv, 1-11. https://link.springer.com/article/10.1007%2fs00421-002-0741-y https://insights.ovid.com/crossref?an=00005768-201109000-00003 https://insights.ovid.com/crossref?an=00124278-201706000-00020 annales kinesiologiae • 10 • 2019 • 2 99 review article doi: https://doi.org/10.35469/ak.2019.185 received: 2019-04-18 udc: 796.012:612.33 physical activity regulates the intestinal microbiota composition mihaela jurdana1 & darja barlič-maganja1 1university of primorska, faculty of health sciences, slovenia corresponding author: mihaela jurdana university of primorska, faculty of health sciences, polje 42, izola, slovenia phone: +386 5 66 26 469 e-mail: mihaela.jurdana@fvz.upr.si abstract gut microbiota is the name given today to the bacterial population living in our intestine. it provides nutrients, metabolites and affects the immune system. recent animals and human studies suggest that regular physical activity increases the presence of beneficial microbial species of gut microbiota and improves the health status of the host. when gut bacteria diversity reduces, there are systemic consequences leading to gastrointestinal, physiological and psychological distress. this review describes the communication pathway of the microbiota-gut-brain axes and other possible mechanisms by which physical activity causes changes in microbiota composition. furthermore, it provides the latest evidence of the beneficial role of exercise, which in turn can affect health and various disease processes. the results of research studies in this area are increasingly becoming a focus of scientific attention. keywords: gut microbiota, physical exercise, health. mailto:mihaela.jurdana@fvz.upr.si 100 mihaela jurdana, darja barlič-maganja: physical activity regulates the intestinal microbiota composition, 99–114 annales kinesiologiae • 10 • 2019 • 2 telesna aktivnost uravnava sestavo črevesne mikrobiote izvleček črevesna mikrobiota je bakterijska združba v črevesju. zagotavlja hranila, metabolite in vpliva na imunski sistem. nedavne študije na živalih in ljudeh nakazujejo, da redna telesna aktivnost povečuje prisotnost koristnih bakterijskih vrst, ki so del črevesne mikrobiote in na ta način izboljšuje zdravstveno stanje gostitelja. upad raznolikosti črevesnih bakterij vodi v sistemske posledice, ki povzročajo gastrointestinalne, fiziološke in psihološke težave. pregledni članek opisuje komunikacijsko pot, os mikrobiota-črevesje-možgani ter druge možne mehanizme, s katerimi telesna aktivnost povzroča spremembe v sestavi mikrobiote. poleg tega ponuja najnovejše dokaze o koristni vlogi telesne aktivnosti, kar lahko vpliva na zdravje in različne bolezenske procese. rezultati raziskav na tem področju so vse bolj v središču pozornosti znanstvenikov. ključne besede: črevesna mikrobiota, telesna aktivnost, zdravje. 101 annales kinesiologiae • 10 • 2019 • 2 mihaela jurdana, darja barlič-maganja: physical activity regulates the intestinal microbiota composition, 99–114 introduction microbiota in gastrointestinal tract the human gastrointestinal tract (git) is inhabited by trillions of microbial cells whose coordinated actions are important in human life, having crucial roles in several physiological and pathological processes (clemente, ursell, parfrey & knight, 2012). these microorganisms are known as gut microbiota and are sometimes referred to as a »forgotten organ« (o’hara & shanahan, 2006). the gut microbiota is mostly made up of two bacterial phyla. more than 90% of them belong to bacteroidetes and firmicutes, including species of ruminococcus, lactobacillus and clostridium genera, whereas the minority of species belong to phyla such as actinobacteria and proteobacteria. firmicutes phyla mainly includes ruminococcus, clostridium, lactobacillus, eubacterium, faecalibacterium and roseburia, while in bacteroides mainly prevotella and xylanibacter are represented (eckburg et al., 2005). the number, type and function of microbiota along the entire git have a great variability. its density and diversity increase steadily along the git. the highest concentration is reached in large bowel where a complex group of microorganisms ferment different non-digestable food components (bäckhed, ley, sonnenburg, peterson & gordon, 2005). the gut microbiota functions are highly preserved between individuals, whereas each individual’s gut microbiota is characterized by a specific combination of bacterial species due to inter-individual and intra-individual variations throughout human life. its composition is influenced by different factors like microbial species acquired at birth, host genetics, immunological factors, drugs like antibiotics and nutrition (bokulich et al., 2016; yatsunenko et al., 2012; kashtanova, popenko, tkacheva, tyakht, alexeev & boytsov, 2016). recent studies indicated that physical activity is also one of the main positive modulators of gut microbiota biodiversity. beneficial effects of exercise on gut microbiota has been supported by investigations performed in animals and confirmed in human studies (ticinesi, lauretani, tana, nouvenne, ridolo & meschi, 2019). the development and maturation of gut microbiota start in early life. colonization of the infant gut should begin already during the antenatal period before the delivery (aagaard, ma, antony, ganu, petrosino & versalovic, 2014). after the birth, the infant gut is exposed to complex surrounding environmental and maternal microbiota which begins to colonize the git. the development and maturation of gut microbiota are influenced by several intrinsic and extrinsic factors, like mode of delivery, mother’s age, diet and metabolic status, type of feeding, family genetics and lifestyle (rodriguez et al., 2015; milani et al., 2017). the introduction of solid food to an infant diet changes the microbiota and by the age of three it resembles a relatively stable adult-like profile with a dense microbial population (milani et al., 2017). in general, changes occur in the elderly population showing a significant decrease in bacterial diversity, especially a decrease in bacteroidetes and an increase in firmicutes (claesson et al., 2012). although these may be related to physiological alterations there is now evidence that diet https://www.ncbi.nlm.nih.gov/pubmed/?term=clemente%20jc%5bauthor%5d&cauthor=true&cauthor_uid=22424233 https://www.ncbi.nlm.nih.gov/pubmed/?term=ursell%20lk%5bauthor%5d&cauthor=true&cauthor_uid=22424233 https://www.ncbi.nlm.nih.gov/pubmed/?term=parfrey%20lw%5bauthor%5d&cauthor=true&cauthor_uid=22424233 https://www.ncbi.nlm.nih.gov/pubmed/?term=knight%20r%5bauthor%5d&cauthor=true&cauthor_uid=22424233 102 mihaela jurdana, darja barlič-maganja: physical activity regulates the intestinal microbiota composition, 99–114 annales kinesiologiae • 10 • 2019 • 2 also plays an important role. dietary factors, particularly carbohydrate and protein intake, are generally considered as the main determinants of gut microbiota composition (milani et al., 2016). the preservation of a normal and healthy gut microbiota plays a critical role in maintaining good health, with possible effects on the motility of git, conversion of food into useful nutrients, fortification of mucosal barrier, the homeostasis of the immune system, and protection against invasion of pathogenic microorganisms. microbiota ferments non-digestible dietary residues producing short-chain fatty acids (scfas, such as n-butyrate, acetate, and propionate) which modulate the host energy balance increasing the nutrients availability (samuel et al., 2008). fermented scfas, secreted into the gut lumen, exceed the epithelial barrier and are released into the bloodstream. in this way they reach different organs and are used as substrates for energy metabolism. hepatocyte cells, in particular, use propionate for gluconeogenesis. scfas are involved in the gut-brain axis, stimulating the release of peptide yy (pyy) and 5-hydroxytryptamine (5-ht). they act as signaling molecules to regulate immune and inflammatory responses (evans, morris & marchesi, 2013). n-butyrate regulates neutrophil function and migration, increases the expression of tight junction proteins in colon epithelia, reduces mucosal permeability and inhibits inflammatory cytokines (nicholson et al., 2012). beside producing scfas, bacterial species of the intestinal microbiota synthesize glycan, amino acids, and vitamins (k, b12, biotin, folate and thiamine), thus participating in the host metabolism (flint, scott, louis & duncan, 2012). the recognition of commensal bacteria by toll-like receptors (tlrs) is necessary to stimulate the epithelial cell proliferation, protecting the epithelial surface against gut injury (akira & hemmi, 2003). paneth cells, the secretory cells of the small intestine epithelium, perceive enteric bacteria through tlrs activation and trigger the expression of various antimicrobial factors. this prevents the penetration of pathogenic bacteria over the intestinal barrier (vaishnava, behrendt, ismail, eckmann & hooper, 2008). the microbiota is also related to the development of the gut associated lymphoid tissue (galt), the host immune system stimulating iga secretion and inhibiting colonization of the git by pathogens. protective functions are performed also by the microbiota through competition with pathogens for nutrients and receptors and the production of antimicrobial molecules to avoid colonization by pathogens (akira & hemmi, 2003). through ligands from commensal bacteria (as lipopolysaccharide, lps), the gut microbiota influences the mucosal immune system development and function (rakoff-nahoum, paglino, eslami-varzaneh, edberg & medzhitov, 2004). furthermore, the innate immune system can also recognize potentially pathogenic microbes through tlrs identification of particular molecules called pathogen associated molecular patterns (pamp). this leads to an increase in cytokine levels and t-cell activation which are necessary for appropriate immune response to pathogens (rakoffnahoum et al., 2004). in the present review, we summarize different experimental evidences about the potential mechanisms by which the physical activity might influence the gut microbiota. besides, we discuss the health benefits of exercise and microbiota diversity. 103 annales kinesiologiae • 10 • 2019 • 2 mihaela jurdana, darja barlič-maganja: physical activity regulates the intestinal microbiota composition, 99–114 methods electronic databases medline, science direct and pubmed including the original science articles and reviews, mainly published in the last two years were used to search the literature. based on the keywords: microbiota, moderate exercise, intensive exercise, gut and health; the role of exercise on microbial composition and benefits to health were described. the search was not restricted to the type of study (i.e., species, metaanalysis, case-control, prospective cohort studies, reviews), sample size, year of publication, publication status or follow-up; however, we only included articles published in english and did not take into account other publications (i.e. conference presentations, abstracts, seminars, doctorate thesis). results microbiota and diseases physiological gut microbiota variations have huge implications on human health. alteration of gut microbiota composition, often defined as dysbiosis, is a cause or a consequence of different acute and chronic diseases not limited only to the git (marchesi et al., 2016; schmidt, raes & bork, 2018). dysbiosis is characterized by reduced bacterial biodiversity, loss of commensals with beneficial metabolic activities and overgrowth of pathogen bacteria (kriss, hazleton, nusbacher, martin & lozupone, 2018). this implies a disruption of the mutual equilibrium between gut bacteria and human physiology resulting in the increased intestinal permeability allowing bacteria or bacterial toxins and metabolites to enter into the host circulation and promote subclinical inflammation (levy, kolodziejczyk, thaiss & elinav, 2017). dysbiosis reduces the microbial metabolism and the formation of nutrients that the body needs for its proper functioning. recent studies have linked gut microbiota with different gastrointestinal disorders like inflammatory bowel disease, ulcerative colitis, crohn’s disease and irritable bowel syndrome (dieterich, schink & zopf, 2018), as well as with metabolic diseases like obesity, diabetes, cardiovascular diseases (arora & bäckhed, 2016) and cancer (garrett, 2015). alterations in microbiota composition are associated with the onset of autoimmune and allergic diseases including multiple sclerosis, rheumatoid arthritis, systemic lupus erythematosus, psoriasis, atopic dermatitis and food allergies (tanaka & nakayama, 2017; mckenzie, tan, macia & mackay, 2017). gut microbiota dysbiosis may be involved in the pathophysiology of neuropsychiatric disorders (depression, schizophrenia, autism spectrum disorder, dementia, alzheimer’s and parkinson’s disease (ghaisas, maher & kanthasamy, 2016; kim & shin, 2018), kidney diseases (knauf, brewer & flavell, 2019), osteoporosis (ohlsson & sjogren, 2015) and liver cirrhosis (qin et al., 2014). https://www.ncbi.nlm.nih.gov/pubmed/?term=dieterich%20w%5bauthor%5d&cauthor=true&cauthor_uid=30558253 https://www.ncbi.nlm.nih.gov/pubmed/?term=schink%20m%5bauthor%5d&cauthor=true&cauthor_uid=30558253 https://www.ncbi.nlm.nih.gov/pubmed/?term=zopf%20y%5bauthor%5d&cauthor=true&cauthor_uid=30558253 https://www.ncbi.nlm.nih.gov/pubmed/?term=arora%20t%5bauthor%5d&cauthor=true&cauthor_uid=27071815 https://www.ncbi.nlm.nih.gov/pubmed/?term=b%c3%a4ckhed%20f%5bauthor%5d&cauthor=true&cauthor_uid=27071815 https://www.ncbi.nlm.nih.gov/pubmed/?term=tanaka%20m%5bauthor%5d&cauthor=true&cauthor_uid=28826938 https://www.ncbi.nlm.nih.gov/pubmed/?term=nakayama%20j%5bauthor%5d&cauthor=true&cauthor_uid=28826938 https://www.ncbi.nlm.nih.gov/pubmed/?term=ghaisas%20s%5bauthor%5d&cauthor=true&cauthor_uid=26627987 https://www.ncbi.nlm.nih.gov/pubmed/?term=maher%20j%5bauthor%5d&cauthor=true&cauthor_uid=26627987 https://www.ncbi.nlm.nih.gov/pubmed/?term=kanthasamy%20a%5bauthor%5d&cauthor=true&cauthor_uid=26627987 https://www.ncbi.nlm.nih.gov/pubmed/?term=kim%20yk%5bauthor%5d&cauthor=true&cauthor_uid=28925886 https://www.ncbi.nlm.nih.gov/pubmed/?term=shin%20c%5bauthor%5d&cauthor=true&cauthor_uid=28925886 https://www.ncbi.nlm.nih.gov/pubmed/?term=knauf%20f%5bauthor%5d&cauthor=true&cauthor_uid=30796361 https://www.ncbi.nlm.nih.gov/pubmed/?term=brewer%20jr%5bauthor%5d&cauthor=true&cauthor_uid=30796361 https://www.ncbi.nlm.nih.gov/pubmed/?term=flavell%20ra%5bauthor%5d&cauthor=true&cauthor_uid=30796361 https://www.ncbi.nlm.nih.gov/pubmed/?term=qin%20n%5bauthor%5d&cauthor=true&cauthor_uid=25079328 104 mihaela jurdana, darja barlič-maganja: physical activity regulates the intestinal microbiota composition, 99–114 annales kinesiologiae • 10 • 2019 • 2 microbiota gut-brain-axis communication mechanism the role of aerobic exercise a sedentary lifestyle is associated with a greater incidence of many diseases: cardiovascular, type 2 diabetes, cancer, obesity, and metabolic syndrome. recently, it has been demonstrated that exercise-induced beneficial modification of the gut microbiota composition is involved in modulation of disease states and modifies host physiology (choi et al., 2013). an imbalance diet with high saturated fats, sugar intake, and low fiber consumption in combination with physical inactivity can influence the composition of the microbiota (proctor, thiennimitr, chattipakorn & chattipakorn, 2017). poor dietary habits can induce gastrointestinal dysfunction and lead to inflammatory state (dalton, mermier & zuhl, 2019). it has been recently demonstrated that probiotic supplementation improves gi function, many symptoms of inflammatory diseases and psychological and cognition disorders (dalton et al., 2019). regular aerobic physical activity can reduce the risk of several diseases and health conditions and improve the quality of life (colcombe et al., 2006). recently, human and animal studies have shown that aerobic exercise increases microbiota diversity altering the bacterial composition and influencing the important metabolites production of gut bacteria, like scfas, release and modulation of mucosal neurotransmitters and a brain-derived neurotrophic factor, also known as bdnf (welly et al., 2016). in this way, aerobic exercise can affect the conditions associated with metabolic diseases, neural and behavioral disorders. many evidences suggested an important influence and communication between human gut microbiota and the brain in a bidirectional manner. the brain affects gut microbiota through the autonomic nervous system (the vagus nerve), while gut microbiota influences the brain through neuroendocrine signaling via hypothalamic-pituitary-adrenal axis (hpaa) and neurotransmitter serotonin (5-ht) regulation (grenham, clarke, cryan, & dinan, 2011; cryan & dinan, 2012; forsythe, kunze, & bienenstock, 2016; dalton et al., 2019). disorders in the gut-brain axis functioning are discussed in the pathogenesis of different pathological states (metabolic and inflammatory diseases, psychiatric and depressive disorders, and neurological disorders) (dieterich et al., 2018). vagus nerve activity allows communication between microbiota and brain because it connects the cns (central nervous system) to ens (enteric nervous system) and transfers the information from the ens to cns that leads to response based on the received information (forsythe, kunze, & bienenstock, 2012). the gut microbiota imbalance can induce cns inflammatory response. it was demonstrated that a decreased vagus nerve activity is associated with irritable bowel syndrome ibs and many other intestinal inflammations, and depression. this communication is influenced by microbiota metabolites because it has been shown that probiotic supplementation of bifidobacterium longum can modify the functional status of the vagus activity in the gut. (bercik et al., 2011). 105 annales kinesiologiae • 10 • 2019 • 2 mihaela jurdana, darja barlič-maganja: physical activity regulates the intestinal microbiota composition, 99–114 hpa hypothalamic-pituitary-axis regulates physical and mental stressors response and it is influenced by microbiota via a complex of neural immunoregulatory mechanism (tsigos & chrousos, 2002). hpa axis is activated by vagus nerve or by metabolites such as lps from the mucosal layer that promotes the release of inflammatory cytokines that exaggerate hpa activation (grenham et al., 2011). hpa axis hyperresponsiveness and disturbances in microbiota have been associated with ibs and psychological disorders (farzi, fröhlich, & holzer, 2018). bdnf acts on neurons of the central nervous system and the peripheral nervous system, promotes the survival of existing neurons, and encourages the growth and differentiation of new neurons and synapses. recently, it has been shown to be an important regulator of gastrointestinal protein expression and regulation (dokladny, zuhl, & moseley 2015). the probiotic supplements of bifidobacterium improved the hpa response and restored the bdnf levels in rodents (sudo et al., 2004). serotonin (5-ht) is an important neurotransmitter and hormone, it appears to play a key role in maintaining mood and cognition balance, intestinal secretion and motility, and is known as a key signaling molecule in the microbiota-gut-brain axis (o’mahony, clarke, borre, dinan & cryan 2015; jenkins, nguyen, polglaze & bertrand, 2016). germ free animals’ studies demonstrated that microbiota plays a role in serotonin regulation and influences brain and gut function (clarke et al., 2013; yano et al., 2015). other studies showed that bacteroides fragilis supplementation improved control of tryptophan metabolism, the precursor of 5-th, synthesis and improved gi function (hsiao et al., 2013). exercise and gut microbiota regular moderate exercise can beneficially affect our body; it can reduce the metabolic and inflammatory disease in both humans and animals. the association between exercise training and alteration in immunity, metabolism and behavior has already been confirmed (walsh et al., 2011). animal studies in animals, different forms of exercise, in particular, voluntary and forced, induced different effects on microbiome composition. many studies with germ-free animals have indicated the relationship between gut microbiota and host function (choi et al., 2013; allen et al., 2018). changes in gut microbiota and its metabolites can affect the structure of the mucus layer and immune system after gut microbiota colonization in germ-free animals. in the study of allen et al. (2018) it was demonstrated that exercise training induced changes in the gut microbiota community structure of donor mice and caused changes of colon physiology in recipient mice after five weeks of gut microbiota transplant and colonization. therefore, the gut microbiota composition of recipient mice is dependent of the physical activity level of their respective donor. this indicates that ex106 mihaela jurdana, darja barlič-maganja: physical activity regulates the intestinal microbiota composition, 99–114 annales kinesiologiae • 10 • 2019 • 2 ercise training directly alters the host response by cytokines and gut metabolite production. scfas that have been shown to be up regulated after exercise training contribute to enhanced energy harvest and reduce gut inflammation in physically active host (turnbaugh et al., 2006). the mechanism of this process still needs to be elucidated. other studies on animals provided evidence that voluntary exercise training increased the level of host butyrate concentrations and butyrate-producing bacterial genera associated with enhanced early life lean mass (mika et al., 2015). since butyrate protects against colon cancer and inflammatory diseases (monda et al., 2017), it has been proposed that butyrate increase is associated with the colon cancer decrease by exercise (matsumoto et al., 2008). the mechanism of gut microbiota changes with host increase in scfas and butyrate and host decrease in colon inflammation in response to exercise is not fully understood. these data underline the need for future investigation. although it is certain that voluntary and/or forced exercise altered the gut microbiota composition in animals. it was confirmed that maternal gut microbiota during pregnancy and lactation had effects on offspring gut microbiota in rats. exercise during pregnancy limited the unfavorable impacts of maternal obesity in offspring, affecting the plasma insulin and glucose concentration (bhagavata srinivasan, raipuria, bahari, kaakoush, & morris, 2018). others observed that when the exercise started in the juvenile period it modified different bacteria ratio with an increase of bacteroidetes and a decrease in firmicutes. furthermore, juveniles exercise causes a major change in genera and lead to an increase in lean body mass, suggesting that early life exercise can influence the gut microbiota composition and may favor optimal development of brain function (mika et al., 2015). many authors provide evidence that a routine physical activity is anti-inflammatory and protective against developing the chronic inflammatory disease (cook et al., 2016). human studies to date, few studies on humans have indicated a positive influence of exercise on gut microbiota and confirmed the findings of the animal studies. it has been shown that low-intensity exercise provides a positive effect on the gut by reducing transient stool time and contact time between pathogens and gastrointestinal mucosa layer (petersen et al., 2017). in this manner, exercise prevents the risk of many diseases such as cancer and other inflammatory diseases. other possible positive effects of exercise can include an elevated scfas and immunoglobulin production, decrease in lps production and increase in butyrate concentration. the increase of fecal butyrate has anti-carcinogenic and anti-inflammatory properties (petersen et al., 2017). exercise-induced changes of microbiota diversity can contribute to reducing obesity and obesity-related complication. in humans, a major study conducted on 86 elite rugby athletes compared to high and low bmi controls, showed a greater gut microbiota richness/diversity in rugby players (clark et al., 2014). the increased microbial diversity was positively correlated with 107 annales kinesiologiae • 10 • 2019 • 2 mihaela jurdana, darja barlič-maganja: physical activity regulates the intestinal microbiota composition, 99–114 protein consumption and creatinine kinase levels, suggesting that both, diet and exercise are drivers of biodiversity in the gut. in addition, cardiorespiratory fitness (crf), an indicator of physical fitness has been positively correlated with microbial diversity in 39 healthy individuals, especially in taxa that augmented the production of butyrate, a gut health indicator (estaki et al., 2016). the authors of this study recommended that exercise could be prescribed in combating dysbiosis-associated diseases. in the pilot study by peterson et al. (2017), the microbiota of 22 professional and 11 amateur competitive cyclists was studied. they demonstrated that gut microbiota profiles of professional cyclists differed from amateur control and found a correlation between certain microorganisms in professional cyclists and high exercise load. this study indicates that exercise load alters the bacterial community structure. although the human study in this field is still scarce, previous animals and humans study showed the effects of exercise on microbiota regardless of diet. murtaza and collaborators examined the effects of different dietary programs during intensified training on stool microbiota of elite endurance athletes (race walkers). this study revealed that dietary patterns exert an impact on gut microbiota profiles. in particular, a ketogenic low carbohydrate, high-fat diet was found to induce alterations in abundances of some bacteria species (murtaza et al., 2019). other longitudinal studies are needed to examine the effect of diets and gut microbiome on athlete training and performance. the health benefits of physical activity in older adults have been established in more scientific studies. recently, data demonstrated the association between physical exercise and gut microbiota diversity in the elderly (jackson et al., 2016). authors of many studies reported that gut microbiota composition is less different in some conditions, such as in hypertensive patients and in patients with obesity-associated inflammation and gastrointestinal diseases (monda et al., 2017; taniguchi et al., 2018). exercise can modulate the gut microbiota diversity and could have positive effects on the pathogenesis of mentioned conditions. since lower inflammation was shown in athletes, it is possible that exercise in older adults could decrease inflammatory markers. exercise determined changes in microbial composition were correlated with the duration of physical activity. it was recently confirmed that short-term endurance exercise has little effect on gut microbiota composition and diversity in elderly men, but mentioned little changes in the microbiota which were associated with lower cardiometabolic risk factors (taniguchi et al., 2018). the study suggests that the gut microbiota is influenced by high-intensity interval training and diet and might play a crucial role in modulating cv disease development (juneau, hayami, gayda, lacroix & nigam 2014). interestingly, a study by tan et al. (2013) revealed that diet and exercise improved sleep quality and changes in gut microbiota composition in subjects with obesity-related disorders. all these data highlight the need for future investigation in humans to elucidate how the moderate and rigorous physical activity induces changes in microbiota diversity, composition and function having beneficial effects on human health. 108 mihaela jurdana, darja barlič-maganja: physical activity regulates the intestinal microbiota composition, 99–114 annales kinesiologiae • 10 • 2019 • 2 table 1 summarizes articles that have investigated the role of exercise on gut microbiome in humans. table 1: association between exercise and gut microbiota. authors subjects type of exercise results clark et al., 2014 elite athletes and controls rugby bacterial diversity was higher in athletes than in control. estaki et al., 2016 healthy participants with similar age and bmi cardio butyrate production petersen et al., 2017 professional and amateur cyclists cycling exercise load influence the bacterial community taniguchi et al., 2018 patients moderate/ vigorous decrease inflammation conclusion the existing study data indicate that exercise can induce alterations in gut microbiota composition with beneficial effects for the host. exercise improves microbiota diversity, maintenance of normal gut physiology and contributes to reducing inflammatory markers in different pathological states. furthermore, exercise stimulates the production of metabolites such as butyrate and scfas, protecting us against gi disorders and colon cancer. this may explain why exercise can be a therapeutic strategy during treatment for many disorders in particular psychological and gi diseases. nevertheless, further studies are needed to understand the mechanisms responsible for these effects. further exploration is required to understand how physical activity and diet independently influence health. in the future, exercise prescription may hopefully contribute to our health status through the modification of gut microbiota. 109 annales kinesiologiae • 10 • 2019 • 2 mihaela jurdana, darja barlič-maganja: physical activity regulates the intestinal microbiota composition, 99–114 references aagaard, k., ma, j., antony, k. m., ganu, r., petrosino, j., & versalovic, j. 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(2012). human gut microbiome viewed across age and geography. nature, 486(7402), 222–227. https://doi.org/10.1038/nature11053. https://doi.org/10.1038/nature11053 _goback _goback _hlk23772821 _goback _goback _hlk27564900 _goback bbib0050 bbib0035 _hlk3367923 _goback annales kinesiologiae • 11 • 2020 • 1 29 influence of physical activity on linear growth in children and adolescents sončka jazbinšek1,2 & primož kotnik1,2 1university of ljubljana, faculty of medicine, slovenia 2department of endocrinology, diabetes and metabolism, university children's hospital, university medical center ljubljana corresponding author: primož kotnik, ph.d. university of ljubljana, faculty of medicine, bohoričeva 20, ljubljana, slovenia phone: +386 1 522 9255 e-mail: primoz.kotnik@mf.uni-lj.si abstract linear growth is the result of bone elongation in children and adolescents mediated by processes of endochondral ossification and maturation of bone tissue. physical activity (pa) importantly influences both processes through systemic and local effects, mediated by growth hormone, insulin-like factor i, sex hormones, thyroid hormones, glucocorticoid hormones and various cytokines with endo-, paraand autocrine function, secreted by adipose tissue (adipokines) or muscles (myokines). it is important to promote a physically active lifestyle in early childhood as it tends to persist into adulthood together with favorable body composition. from the safety point-of-view, recent data suggests that pa does not negatively influence linear growth regardless of its duration or intensity, as long as chronic negative energy balance is prevented by sufficient energy intake. the aim of this review is to describe current scientific knowledge on the mechanisms by which pa could influence linear growth, and present recent studies analyzing its possible effects. keywords: linear growth, physical activity, energy balance, puberty, child review article doi: https://doi.org/10.35469/ak.2020.222 received: 2020-01-04 udc: 612.65:796.012 30 sončka jazbinšek, primož kotnik: influence of physical activity on linear growth in children ..., 29–42 annales kinesiologiae • 11 • 2020 • 1 vpliv telesne dejavnosti na linearno rast otrok in mladostnikov izvleček linearna rast je posledica daljšanja dolgih kosti pri otrocih in mladostnikih zaradi procesov endohondralne osifikacije in dozorevanja kosti. telesna aktivnost ima pomembne učinke na oba procesa preko sistemskih in lokalnih vplivov, posredovanih s strani rastnega hormona, inzulinu podobnega rastnega faktorja 1, spolnih hormonov, ščitničnega hormona, glukokortikoidov ter številnih citokinov z endo, para in avtokrino funkcijo, ki se izločajo iz maščobnega tkiva (adipokini) in mišic (miokini). nedavno pridobljeni podatki raziskav kažejo na to, da telesna aktivnost ne vpliva negativno na linearno rast, ne glede na njeno trajanje ali intenzivnost, če dolgoročno preprečimo negativno energijsko bilanco z zadostnim kaloričnim vnosom. telesno aktivnost v otroštvu je pomembno spodbujati tudi z dolgoročnega zdravstvenega vidika, saj se vzorci aktivnega življenjskega sloga, skupaj z ugodno telesno sestavo, prenašajo iz otroštva v odraslo dobo. namen prispevka je podati trenutne znanstvene podatke o mehanizmih, preko katerih bi telesna aktivnost lahko vplivala na linearno rast. ključne besede: rast, telesna aktivnost, energijska bilanca, puberteta, otrok 31 annales kinesiologiae • 11 • 2020 • 1 sončka jazbinšek, primož kotnik: influence of physical activity on linear growth in children ..., 29–42 introduction basic principles of growth the linear growth of a child results from bone elongation, which is the primary result of a process called endochondral ossification at the growth plate of long bones, short tubular bones of hands and feet and the vertebrae. it is a regulated physiological process, where activation of chondrocytes is followed by their proliferation. newly formed chondrocytes are positioned on top of their predecessors arrayed in columns, which is crucial for bone elongation. at the edge of the proliferative zone closest to the metaphysis, the process of chondrocyte hypertrophy follows. hypertrophic chondrocytes excrete extracellular matrix and attract osteoclasts, osteoblast and formation of new vessels, which remodel newly formed cartilage into bone. the growth velocity depends on the velocity of chondrocyte proliferation and their ability to hypertrophy, which is determined by an intrinsic mechanism within the growth plate (jee & baron, 2016). the highest growth velocity is observed prenatally and declines rapidly after birth as a result of a programmed process intrinsic to the growth plate cartilage called senescence, which is an essential process for bone development. senescence leads to bone maturation and simultaneously to growth cessation (nilsson & barron, 2004). the process is influenced by many, especially local, mediators. their expression depends on systemic mediators such as hormones or inflammatory cytokines. consequently, malnutrition or a chronic inflammatory state causes not only a decline in linear growth but slows down the growth plate senescence as well. when growth-inhibiting conditions are resolved, the acceleration of growth rate is observed, resulting in catch-up growth. catch-up growth is not the result of systemic hormonal changes (e.g., higher levels of circulating growth hormone) but accelerated senescence in the growth plate (forcinito et al., 2011). endocrine regulation of growth growth hormone (gh) and insulin-like growth factor-1 (igf-1) are strong endocrine stimulators of growth. defects in their production lead to growth impairment and decreased adult height, which can be prevented with adequate substitution therapy. gh’s major effector site is the liver, where it stimulates the production of igf-1. additionally, in small part, it also has a direct effect on the growth plate, where it stimulates chondrocyte proliferation and local igf-1 production. igf-1 derived from the liver as well as from the growth plate, stimulates longitudinal growth inciting chondrocyte proliferation, hypertrophy and their secretory function (nilsson, marino, de luca, phillip, & baron, 2005). during puberty, estrogen promotes longitudinal growth through promoting effects of the gh – igf-1 axis. at the same time, it also stimulates growth plate maturation directly through receptors er-α and 32 sončka jazbinšek, primož kotnik: influence of physical activity on linear growth in children ..., 29–42 annales kinesiologiae • 11 • 2020 • 1 er-β, expressed in all zones of growth plates, decreasing proliferative capacity of chondrocytes in the process of senescence (lui, garrison, & baron, 2015; weise et al., 2001). other hormones also play an important role in longitudinal growth, with thyroid hormones, androgens and leptin having a stimulatory effect. excessive exposure to glucocorticoids, on the other hand, has an inhibitory effect on growth. glucocorticoids in supraphysiological levels affect growth directly at the level of the growth plate, decreasing chondrocyte proliferation as well as their hypertrophy and indirectly cause downregulation of growth hormone and igf-1 receptor expression. additionally, they increase the circulating levels of igfbp-1, which could potentially affect the circulating levels of free igf-1 (jee & baron, 2016, gat-yablonski & phillip, 2015; nilsson et al., 2005). endocrine regulation of longitudinal bone growth is governed by a complex network of endocrine signals. most of these hormones regulate growth plate directly by acting on growth plate chondrocytes and indirectly by modulating other endocrine signals in the network. e.g., during puberty, increased estrogen secretion increases gh secretion and stimulates the process of growth and senescence at the level of the growth plate, causing growth acceleration in the beginning and later growth cessation, when the number of chondrocyte progenitor cells decreases (nilsson et al., 2005). calcium and vitamin d in addition to caloric intake, adequate intake of calcium and vitamin d should be ensured for optimal growth plate development (lui, garrison, & baron, 2015; nilsson et al., 2005). calcium is the main mineral component of the skeleton, and for skeletal growth a sufficient calcium supply is therefore essential. accordingly, nutritional factors (like food allergies) that affect calcium metabolism will also be of importance for adult height (christie, hine, parker, & burks, 2002). adequate calcium intake is known to increase peak bone mass in early adulthood; however, welten et al. (1994) observed in a 15-year-long longitudinal study that the only two significant predictors for achieving the highest peak bone mass in early adulthood were regular weight bearing exercise and normal age-related body weight in adolescence. calcium intake did not appear to predict bone density in either sex. the main regulator of calcium metabolism is vitamin d, which regulates the process of endochondral ossification by positively affecting chondrocyte proliferation, hypertrophy and differentiation of osteoblasts. the effect of vitamin d on the skeleton is not only demonstrated by severe deficiency leading to rickets (which is also associated with short stature). in fetal growth, maternal pre-natal vitamin d deficiency has been associated negatively with bone mineralization, lower birth weight and an increased risk of neonates born small for gestational age (eckhardt, gernand, roth, & bodnar 2014; viljakainen et al., 2010). the active form of vitamin d binds with the nuclear receptor (vdr), which is found throughout the body, including in the growth plates. different single nucleotide polymorphisms in the vdr gene relate to the 33 annales kinesiologiae • 11 • 2020 • 1 sončka jazbinšek, primož kotnik: influence of physical activity on linear growth in children ..., 29–42 adult height difference up to 2 cm. furthermore, positive association between serum vitamin d level and height in young adults has also been reported (jorde, svartberg, joakimsen, & grimnes, 2012; kremer, campbell, reinhardt, & gilsanz, 2009). physical activity physical activity (pa) is defined as any activity of the body produced by skeletal muscles that requires energy expenditure. it is considered as a type of structured, organized, and previously planned exercise with the aim of improving or maintaining physical condition. there are different forms and patterns of pa; its intensity is usually divided into light (lpa), moderate (mpa), moderate to vigorous (mvpa) and vigorous intensity activity (vpa). its positive effects on cardiometabolic biomarkers, physical fitness, bone health, motor skill development, psychosocial and cognitive health in children and adolescents are already well known and have recently been evaluated in an extensive review by poitras et al. (2016). in general, higher intensity, frequency and longer duration of pa had a stronger relationship with the positive effects than lower intensity pa. all patterns of activity (sporadic, bouts, continuous) were found beneficial (poitras et al., 2016). by current guidelines 60 minutes per day of mvpa for children and youth is recommended for promotion of health and disease prevention (who, 2010). furthermore, a physically active lifestyle developed in early childhood, together with body composition, tends to persist along the entire life course (fraser et al., 2017). recent data suggests that pa does not negatively influence linear growth regardless of its form, pattern, intensity and duration (alves & alves, 2019), if chronic negative energy balance is prevented by sufficient energy intake. however, less is known about the exact effect of pa at the level of epiphyseal growth plates, altering their growth potential, through systemic and local endocrine mechanisms. these effects are more pronounced in children and adolescents engaged in sports activities, who are usually more physically active than the recommended guidelines. it is thought that pa has a protective role on growth plates in this population; however, if not carefully planned, it could have direct negative consequences on growth plates through injury or indirectly through influencing pubertal development, nutritional levels and body composition (mirtz, chandler, & eyers, 2011; gat-yablonski & phillip, 2015). the aim of this review is to describe current scientific knowledge on the mechanisms by which pa could influence linear growth and present recent studies analyzing its possible effects. 34 sončka jazbinšek, primož kotnik: influence of physical activity on linear growth in children ..., 29–42 annales kinesiologiae • 11 • 2020 • 1 mechanisms through which physical activity could affect the growth plate growth hormone igf-1 axis processes of endochondral ossification and senescence at the growth plate are the main mechanisms being discussed in relation to the effect that pa could have on growth. several interconnected factors influence the growth, with the effect of hormones being the most well studied. pa stimulates secretion of gh from the pituitary gland, which directly at the level of the growth plate and indirectly in the liver stimulates igf-1 production. however, the reports about increased circulating total and free igf1 (not bound to igf-binding proteins igfbp) levels during and after exercise are inconsistent (wang et al., 2011; frystyk, 2010). the effect of these hormones was further evaluated in correlation to igfbp dynamics during exercise because most of igf-1 is bound to igfbps in the circulation. igfbps prolong the half-life of igf-i and act as autocrine and/or paracrine regulators of its biological activities, potentially altering the availability of free igf-1, without changing total igf-1. an increase in igfbp-1 levels is seen during prolonged exercise, whereas reports about igfbp-3 are inconsistent. igfbp dynamics in the circulation are also closely related to changes in glucose and insulin metabolism, glucocorticoid and growth hormone levels. despite their changed levels in the circulation connected with pa, the results of studies on the effect on the circulating igf-1 levels remain inconclusive (frystyk, 2010). as previously mentioned, gh does not only stimulate hepatic, but also local igf-1 production, which increases igf-1 concentration at the growth plate level as well as in muscles (wang et al., 2011; desvigne, barthelemy, frere, gay-montchamp, & costes, 2005). studies suggest that locally/peripherally produced igf-1 is the main determinant of somatic growth and the liver is responsible for circulating igf-1 levels, which control pituitary gh secretion (domene et al., 2007; leroith, bondy, yakar, liu, & butler, 2001). therefore, in the future, tissue-specific levels of igf should be analyzed to assess the effect of pa on the growth plate. puberty and energy balance pubertal development and its growth spurt can be significantly affected by pa. as discussed previously, sex hormones in puberty, especially estrogen in both sexes, have an important role in mediating the effects of gh-igf-1, not only at the level of secretion but also at the level of gh action. estrogen enhances growth through augmentation of gh-dependent chondrocyte proliferation at the growth plate. at the same time, it affects growth plates senescence by reducing the rate of chondrocyte proliferation, growth plate height, number of proliferative chondrocytes, number of hypertrophic chondrocytes, size of terminal hypertrophic chondrocytes and column density, leading to epiphysial fusion and growth cessation (weise et al., 2001). pa is 35 annales kinesiologiae • 11 • 2020 • 1 sončka jazbinšek, primož kotnik: influence of physical activity on linear growth in children ..., 29–42 associated with increased energy consumption and in conjunction with insufficient energy intake results in negative energy balance. this may lead to a decrease in the proportion of adipose tissue and levels of adipokine leptin, which, especially if rapid or marked, further leads to a syndrome called relative energy deficiency in sports (red-s) (mountjoy et al., 2018). periods of rapid growth, such as fetal life and pubertal growth spurt require a certain level of leptin as one of several metabolic factors to allow pubertal maturation to proceed and later reproduction to occur. leptin by itself has also been shown to have a direct positive effect on chondrocyte proliferation and differentiation at the level of the growth plate, increasing the expression of igf-1 receptors locally, and additionally stimulating gh secretion (maqsood et al., 2007; gat-yablonski & phillip, 2015). red-s is characterized by hormonal disorders at several levels, the most important being hypothalamic-pituitary dysfunction (mountjoy et al., 2018). the most frequently described is decreased gonadotropin secretion (hypothalamic hypogonadism), but hormonal disorders are present at other levels. it also interferes with the function of growth factors, thyroid hormone and cortisol. consequently, puberty in boys and girls is delayed. directly and indirectly, hypothalamic hypogonadism decreases bone density, causes disturbances in the functioning of the immune system, hematologic complications and malfunction of the gastrointestinal system, etc. (mountjoy et al., 2018). long-term hypothalamic hypogonadism is also associated with decreased fertility (joy et al., 2014). although research was more focused on girls, it is clear today, that red-s affects boys as well (tenforde, barrack, nattiv, & fredericson, 2016; mountjoy et al., 2018). young athletes, especially in sports, where slim stature is important and dietary restrictions are common, are the most susceptible group for this syndrome; e.g., ballet dancers, gymnasts, bodybuilders, long-distance runners. because of the shortand long-term consequences of intense pa in the case of insufficient energy intake, we should take it into account when planning pa. in case of unsuccessful prevention, the consequences should be dealt with immediately. at an early stage the vast majority of these complications are reversible (mountjoy et al., 2018; fagerberg, 2018). so far there are no reports about linear growth retardation in red-s; however, it has been reported consistently in various studies of male and female adolescents with severe anorexia nervosa, demonstrating partial, but not always complete, catch-up growth after recovery (modan-moses et al., 2012; modan-moses et al., 2003). other hormonal axis and inflammatory cytokines pa also affects the excretion and functioning of several other circulating hormones known to be involved in the regulation of the process of endochondral ossification and senescence. exercise decreases insulin secretion and increases catecholamine, glucocorticoid and androgen secretion. all these effects are measured in the blood; however, less is known about the levels and actions of these hormones at the level of the growth plate, especially in correlation with pa (riddell, 2008). 36 sončka jazbinšek, primož kotnik: influence of physical activity on linear growth in children ..., 29–42 annales kinesiologiae • 11 • 2020 • 1 stressful conditions, such as acute or chronic diseases and malnutrition, increase levels of glucocorticoids and inflammatory cytokines, which are known factors for growth attenuation. as mentioned above, glucocorticoids in supraphysiological levels affect growth directly at the level of the growth plate decreasing chondrocyte proliferation and indirectly cause downregulation of the growth hormone and igf-1 receptor expression (jee & baron, 2016, gat-yablonski & phillip, 2015). inflammatory cytokines, such as tgf-β, il-1β, and il-6, act directly on binding to their receptors in the growth plate cartilage and thereby suppress bone growth. additionally, cytokines have an indirect effect, suppressing levels of circulating igf-1 (cirillo, lazzeroni, sartori, & street, 2017). pa is associated with the secretion of contraction induced myokines and inflammatory mediators. for example, higher-intensity and longer-duration exercise results in increased circulating concentrations of il-6 in humans, with greater levels of il-6 seen in cells with lower glycogen content, and due to the energy crisis in the muscle cell during contraction (carson, 2017). however, the effect of those mediators from active skeletal muscle on children’s growth, who are engaged in professional sports and exceed the recommended time of daily pa, is unknown. mechanical forces on the growth plate in growing children, growth plates are more susceptible to positive as well as negative direct mechanical effects of moving. injuries to growth plate can occur with chronic excessive pa or acute severe injury. the highest incidence of these injuries is between 10 and 16 years of age and they can result in premature locking of the epiphyseal growth plate resulting in permanent growth cessation or limited growth. repetitive trauma can cause the epiphyseal plate to widen (laor, wall, & vu, 2006). thus, age-appropriate intensity and duration of pa is recommended, suited to the individual’s psychological and physical development. it is probably associated with a favorable inflammatory mediator profile and has a beneficial effect on health, growth, and very likely plays a protective role on the growth plate (carson, 2017; mirtz, chandler, & eyers, 2011). on the other hand, physical inactivity is thought to have a negative effect on the growth plates. it is known that load-bearing tissue, such as articular cartilage, will atrophy in the absence of mechanical forces. one can presume that sedentarism may result in inadequate stimulation of the growth plate with a possible result of changed growth potential, however the exact effects of a lack of load bearing through a lack of physical activity on the growth plates remain unknown (darling & athanasiou, 2003; mirtz, chandler, & eyers, 2011). the rising sedentary lifestyle has other well-known consequences, such as higher risk of obesity, higher adipose tissue proportion and lower proportion of non-fatty tissue, described in detail elsewhere (tremblay et al., 2011; kotnik, fischer posovszky, & wabitsch, 2015; wennberg, gustafsson, howard, wennberg, & hammarström, 2014). oftedal et al. (2016) investigated the effect 37 annales kinesiologiae • 11 • 2020 • 1 sončka jazbinšek, primož kotnik: influence of physical activity on linear growth in children ..., 29–42 of inactivity in patients with cerebral palsy on their height. their results showed that an individual’s gross motor capacity affects final height in addition to their gestational age at birth. children whose gross motor function was reduced (level iii or iv in the gross motor function classification system), were significantly shorter and grew slower in comparison to their peers with level i or ii gross motor function capacity. they also spent more time sedentary and had lower habitual physical activity. additionally, weight-bearing pa was shown to increase bone mineral content in patients with spastic cerebral palsy (chad, bailey, mckay, zello, & snyder, 1999). studies on the effect of physical activity on linear growth starting with fetal growth, recent data suggests that in general, in physically active pregnant women fetal growth is not affected, regardless of the pa type and intensity. pa generally benefits women in many ways (reducing edema, constipation, anxiety, insomnia and the risk of depression) (alves & alves, 2019). however, wiebe, boulé, chari and davenport (2015) observed that the weight of newborns was decreased by 200-400g in women preforming vga in the last trimester, without increasing the risk of being born small for gestational age. the current recommendation during pregnancy is for previously sedentary women performing pa of mild to moderate intensity and for previously physically active women performing pa of moderate to vigorous intensity (gregg & ferguson, 2017). in preterm infants passive pa has been shown to affect linear growth. a recent systematic cochrane review by schulzke, kaempfen, trachsel, & patole (2014) assessed 11 trials with 324 preterm infants with gestational age between 26 and 34 weeks, who underwent physical activity interventions ranging from three to eight weeks of duration. the authors concluded that there is evidence suggesting that physical activity programs positively affect linear growth, promote short-term weight gain and bone mineralization in preterm infants. data were inadequate to allow assessment of harm or long-term effects. in healthy preschool children, the data on the effects of pa on linear growth is scarce and does not allow any conclusions. torun and viteri (1994) observed that in malnourished children, 24-48 months old, recovering from protein-energy malnutrition, linear growth was more intense in those who were physically active (lpa and mpa). both groups (inactive and active) had similar dietary intake. after 6 weeks, both groups gained an average of 1.98 kg. however, the active group grew more in length (22 ± 8 vs. 14 ± 6 mm, p < 0.05) and lean body mass (final creatinine-height index): 0.97 ± 0.12 vs 0.89 ± 0.09, p < 0.05). other studies with healthy children did not reveal an affect on linear growth; however, they indicated pa in early life appears to shape, for instance, muscle and adipose tissue. there is a consensus that pa should be incorporated early in a child’s life since body composition and patterns of pa tend to persist into adult life (twisk, 2001; fraser et al., 2017; alves & alves, 2019). 38 sončka jazbinšek, primož kotnik: influence of physical activity on linear growth in children ..., 29–42 annales kinesiologiae • 11 • 2020 • 1 in schoolchildren pa including strength training, vpa and practicing of different competitive sports was not found to influence linear growth. a systematic review of 16 studies with 1008 analyzed participants, assessing the effect of strength training or resistance exercises on the linear growth in children aged 7 to 12 years, did not detect any difference in the linear growth of the children who underwent strength training and those who did not (p = 0.46) (alves & alves, 2019). similarly, it was shown by other studies that performing competitive sport at this age does not compromise linear growth. pa at this age was associated with reduced adipose tissue, an increase in bone (reducing the risk of osteoporosis later in life) and muscle mass (damsgaard, bencke, matthiesen, petersen, & müller, 2000; farr, laddu, blew, lee, & going, 2013; malina, 2006; fuchs, bauer, & snow, 2001). similarly to the previous group, pa including vpa and practice of different competitive sports in adolescence was not found to impair linear growth, as long as negative energy balance is prevented (georgopoulos et al., 2004, malina et al., 2013). additionally, malina (2006) reported that resistance training programs in this age group were not found to influence growth. studies indicate that pa impacts bone and muscle mass growth in this age group. nilsson et al. (2014) showed that the practice of physical exercises in adolescence increases the cortical bone through periosteal expansion, providing a more durable bone throughout life. especially weight-bearing exercises were found consistently connected with increased peak bone mass (chahar, 2014). similarly, it has been shown that muscle mass, which begins to increase with pubertal development, benefits from pa. performing pa in adolescence contributes to a higher percentage of muscle tissue in adult life (chahar, 2014; iuliano-burns, mirwald, & bailey, 2001; alves & alves, 2019). conclusions physical activity is an important component of a healthy lifestyle in children and adolescents. when planning pa we have to keep in mind possible negative influence on the linear growth e.g., by directly affecting growth plates through injury or indirectly through influencing pubertal development, nutritional levels, and body composition. in the future research should focus more on the roles and mechanisms of local mediators (hormones and cytokines) at the level of growth plates in relation to pa. this would enable us to make a better assessments of the effect of pa on linear growth and help us determine the adequate intensity of pa, preventing possible harmful effects on growing children. additionally, with the rising sedentary lifestyle in children and adolescents, further research on the effects of decreased pa on growth plates in this population should be performed. 39 annales kinesiologiae • 11 • 2020 • 1 sončka jazbinšek, primož kotnik: influence of physical activity on linear growth in children ..., 29–42 references alves, j. b. g., & alves, g. v. 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(2014). television viewing over the life course and the metabolic syndrome in mid-adulthood: a longitudinal population-based study. journal of epidemiology & community health, 68(10), 928–933. http://doi.org/10.1136/jech-2013-203504. world health organization. (2010). global recommendations on physical activity for health. world health organization. retrieved from https://www.who.int/dietphysicalactivity/publications/9789241599979/en/. wiebe, h. w., boulé, n. g., chari, r., & davenport, m. h. (2015). the effect of supervised prenatal exercise on fetal growth: a meta-analysis. obstetrics and gynecology, 125(5), 1185-1194. https://doi.org/10.1097/aog.0000000000000801. https://doi.org/10.1152/japplphysiol.00031.2008 https://doi.org/10.1152/japplphysiol.00031.2008 https://doi.org/10.1002/14651858.cd005387.pub3 https://doi.org/10.1002/14651858.cd005387.pub3 https://doi.org/10.1007/s40279-015-0411-y https://doi.org/10.1007/s40279-015-0411-y http://archive.unu.edu/unupress/food2/uid06e/uid06e18.htm http://archive.unu.edu/unupress/food2/uid06e/uid06e18.htm _hlk35418826 _goback _hlk35971111 _hlk35511489 _hlk35972306 _hlk35451145 _hlk35511425 _hlk35973495 _hlk35973574 _hlk35973830 _hlk35975249 _hlk35975104 _gjdgxs 30j0zll 1fob9te _goback _3znysh7 _goback _goback _goback _hlk54274488 _goback annales kinesiologiae • 13 • 2022 • 1 77 reports and reviews/poročila in ocene, 77–84 report of 4th international spe balkan ski conference pamporovo ski resort, bulgaria, 13–17 march 2022 after two successful conferences – one in kopaonik, serbia, and the other in jahorina, bosnia and herzegovina – the third international spe balkan ski conference in rogla, slovenia, was cancelled because of the pandemic. the fourth international conference was organised in bulgaria, at the pamporovo ski resort. the conference was hosted by the association of bulgarian ski instructors – the bulgarian ski school, in cooperation with the science and research centre koper (zrs koper), slovenia, the faculty of sport and physical education of the university of niš, serbia, and the ski instructors association (sitas) of slovenia. the high level of the scientific conference was set by renowned experts in the field of alpine skiing and snowboarding, which was then reinforced by the members of the demo groups on the snow. in the afternoon, we heard renowned speakers such as dieter bubeck, phd (germany), prof. erich muller (austria), prof. lana ružić (croatia), prof. matej supej (slovenia), ron kipp, phd (usa), asa tugetam, phd (sweden) and many others. in more than thirty scientific papers, the participants presented the main idea of the conference, “science, practice and education”, and the main theme “fun and safety in contemporary skiing − the new role of ski instructors/trainers in winter sports and society”. the abstracts published on this occasion present the latest perspectives on the sensitive areas of safety and injuries, preparation, and the development of ski technique, as well as modern possibilities and approaches in the methodology and didactics of teaching skiing. the morning workshops on the snow enriched the theory and were led by members of the demo teams from the participating balkan countries (from bosnia and herzegovina, bulgaria, romania, serbia and slovenia). the morning workshops gave the participants the opportunity to deepen their theoretical knowledge through practical work. another important event in the conference was the “demo team show”, where the audience could admire the perfected skiing techniques of the demo teams of the national ski schools. the honorary members such as the slovenian ski legend bojan križaj and bulgarian olympic gold medallist ekaterina dafovska added to the value of the event. despite the spring-like days in march, the sunny conditions did not affect the conditions on the slopes. the beautiful weather and perfectly groomed slopes further contributed to the excellent conference. the next big event will take place in the upcoming winter season of 2023, with the interski congress in the levi ski resort, finland, where the 5th spe balkan ski conference, which will be held at the predeal ski resort in romania, will also be announced and promoted to the biggest snow sports society in the world. kaja teraž and rado pišot 78 reports and reviews/poročila in ocene, 77–84 annales kinesiologiae • 13 • 2022 • 1 poročilo s 4. mednarodne konference spe balkan ski smučarski center pamporovo, bolgarija, 13.–17. marec 2022 po dveh uspešnih konferencah na kopaoniku v srbiji ter jahorini v bosni in hercegovini je bila tretja mednarodna balkanska smučarska konferenca spe na rogli v sloveniji zaradi pandemije odpovedana. četrta mednarodna konferenca je bila organizirana v bolgariji, v smučarskem središču pamporovo. konferenco je gostilo združenje bolgarskih učiteljev smučanja – bolgarska šola smučanja – v soorganizaciji z znanstveno-raziskovalnim središčem koper (zrs koper), slovenija, fakulteto za šport in telesno vzgojo univerze v nišu, srbija, in združenjem učiteljev smučanja (zuts) slovenije. visoko raven znanstvene konference so postavili priznani strokovnjaki s področja alpskega smučanja in deskanja na snegu, ki so jo nato podkrepili člani demo skupin na snegu. v popoldanskih urah smo prisluhnili priznanim predavateljem, kot so dr. dieter bubeck (nemčija), prof. dr. erich muller (avstrija), prof. dr. lana ružić (hrvaška), prof. matej supej (slovenija), dr. ron kipp (zda), dr. asa tugetam (švedska) in številni drugi. v več kot tridesetih znanstvenih prispevkih so udeleženci predstavili glavno idejo konference znanost, praksa in izobraževanje in glavno temo konference zabava in varnost v sodobnem smučanju – nova vloga smučarskih učiteljev/trenerjev v zimskih športih in družbi. ob tej priložnosti objavljeni povzetki predstavljajo najnovejše poglede na občutljiva področja varnosti in poškodb, priprave in razvoja smučarske tehnike ter sodobne možnosti in pristope v metodologiji in didaktiki poučevanja smučanja. dopoldanske delavnice na snegu so obogatile predstavljeno teorijo, vodili pa so jih člani demo ekip iz sodelujočih balkanskih držav (demo ekipe iz bosne in hercegovine, bolgarije, romunije, srbije in slovenije). dopoldanske delavnice so udeležencem omogočile, da so teoretično znanje poglobili s praktičnim delom na snegu. pomemben dogodek konference je bil tudi „demo team show“, na katerem je občinstvo lahko občudovalo dovršeno tehniko smučanja demo ekip nacionalnih smučarskih šol. častna člana, kot sta slovenska smučarska legenda bojan križaj in bolgarska olimpijska prvakinja ekaterina dafovska, sta še povečala pomembnost dogodka. kljub spomladanskim marčevskim dnevom sončno vreme ni vplivalo na razmere na smučiščih. lepo vreme in odlično urejene proge so še dodatno prispevali k odlični konferenci. naslednji veliki dogodek bo potekal v prihajajoči zimski sezoni 2023, in sicer kongres interski v smučarskem središču levi na finskem, kjer bo najavljena tudi 5. balkanska smučarska konferenca spe, ki bo potekala v smučarskem središču predeal v romuniji, in promovirana v največjem društvu za snežne športe na svetu. kaja teraž in rado pišot _hlk119322918 _hlk110178216 _hlk38187602 _hlk120196417 _hlk120196458 _hlk117871780 _hlk117865098 _hlk118123043 _hlk118137344 _hlk70951511 annales kinesiologiae • 11 • 2020 • 1 43 school chair design and key criteria from the users’ point of view nataša rizman herga 1 , samo fošnarič 2, andreja kolar 1 1 osnovna šola ormož, ormož, slovenia 2 univerza v mariboru, pedagoška fakulteta, maribor, slovenia corresponding author: nataša rizman herga osnovna šola ormož, hardek 5, 2270 ormož phone: +386 41 269 056 e-mail: natasa.rizman@osormoz.si abstract people are becoming increasingly sedentary, including students attending the upper level of primary education. due to school, young people spend a lot of time sitting in class and at home, which has a negative effect on their health, especially if their work environment, including school furniture, does not meet all the criteria in terms of physiological, psychological, and sociological guidelines for healthy furniture design. chairs, as school furniture, have been designed according to standards that take into account ergonomic compliance with the body height of pupils. slovenian classrooms are equipped with standard conventional chairs. in our student-oriented research, we were interested in whether chairs designed according to the standard are suitable for adolescents and what, if any, additional criteria must be met from the users’ point of view. the study included 192 upper level pupils (56.3 % girls and 43.7 % boys), age of 12.4 ± 1.7 years. the research is based on quantitative and qualitative methodology. the descriptive causal non-experimental method was supported by the observation method. the results of the survey show that older students (81.6 %) are of the opinion that they spend more time at school than at home. due to prolonged sitting, older students (55.3 %) report problems more often than younger ones (28.4 %). nearly two-thirds of younger students (63.8 %) also believe they sit more in school than at home. the results show that prolonged sitting negatively affects their health or general well-being. differences between the responses of older and younger pupils are statistically significant both in the opinion expressed regarding the location of sitting (p = 0.010) and in the reporting of problems due to prolonged sitting (p = 0.001). there are no statistically original scientific article doi: https://doi.org/10.35469/ak.2020.235 received: 2020-08-12 udc: 37.091.64:612.76 mailto:natasa.rizman@osormoz.si 44 nataša rizman herga, samo fošnarič, andreja kolar: school chair design and key criteria ..., 43–61 annales kinesiologiae • 11 • 2020 • 1 significant differences between the sexes in both groups of older and younger pupils. pupils sit on hard, uncomfortable, conventional chairs that are not tailored to their needs. they want to use comfortable, soft, swivel chairs with backrests and armrests. the study has shown that, in addition to comfort, school chairs must provide dynamic or active sitting. the present study confirms that static and rigidly shaped school chairs do not offer support for active and restless youth. therefore, chair design must change to meet the physical, ergonomic, cognitive, and social needs of their users. keywords: school, pupil’s view, types of chairs, sitting, health. oblikovanje šolskega stola in ključni kriteriji z vidika uporabnikov povzetek odrasli, mladostniki in otroci postajamo vse bolj sedeča populacija. število sedečih vedenj na predmetni stopnji osnovnošolskega izobraževanja narašča. mladostniki zaradi šole pri pouku in doma veliko časa presedijo kar negativno vpliva na njihovo zdravje, posebej če njihovo delovno okolje vključno s šolskim pohištvom ne zadosti vsem kriterijem glede na fiziološke, psihološke, sociološke smernice pri oblikovanju pohištva. stol kot del šolskega pohištva je oblikovan po standardih, ki upoštevajo ergonomsko skladnost s telesno višino učencev. slovenske učilnice so opremljene s standardnimi konvencionalnimi stoli. v raziskavi osredotočeni na učenca nas je zanimalo ali je po standardu oblikovan stol primeren za mladostnike in katerim dodatnim kriterijem mora le ta zadostiti z vidika uporabnikov. v raziskavo je bilo zajetih 192 učencev predmetne stopnje (56,3 % deklet in 43,7 % fantov), s povprečno starostjo 12, 4 ± 1,7 leta. raziskava temelji na kvantitativni in kvalitativni metodologiji. deskriptivno kavzalno neeksperimentalno metodo smo podprli z metodo opazovanja. rezultati raziskave kažejo, da starejši učenci po njihovem mnenju (81,6 %) presedijo več časa v šoli kot doma. zaradi dolgotrajnega sedenja poročajo o težavah pogosteje starejši učenci (55,3 %) kot mlajši (28,4 %), katerih 63,8 % meni, da več sedijo v šoli kot doma, ki negativno vplivajo na njihovo zdravje oziroma splošno počutje. razlike med odgovori starejših in mlajših učencev so statistično značilne tako pri izraženem mnenju glede lokacije sedenja (p = 0,010) kot pri poročanju težav zaradi dolgotrajnega sedenja (p = 0,001). statistično značilnih razlik med spoloma tako pri starejših kot pri mlajših učencih ni. učenci v šoli sedijo na trdih, neudobnih konvencionalnih stolih, ki niso prilagojeni njihovim potrebam. učenci so poročali, da želijo uporabljati udobne, mehke, vrtljive, stole z naslonjali za hrbet in roke. raziannales kinesiologiae • 11 • 2020 • 1 45 nataša rizman herga, samo fošnarič, andreja kolar: school chair design and key criteria ..., 43–61 skava je pokazala, da mora šolski stol ob udobju zagotavljati tudi dinamično oziroma aktivno sedenje. pričujoča raziskava potrjuje, da statični in togo oblikovani šolski stoli ne nudijo podpore aktivnemu in nemirnemu mlademu človeku. zato je pri oblikovanju je potrebno zadostiti fizičnim, ergonomskim, kognitivnim in socialnim vidikom njihovih uporabnikov. ključne besede: osnovna šola, učenčevo mnenje, vrste stolov, sedenje, zdravje. introduction promoting health in the school environment is especially important because health and education are inextricably linked. the health and safety of children are among the main priorities in schools as healthy children and adolescents are more likely to become healthy adults. humans find sitting to be more comfortable and easier than standing, because in this position static load and energy consumption are lower, the position is more stable, and it does not require intensive strength in the lower limbs. yet sitting is associated with or is the cause of many diseases (nijz, 2014). humans are becoming increasingly sedentary. children, adolescents, adults, and the elderly alike are subject to a more sedentary lifestyle. the environments in which we live increase the sedentary aspects of our lifestyles and reduce the active ones (zupančič-tisovec and remec, 2017). stamenkovič (2018) mentions the consequences of prolonged sitting, which are related to the musculoskeletal system: incorrect posture, weakened muscles, shoulder pain, neck stiffness, headaches, back and arm pain, lower back pain, achy shoulders, coccyx, and legs, dizziness, fatigue, etc. prolonged sitting is detrimental to the whole organism. a sedentary lifestyle is a risk factor which has not received nearly enough attention. sitting also has a negative effect on the health of growing adolescents, who spend a lot of time sitting at school and later at home for schoolwork, and who spend their free time sitting in front of a computer and other screens. a lot of schoolwork is done in a sedentary position. first, they sit in school in class, then sitting continues at home while studying and carrying out school obligations. the first years of life are crucial for the health of the spine, especially during the time of accelerated and rapid growth (attewell, 2003). pupils spend about six hours of the day in school. they can only sit properly for the first three hours. after the third hour, mental and physical fatigue from the previous sitting begins (stamenkovič, 2018). according to observations using the peo method, students do 80 % of schoolwork in class in a sitting position (cardon et al., 2004). these hours and the further hours doing homework have a negative effect on adolescents’ a) health, b) motor skills, and c) learning (their cognitive abilities and motivation itself) (castelluci et al., 2010). among the causes of incorrect or poor posture in children and adolescents are prolonged sitting, 46 nataša rizman herga, samo fošnarič, andreja kolar: school chair design and key criteria ..., 43–61 annales kinesiologiae • 11 • 2020 • 1 inadequate school furniture that is not in line with children’s and adolescents’ anthropometric measurements, physical inactivity, and, especially in young people, heavy school bags. poor or “poorly formed” spines during school ages will cause problems in adulthood (rosenbaum et al., 2007). prolonged sitting affects the elasticity of the intervertebral muscles, resulting in greater pressure on the intervertebral discs, which in turn encourages their deformation and thus poses a greater risk of hernia (hlebš and mavsar, 2016). pain in the lumbar spine occurs in adolescents who are taller. in many countries today’s children differ from previous generations. in general, they are often taller, heavier and less fit. adolescents undergoing their peak increase in height are at greater risk of low back pain. many children (particularly girls) experience puberty earlier than those of previous generations, increasing the potential for musculoskeletal pain and disorders (lueder and berg rice, 2008). during puberty, teenagers gain about 15 % of their ultimate stature and 45 % of their final skeletal mass (spear, 2002). people who sit a lot have been shown to have a less healthy muscular system (bilban and repar, 2009). prolonged sitting correlates with the occurrence of spinal deformities. the goal of ergonomics is to improve the work environment to reduce injuries or pain. school furniture must have a modern ergonomic design and be specially adapted for various forms of schoolwork and in line with the physiological characteristics of children of a certain age (fošnarič, 2001). numerous studies have shown that there are discrepancies between the dimensions of school furniture and anthropometric measurements of students (parcells et al., 1999, panagiotopoulou et al., 2004, domljan et al., 2008, castelluci, 2010, assiri et al., 2019). in slovenia, too, there are discrepancies between the anthropometric dimensions of pupils and the dimensions of the chairs and tables used in classes (šterlek and fošnarič, 2008, starman, 2009, rizman herga and fošnarič, 2017, rizman herga, 2018). childhood is a critical time to learn and develop good postural habits that can be practiced throughout one’s lifetime (lueder and berg rice, 2008). the chair is one of the most anthropomorphic types of furniture. the function of the chair is to support the sitting body. the goal of ergonomics is to ensure that product design matches the physiological and psychological boundaries of the human body, so that products will ensure optimal performance. it is important for growing children to have a properly designed chair and desk, as this provides favourable conditions for the development of healthy posture. the school furniture used currently by young people in slovenian schools is not always in line with standards. for each size class, the required product dimensions are also provided and these are important for ergonomic consistency with the user’s body height. experience and insight into slovenian schools and research show inconsistency; students who utilize specialized classrooms such as science, technology, art, etc. are very heterogeneous in height, yet the classrooms are equipped with chairs (usually only one size per class) which, according to the standard, suit only a few of the students (rizman, herga, and fošnarič, 2012, 2017). the construction, design, material and quality of chairs are not determined by the standard (novak, 1995). of course, school furniture is not the only cause of pain and discomfort. annales kinesiologiae • 11 • 2020 • 1 47 nataša rizman herga, samo fošnarič, andreja kolar: school chair design and key criteria ..., 43–61 however, research has shown that awkward and constrained sitting postures and poorly designed classroom furniture are important contributors to children’s musculoskeletal discomfort (rizman, herga, and fošnarič, 2017). to reduce lower back pain, dynamic chairs are alternatives to the standard chair. dynamic chairs force users into dynamic sitting, which is characterized by continuously changing posture (kirn and starc, 2014). dynamically changing posture is beneficial for users because it periodically loads and unloads different musculoskeletal segments, which reduces overload and injury, and improves the health of cartilage. the purpose of the research was to determine the pupils’ perceptions of sitting, sitting in school, sensations after prolonged sitting, and to investigate the factors that ensure comfortable sitting from the point of view of the pupils. school chairs have changed little over time, compared to office chairs. we were interested in what a pupil-centred research approach would reveal. methodology of research purpose of research and methodology the research is based on quantitative and qualitative methodology. part of the data was obtained with a structured survey questionnaire (descriptive causal non-experimental method), and the qualitative part of the research was obtained with two different methods, observation and structured interview. the research is deductive as we tried to check the results of the questionnaire in the classroom. figure 1. research model. 48 nataša rizman herga, samo fošnarič, andreja kolar: school chair design and key criteria ..., 43–61 annales kinesiologiae • 11 • 2020 • 1 participants the research included 192 (n = 192) pupils averaging age of 12.4 years of age; these pupils were drawn from ormož primary school. the research sample consisted of volunteer pupils. at the level of inferential statistics, the given cohort represents a simple non-probability sample drawn from a hypothetical population of primary school pupils. eight (n = 8) pupils were included in the case study, of which half were younger (5th and 6th grade) and half older (8th or 9th grade), who had classes in the chosen classroom at the time of the experiment. relevant sample characteristics as can be seen from table 1, 60.4 % of the sample were younger pupils – 5th, 6th, and 7th grade – and 39.6 % were older pupils from the 8th and 9th grade of elementary school. there were more girls (56.3 %) than boys. physically active pupils are those who exercise for at least 1 hour a day. 46.4 % of the pupils fall into this category (table 2). other pupils (53.6 %) represent a group that exercises less than the time recommended by the world health organization. table 1. the number (f) and percentage (f %) of pupils by gender. gender and age f f % total (f, f %) younger m 58 50 116, 60.4younger f 58 50 older m 27 35.6 76, 39.6older f 49 64.4 table 2. the number (f) and percentage (f %) of pupils according to their physical activity. daily activity f f % satisfactory 89 46.4 unsatisfactory 103 53.6 total 192 100 annales kinesiologiae • 11 • 2020 • 1 49 nataša rizman herga, samo fošnarič, andreja kolar: school chair design and key criteria ..., 43–61 data collection procedure and instruments the data was collected through online questionnaires. the questionnaire was created using the free online survey tool 1ka. the data was collected in the period from november 2018 to december 2018. with the questionnaire we wanted to obtain answers to questions about sedentary behaviours of adolescents, focusing on sitting in school: how long adolescents sit before, during and after class, how they feel after sitting for a long time, how they assess the comfort of school chairs, and what seats or chairs they would like to use in class. the online questionnaire was created in accordance with the purposes of the study. it consisted of open-ended and closed-ended questions. the reliability of the questionnaire was ensured by the exact nature of the questionnaire instructions, which we changed after the pilot study. the reliability of the questionnaire was determined by using cronbach’s reliability coefficient which confirmed the reliability of the instrument (α = 0.705). during observational case study (january 2019), we checked which chairs (among those offered and evaluated in the questionnaire) pupils actually used in class and how long they used particular chairs (time measurement). pupils could change chairs during lessons or they could stand at a table. pupils’ activities were recorded (to monitor the sitting). after the experiment we used a structured interview to look for rationale and criteria for chair choices, and to determine how pupils felt while sitting, why they changed chairs, etc. data analysis the spss (statistical package for the social sciences) program was used in analysis at the level of descriptive and inferential statistics. data analysis encompassed the application of a factor analysis and cronbach’s alpha coefficient (a) for the analysis of metric characteristics. the chi-square test was used for the analysis of differences between the two groups by gender, age (younger, older) and physical activity (sufficient, insufficient). the mann-whitney test was used to analyse differences between genders in ranking chair assessments. we also used tabular and graphical presentations of absolute (f) and percentage (f %) frequencies. results the results with the interpretation will be presented in two parts. initially, we discuss sitting in school, then focus on school chairs and the pupils’ work environment. 50 nataša rizman herga, samo fošnarič, andreja kolar: school chair design and key criteria ..., 43–61 annales kinesiologiae • 11 • 2020 • 1 adolescent sitting table 3 shows the opinions of adolescents regarding sitting at home and at school, namely their opinion on where they spend more time in a sitting position. older pupils (81.6 %) believe that they spend more time sitting at school than at home. almost two thirds of younger pupils (63.8 %) share that opinion. the difference in responses between pupils by age is statistically significant (χ2 = 9.121; p = 0.010), but not by gender (χ2 = 3.721; p = 0.156). three-quarters of girls (73.1 %) and 66.7 % of boys believe they spend more time sitting at school. table 3. the location where pupils believe they sit most, by gender and age. answer home school χ2 p ge nd er male f 28 56 3.721 0.156 f % 33.3 66.7 female f 29 79 f % 26.9 73.1 ag e younger f 42 74 9.121 0.010 f % 36.2 63.8 older f 14 62 f % 18.4 81.6 table 4 shows the answers to the question of whether the pupils experience any problems due to excessive sitting at school. thirty-seven percent of all surveyed pupils stated that they have occasional problems due to prolonged sitting. we did not detect a statistically significant difference between boys (70.2 % without problems) and girls (53.7 % without problems). however, there is a statistically significant difference (χ2 = 14.005; p = 0.001) between younger and older pupils. older pupils have more problems due to prolonged sitting (55.3 % of pupils with difficulties or occasionally difficulties) than younger pupils (28.4 % of pupils with difficulties). table 5 shows how adolescents feel and what problems they have after prolonged sitting at school. more than half of pupils feel the need to stretch (59 %), more than half (55 %) feel tired and sleepy, and they often mentioned that they feel uncomfortable (29 %). responses listing pain in different parts of the body are also common. many pupils reported pain in the ischial tuberosity (commonly referred to as sitting bones) (31 %), lower back pain (22 %), and neck pain (21 %). only 28 pupils (15 %) feel fine after sitting for a long time. annales kinesiologiae • 11 • 2020 • 1 51 nataša rizman herga, samo fošnarič, andreja kolar: school chair design and key criteria ..., 43–61 table 4. adolescents’ problems due to prolonged sitting at school, by gender and age. answer yes no occasionally χ2 p ge nd er male f 3 59 22 5.490 0.064 f % 3.6 70.2 26.2 female f 5 58 45 f % 4.6 53.7 41.7 ag e younger f 4 83 29 14.005 0.001 f % 3.4 71.6 25 older f 4 34 38 f % 5.3 44.7 50 table 5. number (f) and structural percentages (f %) of adolescents’ problems after prolonged sitting at school. condition/problem f f % unpleasant. 54 29 i feel sleepy and tired. 103 55 i feel the need to stretch. 110 59 fine. 28 15 i have neck pain. 39 21 i have lower back pain. 41 22 i have upper back pain. 28 15 i have a headache. 29 15 my shoulders hurt. 17 9 my buttocks (sitting bones) hurts. 58 31 i feel pain between my shoulder blades. 17 9 other. 17 9 52 nataša rizman herga, samo fošnarič, andreja kolar: school chair design and key criteria ..., 43–61 annales kinesiologiae • 11 • 2020 • 1 school chairs the surveyed pupils gave many interesting, different, and original answers to the open-ended question of what chair they would use in school for classes. similar descriptions were grouped into the same category. table 6 shows that comfort comes first, followed by comfort with dynamic seating, and comfort with functionality. from the answers, we can conclude that the pupils want seats that would be first and foremost comfortable, but at the same time functional and allow for dynamic sitting. table 6. number (f) of descriptions of the chair pupils would like to have in class. description f total f (f %) comfort comfortable 57 214 (63.9 %) soft 105 heated 42 padded 3 massage chair 7 comfort functionality computer chair 14 40 (11.9 %) office chair 8 adjustable 9 with armrests 9 comfort dynamic sitting swivel chair 15 41 (12.2 %) flexible 4 computer chair 14 office chair 8 material wood 6 12 (3.6 %) fabric 3 leather 3 other large 17 28 (8.4 %) ordinary 6 modern, colourful, good 5 annales kinesiologiae • 11 • 2020 • 1 53 nataša rizman herga, samo fošnarič, andreja kolar: school chair design and key criteria ..., 43–61 table 7 shows how pupils rated the school chairs they use in class. the results (mean = 2.427) show that the chairs are on the border between uncomfortable and moderately comfortable. when asked if they would like a padded, soft seat, 181 (94.3 %) answered affirmatively (table 8). table 7. rating of school chairs. number rating 1 v er y u nc om fo rt ab le 2 u nc om fo rt ab le 3 m od er at el y c om fo rt ab le 4 c om fo rt ab le 5 v er y co m fo rt ab le  sd n 29 73 75 9 6 2.427 0.912 f % 15.1 38 39.1 4.7 3.1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 figure 1:different types of chairs used in the study. 54 nataša rizman herga, samo fošnarič, andreja kolar: school chair design and key criteria ..., 43–61 annales kinesiologiae • 11 • 2020 • 1 table 8. the number (f) and structural percentage (f %) for soft chairs. would you like to sit on an upholstered chair? f f % yes 181 94.3 no 11 5.7 figure 2 shows the results of asking pupils to choose from 15 different seats (figure 1). pupils selected a) the seat they liked and b) the seat they would use in class. the figure shows that pupils would use seats 3, 4, 12, and 15. there are no major differences between the seats they like and those they would actually use in class, except for seat number 12 (bean bag chair). pupils like the bean bag chair the most, but it was chosen by far fewer pupils for use in class. figure 2. chairs by likeability and use in class. table 9 shows the number and the structural shares of the chairs that pupils chose to use in class. the legend below the table explains what a specific seat allows or what properties it has. most pupils (27 %) would use seat number 3 in classes. this is followed by seats 12 and 4. annales kinesiologiae • 11 • 2020 • 1 55 nataša rizman herga, samo fošnarič, andreja kolar: school chair design and key criteria ..., 43–61 table 9. number (f) and structural percentages (f %) of seats selected for class. chair 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 feature 1, 4 1, 3, 4 1, 2, 3, 4 1, 2, 3, 4 3, 4 4 1, 3 1, 3, 4 1, 3, 4 1 3, 4 3 1 3, 4 1, 2, 3 f 1 1 44 29 0 0 4 9 13 2 2 38 5 0 14 f % 1 1 27 18 0 0 2 6 8 1 1 23 3 0 9 1. back support 2. armrest 3. padding 4. dynamic sitting during the observation, we measured how long the pupils sat in each chair during class. table 10 shows that they spent most time on chair 3. this is the chair that was most often chosen as the chair that pupils would like to use in class. after chair 3, pupils spent the most time in chairs 1 and 11. table 10. sitting time per chair in class. chair 1 3 6 7 11 12 13 time (s) 3235 8935 901 674 3186 1332 0 figure 3 shows the structural proportions of pupils’ responses regarding the choice of seat in class and the structural proportions of time spent in the chair during class monitoring. the figure shows that the results of the survey and the results of the experiment differ regarding the chairs offered. pupils spent the most time in seats 3, 1, and 11 during the experiment. 56 nataša rizman herga, samo fošnarič, andreja kolar: school chair design and key criteria ..., 43–61 annales kinesiologiae • 11 • 2020 • 1 figure 3. selection and actual use of the chair. discussion sedentary behaviours are on the rise in adolescents as well. the results of the research showed that there are differences of opinion between younger and older pupils. most of the older pupils are of the opinion that they sit more in school than in their free time. however, more than a third of younger pupils think that they spend more time sitting in their free time. the difference between younger and older pupils is statistically significant, while the results in the answers between boys and girls do not differ statistically (χ2 = 3.721; p = 0.156). pupils sit while waiting for classes, during snack and lunch periods, and most of all during the compulsory classes, which are supplemented at the upper level with additional lessons for gifted pupils and for pupils with learning disabilities, elective subjects, etc. sitting time at school is also extended due to the curriculum and obligations of older pupils. prolonged sitting in class makes adolescents feel unwell; they need to stretch, they feel sleepy, they are tired, they have sore buttocks and back pain. more than a third of the surveyed pupils experience the previously described problems due to prolonged sitting. frequent muscle fatigue and pain are the result of prolonged static sitting (ninčević and bilban, 2010). there is no statistically significant difference between genders in frequency of adolescent problems due to prolonged sitting at school. the difference in the frequency of problems between different age groups of the pupils is statistically significant annales kinesiologiae • 11 • 2020 • 1 57 nataša rizman herga, samo fošnarič, andreja kolar: school chair design and key criteria ..., 43–61 (χ2 = 14.005; p = 0.001). older pupils have more problems due to prolonged sitting at school than younger pupils. the objective of the second part of the research was to determine how customized and suitable the school chairs are as part of the student work environment. the school chairs they use were rated “uncomfortable” with an average of 2.427 (sd = 0.912). the current chairs they use in class are wooden conventional chairs; an absolute majority of pupils think they are too hard, uncomfortable, unpleasant, and poorly fitted to their anthropometric measures, which in the long run has a negative impact on all aspects of life and work at school and on the health of pupils. an overview of characteristics of the chair that pupils would like to use in class gave a range of different descriptive answers, which we combined into groups by their meaning. the analysis showed that pupils would primarily like comfortable chairs. this was also confirmed by the answers to the question of whether they would like a padded chair, where the majority of pupils (94.3 %) answered affirmatively. in addition to the comfort provided by a soft, padded, and comfortable chair, pupils would also like chairs that are functional and height-adjustable, with backrests and armrests, and which allow movement described with the words “swivel”, “movable”, and “mobile”. chairs meeting these criteria would allow pupils to sit dynamically. a study comparing dynamic and static sitting concludes that sitting on a dynamic chair has a significant effect on torso kinematics (van dieën, hermans, 2001). in the survey, adolescents could choose from 15 different seats that had different characteristics: back support, armrests, padding, dynamic seating options, or combinations of these options. we first asked them which seat they liked, and in the second part, pupils were asked which of the offered chairs they would use at school in class (appendix 1). seats 3, 4, 12, and 15 were the most popular. all of them are soft, padded and provide support for the back, three have armrests, and two also allow movement – dynamic sitting. for class, pupils would choose chairs that offer comfort, support, and allow dynamic sitting. chair number 12, the bean bag chair, was the exception; it is the most popular among pupils because it provides them with comfort, but fewer than half of the pupils who like it best would actually choose to use it in class. in class, most pupils would use chair 3 (a modern, adjustable office chair), followed by the bean bag chair and a “spinalis” chair, which allows dynamic sitting. the results of the survey were verified by an observational case study. in the classroom where the experiment took place, different seats were installed (numbered 1, 3, 6, 7, 11, 12, and 13 in the survey). pupils involved in the experiment could change seats during class. the results measuring the time spent in each seat showed that during class the pupils spent the most time in chair 3. this is followed by a chair with armrests and a backrest that allows rocking (number 1) and an exercise ball (number 11). all of these seats allow rocking, leaning, bouncing – movements that are becoming ever more rare, especially in the phase of growing up. unfortunately, in the absence of new findings, the basic starting points and guidelines for chair design are still international standards and static anthropometry (parcells et al., castellucci et al., 2010, domljan, 2010). 58 nataša rizman herga, samo fošnarič, andreja kolar: school chair design and key criteria ..., 43–61 annales kinesiologiae • 11 • 2020 • 1 an analysis of the structured interview after the experiment showed that the exercise ball was most often the first choice of the pupils. the reasons for the first choice were varied; the pupils stated that they liked it, it is interesting, it has beautiful colours, it allows rocking or even bouncing. as a disadvantage they stated that sitting on the ball made them restless and that it was difficult to take notes so they moved to a different chair. research has shown that sitting on an exercise ball has some characteristics of walking or standing and therefore occasionally replacing ordinary chairs with exercise balls is recommended (kirn and starc, 2014). when asked why they spent the most time sitting in chair 3, respondents answered that the chair is of suitable height and soft, has armrests and back support, it allowed them to swivel and was in their opinion the best chair (among those offered). to put it in their words, pupils would like to have chairs like office employees have. by analysing the results of the observation sheets we found that in the selected seats the pupils sat dynamically by rocking, swivelling left-right, moving backward and forward, and bouncing; there was limited static sitting. the pupils involved in the experiment were rarely still; they changed sitting positions. the analysis of the experiment showed that younger pupils changed seats more often than older pupils. the results coincide with a study on pupils’ working postures in primary school classrooms in croatia (domljan et al., 2010), which also found that pupils sought comfort by changing their sitting position and that older pupils sat more still than younger pupils. conclusions this paper illustrates the needs of the school workspace from the pupils’ perspective. chairs are a vital part of their work environment, especially for older pupils, who spend more time in sedentary position. due to prolonged sitting at school, pupils feel uncomfortable, report various back pains and describe problems with how they are feeling (drowsiness, fatigue, malaise). the results of the research confirmed the assumptions that pupils feel unwell when sitting at school on conventional chairs. studies in slovenia have shown that there are discrepancies between the dimensions of school furniture and the anthropometric dimensions of pupils who use that furniture. however, compliance with size classes according to the prescribed standards for school furniture should not be the only criterion. the results of the research confirmed the assumptions that pupils feel unwell when sitting in class on conventional chairs. in terms of which properties pupils believe school chairs should have, we found that they want chairs that are comfortable, soft, with back support, armrests, and are adjustable in inclinations and height and allow dynamic sitting, which was shown by case study through observation. pupils need chairs that allow them to rock, swing, turn, and bend in all directions. the results of this study support the existing knowledge that dynamic sitting is better and healthier than static sitting. conventional school chairs are less appropriate for long-term use. school chairs should promote annales kinesiologiae • 11 • 2020 • 1 59 nataša rizman herga, samo fošnarič, andreja kolar: school chair design and key criteria ..., 43–61 sitting dynamics that suit the physiological, psychological, sociological, cognitive, and ergonomic aspects of their users. based on the above, in order to improve the working environment for pupils by tailoring it to them, we suggest that classrooms be equipped with chairs that allow dynamic sitting, and that they also have chairs that allow active sitting (balls). classrooms should be equipped with different types of dynamically and ergonomically designed chairs. it is also necessary to change the pedagogical process itself, so that it allows changing the seating order during class, standing classes, taking walks, etc., with active breaks, a short time for health, active learning, and teaching with research and experience, adapting lessons and the learning environment to the pupils, which does not require large financial investment, but reduces the sedentary way of learning and teaching. for the health of our children, it is necessary to follow the progress of school furniture improvements, provide ergonomically equipped classrooms, and strive to reduce static sitting as much as possible or replace it entirely with dynamic or active sitting – with a single goal: the improved growth and overall development of healthy adolescents. references assiri, a., 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(2001). effects of dynamic office chair on trunk kinematics, trunk extensor emg and spinal shrinkage. ergonomics, 44(7), 739750. https://doi.org/10.1080/00140130120297. https://journals.um.si/index.php/education/article/view/190 https://journals.um.si/index.php/education/article/view/190 https://doi.org/10.1080/00140130120297 _hlk35418826 _goback _hlk35971111 _hlk35511489 _hlk35972306 _hlk35451145 _hlk35511425 _hlk35973495 _hlk35973574 _hlk35973830 _hlk35975249 _hlk35975104 _gjdgxs 30j0zll 1fob9te _goback _3znysh7 _goback _goback _goback _hlk54274488 _goback _goback annales kinesiologiae • 13 • 2022 • 2 185 reports and reviews/poročila in ocene, 185–195 neuroscience of movement twinbrain summer school 2.0, piran, slovenia 4-9 july 2022 in our daily lives, we do many things automatically. and although we often seem to respond without the slightest mental effort, there are a multitude of complex processes going on in our brains. we only realize how difficult a task is when we (re)learn a certain cognitive-motor task, such as keeping our balance on skis or while surfing, or even when grasping a spoon after a stroke. on the other hand, we know of several progressive neurodegenerative diseases that prevent the smooth performance of everyday tasks. james parkinson recognized that progressive parkinson’s disease (pd) is associated with debilitating features including postural instability and gait difficulties (pigd), such as falls and freezing of gait. pd initially causes physical symptoms but later, problems with cognitive function, including forgetfulness and difficulty concentrating, may occur. as the disease worsens over time, many people develop dementia. studying the dynamics of the brain during the most routine movements, such as walking, balancing or learning new motor-cognitive tasks, remains a major challenge for neuroscience. for the twinbrain summer school 2.0, we have invited an international team of experts to report on the latest discoveries in the field of neuroscience on movement topics and to provide insight into how brain imaging technology can contri186 reports and reviews/poročila in ocene, 185–195 annales kinesiologiae • 13 • 2022 • 2 bute to the understanding of brain function and disease development. recent advances in wireless and portable technologies allow us to take experimentation a step further into real life or situations that reflect everyday experiences. therefore, the latest developments in mobile brain/body imaging (mobi) were presented by internationally recognized experts from slovenia, germany, switzerland, italy, belgium, the czech republic, croatia, bosnia and herzegovina and the usa. the twinbrain summer school 2.0 was held on july 4-9, 2022, in piran, slovenia. the next summer school 3.0 is scheduled for june 19-24, 2023, again in piran, slovenia. uroš marušič annales kinesiologiae • 13 • 2022 • 2 187 reports and reviews/poročila in ocene, 185–195 nevroznanost gibanja poletna šola twinbrain 2.0, piran, slovenija, 4. –9. julij 2022 v vsakdanjem življenju veliko stvari počnemo samodejno. in čeprav se pogosto zdi, da se odzovemo brez najmanjšega miselnega napora, v naših možganih potekajo številni kompleksni procesi. kako težka je ta naloga, se zavemo šele, ko se (ponovno) naučimo določene kognitivno-motorične naloge, kot je ohranjanje ravnotežja na smučeh ali med deskanjem ali celo prijemanje žlice po možganski kapi. hkrati poznamo več nevrodegenerativnih bolezni, ki napredujejo in onemogočajo nemoteno opravljanje vsakodnevnih opravil. že james parkinson je poročal, da je progresivna parkinsonova bolezen (pd) povezana z izčrpavajočimi značilnostmi, kot so posturalna nestabilnost in težave pri hoji (pigd) ter tudi padci in zamrznitev hoje. pd na začetku povzroči telesne simptome. pozneje se lahko pojavijo tudi težave s kognitivnimi funkcijami, vključno s pozabljivostjo in nezmožnostjo koncentracije. ko se bolezen sčasoma poslabša, veliko ljudi razvije demenco. proučevanje dinamike možganov med večino rutinskih gibov, kot so hoja, ravnotežje ali učenje novih motorično-kognitivnih nalog, ostaja velik izziv za nevroznanost. na poletno šolo twinbrain 2.0 smo povabili mednarodno ekipo strokovnjakov, da bi 188 reports and reviews/poročila in ocene, 185–195 annales kinesiologiae • 13 • 2022 • 2 poročali o najnovejših odkritjih na področju nevroznanosti gibanja in zagotovili vpogled v to, kako lahko tehnologija slikanja možganov prispeva k razumevanju delovanja teh in razvoja bolezni. novejši napredek na področju brezžičnih in prenosljivih tehnologij nam omogoča, da gremo korak naprej pri eksperimentiranju in sicer v resnično življenje oz. okoliščine, ki odsevajo vsakodnevne izkušnje. zato so najnovejše dosežke na področju mobile brain/body imaging (mobi) predstavili mednarodno priznani strokovnjaki iz slovenije, nemčije, švice, italije, belgije, češke, hrvaške, bosne in hercegovine in zda. poletna šola twinbrain 2.0 je potekala od 4. do 9. julija 2022 v piranu. naslednja poletna šola 3.0 bo predvidoma organizirana od 19. do 24. junija 2023, ponovno v piranu. uroš marušič _hlk122510532 _hlk121925715 _hlk121925783 _hlk117671776 _hlk117676890 _hlk117676830 _hlk122521710 _hlk123029474 _hlk51764713 _hlk51617947 _hlk51764685 _hlk51616945 _hlk51676200 _hlk51710755 _hlk124939594 _hlk124939408 _hlk125008249 _hlk125008423 _hlk125010166 _hlk124768186 _hlk129167818 _hlk129168885 _hlk129939779 _ref116207795 annales kinesiologiae • 12 • 2021 • 1 29 original scientific article doi: https://doi.org/10.35469/ak.2021.305 received: 2021-12-14 udc: 373.3.016:796.011.1 integrating physical activity in mathematics lessons – a pilot study erika černigoj1, tadeja volmut2 1 kindergarten morje lucija, lucija, slovenia 2 university of primorska, faculty of education, koper, slovenia corresponding author: erika černigoj kindergarten morje lucija, lucija, slovenia e-mail: erika.cernigoj@gmail.com abstract introduction: the aim of the study was to investigate the effect of teaching mathematics through physical activity tasks in the sixth grade. with an accelerometer we measured the amount and intensity of physical activity and the time of physical inactivity during school hours and, particularly, during mathematics lessons. methods: twenty-two sixth graders from a slovenian primary school participated in the study. the experimental group consisted of 16 students and the control group consisted of 6 students. mathematics lessons were planned together with the mathematics teacher. this was then carried out in the experimental group. in the control group, the mathematics lessons remained unchanged. the intervention lasted for one week. for the duration of the experiment, students wore an accelerometer on their right hip during school hours. results: we found that the experimental group engaged in moderate to vigorous intensity physical activity for 7.8 minutes more during mathematics lessons (p < 0.001) than the control group. in addition, the experimental group was less physically inactive during math lessons for 6.7 minutes (p = 0.001) than the control group. physical activity during school hours did not differ between groups (p = 0.284). nevertheless, the experimental group spent slightly more time at moderate to vigorous intensity during school hours than the control group and was less physically inactive. conclusion: this study showed that integrating physical activity with mathematics in the academic classroom results in increased moderate to vigorous physical activity compared to a traditional classroom. further research should be conducted to determailto:erika.cernigoj@gmail.com 30 erika černigoj, tadeja volmut: integrating physical activity in mathematics lessons – a pilot study, 29–41 annales kinesiologiae • 12 • 2021 • 1 mine how integrating physical activity with various school subjects affects daily physical activity in children and adolescents. keywords: children, sixth grade, moderate to vigorous intensity, accelerometer vključevanje gibalne aktivnosti v ure matematike pilotna študija izvleček uvod: cilj raziskave je bil ugotoviti učinek vključevanja gibalne/športne aktivnosti v ure matematike na količino in intenzivnost gibalne/športne aktivnosti učencev med šolskim časom in v času ur matematike. metode: v raziskavo je bilo vključeno 22 šestošolcev iz slovenske osnove šole. v eksperimentalno skupino je bilo vključenih 16 učencev, v kontrolno pa 6. z učiteljico matematike smo načrtovali ure matematike z gibanjem, ki jih je izvajala le v eksperimentalni skupini. kontrolna skupina pa je imela ure matematike nespremenjeno, na klasičen način. raziskava je trajala en teden in v tem obdobju so učenci v času šolskega pouka okoli pasu nosili pripet merilnik pospeška. rezultati: ugotovili smo, da so bili učenci eksperimentalne skupine deležni za 7,8 minut več srednje do visoke intenzivnosti gibalne/športne aktivnosti v času ur matematike (p <0.001) v primerjavi z učenci kontrolne skupine. prav tako so bili učenci eksperimentalne skupine pri urah matematike za 6.7 minut manj gibalno neaktivni (p = 0.001) kot učenci kontrolne skupine. gibalna/športna aktivnost v celotnem šolskem času pa se med skupinama ni razlikovala (p = 0.284). kljub temu se je eksperimentalna skupina v šolskem času zadrževala nekoliko več časa v srednji do visoki intenzivnosti ter bila manj gibalno neaktivna kot kontrolna skupina. zaključki: raziskava je pokazala, da z vključitvijo gibalne/športne aktivnosti v ure matematike lahko povečamo čas zadrževanja v srednji do visoki intenzivnosti gibalne/ športne aktivnosti med urami matematike. v prihodnje bi bilo potrebno narediti več raziskav o tem, kako vpliva vključitev gibalne/športne aktivnosti v različne šolske predmete na količino in intenzivnost gibalne/športne aktivnosti otrok v šolskem času. ključne besede: učenci, šesti razred, srednja do visoka intenzivnost, merilniki pospeška annales kinesiologiae • 12 • 2021 • 1 31 erika černigoj, tadeja volmut: integrating physical activity in mathematics lessons – a pilot study, 29–41 introduction today, children worldwide are not getting enough physical activity (pa) and are not meeting the minimum recommendations for moderate to vigorous physical activity (mvpa) (institute of medicine, 2013; naspe, 2019; szabo-reed, willis, lee, hillman, washburn & donnelly, 2017; who, 2019). there is compelling evidence of the benefits of regular pa for a variety of health outcomes, from prevention of cardiovascular disease (penedo & dahn, 2005; warburton, nicol & bredin, 2006), diabetes (warburton et al., 2006), hypertension (warburton et al., 2006), to various cancers (penedo & dahn, 2005). physical activity has benefits only if done regularly and at an appropriate intensity. it is recommended that children engage in physical activity at mv intensity for at least 60 minutes each day (institute of medicine, 2013; naspe, 2019; szabo-reed et al., 2017; who, 2019). children spend a large amount of time at school each day being physically inactive (szabo-reed et al., 2017). one of the ways to increase physical activity in school is to integrate it into school learning (institute of medicine, 2013; szabo-reed et al., 2017). all over the world there are various programs that combine physical activity tasks with academic learning, such as “energizers” (mahar, murphy, rowe, golden, shields & raedeke, 2006), “i-can!” (bartholomew, golaszewski et al., 2018; bartholomew, jowers et al., 2018; bartholomew, jowers & golaszewski, 2019), “move for thought” (vazou, saint-maurice, skrade & welk, 2018; vazou & skrade, 2016), “move-to-improve” (dunn, venturanza, walsh & nonas, 2012), “take10!” (goh, hannon, webster, podlog & newton, 2016; reilly, buskist & gross, 2012; stewart, dennison, kohl & doyle, 2004), “activity bursts in the classroom for fitness” (katz et al., 2010), “instant recess” (whitt-glover, ham & yancey, 2011), “bizzy break” (murtagh, mulvihill & markey, 2013), “excite” (innerd, azevedo & batterham, 2019), “funtervals” (ma, mare & gurd, 2014; ma, mare & gurd, 2015), “physical activity across the curriculum” (donnelly et al., 2009, donnelly et al., 2017; donnelly & lambourne, 2011; mullender-wijnsma, hartman, de greeff, bosker, doolaard & visscher, 2015a; szabo-reed et al., 2017), and “happy 10” (liu et al., 2007). to increase pa during school time among slovenian children, various programs have been used, such as “aktivna pot v šolo in iz nje – pešbus” (institute for spatial policies, 2020), “aktiven šolski odmor” (jurak et al., 2016), “minuta za zdravje” (jurak et al., 2016), “dodatna ura športa v podaljšanem bivanju” (subotić, 2012), and “fit slovenija” (fit slovenia, 2019). however, there are few studies that have integrated physical activity into non-physically-active lessons (bratož, 2015; cotič, ivanič & žakelj, 2010; rabuza, 2010; volk, 2015). other countries (donnelly et al., 2009; innerd et al., 2019; kibbe et al., 2011; martin & murtagh, 2015; norris, van steen, direito & stamatakis, 2020; vetter, orr, o’dwyer & o’connor, 2020) have investigated the impact of integrating physical activity into school lessons on the quantity and intensity of children’s physical activity. many of these studies included pa in mathematics (innerd et al., 2019; kibbe et al., 2011; martin & murtagh, 2015; vetter et al., 2020) or languages lessons (innerd et al., 2019; kibbe 32 erika černigoj, tadeja volmut: integrating physical activity in mathematics lessons – a pilot study, 29–41 annales kinesiologiae • 12 • 2021 • 1 et al., 2011; martin & murtagh, 2015). they indicated that active learning in the classroom successfully increased the amount, duration, and intensity of pa. active learning could increase children’s pa for 2.8 to 7.7 minutes (bartholomew, golaszewski et al., 2018; daly-smith, zwolinsky, mckenna, tomporowski, defeyter & manley, 2018; donnelly et al., 2009; innerd et al., 2019; institute of medicine, 2013; kibbe et al., 2011; martin & murtagh, 2015; norris et al., 2020; szabo-reed et al., 2017; vazou et al., 2018; vetter et al., 2020). similar results were obtained in studies from slovenia. ajdovec (2017) investigated the effect of integrating pa into non-physically active lessons on physical inactivity; on the other hand, ovčjak (2016) integrated pa into music lessons and assessed the amount and intensity of pa during these lessons. many of these studies were conducted with children from 1st to 4th grade. global trends suggest that pa decreases even further as children get older (cox, schofield, greasley & kolt, 2006; who, 2019a). therefore, we were interested in the amount and intensity of pa of older children. methods participants a total of 22 children (mean age: 11.41; 12 boys and 10 girls) from the sixth grade of a primary school in slovenia were recruited. we explained all the details to the headmaster, the mathematics teacher and the parents. the study involved a mathematics teacher who taught both groups the experimental and the control group. 