Monthly Archive for November, 2023

Sport role in multiple sclerosis

If you are interested in learning more about the role of sports in patients with multiple sclerosis, you can read this summary article on this topic.

Donze, Cecile1; Massot, Caroline MD1; Hautecoeur, Patrick2; Cattoir-Vue, Helene1; Guyot, Marc-Alexandre1. The Practice of Sport in Multiple Sclerosis: Update. Current Sports Medicine Reports 16(4):p 274-279, 7/8 2017.

The practice of sport by multiple sclerosis patients has long been controversial. Recent studies, however, show that both sport and physical activity are essential for these patients. Indeed, they help to cope with the effects of multiple sclerosis, such as fatigue, reduced endurance, loss of muscle mass, and reduction of muscle strength. The beneficial effects of physical activity on these patients have been underlined in several studies, whereas those of practicing sport have been the subject of fewer evaluations and assessments. The aim of this update is to report on the effects of sport on multiple sclerosis patients. The benefits of sport have been demonstrated in several studies. It helps multiple sclerosis patients to increase their balance, resistance to fatigue, mobility and quality of life. Several biases in these studies do not enable us to recommend the practice of some of these sports on a routine basis.

Table tennis fights the multiple sclerosis

Antonio Barbera, an Italian doctor living in the United States for over two decades, faced a significant life shift when he experienced two episodes of Multiple Sclerosis (MS), causing severe physical impairments. MS is a neurodegenerative condition affecting the central nervous system, leading to damage to nerve fibers’ protective sheath (myelin) and nerve cells.

After battling the aftermath of MS attacks, BARBERA noticed that playing table tennis (TT) seemed to alleviate one of his “invisible symptoms”—a constant sense of chest tightness. Inspired by this personal revelation, he delved into research to explore the potential benefits of TT for individuals with neurodegenerative conditions like MS, Parkinson’s (PD), and Alzheimer’s (AD).

Antonio founded the non-profit organization Table Tennis Connections, aiming to raise awareness about TT’s multitude of benefits. He initiated the NeuroPongTM Project, a TT program tailored for