16 children participated in the experimental group, 6 children formed the control group. the parents of the children gave their written consent before the study was conducted. intervention the study was conducted in may 2019. the intervention lasted five school days, from monday to friday. during the intervention, children had four lessons of mathematics. one lesson lasted 45 minutes. the teacher integrated pa in mathematics lessons of the experimental group. in the control group, the mathematics lessons remained unchanged. the children from both groups had the same mathematics lessons content. the mathematics lessons were planned together with the mathematics teacher. the pa tasks were of moderate to vigorous intensity, but relatively easy to perform. for example: – true-or-false questions: if the statements were true, students did 5 jumps, if they were false, they did 3 squats; – fit box: we wrote different pa tasks on slips of paper and then put them in a box. the teacher chose a student to answer the questions. if she/he answered annales kinesiologiae • 12 • 2021 • 1 33 erika černigoj, tadeja volmut: integrating physical activity in mathematics lessons – a pilot study, 29–41 correctly, she/he got to take a slip out of the box. the student read the task on the slip and the whole class performed that task. instruments pa was measured using accelerometers (actigraph wgt3w-bt, actigraph, llc) worn on the children’s right hips. data were collected for one week (five days) during school hours. children’s out-of-school pa data were not collected for this study. at the beginning of the study, we demonstrated how to properly fasten the accelerometer around the children’s waists. data analysis accelerometer data were analyzed using activity counts of 15-second epochs. all sequences of 20 minutes or more with consecutive zero counts were excluded from each individuals’ records. to distinguish between physical activity phenotypes, we considered the thresholds proposed by freedson, pober & janz (2005): – physical inactivity (pi): < 100 cpm, – low pa: 100–1262 cpm, – medium pa: 1263–4135 cpm, – vigorous pa: > 4135 cpm. data were organized using the microsoft excel program (microsoft corporation, redmond, usa) and processed using the spss statistical package (ibm corp., armonk, ny, usa). differences between groups in vigorous pa during mathematics lessons were analyzed using the mann whitney u test. this test was used because the data were not normally distributed. for the other intensity levels, the independent samples t-test was used. all statistical decisions were considered at p < 0.05. results from the accelerometer data, we calculated the average of each pa intensity phenotypes during mathematics lessons for both groups (table 1). the results showed that there were differences between the groups in all phenotypes of intensity. during mathematics lessons the experimental group was more pa in mv (p < 0.001; es = 2.37), v (p = 0.002; es = 1.48), m (p < 0.001; es = 2.38) and l (p = 0.005; es = 1.50) intensity compared to the control group. in addition, the experimental group was also less pi (p = 0.001; es = 2.08) during mathematics than the control group. 34 erika černigoj, tadeja volmut: integrating physical activity in mathematics lessons – a pilot study, 29–41 annales kinesiologiae • 12 • 2021 • 1 table 1. comparing the levels of pa and pi between groups in mathematics lessons eg (mean ± sd) cg (mean ± sd) p (es) pa (cpm) 281.0 ± 104.1 69.9 ± 35.2 < 0.001 (2.72) pi (minutes) 33.5 ± 3.7 40.2 ± 2.6 0.001 (2.08) l pa (minutes) 8.5 ± 2.9 4.3 ± 2.3 0.005 (1.50) m pa (minutes) 11.0 ± 3.5 3.6 ± 2.66 < 0.001 (2.38) v pa (minutes) 0.5 ± 0.4 0.1 ± 0.1 0.002 (1.48) mv pa (minutes) 11.5 ± 3.7 3.7 ± 2.7 < 0.001 (2.37) legend: eg ‒ experimental group, sd – standard deviation, cg ‒ control group, p (es) – effect size, pa – physical activity, pi – physical inactivity, v – vigorous, m – medium intensity, l – low intensity, mv – medium to vigorous intensity. we also compared the levels of pa and pi between groups during school time (table 2). the level of physical activity during school hours did not differ significantly between groups. nevertheless, the experimental group spent slightly more time in mv intensity (p = 0.284) than the control group during the whole school period and was less pi (p = 0.284) than the control group. the data showed that the experimental group spent 10.62 minutes more in mvpa than the control group. we believe that this difference is due to the integration of pa into mathematics lessons. we calculated the average level of pa during school time without pa during math lessons and the difference between the groups was only 2.9 minutes in mvpa. we found that students from both groups reached minimum recommendations for physical activity while still in school. annales kinesiologiae • 12 • 2021 • 1 35 erika černigoj, tadeja volmut: integrating physical activity in mathematics lessons – a pilot study, 29–41 table 2. comparing the levels of pa and pi between groups during total school time eg (mean ± sd) cg (mean ± sd) p (es) pa (cpm) 415.7 ± 130.1 430 ± 108.4 0.814 pi (minutes) 180.9 ± 19.9 191.5 ± 20.9 0.284 l pa (minutes) 51.7 ± 12.6 41.6 ± 14.7 0.125 m pa (minutes) 73.8 ± 18.4 61.0 ± 19.7 0.169 v pa (minutes) 5.3 ± 3.1 7.5 ± 2.1 0.128 mv pa (minutes) 79.1 ± 19.9 68.5 ± 20.9 0.284 legend: eg ‒ experimental group, sd – standard deviation, cg ‒ control group, p (es) – effect size, pa – physical activity, pi – physical inactivity, v – vigorous, m – medium intensity, l – low intensity mv – medium to vigorous intensity. discussion the purpose of this study was to investigate the effect of teaching mathematics through pa tasks on pa. using an accelerometer, we measured pa and pi of sixth-grade children during mathematics lessons and during school time. the data for pi during mathematics lessons showed that the control group was 74.4% of the mathematics lessons pi, while the experimental group was only 14.9% of the lessons pi. vazou et al. (2018) also found differences between the groups. they integrated pa in the mathematics lessons of fourth-grade children. during the experimental lessons, they were 40.44% of the lessons pi, in contrast, during control time they were 42% pi. martin and murtagh’s (2015) study showed similar results. children were at 46.49% less pi during the english and mathematics than during regular lessons. ovčjak (2016) measured the pi of slovenian children during active music lessons. she found that in the experimental group 23.9% of lessons were pi and in the control group 62.9%. we can conclude that the other studies found smaller differences between the groups compared to our results. we think that this difference is due to the fact that the other studies included younger children than ours. it is generally believed that pa decreases with age, so this may lead to an increased pi (calvert, mahar, flay & turner, 2018; volmut, pišot & šimunič, 2013; webster, russ, vazou, goh & erwin, 2015). in this study, the experimental group spent 25.56% of lessons in mvpa, the control group 8.22%. other studies have reported similar results (vazou et al., 2018; martin & murtagh, 2015; mullender-wijnsma et al., 2015a, ovčjak, 2016). martin and murtagh (2015) found that children in the experimental group were in mvpa 23.5% of the active lessons. from ours and other studies, we can see that the integration of pa into mathematics lessons can improve primary school children’s mvpa level and reduce 36 erika černigoj, tadeja volmut: integrating physical activity in mathematics lessons – a pilot study, 29–41 annales kinesiologiae • 12 • 2021 • 1 pi during mathematics lessons. it is also interesting to compare our results with those of pušnik (2013). he measured the effective time parameters of physical education and the time children spent in mvpa. he found that children spent 13.22 minutes in mvpa during physical education. this is very close to our results where the experimental group spent 11.5 minutes in mvpa during mathematics lessons. we can assume that the integration of physical activity during mathematics lessons may be closer to mvpa intensity during physical education lessons. however, as we know, children perform complex motor tasks during physical education, while only performing simple motor tasks during experimental mathematics instruction. we also measured pa and pi of sixth-grade children during school hours. we found that the extent of mvpa during school hours did not differ significantly between the groups. the experimental group spent 79.1 minutes in mvpa during all school time and 180.9 minutes pi, while the control group spent 68.47 minutes in mvpa and 191.5 minutes pi. nevertheless, we observed a slight trend in the differences between the groups in mvpa. other studies found significant differences between groups in mvpa (bartholomew, jowers et al., 2018; calvert et al., 2018; erwin, abel, beighle & beets, 2011), but some of them found no differences in pi (bartholomew, jowers et al., 2018). bartholomew et al. (2018) measured pa during school hours when students received 10-15 minutes of active lessons. the results of his study showed that children in experimenting schools took more steps and moved more in percentage points during the school week than students in control schools, but there were no statistically differences in sedentary behavior. another study (riley, lubans, holmes & morgan, 2016) reported that the experimental group engaged in pa significantly more and tended to spend more time in mvpa during school hours compared to the control group. intervention effects were also found for sedentary behavior during school hours. the control group was pi 67.8% of school time, while the experimental group was pi 62.6% of school time. innerd et al. (2019) measured pa at baseline, at the end of the intervention, and 4 weeks after the intervention. the difference in average daily mvpa (experimentalcontrol) was 2.8 minutes/day at 8 weeks and 7.0 minutes/day at follow-up. in addition, donnelly et al. (2009) observed pa during the spring semester in each of the 3 intervention years. children who participated in physically active classes had significantly higher levels of pa during the school day, on weekends, and also on weekdays compared to children in control schools. this could be explained by a change in children’s attitude and their belief that they can be anywhere and in almost any situation pa. after this finding, we could predict that our intervention was too short to obtain reliable data on how the integration of pa into mathematics lessons affects the level of mvpa during school time. this study also has some other limitations. one of them is the small sample size. the participants were only from the sixth grade, and we only included pa in the mathematics lessons. in the future, more research should be done on how the integration of pa into different school subjects affects children and adolescents’ daily pa. unfortunately, our study could not examine how the inclusion of pa tasks affected children’s annales kinesiologiae • 12 • 2021 • 1 37 erika černigoj, tadeja volmut: integrating physical activity in mathematics lessons – a pilot study, 29–41 academic performance particularly in mathematics cognitive ability, or on-task behavior, because the intervention program lasted only five school days, during which students in the experimental and control groups received only four hours of mathematics instruction. a larger effect would not necessarily have been a reflection of the intervention program only, but also of a higher motivation and concentration of students in learning mathematics. in addition, we should not neglect the fact that students learn at home (e.g., write math homework) and that teachers are in all likelihood better prepared for the intervention program when they teach math. teachers are not used to on this type of teaching and therefore take more time to prepare than usual. we need to be careful when comparing our study with others as they may have used different methods to measure and analyze the data. conclusions finally, this study showed that integrating pa with mathematics in the academic classroom resulted in increased mvpa during lessons. in addition, we found that students in both groups achieved the minimum recommendations of pa while still on school time. previous research has shown that physically active classes also improve academic performance (ma et al., 2015; mullender-wijnsma et al., 2015a; mullenderwijnsma, 2015b; mullender-wijnsma, 2016; vazou & skrade, 2016). this should be an additional encouragement for teachers to integrate physical activity into their classes. references ajdovec, a. 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(2011). instant recess: a practical tool for increasing physical activity during the school day. progress in community health partnerships: research, education, and action, 5(3), 289–297. https://doi.org/10.1353/ cpr.2011.0031. https://doi.org/10.3390/children5100140 https://doi.org/10.1080/1612197x.2016.1164226 https://doi.org/10.1080/1612197x.2016.1164226 https://doi.org/10.1111/josh.12878 https://doi.org/10.2478/sjph-2013-0002 https://doi.org/10.1503/cmaj.051351 https://doi.org/10.1111/obr.12285 https://www.who.int/dietphysicalactivity/pa/en/ https://www.who.int/dietphysicalactivity/pa/en/ https://doi.org/10.1353/cpr.2011.0031 https://doi.org/10.1353/cpr.2011.0031 _goback _hlk98923763 _hlk98755967 _hlk79606686 _hlk99786836 _hlk98147084 _hlk99787368 _hlk88552317 _hlk17057094 annales kinesiologiae • 11 • 2020 • 2 131 original scientific article doi: https://doi.org/10.35469/ak.2020.271 received: 2021-02-08 udc: 796.01:616.379-008.64 moderate physical activity improves inflammatory markers (il-6 and tnf alpha) and diabetic profile in the prediabetic population zubia shah1, abdul waheed mughal2, sherbaz khan1, saman tauqir3, inayat shah1 1 institute of basic medical science, khyber medical university, peshawar, pakistan 2 department of sports science and physical education, sarhad university of science and information technology, pakistan 3 department of physiology, gandhara university, peshawar, pakistan corresponding author: inayat shah, phd associate professor (director) institute of basic medical sciences, khyber medical university peshawar, khyber pakhtunkhwa pakistan 25000 phone: +923321431414 e-mail: drinayatshah@kmu.edu.pk abstract purpose: prediabetes is a health condition that precedes type ii diabetes. globally, prevalence of prediabetes is on the rise and approximately 37% of pakistani populations are suffering from it. apart from many other factors, inflammatory markers, especially interleukin 6 (il-6), and tumor necrosis factor – alpha (tnf-α) play a significant part in the development of prediabetes to diabetes. how exercise affects the inflammatory cytokines is elucidated but not completely understood. methods: a non-commercial experimental trial including a total of 48 participants (36 males and 12 females) aged 30.7 ± 7.80 years (mean ± sd) was carried out after ethical approval and written informed consent. demographic data, body plethysmography, exercise parameters, diabetic and inflammatory markers were determined at preand post-interventional stages. the exact intensity of exercise capable of eliciting the required heart rate was determined and each participant was asked to perform moderate intensity exercise (45 minutes including warm up and cool down) at home, monitored through pedometers, 5 days a week for 12 weeks. results: twelve weeks of moderate intensity aerobic exercise (at 55% to 65% of predicted maximum heart rate [pmhr]) had significant positive effects on body composition, including body mass index (bmi) (<0.001), body mass (<0.001), diabetic parameters (fasting blood sugar [fbs] (0.02), glycated hemoglobin hba1c [0.001]) 132 zubia shah, abdul waheed mughal, sherbaz khan, saman tauqir, inayat shah: moderate physical activity ..., 131–144 annales kinesiologiae • 11 • 2020 • 2 and inflammatory parameters (il-6 [0.018]and tnf-α [0.02]). the effects were almost identical for males and females (mild differences). conclusion: moderate intensity exercise significantly decreases the levels of circulating inflammatory cytokines and improves the diabetic profile in prediabetics. in addition, such exercise is easy to incorporate into the lifestyle of the prediabetic population and can be used as an effective strategy for preventing the development of diabetes. keywords: prediabetes, il-6, tnf-α, inflammatory cytokine, moderate intensity aerobic exercise zmerna telesna aktivnost izboljša vrednosti vnetnih kazalcev (il-6 in tnf-alfa) in diabetičnih parametrov pri preddiabetični populaciji izvleček cilj: preddiabetes je zdravstveno stanje, predstopnja sladkorne bolezni tipa 2. njegova razširjenost v svetovnem merilu narašča, omenjeno stanje pa je prisotno že pri 37 % pakistanskega prebivalstva. poleg številnih drugih dejavnikov imajo pri napredovanju preddiabetesa v diabetes pomembno vlogo vnetni kazalci, predvsem il-6 in tnf-α. prispevek osvetljuje vpliv telesne aktivnosti na vnetne citokine, ki pa ga v celoti zaenkrat še ne znamo pojasniti. metode: po pridobitvi etične odobritve in pisnih soglasij smo izvedli nekomercialen poskus z 48 udeleženci (36 moškimi in 12 ženskami) v povprečni starosti 30,7 ± 7,80 let. demografske podatke, telesno pletizmografijo, parametre telesne aktivnosti ter diabetične in vnetne kazalce smo določali pred začetkom in ob koncu poskusa. natančno smo opredelili stopnjo intenzivnosti vadbe, potrebno za dosego zahtevanega srčnega utripa, in vse udeležence prosili, naj 12 tednov po petkrat tedensko izvajajo zmerno intenzivno telesno vadbo (45 minut, vključno z ogrevanjem in ohlajanjem). rezultati: dvanajsttedensko izvajanje zmerno intenzivne aerobne vadbe (pri 55 % do 65 % predvidenega msu) je zelo pozitivno učinkovalo na telesno zgradbo, med drugim na itm (<0,001), težo (<0,001), diabetične parametre (fbs (0,02), hba1c (0,001)) ter vnetne parametre (il-6 (0,018) in tnf-α (0,02)). učinki so bili z le rahlimi razlikami praktično enaki pri moških in ženskah. zaključek: zmerno intenzivna telesna aktivnost znatno zniža raven vnetnih citokinov v krvnem obtoku. zmerno intenzivne aerobne vadbe ni težko vključiti v življenjski slog preddiabetične populacije in jo je zato moč uporabiti kot eno od učinkovitejših strategij za preprečevanje razvoja sladkorne bolezni. ključne besede: preddiabetes, il-6, tnf-α, vnetni citokin, zmerno intenzivna aerobna vadba 133 annales kinesiologiae • 11 • 2020 • 2 zubia shah, abdul waheed mughal, sherbaz khan, saman tauqir, inayat shah: moderate physical activity ..., 131–144 introduction diabetes is a metabolic disorder of epidemic nature worldwide, with defective insulin secretion, action, or combination of both that results in high blood sugar with ultimate damage to different systems of the body including visual, urinary, nervous, and cardiac systems. diabetes is usually preceded by prediabetes, which is a stage of subclinical hyperglycaemia, and at this stage the risk of developing type ii diabetes mellitus (t2dm) is very high. a recent survey has estimated that there are about 38 million prediabetic people in pakistan (aamir et al., 2019). it is highly recommended that, due to increased prevalence of co-morbid conditions in patients with type ii diabetes mellitus, proper exercise programs should be devised based on the best possible research evidence and expertise (hordern et al., 2012). the pathology of diabetes is multi-factorial, complex, and involves the imbalance of many inflammatory cytokines, including il-6 and tnf-α. il-6 is mainly released by muscles during exercise and acts as both a proand anti-inflammatory marker (golbidi, badran & laher, 2011). mode and type of exercise affects the il-6 plasma levels differently, as predominantly more muscle mass involvement in any exercise enhances il-6 more efficiently. insulin resistance in prediabetes and diabetes is mostly tnf-α induced and exercise plays a role in inhibiting this resistance (golbidi et al., 2011). tnf-α is a cytokine with a vital role in fatty acid metabolism and glucose regulation. its levels are high in obese and diabetic patients (straczkowski et al., 2001). regular exercise decreases the activity of tnf-α system activity and results in increased insulin sensitivity (straczkowski et al., 2001). but limited information is available in this regard. exercise has been reported to significantly reduce the endothelial dysfunction and levels of inflammatory marks, which are the two hallmark factors in the development of type ii diabetes mellitus (hopps, canino, & caimi, 2011). regular exercise has been proven to be helpful in modifying many aspects during prediabetic and diabetic conditions, ranging from metabolism of glucose to respiratory capacity of the muscles and cellular respiration at mitochondria along with improving β-oxidation (earnest, 2008). according to exercise guidelines, aerobic exercise ranging from 40% to 85% maximal oxygen consumption (vo2 max) can be performed easily in sedentary populations (earnest, 2008). the existing evidence shows that development of diabetes mellitus (dm) occurs more frequently in inactive individuals; exercise training along with modification in lifestyle is reported to delay the onset of full-blown diabetes, and improve impaired glucose tolerance (igt) and impaired fasting glucose (ifg) at a prediabetic stage (malin, gerber, chipkin, & braun, 2012). as discussed earlier, a large percentage of pakistani population is suffering from prediabetes, which suggests the possibility of a massive disease burden in the near future. therefore, it is timely to investigate the baseline levels of inflammatory markers in prediabetics and how 3 months of regular moderate intensity exercise affects them. https://www.sciencedirect.com/topics/medicine-and-dentistry/glucose-metabolism https://www.sciencedirect.com/topics/medicine-and-dentistry/fatty-acid-oxidation 134 zubia shah, abdul waheed mughal, sherbaz khan, saman tauqir, inayat shah: moderate physical activity ..., 131–144 annales kinesiologiae • 11 • 2020 • 2 methods a total of 48 young prediabetic patients aged 30.7 ± 7.80 years were recruited using convenience sampling technique. the non-commercial experimental trial included 36 males (75%) and 12 females (25%) who were recruited into 12-weeks moderate intensity exercise protocol at 55% to 65% pmhr at the exercise lab of khyber medical university, peshawar, after ethical approval granted by the ethical review board of khyber medical university (dir/kmu-as&rb/tc/001167). using g power 3.1.9.2 software by taking il-6 values for control (2.43 ± 0.32) and prediabetics (2.18 ± 0.28) (20), keeping α=0.05 and power of 0.80, a sample size of 48 participants was calculated. after initial screening and confirmation of prediabetes (hba1c between 5.7 and 6.4% and fbs between 100 and 125 mg/dl), the participant demographics and body plethysmography (mifit, xiaomi, china) were determined, and written informed consent was obtained. males were younger (p = 0.021), taller (p <0.01), heavier (p = 0.06) and had more lean mass (p = 0.03). in addition, 5ml blood was taken aseptically to determine the il-6 and tnf-α levels. the optimization of the exercise to define the exact speed at required intensity (55% to 65% of pmhr) was carried out on the second visit after screening the participants. this was performed using a treadmill attached to a breath-by-breath analyzer (cosmed-srl, italy). this machine performs an accurate measurement of exercise-induced metabolism and calculates the required speed to elicit the desired intensity of exercise. the quantification of exercise was carried out by using pedometers (mi-5 bands, xiaomi, china), which counted the number of steps taken by each individual during the whole exercise session. after the optimization and quantification of exercise, verification of the exercise session was again performed on the following day in what was considered the first interventional trial. it was comprised of a 45-minute session (5 minutes of warm up, 30 minutes of exercise at 55% to 65% of pmhr, and 10 minutes of cooling down). the participants were then asked to continue the same exercise protocol at home, 5 days per week for 3 months. they were supervised through pedometers, records of which were retrieved weekly after synchronizing the pedometer with software. mean steps taken by females were more than males (4517 ± 134 vs. 4125 ± 121, p = 0.023); however, male participants performed more sessions (62 ± 1 vs. 58 ± 1, p = 0.01) during the entire exercise intervention, which lead to no significant difference between the total steps taken during the whole intervention (p = 0.34). measurements for anthropometric, diabetic, and inflammatory parameters were again determined at the post-interventional stage. spss version 20 was used for data analysis. the distribution of the data was assessed by the kolmogorov-smirnov and shapiro-wilk tests and found to be normal. independent sample t statistics for mean difference between the groups (males vs. females) and paired sample statistics across the same group (pre vs. post) were used. 135 annales kinesiologiae • 11 • 2020 • 2 zubia shah, abdul waheed mughal, sherbaz khan, saman tauqir, inayat shah: moderate physical activity ..., 131–144 results a total of one hundred and twenty-six participants of both genders were screened, and out of them forty-eight individuals (36 males and 12 females) with pre-laid criteria were recruited into the study. the main reasons for fewer females in the study is the cultural norm of lesser involvement of females in physical activity programs. the study yielded significant improvement in anthropometric (body mass and bmi) and diabetic parameters (fbs and hba1c), and inflammatory markers (il-6 and tnf-α), pointing towards a very strong role of moderate intensity exercise as an alternative to therapeutics and one of the strongest preventive measures against the development of diabetes. pre-interventional stage the characteristics of all individuals are given in table 1, subdivided by gender for comparing their anthropometric and biochemical parameters. these observations were made at the pre-test stage. a significant difference was observed for age (p = 0.021), height (p < 0.01), and body mass (p = 0.06). females were less muscular (p = 0.03) and exhibited more fat mass (p = 0.04). exercise parameters indicate that at the same intensity males ran at higher speed (p = 0.02) and covered more distance (p = 0.01) at lower heart rate (p = 0.001) during the exercise session, which shows better respiratory fitness in males, as determined by basal oxygen consumption difference bvo2 (p = 0.02). similarly, a trend towards significance was observed for bmi (p = 0.06) and fbs (p = 0.067). at pre-stage levels, hba1c, il6, and tnfα did not show any male to female difference (p = 0.34, 0.8 & 0.9, respectively). inferential statistics further analyses were carried out to assess the effect of a 12-week-long exercise protocol on body composition, substrate metabolism, and inflammatory profile of males and females. this was carried out through a paired sample test and described below: body composition, cardiorespiratory fitness, diabetic and inflammatory profile the analyses revealed a significant reduction in bmi and body mass for both groups. a decrease, although not significant, was observed in body fat percentages of both. the parameters for cardiorespiratory fitness and energy expenditure including basal heart rate (bhr), heart rate during exercise (hr), basal oxygen consumption (bvo2), oxygen consumption during exercise (vo2), and energy expenditure (ee) were determined for both groups. though the changes in the two groups at pre and post levels 136 zubia shah, abdul waheed mughal, sherbaz khan, saman tauqir, inayat shah: moderate physical activity ..., 131–144 annales kinesiologiae • 11 • 2020 • 2 were not significant, as shown in table 2, they do show an improvement in cardiorespiratory fitness and metabolism in both groups. a significant impact of exercise was found on the diabetic (fbs and hba1c) and inflammatory profiles (il6 and tnf-α) for both males and females, as shown in table 2 and figure 1. table 1. characteristics of the participants compared through an independent sample t-test total male female p-value size (n) 48 36 12 age (years) 30.7 ± 7.80 30.5 ± 3.02 31.17 ± 3.7 0.021 height (m) 1.63 ± 0.09 1.65 ± 0.05 1.59 ± 0.3 <0.01 body mass (kg) 75.04 ± 8.24 79.81 ± 6.7 66.8 ± 5.07 0.06 bmi (kg/m2) 26.71 ± 2.07 27.07 ± 1.35 25.61 ± 0.96 0.06 lean mass (kg) 56.6 ± 6.6 65.03 ± 3.2 44.9 ± 1.3 0.03 fat mass (kg) 19.9 ± 4.3 14.27 ± 7.2 21.9 ± 6.8 0.04 resting heart rate 78 ± 5 76 ± 4 81 ± 7 0.30 exercise hr 114 ± 5 111 ± 6 120 ± 4 0.001 fbs (mg/dl) 122 ± 4 123 ± 2 120 ±5 0. 47 hba1c (%) 6.2 ± 0.3 6.08 ± 0. 22 6.2 ± 0.25 0. 34 speed (km/hr) 4.99 ± 0.4 5.3 ± 0.3 4.7 ± 0.3 0.02 distance (km) 2.5 ± 0.8 2.65 ± 0.2 2.35 ± 0.2 0.01 bvo2 (ml/kg/min) 3.9 ± 0.3 4.0 ± 0.2 3.6 ± 0.3 0.02 vo2 (ml/kg/min) 15.98 ± 4.02 17.02 ± 4.3 13.40 ± 2.3 0.004 step count 4211 ± 195 3902 ± 201 4432 ± 174 0.03 il-6 pg/ml 28 ± 4 26 ± 4 29 ±7 0.9 tnf-α pg/ml 24.5 ± 5 24 ± 5 23 ± 6 1.0 the values presented include mean ± sd, body mass index (bmi); fasting blood sugar (fbs), glycated haemoglobin (hba1c), basal oxygen consumption bvo2 (ml/kg/min), and oxygen consumption during exercise (vo2 ). 137 annales kinesiologiae • 11 • 2020 • 2 zubia shah, abdul waheed mughal, sherbaz khan, saman tauqir, inayat shah: moderate physical activity ..., 131–144 table 2. body composition data for males and females at preand post-interventional stages male n = 36 pre post p-value body composition bmi 27.07 ± 1.35 26.6 ± 1.35 <0.001 body mass (kg) 79.81 ± 6.7 78.03 ± 6.8 <0.001 fat % 17.99 ± 2.1 16.34 ±3.2 0.23 cardiorespiratory fitness basal heart rate (bhr) 77 ± 6 75 ± 5 0.6 hear rate during exercise (hr) 111 ± 6 109 ± 6 0.4 basal oxygen consumption (bvo2) 4.0 ± 0.2 3.8 ± 0.4 0.09 oxygen consumption during exercise (vo2) 17.02 ± 4.3 16.02 ± 3.9 0.054 energy expenditure 5.9 ± 1.9 5.2 ± 0.8 0.08 diabetic profile fbs 123 ± 2 114 ± 2 0.02 hba1c 6.08 ± 0. 22 5.78 ± 0. 27 0.001 inflammatory profile il6 26±4 20 ± 6 .017 tnf-α 24 ±5 18 ±6 .018 female n = 12 body composition bmi 25.61 ± 0.96 25.34 ± 0.73 <0.001 body mass (kg) 66.8 ± 5.87 66.08 ± 5.07 <0.001 fat % 32.87 ± 3.4 29.56 ± 4.3 0.64 cardiorespiratory fitness basal heart rate (bhr) 85 ± 3 80 ± 4 0.3 hear rate during exercise (hr) 120 ± 4 116 ± 4 0.23 basal oxygen consump-tion (bvo2) 3.6 ± 0.3 3.5 ± 0.3 0.15 oxygen consumption during exercise (vo2) 13.40 ± 2.3 13.21 ± 3.3 0.6 energy expenditure 4.7 ± 0.5 4.4 ± 0.7 0.34 diabetic profile fbs 120 ±5 95 ±12 .018 hba1c 6.2 ± 0.25 5.87 ± 0.31 .001 inflammatory profile il6 29 ±7 18 ± 6 .048 tnf-α 23 ±6 16 ± 5 .05 bmi: body mass index, fbs: fasting blood sugar, hba1c: glycated haemoglobin, il6: interleukin-6, tnf-α: tumor necrosis factor alpha 138 zubia shah, abdul waheed mughal, sherbaz khan, saman tauqir, inayat shah: moderate physical activity ..., 131–144 annales kinesiologiae • 11 • 2020 • 2 figure 1a: diabetic and inflammatory profiles of male and female participants at pre and post-interventional stages: a) fbs, b) hba1c 139 annales kinesiologiae • 11 • 2020 • 2 zubia shah, abdul waheed mughal, sherbaz khan, saman tauqir, inayat shah: moderate physical activity ..., 131–144 figure 1b: diabetic and inflammatory profiles of male and female participants at pre and post-interventional stages: c) il-6 d) tnf-α 140 zubia shah, abdul waheed mughal, sherbaz khan, saman tauqir, inayat shah: moderate physical activity ..., 131–144 annales kinesiologiae • 11 • 2020 • 2 discussion pathologies related to impaired glucose tolerance (igt) and impaired fasting glucose (ifg) are on the rise, leading to prediabetes and type ii diabetes mellitus (hordern et al., 2012). prevalence of prediabetes is increasing with a projected load of more than 470 million people by the year 2030 across the globe (tabák, herder, rathmann, brunner, & kivimäki, 2012). the beneficial effects of exercise on prediabetes are already established and widely reported; therefore, a minimal recommendation of quantitative and qualitative physical activity has been suggested by who to counter prediabetes and prevent development of full-blown diabetes. however, the exact mechanisms of beneficial effects are poorly known. to date, the pharmaceutical approaches for the prevention of prediabetes have not been evaluated. therefore, the desirable approaches for the prevention of prediabetes are lifestyle modification, exercise intervention, body mass reduction, and different physical activities (grundy, 2012). as diabetes is associated with disturbance in the inflammatory status of the body and prediabetes precedes diabetes, it is more likely that the changes in inflammatory status start before the onset of full-blown diabetes. therefore, this study was designed to investigate effects of incorporating enhanced physical activities of a more structured and rigorous nature than ordinary daily routines. in more specific terms, the effects of exercise at intensity between 55% and 65 % of the pmhr was used as an intervention for change in inflammatory cytokines (il-6 and tnf-α) in prediabetic males and females, with the aim that programmed exercise might influence the il-6 and tnf-α. moreover, it was also aimed at determining whether gender and variations in physical characteristic might be differently influenced. from the findings, it is alarming to mention that out of 126 participants screened for the study based on their phenotypic appearance (age more than 25 years, overweight with central obesity, inactive and sedentary life style), 48 were found to be prediabetic which makes around 38% of the screened population. it is arguable that the majority of the selected participants were based on some observer bias, for example approaching those participant for screening which looked overweight in appearance. however, it still points towards a massive disease burden in the local community. the recruited younger prediabetic population had elevated concentrations of tnf-α and il-6 and at the baseline as shown in table 1. these findings are similar to andonian et al., (2018), who reported an association of the serum il-6 levels with the body composition, which was reported to be greater in prediabetics (andonian et al., 2018). in addition, this study also reported a high concentration of il-6 in males and a low concentration of tnf-α in female participants pointing towards gender based differences. though these differences were not significant, similar cytokine profiles in the prediabetic population with gender disparity have been reported previously (lucas et al., 2013). moreover, serum tnf-α levels decreased significantly after the advised exercise protocol, as shown in table 2 and figure 1. these findings are in line with the findings of starkie, ostrowski, jauffred, febbraio, & pedersen (2003), who suggested that inhibition of tnf-α production in healthy human subjects is affected by physical exercise 141 annales kinesiologiae • 11 • 2020 • 2 zubia shah, abdul waheed mughal, sherbaz khan, saman tauqir, inayat shah: moderate physical activity ..., 131–144 of different intensities (starkie et al., 2003). similarly, keller, keller, giralt, hidalgo, & pederson, (2004) proposed that high tnf-α inhibits insulin receptor, signaling that leads to insulin resistance. they examined the effects of 60 minutes of exercise on overexpressed tnf-α in mice and suggested that the expression decreases after a single bout of exercise (keller et al., 2004; gleeson, 2000). the current study showed that a significant decrease in exercise induced il-6 production. these findings are in line with the findings of pederson & fischer, (2007), who proposed that the tnf-α production is increased in low-grade inflammatory conditions like t2dm and that raised il-6 inhibits the tnf-α induced insulin resistance (pederson & fischer, 2007). olson, dengel, leon, & schimtz, (2007) conducted a study including 28 female participants (with the bmi ≥ 25 kg/m2) and studied different serum markers before and after 1 year of resistance training. they reported that moderate intensity resistance training results in significant improvement of the inflammatory markers creactive protein (crp) and interleukin-6 (il-6) (olson et al., 2007). the increase in some inflammatory markers, such as il-6, also stimulates fat oxidation and lipolysis. exercise provides one of the best tools to expose the body to challenges through increased production of some of the inflammatory markers acutely and then conditioning the body to clear it (peterson & pedersen, 2005). in addition, an improvement in the body composition (body mass, bmi) (p < 0.01 for all) in the prediabetics was observed. from the findings, it is obvious that all participants were overweight at the start due to selection bias. however, similar findings related to greater muscle myostatin, cytokines, and the body composition have been reported elsewhere (andonian et al., 2018). the reductions in body mass parameters are generally perceived as one of the good indicators of any intervention and that was the reason why no drop-out was observed in the study population. similarly, this study reported a significant reduction in hba1c levels (6.2 ± 0.25 to 5.87 ± 0.31 p < 0.001) after exercise training. bweir et al. (2009) recruited 20 inactive diabetic patients and assigned them resistance exercise for 10 weeks, reporting a significant reduction in hba1c levels (bweir et al., 2009). in another study, najafipour et al. conducted a training program on diabetic patients including three 90-minute sessions of exercise per week, at 50%–80% vo2 max, and reported significant improvement in bmi, hba1c, and vo2 max values (p <0.05 for all) (najafipour et al., 2017). vo2 max shows respiratory fitness, and the findings of this study support the already existing literature. though the findings of cardiorespiratory fitness in our cohort were not significant, all the parameters exhibited improvement, as shown in table 2. it can be ascertained that exercise protocols designed at higher intensities may improve cardiorespiratory fitness significantly. participants in our study were sedentary and involving them in high intensity intervention could have created health hazards. it is necessary to note that although the 3-month exercise protocol months did not change the status of the individual from prediabetic to normal, a decrease in diabetic and inflammatory parameters were observed for males and females. therefore, based on the findings of this study it can be assumed that incorporation of this protocol into a 142 zubia shah, abdul waheed mughal, sherbaz khan, saman tauqir, inayat shah: moderate physical activity ..., 131–144 annales kinesiologiae • 11 • 2020 • 2 patient’s lifestyle for longer duration (6 months) may change their prediabetic status to normal. this, however, warrants another study for longer duration. the physical activity guidelines issued by the united states department of health and human services suggest that patients with diabetes should engage in 2.5 hours of physical activity per week and if there are no contraindications they must be encouraged to perform resistance training 3 times per week. there are different studies suggesting that t2dm develops in individuals who are inactive (earnest, 2008; malin, 2012). exercise training, along with lifestyle changes, has favorable effects on averting the onset of prediabetes. it is generally recommended that prediabetic patients should perform moderate intensity exercise for a minimum of 210 minutes per week (hordern et al., 2012). various exercise guidelines by different organizations have recommended that exercise be performed at different intensities based on maximal capacity and little is known regarding the optimal intensities of exercise (earnest, 2008). the general perception is that incorporation of moderate intensity exercise may pose a great challenge to the investigator and the participants. however, it was not the case here and exercise was incorporated as an effective alternative to the life style of all the participants in the study with little motivation and counselling. systemic low-grade chronic inflammation is linked with t2dm, which can lead to the development of various complications. exercise training can improve inflammation biomarkers and reduce the risk of such complications in these subjects (hopps et al., 2011). chronic inflammation-based health problems can be effectively prevented with regular exercise. long-term regular exercise encourages the coping mechanisms in the body to counteract the acute production of inflammatory markers. in this fashion the body becomes more conditioned and effectively counteracts the raised inflammatory markers. it is worth mentioning that such physical activities are easy to incorporate with little motivation and dedication. conclusion significant reduction in inflammatory cytokines (il-6 and tnf-α) was observed after regular 45-minute exercise at 55% to 65% of pmhr training performed for 3 months, which suggests possible preventive effects of exercise on chronic inflammation-based health problems such as diabetes. exercise is a natural way to cope with low-grade anti-inflammatory conditions, has very few side effects and can easily be incorporated into the prediabetic patient’s lifestyle (pederson, 2017). future directions the disease burden of prediabetes is enormous in our area and a strong awareness campaign about the prevention of prediabetes is required. masses with diagnosed prehttps://www.sciencedirect.com/topics/medicine-and-dentistry/type-2-diabetes 143 annales kinesiologiae • 11 • 2020 • 2 zubia shah, abdul waheed mughal, sherbaz khan, saman tauqir, inayat shah: moderate physical activity ..., 131–144 diabetes or at risk should consider adopting an active life style and engaging in physical activities to prevent the development of full-blown type ii diabetes. limitations of the study the current study has some limitations. we did not recruit a control group of healthy patients to compare with our values. moreover, we did not advise vigorous intensity exercise to the participants to look for the effects on il-6 and tnf-α. there were more male than female participants in the study; 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(2012). prediabetes: a high-risk state for diabetes development. the lancet, 379(9833), 2279-2290. https://doi.org/10.1016/s0140-6736(12)60283-9. https://doi.org/10.1016/j.jsams.2011.04.005 https://doi.org/10.1016/j.bbrc.2004.06.129 https://doi.org/10.1016/j.cyto.2013.05.025 https://doi.org/10.1016/j.cyto.2013.05.025 https://doi.org/10.2337/dc11-0925 https://doi.org/10.1136/bmjdrc-2017-000414 https://doi.org/10.1038/sj.ijo.0803534 https://doi.org/10.1111/eci.12781 https://doi.org/10.1111/eci.12781 https://doi.org/10.1016/j.tips.2007.02.002 https://doi.org/10.1016/j.tips.2007.02.002 https://doi.org/10.1152/japplphysiol.00164.2004 https://doi.org/10.1152/japplphysiol.00164.2004 https://doi.org/10.1096/fj.02-0670fje https://doi.org/10.1530/eje.0.1450273 https://doi.org/10.1016/s0140-6736(12)60283-9 _goback _hlk40898474 _hlk34144101 _hlk40871331 _hlk53505499 _hlk33786872 _hlk25864445 _hlk38187602 _hlk71096081 annales kinesiologiae • 12 • 2021 • 1 43 review article doi: https://doi.org/10.35469/ak.2021.320 received: 2022-01-25 udc: 796.926:616-001 physical therapy recommendations for injury prevention in alpine skiing friderika kresal1, špela bračun1, laura tönig1, mojca amon1 1institution for higher education for physiotherapy fizioterapevtika, ljubljana, slovenia corresponding author: mojca amon, institution for higher education for physiotherapy fizioterapevtika, slovenska cesta 58, 1000 ljubljana phone: +386 31 60 84 12 e-mail: amon.mojca@gmail.com abstract introduction: alpine skiers face high speeds, significant forces, natural and unnatural obstacles, and various environmental conditions on the slopes. thus, they are highly exposed to certain injuries, amongst which the most common are those to the knee followed by injuries to the spine, shins, head, as well as arm and thumb injuries. purpose: the purpose was to systematically review the scientific literature on injuries, risk factors, and prevention in competitive alpine skiing and to provide recommendations for injury prevention in the field of physical preparation, kinesiotherapy, and/or specific exercises, and to determine which exercise program would be most appropriate for an alpine ski racer. methods: pubmed, web of science, and cobiss databases were used with prisma method to review the physical therapy recommendations for injury prevention in alpine skiing. results: 10 studies were included in the final systematic review. we have not found any evidence-based prevention programs that are not older than 10 years on the topic of physical preparation for alpine ski racers. we found that most often, the literature describes prevention in terms of equipment, course preparation, course safety awareness, and the experience of the skier. conclusions: the recommendation for the most efficient prevention according to the current literature is to follow the above preventive measures in combination with 44 friderika kresal, špela bračun, laura tönig, mojca amon: physical therapy recommendations for injury prevention ..., 43–55 annales kinesiologiae • 12 • 2021 • 1 appropriate physical preparation, where we recommend relying on research evidence in other (non-contact) sports that have similar injury mechanisms as alpine ski racing. keywords: sports medicine, injury prevention, physiotherapy, alpine skiing fizioterapevtska priporočila za preprečitev poškodb pri alpskem smučanju izvleček uvod: smučarji se na progah soočajo z visokimi hitrostmi, velikimi silami in različnimi okoljskimi pogoji. posledično so izpostavljeni določenim poškodbam, med katerimi so najpogostejše poškodbe kolena; sledijo poškodbe hrbtenice, golenice, glave in poškodbe roke ter palca. cilji: namen je bil sistematično pregledati znanstveno literaturo na temo poškodb, dejavnikov tveganja in preventive pri tekmovalnem alpskem smučanju in podati preventivna priporočila pred nastankom poškodb na področju telesne priprave, kinezioterapije in/ali specifičnih vaj ter ugotoviti, kakšen program vaj bi bil najprimernejši za preventivo pred specifično poškodbo alpskega smučarja tekmovalca. ugotavljamo pomanjkanje preventivnih programov za izboljšanje telesne pripravljenosti smučarjev saj prevladujejo izsledki o preventivi z vidika smučarske opreme, priprave proge, ozaveščenosti o varnosti na progi in izkušenj smučarja. zaključek: priporočila za najučinkovitejšo preventivo glede na trenutno literaturo so upoštevanje zgoraj omenjenih napotkov v kombinaciji z ustrezno telesno pripravo, pri kateri priporočamo opiranje na dokaze raziskav v drugih (nekontaktnih) športih, ki imajo podobne mehanizme poškodb kot alpski smučarji tekmovalci. ključne besede: športna medicina, preprečevanje poškodb, fizioterapija, alpsko smučanje annales kinesiologiae • 12 • 2021 • 1 45 friderika kresal, špela bračun, laura tönig, mojca amon: physical therapy recommendations for injury prevention ..., 43–55 introduction alpine skiing as an activity was not popular before the 18th century. it took another 100 years for it to establish itself as a sport (pfister, 2001). today, skiing and snowboarding are among the most popular winter sports in the world and the organisation of alpine skiing competition is at the highest level (schoenhuber, panzeri, & porcelli, 2018). injury trends have been increasing in recent years, and the current incidence suggests that as many as one in three elite skiers may be injured in a single season (tarka et al., 2019). almost half of all injuries require the skier to be absent from training and competition for more than a month (ostrc, 2019). as in any sport, prevention programs play an important role, preparing the skier physically to reduce the risk of injury. the team of physiotherapists and other health professionals is crucial for the physical preparation of a top alpine skier, and needs to take into account the specificities of each individual and the mechanisms of injury specific to skiing (spörri, kröll, gilgien, & müller, 2017). in addition to good physical fitness, suitable and safe ski equipment, properly prepared slopes, knowledge and experience, awareness of the skier and, above all, good psychological preparation are important for the prevention of alpine skiing injuries. in 2006, the international ski federation (fis), in cooperation with the oslo sports trauma research centre (ostrc), developed the injury surveillance system (iss) to monitor injuries in different skiing disciplines and collect data for more detailed research into the causes of these injuries. the primary aim of the organization is to reduce injuries among skiers, and to propose preventive measures that have not yet been tested in clinical practice (ostrc, 2019). skiing injuries in the world cup, the highest level of competition, the incidence of injuries ranges from 23% to 37% in a single season. almost half of all injuries occur during competition, despite the majority of runs being taken during training (tarka et al., 2019). according to the oslo sports trauma research centre (ostrc) (2019), a total of 1083 injuries were recorded in the alpine skiing world cup seasons between 2006 and 2019 among the 3329 competitors interviewed. as many as 40% of the injuries were those that required the competitor to be absent from training and competition for at least 28 days. the most common type of injury was a joint or ligament injury, followed by bone fracture, muscle or tendon injury, concussion, bumps and contusions, skin injury, and various others. injuries to the knee accounted for the largest proportion of body part injured (41.3%), followed by injuries to the hand, finger and thumb (9.7%), and injuries to the head or face (9.4%) (ostrc, 2019). in their study tarka et al. (2019) also cite the knee as the most commonly injured part of adult competitive skiers, followed by back and tibia injury, then head and upper limb injury. in younger skiers, the knee is also the most common place of injury, followed by the upper limb, spine and lower limb injuries. anterior cruciate ligament (acl) injury is cited as the most common 46 friderika kresal, špela bračun, laura tönig, mojca amon: physical therapy recommendations for injury prevention ..., 43–55 annales kinesiologiae • 12 • 2021 • 1 specific diagnosis in both adult and younger skiers. this is followed by a concussion and tibia fracture. most injuries occur in downhill, followed by supergiant slalom (sg), then giant slalom (gs), and the fewest injuries occur in slalom. in the world cup, knee injuries, the most common, account for 37.7% of injuries. there are at least 5 times as many injuries in the world cup as there are in the european cup. there are almost 7 times more knee joint injuries in the world cup compared to the european cup (ostrc, 2019). methods this article is based on a literature review. data were extracted from slovenian and other sources (pubmed, web of science, and cobiss databases) throughout the world during the period from march 14, 2020 to july 30, 2020. the inclusion criteria for the peer-reviewed literature included ski injury and/or prevention, slovenian or english language, and research that is less than 10 years old. the following keywords were used: alpine skiing, ski injuries, prevention of ski injuries, prevention program, risk factors in alpine skiing. the exclusion criteria were prevention measures that applied to other sports and did not include recommendations aimed at preventing injuries in alpine skiers. we also excluded studies where the full text was not available, studies with fewer than 15 subjects or where subjects withdrew from the study for various reasons, and studies with no conclusion. we reviewed the research summaries, narrowed the selection using inclusion and exclusion criteria, and critically analyzed the selected literature. results the search for the keywords listed above returned 102 hits, and an additional search yielded one additional hit. by screening the titles we first eliminated duplicates and then excluded studies older than 10 years (only keeping those from the 2011‒2021 period). forty-three studies remained, from which we additionally excluded studies not related to sports injuries and/or alpine skiing by reviewing abstracts thus ultimately arriving at 16 studies for full-text review. after the content review, we excluded 6 studies that did not relate to injury prevention. 10 relevant studies were thoroughly analyzed with conclusions described in the discussion. the systematic review process is presented in figure 1. the characteristics of the included studies are shown in figure 1. annales kinesiologiae • 12 • 2021 • 1 47 friderika kresal, špela bračun, laura tönig, mojca amon: physical therapy recommendations for injury prevention ..., 43–55 figure 1.: the characteristics of the included studies (prisma flow diagram). 48 friderika kresal, špela bračun, laura tönig, mojca amon: physical therapy recommendations for injury prevention ..., 43–55 annales kinesiologiae • 12 • 2021 • 1 discussion the incidence of sports injuries, especially in team sports, can generally be reduced through fitness training and prevention programs. on this basis, we hypothesized that there are evidence-based prevention interventions based on pre-injury fitness level in alpine ski racers and derived prevention programs that could be incorporated into the training process of competitive skiers. spörri et al. (2017) in their literature review presented injury prevention for elite alpine skiers through a four-stage model, according to the epidemiology and aetiology of the injury. based on these, they formulated an idea for preventive measures, followed by a test of the effectiveness of the preventive measure or program. they found that the risk factors directly associated with injury were insufficient lower trunk stabilization, gender, skiing difficulty, genetic predisposition and the combination of longer, narrower skis with a smaller radius. otherwise, the review did not provide any specific recommendations related to physical fitness, exercise program, training or kinesiotherapy as parts of an injury prevention program. of all the studies included, this was the only one that linked skiing injury to the strength of insufficient trunk stabilization and not only to equipment, skills and behavior on the slopes. in contrast, audet et al. (2019) described risk factors for injury in skiers in terrain parks, where injuries to skiers and snowboarders occur mainly due to factors such as the level of difficulty of the skiing, listening to music during the sport, previous injury, temperatures between ‒10°c and 0°c, night skiing and snowboarding, and performing more demanding maneuvers. both studies found that risk factors differed according to the type of skiing but were consistent with the level of difficulty of the skiing, i.e., a higher level of difficulty was associated with a higher risk of injury in terrain park skiing or a competition slope. hébert-losier and holmberg (2013) traced more than 80 methods for preventing musculoskeletal injuries and divided them into five groups equipment, education and knowledge, caution and behavior, experience, and other factors. they found that most of the recommendations related to ski equipment or other factors, while none related to physical fitness, exercise, or training. they also highlighted the problem of this under-researched area. audet et al. (2019) found that skiing and snowboarding carry a high risk of head, neck and back injury. cusimano and kwok (2010) found a 15% to 60% reduction in head injuries and a drastic reduction in concussions owing to helmet use. however, they did not associate helmet use with a reduction in the neck or cervical spine injuries. also, bailly et al. (2017) later found that the majority of injured skiers did not use a helmet. in more than half of the cases, the mechanism of injury was a fall. this was followed by, in order of frequency, collision with another skier, a jump, and collision with an obstacle, which also caused serious concussions. sulheim, ekeland, holme, & bahr (2017) found that despite increased helmet use among skiers and boarders, the incidence of head injuries decreased by only 2.2 per cent. they suggest as a possible reason for this the dramatic change in alpine skiing over the last decade due to new, faster and thus more dangerous ski designs, and unsafe slope layout in ski parks. according to the findings of cusimano, luong, faress, leroux, & russell (2013), it could be suggested that the use annales kinesiologiae • 12 • 2021 • 1 49 friderika kresal, špela bračun, laura tönig, mojca amon: physical therapy recommendations for injury prevention ..., 43–55 of a video with instructions and recommendations for safe skiing on the slopes could contribute to safety. contrary to sulheim et al. (2017), haaland, steenstrup, bere, bahr, and nordsletten (2016), who studied the effects of newly introduced rules in skiing and ski equipment on the severity and type of injuries, found that the number of injuries per 100 skiers in a season decreased from 36 to 27 in the period after the new rules were introduced. upper limb injuries decreased for women, while upper and lower limb injuries decreased for men. the most important contributor to the reduction in injuries was the introduction of the rule to combine longer and narrower skis with a smaller radius. ruedl et al. (2011) found that injury onset was independent of average skiing time before the injury, and that injured men were taller, heavier, and skied at higher levels than uninjured men. the main conclusion of this study was that there are no significant gender differences in the mechanisms of anterior cruciate ligament (acl) injury. after a systematic review, we conclude that the best-researched areas for injury prevention are equipment, education (awareness rising) and knowledge, as well as caution and behavior on the ski slope. the results of our systematic review indicate a lack of evidence and, in particular, a lack of research into physical fitness as injury prevention for alpine skiers, as well as a lack of research on prevention programs. the topic of physical fitness as injury prevention for competitive alpine skiers has been poorly researched and even somewhat forgotten (overlooked), as we have not seen any research addressing this type of prevention in alpine skiing in the last two years. based on a systematic review, we found that there are evidence-based injury prevention measures for alpine ski racers that relate to equipment, skills, and experience in critical or unpredictable situations on the ski slope. in this respect, reference can also be made to hébert-losier and holmberg (2013), who found that preventive measures related to equipment dominate instead of prevention in the form of physical training. more than half of the included studies concerned the choice and use of ski helmets. the importance of the role of equipment in injury prevention in alpine skiers is particularly clear when viewed from a sports biomechanics perspective. with the development of alpine skiing, athletes are exposed to greater forces and reaching higher speeds, which require increasing improvement and modernization, even in adapted equipment. with the advancement of technology and materials, there is more sophisticated, aggressive and higher quality ski equipment on the market. the advertising of extremely highquality equipment can be deceptive, leading the recreational skier to exceed his/her technical abilities and consequently putting him/her at a greater risk of injury. in addition to the use of protective equipment, dealing with critical situations on the slopes, attending ski courses and training, developing skiing skills and experience in order to be able to react more appropriately to unpredictable events play a major role in prevention. given the underresearched area, there is still the possibility that well-designed research focused on the question presented could also lead to important conclusions in the intended direction. in this respect, we hope to build on the research of spörri et al. (2017), which highlights, among other things, the insufficient strength of trunk stabilization and genetic predisposition as risk factors for injury. however, we could also refer in part to the research of langran and selvaraj (2002) and mckenna and hammond 50 friderika kresal, špela bračun, laura tönig, mojca amon: physical therapy recommendations for injury prevention ..., 43–55 annales kinesiologiae • 12 • 2021 • 1 (2007) on an individual‘s level of fitness, which found that skiing (and snowboarding) ability, skill level, and experience are important for injury prevention. furthermore, hébert-losier and holmberg (2013) focused their study on the mechanism of injury to the acl. in most cases, it is a backward or forward fall combined with the rotation of the tibia on the femur. as early as 1995, studies by ettlinger, johnson, and shealy had developed a method of interactive training which included a video, an instructor, and group and individual training dedicated to backward falls in combination with the rotational mechanism, and the link between the mechanism and the knee injury. the effectiveness of this method was successfully demonstrated, with a 62% reduction in the number of serious knee injuries. three years later, jørgensen, fredensborg, haraszuk, and crone (1998) showed that the number of injuries was reduced by 30% in crosscountry skiers who watched a ski instruction video. a study by cusimano et al. (2013), however, did not show that watching a safety instruction video reduced the number of injuries. still, it did show that skiers were more aware of safety on the slopes, highlighting another very important preventive measure. the research by ettlinger et al. (1995), langran and selvaraj (2002), mckenna and hammond (2007) show that the central role in prevention is not only occupied by equipment, but also by strategies related to other domains, which may include, in part, specific exercises and physical training programs. in 1987, morrissey, seto, brewster, and kerlan proposed a series of specific movements, stretches and cardiovascular training to reduce the risk of many musculoskeletal injuries in alpine skiers. their proposals are based on the physiological and biomechanical forces experienced by alpine skiers during skiing. for example, knee flexion and extension against resistance, internal rotation of the tibia, stretching of the posterior thigh and calf muscles have been suggested as exercises to prevent knee joint injuries. these exercises are still useful in practice today, even though the nature of alpine skiing has changed considerably since 1987, especially in terms of speed, forces, slopes, conditions, and equipment. for this reason, modern recommendations on training are adapted to the new developments in field, according to koehle, lloydsmith, and taunton (2002). this can be seen when comparing the shape and length of skis. in the 1980s, skis with a side bow were not used. at that time, the most common mechanism of injury to the acl was a backward fall with knee rotation (natri, beynnon, ettlinger, johnson, & shealy, 1999; beynnon, ettlinger, & johnson, 2007). however, as the use of carving skis became more widespread, and forward fall with rotation became the most common mechanism for acl injury (ruedl et al., 2009; ruedl et al., 2011). with advances in skiing, equipment, and technology, understanding of human physiology and its response to sport and exercise has also evolved. in parallel, exercise methodology and concepts have evolved. over the last two decades, deep trunk stabilization exercises have become a predominant component of training programs for a wide variety of sports. according to mcgill (2010), the effective activation of the transversus abdominis, the paraspinal muscles, and the pelvic floor muscles is considered to be the key component for effective sports performance and injury prevention. in addition, neuromuscular activation training has also been identified as effective in preventing knee joint injuries in non-contact sports (hewett, lindenfeld, riccobene, & annales kinesiologiae • 12 • 2021 • 1 51 friderika kresal, špela bračun, laura tönig, mojca amon: physical therapy recommendations for injury prevention ..., 43–55 noyes, 1999; sugimoto et al., 2012a). the inclusion of a physiotherapeutic program of exercises for the neuromuscular junction is recommended for recreational alpine skiers, particularly in this direction, as different forces and variations have different effects on the recruitment patterns of the quadriceps femoris muscle (kröll, wakeling, seifert, & mueller, 2010; kröll, müller, seifert, & wakeling, 2011). musculoskeletal training and deep trunk stabilization training are included in most preventive kinesiotherapy programs for different types of injuries (wilk, macrina, cain, dugas, & andrews, 2012). in addition to strength, flexibility is also important to reduce the risk of injury. a prevention program should also include stretching. stretching has the effect of lengthening muscles and reducing muscle tension, resulting in corrected pelvic and spinal positioning, which reduces lumbar back pain (coburn & malek, 2012). however, mobility has not always been one of the most important components of lumbar prevention programs. in 1984, biering-sørensen found that lumbar mobility can also worsen current lumbar conditions or pain. hewett, ford, hoogenboom, & myer (2010) found that prevention programs that include strength training have the greatest effect on reducing the number of acl injuries. sugimoto, myer, mckeon, & hewett (2012b) demonstrate a lower risk of developing an acl injury if the athlete adheres to a prevention program more than 66% of the time. in theory, the simultaneous development of the biomechanics of sport and the understanding of human physiology should be used in favor of designing specific exercises aimed at injury prevention. this would require updating programs developed more than 30 years ago by scientists such as morrissey et al. (1987) and defining new recommendations for recreational and competitive alpine skiers. for example, in 2010, kiani, hellquist, ahlqvist, gedeborg, & byberg investigated the effectiveness of an injury prevention program for female football players aged between thirteen and nineteen years, that included motor skills, control and activation training. the result showed a 77% reduction in the incidence of knee injuries in the group that underwent the injury prevention training program compared to a control group that did not undergo the same training program. even if the percentage reduction in incidence in alpine skiers using a similar program would be much lower, it would have the potential to significantly reduce the health system costs and morbidity associated with participation in winter sports. boden and prior (2005), however, attribute a different role on the slopes to fatigue, which can lead to serious injuries and even fatalities; and the effects of endurance training on injury prevention in alpine skiers should also be investigated. for example, in recreational skiers, a significant decrease in glycogen stores and an increase in blood lactate could lead to negative effects such as fatigue, inflammatory processes, and reduced neuromuscular function leading to injury (boden & prior, 2005). endurance training can be used to better utilize glycogen stores, reduce lactate production and increase circulating anti-inflammatory cytokines at a given intensity (walsh et al., 2011). in addition to neuromuscular training, trunk stabilization training and endurance training, plyometric training, which focuses on correct joint performance and mechanics, is also mentioned in the literature (pfeiffer, shea, roberts, grandstrand, & bond, 2006). a preventive exercise program that includes several different correctly dosed and graded training components is more 52 friderika kresal, špela bračun, laura tönig, mojca amon: physical therapy recommendations for injury prevention ..., 43–55 annales kinesiologiae • 12 • 2021 • 1 effective than a program that includes only one training component, such as strength or stabilization training alone (grimm, jacobs jr, kim, denney, & shea, 2014; sugimoto, myer, foss, & hewett, 2014). our literature review revealed that the area of prevention in terms of fitness and as a risk factor for injury in alpine skiing is poorly/under researched. many studies have been written on the mechanisms of injury, which, although providing a good starting point for the design of prevention programs, did not follow through in this vein, nor could we find any that did. among recommendations for injury prevention in alpine skiing prevails the use of appropriate ski equipment. although sports medicine experts encourage prevention programs that include sport-specific exercises, none of the studies reviewed put forward specific recommendations that could be highlighted. the incidence of injuries in competitive alpine skiing estimated by tarka et al. (2019) is extremely high. in competitive alpine skiing in addition to a head coach, assistant coaches and a fitness coach, a well-structured team of medical professionals is essential to provide athletes with injury prevention and treatment before, during and after the season. this team consists of a physiotherapist, an orthopaedic specialist or traumatologist, a psychologist, a sports nutritionist, a kinesiologist, and others, among whom close professional collaboration is highly desirable. the role of the physiotherapist, which is essential at this level, is to provide high-quality physiotherapy treatments and knowledge-based rehabilitation at the onset of injury and to provide preventive kinesiotherapy measures. in sports practice, prevention is most often carried out through individually tailored pre-injury prevention programs, based on training to improve fitness levels, which athletes can incorporate into their training process. conclusions conclusions can be drawn regarding preventive measures and recommendations, including the use of appropriate ski equipment especially suitable helmets, skill and experience in critical or unpredictable situations on the ski slope, and the use of evidence-based preventive training programs from other non-contact sports with similar injury mechanisms. at the same time, we can highlight an area that we have identified as problematic, but for which there exist no evidence-based solutions yet. we would like to encourage researchers to conduct research into risk factors and injury prevention measures in alpine skiing, focusing on the two factors already mentioned (trunk stabilization and genetic predisposition) and definitively confirm or reject them. otherwise, they should be guided by the desire to determine findings that would serve to design prevention programs for the most common injuries to alpine ski racers. as the area of causes and mechanisms of injury is more researched than the area of prevention, the latter should be a prerequisite for more extensive research. further research should investigate the role and effects of targeted prescribed exercises to improve fitness that would reduce the incidence and complexity of musculoskeletal injuries. research to demonstrate the effectiveness of prevention programs at the highest level of skiing is annales kinesiologiae • 12 • 2021 • 1 53 friderika kresal, špela bračun, laura tönig, mojca amon: physical therapy recommendations for injury prevention ..., 43–55 complex, requiring a large number of subjects, and accurate recording and analysis of data, as well as accurate identification and consideration of other factors that may influence the occurrence of injuries, regardless of an athlete‘s fitness level. the findings are relevant to alpine skiers, physiotherapists, other health professionals, coaches and anyone else involved in the competition or preparation of alpine skiers. references audet, o., hagel, b. e., nettel-aguirre, a., mitra, t., emery, c. a., macpherson, a., ... & goulet, c. 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(2012). recent advances in the rehabilitation of anterior cruciate ligament injuries. journal of orthopaedic & sports physical therapy, 42(3), 153-171. https://doi.org/10.2519/jospt.2012.3741. https://doi.org/10.1007/s00167-009-0860-7 https://doi.org/10.1055/s-0031-1279719 https://doi.org/10.1007/978-3-319-61355-0 https://doi.org/10.1007/s40279-016-0601-2 https://doi.org/10.4085/1062-6050-47.6.10 https://doi.org/10.1136/bjsports-2011-090895 https://doi.org/10.1136/bjsports-2011-090895 https://doi.org/10.1007/s40279-013-0135-9 https://doi.org/10.1007/s40279-013-0135-9 https://doi.org/10.1136/bjsports-2015-095798 https://doi.org/10.1177/1941738119825842 https://doi.org/10.1177/1941738119825842 http://eir-isei.de/2011/eir_17_2011.pdf#page=4 https://doi.org/10.2519/jospt.2012.3741 _goback _hlk98923763 _hlk98755967 _hlk79606686 _hlk99786836 _hlk98147084 _hlk99787368 _hlk88552317 _hlk17057094 annales kinesiologiae • 13 • 2022 • 1 23 original scientific article doi: https://doi.org/10.35469/ak.2022.308 received: 2021-11-30 udc: 613.25-053.2-056.34: 616-036.21 body mass index changes in children and adolescents with intelectual disability during the covid-19 pandemic nika šuc1, blaž lešnik2 1 center janez levec ljubljana, slovenia 2 faculty of sport, university of ljubljana, slovenia corresponding author: nika šuc center janez levec ljubljana, karlovška 18, 1000 ljubljana, slovenia tel.: +386 41 805 033 e-mail: nika_suc@yahoo.com abstract introduction: intellectual disability (id) is a generalized neurodevelopmental disorder characterized by significantly impaired intellectual and adaptive functioning. body mass index (bmi) is a value derived from the mass (weight) and height of a person. due to the covid-19 pandemic, there was a lockdown of all schools and other daily sport activities. methods: we measured the height and weight of 100 children and adolescents with intellectual disabilities. the measurements were taken in september 2020 and then six months later, in march 2021. the calculated bmi was transformed into ageand sex-standardized values (zbmi). mean bmi and zbmi were compared over time and between sexes using a paired t-test and two-way mixed analysis of variance (anova). the effect size was estimated using cohen’s d. results: on average across all groups, bmi increased by 0.5kg/m2 in the studied period. the increase in mean bmi was statistically significant for both groups of girls; the difference between girls and boys in bmi increase was marginally statistically significant. the analysis of zbmi confirmed that the observed changes were likely not simply a consequence of maturation. discussion: one effect of the covid-19 pandemic and restrictions related to it was the increase in bmi values in children and youth. with our results, we can relate this data also to the population with id. although we have provided intervention programs and encouraged pupils and their parents to be more physically active during lockdown, mailto:nika_suc@yahoo.com 24 nika šuc, blaž lešnik: body mass index changes in children and adolescents with intelectual disability ..., 23–33 annales kinesiologiae • 13 • 2022 • 1 the importance of school and after-school activities regarding physical fitness status is clearly evident. keywords: body mass index, youth with intellectual disability, covid-19 pandemic indeks telesne mase pri otrocih in mladostnikih z motnjo v duševnem razvoju med epidemijo covida-19 izvleček uvod: motnja v duševnem razvoju je motnja, za katero je značilna pomembna omejitev tako intelektualnega delovanja kot prilagojenega vedenja, ki se kaže v pojmovnih, socialnih in praktičnih spretnostih prilagajanja. indeks telesne mase (itm) je antropološka mera, ki je definirana kot telesna masa v kilogramih, deljena s kvadratom telesne višine v metrih. v času pandemije covid-19 je bilo uvedeno popolno zaprtje šol in ostalih dnevnih prostočasnih aktivnosti. metode: septembra 2020 in ponovno marca 2021 smo izmerili maso in višino 100 mladostnikov z motnjo v duševnem razvoju,. izračunane vrednosti itm smo pretvorili v standardizirane (zitm) glede na starost in spol. za primerjavo povprečja itm in zitm med skupinami in skozi čas, smo uporabili test t in analizo variance, velikost učinka pa smo ocenili s cohenovim d. rezultati: v povprečju se je itm zvišal za 0,5 kg/m2. povečanje itm je bilo statistično značilno pri obeh skupinah deklet; razlika med deklicami in dečki v povečanju povprečnega itm je bila mejno statistično značilna. analiza zitm je pokazala, da opažene spremembe po vsej verjetnosti niso bile zgolj posledica telesnega razvoja. razprava: ena izmed posledic pandemije in restrikcij povezanih z njo, je tudi zvišanje itm pri otrocih in mladostnikih. z našimi rezultati lahko pokažemo, da se je itm zvišal tudi pri osebah z motnjami v duševnem razvoju. kljub interventnim programom med zaprtjem šol in spodbujanju učencev in staršev k večji aktivnosti, lahko vidimo kako pomembne so šolske in obšolske dejavnosti za razvoj in ohranjanje normalne telesne teže. ključne besede: indeks telesne mase, mladostniki z motnjo v duševnem razvoju, pandemija covid-19 annales kinesiologiae • 13 • 2022 • 1 25 nika šuc, blaž lešnik: body mass index changes in children and adolescents with intelectual disability ..., 23–33 introduction intellectual disability affects about 1% of the population, and of those about 85% have mild intellectual disability (schalock, luckasson, & tasse, 2021). males are more likely to be diagnosed with intellectual disabilities than females. intellectual disability is identified by problems in both intellectual and adaptive functioning (schaepper, hauser, & kagadkar 2021). a full-scale iq score of around 70 to 75 indicates a significant limitation in intellectual functioning. however, the iq score must be interpreted in the context of the person’s difficulties regarding general mental abilities. three areas of adaptive functioning are considered: conceptual – language, reading, writing, math, reasoning, knowledge, and memory; social – empathy, social judgment, communication skills, the ability to follow rules and the ability to make and keep friendships; practical – independence in areas such as personal care, job responsibilities, managing money, recreation, and organizing school and work tasks (golubović, maksimović, golubović, & glumbić, 2012). adaptive functioning is assessed through standardized measures with the individual and interviews with others, such as family members, teachers, and caregivers. intellectual disability is identified as mild (most people with intellectual disability are in this category), moderate or severe. the symptoms of intellectual disability begin during childhood; delays in language or motor skills may be seen by the age of two, but mild levels of intellectual disability may not be identified until school-going age. intellectual disability can be associated with a genetic syndrome, such as down syndrome or fragile x syndrome; it may develop following an illness such as meningitis, whooping cough or measles; it may result from head trauma during childhood; or it may result from exposure to toxins such as lead or mercury. other factors that may contribute to intellectual disability include brain malformation, maternal disease, environmental influences (alcohol, drugs, or other toxins), laborand delivery-related events, infection during pregnancy, and problems at birth. individuals with intellectual disabilities are at higher risk for health disparities including being overweight and obese; however, little is known at the population level about the bmi status of children and youth with intellectual disabilities (lloyd, foley, & temple, 2014). the body mass index (bmi) is defined as the body mass divided by the square of the body height (expressed in kg/m2). it is a convenient rule-of-thumb to broadly categorize a person as underweight, normal weight, overweight, or obese based on tissue mass (muscle, fat, and bone) and height. major adult bmi classifications are underweight (under 18.5kg/m2), normal weight (18.5 to 24.9), overweight (25 to 29.9), and obese (30 or more). when used to predict an individual’s health, rather than as a statistical measurement for groups, the bmi has limitations that can make it less useful than some of the alternatives, especially when applied to individuals with abdominal obesity, short stature, or unusually high muscle mass (temple, foley, & lloyd, 2014). people with bmis under 20 and over 25 have been associated with higher all-cause mortality, with the risk increasing with distance from the 20–25 range. bmi is used differently for children. it is calculated in the same way as for adults but then compared to typical values for other children of the same age. instead of comparison against fixed thresholds for https://en.wikipedia.org/wiki/human_body_weight https://en.wikipedia.org/wiki/square_(algebra) https://en.wikipedia.org/wiki/human_height https://en.wikipedia.org/wiki/muscle https://en.wikipedia.org/wiki/abdominal_obesity https://en.wikipedia.org/wiki/short_stature https://en.wikipedia.org/wiki/short_stature https://en.wikipedia.org/wiki/bodybuilding 26 nika šuc, blaž lešnik: body mass index changes in children and adolescents with intelectual disability ..., 23–33 annales kinesiologiae • 13 • 2022 • 1 underweight and overweight, the bmi is compared against the percentiles for children of the same sex and age (ptomey et al., 2020). a bmi that is less than the 5th percentile is considered underweight and above the 95th percentile is considered obese. children with a bmi between the 85th and 95th percentile are considered overweight. obesity is a major health concern due to its increasing prevalence, particularly in people with intellectual disabilities. there has been a marked increase in the proportion of adults who were obese, from 13.2% in 1993 to 26.0% in 2013 for men, and from 16.4% to 23.8% for women (health & social care information centre, march 2015). this is a cause of significant concern as obesity in turn increases the attributable risk for diabetes, cancer, and cardiovascular disease (guh et al., 2009). another cross-sectional study suggested a higher prevalence of obesity in people with intellectual disabilities when compared with the general population. the gender ratio showed that 39.3% of women and 27.8% of men with intellectual disability were obese compared to 25.1% of women and 22.7% of men in the general population (melville et al., 2008). the coronavirus disease 2019 (covid-19) has an impact on physical activity (pa) behaviors worldwide. people around the world stayed at home and self-isolated, due to the lockdown policy. although a lockdown is considered essential and the best recommendation for preventing the spread of the disease, it may create new challenges. staying at home for a prolonged period can lead to disturbing consequences, such as weight gain, social isolation and may also cause a reduction in pa levels. the decrease in pa levels may be especially apparent among active individuals habitually practicing sports. diminished pa resulting from home isolation may worsen a wide range of health conditions, including chronic ones, such as cardiac and metabolic diseases as well as infectious diseases, due to negative immune-modulation even without substantial weight gain. therefore, maintaining an active lifestyle at home, including mainly pa, is extremely important for the general population’s health, especially for people with additional risk factors, including older adults, during the quarantine (dor-haim, katzburg, revach, levine, & barak, 2021). in relation to the facts outlined above, the aim of our observational study was to estimate the impact of covid-19 and associated lockdown policy on the bmi of children and adolescents with intellectual disabilities in slovenia. methods we measured the height and weight of 100 children and adolescents with moderate intellectual disability. they constituted a convenience sample of students of a special education center where the first author works. the sample consisted of 23 girls aged 6–14 years, 19 girls aged 15–26 years, 32 boys aged 6–14 years, and 28 boys aged 15–26 years. the measurements were performed by the first author in september 2020 and then after six months, in march 2021, as part of regular physical education lessons. in the period between both measurements, the school was closed for 10 weeks due to the https://en.wikipedia.org/wiki/percentile annales kinesiologiae • 13 • 2022 • 1 27 nika šuc, blaž lešnik: body mass index changes in children and adolescents with intelectual disability ..., 23–33 covid-19 pandemic. we calculated the bmi of all participants in both periods, and standardized the values based on age (in months) and sex, thus obtaining zbmi values according to who guidelines (world health organization, 2007). for the 17 participants aged 20 to 26 years, the standards for 19-year-olds were used (which are practically identical to those for adults). the differences in mean bmi increase according to sex and age group were tested using a two-way analysis of variance (anova). mean bmi and zbmi were compared between the two measurements using a paired t-test within each group and the pooled sample. the effect size was estimated using cohen’s d. no a priori statistical power analysis or sample size estimation was performed. the study was approved by the committee for ethical issues in the field of sport of the faculty of sport, university of ljubljana (no. 12/2022). results on average across all groups, bmi increased by 0.5 kg/m2 in the studied period. descriptive statistics, results of paired t-tests and effect sizes for bmi and zbmi increase are reported in table 1. the increase in mean bmi was statistically significant for both groups of girls, marginally statistically significant for the younger boys and not statistically significant for older boys. anova showed that the difference between girls and boys in bmi increase was marginally statistically significant (p=0.070 for the effect of gender); the effect of age group on mean bmi increase was not statistically significant (p=0.319), nor was there a statistically significant interaction (p=0.929). for the increase in zbmi, none of the effects was statistically significant (p=0.167 for gender, p=0.814 for age group, p=0.301 for interaction). these findings are illustrated in figure 1. 28 nika šuc, blaž lešnik: body mass index changes in children and adolescents with intelectual disability ..., 23–33 annales kinesiologiae • 13 • 2022 • 1 ta bl e 1: d es cr ip tiv e st at is tic s, r es ul ts o f p ai re d tte st s, e ffe ct s iz e es tim at es a nd e st im at es o f r el at iv e b m i an d zb m i in cr ea se in th e st ud ie d pe ri od . b m i se pt em be r 20 20 m ar ch 2 02 1 re la ti ve c ha ng e of m ea n m ed ia n re la ti ve ch an ge g ro up n m ea n sd m ea n sd p (t -t es t) d (9 5% c i) g ir ls 6 -1 4 y 21 20 .4 6. 2 21 .3 7. 1 0. 00 7 0. 65 (1 .1 2, 0 .1 7) +4 .4 % +3 .4 % g ir ls 1 526 y 19 28 .0 7. 1 28 .6 6. 6 0. 00 7 0. 69 (1 .1 9, 0 .1 8) +2 .3 % +1 .9 % b oy s 614 y 32 20 .6 5. 1 21 .0 4. 8 0. 05 6 0. 35 (0. 01 , 0 .7 1) +2 .1 % +0 .8 % b oy s 15 -2 6 y 28 23 .7 5. 2 23 .9 4. 9 0. 41 5 0. 16 (0. 22 , 0 .5 3) +0 .8 % +1 .3 % zb m i se pt em be r 20 20 m ar ch 2 02 1 re la ti ve c ha ng e of m ea n m ed ia n re la ti ve ch an ge g ro up n m ea n sd m ea n sd p (t -t es t) d (9 5% c i) g ir ls 6 -1 4 y 21 0. 72 1. 64 0. 80 1. 75 0. 36 9 0. 20 (0. 23 , 0 .6 3) +1 0. 3% +1 0, 4% g ir ls 1 526 y 19 1. 46 1. 54 1. 62 1. 37 0. 00 6 0. 71 (0 .2 0, 1 .2 1) +1 1. 2% +1 1, 0% b oy s 614 y 32 1. 25 1. 94 1. 30 1. 83 0. 49 8 0. 12 (0. 23 , 0 .4 7) +4 .0 % -8 ,5 % b oy s 15 -2 6 y 28 0. 52 1. 35 0. 52 1. 35 0. 91 5 -0 .0 2 (0. 39 , 0 .3 5) -1 .1 % +2 ,2 % n ot es : n – s am pl e si ze ; s d – s ta nd ar d de vi at io n; c i – c on fid en ce in te rv al annales kinesiologiae • 13 • 2022 • 1 29 nika šuc, blaž lešnik: body mass index changes in children and adolescents with intelectual disability ..., 23–33 figure 1: mean bmi (top panel) and zbmi (bottom panel) change (with a 95% confidence interval, ci) from september to march according to sex and age group. because the groups did not differ statistically significantly in mean zbmi change, we analyzed the mean zbmi change between the two time points for the pooled sample. it was marginally statistically significant (p=0.075). hence, the confidence interval for the estimated effect size contained zero, but very close to the lower limit (d=0.18, 95% ci -0.02 to 0.38), and the distribution of within-participant changes contained both positive and negative values, with the majority being positive (figure 2). overall, the mean within-participant increase in zbmi was 0.06. 30 nika šuc, blaž lešnik: body mass index changes in children and adolescents with intelectual disability ..., 23–33 annales kinesiologiae • 13 • 2022 • 1 figure 2: mean bmi (top panel) and zbmi (bottom panel) change (with a 95% confidence interval, ci) from september to march according to sex and age group. discussion and conclusion our data show that during the studied period, which included a 10-week lockdown, bmi in pupils with intellectual disabilities tended to increase on average more than what would be expected due to maturation alone. as expected, the average bmi of the pupils was higher than in their counterparts in the general population in the beginning (the starting mean zbmi values were positive), but this was more pronounced at the end of the studied period. in general, the effect seemed to be somewhat larger in girls than boys (and likely absent among the oldest boys). although we had online sports classes, supported and encouraged families to lead an active lifestyle and pupils returned to school much earlier than the majority population, there was still an increase in bmi in six months in all four groups. we assume that not only the school lockdown but also the general lockdown had an impact on increased bmi. there were a lot fewer possibilities for indoor and outdoor activities and there were no after-school activities, such as the special olympics program and training sessions, in which the population with intellectual disabilities is highly engaged (lloyd, temple, & foley, 2012). studies related to the slovenian slofit program suggest that the general fitness of the majority population dropped by 17% on average in almost all measurements of the slofit program. part of those are also height and weight, and the bmi has increased in children and youth during the pandemic limitations on schools, sports programs and other social-life activities (recek, 2020). studies show that the intervention programs annales kinesiologiae • 13 • 2022 • 1 31 nika šuc, blaž lešnik: body mass index changes in children and adolescents with intelectual disability ..., 23–33 provided during lockdown were excellent; we had online classes, professional recommendations, tv and online classes, etc., to encourage pupils to be as active as possible and maintain their physical fitness. although all the programs were successful in terms of time spent outside and being active, there was a lack of moderate-to-vigorous physical activity (mvpa). studies suggest that most of the mvpa is performed in the school environment (morrison, meh, sember, starc, & jurak, 2021). bmi status is a significant indicator of health, and these findings suggest that being overweight and obesity are significant health concerns for children and youth with intellectual disabilities. it is critical that health professionals increase health promotion efforts, including physical activity and healthy eating behaviors for children and youth with intellectual disabilities. we assume that the lockdown resulted in a reduction in physical activity below the minimum recommendations of health organizations, which is in line with other studies that showed a decline in physical activity levels during closure times (chen et al., 2020, balanzá-martinez, atienza-carbonell, kapczinski, & de boni, 2020). the study suggests that pandemics such as the current pandemic pose unique health issues caused by the requirements to stay at home, leading to a reduction in physical activity, among all people and especially among physically active individuals habitually practicing sports (ravalli, & musumeci 2020). although a lockdown may be required to mitigate a pandemic, it also generates new health challenges. staying at home for a prolonged period of time may increase sedentary habits and decrease physical activity levels that may lead to disturbing consequences such as an increased risk of worsening health conditions (including chronic ones), weight gain, insufficient sunlight exposure, social isolation, and poor metabolic health. a us study found that the covid-19 pandemic period was associated with an excess increase in bmi of 0.24kg/m2 per year more than in the previous pre-pandemic period, even when controlling for socioeconomic status, race and ethnicity, baseline bmi category, and type of bmi ascertainment. our findings validate the predictions of many scholars that weight increases among children because of the cumulative effects of anticipated decreases in physical activity and increases in sedentary behavior, screen time, and high-calorie diets among children during the pandemic (knapp et al, 2022). altogether, sedentary behavior and low levels of physical activity can have adverse effects on a person’s overall well-being and quality of life (laron, & goldwag, 2020). several authors followed children and youth and their development during the pandemic; most of the findings report an increased bmi (woolford et al., 2021). after such devastating results of so many studies, the health program and school prevention programs should increase the level of physical activity, promote a healthy and active life style and try to rebalance the current situation of increased bmi of youth after all the restrictions. we must not forget to also include pupils with intellectual disabilities, as they are even more affected by staying at home with even less social life and opportunities to be active and lead a healthy lifestyle. the main limitation of our study is that we do not have strictly comparable data on how the 10-week lockdown affected the majority population in this age group. in addition, we only measured height, weight, and bmi, but we did not compare other 32 nika šuc, blaž lešnik: body mass index changes in children and adolescents with intelectual disability ..., 23–33 annales kinesiologiae • 13 • 2022 • 1 potentially relevant indicators such as skinfold or general fitness level of the target population. acknowledgements we are grateful to colleagues at the center janez levec ljubljana for their contribution to this work; not only for help with the measurements, but also for doing a great job teaching online during school lockdowns and encouraging students and their parents to be physically active as much as possible. we thank prof. gaj vidmar, phd, for help with the statistical analysis. references balanzá-martínez, v., atienza-carbonell, b., kapczinski, f. & de boni, r. b. 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https://www.psychiatry.org/patients-families/intellectual-disability/what-is-intellectual-disability https://www.psychiatry.org/patients-families/intellectual-disability/what-is-intellectual-disability https://doi.org/10.1111/jir.12011 https://doi.org/10.1001/jama.2021.15036 https://doi.org/10.1001/jama.2021.15036 https://www.who.int/tools/growth-reference-data-for-5to19-years/indicators/bmi-for-age https://www.who.int/tools/growth-reference-data-for-5to19-years/indicators/bmi-for-age _hlk119322918 _hlk110178216 _hlk38187602 _hlk120196417 _hlk120196458 _hlk117871780 _hlk117865098 _hlk118123043 _hlk118137344 _hlk70951511 annales kinesiologiae • 13 • 2022 • 2 89 editorial being physically active can improve your brain health, help manage weight, reduce the risk of disease, strengthen your bones and muscles, and improve your abilities in many everyday activities. professional athletes are well-known for the stress and strain they put on their bodies, and it is generally accepted that they will eventually suffer physical damage. however, as more male athletes report their personal experiences, more attention is being paid to mental health as well. stress can be amplified in elite sports, and the pressures they experience in terms of competition and performance can be compounded by adverse life events. the fields of sport psychology and sport psychiatry are rapidly evolving and aim to understand, diagnose, treat and rehabilitate athletes. in this issue, we present a study that examined the prevalence of eating disorders and other behaviours in male and female slovenian athletes relating to depressive symptoms and alcohol use. significant differences were found between male and female athletes, and an association was found between eating disorders and depression. the unique repetitive nature of ballet dance, which often exceeds the stress limits of anatomical structures, leaves dancers vulnerable to injury. this volume evaluates the effectiveness of physiotherapeutic and athletic interventions in treating injuries in ballet dancers. in recent years, numerous studies have attempted to gather as much information as possible about the abilities and characteristics of young soccer players. based on the results, most of the conclusions of previous studies that investigated the morphological characteristics of young soccer players can be confirmed. these results indicate that younger soccer players have lower absolute values of morphological characteristics compared to older players. outdoor adventure education programming is often referenced as an effective intervention that encourages a wide range of outcomes in participants such as increased confidence, independence and communication skills. but as outdoor adventure education continues to grow globally, what does the academic literature say about outcomes related to these programs? in this issue, you will find a summary of the academic literature on one of the major international providers of outdoor adventure education, outward bound. fifty-four studies published between 1995 and 2019 have been summarized in this review. recommendations are made for developing more rigorous methods for understanding the role of the physical environment in the learning experience and for using theoretical approaches to integrate outdoor adventure education into broader academic fields. james parkinson recognized that progressive parkinson’s disease (pd) is associated with debilitating postural instability and gait difficulty (pigd) such as falls and freezing of gait. pd initially causes physical symptoms but later, problems with cognitive function, including forgetfulness and difficulty concentrating, may occur. as the disease worsens over time, many people develop dementia. for this reason, we are pleased to report on the activities of the twinbrain summer school “neuroscience of movement: 90 annales kinesiologiae • 13 • 2022 • 2 exploring brain dynamics in parkinson’s disease and related disorders”, which was held in piran, slovenia in july 2022. two other activities that we are presenting in this issue are the 4th international conference on technology innovations for healthcare (icdht), magdeburg, germany, and the annual “knowledge for health” event, traditionally organised for the general public by zrs koper and the izola general hospital. mihela jurdana, editor annales kinesiologiae • 13 • 2022 • 2 91 uvodnik gibalna/športna aktivnost lahko izboljša delovanje možganov, pomaga uravnavati telesno maso, zmanjša tveganje za bolezni, okrepi kosti in mišice in izboljša številne sposobnosti vsakega posameznika pri vsakodnevnih dejavnostih. poklicni športniki so dobro znani po tem, da zelo obremenjujejo svoje telo, in v splošnem velja, da bodo sčasoma utrpeli telesne poškodbe. ker vse več moških športnikov deli svoje osebne izkušnje, se vse več pozornosti namenja duševnemu zdravju v vrhunskem športu. stres se lahko v vrhunskem športu dodatno poveča, pritisk, ki ga doživljajo v zvezi s tekmovanjem in uspešnostjo, pa lahko povečajo še neugodni življenjski dogodki. področji športne psihologije in športne psihiatrije se hitro razvijata ter sta usmerjeni v razumevanje, diagnosticiranje, zdravljenje in rehabilitacijo športnikov. v tej številki med drugim predstavljamo raziskavo, ki je proučevala razširjenost prehranskih motenj in vedenja pri slovenskih športnikih in športnicah v povezavi z depresijo in zlorabo alkohola. ugotovljene so bile pomembne razlike med športniki in športnicami ter povezava med motnjami hranjenja in depresijo. zaradi edinstvene ponavljajoče se narave gibov pri baletnem plesu, ki pogosto presega meje obremenitve anatomskih struktur, so baletnice in baletniki pogosto izpostavljeni poškodbam. v tej številki avtorji predstavljajo oceno učinkovitost fizioterapevtskih in kinezioloških obravnav pri zdravljenju poškodb baletnih plesalcev. v zadnjih letih so številne raziskave poskušale zbrati čim več informacij o sposobnostih in značilnostih mladih nogometašev. na podlagi rezultatov je mogoče potrditi večino ugotovitev prejšnjih raziskav, ki so proučevale morfološke značilnosti. ti rezultati kažejo, da imajo mladi nogometaši v primerjavi s starejšimi nižje vrednosti morfoloških značilnosti. programi izobraževanja na prostem se pogosto omenjajo kot učinkovita intervencija, ki pri udeležencih spodbuja širok nabor rezultatov, kot so večja samozavest, neodvisnost in komunikacijske spretnosti. ker pa trend izobraževanja na prostem globalno narašča, se avtor članka v tej številki sprašuje, kaj o rezultatih, povezanih s tovrstnimi programi, pravi strokovna literatura. v temeljitem preglednem članku boste našli povzetek strokovne literature o enem od glavnih mednarodnih ponudnikov izobraževanja na prostem outward bound. v pregledu je povzetih 54 raziskav, objavljenih med letoma 1995 in 2019. navedena so priporočila za razvoj strožjih metod za razumevanje vloge fizičnega okolja pri učni izkušnji in za uporabo teoretičnih pristopov za vključevanje izobraževanja na prostem v širša akademska področja. james parkinson je ugotovil, da je progresivna parkinsonova bolezen (pb) povezana z izčrpavajočimi značilnostmi posturalne nestabilnosti in težavami s hojo (pnth), kot so padci in zamrznitev hoje. pb sprva povzroča telesne simptome. pozneje se lahko pojavijo težave s kognitivnimi funkcijami, vključno s pozabljivostjo in nezmožnostjo koncentracije. ko se bolezen sčasoma poslabša, se pri številnih ljudeh razvije demenca. zato z veseljem poročamo o dejavnostih poletne šole twinbrain nevroznanost gibanja: raziskovanje možganske dinamike pri parkinsonovi bolezni in sorodnih motnjah, ki je 92 annales kinesiologiae • 13 • 2022 • 2 julija 2022 potekala v piranu. drugi poročili se nanašata na 4. mednarodno konferenco o tehnoloških inovacijah v zdravstvu (icdht), ki je potekala v magdeburgu v nemčiji, ter na vsakoletni dogodek znanje za zdravje, ki ga za širšo javnost tradicionalno organizirata zrs koper in splošna bolnica izola. mihaela jurdana, urednica _hlk122510532 _hlk121925715 _hlk121925783 _hlk117671776 _hlk117676890 _hlk117676830 _hlk122521710 _hlk123029474 _hlk51764713 _hlk51617947 _hlk51764685 _hlk51616945 _hlk51676200 _hlk51710755 _hlk124939594 _hlk124939408 _hlk125008249 _hlk125008423 _hlk125010166 _hlk124768186 _hlk129167818 _hlk129168885 _hlk129939779 _ref116207795 annales kinesiologiae • 13 • 2022 • 1 1 editorial excess body fat is a serious health risk leading to problems such as hypertension, elevated blood lipids (fats and cholesterol), diabetes mellitus type 2, cardiovascular disease, respiratory dysfunction and gallbladder disease. individuals who accumulate a lot of visceral fat are at higher risk than those who are more likely to accumulate fat on their thighs and buttocks. these days, people are more concerned than ever about how much they weigh. similarly, scientists propose a range of classification strategies based on body mass or composition, as is also evident in several publications in this issue of annales kinesiologiae. however, pure body mass or the body mass index is not an appropriate measure of health. for example, being thin does not necessarily mean that you have a lower health risk. in fact, the obsession with becoming thin often leads to serious eating disorders such as anorexia and bulimia. being thin simply means weighing less than the recommended levels. it is important to distinguish between healthy leanness and unwanted thinness. there are also several important reasons to monitor body composition: – to develop holistic physical fitness programs; – to monitor body mass change = body fat loss with muscle growth; – to provide a baseline for diet and the treatment of obesity; – to follow changes due to growth, development, maturation and ageing; – to individualise and optimise the performance of athletes. the simplest 2-component body composition models divide it into a fat component and a fat-free component, and not all fat is considered unhealthy. this is an important advance over body mass indexing. essential fat is found in the bone marrow, heart, lungs, liver, spleen, kidneys, intestines, muscles and fat-rich tissues, while storage fat accumulates in the adipose tissue. in addition, storage fat is found around the internal organs and under the skin. fat-free mass is the weight of your muscles, bones, ligaments, tendons and internal organs, with essential fat subtracted. the search for methods to determine body composition went through several phases (with the methods of each phase labelled): (1) precision without biology (anthropometry); (2) biology without precision (dilution methods); (3) in search of precision (bioimpedance); and (4) in search of accuracy (dual-energy x-ray absorptiometry). as bioimpedance is a very affordable method with a high potential for error of < 4%, one should consider multiple standards for a valid evaluation: – supine position with arms and legs abducted by 30 deg and 45 deg, respectively; – no eating for 12 hours and no drinking for 4 hours before the test; – no exercise within 12 hours of the test; – urinate within 30 minutes of the test: – no alcohol consumption within 48 hours of the test – no diuretics within 7 days of the test. 2 annales kinesiologiae • 13 • 2022 • 1 these standards for valid bioimpedance assessment are difficult to achieve, and many authors simply ignore them. nevertheless, body composition is an integral component of overall health and physical fitness that leads to important decision-making strategies for our health. on the other hand, dual-energy x-ray absorptiometry (dexa or dxa) measures body fat, muscle and the total body bone mineral (tbbm) using two x-ray energies. dexa is fast and has low radiation exposure. the analysis can be broken down into regional levels. while dexa is the gold standard for measuring bone mineral density, it is also used to estimate total and regional body fat and lean mass. therefore, i would like to point out to scientists that they need to be aware of the measurement standards to be followed and to choose state-of-the-art methods for valid results in order to ensure high-quality result interpretation. boštjan šimunič, editor annales kinesiologiae • 13 • 2022 • 1 3 uvodnik čezmerna telesna maščoba pomeni resno tveganje za zdravje, ki vodi v bolezni, kot so povišan krvni tlak, povišane vrednosti lipidov (maščob in holesterola) v krvi, sladkorna bolezen tipa 2, bolezni srca in ožilja, motnje v delovanju dihal in bolezni žolčnika. posamezniki, ki si naberejo veliko visceralne maščobe, so bolj ogroženi kot tisti, ki si maščobo bolj nabirajo na stegnih in zadnjici. danes se ljudje bolj kot kdaj koli prej ukvarjajo s tem, koliko tehtajo. podobno tudi znanstveniki predlagajo različne strategije razvrščanja glede na telesno maso ali sestavo, kar je razvidno tudi iz več objav v tej številki revije annales kinesiologiae. vendar samo telesna masa ali indeks telesne mase ni ustrezno merilo našega zdravja. na primer, če ste vitki, to še ne pomeni, da je vaše tveganje za zdravje manjše. pravzaprav obsedenost z vitkostjo pogosto vodi v resne motnje hranjenja, kot sta anoreksija in bulimija. biti vitek preprosto pomeni tehtati manj, kot je priporočeno. pomembno je ločiti med zdravo vitkostjo in neželeno vitkostjo. je tudi več pomembnih razlogov za spremljanje telesne sestave: – za razvoj celostnih programov telesne pripravljenosti, – za spremljanje sprememb telesne mase = izguba telesne maščobe z rastjo mišic, – za zagotavljanje izhodišč za dieto in zdravljenje debelosti, – za spremljanje sprememb zaradi rasti, razvoja, transformacijskih procesov in staranja, – za individualizacijo in optimizacijo zmogljivosti športnikov. najpreprostejši dvokomponentni modeli telesne sestave se delijo na maščobno in pusto komponento, pri čemer vsa maščoba ne velja za nezdravo. to je pomemben korak naprej v primerjavi z indeksom telesne mase. zdravju koristno maščobo najdemo v kostnem mozgu, srcu, pljučih, jetrih, vranici, ledvicah, črevesju, mišicah in tkivih, bogatih z maščobo, medtem ko se maščoba kopiči predvsem tudi v visceralnem in podkožnem maščevju. pusta masa je masa mišic, kosti, vezi, kit in notranjih organov, od katere je odšteta tudi zdravju koristna oziroma potrebna maščobna masa. iskanje metod za določanje telesne sestave je potekalo v več fazah (s primeri najbolj razširjenih metod te faze): 1. natančnost brez biologije (antropometrija); 2. biologija brez natančnosti (metode presnavljanja snovi); 3. iskanje natančnosti (bioimpedanca) in 4. iskanje natančnosti (dvoenergijska rentgenska absorpciometrija). ker je bioimpedanca cenovno zelo dostopna metoda s potencialno nizko napako merjenja < 4 %, je treba za veljaven rezultat merjenja upoštevati več standardov: – ležeči položaj z abduciranimi rokami in nogami za 30 oziroma 45 stopinj, – 12 ur ne jesti in 4 ure pred testom ne piti, – brez vadbe 12 ur pred testom, – urinirati 30 minut pred testom, – ne uživati alkohola 48 ur pred testom, – ne jemati diuretikov 7 dni pred testom. 4 annales kinesiologiae • 13 • 2022 • 1 za veljavno oceno bioimpedance je namreč te standarde težko doseči, zato jih številni avtorji preprosto ne upoštevajo, čeprav je telesna sestava sestavni del splošnega zdravja in telesne pripravljenosti, ki vodi do pomembnih strategij odločanja o našem zdravju. po drugi strani pa dvoenergijska rentgenska absorpciometrija (dexa ali dxa) z dvema energijama rentgenskih žarkov meri telesno maščobo, mišice in kostno mineralno gostoto celega telesa (tbbm). metoda dexa je hitra in pri njej je izpostavljenost sevanju majhna. analizo je mogoče razdeliti na regionalna območja telesa. čeprav je dexa zlati standard za merjenje mineralne kostne gostote, se uporablja tudi za oceno skupne in regionalne telesne maščobe in puste mase. zato bi rad opozoril znanstvenike, da se morajo zavedati merilnih standardov, ki jih je treba upoštevati, in ustrezno izbrati merilne metode za veljavno merjenje, da bi zagotovili visoko kakovost interpretacije rezultatov. boštjan šimunič, urednik _hlk119322918 _hlk110178216 _hlk38187602 annales kinesiologiae • 13 • 2022 • 2 191 reports and reviews/poročila in ocene, 185–195 “knowledge for health”: integrated health care koper, slovenia, 1 october 2022 the annual “knowledge for health” event was held on 1 october, international day of older persons. the united nations general assembly proclaimed this day to highlight the often overlooked role and position of this population group in society, despite the fact that the proportion of older people in the population is increasing. experts from various fields participated in the event, which was aimed at a broad audience and was intended to highlight the issue of holistic health at the intersection of muscular, cognitive and cardiovascular health. talking about the consequences of an inappropriate lifestyle and how to take care of one’s health in a holistic way that is also accessible to the general public remains the main goal of the initiators of the “knowledge for health” event, held for the eleventh consecutive year in collaboration with the institute for kinesiological research of the scientific research centre (zrs) koper and the izola general hospital. during this period, numerous meetings and discussions were held and thousands of measurements of physical and functional fitness and risk factors were performed. numerous public lectures were held with top experts who have time and again offered new insights for health. this year’s event took place in the morning at taverna in koper, slovenia, and included measurements of physical characteristics, functional abilities and health risk 192 reports and reviews/poročila in ocene, 185–195 annales kinesiologiae • 13 • 2022 • 2 factors. participants had the opportunity to assess their cardiovascular, muscular and cognitive health through simple but relevant tests. on the occasion of the international day of older persons, the organizers of the event emphasized the importance of monitoring sarcopenia for general health. they identified severe sarcopenia in 9% of those measured and urged them to change their lifestyle for better health. sarcopenia can have very serious consequences, such as insufficient muscle strength, decreased metabolic capacity, decreased aerobic capacity, leading to physical limitations, immobility, poorer quality of life, more fragile bones, cognitive decline, cardiovascular disease and ultimately premature death. this is mainly due to the excessive loss of muscle fibers and the reduction of the remaining fibers. what causes this is not yet entirely clear, and the answer is certainly very broad, which is why it is a syndrome rather than a disease. however, we can confirm with certainty that one of the causes is a lack of proper exercise with sufficient intensity to stimulate the repair and growth of muscle fibers. in addition to proper exercise, adequate protein intake is also important to support muscle repair after exercise. the testing of participants at the “knowledge for health” event is an example of knowledge transfer to the general public, as it comes directly from the research work of colleagues from the institute for kinesiology research, zrs koper. the irreversibility of the processes of muscle deterioration in the elderly motivated prof. dr boštjan šimunić to obtain two new national research projects. the “validation of a musclequality marker for the diagnosis of sarcopenia (arrs j7-2605)” project will develop a method that will enable the early detection of changes in muscle properties and performance during ageing, before they become visible with standard clinical instruments. the goal is to allow early intervention before sarcopenia actually sets in. the “neuromuscular decline after physical inactivity: a comparison of younger and older adults (arrs j5-4593)” project aims to investigate the mechanisms and temporal patterns of muscle mass and performance decline in younger and older adults, which is critical for understanding the processes of decline and for developing preventive and curative interventions/guidelines. the central nervous system controls muscle function and has been shown to be a key determinant of muscle performance. under the leadership of assoc. prof. dr uroš marušič, the researchers have been awarded the “twinning the brain with machine learning for neuromuscular efficiency – twinbrain” international project, which investigates brain function during movement, during execution of various movements, and during motor learning with and without skeletal movement. with the completion of the testing in taverna in koper, each participant received a ticket to the afternoon part of the event, which took place at koper theatre, where a panel of experts spoke about the importance and role of monitored characteristics in health. too often we want to “measure health”, compare ourselves to the norms without knowing more about the parameters and indicators of (un)healthiness that are being measured. high-profile speakers and top experts tried to find answers to the question of what holistic health is and how muscular, cognitive and cardiovascular health form a whole. prim. dorjan marušič, md, phd, spoke about cardiovascular health, bojan annales kinesiologiae • 13 • 2022 • 2 193 reports and reviews/poročila in ocene, 185–195 rojc, md, phd, spoke about neuromuscular health and uroš marušič, phd, associate professor, spoke about cognitive health. the discussion was moderated by the founding fathers of the meeting, prof. dr rado pišot and assoc. prof. dr mladen gasparini. the event was another in the series of events that brought together koper theatre, zrs koper and izola general hospital in an effort to contribute to the health and quality of life of our citizens, and was therefore once again supported by the koper city council. boštjan šimunić, nika štravs, matej kleva, peter čerče 194 reports and reviews/poročila in ocene, 185–195 annales kinesiologiae • 13 • 2022 • 2 »znanje za zdravje«: celostna skrb za zdravje koper, slovenija, 1. oktober 2022 vsakoletni dogodek »znanje za zdravje« je tokrat potekal 1. oktobra, ob mednarodnem dnevu starejših. generalna skupščina združenih narodov je ta dan razglasila zaradi pogosto spregledane vloge in položaja, ki ga ima ta skupina prebivalstva v družbi, čeprav se delež starejše populacije povečuje. strokovnjaki z različnih področji so na dogodku, ki je namenjen najširši zainteresirani javnosti, poskušali osvetliti problem celostnega zdravja v preseku med mišičnim, kognitivnim in srčno-žilnim zdravjem. spregovoriti o posledicah neustreznega življenjskega sloga in kako celostno poskrbeti za svoje zdravje na način, ki je dostopen najširši javnosti, tudi sicer ostaja glavno vodilo pobudnikov dogodka »znanje za zdravje«, ki je že enajsto leto zapored potekal v sodelovanju inštituta za kineziološke raziskave znanstveno-raziskovalnega središča (zrs) koper in splošne bolnišnice (sb) izola. v tem času so izvedli številna srečanja in pogovore, več tisoč meritev telesne in funkcionalne pripravljenosti ter dejavnikov tveganja. organizirali so številna javna predavanja z vrhunskimi strokovnjaki, ki so vedno znova ponudili nova znanja za zdravje. na letošnji prireditvi so v koprski taverni v dopoldanskem času potekale meritve telesnih značilnosti, funkcionalnih sposobnosti in dejavnikov tveganja za zdravje. udeleženci so imeli možnost na osnovi preprostih, vendar relevantnih meritev preveriti svoje srčno-žilno, mišično in kognitivno zdravje. ob svetovnem dnevu starejših so organizatorji dogodka posebej poudarili pomen spremljanja sarkopenije za celostno zdravje. pri kar 9 % izmerjenih so odkrili hudo obliko sarkopenije in jih opozorili, naj spremenijo svoj življenjski slog za kakovostnejše zdravje. sarkopenija lahko privede do zelo hudih posledic, kot so premajhna mišična annales kinesiologiae • 13 • 2022 • 2 195 reports and reviews/poročila in ocene, 185–195 moč, manjše presnovne sposobnosti in manjše aerobne sposobnosti, vse to pa vodi v gibalne omejitve, nemobilnost, slabšo kakovost življenja, krhkejše kosti, kognitivni upad, srčno-žilne bolezni in v skrajni posledici v prezgodnjo smrt. razlog je predvsem v preveliki izgubi mišičnih vlaken in zmanjšanju tistih, ki še ostanejo. kateri so vzroki, ki privedejo do tega, še ni popolnoma jasno, in odgovor je gotovo zelo širok, zato je to tudi sindrom, bolj kot bolezen. prav gotovo pa lahko kot enega od vzrokov potrdimo pomanjkanje primerne, dovolj intenzivne gibalne vadbe, ki spodbuja obnovo in rast mišičnih vlaken. ob pravilni vadbi je pomemben tudi zadosten vnos beljakovin, ki podpirajo obnovo mišic po vadbi. na dogodku »znanje za zdravje« izvedene meritve udeležencev so primer prenosa znanja v širšo javnost, saj izhajajo neposredno iz raziskovalnega dela sodelavk in sodelavcev inštituta za kineziološke raziskave zrs koper. ireverzibilnost procesov upada mišične mase pri starejših je namreč motivirala prof. dr. boštjana šimuniča k pridobitvi dveh novih nacionalnih raziskovalnih projektov. v sklopu projekta validacija markerja mišične kakovosti za diagnosticiranje sarkopenije (arrs j7-2605) razvijajo metodo, ki bo omogočala zgodnjo zaznavo sprememb v mišičnih značilnostih in zmogljivostih med staranjem, še preden bo ta vidna s standardnimi kliničnimi orodji. cilj je zagotoviti še pravočasno ukrepanje pred dejanskim nastopom sarkopenije. v sklopu projekta »upad živčno-mišičnega sistema po gibalni neaktivnosti: primerjava mlajših in starejših odraslih (arrs j5-4593)« pa nameravajo proučiti mehanizme in časovne zakonitosti upada mišične mase in zmogljivosti pri mlajših in starejših, kar je ključno za razumevanje procesov upada ter oblikovanje preventivnih in kurativnih ukrepov/smernic. centralni živčni sistem nadzoruje delovanje mišic in je bil prepoznan za ključni dejavnik mišične zmogljivosti. pod vodstvom izr. prof. dr. uroša marušiča so raziskovalci pridobili mednarodni projekt twinning the brain with machine learning for neuromuscular efficiency – twinbrain, v sklopu katerega proučujejo delovanje možganov med gibanjem, v procesu izvedbe različnih gibov, med motoričnim učenjem s premikanjem skeleta in brez premikanja. z opravljeno meritvijo v koprski taverni je vsak udeleženec pridobil vstopnico za popoldanski del dogodka, ki je potekal v gledališču koper. na njem so strokovnjaki spregovorili o pomenu in vlogi spremljanih značilnosti za zdravje. prevečkrat si namreč želimo »izmeriti zdravje«, se primerjati z veljavnimi normami, ne da bi hkrati o merjenih parametrih in kazalnikih (ne)zdravja vedeli kaj več. eminentni predavatelji, vrhunski strokovnjaki, so poskušali poiskati odgovore na vprašanja, kaj sploh je celostno zdravje ter kako mišično, kognitivno in srčno-žilno zdravje tvorijo celoto. prim. mag. dorjan marušič, dr. med., je tako spregovoril o srčno-žilnem zdravju, doc. dr. bojan rojc o nevromišičnem zdravju, izr. prof. dr. uroš marušič pa o kognitivnem zdravju. pogovor sta povezovala idejna očeta srečanja prof. dr. rado pišot in doc. dr. mladen gasparini. dogodek je ponovno združil gledališče koper, zrs koper in sb izola v želji, da bi prispevali h kakovosti zdravja in življenja naših občanov, zato ga je tudi tokrat podprla mestna občina koper. boštjan šimunić, nika štravs, matej kleva, peter čerče annales kinesiologiae • 6 • 2015 • 1 69 reports and reviews/poročila in ocene, 69–78 book review anton zupan in matej plevnik: swimming and other forms of aquatic exercise for people with neuromuscular disorders koper, annales university press; ljubljana, muscular dystrophy association of slovenia, european alliance of neuromuscular disorders associations, 2014, 96 pages the book »swimming and other forms of aquatic exercise for people with neuromuscular disorders« was written by anton zupan and matej plevnik. the authors are adressing the current issue of extremely complex to deal with people with neuromuscular problems in the field of kinesiology. as the experts of the matter they are focusing in particular on swimming and other forms of targeted exercise in the water. in the book, which is intended for people with neuromuscular disorders, who are advocating the improvment of their own health and well being, they firstly deal with the swimming area, hydrotherapy and theraupetic recreation. they also emphasise the importance of knowing the swimming pools, physical properties of the water and physiological effects of swimming in order to properly define the scope of the fundamental framework. in continuation they are debating of the particular importance of swimming, hydrotherapy and theraupetic recreation in which they are also introducing limits for implementation of the activities in the subject area, which is of utmost importance for sustainable provision of safety. in the middle part of the book, the authors write about the key topic: the role of the assistant in swimming, hydrotherapy and therapeutic recreation for people with neuromuscular disorders, where they originally introduce and use their experience from theory and practice and their exceptional sense for working with people with special needs. they give their attention to the role of helping and support with swimming, hydrotherapy and theraupetic recreation. the extremly useful instructions are described very detailed and comprehensive, starting with entering the water, walking on a slippery surface when transferring the patient into the water and also the use of the lift 70 reports and reviews/poročila in ocene, 69–78 annales kinesiologiae • 6 • 2015 • 1 and the wheelchair for helping with the transfer of the patient. their task is done with the special highlight on friendly and safe accompany of the patient going in and out of the water. the authors continue showing their knowledge with interesting techniques of independent maintenance of the body position in water and the presentation of possible rescuing the patient. in the conclusion of this review, we can summarize that the book has a highly scientific and useful value. it represents a sourceful theorethic work and at the same time offers a useful practical model of professional work oriented towards the user / user friendly on this field. it can serve as a manual for competent and professional work, i would recommend it also as a useful support handbook in a lifelong learning process and last but not least as a important scientific base for the preparation of curriculum treatment of persons with disabilities in the field of kinesiology. iztok retar annales kinesiologiae • 6 • 2015 • 1 71 reports and reviews/poročila in ocene, 69–78 recenzija knjige anton zupan in matej plevnik: plavanje in druge oblike vodne vadbe za osebe z živčno-mišičnimi motnjami koper, univerzitetna založba annales; ljubljana, društvo distrofikov slovenije, european alliance of neuromuscular disorders associations, 2014, 96 strani knjigo "plavanje in druge oblike vodne vadbe za ljudi z živčno-mišičnimi motnjami" sta napisala anton zupan in matej plevnik. avtorja naslavljata aktualno problematiko izjemno zahtevnega ravnanja z ljudmi z živčno-mišičnimi boleznimi na kineziološkem področju. kot dobra poznavalca problema se osredotočata zlasti na plavanje in tudi na druge oblike ciljane telesne vadbe v vodi. v knjigi, ki jo namenjata ljudem z živčno-mišičnimi boleznimi, ki se zavzemajo za izboljšanje in ohranjanje svojega dobrega počutja in predvsem zdravja, najprej temeljito obravnavata področje plavanja, hidroterapije in terapevtske rekreacije. poudarjata tudi pomen poznavanja kopališča, fizikalnih lastnosti vode in fizioloških učinkov plavanja, s čimer primerno opredelita temeljni okvir področja delovanja. v nadaljevanju poglobljeno obravnavata poseben pomen plavanja, hidroterapije in terapevtske rekreacije, pri čemer predstavita tudi omejitve za izvajanje omenjenih aktivnosti na predmetnem področju, kar je za trajnostno zagotavljanje varnosti izjemnega pomena. osrednji del avtorja namenita temi, ki je ključnega pomena: kako uspešno ravnati z ljudmi z živčno-mišičnimi motnjami na kineziološkem področju? avtorja izvirno predstavita in uveljavita svoje izkušnje iz prakse in teorije ter izjemen občutek za delo z ljudmi s posebnimi pričakovanji in potrebami. precejšnjo pozornost namenita vlogi pomoči in podpore pri plavanju, hidroterapiji in terapevtski rekreaciji. celovito in podrobno opišeta izjemno uporabna navodila tako, da najprej obravnavata vstop v vodo, nato preventivno hojo na spolzki površini pri prenosu pacienta v vodo kot v nadaljevanju tudi rabo dvigala in vozička. nalogo opravita s posebnim poudarkom na prijaznem in varnem spremljanju uporabnika v vodo in iz nje. avtorja svoje poznavanje področja 72 reports and reviews/poročila in ocene, 69–78 annales kinesiologiae • 6 • 2015 • 1 zanimivo nadaljujeta s tehnikami samostojnega vzdrževanje telesa v vodi in se osredotočita tudi na predstavitev morebitnega reševanja. v zaključku recenzije lahko povzamemo, da ima knjiga visoko tako znanstveno kot uporabno vrednost. predstavlja izvirno teoretično delo in hkrati ponuja uporaben praktični model strokovnega dela, usmerjenega na uporabnika na predmetnem področju. knjiga lahko služi kot priročnik za kompetentno strokovno delo, priporočamo pa jo tudi kot učinkovito podporno gradivo za vseživljensko učenje in ne nazadnje tudi kot pomembno strokovno podlago za pripravo učnega načrta ravnanja z osebami s posebnimi potrebami na kineziološkem področju. iztok retar _enref_26 _goback _goback _goback _goback bm3 _goback _goback annales kinesiologiae • 12 • 2021 • 1 15 prevalence of depression and anxiety symptoms among female football players and non-players katarina puš1, tanja kajtna2 1 science and research centre koper, slovenia 2 university of ljubljana, faculty of sport, slovenia corresponding author: katarina puš science and research center koper, garibaldijeva ulica 1, 6000 koper, slovenia phone.: +386 31 814 753 e-mail: katarina.pus@zrs-kp.si abstract purpose: depression and anxiety are mental illnesses which affect many people worldwide. the purpose of this study is to determine the prevalence of depression and anxiety symptoms among slovenian female football players and non-players. methods: the sample consisted of slovenian female football players playing in the slovenian 1st female football league or youth league (n = 78) and non-player peers (n = 120) with an average age of the total sample 22±4 years. the participants filled out a questionnaire including some general questions (age, physical activity levels, participation in competitive sports), beck depression inventory (bdi-ii), beck anxiety inventory (bai), and depression, anxiety and stress scale (dass-21). results: the most commonly observed were normal and mild levels of depression and anxiety. according to the results of depression in bdi-ii, 43.6% of athletes experienced moderate to severe depression compared to 15.8% of peers (p = 0.001). results from dass-21 show that 71.8% of athletes experience normal to mild symptoms of depression and 56.4% experience the same levels of anxiety. similarly, 75% of peers experience normal to mild depressive symptoms and 56.7% reported normal to mild symptoms of anxiety. no statistical differences were found in these categories. conclusion: we have gained insight into the current prevalence of depression and anxiety among female football players and their peers but more research needs to be done. keywords: depression, anxiety, prevalence, female football players, adolescence original scientific article doi: https://doi.org/10.35469/ak.2021.304 received: 2021-11-26 udc: 796.332-055.2:616.89-008 mailto:katarina.pus@zrs-kp.si 16 katarina puš, tanja kajtna: prevalence of depression and anxiety symptoms among female ..., 15–27 annales kinesiologiae • 12 • 2021 • 1 prevalenca simptomov depresije in anksioznosti med slovenskimi nogometašicami in njihovimi vrstnicami izvleček namen: depresivnost in anksioznost sta duševni bolezni, ki prizadeneta večje število ljudi po vsem svetu. namen raziskave je ugotoviti prevalenco simptomov depresije in anksioznosti med slovenskimi nogometašicami in njihovimi vrstnicami. metode: vzorec predstavljajo nogometašice, ki nastopajo v prvi slovenski ženski nogometni ligi in ligi kadetinj do 17 let in njihove vrstnice. povprečna starost znaša 22 let ± 4 leta. v raziskavi je sodelovalo 232 merjenk, 198 jih je v celoti izpolnilo vprašalnik (85,34 %), od tega 78 nogometašic. vprašalnik je vseboval splošna vprašanja o starosti, stopnji aktivnosti, sodelovanju v tekmovalnem športu in stopnji izobrazbe ter beckov vprašalnik depresivnosti (bdi-ii), beckov vprašalnik anksioznosti (bai) in vprašalnik depresivnosti, anksioznosti in stresa (dass-21). rezultati; rezultati bdi-ii kažejo, da je 43,6 % nogometašic občutilo zmerno do resno stopnjo simptomov depresije, v primerjavi s 15,8 % vrstnic (p = 0,001). rezultati dass-21 kažejo, da ima 71,8 % nogometašic normalne do blage simptome depresije in da jih 56,4 % občuti normalne do blage simptome anksioznosti. podobno, 75 % vrstnic doživlja normalne do blage simptome depresije in 56,7 % anksioznost enake stopnje. v teh kategorijah nismo ugotovili statistično značilnih razlik med skupinama. zaključek: z raziskavo smo dobili vpogled v trenutno stanje pojavljanja simptomov depresivnosti in anksioznosti med nogometašicami in njihovimi vrstnicami, vendar je za zanesljivejše sklepe potrebno dodatno raziskovanje področja duševnega zdravja. ključne besede: depresivnost, anksioznost, prevalenca, nogometašice, adolescenca 17 annales kinesiologiae • 12 • 2021 • 1 katarina puš, tanja kajtna: prevalence of depression and anxiety symptoms among female ..., 15–27 introduction depression is a common mental disorder which affects more than 300 million people worldwide and is a big risk factor for suicide. prevalence of depression varies across countries, from 1.5% in taiwan to 19% in beirut (bromet et al., 2011). in european countries the lifetime prevalence of major depression is 11.32% and the average 12-month prevalence is 5.2% (gutiérrez-rojas, porras-segovia, dunne, andradegonzález, & cervilla, 2020). the disorder manifests as constant sadness, loss of interest in activities that used to be enjoyable, and the inability to complete everyday chores, the condition lasting for at least two weeks. common symptoms are lack of energy, changes in appetite or weight, disruptive sleep disorders, anxiety, lack of attention, feelings of guilt and self-harm or suicidal thoughts (world health organization, 2021). the first onset of depression occurs in adolescence with 5% in early adolescence and 20% in late adolescence. a high number of adolescents displaying some of these symptoms do not get diagnosed and are not treated, even though that increases the risk factors for depression in later life (alaie et al., 2019). throughout the history of depression research, there have been many explanatory theories, most widely known are biological ones claiming depression develops due to lack of noradrenaline, endocrine disorders, sleep disturbances, changes in brain structures, and genetics. psychological theories explain depression through psychoanalysis, attachment theory, behavioral models, cognitive models, self-control models, interpersonal theory, stressful life events, and sociocultural models (bernaras, jaureguizar, & garaigordobil, 2019). high-risk groups for depression are suicide attempt survivors, and people with exceptional psychosocial stress, mental disorders (anxiety, psychosis, addictions), or family history of depression, those suffering from chronic conditions, people with an unexplained somatic syndrome, frequent users of health services, post-partum women, and people with diabetes mellitus (konec juričič, roškar, & jelenko roth, 2016). depression disorders differ in the duration, intensity and periods during which they occur. disruptive dysregulation mood disorder is a chronic condition characterized by highly expressed irritability. there are two clinical manifestations, the first is frequent outbursts of anger as a response to frustration which occur at least three times a week for at least one year in two different settings. angry outbursts can be verbal or behavioral, e.g., aggression towards objects, the self or other people. the second manifestation occurs during outbursts of anger, when an individual is chronically irritated or angry and is present most days. the disorder first presents itself before the age of 10, symptoms changing during adolescence. children and adolescents affected by disruptive dysregulation mood disorder are more prone to developing depression and anxiety in adult life (american psychiatric association, 2013). major depressive disorder or clinical depression is characterized by a depressed mood throughout the whole day most days, in children and adolescents manifested as irritability. clinical depression causes a lack of interest in previously enjoyed everyday activities, extreme weight loss or weight gain, insomnia or hypersomnia, psychomotor agitation or retardation, tiredness or lack of energy, feelings of guilt, lack of ability to 18 katarina puš, tanja kajtna: prevalence of depression and anxiety symptoms among female ..., 15–27 annales kinesiologiae • 12 • 2021 • 1 think and concentrate, thoughts about death, suicidal thoughts without a plan, suicide planning, and suicide attempt (bernaras et al., 2019). clinical depression has a high mortality rate, mostly by suicide. the course of the disease is variable, some people never or very rarely experience remission while others can live without symptoms for years (american psychiatric association, 2013). dysthymia or persistent depressive disorder is defined as chronic clinical depression and dysthymic disorder and manifests as a depressive mood throughout most days for at least two years. the prevalence of this disorder in the us is 0.5% (bernaras et al., 2019). premenstrual dysphoric disorder is diagnosed when during the majority of menstrual cycles at least five of the following symptoms are present: emotional lability, intense irritability, anger or interpersonal conflicts, depressive mood and/or anxiety symptoms, which can be accompanied by behavioral or somatic symptoms. prevalence of this disorder is 1.8% among women, with 1.3% of women experiencing functional impairment (bernaras et al., 2019). substance or medication-induced depression can be caused by substances or medication, as the appellations suggest. it is defined as the presence of depressive symptoms after usage of a certain substance that persist even after the physiological effects have disappeared. this type of depression can be induced by drugs, toxins, psychotropic drugs and others and it develops in the first month of use. prevalence in the us is 0.26% (bernaras et al., 2019). anxiety is a common name for many mental disorders which are usually exhibited as excessive fear and worry. anxiety disorders are prevalent worldwide, ranging from 3.8 to 25%; furthermore their prevalence among people with chronic conditions is 70%. anxiety is a feeling of fear, worry or nervousness and often includes feelings of distress, powerlessness and a somatically aroused central nervous system. it often prompts responses to perceived danger which can be real or imaginary. there are different types of anxiety disorders: generalized anxiety disorder, social anxiety, separation anxiety, panic disorder and others. anxiety is correlated with risk factors for cardiovascular conditions (freidl et al., 2017; kandola et al., 2018). anxiety disorders can have different causes but are often a consequence of temperament, early experiences and specific life events (barlow, 2000). among the causes is heightened sensitivity to negative events, threatening objects or information, which increases the risk of negative feelings. the anxiety disorder is characterized by increased physiological responses, including dry mouth, nausea, feeling unwell, chest pain and shortness of breath. the second cause is the child’s feeling of not being able to control things like behaviour of their parents or peers and the tendency to react negatively to stressful events. the third cause is specific life events and experiences, such as trouble in the child’s parents’ relationship, dangerous attachment, critical parents with high expectations or anxious parents (dobnik renko, 2020). anxiety disorders that develop in early childhood can become chronic and have a high probability of recurrence. the presence of anxiety during adolescence increases the likelihood of the individual developing anxiety in adult life by two to three times 19 annales kinesiologiae • 12 • 2021 • 1 katarina puš, tanja kajtna: prevalence of depression and anxiety symptoms among female ..., 15–27 and similarly increases the risk of developing depression in adult life. adolescents that suffer from anxiety have trouble in different areas such as general health, schoolwork, and later in adult life physical and cognitive functions. proven risk factors that are the same for the development of anxiety and depression are female gender and stressful life events. in addition, loneliness, emotional reliance and dysfunctional relationships in the family or with peers also increase the risk of developing depression and anxiety (essau, 2003; essau, lewinsohn, olaya, & seeley, 2014; lewinsohn, rohde, & seeley, 1998; woodward & fergusson, 2001). depression and anxiety are fairly present among athletes, especially younger ones both disorders are prevalent in 15.6% to 21% of student-athletes who are more exposed to certain risk factors than the general population. these include injuries, unfulfilled expectations, and overtraining (wolanin, gross, & hong, 2015). important factors are various personal characteristics, including perfectionism, poor negative-stress coping skills, and internal attributions for failure, poorer performance than expected, guilt and shame (nixdorf, beckmann, nixdorf, & nicholls, 2020). in a female football team consisting of 18 to 26 players, 2 to 4 players (14%) show serious signs and symptoms of depression. groups of second league players who are younger than 20 years old, have less competitive experience, who describe their health as average or poor, and less frequently start the games are at greater risk of developing depression and anxiety (junge & prinz, 2018). the main causes of anxiety among elite athletes are pressure from competition, media, career instability or dissatisfaction, and injuries. female gender, younger age and less experience in competing increase risk factors for developing anxiety disorder (rice et al., 2019; rocha & osório, 2018). the prevalence of mild to severe depression among female athletes ranges from 9.8% to 36.5% (gorczynski, coyle, & gibson, 2017). the aim of this research is to determine the prevalence of depression and anxiety among slovenian female football players and their non-player peers and compare the prevalence in order to find differences between the two groups. methods participants the sample consisted of slovenian female football players who play in the slovenian 1st female league or youth league and their non-player peers. the average age of subjects was 22±4 years. the upper age limit was 35 years, whereas the lower age limit was 15. the sample consisted of 232 subjects of which 198 filled out the questionnaires completely (85.34%), 78 of them were football players aged 19.3±3.9, and 120 were non-active peers aged 23.3±4.2. football players were contacted through club and national team coaches and physical education teachers who invited them to participate. non-players were selected from two sources: the same high schools as football players, reached via physical education teachers, and faculties of the university of ljubljana, 20 katarina puš, tanja kajtna: prevalence of depression and anxiety symptoms among female ..., 15–27 annales kinesiologiae • 12 • 2021 • 1 via student organizations. all of the subjects decided to participate in the study voluntarily with no compensation. instruments we used three questionnaires that were translated into the slovenian language: beck depression inventory-ii (bdi-ii), beck anxiety inventory (bai), and depression, anxiety and stress scale (dass-21). we added general information questions about age, activity levels and participation in competitive football. all questionnaires are selfreported measures of depressive or anxiety symptoms. bdi-ii is a 21-item questionnaire that assesses an individual’s depressive symptoms over the course of 2 weeks. it uses a 4-level scoring scale from 0 (not at all) to 3 (severe). scores are summed to derive depressive symptoms severity: scores between 0 and 13 represent minimal depression, between 14 and 19 mild depression, between 20 and 28 moderate depression, and between 29 to 63 severe depression. cronbach’s alpha of bdi-ii is 0.844. bai consists of 21 questions about anxiety symptoms and its purpose is to distinguish anxiety from depression. it uses a 4-level scoring scale from 0 (not at all) to 3 (severe). scores are calculated as a sum of all, where scores between 0 and 7 represent minimal anxiety, between 8 to 15 mild anxiety, 16 to 25 moderate anxiety, and 26 to 63 severe anxiety. cronbach’s alpha of bai is 0.875. dass-21 is an abbreviated version of lovibond and lovibond’s 42-item depression, anxiety and stress scale (dass) and has been constructed to measure multiple dimensions of depression, anxiety and stress. it consists of 21 questions, 7 per dimension, which are scored on 4 levels: 0 (not at all) to 3 (severe). the maximal score in each dimension is 21. we only used scores for depression and anxiety (lovibond & lovibond, 1995). cronbach’s alpha of dass-21 is 0.710 for the anxiety subscale and 0.804 for the depression subscale. all of the questionnaires were translated into the slovenian language as an internal tool by psychological office brst psihologija. procedure before participating in the study, underage subjects needed to obtain a legal guardian’s consent. the participants connected to an online call where they were sent a link to the questionnaires. they remained on the online call the whole time during answering in order to have the option to ask questions if needed. 21 annales kinesiologiae • 12 • 2021 • 1 katarina puš, tanja kajtna: prevalence of depression and anxiety symptoms among female ..., 15–27 statistical analysis statistical analysis was conducted in ibm spss 25 (spss inc., armonk, ny, usa) and the data were edited in microsoft excel 2019 (microsoft corporation, redmond, washington, usa). frequency distribution was calculated for descriptive variables, and averages and standard deviations were calculated for numerical variables. we used cross-tabulations to get prevalence among football players and non-players. as data were not normally distributed, we used the mann-whitney test to examine differences. results results of the bdi-ii presented in table 1 show that 47.4% of football players have experienced minimal depression, 9% have experienced mild depression and 43.6% show symptoms of moderate to severe depression. in comparison, 64.2% of their peers report minimal depression, 20% mild depression, and 15.8% moderate to severe depression. in football players the mean score was 15.65±9.5 and for non-player peers the mean score was 11.32±8.4. the mann-whitney test revealed differences between the groups (p = 0.001). table 1. depressive symptoms categories (bdi-ii) in female football players and nonplayers group bdi_ii depressive symptoms categories minimal mild moderate to severe total football players count 37 7 34 78 % of the group 47.4% 9.0% 43.6% 100.0% non-players count 77 24 19 120 % of the group 64.2% 20.0% 15.8% 100.0% total count 114 31 53 198 % of total 57.6% 15.7% 26.8% 100.0% results of depression symptoms from the dass-21 questionnaire (table 2) show that 71.8% of female football players experience normal to mild levels of depression, while 10.3% show severe to extremely severe symptoms of depression. the same questionnaire gave similar results for the peer group – 75% of peers report experiencing 22 katarina puš, tanja kajtna: prevalence of depression and anxiety symptoms among female ..., 15–27 annales kinesiologiae • 12 • 2021 • 1 normal to mild levels of depression and 11.7% serious to severe depression. football players’ mean score was 9.13±7.5 and non-player peers’ mean score was 9.33±8.4. the mann-whitney test revealed no differences between the groups (p = 0.703). table 2. depressive symptoms categories (dass-21) in female football players and non-players group dass-21 depressive symptoms categories normal to mild moderate severe to extremely severe total football players count 56 14 8 78 % of the group 71.8% 17.9% 10.3% 100.0% non-players count 90 16 14 120 % of the group 75.0% 13.3% 11.7% 100.0% total count 146 30 22 198 % of total 73.7% 15.2% 11.1% 100.0% results of the bai (table 3) show that 79.5% of female football players experience low levels of anxiety, similar to 75% of their peers. according to the results of this questionnaire, none of the football players shows symptoms of severe anxiety. football players mean score was 14.36±8.5 and non-player peers mean score was 14.22±9.8. the mann-whitney test revealed no differences between the groups (p = 0.387). results of anxiety symptoms from the dass-21 questionnaire (table 4) show that 56.4% of football players experience normal to mild levels of anxiety, similarly to 56.7% of their peers. results for moderate, severe and extremely severe levels of anxiety were similar in both groups – 21.8% of female football players report moderate levels of anxiety, as do 21.7% of their peers. prevalence for severe to extremely severe anxiety were 21.8% in football players and 21.7% in their peer group. football players’ mean score was 9.13±7.5 and non-player peers’ mean score was 9.9±7.6. the mann-whitney test revealed no differences between the groups (p = 0.973). 23 annales kinesiologiae • 12 • 2021 • 1 katarina puš, tanja kajtna: prevalence of depression and anxiety symptoms among female ..., 15–27 table 3. anxiety symptoms categories (bai) in female football players and non-players group bai anxiety symptoms categories minimal mild severe total football players count 62 16 0 78 % of the group 79.5% 20.5% 0.0% 100.0% non-players count 90 25 5 120 % of the group 75.0% 20.8% 4.2% 100.0% total count 152 41 5 198 % of total 76.8% 20.7% 2.5% 100.0% table 4. anxiety symptoms categories (dass-21) in female football players and nonplayers group anxiety symptoms categories normal to mild moderate severe to extremely severe total football players count 44 17 17 78 % of football players 56.4% 21.8% 21.8% 100.0% non-players count 68 26 26 120 % of football players 56.7% 21.7% 21.7% 100.0% total count 112 43 43 198 % of total 56.6% 21.7% 21.7% 100.0% discussion prevalence of depression and anxiety differ due to many factors: demographic variables, physical health variables, mental health variables, and sociocultural elements. we used only female football players who live in slovenia and their non-player peers from the same environment. the response rate for our research was 85.34%. slovenian female football players are not professionals, which means their primary income is not from playing football. consequently, they are exposed to more risk factors for developing depressive or anxiety symptoms because their risk factors are combined from foot24 katarina puš, tanja kajtna: prevalence of depression and anxiety symptoms among female ..., 15–27 annales kinesiologiae • 12 • 2021 • 1 ball and everyday life. it is widely known that minor everyday problems or long-term stress create higher stress levels than major life events (beable, fulcher, & lee, 2017). these risk factors can be the same as for their peers with the addition of stress coming from the football setting. we measured point prevalence for different levels of depression and anxiety and compared the groups. this study focused on self-reported measures of depression and anxiety symptoms and was conducted during the covid-19 pandemic, which could have affected the results of the study. the pandemic caused psychological and social problems for a major proportion of the world’s population. 53.8% of chinese residents described the effect of the pandemic as moderate to serious to their mental health. strict lockdowns caused people to move away from each other, both physically and emotionally. lack of interpersonal contact can cause or worsen depression and anxiety and also the symptoms of both disorders. in addition, women are more prone to developing depression thus there are more chances they have been more affected during the pandemic than males. also, the period was more stressful for high school and college students who had more distance learning and more uncertainty about going back to school or college, which may be one of the reasons for the increased incidence of depression and anxiety. younger generations are more likely to use social networks, which can contain incorrect information, which can trigger feelings of anxiety, as well as tabloids (ustun, 2021). in slovenia, sports competitions were limited and even cancelled for a while, for a certain amount of time group training was not allowed either. these measures have had different effects on athletes. results of the questionnaires can differ depending on the part of the season; this research was conducted during the winter break of the 2020/21 season. knowing that the pandemic is a state of emergency, this has to be taken into account while interpreting the results as every individual responds and adapts in their way. our study has found significant differences between groups in depressive symptoms according to the results of bdi-ii, showing that moderate to severe depression was more present in a group of football players who have experienced additional stress compared to their peers due to stopped competition and limited training processes. people who experience exceptional psychosocial stress are more prone to developing depression and as mentioned, a pandemic is a state of emergency which triggers different responses in every individual and depressive symptoms can be one of them. ustun (2021) found that 65.8% of the research subjects felt deprived of social life and entertainment, which can cause symptoms of depression especially among extroverted people. differences can also be seen due to the high sensitivity of the questionnaire. beck depression inventory and beck anxiety inventory do not have validated translations in the slovenian language, meaning that their results cannot be applied to the whole population. still, the questionnaires are well-accepted self-report measures for depression and anxiety, in both clinical and research settings. most research about depression and anxiety among athletes is done on individual sports athletes, retired athletes, and student-athletes, especially in the us and uk (lebrun, macnamara, rodgers, & collins, 2018; newman, howells, & fletcher, 2016). this research has studied females from a team sport and their non-player peers, which 25 annales kinesiologiae • 12 • 2021 • 1 katarina puš, tanja kajtna: prevalence of depression and anxiety symptoms among female ..., 15–27 is a less researched area. junge & feddermann-demont (2016) found that 2.3 female football players experience at least mild symptoms of depression, which represented 13% of their sample. similar to our study, they found that depression was similarly present in the general female population. anxiety symptoms were present among 1.4% of the players and half of these had had accompanying symptoms of depression. according to this study, anxiety symptoms are less common among athletes than in the general population. even though our research did not find statistically significant differences between most groups, depression and anxiety are conditions that are more common worldwide and the pandemic only increased the number of affected people. due to this growth, it is important to talk about it to make the public aware and also scientifically support the findings in order to reduce the incidence of mental illness. in the future, we would like to see more research on this topic and thus alleviate the symptoms of individuals affected by these disorders. conclusion in conclusion, this study has offered an insight into the current situation among slovenian female football players and their peers. despite the size of the sample, we have not reached strong conclusions. most commonly observed were symptoms of normal to mild levels of depression and anxiety among both groups from the questionnaires, which is not concerning. this study provided a start of research during the covid-19 pandemic and the outcomes, as mentioned before, are not too concerning. this area of research needs more attention, especially after the pandemic which has influenced individuals differently, and after strong scientific conclusions have been reached, recommendations need to be made in order to lower the prevalence and some of the risk factors of depression and anxiety. a very important factor is the identification of individuals prone to psychological disorders and the preservation or improvement of their mental health. limitations of the study a number of limitations can be noted. the standardized questionnaires that were used do not have a validated translation in the slovenian language and the results cannot be generalized to the whole population. participants completed the questionnaire online and this may have 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https://www.who.int/news-room/fact-sheets/detail/depression _goback _hlk98923763 _hlk98755967 _hlk79606686 _hlk99786836 _hlk98147084 _hlk99787368 _hlk88552317 _hlk17057094 annales kinesiologiae • 12 • 2021 • 2 91 original scientific article doi: https://doi.org/10.35469/ak.2021.324 received: 2022-04-01 udc: 796.82:613.24 the effect of rapid weight loss on the handgrip strength of national-level wrestlers carlo rossi1, roberto roklicer2, antonino bianco1, marko manojlovic2, barbara gilic3,4, tatjana trivic2 and patrik drid2 1 sport and exercise sciences research unit, university of palermo, palermo, italy 2 faculty of sport and physical education, university of novi sad, serbia 3 university of split, faculty of kinesiology, split, croatia 4 university of zagreb, faculty of kinesiology, zagreb, croatia corresponding author: patrik drid university of novi sad, faculty of sport and physical education, lovćenska 16, 21000 novi sad, serbia phone: +381641118884 e-mail: patrikdrid@gmail.com abstract the effects of rapid weight loss (rwl) in combat sports athletes is an area that is not yet fully discovered. therefore, the goal of this study was to determine the impact of weight loss on hgs (handgrip strength) in greco-roman wrestlers. this cross-over study included ten athletes examined for hgs during three time points for each hand. the first measurement – baseline (bl), was performed before weight reduction. the second measurement ‒ phase 1 (p1), was taken after high-intensity sports specific training (hisst) combined with rwl. in this phase, participants had to lose 5% of their body mass within three days, after which hisst was carried out (on day 3). the third measurement ‒ phase 2 (p2), was performed seven days after p1, which included hisst with no rwl. when comparing the hgs values, significantly higher values were observed only when p1 was compared with p2 for the left hand (p=0.039). this means that the grip was significantly stronger after rwl was conducted together with hisst. this research could be of great importance to combat sports coaches and athletes as it evaluates the effect of rwl on performance parameters. therefore, the results of our study could serve to improve the wrestlers’ weight-reduction plan. keywords: greco-roman, performance, weight reduction, wrestling 92 carlo rossi, roberto roklicer, antonino bianco, marko manojlovic, barbara gilic, tatjana trivic and patrik drid: the effect ..., 91–101 annales kinesiologiae • 12 • 2021 • 2 učinki naglega zmanjševanja telesne mase na moč oprijema pri reprezentančnih rokoborcih izvleček učinki naglega zmanjševanja telesne mase pri športnikih v borilnih disciplinah so področje, ki še ni povsem raziskano. zato je bil cilj te študije ugotoviti, kako nagla izguba telesne mase vpliva na moč oprijema pri rokoborcih v grško-rimskem slogu. v pričujočo navzkrižno študijo smo vključili deset športnikov, pri katerih smo preverjali moč oprijema za vsako roko v treh različnih časovnih obdobjih. prvo meritev ‒ ki je predstavljala izhodišče ‒ smo opravili pred začetkom zmanjševanja telesne mase. drugo meritev ‒ 1. faza ‒ smo opravili po visokointenzivni športnospecifični vadbi v kombinaciji z naglo izgubo telesne mase. v tej fazi so sodelujoči morali v treh dneh za 5 odstotkov zmanjšati svojo telesno maso, nato pa opraviti visokointenzivno športnospecifično vadbo (tretji dan). tretja meritev ‒ 2. faza ‒ je bila izvedena sedem dni po 1. fazi in je vključevala visokointenzivno športnospecifično vadbo brez zmanjševanja telesne mase. pri primerjavi podatkov o moči oprijema smo občutno višje vrednosti zaznali med rezultati meritev v 1. in 2. fazi za levo roko, saj so slednji pokazali, da se je moč oprijema občutno povečala po zmanjšanju telesne mase v kombinaciji z visokointenzivno športnospecifično vadbo. študija, ki meri učinke naglega zmanjšanja telesne mase na parametre zmogljivosti, prinaša pomembne uvide za trenerje in športnike v borilnih disciplinah in bi lahko pripomogla k izboljšanju programov za zmanjševanje telesne mase pri rokoborcih. ključne besede: grško-rimski slog, zmogljivost, zmanjševanje telesne mase, rokoborba annales kinesiologiae • 12 • 2021 • 2 93 carlo rossi, roberto roklicer, antonino bianco, marko manojlovic, barbara gilic, tatjana trivic and patrik drid: the effect ..., 91–101 introduction to be successful in wrestling, an athlete must possess high levels of physical and psychological readiness. indeed, wrestling is a very demanding and vigorous sport that consists of two 3-minute rounds, with a break of 30 seconds in between (yoon, 2002). thus, both aerobic and anaerobic energy systems are taxed during a wrestling match (nikooie, cheraghi, & mohamadipour, 2017). specifically, the anaerobic system provides explosive and short bursts of maximal power and strength, while the aerobic system is responsible for sustained effort during the match (demirkan, koz, kutlu, & favre, 2015). furthermore, wrestling requires highly developed upper-body strength and power, particularly handgrip strength (gerodimos et al., 2013; demirkan et al., 2015). handgrip strength (hgs) in hand-to-hand combat sports, including wrestling, is essential for movements such as pulling, pushing, throwing and controlling the opponent, which are important determinants of the match outcome (cronin, lawton, harris, kilding, & mcmaster, 2017). moreover, possessing high hgs and endurance is very important in the later rounds of the match and can influence the continuation or end of the dominance of the opponent (franchini, schwartz, & takito, 2018). also, hgs is essential in several wrestling holds because various take-down and defensive maneuvers are based on a strong grip (gerodimos et al., 2013). indeed, a very strong relationship was recorded between hgs and success in wrestling (i.e., competition ranking) (garcíapallarés, lópez-gullón, muriel, díaz, & izquierdo, 2011; nikooie et al., 2017). also, elite male wrestlers had stronger handgrip compared to sub-elite wrestlers (nikooie et al., 2017). it is important to note that both absolute and relative strength was higher in elite than in sub-elite wrestlers, which supports the hypothesis that handgrip can be observed as a determinant of overall strength in athletes (garcía-pallarés et al., 2011). in combat sports, athletes are categorized into weight classes according to their body mass in order to reduce the difference in strength and size of the competitors. the aim of dividing athletes into weight classes is to create equal competition conditions for each athlete (castor-praga, lopez-walle, & sanchez-lopez, 2021). however, in order to drop the weight into a class where an athlete would have an advantage over the lighter and weaker opponent, rapid weight loss is commonly practiced among combat sports athletes (khodaee, olewinski, shadgan, & kiningham, 2015; ranisavljev et al., 2022; todorović et al., 2021). rapid weight loss (rwl) stands for a method characterized by losing at least 5% of body weight in fewer than seven days prior to competition (khodaee et al., 2015). however, such large alterations in body weight, although without conclusive scientific evidence, most likely impact athletes’ performance. namely, rwl leads to detriments on anaerobic performance, which is related to reduced glycogen depletion and buffering capacity (lakicevic et al., 2020). reduced muscle glycogen can impair excitation-contraction coupling in the muscle and accelerate the onset of muscle fatigue, which can reduce exercise performance (ørtenblad, westerblad, & nielsen, 2013). recent studies revealed that rwl leads to significant muscle damage in combat sports athletes and impairs heart rate recovery in national-level wrestlers (roklicer et al., 2020; roklicer et al., 2022). 94 carlo rossi, roberto roklicer, antonino bianco, marko manojlovic, barbara gilic, tatjana trivic and patrik drid: the effect ..., 91–101 annales kinesiologiae • 12 • 2021 • 2 to the best of the authors’ knowledge, no study has examined the influence of rwl combined with hisst on hgs in wrestlers. thus, the aim of this study was to determine the impact of rwl on hgs in wrestlers. methods participants this cross-over study was carried out on a total of 10 male national level grecoroman wrestlers (22.44 ± 4.53 years; mean body weight: 73.36 ± 4.42 kg; mean body height: 174.43 ± 3.78 cm). to be included in the experiment, wrestlers had to have at least five years of competitive experience. additionally, participants were eligible only if they had used rwl methods within the previous two years. participants were free of injury at the time of the testing. the procedures were fully explained to the participants before conducting the study. each respondent participated voluntarily by signing the informed consent. body composition parameters were measured using a body composition analyzer (omron bf511, omron healthcare ltd., matsusaka, japan). all procedures were carried out in accordance with the declaration of helsinki. the study was approved by the ethical board of the university of novi sad, serbia (ref. no. 46-06-02/2020-1). experimental approach to the problem handgrip strength was measured at three time points. the first measurement – (bl) was conducted before the weight reduction. the second measurement – phase 1 (p1), was done after the high-intensity sport-specific training (hisst) combined with rwl. for this phase, participants had to lose 5% of their body mass within three days, after which the hisst was carried out (on day 3). the third measurement – phase 2 (p2), was carried out seven days following p1 and included hisst (after which the measurements were done) with no rwl. isometric handgrip strength the maximum grip strength was measured for both hands with a takei portable dynamometer (takei scientific instruments co., tokyo, japan). participants stood with the abducted shoulder. the dynamometer was previously adapted to the size of the participant’s hands and held with the arms parallel to the body without squeezing/attaching the arm against the body. the position of the hand remained constantly downwards, and the palm did not bend at the wrist joint. subjects were asked to do a maxiannales kinesiologiae • 12 • 2021 • 2 95 carlo rossi, roberto roklicer, antonino bianco, marko manojlovic, barbara gilic, tatjana trivic and patrik drid: the effect ..., 91–101 mum voluntary contraction on the dynamometer for 5 seconds. all subjects performed three trials for each hand, and the best performance was used for further analysis. statistical analysis the results are presented as mean and standard deviation. the normality of the distribution was determined by the shapiro-wilks test. to compare the means between the handgrip strength measurements, one way anova for repeated measures with lsd post hoc analysis was conducted. all statistical procedures were done using ibm spss statistics for windows, 20.0 (ibm corp 20, armonk, ny, usa). the significance level was set at p≤0.05. results the wrestlers’ characteristics are presented in table 1. according to the results obtained, statistically significant differences were observed across the three time points. the values obtained in p1 were significantly lower for body weight, bmi, fm, and vbf, while muscle mass increased significantly compared to the baseline measurement. the results in p2 were significantly higher for body weight, bmi, fm, and vbf, while muscle mass was significantly lower in this phase compared to p1. basal metabolic rate was not significantly different across the three time points. table 1. descriptive characteristics of body composition of wrestlers (n=10) bl p1 p2 body weight (kg) 73.36±4.42 69.27±4.12* 72.38±4.17# bmi (kg/m2) 24.11±0.96 22.62±0.98* 23.64±1.07# fm (%) 16.37±2.22 12.74±3.15* 14.98±2.47# mm (%) 42.51±1.41 44.64±2.14* 43.36±1.71# vbf (%) 6.11±1.05 4.88±1.16* 5.66±1.32# basal metabolic rate (kcal) 1717.33±64.98 1677.11±61.49 1704.11±56.43 values are presented as mean and standard deviation (m±sd); bl – baseline values; p1 – phase one: hisst combined with rwl; p2 – phase two: hisst with no rwl procedures included; bmi – body mass index (kg/m2); fm – fat mass (%); mm –muscle mass (%); vbf – visceral body fat (%);* statistically significant difference compared to baseline values, p≤0.001; # statistically significant difference compared to p1, p≤0.01. 96 carlo rossi, roberto roklicer, antonino bianco, marko manojlovic, barbara gilic, tatjana trivic and patrik drid: the effect ..., 91–101 annales kinesiologiae • 12 • 2021 • 2 the handgrip strength values for both hands are presented in table 2. although the higher values for the right hand are visible in p1 and p2 in comparison to the baseline, the difference remained statistically insignificant. as for the left hand, similar values were obtained during bl and p2. however, according to lsd pairwise comparisons, significantly higher handgrip strength was observed in p1 only when compared to p2, p=0.039 (figure 1). figure 1. handgrip strength differences in greco-roman wrestlers. legend: * significantly different compared to p2 (left handgrip) p<0.05; bl – baseline measurement; p1 – phase one: hisst combined with rwl; p2 – phase two: hisst with no rwl procedures included; hg – right and left handgrip strength; kg – kilograms. annales kinesiologiae • 12 • 2021 • 2 97 carlo rossi, roberto roklicer, antonino bianco, marko manojlovic, barbara gilic, tatjana trivic and patrik drid: the effect ..., 91–101 table 2. handgrip strength of wrestlers. bl p1 p2 f p partial eta squared hg right (kg) 55.55 ±5.81 56.66 ±7.28 56.44 ±8.35 0.104 0.857 0.013 hg left (kg) 54.55 ±6.06 57.55 ±4.44* 54 ±4 1.845 0.199 0.187 values are presented as mean and standard deviation (m±sd); bl – baseline values; p1 – phase one: hisst combined with rwl; p2 – phase two: hisst with no rwl procedures included; f – f ratio; hg right – right-hand handgrip strength; hg left – left-hand handgrip strength; *statistically significantly different compared to p2 according to post hoc pairwise comparisons, p≤0.05. discussion to the author‘s knowledge, this is the first cross-over design study that analyzes the impact of combining rwl with hisst and hisst alone on hgs performance in national-level greco-roman wrestlers. the obtained results demonstrated changes in hgs values in the phase when body weight reduction was implemented. maximum grip strength production significantly increased only for the left hand of the athletes. there are not many previous studies examining the influence of rwl on hgs in wrestlers. research conducted on elite wrestlers showed a decrease in hgs performance after applying rwl (jlid, maffulli, elloumi, moalla, & paillard, 2013). on the other hand, weight loss failed to alter the hgs values in college wrestlers (serfass, stull, alexander, & ewing jr., 1984; marttinen, judelson, wiersma, & coburn, 2011). in contrast to the results of these studies, this research reported a positive effect of rwl on hgs values. isometric strength production was higher for the left hand during the combined phase of rwl with hisst compared to values observed in p2. the average hgs performance of the right hand was also increased, albeit without statistical significance. several possible mechanisms may explain these findings. athletes have probably experienced psychological arousal due to reaching the target weight for the category in which they intend to compete, which potentially leads to improved strength performance. additionally, changes in body composition may be related to the results shown. the increase in muscle mass, as well as the decrease in fm and vbf during the application of rwl, are probably responsible for the positive alterations in hgs values. due to the already mentioned importance of hgs in separating more successful wrestlers from less successful ones, coaches and athletes could probably implement rwl before the competition. of course, the weight loss process must be conducted with some caution due to the negative impact on other health aspects of athletes. future studies on larger 98 carlo rossi, roberto roklicer, antonino bianco, marko manojlovic, barbara gilic, tatjana trivic and patrik drid: the effect ..., 91–101 annales kinesiologiae • 12 • 2021 • 2 samples are needed to clearly understand the results obtained in this study. in combat sports, the link between weight loss and hgs has been most investigated in judo. as in wrestling, the previous findings are inconsistent. some studies have reported that rwl reduces hgs values in judo athletes (degoutte et al., 2006; clarys, ramon, hagman, deriemaeker, & zinzen, 2010; isacco et al., 2020). however, the weight loss did not change the hgs performance of the left hand in national level judokas (filaire et al., 2001). additionally, weight reduction did not affect the maximal isometric strength in czech judokas, although marginally higher average hgs values were observed for both the left and right hand after the rwl period (coufalová, cochrane, maly, & heller, 2014). the results are also in conflict in mixed martial arts (mma). camarço et al. (2016) failed to find alterations in hgs values after rwl was applied. contrary, rwl significantly decreased hgs performance in amateur mma fighters (alves et al., 2018). all studies demonstrated a negative or no effect of rwl on hgs values in combat athletes. only the results of our research showed a positive impact of rwl on hgs performance. the cross-over design of the presented study may be a factor that contributed to the final outcome. some of the future research could focus on the influence of rwl on hgs in combat sports like sambo, taekwondo, or boxing. finally, this study has several relevant limitations that should be mentioned. first, the study was conducted on a relatively small sample . second, the respondents were national-level wrestlers. participants’ hand dominance was not reported prior to testing. future studies should monitor glycogen and various inflammation and muscle damage levels along with subjective levels of physical and/or mental arousal. additionally, future studies should investigate the impact of rwl on hgs values in elite wrestlers. finally, athletes were free to choose weight loss methods. hence, wrestlers most likely used different techniques of rwl. conclusion the aim of this study was to determine hgs in national-level wrestlers. particularly, the impact of rwl on the handgrip strength was measured during baseline and two different phases ‒ p1 and p2. comparing the hgs values, a significant difference was observed only when p1 was compared to p2 for the left hand. specifically, the handgrip was stronger after rwl was included along with hisst. this phenomenon may be interpreted as psychological arousal of athletes who have attained the target weight for a certain category they tend to compete in. this research could be of great importance for combat sports coaches and athletes as it evaluates the effect of rwl on performance parameters. although further studies on this matter would be of great importance, the findings of our study might serve to improve the wrestlers’ weight reduction plan. annales kinesiologiae • 12 • 2021 • 2 99 carlo rossi, roberto roklicer, antonino bianco, marko manojlovic, barbara gilic, tatjana trivic and patrik drid: the effect ..., 91–101 conflict of interest the author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. references alves, r. c., alves bueno, j. c., borges, t. o., zourdos, m. c., de souza junior, t. p., & aoki, m. s. 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(2002). physiological profiles of elite senior wrestlers. sports medicine, 32(4), 225–233. https://doi.org/10.2165/00007256-200232040-00002. https://doi.org/10.3390/ijerph182111356 https://doi.org/10.3390/ijerph182111356 https://doi.org/10.2165/00007256-200232040-00002 _hlk89942516 _hlk103676616 _hlk111804760 _hlk111802738 _hlk30149664 _hlk111710665 annales kinesiologiae • 13 • 2022 • 1 35 original scientific article doi: https://doi.org/10.35469/ak.2022.344 received: 2022-09-15 udc: 612-053.9 fat mass to fat-free mass ratio and body composition in participants with chronic leg problems mihaela jurdana1, ana tomažič1, boštjan žvanut1 1 university of primorska, faculty of health sciences, izola, slovenia corresponding author: boštjan žvanut university of primorska, faculty of health sciences, izola, polje 42, si-6310 izola, slovenia phone: +386 5 662 64 60; fax: +386 5 662 64 80 e-mail: bostjan.zvanut@fvz.upr.si abstract background & aim: low fat-free mass (ffm) or high fat mass (fm) in older adults are abnormal body composition phenotypes associated with morbidity. the dual burden of excessive fm and low ffm may lead to a higher risk of cardiovascular and other diseases and disability and lower physical performance compared with individuals with normal body composition or low ffm or high fm alone. both conditions lead to poorer health and can be identified by a high fm/ffm ratio. because few studies have examined the effects of abnormal body composition using the fm/ffm ratio, the aim of this study is to determine the fm/ffm values by gender in patients with knee and hip pathologies and compare them with body composition parameters. this condition is important when surgery is required because abnormal body composition leads to an increase in infections and other postoperative complications. methods: a total of 93 participants aged 64.71 ± 7.71 years in women and 65.9 ± 9.9 years in men with a body mass index (bmi) ≥25 kg/m2 were recruited from the valdoltra orthopaedic hospital (ankaran, slovenia). the waist circumference (wc) and anthropometric data (bmi), as well as body composition data (fm, ffm, % of body water, estimated by bioelectrical impedance bia) were measured. in addition, the body composition phenotypes (fm/ffm ratio) were calculated. results: the fm/ffm index was higher in females. the female group with fm/ ffm (0.68) and those with a higher fm/ffm (0.92) correlated positively with wc. male participants were excluded for further analysis because only two males had fm/ ffm > 0.80. the fm/ffm of the remaining male participants was 0.53 ± 0.09. 36 mihaela jurdana, ana tomažič, boštjan žvanut: fat mass to fat-free mass ratio and body composition ..., 35–45 annales kinesiologiae • 13 • 2022 • 1 conclusions: fm/ffm provide information on patient body composition and identify individuals at risk of body composition abnormalities in women only. keywords: fat-mass, fat-free mass, waist circumference, older adults, knee, hip. razmerje med maščobno maso in pusto mišično maso ter sestava telesa pri bolnikih s kroničnimi težavami spodnje okončine izvleček izhodišča: zmanjšan delež puste mišične mase (ffm) ali povečan delež maščevja (fm) vodi pri starejših odraslih do sprememb v telesni sestavi, ki odstopajo od mejnih vrednosti, kar je povezano z obolevnostjo. sočasna prisotnost povečane fm in zmanjšane ffm lahko v primerjavi s posamezniki z normalno telesno sestavo ali samo z nizko ffm ali visoko fm poveča tveganje za razvoj srčno-žilnih in drugih bolezni, invalidnost in nižjo telesno zmogljivost. oba dejavnika poslabšata zdravstveno stanje posameznika, ki ga lahko identificiramo s pomočjo povečanega razmerja fm/ffm. zato je namen te raziskave določiti vrednosti fm/ffm pri preiskovancih s patologijo kolena in kolka ter jih primerjati s parametri telesne sestave. poznavanje vrednosti fm/ffm je ključnega pomena v primerih, ko je potreben operativni poseg, saj telesna sestava, ki odstopa od mejnih vrednosti vodi do večjega tveganja za razvoj pooperativnih zapletov. metode: v raziskavo je bilo vključenih 93 preiskovancev iz ortopedske bolnišnice valdoltra (ankaran, slovenija), starih 64,71 ± 7,71 let (ženske) in 65,9 ± 9,9 let (moški) z indeksom telesne mase (itm) ≥25 kg/m2, napotenih na ortopedsko specialistično obravnavo. izmerjeni so bili antropometrija (itm), obseg pasu (wc) ter telesna sestava (fm, ffm, % telesne vode, ocenjeni z bioeletrično impedančno analizo-bia). s pomočjo indeksa fm/ffm so bili določeni fenotipi telesne sestave. rezultati: indeks fm/ffm je bil višji pri ženskah. tako skupina žensk s fm/ffm (0,68), kot skupina z višjim fm/ffm (0,92) sta pozitivno korelirali z obsegom pasu. ker sta imela samo dva moška fm/ffm >0,80 smo moške preiskovance iz nadaljnje analize izključili. fm/ffm preostalih moških preiskovancev je znašal 0,53 ± 0,09. zaključek: razmerje fm/ffm nam poda pomembno informacijo o značilnostih pacientove telesne sestave ter pomaga identificirati bolnike, pri katerih obstaja tveganje za spremenjeno telesno sestavo. v naši študiji smo s pomočjo indeksa ugotovili, pomembne značilnosti v spremembi telesne sestave pri preiskovankah ženskega spola. ključne besede: maščobna masa, pusta mišična masa, obseg pasu, starejši odrasli, koleno, kolk. 37 annales kinesiologiae • 13 • 2022 • 1 mihaela jurdana, ana tomažič, boštjan žvanut: fat mass to fat-free mass ratio and body composition ..., 35–45 introduction the ageing of the population and the rise in obesity prevalence worldwide are the two major risk factors for non-communicable diseases, including degenerative diseases, sarcopenia, frailty, increased morbidity and mortality, with negative implications for the public health system (merchant et al., 2021). elevated body mass index (bmi), waist circumference (wc), and/or waist-to-hip ratio are commonly used to define obesity. bmi needs to be interpreted with caution in older adults as loss of physiological body height may lead to over-interpretation and lack of correlation with the percentage of body fat, the distribution of fat, or body composition (batsis et al., 2016). additionally, bmi has a limited ability to distinguish between muscle mass and fat accumulation and does not provide information on body composition (prado et al., 2012). therefore, a better understanding of body composition may require more specific measurements, such as fat mass (fm) and fat free mass (ffm), which can be obtained by bioelectrical impedance analysis (bia) (prado et al., 2012). the fat mass to fat-free mass ratio (fm/ffm) is an integrated metabolic index for assessing body composition, which evaluates the combined effect of the ratio between fm and ffm (godziuk, woodhouse, prado, & forhan, 2020; rugila et al., 2022) in other words, fm/ffm indicates whether the amount of fm is adequate for the amount of ffm in an individual. theoretically, higher values of the ratio indicate a less favorable balance between fm and ffm, and a high fm/ffm ratio already has negative effects on physical abilities and contributes to morbidity and mortality in many patients (prado et al., 2012). despite these clinical associations previously found with fm/ffm in chronic disease, this ratio has not been studied in patients with chronic knee or hip pain. the clinical impact of higher versus lower fm/ffm in these patients requires increased attention due to the accelerated loss of ffm associated with pain, mobility limitations and obesity-related inflammation (godziuk et al., 2020). in addition, a loss of muscle mass is associated with prolonged hospital stays, infections, and other complications and disability (prado et al., 2012). thus, the aim of this study is to determine the fm/ffm values and compare the body composition of patients with higher and lower fm/ffm values by gender. screening of this ratio may be important in order to identify patients with abnormal body composition, especially if surgery is indicated, to avoid complications after surgery. our hypothesis is that higher fm/ffm values in these individuals are associated with abnormalities in body composition. 38 mihaela jurdana, ana tomažič, boštjan žvanut: fat mass to fat-free mass ratio and body composition ..., 35–45 annales kinesiologiae • 13 • 2022 • 1 methods study design in this cross-sectional study, 93 participants (caucasian origin), women with a mean age of 64.71 ± 7.71 years and men with a mean age of 65.90 ± 9.90 years with knee and hip problems, referred to an orthopedist for further diagnosis, were recruited at the valdoltra orthopaedic hospital (ankaran, slovenia), excluding participants with cancer and acute illness, patients with pacemakers, and patients with a bmi ≤ 25 kg/m2. participants were examined in 2019 in the departments of the mentioned institution and underwent anthropometric measurement and body composition analysis. the national medical ethics committee of slovenia (code 0120-557/2017/4) approved the study. all the participants were fully informed about the procedures before written informed consent was obtained. anthropometric data at the study site, body height, body mass and wc were measured according to a standardized protocol. all the measurements were taken between 7 and 8 am after fasting overnight. the body height (cm) of the subjects was measured to the nearest 0.1 cm while standing, without shoes, using a leicester height measure (invicta plastics limited, oadby, england). the body mass (kg) of the participants wearing light clothing without shoes was measured with an accuracy of 0.1 kg. the wc (cm) was measured in the standing position halfway between the costal arch and the iliac crest with a nonstretchable tape measure. the bmi (kg/m2) was calculated using the formula body mass (kg) / body height (m2). body composition measurements fm (kg) and ffm (kg) were estimated by bioelectrical impedance analysis (bia) using the tanita bc 418ma (tanita corporation, arlington heights, il) and the data was analyzed with the software provided by the manufacturer. the fm to ffm ratio (fm/ffm) was calculated as an index of obesity combined with sarcopenia and the following cut-off values were used (biolo et al., 2015; prado et al., 2012): fm/ffm ratio < 0.40 for metabolically healthy obese individuals in whom the increase in fm was minor compared to that in ffm; fm/ffm ratios between 0.40 and 0.80 for obese phenotypes in whom fm predominated ffm, but ffm is still adequately maintained; fm/ffm ratios > 0.80 for obese phenotypes with sarcopenia in whom fm was increased and ffm was reduced. 39 annales kinesiologiae • 13 • 2022 • 1 mihaela jurdana, ana tomažič, boštjan žvanut: fat mass to fat-free mass ratio and body composition ..., 35–45 statistics statistical analyses were performed using ibm spss ver. 26. univariate data analysis was performed by calculating the frequencies and percentages for qualitative variables, mean and/or median, standard deviation (sd) were calculated for quantitative variables. to assess the normality of the distribution, kolmogorov-smironov and shaphiro-wilk tests were performed. normality was additionally assessed by evaluating the histogram, skewness, and kurtosis. the independent sample t-test was used to determine the statistically significant differences between the two groups because the variables in both groups followed the normal distribution. the pearson’s correlation coefficient was calculated to determine the association between normally distributed variables. results the participant characteristics are shown in table 1. the female and male participants were comparable in age and bmi. male participants had higher body mass, % body water, ffm and wc whereas fm and the fm/ffm ratio were higher in females. we excluded male participants from further analysis because only two men had fm/ffm > 0.80 (1.0 ± 0.13); the fm/ffm of the remaining male participants was 0.53 ± 0.09. table 1. general characteristics of the participants parameters men n=37 (45.8%) women n = 56 (54.2%) age [years] 64.71 ± 7.71 65.90 ± 9.90 anthropometric measurements body mass [kg] 93.2 ± 16.0 78.9 ± 12.9 body height [cm] 172 ± 7 160 ±7 wc [cm] 109 ± 14 101 ± 11 bmi [kg/m²] 31.4 ± 4.8 30.8 ± 5.0 body composition measurements ffm [kg] 59.7 ± 7.1 43.3 ± 4.6 body water [%] 48.7 ± 3.2 41.1 ± 2.9 fm [kg] 30.4 ± 10.6 43.3 ±4.6 fm/ffm 0.50 ± 0.16 0.75 ± 0.15 legend: all the values are mean ±sd, bmi body mass index, wc waist circumference, fm fat mass, ffm fat free mass, fm/ffm ratio ratio between fat mass and fat free mass 40 mihaela jurdana, ana tomažič, boštjan žvanut: fat mass to fat-free mass ratio and body composition ..., 35–45 annales kinesiologiae • 13 • 2022 • 1 therefore, we divided the females into two groups based on the cut-off values for the fm/ffm ratio: fm/ffm between 0.40 and 0.80 and fm/ffm ≥ 0.80 (table 2). table 2. body composition data in women with medium and higher fm/ffm (0.4 < fm/ffm < 0.8 and fm/ffm ≥ 0.8). fm/ffm 0.4 < fm/ffm < 0.8 fm/ffm ≥ 0.8 independent sample t-test (p)parameters (n=41) (n=15) cohen d age [years] 66.62 ± 9.82 65.85 ± 9.55 .704 body mass [kg] 72.33 ± 8.11 91.31 ± 11.12 < .001 -2.112 body height [cm] 159.05 ± 6.94 160.53 ± 7.58 .318 wc [cm] 97.07 ± 7.93 110.18 ± 9.07 < .001 -1.581 bmi [kg/m²] 28.66 ± 3.32 35.56 ± 4.79 < .001 -1.837 body water [%] 42.38 ± 2.18 38.13 ± 1.76 < .001 2.044 fm [%] 38.95 ± 3.34 46.28 ± 2.68 < .001 -2.304 fm [kg] 28.3 ± 4.9 42.4 ±7.0 < .001 -2.481 ffm [kg] 41.63 ± 3.61 46.31 ± 4.63 < .001 -1.200 fm/ffm ratio .68 ± .09 .92 ± .11 < .001 -2.511 legend: all values are mean ± sd, bmi body mass index, wc waist circumference, fm fat mass, ffm fat free mass, fm/ffm ratio ratio between fat mass and fat free mass forty-one of the women were classified in the obesity phenotype group: fm/ffm ratio (0.68 ± 0.09), while fifteen women had an obesity phenotype combined with a low ffm: fm/ffm ratio (0.92 ± 0.11). in addition, women with a higher fm/ffm ratio (≥ 0.8) exhibited significantly greater body mass, bmi, wc, ffm and fm and a significantly lower % of body water when compared to the group with a lower fm/ffm. pearson’s correlation analysis revealed a significant, positive correlation in both groups between fm/ffm and bmi (overall: r = 0.742, p < 0.01; for 0.4 < fm/ffm < 0.8: r = 0.659, p < 0.01; for fm/ffm ≥ 0.8: r = 0.676, p < 0.01, figure 1a) and wc (overall: r = 0.768, p < 0.01; for 0.4 < fm/ffm < 0.8: r = 0.741, p < 0.01; fm/ffm ≥ 0.8: r = 0.542, p < 0.01, figure 1b). in addition, a significant, negative correlation was identified between fm/ffm and % of body water (overall: r = 0.907, p <0.01; for 0.4 < fm/ffm < 0.8: r = 0.869, p < 0.01; for fm/ffm ≥ 0.8: r= 0.874, p <0.01, figure 1c). 41 annales kinesiologiae • 13 • 2022 • 1 mihaela jurdana, ana tomažič, boštjan žvanut: fat mass to fat-free mass ratio and body composition ..., 35–45 figures 1a, 1b: scatter diagrams of the fm/ffm ratio and bmi (a) and wc (b). a) b) 42 mihaela jurdana, ana tomažič, boštjan žvanut: fat mass to fat-free mass ratio and body composition ..., 35–45 annales kinesiologiae • 13 • 2022 • 1 discussion in this cross-sectional study, the majority of the participants with hip or knee joint problems and associated leg pain were obese with normal ffm, while obesity associated with lower ffm was only found in women. a higher fm/ffm (> 0.8) is significantly associated with worse body composition parameters (body mass, bmi, wc, fm, ffm) in female patients. the ageing process in the increasing population of older adults is associated with an increase in chronic health conditions and a high prevalence of functional limitations and disabilities associated with a decrease in muscle mass and strength (delmonico & beck, 2017). in addition, obese adults have greater skeletal muscle mass than normal body mass adults of the same age and sex, as we confirmed in this study. these differences are the result of muscle anabolism induced by the loading effect of the higher body mass in obesity (biolo et al., 2015; morse & soeldner, 1964). in our study, the fm/ffm ratio in both female groups correlated strongly and positively with wc. the wc is a surrogate marker for assessing the risk of visceral/abdominal fat accumulation (ma et al., 2021). the association between abdominal fat and muscle mass loss is explained by several mechanisms. abdominal obesity is characterized by systemic inflammation, oxidative stress and insulin resistance, which affect muscle proteolysis and inhibit protein synthesis (biolo et al., 2015). adipose tissue is actively involved in metabolic regulation and secretes pro-inflammatory cytokines such figure 1c: scatter diagrams of the % of body water. c) 43 annales kinesiologiae • 13 • 2022 • 1 mihaela jurdana, ana tomažič, boštjan žvanut: fat mass to fat-free mass ratio and body composition ..., 35–45 as interleukin-6 (il -6) and tumor necrosis factor-α (tnf-α), as well as the hormone leptin. the pro-inflammatory cytokines have effects on the brain, liver, and pancreas, which control appetite, carbohydrate and fat metabolism, and energy balance (dhawan & sharma, 2020; roubenoff, 2000). the increase in fm and the accompanying release of pro-inflammatory cytokines lead to insulin resistance, which reduces the normal anabolic effect of insulin on amino acid transport in muscle (kim et al., 2000). in addition, there is evidence that leptin reduces growth hormone secretion, suppressing another important anabolic stimulus (obradovic et al., 2021). in addition, there are a number of explanations for the association between body fat, muscle mass and musculoskeletal pain, including the upregulation of pro-inflammatory cytokines released by adipose tissue (younger, kapphahn, brennan, sullivan & stefanick, 2016). inflammation triggered by pro-inflammatory cytokines is known to be associated with physical pain, particularly in women (walsh et al., 2018). in addition, a higher fm/ffm is a determinant factor of physical inactivity (rugila et al., 2022). according to the fm/ffm ratio, obese women in this study had predominantly more fat mass and less muscle mass. this could be a result of the different distribution of body fat between the sexes (prado et al., 2012). physical activity became more difficult in this condition and their habitual level decreased further. the fm/ffm ratio may help reinforce the notion that body composition is a more informative measure of risk for musculoskeletal pain and immobility (walsh et al., 2018). taken together, these findings support the hypothesis that a higher fm/ffm ratio (> 0.8) may associate obesity with an additional decrease of ffm due to immobility and inflammation. this could be important information for sarcopenia screening in participants scheduled for surgery to avoid complications. this study should be considered in light of certain limitations. first, the study included a relatively small sample size. second, there is a lack of additional measurements of inflammatory markers and muscle function, which would certainly be of interest. finally, this study is cross-sectional. conclusions a higher value of the fm/ffm ratio, studied for the first time in participants with chronic knee or hip pain, was significantly associated with abdominal obesity and is useful for identifying individuals at risk of body composition abnormalities. the clinical implications of an fm/ffm > 0.8 in these participants require increased attention, as accelerated loss of ffm and complications may occur if surgery is indicated. acknowledgements we thank the participants for their time and the entire staff of the valdoltra orthopaedic hospital, slovenia. 44 mihaela jurdana, ana tomažič, boštjan žvanut: fat mass to fat-free mass ratio and body composition ..., 35–45 annales kinesiologiae • 13 • 2022 • 1 references batsis, j. a., mackenzie, t. a., bartels, s. j., sahakyan, k. r., somers, v. k., & lopezjimenez, f. 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(2018). the association between body fat and musculoskeletal pain: a systematic review and meta-analysis. bmc musculoskeletal disorders, 19(1), 233. https://doi. org/10.1186/s12891-018-2137-0. younger, j., kapphahn, k., brennan, k., sullivan, s. d., & stefanick, m. l. (2016). association of leptin with body pain in women. journal of women’s health, 25(7), 752–760. https://doi.org/10.1089/jwh.2015.5509. https://doi.org/10.1016/j.hrtlng.2022.07.006 https://doi.org/10.1186/s12891-018-2137-0 https://doi.org/10.1186/s12891-018-2137-0 https://doi.org/10.1089/jwh.2015.5509 _hlk119322918 _hlk110178216 _hlk38187602 _hlk120196417 _hlk120196458 _hlk117871780 _hlk117865098 _hlk118123043 _hlk118137344 _hlk70951511 annales kinesiologiae • 13 • 2022 • 1 5 effects of inspiratory muscle training on physical performance during backpack carrying monika jeruc tanšek1, andrej švent2, alan kacin1 1 university of ljubljana, faculty of health sciences, physiotherapy department, slovenia 2 intact d.o.o., slovenia corresponding author: alan kacin university of ljubljana, faculty of health sciences, physiotherapy department, zdravstvena pot 5, 1000 ljubljana, slovenia phone: +386 1 300 11 19 email: alan.kacin@zf.uni-lj.si abstract purpose: restricting chest movement when carrying a loaded backpack reduces efficiency and increases the work of the respiratory muscles. the aim of the present study was to investigate the effects of six weeks of inspiratory muscle training (imt) on respiratory muscle strength and endurance and on physical performance when carrying a load methods: twenty male (age: 32.2 ± 3.4 years) members of the special operations unit of the slovenian army volunteered to participate. the experimental group (n=10) trained their respiratory muscles for six weeks against an incremental inspiratory resistance with a breathing apparatus. the placebo group (n=10) performed the same imt protocol but with a sham inspiratory resistance. assessment of the subjects before and after imt included measurements of the maximal inspiratory and expiratory pressures, heart rate measurements, and ratings of perceived physical and respiratory exertion before and after a 60-min walk test with a 25-kg backpack results: after six weeks of imt, the maximum inspiratory pressure measured before and after the 60-minute walk test increased significantly (p < 0.001) in the experimental group by 47 ± 13% and 58 ± 20%, respectively. inspiratory fatigue was also significantly lower in the experimental group. no changes were observed in the heart rate and the rating of perceived exertion during the walking test. in the placebo group, no significant changes were observed in the measured parameters after imt. original scientific article doi: https://doi.org/10.35469/ak.2022.335 received: 2022-07-25 udc: 796.015:612.2 mailto:alan.kacin@zf.uni-lj.si 6 monika jeruc tanšek, andrej švent, alan kacin: effects of inspiratory muscle training on physical performance ..., 5–21 annales kinesiologiae • 13 • 2022 • 1 conclusion: six weeks of imt with progressive breathing resistance improves strength and reduces fatigue of the respiratory muscles. individuals who perform tasks that require them to carry a heavy backpack for extended periods of time may benefit from imt. keywords: load-carrying, respiratory muscle fatigue, respiratory muscle training, thoracic motion restriction. učinki vadbe inspiratornih mišic na telesno zmogljivost med nošenjem nahrbtnika izvleček cilj: omejitev gibanja prsnega koša med nošnjo obteženega nahrbtnika zmanjša učinkovitost in poveča delo dihalnih mišic. cilj pričujoče študije je bil raziskati učinke šesttedenske vadbe inspiratornih mišic (vim) na jakost in vzdržljivost dihalnih mišic ter telesno zmogljivost med prenašanjem bremena. metode: prostovoljno je sodelovalo 20 moških (starost: 32,2 ± 3,4 let) pripadnikov enote za specialno delovanje slovenske vojske. eksperimentalna skupina (n=10) je šest tednov neprekinjeno vadila proti naraščajočemu uporu pri vdihu s posebno dihalno napravo. placebo skupina (n=10) je izvedla enak protokol vim z napravo, vendar le z navideznim inspiratornim uporom. začetno in končno testiranje preiskovancev je vključevalo meritve največjih inspiratornih in ekspiratornih tlakov, meritve frekvence srčnega utripa in oceno občutenja telesnega in dihalnega napora pred in po 60-minutnem testu hoje s 25-kg nahrbtnikom. rezultati: po šesttedenski vim se je največji inspiratorni tlak izmerjen pred in po testu hoje pomembno (p < 0,001) povečal v eksperimentalni skupini, in sicer za 47 ± 13 % pred testom in za 58 ± 20 % po testu. značilno se je zmanjšala tudi inspiratorna utrujenost v eksperimentalni skupini. odziv frekvence srčnega utripa in ocena občutenja napora med testom hoje se po vim ni spremenila. v placebo skupini po vim nismo opazili pomembnih sprememb v nobenem izmerjenem parametru. zaključek: šesttedenska vim s progresivnim inspiratornim uporom izboljša jakost inspiratornih mišic in zmanjša njihovo utrudljivost. tovrstna dihalna vadba ima lahko pozitivne učinke za ljudi med opravljanjem nalog, ki zahtevajo dolgotrajno nošenje težkega nahrbtnika. ključne besede: prenašanje bremen, utrujenost dihalnih mišic, vadba dihalnih mišic, omejitev gibanja prsnega koša. 7 annales kinesiologiae • 13 • 2022 • 1 monika jeruc tanšek, andrej švent, alan kacin: effects of inspiratory muscle training on physical performance ..., 5–21 introduction carrying a load with a backpack is defined as the movement of a person with an additional mass on the trunk supported by shoulder straps (knapik, harman, steelman & graham, 2012). it is a common form of occupational physical activity, especially for soldiers, firefighters and rescue workers, as well as for various forms of sports and recreational activities. the load carried in a backpack restricts the movement of the chest and the amount of air a person can inhale, increasing the work of breathing (dominelli, sheel & foster, 2012; faghy & brown, 2014b). in this case, the respiratory muscles are working outside the optimal limits of their length-tension curve (romer & polkey, 2008). altered respiratory mechanics lead to accelerated fatigue of the respiratory muscles (faghy & brown, 2014a; faghy & brown, 2014b), which can reduce physical performance by reducing the blood flow to other skeletal muscles and increasing the perception of physical and respiratory effort (dempsey, romer, rodman, miller, & smith, 2006; harms, et al., 1997). the actual effect of carrying an extra load in a backpack on respiratory muscle function under different working conditions has not been studied in detail. butcher, jones, eves and petersen (2006) reported a significant reduction in the maximum airway pressure in professional firefighters wearing a heavy backpack and a respiratory mask during both long-duration low-intensity physical activities and short-duration high-intensity physical activities. however, it is difficult to assess the individual effects of wearing a backpack and using a breathing mask because the mask itself increases the work of breathing (eves, jones & petersen, 2005). in subjects of varying fitness levels, wearing a 25 kg backpack without a breathing mask has been shown to reduce the maximum inspiratory pressure (mip) by 11% during 60 min walking (58% v̇o2max) on a treadmill and by a further 5% during subsequent high-intensity running (faghy & brown, 2014a; faghy & brown, 2014b; faghy, blacker & brown, 2016). the physical training of members of military special forces includes both low intensity activities (e.g. military patrols) and high-intensity activities (e.g. military interventions and combat operations) while wearing a backpack, so it might be useful to include respiratory muscle training in their training routine. by using special training aids and training programs, one can strengthen the inspiratory or expiratory respiratory muscles in isolation or both at the same time. inspiratory muscle training (imt) adds resistance to the inspiratory flow and primarily strengthens the inspiratory muscles, especially the abdominal diaphragm, which creates an intrathoracic negative pressure during inspiration. imt is commonly used to reduce respiratory effort during physical activity in elite athletes (hajghanbari et al., 2013) and healthy individuals (illi, held, frank & spengler, 2012; sales et al., 2016) as it significantly increases the strength of the inspiratory intercostal muscles, as well as the diaphragm (verges, lenherr, haner, schulz, & spengler, 2007; romer & polkey, 2008). this has been shown to improve athletic performance (hajghanbari et al., 2013), e.g. cycling (romer, mcconnell & jones, 2002; johnson, sharpe & brown, 2007; mcconnell, 8 monika jeruc tanšek, andrej švent, alan kacin: effects of inspiratory muscle training on physical performance ..., 5–21 annales kinesiologiae • 13 • 2022 • 1 2011), running (tong et al., 2008), swimming (yañez-sepulveda et al., 2021) and rowing (griffiths & mcconnell, 2007). respiratory muscle performance can be improved with various training protocols, most of which result in increased respiratory muscle strength and, to a lesser extent, improved muscle endurance (fernández-lázaro et al., 2021). imt protocols vary and depend on the respiratory device used, the characteristics of the exerciser and the desired effects. in general, a minimum of four weeks of regular imt, usually performed twice daily for at least 5 days per week at 50-70% of the maximum inspiratory pressure (mip), is required for improvement in respiratory muscle strength (mcconnell, 2013). moderateto high-intensity imt (∼60% mip) can increase maximal contraction velocity and inspiratory muscle strength. faghy & brown (2016) reported that six weeks of imt performed twice daily increased the maximal inspiratory pressure at rest by 31% and significantly attenuated the cardiovascular and perceptual responses to 60 minutes of walking with a 25-kg backpack at a steady pace, while improving performance by 8% during high-intensity timed runs. because the relative intensity of their imt protocol was kept constant at 50% of the maximal inspiratory muscle pressure, we hypothesize that even higher training effects can be achieved with a more progressive inspiratory resistance protocol. the progressivity of inspiratory resistance is likely to be of critical importance for training individuals with high levels of physical fitness, such as members of military special forces. the aim of our study was therefore to investigate the effects of six weeks of imt with progressive breathing resistance in members of military special forces on respiratory muscle strength and endurance, heart rate response and the perception of effort when walking with a heavy backpack. methods we conducted a controlled prospective intervention study on a sample of members of the special unit of the slovenian army (sou sa). the study was approved by the medical ethics committee of the republic of slovenia (no. 0120-494/2017/7), the ministry of defence of the republic of slovenia and the general staff of the slovenian army. study sample all the potential sou sa candidates were first given important information regarding the purpose and procedure of the study. twenty male (mean age: 32.2 ± 3.4 years, age range: 27-38 years) members of the sou sa site completed a questionnaire on their general health and signed a declaration in which they volunteered to participate in the study. exclusion criteria for the subjects were cardiovascular, respiratory or me9 annales kinesiologiae • 13 • 2022 • 1 monika jeruc tanšek, andrej švent, alan kacin: effects of inspiratory muscle training on physical performance ..., 5–21 tabolic diseases, a history of peripheral or central thromboembolism, radiculopathy or other peripheral neurological disorders of the lower limbs. assessment of general fitness the assessment of general physical fitness was based on regular military tests performed by the subjects in the three months prior to the start of the study. the tests included two minutes of push-ups, two minutes of abdominal crunches and a fast run of 3200 meters. the result achieved by the subject in each test task was converted into points using a motor test scoring system defined by gender and age categories (ivšek & pograjc, 2014). study design the twenty subjects were randomly divided by lot into two groups of equal size. the experimental group (eg) performed a six-week imt program with a breathing device that provided a progressive increase in inspiratory resistance. the placebo group (pg) performed the same program with a device that did not add inspiratory resistance but had a virtual resistance regulator installed. both groups were tested before and after the completion of the six-week imt program, as described below. tests and measurements all the tests and measurements were carried out in the sports hall of vojašnica edvarda peperka, moste-polje ljubljana. on the day of the test, the subjects ate a small meal two to three hours before the exercise and abstained from coffee or alcoholic beverages for at least 24 hours before the exercise. the subjects were familiarised with all the tests and measurement protocols before the first data collection. heart rate and aerobic capacity the subjects were placed in a stationary, semi-recumbent position on the examination table for 10 minutes and their heart rate was measured using a monitor with a chest strap (polar m430 polar electro, europe ag, val-de-travers, switzerland). the polar fitness test™, which assesses a person’s maximum oxygen consumption (v̇o2max) based on resting heart rate variability, gender, age, height, body weight and selfassessed physical activity level, was used to assess aerobic capacity. 10 monika jeruc tanšek, andrej švent, alan kacin: effects of inspiratory muscle training on physical performance ..., 5–21 annales kinesiologiae • 13 • 2022 • 1 respiratory muscle strength and fatigue measurements were taken using an inspiratory and expiratory microrpm® pressure measurement device (vyaire medical inc., illinois, usa). respiratory muscle strength was measured using the maximum inspiratory pressure (mip) and maximum expiratory pressure (mep) in cm h2o (faghy & brown, 2016). the mip measurement was derived from the residual volume (maximal expiration) and the mep measurement of the total lung capacity (maximal inspiration). each measurement was taken five times. the minimum and maximum values were excluded and the average of the remaining three measurements was calculated (mcconnell, 2013). the respiratory muscle fatigue was determined from the difference (∆) between the mip and mep values obtained before (pretest) and immediately after (posttest) the 60-minute walking test. walking test with a backpack before the 60-minute walking test, the subjects put on a military backpack (v2 plus system, tasmanian tiger gmbh, dasing, germany) that was evenly filled with a 25-kg load. each subject adjusted and fastened the straps of the backpack individually before performing the test. the subjects completed the 60-minute walking test on a leveled technogym skillrun™ treadmill (technogym, cesena, italy). before they started walking, subjective ratings of overall perceived exertion (rpe) were assessed using the 15-item rpe scale and respiratory effort was assessed using the cr10 rpe scale (borg, 1982). the heart rate was measured and recorded continuously during the test. the test began with a three-minute warm-up period so that the subjects gradually reached a target speed of 6.5 km/h, which they then maintained for 60 minutes (faghy et al., 2016). every ten minutes, the subjects rated the overall physical effort and respiratory effort. after completing the test, the subjects removed their backpacks, cooled down by walking slowly on a treadmill for 5 minutes, and then rested under control for another 20 minutes. inspiratory muscle training intervention the experimental group (n=10; eg) exercised with the powerbreathe® (medium resistance) inspiratory muscle strengthening device (powerbreathe international ltd., southam, uk) with an initial resistance of 60% mip. the placebo group (n=10; pg) performed the same imt program using the same respirator with the internal inspiratory valve removed, minimizing the respiratory resistance. every two weeks, the subjects’ mip was measured again and inspiratory resistance was adjusted accordingly with an additional 10% increase to reach the final training target of 80% mip. the mip was reassessed in pg at the same time points and the breathing resistance was adjusted 11 annales kinesiologiae • 13 • 2022 • 1 monika jeruc tanšek, andrej švent, alan kacin: effects of inspiratory muscle training on physical performance ..., 5–21 virtually. all subjects performed 30 consecutive maximal breaths twice daily. each maximal inspiration was followed by an active forced expiration to expiratory residual volume (mcconnell, 2011). both groups kept an exercise diary that encouraged them to perform imt regularly; compliance with the program was checked weekly by the investigators the powerbreathe® respirator works on the principle of suprathreshold inspiratory loading. this requires the subject to generate an inspiratory pressure that exceeds the pressure threshold set on the device in order to open the inspiratory valve. the inspiratory threshold is increased by tensioning the spring attached to the air valve of the device. the advantage of suprathreshold loading is that the increase in inspiratory resistance does not affect the actual airflow through the unit. furthermore, the load resistance can be assessed objectively (mcconnell 2011; mcconnell, 2013). statistical analysis and data processing the normality of the data distribution was analyzed using the shapiro-wilk test, which showed the adequacy of the parametric tests. the effect of training was assessed by comparing the mean values of heart rate and maximum respiratory pressures measured at rest prior to the 60-minute walk test (pretest), before and after the six-week imt period. the effect of imt on fatigue during walking was assessed by comparing the heart rate and rpe at the end of the walking (posttest) and ∆ mip and ∆ mep. the means were compared using the independent samples t-test and the two-way factorial anova (group × time) with repeated measures for the time factor. if the factor interaction was statistically significant, a pairwise comparison was performed using tukey’s hsd post-hoc test. the threshold for statistical significance was set at p < 0.05 for all analyses. results are presented as means ± standard deviations unless otherwise stated. results subjects from eg and pg did not differ significantly in age, anthropometric characteristics, general physical fitness, and aerobic capacity. the detailed analysis of group characteristics is shown in table 1. 12 monika jeruc tanšek, andrej švent, alan kacin: effects of inspiratory muscle training on physical performance ..., 5–21 annales kinesiologiae • 13 • 2022 • 1 table 1: comparison of the basic subjects’ characteristics across groups. eg pg p-value age (years) 33.3 ± 4.1 31.2 ± 2.8 0.258 body height (cm) 180.6 ± 7.4 179.3 ± 4.5 0.641 body weight (kg) 85.7 ± 5.6 82.7 ± 5.6 0.246 bmi (kg/m2) 26.4 ± 2.3 25.6 ± 2.8 0.396 3200 m run (min) 13.3 ± 1.1 13.2 ± 1.1 0.843 abdominal crunches (no./2 min) 87.3 ± 9.3 86.4 ± 9.0 0.843 push-ups (no./2 min) 81.5 ± 7.2 79.4 ± 8.1 0.547 v̇o2max (ml/kg/min) 47.8 ± 3.08 49.3 ± 2. 79 0.485 eg – experimental group; pg – placebo group; bmi – body mass index; 2max – maximal pulmonary oxygen consumption respiratory muscle strength the interaction of factors during the six-week imt was significant (p < 0.001) for the pretest mip. the pretest mip increased significantly (p < 0.001) in the eg by 63 ± 15 cm h2o (47 ± 13%) after training. there was no significant change (p = 0.162) in the pretest mip in the pg after training. the pretest mip was significantly higher (p < 0.001) in the eg after training (figure 1). the interaction of factors during the six weeks of imt was significant (p < 0.001) for the posttest mip. the posttest mip increased significantly (p < 0.001) in the eg by 71 ± 20 cm h2o (58 ± 20%) after training. there was no significant change (p = 0.306) in the posttest mip in the pg after training. the posttest mip was significantly higher (p < 0.001) in the eg after training (figure 2) 13 annales kinesiologiae • 13 • 2022 • 1 monika jeruc tanšek, andrej švent, alan kacin: effects of inspiratory muscle training on physical performance ..., 5–21 *** indicates the pretest to posttest difference in the eg at p < 0.001. ### indicates the difference between the groups at p < 0.001. figure 1: comparison of the mean (standard deviation) maximum inspiratory pressure (mip) measured before the 60-minute walk test between the experimental group (eg) and the placebo group (pg) before and after the inspiratory muscle training program. *** indicates the pretest to posttest difference in the eg at p < 0.001. ### indicates the difference between the groups at p < 0.001. figure 2: comparison of the mean values (standard deviation) of the maximum inspiratory pressure (mip) measured after the 60-minute walk test between the experimental group (eg) and the placebo group (pg) before and after the inspiratory muscle training program. eg before eg after pg before pg after eg before eg after pg before pg after 14 monika jeruc tanšek, andrej švent, alan kacin: effects of inspiratory muscle training on physical performance ..., 5–21 annales kinesiologiae • 13 • 2022 • 1 the interaction of factors during six weeks of imt was not significant for the pretest mip (p = 0.556) and the posttest mip (p = 0.279) (figures 3 and 4). figure 3: comparison of the mean (standard deviation) maximum expiratory pressure (mep) measured before the 60-minute walk test between the experimental group (eg) and the placebo group (pg) before and after the inspiratory respiratory muscle training program. figure 4: comparison of the mean (standard deviation) maximum expiratory pressure (mep) measured after the 60-minute walk test, between the experimental group (eg) and the placebo group (pg) before and after the inspiratory respiratory muscle training program. eg before eg after pg before pg after eg before eg after pg before pg after 15 annales kinesiologiae • 13 • 2022 • 1 monika jeruc tanšek, andrej švent, alan kacin: effects of inspiratory muscle training on physical performance ..., 5–21 respiratory muscle fatigue the interaction of factors during the six-week imt was also significant (p < 0.001) for ∆ mip during the 60-minute walk test. the ∆ mip decreased (p < 0.01) from -12 ± 4 cmh2o before the training to -4 ± 4 cmh2o afterward. in contrast, the ∆ mip in pg before (-12 ± 3 cmh2o) and after (-12 ± 4 cmh2o) the training was no different (p = 0.991). the ∆ mip after imt was significantly lower in eg (p < 0.001). the interaction of the factors for ∆ mep during the 60-min walk test was also significant (p < 0.01). the ∆ mep decreased from -15 ± 5 cmh2o before the training to -7 ± 5 cmh2o afterward. in contrast, the ∆ mip in the pg before (-19 ± 7 cmh2o) and after (-16 ± 4 cmh2o) the training was no different (p = 0.549). the ∆ mep after imt was significantly lower in eg (p < 0.01). heart rate and perceived exertion the interaction of the factors during the six-week imt was not significant for the heart rate (p = 0.215), respiratory effort (p = 0.327), and overall body exertion (p = 0.644) (figure 5). 16 monika jeruc tanšek, andrej švent, alan kacin: effects of inspiratory muscle training on physical performance ..., 5–21 annales kinesiologiae • 13 • 2022 • 1 figure 5. the mean (standard deviation) heart rate response (a) and ratings of overall body effort (b) and respiratory effort (c) during the 60-minute walk test before and after the six-week program of inspiratory muscle training for the experimental (eg) and placebo groups (pg). 17 annales kinesiologiae • 13 • 2022 • 1 monika jeruc tanšek, andrej švent, alan kacin: effects of inspiratory muscle training on physical performance ..., 5–21 discussion the main objective of the present study was to evaluate the effects of six weeks of imt with progressive inspiratory resistance in members of military special forces on respiratory muscle strength and endurance, heart rate response and the perception of exertion when walking with a heavy backpack. the results show that the experimental group increased inspiratory muscle strength (mip) by 47% as a result of the training, while there was no effect on the expiratory muscle strength (mep). in addition, a significant reduction in inspiratory and expiratory fatigue during the 60-minute walk test with a 25-kg backpack was found in the experimental group, but this was not reflected in the rpe or hr values during the test. in contrast, there was no significant improvement in any of the measured physiological parameters in the placebo group. thus, our results fully confirm the findings of the meta-analysis on the effects of imt in various types of athletes (karsten, ribeiro, esquivel & matte, 2018) and highlight the importance of the progressivity and specificity of breathing resistance for optimal training adaptation (mcconnell, 2011). a direct comparison with the results of the methodologically most similar study by faghy and brown (2016) confirms our initial assumption that progressive inspiratory resistance further enhances the effects of imt. indeed, faghy and brown (2016) achieved a 31% increase in mip in the pretest and 19% in the posttest after six weeks of imt in moderately physically fit healthy subjects, while our study achieved a 47% increase in mip in the pretest and as much as 58% in the posttest in very physically fit subjects during the same training period. the training effect was substantially higher in our subjects despite their higher baseline level of physical fitness. imt also had a positive effect on the endurance of the respiratory muscles of the experimental group. the initial inspiratory and, interestingly, expiratory fatigue induced by the 60-minute walk test were reduced by 8 cmh2o. however, these changes were too small to reduce the subjective ratings of whole-body exertion or respiratory effort. considering that the weight of a backpack is critical to respiratory fatigue under given exercise conditions, the weight of the backpack in our study appears to have been too low to cause noticeable respiratory fatigue and impair physical performance. indeed, dominelli, sheel and foster (2012) have shown that a backpack weighing less than 35 kg has no effect on respiratory mechanics and thus on the demand for respiratory effort during short periods of walking. consistent with this, shei, chapman, gruber & mickleborough (2017) reported that six weeks of flow-resistive imt improved physical performance in recreational athletes but did not attenuate diaphragmatic fatigue during constant-load running to volitional exhaustion with a 10-kg backpack. indeed, faghy and brown (2014a; 2014b) have shown that prolonged low-intensity physical activity with a backpack weighing less than 25 kg does not cause premature fatigue of the inspiratory respiratory muscles, although it does cause certain changes in the cardiovascular and metabolic responses and perceived physical exertion. they also highlight other factors that may mitigate premature inspiratory respiratory muscle fatigue, namely previous regular exercise, male gender, higher body mass, higher skeletal 18 monika jeruc tanšek, andrej švent, alan kacin: effects of inspiratory muscle training on physical performance ..., 5–21 annales kinesiologiae • 13 • 2022 • 1 muscle strength and higher aerobic capacity (faghy & brown, 2014a; faghy & brown, 2014b). all of these factors were present in our subjects, which most likely contributed to the low perceived respiratory muscle fatigue during the 60-minute walking test. respiratory muscle fatigue due to the altered movement mechanics and excessive load on the chest when carrying a heavy backpack is clearly progressive (butcher, et al., 2006; faghy & brown, 2014a; faghy & brown 2014b), so training-induced increases in respiratory muscle strength cannot completely prevent it. wearing a backpack also requires a greater activity of the abdominal diaphragm to stabilize the thoracolumbar spine, which further accelerates diaphragm fatigue and worsens the mechanics and economy of breathing. it is therefore not surprising that imt can also improve postural control when carrying loads and consequently reduce lower back pain (janssens et al., 2015). the main limitation of our study protocol was that it failed to produce detectable changes in the heart rate and ratings of perceived physical and respiratory exertion between the experimental and placebo groups. the most likely reason for this is that the intensity of the 60-minute walk test or the weight of the backpack was too low for the given population sample. to effectively stress the respiratory muscles, subjects must be exposed to a combination of prolonged moderateto high-intensity physical activity while carrying a backpack weighing at least 25 kg. a two-stage testing protocol, such as that used by faghy and brown (2016), or a multi-stage protocol with progressive walking speeds and treadmill incline, such as that used by armstrong, ward, lomax, tipton, and house (2019), would most likely be more appropriate the recommended intensity of imt is between 50 and 70 per cent of the mip, exercise duration is up to 30 breathing cycles and exercise frequency is twice daily, every day per week (mcconnell, 2013). to optimize the training protocol for the needs of our study, we considered the basic principles of physical training: progressive overload and specificity. the progressivity of exercise overload is primarily achieved through incremental intensity (resistance), but increasing the time and frequency of exercise can have an additional effect. in our study, we only ensured the progressivity of the overload during the six-week training period by increasing intensity, i.e. by increasing the inspiratory resistance threshold on the respirator by 10% every two weeks. it could be that an additional modulation of the breathing exercise time, i.e. the number of breathing cycles, would further improve the training effect, especially the endurance of the inspiratory muscles. this should be tested in future studies. on the other hand, an additional increase in daily exercise frequency would not be feasible in our subjects, as performing imt twice a day, seven days a week, was already at the upper limit of their busy daily schedule. conclusion the aim of this study was to determine whether six weeks of imt could increase the strength and endurance of the respiratory muscles, thereby delaying their fatigue when carrying a backpack during physical activity. the imt protocol used in previ19 annales kinesiologiae • 13 • 2022 • 1 monika jeruc tanšek, andrej švent, alan kacin: effects of inspiratory muscle training on physical performance ..., 5–21 ous studies was improved on by progressively increasing the inspiratory resistance to ensure a more optimal overload of the respiratory muscles. our results show that mit significantly increases inspiratory strength and reduces muscle fatigue during a 60-minute walk with a 25-kg backpack. however, the positive changes in inspiratory pressure were not reflected in the perception of whole-body exertion and respiratory effort or in cardiovascular responses. various groups of physically demanding occupations (e.g. military, firefighters, rescue workers, etc.), as well as people engaged in recreational activities that involve carrying heavy backpacks (hikers, alpinists, skiers, etc.), could benefit from mit. acknowledgments we would like to thank the ministry of defence of the republic of slovenia and the slovenian army for their support and logistical assistance in our study. our special thanks go to the former major general of the slovenian army dr andrej osterman. we would also like to thank the management of vojašnica edvarda peperka, moste-polje ljubljana, for allowing us to use their sports hall for tests and measurements. above all, we would like to thank all the test subjects who participated in the study, i.e. the members of the special operations unit of the slovenian army. references armstrong, n. c. d., ward, a., lomax, m., tipton, m. j. & house, j. r. 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(2007). increased fatigue resistance of respiratory muscles during exercise after respiratory muscle endurance training. american journal of physiology-regulatory, integrative and comparative physiology, 292(3), r1246–r1253. https://doi.org/10.1152/ajpregu.00409.2006. yañez-sepulveda, r., alvear-ordenes, i., tapia-guajardo, a., verdugo-marchese, h., cristi-montero, c., & tuesta, m. (2021). inspiratory muscle training improves the swimming performance of competitive young male sprint swimmers. the journal of sports medicine and physical fitness, 61(10),1348−1353. https://doi.org/10.23736/ s0022-4707.21.11769-4. https://doi.org/10.1519/jsc.0b013e3182429853 https://doi.org/10.1519/jsc.0b013e3182429853 https://doi.org/10.1097/00005768-200205000-00010 https://doi.org/10.1152/japplphysiol.01157.2007 https://doi.org/10.1152/japplphysiol.01157.2007 https://doi.org/10.1016/j.ptsp.2015.08.001 https://doi.org/10.1007/s40362-017-0046-5 https://doi.org/10.1139/h08-050 https://doi.org/10.1139/h08-050 https://doi.org/10.1152/ajpregu.00409.2006 https://doi.org/10.23736/s0022-4707.21.11769-4 https://doi.org/10.23736/s0022-4707.21.11769-4 _hlk119322918 _hlk110178216 _hlk38187602 annales kinesiologiae • 13 • 2022 • 2 131 original scientific article doi: https://doi.org/10.35469/ak.2022.367 received: 2022-11-28 udc: 572.087:796.332.071.2 body composition of young soccer players erol kovačević1, denis čaušević1, seth spicer3, siniša kovač1, ivor doder1, slavenko likić1, boris metikoš2 1university of sarajevo, faculty of sport and physical education 2 university of applied sciences, zagreb 3 rowan university school of osteopathic medicine, stratford, new jersey, usa corresponding author: denis čaušević, phd faculty of sport and physical education, university of sarajevo, bosnia and herzegovina, patriotske lige 41, 71000 sarajevo, bosnia and herzegovina e-mail: denis.causevic@fasto.unsa.ba abstract purpose: the main aim of this study was to examine and analyse the body composition of young soccer players across different age groups. methods: a cross-sectional study was carried out among 126 young soccer players divided into age categories: u15 – 53 players (age=14.68±0.47); u17 – 51 players (age=16.47±0.50); u19 – 22 players (age=18.05±0.38). the subjects’ height was measured using an anthropometer, while their body composition was measured using the tanita bc-420ma digital scale. results: on average, soccer players in the u15 group had significantly lower body height, weight, body mass index and fat free mass than u17 and u19 players, but had a higher percentage of body fat (p < 0.05). in addition to the percent of body fat mass, which tends to significantly decrease with age, the results also demonstrate significant non-linear increases in body height, weight, and lean body composition concurrent with the players’ ages. conclusion: these results indicate that younger soccer players have lower absolute values of morphological characteristics compared to senior players. keywords: bmi, anthropometry, fitness, body fat, soccer mailto:denis.causevic@fasto.unsa.ba 132 erol kovačević, denis čaušević, seth spicer, siniša kovač, ivor doder, slavenko likić, boris metikoš: body ..., 131–141 annales kinesiologiae • 13 • 2022 • 2 telesna sestava mladih nogometašev izvleček cilj: glavni cilj te raziskave sta bili proučitev in analiza telesne sestave mladih nogometašev v različnih starostnih skupinah. metode: med 126 mladimi nogometaši, razdeljenimi po starostnih kategorijah u15 – 53 igralcev (starost = 14,68 ± 0,47) –, u17 – 51 igralcev (starost = 16,47 ± 0,50) – in u19 – 22 igralcev (starost = 18,05 ± 0,38) –, je bila izvedena presečna študija. telesna višina vseh udeležencev je bila izmerjena z antropometrom, telesna sestava pa z digitalno tehtnico tanita bc-420ma. rezultati: nogometaši iz skupine u-15 so imeli v povprečju bistveno nižjo telesno višino, težo, indeks telesne mase in maso brez maščobe kot igralci u-17 in u-19, vendar so imeli višji odstotek telesne maščobe (p < 0,05). poleg odstotka telesne maščobne mase, ki se s starostjo značilno zmanjšuje, rezultati kažejo tudi značilno nelinearno povečanje telesne višine, telesne mase in puste telesne sestave, sočasno s starostjo igralcev. zaključek: ti rezultati kažejo, da imajo mlajši nogometaši nižje absolutne vrednosti morfoloških značilnosti v primerjavi s starejšimi. ključne besede: itm, antropometrija, telesna pripravljenost, telesna maščoba, bioelektrična impedanca 133 annales kinesiologiae • 13 • 2022 • 2 erol kovačević, denis čaušević, seth spicer, siniša kovač, ivor doder, slavenko likić, boris metikoš: body ..., 131–141 introduction soccer is one of the most popular sports today, played by men, women and children all over the world. in the last few years, numerous studies have tried to gather as much information as possible about the abilities and characteristics of young soccer players (čović et al., 2017; nikolaidis et al., 2016; castillo, yanci, cámara, & weston, 2016; figueiredo, gonçalves, coelho e silva, & malina, 2009), with the aim of achieving better planning and programming of sports training, but also of higher-quality selection. studies have confirmed the importance and role of body composition as one of the key indicators of physical fitness and general health of athletes in soccer (mala, maly, zahalka, & hrasky, 2015). body composition provides us with an athlete‘s detailed physiological profile (mala et al., 2015), which is considered one of the key elements of the soccer game because it greatly affects the possibility to complete 90 minutes of competitive play. researching the influence of body composition on player performance in soccer is particularly complex, because success in the game depends on how the individual characteristics of 11 players come together to form a dynamic team. previous research has pointed to the negative effects of excess adipose tissue, considering that it acts as dead weight in activities during which the body’s mass must be repeatedly raised against gravity during locomotion and jumping (reilly, 1997; talović et al., 2018), which ultimately leads to reduced performance and increased energy requirements in the soccer game. in contrast, a high percentage of fat-free mass is a desirable indicator given that it contributes to the production of power during high-intensity activities such as soccer. body composition data can be an indicator of an athlete’s nutritional state; moreover, it can provide information on current body fluid homeostasis (andreoli et al., 2003). andreoli et al. (2003) state that the assessment of intracellular and extracellular mass is one of the best predictors of muscle efficiency that can ultimately predict physical performance. changes in body composition, such as an increase in lean mass or a decrease in fat-free mass, can therefore be expected to improve a player’s performance in regards to the specific speed and agility demands experienced during a soccer game. it has been proven that age influences physical performance, especially in young people, because of its strong relationship to the growth of individuals and their level of experience (frança et al., 2022; mroczek, golachowska, & kaczorowska, 2022). however, to date there has been little research on the body composition trends of adolescent soccer players (u15, u17 and u19). this information is of great interest for coaches, especially when it comes to optimizing and selecting training programmes that can improve players‘ long-term development. therefore, the aim of this study was to examine and analyse the body composition of young soccer players across different age groups. 134 erol kovačević, denis čaušević, seth spicer, siniša kovač, ivor doder, slavenko likić, boris metikoš: body ..., 131–141 annales kinesiologiae • 13 • 2022 • 2 methods sample of subjects this cross-sectional study included 126 young soccer players. players were categorized by age categories: u15 – 53 players (14.68±0.47 years); u17 – 51 players (16.47±0.50 years); u19 – 22 players (18.05±0.38 years). all participants had competed at the regional level in bosnia and herzegovina. the testing was conducted at the institute of sport at the university of sarajevo by the faculty of sports and physical education. the protocols were carried out by qualified personnel of the research team. participation in this study was voluntary, all players and their parents were fully informed verbally and in writing about the demands and nature of the study, and written parental consent was obtained for all participants. body composition body height in all subjects was measured with a possible error of 0.1 cm using an anthropometer (holtain 610, crymych, united kingdom), and body composition was measured using the tanita scale (tanita bc-418, tokyo, japan). the measurements took place early in the morning (09:00) for three consecutive days. a group of 40 to 45 players was evaluated each day and the average time between the first and last review was approximately 35 minutes. at the time of evaluation, participants were in a fasted state and wore only their underwear. during the testing procedure all participants were barefoot with their arms held nearly 45° from their trunk. body composition variables included: body mass (bm), body mass index (bmi), body fat percentage (bf%), fat mass (fm) and fat-free mass (ffm) (kapo et. al., 2018). statistical analysis descriptive statistics were presented as means ± standard deviation (mean±sd). normality and equality of variance of the variables were assessed using a shapiro-wilk test. a one-way analysis of the variance (anova) and post hoc comparisons using the bonferroni adjustment were conducted to investigate differences in age and body composition between groups. all data were processed using ibm spss statistics software 22.0 (spss inc., chicago, il, usa). the significance level was set at p ≤ 0.05. 135 annales kinesiologiae • 13 • 2022 • 2 erol kovačević, denis čaušević, seth spicer, siniša kovač, ivor doder, slavenko likić, boris metikoš: body ..., 131–141 results the variables for body composition (u15, u17 and u19) of subjects are shown in table 1. the results of the one-way anova between groups suggest significant differences in body composition. the u15 group had significantly lower body mass (f = 29.308, p ≤ 0.01); body height (f = 42.636, p ≤ 0.01), greater bf% (f = 15.003, p ≤ 0.01), and lower ffm (f = 39.543, p ≤ 0.01) than their older peers. in terms of ffm, the u17 group also had a significantly lower mean value than the u19 group (table 2). table 1. results of descriptive parameters of u15, u17 and u19 u15 (n=53) u17 (n=51) u19 (n=22) anova mean±sd mean±sd mean±sd f p age [years] 14.68±0.47 16.47±0.50 18.05±0.38 687.822 .000* bm [kg] 53.61±7.85 61.52±9.80 69.43±6.28 29.308 .000* height [cm] 165.14±6.48 174.55±7.38 179.22±6.01 42.636 .000* bmi [kg · m–2] 19.72±2.35 19.91±2.85 21.65±1.43 5.121 .007* bf [%] 13.48±5.29 9.77±2.84 8.86±2.98 15.003 .000* fm [kg] 7.45±3.82 6.22±2.69 6.20±2.21 2.348 .100 ffm [kg] 46.21±5.76 54.32±10.03 63.22±5.70 39.543 .000* 136 erol kovačević, denis čaušević, seth spicer, siniša kovač, ivor doder, slavenko likić, boris metikoš: body ..., 131–141 annales kinesiologiae • 13 • 2022 • 2 table 2. differences among the categories group (i) group (j) mean difference (i-j) sig. bm [kg] u15 u17 -7.90 .000* u15 u19 -15.81 .000* u17 u19 -7.91 .001* height [cm] u15 u17 -9.41 .000* u15 u19 -14.08 .000* u17 u19 -4.67 .024* bmi [kg · m–2] u15 u17 -0.19 .693 u15 u19 -1.92 .002* u17 u19 -1.73 .007* bf [%] u15 u17 3.71 .000* u15 u19 4.61 .000* u17 u19 0.90 .385 fm [kg] u15 u17 1.23 .049* u15 u19 1.24 .123 u17 u19 0.01 .990 ffm [kg] u15 u17 -8.10 .000* u15 u19 -17.00 .000* u17 u19 -8.89 .000* 137 annales kinesiologiae • 13 • 2022 • 2 erol kovačević, denis čaušević, seth spicer, siniša kovač, ivor doder, slavenko likić, boris metikoš: body ..., 131–141 figure 1. body composition trend lines according to age groups 138 erol kovačević, denis čaušević, seth spicer, siniša kovač, ivor doder, slavenko likić, boris metikoš: body ..., 131–141 annales kinesiologiae • 13 • 2022 • 2 discussion the aim of this study was to examine and analyse the body composition of young soccer players across different age groups (u15, u17, u19). to generalize the findings of this study, the age of a soccer player effects their body composition (graph 1). the mean body height, weight, body mass index and fat-free mass of u15 soccer players was significantly lower than those of the u17 and u19 age groups, while the percentage of body fat mass and total fat mass was significantly higher. our results showed that the u19 group was substantially taller and heavier than the younger groups while exhibiting a lower bf% and greater ffm. in comparison to the previous studies (spehnjak et al., 2021; nikolaidis et al., 2016), the current sample of soccer players has similar body size when comparing height and weight. it is evident that there is a trend of increasing height and body mass from u15 to u19. these results indicate that the morphological growth of young soccer players continues during that period, which is in agreement with previous studies (spehnjak et al., 2021, matta, figueiredo, garcia, & seabra, 2014, da silva, bloomfield, & marins, 2008). body mass index results show that young soccer players in all selections have bmi values in a normal range. these results are also in agreement with the results of previously published studies (spehnjak et al., 2021; nikolaidis et al., 2016; mroczek et al., 2022). however, as a predictor of high performance and especially motor and functional abilities, indicators of ffm play a significantly greater role (milsom, barreira, burgess, iqbal, & morton, 2014). regarding the ffm expressed in kg, the results show that there is an evident increase from an average of 46.2 kg in the u15 selection, over 54.3 kg in the u17 all the way to 63.2 kg in the u19. these increases of 16.1% between u15 and u17 and 15.1% between u17 and u19 are attributable primarily to increased muscle mass considering the results in figure 1. similar results were obtained in some earlier studies by milsom et al. (2015), who reported that ffm increased by 29.1% between u15 to u17. evidently, this is the period in which there is a significant increase in fat free mass in young soccer players, and mala et al. (2020) state that the highest percentage of relative lean mass was observed in the u18 category. the same authors state that age had a significant influence on the proportions of muscle mass, and thus a significant increase in the percentage of muscle mass. in previous studies, it has been reported that the bf% tends to decrease with age (leão et al., 2019; milsom et al., 2015; nikolaidis et al., 2011) which was also confirmed in this study. bf% in young soccer players in our research ranged from approximately 8.86±2.98% in the u19 selection to 13.48±5.29% in the u15 category. these results are consistent with most previously published studies. thus, marković and bradić (2009) state that elite soccer players have a relatively low percentage of body fat of around 10%. these results are consistent with the results of mala et al. (2020), who state that the percent of adipose tissue in younger players (u12 to u15) was greater than 10%, while older players (u16 to adult) had lower bf% values. in this study, it is interesting that young soccer players from the u15 selection have body fat percentage 139 annales kinesiologiae • 13 • 2022 • 2 erol kovačević, denis čaušević, seth spicer, siniša kovač, ivor doder, slavenko likić, boris metikoš: body ..., 131–141 values close to the older categories, which deviates from some earlier research. specifically, in the study by spehnjak et al. (2021), the percentage of body fat in the u15 category was 12.9 ± 6%, and in the study by nikolaidis et al. (2016) was 17.4 ± 3%. the reason for this may be the higher training load of the players in this study, but since there are no objective indicators, this remains based on assumptions. this study has some limitations. one of the limitations was that the athlete’s dietary intake was not monitored during the stay-at-home orders. another is that longitudinal data would be more informative to account for the fact that this study did not assess the players maturity status. conclusion based on the results of the realized study, it is possible to confirm most of the conclusions of previously conducted studies that studied the morphological characteristics of young soccer players. the determination of the morphological profile is important from the aspect of selection and prediction of future success in the game. the process of identification and selection of young soccer players is very demanding, and morphology is one of the factors that can influence the final success of individuals in the soccer game. the results of this study, as well as the conclusions of earlier research, indicate that younger soccer players have lower absolute values of morphological characteristics compared to senior players. these values should be taken into account, especially when it comes to the u15 category as well as all younger categories, which means, when the process of growth and development has not yet concluded, and which is known to depend on a large number of both exogenous and endogenous factors. finally, it should be noted that the morphological profile is the basis for monitoring growth and development, and that it most often follows the development curve of young soccer players with minor individual deviations. references andreoli, a., melchiorri, g., brozzi, m., di marco, a., volpe, s. l., garofano, p., ... & de lorenzo, a. 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(2018). strength asymmetry differences between premier league and first league football referees. acta kinesiologica, 12(1), 86–92. https://doi.org/10.1080/15438627.2016.1222281 https://doi.org/10.1080/026404197367263 https://doi.org/10.1080/026404197367263 https://doi.org/10.3390/ijerph18094982 https://doi.org/10.3390/ijerph18094982 _hlk122510532 _hlk121925715 _hlk121925783 _hlk117671776 _hlk117676890 _hlk117676830 _hlk122521710 _hlk123029474 _hlk51764713 _hlk51617947 _hlk51764685 _hlk51616945 _hlk51676200 _hlk51710755 _hlk124939594 _hlk124939408 _hlk125008249 _hlk125008423 _hlk125010166 _hlk124768186 _hlk129167818 _hlk129168885 _hlk129939779 _ref116207795 annales kinesiologiae • 12 • 2021 • 2 73 the effect of phonated breathing on oxygen uptake during and after submaximal cycling kaja stanković1, nejka potočnik1 1institute of physiology, medical faculty, university of ljubljana, slovenia corresponding author: nejka potočnik university of ljubljana, medical faculty, institute of physiology, zaloška 4, 1000 ljubljana, slovenia phone: +386 1 543 7523 e-mail: nejka.potocnik@mf.uni-lj.si abstract purpose: positive expiratory pressure (pep) exhalation during exercise is reported to improve body adaptation to exercise and enhance the exercise tolerance in patients with chronic obstructive pulmonary disease. wearing mouthguards results in lower oxygen consumption and increased performance by increasing pep in athletes. airway resistance during expiration can be manipulated by phonation. thus, the aim of our study was to examine the effects of phonated breathing on cardiopulmonary adaptation to moderate exercise and subsequent recovery. methods: 26 young healthy participants conducted the same moderate steady cycling protocol using three different breathing patterns: spontaneous breathing (brp1), phonated breathing pronouncing the sound “h” (brp2) and phonated breathing pronouncing the sound “sh” (brp3). heart rate, oxygen consumption, co2 production, respiratory rate, tidal volume, respiratory exchange ratio and ventilatory equivalents were measured (cosmed, italy) before, during and 20 minutes after cycling. data were analyzed using spss, with significance level p<0.05. results: the analysis revealed no significant differences related to the breathing economy; respiratory rate was increased, and tidal volume decreased with spontaneous breathing compared to both phonated breathing patterns during exercise; no effect of brps on cardiopulmonary parameters was found in recovery. conclusion: our results do not confirm the assumption that pep breathing improves exercise economy probably because of the low exercise intensity applied. further studies should be conducted at higher exercise loads or in patients with pulmonary dysfunction. keywords: phonated exhalation, breathing pattern, positive expiratory pressure, metabolic efficiency, moderate exercise original scientific article doi: https://doi.org/10.35469/ak.2021.329 received: 2022-07-05 udc: 612.2:796.01 74 kaja stanković, nejka potočnik: the effect of phonated breathing on oxygen uptake ..., 73–89 annales kinesiologiae • 12 • 2021 • 2 vpliv dihalnega vzorca na ventilacijo in privzem kisika med in po submaksimalni vadbi na sobnem kolesu izvleček cilj: izdih s pozitivnim tlakom (pep) izboljša zmožnost fiziološke prilagoditve na napor ter vadbeno toleranco pri bolnikih s kronično obstruktivno pljučno boleznijo. nošenje ustnih varoval, ki prav tako povečale upor v dihalnih poteh, zmanjša porabo kisika in poveča zmogljivost športnikov. upor v dihalnih poteh lahko spreminjamo s fonacijo. tako je namen naše raziskave ugotoviti, ali fonacija med zmerno telesno vadbo vpliva na spremembe srčnih in dihalnih parametrov med in po taki vadbi metode: 26 mladih prostovoljcev je trikrat izvedlo enako zmerno kolesarjenje, vsakič ob uporabili drugačnega dihalnega vzorca (dv): spontano dihanje (dv1) in izdih ob izgovarjanju glasu h (dv2) oziroma š (dv3). pred, med in 20 minut po vadbi smo merili srčno frekvenco, porabo kisika, izločanje ogljikovega dioksida, frekvenco in volumen dihanja, pljučno ventilacijo, respiratorni količnik in ventilacijske ekvivalente z metabometrom cosmed. podatke smo obdelali s programom spss in postavili mejo signifikantnosti pri p<0,05. rezultati: analiza rezultatov ni pokazala nobenih statistično značilnih sprememb metabolnih parametrov, kakor tudi ne srčne frekvence z ozirom na uporabljen dv. značilno povečana je bila le frekvenca dihanja in zmanjšan dihalni volumen pri spontanem dihanju glede na oba s fonacijo povezana dv med naporom. v okrevanju po naporu ni bilo nobenih razlik v merjenih parametrih. zaključek: rezultati naše študije niso potrdili domneve, da dihanje s pep, ki ga povzročimo s fonacijo, poveča učinkovitost telesne vadbe, zmanjša porabo kisika in izboljša telesno zmogljivost vendar ocenjujemo, da je bila intenziteta vadbe v naši študiji premajhna, da bi se tovrstne razlike izkazale. zato bi bilo treba opraviti še nadaljnje raziskave in sicer z večjo obremenitvijo pri zdravih preiskovancih ali pa na bolnikih z respiratorno motnjo. ključne besede: fonacija, dihalni vzorec, pozitivni tlak v dihalnih poteh med izdihom, metabolna učinkovitost, zmerna vadba 75 annales kinesiologiae • 12 • 2021 • 2 kaja stanković, nejka potočnik: the effect of phonated breathing on oxygen uptake ..., 73–89 introduction breathing patterns (brp) differ according to breathing frequency, breathing depth, inhalation/exhalation time relationship, and maneuvers applied during expiration (dallam & kies, 2020). expiratory maneuvers are particularly important since changing the resistance of the airways upon expiration can help maintain a positive pressure until the end of exhalation, thus keeping the alveoli and airways open (francis & brasher, 1991) longer during the exhalation period. phonation requires sustained/controlled exhalation. during speech and singing, breath duration and flow rates are controlled to support sound generation by the larynx (lewis et al., 2021). regulation of the glottic aperture by laryngeal muscle activity also helps to control ventilation (lewis et al., 2021). therefore, the larynx could be considered a key modulator of expiratory flow upon phonation. pronunciation of different voices can be used to change the resistance in the airways during exhalation (hoffmann, torregrosa, & bardy, 2012). grunting has been shown to improve force production during exercise (o'connell et al., 2016). in elite sports, there is a continuous search for strategies to improve performance (harbour, stöggl, schwameder, & finkenzeller, 2022). on the other hand, in patients with compromised breathing, strategies to minimize breathing effort during exercise would be appreciated to allow these patients to minimize the exercise associated discomfort (fagevik olsén, lannefors, & westerdahl, 2015). the way we breathe strongly affects not only the respiratory system itself but also other systems in our body: cardiovascular, nervous, endocrine, lymphatic, immune, digestive (saoji, raghavendra, madle, & manjunath, 2018). to manipulate exhalation, pursed lip breathing (tiep, burns, kao, madison, & herrera, 1986), specially designed mouthguards (lässing et al., 2021) or simply phonation of some particular voices could be applied during exercise to increase the airways resistance during exhalation. by breathing out against increased resistance, positive expiratory pressure (pep) is achieved and it is commonly believed that pep improves ventilation, at least in patients with pulmonary diseases (fagevik olsén & westerdahl, 2009; fagevik olsén , lannefors, & westerdahl, 2015), and potentially during exercise (phimphasak, ubolsakka-jones, & jones, 2018). there are only a few studies about the effects of brp on the physiological response to exercise (green, benson, & martin, 2018; lässing et al., 2021). our recent study (klanjšček, 2018) found that brps with increased expiratory resistance had a significant favorable effect on the economy of short-lasting trunk stabilization exercise. expiratory resistance was manipulated by pronouncing different sounds during exercise (klanjšček, 2018) ‒ sound “sh” (as in push to increase resistance, and “h” (as in host) to decrease it ‒ and compared to spontaneous breathing. oxygen consumption and carbon dioxide production decreased during short-lasting trunk stabilization exercise in the “sh” breathing pattern compared to the “h” breathing pattern and spontaneous breathing. additionally, the respiratory quotient, ventilation, and heart rate during exercise decreased while ventilatory equivalents increased in the “sh” pattern compared to the “h” pattern and spontaneous breathing. the participants 76 kaja stanković, nejka potočnik: the effect of phonated breathing on oxygen uptake ..., 73–89 annales kinesiologiae • 12 • 2021 • 2 perceived the “sh” pattern to be significantly easier compared to the other two brps (klanjšček, 2018). thus, we aimed to test whether the brp where exhalation is manipulated by pronouncing different sounds during exercise affects the physiological response to aerobic exercise. to this purpose, the heart rate, oxygen consumption, co2 production, and ventilation were measured before, during and after moderate cycling at constant load using the three different brps: the pronunciation of “sh” or “h” during exhalation, and spontaneous breathing. crossover design was used to avoid differences between participants. methods the study was performed in the exercise physiology laboratory of the institute of physiology, medical faculty, university of ljubljana. ethical approval of the study was obtained from the national ethics committee (no. 0102-326 / 2018/5). subjects 26 healthy participants with comparable levels of physical activity were recruited by public invitation to participate voluntarily in this crossover study. their physical examination and histories revealed no autonomic dysfunction, chronic diseases, medication usage or smoking. their ecg and arterial blood pressure values were normal. written informed consent was obtained before participation. the trial included 18 women and 8 men, 20.85 ± 0.2 years old, with body mass index (bmi) 22.97 ± 0.59 kg/m2. experimental procedure the study was carried out in a climate controlled laboratory room between 9 and 12 am. the participants refrained from physical exertion for at least 1 day before the first exercise test and were asked not to perform additional physical activities during the experiment period. they were not allowed to consume any alcohol, caffeine or tobacco for at least 2 hours before the beginning of each exercise test and were asked to eat a light meal 1 hour before coming to the laboratory. each participant visited the laboratory 3 times in february and march with at least one relaxing day between the two consecutive visits. during the three visits, participants performed the same submaximal aerobic cycling with different brps during exercise. the brp applied during a particular visit was chosen randomly and marked brp1 for spontaneous breathing and brp2/brp3 for exhaling upon pronouncing “h”/“sh”, respectively. each session started with blood pressure measurement at sitting rest and an explanation of the breathing technique for the selected brp. a silicone breathing mask was 77 annales kinesiologiae • 12 • 2021 • 2 kaja stanković, nejka potočnik: the effect of phonated breathing on oxygen uptake ..., 73–89 placed upon the mouth and nose (quark, cosmed, italy) to measure oxygen consumption, co2 production, and ventilation; ecg electrodes and a finger cuff for continuous blood pressure tracing were attached (finapres 2300, ohmeda, usa). the measurement consisted of 5 minutes sitting at rest on a cycloergometer ergoselect 100 (ergoline, germany) (baseline), 5 minutes of cycling at 100 w (women) and 140 w (men), respectively, at a cadence of 60 rpm and followed by 10 minutes of passive recovery. during cycling, a randomly selected brp was applied. data acquisition and statistical analysis signals were captured simultaneously breath by breath using quark cpet hardware and software (cosmed, italy); arterial blood pressure and ecg were recorded by dataq system (dataq instruments inc., di-720 series, ohio, usa). for analysis, three separate intervals were determined: the last three minutes of sitting rest (baseline), the last three minutes of cycling (exercise), and the last three minutes of recovery (recovery). oxygen consumption per body mass (vo2/kg), co2 production per kg (vco2/kg), respiratory exchange ratio (rer), ventilator equivalents (veq for o2 and co2), respiratory rate (rr), tidal volume (vt), and heart rate (hr) were determined. the data are presented on graphs as mean values ± standard deviation (sd). additionally, enhanced post-exercise oxygen consumption (o2 debt) and oxygen deficit (o2 deficit) at the onset of exercise were determined using quark cpet analyzing software (cosmed, italy) based on the work of hughson and morrissey (hughson and morrissey 1983). statistical analysis was completed using ibm spss statistics, version 27 (ibm, new york, usa). data were tested for normality and a p<0.05 level of confidence was selected. we compared mean differences in measured parameters over time (before and during exercise + recovery) for all three brps with a one-way repeated measures anova (ranova). the assumption of sphericity was checked using mauchly's test; greenhouse-geisser or huynh-feldt corrections were applied when sphericity assumption was violated as published elsewhere (hopkins, marshall, batterham, & hanin, 2009). when detecting a significant time effect, corresponding contrast tests were used to identify differences between means according to brp and time interval. for post hoc comparisons a least significant difference test was applied and the bonferroni correction was used to eliminate type i error in multiple comparisons (hopkins et al. 2009). in case of significant differences, cohen’s d was determined to represent the effect size (es) (hopkins et al., 2009). 78 kaja stanković, nejka potočnik: the effect of phonated breathing on oxygen uptake ..., 73–89 annales kinesiologiae • 12 • 2021 • 2 results rr increased during exercise in all three brps (figure 1, table 1), most in brp1, where the mean value was 22.56 ± 1.1 min-1. rr in brp1 was significantly higher than in brp2 (p < 0.001) and brp3 (p = 0.007). there were no statistical differences between brp2 and brp3 (p = 0.103). after exercise, rr dropped as expected, but in the last 3 minutes of recovery it was still higher than the baseline values in all brps, but significantly higher only in brp1 (p = 0.001) (table 1). table 1: effect sizes presented as cohen’s d values for all significant differences. rr vt ve rer vo2/ kg vco2/ kg veq for o2 veq for co2 brp1base/ex 1.59 3.53 6.46 1.34 6.94 6.48 1.50 4.03 brp1base/rec 0.67 1.26 0.80 0.99 0.60 brp1ex/rec 1.227 3.42 6.27 0.81 6.71 6.58 2,19 3.23 brp2base/ex 0.41 3.46 4.00 1.18 6.54 6.59 1.81 2.38 brp2base/rec 0.68 0.82 6.82 brp2ex/rec 0.22 3.54 5.01 1.43 6.69 6.89 2.44 6.89 brp3base/ex 0.41 3.24 4.42 1.50 7.49 6.76 1.41 2.40 brp3base/rec 0.46 1.10 0.76 0.63 1.14 0.63 brp3ex/rec 0.47 3.23 4.36 0.88 6.55 6.07 1.96 6.37 brp1ex/brp2ex 0.72 1.05 brp1ex/brp3ex 0.14 0.35 brp2ex/brp3ex 0.72 brp1 – breathing pattern 1, brp2 breathing pattern 2, brp3 – breathing pattern 3, base – baseline, ex – exercise, rec – recovery, rr – respiratory rate, vt – tidal volume, ve – ventilation, rer – respiratory exchange ratio, vo2 /kg – oxygen consumption per body mass, vco2 /kg – carbon dioxide production per body mass, veq for o2 – ventilatory equivalent for oxygen, veq for co2 ventilatory equivalent for carbon dioxide. 79 annales kinesiologiae • 12 • 2021 • 2 kaja stanković, nejka potočnik: the effect of phonated breathing on oxygen uptake ..., 73–89 figure 1: changes in rr during rest, exercise and recovery in different brps. values are presented as the mean ± sd. * significant difference between brp1 and brp2, # significant difference between brp1 and brp3, § significant difference in all brps between rest and exercise, ω significant difference in all brps between exercise and recovery, ∞ significant difference in all brps between rest and recovery. figure 2: changes in tidal volume during rest, exercise and recovery in different brps. values are presented as the mean ± sd. * significant difference between brp1 and brp2, # significant difference between brp1 and brp3, ‡ significant difference between brp2 and brp3, § significant difference in all brps between rest and exercise, ω significant difference in all brps between exercise and recovery, ∞ significant difference in all brps between rest and recovery. 80 kaja stanković, nejka potočnik: the effect of phonated breathing on oxygen uptake ..., 73–89 annales kinesiologiae • 12 • 2021 • 2 figure 2 shows the changes in vt, related effect sizes are presented in table 1. the value increased the most in the group with brp2, which had the lowest rr during exercise. we found significant differences between all three brp; the statistical difference between brp1 and brp2 was p < 0.001, between brp1 and brp3 p = 0.016 and between brp2 and brp3 p = 0.002. as can be seen from figure 2, the values returned to baseline values at recovery; only in brp3 did we find a significant difference between baseline and recovery (p = 0.008). during exercise ventilation increased (figure 3, table 1), but no significant differences were found between the groups. during the recovery, the values dropped but not to baseline values. ventilation in recovery was significantly higher compared to baseline (p <0.001 for brp1 and brp3, and p = 0.003 for brp2, respectively). figure 3: changes in ventilation during rest, exercise and recovery in different brps. values are presented as the mean ± sd. § significant difference in all brps between rest and exercise, ω significant difference in all brps between exercise and recovery, ∞ significant difference in all brps between rest and recovery. figure 4 shows the changes in rer. no significant differences were found between brps; related effect sizes are reported in table 1. in recovery, the rer remained elevated above the resting value. it was significantly higher in the groups with brp1 (p < 0.001) and brp3 (p = 0.001); in the group with brp2 we did not find a difference (p = 0.333). as expected, vo2/kg increased during exercise and remained increased at the end of the measurement (fig. 5, table 1). as can be seen from figure 5, no significant differences were observed with regard to brps, neither at rest nor during exercise or recovery. 81 annales kinesiologiae • 12 • 2021 • 2 kaja stanković, nejka potočnik: the effect of phonated breathing on oxygen uptake ..., 73–89 figure 4: changes in respiratory exchange ratio during rest, exercise and recovery in different brps. values are presented as the mean ±sd. § significant difference in all brps between rest and exercise, ω significant difference in all brps between exercise and recovery, ∞ significant difference in all brps between rest and recovery. figure 5: changes in oxygen consumption during rest, exercise and recovery in different brps. values are presented as the mean ±sd. § significant difference in all brps between rest and exercise, ω significant difference in all brps between exercise and recovery. 82 kaja stanković, nejka potočnik: the effect of phonated breathing on oxygen uptake ..., 73–89 annales kinesiologiae • 12 • 2021 • 2 regarding vco2/kg, there were no significant differences between groups during rest and exercise, we did, however, find a significant difference between baseline and recovery in brp3 (p < 0.001) (fig. 6, table 1). figure 6: changes in production of carbon dioxide during rest, exercise and recovery in different brps. values are presented as the mean ± sd. § significant difference in all brps between rest and exercise, ω significant difference in all brps between exercise and recovery, ∞ significant difference in a particular brp between rest and recovery. figure 7 presents the change in veq for o2. no statistical differences were found between the groups in any of the phases, but a higher value was observed in the brp2 and brp3 groups at rest and lower during exercise compared to brp1. we found a statistical difference between baseline and exercise as well as between rest and exercise with respect to recovery, which was p < 0.001 in all brps (table 1). no significant differences between groups were observed during exercise and recovery in veq for vco2 (figure 8). statistical differences were observed between baseline and recovery. in the group with brp1 the difference was p = 0.009; in the group with brp2 p = 0.007; and in the group with brp3 p = 0.002. veq for co2 was significantly increased during exercise compared to rest or recovery (p < 0.001) (table 1). 83 annales kinesiologiae • 12 • 2021 • 2 kaja stanković, nejka potočnik: the effect of phonated breathing on oxygen uptake ..., 73–89 figure 7: changes in ventilatory equivalent of oxygen during rest, exercise and recovery in different brps. values are presented as the mean ± sd. § significant difference in all brps between rest and exercise, ω significant difference in all brps between exercise and recovery, ∞ significant difference in all brps between rest and recovery. figure 8: changes in ventilatory equivalent of carbon dioxide during rest, exercise and recovery in different brps. values are presented as the mean ± sd. § significant difference in all brps between rest and exercise, ω significant difference in all brps between exercise and recovery, ∞ significant difference in all brps between rest and recovery. 84 kaja stanković, nejka potočnik: the effect of phonated breathing on oxygen uptake ..., 73–89 annales kinesiologiae • 12 • 2021 • 2 figure 9 shows o2 deficit and o2 debt throughout the three brps. o2 deficit (but not o2 debt) in spontaneous breathing was significantly higher compared to other brps (es = 0.42 for brp1 compared to brp2 and 0.36 for brp1 compared to brp3, respectively). o2 debt was significantly lower compared to o2 deficit in all brps (es = 0.87 for brp1, 0.20 for brp2 and 0.15 for brp3, respectively). figure 9: changes in oxygen deficit (o2 deficit) and oxygen debt (o2 debt) throughout all breathing patterns: spontaneous breathing (brp1), pronouncing “h” (brp2) and pronouncing “sh” (brp3), respectively. * significant with respect to brps. # deficit versus debt. discussion our first main finding was that phonation during moderate exercise has a minimal effect on the respiratory response to exercise and recovery in young, healthy participants. our second main finding was that phonated breathing during moderate exercise provoked an increased rate of perceived exertion compared to spontaneous breathing. and our third main finding was that oxygen deficit at the onset of moderate exercise is significantly higher in spontaneous compared to phonated breathing. on the other hand, epoc was not affected by brp, indicating that in a steady state during moderate exercise excessive oxygen deficit was successfully eliminated by aerobic metabolism. 85 annales kinesiologiae • 12 • 2021 • 2 kaja stanković, nejka potočnik: the effect of phonated breathing on oxygen uptake ..., 73–89 although not significantly different, evidently lower rer during steady state exercise in brp3 compared to other brps suggested that restricted air flow during expiration may cause co2 retention. this assumption was supported by the increased co2 exhalation in the recovery phase after exercise (fig.6) in brp3. additionally, during steady state exercise, rr in brp3 was higher compared to that in brp2, presumably because of the stimulation of the inspiratory center by increased arterial co2 partial pressure. rr during spontaneous breathing was significantly increased compared to those in both brp2 and brp3 because of phonation excluding prolonged exhalation. breathing against increased airway expiratory resistance (pronunciation of “sh”) versus open airway expiration (pronunciation of “h”) does not appear to alter airway diameter sufficiently to augment the minute ventilation response during moderate exercise. even upon spontaneous breathing, minute ventilation was not changed compared to phonated breathing patterns. the similar minute ventilation across all brps at steady state moderate exercise corresponding to an oxygen uptake of 23.5 ml/kg/min suggests that all brps applied can accommodate a moderate level of exercise intensity in young healthy participants (plowman and smith n.d.). in our study, vo2 did not differ during moderate physical activity at different brps. this finding is not in compliance with our previous study, where the reduced vo2 in the low-intensity trunk stabilization exercise with hand-oscillation was confirmed upon phonated exhalation while pronouncing “sh” (klanjšček, 2018). one possible explanation for this could be that the participants breathed in respiratory coupling with locomotion in the previous study. the entrainment could be responsible for better breathing economy (sporer, foster, sheel, & mckenzie, 2007). further, vo2 was measured at the onset of trunk stabilization exercise in our previous study and not during the steady state, and thus was accompanied by anaerobic metabolism. when substituting anaerobic metabolism with aerobic in the continuation of trunk stabilization exercise, the differences in vo2 between different brps decreased. this could imply that as the exercise is aerobic, the beneficial effects of pep exhalation are decreased. the association between anaerobic metabolism and breathing economy in connection to the use of a mouthguard was established (schulze, kwast, & busse, 2019). the results of the studies examining the effect of different mouthguards on athletes’ performance concluded that the economy of breathing is improved by wearing mouthguards at high but not moderate exercise intensities (lässing et al., 2021; schulze et al., 2019). the mechanism proposed is altered exhalation, potentially against higher resistance produced by mouthguards (schulze et al., 2019). the impact of breathing using mouthguards is being researched in connection with sports that due to their nature need this type of protection (such as rugby and hockey) (phimphasak et al., 2018; schulze et al., 2019). studies including young healthy athletes have found that altered exhalation due to wearing this equipment reduces the proportion of anaerobic metabolism at high-intensity exertion, compared to unmodified exhalation when not wearing it (lässing et al., 2021). francis and colleagues (francis & brasher, 1991) described reduced vo2 and veq for o2 upon mouthguard usage at high-intensity exercise 86 kaja stanković, nejka potočnik: the effect of phonated breathing on oxygen uptake ..., 73–89 annales kinesiologiae • 12 • 2021 • 2 but not at low-intensity exercise. since we did not confirm the beneficial effect of brp3 in our study, we may speculate again that the beneficial effect of phonated expiration is limited to predominantly anaerobic or high-intensity load. additional investigations should be conducted to test this assumption. phonated exhalation can be compared to breathing with pursed lips. there are some articles about the effects of pursed lip breathing on the breathing load, but only researched in patients with impaired pulmonary function (sakhaei, sadagheyani, zinalpoor, markani, & motaarefi, 2018). sakhaei and colleagues (sakhaei et al., 2018) found that in patients with copd, oxygenation and co2 excretion improve – as respiratory work is reduced upon pep provoked by pursed lips, while de araujo (pereira de araujo, karloh, martins dos reis, palú, & fleig mayer, 2015) and colleagues found that this type of breathing reduces dynamic hyperinflation, improving tolerance for exercise and o2 saturation in the blood during exercise in copb. breslin (breslin, 1992) found that spontaneous rhythmic breathing through pursed lips can affect the coordination of respiratory muscle recruitment and provides patients with a sense of control over ventilation, which results in less anxiety, panic, and consequently reduces dyspnea. exercise in healthy participants can be seen as a model of impaired pulmonary function, as it increases the load on the respiratory system due to increased need for o2 and produces more co2. based on our results we can conclude that the intensity of moderate exercise applied in our study was not high enough to reveal the advantages of pep breathing during exercise in young healthy adults. the physiological effects of phonated breathing in copb patients should be examined to determine the potential benefits of phonated exhalation (decrease exercise respiratory load and perceived exertion) during exercise in such patients. we found a significantly increased o2 deficiency at the onset of moderate exercise upon spontaneous breathing compared to both phonated breathing patterns, indicating that spontaneous respiration was the least economical at the onset of exertion. on the contrary, the epoc did not differ with regard to brp. this finding supports our speculation that beneficial effects of breathing against increased airway expiratory resistance, as in the pronunciation of “sh”, are manifested only when exercise metabolism is preferentially anaerobic. epoc is decreased compared to o2 deficit at spontaneous breathing, presumably because the products of anaerobic metabolism were removed and aerobically metabolized during steady state exercise due to its low intensity. o2 deficit and epoc did not differ with respect to the sound pronounced. further studies should be directed to explain this finding. bonsignore and colleagues (bonsignore, morici, abate, romano, & bonsignore, 1998) chose the veq for o2 and co2 as the main measure of respiratory efficiency. in our study, we found that both veq for o2 and co2 decreased during physical exertion compared to baseline, indicating that moderate exercise made the respiration more efficient (plowman & smith, n.d., 2013); and there were no significant differences between individual brps. differences were indicated, yet not significant: both veq upon brp2 and brp3 during exercise were lower than during spontaneous respiration. these observations can be linked to a study by francis and brasher (francis & brasher, 1991) 87 annales kinesiologiae • 12 • 2021 • 2 kaja stanković, nejka potočnik: the effect of phonated breathing on oxygen uptake ..., 73–89 who found a lower veq for o2 in subjects wearing mouthguards, indicating improved alveolar ventilation and oxygenation that allows an individual to maintain a certain level of exercise with less loss to the metabolic system; and to a study by delaney and montgomery (delaney & montgomery, 2005), who found that mouthguards obstruct airflow and thus affect vo2 and ventilation during strenuous exercise. again, both studies have demonstrated greater breathing efficiency in subjects using mouth protective devices only at maximum load. there are some limitations to this research: in all participants the same load (140 w for males and 100 w for females) was applied as moderate exercise, neglecting individual differences, and the correctness of breathing pattern implementation was not controlled as the participant’s mouth was covered by a breathing mask. in conclusion, we found no physiological benefits of phonation applied upon moderate exercise that could advocate its use for economizing breathing at higher metabolic demand. however, decreased oxygen deficit at the onset of moderate exercise upon phonated compared to spontaneous breathing confirmed its positive effects on the anaerobic phase at the onset of exercise. this finding may potentially provide benefits for patients with compromised respiratory function owing to an enhanced proportion of anaerobic metabolism even at moderate exercise loads, however, further studies need to be conducted to test this assumption. on the other hand, “sh” pronouncing breathing may provoke co2 retention at higher exercise intensities. because phonated breathing during exercise is an atypical breathing pattern, it is subjectively rated as uncomfortable compared to spontaneous breathing, yet the latter does not differ from phonated breathing with regard to breathing efficiency. it is therefore probable that in athletes exercising at higher loads phonated breathing may potentially provide benefits in terms of attenuating oxygen deficit. references bonsignore, m. r., morici, g., abate, p., romano, s., & bonsignore, g. 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+386 2 229 37 41 e-mail: stojan.puhalj@um.si abstract in alpine skiing we encounter many factors that affect the competitor to a greater or lesser extent and must be overcome or exploited in various ways. broadly speaking, the nature of the activity plays its role just like the equipment, the spectators, the coach, etc., but the most important role is played by the competitor himself. optimal synthesis is required for successful participation of top competitors with regard to physical, psychological and social skills and characteristics. during the transformation process (training) we help the competitor with different methods and means to transform from the initial to the final state, which is basically conscious transformation of numerous skills and characteristics of the competitor with impact on their personality as well. in this study we wanted to establish the extent to which certain anthropometric and motor skill parameters are related to competitive performance of younger boys aged 12 to 13 years in the rauch cup in the season 2014/15. based on the measurements of seven tests of motor skills (mskok10 – ten jumps with both feet, tesjcas – squat jump, ms20nvzp – 20m sprint, treaopto – optojump – squat jump, mt400 – 400m run, mros equilibrium stability index, and ski9 – figures-of-eight around 9 pins) and one measurement of anthropometric dimension (abmi body mass index), we used the pearson correlation coefficient to determine the correlation between individual variables and the performance of a sample of 34 young competitors in alpine skiing. the correlation of the whole set of variables regarding performance was determined using regression analysis. we have established a statistically significant correlation between the number of original scientific article doi: https://doi.org/10.35469/ak.2021.338 received: 2022-08-22 udc: 796.926:796.012.1 104 stojan puhalj, blaž lešnik, alexander povhe, robi kelc, črtomir matejek: correlations between motor ..., 103–115 annales kinesiologiae • 12 • 2021 • 2 achieved points and variables mskok10, ms20nvzp, mt400 and ski9 at the risk level of 1%. in the cases of treaopto, mrosi and tesjcas the correlation coefficients did not show statistically significant correlation. for the set of motor and anthropometric variables we have established a high and statistically significant linear correlation to the criteria (r=0.76, p=0.003). we have also established that the linear correlation between all motor skill variables and performance is high (r=0.72, p=0.006). the findings of this study show the suitability of the chosen variables in determining the potential success of young alpine skiers. keywords: alpine skiing, young competitors’ performance, motor abilities, anthropometry povezanost antropometričnih in motoričnih spremenljivk z uspešnostjo mlajših dečkov v alpskem smučanju izvleček v raziskavi smo ugotavljali, v kolikšni meri so določeni antropometrični in motorični parametri povezani s tekmovalno uspešnostjo mlajših dečkov na tekmovanjih za pokal rauch v sezoni 2014/15. na podlagi meritev sedmih testov motoričnega prostora (mskok10, tesjcas, ms20nvzp, treaopto, mt400, mrosi, ski9) in ene meritve antropometričnega prostora (abmi), smo s pomočjo pearsonovega korelacijskega koeficienta ugotavljali povezanost posameznih spremenljivk z uspešnostjo za vzorec 34 mlajših dečkov, ki so bili v smučarski sezoni 2014/15 stari 12 oz. 13 let. povezanost celotnega sklopa spremenljivk motoričnih in antropometričnih prostorov s tekmovalno uspešnostjo smo ugotavljali s pomočjo regresijske analize. kriterijsko spremenljivko tekmovalna uspešnost je predstavljalo skupno število doseženih točk šestih pokalnih tekmovanj za pokal rauch v sezoni 2014/15. ugotovili smo, da statistično značilna povezanost med številom doseženih točk in spremenljivko abmi ne obstaja. stopnja povezanosti je neznatna in negativna (r = -0,023). ugotovili smo, da obstaja statistično značilna povezanost med številom doseženih točk in spremenljivkami mskok10, ms20nvzp, mt400 in ski9 pri stopnji tveganja 1 %. v primeru treaopto, mrosi in tesjcas izračun korelacijskih koeficientov ni pokazal statistično značilne povezanosti. za sklop vseh motoričnih in antropometričnih spremenljivk smo ugotovili, da je linearna povezanost s kriterijem visoka (r=0,76, p=0,003). ugotovili smo tudi, da je linearna povezanost med vsemi motoričnimi spremenljivkami hkrati in kriterijem visoka (r=0,72, p=0,006). ugotovitve raziskave kažejo na ustreznost izbire spremenljivk pri ugotavljanju potencialne uspešnosti mladih alpskih smučarjev. ključne besede: alpsko smučanje, uspešnost mladih tekmovalcev, gibalne sposobnosti, morfologija annales kinesiologiae • 12 • 2021 • 2 105 stojan puhalj, blaž lešnik, alexander povhe, robi kelc, črtomir matejek: correlations between motor ..., 103–115 introduction modern skiing (alpine skiing) is a complex, high-speed winter sport. dynamic changes and operational structures impose increasing requirements on athletes a solid base of technical skills, physical, tactical, and psychological training. an alpine skier is first and foremost an athlete whose body should function synchronously, like a perfect mechanism, in the specific conditions of the different disciplines of alpine skiing and depending on a wide variety of environmental variables, to be able to achieve their athletic potential (kostadinov & yordanov, 2021). alpine skiing is a winter sport that involves individual descents on snow slopes with pre-determined ski routes using skis and attached bindings. the competitions are organized according to a certain order, in which all competitors see the results at the end of the competition (toma et al., 2019). there are many factors that affect the competitor to a greater or lesser extent and must be overcome or utilized in various ways. the skier’s successful performance depends on many variables. alpine skiing is one of the most complex disciplines to analyze as the skier trajectory is curved and the athlete is moving within a broad open space, down the slope according to the directions and finish, the snow/snow base (moving the body upwards and downwards) and gates (left and right movement) (erdmann et al., 2017). generally, the natural environment with various weather conditions plays just as important a role in competitive alpine skiing as the equipment, the spectators, the coach, etc. however, the most important are the competitors themselves. optimal synthesis is required for successful participation of top competitors with regard to physical, psychological and social skills and characteristics. during the transformation process (training) we help the competitor with different methods and means to transform from the initial to the final state, which is basically conscious transformation of numerous skills and characteristics of the competitor with impact on their personality as well (petrović, šmitek & žvan, 1983). according to petrović et al. (1983), the psychosomatic status is defined as multidimensional and suprasummative in terms of its effects, indicating that a change in a certain factor conditions a change of other factors. human movement depends on human motor functions/mobility, characteristics, and skills according to pistotnik (2011). skills are natural human features, representing the level of utilization of different body management systems for achieving the movement objectives set. it can be said that success in alpine skiing largely depends on the degree of accepted and built specific motor skills (kuna, franjko, & males, 2008). the characteristics are dimensions representing the human appearance and their reaction to the environment, whereas skills or knowledge are defined by learning the acquired movement patterns, which are realized on the basis of abilities and characteristics. motor skills are indispensable components of human physical activity, enabling the potential for specific efforts and utilization of the body’s functional potential. they develop naturally up to a certain level, depending on many factors, and can be perfected through practice (plastoi, 2018). the anthropometric methods, defined as measurement of the dimensions of the human body, also have a significant impact on successful competitive alpine skiing (cramer & rayan, 2012). hadzic, bjelica, georgiev, vujovic, and popovic (2014) analyzed the 106 stojan puhalj, blaž lešnik, alexander povhe, robi kelc, črtomir matejek: correlations between motor ..., 103–115 annales kinesiologiae • 12 • 2021 • 2 differences in the basic turn technique as one of the ski school elements with regard to anthropometric characteristics. it has been demonstrated that there is a statistically significant difference in the technique of the basic turn with regard to the anthropometric characteristics of the subjects. petrović et al. (1983) stated that the ability to kinetically solve spatial problems and timing ability are especially important for alpine skiing, because skiing involves, among other things, different speed combinations of gates and, above all, uneven terrain formation. it could be argued that success, even among young athletes, is mainly the result of properly planned training, talent and hard work. there are only a few who tolerate the psychophysical efforts well and maintain long-term motivation, and even fewer who respond positively to challenges by adapting and making the changes necessary for later top achievements (bačanac & škof, 2007). even in alpine skiing, performance reflects the entire personality of the competitor and must be addressed in a sufficiently complex manner. it consists of several individual skills used under given performance conditions (ehlenz, grosser & zimmermann, 1985). in this study we aimed to establish the extent to which certain anthropometric and motor skill parameters are related to competitive performance of younger male skiers. methods the measurements were performed on september 20, 2014 at the faculty of sports, university of ljubljana (slovenia), in the morning. students and alpine skiing instructors of the faculty of sports, university of ljubljana assisted in measuring, setting up and organizing. as part of the regular measurements, carried out twice a year, several anthropometric, motor, psychological dimensions and other parameters were measured, among which we focused on seven motor and one anthropometric dimension. the measurement was performed in the lobby of the faculty before the subjects headed for warmup to perform motor skill test at the faculty hall, and later for a sprint and 400-meter run at the athletic stadium. participants and recruitment the study included a sample of 34 younger boys who competed in the rauch cup in slalom, giant slalom and super giant slalom during the season 2014/15. the overall number of competitors was larger, but only 34 were anthropometrically measured and had their motor skills measured at the faculty of sports in october 2014, on account of having achieved a ranking and consequently points at the rauch cup. certain individuals did not take part in the measurements for subjective reasons. therefore, we excluded from the sample all those who were not the subject of measurements and those who did not score points during the 2014/15 season. 21 subjects were born in 2001, the other 13 in 2002, belonging to the age categories of 12 and 13 years. annales kinesiologiae • 12 • 2021 • 2 107 stojan puhalj, blaž lešnik, alexander povhe, robi kelc, črtomir matejek: correlations between motor ..., 103–115 measurement procedures the measurements performed at the faculty of sports covered several different anthropometric and motor skills, of which we focused on the following eight: – anthropometric body mass index (abmi) – ten jumps (mskok10) – squat jump – tensiometer (tesjcas) – 20-meter sprint – start with legs parallel (ms20nvzp) – squat jump – optojump (treaopto) – 400-meter run (mt400) – stability index – biodex (mrosi) – figures-of-eight around 9 pins (ski9) the criterion variable is the actual performance of all measured competitors at the rauch cup during the 2014/2015 season. it is expressed as a total of points in the rauch cup competitions. during this season, 2 slalom, 3 giant slalom and 1 super giant slalom races were successfully held at the rauch cup, the results of which were considered in the scoring for the final ranking. in these competitions, the ranked competitors achieved a certain number of points for a certain ranking determined by the skiing association of slovenia. statistical analysis we used the spss program statistical package for social sciences (ibm corporation, armonk, new york, usa) for the statistical data processing. the normality of data was confirmed using the shapiro-wilk test. when processing basic statistics of independent variables, we determined the minimum value, the maximum value, the range between the minimum and maximum values, arithmetic mean, and standard deviation. to determine whether we could set the selected variables as comparative performance units of the rauch cup, we calculated the pearson correlation coefficient for each of the eight selected variables in relation to the subjects’ performance. results the first part of data presentation displays the calculation of basic statistics for anthropometric and motor variables. in the second part of data analysis, we demonstrated the calculation of the pearson correlation coefficients between individual anthropometric variables and motor skills in relation to the criterion variable (points at the rauch cup competition). the third part represents the calculation of the correlation of all variables with the criterion, for which we performed the regression analysis and 108 stojan puhalj, blaž lešnik, alexander povhe, robi kelc, črtomir matejek: correlations between motor ..., 103–115 annales kinesiologiae • 12 • 2021 • 2 calculated the multiple correlation coefficient. the same principle of data presentation was applied for the set of motor variables. table 1. the results of basic statistics of anthropometric and motor variables for younger boys. n range min max am sd abmi 36 10.3 15.3 25.6 19.88 2.65 mskok10 36 9.64 16.04 25.68 19.54 2.23 tesjcas 36 346 238 584 365.35 75.61 ms20nvzp 36 1.99 5.59 7.58 6.64 .45 mt400 36 34.58 65.56 100.14 79.08 7.94 mrosi 36 3.2 .6 3.8 1.50 .73 ski9 36 8.1 28.2 36.3 3182 2.16 treaopto 36 .220 .374 .594 .467 .05 note: n = number of subjects; range = range between minimal and maximum value; min = minimal value; max = maximum value; am = arithmetic mean; sd = standard deviation. the acronyms of variables (test) are explained in the chapter independent variables sample. as can be seen from table 1, the abmi values differ between the subjects, specifically for 10.3. such a wide range can be explained by the age of the subjects, as they were born in 2001 or 2002. in this phase of the pre-puberty period, accelerated growth can occur in some individuals while physical development is slightly delayed in others. the results of the basic statistics of motor variables also show that the values for most of the motor skill variables are less scattered, which is mainly indicated by the low values of the standard deviation. a somewhat greater dispersion of results only can be detected in the mrosi variable (am=1.5; sd=0.73) ambi (body mass index) and performance (points) in the rauch cup. the calculation of the pearson correlation coefficient showed that there is no statistically significant correlation between the number of points achieved and the abmi variable. the correlation level is insignificant and negative (r = 0.023). annales kinesiologiae • 12 • 2021 • 2 109 stojan puhalj, blaž lešnik, alexander povhe, robi kelc, črtomir matejek: correlations between motor ..., 103–115 table 2. the pearson correlation coefficient values between motor skill variables and performance (points) in the rauch cup. test points mskok10 r .577** sig. (2-‐tailed) .000 tesjcas r -.106 sig. (2-‐tailed) .552 ms20nvzp r .611** sig. (2-‐tailed) .000 mt400 r -.513** sig. (2-‐tailed) .002 mrosi r .259 sig. (2-‐tailed) .139 ski9 r -.477** sig. (2-‐tailed) .004 treaopto r -.161 sig. (2-‐tailed) .362 note: sig. = statistical significance of correlation; ** = correlation is statistically significant at the risk level of 1%; r = pearson correlation coefficient. table 2 presents the pearson correlation coefficients for motor space in relation to performance (points). it shows that there is a statistically significant correlation between the number of points achieved and the variables mskok10, ms20nvzp, mt400 and ski9 at a risk level of 1%. in the cases of treaopto, mrosi and tesjcas, the calculation of correlation coefficients did not show a statistically significant correlation. 110 stojan puhalj, blaž lešnik, alexander povhe, robi kelc, črtomir matejek: correlations between motor ..., 103–115 annales kinesiologiae • 12 • 2021 • 2 table 3. the result of the correlation of all anthropometric and motor skill variables with performance (points) in the rauch cup. r r2 adjusted r2 sig f .752a .566 .427 .003 note: r = correlation coefficient; r2 = coefficient of determination; adjusted r2: adjusted coefficient of determination; sig f = statistical significance of correlation; a = predictors: constant (points), abmi, treaopto, mrosi, tesjcas, mt400, ski9, mskok10. it is evident from table 3 that the coefficient of multiple correlation is r = 0.752, indicating that the linear correlation between all variables and the criterion is high. the correlation between all variables and performance is statistically significant (sig f = 0.003). the coefficient of determination is r2 = 0.566, which means that 56.6% of the performance variance can be explained by motor skill and anthropometric variables. table 4: the result of the correlation between all motor skill variables and performance (points) in the rauch cup. r r2 adjusted r2 sig f .716a .512 .381 .005 legend: r = correlation coefficient; r2 = coefficient of determination; adjusted r2 = adjusted coefficient of determination; sig f = statistical significance of correlation; a = predictors: constant (points), treaopto, mrosi, tesjcas, mt400, ski9, mskok10, ms20nvzp. the multiple correlation coefficient is r = 0.716, which indicates that a linear correlation between all motor skill variables at the same time and the criterion is high, as can be seen in table 4. the correlation between all motor skill variables and performance is statistically significant (sig f = 0.005). the coefficient of determination is r2 = 0.512, which means that 51.2% of the performance variance can be explained by motor skill variables. discussion studies establishing a correlation between various dimensions of an athlete’s psychosomatic status and their performance undoubtedly represent the foundation for potential changes and qualitative improvement in various fields, especially concerning the successful and healthy development of an athlete. since alpine skiing is a complex, annales kinesiologiae • 12 • 2021 • 2 111 stojan puhalj, blaž lešnik, alexander povhe, robi kelc, črtomir matejek: correlations between motor ..., 103–115 individual-structural sport, many different factors have an impact on the competitor. success in this sport depends on an optimal combination of physical, psychological, and social dimensions. it is known that movement skills are the most reliable predictors of potential success, and anthropometric characteristics do not fall behind much in importance. through a transformation process, we achieve changes in the psychosomatic status of the competitor. because it is multidimensional and suprasummative (petrović et al., 1983), a change in one factor causes a change in other factors. the level of the subjects’ development is substantially related to the competitive performance in the category of younger boys, because some of them experience accelerated growth of individual parts of the body at that age. this can have a positive as well as a negative effect on motor skills. development in individuals may also be delayed, depriving them of movement skills, which can be particularly pronounced in sports. petrović et al. (1983) state that the transformation process can have an inhibitory effect on certain abilities and characteristics during the growing-up phase. in the present study, we were interested in the direct correlations between motor skills and anthropometric characteristics and competitive performance for the category of younger boys in alpine skiing. the goal was to determine the correlation level between an individual motor skill and anthropometric variables and competitive performance as well as the impact of all selected motor skill and anthropometric variables on competitive performance. further, we calculated the correlation between the entire set of motor skill variables and the performance of the competitors at the rauch cup. during the analysis of the basic statistics, we determined that the body mass index values vary considerably among the subjects, which is most likely the result of the already mentioned differences in the stages of development. the calculation of the pearson correlation coefficient showed that the correlation between the body mass index and performance is negligible (r = -0.023) and statistically insignificant, which confirms the assumptions regarding the differences in development in the considered age category. we found that in our sample the 20-meter sprint from a high start with legs parallel (ms20nvzp) is mostly related to competitive performance (r = 0.611) and that the correlation is statistically significant (sig f = 0.000). the test assesses the basic movement ability of speed and is also mainly related to explosive power (acceleration at the start). a similar level of correlation (r = 0.577) and statistical significance (sig f = 0.000) was achieved by the ten-jump test (mskok10). it indicates the repetitive explosive force as a manifestation of the energy component of power. especially in slalom and giant slalom, this phenomenon is expressed when connecting relatively short turns and relying on repetitive power for speed control and (lateral) relief. the mt400 (r = -0.513) and ski9 (r = -.477) tests, which are negatively correlated to competitive performance, revealed a statistically significant correlation. a 400-meter run expresses speed endurance, which is defined by the energy component of the movement and prevails in efforts of up to two minutes. the test is physiologically related to the duration of the activity on the track. ski9 is the only test in our study that represents 112 stojan puhalj, blaž lešnik, alexander povhe, robi kelc, črtomir matejek: correlations between motor ..., 103–115 annales kinesiologiae • 12 • 2021 • 2 special motor skills, i.e., agility, which is defined by rapid changes of direction as a manifestation of coordination. it is also defined by explosive power and speed (petrović et al., 1983), which is also evident if we follow the course of the test. among the previously presented statistically characteristic correlations, ski9 is the only variable that belongs to the subspace of the informational component of movement. because it is a distinctly skiing test, we expected a similar result. the results of motor skill tests and anthropometric measurements presented so far were not surprising. we find it all the more interesting that the correlation of the variable tesjcas (squat jump on a tensiometer) is not statistically significant and that it stands in a negative, insignificant correlation with performance (r = -0.016). a particularly interesting fact is that we measured explosive thrust power with this test and expected higher correlation values, similar to those in the ten jumps test. the findings of this study do not comport with the findings of the study conducted by lešnik and žvan (2000), who found a statistical significance for two tests of explosive power (triple jump and standing long jump), but for another generation of competitors. the balance and stability test (mrosi) revealed a low (r = 0.259) and statistically insignificant correlation with the criterion variable. obviously, balance in the considered age categories does not yet affect performance, as can also be seen in the study by lah (2014), who investigated the impact of balance between the categories of younger and older boys and girls on the performance in alpine skiing. the correlations were insignificant for all four groups of subjects. the last studied test of motor skill dimensions was a squat jump between the bars of the optojump device (treaopto), which was defined by reaction speed. it revealed a negligible negative correlation (r = -0.161) and statistical insignificance. for the entire set of all studied variables, we found that there is a statistically significant correlation (sig f = 0.003) with performance at the competition (r = 0.752). the coefficient of determination was r2 = 0.566, which means that 56.6% of the performance variance can be explained by motor and anthropometric variables. the set of all motor variables, which we additionally calculated, is statistically significantly correlated (sig f = 0.005) with competitive performance (r = 0.716). we were therefore able to explain the 51.2% of the performance variance with motor skills variables (r2 = 0.512), which represents a slightly smaller share than for the set of all variables. from the obtained results of the set of all variables and set of motor skill variables, we can conclude that the body mass index (abmi) itself is not statistically significantly related to the points; however, as a whole (together with the motor skill variables) it clearly contributes to the proportion of explained variance. the present study rebutted the findings of lah (2014), who determined a weak and uncharacteristic correlation between balance (mrosi) and competitive performance. for the variable treaopto (reaction speed), and especially for the variable tesjcas (explosive power), we expected higher correlation values and statistical significance. however, the results of the basic statistics of these three dimensions varied considerably, which we tried to explain with the differences in the development level of the studied age category and with the assumption that not all competitors have the same predispositions, opportunities and desire for successful participation in top alpine annales kinesiologiae • 12 • 2021 • 2 113 stojan puhalj, blaž lešnik, alexander povhe, robi kelc, črtomir matejek: correlations between motor ..., 103–115 skiing. since the sample represented an already selected population, de costa (2009) similarly drew attention to the fact that currently children are directed to alpine skiing based on social criteria and increasingly less on motor skill criteria. to consider theory and practice, it can be said that the findings of the present study represent a foundation for further research, as balance, reaction speed and explosive thrust tests did not show any statistical significance. in their study, bandalo and lešnik (2011) proposed to reduce the number of variables from the battery of tests for determining motor skills and anthropometric characteristics in the future. we support this idea; however, in the future, regular studies in this field are required to determine important motor and anthropometric dimensions and tests, because bandalo and lešnik (2012) established in their study that over a period of four years (2007 to 2010) the correlation between anthropometric and motor skill variables and performance varied. conclusion we established a statistically significant value of the multiple correlation coefficient (r = 0.752), which means that 56.6% of the variance of the actual performance can be explained by the considered motor skill and anthropometric variables (r2 = 0.566). today’s (sedentary) lifestyle and greater involvement of young people in other non-sport fields, together with the relatively high costs of skiing and ski training, which often do not allow the parents to enroll their children in ski schools, result in a fundamentally limited selection process. we will not change this fact with our research, but we can conclude that not all competitors who were the subjects of measurement at the faculty of sports are part of the skiing circuit on account of extremely positive physical reasons. on the other hand, having considered a sample of younger boys, we can conclude that the stage of development plays an important role in the separation of the physically more successful from the physically disadvantaged competitors. therefore, it is necessary to pay special attention to the latter in terms of social and psychological support. we have proposed the idea of managing the mentioned groups of competitors separately during the transformation process, although it is clear that in practice this may be problematic. undoubtedly, with a proper mindset and efforts we can ensure less discomfort or neglect among young ambitious competitors. in the future, it will be necessary to monitor the development of young athletes even more systematically. 12 13 years is a sensitive period, which is why it is all the more important that the battery of tests is effective and provides information about the athlete necessary for the professionals in the field to guide them properly during the training process. the fact remains that many other areas contribute to competitive performance, such as psychological preparation, personality traits, as well as tactical preparation. in any case, it would be necessary to include in future studies the aspect of skiing techniques, which has already been shown to be necessary in past studies (puhalj, 2018). 114 stojan puhalj, blaž lešnik, alexander povhe, robi kelc, črtomir matejek: correlations between motor ..., 103–115 annales kinesiologiae • 12 • 2021 • 2 our findings show that we are on the right track. therefore, we will continue with the introduction of the most up-to-date measurement methods and try to connect them with the measurements performed in the older 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(2019). dynamics of salivary cortisol and testosterone during competition stress in alpine skiing in adults and children. cognition, brain, behavior. an interdisciplinary journal 23(1) 29-41. https://doi.org/10.24193/cbb.2019.23.02. https://hrcak.srce.hr/256931 http://webbut2.unitbv.ro/bu2017/series ix/2018/buletin i pdf/09_plastoi.pdf http://webbut2.unitbv.ro/bu2017/series ix/2018/buletin i pdf/09_plastoi.pdf https://doi.org/10.24193/cbb.2019.23.02 _hlk89942516 _hlk103676616 _hlk111804760 _hlk111802738 _hlk30149664 _hlk111710665 annales kinesiologiae • 13 • 2022 • 2 115 original scientific article doi: https://doi.org/10.35469/ak.2022.358 received: 2022-11-05 udc: 796.071.2:159.97 disordered eating attitudes, depressive symptomatology and alcohol consumption in young athletes uroš perko1, maša černelič-bizjak2 1 institute mitikas, slovenia 2 university of primorska, faculty of health sciences, slovenia corresponding author: uroš perko institute mitikas, cankarjeva street 39, mekinje, si-1241 kamnik, slovenia phone: +386 31 828 782 e-mail: uros.perko@siol.net abstract purpose: the aim of the study was to investigate the prevalence of disordered eating behaviours and attitudes in slovenian male and female categorized athletes in relation to depressive symptoms and their alcohol consumption. methods: the sample included 198 categorized athletes between 18 and 20 years of age. the eating attitude test, the center for epidemiologic studies depression scale, and the alcohol use disorders identification test were used to measure disordered eating behaviours, level of depression, and alcohol use, respectively. results: significant differences were found between female and male athletes, with female athletes reporting higher levels of disordered eating attitudes and depressive symptoms. 13.90% of athletes reported clinically significant eating disorder symptoms, 40% reported clinically significant depressive symptoms, and 10.50% reported risky alcohol use. results also showed that athletes with higher eating disorder attitudes had higher depressive levels. conclusion: these findings have important practical value and point to the importance of building a professional team trained to recognize mental health problems in athletes in order to provide appropriate help. keywords: disordered eating behaviours, athletes, depression, alcohol consumption 116 uroš perko, maša černelič-bizjak: disordered eating attitudes, depressive symptomatology and alcohol ..., 115–130 annales kinesiologiae • 13 • 2022 • 2 moteno prehranjevanje in odnos, depresivna simptomatika in vnos alkohola pri mladih športnikih izvleček namen: namen raziskave je bil ugotoviti razširjenost motenega prehranjevalnega vedenja med slovenskimi kategoriziranimi športniki in športnicami v povezavi s simptomi depresivnosti in uživanjem alkohola. metode: v vzorec je bilo vključenih 198 kategoriziranih športnikov, starih od 18 do 20 let. za merjenje motenega prehranjevanja, stopnje depresivnosti in uživanja alkohola so bili uporabljeni test odnosa do prehranjevanja, lestvica depresivnosti centra za epidemiološke študije in test identifikacije motenj uživanja alkohola. rezultati: ugotovljene so bile pomembne razlike med športnicami in športniki, pri čemer so športnice poročale o višjih stopnjah motenega prehranjevanja in depresivnih simptomov. 13,90 % športnikov je poročalo o klinično pomembnih simptomih motenj hranjenja, 40 % o klinično pomembnih depresivnih simptomih in 10,50 % o tveganem uživanju alkohola. rezultati so tudi pokazali, da so imeli športniki z več simptomi motenega prehranjevalnega vedenja višje ravni depresivnosti. zaključek: te ugotovitve imajo pomembno praktično vrednost in potrjujejo pomembnost oblikovanja strokovnega tima, usposobljenega za prepoznavanje duševnih težav in nudenja ustrezne pomoči športnikom. ključne besede: moteno prehranjevalno vedenje, športniki, depresivnost, uživanje alkohola annales kinesiologiae • 13 • 2022 • 2 117 uroš perko, maša černelič-bizjak: disordered eating attitudes, depressive symptomatology and alcohol ..., 115–130 introduction in sports that emphasize leanness or a low body weight, especially in endurance, aesthetic and weight class sports, athletes adhere to rigid diets and strenuous exercise regimens to optimize performance. this may increase the risk of disordered eating behaviours and vulnerability to develop ed (knapp, aerni, & anderson, 2014). eds are serious mental disorders, characterized by an excessive preoccupation with food, body weight and figure, and are classified in the diagnostic and statistical manual of mental disorders (dsm-5; american psychiatric association, 2013), or in the international classification of diseases (icd-10; world health organization, 2018). to meet clinical criteria, the conditions must impair physical health or psychosocial functioning. the dsm-5 categorizes eds into several specific types, including: anorexia nervosa (an), bulimia nervosa (bn), binge eating disorder (bed), unspecified feeding or eating disorder (ufed) etc. the aetiology of eds is multifactorial, being influenced by genetic, environmental and psychological factors but also factors specific to the practicing of sport (sanchis, balmaseda, & hidalgo, 2022). these factors are particularly present in some disciplines involving endurance, those that have weight categories, or where low weight is a competitive advantage and aesthetics are important (sanchis et al., 2022; joy, kussman, & nattiv, 2016; mcdonald, pritchard, & mcguire, 2019). athletes face a unique set of ed risk factors related to sport participation, such as performance pressure, and injury (bratland-sanda & sundgot-borgen, 2013; sundgot-borgen & torstveit, 2010). in addition, teammates are also an important source of influence on athletes’ eating attitudes and behaviours, and critical comments and body comparisons among teammates may promote disordered eating (scott, haycraft, & plateau, 2019). this context might put athletes at risk for the development of pathological attitudes or behaviours, as seen in clinical ed. while research indicates an increase in ed point prevalence in the general population in recent years from 3.5% in 2000–2006 to 7.8% in 2013–2018 (galmiche, déchelotte, lambert, & tavolacci, 2019), the estimated prevalence of de and/or eds in athletes ranged from 0% to 19% in men and 6% to 45% in women (reardon et al., 2019; kristjánsdóttir, sigurðardóttir, jónsdóttir, þorsteinsdóttir, & saavedra, 2019; ackerman et al., 2019), with higher prevalence compared to the general population (martinsen & sundgot-borgen, 2013). identifying eating disorders in this population is complicated (chapa et al., 2018) and the nature of the relationship between athletic involvement and eating problems is still unclear. however, athletes suffer from a number of negative effects on their health and performance related to their disordered eating behaviours (joy et al., 2016), which can negatively affect the well-being of the athlete. more specifically, several findings showed a significant association between depression and eating disorders (deepthi, praveen, chandrashekhar-rao, vincent, & kishore, 2014), as depression is one of the comorbid illnesses of eds (godart et al., 2015; mcintyre & calabrese, 2019), and the relationship is interrelated and bi-directional (villamisar, dattilo, & pozo, 118 uroš perko, maša černelič-bizjak: disordered eating attitudes, depressive symptomatology and alcohol ..., 115–130 annales kinesiologiae • 13 • 2022 • 2 2012). depression is manifested by a constant feeling of sadness and lack of interest in pleasurable activities, lack of energy, changes in appetite or weight, disruptive sleep disorders, anxiety, lack of attention, feelings of guilt and self-harm or suicidal thoughts. some studies showed that depression leads to progression of eating pathology (villamisar et al., 2012; jones, buckner, & miller, 2014); in addition, improper nutrition and severe fasting can create chemical imbalances that play a significant role in causing certain types of depression (sathyanarayana, asha, ramesh, & jagannatha, 2008). in a study assessing depression in collegiate athletes over a 3-year period (wolanin, hong, marks, panchoo, & gross, 2016) results showed that 23.7% of athletes reported clinically relevant depressive symptoms, with 6.3% reporting moderate to severe depression, similar to non-athletes. the relationship between eds and alcohol consumption has also attracted considerable attention as it is well known that eds often co-occur with substance use disorders (sud) (fouladi et al., 2015). it has also been suggested that depressive symptoms are an underlying factor for the relationship between the clinical variables and the comorbidity between alcohol use and eds, such as bulimia nervosa (vaz-leal et al., 2015). when considering alcohol consumption in the population of athletes, most studies have found that participation in sports is positively associated with alcohol use, and recent meta-analyses showed that the prevalence for alcohol misuse ranged around 19% (gouttebarge et al., 2019), while some studies report less susceptibility to problematic alcohol consumption (purcell, rice, butterworth, & clements, 2020). the serious health consequences of disordered eating behaviours and the short and long-term consequences that can impair athletic performance, as well as the conflicting findings in the literature on ed in sport, argue for the need to further investigate the prevalence of disordered behaviours, related symptoms in athletes and its associated risk factors. for these reasons, the aims of the current study were: to examine the prevalence of disordered eating behaviours and disordered attitudes in male and female categorized athletes and to examine the relationships between eating behaviours and psychological dimensions such as depression and behavioural dimensions such as alcohol use, and to assess the difference between groups based on these variables. methods study design this study is a descriptive, correlational study with a cross-sectional design based on self-reporting. we used a non-random, purposive sample. to participate in the study, we invited athletes who were categorized in the year of the implementation of the research plan according to the standards for categorization of athletes established by the olympic committee of slovenia. the inclusion criteria for participation in the study were: the age of the athlete between 18 and 20 years and the categorization of the atannales kinesiologiae • 13 • 2022 • 2 119 uroš perko, maša černelič-bizjak: disordered eating attitudes, depressive symptomatology and alcohol ..., 115–130 hlete at the beginning of the study. the exclusion criteria were either lack of consent to participate in the study or failing to complete the questionnaires. the athletes were contacted through the coaches of their clubs and national teams, who invited them to participate. all subjects voluntarily chose to participate in the study without compensation. participants the participants were 198 categorized slovenian athletes (according to the olympic committee of slovenia, 2018). there were 120 male and 95 female athletes who participated in both individual and group sports and were between 18 and 20 years old. the average age of the athletes was 18.34 years with a standard deviation of 0.48 years. instruments and measurements the evaluation protocol consisted of three self-reported measures to assess symptoms of disordered eating, depression, and alcohol consumption. informed consent was obtained from the authors for the use of the questionnaires. we followed the ethical principles of using and adapting the questionnaires into the slovenian language and carried out the intended methodological procedures of translation and adaptation. the 26-item eating attitudes test (eat-26) is a commonly used tool to assess eating disorder risk and symptoms and concerns characteristic of eds (garner & garfinkel, 1979). it is one of the most widely used screening instruments in the field of eating disorders, in both clinical and epidemiological studies, to assess a range of behaviours and attitudes toward eating, weight, and abnormal eating habits and concerns about weight (garner, olmsted, bohr, & garfinkel, 1982). it consists of a self-administered questionnaire with 26 items. each item is a 6-point likert scale ranging from “never” to “always” and is a valid instrument for examining and assessing the risk of an eating disorder. twenty-six of the items make up the following three subscales: dieting (13 items) assesses inadequate food intake and obsession with weight loss; bulimia and preoccupation (6 items) assesses excessive eating with loss of control (binge eating) with vomiting and various thoughts and preoccupations with food and eating; the oral control scale (7 items) assesses self-control in food intake and environmental pressure for weight loss. the cut-off point proposed in the original 1979 version is 20. scores above 20 indicate the need for further assessment by a qualified professional. low scores (below 20) may nevertheless indicate serious eating problems, as denial of symptoms can be a problem in eating disorders. in the present study, the cronbach’s alpha coefficient was 0.82. the center for epidemiologic studies depression scale –– ces-d (radloff, 1977) was used to assess depression symptoms. this is a self-report assessment of symptoms associated with depression, such as restless sleep, loss of appetite, and loneliness. it contains 20 items rated on a 4-point scale with subscale scores ranging from 0 to 60, 120 uroš perko, maša černelič-bizjak: disordered eating attitudes, depressive symptomatology and alcohol ..., 115–130 annales kinesiologiae • 13 • 2022 • 2 with higher scores indicating a more severe symptom of depression. a total score of 16 or higher indicates clinically significant depression (okun, stein, bauman, & silver, 1996; junge & feddermann-demont, 2016; prinz, dvorak & junge, 2016). in this study, the cronbach’s alpha was 0.9. the alcohol use disorders identification test (audit; babor, higgins-biddle, saunders, & monteiro, 2001) was used to assess alcohol use. the audit is a well-validated and reliable 10-item questionnaire developed by the world health organization (who) to identify individuals whose alcohol use has become hazardous or harmful. audit -a total score of 8 and above has been shown to be a reliable indicator of hazardous alcohol-related behaviour. the audit consists of three subscales that assess alcohol use (audit-c; three items assessing frequency and quantity of alcohol use), symptoms of alcohol dependence (audit-d; three items), and harmful consequences of alcohol use (audit-h; four items assessing frequency of negative events). the subscale audit-c is considered a sensitive indicator of alcohol use. in the present study, we use only the audit total score (α = 0.81) in the analyses. procedure data and contacts were obtained through the individual coaches and selectors of each national team and federation. athletes who met the inclusion criteria received an email invitation to participate in the study with a detailed description of the research, goals, and objectives. the purpose of the study and procedures were explained in detail to all participants. the survey was completed electronically; the link was sent to participants’ email addresses. this study was conducted in accordance with the guidelines of the declaration of helsinki. ethical considerations such as anonymity, confidentiality, and voluntary participation were ensured in accordance with the ethical principles for psychologists of the american psychological association. this study was approved by the national medical ethics committee of slovenia (kme, no. 0120-95/2018/6). statistical analysis the data were edited in microsoft excel 2019 (microsoft corporation, redmond, washington, usa) and statistical analysis was conducted in ibm spss 20.0 (statistical package for social sciences inc., chicago, usa). cronbach’s alpha was calculated to assess internal consistency of the measurement instruments. frequency distribution was calculated for descriptive variables, and averages and standard deviations were calculated for numerical variables. to determine the differences in studied symptoms between participants we used the mann-whitney u-test. annales kinesiologiae • 13 • 2022 • 2 121 uroš perko, maša černelič-bizjak: disordered eating attitudes, depressive symptomatology and alcohol ..., 115–130 results descriptive statistics for the enrolled subjects (mean, standard deviation, skewness and kurtosis values) are presented in table 1. the average score on the ces-d questionnaire was high, indicating possible more serious depressive symptoms. the average score on audit and eat-26 was relatively low. the results revealed that most of the data did not follow normal distribution, therefore non-parametric statistics were performed in further analysis. moreover, correlational analysis with spearman test was applied in order to explore the relations between the main variables. the eating attitude test (eat-26) had a statistically significant positive correlation with depression, that is, as the scores in the subscales of depression increased, the attitude to eating worsened (table 1). table 1: descriptive statistics and correlations for study variables (n=198) variable n m sd skewness kurtosis 1 2 1. eat-26 180 9.05 8.88 1.95 5.24 2. ces-d 198 15.59 9.83 0.99 0.87 0.44** 3. audit 172 3.32 3.80 2.40 8.56 0.15* -0.01 note: *p<.05. **p<.01. ***p<.001. next, we found that 25.3% of the female athletes demonstrated problematic eating attitudes (eat-26 > 20), and report clinically significant eating disorder symptoms (table 2). the authors of eat-26 give a cut-off point of 20, which helps identify individuals with clinically (in)significant eating disorder symptoms, with good sensitivity and specificity and high internal consistency (garner et al., 1982). a score of 20 or above on the eat-26 test indicates that further clinical investigation is needed. as shown in table 2, 13.9% of athletes report clinically significant symptoms of eating disorders. moreover, a score above 16 on the ces-d may indicate a high level of depressive symptomatology, e.g. clinical depression, with good sensitivity and specificity and high internal consistency (lewinsohn, seeley, roberts, & allen, 1997). in studies (armstrong & oomen-early, 2009; junge & feddermann-demont, 2016; prinz et al., 2016), the cut-off value of 16 points is most frequently used, while some studies (nixdorf, frank, hautzinger, & beckmann, 2013; nixdorf, frank, & beckmann 2016) used a more conservative score value of 22 points. in this study, both values were considered. moreover, the proportions of young athletes exceeding the cut-off value of 16 points on the ces-d test was very high, i.e. 40.9%. the highest score, i.e. ces-d ≥ 22, was observed in 25.2% of participants, which means that they very likely experience clinically significant depressive symptoms. in the results separated by gender, we can see 122 uroš perko, maša černelič-bizjak: disordered eating attitudes, depressive symptomatology and alcohol ..., 115–130 annales kinesiologiae • 13 • 2022 • 2 that 59.1% of women report experiencing clinically significant depressive symptoms, (ces-d ≥ 16). the highest score, i.e. ces-d ≥ 22, was reported by 38.6% of women. for men, 26.3% of respondents exceed 16 points, and 14.5% exceed 22 points or more. the authors of the audit test (babor et al., 2001) give a cut-off point of 8, which helps to identify individuals with risky and harmful drinking patterns with good sensitivity and specificity and high internal consistency (conigrave, saunders, & reznik, 1995). in this study 10.50% of athletes reported risky and harmful alcohol consumption and drinking patterns. the results, separated by gender, showed that 12.2% of men exceed audit > 8, slightly less women, 8.1%. table 2: results split across cut-off point relevant clinical categories variable/ total score male female total eat-26 n % n % n % low score 96 95.00 59 74.70 155 86.10 high score 5 5.00 20 25.30 25 13.90 ces-d low score 81 73.70 36 40.90 117 59.10 high score 13 11.80 18 20.50 31 15.70 severe score 16 14.50 34 38.60 50 25.20 audit low score 86 87.80 68 91.90 154 89.50 high score 12 12.20 6 8.10 18 10.50 in addition, the analysis revealed some statistically significant differences between the groups of male and female elite athletes, which are shown in table 3. on eat-26, female athletes scored statistically significantly higher than male athletes (u = 5.012, p = 0.003), indicating that female athletes are at higher risk for eating disorders. females also achieve statistically significantly higher mean scores than males on the ces-d (u = 6.707, p = 0.000), thus reporting higher levels of depressive symptoms. on the audit, there were no statistically significant differences in mean scores between genders (u = 3.150, p = 0.135). annales kinesiologiae • 13 • 2022 • 2 123 uroš perko, maša černelič-bizjak: disordered eating attitudes, depressive symptomatology and alcohol ..., 115–130 tabela 3: comparison of male and female athletes on eat-26, ces-d, and audit questionnaires eat-26 diference male n m sd u p 101 6.92 5.97 5.012 0.003* female 79 11.78 11.03 ces-d diference male n m sd u p 110 12.58 7.80 6.707 0.000** female 88 19.36 10.80 audit diference male n m sd u p 98 3.47 4.37 3.150 0.135 female 74 2.40 2.80 discussion the purpose of the current study was to examine the prevalence of disordered eating behaviours and attitudes in male and female categorized athletes and to examine the relationships between eating behaviours and psychological dimensions such as depression and behavioural dimensions such as alcohol use. the serious health consequences of eating disorders, depression, and alcohol abuse, as well as the shortand long-term consequences that can impair athletic performance, point to the need for further investigation of these risk factors in athletes. we found a significantly increased prevalence of pathological attitudes or behaviours as seen in clinical eating disorders. as many as one quarter (25.30%) of young female athletes reported behaviours and attitudes related to food, weight, abnormal eating habits, and concerns about weight that indicate risk for an eating disorder, as well as symptoms and concerns characteristic of eds. among male athletes, this percentage is much lower at 5%. lower scores may still be associated with severe eating disorder symptomatology, as symptom denial can be a major problem in eating disorders (garner et al., 1982). therefore, some authors use a cut-off point of 10 (rosendahl, bormann, aschenbrenner, aschenbrenner, & strauss, 2009). these findings are consistent with the known fact that women are affected by ed to a greater extent than men (keel & forney, 2013; kristjánsdóttir et al., 2019). furthermore, reports of ed prevalence in sport worldwide vary by gender, sport, and level of competition from 0% to 19% in male athletes and 6% to 45% in female athletes (bratland-sanda & sundgot-borgen, 124 uroš perko, maša černelič-bizjak: disordered eating attitudes, depressive symptomatology and alcohol ..., 115–130 annales kinesiologiae • 13 • 2022 • 2 2013). however, the question of whether athletes really represent a subgroup at risk of developing an eating disorder remains controversial. moreover, the results of this study showed a significant association between increased attitudes toward eds and depression symptoms. these results are consistent with those of other studies showing that depression is significantly associated with eating disorder (deepthi et al., 2014; manaf, saravanan, & zuhrah, 2016; mcintyre, & calabrese, 2019; wolanin et al., 2016). 40% of all participating athletes exceed the cut-off point of 16 on the ces-d. of particular note is the percentage of 59.10% of young categorized athletes who have clinically significant depressive symptoms. even when using a more conservative cut-off point of 22, the number is still extremely high, with 38% of young athletes exceeding the above cut-off point. of concern is the fact that more than half of the young female athletes and slightly more than a quarter of the young male athletes showed clinically significant symptoms of depression. compared to other studies, our athletes showed clinically significant symptoms of depression (ces-d ≥ 16) more frequently than athletes in other studies (armstrong & oomen-early, 2009; junge & feddermann-demont, 2016; nixdorf et al., 2013; prinz et al., 2016). in the aforementioned studies, the percentage of athletes exceeding 16 points on the ces-d ranges from 12% to 20%, and the mean scores range from 8 to 12 points. the results also showed some differences in reported depression symptoms related to gender. similar to other studies, our female athletes were more likely to report significant depressive symptoms and achieved higher mean scores than men. in a well-designed study (wolanin et al., 2016) using the ces-d scale to assess depression in 465 athletes over a 3-year period, it was found that females had the highest rates of depression on the ces-d scale. they also found that 23.7% of athletes reported clinically relevant depressive symptoms, with 6.3% reporting moderate to severe depression, similar to non-athletes (wolanin et al., 2016). the scores obtained in our study on the audit questionnaire were not high. the average score for the participants was 3.01. however, it should be noted that still 10.50% of the participants obtained a score higher than 8 points on audit, among them 12.20% of male athletes and 8.10% of female athletes. the percentages may not seem high, but great caution must be taken when interpreting them, as the issue of excessive alcohol consumption, harmful patterns, and alcohol dependence is very complex and sensitive. if we consider the three facts, first that participants do not usually report actual amounts and that we can usually add one point to each score (babor et al., 2001); second, that alcohol has different effects depending on age and gender, so that the cut-off point for women and adolescents is often recommended at 7 rather than 8, leaving the determination of the cut-off point to judgment even by national and cultural standards; and third, that any time when young people drink alcohol is a risky drinking pattern (sorko & boben, 2014). based on what has been written we can assume that the observed average scores are not particularly low. however, considering the low age of the athletes in our sample, the results are concerning. importantly, four participants reported a value higher than 17 points. however, this is a value that may already indicate alcohol dependence syndrome. annales kinesiologiae • 13 • 2022 • 2 125 uroš perko, maša černelič-bizjak: disordered eating attitudes, depressive symptomatology and alcohol ..., 115–130 different authors (brenner & swanik, 2007; diehl, thiel, zipfel, mayer, & schneider, 2014; dunn, thomas, swift, & burns, 2011; dunn & thomas, 2012; du preez et al, 2017; lakasing & mirza; 2009; lisha & sussman, 2010; lorente, souville, griffet, & grélot, 2004; o’brien, ali, cotter, o’shea, & stannard, 2007; peretti-watel et al., 2003) indicate a positive association between sport participation and alcohol consumption, and that alcohol consumption among athletes is often risky and can lead to dependence. based on our results we cannot conclude that there is a positive association between sport participation and alcohol consumption. regarding the difference between our population and the general population of 18–20-year-old young adults, it should be noted that comparison is difficult because diagnostic and screening methods are different. globally, it is estimated that 12–50% of college students have at least one diagnostic criterion for one or more mental disorders (bruffaerts et al., 2018). studies conducted on different samples of college students have found a moderate to high prevalence of depression in this population (al bahhawi et al., 2018, ramón-arbués et al., 2020). in the study conducted with 1210 participants in 194 cities in china using online questionnaires, 69.7% of participants were found to have normal depression, 13.8% had mild depression, 12.2% had moderate depression, and 4.3% had severe or extreme depression (wang et al., 2020). another recent study found that of the participants, 47% had minimal depression symptoms and 5% had severe depression symptoms (ustun, 2021). in our study, the response rate (exceeding the cut-off value) for depressive symptoms was very high, 40.90%. in a study of hong kong college students using audit (n = 345), 35.4% scored 8–15 points and 7.8% scored 16–19 points, and 0.9% scored 20 or more points (chow, ling poon, lui, chan, & lam, 2021). an australian study reported an average audit score of first-year college students of 10.79 (corney & du plessis, 2022), compared with our result, i.e. 3.01. worldwide, many epidemiological studies have been conducted on ed with different prevalence rates. in india, among 1600 students aged 15–25 years, 10.6% of the total population had high eat -26 scores (nivedita, sreenivasa, rao, & malini, 2018). the prevalence scores from our study (13.90% with high score in eat-26) are higher than this report. another study (syed et al., 2018) conducted on 250 adolescent college students in pakistan found that 29.2% of young girls had eat-26 scores of 20 or higher. it should be emphasized that it is not necessarily the case that elite sport and its demands are factors that directly cause the occurrence and frequency of symptoms of certain mental health problems (perko, 2021). sport, for example, can act as a positive factor that alleviates the unpleasant symptoms of mental disorders, and as such is only a training ground where latent or pre-existing problems can manifest themselves. of course, to confirm this assumption, a long-term study would have to be conducted. 126 uroš perko, maša černelič-bizjak: disordered eating attitudes, depressive symptomatology and alcohol ..., 115–130 annales kinesiologiae • 13 • 2022 • 2 conclusion the findings of the present study suggest that the percentage of young athletes presenting clinically significant symptoms of eating disorders, depression, and risky alcohol consumption is high. male and female athletes reported clinically significant symptoms of depression in 40.90%, clinically significant symptoms of eating disorders in 13.90%, and risky and harmful alcohol abuse in 10.50%. it is important to treat and recognize the symptoms and build a professional team trained in recognizing mental problems in athletes in order to provide 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a longitudinal small sample comparison of muscle contractile properties, motor abilities and lifestyle characteristics of athletes and non-athletes saša pišot1, rado pišot1, boštjan šimunič1 1 science and research centre koper, slovenia corresponding author: saša pišot science and research centre koper, garibaldijeva 1, 6000 koper, slovenia tel.: +386 5 663 77 00 e-mail: sasa.pisot@zrs-kp.si abstract introduction: because healthy behaviors learned early in life are more likely to be maintained during adulthood, we aimed to investigate longitudinal changes of participants that were regularly involved in extracurricular sport activities (athletes; n = 7; 4 boys) and those that were not (non-athletes, n = 6; 3 boys) methods: participants of both groups were invited for re-assessment at the age of 27, in 2019, 12 years after they participated in a 5-year longitudinal study as adolescents (9–14 years of age, in the period 2001‒07). we investigated vastus lateralis (vl) and biceps femoris (bf) contractile properties (tensiomyography), maximal running speed (photocells), anthropometric measures (bioimpedance), maximal vertical jumping height (squat and countermovement jumps on a ground reaction force plate), and lifestyle characteristics (gpaq and ehis surveys). results: based on cohen’s d effect size we found that athletes have lower body mass index, higher maximal running speed, better maximal vertical jumping height, and shorter bf contraction time, not found in vl, compared to non-athletes. furthermore, athletes also exhibit healthier lifestyle characteristics such as lower sedentary time and higher daily energy expenditure than non-athletes. athletes follow diet regimens consisting of more regular meals with more protein and indulge less in health-risk behavior (smoking and alcohol consumption). however, the self-perception of health and quality of life was lower in athletes than in non-athletes. conclusion: eu regulations and the beginning of the covid-19 pandemics prevented us from conducting a study on a more representative sample. nevertheless, we could confirm that regular sport participation yields better physical performance 118 saša pišot, rado pišot, boštjan šimunič: time passes – healthy habits stay? ..., 117–133 annales kinesiologiae • 12 • 2021 • 2 and a healthier lifestyle but could also have a negative impact on health (injuries) and quality of life. keywords: motor development, tensiomyography, sport, physical exercise, healthy lifestyle čas mineva zdrave navade ostanejo? longitudinalna primerjava kontraktilnih lastnosti mišic, gibalnih sposobnosti in značilnosti življenjskega sloga športnikov in nešportnikov na majhnem vzorcu izvleček uvod: namen raziskave je ugotoviti longitudinalne spremembe v skupini preiskovancev, ki so se redno ukvarjali z obšolskimi športnimi dejavnostmi (skupina športnikov; n = 7, 4 dečki), in tistih, ki se niso kontinuirano ukvarjali s športom (skupina nešportnikov, n = 6, 3 dečki). metode: udeleženci obeh skupin so bili povabljeni na ponovne meritve pri starosti 27 let, leta 2019, torej 12 let po tem, ko so bili v starosti od 9-14 let, v obdobju 20012007 vključeni v petletno longitudinalno študijo. preučevali smo kontraktilne lastnosti mišic: vastus lateralis (vl) in biceps femoris (bf) (z metodo tenziomiografije), hitrost sprinta z letečim štartom (s fotokamerami), antropometrične podatke (z bioimpedanco), dosežek navpičnega skoka (skoki na tenziometrijski plošči s pomočjo in brez pomoči rok) ter nekatere značilnosti življenjskega sloga (anketi gpaq in ehis). rezultati: na podlagi velikosti učinka (cohenove d) smo ugotovili, da imajo športniki v primerjavi z nešportniki nižji indeks telesne mase, večjo hitrost teka, boljšo zmogljivost vertikalnih skokov in krajši čas krčenja bf, kar pri vl nismo ugotovili. poleg tega imajo športniki tudi bolj zdrave vzorce življenjskega sloga, manj sedijo in več gibajo (večja dnevna poraba energije) kot nešportniki. nadalje prehrano športnikov sestavljajo bolj redni obroki z več beljakovinami, poleg tega imajo manj zdravju nevarnih praks (kajenje in uživanje alkohola). kljub temu pa so športniki svoje zdravje in kakovost življenja ocenili nižje kot nešportniki. zaključek: regulativni predpisi eu za področje varovanja osebnih podatkov (gdpr) kot tudi začetek pandemije covid-19 so nas pri izvedbi študije na bolj reprezentativnem vzorcu močno ovirali. kljub temu smo lahko potrdili, da redno ukvarjanje s športom ohranja boljšo telesno zmogljivost, bolj zdrav življenjski slog, kar pa lahko vpliva na zdravje (poškodbe) in kakovost življenja. ključne besede: gibalni razvoj, tenziomiografija, šport, gibalna aktivnost, zdrav življenjski slog 119 annales kinesiologiae • 12 • 2021 • 2 saša pišot, rado pišot, boštjan šimunič: time passes – healthy habits stay? ..., 117–133 introduction most research into healthy behavior and predictors of these behaviors generally focuses on individuals’ incentives to adopt positive health practices at a single point in time and do not provide a framework for how healthy behaviors may change over time. frech (2012) indicates several reasons to investigate how and why engagement in healthy behavior changes across pivotal life course stages (frech, 2012). first, because healthy behaviors learned early in life are more likely to be maintained during adulthood (lau, quadrel, & hartman, 1990; telama et al., 1997) and because healthpromoting behaviors aid in preventing or delaying chronic or life-threatening disease. and secondly, to evaluate whether personal and social resources at one life course stage (for example during adolescence) exert an enduring or cumulative impact on healthy behaviors at later life course stages. therefore, sport and sport participation are viewed as an effective activity for solving problems and improving quality of life for individuals and society alike. not just for increasing self-confidence, self-esteem, and positive body image, building our character in the form of discipline, teamwork, and responsibility, as well as our importance, but also creating motor and sport-specific skills convertible into physical capital and improving health, fitness, and an overall sense of physical well-being (coakley, 2011). researchers have given considerable attention to the athlete development process, e.g., positive youth development through sport (holt, 2008). utilization of skeletal muscle mass to produce power is of great importance in sport. however, skeletal muscle is also indispensable for locomotion, maintenance of body posture, thermoregulation, sugar and lipid metabolism and, therefore, for general health. to realize locomotion, the muscles must produce power by generating force and shortening velocity at the same time. the speed of muscle contraction is largely determined by fiber type composition. in children, knowing the fiber type composition may be used to help in formulating an informed decision regarding taking up a sport in which the child most likely will excel. while there are numerous data on the fiber type composition of various skeletal muscle in adults and adolescents, we are aware of only seven cross-sectional studies on the fiber type composition of muscle in children between the ages of 2 months and 11 years (bell, macdougall, billeter, & howald, 1980; glenmark, hedberg, & jansson, 1992; kriketos et al., 1997; lexell, sjöström, nordlund, & taylor, 1992; lundberg, eriksson, & mellgren, 1979; österlund, thornell, & eriksson, 2011; verdijk et al., 2014). furthermore, only one study presented longitudinal data of vl composition from adolescence to adulthood (glenmark et al., 1992) and found lower proportion of slow twitch fibers in vl muscle in girls at the age of 16 and the opposite at the age of 27. especially where it is very difficult, for ethical reasons, to invasively measure skeletal muscle myosin heavy chain proportion or fiber type composition, tensiomyography (tmg) provides non-invasive information on changes in functional skeletal properties (valenčič & knez, 1997). specifically, it was established that tmg-derived contraction time (tc) could be used to non-invasively estimate skeletal muscle mhc type 1 proportion (šimunič, degens, & rittweger, 2011). 120 saša pišot, rado pišot, boštjan šimunič: time passes – healthy habits stay? ..., 117–133 annales kinesiologiae • 12 • 2021 • 2 in the period 2002‒07 we followed with tmg screening >300 children in six yearly assessments. approximately one third (107) were measured on all occasions and analyzed (pišot et al., 2004; šimunič et al., 2017; završnik et al., 2016; završnik, pišot, šimunič, kokol, & blažun vošner, 2017). briefly, we found that boys in general had slower muscles than girls. during early maturation in the vl muscle there is a slow-tofast transition that begins between 6 and 10 years of age, which then appears to stabilize to adult proportions. regular participation in sport was associated with a faster biceps femoris (bf), but not in vl, for both sexes (šimunič et al., 2017). we also found correlation between muscle contractile properties and the running speed that was biased for both sexes. specifically, the running speed was less correlated with vl tc in boys than in girls. however, boys’ running speed was more correlated with bf tc than in girls (završnik et al., 2016, 2017). our data thus represent a first non-invasive, if indirect, indication of developmental trends in changes in muscle fiber type composition in children. the most interesting finding for us was that regular sport participation in children aged between 9 and 14, compared to children without any extracurricular sport participation, impacted tc in non-gravitational bf muscle but not gravitational vl muscle, in both sexes (šimunič et al., 2017). however, it remains to be seen whether the continuation of exercise (sport participation) through adolescence to adulthood could further impact tc in both muscles. even more, it would be interesting to see the effect of continued sport participation on motor abilities, body characteristics and main characteristics of healthy lifestyle (nutrition, pa, habits) in the later adolescence and early adulthood of participants. after carrying out a 5-year longitudinal monitoring of skeletal muscle contractile properties and motor abilities in >300 children within two consecutive research projects: (i) “the role of biomechanical properties of skeletal muscle in the motor development of children”, 2001‒04; and (ii) “monitoring of changes in skeletal muscle biomechanical characteristics in early childhood and adolescence”, 2004‒07, we invited those same subjects for a follow-up assessment in 2019 with the purpose of longitudinally investigate the changes in skeletal muscle contractile properties, physical activity level, nutrition, and health related habits. methods in previous analyses we investigated motor abilities development in 9‒14 year-old children as a factor of sex and sport participation. furthermore, in 2019 we invited the subjects to participate again (12 years later), taking the same measurements. furthermore, at the final assessment we investigated basic lifestyle characteristics which we obtained by a questionnaire including demographic data, physical activity, nutrition and smoking habits. additionally, the participants were asked about their participation in organized sports, their sport injury history and important life stress events. results of the first six assessments of vastus lateralis (vl) and biceps femoris (bf) contractile 121 annales kinesiologiae • 12 • 2021 • 2 saša pišot, rado pišot, boštjan šimunič: time passes – healthy habits stay? ..., 117–133 properties (tensiomyography), flying running speed (photocells), anthropometric measures (bioimpedance), and vertical jumping performance (squat and countermovement jumps on a ground reaction force plate) were previously reported in four scientific publications (pišot et al., 2004; šimunič et al., 2017; završnik et al., 2016, 2017). this manuscript presents data from a 12-year follow-up in a subsample of the same participants. participants and recruitment during the recruitment we focused on inviting the 107 participants who were consistently present for all six annual measurements during the 2002‒07 period. the participants came from the slovene towns of koper, izola, piran, ljubljana, and maribor. due to strict personal data protection legislation (eu 2016/679, general data protection gdpr), we had many problems in re-establishing contacts to recruit participants for follow-up measurements, as we only had a database with the first and last names and their elementary school. the principals of the elementary schools could not provide us with the subjects’ contact information, so we had to resort to the “snowball” method and social media. we searched for potential acquaintances to contact the participants and after they agreed to be contacted, we invited them to participate in the follow-up. this was usually done through their social media (facebook and instagram) or by a phone call. in addition, our research organization advertised the invitation to participate in the follow-up through various media (official website, facebook). despite an enormous amount of time and effort invested, we kept receiving responses of interested candidates, but mostly ones who had not participated in our previous measurements from 2002‒07 and thus were not eligible for the follow-up. over the course of about six months, we were able to recruit 13 participants. we divided these participants into two groups: a group of athletes, who had regularly participated in organized sport activities during the past 12 years (athletes; n = 7; 4 boys) and non-athletes (n = 6; 3 boys). specifically, it was evident from their questionnaire data that seven of them continuously participated in various sports from the age of 9 to 25 and were classified as athletes, while six of them had not participated in any sports for at least the past 10 years (non-athletes), although five of them had been active during the period of primary school. table 1 summarizes the proportion of those involved in organized sport activities in three age-periods for both studied groups. 122 saša pišot, rado pišot, boštjan šimunič: time passes – healthy habits stay? ..., 117–133 annales kinesiologiae • 12 • 2021 • 2 table 1: proportion of participants’ sport participation in the two studied groups: (i) those who continuously practiced sport from 14 to 26 years of age (athletes); and (ii) those who did not practice sport at all or only until they were 16 years old (nonathletes). athletes non-athletes n 7 6 sport participation in the age period of 9‒14 5 out of 7 5 out of 6 sport participation in the age period of 14-16 7 out of 7 2 out of 6 sport participation in the age period of 16-26 7 out of 7 0 out of 6 measurement procedures the follow-up measurements consisted of the following test battery: arm strength (dominant hand compression dynamometer), tmg of two muscles, maximal running speed (7-meter sprint with flying start), maximal vertical jump height, body height, mass, mass index, and composition measurement (fat mass, muscle mass). after the tests, each subject was asked to complete a specific questionnaire consisting of several sets of validated questions (gpaq, ehis) to provide data on their current pa status, injury history, health status, and lifestyle to allow capturing possible factors that might influence general fitness (biomechanical muscle characteristics) at each stage of the subject’s life (high school, university, and current age). tensiomyography (tmg) the tmg method measured the contractile properties of two skeletal muscles in the dominant site (vastus lateralis – vl, and biceps femoris – bf). each muscle was stimulated with single electric pulses, rectangular in shape, lasting 1 ms. the pulse amplitude was gradually increased until the maximum response was obtained. we saved the two largest responses for further processing and took the average of both for further analyses. we calculated two contractile parameters for each response: a maximal amplitude (dm, in mm) to be used for the calculation of contraction time (tc, in ms) between 10 % to 90 % dm. 123 annales kinesiologiae • 12 • 2021 • 2 saša pišot, rado pišot, boštjan šimunič: time passes – healthy habits stay? ..., 117–133 measurement of body composition after body mass and height were measured, body mass index was calculated, and composition was measured using a bioimpedance meter (maltron bioscan 916s, uk). we ensured that participants were calm, normally hydrated, and rested for at least 20 minutes before the measurement. fat mass was measured via a 4-point measurement. maximal running speed after a standardized 10-minute warm-up, the maximal running speed was measured with a flying start over a distance of 7 meters. we assured plenty of room to accelerate and decelerate before and after assessment gates (powertimer 300, newtest, finland), respectively. each participant made three attempts and the best result was taken for further analysis. maximal vertical jumping height we measured the height of the vertical jump without using hands (hands on the hips). each participant performed three countermovement and three squat jumps on a ground reaction force plate (quattro jump 9290ad, kistler ltd., austria). the best result was taken for further analysis. questionnaire the questionnaire designed for this study consisted of several sets of validated questions and covered basic socio-demographic data, health status and nutrition, physical/sport activity, and aspects of sedentary time. we used an adapted part of the european health interview survey – ehis to assess eating habits (regular diet, type of diet) and indicators of quality of life. additionally, physical/sport activity was assessed by a self-reported validated questionnaire the global physical activity questionnaire – gpaq (armstrong & bull, 2006). statistics due to the small sample size, we did not perform classical parametric statistical analysis. we performed the non-parametric mann-whitney test to compare athletes vs. non-athletes only for indicative purposes. since small samples yield low statistical power and only large effects will end up significant, we rather calculated effect sizes – cohen’s d values ‒ and interpreted main findings based on the effect size (low 124 saša pišot, rado pišot, boštjan šimunič: time passes – healthy habits stay? ..., 117–133 annales kinesiologiae • 12 • 2021 • 2 < 0.20; moderate 0.20 ≤ cohen’s d < 0.8 and high ≥ 0.8). for comparing correlations between lifestyle characteristics and motor abilities and muscle characteristics, we used the spearman rho coefficient indicating significant correlations at p < 0.05. results we were able to repeat the longitudinal monitoring of the biomechanical characteristics of skeletal muscle only on a sample of 13 (7 male) participants at the age of 27 years: 4 participants from maribor, and 9 from koper over 7 testing days executed in january, february, and october 2019. in all comparisons there were no statistical differences confirmed by the mannwhitney test; however, due to lower sensitivity of statistical tests in very small samples, we interpreted effect sizes. table 2 shows a progressive trend in basic anthropometric data of pooled participants indicating normal growth. when comparing athletes and non-athletes (table 4), we found that athletes had moderately to significantly lower body mass index (effect size from 0.42 to 1.07) throughout the whole period and lower fat mass (effect size 0.65) at the age of 27 years. this is consistent with lesser sedentary time (effect size 0.55) and higher daily energy consumption (effect size 0.47) compared to non-athletes. table 3 presents motor abilities in pooled participants. when comparing athletes and non-athletes (table 4), we could not confirm higher running speed in athletes throughout all periods. however, countermovement and squat jump heights were higher in athletes when compared to non-athletes at the age of 27 (effect size 0.81 and 0.74, respectively). vl tc was not lower in athletes; it was, however, lower in bf with the largest effect size at the age of 27 years (0.64). table 2. basic anthropometric data of pooled participants. age 9 years 10 years 11 years 12 years 13 years 14 years … 27 years n 13 13 13 13 13 13 … 13 body mass index / kg/m2 17.1 ± 2.5 17.9 ± 2.6 18.0 ± 2.9 19.5 ± 3.0 20.0 ± 2.7 20.3 ± 2.4 … 22.8 ± 3.3 body height / m 1.41 ± .06 1.45 ± .07 1.49 ± .07 1.58 ± .07 1.65 ± .08 1.69 ± .08 1.76 ± .09 body mass / kg 34.3 ± 7.0 37.9 ± 8.2 40.4 ± 9.1 48.9 ± .11 54.8 ± 10.7 58.2 ± 9.7 71.6 ± 14.4 125 annales kinesiologiae • 12 • 2021 • 2 saša pišot, rado pišot, boštjan šimunič: time passes – healthy habits stay? ..., 117–133 table 3. pooled data of selected motor abilities. age 9 years 10 years 11 years 12 years 13 years 14 years … 27 years n 13 13 13 13 13 13 … 13 running speed / m/s 5.6 ± 0.5 5.6 ± 0.4 5.7 ± 0.4 6.0 ± 0.4 6.3 ± 0.8 6.2 ± 0.4 … 6.4 ± 0.5 cmj height / cm … 29.8 ± 5.6 squat jump height / cm … 28.3 ± 5.2 cmj – countermovement jump table 4. comparison between athletes and non-athletes group athletes non-athletes effect size* number 7 6 body mass index / kg/m2 9 years 16.7 ± 2.9 17.7 ± 1.9 0.54 10 years 17.3 ± 3.0 18.7 ± 2.2 0.63 11 years 17.4 ± 2.9 18.7 ± 2.9 0.48 12 years 18.7 ± 3.1 21.0 ± 2.4 0.98 13 years 19.4 ± 3.3 20.7 ± 1.8 1.07 14 years 19.9 ± 2.7 20.8 ± 2.0 0.42 … … … … 27 years 21.9 ± 3.7 23.1 ± 2.5 0.65 fat mass / % 27 years 22.7 ± 6.4 23.7 ± 3.0 0.33 running speed / m/s 9 years 5.5 ± 0.4 5.7 ± 0.5 -0.39 10 years 5.7 ± 0.4 5.6 ± 0.4 -0.15 11 years 5.6 ± 0.4 5.7 ± 0.4 -0.41 12 years 5.9 ± 0.4 6.0 ± 0.4 -0.02 13 years 6.0 ± 0.3 6.1 ± 0.3 -0.39 14 years 6.1 ± 0.4 6.3 ± 0.3 -0.64 … … … … 27 years 6.4 ± 0.5 6.3 ± 0.5 0.31 126 saša pišot, rado pišot, boštjan šimunič: time passes – healthy habits stay? ..., 117–133 annales kinesiologiae • 12 • 2021 • 2 group athletes non-athletes effect size* number 7 6 countermovement jump height / cm 27 years 31.6 ± 5.7 27.6 ± 5.0 0.81 squat jump height / cm 27 years 29.9 ± 5.3 26.1 ± 7.2 0.74 contraction time of vastus lateralis / ms 9 years 20.7 ± 2.5 19.2 ± 2.6 -0.57 10 years 19.0 ± 2.1 17.6 ± 2.1 -0.64 11 years 19.3 ± 4.2 19.2 ± 2.8 -0.01 12 years 21.7 ± 4.4 20.4 ± 2.3 -0.56 13 years 21.6 ± 3.6 22.1 ± 2.4 0.22 14 years 22.7 ± 3.7 23.7 ± 3.3 0.30 … … … … 27 years 21.5 ± 3.0 21.4 ± 2.2 -0.05 contraction time of biceps femoris / ms 9 years 32.1 ± 3.5 34.2 ± 7.3 0.29 10 years 31.2 ± 2.9 32.8 ± 9.1 0.17 11 years 32.0 ± 3.5 33.9 ± 6.6 0.29 12 years 31.1 ± 4.5 33.3 ± 8.6 0.26 13 years 29.4 ± 3.7 36.9 ± 13.0 0.58 14 years 29.6 ± 1.8 34.9 ± 12.8 0.41 … … … … 27 years 29.1 ± 2.8 33.9 ± 7.6 0.64 sedentary time / min 27 years 335 ± 157 417 ± 147 0.55 daily energy consumption / met 27 years 4663 ± 2823 3346 ± 2780 0.47 met… metabolic equivalent; *positive values of effect size denote better results for athletes. data from gpaq showed higher daily energy consumption (met) because of sport participation of athletes in parallel to lower daily sedentary time than in non-athletes. even more, sedentary time at age of 27 years correlates negatively with body mass index (r = −0.47) and fat mass (r = -0.59), and positively with bf tc at this same age (r = 0.50). 127 annales kinesiologiae • 12 • 2021 • 2 saša pišot, rado pišot, boštjan šimunič: time passes – healthy habits stay? ..., 117–133 additionally, the differences in certain socio-demographic factors and lifestyle characteristics between athletes and non-athletes were examined, which are shown in table 5. table 5: comparison of some lifestyle characteristics of athletes and non-athletes group athletes non-athletes effect size* n 7 6 self-assessment of…: general health status 3.8 ± 0.6 4.2 ± 0.6 0.67 physical capability 3.3 ±0.7 3.3 ±0.9 0.00 psychological status 3.8 ±0.6 3.8 ±0.6 0.00 general quality of life 3.8 ±0.6 4.2 ±0.3 1.33 eating habits breakfast 5.7 ±0.67 4.0 ±1.9 0.89 morning snack 3.2 ± 1.0 2.4 ± 1.6 0.50 lunch 5.5 ±0.7 5.8 ±0.3 1.00 afternoon snack 3.3 ± 1.6 2.5 ±1.0 0.80 dinner 5.2 ±1.4 5.5 ±0.7 0.43 food consumption whole-grain bread 4.0 ± 1.2 4.3 ± 2.0 0.15 olive oil 4.3 ± 1.3 5.8 ± 1.0 1.50 milk and low-fat dairy 3.8 ± 1.2 4.8 ± 2.0 0.50 cottage cheese, yogurt, cheese 4.2 ± 1.5 4.3 ± 2.0 0.05 dark chocolate 2.3 ± 1.3 2.0 ± 0.9 0.33 meat products 3.7 ± 1.2 2.0 ± 1.3 1.31 red meat 2.8 ± 1.2 3.0 ± 1.3 0.15 poultry 3.8 ± 1.2 2.5 ± 1.4 0.93 bacon 2.0 ± 0.9 2.3 ± 1.2 0.25 fish 2.7 ± 1.0 2.3 ± 0.7 0.57 fizzy and non-fizzy non-alcoholic drinks 3.0 ± 1.0 3.8 ± 2.2 0.36 alcohol beverages 2.3 ± 0.4 3.7 ± 0.9 1.56 fried dishes 2.8 ± 1.0 3.3 ± 1.2 0.42 * effect sizes are presented as absolute values. 128 saša pišot, rado pišot, boštjan šimunič: time passes – healthy habits stay? ..., 117–133 annales kinesiologiae • 12 • 2021 • 2 a noticeable difference between the groups was that athletes reported predominantly standing (physical work) while non-athletes, all but one, reported predominantly sedentary work. there were no differences between athletes and non-athletes in terms of subjective assessment of physical fitness, mental well-being, and health concerns, but interestingly athletes rated their general health (effect size 0.67) and their overall quality of life (effect size 1.33) lower than did non-athletes. much of the difference between the groups was reflected in eating habits, with athletes eating more regularly and skipping breakfast and afternoon snack less often (effect sizes 0.89 and from 0.50 to 0.80, respectively) than non-athletes. in terms of food choices athletes are more likely to eat meat products (effect size 1.31), especially poultry (effect size 0.93). non-athletes, on the other hand, are more likely to consume olive oil (effect size 1.50) and alcoholic beverages (effect size 1.56). discussion based on effect sizes, due to low number of participants, we could conclude that at the age of 27 years athletes had lower body mass index, fat mass, sedentary time, bf tc and higher running speed, countermovement and squat jump heights and daily energy consumption when compared to non-athletes. similar trends as at 27 years were also found in the age period from 9 to 14 years, but only for two abovementioned longitudinal variables: body mass index and bf tc. interestingly, only running speed was at 9‒14 years lower in athletes than in non-athletes, the opposite as at 27 years. at the age of 27, the largest effect size was recorded for countermovement jump height, squat jump height, body mass index, and bf tc (effect sizes > 0.60). this is the first study to collect 18 years of longitudinal data on tmg parameters from childhood to adulthood. we have previously reported that children’s regular participation in sports was associated with shorter bf tc, but not with vl tc, as found here. more specifically, bf tc differences were observed between sedentary and athletic groups in boys and girls and were significant at 12 years of age (šimunič et al., 2017). as this sample was a sub-sample of the previous study a similar result could be confirmed for the period of 9-14 years. however, this trend was maintained or even slightly increased with regular sport exercise until the age of 27 years. although short tc was confirmed in bf it was not the case for vl tc, which seems to be independent from regular exercise. a similar situation was observed in adult track and field sprinters where sport participation resulted in a higher proportion of type iic fibers in the bf, which was also associated with a lower bf tc (19.5 vs. 30.2 ms in sprinters vs. sedentary subjects, respectively) (dahmane, djordjevič, & smerdu, 2006). it could be that the habitual loading of weight-bearing muscles (as for vl) through normal daily physical activity is already relatively high in non-athletes and that the non-weight bearing muscles are more heavily loaded during exercise (šimunič et al., 2017). if so, this may explain the grater adaptation to regular exercise in bf than in vl. our group of athletes consisted of three handball players, two volleyball players, one dancer and one 129 annales kinesiologiae • 12 • 2021 • 2 saša pišot, rado pišot, boštjan šimunič: time passes – healthy habits stay? ..., 117–133 multisport athlete. when we compare their average bf tc’s at the age of 27 years (29.6 ms) with the averages of other groups of adult athletes, e.g., male sprinters at 19 ms (šimunič et al., 2017), beach volleyball players at 25 ms (rodríguez ruiz et al., 2012), gymnasts at 27 ms (šimunič et al., 2017), and football players at 28 ms (rey, lagopeñas, lago-ballesteros, & casáis, 2012) they have a longer bf tc, but a shorter bf tc than non-athletes with 32 ms (šimunič, 2012; šimunič, pišot, rittweger, & degens, 2018). thus it appears that participation in sports during childhood may lead to a faster profile of bf tc, an important muscle for fast explosive sports such as football, volleyball, sprinting, and gymnastics as well as for overall knee health (biscarini, botti, & pettorossi, 2013; guelich, xu, koh, nuber, & zhang, 2016). to support this, we have previously reported that children who regularly participate in sports also have higher running speed (volmut, pišot, & šimunič, 2016) and that this was negatively correlated with bf tc (pišot et al., 2004; završnik et al., 2016) but only in boys beyond the age of 13 years. and indeed, we were able to confirm higher sprinting velocity in athletes only at the age of 27 years, and not before, as five of the six participants in the nonathlete group also practiced sports during the age period of 9‒14 years. for all other non-longitudinal variables of body composition and muscle performance, which were not assessed until age 27, differences between the two groups were in favor of the athletes. specifically, athletes had lower fat mass, which is indicative of a lower body mass index, and had higher jumping performance, an indicator of overall body strength. regarding lifestyle variables, athletes had lower sedentary time and higher daily energy consumption. although we have found moderately lower sedentary time in athletes, when compared to non-athletes, it is not always so, as previous studies reported that athletes can be highly active and have high sedentary time, because of an independent relationship between moderate-to-vigorous physical activity time and sitting time (swartzendruber, croteau, & maine, 2020; weiler, aggio, hamer, taylor, & kumar, 2015). the relationship among high sedentary time for athletes’ health, risk of cardiovascular and metabolic diseases, despite high activity level, remains to be seen. in their self-reporting, athletes rated their health and quality of life worse than did non-athletes. although their health status did not reflect any serious medical condition or show any chronic diseases, we can speculate that athletes report lower qol due to their recent injury experience as these lower scores primarily affect social and global functioning, suggesting that they feel that their injuries limit their ability to participate in sports and social life (mcguine, winterstein, carr, hetzel, & scott, 2012; valovich mcleod, bay, parsons, sauers, & snyder, 2009). it is also evident that athletes eat more regularly, place more emphasis on breakfast, eat healthy snacks with higher intake of animal-sourced protein, and consume less fats and less alcohol. our findings are consistent with adolescent athletes eating healthier and having more varied diets (von rosen, olofsson, väsbom, & heijne, 2019). the major limitation of the study was the small sample number and low response rate of participants for re-testing (11 %). this is a major shortcoming of all longitudinal studies due to the eu regulation of personal data protection, disinterest of participants in attending the later measurements, and certainly in this case the covid-19 pandem130 saša pišot, rado pišot, boštjan šimunič: time passes – healthy habits stay? ..., 117–133 annales kinesiologiae • 12 • 2021 • 2 ics. furthermore, we had both sexes in both groups but of similar distribution. therefore, we have done only effect size estimation without statistical hypothesis testing. conclusion despite the small sample we can identify a trend which confirms that many years of sports participation and regular exercise have positive effects on physical fitness and motor abilities, and especially on the contractile properties of the skeletal muscles. athletes have lower body mass index, exhibit greater running speed, better jumping performance and shorter contraction time of the posterior thigh muscle. athletes also spent less time sitting and have higher daily energy expenditure than non-athletes, but this was not reflected on fat mass. the contraction time of the anterior thigh muscles, which did not differ between the groups, confirms our previous findings that the daily stimulus of the postural muscles is large enough to maintain contractile properties, which is not the case for the posterior thigh muscles, which are less used during daily tasks. we also found healthier lifestyle habits in athletes. they practice healthier diet regimes with more regular meals containing more protein (meat products, poultry) as well as fewer health-risk practices (smoking and alcohol consumption); regarding the self-assessed quality of life, athletes reported lower health status and general quality of life, which can be explained by the reported injuries and strict sport regimes of athletes. acknowledgements we would like to thank the participants, the research teams from the institute for kinesiology research of the science and research centre koper and the faculty of education university of maribor, and everyone who helped with recruitment of subjects for repeated measurement study. special thanks to the companies who provided additional incentives with practical rewards. the research study was co-funded by the slovenian research agency (research program: p5-0381 kinesiology for quality of life) and foundation for financing sports organisations in the republic of slovenia (fundacija za financiranje športnih organizacij v republiki sloveniji). references armstrong, t., & bull, f. 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(2016). lower correlation between biceps femoris contraction time and maximal running speed in children than in adults: a longitudinal study in 9to 14-year old children. annales kinesiologiae, 7(1), 21–42. http://ojs.zrs-kp.si/index.php/ak/article/view/112. https://doi.org/10.1080/17461391.2018.1552721 https://doi.org/10.1080/17461391.2018.1552721 https://doi.org/10.1136/bmjsem-2015-000023 https://doi.org/10.1177/0300060516687212 http://ojs.zrs-kp.si/index.php/ak/article/view/112 http://ojs.zrs-kp.si/index.php/ak/article/view/112 _hlk89942516 _hlk103676616 _hlk111804760 _hlk111802738 _hlk30149664 _hlk111710665 annales kinesiologiae • 7 • 2016 • 1 67 elements of safety in paragliding janez mekinc1 katarina mušič1 1university of primorska, faculty of tourism studies – turistica, portorož, slovenia corresponding author: janez mekinc university of primorska, faculty of tourism studies – turistica, portorož, slovenia phone: 00 386 41 398 129 e-mail: janez.mekinc@fts.upr.si abstract paragliding is an opportunity for tourism development, depending on what position the sport has place in the local community, the restrictions for paragliders and the safety components of the region. the paper explores the phenomenon of paragliding and safety elements in the upper soča region, one of ten best paragliding sites in the world (placestoseeinyourlifetime, 2015). the purpose of the research is to analyse the safety elements, the development and the risk of paragliding. the goals of the research are to propose solutions in order to improve the safety conditions for paragliding and to make suggestions on the further development of paragliding within the framework of tourism in the upper soča destination. according to the interviewees, paragliding is becoming safer from year to year. this is also supported with the ever-growing numbers of pilots, and on the other hand, the number of accidents that do not follow the same trend. the identified causes for the accidents are human errors or weather conditions. the statistical data confirmed the paragliding in the upper soča region, with its unique geographical location, has a positive impact on local tourism and its development. the results of the study are useful for paragliders, local tourism stakeholders, researchers of sport tourism, as well to municipalities in the upper soča region. keywords: paragliding, safety, tourism, the upper soča valley. original scientific article udc: 797.553:338.48(497.4posočje) received: 2015-08-07 68 janez mekinc, katarina mušič: elements of safety in paragliding, 67–80 annales kinesiologiae • 7 • 2016 • 1 elementi varnosti v jadralnem padalstvu izvleček jadralno padalstvo je lahko, odvisno od odnosa lokalne skupnosti do tega športa, omejitev, ki so jim jadralni padalci podvrženi in varnostnih elementov na destinaciji, kjer se izvaja jadralno padalstvo, priložnost za razvoj športnega turizma. članek raziskuje pojav jadralnega padalstva in z njim povezanih varnostnih vprašanj na območju zgornjega posočja, ki ga poznavalci uvrščajo med 10 najboljših območij za letenje z jadralnimi padali na svetu (placestoseeinyourlifetime, 2015). namen raziskave je analizirati varnostne elemente, razvoj varnosti in tveganja v jadralnem padalstvu. temeljna cilja raziskave sta priprava predlogov za izboljšanje varnostnih elementov jadralnega padalstva in priprava predlogov za razvoj turističnega jadralnega padalstva v zgornjem posočju. jadralno padalstvo je po oceni intervjuvancev iz leta v leto varnejši šport, kar posledično povečuje število pilotov, turističnih letov, vendar pa tudi število nesreč. najpogostejši vzroki nesreč so človeške napake ali vremenske razmere. podatki kažejo, da je zgornje posočje s svojo edinstveno geografsko lego in klimatskimi pogoji, idealna ter konkurenčna destinacija za razvoj turističnega jadralnega padalstva, ki ima neposreden vpliv na razvoj lokalnega turizma. ugotovljeno je bilo, da je potrebno načrtovati vzpostavitev infotočk za jadralne padalce, kjer bo mogoče pridobiti ustrezne informacije za načrtovanje poletov. rezultati raziskave so koristni za jadralne padalce in njihova društva, za vse lokalne turistične subjekte (lokalna turistična organizacija, gostinci in ponudniki prenočišč, turistične agencije, itd.), raziskovalce športnega turizma, kot tudi za občine zgornjega posočja. ključne besede: jadralno padalstvo, varnost, turizem, zgornje posočje introduction among cultural, spa and business tourism, sport tourism is one of the fastest growing segments of tourism. throughout the last few years, sports, especially adventure sports, are becoming more and more interesting. for the active tourist, sport has become an integral part of life also when on holiday (slak valek, shaw, & bednarik, 2014). some find in it relaxation, entertainment, socializing, and for some it has become the meaning of life. on the other hand, there are also some who make a living out of it, and others that have upgraded it into pure competition. a safety audit to analyse and define safety risks should become a part of the process of developing a sport tourism product. the level of possibility of a safety risk occurrence and the level of consequences should be recognized, defined and managed annales kinesiologiae • 7 • 2016 • 1 69 janez mekinc, katarina mušič: elements of safety in paragliding, 67–80 afterwards. overall safety of a sport tourist product and the possibility of assuring personal safety are the two factors which influence the tourist‘s decision of using the services again. event-specific risks and security strategies differ not only in their main causes, forms, and effects but also in their symbolism and indirect consequences (perić, vitezić, & mekinc, 2016). paragliding is very popular and opens up a whole new world of wonderful experiences for the people who practice it. it can range from simple rides from the top of a hill, or a trek to the top of a mountain from which one can glide down the valley. for the daring that seek something more, paragliding also offers aerobatic manoeuvres, crosscountry flights and official competitions. its appeal to all thrill-seekers throughout the world lies in its ease of use and the affordable price and it is now promoted in almost all countries around the globe. among the most popular ones is the upper soča valley. it offers excellent conditions for the implementation of this sport, where paragliders can see natural and historical places from the air (gradišek, 2008). so it is of no surprise that paragliding has a significant impact on the development of tourism in this region. in this paper, we discuss paragliding through the perspective of safety. it is explored from its early beginnings, and into what has evolved, and where the risks are. we also review the related laws that regulate the sport, what kind of impact on tourism it brings, and present the opportunities and improvements. as stated before, the upper soča valley is, with its natural resources and weather conditions, very interesting for paragliders. we have to emphasize that although the season takes place only in warmer months of the year, and although a large proportion of the region lies in the triglav national park, it is popular with tourists. the area is, therefore, protected with the following laws and regulations: the law on the triglav national park (tnp), the law on air navigation (zzrap) and the regulations in the field of paragliding. the development of sports tourism in the municipalities of tolmin, kobarid and bovec are still restricted due to the poor transportation links to central slovenia and to the north, the underdeveloped public transport and the tourist signs. a milestone for slovenian paragliding was set in 1984 when dare svetina flew from dobrča hill (kačičnik, 1995). only three years later, in 1987, svetina organized the first slovenian championship in paragliding. in same year, 1987, sandi marinčič, vlasta kunaver and igor krevelj flew from triglav, the highest slovenian mountain. the next year there were more than 120 pilots and paragliding became officially recognized (glušič, 2003). now, 26 years further on, we have 1,326 registered paragliders (humphrey, 2014). kaniamos (2008) says that paragliding is flying where the pilot hangs below the wing, on lines in a custom-made seat. the basic equipment consists of a glider, a parachute, a seat, a spare reserve parachute and a helmet. accessories vary from a variometer, navigational instruments, a radio station, gloves, appropriate footwear and clothing. a radio station is also defined in the third paragraph of article 21 of the hang gliding and paragliding regulation, but it is only mandatory when training a novice pilot (decree on hang gliding and paragliding, 1999). in the municipalities of kobarid and tolmin they sell permits that are obligatory for foreign pilots. they are used as the right for take-off and landing in this valley. slove70 janez mekinc, katarina mušič: elements of safety in paragliding, 67–80 annales kinesiologiae • 7 • 2016 • 1 nians are not required to buy them as being the members of the paragliding associations automatically makes them the members of the slovenian free flight association. the alliance also offers benefits such as insurance for the liability for damages against a third party, subscription to the ikarus journal which is designed for paragliders and hang gliders. through the alliance, all the necessary procedures of registering the takeoffs and landing sites are managed (slovenian free flight association, 2015). in the region, we have three paragliding associations, which maintain the take-off and landing sites. the posočje free flight association was founded in 1981 as the first hang gliders were already flying from the kobala hill in 1975. the first paraglider took off from the same hill in the year 1985. the take-off and landing points are marked with information boards and other information. as mentioned before, one needs a permit that is sold for a day (€4.00), three days (€11), ten days (€20) or a season (€35), covering takeoff and landing (adrenalin gornje posočje, 2014). table 1: number of permits sold / foreign arrivals, 2008-2012. no. of permits sold foreign arrivals permits sold / arrivals (%) 2008 7,181 27,088 26.5 2009 6,289 25,622 24.5 2010 6,219 24,770 25.1 2011 7,748 30,446 25.4 2012 8,454 31,887 26.5 source: adapted from the adrenalin gornje posočje and statistical office rs, 2015. according to table 1, through the number of sold permits and number of arrivals we can estimate a percentage of foreign paragliders who visit the area. we need to eliminate domestic arrivals from the analysis, as well as the ones from the municipalities of bovec since the permits are not sold there, the vast majority of paragliders stationed in tolmin and kobarid, and competitors. from 2008 to 2012, the proportion of paragliders ranged around stable 25.6% (adrenalin gornje posočje, 2014). the regulation of hang gliding and paragliding states “the take-off and landing points have to meet the safety criteria” (decree on hang gliding and paragliding, 1999). further it is provided that “records of organized take-off and landing places are kept by the administration”. organized flying from the official spots will be permitted upon registration. for registration, the following is required: a consent by the land owner, an expert opinion by the management board of slovenian nature conservation body which states that the take-off point, the landing site and the flight area are not in conflict with environmental restrictions. also, if the new take-off or landing area needs construction work or change of land use, then the municipality needs to give its annales kinesiologiae • 7 • 2016 • 1 71 janez mekinc, katarina mušič: elements of safety in paragliding, 67–80 opinion. if the proposed new flying or landing area is in the zone of a sport airfield, the airport management also needs to give their approval. the safety of paragliding is always the foremost criteria. an experienced pilot is able to assess to what extent an environment is safe or unsafe to fly – regarding his or her skills, experience, or equipment. the beginners should fly under the supervision of their instructor, who will complement their lack of experience. it should be noted that almost all accidents occur due to human error and not due to the nature of the sport. there are also test pilots who are constantly exploring the limits of the equipment in order to test the security restrictions. but there are also pilots who do not respect even the most basic safety principles (kaniamos, 2008). decree on hang gliding and paragliding (1999) defines the conditions for the construction, operation and maintenance of hang-gliders and paragliders, and the conditions associated with the determination of their ability to fly. moreover, the owner or operator of a paraglider is required (every two years) to carry out a technical examination of the materials used and the construction, which must be conducted by an authorized person or the manufacturer. in accordance with the above mentioned decree, accidents will be investigated by a permanent commission appointed by the administration and carried out in accordance with the standards of the investigation of aircraft accidents, serious incidents and incidents relating to aircraft. the slovenia free flight association (2014) has also determined a statutory height of flight in the upper soča valley stating it is permissible to fly 2,895 meters above sea level. in 2014, the ministry of infrastructure of the republic of slovenia adopted the regulation on compulsory registration of paragliders and kites. the regulation has raised a lot of questions. the regulation provides compulsory registration of all the flying equipment in a special register. by the provisions of the regulation, paragliders can fly only if their parachutes are recorded in a special register. this applies to both slovenian and foreign paragliders (rules on nationality, registration and other marks on civil aircraft, 2014). even before the rule entered into force, the slovenia free flight association pointed out the economic damage to tourism since slovenia would be the only country in the eu demanding such a rule. the federation also argued that it does not solve or bring any additional safety features, which was the main objective when the ministry adopted the new rule. on all of these facts, the ministry of infrastructure of the republic of slovenia was also warned by the european hang gliding and paragliding union (2014). the slovenia free flight association (2014) also added that the ministry, with such actions complicates the position of slovenian providers in the paragliding sport as such. a possible solution lies in article 153 of the aviation act (2006) authorized by the the ministry to define exceptions to the paragliders and hang-gliders registration. two mountain rescue services (mrs) operate in the upper soča valley. the mrs bovec station was founded in 1947 and the tolmin mountaineering association with its mrs station was founded in 1948 (slovenian mountain rescue association, 2015). the information regarding paragliding accident statistics was obtained from the archives of mrs tolmin. mrs bovec data with reference to paragliding accidents was negligible, 72 janez mekinc, katarina mušič: elements of safety in paragliding, 67–80 annales kinesiologiae • 7 • 2016 • 1 as they had only three in the last five years (cuder, personal communication, december 15, 2014). table 2 presents the statistics on mrs tolmin (2014) rescues in their area, which covers the area from the italian border on the south side of the kobariški stol mountain, through srpenica, polovnik, krasji top, vršiči, krnčica, krn, the summits of sand, prehodci and bogatin, over the entire ridge from tolminsko-bohinj to lajnar, porezna-gradiške and then down to sežana. all paragliding rescue operations that were not performed in the upper soča valley were excluded from the analysis. table 2: number of interventions mrs tolmin, 2010-2014. no. of rescue operations involving paragliders slovenian paragliders foreign paragliders cancelled missions 2010 28 0 26 2 2011 44 4 35 5 2012 44 5 35 4 2013 20 3 15 2 2014 23 1 19 3 source: mountain rescue service tolmin, 2015. in 2010, the rescue team was involved in 28 cases, among them, eight cases demanded help from a helicopter. in two cases, the intervention was cancelled as the paraglider reported he was fine and safe. all the actions involved foreign paragliders, most of them were injured, and one died. in 2011 the rescue team had 44 missions (five times they proved to be a false alarm) and only in four cases the paragliders were slovenians. in the same year the helicopter was used 12 times. in 2012, they had 44 missions as well. they had to rescue 5 slovenians, cancel 4 missions and rescue 35 foreigners. in 2013, the number of rescue missions was reduced to 20 (3 slovenians, 15 foreigners), 2 of the missions were cancelled as the paragliders had already been safe. the helicopter rescued paragliders in 6 cases. in the year 2014, the mrs tolmin rescued 23 paragliders: 1 slovenian, 19 foreign paragliders and in 3 cases the rescue process was stopped because the paraglider reported he was fine and safe. the helicopter intervened 11 times. the results of the analysis stressed that foreign nationals were involved in 90.91% of all mountain rescue missions (mrs tolmin, 2015). annales kinesiologiae • 7 • 2016 • 1 73 janez mekinc, katarina mušič: elements of safety in paragliding, 67–80 methods the purpose of this study was to obtain a snapshot of the current state of paragliding and security in the upper soča area. subjects in the study performed in 2015, we included 5 paragliders who have experience with flying in the upper soča area and are also the key players in the paragliding community. the first is a paragliding instructor, a competitor, as well as someone who offers accommodation and transport for tourists, therefore, he is familiar with all the aspects of paragliding safety and tourism issues. we also included two female representatives of the paragliding community who attended formal schooling and one of them has just started to compete. the last two interviewees have lots of experience flying as well as offering tandem flights to tourists. all the interviewees went through formal education and passed the paragliding exam which gave them the right to gain the license. their knowledge was also upgraded with a number of theoretical lectures on the topic of security, meteorology and first aid, manoeuvring and controlling parachutes at different speeds and in different difficult situations. all of this led them to master the parachute on the ground and in the air, and gave them what they needed for independent flying. project procedure the research performed in 2015 used various methods for data collection. the main method was qualitative research with a semi-structured interview. the research includes interviews with key stakeholders, a case study of paragliding accidents, swot analysis and the impact of paragliding on tourism in the upper soča destination. data analysis the main method of research was a qualitative research in the form of semi-structured interviews, which gave us an insight into the safety through the eyes of the paragliding pilots. through the interviews, we were trying to figure out the problems that might affect the security factor and tourism in valley. the interviews contained the questions from the following topics: paragliding career interviewee; challenges in the training of new paragliders (mastering techniques of flight, flight safety); safety in paragliding; accidents in paragliding; development of paragliding in the upper soča valley. furthermore, based on the findings of our study, we made the swot analysis and the synthesis of the key strategic factors. 74 janez mekinc, katarina mušič: elements of safety in paragliding, 67–80 annales kinesiologiae • 7 • 2016 • 1 results and discussion the interviewees shared the opinion that paragliding was a safe sport if you followed the correct steps and had the right approach: – they stressed that every paraglider should be able to assess his or her own abilities, know the weather conditions and patterns, as well as to know the equipment, so the risks are minimal. – when asked about the inherent dangers associated with flying in the alps, they all agreed that knowing the local meteorology and the techniques of flying are the two main focuses for them. also, that is something that too many of the foreign paragliders ignore or are just not aware of. many times such paragliders arrive to the valley from the plains, where the flight mode is completely different. it is also important that the pilot is able to react correctly when a critical situation occurs (wind closing the parachute, a strong swing ...). – the main problem when it comes to safety is in the badly organized and inexperienced foreigners that do not know and respect the local characteristics of the weather and the air currents. prior to buying a paragliding ticket – a permit – every pilot should show a certificate of insurance in the event of an accident, which could provide cover for the cost of the rescue. – special attention should also be paid to the foreign instructors and their students because at the moment there is no proper supervision. there should be more effort invested in informing foreign pilots about the conditions of flying here and drawing their attention to greater precaution measures. – one of the possible measures to increase safety is enabling a local paragliding association to ban any pilots who ignore or disrespect the weather conditions when they fly. paragliding, according to the interviewees, developed in parallel with other sports in the upper soča valley. given the fact that the upper soča area is among the ten best paragliding destinations in the world, this should be a pathway for further development (placestoseeinyourlifetime, 2015). on its own, the segment of foreign paragliding tourism in tolmin and kobarid represents around 25% of all foreigners who visit the two municipalities. this information could accelerate the number of new take-off sites, better road communications, the organization of paragliding events and additional activities on non-flying days. with the increased number of tourists and paragliders among them, we also notice more providers who offer their shuttle or sleepover services to paragliders, but lack any knowledge about safety questions. most of them have no other connection with paragliding. that is why they should be informed and educated, so they could provide extra information to their guests regarding flying in this area. the interviewees take accidents in paragliding as an integral part of the risk of sport, but emphasize that paragliding associations offer enough information to foreign pilots, however, they do not abide by the instructions. this is also confirmed by the fact that among those who were injured, 90% of cases come from outside slovenia. the basic reason for getting themselves into trouble was ignoring the meteorology and the techannales kinesiologiae • 7 • 2016 • 1 75 janez mekinc, katarina mušič: elements of safety in paragliding, 67–80 niques of flying in the alpine world. all of the interviewees pointed out that paragliding was safe as much as the pilot was. based on the findings of our study, we made the swot analysis and the synthesis of the key strategic factors. the swot analysis provides a starting point to build on strengths, addresses the weaknesses, exploits the opportunities and avoids the risks. strengths and weaknesses relate to internal factors, whereas opportunities / threats relate to external factors. the internal factors have their own area of influence to adapt, develop, or otherwise act. the external factors are beyond our control and we can do nothing else than to adapt to them. the external factors could act in our advantage if we accept them with flexibility. the swot analysis allows us to identify and reflect what will be key factors in the placement of the product / service on the market (uran, 2006). in our case, we stressed the key opportunities and the advantages of paragliding in the upper soča region. stakeholders of upper soča region should use strengths and opportunities as advantage in the market of paragliding destinations. on the other hand, tourism stakeholders should try with different policies and actions to overcome disadvantages and convert them into advantages. threats should be converted into opportunities. the upper soča region has a potential for further tourism products development and paragliding is one of the most important ones. the swot matrix below shows a general overview of the strengths, weaknesses, opportunities and threats of our study. table 3: swot matrix. strengths weaknesses • ideal climate, weather and wind conditions for safe paragliding • the geographical features of the region enable safe paragliding • qualified local paragliding instructors • a positive attitude of local people to paragliding in the case of an accident inadequate legislation regulating the safety and security of paragliding limited activities due to the triglav national park protected area misinformed tourism stakeholders regarding the main safety data for paragliding opportunities threats develop pilot-friendly compulsory insurance which would include rescue mission mediate appropriate information and training for foreign pilots (flying characteristics of the region) ignorance of the weather and geographical features of the region poor know-how of flying in the alps increasing number of new providers with strong commercial interest which often outweigh the safety factors unsuitable paragliding equipment 76 janez mekinc, katarina mušič: elements of safety in paragliding, 67–80 annales kinesiologiae • 7 • 2016 • 1 paragliding is becoming increasingly important for tourism in the upper soča region due to the increasing number of competition and paragliders. paragliding events also attract other visitors. the study confirmed the importance of relevant information for pilots provided by tourism stakeholders or accommodation providers and other tourism stakeholders in the region. the relevant information about climate conditions and geographical features are the key elements of safety and security in paragliding. pilots need information for the flying plan preparation and the execution of courses. the challenge to improve safety of pilots could be seen in the workshops for tourism stakeholders. the purpose of workshops for tourism stakeholders is to provide the flying expertise in the upper soča region by paragliding professionals. local paragliding clubs, in collaboration with municipal authorities, should provide that kind of workshops free of charge. furthermore, municipal authorities should support local paragliding clubs which take care and maintain the availability and suitability of takeoff and landing places. the suitability of take-off and landing places is very important for paragliding safety. one of the advantages of the upper soča region is its location in the protected area of triglav national park. on the other hand, being part of the triglav national park protected area is an obstacle and weakness because the law on the triglav national park (2010) defined many prohibitions. in accordance with article 13, it is not allowed (for paragliders, hang gliders or balloons) to land anywhere else except at appointed and designated locations, where such activity does not compromise the objectives of the national park. paragliding clubs could offer trainings which relate to the characteristics of flying in this region. the main safety problems of paragliding in the upper soča are inexperienced foreign pilots who do not know the weather characteristics and wind conditions in the region. flying registration permit should include insurance in the event of an accident, which covers the cost of rescue mission. furthermore, proper supervision of the foreign instructors and their pupils should be assured in the future. risk assessment is the foundation and a core virtue in paragliding and is the main point of safe practice. it depends on human qualities and covers the acceptance of one’s limits, the care for their own safety and excessive risk when demonstrating their skills (revenko, 2006). that excessive risk while demonstrating skills against other pilots is one of the potential hazards that affect the pilot‘s attention, which was also highlighted by mole (2015). he noted that in this way the likelihood of an accident increases. an assessment of where the limit is and what constitutes the danger differs from pilot to pilot. as said by jacobs (in revenko, 2006), it is more likely to be an experienced pilot who embarks on dangerous adventures, as an experienced pilot’s perception of danger varies throughout the experience, which is associated with a greater degree of confidence in his / her own skills. but that does not mean that even the best pilots do not make mistakes. measures to reduce these risks of an accident are: a realistic selfassessment of one’s physical and mental condition, taking advice from senior pilots, analysing the weather, mastering all phases of the flight. the hazard assessment deannales kinesiologiae • 7 • 2016 • 1 77 janez mekinc, katarina mušič: elements of safety in paragliding, 67–80 pends on the pilot‘s experience. da paixão and tucher (2012) stated in their study that paragliders highlight the importance of the procedures and actions that can minimize and predict imminent danger. this is also confirmed with mole (2015), who emphasizes the development of a safe routine which must be followed each time one flies. furthermore, da paixão and tucher (2012) came to the conclusion that all paragliders place great emphasis on the management of all phases of their flight, as well as on highquality equipment and its maintenance. at the same time, they give priority to established procedures over practice. the result of their research came to the conclusion that the biggest challenge paragliders face is the realization that their activity can harm or seriously injure them. in hi safety issue, roti (2015) broke it down to these conclusions: the most important elements of a safe flight is to plan your flight first in your head and try to realize every possible scenario what could go wrong and your reactions to them, train your body and mind, and gradually upgrade your skills, know your equipment and keep in mind that most accidents in paragliding can be predicted and prevented. mole (2015) adds the following instructions to the security features: focus your attention on the pre-take-off phase, go through a safety check, do not exceed boundaries during any phase of the flight, constantly analyse the situation, allow yourself an adequate margin of risk, do not exaggerate with excess equipment, analyse your own accident or emergency procedures and those of the others, consider and follow the warning signs and only fly using equipment adapted to your knowledge and your level of experience. conclusion paragliding is a recreational and a competitive sport. in recent years, the development of equipment, availability of the weather conditions data, and the web terrain analysis has transformed the sport in a way that the performance and safety have increased as well as the number of pilots that practice this sport. we have learned that many factors contribute to a safe take-off and landing. every individual must primarily examine the conditions in which he or she flies and be aware of his or her own abilities and limits. these are the fundamental conditions for reducing the risk. but no matter how good the preparation is, it cannot overrule all the variables that can occur to the pilot during take-off, the landing phase or during the flight. therefore, the main cause of many accidents is a sudden gust of wind or a human error. the upper soča valley is one of the best destinations to fly in the world. the study confirmed that there is a lack of inadequate expertise among those who offer accommodation to paragliders or the information provided is very poor. the opportunity to improve this situation is to provide free training for these accommodation providers. help from the local and government authority to empower the local associations, so that they could work hand in hand with the municipality and strictly implement the control over permits and paragliders, could be a second contributing factor that would make a difference with respect to safety. 78 janez mekinc, katarina mušič: elements of safety in paragliding, 67–80 annales kinesiologiae • 7 • 2016 • 1 the analysis of the legislation showed that the required conditions for independent flying and those of pupils are properly defined with a licence and an instructor that has to be with his student during his initial flights. also, the air space of slovenia has prescribed corridors in which flying is allowed. it was also shown that the regulations endorsed by the government do not necessarily have an impact on safety. the last such rule was made in 2014 when the government wanted to indorse mandatory registration of hang-gliders and paragliders, which would represent something unique in europe but was not implemented after the association for free flying slovenia had presented its arguments. they argued that such a rule would mean a loss of foreign and domestic tourists and not a contribution to safety (srečko jost, personal communication, march 11, 2015). paragliding tourism in the upper soča valley is becoming increasingly important. an analysis of paragliding accidents has shown that this is the area where most of them happen. in the last five years, the mountain rescue services in tolmin concluded 143 actions where a paraglider was in need of assistance, and only in 13 cases slovenian paragliders were in need of help. the most common cause of accidents was the lack of knowledge of meteorology and flying techniques. as shown, the rescuers also had problems locating the injured paragliders. thus, one of the aspects to look at when addressing safety is that all paragliders should use one official frequency so that rescuers could reach them easily. this is important because the pilots are flying over and in between mountainous terrain, where there is no complete coverage of the mobile signal. currently, foreigners use other frequencies, making communication difficult. another measure to increase security would also be the introduction of a mandatory commercial insurance similar to the ones 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http://pxweb.stat.si/pxweb/dialog/varval.asp?ma=2164507s&ti=prihodi+in+preno%e8itve+turistov+po+skupinah+nastanitvenih+objektov+in+po+dr%9eavah%2c+ob%e8ine%2c+slovenija%2c+letno&path=../database/ekonomsko/21_gostinstvo_turizem/02_21645_nastanitev_letno/&lang=2 http://pxweb.stat.si/pxweb/dialog/varval.asp?ma=2164507s&ti=prihodi+in+preno%e8itve+turistov+po+skupinah+nastanitvenih+objektov+in+po+dr%9eavah%2c+ob%e8ine%2c+slovenija%2c+letno&path=../database/ekonomsko/21_gostinstvo_turizem/02_21645_nastanitev_letno/&lang=2 http://pxweb.stat.si/pxweb/dialog/varval.asp?ma=2164507s&ti=prihodi+in+preno%e8itve+turistov+po+skupinah+nastanitvenih+objektov+in+po+dr%9eavah%2c+ob%e8ine%2c+slovenija%2c+letno&path=../database/ekonomsko/21_gostinstvo_turizem/02_21645_nastanitev_letno/&lang=2 http://pxweb.stat.si/pxweb/dialog/varval.asp?ma=2164507s&ti=prihodi+in+preno%e8itve+turistov+po+skupinah+nastanitvenih+objektov+in+po+dr%9eavah%2c+ob%e8ine%2c+slovenija%2c+letno&path=../database/ekonomsko/21_gostinstvo_turizem/02_21645_nastanitev_letno/&lang=2 http://pxweb.stat.si/pxweb/dialog/varval.asp?ma=2164507s&ti=prihodi+in+preno%e8itve+turistov+po+skupinah+nastanitvenih+objektov+in+po+dr%9eavah%2c+ob%e8ine%2c+slovenija%2c+letno&path=../database/ekonomsko/21_gostinstvo_turizem/02_21645_nastanitev_letno/&lang=2 80 janez mekinc, katarina mušič: elements of safety in paragliding, 67–80 annales kinesiologiae • 7 • 2016 • 1 zakon o triglavskem narodnem parku [the law on the triglav national park] (2010). uradni list rs [official gazette rs] srs, nos. 17/81, 18/81 corr. , 42/86, nos. 8/90, 35/01 , 110/02 zgo-1 and 52 / 10 tnp-1the law on the triglav national park act (official gazette srs, nos. 17/81, 18/81 corr., 42/86, official gazette of rs, nos. 8/90, 35/01, 110/02 zgo-1 and 52 / 10 tnp-1) zveza za prosto letenje slovenije [slovenian free flight association] (2015). retreived april 18th 2015 from http://sffa.org/ http://www.uradni-list.si/1/objava.jsp?sop=1981-21-0088 http://www.uradni-list.si/1/objava.jsp?sop=2001-01-2045 http://www.uradni-list.si/1/objava.jsp?sop=2002-01-5387 http://www.uradni-list.si/1/objava.jsp?sop=2010-01-2821 http://sffa.org/ annales kinesiologiae • 13 • 2022 • 2 93 injury prevention and physiotherapy procedures for ankle injuries in ballet dancers: a literature review pia lina vilar1, tine kovačič1, mitja gerževič1,2 1alma mater europaea – ecm, department of physiotherapy 2milleo, sports, tourism and education, mitja gerževič s.p. corresponding author: mitja gerževič department of physiotherapy, alma mater europaea – ecm, slovenska ulica 15, 2000 maribor, slovenia e-mail: mitja.gerzevic@almamater.si abstract the aim of this study was to investigate the most frequent, effective and up-to-date injury prevention and physiotherapy procedures used in relation to ballet dancers’ ankle injuries. a literature review with a qualitative analysis was performed using the following databases: pubmed, sage, sciencedirect, plosone and cochrane library. the inclusion criteria were: both genders, age > 18, journal impact factor > 0, age of study ≤ 10 years and the following search keywords were used: “ankle”, “injury”, “ballet”, “dancers”, “physiotherapy”, “physical therapy” and “prevention”. a total of 520 articles were found, out of which six were determined to be appropriate according to the inclusion and exclusion criteria. they dealt with the prevention/ rehabilitation of ankle sprains (n=2), tendinopathy of the achilles tendon (n=2), tendinitis of the m. hallucis longus (n=4), rupture of the achilles tendon (n=2), and anterior (n=3) and posterior (n=4) impingement syndrome. it was found that for injury prevention in ballet, strengthening and stretching exercises are the most often used methods, while rest, ice therapy, muscle strengthening exercises, foot braces and dance technique optimisation are the most frequently used methods in injury management. these seem to also be the most up-to-date injury prevention and physiotherapy procedures, while the most effective procedures could not be retrieved due to a lack of relevant studies, which prevented the quantitative comparison of their effectiveness. the published clinical evidence endorses physiotherapy/kinesiotherapy as an effecreview article doi: https://doi.org/10.35469/ak.2022.349 received: 2022-10-14 udc: 792.82:615.8 mailto:mitja.gerzevic@almamater.si 94 pia lina vilar, tine kovačič, mitja gerževič: injury prevention and physiotherapy procedures ..., 93–113 annales kinesiologiae • 13 • 2022 • 2 tive ankle injury prevention and management modality in ballet dancers, although additional studies with a better quality of methodology are required. keywords: rehabilitation, ballet, ankle, injury, physiotherapy, prevention preventivna vadba in fizioterapevtski postopki pri poškodbah gležnja baletnih plesalcev: pregled literature izvleček cilj študije je bil raziskati najpogostejše, najučinkovitejše in najsodobnejše preventivne in fizioterapevtske postopke pri poškodbah gležnja baletnih plesalcev. pregled literature s kvalitativno analizo je bil opravljen s pomočjo naslednjih podatkovnih baz: pubmed, sage, sciencedirect, plosone in cochrane library. pri tem smo uporabili naslednje vključitvene kriterije: oba spola, starost > 18 let, faktor vpliva publikacije > 0, starost študije ≤ 10 let ter naslednje iskalne ključne besede: »ankle«, »injury«, »ballet«, »dancers«, »physiotherapy«, »physical therapy« in »prevention«. skupno smo našli 520 člankov, izmed katerih je bilo glede na vključitvene in izključitvene kriterije primernih 6 člankov. ti so obravnavali preventivo/rehabilitacijo zvina gležnja (n=2), tendinopatijo ahilove tetive (n=2), tendinitis m. hallucis longus (n=4), rupturo ahilove tetive (n=2) ter anteriorni (n=3) in posteriorni (n=4) utesnitveni sindrom. ugotovili smo, da se v preventivne namene najpogosteje uporabljajo krepilne in raztezne vaje, za fizioterapevtsko obravnavo poškodb pa počitek, terapija z ledom, vaje za krepitev mišic, nožne opornice in optimiziranje plesne tehnike. slednji so kot kaže tudi najsodobnejši preventivni in fizioterapevtski postopki, medtem ko najučinkovitejših preventivnih in fizioterapevtskih postopkov ni bilo mogoče izluščiti, saj je bilo premalo študij za kvantitativno primerjavo učinkovitosti med postopki, kar nakazuje potrebo in možnosti za nadaljnje raziskovanje. objavljeni klinični dokazi potrjujejo, da je fizioterapija/kinezioterapija učinkovito preventivo in kurativno sredstvo pri poškodbah gležnja baletnih plesalce, čeprav so potrebne dodatne študije z bolj kakovostno metodologijo. ključne besede: rehabilitacija, balet, gleženj, poškodba, fizioterapija, preventiva poškodb 95 annales kinesiologiae • 13 • 2022 • 2 pia lina vilar, tine kovačič, mitja gerževič: injury prevention and physiotherapy procedures ..., 93–113 introduction classical ballet is considered a high-performance dance art form that requires an advanced level of technical skills (campbell, lehr, livingston, mccurdy, & ware, 2019). it demands from the dancer a similar level of development of motor and functional abilities and physiological characteristics as some top athletes have. due to strict schedules and repetitive movements during exercise, training sessions and performances, where specific ballet movements are often performed with large amplitudes and in extreme positions at the limits of the range of motion, where muscles, tendons and other passive structures are weaker and thus more prone to injuries, ballet dancers experience relatively large loads on joints, muscles, tendons and ligaments. therefore, they have an increased chance of acute and chronic injuries (bickle, deighan, & theis, 2018; leanderson et al., 2011; nunes et al., 2019). ballet dancers can jump up to 200 times in an hour and a half. the force acting on the lower limbs during jumps can represent up to 12 times their body weight, which increases the risk of injury to the lower limbs, especially the ankle (steinberg et al., 2018). previous research has shown that the lower extremities account for the largest share (77%) of ballet dancer injuries (bickle et al., 2018; leanderson et al., 2011; rietveld, 2013; nunes et al., 2019). more specifically, ankle injuries account for up to 33% of all injuries (ekegren, quested, & brodrick, 2014) in ballet, which, according to most authors, is also the most frequently injured body part in rhythmic gymnastics (meeusen & borms, 1992). in ballet, the most common of these injuries is the lateral sprain, which most often occurs during the landing phase or when rising to the tips of the toes, when the foot is less stable (morton, 2013). in addition to ankle sprains, the following are common ankle injuries: fractures, achilles tendinopathy, achilles tendon ruptures, posterior and anterior impingement syndromes, and m. flexor halluces longus tendinitis (kadel, 2014; morton, 2013). a meta-analysis by doherty et al. (2014) found that the female gender is a risk factor for lateral ankle sprain (las), with a cumulative incidence rate for females of 13.6 per 1000 exposures (95% ci: 13.25, 13.94). conflicting evidence exists that previous las elevates risk for a subsequent las (vuurberg et al. 2018). there is also conflicting evidence on the role of injury severity in the clinical course after a las, as well as weak evidence for primary injury prevention regarding the use of prophylactic balance training exercises in individuals who have not experienced a first-time las (martin et al. 2021). regarding the secondary prevention of recurrent las following an initial sprain, there is strong evidence that physiotherapists should use proprioceptive and balance-focused therapeutic exercise training programmes to address impairments identified during physical examination to reduce the risk of a subsequent injury in patients with a first-time las (martin et al. 2021), yet there is a lack of evidence for the use of these interventions for ballet dancers. vuurberg and colleagues (2018) reported that while there is evidence to support the use of exercises to prevent recurrent sprains, there is a lack of evidence to support the use of prophylactic exercises to prevent first-time ankle sprains and a lack of evidence to support the use of these interventions in professional ballet dancers. according to vera 96 pia lina vilar, tine kovačič, mitja gerževič: injury prevention and physiotherapy procedures ..., 93–113 annales kinesiologiae • 13 • 2022 • 2 and colleagues (2020), their randomised controlled investigation of an injury prevention programme was the first of its kind for professional ballet dancers. due to the high incidence of ankle injuries (bickle et al., 2018; ekegren et al., 2014; leanderson et al., 2011; rietveld, 2013; nunes et al., 2019) and based on current clinical practice guidelines (cpg) (martin et al., 2021) there is conflicting evidence as to the best way to augment the components of rehabilitation programmes (e.g. by written instructions, exercise-based videos or app-based instruction) in patients with acute and post-acute ankle sprains and other injuries. the physiotherapist should determine what actions to take according to the individual’s specific motor and functional abilities, learning needs and access to relevant treatment options such as proprioceptive and neuromuscular therapeutic exercises in order to improve dynamic ankle stability and patient-perceived stability during function (ballet training sessions and performances) in individuals with chronic ankle instability (cai) in order to prevent further injuries. although the cpg describe evidence-based physiotherapy practice, including diagnosis, prognosis, intervention, and assessment of the outcome of patients with ankle injuries commonly managed by orthopaedic or sports physiotherapists, there is a lack of evidence for the use of these approaches for professional ballet dancers due to extremely high demands on dynamic ankle stability. as biernacki, stracciolini, fraser, micheli, & sugimoto (2018) established, there is no consensus in the literature regarding risk factors for ballet-related injury in females, despite the high prevalence of dance injuries among this group. this may stem from methodological inconsistencies including a lack of standard definition of injury, time loss and medical attention, and limited high-quality original studies. in the previous systematic reviews of studies which assessed the effects of the therapeutic alliance on the effectiveness of primary and secondary prevention strategies for ankle injuries there is a lack of evidence pertaining to the therapeutic alliance in rehabilitation of musculoskeletal conditions (doherty et al., 2014; vuurberg et al., 2018). due to the heterogeneity of impairments and activity limitation experienced by individuals with las and cai, methods should be tailored to the specific needs of the patient. furthermore, intrinsic and environmental factors that mediate outcomes should also be addressed when prescribing treatments for individuals with las and cai (martin et al., 2021). therefore, it was the aim of this study to determine, through a literature review, the most up-to-date, most common and most effective prevention and physiotherapy procedures for ballet dancers’ ankle injuries. based on this, the following two research questions were posed: i) “what are the state-of-the-art physiotherapy treatments for ankle injuries in ballet dancers?” and ii) “what are the most common and the most effective prevention procedures for ankle injuries in ballet dancers?” 97 annales kinesiologiae • 13 • 2022 • 2 pia lina vilar, tine kovačič, mitja gerževič: injury prevention and physiotherapy procedures ..., 93–113 methods procedures in this literature review, a qualitative research method was used. a compilation method was used to collect the most relevant original scientific and review articles and to describe and summarise their findings. the method of analysis and synthesis was used to analyse and integrate the facts already known in order to deepen the knowledge of the problem we identified in this literature review. the method of comparison was used to compare the different findings and conclusions of the collected articles in an attempt to arrive at the most common, effective and up-to-date preventive and physiotherapeutic procedures in the management of various ankle injuries in ballet dancers. the conclusion and findings were thus formulated using the method of deduction. in the introduction, the known facts were described and the key concepts, problem, aim and research questions were defined based on a review of domestic and international literature as well as based on our professional experience in the field of classical ballet. the literature review was performed using the following specialised scientific databases: pubmed, sage, sciencedirect, plosone and cochrane library, and the following keywords: “ankle”, “injury”, “ballet”, “dancers”, “physiotherapy”, “physical therapy” and “prevention”. the search syntax was performed in four stages, using four combinations of keywords (search strings). the first search string was related to rehabilitation with the following combination of keywords used in all databases: “rehabilitation” and “ballet” and “dancers” and “ankle” and “injury”, while the second one was related to prevention and was also used in all databases with the following keywords combination: “prevention” and “ballet” and “dancers” and “ankle” and “injury”. since there were no hits in the cochrane library using the previous two search strings, the next two were used in the cochrane library only, first “ballet” and “injury” and “prevention” and then “ballet” and “dancer” and “ankle” (table 1). the literature review included articles that dealt with professional ballet dancers over the age of 18, to avoid the influence of growth and development on the results. the focus was on the most up-to-date, most common and most effective prevention and physiotherapy procedures for ballet dancers’ ankle injuries. all articles were first evaluated for adequacy based on title, then based on the abstract, then based on a quick full-text overview and finally based on the following specific inclusion and exclusion criteria. the inclusion criteria were: i) both genders, ii) age of dancers > 18 years, iii) professional ballet dancers with ankle injuries in rehabilitation, iv) prevention exercise for ankle injuries, v) age of the study ≤ 10 years, vi) publication impact factor > 0, and vii) articles accessible in full-text, while the exclusion criteria were other injuries of ballet dancers and/or no physiotherapy treatment and/or without ankle injury prevention exercises. 98 pia lina vilar, tine kovačič, mitja gerževič: injury prevention and physiotherapy procedures ..., 93–113 annales kinesiologiae • 13 • 2022 • 2 data analysis to facilitate editing and data collection, microsoft office excel 2016 (microsoft corporation, new york, usa) was used and the results were presented with the help of tables and diagrams. the search process and the final selection of articles was performed and presented using the prisma diagram (page et al. 2021). also presented are all the physiotherapy procedures discussed in the studies. the content and characteristics of the studies found in the field of prevention exercises and physiotherapy for ankle injuries were qualitatively analysed and described in detail. on this basis, guidelines and practical examples of exercises and training methods for prevention of ankle injuries in ballet dancers were prepared. results results of the search and selection procedure of articles based on search keywords and their combinations (search strings) in connection with ballet and ankle injuries of ballet dancers, we found a total of 520 articles in the research databases. out of these, 30 were repeated in different databases, which gave a final total number of 490 articles. of these, 130 matched by title, 60 by abstracts and 33 by quick full-text overview. finally, there were 6 full-text articles on the defined topic matching also the inclusion and exclusion criteria. an overview of the search and selection procedure is presented in the prisma diagram in figure 1, while the extended and detailed search results for individual databases using different search strings (syntaxes) are presented in table 1. an overview of the finally selected articles’ titles, journals’ impact factors, field of study and injuries considered are shown in table 2. 99 annales kinesiologiae • 13 • 2022 • 2 pia lina vilar, tine kovačič, mitja gerževič: injury prevention and physiotherapy procedures ..., 93–113 figure 1: search and selection procedure for the literature review search and selection procedure in the study in cl ud ed o ve rv ie w se ar ch hits in the databases: pubmed (n = 77) sciencedirect (n = 324) sage (n = 97) plosone (n = 9) cochrance library (n = 13) consulted article title (n = 520) articles included in the study (n = 6) excluded articles before consulting abstract: duplicated articles (n = 30) unsuitable title (n = 360) unsuitable articles according to abstract (n = 70) excluded articles: without impact factor (n = 15) minor participants involved (n = 7) unsuitable content (n = 2) amateur dancers involved (n = 2) inability to get full-text (n = 1) unsuitable articles according to content (n = 27) consulted article abstracts (n = 130) quick full-text overview (n = 60) compliance with selected criteria (n = 33) 100 pia lina vilar, tine kovačič, mitja gerževič: injury prevention and physiotherapy procedures ..., 93–113 annales kinesiologiae • 13 • 2022 • 2 ta bl e 1: d et ai le d se ar ch r es ul ts a cr os s da ta ba se s us in g di ffe re nt s ea rc h st ri ng s (s yn ta xe s) n o. se ar ch s tr in gs d at ab as e to ta l hi ts su it ab le ar ti cl es b y ti tl e d up lic at ed ar ti cl es su it ab le ar ti cl es b y ti tl e su it ab le ar ti cl es by q ui ck fu llte xt ov er vi ew su it ab le ar ti cl es by im pa ct fa ct or su it ab le ar ti cl es b y th e cr it er ia an d fu llte xt 1 “r eh ab ili ta tio n” an d “b al le t” an d “d an ce rs ” an d “a nk le ” an d “i nj ur y” sa g e 42 7 1 5 5 0 0 sc ie nc ed ir ec t 20 5 54 11 6 2 0 0 pu bm ed 31 17 0 14 8 6 3 pl os o ne 0 0 0 0 0 0 0 c oc hr an e l ib ra ry 0 0 0 0 0 0 0 27 8 78 12 25 15 6 3 2 “p re ve nt io n” an d “b al le t” an d “d an ce rs ” an d “a nk le ” an d “i nj ur y” sa g e 55 17 8 4 4 0 0 sc ie nc ed ir ec t 11 9 34 3 13 5 2 1 pu bm ed 46 22 6 13 6 7 1 pl os o ne 9 2 0 1 1 0 0 c oc hr an e l ib ra ry 0 0 0 0 0 0 0 22 9 75 17 31 16 9 2 3 “b al le t” a nd “i nj ur y” a nd “p re ve nt io n” c oc hr an e l ib ra ry 6 2 0 2 1 1 1 6 2 0 2 1 1 1 4 “b al le t” a nd “d an ce r” a nd “a nk le ” c oc hr an e l ib ra ry 7 5 1 2 1 2 0 7 5 1 2 1 2 0 to ta l 52 0 16 0 30 60 33 18 6 101 annales kinesiologiae • 13 • 2022 • 2 pia lina vilar, tine kovačič, mitja gerževič: injury prevention and physiotherapy procedures ..., 93–113 ta bl e 2: f in al ly se le ct ed a rt ic le s’ ti tle s, jo ur na ls ’ i m pa ct fa ct or s, fi el d of st ud y, in ju ri es c on si de re d an d su m m ar y of st ud ie s’ re su lts no. author (year of publication) title impact factor article type field of study (prevention, injury, rehabilitation) results ankle sprain ankle fracture achilles tendinopathy rupture of achilles tendon posterior impingement syndrome anterior impingement syndrome tendinitis of flexor hallucis longus 1 v er a et a l. (2 02 0) a n in ju ry pr ev en tio n pr og ra m fo r p ro fe ss io na l b al le t 2. 49 2 c lin ic al st ud y pr ev en tio n (d an ce -s pe ci fic in ju ry p re ve nt io n pr og ra m m e) 82 % d ec re as e in in ju ry ra te fo r t he in te rv en tio n gr ou p an d an e xt en de d pe ri od fr om p re vi ou s in ju ry to su bs eq ue nt in ju ry . 2 m or to n (2 01 3) t he v ir tu os o fo ot 1. 77 4 r ev ie w in ju ry 1. a ny in ju ry to th e fo ot a nd a nk le w ill h av e a ri pp le e ff ec t f ur th er u p th e ki ne tic c ha in . 2. a ny c lin ic al e xa m in at io n sh ou ld in vo lv e a gl ob al p er sp ec tiv e. 3. c or re ct e ar ly d ia gn os is a nd tr ea tm en t i s vi ta l t o th ei r p hy si ca l, ps yc ho lo gi ca l a nd fi na nc ia l w el lbe in g. 4. w he n tr ea tin g a da nc er , t he cl in ic ia n sh ou ld a ls o be a w ar e of th e hi gh to le ra nc e fo r p ai n in th is el ite g ro up o f a th le te s. x x x x x re ha bi lit at io n x x x x 3 r ie tv el d (2 01 3) d an ce rs a nd m us ic ia ns ’ i nj ur ie s 1. 77 4 r ev ie w in ju ry 1. u ni la te ra lly p ai nf ul a ra be sq ue is a s po nd yl ol ys is / st re ss fr ac tu re of th e ve rt eb ra l a rc h un til p ro ve n ot he rw is e. 2. p os te ri or a nk le im pi ng em en t, w ith o r w ith ou t t en ov ag in iti s of th e m .fl ex or h al lu ci s lo ng us is th e m os t co m m on d an ce rs ’ i nj ur y. 3. t he ru le o f t hu m b is to n ot op er at e on a h al lu x va lg us in a n ac tiv e da nc er o r d an ce -t ea ch er . x x x re ha bi lit at io n x x 102 pia lina vilar, tine kovačič, mitja gerževič: injury prevention and physiotherapy procedures ..., 93–113 annales kinesiologiae • 13 • 2022 • 2 no. author (year of publication) title impact factor article type field of study (prevention, injury, rehabilitation) results ankle sprain ankle fracture achilles tendinopathy rupture of achilles tendon posterior impingement syndrome anterior impingement syndrome tendinitis of flexor hallucis longus 4 vo ss el le r et a l. (2 01 9) a nk le in ju ri es in d an ce rs 2. 28 6 r ev ie w in ju ry 1. a te am a pp ro ac h to tr ea tm en t w ith k no w le dg ea bl e ph ys ic al th er ap is ts c an o bv ia te th e ne ed fo r su rg ic al tr ea tm en t. 2. if s ur gi ca l t re at m en t p ro ve s ne ce ss ar y, g oo d re su lts c an b e ac hi ev ed w ith s ou nd s ur gi ca l te ch ni qu e an d a w el lth ou gh tou t re ha bi lit at io n pr og ra m m e. x x x re ha bi lit at io n x x 5 k ad el (2 01 4) fo ot a nd a nk le pr ob le m s in d an ce rs 0. 93 0 r ev ie w in ju ry 1. t o ke ep d an ce rs h ea lth y, th e he al th c ar e te am a nd th e da nc er m us t w or k to ge th er . 2. t he p hy si ci an m us t b e an ad vo ca te fo r t he d an ce r a nd w or k to p ro vi de a n ac cu ra te d ia gn os is an d an e ff ec tiv e tr ea tm en t s tr at eg y. 3. m on ito ri ng p er fo rm an ce a nd re he ar sa l l oa d, fi tn es s, a nd g en er al he al th o f t he d an ce r w ill h el p to m ax im is e th e da nc er ’s h ea lin g po te nt ia l. 4. c or re ct io n of m us cl e im ba la nc es , a tte nt io n to p ro pe r te ch ni qu e, s eq ue nt ia l s ki ll pr og re ss io n, a nd p ro pe r s ho e fit m ay h el p lim it ac ut e in ju ri es to th e da nc er . 5. c re at iv ity is n ee de d to m od if y tr ea tm en t p la ns to a cc om m od at e th e da nc er ’s n ee d to m ai nt ai n st re ng th , fl ex ib ili ty , a nd fi tn es s du ri ng re co ve ry . x x x x x x re ha bi lit at io n x x x x x 103 annales kinesiologiae • 13 • 2022 • 2 pia lina vilar, tine kovačič, mitja gerževič: injury prevention and physiotherapy procedures ..., 93–113 no. author (year of publication) title impact factor article type field of study (prevention, injury, rehabilitation) results ankle sprain ankle fracture achilles tendinopathy rupture of achilles tendon posterior impingement syndrome anterior impingement syndrome tendinitis of flexor hallucis longus 6 c am pb el l et a l. (2 01 9) in tr in si c m od ifi ab le ri sk fa ct or s in b al le t da nc er s: a pp ly in g ev id en ce -b as ed pr ac tic e pr in ci pl es to e nh an ce c lin ic al ap pl ic at io ns 1. 92 6 r ev ie w pr ev en tio n (r is k fa ct or s an d sc re en in g to ol s id en tifi ca tio n) 1. id en tifi ca tio n of s ev en in tr in si c m od ifi ab le fa ct or s sp ec ifi ca lly fo r b al le t d an ce rs a nd s ev en ap pr op ri at e sc re en in g to ol s. 2. in tr in si c m od ifi ab le ri sk fa ct or s: hy pe rm ob ili ty , f at ig ue , o ve ru se , ne ur om us cu la r d ys fu nc tio n, d eg re e of tu rn ou t, w ea kn es s of c or e an d lo w er e xt re m ity m us cu la tu re , a nd lo w er e xt re m ity ra ng e of m ot io n (r o m ) d is cr ep an ci es . 3. a pp ro pr ia te s cr ee ni ng to ol s: m ov em en t c om pe te nc y sc re en in g (m c s) , b ei gh to n h yp er m ob ili ty sc al e (b h s) , r ol lin g (t o de te ct co m pe ns at io n an d ne ur om us cu la r dy sf un ct io n) , s ta r e xc ur si on b al an ce t es t ( se b t ), fu nc tio na l a gi lit y sh or tte rm f at ig ue pr ot oc ol (f a st -f p) , s lo w l in ea r o xi da tiv e fa tig ue p ro to co l ( sl o fp ) a nd t ot al p as si ve t ur no ut (t pt ). 104 pia lina vilar, tine kovačič, mitja gerževič: injury prevention and physiotherapy procedures ..., 93–113 annales kinesiologiae • 13 • 2022 • 2 results of the most common prevention and treatment procedures of ankle injuries in ballet dancers the physiotherapy procedures discussed in the reviewed articles have been collected and arranged by individual types of injuries in table 3. the review showed that the most common procedures in the treatment of ankle injuries in ballet dancers are the following: rest (kadel, 2014; morton, 2013), ice therapy (kadel, 2014; vosseller, dennis, & bronner, 2019), muscle strengthening (kadel, 2014; morton, 2013), night brace (kadel, 2014; vosseller et al., 2019) and optimising ballet technique (morton, 2013; kadel, 2014; vosseller et al., 2019; rietveld, 2013). for injury prevention purposes, mainly strengthening and stretching exercises are used, to which functional joint stabilisation and plyometric exercises can be added (vera et al., 2020). results related to ankle sprain kadel (2014) states that the ankle sprain is the most common ballet injury. most often, an inversion ankle sprain occurs (the foot turns inward). conservative rehabilitation should thus include: a compression bandage, ice therapy, ankle brace, wearing good athletic shoes outside of ballet training and rest from training as long as the ankle is painful. some sprains also require the wearing of a special therapeutic shoe, which the ballet dancer wears when walking and sleeping. it is recommended that dancers who have had multiple ankle sprains perform floor barre ballet classes, combined with pilates and gyrotonics training before returning to the ballet halls (kadel, 2014). results related to achilles tendinopathy morton (2013) states that achilles tendinopathy occurs in both men and women and can be seen in many other dance styles as well. for conservative rehabilitation, both authors recommend rest, use of physiotherapy and careful active stretching of the achilles tendon and triceps surae muscles. kadel (2014) states that it is useful to add deep tissue massage, while morton (2013) adds that it is also necessary to correct any incorrect ballet technique (e.g. foot tilt in the direction of pronation, incomplete landing) so that dancers avoid new injuries and, in their free time, to wear shoes that are large, wide, hard and supportive for the feet. results related to achilles tendon rupture kadel (2014) and morton (2013) state that achilles tendon rupture occurs after the age of 30 and that the injury is more common in men than in women. kadel (2014) adds that the rupture of the achilles tendon is felt as a sharp pain and that the ballet dancer 105 annales kinesiologiae • 13 • 2022 • 2 pia lina vilar, tine kovačič, mitja gerževič: injury prevention and physiotherapy procedures ..., 93–113 table 3: physiotherapy and other procedures discussed in the articles included in the literature review author(s) (year of publication) injury physiotherapy and other procedures morton (2013) kadel (2014) sprain compression bandage, ice therapy, ankle brace, wearing good athletic shoes outside of ballet training and taking a rest from training, wearing a special therapeutic shoe, ankle and core strength exercises, sensorimotor training, range of motion (rom) training, manual therapy (ankle mobilisation) and edema control morton (2013) kadel (2014) achilles tendinopathy rest, physiotherapy, careful active stretching of the achilles tendon and triceps surrae muscles, deep tissue massage and elimination of incorrect ballet technique morton (2013) kadel (2014) rupture of achilles tendon there is no conservative treatment, as surgery is recommended morton (2013) kadel (2014) rietveld (2013) vosseller et al. (2019) posterior impingement syndrome limiting painful activities, including stopping tiptoe dancing, physiotherapy (muscle strengthening and ankle mobilisation), eliminating improper ballet technique, ice therapy and antiinflammatory medications rietveld (2013) vosseller et al. (2019) kadel (2014) anterior impingement syndrome avoiding ballet jumps, squats/demi-pliés; raising the heel with an insole in both ballet shoes and day shoes; physiotherapy (correction of incorrect foot posture) and the use of day and night braces. morton (2013) kadel (2014) rietveld (2013) vosseller et al. (2019) tendinitis of m. flexor hallucis longus rest; discontinuing the use of ballet pointe, grand plié and jumps; physiotherapy, stretching the flexor hallucis longus; optimising dance technique; antiinflammatory medications, ice therapy, ultrasound therapy; functional exercise; good everyday footwear and use of a night brace. / ankle fracture / 106 pia lina vilar, tine kovačič, mitja gerževič: injury prevention and physiotherapy procedures ..., 93–113 annales kinesiologiae • 13 • 2022 • 2 is unable to rise to half-toes or demi-pointe. an achilles tendon rupture usually occurs during a rebound or eccentric load landing. it also means that the thompson’s test is positive. the authors do not mention conservative treatment, as surgery is recommended for this injury. despite undergoing surgery, the dancer will be able to continue their dance career, but rehabilitation may take up to a year (morton, 2013; kadel, 2014). results related to posterior impingement syndrome the authors describe posterior impingement syndrome or “dancer’s heel” as a painful condition occurring due to the compression of soft tissues on the back of the tibiae and calcaneus during plantar flexion (rietveld, 2013; vosseller et al., 2019; kadel, 2014; morton, 2013). for conservative treatment, it is first recommended to limit ballet activity that is painful, including ceasing to dance on the toes (kadel, 2014; morton, 2013; vosseller et al., 2019), as well as using physiotherapy, where muscle strengthening and ankle mobilisation (kadel, 2014; morton, 2013), eliminating incorrect ballet technique (kadel, 2014; vosseller et al., 2019) and using ice therapy and anti-inflammatory drugs (vosseller et al., 2019). rietveld (2013) recommends that if the condition does not subsequently improve, an injection of cortisol is used, which also acts as an anti-inflammatory drug (corticosteroid). if conservative treatment does not help, surgery is recommended (rietveld, 2013; vosseller et al., 2019; kadel, 2014; morton, 2013). results related to anterior impingement syndrome anterior impingement syndrome can be the result of hypertrophied (thickened) soft tissues or osteophytes at the anterior edge of the tibiotalar joint (kadel, 2014). kadel (2014) hypothesises that osteophytes are the result of repeated ankle sprains or microtraumas from extreme dorsiflexion and plantarflexion positions. in conservative treatment, kadel (2014) recommends avoiding ballet jumps and squats/demi-pliés and heel elevation with insoles in both ballet shoes and day shoes. physiotherapy should also include correcting incorrect foot posture. using day and night splints can relieve pain and inflammation. if the pain persists, surgery is recommended (kadel, 2014). results related to tendinitis of flexor hallucis longus flexor hallucis longus tendinitis injury is very common in dancers. this injury is also called “dancer’s tendinitis” (morton, 2013; kadel, 2014; rietveld, 2013). it is more common in the female population due to the repetitive movement from dorsiflexion (demi-plié) to plantarflexion (standing on the tips of the toes). for conservative treatment, it is recommended to rest and stop using ballet pointe shoes, stop performing grand plié and jumps (kadel, 2014; morton, 2013; vosseller et al., 2019), use physi107 annales kinesiologiae • 13 • 2022 • 2 pia lina vilar, tine kovačič, mitja gerževič: injury prevention and physiotherapy procedures ..., 93–113 otherapy (kadel, 2014), stretch the flexor hallucis longus, optimise dance techniques (rietveld, 2013; vosseller et al., 2019), use anti-inflammatory drugs (kadel, 2014; vosseller et al., 2019), ice therapy, ultrasound, functional exercise, good daily footwear and, if necessary, night braces (kadel, 2014; vosseller et al., 2019). results related to ankle fracture unfortunately, the ankle fracture was not mentioned in the analysed articles, nor was rehabilitation. results related to the prevention of ballet dancers’ injuries out of all the retrieved articles, injury prevention exercises in ballet dancers were discussed by campbell et al. (2019) and vera et al. (2020) only. campbell et al. (2019) identify seven different intrinsic modifiable risk factors for injury: i) hypermobility, ii) fatigue, iii) overuse, iv) degree of turnout, v) neuromuscular dysfunction, vi) weakness of core and lower extremity musculature, and vii) lower extremity range of motion discrepancies, which are all commonly present in the ballet population. the authors emphasise that much care must be taken when creating an injury prevention programme for ballet dancers and take into account the mentioned seven internal factors in order to avoid the most common ballet injuries. vera et al. (2020), however, addressed a general whole-body injury prevention programme for ballet dancers. the study was conducted on 39 professional dancers with 19 dancers in the control group (9 men and 10 women, average age 26.6 ± 4.0 years) and 20 dancers in the experimental group (11 men and 9 women, average age 25.1 ± 5.1 years). the dancers carried out the injury prevention programme 3 times a week. it included a total of 24 exercises, which were arranged in such a way that each training day included different exercises. the injury prevention exercise programme lasted 30 minutes per session over a period of 52 weeks. dancers performed 10–30 repetitions or 15–45 seconds of each exercise in 2 to 3 sets with 30 to 60 seconds of rest between sets. when the exercises were no longer challenging enough for the participants the intensity was increased by carrying out more difficult variants of the exercises, using stronger elastics and free weights. the dancers carried out the injury prevention programme without supervision, however, they had supervision for as long as they needed. the results of this study showed an 82% reduction in injuries and a longer period of time passing before the reappearance of old or appearance of new injuries. 108 pia lina vilar, tine kovačič, mitja gerževič: injury prevention and physiotherapy procedures ..., 93–113 annales kinesiologiae • 13 • 2022 • 2 discussion the aim of this literature review was to identify the most common, most effective and up-to-date injury prevention and physiotherapy procedures for ankle injuries in ballet dancers. the results of the review and qualitative analysis performed showed that, despite the small number of studies in this field, the research questions on the state-of-the-art physiotherapy treatments and the most common and effective prevention procedures for ballet dancers’ ankle injuries could be at least partly answered. most of the articles were review articles (5 out of 6), which means that relatively few original scientific studies on prevention and physiotherapeutic procedures for ankle injuries have been performed in the last 10 years. this prevented the authors from directly answering the question of which prevention and physical therapy procedures are most effective. however, it was possible to identify the state of the art and the most common physiotherapy treatments and prevention procedures for ankle injuries in ballet dancers. it was found that among all injuries, ankle injuries are the most common in ballet dancers and seven different ankle injuries were most commonly evidenced in the reviewed literature. these are ankle sprain, achilles tendinopathy, rupture of the achilles tendon, anterior and posterior impingement syndromes, tendinitis of m. flexor hallucis longus and ankle fracture. this is in accordance with earlier studies, where the incidence of achilles, peroneal, flexor hallucis longus and tibialis posterior tendinopathies, ankle impingement, stress fractures and metatarsalgia was the highest in ballet dancers (nilsson et al., 2001 in sobhani, dekker, postema, & dijkstra, 2012) or in theatrical dancers (rovere et al., 1983 in sobhani et al., 2012), as well as in running and soccer (sobhani et al., 2012). comparing the results of this literature review to studies in other sports, where most frequently studied are soccer, running and gymnastics, it has been similarly shown that the most frequently studied overuse injuries are achilles tendinopathy (in 44% of studies) and tendinopathy of other foot and ankle muscles, such as toe extensors and flexors, the tibialis anterior and posterior, and peroneal tendinopathies, as well as plantar fasciitis and stress fractures (sobhani et al., 2012). however, weak methodology and poor reporting were highlighted, especially lack of a clear case definition, description of assessment procedures and reporting sample characteristics (sobhani et al., 2012), showing the need for more and better original scientific studies. regarding rehabilitation, the most frequently used modalities and/or interventions for the management of ankle injuries in ballet dancers are rest, ice therapy, muscle strengthening exercises, foot braces and dance technique optimisation. of course, treatment of each individual injury has also some individual and specific modalities and procedures, as presented in table 3. interestingly, among all evidenced injuries, specific physiotherapy treatments for ankle fractures could not be found in this literature review, even though earlier studies identified stress fractures as one of the prevalent injuries in ballet and theatrical dancers as well as in athletes of other sports (sobhani et al., 2012). for ankle sprains, as the most common injury in sports, at the time of injury, chen, mcinnis and borg-stein (2019) first recommend the application of the ottawa ankle 109 annales kinesiologiae • 13 • 2022 • 2 pia lina vilar, tine kovačič, mitja gerževič: injury prevention and physiotherapy procedures ..., 93–113 rules to assess risk of fracture and reduce unnecessary radiographs, since these rules represent highly sensitive tools for detecting fracture in the setting of acute ankle sprain. further, they report that modalities, such as rice therapy (rest, ice, compression and elevation), electrical stimulation, oral and topical nonsteroidal anti-inflammatory drugs (nsaid) and tylenol do not accelerate recovery, but are reasonable interventions for short term pain reduction. they also suggest early mobilisation (manual therapy) after acute lateral sprain as it has been shown to improve ankle dorsiflexion, pain reduction and stride length and thus accelerate return to play. besides this, the introduction of early neuromuscular training programmes, typically balance and proprioception tasks with recurrent voluntary or involuntary destabilisation during exercise showed to be beneficial in all athletes with ankle sprains to reduce the risk of recurrent sprains, since ankle joint position sense, muscle reaction time and functional outcome scores improve with such exercises (chen et al., 2019). in addition, the same authors found that although neuromuscular training programmes are effective for the prevention of recurrent sprains, the evidence for reducing the rate of first-time ankle sprains is not so robust. in addition, non-rigid ankle bracing is recommended for 1 year after ankle sprain to prevent recurrent sprain. finally, chen et al. (2019) endorse surgical referral and consideration of stabilisation for cases of chronic ankle instability that do not respond to non-operative measures after concomitant pathologies have been ruled out. the retrieved studies in this literature review and the presented physiotherapy modalities, procedures and/or treatments are also the most up-to-date ones for ballet dancers’ ankle injuries, which are in line also with professional guidelines for physical therapy, medical and sports rehabilitation such as the clinical practice guidelines (martin et al., 2021). regarding the most up-to-date and effective prevention procedures for ankle injuries in ballet dancers, based on the only available study of vera et al. (2020) it is clear that too little original scientific studies, especially randomised controlled investigations, have been performed in the last 10 years. nevertheless, vera et al. (2020) found out as much as an 82% reduction in injuries after a 52-week period of a whole-body prevention exercise, as well as longer period of time for the recurrence of old or occurrence of new injuries in ballet dancers. however, for all sports/athletes in general, chen et al. (2019) recommend the introduction of early mobilisation after acute ankle sprain injuries and early (as soon as tolerated after injury) as well as preventive neuromuscular training programmes for reducing the risk of recurrence of ankle sprains, resulting in higher overall activity levels without increasing pain, swelling, or the rate of reinjury when compared with traditional rice therapy (bleakley et al., 2010). on the other hand, due to lack of original scientific studies it was not possible to determine whether and which of these procedures are the most effective. to answer this question, we would need to quantitatively analyse, using meta-analysis, the results of the control and experimental groups before and after the intervention in a larger or more relevant number of original scientific articles/studies and compare the effect sizes of each intervention in these studies. 110 pia lina vilar, tine kovačič, mitja gerževič: injury prevention and physiotherapy procedures ..., 93–113 annales kinesiologiae • 13 • 2022 • 2 in addition to an injury prevention programme, which should be implemented by all ballet dancers regardless of age and gender, the authors believe that it is also necessary to reduce or limit the risk factors of elite/professional ballet injuries, as found out by biernacki et al. (2018) and campbell et al. (2019). these parameters are: alignment, poor lumbopelvic movement control, inappropriate transversus abdominis contraction, decreased lower-extremity strength, and poor aerobic fitness (biernacki et al., 2018), and hypermobility, fatigue, overload, degree of leg opening, neuromuscular dysfunction, trunk and lower extremity weakness, and lower extremity range of motion commonly present in the ballet dancer population (campbell et al., 2019). this means that firstly, the duration of the ballet class could be reduced by focusing on the quality of the training and optimising the training techniques, means and methods used. this could reduce one of the essential training parameters that affects injuries, i.e. the extent or the volume of exercise (duration, number of repetitions, sets, etc.), which would affect both the onset of fatigue and the possibility of acute and chronic overuse injuries. secondly, nutritional consultants or nutritionists should be involved in ballet institutions, as this would avoid injuries resulting from malnutrition or nutritional deficiencies, as well as too frequent nutritional disorders, especially among female ballet dancers (obrul, 2020). thirdly, as far as environmental conditions are concerned, the ballet dancers themselves have no influence on them, but the management of the ballet institution has and as such should ensure that the dancers have optimal and safe working or training conditions (e.g. suitable temperatures, the right choice of floor and work space). ballet dancers are ultimately responsible for choosing suitable training/ dance shoes – ballet pointe shoes, but also for choosing suitable everyday shoes, because the wrong ones can also cause certain micro-injuries, which over time can lead to other, more serious injuries. unfortunately, the individual has no influence on certain causes or risk-factors, such as general accidents and anatomical factors. however, they have an influence on previous injuries or on their occurrence in the future, namely by following prevention guidelines and recommendations as much as possible in the given situation. this literature review showed that in the future more original scientific studies based on different injury prevention programmes for the whole body or specific body parts, for instance for the foot and ankle, are needed or studies older than 10 years should be analysed. however, by analysing older studies, it would be inappropriate to consider the prevention procedures to be the most up-to-date. in addition, future research should involve more professional ballet dancers so that the findings have less variance and greater statistical power. it would also be advisable for researchers to work with dance or ballet institutions so that ballet dancers would have injury prevention exercise programmes included in their daily or at least weekly schedules. in this way, a greater and more accurate insight into the effectiveness of injury prevention procedures could be achieved. the findings of this literature review should also be tested with further studies to determine which physiotherapy and injury prevention procedures are the most appropriate and efficient in the treatment or prevention of ankle or other injuries in ballet dancers. 111 annales kinesiologiae • 13 • 2022 • 2 pia lina vilar, tine kovačič, mitja gerževič: injury prevention and physiotherapy procedures ..., 93–113 it would thus make sense to conduct randomised controlled clinical research to verify the success and effectiveness of specific injury prevention programmes in practice. limitations of the study one of the major limiting factors of this study was the quite restrictive inclusion and exclusion criteria, which most probably significantly limited the amount of literature retrieved. especially the age of the study and the impact factor, as could be seen from the prisma diagram in the methods section (figure 1). conclusion in this literature review the most common, effective and up-to-date injury prevention and physiotherapy procedures for ballet dancers’ ankle injuries were qualitatively analysed. it was found that ballet dancers experience a high incidence of ankle injuries, which is also the case in other sports, especially in soccer, running and gymnastics, yet there have been very few in-depth and original scientific studies on this topic in the last 10 years, with only one randomised controlled investigation in the field of prevention of ballet injuries in general. due to the small number of retrieved articles, it was not possible to directly answer the question on what the most successful physiotherapy procedures for the treatment of ankle injuries in ballet dancers are. however, it was possible to determine the most up-to-date procedures that were used in the reviewed literature, which actually represent the general guidelines for treatment, regardless of where the injury occurs. the most common procedures for treating ankle injuries in ballet dancers were shown to be rest, ice therapy, muscle strengthening, use of a night brace and optimising ballet technique (morton, 2013; kadel, 2014; vosseller et al., 2019; rietveld, 2013). for prevention purposes, mainly strengthening and stretching exercises are used, to which functional joint stabilisation and plyometric exercises can be added (vera et al., 2020). clearly, further high-quality research designs with a low risk of bias are necessary to further evaluate the effectiveness of specific prevention exercises programme and the optimal timing of the intervention for the prevention of ankle injuries in ballet dancers. also, future studies are needed to validate this conclusion regarding injury prevention exercise programmes to properly and efficiently address future ankle injuries and to reduce the risk of a subsequent injuries in professional ballet dancers. acknowledgements the first and the last author contributed equally to the preparation of this article. 112 pia lina vilar, tine 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(2001). management of ankle sprains. american family physician, 63(1), 93–104. retrieved from https://www. aafp.org/pubs/afp/issues/2001/0101/p93.html. https://dance-academy.almamater.si/wp-content/uploads/2020/09/20_monja-obrul_vpliv-prehrane-na-plesalce-revidirano.pdf https://dance-academy.almamater.si/wp-content/uploads/2020/09/20_monja-obrul_vpliv-prehrane-na-plesalce-revidirano.pdf https://doi.org/10.1136/bmj.n160 https://doi.org/10.1136/bmj.n160 https://doi.org/10.1007/s10067-013-2184-8 https://doi.org/10.1111/j.1600-0838.2012.01509.x https://doi.org/10.1123/jsr.2018-0052 https://doi.org/10.1177/2325967120937643 https://doi.org/10.1177/2325967120937643 https://doi.org/10.5435/jaaos-d-18-00596 https://doi.org/10.5435/jaaos-d-18-00596 https://doi.org/10.1136/bjsports-2017-098106 https://www.aafp.org/pubs/afp/issues/2001/0101/p93.html https://www.aafp.org/pubs/afp/issues/2001/0101/p93.html _hlk122510532 _hlk121925715 _hlk121925783 _hlk117671776 _hlk117676890 _hlk117676830 _hlk122521710 _hlk123029474 _hlk51764713 _hlk51617947 _hlk51764685 _hlk51616945 _hlk51676200 _hlk51710755 _hlk124939594 _hlk124939408 _hlk125008249 _hlk125008423 _hlk125010166 _hlk124768186 _hlk129167818 _hlk129168885 _hlk129939779 _ref116207795 annales kinesiologiae • 6 • 2015 • 1 3 safety considerations with blood flow restricted resistance training alan kacin1, benjamin rosenblatt2, tina grapar žargi1, anita biswas2 1 university of ljubljana, faculty of health sciences, department of physiotherapy ljubljana, slovenia 2 english institute of sport, bisham abbey national sports centre, marlow, sl7 1rr, united kingdom corresponding author: alan kacin, rpt, phd university of ljubljana, faculty of health sciences, department of physiotherapy zdravstvena pot 5, 1000 ljubljana, slovenia phone: +386 1 300 11 43 skype: alankacin e-mail: alan.kacin@zf.uni-lj.si abstract blood flow restricted resistance (bfrr) training with pneumatic tourniquet has been suggested as an alternative for conventional weight training due to the proven benefits for muscle strength and hypertrophy using relatively low resistance, hence reducing the mechanical stress across a joint. as such, it has become an important part of rehabilitation programs used in either injured or operated athletes. despite a general consensus on effectiveness of bfrr training for muscle conditioning, there are several uncertainties regarding the interplay of various extrinsic and intrinsic factors on its safety and efficiency, which are being reviewed from a clinical perspective. among extrinsic factors tourniquet cuff pressure, size and shape have been identified as key for safety and efficiency. among intrinsic factors, limb anthropometrics, patient history and presence of cardiac, vascular, metabolic or peripheral neurologic conditions have been recognized as most important. though there are a few potential safety concerns connected to bfrr training, the following have been identified as the most probable and health-hazardous: (a) mechanical injury to the skin, muscle, and peripheral nerves, (b) venous thrombosis due to vascular damage and disturbed hemodynamics and (c) augmented arterial blood pressure responses due to combined high body exertion and increased peripheral vascular resistance. based on reviewed literature and authors’ personal experience with the use of bfrr training in injured athletes, some guidelines for its safe application are outlined. also, a comprehensive risk assessment review article udc: 615.825:796.071.2 received: 2015-08-19 mailto:alan.kacin@zf.uni-lj.si 4 alan kacin, benjamin rosenblatt, tina grapar žargi, anita biswas: safety considerations with blood ..., 3–26 annales kinesiologiae • 6 • 2015 • 1 tool for screening of subjects prior to their inclusion in a bfrr training program is being introduced. keywords: blood flow restricted exercise, health risk assessment, tourniquet cuff efficiency, rehabilitation of athletes. varna uporaba vadbe z zmanjšanim pretokom krvi izvleček vadba proti majhnem uporu s sočasno zmanjšanim pretokom krvi v aktivnih mišicah (ishemična vadba) dokazano spodbuja hipertrofijo in izboljša mišično jakost primerljivo s standardno vadbo proti velikem uporu, vendar ob znatno manjši mehanski obremenitvi sklepa. zato se ishemično vadbo pospešeno vključuje v fizioterapevtske programe, zlasti pri športnikih s poškodbami ali operativnimi posegi na sklepih spodnjih ali zgornjih udov. kljub splošnem strinjanju glede pozitivnih učinkov na mišično zmogljivost ostaja vrsta nejasnosti glede medsebojnega učinkovanja vrste intrinzičnih in ekstrinzičnih dejavnikov, ki se pojavijo med ishemično vadbo in zelo verjetno vplivajo na njeno učinkovitost in varnost. regulacija in velikost manšetnega tlaka ter oblika in velikost manšete so bili prepoznani kot ključni ekstrinzični dejavniki varnosti in učinkovitosti. med intrinzičnimi dejavniki pa so bili v tem pogledu kot najbolj pomembni prepoznani sledeči: antropometrija uda in prisotnost preteklih ali sedanjih srčnih, žilnih, presnovnih ali perifernih živčnih okvar pacienta. izmed vrste potencialnih zdravstvenih problemov, povezanih z ishemično vadbo, so najbolj verjetni in zdravje ogrožajoči (a) mehanske poškodbe kože, mišic in perifernih živcev, (b) globoka venska tromboza zaradi poškodb ožilja in spremenjene hemodinamike in (c) povečan odziv arterijskega krvnega tlaka zaradi povečanega občutka napora in upora perifernega ožilja zaradi nameščene manšete. na podlagi objavljenih podatkov v literaturi in osebnih izkušenj avtorjev članka z uporabo ishemične vabe pri športnikih so podana priporočila za njeno varno uporabo. v članku je predstavljen tudi enostaven in razumljiv pripomoček za presojanje dejavnikov zdravstvenega tveganja posameznika pred vključitvijo v program ishemične vadbe. ključne besede: vadba z oviranim pretokom krvi, ocena dejavnikov tveganja, učinkovitost manšetnega sistema, fizioterapija in rehabilitacija športnikov annales kinesiologiae • 6 • 2015 • 1 5 alan kacin, benjamin rosenblatt, tina grapar žargi, anita biswas: safety considerations with blood ..., 3–26 introduction blood flow restricted resistance (bfrr) training, its most featured version also known as kaatsu training, has long been suggested as an alternative for conventional weight training due to the proven benefits for muscle strength and hypertrophy using relatively low resistance, hence reducing the mechanical stress across a joint. it has been used in the elderly to maintain muscle mass (fry et al., 2010) and in athletes to improve performance (takarada et al., 2002; cook, murphy & labarbera, 2013) or to accelerate post-surgical rehabilitation (ohta et al., 2003). increases in muscle hypertrophy following low load bfrr training are well documented and are one of the primary reasons behind utilizing this form of exercise (wernbom, augustsson & raastad, 2008). interestingly, despite lower mechanical stress to the tissues, favourable adaptations in bone turnover have also been demonstrated with bfrr training (karabulut et al., 2011). however, the positive adaptation of muscle to bfrr training seems to extend beyond mimicking hypertrophic effects of high-resistance training. namely, improvements in vascular function (patterson & ferguson, 2010; hunt, walton & ferguson, 2012; hunt, galea, tufft, bunce & ferguson, 2013; evans, vance & brown 2010), enhanced oxygen delivery and muscle endurance (takarada, sato & ishii, 2002; kacin & strazar, 2011) as well as cardiorespiratory endurance (abe et al., 2010; park et al., 2010) have been also reported with bfrr training. a recent case study even reports of an increased rate of healing in patient with osteochondral fracture (loenneke, young, wilson & andersen, 2013b). an increasing number of published research supports the efficacy of the technique, whereas its safety has not been extensively studied. similar to the use of surgical tourniquets on limbs of resting patients (fitzgibbons, digiovanni, hares & akelman, 2012; estebe, davies & richebe, 2011) the major concerns are due to (a) a mechanical injury to the skin, muscle, and peripheral nerves and (b) venous thrombosis due to vascular damage and disturbed hemodynamics, but also (c) augmented arterial blood pressure (abp) responses due to combined high body exertion and increased peripheral vascular resistance induced by the tourniquet. in addition, ischemic-reperfusion injury with local or systemic effect may also play a role. the only epidemiological study available has shown a surprisingly low occurrence of any adverse effects of bfrr training other than skin bruising, in various populations in japan (nakajima et al., 2006). general and specific health concerns with bfrr training in healthy people have been reviewed in depth by manini and clark (2009), loenneke, wilson, wilson, pujol & bemben (2011) and pope, willardson & schoenfeld (2013). the present review thus addresses safety and efficiency of bfrr training from clinical perspective, in regard to a complex interplay of various extrinsic (tourniquet system and exercise) and intrinsic (anthropometrics, medical history and life style) factors. based on reviewed evidence and our clinical experience with bfrr training in injured and operated athletes we set about developing a risk assessment tool. the tool will allow physiotherapists and non-medi6 alan kacin, benjamin rosenblatt, tina grapar žargi, anita biswas: safety considerations with blood ..., 3–26 annales kinesiologiae • 6 • 2015 • 1 cal staff such as strength and conditioning coaches, to manage the risk to the athletes whilst allowing them to benefit from an effective technique. methods methods of literature review and clinical commentary were combined when preparing this manuscript. the search of scientific literature published in english language was performed until march 2015 in various electronic databases (pubmed, wos, medline, pedro and sciencedirect) by the following key words and phrases: blood flow restricted exercise, ischemic training, reperfusion injury, safety and efficiency of pneumatic tourniquets and health risk assessment for vascular occlusion. initial search gave 1582 results which were refined by use of various key word combinations and addition of new phrases most frequently associated with the topics of interest (rhabdomyolysis, reperfusion injury, contour and cylindrical cuffs, nerve injury etc.). the second selection produced 133 publications, which were further reduced to 83 entries, based on abstract content match with the topics, type of publication, research type and design, sample size and full text availability. case studies or reports and book chapters were included only for the topics not studied by rcts or other controlled cohort studies. proposed mechanisms of muscle adaptation to bfrr training how the positive training adaptations reviewed and discussed above are elicited by muscle blood flow occlusion during exercise remains debatable. the proposed mechanisms were reviewed on several occasions, most recently and in-depth by pope et al. (2013) and heitkamp (heitkamp, 2015), who listed all hypothetical physiological triggers identified so far: (a) hypoxia-induced additional or preferential recruitment of fast-twitch muscle fibers, (b) greater duration of metabolic acidosis via the trapping and accumulation of intramuscular protons (h+ ions) and stimulation of metaboreceptors, possibly eliciting an exaggerated acute systemic hormonal response, (c) external pressure-induced differences in contractile mechanics and sarcolemmal deformation, resulting in enhanced growth factor expression and intracellular signalling, (d) metabolic adaptations to the fast glycolytic system that stem from compromised oxygen delivery, (e) production of reactive oxygen species (ros) that promotes tissue growth, (f) gradient-induced reactive hyperemia after removal of the external pressure, which induces intracellular swelling and stretches cytoskeletal structures that may promote tissue growth, and (g) activation of myogenic stem cells with subsequent myonuclear fusion with mature muscle fibers. given that detailed review of all these mechanisms is not the primary aim of the present review, only mechanisms most closely related to the safety of tourniquet application will be discussed in the following. annales kinesiologiae • 6 • 2015 • 1 7 alan kacin, benjamin rosenblatt, tina grapar žargi, anita biswas: safety considerations with blood ..., 3–26 when performing bfrr exercise with a pneumatic tourniquet system, a tourniquet cuff is applied to the proximal part of the upper or lower limb and inflated to the set pressure. with gradual mechanical compression of all soft tissues under the cuff, a reduction in vascular diameter is achieved, resulting in occluded venous and reduced or completely occluded arterial blood flow to the muscles at and distal to the cuff. during muscle contraction, an increase in intra-muscular pressure is generated under the pressurized cuff, further disturbing muscle blood flow. in case of isometric muscle contraction, the contraction-induced muscular pressure is basically constant, whereas during concentric/eccentric contractions it changes in a cyclical manner. if a rigid cuff with no regulation of pressure is used, effective tourniquet pressure during contractions is ~50 % higher than the set value, with ~65−75 % variation between concentric and eccentric phase of contraction (figure 1). depending on the cumulative degree of blood flow reduction and exercise intensity, variable levels of muscle edema, ischemia and hypoxia develop in the muscle during the exercise. following deflation of the tourniquet, reperfusion of the limb takes place. figure 1: cyclic changes in rigid contour tourniquet cuff (13 cm wide) pressure during ten concentric / eccentric knee-extension contractions performed at 20 % 1rm by a representative subject. set pressures were (a) 100 mmhg and (b) 150 mmhg, with no pressure regulation provided during exercise (author’s unpublished data). 8 alan kacin, benjamin rosenblatt, tina grapar žargi, anita biswas: safety considerations with blood ..., 3–26 annales kinesiologiae • 6 • 2015 • 1 there is a lack of a most optimal degree of venous and arterial blood flow reduction for muscle conditioning is. although sound experimental evidence is still scarce, it can be assumed that two distinct changes in muscle hemodynamics are achieved during the dynamic leg exercise, by inducing either predominant venous-lymphatic occlusion (tourniquet pressure of ~60 mmhg) or intermittent complete arterial occlusion (≥150 mmhg). in the case of predominantly venous occlusion (vo), blood inflow to the muscle is not compromised, resulting in progressive rise in venous pressure (iida et al., 2007). given that capillary pressure is four times more sensitive to increased venous pressure, the result is augmented capillary filtration. fluid shift from vasculature to extracellular compartments, combined with completely blocked lymphatic outflow, results in soft-tissue edema and increased interstitial fluid pressure (levick & michel, 2010). consequently, some of the fluid is forced across the sarcolemma into the intracellular compartment, along with non-selective transport of various smaller molecules. due to progressive congestion of blood in the muscle during the exercise, substantial metabolite accumulation and tissue hypoxia are eventually developed. in contrast, the resistance on both sides of the capillaries is equally reduced during complete arterial occlusion (ao) hence no detectable muscle swelling occurs during dynamic exercise. it does however substantially increase hypoxia and metabolic stress in the muscle and hence post-ischemic hyperemia. as shown by near-infrared spectroscopy, a substantial hypoxia of vastus lateralis muscle is induced after only a few initial contractions with intermittent complete ao (tourniquet pressure ≥230 mmhg, width 13 cm) (kacin & strazar, 2011). upon the release of tourniquet, augmented reperfusion (active hyperemia) is driven by accumulated metabolites in the muscle cells which increases pressure gradient across sarcolemma and further cell swelling. it is speculated that cell swelling per se induces muscle protein synthesis (loenneke, fahs, rossow, abe & bemben, 2012a) as it is the case with other type of cells (lang et al., 2000). furthermore, signs of muscle damage and prolonged (up to 48 hrs.) sarcolemmal permeability were demonstrated after only one bout of bfrr exercise (wernbom, paulsen, nilsen, hisdal & raastad, 2012), which suggests a thin line between hypertrophic stimulus and potential muscle injury. a reduced muscle compliance to palpation can be noted after bfrr exercise, and subjects describe muscle as “hard” or “pumped up” for a short period after bfrr (authors’ unpublished observations). it was also demonstrated that transient increase in sarcolemma permeability and cell swelling is an important trigger of hypertrophy and augmented satellite cell activation (nielsen et al., 2012). also, muscle hypertrophy and strength gains are shown to have a good correlation (r=0.60-0.88) with metabolic stress (takada et al., 2012; sugaya, yasuda, suga, okita & abe, 2011). importantly, metabolic perturbation induced by disrupted hemodynamics increases the magnitude of muscle activation, presumably of fast-twitch fibers, during low load bfrr training compared to free blood flow training of same intensity (yasuda et al., 2009; yasuda et al., 2014; yasuda, loenneke, ogasawara & abe, 2013). this is seen as one of the key acute adaptations which lead to strength gains following low load bfrr training (takarada et al., 2000). annales kinesiologiae • 6 • 2015 • 1 9 alan kacin, benjamin rosenblatt, tina grapar žargi, anita biswas: safety considerations with blood ..., 3–26 however, based on our clinical observations with preoperative conditioning of 23 athletes scheduled for acl reconstruction, the same degree of blood flow restriction does not have the same effect on muscle activation and performance of power or endurance trained individuals of different build, even when tourniquet pressure is corrected for resting arterial pressures and leg circumference by graham’s formula (graham, breault, mcewen & mcgraw, 1993). the number of repetitions performed was up to 40 % higher in endurance compared to power athletes (authors’ unpublished observations). this may be due to different proportions of type i and type ii muscle fibers and, hence, different effect of blood deprival on muscle fatigability. a similar observation was recently reported by downs et al. (2014), who noted a ~10-15% lower rate of fatigue, calculated from the decrease in number of repetitions, for ankle plantar flexors compared to knee extensors at the same vascular occlusion, which was attributed to profoundly different muscle composition between muscle groups (gregory, vandenborne & dudley, 2001). to provide sufficient training stimulus of bfrr exercise regardless of training status and muscle composition, our patients / athletes perform each exercise set to volitional failure. this, however, substantially increases the whole body exertion and cardiac load, thus patients with a history of cardiorespiratory disease must be excluded. optimization of exercise parameters for bfrr training in different patient populations needs to be systematically addressed in further investigations. potential safety and efficiency issues with bfrr training long-lasting (>30 min) ao induced by pneumatic tourniquets is routinely used during limb surgery in order to prevent bleeding. tourniquet pressure above 170 mm hg for upper and 270 mm hg for lower limbs is usually used, which in combination with prolonged constant compression poses a threat of mechanical and, upon the release of tourniquet, ischemia-reperfusion injury of the vascular, neural, metabolic and musculoskeletal systems (fitzgibbons et al., 2012). ischemia is the reduction of blood supply to a tissue which results in a lack of oxygen and substrates for cellular metabolism (ames & nesbett, 1983). a prolonged complete ischemia and a rapid reperfusion of tissues upon the release of blood flow are the causes of reperfusion injury (estebe, davies & richebe, 2011; wakai et al., 2001; hughes, hendricks, edwards & middleton, 2010; hughes et al., 2007). it is well known that irreversible skeletal muscle damage occurs after three hours of ischemia in normothermic conditions (blaisdell, 2002; pedowitz et al., 1991) but adverse cellular events begin much earlier. research shows that reperfusion injury causes cell apoptosis, presumably by negative influences on microcirculation, subsequent local inflammatory response and production of reactive oxygen species (blaisdell, 2002; carden & granger, 2000). in contrast, short episodes of ischemia − reperfusion are speculated to be the trigger for cellular adaptation to bfrr training (wernbom et al., 2008; manini & clark, 2009) and were demonstrated to have both a cardio-protective (zhu et al., 2013) and a muscle performance enhancing effect (de groot, thijssen, sanchez, ellenkamp & hopman, 2010). however, an optimal protocol 10 alan kacin, benjamin rosenblatt, tina grapar žargi, anita biswas: safety considerations with blood ..., 3–26 annales kinesiologiae • 6 • 2015 • 1 for effective and safe bfrr training remains elusive. strength gains and hypertrophy comparable to standard high load strength training were reported with various combinations of exercise and tourniquet parameters (see (wernbom et al., 2008; loenneke, wilson, marin, zourdos & bemben 2012c) for review). in addition, enhanced muscle endurance capacity and hemodynamics were demonstrated with a combination of either extremely low load (40 − 50 rm) exercise and high tourniquet pressures (150 − 230 mmhg, width 13-15 cm) with reperfusion between four sets for lower limbs (kacin & strazar, 2011; evans et al., 2010) or low to medium load (25 % and 50 % 1rm) exercise with low pressure (110 mmhg) without reperfusion between three sets for lower and upper limbs (patterson & ferguson, 2010; hunt et al., 2012; hunt et al., 2013). morphologic adaptation occurred at all levels of the vascular tree with enhanced peak reactive hyperemia and transient improvement in artery function preceding changes in artery structural capacity (hunt et al., 2013). although tourniquet pressure is usually regarded as a key extrinsic factor of blood flow reduction, other extrinsic and intrinsic confounding factors like 1) tourniquet width and shape (moore, garfin & hargens, 1987; crenshaw, hargens, gershuni & rydevik, 1988; pedowitz et al., 1993), 2) limb circumference (graham et al., 1993; tuncali et al., 2006) and 3) individual’s arterial blood pressures (abp) (newman & muirhead, 1986; graham et al., 1993) substantially affect the final degree of occlusion. influence of tourniquet cuff design and pressure various combinations of tourniquet pressure (range 50 − 230 mmhg) and cuff width (range 3.3 − 20.5 cm) were used in bfrr exercise studies. although tourniquet pressures and exposure times used are lower compared to the ones in surgery, the stretching and shear forces in the tissue are most likely to be much higher due to muscle contractions under pressurized tourniquet cuff. as shown in figure 1, the cuff pressure during concentric phase of contraction peaks ≥ 50 % above the value set on the resting muscle prior to the exercise, which reflects a very high increase in intramuscular forces at the site of cuff compression. tourniquet system that provides a fast responsive and accurate cuff pressure regulation during muscle contractions is thus essential for a safe and efficient application of bfrr exercise. in a resting limb, the same reduction of blood flow can be achieved using a wider tourniquet cuff at much lower pressures (moore et al., 1987; crenshaw et al., 1988; pedowitz et al., 1993). likewise, contoured (cone) cuffs induce arterial occlusion at lower pressures than straight (cylindrical) ones (younger, mcewen & inkpen, 2004; pedowitz et al., 1993). given that the shape and width of the cuff influence pressure distribution and sheer forces in the underlying muscle tissue (pedowitz et al., 1991), using the lowest pressures possible to achieve the desired training effect should minimize the risk of soft tissue damage. cuff width, shape and pressure also have an important influence on pain provocation and, hence, patient comfort during the application. when compared at the same inflation pressure (sbp×1.3≈160 mm hg), wide rigid cuffs (13.5 annales kinesiologiae • 6 • 2015 • 1 11 alan kacin, benjamin rosenblatt, tina grapar žargi, anita biswas: safety considerations with blood ..., 3–26 cm) provoke somewhat higher pain levels (~2 points on borg’s cr-10) and perception of effort (~1.5 point on 6 − 20 borg’s scale) during lower limb exercise than narrow belt-like elastic cuffs (5 cm) (rossow et al., 2012). given that at the same pressure a wider cuff induces more blood-flow restriction, such comparisons may be deceptive. as demonstrated already by estebe, le naoures, chemaly and ecoffey (2000) on resting upper limbs, wider cuffs (14 cm) indeed provoke more pain than narrow cuffs (7 cm) when compared at same absolute pressure (~260 mm hg), but less pain when compared at individual occlusion pressure. the latter was on average 55 mmhg lower with wider cuffs (202 mmhg for narrow and 147 mmhg for wide cuffs) (estebe et al., 2000), suggesting that wider cuffs might in fact provoke less discomfort and pain for the same occlusion stimulus also during the exercise. given that different pressures and conditions (exercise vs. rest) were scrutinized in these studies, more research is needed in this regard. in many published bfrr exercise studies, there is a lack of detailed technical characteristics of the tourniquets and pressure systems used. the degree of blood flow reduction is, thus, difficult to estimate, but according to significant differences in various confounding factors listed above, vast variations between and within studies are likely. meta-analysis of well-designed and controlled bfrr studies (loenneke et al., 2012c) revealed a difficulty in estimating the actual impact of various tourniquet pressures on gains in muscle mass and strength, which is not surprising due to large variations in tourniquet systems used. there is a clear need for a systematic study of differences in intramuscular responses induced by various tourniquet systems used for bfrr training. impact of limb anthropometrics on pressure transmission transmission of pressure from a tourniquet to the underlying tissues showed to be exponentially inverse to extremity circumference (tuncali et al., 2006) and to the ratio between circumference and tourniquet cuff width (graham et al., 1993). similarly, significant negative correlations between tissue oxygenation and leg lean body mass, total lean body mass, and thigh circumference were reported by karabulut, mccarron, abe, sato & bemben (2011b). furthermore, it was established that as much as ~80% of variability in the occlusion pressures with the use of rigid wide cuffs can be explained by the ratio of muscle to subcutaneous fat cross-sectional areas and only ~20% by either systolic (sap) or diastolic (dap) blood pressure (loenneke et al., 2012d), which counters the previous reports (newman & muirhead, 1986; graham et al., 1993). with an application of elastic belt-like tourniquet cuffs, the total variance in occlusion pressures explained by anthropometrics was much smaller, and was even non-significant for sap. taken together, the transmission of cuff pressure to the center of the limb, where the majority of large blood vessels is located, seems to be negatively related to the limb circumference and positively related to the cuff width. 12 alan kacin, benjamin rosenblatt, tina grapar žargi, anita biswas: safety considerations with blood ..., 3–26 annales kinesiologiae • 6 • 2015 • 1 considerations for clinical screening and risk assessment the use of bfrr training for musculoskeletal rehabilitation is relatively new and rapidly evolving. to improve our understanding of the risks associated with this form of training, a thorough screening and regular auditing processes need to be established by all users of the technique. we consider that a high quality screening process, including a medical practitioner is essential to safe guard against potential adverse reactions associated with this form of exercise. the purpose of a screen is to filter out those patients that may be at increased risk of injury for medical or other reasons. a further purpose is to identify the factors which will reduce the risk of injury to potentially overstressed structures reviewed below. considering the safety aspects of bfrr training using these principles relies on a comprehensive personal medical, social and family history. particular attention needs to be paid to any condition or lifestyle activity that may have impact on any of the systems outlined below. in the development of a risk assessment tool we addressed the following principles: • identification of the structures affected by blood flow restriction; • identification of which subjects / patients may be at higher risk from the potential negative effects of bfrr training and determination of the level of precaution required; • development of an easy-to-use risk assessment tool; • review of any adverse reactions; • review and update of the risk assessment tools as necessary. in the process of identifying potential risks, the structures which may be affected by the application of a tourniquet must be considered. we addressed each of these structures individually when determining which medical conditions may increase the risk of exposure to bfrr exercise. skin and subcutaneous tissues pressure necrosis and frictional burns can occur due to inadequate padding, poor application of the tourniquet, and movement of the fully inflated tourniquet over bare skin. soft wrinkle-free padding should be used below the cuff (van der spuy, 2012) to avoid these issues. stretch sleeves made of two-layer elastic material were shown to provide the most effective protection against skin injury during application of surgical tourniquets (olivecrona, tidermark, hamberg, ponzer & cederfjäll, 2006). frictional burns and pinching are more likely to occur during bfrr exercise if no padding is used. annales kinesiologiae • 6 • 2015 • 1 13 alan kacin, benjamin rosenblatt, tina grapar žargi, anita biswas: safety considerations with blood ..., 3–26 musculoskeletal system in the musculoskeletal system, consideration must be given to the effect of bfrr on muscle and joints. excessive and unaccustomed exercise may result in muscle damage and delayed-onset soreness. both of these have also been reported after a low load bfrr training (umbel et al., 2009), but this may be evidence of the adaptations necessary for a training effect rather than an adverse response. it was shown that excessive pressures combined with a wide tourniquet can provoke paraesthesia in the thighs during the exercise. in addition, suppressed muscle hypertrophy in vastus intermedius muscle with signs of atrophy at the site of tourniquet compression were observed after four weeks of bfrr training (kacin & strazar, 2011). lack of blood perfusion to a limb and extreme physical exertion are both wellknown causes of rhabdomyolysis. this is a clinical syndrome resulting from skeletal muscle damage and the release of potentially toxic substances into the circulation (allison & bedsole, 2003). it may be caused by trauma or muscle hypoxia and manifests as muscle pain and weakness. there was also a case report of rhabdomyolysis following the initial exposure to bfrr training (iversen & rostad, 2010). other potential causes of rhabdomyolysis, which need to be excluded prior to bfrr training, are outlined in table 1. consideration must, therefore, be given in the case when other conditions associated with rhabdomyolysis are present. this includes restricted calorific intake (particularly with low levels of potassium, phosphate and magnesium), a history of severe heat illness / injury, a recent muscle trauma or a crush injury. caution must, therefore, be taken in individuals who lack any previous training history as unaccustomed exercise can also be associated with an increased risk of rhabdomyolysis. the personal experience of the authors is of the use of bfrr in the rehabilitation of musculoskeletal injuries. when determining potential risk factors for the use of this technique in patients after acl reconstruction with or without partial menisectomy (n=32), we were concerned about the potential negative effect on post-surgical patients with a swollen joint, due to congestion of tissues or swelling that may result from the external restriction of blood and lymphatic vessels. this may also have impact on those with an inflammatory arthropathy, synovitis, haemarthrosis or septic arthritis. indeed, in case of post-surgical synovitis (n=1) or haemarthrosis (n=1) exacerbation of symptoms were induced by bfrr (authors’ unpublished observations), hence, alternative forms of training should be considered. 14 alan kacin, benjamin rosenblatt, tina grapar žargi, anita biswas: safety considerations with blood ..., 3–26 annales kinesiologiae • 6 • 2015 • 1 table 1: types and causes of rhabdomyolysis. (allison & bedsole, 2003) type cause trauma or muscle compression crush syndrome prolonged immobilization non-traumatic exertional rhabdomyolysis unaccustomed exertion in untrained individuals hyperthermia: malignant hyperthermia, neuroleptic malignant syndrome metabolic myopathies: mitochondrial myopathies, mcardles etc non-traumatic and non-exertional rhabdomyolysis drugs: alcohol, heroin, cocaine, amphetamines, methadone, and d-lysergic acid diethylamide (lsd), antipsychotics, statins, selective serotonin reuptake inhibitors, zidovudine, colchicine, lithium, antihistamines, and several others toxins: metabolic poisons, such as carbon monoxide, snake venoms, insect venoms, including wasp and bee stings, mushroom poisoning viral infections: acute viral infections (eg influenza a and b), coxsackievirus, epstein-barr, herpes simplex, parainfluenza, adenovirus, echovirus, human immunodeficiency virus, and cytomegalovirus bacterial infections: bacterial pyomyositis legionella, tularemia, streptococcus and salmonella, e. coli, leptospirosis, coxiella burnetii (q fever), and staphylococcal infection electrolyte disorders: hypokalemia, hypophosphatemia, diabetic ketoacidosis or nonketotic hyperglycemia, hypophosphatemia, hypocalcemia hyponatremia hypernatremia inflammatory myopathies: inflammatory myopathies, dermatomyositis, polymyositis endocrine disorders: diabetes, hyper and hypo-thyroidism cardiac function and arterial blood pressure in healthy population, a substantially higher exercise-induced increase in sap, dap and mean abp and heart rate (hr) compared to free flow exercise were found after two or more subsequent sets of bfrr exercise with no reperfusion between the sets (renzi, tanaka & sugawara 2010; vieira, chiappa, umpierre, stein & ribeiro 2013; takano et al., 2005). as demonstrated by renzi et al. (2010), increased hr during blood flow http://www.uptodate.com/contents/methadone-drug-information?source=see_link http://www.uptodate.com/contents/zidovudine-drug-information?source=see_link http://www.uptodate.com/contents/colchicine-drug-information?source=see_link http://www.uptodate.com/contents/lithium-drug-information?source=see_link annales kinesiologiae • 6 • 2015 • 1 15 alan kacin, benjamin rosenblatt, tina grapar žargi, anita biswas: safety considerations with blood ..., 3–26 restricted walking exercise (cuff pressure 160 mmhg, width not reported) compensates for a compromised venous return and, hence, reduced the stroke volume, which results in a three-fold greater index of myocardial oxygen demand. a report by vieira et al. (2013) corroborates the exaggerated heart rate (hr) and abp responses to single-arm bfrr exercise (cuff pressure 120 mmhg, width not reported) performed at 30 % 1rm in both young and older healthy men. similar findings were recently reported for unilateral leg bfrr exercise with two different tourniquet cuff pressures (1.3×dap and 1.3×sap, width 6 cm), with the exception of an attenuated rather than augmented hr response (downs et al., 2014). it appears that bfrr exercise can either increase or decrease a normal hr response, depending on the interplay between cardio acceleration driven by increased sympathetic drive and reduced stroke volume and cardio deceleration driven by increased cardiac afterload and decreased preload. these findings show that a lack of reperfusion during the short rest between exercise sets progressively exacerbates cardiac load and cardiovascular demand. however, if exercise protocols are not matched for work and intensity, but performed until volitional failure, acute hr and abp responses are similar between bfrr and free flow exercise (loenneke et al., 2012b; kacin, strazar, palma & podobnik 2011; kacin & strazar, 2011). from clinical perspective it is important that cardiac and blood pressure responses to low-load bfrr exercise are still significantly lower than during the standard high-load resistance exercise despite a higher perception of exertion (poton & doederlein polito, 2014). the latter is apparently driven predominantly by peripheral sensations from the occluded limb. given that a low load bfrr exercise does not induce post-exercise hypotension comparable to a free flow high load resistance exercise (rossow et al., 2011), it appears that an overall level of exertion determines systemic cardiovascular responses, more than blood flow restriction per se. the safety of bfrr exercise in patient populations at increased risks for cardiovascular events has not been systematically studied so far. a recent pilot study of nine patients with stabile ischemic cardiac disease (madarame, kurano, fukumura, fukuda & nakajima, 2013) also revealed an augmented exercise-induced increase in heart rate and plasma noradrenaline concentration during the bfrr exercise, although the subjects performed a fixed number of repetitions per set rather than exercising to volitional failure. despite an increased body exertion, no warning signs of any cardiovascular events were observed in these patients (madarame et al., 2013). thus, subjects with a history of or an increased risk of cardiovascular disease should be thoroughly screened prior to their inclusion to bfrr training program and closely monitored for excessive hr and abp responses during the exercise. exercise is advised not to be performed to volitional failure and should also allow longer and more frequent reperfusion during multiple sets. in our experience, six sets of bfrr with 45 − 60s reperfusion between two consecutive sets is better tolerated by acl deficient (n=32) patients or those with knee osteoarthritis (n=12), than three or four sets without reperfusion. it can be assumed that such bfrr exercise protocol is also more appropriate for people with moderate risk for cardiovascular events. an alternating exercise for agonistic and antagonistic muscles can further reduce the stress, but most likely reduces the bfrr exercise effect. 16 alan kacin, benjamin rosenblatt, tina grapar žargi, anita biswas: safety considerations with blood ..., 3–26 annales kinesiologiae • 6 • 2015 • 1 little is known about the long-term effects of bfrr training on cardiovascular regulation. a study of kacin and strazar (2011) revealed a small, but significant increase in pre-exercise resting diastolic arterial pressure after a 4-week bfrr training program, which may indicate chronically elevated levels of stress hormones due to repetitive high body exertion in healthy individuals. this observation warrants a further investigation both in healthy individuals and cardiac patients. vascular considerations overall, there is evidence that there are vascular benefits to the use of blood flow restriction (patterson & ferguson, 2010; hunt et al., 2012; hunt et al., 2013), however, blood flow through vessels is affected by a number of factors including the vessel diameter and blood turgidity. any condition that interferes with a ‘normal’ blood flow may contribute to and compound these compressive effects by impacting on the turgidity of the blood. it stands to reason that any condition affecting blood flow through the limb to be trained and the wider cardiovascular system may show impact on the risk to the patient. nakajima estimated the risk of venous thrombus to be 0.055 % in their epidemiological study in japan (nakajima et al., 2006), nonetheless it is very low, it is a real risk. consideration must therefore be given to a personal or family history of conditions affecting blood flow through local vessels or the wider cardiovascular system. these are outlined in table 2. table 2: medical and social factors which may affect limb muscle blood flow. lifestyle travel periods of immobilization medication smoking personal medical history clotting disorders connective tissue disorders thrombosis (deep vein, pulmonary embolus, stroke) traumatic injury to blood vessels or nerves, compartment syndrome, fractures or surgery non traumatic injury etc. diabetes/ hypertension/ peripheral vascular disease liver/ renal disease pregnancy family history clotting disorders connective tissue disorders sickle cell anemia annales kinesiologiae • 6 • 2015 • 1 17 alan kacin, benjamin rosenblatt, tina grapar žargi, anita biswas: safety considerations with blood ..., 3–26 despite the potential risk, there is a growing body of evidence that bfrr exercise does not increase risk of venous thrombosis, at least in healthy individuals. a single bout of blood flow restriction exercise show to augment fibrinolytic potential (clark et al., 2011) without affecting coagulation (clark et al., 2011; madarame et al., 2010; fry et al., 2010) and inflammatory responses (clark et al., 2011). the question whether this holds true also for patients with increased risk for cardiovascular events has not been systematically studied yet. a recent pilot study of madarame et al. (2013) showed that hemostatic and inflammatory responses are not significantly increased by a single bout (4 sets without reperfusion) of bfrr exercise performed at 20 % 1rm (5 cm wide elastic cuff with pressure 200 mmhg) in patients with stabile ischemic heart disease. however, these results should not be directly extrapolated to other patient populations and the interpretation must be taken with caution; the number of subjects was rather small and the degree of blood flow restriction must have been different between subject at a given tourniquet pressure. neural considerations disruptions in peripheral nerve function may be due to both compression and local asphyxiation (ochoa, fowler & gilliatt, 1972). under lower levels of compression, disruptions are usually due to local ischemia (brown & brenner, 1944) unless the duration of compression is prolonged, in which case disruption is due to the pressure effects alone. in experiments looking into the effects of tourniquet pressure on the tissues beneath it, higher pressures have been shown to cause localized conduction block as a result of mechanical deformation nerve fibers (ochoa, fowler & gilliatt, 1972), with large nerve fibers being affected more than those that are smaller (bolton & mcfarlane, 1978; larsen & hommelgaard, 1987). lundborg, gelberman, minteer-convery, lee & hargens (1982) reported hand numbness resulting from tourniquet compression of arm likely due to nerve ischemia and conduction block, with similar numbness reported also in the thigh during the bfrr exercise by kacin and strazar (2011). such acute nerve compression, however, does not usually have a long-term negative effect on nerve conduction velocities, at least in healthy adults (clark et al., 2011). it is well known that peripheral nerve function (both sensory and motor) in diabetics is reduced early in the disease and that this is also likely to be due to ischemia (gregersen, servo, borsting & theil, 1978) although the deterioration in nerve function can be reduced by maintaining good control of blood sugars. therefore, the relative risk of nerve injury in diabetics using bfrr may be considered to be higher than in the general population. in assessing risk, it also stands to reason that any history of previous disruption to the peripheral nervous system particularly if due to compression, places a patient at a higher risk of re-injury during bfrr training. caution is particularly advised in paralympic athletes with a spinal cord injury, direct peripheral nerve injury (such as post-traumatic joint dislocation) or a complex regional pain syndrome. 18 alan kacin, benjamin rosenblatt, tina grapar žargi, anita biswas: safety considerations with blood ..., 3–26 annales kinesiologiae • 6 • 2015 • 1 metabolic and systemic conditions there is good evidence that bfrr training is beneficial in diabetics (satoh, 2011). however, besides the potential risk of adverse neural effects described above, there is a well-documented increased risk of peripheral vascular disease with disordered regulation of cutaneous blood flow and increased susceptibility to leg ulcers and limb loss in this population (sima, thomas, ishii & vinik, 1997). there is an argument that any method that restricts blood flow may compound these issues. in athletes with diabetes, there is a likelihood of fewer other confounding risk factors than in non-athletic diabetic patients. we would, nevertheless, consider that, before using this form of training in a diabetic athlete, a medical assessment of the overall risk versus benefit for the individual should be undertaken. in addition, based on the extensive kaatsu work in japan (nakajima et al., 2006) the risks of adverse effects are not as high as may be first considered, so this valuable method of training should not be automatically excluded. in other diabetic populations the risk may be higher and each person should be assessed individually as to their suitability. paralympic athletes may include those with duchene muscular dystrophy. this is a condition in which the protein, dystrophin, is absent and causes an increase in sarcolemma damage in response to the exercise (markert, ambrosio, call & grange, 2011). loenneke et al. (2013a) suggested that bfrr may be a good way to improve symptoms in this group of patients for whom exercise may improve their condition, but may also be associated with muscle damage, as discussed above. in considering the use of bfrr training in paralympic athletes and other people with this condition, sound medical reasoning was used in the authors’ clinical practice whilst acknowledging the absence of strong medical evidence as to its risks or benefits. other less common conditions for consideration and rarely seen in our population, include genetic muscle diseases comprising familial paroxysmal rhabdomyolysis, mcardles, myopathies, and severe hypothyroidism. the only published evidence on these conditions is a case study in inclusion body myositis in which a patient gained improvements in strength and motor function after bfrr training with no adverse effects on his disease (gualano et al., 2010). certain medication such as statins and some medications for parkinson’s disease are also associated with this, which also increases the risk of adverse effects (table 1). developing a risk assessment tool considering the safety aspects of bfrr training using these principles relies on a comprehensive personal, medical, social and family history. particular attention needs to be paid to any condition or lifestyle activity that may impact on any of the systems outlined above. in recognition of this the following screening tool was developed (figure 2). annales kinesiologiae • 6 • 2015 • 1 19 alan kacin, benjamin rosenblatt, tina grapar žargi, anita biswas: safety considerations with blood ..., 3–26 figure 2: clinical screening tool for risk assessment of subjects prior to their inclusion in blood flow restricted resistance training program. magnitude of risk medical history or lifestyle factor patient response decision absolute do you have a family history of clotting disorders (e.g. sle (lupus), haemophilia, high platelets)? yes stop no continue do you have level 1 hypertension (sap ≥ 140 mmhg)? yes stop no continue do you have a past history of dvt or pulmonary embolus? yes stop no continue have you suffered from a haemorrhagic or thrombotic stroke? yes stop no continue relative do you have a family history of clotting disorders (e.g. sle (lupus), haemophilia, high platelets)? yes seek medical advice no continue do you smoke? yes seek medical advice no continue are you on any medication including the contraceptive pill? yes seek medical advice no continue do you have a history of injury to your arteries or veins? yes seek medical advice no continue do you have a history to any of your nerves (including back or neck injury)? yes seek medical advice no continue do you have diabetes? yes seek medical advice no continue does one of your parents or siblings have diabetes? yes seek medical advice no continue do you have hypertension (sap 120-140 mmhg)? yes seek medical advice no continue do you have metal work in situ? yes seek medical advice no continue do you have any undiagnosed groin/calf pain? yes seek medical advice no continue do you have/have you suffered from compartment syndrome? yes seek medical advice no continue have you had surgery in past 4 weeks? yes seek medical advice no continue have you had a journey lasting more than 4 hours or a flight in the last 7 days? yes seek medical advice no continue do you have any other medical conditions including a history of synovitis? yes seek medical advice no continue 20 alan kacin, benjamin rosenblatt, tina grapar žargi, anita biswas: safety considerations with blood ..., 3–26 annales kinesiologiae • 6 • 2015 • 1 if it is considered that an athlete may benefit from bfrr training, they ought to be subjected to a series of questions to determine whether their medical history or lifestyle may increase the risk of illness or injury when using bfrr training. the purpose of the questions is to assess whether the athlete is at higher than normal risk of adverse reactions or injury whilst using this form of training. the risk factors were separated into ‘absolute’ and ‘relative’, where the following absolute risk factors were recognized: • history or presence of clothing disorders (including sle, hemophilia and high plateles count); • history or presence of deep vein thrombosis (dvt) or pulmonary embolism; • history of thrombotic or haemorrhagic stroke; • presence of level 1 hypertension or higher. if patients / athletes show an absolute risk factor then they are automatically excluded from bfrr training. if they do not, then they are able to continue with the assessment tool. if they showany relative risk factor, a referral is made to a medical practitioner prior to progression with bfrr training. the tool was designed so it can be used at the point of contact by a non-medical practitioner, but with a clear understanding that the final decision about the suitability of an athlete for bfrr is ultimately a medical one. the following precaution measures in different patient populations are suggested: 1. where there may be an increased risk of thrombotic events screening should be considered and at the very least, close monitoring is advised and a low threshold maintained for using a different form of resistance training. 2. subjects with a history or increased risk of cardiovascular disease should be thoroughly screened prior to their inclusion to bfrr training program and closely monitored for excessive hr and abp responses during the exercise. the exercise not performed to volitional failure with longer and more frequent reperfusions allowed during multiple sets is also advised. 3. those who may be at a higher risk of nerve injury such as diabetics should be fully examined for evidence of current compromise and monitored for any changes in sensation, or development of paraesthesia in the exercising limb. in these subjects, monitoring blood glucose levels should be considered and in those with poorly controlled diabetes, other forms of training may be advisable. 4. in all subjects, but particularly where factors that may contribute to the development of rhabdomyolysis exist, monitoring for excessive muscle pain and weakness, changes in urine color and systemic symptoms of malaise are essential during bfrr training. where there is a high level of suspicion, appropriate medical advice should be sought early and training should be ceased. annales kinesiologiae • 6 • 2015 • 1 21 alan kacin, benjamin rosenblatt, tina grapar žargi, anita biswas: safety considerations with blood ..., 3–26 conclusions tourniquet design and pressure and whether a patient / athlete is at a high risk of adverse reactions are the two key considerations which can be managed to increase the safety and efficiency of bfrr training. a pneumatic tourniquet is very easy to use, but is a rather crude method of blood flow restriction, hence, a safe and efficient application can be provided only by well-controlled tourniquet pressure on tissues. the degree of blood flow reduction and tissue compression induced by pneumatic cuffs during dynamic exercise most likely varies greatly between subjects in published studies, thus, precise parameters for a safe and efficient application cannot be established from available data. tourniquet pressure during bfrr training should be set individually, where at least subject’s limb circumference and composition (skinfold), arterial blood pressures and cuff design (width and shape) are to be taken into the account. we consider that a high quality screening process including a medical practitioner is the best way to safeguard against adverse reactions associated with this form of exercise. to improve our understanding of the risks associated with bfrr training, a thorough and regular auditing process needs to be established. conflicts of interest authors declare no conflict of interest or financial benefit connected with this manuscript. references abe, t., fujita, s., nakajima, t., et al. 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article doi: https://doi.org/10.35469/ak.2022.365 received: 2022-11-24 udc: 796.062:005.7 the decision-making style structure of slovenian sports managers edvard kolar1, matej tušak2 1 university of maribor, faculty of organizational science, slovenia 2 university of ljubljana, faculty of sport, slovenia corresponding author: edvard kolar university of maribor, faculty of organizational science, kidričeva cesta 55a, 4000 kranj phone: +386 41 376 381 e-mail: edvard.kolar@guest.um.si abstract purpose: decisions that we make are always burdened with consequences, which are the inevitable result of our decision-making. the decision-making style (dms) is the way in which managers acquire, process and use information in decision-making processes. the goals of the present research are to define the factor structure of dms for a sample of slovenian sports managers and to determine the characteristics of their dms structure. methods: 80 managers of slovenian sports organizations filled in an anonymous internet survey. the dms was measured with the use of the general decision-making style inventory (gdms), which was translated into the slovenian language. the gdms questionnaire measures five different decision-making styles: rational, intuitive, dependent, avoidant and spontaneous. the factor analysis (fa) method was used to test the assumption about the structure of the dms. the internal consistency was measured using cronbach’s alpha coefficient. the pearson correlation coefficient was used to study the relationship between the dms. results: after three successive implementations of fa, we developed an optimized dms model with 20 items confirming that when making decisions, sports managers use a combination of all five dms. slovenian sports managers mostly use the rational and dependent dms, indicating that they are mostly rational decision-makers. we also recognized the correlation between the rational and the dependent style, but since the structure of the dms in our sample is dominated by the rational dms, we could conclude that this is a dependent-rational dms, where mangers seek advice, opinions and knowledge from colleagues when making decisions to increasing their rationality. mailto:edvard.kolar@guest.um.si 48 edvard kolar, matej tušak: decision-making style structure of slovenian sports managers , 47–73 annales kinesiologiae • 13 • 2022 • 1 conclusions: we can conclude that the recognized average structure of the dms is functional and healthy; furthermore, slovenian sports managers are on average rational decision-makers who, due to the specific organizational characteristics of sports organizations, look for confirmation and opinions on future decisions in the broader environment of the organizations’ stakeholders. keywords: slovenian sports managers, decision-making styles, structure. struktura stilov odločanja slovenskih športnih menedžerjev izvleček namen: odločitve, ki jih sprejemamo, so vedno obremenjene s posledicami, ki so neizogiben rezultat našega odločanja. stil odločanja (dms) je način, na katerega menedžerji pridobivajo, obdelujejo in uporabljajo informacije v procesih odločanja. cilja te raziskave sta opredelitev faktorske strukture dms na vzorcu slovenskih športnih menedžerjev in opredelitev značilnosti strukture njihovih stilov. metode: 80 menedžerjev slovenskih športnih organizacij je izpolnilo anonimno spletno anketo. dms je bil merjen z uporabo splošnega vprašalnika stilov odločanja (gdms), ki je bil preveden v slovenski jezik. vprašalnik gdms meri pet različnih stilov odločanja: racionalnega, intuitivnega, odvisnega, izogibajočega in spontanega. za preverjanje predpostavke o strukturi dms je bila uporabljena metoda faktorske analize (fa). notranja konsistentnost je bila preverjena s cronbachovim koeficientom. pearsonov korelacijski koeficient je bil uporabljen za proučevanje povezanosti med stili odločanja. rezultati: po treh zaporednih izvedbah fa smo razvili optimiziran model stilov odločanja z 20 postavkami vprašalnika, ki potrjuje, da športni menedžerji pri odločanju uporabljajo kombinacijo vseh petih stilov odločanja. večinoma uporabljajo racionalni in odvisni stil, kar kaže, da so večinoma racionalni odločevalci. ugotovljena je bila tudi korelacija med racionalnim in odvisnim stilom, ker pa v strukturi našega vzorca prevladuje racionalni stil, bi lahko sklepali, da gre za odvisno-racionalni stil odločanja, v okviru katerega menedžerji pri sprejemanju odločitev iščejo nasvete, mnenja in znanje pri sodelavcih zaradi povečanja racionalnosti svojih odločitev. zaključek: ugotovili smo, da je ugotovljena povprečna struktura stilov odločanja funkcionalna in zdrava. slovenski športni menedžerji so v povprečju racionalni odločevalci, ki zaradi posebnih organizacijskih značilnosti športnih organizacij iščejo potrditev in mnenja o prihodnjih odločitvah v širšem okolju deležnikov organizacije. ključne besede: slovenski športni menedžerji, stili odločanja, struktura. annales kinesiologiae • 13 • 2022 • 1 49 edvard kolar, matej tušak: decision-making style structure of slovenian sports managers , 47–73 introduction decision-making is a process resulting in a decision (tomić, 2007). “decisions are an essential part of our lives, both in the work environment and outside of it. decisions are made by those who are responsible for choosing between two or more options,” (heller & hindle, 2001). a decision, as a result of a decision-making process, can be defined as “a judgment or choice between two or more options that develops from an infinite number of situations, from solving a problem to taking action in a certain direction,” (heller & hindle, 2001). bohanec (2012) writes that a decision is a conscious and irreversible sharing of resources with the aim of achieving the desired goals. the decisions we make are always burdened with consequences, which are inevitable results of our decision-making. therefore, it is particularly important how we decide on matters (or problems). the decisions we make define our past and significantly design our future. decisions made by managers about a company define the company’s past performance, its current market, economic and social position and its future place in the industry, national economy and global environment. the essence of the managerial function is the coordination of technically divided work and the implementation of the joint work tasks of the association with the help of others; i.e., delegating and solving problems that arise, or making decisions. thus, we could define the content of management work as coordination and delegation (responsibilities, duties and powers), while the method of managerial work is decision-making (kolar & jurak, 2014). because of this, managers are often called decision-makers (daft, 2010). the results of their decisions are reflected in the growth, prosperity or collapse of the organizations they deal with (daft, 2008). simon (1960) wrote that decision-making and management are synonymous terms. the general idea of the decision maker is an individual who evaluates and chooses between possible decisions. when solving problems, decision-makers are faced with situations representing a gap between the desired (the goal of the decision) and the actual state (initial state); in order to bridge this gap, they perform intellectual (cognitive) activities, while the future steps that need to be taken are unknown (klein & methlie, 1992). every decision refers to an object, and the reason for its adoption is a certain purpose, which manifests itself as an intended change of that object in favour of the one who makes the decision (rozman & kovač, 2012). a fundamental condition for ensuring the success and efficiency of n organization is that the managers at all levels of management make valid decisions. simon (1987) claims that it is highly unlikely to find two types of managers (at least not good managers) who can be classified as making decisions solely based on intuition or making decisions solely based on rational/analytical techniques. it is more likely that we will find a range of combinations or the related use of intuition and rational-analytical techniques in decision-making processes. rowe, boulgarides and mcgrath (1984) point out that the decision-making style reflects the way a person uses information to make decisions. avsec (2012) accordingly stated that, despite the fact that the nature of the problem and situational factors play an important role in decision50 edvard kolar, matej tušak: decision-making style structure of slovenian sports managers , 47–73 annales kinesiologiae • 13 • 2022 • 1 -making, we can assume that, regardless of the decision-making problem, individuals differ in the frequency of use of individual decision-making styles. remenova and jankelova (2019) state that the decision-making style can be understood as the result of a cognitive process that leads to the choice of solutions from among several alternatives. the authors also note that managers generally use a combination of at least two decision-making styles, varying based on the characteristics and weight of the decision problem. driver (1979) defined decision-making styles as learned patterns of response that people use when making decisions. the decision-making style is therefore the way managers acquire, process and use information in decision-making processes. this is a set of qualitative indicators that manifest themselves within the decision-making process in the form of a decision-making style and represent a typical method of enforcing decisions. managers’ decision-making styles significantly contribute to their individual performance and thus to the performance of organizations (abdelsalam, daeoud & elkadi, 2013); therefore, as pointed out by rowe and boulgarides (1992), they need to be measured, because decision-making styles should form the backbone of effective decision-making. knowledge of decision-making styles and their use in the management structure directly contributes to increasing the competitive advantage of organizations (remenova & jankelova, 2019) and can also represent one of the main sources of risk for the successful operation of organizations. several authors have worked on defining decision-making styles. it is typical of research in the field of decision-making styles that in addition to defining the styles, authors often build different models and constructs, including a varying number of decision-making styles, as well as different inventories for determining the dominant styles of individual subjects (harren, 1979; rowe & mason, 1987; hunt, krzystofiak, meindl, & yousry, 1989; scott & bruce 1995; nygren, 2000). berisha, pula and krasniqi (2018), based on a review of a large number of studies, concluded that one of the most frequently used and validated questionnaires for discovering decision-making styles is the general decision-making style inventory (gdms) developed by scott and bruce (1995). scott and bruce (1995) defined decision-making styles as a learned response or behavioural pattern of an individual who is faced with a decision-making situation. they claimed that it is not a personality trait, but rather a tendency to react in a specific way in a decision-making situation, whereby the characteristics of the situation itself can have a significant influence. the authors also stated that individual styles are not mutually exclusive and that individuals do not rely exclusively on one decision-making style. the results of their study showed that individuals use a combination of decision-making styles when making important decisions. based on the questionnaire, which contained 37 items and was used on the initial sample of subjects (military officers), with the use of factor analysis, the authors discovered a structure based on five factors (decision-making styles) and then reduced the questionnaire to 25 items. in the subsequent steps of the analysis, the questionnaire was tested with the use of the factor analysis method (the principal axes method with varimax factor rotation) on the remaining three different samples. the results of the study showed that the structure of the decision-making styles consists of five styles and that the questionnaire can be used annales kinesiologiae • 13 • 2022 • 1 51 edvard kolar, matej tušak: decision-making style structure of slovenian sports managers , 47–73 regardless of the decision-making context or situation (scott & bruce, 1995). the five decision-making styles included in the gdms inventory are defined as (thunholm, 2004; faletič & avsec, 2013): – rational style: characteristic of people who search for information in detail and comprehensively and logically evaluate all the alternatives. they mainly focus on logic, order and the systematic analysis of information; – intuitive style: characteristic of those who pay a lot of attention to details in the information flow and, instead of systematically searching and processing information, mainly consider their feelings about whether a certain decision is correct or not; – dependent style: characteristic of people who seek advice, support and confirmation from others before making an important decision; – spontaneous style: characteristic of those who have a sense of urgency and thus a desire to complete the decision-making process as soon as possible and make a decision; – avoidant style; characteristic of people who want to avoid making a decision whenever possible. in various studies on samples from different countries, numerous authors (loo, 2000; thunholm, 2004; spicer & sadler-smith, 2005; gambetti, fabbri, bensi & tonetti, 2008; curşeu & schruijer; 2012; erenda, meško & bukovec; 2014; bavoľár & orosová, 2015; alacreu-crespo et al., 2019) have confirmed the validity (using factor analysis) and reliability (using cronbach’s alpha coefficient) of the gdms inventory as suggested by scott and bruce (1995). in the aforementioned preliminary research, the authors tested the validity of the five-factor structure of decision-making styles on samples of managers, various profiles of students, the general population, military officers and others. in the present study, we will determine the factor structure of decision-making styles using a sample of slovenian sports managers. sports managers usually work in the specific environment of non-profit sports organizations, which in terms of legal, structural and procedural characteristics, are significantly different to for-profit organizations (companies). one of the important characteristics of sports organizations is that they are interest-type associations, in which the interests of different stakeholders are in constant conflict (tavčar & trunk širca, 2002). participants in sports organizations are individuals (officials, coaches and athletes), groups (professional and other) and associations (societies and clubs), all with their own interests and with the possibility of significantly acting and influencing the operation of the organization. furthermore, in non-profit sports organizations, it is necessary to deal with a large number of volunteers (santos, batista & carvalho, 2022) and to generate and obtain financial resources from a large number of different sources (sponsorships, donations, national and local budgets, sales of products and services, etc.). finally, a “unique” governmental-managerial process is established in non-profit sports organizations; they are led by a committee of elected volunteers (governmental organizational function) who form very sensitive relations with professional (management) staff (young, 1998; kolar & jurak, 2014). 52 edvard kolar, matej tušak: decision-making style structure of slovenian sports managers , 47–73 annales kinesiologiae • 13 • 2022 • 1 all of the aforementioned specifics of the structure and operation of non-profit sports organizations have a significant impact on the management and decision-making processes in these types of organizations and thus probably on the structure of the decision-making styles of the sports managers. the goals of the present research are to define the factor structure of decision-making styles using a sample of slovenian sports managers and to determine the characteristics of their structure of decision-making styles. according to the described structural and operational differences in the functioning of non-profit sports organizations, we can define the hypothesis that in the structure of decision-making styles of the sample of managers in our research, the dependent decision-making style will be more emphasized than the intuitive and spontaneous style, which enables faster and quick decisions. we assume that sports managers have to coordinate decisions with much more diverse stakeholder interests than is typical for for-profit organizations (companies). methods participants the sample consisted of 80 managers of slovenian sports organizations, which is more than the minimum requirement for executing the factor analysis (de winter, dodou & wieringa, 2009, andrew, pedersen & mcevoy, 2010). the average age of the subjects was 47.5±10.6 years and the average work experience as a manager was 15.61±9.7 years. the upper age limit was 68 years, whereas the lower age limit was 28 years. the most experienced manager had 40 years and the least experienced 1 year of work experience. the sample consisted of 56 men (70%) and 24 women (30%). the sample is comparable to samples of sports managers by other authors (barros & lucas, 2001; case & branch, 2003; retar, plevnik & kolar, 2013). the slovenian olympic committee sent the managers of slovenian sports organizations an invitation to participate in the study and to fill in an anonymous internet survey. the invitation was sent three times at one-month intervals. all the subjects participated in the study voluntarily and without any compensation. instrument the decision-making style was measured with the use of the general decision-making style inventory – gdms (scott & bruce, 1995), which was translated into the slovenian language. the gdms questionnaire measures five different decision-making styles: rational, intuitive, dependent, avoidant and spontaneous. the questionnaire consists of 25 items (5 for each decision-making style) ranging on a five-point likert scale from strongly disagree (1) to strongly agree (5). the total score of all five decision-making styles was obtained by adding the item score of the decision-making annales kinesiologiae • 13 • 2022 • 1 53 edvard kolar, matej tušak: decision-making style structure of slovenian sports managers , 47–73 style and the score ranges from 5 to 25. gdms scales have previously shown good psychometric characteristics (scott & bruce, 1995; loo, 2000; thunholm, 2004; spicer & sadler-smith, 2005; gambetti, et. al, 2008; curşeu & schruijer; 2012; avsec, 2012; erenda, et al.; 2014; bavoľár & orosová, 2015; alacreu-crespo, et. al, 2019). in this study, the alpha coefficients of the scales ranged between 0.572 (spontaneous) and 0.814 (avoidant). the cronbach’s alpha for the whole gdms is 0.69, which is a good indicator of internal consistency. the slovenian version of the gdsm inventory has already been used and validated in several research projects and using different samples in slovenia (avsec, 2012; faletič & avsec, 2013; erenda, et al.; 2014); in the present study, general information questions about gender, age, experiences in management, level of education and field of education were added. statistical analysis statistical data processing was carried out using the statistical package for the social sciences 29 (ibm spss inc., armonk, ny, usa). the factor analysis method – principal component factoring (pcf) and varimax rotation of factors – was used to test the assumption about the structure of decision-making styles (scott & bruce, 1995). factor extraction was carried out with the use of kaiser-guttman’s criterion (eigenvalue > 1). before applying the factor analysis (fa), the data adequacy was tested with the keiser-meyer-olkin measure of sampling adequacy (kmo) and bartlett’s test of sphericity. values of the kmo test above 0.6 indicate that the analyzed data is suitable for the use of fa (tabachnick & fidell, 2007). bartlett’s test must show significant differences at a risk level of less than 5% (p < 0.05), showing that the correlation matrix is not uniform and that the observed variables are related to a certain extent. the internal consistency of the overall scale and subscales was measured using cronbach’s alpha coefficient. pearson correlation coefficient was used to study the relationship between the gdms’ styles. results table 1 shows descriptive statistics for five decision-making styles. the average values of the individual decision-making style use (mean/value) were calculated from the original model of items assigned to an individual decision-making style (scott & bruce, 1995). the average share of the individual decision-making style use (mean/% of maximum) in relation to the maximum possible total value of the sum of items originally dedicated to the individual decision-making style (maximum = 25) was calculated for each decision-making style. 54 edvard kolar, matej tušak: decision-making style structure of slovenian sports managers , 47–73 annales kinesiologiae • 13 • 2022 • 1 table 1: descriptive statistics and internal consistency of decision-making styles. variable p os si bl e ra ng a ct ua l r an ge mean st an da rd d ev ia ti on sk ew ne ss k ur to si s c ro nb ac h α v al ue % o f m ax im um dms rational 5–25 15–25 21.35 85.40% 2.081 -0.283 0.885 0.777 dms intuitive 5–25 7–21 15.30 61.20% 3.235 -0.537 0.024 0.667 dms dependent 5–25 10–23 17.53 70.10% 3.027 -0.211 -0.365 0.694 dms avoidant 5–25 5–18 9.21 36.85% 3.129 0.439 -0.508 0.814 dms spontaneous 5–25 6–20 12.80 51.20% 2.558 0.122 -0.044 0.572 key: dms rational = rational style; dms intuitive = intuitive style; dms dependent = dependent style; dms avoidant = avoidant style; dms spontaneous = spontaneous style. the structure of the decision-making styles (table 1) revealed that slovenian sports managers on average most often use the rational and dependent decision-making styles. these are followed by the intuitive and spontaneous decision-making styles whereas sports managers in slovenia are least likely to use the avoidant decision-making style. similar results on the structure of decision-making styles in different samples (middle managers, teachers, students, military officers and engineers) were also found by other authors (scott & bruce, 1995; hariri, monypenny & prideaux, 2014; ghazi & hu, 2016; berisha, et al., 2018; krasniqi, berisha & pula, 2019). the internal consistency, calculated using cronbach’s alpha coefficient, was 0.686 for the overall scale and between 0.572 (dms spontaneous) and 0.814 (dsm avoidant) for the five subscales. the reliability coefficient of the questionnaire items for the spontaneous style can be assessed as sufficient, while the other coefficients indicate moderate to robust internal consistency (taber, 2018). before applying fa, the kaiser-meyer-olkin (kmo) test and bartlett’s test of sphericity (table 2) were carried out to evaluate the factorability. the kmo measure of sampling adequacy was 0.689 (the required minimum is above 0.6) and the significance of bartlett’s test of sphericity was 0.000 (p < 0.01). the results of both tests show that the studied sample is suitable for performing fa. annales kinesiologiae • 13 • 2022 • 1 55 edvard kolar, matej tušak: decision-making style structure of slovenian sports managers , 47–73 table 2: the kaiser-meyer-olkin (kmo) test and bartlett’s test of sphericity. kmo and bartlett‘s test kaiser-meyer-olkin measure of sampling adequacy. 0,689 bartlett‘s test of sphericity approx. chi-square 824.326 df 300 sig. 0.000 the structure of the decision-making styles of slovenian sports managers was verified by fa using the method of principal components with varimax rotation (table 3). the fa procedure based on kaiser-guttman’s criterion extracted seven (7) factors, which cumulatively explain 66.65% of the total variance. table 3 shows a scree plot diagram with the factor eigenvalue curve bend at the fifth factor, meaning that a five-factor solution corresponds to the basic gdms model and could also be considered a valid result of the fa (scott & bruce, 1995; spicer & sadler-smith, 2005). thus, the rotated solution with five factors explains 54.57% of the total variance of the observed variables. table 4 shows the factor structure and factor loadings of the items included in the gdms inventory, which were obtained by the orthogonal rotation of the factors using the varimax method. it can be observed that all the items measuring a rational decision-making style (dmsrat1 to dmsrat5) from the original model are related to the first factor (factor loadings from 0.637 to 0.725). the first factor explains 13.91% of the total variance of the rotated solution (table 3) and can be named the “rational style”. the second factor is associated with four items measuring the avoidant style (dmsavo2, 3, 4 and 5) and one of the spontaneous decision-making style items (dmsspo2). the projections of avoidant style items on the second factor are high (factor loadings from 0.663 to 0.876), while the projection of the dmsspo2 on the same factor is very low (0.382). therefore, the second factor can be named the “avoidant style”, explaining 13.61% of the total space of the rotated solution (table 3). the third factor (table 4) is explained with three items measuring the intuitive decision-making style (dmsint1, 2 and 5). projections of items on this factor are very high for all three items (factor loadings from 0.797 to 0.871). the third factor explains 10.61% of the total variance of the rotated solution (table 3) and can be named the “intuitive style”. the fourth factor is explained with four dependent decision-making style variables (dmsdep1, 2, 3 and 4) with relatively high projections on the factor (factor loadings from 0.636 to 0.788). the fourth factor explains 8.90% of the total variance (table 3) and can be named the “dependent style”. the fifth factor is explained with only two items, both belonging to the spontaneous decision-making style (dmsspo1 and 3). their projections on the factor are high (factor loadings 0.735 and 0.801). the fifth factor explains 7.54% of the total variance of the rotated solution (table 3) and can be named the “spontaneous style”. the sixth factor of the rotated solution is explained with four variables, which, in 56 edvard kolar, matej tušak: decision-making style structure of slovenian sports managers , 47–73 annales kinesiologiae • 13 • 2022 • 1 total variance explained c om po ne nt initial eigenvalues extraction sums of squared loadings rotation sums of squared loadings to ta l % o f v ar ia nc e c um ul at iv e % to ta l % o f v ar ia nc e c um ul at iv e % to ta l % o f v ar ia nc e c um ul at iv e % 1 5.022 20.087 20.087 5.022 20.087 20.087 3.479 13.917 13.917 2 3.451 13.803 33.890 3.451 13.803 33.890 3.403 13.612 27.529 3 2.943 11.774 45.664 2.943 11.774 45.664 2.654 10.615 38.144 4 1.704 6.816 52.480 1.704 6.816 52.480 2.226 8.903 47.048 5 1.347 5.389 57.869 1.347 5.389 57.869 1.884 7.538 54.586 6 1.155 4.621 62.490 1.155 4.621 62.490 1.628 6.511 61.097 7 1.039 4.155 66.645 1.039 4.155 66.645 1.387 5.549 66.645 8 0.915 3.662 70.307 9 0.860 3.441 73.748 10 0.813 3.253 77.001 11 0.700 2.799 79.800 12 0.634 2.537 82.336 13 0.620 2.481 84.817 14 0.572 2.287 87.104 15 0.471 1.886 88.990 16 0.429 1.716 90.705 17 0.398 1.594 92.299 18 0.367 1.467 93.765 19 0.329 1.318 95.083 20 0.300 1.200 96.283 21 0.267 1.068 97.351 22 0.215 0.859 98.211 23 0.171 0.683 98.894 24 0.164 0.656 99.550 25 0.112 0.450 100.000 table 3: fa of the original gdms inventory with 25 items. annales kinesiologiae • 13 • 2022 • 1 57 edvard kolar, matej tušak: decision-making style structure of slovenian sports managers , 47–73 table 4: factor structure and factor loadings of the 25 items of the gdms inventory. rotated component matrixa component 1 2 3 4 5 6 7 dmsrat3 0.725 dmsrat5 0,716 dmsrat4 0.714 dmsrat1 0.670 dmsrat2 0.637 dmsavo3 0.876 dmsavo2 0.769 dmsavo5 0.760 dmsavo4 0.663 dmsspo2 0.382 dmsint2 0.871 dmsint5 0.821 dmsint1 0.797 dmsdep1 0.788 dmsdep4 0.679 dmsdep3 0.671 dmsdep2 0.636 dmsspo3 0.801 dmsspo1 0.735 dmsdep5 0.613 dmsint4 0.563 dmsavo1 0.479 dmsspo4 0.373 dmsint3 0.746 dmsspo5 0.662 notes: dmsrat1-5 = rational style items 1 to 5; dmsint1 – 5 = intuitive style items 1 to 5; dmsdep1 – 5 = dependent style item 1 to 5; dmsavo1-5 = avoidant style items 1 to 5; dmsspo1 – 5 = spontaneous style items 1 to 5. 58 edvard kolar, matej tušak: decision-making style structure of slovenian sports managers , 47–73 annales kinesiologiae • 13 • 2022 • 1 the original gdms inventory model, are classified as different decision-making styles. with the exception of the rational style variables, all the other decision-making styles are related to this sixth factor. projections of individual items in the sixth factor are lower than for the first five factors (factor loadings from 0.373 to 0.613). the sixth factor explains 6.51% of the total variance of the rotated solution (table 3) and can be named the “non-rational style” or “descriptive style”, as the variables associated with this factor measure all the decision-making styles from the original model with the exception of the rational style. items explaining this decision-making style deviate from the rational or normative model of decision-making, assuming that the decision-maker is entirely rational and fully follows the decision-making process. observing this aspect, these items primarily belong to the descriptive rather than rational decision-making styles (bohanec, 2001). the seventh factor is explained with two variables belonging to the intuitive and spontaneous decision-making styles. the projection of both variables in the seventh factor is relatively high (dmsint3 = 0.746 and dmsspo = 0.662) with the factor explaining 5.55% of the total variance (table 3). the association of these two variables in the same factor is not surprising, as different authors have found statistically significant correlations between the intuitive and spontaneous decision-making styles (scott & bruce, 1995; thunholm, 2004; spicer & sadler-smith, 2005; wood, 2012; verma, rangnekar & barua, 2012; curşeu & schruijer, 2012; faletič & avsec, 2013; reyna, ortiz & revilla, 2014; hariri, et al., 2014; bavoľár & orosová 2015; berisha, et al., 2018; geisler & allwood, 2018). based on this, it can be concluded that both styles have the same cognitive structure in the background, which could be named the intuitive-experiential cognitive style (sagiv, amit, ein-gar & arieli, 2013; alacreu-crespo, et. al, 2019). as thunholm (2004) states, the spontaneous decision-making style could also be named the high-speed intuitive style due to the urgency of the decision-making process. as a result, we have named the seventh factor the “high-speed” decision-making style. since the scree plot diagram analysis revealed that it is possible to interpret the factor structure with only five factors (table 3) and as the sixth and seventh factors are unclear, we further checked how the variables are projected within the five-factor structure of the decision-making styles of sports managers. table 5 shows the five-factor structure of the decision-making styles of slovenian sports managers. the factor structure with a limited number of extracted factors (five) explains 57.87% of the total variance – 8.78% less than the full seven-factor model. this structure is also characterized by higher eigenvalues of all five extracted factors; also, a larger part of the total variance is explained than for the five factors within the seven-factor model (+ 3.30%). eight items are projected onto the first factor, which explains 15.67% of the total variance. all the items measuring the avoidant decision-making style in the original gdms inventory are related to this factor (factor loadings 0.489 and 0.832). furthermore, two variables measuring the spontaneous decision-making style (dmsspo4 = 0.541 and dmsspo2 = 0.489) and a single variable measuring the dependent decision-making style (dmsdep5 = 0.658) are also related to the first factor. in contrast, within the seven-factor solution, the variables dmsdep5 and dmsspo4 were connected to the sixth factor (non-rational style) and the variable annales kinesiologiae • 13 • 2022 • 1 59 edvard kolar, matej tušak: decision-making style structure of slovenian sports managers , 47–73 table 5: factor structure and factor loadings with a limited number of extracted factors. rotated component matrixa component 1 2 3 4 5 dmsavo5 0.832 dmsavo3 0.808 dmsavo2 0.752 dmsdep5 0.658 dmsavo1 0.619 dmsspo4 0.541 dmsavo4 0.495 dmsspo2 0.489 dmsrat3 0.742 dmsrat5 0.693 dmsrat4 0.678 dmsrat1 0.664 dmsrat2 0.659 dmsint2 0.858 dmsint1 0.817 dmsint5 0.788 dmsint4 0.566 dmsdep1 0.793 dmsdep2 0.627 dmsdep3 0.564 dmsdep4 0.503 0.556 dmsspo3 0.774 dmsspo1 0.687 dmsint3 0.686 dmsspo5 0.435 eigenvalues 3.918 3.436 2.762 2.335 2.017 % of variance 15.672 13.744 11.048 9.339 8.066 60 edvard kolar, matej tušak: decision-making style structure of slovenian sports managers , 47–73 annales kinesiologiae • 13 • 2022 • 1 dmsspo2 was connected with the lowest projection to the second factor (avoidant style). as the first factor includes all five variables measuring the avoidant style (dmsavo1 5), as well as a variable from a seven-factor model structure with a projection on the avoidant style factor (table 4) and two variables with a projection on the sixth factor (non-rational style), it can be named the “avoidant style”. the second factor is explained with five items measuring the rational decision-making style (dmsrat1 5). the projections of items on this factor are high for all five items (factor loadings from 0.659 to 0.742). the second factor explains 13.74% of the total variance and can be named the “rational style”. the third factor is explained with four items measuring the intuitive decision-making style (dmsint1, 2, 4 and 5). the projections of items on this factor are moderate to very high (factor loadings from 0.566 to 0.858). the third factor explains 11.05% of the total variance and can be named the “intuitive style”. the fourth factor is, as in the seven-factor model, explained with four dependent decision-making style variables (dmsdep1, 2, 3 and 4). projections of items on this factor are moderate to high (factor loadings from 0.556 to 0.793); the fourth factor explains 9.34% of the total variance and can be named the “dependent style”. the fifth factor is a combination of the fifth (spontaneous style) and seventh (high-speed style) factors from the seven-factor model structure. this factor is explained with three variables measuring the spontaneous decision-making style in the original model (dmsspo1, 3 and 5) and a variable measuring intuitive style (dmsint3), together explaining 8.07% of the total variance of the studied space. with the exception of the variable dmsspo5, which has a slightly lower projection on the fifth factor (0.435), other variables have high projections (factor loadings from 0.686 to 0.774). the fifth factor is named the “spontaneous style”. in this way, the developed five-factor decision-making styles structure model forms individual factors or decision-making styles more clearly and, at the same time, establishes the same structure as the original gdms inventory (scott & bruce, 1995), which was confirmed by other authors (loo, 2000; thunholm, 2004; spicer & sadler-smith, 2005; gambetti, et al., 2008; curşeu & schruijer; 2012; avsec, 2012; erenda, meško & bukovec; 2014; bavoľár & orosová, 2015; alacreu-crespo, et. al, 2019). regardless of the increased clarity of the five-factor structure model, some variables are nevertheless distributed outside the predicted decision-making styles. some other authors have also faced a similar problem with different samples; they named the variables that were not distributed among the factors in accordance with the intended model as “problematic items”. one such item, which in the resulting five-factor structure (table 5), was not projected onto the factors in accordance with the original model, is dmsdep5 (i like to have someone to steer me in the right direction when i am faced with important decisions) (baiocco, laghi, d´alesio, gurrieri & di chiacchio, 2007; fischer, soyez & gurtner, 2015; del campo, pauser, steiner & vetschera, 2016). this particular item did not project onto a dependent style factor in either seven-factor or five-factor structure models. two further variables were also not projected onto a spontaneous style factor in either of the two models; namely, dmsspo4 (i often make impulsive decisions) annales kinesiologiae • 13 • 2022 • 1 61 edvard kolar, matej tušak: decision-making style structure of slovenian sports managers , 47–73 and dmsspo2 (i often make decisions on the spur of the moment) (fischer, et al., 2015). in the continuation of the present study, we designed the “optimized structure model” by removing the mentioned variables from the structure of the decision-making styles of slovenian sports managers. in order to balance the number of items for each decision-making style (four items per style), we also removed the variables that, in the five-factor structure model (table 5), had the smallest projections on the avoidant style factor (dmsavo4 i generally make important decisions at the last minute) and the rational style factor (dmsrat2 i make decisions in a logical and systematic way). both of these variables have also been characterized as problematic by other authors (baiocco, et. al, 2007; fischer, et al., 2015). based on previous projections of the variable dmsint3 (i generally make decisions that feel right to me) onto the high-speed (table 4) and spontaneous (table 5) styles, we assumed that in the continuation of the research, this variable would also have a high projection on the spontaneous decision-making style. table 6: descriptive statistics and internal consistency of the optimized structure model of decision-making styles. v ar ia bl e p os si bl e ra ng a ct ua l r an ge mean st an da rd d ev ia ti on sk ew ne ss k ur to si s c ro nb ac h α v al ue % o f m ax im um dms rational 5–20 12–20 17.03 85.13% 1.736 -0.203 0.630 0.740 dms intuitive 5–20 4–18 12.43 62.13% 2.997 -0.591 0.258 0.775 dms dependent 5–20 9–20 15.28 76.38% 2.648 -0.087 -0.520 0.705 dms avoidant 5–20 4–14 7.18 35.88% 2.540 0.403 -0.706 0.814 dms spontaneous 5–20 5–17 12.56 62.81% 2.609 -0.575 0.051 0.609 table 6 reveals no changes in the order of the average use of individual decision-making styles, between the optimized structural model of the decision-making styles of slovenian sports managers (20 items; 4 items per decision-making style) and the original gdms inventory model (25 items, 5 items per decision-making style). the internal consistency, calculated using cronbach’s alpha coefficient, was 0.637 for 62 edvard kolar, matej tušak: decision-making style structure of slovenian sports managers , 47–73 annales kinesiologiae • 13 • 2022 • 1 the overall scale and between 0.609 (dms spontaneous) and 0.814 (dsm avoidant) for the five subscales. the reliability coefficients for the intuitive (dms intuitive α = 0.775), dependent (dms dependent α = 0.705) and spontaneous (dms spontaneous α = 0.609) subscales were higher in comparison to the original model, whilst the reliability coefficient was slightly lower for the rational style subscale (dms rational α = 0.740) and equal for the avoidant decision-making style subscale. the kmo measure of sampling adequacy was 0.646 (the required minimum is above 0.6) and the significance of bartlett’s test of sphericity was 0.000 (p < 0.01) (table 7). the results of both tests show that the studied sample is suitable for performing fa. table 7: the kaiser-meyer-olkin (kmo) test and bartlett’s test of sphericity for the optimized model. kmo and bartlett‘s test kaiser-meyer-olkin measure of sampling adequacy 0.646 bartlett‘s test of sphericity approx. chi-square 592.612 df 190 sig. 0.000 the optimized structure with 20 items of the decision-making styles of slovenian sports managers was verified by fa using the method of principal components with varimax rotation (table 8). the fa procedure, based on kaiser-guttman’s criterion, extracted five (5) factors that cumulatively explained 61.60% of the total variance, which is 3.73% more than in the five-factor structure of the original gdms inventory with 25 items (table 5). table 9 shows the factor structure and factor loadings of the 20 items included in the optimized model inventory, obtained by the orthogonal rotation of the factors using the varimax method. four avoidant style variables (dmsavo1, 2, 3 and 5) are associated with the first factor (factor loadings from 0.618 to 0.859), together explaining 14.39% of the total variance (table 8). this first factor can be named the “avoidant style”. the second factor is explained with four items measuring the intuitive decision-making style (dmsint1, 2, 4 and 5). the projections of items on this factor are very high for three items (factor loadings from 0.803 to 0.856) and moderate for dmsint4 (0.569). the second factor explains 13.45% of the total variance and can be named the “intuitive style”. the third factor is explained with four items measuring the rational decision-making style (dmsrat1, 3, 4 and 5). the projections of items on this factor are high for all four items (factor loadings from 0.661 to 0.754). the third factor explains 13.29% of the total variance and can be named the “rational style”. four variables measuring annales kinesiologiae • 13 • 2022 • 1 63 edvard kolar, matej tušak: decision-making style structure of slovenian sports managers , 47–73 table 8: fa of the optimized structure model inventory with 20 items. total variance explained c om po ne nt initial eigenvalues extraction sums of squared loadings rotation sums of squared loadings to ta l % o f v ar ia nc e c um ul at iv e % to ta l % o f v ar ia nc e c um ul at iv e % to ta l % o f v ar ia nc e c um ul at iv e % 1 3.547 17.735 17.735 3.547 17.735 17.735 2.878 14.388 14.388 2 3.129 15.646 33.380 3.129 15.646 33.380 2.689 13.446 27.834 3 2.785 13.925 47.305 2.785 13.925 47.305 2.658 13.288 41.121 4 1.577 7.887 55.192 1.577 7.887 55.192 2.188 10.942 52.063 5 1.282 6.408 61.600 1.282 6.408 61.600 1.907 9.536 61.600 6 0.984 4.920 66.519 7 0.882 4.409 70.928 8 0.809 4.044 74.972 9 0.798 3.988 78.961 10 0.658 3.289 82.250 11 0.624 3.119 85.369 12 0.580 2.901 88.271 13 0.509 2.543 90.813 14 0.374 1.871 92.684 15 0.326 1.632 94.317 16 0.307 1.536 95.852 17 0.261 1.306 97.158 18 0.238 1.190 98.348 19 0.208 1.040 99.388 20 0.122 0.612 100.000 64 edvard kolar, matej tušak: decision-making style structure of slovenian sports managers , 47–73 annales kinesiologiae • 13 • 2022 • 1 table 9: factor structure and factor loadings of the optimized model inventory with 20 items. rotated component matrixa component 1 2 3 4 5 dmsavo3 0.859 dmsavo5 0.833 dmsavo2 0.828 dmsavo1 0.618 dmsint2 0.856 dmsint1 0.811 dmsint5 0.803 dmsint4 0.569 dmsrat3 0.754 dmsrat5 0.732 dmsrat4 0.716 dmsrat1 0.661 dmsdep1 0.812 dmsdep3 0.635 dmsdep2 0.594 dmsdep4 0.581 dmsspo3 0.790 dmsint3 0.705 dmsspo1 0.677 dmsspo5 0.433 annales kinesiologiae • 13 • 2022 • 1 65 edvard kolar, matej tušak: decision-making style structure of slovenian sports managers , 47–73 the dependent decision-making style have a projection on the fourth factor. the projections of the variables on this factor range from moderate for the variables dmsdep4 (0.581), dmsdep2 (0.594) and dmsdep3 (0.635) to very high for the variable dmsdep1 (0.812). the fourth factor explains 10.94% of the total variance and can be named the “dependent style”. the fifth factor combines three variables measuring the spontaneous decision-making style (dmsspo1, 3 and 5) and a variable measuring the intuitive style (dmsint3); this factor is identical to the fifth factor extracted in a five-factor structure with 25 items (table 5). with the exception of the variable dmsspo5, which has a low but still satisfactory projection onto this factor (0.433), the other variables have high projections (factor loadings from 0.677 to 0.790). the fifth factor explains 9.54% of the total variance. table 10: correlations between the decision-making styles in the optimized structure model inventory with 20 items. correlations dms rational dms intuitive dms dependent dms avoidant dms spontaneous dms rational 1 dms intuitive -0.143 1 dms dependent .348** 0.012 1 dms avoidant -0.211 0.020 0.175 1 dms spontaneous -0.087 .278* -0.036 -0.025 1 notes: * p < 0.05; ** p < 0.01. table 10 shows the correlations between the extracted factors within the optimized model of the decision-making styles of slovenian sports managers. correlation analysis showed that the rational and dependent decision-making styles are statistically significantly related at a 1% risk level. a statistically significant association at a 5% risk level was also found between the intuitive and spontaneous decision-making styles. similar conclusions were also reached by other authors (scott & bruce, 1995; thunholm, 2004; spicer & sadler-smith, 2005; baiocco, laghi & alessio, 2009; wood, 2012; verma, et al., 2012; curşeu & schruijer, 2012; faletič & avsec, 2013; reyna, et. al., 2014; hariri, et al., 2014; bavoľár & orosová 2015; berisha, et al., 2018; geisler & allwood, 2018). these findings are consistent with the expectations; namely, both types of connections are characterized by the same cognitive style in the background, defining the manifestation of the aforementioned styles. thus, the rational and dependent decision-making styles have a background in the rational-analytical cognitive style, while the intuitive 66 edvard kolar, matej tušak: decision-making style structure of slovenian sports managers , 47–73 annales kinesiologiae • 13 • 2022 • 1 and spontaneous decision-making styles have a background in the intuitive-experiential cognitive style (sagiv et. al, 2013; alacreu-crespo et al., 2019). discussion the decision-making style focuses attention on how an individual obtains, uses and interprets information. thunholm (2004) defined a decision-making style as a response pattern that an individual shows when faced with a decision problem. this response pattern depends on the decision situation, the decision problem and the decision maker. faletič and avsec (2013) stated that although the nature of the problem and the situational factors play an important role in decision-making, we can assume that individuals differ in the frequency of using individual decision-making styles regardless of the decision-making problem. managers’ decision-making styles contribute significantly to their individual performance and thus to the performance of organizations (abdelsalam, dawoud & elkadi, 2013); therefore, as pointed out by rowe and boulgarides (1992), they need to be measured, because decision-making styles should form the backbone of effective decision-making. the present study deals with determining the structure of the decision-making styles of slovenian sports managers. the gdms inventory (scott & bruce, 1995) with a five-factor structure was used to measure decision-making styles. after three successive implementations of fa using the method of principal components with the orthogonal rotation of factors using the varimax method, we developed a five-factor model of decision-making styles with 20 items. the results and a comparison of the individual obtained models are presented in table 11. table 11 shows the basic characteristics of all three studied factor models. in all three models, the first five extracted factors form the original structure of the model developed by scott and bruce (1995), which was confirmed by the authors earlier mentioned. the developed optimized structure model inventory includes 20 items measuring the avoidant, intuitive, rational, dependent and spontaneous decision-making styles. this model has relatively good internal consistency, both at the level of the entire model and at the level of the individual decision-making styles. individual factors also explain the variance of the space of decision-making styles in a more balanced way compared to the other two models with 25 items. another advantage of the developed optimized model is the balanced number of items measuring the individual decision-making styles, allowing us to determine a clearer structure of decision-making styles, both at the level of the individual decision-maker and at the level of the entire sample. in all three factor models, the rational, avoidant and dependent styles showed the greatest stability of the structure of the included items. the stability of the intuitive style was relatively good, while the spontaneous style scale proved to be very unstable and problematic (fischer et. al, 2015). based on the optimized structure model inventory, we calculated the structure of the decision-making styles of slovenian sports managers (table 6), confirming that when annales kinesiologiae • 13 • 2022 • 1 67 edvard kolar, matej tušak: decision-making style structure of slovenian sports managers , 47–73 ta bl e 11 : b as ic c ha ra ct er is tic s of a ll th re e fa ct or m od el s of th e de ci si on -m ak in g st yl e st ru ct ur e of s lo ve ni an s po rt s m an ag er s. solution 7fa ct or s so lu ti on 5fa kt or s ol ut io n o pt im iz ed s tr uc tu re m od el in ve nt or y (2 5 it em s) (2 5 it em s) (2 0 it em s) % o f va ri an ce 66 .6 45 % 57 .8 69 % 61 .6 00 % extracted factors (decion-making styles) factor name no of items % of variance α factor name no of items % of variance α factor name no of items % of variance α r at io na l s ty le 5 13 .9 2% 0. 77 7 a vo id an t st yl e 8 15 .6 7% 0. 82 8 a vo id an t st yl e 4 14 .3 9% 0. 81 4 a vo id an t s ty le 5 13 .6 1% 0. 81 0 r at io na l st yl e 5 13 .7 4% 0. 77 7 in tu iti ve st yl e 4 13 .4 5% 0. 77 5 in tu iti ve s ty le 3 10 .6 1% 0. 82 4 in tu iti ve st yl e 4 11 .0 5% 0. 77 5 r at io na l st yl e 4 13 .2 9% 0. 74 0 d ep en de nt s ty le 4 8. 90 % 0. 70 5 d ep en de nt st yl e 4 9. 34 % 0. 70 5 d ep en de nt st yl e 4 10 .9 4% 0. 70 5 sp on ta ne ou s st yl e 2 7. 54 % 0. 69 7 sp on ta ne ou s st yl e 4 8. 07 % 0. 60 9 sp on ta ne ou s st yl e 4 9. 54 % 0. 60 9 n on -r at io na l st yl e 4 6. 51 % 0. 60 2 h ig h sp ee d st yl e 2 5. 55 % 0. 41 3 68 edvard kolar, matej tušak: decision-making style structure of slovenian sports managers , 47–73 annales kinesiologiae • 13 • 2022 • 1 making decisions, sports managers use a combination of all five decision-making styles (scott & bruce, 1995; thunholm, 2004; avsec, 2012; faletič & avsec, 2013). slovenian sports managers mostly use the rational (atilgan & kaplan, 2022) and dependent decision-making styles, indicating that they are mostly rational decision-makers. rational decision-makers characteristically follow a decision-making process involving the critical evaluation of evidence and a structured process that requires time and conscious effort before making and implementing decisions (fitzgerald, mohammed & kremer, 2017). rational and intuitive decision-making styles are defined as functional decision-making styles, the use of which leads to various positive outcomes (faletič & avsec, 2013; alacreu-crespo, et. al, 2019). in contrast to a number of other studies, in our sample, the dependent decision-making style emerged as the second most used style (spicer & sadler-smith, 2005; curşeu & schruijer, 2012; erenda, meško & bukovec, 2014; alacreu-crespo et al., 2019; el othman et. al, 2020). the dependent decision-making style has a statistically significant positive correlation with emotional (seeking moral support) and instrumental social support (seeking advice, help and information from others). connection with both aspects of support indicates that individuals who predominantly use the dependent decision-making style, seek support within their environment for the decision-making processes (alacreu-crespo et al., 2019). however, it has to be emphasized that the dependent style is not necessarily dysfunctional, as it also correlates with positive outcomes when it is defined on the basis of behaviour, such as seeking advice and support and not shifting responsibility to others (faletič & avsec, 2013; fischer et. al, 2015). frequent use of the dependent decision-making style in slovenian sports managers is probably related to specific characteristics for this type of organization (young, 1998; kolar & jurak, 2014). sports managers mostly work in interest-type associations, where the interests of various participants and stakeholders (athletes, volunteers, employees, associations, the state, local communities, sponsors, etc.) overlap or are even in conflict. managers need to constantly coordinate and consider all these interests in the decision-making processes in order to achieve the organization’s strategic and operational goals (parent, 2010). in these organizations, there is also a “unique” governmental-managerial process, led by a committee of elected volunteers (governmental organizational function) who form very sensitive relations with the professional (management) staff (young, 1998; kikulis, slack & hinings, 1995). when regulating this process, the managers are in a subordinate position, as they are appointed by the governmental function and therefore need to act in accordance with the interests of the government. in order to avoid a conflict between the managerial and governmental structures, the managers depend on the opinions, directions and decisions of the government, otherwise the negative consequences would mostly be reflected on the managers. the structure of decision-making styles also shows that sports managers use an intuitive and spontaneous decision-making style to a lesser extent, which means that they are less likely to make decisions quickly, unconsciously and based on experience (simon, 1987; epstein, 1994; kahneman, 2003; dane & pratt, 2007). this is probably also related to the aforementioned specifics of this type of organization. sports managers use an avoidant decision-making style least often or to a negligible extent, which annales kinesiologiae • 13 • 2022 • 1 69 edvard kolar, matej tušak: decision-making style structure of slovenian sports managers , 47–73 is good, because this decision-making style is defined as pathological and dysfunctional and, as such, does not lead to decisions (mitchell, shepherd & sharfman, 2011; faletič & avsec, 2013). finally, it is necessary to mention the recognized connection between the rational and the dependent styles, which are together also classified as a non-functional decision-making style. since the structure of the decision-making styles in our sample is dominated by the rational decision-making style, we could conclude that this forms a dependent-rational decision-making style, which can be characterized as functional (faletič & avsec, 2013; fischer et. al, 2015). it is typical for such decision-makers to seek advice, opinions and knowledge from colleagues when making decisions, thus using the dependent style and increasing the rationality of their decisions (vroom, 2003; khasawneh, alomari & abu-tineh, 2011). such an understanding is in accordance with the theory of extended rationality (secchi, 2010), where a decision-maker reduces the influence of the limitations of rationality, which arise from an individual’s abilities to acquire and process information (simon, 1976). conclusion the decision-making process of managers has an important impact on the development and growth of sports organizations; therefore, the knowledge of the way managers make decisions is very important. in the present study, we found that the structure of the decision-making styles of slovenian sports managers is formed as a combination of five decision-making styles, with the rational and dependent decision-making styles being predominant. we can conclude that the recognized average structure of decision-making styles is functional and healthy; furthermore, slovenian sports managers are, on average, rational decision-makers who, due to the specific organizational characteristics of sports organizations, look for confirmation and opinions on future decisions in the broader environment of the organizations’ stakeholders. this study also developed an instrument for measuring the decision-making styles of sports managers, which assumes a five-factor structure of decision-making styles and is consistent with the gdsm inventory developed and proposed by scott and bruce (1995). by using the questionnaire, it is possible to predict the behaviour of individual decision-makers in decision-making situations, which can be an important tool when choosing a manager for an individual sports organization or placing them in the overall organizational structure of a sports organization. limitations of the study there are some limitations that should be considered for a more valid understanding of the results obtained. the participants completed the questionnaire online and this may have influenced the results. the study could be improved with a larger sample, 70 edvard kolar, matej tušak: decision-making style structure of slovenian sports managers , 47–73 annales kinesiologiae • 13 • 2022 • 1 which means that we need to be careful when generalizing the 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(1998). nonprofit management studies in the united states: the state of the art. european journal for sport management, 5(2), 30–44. _hlk119322918 _hlk110178216 _hlk38187602 _hlk120196417 _hlk120196458 _hlk117871780 _hlk117865098 _hlk118123043 _hlk118137344 _hlk70951511 annales kinesiologiae • 6 • 2015 • 1 39 injury risk factors in children and youth in physical / sports activity marina dobnik university of primorska, faculty of mathematics, natural sciences and information technologies, applied kinesiology glagoljaška 8, 6000 koper, slovenia tel: +386 40 779 779 e-mail: marina.dobnik@gmail.com abstract purpose: the aim of the article is to define the injury risk factors in physical / sports activity and how they may correlate. methods: a systematic review of electronic databases medline, google scholar, sciencedirect and cinahl in may 2015 has provided potentially suitable articles, 10 of which were deemed original for a further detailed review. the studies include children and youth aged 0 to 19 and consider different possible injury risk factors in children in physical / sports activity. results: the majority of article authors (7) in selected studies share the opinion that rather than in girls, injuries are more common in boys. one of the authors claims that the factor of gender carries no substantial emphasis. the highest number of physical / sports activity-related injuries occurs in older children and adolescents. one of the selected studies finds that overweight youth develop a higher risk of sports injuries. the opinions of the authors differ when it comes to the level of physical / sports activity. some authors conclude that children who are more active suffer fewer injuries, while other authors believe the actively involved children to be subject to a higher number of injuries. younger children (up to the age of 12) are subject to injuries while involved in an unorganised type of activity, whether during active games outside or inside, walking or running freely. older children and adolescents (aged above 12 years) sustain injuries more often in an organised type of activity. conclusion: given the selected studies we were not able to introduce general conclusions regarding the connection between various injury risk factors, since all studies partially differ from each other, regarding age range of study participants, geographical sampling, selected injury risk factors, and different injury definitions. it can be concluded that a higher level of physical / sports activity brings a higher risk of injury. keywords: physical activity, occurrence, fractures, aerobic fitness, motor skills, health. review article udc: 616-001:796.01-053.3/.6 received: 2015-09-08 mailto:marina.dobnik@gmail.com 40 marina dobnik: injury risk factors in children and youth in physical / sports activity, 39–57 annales kinesiologiae • 6 • 2015 • 1 dejavniki tveganja poškodb otrok in mladostnikov pri gibalni/športni aktivnosti izvleček namen: namen prispevka je ugotoviti, kateri so dejavniki tveganja poškodb pri gibalni/športni aktivnosti, ter ugotoviti morebitne povezave med njimi. metode: s sistematičnim pregledom elektronskih baz podatkov medline, google scholar, sciencedirect in cinahl smo v maju 2015 poiskali potencialno primerne članke in 10 izvirnih vključili v detajlni pregled. študije zajemajo otroke in mladostnike, stare od 0 do 19 let, in raziskujejo možne dejavnike tveganja poškodb otrok pri gibalni/ športni aktivnosti. rezultati: večina avtorjev člankov (7) izbranih študij je mnenja, da se večkrat poškodujejo fantje kot dekleta oziroma eden od avtorjev navaja, da je velikost efekta spola zanemarljiva. največ poškodb zaradi g/ša nastane pri starejših otrocih in pubertetnikih. ena od izbranih študij ugotavlja, da imajo debeli mladostniki večje tveganje za nastanek športnih poškodb. pri nivoju g/ša so mnenja avtorjev deljena. nekateri avtorji so ugotovili, da se aktivnejši otroci manj poškodujejo, drugi avtorji menijo, da se aktivnejši poškodujejo večkrat. mlajši otroci (do 12 let) se največkrat poškodujejo v neorganizirani obliki vadbe, med aktivno igro na prostem ali v notranjih prostorih, hojo ali tekom naokoli, starejši otroci in pubertetniki (nad 12 let) pa pogosteje v organiziranih oblikah vadbe. zaključek: na podlagi izbranih študij ni mogoče podati splošnih zaključkov glede povezave med različnimi dejavniki tveganja poškodb, saj se vse študije deloma razlikujejo med sabo, bodisi s starostnim razponom udeležencev študij, z geografskim zajemom vzorca, z izbranimi dejavniki tveganja poškodb in v različni definiciji poškodb. zaključimo lahko, da s količino g/ša obstaja tudi večje tveganje za nastanek poškodb. ključne besede: telesna dejavnost, pojavnost, zlomi, aerobna vzdržljivost, motorične sposobnosti, zdravje introduction in the recent years, we have been witnessing a great transition and a growing number of scientific results of how physical / sports activity (hereinafter referred to as p / sa) and physical training effect growth and development, functional capacities, as well as the prevention of numerous early-stage chronic diseases, regarded as the results of the p / sa level in adulthood (završnik & pišot, 2005). although p / sa brings numerous health benefits, e.g. affecting the fundamental motor skills (okely, booth, & patterson, 2001), preventing obesity (wong et al., 2008), annales kinesiologiae • 6 • 2015 • 1 41 marina dobnik: injury risk factors in children and youth in physical / sports activity, 39–57 coronary heart disease, type 2 diabetes mellitus, hypertension, and osteoporosis (hallal, victoria, azavedo, & wells, 2006), it also presents a certain injury risk. given the physical and physiological differences between children and adults, children seem to be more susceptible to certain injuries, e.g. slipped capital femoral epiphysis and “osgood-schlatter’s” (emery as cited in theisen et al., 2014). consequently, the results from studies in adults cannot be used to describe the extent and injury risk factors in children. injuries in children are generally less serious than in adults (collard et al., 2008); however, they are more frequent in sports and physical activities, and are, as such, of great importance for public health and as an economic burden. the long-term consequences of sports injuries in childhood often emerge in adulthood (accelerated development of osteoarthritis) (saxon, finch, & bass, 1999). along with the p / sa-related shortand long-term consequences, medical costs arise (economic burden to a country). the social and economic effect encompasses the indirect injury-related costs as well, e.g. the absence from work of parents of injured children (sick leave due to rehabilitation programme and health care of injured children, transportation to physiotherapy facilities, etc.) (cumps, verhagen, annemans, & meeuse, 2008). the key to developing preventive programmes is to define the p / sa-related injury risk factors and mechanisms (van mechelen et al. as cited in collard et al., 2008). risk factors are divided into two categories (van mechelen et al. as cited in collard et al., 2008; meeuwisse et al., 2007; frisch, croisier, urhausen, she, & theisen, 2009): • intrinsic risk factors or characteristics related to individuals, including age, gender, body composition, previous injuries, aerobic fitness, and skill level; • extrinsic (environmental) risk factors or characteristics not related to individuals, including sports factors, protective equipment, and sports equipment. the following paragraphs will concentrate on the selected intrinsic p / sa-related injury risk factors, since mixed opinions and findings are common in these cases. using the term p / sa, any movement having higher energy consumption than inactivity (pišot, 2004) will be taken into consideration. this means all types and forms of physical / sports activity, including physical activities in school, at home, in leisure time, outside, in sports, when going to school, etc. age there are several studies that consider age a possible injury risk factor; these studies differ though, since they focus on a narrow age range, which makes it difficult to determine any possible connections between age and injury incidence. moreover, different research methods are used. apparently, the authors of the studies ascertain that children aged 13 or more face a higher injury risk than younger children (emery as cited in theisen et al., 2014). similar goes for young athletes, since athletes in puberty are more susceptible to injuries than athletes who have not reached puberty yet. it has been ascertained that team sports represent a higher risk factor (up to 2 times) compared to individual sports (frisch, urhausen, croisier, windal, & theisen, 2011). 42 marina dobnik: injury risk factors in children and youth in physical / sports activity, 39–57 annales kinesiologiae • 6 • 2015 • 1 gender the authors have a mixed opinion on gender being an injury risk factor. several articles show that boys develop a higher risk of injuries (fras, 2002; koprivnik et al., 2012); however, the findings seem to depend on the specificity of the injuries. this is why murphy et al. (2002) determine that girls are subject to a higher risk of anterior cruciate ligament injury, as well as severe knee injuries. we find the studies to be very diverse, which again makes the generalisation of the results difficult. body composition we have observed that quite a few studies search for the connections between body composition and injuries, but the results cannot be generalised, since different authors resort to different techniques for measuring body composition, e.g. height and mass, lean muscle mass, body fat content or body mass index (murphy et al., 2002). emery (as cited in theisen et al., 2014) ascertains that taller and heavier athletes are more susceptible to injuries; however, the relationship between the body size and the performance variable is not necessarily linear (welsman & armstrong as cited in collard et al., 2008). physical abilities in literature, there are only a few studies that mention the connection between aerobic fitness and injuries. the authors of these studies use different terminology to characterise the term aerobic fitness, which makes it hard to compare various conclusions (taimela et al., 1990). in connection with physical abilities, personal characteristics have a special meaning − not only for success in sports but also for preventing injuries; it has been ascertained that poor balance (shown as an example of risk factor in soccer) was connected to a higher risk of ankle sprains in older adolescent soccer players (mcguine & keene, 2006), while in younger soccer players this connection could not be observed (frisch et al., 2011). some findings show that the strength of individual muscle groups could be connected to a specific injury such as the rupture of the anterior cruciate ligament (hewett et al., 2005) or ankle sprains (willems et al., 2005); however, there is no certain way of determining the connection between the strength of muscles and sports injuries in general (frisch et al., 2011). the fact that different studies provide different injury definitions needs to be emphasised. some authors only concentrated on injuries that required medical or professional attention, while others focused on injuries where professional attention was not needed and home treatment sufficed; additionally, there are others who only considered sports injuries. as such, this vast range of injury definitions between individual studies could annales kinesiologiae • 6 • 2015 • 1 43 marina dobnik: injury risk factors in children and youth in physical / sports activity, 39–57 affect the results of the studies and, consequently, lead to a poor comparison of the findings. this demands a careful approach to the use of injury definitions. due to a current low level of activity in children and youth, lately there have been efforts emerging to raise the levels of physical activity, aerobic fitness and motor skills in children and youth. until now, little attention in literature has been paid to the question, whether it would be logical to expect a higher number of injuries when given a higher level of physical activity or whether a higher level of physical activity, better aerobic fitness or motor skills could protect children from suffering from injuries during physical activity or even in other circumstances. therefore, we will try to find out whether gender, age, weight, type of exercise and level of p / sa present the p / sa-related injury risk factors. methods electronic databases medline, google scholar, sciencedirect and cinahl were used to search for suitable literature sources, including the articles published until may 2015. different keywords were used in search combinations: “risk factors”, “physical activity”, “children”, “youth”, and “injuries”. based on the keywords given we found a database of potentially suitable articles that would be used in the analysis. after reviewing the articles and based on their suitability we have opted for the ones that would be included in a detailed review. different criteria for including/rejecting an individual study have been set for the article purposes: • the participants in the study are children or youth of both genders aged 0 to 19; • the study focuses on the connections among the intrinsic p / sa-related injury risk factors; • the study includes a control group; • the study is prospective, cross-sectional, and longitudinal. results overview of studies among the potentially suitable articles found in electronic databases, ten (table 1) were selected for a detailed discussion according to their suitability; six of them are based on a cross-sectional study, three on a prospective cohort study, and one on a longitudinal study, all of which had been carried out in the netherlands, australia, switzerland, usa, canada and ireland. individual studies encompass children and youth aged 0 to 19, with the size of the sample from 100 to 7041. both, boys and girls were included in all studies. 44 marina dobnik: injury risk factors in children and youth in physical / sports activity, 39–57 annales kinesiologiae • 6 • 2015 • 1 questionnaires were used to gather the information on p / sa and other injury risk factors in children and youth, participating in the studies. one of the studies included gathering information on p / sa (extent, duration, and intensity) with the use of accelerometers (martin-diener, wanner, kriemler, & martin, 2013). information for researching the injuries that occurred during the studies were gathered with the use of questionnaire-reports on a weekly basis (bloemers et al., 2012; clark, tobias, murray, & boreham, 2011), with the use of two-week reports by the parents of children, included in the studies (schwebel, binder, mcdermott sales, & plumert, 2002), two-month parents’ reports (spinks, macpherson, bain, & mcclure, 2006), and reports after a 12-month period according to parents’ recall (martin-diener et al., 2013; richmond, kang & emery, 2012; emery & thyreman, 2009; michaud, renaud & narring, 2001) as well as reports after a 12-month period according to children’s recall (williams, wright, currie, & beattie, 1998). all the studies reported all possible injuries, except for the clark et al. (2011) study which mentioned only fractures, and the richmond et al. (2012) and emery et al. (2009) studies which focused only on sports injuries. for two years the brudvik (2000) study kept track of all the hospital-treated injuries that occurred in children involved in p / sa. filling out the questionnaires, the circumstances of individual injuries were clarified by the parents of the injured children. the bloemers et al. (2012) study defined injuries as all the injuries that caused a pause in previous activities; the spinks et al. (2006) study defined all the injuries that required administering first aid; the martin-diener et al. (2013), brudvik (2000) and michaud et al. (2001) studies defined all the injuries that required medical or professional attention; the schwebel et al. (2003) and williams et al. (1998) studies defined all the injuries where professional attention was not needed and where home treatment sufficed, or where a visit to a doctor or a hospital was paid; the richmond et al. (2012) study defined all the injuries that required medical attention; the emery et al. (2009) study defined all sports injuries that occurred in the last year, and the clark et al. (2011) study defined all the fractures regardless the trauma level. all the studies were searching for connections between different injury factors and p / sa. the gender and age of study participants were considered possible risk factors by all studies. other injury risk factors were the p / sa level (spinks et al., 2006; martin-diener et al., 2013; richmond et al., 2012; emery et al., 2009; williams et al., 1998; michaud et al., 2001), the type of exercise (organised/unorganised type) (spinks et al., 2006; martin-diener et al., 2013; schwebel et al., 2003; richmond et al., 2012; emery et al., 2009; brudvik, 2000; williams et al., 1998; michaud et al., 2001), the environment where the injuries occurred (school, other) (spinks et al., 2006; brudvik, 2000), the type of sports (spinks et al., 2006; clark et al., 2011; emery et al., 2009, brudvik, 2000; michaud et al., 2001), the level of aerobic fitness (martin-diener et al., 2013; clark et al., 2011), selected motor skills (martin-diener et al., 2013; clark et al., 2011), body mass index (martin-diener et al., 2013; richmond et al., 2012; clark et al., 2011; emery et al., 2009), and bone mass (clark et al., 2011). annales kinesiologiae • 6 • 2015 • 1 45 marina dobnik: injury risk factors in children and youth in physical / sports activity, 39–57 age as injury risk factor the fact that the selected studies deal with different age groups makes it hard to present accurate and reliable findings. arranging studies into groups according to the approximate combined age of the participants, we see there are mixed opinions on the matter. the martin-diener et al. (2013) study shows that children between the ages of 8 and 9 are subject to a higher risk of injury when compared to children aged 7 to 8 (the study included children between the ages of 7 and 9). the schwebel et al. (2003), emery et al. (2009), brudvik (2000) and williams (1998) studies show that according to the age of the participants (6−8 years; 12–15 years; 0–6 / 6–15 years and 11, 13, 15 years of age) there are no statistically significant distinctions in injuries. although the brudvik (2000) study finds no statistically significant distinctions in injuries according to the age of participants, it shows that girls are more prone to injuries around the age of 2 and between the ages of 10–12, while boys are subject to injuries almost equally as often, regardless of age. the williams et al. (1998) study also finds that older children (15) develop a slightly higher risk of injuries than younger children (aged 11 and 13). the same study claims that the number of p / sa-related consequences (injury occurrence) increases in relation to age and is most common in 15-year-olds. the bloemers et al. (2014) study determines that the majority of all injuries occurs between the ages of 10 and 11 (the study included children aged 10 to 12). the richmond et al. (2012) study ascertains that older adolescents (18−19 years old) are subject to a higher risk of medically-treated injuries when compared to younger adolescents (12−17 years old); however, children aged 14 to 15 face the highest risk of injury in all types of injuries, not only the medically-treated. this statement is consistent with the results of the clark et al. (2011) study, since it shows that children aged 14.1 ± 1.5 suffer more fractures than children aged 13.8 ± 1.5 (the study included children and youth between the ages of 12 and 16). the latter is also consistent with the findings of the michaud et al. (2001) study which claims that the frequency of all injuries increases between the ages of 9 and 16 (peaking between the ages of 14 and 16) and decreases afterwards. a similar frequency applies to all the p / sa-related injuries. gender as injury risk factor considering all the injuries (occurring in leisure time and during organised activity), the spinks et al. (2006) and michaud et al. (2001) studies ascertain that boys suffered more injuries than girls (the spinks et al. (2006) study claims this number to be even twice as high). the schwebel et al. (2003), clark et al. (2011), brudvik (2000) and williams (1998) studies also find the injury risk level slightly higher in boys. on the contrary, the bloemers et al. (2014) study, performed on children aged 10 to 12, finds the injury risk factor higher in girls than in boys. the martin-diener et al. (2013), richmond et al. (2012), and emery and tyreman (2009) studies observe no connection between gender and risk of injuries. however, the emery et al. (2009), brudvik (2000), 46 marina dobnik: injury risk factors in children and youth in physical / sports activity, 39–57 annales kinesiologiae • 6 • 2015 • 1 and michaud et al. (2001) studies find that gender as injury risk factor in sports injuries is closely related to other injury risk factors, e.g. type of sports and type of injury. the emery et al. (2000) study shows that according to the type, most common injuries in boys are concussion, fracture or bleeding, while in girls these injuries are ligament sprains and muscle strains. the williams et al. (1998) study reports of most common type of injuries in girls to be ligament sprains and dislocations, while in boys most common injuries are dislocations (especially of the lower extremities) and fractures. p / sa level as injury risk factor lately, the p / sa level has become the main topic. the term describes the weekly amount, duration and intensity of p / sa. one of our goals was to determine whether there is a connection between the p / sa level (low, mid, and high) and a higher risk of injuries. the bloemers et al. (2012) study observes a direct connection between the p / sa level and the p / sa-related injuries, namely the risk of injuries having decreased by the increase in the p / sa level and the most active children being subject to the lowest risk of injuries, respectively (the study was performed on children aged 10 to 12). on the contrary, the richmond et al. (2012) study, performed on children and youth aged 12 to 19, reports of the connection between the level of physical activity and all types of sports injuries, proving that the participants on a higher level of physical activity are subject to a 4.2-times higher risk of injuries when compared to the participants on a lower level of physical activity. a similar opinion is expressed in the emery et al. (2009) study, determining an increased risk of sports injuries when the extent and the duration levels of p / sa are higher. regarding the level of physical activity, the martin-diener et al. (2013) study, performed on children aged 7 to 9, shows a higher injury incidence in girls than in boys. on the contrary, the spinks et al. (2006), williams et al. (1998), and michaud et al. (2001) studies ascertain the boys to be more active than the girls and at the same time to be subject to up to twice as many injuries. the spinks et al. (2006) study finds that according to the number of hours of physical activity most injuries in children occur during an organised type of exercise (participants aged 4 to 12). the richmond et al. (2012) study observes the same fact with sports injuries (participants aged 12 to 19). type of exercise as injury risk factor in the following part we focused on different types of exercise. the martin-diener et al. (2013) study has ascertained that the majority of p / sa-related injuries occur while playing outside or inside and during free (unorganised) walks or runs, regarding children between the ages of 7 and 9. the schwebel et al. (2003) study reports of the same fact in children aged 6 to 8. this result is consistent with the result of the spinks et al. (2006) study that observes 504 p / sa-related injuries during the experiment, 314 (62 annales kinesiologiae • 6 • 2015 • 1 47 marina dobnik: injury risk factors in children and youth in physical / sports activity, 39–57 %) of which occurred outside of school environment, with 94 (30 %) cases presenting serious injuries that demanded professional attention. while the bloemers et al. (2014) study finds no connection between physical education in school and increased risk of injuries in children aged 10 to 12, the richmond et al. (2012) and michaud et al. (2001) studies discover a slightly increased risk of injuries in organised types of exercise. similar conclusions are drawn also by the emery et al. (2009) study, determining that among all the children suffering at least one injury at the time of the study, there were 70.53 % of those who had been taking part in organised sports activities, either in clubs or in school sports teams, where the injuries occurred. similar conclusions are also mentioned in the williams et al. (2009) study which finds that 25.1 % of all the injuries occur within the official sports activities (organised in schools or clubs), whereas 7.9 % occur during unorganised types of exercise. physical and functional capacities as injury risk factor we were interested in exploring physical capacities and aerobic fitness in children and youth, since it is a very interesting and rarely investigated p / sa-related injury risk factor, and especially because the opinions on the matter in the available literature and in public are very diverse. among the studies reviewed, the martin-diener et al. (2013) study, performed on children aged 7 to 9, proved that a low level of aerobic fitness and a high level of motor skills are connected to the risk of injuries, given the level of impartially measured p / sa. the study also showed that injury incidence was higher in children with the lowest level of aerobic fitness, compared to those with the mid-level of aerobic fitness. injury incidence was higher in children with a high level of motor skills, compared to those with a normal range of motor skills. while the clark et al. (2011) study observed the fact that there is a positive connection between aerobic fitness and fractures – the highest incidence of fracture was noticed in participants with low-strength fist clenching – it could not establish the connection between high-strength fist clenching and a high level of aerobic fitness. the study also showed that children with a higher level of aerobic fitness, suffering from fractures, were taller, meaning this study proved that individuals with the highest level of aerobic fitness and the lowest strength in fist clenching were subject to a higher risk of fracture. additionally, the study showed that the individuals with the highest level of aerobic fitness and the lowest vertical jump were subject to a higher risk of fracture as well. bone mass can be regarded as one of the most interesting risk factors. the clark et al. (2011) study ascertained a strong connection between the strength of fist clenching and the bone mass measurements. the authors believe that muscles can play a very important role in protecting the bones, since they absorb the extra shock or stress. 48 marina dobnik: injury risk factors in children and youth in physical / sports activity, 39–57 annales kinesiologiae • 6 • 2015 • 1 body mass index as injury risk factor one of the most interesting p / sa-related injury risk factors is the body mass index of children or youth. the martin-diener et al. (2013), clark et al. (2011), bloemers et al. (2012), and emery et al. (2009) studies did not find any connection between overweight children (aged 7 to 9, 12 to 16, 10 to 12, and 12 to 15) and an increased risk of injuries. the richmond et al. (2012) study also could not show any statistical connection between all the injuries and the overweight youth, when compared to the normal-weight youth aged 12 to 19. the same study found a connection between overweight youth and an increased risk of all injuries, namely overweight youth develops a higher risk of sports injuries, when compared to normal-weight youth (this connection could not be seen in professionally attended injuries). the majority of studies in our review did not report of height as a possible p / sa-related injury risk factor, except for the clark et al. (2011) study, which could not establish this connection. discussion studies included in the overview share the opinion that p / sa is beneficial to children’s health, although it can increase the risk of possible injuries. it is difficult to find existing studies in the literature which deal with the same injury risk factors in children of the same age. common injury risk factors in the studies included in the overview are age and gender. besides age and gender, the chosen studies performed in different countries, pertaining to different age groups, research other injury risk factors as well (different among studies). thus, it is difficult to define the common guidelines and offer opinion on the results of the mentioned studies. different studies offer no clear definition on physical activity-related injuries. a p / sa-related injury is a common term used to describe injuries which occur during different physical and/or sports activities and differ in their severity (serious and less serious injuries). definitions of injuries in selected studies include either all injuries (bloemers et al., 2012; schwebel et. al, 2003), or all injuries where administering first aid (spinks et al., 2006) or medical personnel (martin-diener et al., 2013; brudvik, 2000; michaud et al., 2001) were required, sports injuries alone (richmond et al., 2012; emery et al., 2009), or fractures alone (clark et al., 2011). if p / sa-related injuries were noted only through medical channels (martin-diener et al., 2013; brudvik, 2000), mostly severe or serious injuries were registered, without any records of less serious injuries. it is evident that it is hard to offer general findings on p / sa-related injuries, based on the published data of selected studies. we are well aware that studies depend on local conditions and are often directed towards researching the problems of individual sports disciplines. opinions on the connection between the p / sa-related injuries and the age factor are not standardised. the results of the selected studies foresee that older children and adolescents are most exposed to such injuries. these two groups are more frequently annales kinesiologiae • 6 • 2015 • 1 49 marina dobnik: injury risk factors in children and youth in physical / sports activity, 39–57 involved in organised sports and opt for more dangerous leisure activities; they are on the brink of or have already reached puberty in which a non-linear process of growth is present. apart from that, children of the same chronological age can differ greatly in the sense of their biological maturity and development. since the studies presented here (except for the michaud et al. (2001) study) do not report on the chronological and biological age of the participants simultaneously, it would be logical to study both combinations in the future. the michaud et al. (2001) study emphasises a higher risk of injuries regarding a child’s biological growth in comparison to the actual body weight, height, body mass index, and chronological age. gender is the next injury risk factor on which the opinions differ substantially. the majority of the authors of selected studies believes that boys are more prone to injuries (spinks et. al, 2003; clark et al., 2011; michaud et al., 2001; schwebel et al., 2003; clark et al., 2011; brudvik, 2000; williams et al., 1998) than girls, or that these connections are negligible (martin-diener et al., 2013; schwebel et al., 2003). the prevailing opinion of the general public is that boys get injured more often than girls; the reason behind it can perhaps be found in the fact that boys are usually more courageous (aggressive) than girls, they take part in more lively sports activities (soccer, basketball, etc.) in comparison to girls (e.g. dancing, etc.), and are therefore exposed to more opportunities to injure themselves (taimela et al., 1990). the reasons for injuries in girls could include anatomic, hormonal and neuromuscular factors (murphy et al., 2002). adolescent girls usually reach their maximum height approximately at the age of 12, which makes them clumsier and more prone to injuries during this period. it is possible that the results differ in regards to the fact which geographical area the study was performed in. it would be interesting to study the correlation between the gender and the age of children and youth and the p / sa-related injuries in slovenia. since there have been a lot of efforts over the past few years to increase p / sa among children and youth, the findings concerning the p / sa intensity level and the p / sa-related injuries are of great interest. some authors believe that more active children are less prone to injuries (bloemers et al., 2012; martin-diener et al., 2013), while others feel that more active children are more likely to get injured (richmond et al., 2012; williams et al., 1998; emery et al., 2009). a question that arises here is which child is active and which one inactive, and where the line between both groups of children can be drawn. almost all studies have measured the level of physical activity with questionnaires (the question of the reliability of answers arises), while the martin-diener et al. (2013) study was the only one that used accelerometers, producing impartial results. an interesting p / sa-related injury risk factor is also the body mass index in children and adolescents. most authors of these studies who have researched this correlation (martin-diener et al., 2013; clark et al., 2011; richmond et al., 2012; emery et al., 2009) did not find any connection between over-weight children (aged 7–9, 12–16, 12–19, 12–15) and the increased p / sa-related injury risk. moreover, richmond et al. (2012) determined that over-weight young people are more sports injury-prone than those of normal weight. it should be taken into account that the latter authors focused mainly on sports injuries and not on any other potential injuries that could arise during 50 marina dobnik: injury risk factors in children and youth in physical / sports activity, 39–57 annales kinesiologiae • 6 • 2015 • 1 p / sa. it should also be clear that all the studies which research the mentioned correlation (clark et al., 2011; martin-diener et al., 2013; richmond et al., 2012; emery et al., 2009) used the data on height and weight of each individual for the measuring of the body mass index. more precise and reliable results could be attained by body composition analysis measurements. strel et al. (2008) determined that in the period between 1987 and 2007 the share of over-weight and obese young people in slovenia, aged between 6 and 19, increased from 15.6 % to 28.9 % in boys and from 15.6 % to 24.1 % in girls. other authors (malina et al., 2005; pišot & planinšec, 2005) also determined that the modern way of living influences the increase in over-weight body mass, which can often lead to improper physical and motor-skill development (horvat & magajna, 1989; marjanovič & zupančič, 2004). the mentioned process can be transferred also onto the active period of adulthood (fras, 2002) and results in different injuries and illnesses, which effectively decreases the quality of life of an individual and the society as a whole. it would be interesting to study whether over-weight children are also clumsier and inept or if they have disproportionally developed elementary motor-skill patterns, and are consequently not taking part in physical activities enough or spend their leisure time mainly in front of computers and tvs. as mentioned in the results chapter, the field of motor-skill development, as a potential predictor of injuries, often remains overlooked. there are opposing opinions on this subject in the selected studies. early studies (angle as cited in schwebel et al., 2002) mention pe teachers who assessed that children with inferior motor skills suffer more injuries in school environment. others have established that boys with better motor skills (assessed by their mothers) and girls (assessed by sports educators) get injured more often (angle as cited in schwebel et al., 2002). an extensive study, made in the 1980s about children’s motor skills and injuries, was a longitudinal study which included 822 children from dunedin in new zealand. in the study, children were observed from their birth up to the age of 7 (langley, silva, & williams as cited in schwebel et al., 2002). it was determined that stronger and motorically more skilled children injured themselves more often, while a positive correlation between the child’s history of injuries (from their birth up to age 7), bigger muscular strength and dexterity was also determined. it was also established that agility and delicate motor skills are not connected to the history of injuries. the findings of studies from the past are quite different and mixed. positive as well as negative relations between both variables were observed in the past. one of the most comprehensive studies up till now (langley et al. as cited in schwebel et al., 2002) determined a positive correlation between an injury and well-developed motor skills – especially strength, followed by coordination, balance, and agility. this finding is contrary to the belief that clumsy children (those with bad coordination and balance) get injured most often. if motorically (less) capable or (in)competent children are to be related to the findings of the selected studies, in which authors dealt with organised and non-organised exercise, some interesting questions can be posed and connections established. martin-diener et al. (2013) have determined in their study that most physical activity-related injuries in children aged 7 to 9 occur while playing outside or inside, while walking annales kinesiologiae • 6 • 2015 • 1 51 marina dobnik: injury risk factors in children and youth in physical / sports activity, 39–57 or running freely – unorganised activities. these findings have also been confirmed by schwebel et al. (2003) in their study which included children of ages between 6 and 8, and spinks et al. (2006) who determined that the majority (62 %) of all injuries occurred outside the school environment. the brudvik (2000) study also determines that 62 % of children aged 0–6 are subject to injuries occurring at home or in the close proximity, while only 13 % of children’s injuries occur in the kindergarten; 37 % of children aged 6–15 sustain injuries at home, 25 % in school, and 10 % in organised sports activities. what is also interesting are sports injuries mentioned in the emery et al. (2009) study, including 12–15-year-olds, where the study finds that the majority of sports injuries (70.53 %) occur in organised types of activity, either in clubs or school sports teams. thus, we can deduce that younger age groups (mainly pre-school children or lower-grade school children) sustain injuries more often during leisure or unorganised activities, whereas older children (aged 12 and above) tend to take part in organised types of exercise more often, which results in more injuries. in the future, it would be sensible to study in greater detail why most injuries in children of lower age groups occur during their leisure time (during unorganised activities), when they are left to do what they want. are these injuries a result of the (in)consistency of elementary motoric patterns, physical characteristics, child’s motor skills, or maybe the over-protectiveness of their parents or the environment itself or maybe even of overestimating their own physical abilities. therefore, future studies, made on the basis of the mentioned results and findings, should form a model which would predict the possibility of injuries on the basis of predicators, deriving from the consistency of elementary motoric patterns, physical characteristics, and motor skills. conclusion the development in the early childhood is very dynamic and wholesome. within this period, p / sa are of great significance, since they represent important means for acquiring different information and new experience as well as for the development of motor and functional capacities. children are most susceptible to the changes and the development of skills and knowledge as well as to the adaption to the environment and its characteristics before they hit puberty (pišot & planinšec, 2005). i believe that children or adolescents will acquire experience only by being free and allowed to make their own mistakes, go through some awkward situations such as for example the p / sa-related injuries, thereby testing the limitations of themselves and the world around them. to make their journey as painless as possible, it is up to us to include children in an encouraging environment right from the start, in which they will be able to develop their motor skills and gather motor-skill knowledge and experiences. in order to secure such an encouraging environment, it is important to research the field of p / sa-related injuries and injury risk factors in greater detail. in regards to the chosen studies and their findings, reliable conclusions actually cannot be drawn, since different studies are based on different data and a different selection 52 marina dobnik: injury risk factors in children and youth in physical / sports activity, 39–57 annales kinesiologiae • 6 • 2015 • 1 st ud y ty pe o f s tu dy a ge , l oc at io n, sa m pl e in ju ri es in ju ry ri sk fa ct or s r es ul ts – is th er e a co nn ec tio n be tw ee n a ri sk f ac to r an d th e p/ sa -r el at ed in ju ri es ? b lo em er s et a l. (2 01 2) pr os pe ct iv e co ho rt a ge : 1 0– 12 c ou nt ry : n et he rla nd s n : 9 95 d : a ll in ju ri es th at s to pp ed a ny on go in g ac tiv iti es . a : w ee kl y re po rt s a ge g en de r p / s a le ve l e xe rc is e ty pe ph ys ic al /f un ct io na l c ap aci tie s b od y m as s in de x y es y es y es n o n ot re po rt ed n o sp in ks e t a l. (2 00 6) pr os pe ct iv e co ho rt a ge : 4 –1 2 c ou nt ry : a us tr al ia n : 7 67 d : a ll in ju ri es th at re qu ir ed a dm ini st er in g fir st a id . a : p ar en ts re po rt in g ev er y tw o m on th s a ge g en de r p / s a le ve l e xe rc is e ty pe n ot re po rt ed y es y es y es m ar tin -d ie ne r et a l. (2 01 3) c ro ss -s ec tio na l a ge : 7 –9 c ou nt ry : s w itz er la nd n : 2 49 d : a ll in ju ri es th at re qu ir ed m ed ica l o r p ro fe ss io na l a tte nt io n. a : p ar en ts re po rt in g w ith a 12 -m on th re ca ll a ge g en de r, p / s a le ve l e xe rc is e ty pe ph ys ic al / fu nc tio na l c ap aci tie s b od y m as s in de x y es n o y es y es n o sc hw eb el e t a l. (2 00 3) l on gi tu di na l a ge : 6 a nd 8 c ou nt ry : u sa n : 1 00 d : a ll in ju ri es th at re qu ir ed n o at te nt io n, tr ea te d at h om e or b y a do ct or / in a h os pi ta l. a : p ar en ts re po rt in g ev er y 2 w ee ks a ge g en de r e xe rc is e ty pe n o y es y es ta bl e 1: s um m ar y of s tu di es in cl ud ed in th e re vi ew a rt ic le annales kinesiologiae • 6 • 2015 • 1 53 marina dobnik: injury risk factors in children and youth in physical / sports activity, 39–57 r ic hm on d et a l. (2 01 2) c ro ss -s ec tio na l a ge : 1 2– 19 c ou nt ry : c an ad a n : 4 33 9 d : a ll sp or ts in ju ri es th at re qu ire d m ed ic al a tte nt io n. a : p ar en ts re po rt in g w ith a 12 -m on th re ca ll. a ge g en de r p / s a le ve l e xe rc is e ty pe b od y m as s in de x y es n o y es y es y es c la rk e t a l. (2 01 1) c ro ss -s ec tio na l a ge : 1 2– 16 c ou nt ry : n or th er n ir el an d n : 1 59 0 d : a ll fr ac tu re s, re ga rd le ss o f t he le ve l o f t ra um a. a : q ue st io nn ai re w ith w ee kl y re po rt in g a ge g en de r ph ys ic al / fu nc tio na l c ap aci tie s b od y m as s in de x y es y es y es n o e m er y an d ty re m an (2 00 9) c ro ss -s ec tio na l a ge : 1 2– 15 y ea rs c ou nt ry : c an ad a n : 1 46 6 d : s po rt in ju ry w as d efi ne d as a po si tiv e re sp on se to th e qu es tio n: “h av e yo u su st ai ne d at le as t o ne sp or ts in ju ry in th e pa st y ea r? a : w eb -b as ed q ue st io nn ai re w ith a 12 -m on th re ca ll pe ri od a ge g en de r p / s a le ve l e xe rc is e ty pe b od y m as s in de x n o n o y es y es n o b ru dv ik (2 00 0) pr os pe ct iv e co ho rt a ge : 0 –6 y ea rs an d 6– 15 y ea rs c ou nt ry : n or w ay n : 7 04 1 d : a ll in ju ri es th at re qu ir ed m ed ica l a tte nt io n. a : q ue st io nn ai re fo r p ar en ts , tw oye ar m ed ic al re co rd s a ge g en de r e xe rc is e ty pe y es y es y es w ill ia m s et a l. (1 99 8) c ro ss -s ec tio na l a ge : 1 1, 1 3, a nd 15 y ea rs c ou nt ry : s co tla nd n : 4 71 0 d : a ll in ju ri es in th e la st 1 2 m on th s. a : q ue st io nn ai re fo r c hi ld re n w ith a 1 2m on th re ca ll pe ri od a ge g en de r e xe rc is e ty pe p / s a le ve l n o y es y es y es m ic ha ud e t a l. (2 00 1) c ro ss -s ec tio na l a ge : 9 –1 9 ye ar s c ou nt ry : s w itz er la nd n : 3 51 6 d : a ll in ju ri es th at re qu ir ed m ed ica l a tte nt io n. a : q ue st io nn ai re fo r p ar en ts w ith a 12 -m on th re ca ll pe ri od a ge g en de r e xe rc is e ty pe p / s a le ve l y es y es y es y es n n um be r, a a ss es sm en t, d d efi ni tio n 54 marina dobnik: injury risk factors in children and youth in physical / sports activity, 39–57 annales kinesiologiae • 6 • 2015 • 1 of risk factors, which limits our conclusions. it is confusing that the same risk factors in different studies bring different results. on the one hand, some studies offer positive correlations, while on the other there are negative correlations – there is no common denominator. maybe this depends on the geographic area in which the study was made. although primarily selected studies, which in individual parts explained different levels of p / sa-related injury-occurrence, differed methodologically, they showed p / sa-related injuries to be significant, representing a large portion of all injuries among children and adolescents in different countries of the world. the fact that injuries usually do not occur due to just one risk factor, should also be taken into consideration. the results would probably be more standardised if the selected studies included injury risk factors in a more complex manner. if we take for example the level of p / sa as an injury risk factor, some authors of the selected studies predominantly determined that more active children get injured less often, but on the other hand, other authors determined just the opposite. therefore, it would be sensible to determine the correlations between completely non-active children and active children who take part in p / sa and are therefore more exposed to injuries, and, thereby, to establish what influences the occurrence of such injuries. perhaps the reason lies in the (in)consistency of elementary motoric patterns, in physical characteristics, perhaps in a child‘s motor skills, parents‘ over-protectiveness, in the environment or in overestimating one‘s own physical capabilities. to develop an appropriate policy and prevention strategies in slovenia, concerning the prevention of p / sa-related injuries among children and adolescents, it would be wise to thoroughly study different p / sa-related injury risk factors in children. thus, the definition of p / sa-related injuries should be unified, taking into account formal (organised) types of sports exercise as well as informal (unorganised, leisure) types of physical activities. the injuries differ in type (sprain, fracture, dislocation, etc.) and mechanism. it should be taken into account that sports disciplines differ significantly, meaning that all injuries sustained in sports activities should not be generalised for all sports disciplines. each sports discipline has its own set of rules and characteristics, within which there are specific risk factors which demand special attention (especially of the coaches in organised sports disciplines). within each sports discipline we can expect certain types and mechanisms of injuries to have a greater occurrence probability. as already mentioned, the results of the selected studies cannot be generalised, since studies pertain to different age groups. can the sample in the selected studies actually represent the entire population? all these are methodological limitations, due to which all the data on p / sa-related injuries in the selected studies and other published literature differ. therefore, the selected studies are a good starting point towards the direction, mentioned already in the discussion – towards establishing a model which would predict the possibility of injury occurring on the basis of predicators, deriving from the consistency of elementary motoric patterns, physical characteristics, and motor skills. with such a model of predicting and classifying injuries, the findings could maybe predict the trends being introduced in these fields, and by that provide the possibilities for the deannales kinesiologiae • 6 • 2015 • 1 55 marina dobnik: injury risk factors in children and youth in physical / sports activity, 39–57 velopment and establishment of intervention measures and introduce some guidelines for the prevention of injuries due to child‘s potential motoric (in)competence. pišot et al. 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(2005). gibalna/športna aktivnost za zdravje otrok in mladostnikov. koper: založba annales, univerza na primorskem, znanstveno raziskovalno središče, inštitut za kineziološke raziskave. http://dx.doi.org/10.1016/j.jsams.2012.11.898 http://link.springer.com/content/pdf/10.2165%2f00007256-199928020-00005.pdf http://dx.doi.org/10.1016/s0022-4375(02)00073-7 http://injuryprevention.bmj.com/content/12/6/390.short http://link.springer.com/article/10.2165/00007256-199009040-00002 http://www.nrcresearchpress.com/doi/pdf/10.1139/h07-182 http://www.nrcresearchpress.com/doi/pdf/10.1139/h07-182 http://ajs.sagepub.com/content/33/3/415.full http://bjsm.bmj.com/content/32/4/291.full.pdf+html http://annals.edu.sg/pdf/37volno4apr2008/v37n4p286.pdf _enref_26 _goback _goback _goback _goback bm3 _goback _goback annales kinesiologiae • 6 • 2015 • 2 93 an overview of training methods that promote the highest lipid oxidation during and after a single exercise session barbara purkart1, boštjan šimunič2, mitja gerževič2 1physiotherapy centre barbara purkart k.d., ulica gradnikove brigade 8, 1000 ljubljana, slovenia 2university of primorska, science and research centre, institute for kinesiology research, garibaldijeva 1, 6000 koper, slovenia corresponding author: mitja gerževič university of primorska, science and research centre, institute for kinesiology research, garibaldijeva 1, 6000 koper, slovenia tel.: +386 5 663 58 05, +386 5 663 77 31 e-mail: mitja.gerzevic@zrs.upr.si abstract given that physical activity is the most effective way to increase lipid oxidation, its effects are influenced by several factors. the goal of this review was to identify the most effective methods that facilitate the highest lipid oxidation during and after a single exercise session. for this purpose, the available scientific literature was examined using pubmed, web of science, google scholar and cochrane library databases up to june 2013 with the following keywords: excess post exercise oxygen consumption, exercise fatty acid, energy expenditure exercise and interval training. from the identified 48,583 potentially relevant references, 172 of them met all the required criteria. it was found out that prolonged (> 30 min) moderate intensity (55 − 70 % vo2max) exercise such as walking, jogging or cycling is the most effective way to increase lipid oxidation during and after a single exercise session. low-volume high-intensity interval exercise is supposed to be as effective as traditional exercise with continuous endurance, with the main effect on lipid oxidation after the session and similar long-term metabolic adaptations. however, more research is still needed to compare the effects of regular resistance exercise with traditional endurance and high-intensity interval exercise. finally, nutrition is also a significant factor since food rich in fat and low in carbohydrates promotes greater lipid oxidation. keywords: endurance exercise, interval exercise, training, nutrition, fatty acid, triacylglycerol. review article udc: 796.015:613.2 received: 2015-08-07 mailto:mitja.gerzevic@zrs.upr.si 94 barbara purkart, boštjan šimunič, mitja gerževič: an overview of training methods that promote the ..., 93–118 annales kinesiologiae • 6 • 2015 • 2 pregled vadbenih metod, ki spodbudijo največjo oksidacijo lipidov med in po posamezni vadbeni enoti izvleček glede na to da je gibalna oz. telesna aktivnost najbolj učinkovit način povečanja oksidacije maščob, pa na njihovo porabo vpliva še vrsta drugih dejavnikov. cilj tega preglednega članka je bil ugotoviti vplive in najbolj učinkovite metode za spodbujanje oksidacije maščobnih kislin med vadbeno enoto in po njej. pregledali smo razpoložljive članke, ki so bili objavljeni do junija 2013 v sledečih bazah: pubmed, web of science, google scholar in cochrane library. pri iskanju smo uporabili naslednje ključne besede: poraba kisika po vadbi, poraba maščobnih kislin med telesno aktivnostjo, poraba energije med telesno aktivnostjo in intervalni trening. tako smo dobili 48.583 člankov, od katerih je našim kriterijem ustrezalo 172 člankov. ugotovili smo, da je dolgotrajna telesna aktivnost srednje intenzivnosti, kot sta hoja in lahkoten tek, najbolj učinkovit način za povečevanje oksidacije maščobnih kislin. visokointenzivna intervalna vadba je bolj učinkovita s stališča porabe energije, vendar pri enaki porabi maščobnih kislin. potrebnih bo še nekaj nadaljnjih raziskav, ki bodo primerjale učinke redne vadbe za moč ter redne klasične aerobne in intervalne vadbe za razvoj vzdržljivosti. k večji oksidaciji maščobnih kislin pomembno vpliva tudi prehrana: hrana, bogata z maščobami in z nizko vsebnostjo ogljikovih hidratov, najbolj vzpodbuja oksidacijo maščobnih kislin. ključne besede: vadba vzdržljivosti, intervalna vadba, trening, prehrana, maščobne kisline, triglicerol introduction two of the greatest health threats in modern lifestyle are imbalanced nutrition and a sedentary lifestyle. excessive diet and an increased sedentary lifestyle lead to obesity and metabolic syndrome which are both associated with numerous comorbidities (poirier et al., 2006). an excessive carbohydrate intake, especially fructose, leads to an increase in body weight, visceral adipose tissue, muscle fat, as well as liver fat; furthermore, sugar enhances lipogenesis and the production of uric acid including an increase in plasma triacylglycerols (tg) concentrations (bray, 2013). lipids are implicated in the pathogenesis of several common human diseases, including: metabolic syndrome, cardiovascular disease and type 2 diabetes (kiens, 2006). enhanced lipid oxidation might be beneficial for counteracting lipid accumulation. physical activity (pa) is the most effective way to increase lipid oxidation, due to the fact that it increases the metabolic rate (kiens, alsted, & jeppesen, 2011). during pa the body has a higher energy demand. the body provides energy for pa converting chemical energy annales kinesiologiae • 6 • 2015 • 2 95 barbara purkart, boštjan šimunič, mitja gerževič: an overview of training methods that promote the ..., 93–118 to mechanical energy and heat. this chemical energy is derived from macronutrients (carbohydrates, proteins and lipids) in the body and converted to adenosine triphosphate (atp) energy molecules, which are used for work. depending on the intensity and the duration of pa, different metabolic pathways provide energy: atp-phosphocreatine (pcr) system, anaerobic glycolysis and aerobic glycolysis with carbohydrate, protein and lipid oxidation (frayn, 2010; mcardle, katch, & katch, 2010). normally, during prolonged lowto moderatepa intensities (33 − 65 % of maximal oxygen consumption − vo2max), lipids metabolised at the highest rate, reaching their maximum at ~64 ± 4 % vo2max, whereas, at higher intensities, carbohydrates become the primary energy source (achten, gleeson, & jeukendrup, 2002; pérez-martin et al., 2001). the type of energy source used depends on several factors, not just intensity, but also duration and the type of pa (antonutto & di prampero, 1995), gender, aerobic fitness, nutrition (kiens, 2006), substrate availability within skeletal muscles (jeppesen & kiens, 2012; kiens et al., 2011), amount of fatty tissue and the neuro-hormonal influence on the oxidation (astrup et al., 1992; mittendorfer, fields, & klein, 2004). however, during pa, the lipid used for energy turnover is derived from different sources (kiens, 2006; kiens et al., 2011): blood fatty acids bound to albumin, fatty acids liberated from the hydrolysis of circulating tg and fatty acids from lipolysis of tg located in lipid droplets in skeletal muscles – muscle tg. given that endurance pa is the most effective way to increase lipid oxidation (kiens et al., 2011), its effects are influenced by several factors, and because different types of interval training and resistance exercise are used and promoted in sport and kinesiology practice, it will be the goal of this review to identify what are the influences and which are the most effective methods for facilitating the highest lipid oxidation during and after a single workout. metodhs for the purposes of this review, the available articles in pubmed, web of science, google scholar and cochrane library were analysed up to june 2013. the following keywords were used for searching: excess post exercise oxygen consumption, exercise fatty acid, energy expenditure exercise and interval training. this search strategy identified 48,583 potentially relevant references, while only 172 articles met all the search topic requirements. lipid oxidation during endurance physical activity the factors influencing lipid oxidation during endurance physical activity are: intensity, duration and type of pa, food intake, amount of fatty tissue, gender and physical fitness. 96 barbara purkart, boštjan šimunič, mitja gerževič: an overview of training methods that promote the ..., 93–118 annales kinesiologiae • 6 • 2015 • 2 effect of intensity on lipid oxidation during activity pa can be divided into low-, moderate-, and highintensity activities. in literature, boundaries between these levels are not strictly defined and they range from up to 55 % vo2max for low-intensity, from 55 % to 70 % vo2max for moderate-intensity, and exceeding 75 % vo2max for high-intensity pa. during low and moderate-intensity endurance pa, the predominant energy sources are lipids (pillard et al., 2010). lipid oxidation during high-intensity pa is lower than during moderate-intensity (jeppesen & kiens, 2012). at the beginning of the previous century, it was discovered that by measuring the respiratory exchange ratio (rer), which is the ratio between eliminated co2 and utilized o2 during respiration, it is possible to determine also the type of energy source used (scott, 2005). if rer is around 1, the body uses carbohydrates, while if it is between 0.7 and 0.8, the body uses more lipids (walsch, 2003) for energy transfer. by measuring rer, it was discovered that lipid oxidation increases from rest to an intensity level of 65 % vo2max. lipid oxidation during endurance pa that lasts from 60 to 90 min increases by 5 to 10 times (krogh & lindhard, 1920, in jeppesen & kiens, 2012; cristensen & hansen, 1939, in jeppesen & kiens, 2012). further studies using rer measurements and monitoring of isotopes have confirmed the highest oxidation of lipids during moderate-intensity endurance pa, namely, at the intensity level of 65 % vo2max, compared to low-intensity (25 % vo2max) and high-intensity (85 % vo2max) (romijn et al., 1993). with the increased intensity of pa, lipid oxidation decreases. during 30 minutes of cycling, for example, at the intensity level of 75%, lipid oxidation is lower than at the intensity level of 55 % vo2max (van loon et al., 2001). even though, it has been known for almost a century that a total amount of oxidised fatty acids during high-intensity pa is lower than during moderate-intensity pa, the mechanisms behind this are still not clear. the limiting factor of fatty acid oxidation during the transition from rest to low or moderate-intensity pa is most probably the transport of fatty acid through the sarcolemma (bonen, luiken, arumugam, glatz, & tandon, 2000; jepessen et al., 2011). when considering transition from moderate to high intensity pa, some earlier authors argue that oxidation of plasma fatty acids, lipoprotein derived tgs and muscular tgs probably decrease due to unavailability of free carnitine and / or decrease in the intracellular ph, but not as a consequence of a decrease in plasma free fatty acids availability (van loon, greenhaff, constantin teodosiu, saris, & wagenmakers, 2001). modern studies prefer the notion that the availability of free carnitine in blood is the sole factor limiting the transport of fatty acids to the mitochondria in the muscle (roepstorff et al., 2005; kiens et al., 2011; jeppensen & kiens, 2012). when considering lipid oxidation during endurance pa, moderate intensity is shown as the most effective from the point of highest lipid oxidation during pa. annales kinesiologiae • 6 • 2015 • 2 97 barbara purkart, boštjan šimunič, mitja gerževič: an overview of training methods that promote the ..., 93–118 effects of duration and type of activity on lipid oxidation during activity the type of energy source used during pa is not determined only by intensity level (as described above), but also by duration and type of pa. phosphagens (adenosine triphosphate and creatine phosphate) are used during the first 5 to 10 seconds of maximum pa, followed by (rapid) anaerobic glycolysis, if maximum effort continues beyond 10 seconds (obviously the intensity decreases). at this stage, glycolysis maintains the energy transfer up to 2 or 3 minutes, with the glycogen in the muscle as the main energy source (mcardle et al., 2010). when intense exercise continues beyond several minutes, aerobic metabolism provides nearly all of the energy transfer. at this point, fat becomes the primary energy fuel and lipid oxidation the primary process of energy transfer for exercise and recovery when high-intensity, long-duration exercise depletes glycogen (mcardle et al., 2010) or when carbohydrates sparing and promotion of fat utilization occur as a training adaptation (åstrand, rodahl, dahl, & strømme, 2003; fox & mathews, 1981). there are various lipids sources. during moderate-intensity pa, less than a half of lipids is derived from upper-body subcutaneous adipose tissue, a quarter comes from muscular tgs, and the rest is distributed among fatty acids from lower-body subcutaneous adipose tissue, intra-abdominal adipose tissue, plasma tgs and other (horowitz, 2003). if pa is so intense or long that glycogen stores are exhausted, the energy derived from glycogen breakdown is supplemented by the breakdown of proteins (kisner & colby, 2007). nonetheless, the total energy expenditure of jogging exceeds that of walking (wilkin, cheryl, & haddock, 2012), fractional lipid oxidation remains at comparable levels, since the respiratory exchange ratio does not demonstrate a discernible pattern between walking and running (stamford, 1975), meaning that carbohydrate and lipid oxidation increase simultaneously. at same relative intensity, expressed in per cent of vo2max, lipid oxidation is significantly higher while running compared to cycling (capostagno & bosch, 2010), also, more energy is being utilised (zeni, hoffman, & clifford, 1996; kravitz, robergs, heyward, wagner, & powers, 1997). when considering lipid oxidation, moderate intensity activity has to last at least 20 minutes to begin utilising lipids. the upper limit is dependable on individual body’s glycogen storage capacity, to avoid undesirable protein depletion. jogging and walking are shown to be more effective at lipid oxidation than cycling. effects of food ingestion on lipid oxidation during activity the ingested food has also an effect on lipid oxidation as muscles adjust the levels of muscle enzymes depending on the food ingested (spriet, 2011). in addition, most liver enzymes, which regulate glycolysis and fatty acid oxidation, are also regulated by nutrient availability (rui, 2014). a 7-week diet, rich in fats, increases muscles’ ability to metabolized lipids, by increasing activity of enzymes and binding proteins, involved in the process of fatty acid oxidation in the muscle (helge & kiens, 1997; kiens, 98 barbara purkart, boštjan šimunič, mitja gerževič: an overview of training methods that promote the ..., 93–118 annales kinesiologiae • 6 • 2015 • 2 2006). when untrained men were consuming fat rich diet for three days leading up to a moderate-intensity pa (cycling at an intensity of 70 % vo2max), lipid oxidation was significantly higher, compared to when they consumed a diet rich in carbohydrates (christensen & hansen, 1939, in kiens et al., 2011). in the study performed by galbo, holst, and christensen (1979), seven untrained men ran on a treadmill at 70 % vo2max intensity until exhaustion. four days prior to the pa they were consuming carbohydrate and fat rich diets respectively. when they consumed fats, their glucagon, epinephrine, cortisol and growth hormone levels rose significantly compared to the carbohydrate diet. food consumption in the days leading up to the pa affected not only their bodies’ energy stores, but also their hormone reaction, directly affecting their oxidation during pa. food rich in carbohydrates, on the other hand, promotes oxidation of glucose, production of lactate and inhibits oxidation of lipids (galbo et al., 1979). a more recent study by helge found once again a significantly greater lipid oxidation in the group that consumed fat rich diet (helge, richter, & kiens, 1996; helge, wulff, & kiens, 1998). measuring exhaustion time parameters at the same absolute workload showed that endurance performance was enhanced similarly after both two and four weeks of adaptation to training and a fat-rich or a carbohydrate-rich diet (helge et al., 1998). helge, watt, richter, rennie, and kiens (2001) also demonstrated that circulating tg made a significant contribution to fuel utilization during endurance training after adaptation to a fat-rich diet. the increased lipid oxidation observed after training (cycling 60 to 75 minutes per session at 65 to 85 % vo2max, four times per week, seven weeks) and fat diet adaptation originated from both a higher plasma fatty acid oxidation and utilization of circulating tg. in contrast, the carbohydrate sparing observed after fat diet adaptation was due to muscle glycogen sparing and not to a diminished plasma glucose uptake (helge et al., 2001). a longer-term adaptation to a fat-rich diet also leads to measurable changes in the capacity to recruit, transport and oxidize lipids (helge & kiens, 1997). another physiological process that increases lipid oxidation is starvation (cahill, 2006). in the fasted state, fatty acids are oxidized mainly in the mitochondria to generate energy supply as well as ketone bodies (rui, 2014). free fatty acid levels were increased approximately 9-fold after 60 h of fasting in healthy male subjects, leading to elevated muscular tg levels and decreased muscular insulin sensitivity (hoeks et al., 2010). despite an increase in whole-body lipid oxidation, hoeks et al. (2010) observed a reduction in mitochondrial capacity. van proeyen, szlufcik, nielens, ramaekers, and hespel (2011) investigated the effect of endurance training in the fasted state vs. training in the fed state on muscle oxidation and substrate utilization. they found out that moderate-intensity endurance training on an empty stomach significantly stimulates muscle cells to increase lipid oxidation and facilitate utilizing muscular tgs, compared to the group that consumed carbohydrates prior to, and during pa (untrained men, cycling 60 to 90 minutes daily for 6 weeks at intensity level of 70 % vo2max) (van proeyen et al., 2011). availability of endogenous fuels in muscles affects lipid oxidation in muscles as well as on the level of entire body. the amount of muscular tgs in muscles before the activity also influences lipid oxidation, in addition to intensity, duration and type of activity as well as gender, fitness level and ingested food (kiens, 2006). modeannales kinesiologiae • 6 • 2015 • 2 99 barbara purkart, boštjan šimunič, mitja gerževič: an overview of training methods that promote the ..., 93–118 rately trained boys showed 2.5 times local lipid oxidation in their muscles when they consumed fat rich diet, compared to carbohydrate rich diet (which replenished glycogen stores in muscles), at same workload (60 minutes of cycling at 65 % vo2max intensity). since it is spent for acetyl-carnitine formation, free carnitine availability significantly decreases, reducing lipid oxidation capability during endurance pa (roepstorff et al., 2005). when muscle glycogen stores are low, a two times higher concentration of fatty acids can be observed in the plasma, as well as a significantly increased concentration of enzymes and binding proteins that participate in lipid oxidation (wojtaszewski et al., 2003). it has been shown that glycogen stores are inversely proportional to the levels of free carnitine. when glycogen stores in muscles are high, there is very little free carnitine in the cells; this limits fatty acid transport into mitochondria, which consequently limits lipid oxidation in the muscles (jeppesen & kiens, 2012). the intake of carnitine dietary supplement increased ability to metabolise lipids during low-intensity endurance pa (untrained healthy men cycled for 30 minutes at 50 % vo2max intensity), a 44 % decrease in lactate concentration in the blood during high-intensity pa (30 minutes of cycling at 80 % vo2max intensity) was also observed (wall et al., 2011). this may indicate increased lipid oxidation while taking carnitine dietary supplement at higher intensities as well (jeppesen & kiens, 2012). when considering lipid oxidation, after adaptation to a high-fat diet due to an increased uptake of lipids originating from the bloodstream and only a minor extent to an increased muscle tg utilization, greater lipid oxidation is observed during pa. the intake of carnitine dietary supplement might also stimulate lipid oxidation. training on an empty stomach stimulates muscle cells to increase lipid oxidation and facilitate utilizing muscular tgs. effects of adipose tissue amounts on lipid oxidation during activity the amount of fat tissue also affects the capability of lipid oxidation. chronic imbalances between energy intake and oxidation ultimately result in excess intracellular lipid accumulation, both at the whole body level and in individual organs or tissues. obese and overweight people have a higher concentration of plasma fatty acids, most likely due to increased fatty acid release from an expanded fat mass; providing a link between obesity and ectopic lipid accumulation (savage, petersen, & schulman, 2007). “sedentary overweight subjects, compared to controls at the same exercise intensities, exhibit an alteration of the balance of substrate oxidation, reflected by lower rates of lipid oxidation and a shift of quantitative parameters to lower intensities” (pérez-martin et al., 2001). the amount of fatty acids increases as a reaction to low-intensity pa (untrained men cycling for 90 minutes at 50 % vo2max intensity). the increase in fatty acids oxidation during exercise is ≈ 50 % lower in obese and ≈ 35 % lower in overweight people when compared to lean controls (scheen, pirnay, luyckx, & lefebvre, 1983; mittendorfer et al., 2004). the obese have four times higher transport of fatty acids through sarcolemma (bonen et al., 2004) and fatty acids penetrate into muscles, where they accumulate as muscular tgs (goodpaster, theriault, watkins, & kelley, 2000). 100 barbara purkart, boštjan šimunič, mitja gerževič: an overview of training methods that promote the ..., 93–118 annales kinesiologiae • 6 • 2015 • 2 the accumulation of muscular tgs in muscles may result in insulin resistance and the development of diabetes (kelley & goodpaster, 2001). the rate of total fat oxidation, assessed by indirect calorimetry during the last 30 minutes of exercise, was not significantly different between groups: lean, overweight and obese (mittendorfer et al., 2004). that is why comparable rer levels were measured in overweight and lean untrained men (30 minutes cycling at anaerobic threshold) (wong & harber, 2006). fat oxidation provided ∼30 % of total energy requirements during the exercise in lean, overweight, and obese men. however, the source of fatty acids used as fuel during the exercise varied between groups. in lean subjects about one-half of the fatty acids oxidized during the exercise, having derived from systemic plasma fatty acids and the other half from non-systemic fatty acids. the relative contribution of systemic plasma fatty acids to total fat oxidation decreased and the relative contribution of non-systemic fatty acid to total fat oxidation increased with increasing adiposity. presumably, the predominant source of non-systemic fatty acids was the fatty acids that were released during lipolysis of intramuscular tg (mittendorfer et al., 2004). “lipid accumulation in skeletal muscle and liver may be a result of increased delivery / synthesis of fatty acids to / in these tissues in those conditions in which energy intake exceeds adipose tissue storage capacity (as seen in obesity and lipodystrophy), or a consequence of either acquired or inherited mitochondrial dysfunction” (savage et al., 2007). obese people have a lower expression of the adipose tissue hormone adiponectin (civitarese et al., 2006), which is one of the hormones (along with leptin and fgf21) that enhance mitochondrial proliferation in white adipose tissue and whole-body energy expenditure associated with the lipid burning in beige adipocytes (unger, scherer, & holland, 2013). in addition to lower hormonal response to endurance pa, ineffective lipid oxidation can be observed with obese people. they have smaller mitochondria and / or impaired oxidation process within the mitochondria thus, being handicapped in their effort to lose fat (colberg, simoneau, thaete, & kelly, 1995; borer, 2008). it is possible that “hyperinsulinemia” in overweight and obese compared with lean men contributed also to the blunted lipolytic response to exercise. although the relative decrease in plasma insulin concentration was similar in lean, obese and overweight, the absolute plasma insulin concentrations were greater during exercise in overweight and obese than in lean subjects. it is also likely that the attenuated lipolytic response to exercise in overweight and obese men was caused by a blunted increase in epinephrine secretion and a concomitant reduction in adipose tissue lipolytic response to circulating catecholamines (mittendorfer et al., 2004). “adipocyte dysfunction due to either obesity or lipodystrophy is associated with excessive and untimely delivery of fatty acids to the liver and skeletal muscle and probably contributes to insulin resistance in both organs by altering the balance between fatty acids uptake / synthesis and the disposal leading to increases in intracellular lipid content.” also, an increasingly sedentary lifestyle and the associated relative increase in fat mass almost certainly contribute to aging induced insulin resistance. muscle insulin resistance and accumulation of muscular tg precede the development of hepatic insulin resistance and type 2 diabetes (savage et al., 2007). exercise (insulin resistant boys; 45 minutes on elliptical annales kinesiologiae • 6 • 2015 • 2 101 barbara purkart, boštjan šimunič, mitja gerževič: an overview of training methods that promote the ..., 93–118 trainer) resulted in a greater than threefold increase in postprandial net muscle glycogen synthesis, reflecting improved muscle insulin responsiveness, and a ≈ 40 % reduction in net hepatic tg synthesis. the changes in the whole body energy storage were accompanied by a ≈ 30 % decrease in hepatic lipogenesis and were independent of changes in fasting or postprandial plasma glucose and insulin concentrations (rabol, petersen, dufour, flannery, & schulman, 2011). exercise, as well as weight loss, reduced insulin resistance (houmard et al., 2002). when considering lipid oxidation, it seems an inverse relationship between adiposity and the lipolytic response to exercise. the limited availability of systemic plasma fatty acids as a fuel in overweight and obese men was associated with a compensatory increase in the oxidation of non-systemic fatty acids. effects of gender and fitness level on lipid oxidation during activity women utilise more of lipids than men at the same relative activity intensity level (kiens, 2006), lipid oxidation remains the same during luteal and follicular phase of the menstrual cycle (matsuo, saitoh, & suzuki, 1999). due to adaptation mechanisms, regular endurance pa increases lipid utilisation during pa (costill, fink, getchell, ivy, & witzmann, 1979; koivisto, hendler, nadel, & felig, 1982; gollnick, 1977; short & sedlock, 1997; jeppesen & kiens, 2012). an increased lipid oxidation occurs due to increased capillary density (kiens, essen-gustavsson, christensen, & saltin, 1993), increased lipid binding protein activity, an increase of fatty acid oxidation controlling enzymes (kiens & lithell, 1993; alsted et al., 2009; jeppesen et al., 2012), reduced insulin secretion and increased activation of adiponectin hormone in the adipose tissue (civitarese et al., 2006). these adaptations to regular endurance pa increase the ability of mobilisation, transportation and oxidation of lipids in people with aerobic stamina (henriksson, 1977; kiens et al., 1993; jeppesen et al., 2012). when considering lipid oxidation, women utilise more lipids than men, and after adaptation to training, greater lipid oxidation (recruit, transport and oxidize lipids) is observed during pa. lipid oxidation after continuous activitiy following pa, body immediately requires oxygen to regenerate its oxygen energy supplies (in myoglobin and haemoglobin), synthesis of phosphagens, removal of lactate from blood, increased need for oxygen in tissues due to increased temperature, an increase in catecholamine concentration and increased heart and respiratory muscles activity (børsheim & bahr, 2003). the period following the pa is known as the “excess post-exercise oxygen consumption” phase (epoc) (scott, 1997). increased lipid oxidation and decreased carbohydrate oxidation can be observed during most of the epoc period (maehlum, grandmontagne, newsholme, & sejersted, 1986; bahr, ingnes, vaage, sejersted, & newsholme, 1987; bahr, hansson, & sejersted, 1990; chad & quigley, 1991; short & sedlock, 1997), thus, it was imperative to further study the literature on 102 barbara purkart, boštjan šimunič, mitja gerževič: an overview of training methods that promote the ..., 93–118 annales kinesiologiae • 6 • 2015 • 2 how it describes the epoc amount and duration, and how lipids are utilised after pa. amount and duration of epoc are influenced by intensity and duration of pa (sedlock, fissinger, & melby, 1989), the method of carrying out the pa (almuzaini, potteiger, & green, 1998), the menstrual cycle (matsuo et al., 1999), aerobic fitness level (sedlock, lee, flynn, park, & kamimori, 2010) and amount of fatty tissue (wong & harber, 2006). gender per se (lamont, romito, & rossi, 2010), the amount of active muscles (sedlock, 1991b) and nutrition (bahr & sejersted, 1991b) show no effect on epoc. effect of intensity and duration of activity on lipid oxidation after activity intensity of pa is exponentially related to the epoc level (brehm & gutin, 1986; sedlock et al., 1989; gore & withers, 1990; bahr & sejersted, 1991a; frey, byrnes, & mazzeo, 1993; smith and naughton, 1993; hardman, 2001; børsheim & bahr, 2003), the duration of pa on the other hand is in linear relation to the epoc level (bahr et al., 1987; chad & wenger, 1988; sedlock et al., 1989; gore & withers, 1990; smith & mc naughton, 1993). lipid oxidation following low-intensity long-term pa can be more than three times higher than during resting state (within three hours following 120 minutes of pa at 51 % vo2max intensity) (bahr et al., 1990), low-intensity and / or short-term pa, however, does not lead to longer epoc (børsheim & bahr, 2003). when epoc length was studied at constant intensity level and various durations of moderate-intensity pa (cycling at 70 % vo2max intensity), it was discovered that epoc after 30, 45 and 60 minutes of moderate-intensity pa lasted ≈ 2 hours, ≈ 3 hours and ≈ 7 hours, respectively (chad & wenger, 1988), after 80 minutes of cycling up to 12 hours (maehlum et al., 1986; bahr et al., 1987). when epoc length was studied at constant duration (80 minutes of cycling) and various intensity levels of moderate-intensity pa (29 %, 50 % and 75 % vo2max), it was discovered that epoc lasted respectively for ≈ 20 minutes, ≈ 3 hours and ≈ 10 hours after the activity; respective epoc amounts were ≈ 10 kcal, ≈ 30 kcal and ≈ 150 kcal (bahr & sejersted, 1991b). epoc amount studies on trained participants, 8 hours after a 20-, 50-, and 80-minute run at of 70% vo2max intensity, showed the values of ≈ 25 kcal, ≈ 50 kcal and ≈ 75 kcal, respectively (gore & withers, 1990). studying effect of intensity and duration on amount and duration of epoc in trained men, showed that short term high-intensity pa brought about significantly higher epoc (≈ 30 kcal) than a low-intensity pa, regardless of its duration (≈ 15 kcal). a short-term low-intensity pa resulted in significantly shorter epoc (≈ 20 minutes), compared to a long-term low-intensity pa (≈ 30 minutes) and a short-term high-intensity pa (≈ 35 minutes) (sedlock et al., 1989). annales kinesiologiae • 6 • 2015 • 2 103 barbara purkart, boštjan šimunič, mitja gerževič: an overview of training methods that promote the ..., 93–118 effect of dividing activity into sets and amount of working muscles on lipid oxidation after activity studying whether dividing pa into sets has any effect, it was found that the epoc amount after 2 sets separated by 6 hours of rest (15 minutes of cycling at 70 % vo2max intensity) was significantly greater than if same pa was done in a single set (30 minutes of cycling at 70 % vo2max intensity) (almuzaini et al., 1998). similar findings were reached in an earlier study where the epoc amount after two sets (25 minutes of running at 70 % vo2max intensity) was significantly greater than if the pa was done in a single set (50 minutes of running at 70 % vo2max intensity) (kaminsky, padjen, & laham-saeger, 1990). epoc amount and duration following pa for upper limbs (20 minutes, at 60 % vo2max intensity on upper limb cycle ergometer) and pa for lower limbs (20 minutes, 60 % vo2max intensity on lower limb cycle ergometer) are virtually the same (23 minutes and ≈ 9 kcal for the upper limbs and 24 minutes and ≈ 10 kcal for the lower limbs). it can be concluded that the amount of active muscles as well as absolute vo2max value do not affect the amount and the duration of epoc (sedlock, 1991b). effects of gender on lipid oxidation after activity when comparing low-intensity pa (50 % vo2max, 500 kcal) and high-intensity pa (75 % vo2max, 500kcal) in women, three hours after a high-intensity pa (≈ 40 kcal) epoc amount was greater than after low-intensity pa (≈ 20 kcal). during and after a low-intensity pa, more lipids were used (≈ 37 g) than during and after a high-intensity pa (≈ 28 g). this difference, however, was not statistically significant (p = 0.07) (phelain, reinke, harris, & melby, 1997). the study has two obvious shortcomings: lipid oxidation following a high-intensity pa was still increased, indicating epoc after high-intensity pa lasts longer than three hours, which in turn indicates that the epoc period was not measured in its entirety, and, secondly, the effect of menstrual cycle was not taken into account. epoc and lipid oxidation after pa (60 minutes of cycling at 60 % vo2max intensity) are significantly greater in luteal than in follicular phase of the menstrual cycle (matsuo et al., 1999). not controlling the menstrual cycle could be the reason why no statistically significant differences were found in the amount and duration of epoc (women cycling at various intensities) (sedlock, 1991a). normalising absolute epoc value to lean mass results in disappearing gender differences (tahara et al., 2008; lamont et al., 2010). 104 barbara purkart, boštjan šimunič, mitja gerževič: an overview of training methods that promote the ..., 93–118 annales kinesiologiae • 6 • 2015 • 2 effects of amount of fatty tissue, food ingestion and fitness level on lipid oxidation after activity epoc in lean people lasts longer and is greater by one third than in overweight and obese people. overweight and obese people have significantly higher rer value, which indicates that during the regeneration phase they use less lipids and that pa has a reduced effect on lipid oxidation increase during rest than in lean people (wong & harber, 2006). similar conclusions were drawn in an earlier study; it was found that during rest neither low-intensity pa (40 % vo2max) nor moderate-intensity pa (70 % vo2max) resulted in fatty acid oxidation increase in obese people (van baak, 1999). ingesting food prior to moderate-intensity pa had no effect on the epoc amount and duration (bahr & sejersted, 1991b). regular pa results in increased recovery effectiveness following pa (hagberg, hickson, ehsani, & holloszy, 1980): blood lactate level decreases, as does rectal temperature and hormonal response (sedlock et al., 2010), thus reducing the epoc duration (frey et al., 1993; sedlock, 1994; short & sedlock, 1997). the amount of epoc when comparing relative values is identical (kaminsky et al., 1986; sedlock, 1994; short & sedlock, 1997; børsheim & bahr, 2003; sedlock et al., 2010). if we compare absolute values, epoc amount following a regular pa is significantly reduced (sedlock et al., 2010), while the ability to metabolise fatty acids increases (kaminsky, knowlton, perkins, & hetzler, 1986; short & sedlock, 1997; børsheim & bahr, 2003; gill et al., 2006; ferreira et al. 2011). energy expenditure was significantly higher during rest even up to 48 hours after moderate-intensity pa (60 minutes running at 70 to 75 % vo2max intensity) (jamurtas et al., 2004). in spite of all this, we must be aware that epoc represents only up to 10 % of energy expended during pa (lecheminant et al., 2008) or, depending on pa duration (from 20 to 80 minutes) and intensity (30, 50 or 70 % vo2max) only 1 to 8.9 % of energy expended during pa (gore & withers, 1990). when considering lipid oxidation in recovery phase after pa, the increased lipid oxidation can be observed during most of the epoc period. intensity of pa is exponentially related to the epoc level, the duration of pa on the other hand is in linear relation to the epoc. dividing pa into sets causes greater epoc than if the pa is in a single set. epoc in lean people lasts longer and is greater. normalising absolute epoc value to lean mass results in disappearing gender differences, however, lipid oxidation after pa is significantly greater in luteal than in follicular phase of the menstrual cycle. if we compare absolute values, epoc amount following regular pa is significantly reduced when comparing relative values is identical, while the ability to metabolise lipids increases. the amount of active muscles as well as ingested food prior to pa has no effect on the amount and duration of epoc. annales kinesiologiae • 6 • 2015 • 2 105 barbara purkart, boštjan šimunič, mitja gerževič: an overview of training methods that promote the ..., 93–118 interval training and lipid oxidation during a high intensity pa, oxidation of plasma fatty acids, muscle and plasma tgs are lower than during a moderate intensity pa, despite greater energy expenditure (van loon et al., 2001; jeppesen & kiens, 2012). plasma glucose and muscle glycogen utilization is directly proportional to pa intensity (romijn et al., 1993; van loon et al., 2001), while the mechanism balancing lipid oxidation has yet to be explained (jeppesen et al., 2011). “carnitine could act as an acceptor of acetyl groups from acetyl-coa, by forming acetylcarnitine, a reaction catalyzed by the mitochondrial enzyme carnitine acetyltransferase, when acetyl-coa is generated faster than utilized by the krebs cycle” (jeppesen & kiens, 2012). with increasing exercise intensities, muscle acetylcarnitine content is increased concomitantly with a decrease in the free carnitine content (jeppesen & kiens, 2012). on the other hand, a low muscle content of free carnitine is supposed to lead to a diminished supply of the long chain fatty acid coa to β-oxidation, limiting long chain fatty acid oxidation during high intensity exercise. thus, an increased availability of pyruvate, acetyl-coa formation, and ‘binding’ of the free carnitine during high intensity exercise also provide a potential mechanism, whereby fatty acid oxidation is down-regulated” (jeppesen & kiens, 2012). a comparison was made between lipid oxidation in untrained boys (aged 8 to 12), during and two hours after pa (30 minutes of cycling at intensity that maximises lipid oxidation determined for individual boy) and during and two hours after pa to which high-intensity short-term burst was added (cycling at intensity that utilized maximum lipids and every two minutes four seconds of maximum intensity). it was found that the amount of lipids metabolised and the epoc amount were the same, for the same work performed (crisp, fournier, licari, braham, & guelfi, 2012). the same epoc amount and the duration was found in adult men as well following interval pa (three minutes of cycling at 30 % vo2max intensity and two minutes at 90 % vo2max intensity, seven repetitions) and continuous moderate-intensity pa (≈ 30 minutes of cycling at 65 % vo2max intensity) for the same work performed. rer values were significantly lower in the 2-hour period following interval pa (mcgarvey, jones, & petersen, 2005). absolute values of metabolised fatty acids during and following the exercise were, unfortunately, not measured, so we still do not know whether lipid oxidation during and following a continuous pa is lower, equal or higher than during and after an interval pa for the same work performed. however, hazell, olver, hamilton, and lemon (2012) have recently demonstrated a similar total vo2 over 24 hours after sprint (high-intensity) interval exercise (four times 30-second maximal cycling at resistance of 10 % body mass with four-minutes rests) and continuous endurance exercise (30 minutes cycling at ~ 70 % vo2max) session (sie = 498.0 ± 29.4 l; cee = 500.2 ± 49.2 l; ctrl = 400.2 ± 44.6 l), indicating that the significant body-fat losses observed previously with sprint interval trainings are partially due to increases in oxidation post exercise. comparing the two hours following the high-intensity short-term burst of activity (four repetitions of 30-second intervals of sprinting on a cycle ergometer and 4.5 minutes of rest) to resting, a 75 % lipid oxidation increase was found (chan & burns, 106 barbara purkart, boštjan šimunič, mitja gerževič: an overview of training methods that promote the ..., 93–118 annales kinesiologiae • 6 • 2015 • 2 2013). the epoc duration and the amount following the interval pa depends on a number of high-intensity short-term burst (bahr, grønnerød, & sejersted, 1992) and work to rest ratio (gosselin, kozlowski devinney-boymel, & hambridge, 2012). after two minutes of cycling at 108 % vo2max intensity, epoc amount is ≈ 30 kcal and lasts 30 minutes; after 2 series with a 3-minute break, epoc amount is ≈ 35 kcal and lasts 60 minutes; after 3 sets with two 3-minute breaks epoc amount is ≈ 80 kcal and lasts 4 hours (bahr et al., 1992). the highest energy expenditure and the lowest blood lactate values are found when using 30 seconds of moderate-intensity pa and 30 seconds of high-intensity short-term activity (gosselin et al., 2012; zuniga et al., 2011). in a recent study (kelly, king, goerlach, & nimmo, 2013), two commonly used high-intensity short-term activity protocols (10 times 1 minute of high-intensity cycling followed by a one-minute rest and 10 times 4-minute high-intensity cycling followed by a 2-minute rest), supposedly suitable for untrained people and people suffering from chronic diseases, were compared. it was discovered that during the 60 minutes after interval exercises, rer was lower in both protocols. but during the slow phase of epoc period (from 1.25 to 9.25 hours) there were no significant differences between rer values or energy expenditure. they conclude that the effect on post-exercise metabolic rate was transient and relatively minor (kelly et al., 2013). interval training causes both central (cardiovascular) and peripheral (skeletal muscle) body adaptations (gibala, little, macdonald, & hawley, 2012). high-intensity short-term training (10 x 2 minutes 105 % vo2max with 2 minutes breaks) increased the anaerobic threshold significantly more than endurance training (50 % vo2max, 55 minutes or 70 % vo2max 35 minutes) in the same time period (poole & gaesser, 1985). modern studies have come to similar conclusions. just two-week high-intensity intermittent training (7 sessions every second day, each session consisted of 10 4-min cycling bouts at 90 % vo2max separated by 2 minutes of rest), increased post-training whole body lipid oxidation during the 60 minutes of cycling at 60 % vo2max in moderate trained women (menstrual cycle was not monitored) (talanian, galloway, heigenhauser, bonen, & spriet, 2007). studies show that low-volume high-intensity interval training increases a body’s capability of lipid oxidation just as effectively as higher-volume moderate-intensity endurance training (gibala et al., 2006; gibala & mcgee, 2008). however, considering time, interval training is a more time efficient strategy than continuous training (burgomaster et al., 2008). interval training is safe for healthy people as well as people “at risk” (shiraev & barclay, 2012). studies on obese and metabolic syndrome patients report a similar or a greater effect of high-intensity interval training compared to endurance training on life quality, cardio-metabolic risk factors, aerobic fitness and cardio-vascular function, as well as blood glucose reduction, insulin signalling in adipose tissue and skeletal muscles, lowering the mean arterial blood pressure, and finally, on adipose tissue lipogenesis reduction, body weight and adipose tissue reduction (earnest, 2008; guiraud et al., 2012; hansen, dendale, van loon, & meeuseen, 2010; kessler, sisson, & short, 2012; tjønna et al., 2008). in practice, this translates to similar or greater effect, for at least 60 % less time spent doing high-intensity interval training compared to endurance training. this is a very significant aspect considering annales kinesiologiae • 6 • 2015 • 2 107 barbara purkart, boštjan šimunič, mitja gerževič: an overview of training methods that promote the ..., 93–118 that “a lack of time” is the most commonly cited obstacle for participating in regular pa (stutts, 2002; kimm et al., 2006). when considering lipid oxidation, interval training is at least as effective as endurance training, with less time invested. some people also find it more interesting. resistance training and lipid oxidation muscles do not utilize lipids during resistance exercises (melby, scholl, edwards, & bullough, 1993). resistance exercises are first ensued by anaerobic regeneration, the so-called “delayed glycolysis”, a glycolytic process at the start of regeneration. it is significantly faster and more effective at phosphagens re-synthesis than at aerobic processes. it ensures re-synthesis of depleted phosphagens, up to the levels allowing oxidative processes to allow sufficient regeneration (margaria et al., 1933, in di prampero & feretti, 1999). an increase in lipid oxidation has been found during epoc period 30 to 120 minutes after finishing a resistance exercise (binzen, swan, & manore, 2001). intensity has been identified as a significant factor in epoc amount following resistance exercise (thornton & potteiger, 2002) as well as the speed of execution (scott, 2012) and the size of active muscle groups, a slight dependency on breaks between sets was also observed (farinatti & castinheiras, 2011; haltom et al., 1999). no dependency was found towards the order in which the resistance exercise is carried out (da silva, brentano, & kruel, 2010), or the type of muscle contraction (scott, 2012). during the first two hours following resistance exercise (2 sets, 8 repetitions at 85 % 8 rm), the epoc amount was significantly higher than after the activities for strength endurance (2 sets, 15 repetitions 45 % 8 rm) at equal work carried out. no difference in rer was found following the resistance exercise or the activities for strength endurance (thornton & potteiger, 2002). absolute lipid oxidation values were not measured, so we cannot conclude whether lipid oxidation after resistance exercise differs from those following activities for strength endurance. epoc amount is dependent on execution speed of resistance exercises; it is significantly greater during slower execution (4s lift / 1s release or 1s lift / 4s release) in comparison to faster execution (1.5 second lift / 1.5 second release) (scott, 2012). the epoc amount following the resistance exercise of larger muscle groups is significantly greater than following resistance exercise of smaller muscle groups at equal repetitions and unequal work performed. duration of rest between sets (1 or 3 minutes) had no effect on epoc in larger muscle groups (farinatti & castinheiras, 2011). a shorter break between sets (20 seconds; 2 circular exercises for the upper and lower part, 20 repetitions 75 % 20 rm) resulted in significantly greater epoc amount compared to same resistance exercise with a 1-minute break (haltom et al., 1999). epoc amount during the first 2 hours following resistance exercise was ≈ 30 kcal (binzen et al., 2001). part of these calories is used for delayed glycolysis and part for lipid oxidation. regular resistance training, however, increases muscle mass, therefore increasing oxidation rate during rest as well as absolute lipid utilisation (dolezal, potteiger, jacob108 barbara purkart, boštjan šimunič, mitja gerževič: an overview of training methods that promote the ..., 93–118 annales kinesiologiae • 6 • 2015 • 2 sen, & benedict, 2000). significantly, increased oxidation was found even 38 hours after the resistance training (31 minutes, 10 repetitions, maximum until exhaustion, for the entire body) (schuenke, mikat, & mcbride, 2002), and 24 hours following the resistance training (60 minutes, 70 – 75 %, 1 repetition maximum, for the entire body) (jamurtas et al., 2004). heden (2011) found that in overweight people, there was a ≈ 5 % increase in oxidation rate up to 72 hours during rest after the resistance training, following the recommendations of the american society for sport medicine (haskell et al., 2007; heden, 2011). measuring local fatty acid oxidation during resistance exercise for the individual muscle groups (dean et al., 2000) and (helge, stallknecht, richter, galbo, & kiens, 2007) concluded that resistance exercise caused no noticeable hormonal changes and enabled exceptionally good circulation and oxygen supply to active muscles. by monitoring isotopes, muscle biopsies, oxygen consumption and rer during unilateral extension of the knee against resistance intensity ranging from 25 % to 85 % of maximum power – pmax), the total fatty acid oxidation in the thigh increased 15 times (at 25 % pmax intensity) compared to rest, and remained the same regardless of the intensity. free fatty acid oxidation in the thigh increased with resistance exercise intensity, reducing oxidation of plasma tg and muscular tg. at 100 % pmax intensity fatty acid oxidation capability decreased by a third compared to 85 % pmax intensity. these results contradict activities that incorporate the muscles of entire body, such as cycling, where maximum lipid utilisation is at 65 % vo2max. the reason may lie in significantly greater blood circulation in the active muscles, when we perform resistance exercise for individual muscle groups than when we perform pa that includes greater muscle mass. this “super fusion” creates muscle environment that retains free carnitine and promotes lipid oxidation processes even at 80 % pmax intensity. at intensities exceeding 80 % pmax, the availability of free carnitine decreases, heavily diminishing the ability of lipid oxidation (jeppeson & kiens, 2012). when combining endurance pa with resistance exercise it was found that the order of pa and the resistance exercise execution had no effect on the size and the duration of epoc (drummond, vehrs, schaalje, & parcell, 2005; oliveira & oliveira, 2011). the order, however, did have an effect on rer. execution of endurance pa prior to resistance exercise resulted in significantly lower rer, resulting in higher lipid oxidation, compared to the reverse order of endurance pa following resistance exercise (oliveira & oliveira, 2011). resistance exercise (3 series at 70 % 1 repetition maximum, 10 repetitions, 105-second break between series or exercises, 7 exercises for upper and lower body), moderate-intensity pa (25 minutes of running at 70 % vo2max intensity), combination of moderate-intensity pa and resistance exercise (there was a 5-minute break in between) or resistance exercise and moderate-intensity pa, resulted in the same epoc duration (≈ 40 minutes) following the session (drummond et al., 2005). when considering lipid oxidation, the total amount of lipids utilized during and following resistance exercise is negligible compared to lipid oxidation during and following the endurance pa or interval training, but regular resistance training increases muscle mass, therefore increasing oxidation rate and lipid utilisation during rest. annales kinesiologiae • 6 • 2015 • 2 109 barbara purkart, boštjan šimunič, mitja gerževič: an overview of training methods that promote the ..., 93–118 conclusions prolonged (> 30 minutes) moderate intensity (55 – 70 % vo2max) pa, such as walking, jogging or cycling, are the most effective way to increase lipid oxidation during and after a single exercise session. studies also suggest no difference in lipid oxidation between periods following low-volume high-intensity interval exercise and traditional continuous endurance pa. however, time benefit of low-volume, high-intensity interval exercise compared to traditional endurance pa is significant. further research is required to confirm whether adding just a few seconds of sprints during moderate-intensity endurance pa every so often would result in the same lipid oxidation as during a continuous pa without sprint intervals. regularity of pa seems most important. regular continuous and regular interval exercise or activity triggers the same adaptation mechanisms, and increases one’s fatty acid mobility, transport and oxidation capability. further research is necessary to compare the effects of regular resistance, regular endurance and regular interval training on lipid oxidation effectiveness. both regular endurance and regular interval training increase a certain amount of muscle mass, therefore increasing resting oxidation. it may also be of interest to compare the effects of nordic walking, which additionally activates upper limb muscles in the movements and, thus, more muscle mass, as well as resistance exercise of the entire body on the effect of lipid oxidation. nutrition also significantly affects lipid oxidation. food rich in fat and low in carbohydrates encourages lipid oxidation. it is essential not to exceed body’s daily energy requirements, which leads to increased body weight and obesity. obese and overweight people are recommended to take part in regular endurance or interval training. however, from the standpoint of relieving lower limbs joints, it may be better to participate in cycling or swimming, despite lower lipid oxidation potential. references achten, j., gleeson, m., & jeukendrup, a. e. 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(2011). physiological responses during interval training with different intensities and durations of exercise. journal of strength and conditioning research, 25(5), 1279– 1284. view item http://ajpendo.physiology.org/content/284/4/e813.full-text.pdf+html http://dx.doi.org/10.1210/jc.2005-1148 http://jama.jamanetwork.com/article.aspx?articleid=402029 http://journals.lww.com/nsca-jscr/abstract/2011/05000/physiological_responses_during_interval_training.13.aspx _goback _goback _goback _goback _goback _goback _goback annales kinesiologiae • 13 • 2022 • 2 143 original scientific article doi: https://doi.org/10.35469/ak.2022.368 received: 2022-10-06 udc: 37.015.31:379.83 outward bound and outdoor adventure education: a scoping review, 1995-2019 timothy j. mateer1, joshua pighetti1, b. derrick taff1, & pete allison1 1 the pennsylvania state university corresponding author: pete allison, phd the pennsylvania state university, 701h donald h. ford building, university park, state college, pa 16802, usa phone: +1 814 470 5954 e-mail: pra7@psu.edu abstract outdoor adventure education (oae) programming is often referenced as an effective intervention that encourages a wide array of outcomes in participants such as increased confidence, independence, and communication skills. however, as outdoor adventure education continues to increase globally, what does the academic literature say about the outcomes related to these programs? hattie, marsh, neill, and richards (1997) conducted the last major review of program efficacy in this realm. this updated scoping review, largely following prisma guidelines (tricco et al., 2018), aims to summarize the academic literature on one of the primary outdoor adventure education providers internationally, outward bound (ob). fifty-four studies, published between 1995 and 2019, have been summarized in this review. utilizing outward bound international’s (obi) framework of “people”, “place”, and “process”, themes and gaps in the literature are explored. specifically, the ob literature has progressed since 1995 in demonstrating social and emotional outcomes in a variety of settings, a better understanding of the nature of effective programming, and further documenting the role the instructor plays in the learning experience. recommendations are provided on developing more rigorous methodologies for future research, understanding the role of the physical environment in the learning experience, and utilizing theoretical approaches to integrate outdoor adventure education into broader academic realms. keywords: outdoor education, adventure education, outward bound, emotional learning, experiential learning, scoping review 144 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 annales kinesiologiae • 13 • 2022 • 2 organizacija outward bound in izobraževanje skozi pustolovščine na prostem: pregledna študija, 1995–2019 izvleček programi izobraževanja na prostem se pogosto omenjajo kot učinkovita intervencija, ki pri udeležencih spodbuja širok nabor rezultatov, kot so večja samozavest, neodvisnost in komunikacijske spretnosti. ker pa trend izobraževanja na prostem globalno še naprej narašča nas zanima, kaj o rezultatih, povezanih s temi programi, pravi strokovna literatura? hattie, marsh, neill in richards (1997) so opravili zadnji večji pregled učinkovitosti programov na tem področju. namen tega posodobljenega pregleda obsega, ki sledi smernicam prisma (tricco et al., 2018), je povzeti znanstveno literaturo o enem od glavnih ponudnikov izobraževanja skozi pustolovščine na prostem na mednarodni ravni, outward bound. v tem pregledu je bilo povzetih štiriinpetdeset študij, objavljenih med letoma 1995 in 2019. z uporabo okvira outward bound international „ljudje“, „kraj“ in „proces“ so raziskane teme in vrzeli v literaturi. natančneje, literatura o outward boundu je od leta 1995 napredovala pri dokazovanju socialnih in čustvenih rezultatov v različnih okoljih, boljšem razumevanju narave učinkovitega programiranja in nadaljnjem dokumentiranju vloge, ki jo ima inštruktor pri učni izkušnji. podana so priporočila za razvoj strožjih metodologij za prihodnje raziskave, razumevanje vloge fizičnega okolja pri učni izkušnji in uporabo teoretičnih pristopov za vključevanje izobraževanja na prostem v širša akademska področja. ključne besede: izobraževanje na prostem, izobraževanje skozi pustolovščine, outward bound, čustveno učenje, izkustveno učenje, pregledne študije annales kinesiologiae • 13 • 2022 • 2 145 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 introduction time spent outdoors has been associated with both mental and physical benefits (kuo, 2015), and research has found that outdoor experiential learning programs, such as those offered by outward bound (ob), can promote positive development for adolescent participants (orson, mcgovern, & larson, 2020). ob is one of, if not the, largest provider of outdoor adventure education globally. how effective these educational experiences are is unclear. it has been over 20 years since hattie, marsh, neill, and richards (1997) stated in their prominent meta-analysis on outdoor adventure education that “adventure programs can obtain notable outcomes and have particularly strong, lasting effects. it is clear, however, that adventure programs are not inherently good. there is a great deal of variability in outcomes between different studies, different programs, and different individuals” (p. 77). since this meta-analysis, research on outdoor adventure education has paralleled the field’s growth, becoming a focal area for several academic journals such as journal of outdoor recreation, education, and leadership; journal of experiential education; journal of outdoor and environmental education; and journal of adventure education and outdoor learning. while the body of research around these educational programs has continued to grow, the reviews that have been undertaken are weak and easily criticized. for example, fiennes et al. (2015) noted that “we found 15 systematic reviews of the effects of outdoor learning. they provide extensive evidence of the effects of outdoor learning. however, the set is somewhat confusing because many of them overlap in terms of the primary studies they include.” (p. 5) and go on to note that “almost all outdoor learning interventions have a positive effect” (p. 7). however, the methodological challenges of the previous systematic and scoping reviews of outdoor learning literature have not been addressed primarily because they have repeatedly used too wide a definition, thus creating too much diversity in the evidence. thus, in this work, we focused exclusively on one organization to minimize this problem. a lack of recent synthesis on outdoor adventure education has potentially hindered progress in research moving forward given the inability to clearly state what is known and unknown about the subject. by reviewing the current state of knowledge about these educational programs, more effective studies and practices can be informed. while summarizing the entire field of research on outdoor adventure may be too broad and unrealistic in a single review, compiling information from specific programs and the associated educational interventions will prove useful and provide opportunities to generalize to the broader literature and practices. ob exists as one of these arguably representative programs, serving as a primary provider of outdoor adventure programming in countries across the world. originally founded in britain in 1941 by kurt hahn and lawrence holt, ob originally focused on character development for young men (millikan, 2006). since these early stages, ob’s focus has transitioned from character development to personal growth while also expanding its program internationally to include a wide variety of audiences (freeman, 2011; millikan, 2006). like many other outdoor adventure programs, ob attempts to 146 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 annales kinesiologiae • 13 • 2022 • 2 provide transformative learning for individuals of all ages through challenging experiences in natural environments (ob trust, 2017). since its founding years, ob has now expanded to serve over 150,000 students each year in over 30 countries (obi, 2020). as such, ob has been associated with a number of positive outcomes identified as essential for the labor market and associated with positive youth development, such as improved goal-setting (ang, farihah, & lau, 2014), resilience, leadership skills, the transfer of learning (jostad, paisley, & gookin, 2012), general psychological well-being, improved sense of belonging, and empowerment (d’amato & krasny, 2011). additionally, research suggests that participation in ob has been associated with increases in youth autonomy and self-confidence (orson et al., 2020). the studies reviewed in this article generally reflect the diversity of the courses: some explore day-programs utilizing high ropes courses to facilitate teambuilding activities, others examine extended backcountry expeditions and their associated outcomes, and others still look at classrooms utilizing the ob framework to facilitate experiential learning, amongst many others. while diverse in nature, understanding the commonalities and differences amongst these educational experiences can help work towards developing a general model of learning for the ob experience. a limited understanding of these common traits between programs was a weakness in the academic literature identified by hattie et al. (1997). therefore, the research question guiding this review is what is known of the outdoor adventure education process through ob from academic literature published following hattie and colleagues’ (1997) meta-analysis? we utilize ob’s conceptualization of “people”, “place”, and “process” as educational components to present our findings in an attempt to bridge this gap between research and practice. what constitutes each of these components within the ob experience is detailed further in the methods section and those that follow. the upcoming sections of this paper outline details on how the scoping review was conducted. this is followed by three sections outlining trends and progress on how the academic literature has developed since hattie et al. (1997) within the categories of people, place, and process. each of these sections conclude with recommendations for future research on how forthcoming studies can better understand these concepts and integrate them into a more holistic understanding of the ob process. finally, a general discussion follows each of these three sections in which we present an argument for greater theoretical rigor in ob research. this scoping review, largely following prisma methodologies and previous methodological guidelines established through arksey and o’malley (2005), levac, colquhoun and o’brien (2010), and specifically the extension for scoping reviews (tricco et al., 2018), is intended to be of use for two primary audiences: ob practitioners who wish to understand the best practices supported by previous research, and educational researchers looking to build upon the previous work examining ob courses and methodology. annales kinesiologiae • 13 • 2022 • 2 147 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 methods scoping review process this study utilized a scoping review methodology (arksey & o’malley, 2005; levac et al., 2010; moher, liberati, tetzlaff, & altman, 2009; tricco et al., 2018) to summarize the academic literature on ob. this approach looks to review the literature with the goal of summarizing and reporting what is currently known on the subject and identifying gaps in current understanding (arksey & o’malley, 2005). it is considered especially useful when the field being reviewed is heterogeneous (pham et al., 2014), as is the case with research done on ob programming given the variety of programs offered and methodologies utilized to study the program. as will be obvious when discussing the findings, a broad array of methods have been used to study ob programming. these methods have ranged from intensive ethnographic studies to widely distributed surveys. due to the wide variety of data being interpreted, a scoping review methodology was chosen over the meta-analysis technique utilized by hattie et al. (1997). locating studies relevant to the research question we identified relevant studies for inclusion through database searching. the following databases were utilized: worldcat, academic search complete (ebsco), eric (proquest), and google scholar. for each of these databases, the following terms were entered: “outward bound” and “education”, “outward bound” and “adventure”, “outward bound” and “experiential”, and “outward bound” and “learning”. in addition, an email message was distributed via obi requesting various practitioners across the ob network (in 37 different countries) to forward relevant studies to the authors for review. the following additional filters were applied to these searches to increase the relevance of the gathered studies: – articles must have been published in a peer-reviewed academic journal. – the articles must have been published after 1995. using hattie et al. (1997) as a benchmark, this scoping review aims to summarize the research on ob programming from that point forward. – articles must have been published in english, the first language of all the authors of this review. these inclusion criteria aim to parallel the recommendations made by levac et al. (2010) where the established inclusion criteria allow for a breadth of studies to be collected that characterizes a given field while also acknowledging relevant limitations. 148 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 annales kinesiologiae • 13 • 2022 • 2 selecting studies that meet the inclusion criteria this initial search provided over 1000 potentially relevant research articles. the titles and abstracts of these initial results were reviewed by the first author. many articles at this stage presented research on other outdoor adventure programs or were not presented in peer-reviewed academic journals and were thus excluded from further consideration in this review. this resulted in 148 research articles being downloaded for closer reading. in following the recommendations for screening and eligibility criteria established by prisma, and those of previous studies (i.e., arksey & o’malley, 2005; levac et al., 2010), the research team met regularly to discuss inclusion criteria. in total, 54 studies were determined to fully meet the inclusion criteria after overlaying these additional inclusion criteria and were included in this scoping review (indicated using an asterisk in the reference list). extracting data from the studies the research team met regularly to determine the most useful data to extract from the included studies to best answer the outlined research questions. the information extracted from each study included study goals and research questions, study characteristics and data collection methods, and the primary findings from the study. as suggested by levac et al. (2010), two authors extracted data from five of the same articles and the results were compared to establish consistency in the data extraction methods, and rather than quantifying the findings, we followed prisma methods for qualitative synthesis during this inclusion phase of the research process. a similar process is used in establishing coding consistency in qualitative research projects (saldaña, 2009). differences in extraction methods were discussed and a mutual understanding of what to record from each included study was established. this allowed for greater consistency across the research team during data collection. summarizing and synthesizing the findings following the recommendations outlined in levac et al. (2010), the process of summarizing the findings from this scoping review were developed referencing qualitative research techniques. as detailed by saldaña (2009), broad thematic categories were developed from information extracted during the initial analysis. the initial information gathered from each research article studying ob was summarized into larger categories in order to present the findings within a cohesive, logical framework. this was done through an iterative process with the research team meeting regularly to discuss the emergent themes. these findings were considered within the context of their broader annales kinesiologiae • 13 • 2022 • 2 149 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 implications of identifying productive directions for future research, as well as how research can inform more effective ob programming. given the broader themes found within the academic literature and the goals of this scoping review, it was decided that the “three ps” of ob programming people, place, and process provided an effective framework for conceptualizing the findings. this framework has been recently adopted by obi as a guide for implementing the curriculum across ob schools globally. by utilizing these categories to summarize the selected studies, the academic research on outdoor adventure education can be organized in a manner that is meaningful to the unique educational context it is intended for. in implementing this framework to conceptualize the initial information extracted from each article, “people”, “place”, and “process” were adapted as follows to summarize the studies and findings for this scoping review: 1. people: the findings are relevant to a specific population of interest and how the ob experience is perceived by or impacts them. 2. place: the findings are relevant to how the physical environment or setting influences the learning or developmental experience. 3. process: the findings are relevant to program activities, elements, or instructional techniques and how they influence the ob experience, including the corresponding outcomes. the following sections utilize this framework in categorizing papers based on their research goals and objectives. the broad themes and findings are reviewed within each of the “three ps” categories. review of research methods research approach responding positively to hattie et al’s (1997) recommendation to consider alternative research designs beyond the dominant use of a pretest-posttest design, literature on ob programming between 1995 and 2019 is distributed nearly evenly between quantitative, qualitative, and mixed methodology approaches. of the 54 studies, 18 studies (33.3%) were constructed as quantitative research, 19 (35.2%) as qualitative, and 17 (29.6%) as a mixed methodology approach based on their design characteristics compared to creswell’s (2014) definitions of the three approaches. quantitative research regardless of the design, all 18 quantitative articles applied self-administered surveys, scales, or questionnaires. examples of established surveys and scales used or modified among the studies are the ob outcomes instrument (oboi; ewert, 2014; faircloth & bobilya, 2013), the mississippi scale for combat-related ptsd and the 150 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 annales kinesiologiae • 13 • 2022 • 2 impact of events scale (hyer, boyd, scurfield, smith, & burke, 1996). these instruments were used to measure dimensions such as resilience (ewert, 2014; neill & dias, 2001), positive and negative affect (kirwin et al., 2019), long-term outcomes (gassner, 2008; gassner & russell, 2008) and personal effectiveness and locus of control (greffrath et al., 2011). qualitative research throughout the qualitative studies, an array of data collection methods were utilized. of the 19 qualitative articles, 14 employed one of the five qualitative designs highlighted by creswell (2013) six case studies, five ethnographies of various constructs, two phenomenological studies, and one each of grounded theory approach and narrative. the data collection methods used in the 14 studies demonstrating the five designs brought into focus by creswell (2013) corresponded with the data collection methods characteristic of each design (see table 1). the remaining five studies were two historical analyses, two interpretive studies, and a heuristic design. table 1. qualitative data collection narrative phenomenology grounded theory ethnography case study l it er at ur e in r ev ie w video, interviews interviews, semi-participant observations, document analysis interviews interviews, document analysis, observation, self-reflection interviews, photography, moodboards, document analysis, observations, open response survey self-reported data in the qualitative research articles were collected through interviews and with open response surveys. interviews were the most prominent self-reported qualitative data collection method, occurring in 13 studies. data from open-ended questionnaires were utilized in only two case studies (leberman & martin, 2002; martin, leberman, & neill, 2002). observations were conducted in eight studies, one of which used video to record and observe afterwards (benham & shephard, 1995). data from the observations were also used to construct narratives (benham & shephard, 1995), to explore through phenomenology (broaddus et al., 2013), and to gain an ethnographic perspective (lowan, 2009; vernon, 2015). two studies (freeman, 2011; millikan, 2006) were reliant solely on document analysis to develop their historical analyses of annales kinesiologiae • 13 • 2022 • 2 151 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 ob programming. other applications of document analysis have been exemplified in case studies (hickman dunne, 2018; klein & riordan, 2009; klein & riordan, 2011) and in ethnographies (lowan, 2009; newbery, 2004) as the documents acted as tools for triangulation. mixed method research the majority of mixed-method research has predominantly been conducted using a dominant-less dominant design with quantitative data collection methods supplemented by qualitative data collection. seven of the 17 mixed-method studies used surveys, ranging from mixed-response surveys with as few as three open-ended questions (martin & legg, 2002) to exclusively open-response surveys (bobilya, kalisch, & daniel, 2014; mckenzie, 2003). the remaining 10 studies integrated more formal qualitative data collection methods such as observations (e.g., hanna, 1995; mckenzie, 2003), document analysis (e.g., jirásek & dvorackova, 2016), and interviews (e.g., gassner, kahlid, & russell, 2006; mott & martin, 2017). although grounded theory, case study, and phenomenology are most typically categorized as a qualitative research strategy (creswell, 2013), five studies incorporated quantitative data collection within these traditionally qualitative designs (bobilya et al., 2014; jirásek & dvorackova, 2016; martin & leberman, 2008; mckenzie, 2003; mott & martin, 2017). data collection an analysis of the timing of data collection in ob programming literature was conducted to depict the length of time the data represent in relation to ob programming. data collection across the literature occurred in a range from pre-program to up to eight years after ob programs conducted between 1995 and 2020. a frequency table of when data collection among the three research designs occurred is described in table 2. among the literature, 24 articles reported on data collected at one timepoint whereas the remaining 30 articles collected data at two or more timepoints. studies using a single timepoint data collection period were non-experimental or qualitative in nature. studies that gathered data at multiple time points took on a quantitative quasi-experimental or single-sample repeated measures design, or a longitudinal approach in a qualitative or mixed methods approach. 152 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 annales kinesiologiae • 13 • 2022 • 2 table 2. frequency of data collection periods p re -p ro gr am d ur in g p ro gr am im m ed ia te ly p os tp ro gr am u p to 6 m on th s af te r 6 m on th s – 1 ye ar af te r 1 ye ar + a ft er u ns pe ci fie d quantitative (n = 18) 11 0 14 7 0 2 0 qualitative (n = 19) 0 12 8 5 3 1 4 mixed methods (n = 17) 8 2 15 4 3 4 1 total 19 14 37 19 3 7 5 several notable findings on data collection arose. first, no qualitative research collected data prior to the ob programming. the data collection methods conducted during programming were primarily of a qualitative nature, except for jirásek & dvorackova (2016), who administered a quantitative frequency chart at three points during programming. while no qualitative data were collected pre-program in a qualitative study, eight mixed-method studies incorporated pre-program and post-program quantitative surveys in addition to qualitative data collection methods such as interviews, focus groups, observations, and document analysis that occurred during or after programming (e.g., greffrath et al., 2011; hanna, 1995; harper, norris, & d’astous, 2014). finally, among all 54 studies, only one study under review (mott & martin, 2017) collected and examined data beginning with the pre-program and extending to over 1 year proceeding program participation. people, place, and process the 54 reviewed studies provide insight into how research has further developed in understanding the people, place, and process of the ob learning experience since 1995. while these categories are not mutually-exclusive, we have used people, place, and process as a means to organize the results of this study. a brief overview of each study reviewed is provided in table 3 (on pages 158 to 168). the information in table 3 is intended to provide context on the diverse areas that these studies were conducted in and the various methodologies utilized to produce the current state of knowledge on annales kinesiologiae • 13 • 2022 • 2 153 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 ob programming since hattie et al. (1997). we hope this table will serve as a quick reference for individuals seeking more information on a study referenced in a later section as all relevant background information cannot be immediately included in the text of the manuscript. findings within each of the people, place, and process categories are outlined briefly in the following paragraphs prior to being explored in greater depths in the subsequent categories. regarding the people aspect of the ob experience, a considerable amount of research in the past 25 years has focused on unique groups of interest and documented how the outdoor adventure education experience impacts these diverse populations. specifically, a large portion of recent research has examined veterans and other at-risk populations and the expansion of ob outside of traditional eurocentric and north american settings. given that hattie et al. (1997) noted the lack of participant background information incorporated into early ob research, this has been one area in which the literature has seen a notable expansion since 1995. while this progress has been promising, we recommend that researchers look to more modern research techniques in human development and educational literature to further build upon this initial progress. studies examining the influence of place on the ob educational experience have been surprisingly scant since 1995. two primary lines of research have emerged from this relatively small body of literature, exploring the influence of the physical environment on the learning process or the influence of an ob course on the participants’ pro-environmental learning outcomes. given that learning in challenging outdoor environments is touted as a primary component of the ob experience (ob trust, 2017), this presents a promising direction for future research. this could be an especially important gap in knowledge to explore if competing models of learning through outdoor adventure education are to be developed, something that has still not come to fruition in the academic literature since hattie et al. (1997) called for it almost twenty years ago. lastly, and somewhat unsurprisingly, process represents a well-studied aspect of the ob educational experience since 1995. research has examined specific parts of the ob experience such as the final expedition (the autonomous final journey independent of course instructors on ob expeditions), the solo camping experience incorporated into many expeditions, course facilitation by instructors, social relations, perceptions of challenge, and post-course learning outcomes. this represents considerable progress since 1995 as hattie et al. (1997) noted that many outcomes from the outdoor adventure education experience were not linked back to specific course components or that the nature of many programs had not been well documented. additionally, some of this research on the ob learning process has begun to “ascertain the effects of the instructor” (p. 72), another suggestion for future research made by hattie et al. (1997). to further develop our understanding of the ob learning process, we point to other educational and psychological concepts that could add greater methodological rigor and theoretical grounding to the field of outdoor adventure education research. the following three sections expand upon the information provided in the preceding paragraphs in greater detail. each of the three outlined components of the ob learning experience – people, place, and process – are inherently interrelated with the other 154 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 annales kinesiologiae • 13 • 2022 • 2 components. we do not aim to explore each of these parts in isolation in the following sections. rather, we attempt to explore the nuances that emerge in our understanding of outdoor adventure education when each element is the focal area of study. general themes and findings within people, place, and process are discussed and benchmarked against the state of the academic literature reviewed by hattie et al. (1997). we then conclude each section with recommendations for future research and how studies on ob can continue to develop in rigor and applicability to practice. a brief general discussion is then presented in the conclusion making the case for greater theoretical rigor within the field of outdoor adventure education. people the academic literature on “people” has primarily explored the ob experience through two primary lenses: how programming helps veterans and other at-risk populations and how ob coursework manifests itself across multiple cultures in educating different audiences. for various populations acting as participants in the ob experience, social-emotional growth, defined in a variety of ways, was supported by findings. there was less evidence that the ob experience aided in helping specific psychological issues in at-risk populations. furthermore, interactions between the culture of the participants and the cultural roots of the programming may play a role in determining program outcomes. despite the mixed results on these fronts, the social-emotional growth provided evidence that most populations gained outcomes such as confidence, goal-setting skills, and interpersonal skills from their ob experience. while many of these findings parallel those reported by hattie et al. (1997), significant progress has been made in the area of their call to better incorporate the background of the participants into the study design. we conclude this section by indicating some methodological approaches for quasi-experimental designs that may help researchers better understand the effects of the ob educational experience on unique populations. four studies specifically focused on ob’s effect on veteran populations in canada and the united states, examining how it helped ease their transition back into everyday life (ewert, 2014; harper et al., 2014; hyer et al., 1996; scheinfeld, rochlen, & russell, 2017). while each of these studies defined social-emotional constructs in slightly different terms, the ob experience was linked to various outcomes for veteran populations in north america such as increased interpersonal skills, goal-setting, and self-confidence (ewert, 2014; harper et al., 2014). scheinfeld et al. (2017) similarly found that an ob course helped improve various aspects of mental health (e.g. distress and the perception of interpersonal relationships) for individuals. despite these positive findings in other studies, hyer et al. (1996) found that the ob experience had no effect on the post-traumatic stress disorder symptoms of veteran participants. similar studies examining the influence of ob educational experiences on other at-risk adult populations have paralleled the results found in veteran populations. outcomes included improved goal-setting abilities, interpersonal skills, and confidence annales kinesiologiae • 13 • 2022 • 2 155 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 (leberman, 2007; maxwell, perry, & martin, 2008; walker, onus, doyle, clare, & mccarthy, 2005). maxwell et al. (2008) notably departed from approaches taken by other studies on populations of interest by purposively sampling individuals that dropped out of an ob educational intervention focused on helping those facing long-term unemployment. the findings indicate that a lack of social integration contributed to the individuals discontinuing their participation in the program (maxwell et al., 2008). while this finding is largely in line with those of other studies, this study design presents a promising alternative to understanding ob programming. additionally, as a notable parallel to hyer et al.’s (1996) findings on veterans, walker et al. (2005) also found that their at-risk adult population, those recovering from traumatic brain injuries, saw increased emotional growth but no improvement in their specific psychological condition after an ob course. while this body of evidence suggests that ob course participation can result in social and emotional growth for at-risk adult populations, it is not as effective in improving psychological conditions that are unique to specific at-risk groups (hyer et al., 1996; walker et al., 2005). four additional studies examined the impacts of the ob experience on at-risk youth in various contexts (ang et al., 2014; broaddus et al., 2013; fischer & attah, 2001; pommier & witt, 1995). these studies provided similar evidence for social-emotional growth to what was found within veteran ob participants and other at-risk adult populations. the varied contexts within which these studies were conducted provides interesting insight into how different cultures intersect with programming for at-risk youth. for example, purdie and neill (1998) examined under-achieving japanese students enrolled in a 22-day ob australia program. the participants showed a significant decrease in confidence and peer relations when surveyed post-program. when compared to a population of australians enrolled in a similar course, the japanese students rated the group cohesion and course value significantly lower than their australian counterparts (purdie & neill, 1998). alternatively, two other ob interventions for at-risk youth that were provided within the individuals’ own culture, the united states (broaddus et al., 2013) and singapore (ang et al., 2014) respectively, were more successful in achieving their desired goals. while this contrast was only examined explicitly by purdie and neill (1998), these findings suggest that cultural factors may play a role in determining the success of an ob educational program for at-risk individuals. this may be especially true as ob programming has had difficulty in moving past its roots in traditional character-building practices originating in the european context (freeman, 2011; millikan, 2006). in addition to these studies, sibthorp, funnell, riley, chan, and meerts-brandsma (2018) specifically examined how course language administration (as a potential proxy for the participants’ cultural views) influenced program outcomes for youth in an ob hong kong program. this was found to have no effect on the course outcomes (sibthorp et al., 2018). while this contrasts with the findings of other studies, this may be due to language preference not being an adequate representation of the participants’ cultural views. as a whole, these studies suggest that the intersection of participant and program culture may matter for at-risk youth learning outcomes. 156 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 annales kinesiologiae • 13 • 2022 • 2 in complement to these trends within at-risk youth studies, a variety of research projects have explored how ob courses have become tailored to various geographical and cultural contexts of participants. the use of “dramaturgy” in the czech republic (jirásek, jirásková, majewská, & bolcková, 2017; jirásek, veselský, & poslt, 2017; martin, 2011; martin et al., 2002) or incorporating indigenous perspectives into ob canada courses (lowan, 2009) are examples of this. the dialectic nature of individuals’ cultural backgrounds interacting with ob course content exemplifies how the people of ob courses are continually co-creating the learning process and how the experiences are simultaneously influencing them. jirásek, veselský, et al. (2017) discuss how the “dramaturgical” approach to ob education in the czech republic is grounded in the unique people, place, and culture of the area. martin (2011) used an autoethnographic approach to summarize his past work studying dramaturgical techniques, stating that the dramaturgy approach supported the holistic development of participants through a variety of games stimulating different learning and development styles, including physically, socially, psychologically, and spiritually (martin, 2011). these assertions have been supported empirically by other studies (jirásek & dvorackova, 2016; martin et al., 2002). lowan (2009), utilizing a collaborative ethnographic approach in a canadian context, asserts that “grounding indigenous education programs in the teachings and traditions of respective indigenous cultures in order to support decolonization and cultural revitalization” can help improve program efficacy. taken as a whole, these studies examining ob across cultural contexts suggest that tailoring educational programming to the unique background of the participants may help improve the course outcomes. while the findings across many of these unique groups parallel the social and emotional outcomes already reported by hattie et al. (1997), studies within this variety of unique contexts represent significant progress in terms of their call to further incorporate participant background into the study design. as lerner (2018) asserts in his writing on human development research, growth and change throughout the lifespan is a non-ergodic process. therefore, researchers should take an idiographic approach and study a phenomenon of interest across many contexts. commonalities should then be identified across these contexts to find generalizable concepts (lerner, 2018). while social and emotional growth within these various unique populations and contexts may simply reinforce hattie et al.’s (1997) general findings, the consistency across these various groups is encouraging. we wish to conclude this section by briefly looking at other research approaches within the educational and human development literature to identify ways in which the people aspect of the ob experience may be studied more effectively. many studies within this section took a broad array of descriptive and reductionist approaches to understanding ob programs. while much of the rich qualitative data presented through these studies have helped further the theoretical understanding of learning in outdoor adventure education, the preand post-test approaches utilized do not fully explore the complexity of the learning experience for participants. approaches such as propensity score matching (caliendo & kopeinig, 2008; dehejia & wahba, 2002) and regression annales kinesiologiae • 13 • 2022 • 2 157 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 discontinuity design (cappelleri & trochim, 2001; cook, 2008) provide opportunities to more fully account for participant background when studying educational processes and outcomes. propensity score matching allows researchers to “find in a large group of nonparticipants those individuals who are similar to the participants in all relevant pretreatment characteristics” (p. 32, caliendo & kopeinig, 2008). this way, quasi-experimental studies can more effectively isolate the effects of ob educational intervention while also acknowledging the relevant background characteristics of those involved in the learning process. similarly, regression discontinuity design examines similar individuals who fall above or below a certain threshold in qualifying for a program or intervention. the regression analysis then explores whether “a treatment effect appears as a ‘jump’ or discontinuity at the cutoff point in the regression function linking the assignment variable to the outcome” (p. 152, cappelleri & trochim, 2001). this may prove to be a useful approach in designing future quasi-experimental studies, especially for ob programs that target qualifying at-risk populations such as that done by ang et al. (2014). as ob research continues to explore the program’s influence for new and different populations, methodological advances will also help to better understand the program effects in these different contexts. place ob asserts that challenging experiences in outdoor environments are a central element of their programming (ob trust, 2017). to cater for a wide array of participants around the world, there are ob schools in 37 locations across 34 countries on six continents around the world (obi, 2023). the articles under review discuss research conducted in ob programs from 10 different countries, representing 28.6% of the countries covered by obi. given that the physical environment is touted as a critical component within ob, this section reviews research that has explored its role within the learning experience. relative to other areas of the ob experience, studies that have explicitly examined “place” as a central concept have been relatively scarce. hattie et al. (1997) called for an expansion of competing models within the outdoor adventure education literature. understanding the physical environment as an interrelated component of the learning experience is necessary if these models are to be developed. this section concludes with recommendations for future research on how to better incorporate place into future ob research. recommendations include incorporating research on the sense of place and perspectives from environmental psychology. the link between culture and place represents an interrelationship within which ob courses can ground their practice of promoting learning outcomes. this lens inherently acknowledges people grounded in place as a driver of the learning process. lowan (2009) linked these elements via collaborative ethnography in a canadian indigenous context. they assert that indigenous ob programming should be designed specifically around the symbiotic relationship indigenous peoples have with their unique geographi158 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 annales kinesiologiae • 13 • 2022 • 2 cal location (lowan, 2009). furthermore, a pair of studies examining the dramaturgical approach to ob programming in the czech republic found that the course helped to inspire a strong spiritual connection to nature and appreciation for human-nature relationships (jirásek, jirásková, et al., 2017; jirásek, veselský, et al., 2017). as outlined in the previous section, cultural context may play an integral role in ob programming outcomes. it is of note that a large portion of studies with findings relevant to the physical environment were also grounded in a specific culture. two additional studies that did not find pro-environmental outcomes for ob participants were not as closely grounded in a specific culture or location (hanna, 1995; martin, bright, cafaro, mittelstaedt, & bruyere, 2009). other studies have more closely examined how the physical environment influences the ob learning process. many of these studies focused on challenge and risk and how such elements promote learning amongst participants. hickman dunne (2018) explored how participants interpret their interactions with the physical environment in the context of outdoor adventure education in a british setting. using an ethnographic approach, they found that participants derived both joy and unpleasant memories from their interactions with the physical environment. outdoor adventure equipment and clothing also emerged as a dominant theme with participants often expressing frustration with its appearance or function, while its necessity was acknowledged by both participants and staff (hickman dunne, 2018). given this challenge and the corresponding risk specifically associated with the physical environment on ob courses, a small body of studies also explored how safety and risk influenced the course outcomes (holden, 2004; leberman & martin, 2002; mott & martin, 2017). the staff working for ob new zealand saw risk mitigation as one of their primary jobs (mott & martin, 2017). this represents a balancing act for ob program managers as challenge via the physical environment is acknowledged as a central part of program learning (hickman dunne, 2018), yet risk mitigation is a vital component of program management (mott & martin, 2017). these findings indicate that the physical environment and the associated challenge are inextricably related to the ob learning process, much of which has already been acknowledged by ob practitioners. despite this, the specific relationships between challenges involving the physical environment and learning outcomes have largely been unexplored. as place remains a relatively understudied idea within the academic literature on ob, there are ample opportunities to look to other areas of research for inspiration on how to explore this concept. research on sense of place (e.g. kudryavtsev, stedman, & krasny, 2012; stedman, 2003; white, virden, & van riper, 2008) may provide one direction on how to study the physical environment embedded within the ob learning experience. the literature on sense of place often defines the concept as having three components: the physical environment, human behavior, and psychosocial processes (stedman, 2003). studies that have previously explored ob programs embedded within specific areas and cultural contexts somewhat unsurprisingly were found to have the strongest outcomes related to the physical environment (jirásek, jirásková, et al., 2017; jirásek, veselský, et al., 2017; lowan, 2009). despite this, none of the aforementioned annales kinesiologiae • 13 • 2022 • 2 159 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 studies explored these relationships in a way that grounded the research in a broader sense of place theory. as ob presents the opportunity for individuals to experience a relationship with the physical environment in new and challenging ways (hickman dunne, 2018; holden, 2004; leberman & martin, 2002; mott & martin, 2017), individuals may experience a shift within the tripartite framework that makes up a sense of place. this shifting sense of place may then have implications for the learning processes and outcomes. furthermore, while outdoor adventure education does not explicitly hold connectedness to nature as one of its primary goals, the wide variety of writings within the field of environmental psychology could help provide insight into how the physical environment influences the learning process. for example, concepts such as the affective forecasting of experiences in nature (nisbet & zelenski, 2011), linked pathways between nature and general health (kuo, 2015), and the mental health benefits of outdoor recreation (lackey et al., 2021) all indicate that individuals feel mentally and physically better when immersed in natural environments. these shifts linked to elements of the physical environment potentially hold implications for the learning experience in outdoor adventure education. despite this possible connection, there are currently few studies exploring these relationships. the physical environment represents an element of the ob learning experience that is inextricably linked to other parts of the process. the physical environment of ob courses helps to facilitate challenge (hickman dunne, 2018) while also connecting individuals to each other (lowan, 2009). if the field is to develop effective models of learning in the setting of outdoor adventure education, as hattie et al. (1997) called for over 20 years ago, these relationships need to be explored further. research opportunities can take advantage by examining the role of ‘place’ in any one of the remaining 71.4% countries with ob programming yet to be studied. the research recommendations indicate ways forward in which the field of outdoor adventure education research can begin to explore these gaps in understanding. process the following section focuses on the ob process, specifically exploring course activities that facilitate learning and the outcomes that correspond to these activities. in examining ob learning processes broadly, the relationships with other participants, course challenges, and instructor facilitation were all identified as elements of the ob experience that impact participant learning. regarding expedition-based programs, the solo camping experience and the final expedition have both been retrospectively cited as specific course elements that also contribute heavily to the learning outcomes. a broader understanding of the learning outcomes linked to these course elements does not seem to have progressed significantly since the broad social and emotional components identified by hattie et al. (1997). despite a lack of progress on this front, linking outcomes back to course elements and the learning process does show a significant 160 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 annales kinesiologiae • 13 • 2022 • 2 step forward in the academic literature since 1995. we specifically explore the role the instructor plays in the learning process for individuals as hattie et al. (1997) identified this as a major gap in the literature over 20 years ago. finally, as in previous sections, this section concludes with recommendations for future research on how to better understand the learning processes of ob. specifically, we recommend utilizing a life course approach to studying the relationship between the learning process and outcomes. future researchers can also look at the ways specific ob organizations have built upon the general ob model in attempts to improve program efficacy. the growth of social relationships (closely related to the people category previously outlined) and challenge (closely linked to the place category previously outlined) are two course components that have been consistently identified across studies as being impactful for ob participants. regarding social relationships amongst participants, this has been found to be an impactful course element in a variety of contexts. locations in which studies have identified the importance of social relationships for ob learning include: new zealand (martin & leberman, 2005), australia (neill & dias, 2001), hong kong (sibthorp et al., 2018), the czech republic (jirásek & dvorackova, 2016), and the united states (goldenberg, klenosky, mcavoy, & holman, 2002; goldenberg, mcavoy, & klenosky, 2005). as outlined previously in the section on people, maxwell et al. (2008) exemplify the role social relationships play in the ob experience. in purposively sampling individuals who dropped out of an ob program focused on at-risk individuals, a lack of social integration into the program was cited as one of the predictive components leading to dropout (maxwell et al., 2008). given the need for teamwork on ob courses due to the challenging nature of the experience (goldenberg et al., 2002; goldenberg et al., 2005; greffrath et al., 2011), social relationships seem to be a key component for success. in examining the other end of the dialectic relationship between course components that lead to positive learning outcomes, course challenges, which are often an impetus to form close social bonds on ob courses, have also been cited frequently as an impactful element of the ob experience (goldenberg et al., 2002; goldenberg et al., 2005; tolich, 2012). the challenge explored in this section is often facilitated by the physical environment in which ob courses are situated (hickman dunne, 2018). while these challenges leading to growth exist across ob course types (greffrath et al., 2011), two specific challenging elements that have been frequently cited in previous studies are traditionally associated with expedition-based programs. these two course components are the solo camping experience and the final expedition in which participants autonomously complete a task without the guidance of the instructor (bobilya et al., 2014; gassner et al., 2006; gassner & russel, 2008; kalisch, bobilya, & daniel, 2011). bobilya et al. (2014) specifically explored perceptions of the final expedition for program participants at the north carolina ob school. they found that the autonomy and teamwork associated with the experience were both impactful for participants (bobilya et al., 2014). in a similarly structured study, kalisch et al. (2011) explored participant perceptions of the solo camping experience. the participants reported feeling both peaceful and anxious while also taking the time to reflect (kalisch et al., 2011). while it annales kinesiologiae • 13 • 2022 • 2 161 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 is beyond the scope of this review to cover all the forms of challenge that have been documented by the ob literature, these examples indicate that both internal reflection and external collaboration facilitated by challenging experiences are part of the learning process in ob courses. we now turn our attention to the influence of course instructors within the ob experience. as mentioned previously, this is a specific element of the learning process that hattie et al. (1997) noted as under-researched. since 1995, a wide variety of studies have been conducted examining the role of instructors and the broader administration within the ob experience (hovelynck, 2001; galloway, 2007; mckenzie, 2003; sibthorp et al., 2018). many of the reviewed studies list instructors as an impactful element of ob courses without exploring the relationship in further detail (gassner & russel, 2008; martin & leg, 2002; mckenzie, 2003; sibthorp et al., 2018). this evidence indicates that course instructors play the primary role in facilitating the ob learning process but does not provide much context for the nature of the process. as a beneficial complement to some of the previously cited studies, researchers have collected qualitative data to provide further context on the role of ob instructors. interviews conducted by hovelynck (2001) in belgium with ob instructors found that group development is key to their educational model. the conversations they facilitate transition from technical aspects of an activity to the communication methods themselves, then to the group “owning up” to communication development, and finally to the development of a group theme. this process inherently weaves personal and group learning together (hovelynck, 2001). furthermore, martin, dench, and paku (2016) conducted a broad study using semi-structured interviews to examine how school and executive directors perceive the culture of ob new zealand. the findings show that these managerial positions believe that, while language has changed over the years, the primary learning outcome of this program is still self-discovery and that course instructors play a key role in facilitating experiences (martin et al., 2016). this conceptualization of instructor roles aligns well with impactful elements of the learning process that have been previously cited. in both the solo camping experience and the final expedition, the instructor facilitates a learning process with the goal of eventually fully turning the leadership over to the group and individual (bobilya et al., 2014; gassner et al., 2006; gassner & russel, 2008; kalisch et al., 2011). within this thread of thought, ob instructors can be seen as catalysts coordinating learning experiences across various interrelated parts within an outdoor adventure education course. following the review of the course components that help to contribute to the ob learning process, we turn our attention briefly to the outcomes associated with these course components. while understanding how these course elements contribute to the learning process represents significant progress since hattie et al. (1997), the understanding of course outcomes has seemingly not advanced as much. the inconsistent language across studies describing social and emotional growth has likely hindered the ability for studies to build upon each other. the following summarizes the social and emotional growth outcomes identified by studies in this section: savoring, mindfulness, and positive affect (kirwin et al., 2019); initiative, self-confidence, and kindness 162 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 annales kinesiologiae • 13 • 2022 • 2 (sibthorp et al., 2018); self-confidence, self-awareness, and time management (martin & leberman, 2005); accomplishment, autonomy, community, and teamwork (bobilya et al., 2014); self-confidence and reliance, interpersonal effectiveness, and mental toughness (bobilya, kalisch, daniel, & coulson, 2015); and resilience (neill & dias, 2001), to name a few. these all fall under the umbrella of “personal growth” (freeman, 2011) or “self-discovery” (millikan, 2006), which are at the heart of the ob philosophy and programming. we conclude this section with recommendations on how researchers examining ob programming can further their understanding of the learning process. it is notable that many studies simply examined the outcomes linked to course components without probing the learning process further. taking a life course approach to understanding post-course outcomes (e.g. colley, currie, & irvine, 2019; tsang & havitz, 2014) represents one direction that researchers could take to better understand how learning processes are effective beyond preand post-program measures. in this approach, researchers purposively sample individuals with a common experience (in this case, an ob course), and have participants reflect on the meaning and nature of the experience later in life (colley et al., 2019; elder, 1994; tsang & havitz, 2014). this can potentially help researchers understand how course components such as social relationships or the solo camping experience potentially trigger a cascading effect that leads to positive outcomes later in life (masten & cicchetti, 2010). this approach could help to add depth and understanding to the relationship between learning outcomes and the educational process. additionally, as has been done extensively with the dramaturgical approach to the ob experience (jirásek, jirásková, et al., 2017; jirásek, veselský, et al., 2017; martin, 2011; martin et al., 2002), purposively sampling and studying unique variations on the ob experience may help provide a better understanding of impactful learning processes. as martin et al. (2002) did, these approaches to the learning process can then be piloted in other settings. these program variations can help provide new directions on how to further develop ob programming more broadly. discussion and conclusion we now conclude this scoping review by making a brief case for the incorporation of broader theory within the academic literature studying ob. in examining the studies reviewed within this manuscript, the following statement by hattie et al. (1997) remains relevant: “adventure programs have been conducted as if they operated in isolation from the educational world. there is little incorporation of research on group dynamics, attitude change, educational theory, and cognitive processes” (p. 77). the reviewed studies have provided rich descriptions of what makes the learning process effective on ob courses, but there have been only limited attempts to reintegrate findings into broader educational or developmental conversations following these descriptive results. in studying psychological processes such as learning in an ob program, it is important for theory to remain at the forefront of discussions (bringmann & eronen, 2016). this can annales kinesiologiae • 13 • 2022 • 2 163 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 help to maintain a strong conceptual understanding of the relationships between course elements and provide direction on how to improve programming. considering perspectives such as the relational developmental systems metatheory (lerner, 2018) in ob research may provide a useful shift in perspective for the future of the academic literature. this theory about theories acknowledges that “change across life occurs through mutually influential relations between individuals and their contexts” (p. 18, lerner, 2018). this perspective presents the opportunity to acknowledge many of the tensions that we have probed throughout this review and incorporate them into the study design. these include but are certainly not limited to the relationship between the cultural roots of a program and the cultural roots of the participants, the connection between the challenge presented via the physical environment and the growing social relations between participants, and the relationship between participant backgrounds and the corresponding learning outcomes. each of these elements creates a “layer” to the learning experience that is in dynamic tension with the other layers. the broader fields of human development and education have approached this tension through more specific theories, such as self-determination theory (ryan & deci, 2000) or transformative learning theory (mezirow, 1997), which bring forward new perspectives for ob and outdoor adventure education researchers more broadly. what other broader perspectives should researchers consider? it is our hope that the conceptual (e.g. utilizing sense of place as a research lens) or methodological (e.g. regression discontinuity for quasi-experimental designs) recommendations at the end of each section (people, place, and process) can provide some direction for these future directions. obviously, there are innumerable theories and lenses for outdoor adventure education researchers to examine beyond those recommended in this paper, and we look forward to seeing the innovative perspectives that evolve in the future. with this final recommendation, we return to the original goals of this paper. this scoping review was intended to provide perspective on how the academic literature has developed since the prominent meta-analysis conducted by hattie et al. (1997) and provide recommendations for future directions for the field of study. research has moved forward on several fronts, such as better incorporating participant background into studies, documenting effective program elements, and better understanding the role the instructor plays in the ob experience. other areas, such as understanding the role the physical environment plays (place) within the ob experience and understanding the nature of outcomes beyond social-emotional growth have not progressed as quickly. we hope that by examining the other areas of academic literature recommended throughout this article, these gaps in knowledge can be explored more effectively in the future. there is evidence that ob and outdoor adventure education more broadly provide impactful experiences for participants, and growing evidence supports this claim on an international scale. but as hattie et al. (1997) stated, these programs are not inherently good. academic research has the responsibility of helping ob and the broader field of outdoor adventure education build toward more effective programming. progress has been made on this front since hattie et al. (1997), and it is our hope that this scoping review can help this progress continue in the future. 164 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 annales kinesiologiae • 13 • 2022 • 2 ta bl e 3. a b ri ef o ve rv ie w o f t he s tu di es in cl ud ed fo r re vi ew in th is m an us cr ip t a ut ho rs p ro gr am p ro vi de r st ud y p op ul at io n st ud y m et ho ds sa m pl e si ze a ng e t a l., 2 01 4 o ut w ar d b ou nd si ng ap or e a tri sk y ou th pa rt ic ip at in g in a fi ve da y ce nt er -b as ed o ut do or ad ve nt ur e pr og ra m y ou th a tr is k pr og ra m e va lu at io n su rv ey ad m in is te re d at th re e po in ts : p re -p ro gr am , o ne m on th p os tpr og ra m , a nd th re e m on th s po st pr og ra m ; b eh av io ra l d at a (n um be r o f c la ss es a nd ex tr ac ur ri cu la r a ct iv iti es s ki pp ed in th e pa st w ee k) co lle ct ed fr om s ch oo l p re -p ro gr am a nd 3 -m on th s af te r t he p ro gr am 13 6 (c on tr ol =6 0, tr ea tm en t= 76 ) b en ha m & sh ep ar d, 1 99 5 u ns pe ci fie d, pr og ra m to ok p la ce on th e sh or e of l ak e m ic hi ga n in th e u ni te d st at es a fr ic an a m er ic an s ch oo l le ad er s pa rt ic ip at in g in a ce nt er -b as ed p ro fe ss io na l de ve lo pm en t p ro gr am v id eo re co rd ed p ar tic ip an ts ' a ct iv iti es a t t he pr of es si on al d ev el op m en t r et re at fo r a fr ic an a m er ic an e du ca to rs th ro ug ho ut th e w ee k; e ac h pa rt ic ip an t p ar tic ip at ed in a n in te rv ie w a t t he co nc lu si on o f t he w ee k an d th re e fo llo w -u p in te rv ie w s ov er th e fo llo w in g si x m on th s 5 b ob ily a et a l., 20 14 n or th c ar ol in a o ut w ar d b ou nd sc ho ol in di vi du al s en ro lle d in e xp ed iti on -b as ed pr og ra m s of 7 -5 0 da ys fi na l e xp ed iti on s ur ve y so lic iti ng o pe nen de d re sp on se s co m pl et ed o n th e la st d ay o f t he fi na l ex pe di tio n 33 1 b ob ily a et a l., 20 15 n or th c ar ol in a o ut w ar d b ou nd sc ho ol in di vi du al s en ro lle d in e xp ed iti on -b as ed pr og ra m s of 8 -2 8 da ys po st -c ou rs e su rv ey : o pe nen de d qu es tio ns o n co nt en t l ea rn ed a nd th e in te nt io n to tr an sf er le ar ni ng ; t w oye ar fo llo w -u p: o pe nen de d qu es tio ns on c on te nt le ar ne d an d th e w ay s sk ill s w er e ut ili ze d po st -c ou rs e; th e re su lts w er e in de pe nd en tly c od ed by th re e re se ar ch er s. po st c ou rs e= 36 9, tw oye ar =3 0 b ob ily a et a l., 20 17 n or th c ar ol in a o ut w ar d b ou nd sc ho ol in di vi du al s en ro lle d in e xp ed iti on -b as ed pr og ra m s of 4 -2 8 da ys o pe nen de d su rv ey q ue st io ns c om pl et ed o n th e fin al d ay o f p ro gr am m in g on p os tpr og ra m le ar ni ng an d gr ow th , t he re sp on se s w er e co de d an d th em es de ve lo pe d in du ct iv el y 18 9 annales kinesiologiae • 13 • 2022 • 2 165 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 a ut ho rs p ro gr am p ro vi de r st ud y p op ul at io n st ud y m et ho ds sa m pl e si ze b ro ad du s et a l., 20 13 b al tim or e c he sa pe ak e b ay o ut w ar d b ou nd b al tim or e po lic e offi ce rs an d m id dl e sc ho ol st ud en ts p ar tic ip at in g in a on eda y te am bu ild in g pr og ra m su rv ey s us ed to m ea su re b ot h re si lie nc e an d se lf co ns tr uc ts ; o ut w ar d b ou nd o ut co m es in st ru m en ts w as u se d to m ea su re s el fco ns tr uc ts ; t he m ul tid im en si on al r el at io ns hi p q ue st io nn ai re w as us ed to m ea su re re si lie nc e 27 e w er t, 20 14 o ut w ar d b ou nd fo r v et er an s u ni te d st at es v et er an s in a fi ve -d ay o ut do or ad ve nt ur e pr og ra m su rv ey s us ed to m ea su re b ot h re si lie nc e an d se lf co ns tr uc ts ; o ut w ar d b ou nd o ut co m es in st ru m en ts w as u se d to m ea su re s el fco ns tr uc ts ; t he m ul tid im en si on al r el at io ns hi p q ue st io nn ai re w as us ed to m ea su re re si lie nc e 31 0 fa ir cl ot h & b ob ily a, 2 01 3 n or th c ar ol in a o ut w ar d b ou nd sc ho ol in di vi du al s en ro lle d in e xp ed iti on -b as ed pr og ra m s of 4 -2 8 da ys ps yc ho m et ri c in ve st ig at io n of th e n or th c ar ol in a o ut w ar d b ou nd s ch oo l c ou rs e im pr es si on s ur ve y, an a da pt ed v er si on o f t he o ut w ar d b ou nd o ut co m es in ve nt or y; a na ly si s in cl ud ed d es cr ip tiv e st at is tic s, in te rite m c or re la tio ns , t es tre te st re lia bi lit y, ex pl or at or y fa ct or a na ly si s, a nd in te rn al c on si st en cy 26 8 fi sc he r & a tta h, 2 00 1 n or th c ar ol in a o ut w ar d b ou nd sc ho ol te en s in fo st er c ar e pa rt ic ip at in g in a s ev en da y ou td oo r a dv en tu re co ur se pr e a nd p os tpr og ra m s ur ve ys c on si st in g of b ot h sc al ed a nd o pe nen de d qu es tio ns fo cu si ng o n pr og ra m p ar tic ip an t b eh av io r a nd e xp er ie nc es w er e gi ve n to th e pr og ra m p ar tic ip an ts , f os te r ca re w or ke rs , a nd fo st er p ar en ts a t t hr ee p oi nt s: pr epr og ra m , p os tpr og ra m , a nd th re e m on th s po st pr og ra m . 23 fo uh ey & sa ltm ar sh , 1 99 6 t ho m ps on is la nd o ut w ar d b ou nd e du ca tio n c en te r u ni ve rs ity s tu de nt s en ro lle d in a s er vi ce le ar ni ng p ro gr am e xa m in ed c ou rs e co m po ne nt s th ro ug h th e le ns of v ar io us e xp er ie nt ia l e du ca tio n an d ou td oo r ad ve nt ur e th eo ri es . 610 fr ee m an , 2 01 1 h is to ri ca l a na ly si s n /a h is to ri ca l a na ly si s of p ri or re se ar ch , w ri tin gs fr om pr om in en t e du ca to rs , a nd o th er re le va nt d oc um en ts . n /a 166 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 annales kinesiologiae • 13 • 2022 • 2 a ut ho rs p ro gr am p ro vi de r st ud y p op ul at io n st ud y m et ho ds sa m pl e si ze g al lo w ay , 2 00 7 n or th c ar ol in a o ut w ar d b ou nd sc ho ol ; v oy ag eu r o ut w ar d b ou nd sc ho ol o ut w ar d b ou nd c ou rs e le ad er s o ut do or l ea de r e xp er ie nc e u se h is to ry s ur ve ys an d fa ct or ia l d ec is io n v ig ne tte s (p ro vi di ng le ad er sh ip c ho ic es fo r v ar io us o ut do or a dv en tu re re la te d m ed ic al d ec is io ns ) p ro vi de d to tr ip le ad er s, re sp on se s an al yz ed v ia a h ie ra rc hi ca l l in ea r m od el . 10 3 g as sn er , 2 00 8 o ut w ar d b ou nd si ng ap or e a du lts w ho p ar tic ip at ed in th e c la ss ic c ha lle ng e co ur se (2 1 da y ex pe di tio n) su rv ey w ith p ar tic ip an ts ra tin g ho w im pa ct fu l di ff er en t c ou rs e co m po ne nt s w er e on th ei r c ur re nt liv es 31 8 g as sn er & r us se ll, 2 00 8 o ut w ar d b ou nd si ng ap or e a du lts w ho p ar tic ip at ed in th e c la ss ic c ha lle ng e co ur se (2 1 da y ex pe di tio n) su rv ey w ith p ar tic ip an ts re tr os pe ct iv el y ex am in in g th e ov er al l i m pa ct o f t he ir o ut w ar d b ou nd c ou rs e on th ei r c ur re nt li ve s an d ho w im pa ct fu l v ar io us as pe ct s of th e ex pe ri en ce w er e 31 8 g as sn er e t a l., 20 06 o ut w ar d b ou nd si ng ap or e a du lts w ho p ar tic ip at ed in th e c la ss ic c ha lle ng e co ur se (2 1 da y ex pe di tio n) q ue st io nn ai re a sk in g pa rt ic ip an ts to ra te th e pe rc ei ve d im pa ct o f t he ir o ut w ar d b ou nd c ou rs e an d th e co ur se c om po ne nt s co nt ri bu tin g to th es e im pa ct s 31 8 g ol de nb er g et al ., 20 02 n or th c ar ol in a o ut w ar d b ou nd sc ho ol in di vi du al s en ro lle d in ex pe di tio n pr og ra m s of 421 d ay s in le ng th q ue st io nn ai re a sk in g pa rt ic ip an ts to id en tif y im pa ct fu l c ou rs e co m po ne nt s, th e ou tc om es re la te d to th os e co ur se c om po ne nt s, a nd u lti m at el y th e br oa de r v al ue s im pa ct ed b y th os e ou tc om es ; re sp on se s ar ra ng ed in to h ie ra rc hi ca l v al ue m ap s 21 6 g ol de nb er g et al ., 20 05 n or th c ar ol in a o ut w ar d b ou nd sc ho ol in di vi du al s en ro lle d in ex pe di tio n pr og ra m s of 421 d ay s in le ng th q ue st io nn ai re a sk in g pa rt ic ip an ts to id en tif y im pa ct fu l c ou rs e co m po ne nt s, th e ou tc om es re la te d to th os e co ur se c om po ne nt s, a nd u lti m at el y th e br oa de r v al ue s im pa ct ed b y th os e ou tc om es ; re sp on se s ar ra ng ed in to h ie ra rc hi ca l v al ue m ap s 21 6 annales kinesiologiae • 13 • 2022 • 2 167 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 a ut ho rs p ro gr am p ro vi de r st ud y p op ul at io n st ud y m et ho ds sa m pl e si ze g re ff ra th e t a l., 20 11 o ut w ar d b ou nd so ut h a fr ic a 3r dye ar u ni ve rs ity st ud en ts p ar tic ip at in g in tw o di ff er en t o ut do or ad ve nt ur e ed uc at io n pr og ra m s a c ro ss ov er re se ar ch d es ig n w ith tw o se pa ra te ex pe ri m en ta l g ro up s pa rt ic ip at in g in e ith er a c en tr eba se d ad ve nt ur e pr og ra m o r a n ex pe di tio nba se d w ild er ne ss p ro gr am , t he g ro up s sw itc he d tr ea tm en ts af te r fi ve m on th s; g ro up s co m pl et ed p re a nd po st -p ro gr am " r ev ie w o f p er so na l e ff ec tiv en es s an d l oc us o f c on tr ol " su rv ey s fo r e ac h tr ea tm en t; po st -t re at m en t s em ist ru ct ur ed in te rv ie w s an d fo cu s gr ou ps w er e al so c on du ct ed 28 h an na , 1 99 5 c ol or ad o o ut w ar d b ou nd s ch oo l y ou th e nr ol le d in pr og ra m s of 1 011 d ay s su rv ey m ea su ri ng m in im al im pa ct k no w le dg e, b as ic ec ol og ic al k no w le dg e, w ild er ne ss is su e at tit ud es , a s w el l a s pr ed is po si ng fa ct or s, b eh av io ra l i nt en tio n, an d se lf -r ep or te d be ha vi or fo r o ut w ar d b ou nd a nd a ud ub on f ie ld e co lo gy c am ps a t t hr ee ti m e po in ts : pr epr og ra m , p os tpr og ra m , a nd s ix m on th s af te r pr og ra m c on cl us io n 32 h ar pe r e t a l., 20 14 o ut w ar d b ou nd c an ad a c an ad ia n ve te ra ns pa rt ic ip at in g in a s ev en da y ou td oo r a dv en tu re ed uc at io n pr og ra m u til iz ed th e o ut w ar d b ou nd o ut co m es in ve nt or y to m ea su re p sy ch os oc ia l c on st ru ct s pr epr og ra m , im m ed ia te ly p os tpr og ra m , a nd s ix w ee ks p os tpr og ra m ; 1 2 se m ist ru ct ur ed in te rv ie w s ex am in in g co ur se o ut co m es , h ea lth a nd w el lb ei ng , a nd th e co ur se in re la tio n to p ar tic ip an t’s c ar ee r a nd m ili ta ry se rv ic e w er e al so c on du ct ed su rv ey =5 0, in te rv ie w =1 2 h ic km an d un ne , 2 01 8 o ut w ar d b ou nd tr us t ( u ni te d k in gd om ) sc ho ol g ro up s ba se d in th e u ni te d k in gd om o n ou td oo r e xp ed iti on s se m ist ru ct ur ed in te rv ie w s w ith o ut w ar d b ou nd tr us t s ta ff ; a n et hn og ra ph y of fo ur s ch oo l g ro up tr ip s th ro ug h th e o ut w ar d b ou nd t ru st ; p ai re d fo llo w -u p in te rv ie w s w ith p ar tic ip an ts in cl ud in g m oo d bo ar d ac tiv ity st aff =2 6, pa rt ic ip an ts =4 4 168 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 annales kinesiologiae • 13 • 2022 • 2 a ut ho rs p ro gr am p ro vi de r st ud y p op ul at io n st ud y m et ho ds sa m pl e si ze h ol de n, 2 00 4 n or th c ar ol in a o ut w ar d b ou nd sc ho ol a du lts p ar tic ip at in g in an e xp ed iti on -b as ed pr og ra m o f a t l ea st 1 4 da ys a q ua si -e xp er im en ta l d es ig n w ith s om e co ur se s be in g in fo rm ed a bo ut th e pr es en ce o f a s at el lit e ph on e an d ot he rs n ot ; a ll th e pa rt ic ip an ts fi lle d in a p os tco ur se s ur ve y m ea su ri ng w ild er ne ss ex pe ri en ce , r is kta ki ng , t he p er ce pt io n of s af et y, a nd le ve l o f s tr es s. 26 1 h ov el yn ck , 20 01 o ut w ar d b ou nd b el gi um o ut w ar d b ou nd c ou rs e le ad er s m ul tip le s em ist ru ct ur ed in te rv ie w s w ith c ou rs e le ad er s di sc us si ng 2 -3 m om en ts p er d ay p er pr og ra m a nd h ow th ey w er e fa ci lit at ed 8 h ye r e t a l., 19 96 pa ci fic c re st o ut w ar d b ou nd sc ho ol ; n or th c ar ol in a o ut w ar d b ou nd s ch oo l v ie tn am w ar v et er an s w ith c hr on ic p t sd pa rt ic ip at in g in a fi ve da y ou td oo r a dv en tu re ed uc at io n pr og ra m v et er an s in a m ul tiw ee k pt sd tr ea tm en t p ro gr am ad m in is te re d a 5da y o ut w ar d b ou nd p ro gr am in lie u of s ch ed ul ed tr ea tm en t ( th e co nt ro l g ro up d id no t a tte nd th e o ut w ar d b ou nd p ro gr am ); v et er an s su bj ec t t o a ba tte ry o f s ur ve ys m ea su ri ng s ym pt om ch an ge in p t sd s ub je ct s pr epr og ra m , i m m ed ia te ly po st -p ro gr am , a nd o n ex it fr om th e m ul tiw ee k tr ea tm en t; th e o ut w ar d b ou nd p ar tic ip an ts a ls o fil le d in a s ur ve y an d pr ov id ed o pe nen de d co m m en ts o n th ei r p er ce pt io n of th e ex pe ri en ce 21 9 (c on tr ol =1 11 , tr ea tm en t= 10 8) ji rá se k et a l., 20 16 v ac at io n sc ho ol o f l ip ni ce -o ut w ar d b ou nd c ze ch r ep ub lic a du lts p ar tic ip at in g in a 12 -d ay e xp ed iti on m ix ed m et ho d de si gn in cl ud in g fr eq ue nc y ch ar ts w ith p ar tic ip an ts id en tif yi ng c lo se re la tio ns hi ps in th e gr ou p re co rd ed a t t hr ee p oi nt s th ro ug ho ut th e ex pe di tio n, p os tco ur se re fle ct iv e es sa ys , a po st -c ou rs e su rv ey o n gr ou p co he si on , a nd m id co ur se a nd p os tco ur se m in d m ap s ex pl or in g ho w pa rt ic ip an ts fe el a bo ut th e o ut w ar d b ou nd c ou rs e 26 ji rá se k, ji rá sk ov á et a l., 20 17 v ac at io n sc ho ol o f l ip ni ce -o ut w ar d b ou nd c ze ch r ep ub lic a du lts p ar tic ip at in g in a 12 -d ay e xp ed iti on po st -c ou rs e un st ru ct ur ed in te rv ie w s an d th e de ve lo pm en t o f s ys te m ic c on st el la tio ns ; c on te nt an al yz ed fo r s pi ri tu al e le m en ts o f t he e xp er ie nc e 12 annales kinesiologiae • 13 • 2022 • 2 169 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 a ut ho rs p ro gr am p ro vi de r st ud y p op ul at io n st ud y m et ho ds sa m pl e si ze ji rá se k, v es el sk ý et a l., 20 17 v ac at io n sc ho ol o f l ip ni ce -o ut w ar d b ou nd c ze ch r ep ub lic a du lts p ar tic ip at in g in a 12 -d ay e xp ed iti on -b as ed pr og ra m u ns tr uc tu re d in te rv ie w s on th e sp ir itu al a sp ec ts o f th e ex pe di tio n pa ir ed w ith th e pr ag ue s pi ri tu al ity q ue st io nn ai re . 12 k al is ch e t a l., 20 11 n or th c ar ol in a o ut w ar d b ou nd sc ho ol in di vi du al s en ro lle d in e xp ed iti on -b as ed pr og ra m s of 7 -4 5 da ys pa rt ic ip an ts g iv en a n op en -e nd ed s ur ve y on th ei r pe rc ep tio ns o f t he s ol o ex pe ri en ce d ur in g th e la st ho ur o f t he s ol o, re sp on se s co de d fo r s al ie nt th em es an d fr eq ue nc y ta bl es c on st ru ct ed 33 5 k ir w in e t a l., 20 19 o ut w ar d b ou nd c an ad a in di vi du al s en ro lle d in an e ig ht -d ay e xp ed iti on ba se d pr og ra m t hr ee p re vi ou sl y de ve lo pe d su rv ey s w er e us ed to m ea su re s av or in g, m in df ul ne ss , a nd p os iti ve a ff ec t in b ot h th e co nt ro l ( no o ut w ar d b ou nd p ro gr am pa rt ic ip at io n) a nd e xp er im en ta l ( pa rt ic ip at io n in th e ei gh tda y o ut w ar d b ou nd m in df ul ne ss pr og ra m ) g ro up s at th re e tim e pe ri od s: p re -p ro gr am , im m ed ia te ly p os tpr og ra m , a nd th re e m on th s po st pr og ra m 30 (c on tr ol =1 6, tr ea tm en t= 14 ) k le in & r io rd an , 2 00 9 e xp ed iti on ar y l ea rn in g sc ho ol s o ut w ar d b ou nd e du ca to rs in n ew y or k c ity a q ua lit at iv e ca se s tu dy a na ly zi ng h ar dc op y m at er ia ls li ke s tu de nt w or k, c la ss ro om o bs er va tio ns , an d te ac he r i nt er vi ew s; a na ly ze d fo r s al ie nt th em es by b ot h au th or s 8 k le in & r io rd an , 2 01 1 e xp ed iti on ar y l ea rn in g sc ho ol s o ut w ar d b ou nd e du ca to rs in n ew y or k c ity a q ua lit at iv e ca se s tu dy c om pr is in g in te rv ie w s, si te v is its , a nd d oc um en t a nd a rt if ac t a na ly si s; da ta w er e co de d an d an al yz ed v ia a na ly tic m em os , tr ia ng ul at io n, a nd m em be r c he ck s 8 170 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 annales kinesiologiae • 13 • 2022 • 2 a ut ho rs p ro gr am p ro vi de r st ud y p op ul at io n st ud y m et ho ds sa m pl e si ze l eb er m an , 20 07 o ut w ar d b ou nd n ew z ea la nd fe m al e off en de rs to b e re le as ed fr om pr is on w ith in o ne y ea r pa rt ic ip at in g in a 2 0da y ou td oo r a dv en tu re ed uc at io n co ur se 27 s em ist ru ct ur ed in te rv ie w s at th e en d of th e co ur se ; f ol lo w -u p in te rv ie w s w ith 1 4 w om en th re e m on th s af te r t he e nd o f t he c ou rs e; fi el d ob se rv at io ns , i ns tr uc to r r ep or ts , a nd c as e offi ce r r ep or ts w er e al so u til iz ed ; a na ly ze d in a ph en om en ol og ic al m an ne r 27 l eb er m an & m ar tin , 2 00 2 o ut w ar d b ou nd c ze ch r ep ub lic , o ut w ar d b ou nd n ew z ea la nd in te rn at io na l p ar tic ip an ts in th e c ze ch r ep ub lic ; fe m al e off en de rs in n ew z ea la nd ; b ot h pa rt ic ip at in g in m ul tida y ou td oo r a dv en tu re ed uc at io n pr og ra m s tw o se pa ra te s tu di es a na ly zi ng c om fo rt , r is k, a nd th e re la tio ns hi p th es e co nc ep ts h av e to le ar ni ng ; fo r o ut w ar d b ou nd c ze ch r ep ub lic , p ar tic ip an ts co m pl et ed a n op en -e nd ed q ue st io nn ai re 6 -m on th s af te r c ou rs e co nc lu si on ; f or o ut w ar d b ou nd n ew z ea la nd , i nt er vi ew s co nd uc te d po st -c ou rs e an d th re e m on th s af te r c ou rs e co nc lu si on . o ut w ar d b ou nd c ze ch r ep ub lic =2 5, o ut w ar d b ou nd n ew z ea la nd =2 7 l ow an , 2 00 9 o ut w ar d b ou nd c an ad a fo rm er g iw ay ki w in st ud en ts , o ut w ar d b ou nd s ta ff m em be rs , a bo ri gi na l e ld er s, a nd co m m un ity m em be rs in vo lv ed w ith th e pr og ra m a c ol la bo ra tiv e et hn og ra ph y st ud y co ns is tin g of in te rv ie w s, fi el d jo ur na l f ro m re se ar ch er , co lla bo ra tiv e ex am in at io n of p ar tic ip an ts ' c ou rs e jo ur na ls , a nd c ou rs e ar tif ac ts 9 m ar tin & l eg g, 20 02 o ut w ar d b ou nd n ew z ea la nd in di vi du al s en ro lle d in ni ne -d ay a nd 2 2da y ex pe di tio nba se d co ur se s a m ix ed m et ho d lo ng itu di na l s tu dy , a dm in is te ri ng a m ul tid im en si on al s el fco nc ep t q ue st io nn ai re pr ean d po st -p ro gr am ; t hr ee o pe nen de d qu es tio ns w er e ad m in is te re d pr epr og ra m , p os tpr og ra m , a nd si x m on th s af te r t he p ro gr am e xa m in in g co ur se at m os ph er e; q ue st io ns e xa m in ed c ou rs e ou tc om es an d w ha t e le m en ts o f t he c ou rs e co nt ri bu te d to th em 93 annales kinesiologiae • 13 • 2022 • 2 171 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 a ut ho rs p ro gr am p ro vi de r st ud y p op ul at io n st ud y m et ho ds sa m pl e si ze m ar tin , 2 01 1 v ac at io n sc ho ol o f l ip ni ce -o ut w ar d b ou nd c ze ch r ep ub lic se lf -e xa m in at io n an d re fle ct io n a ut oe th no gr ap hy u si ng p ar tic ip an t o bs er va tio n w ith th e au th or e xa m in in g th e pe rs on al m ea ni ng o f t he o ut w ar d b ou nd e xp er ie nc e 1 m ar tin & l eb er m an , 20 05 o ut w ar d b ou nd n ew z ea la nd pa rt ic ip an ts w ho w er e 16 y ea rs a nd o ld er pa rt ic ip at in g in a v ar ie ty of o ut do or a dv en tu re co ur se s a m ix ed m et ho d lo ng itu di na l a pp ro ac h, c on du ct in g qu es tio nn ai re s on th e fir st d ay , l as t d ay , a nd 1 2 w ee ks a ft er p ro gr am c om pl et io n; s ur ve ys a nd o pe nen de d qu es tio ns e xa m in ed le ar ni ng a ro un d a va ri et y of c on ce pt s su ch a s le ad er sh ip , s el fco nfi de nc e, a nd so ci al c om pe te nc e 15 7 m ar tin e t a l., 20 16 o ut w ar d b ou nd n ew z ea la nd sc ho ol a nd e xe cu tiv e di re ct or s a c as e st ud y fr am ew or k on o rg an iz at io na l c ul tu re w ith p ri m ar y da ta b ei ng c ol le ct ed th ro ug h se m ist ru ct ur ed in te rv ie w s; fi nd in gs fu rt he r t ri an gu la te d vi a an al ys is o f o ut w ar d b ou nd n ew z ea la nd a nn ua l re po rt s an d re se ar ch er s' fir st ha nd k no w le dg e of o ut w ar d b ou nd 14 m ar tin e t a l., 20 02 o ut w ar d b ou nd c ze ch r ep ub lic , o ut w ar d b ou nd a us tr al ia in di vi du al s en ro lle d in 14 -d ay e xp ed iti on -b as ed pr og ra m s o pe nen de d su rv ey q ue st io ns w er e ad m in is te re d to pa rt ic ip an ts 6 -m on th s af te r a ll co ur se s; s ec on da ry fo llo w -u p w as d is tr ib ut ed to tw o co ur se s on e ye ar af te r c om pl et io n an d tw o ye ar s af te r c om pl et io n fo r th e th ir d co ur se ; e xa m in ed th e im pa ct fu l e le m en ts of o ut w ar d b ou nd c ou rs es u til iz in g a dr am at ur gi ca l ap pr oa ch to e du ca tio n 70 m ar tin e t a l., 20 09 c ol or ad o o ut w ar d b ou nd s ch oo l 7t h an d 8t h gr ad e st ud en ts e nr ol le d in a n e xp ed iti on ar y l ea rn in g o ut w ar d b ou nd s ch oo l e xa m in in g th e in flu en ce o f a w at er sh ed e du ca tio n un it; c hi ld re n’ s e nv ir on m en ta l v ir tu e sc al e su rv ey ad m in is te re d pr e a nd p os tpr og ra m to p ar tic ip an ts ; re su lts c om pa re d to a c on ve ni en ce s am pl e of e ig ht hgr ad e st ud en ts in c ol or ad o se rv in g as a c on tr ol gr ou p 11 2 (t re at m en t= 45 , c on tr ol =6 7) 172 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 annales kinesiologiae • 13 • 2022 • 2 a ut ho rs p ro gr am p ro vi de r st ud y p op ul at io n st ud y m et ho ds sa m pl e si ze m ax w el l e t a l., 20 08 o ut w ar d b ou nd n ew z ea la nd y ou ng a du lts fa ci ng lo ng -t er m u ne m pl oy m en t w ho a re p ar tic ip at in g in a 2 1da y re si de nt ia l pr og ra m a na ly si s of o ut w ar d b ou nd p ar tic ip an t d at a in cl ud in g de m og ra ph ic s, e xt er na l e nv ir on m en ta l fa ct or s, in te rn al e nv ir on m en ta l f ac to rs , a nd s oc ia l in te gr at io n; in te rv ie w s co nd uc te d w ith a s am pl e of 10 p ro gr am d ro po ut s su rv ey =5 85 , in te rv ie w =1 0 m ck en zi e, 20 03 o ut w ar d b ou nd w es te rn c an ad a a du lts , y ou th , f em al e su rv iv or s of a bu se , an d at -r is k yo ut h pa rt ic ip at in g in o ut do or ad ve nt ur e co ur se s ra ng in g fr om 7 to 3 6 da ys in le ng th a n in te rp re tiv e ca se s tu dy e xa m in in g o ut w ar d b ou nd s tu de nt le ar ni ng p ro ce ss es ; d at a co lle ct io n co ns is te d of a p os tpr og ra m q ue st io nn ai re , in te rv ie w s, re se ar ch er o bs er va tio n of g ro up di sc us si on s su rv ey =9 2, in te rv ie w =2 0 m ill ik an , 2 00 6 h is to ri ca l a na ly si s n /a h is to ri ca l a na ly si s of o ut w ar d b ou nd p ro gr am m in g n /a m ot t & m ar tin , 20 17 o ut w ar d b ou nd n ew z ea la nd in di vi du al s en ro lle d in v ar io us o ut do or ad ve nt ur e co ur se s a m ix ed m et ho ds d es ig n co ns is tin g in te rv ie w s, in ci de nt re po rt a nd q ua lit y co nt ro l f or m a na ly si s, an d pr e a nd p os tpr og ra m e va lu at io n qu es tio nn ai re s an al yz in g pe rc ep tio ns o f r is k an d sa fe ty o n o ut w ar d b ou nd n ew z ea la nd c ou rs es su rv ey = 6 79 2, in te rv ie w = 5 n ei ll & d ia s, 20 01 o ut w ar d b ou nd a us tr al ia y ou ng a du lts o n a 22 da y ex pe di tio n or ie nt ed pr og ra m a q ua si -e xp er im en ta l d es ig n; th e ex pe ri m en ta l gr ou p co m pl et ed a r es ili en ce s ca le fo r p re a nd po st -p ro gr am m ea su re s an d th e so ci al s up po rt sc al e up on c ou rs e co m pl et io n; c on tr ol g ro up o nl y co m pl et ed r es ili en ce s ca le fo r p re a nd p os t pr og ra m m ea su re s 72 (t re at m en t= 41 ; c on tr ol =3 1) n ew be ry , 2 00 4 g en er al o ut w ar d b ou nd pr og ra m m in g fe m al e o ut w ar d b ou nd in st ru ct or s a q ua lit at iv e de si gn c om pr is in g se m ist ru ct ur ed in te rv ie w s co nd uc te d ov er 6 m on th s be tw ee n 19 99 20 00 , i nd iv id ua l r efl ec tiv e jo ur na l t ra ns cr ip ts a nd a gr ou p in te rv ie w . 4 annales kinesiologiae • 13 • 2022 • 2 173 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 a ut ho rs p ro gr am p ro vi de r st ud y p op ul at io n st ud y m et ho ds sa m pl e si ze po m m ie r & w itt , 1 99 5 o ut w ar d b ou nd fa m ily in n ee d of se rv ic es p ro gr am a do le sc en t s ta tu s off en de rs a nd p ar en ts pa rt ic ip at in g in a m ul tim on th s up po rt p ro gr am a lo ng itu di na l q ua nt ita tiv e st ud y; s ur ve ys w er e ad m in is te re d be fo re th e pr og ra m s ta rt , 2 8 da ys af te r t he p ro gr am s ta rt , a nd fo ur m on th s af te r t he pr og ra m s ta rt ; c on tr ol g ro up w as n ot e xp os ed to th e fa m ily in n ee d of s er vi ce s pr og ra m 10 7 (t re at m en t= 61 ; c on tr ol =4 6) pu rd ie & n ei ll, 19 98 o ut w ar d b ou nd a us tr al ia u nd er -a ch ie vi ng ja pa ne se s tu de nt s pa rt ic ip at in g in a 2 2da y ou td oo r a dv en tu re pr og ra m in a us tr al ia , pr og ra m a cc om pa ni ed b y a la ng ua ge d ev el op m en t co m po ne nt c on tr ol a nd e xp er im en ta l g ro up s co m pl et ed th e "a bo ut m ys el f" s el fco nc ep t i ns tr um en ts a t t hr ee tim e pe ri od s: p re -c ou rs e, im m ed ia te ly p os tco ur se , an d si x w ee ks p os tco ur se ; e xp er im en ta l g ro up al so c om pl et ed " e va lu at io n of c ou rs e" in st ru m en t im m ed ia te ly p os tco ur se ; m ul tiv ar ia te re pe at ed m ea su re s an al ys is w as u til iz ed a nd c ha ng e sc or es w er e co m pa re d to p re vi ou s fin di ng s w ith in pr im ar ily w es te rn p op ul at io ns 72 (t re at m en t= 32 ; c on tr ol -4 2) sc he in fe ld e t al ., 20 17 o ut w ar d b ou nd fo r v et er an s u ni te d st at es v et er an s pa rt ic ip at in g in a s ix da y ou td oo r a dv en tu re ed uc at io n pr og ra m a q ua si -e xp er im en ta l s tu dy w ith e xp er im en ta l a nd co nt ro l g ro up s co m pl et in g pr e a nd p os tpr og ra m su rv ey s m ea su ri ng d em og ra ph ic in fo rm at io n, m as cu lin e ro le c on fo rm ity , a nd m en ta l h ea lth sy m pt om s 19 9 (t re at m en t= 18 1; c on tr ol =1 8) si bt ho rp e t a l., 20 18 o ut w ar d b ou nd h on g k on g se co nd ar y an d un iv er si ty st ud en ts p ar tic ip at in g in a v ar ie ty o f o ut do or ad ve nt ur e ed uc at io n pr og ra m s a p re a nd p os tco ur se a dm in is tr at io n of th e o ut w ar d b ou nd h on g k on g pe rf or m an ce e va lu at io n q ue st io nn ai re ; s ur ve y re su lts u se d to ex pl or e ho w c ou rs e ou tc om es w er e re la te d to c ou rs e la ng ua ge , s en se o f b el on gi ng , a nd te ac he rst ud en t re la tio ns hi p 22 92 to lic h, 2 01 2 o ut w ar d b ou nd n ew z ea la nd se lf -e xa m in at io n an d re fle ct io n a n au to et hn og ra ph ic s tu dy fr om a re se ar ch er pa rt ic ip an t l en s on th e m ea ni ng o f t he o ut w ar d b ou nd e xp er ie nc e 1 174 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 annales kinesiologiae • 13 • 2022 • 2 a ut ho rs p ro gr am p ro vi de r st ud y p op ul at io n st ud y m et ho ds sa m pl e si ze v er no n, 2 01 5 u ni te d st at es , un sp ec ifi ed pr og ra m p ro vi de r st ud en ts fr om a d iv er si ty pr og ra m p ar tic ip at in g in an u ns pe ci fie d o ut w ar d b ou nd p ro gr am a q ua lit at iv e st ud y co ns is tin g ob se rv at io ns co up le d w ith jo tti ng s, fi el d no te s, p ho to gr ap hs , an d au di o re co rd in gs ; i nt er vi ew s w ith s tu de nt s an d ad m in is tr at or s n /a w al ke r e t a l., 20 05 o ut w ar d b ou nd a us tr al ia in di vi du al s w ith re ce nt br ai n in ju ry p ar tic ip at in g in a n o ut w ar d b ou nd co ur se e m be dd ed in a br oa de r t re at m en t pr og ra m u po n co m pl et io n of th e pr og ra m , p ar tic ip an t g oa ls w er e an al yz ed fo r c om pl et io n; p re a nd p os tm ea su re s us in g th e d ep re ss io n, a nx ie ty , a nd s tr es s sc al es , t he g en er al w el lb ei ng q ue st io nn ai re , a nd th e e ur op ea n b ra in in ju ry q ue st io nn ai re w er e al l ga th er ed ; p os tpr og ra m e ffi ca cy s co re s fo r d iff er en t pr og ra m e le m en ts a nd th e pr og ra m a s a w ho le w er e ga th er ed 11 w an g et a l., 20 06 o ut w ar d b ou nd si ng ap or e fe m al e se co nd ar y sc ho ol st ud en ts p ar tic ip at in g in a fi ve -d ay o ut do or ad ve nt ur e ed uc at io n pr og ra m pr e a nd p os tpr og ra m s ur ve ys w er e ad m in is te re d to p ar tic ip an ts m ea su ri ng le ad er sh ip , s oc ia l s ki lls , in te rp er so na l s ki lls , s el fes te em , m ot iv at io n fo r pa rt ic ip at in g in th e pr og ra m (p re -p ro gr am o nl y) , an d sa tis fa ct io n w ith th e ex pe ri en ce (p os tpr og ra m on ly ) 14 9 annales kinesiologiae • 13 • 2022 • 2 175 timothy j. mateer, joshua pighetti, b. derrick taff, pete allison: outward bound and outdoor adventure education ... , 143–181 references1 *ang, r. p., farihah, n., & lau, s. 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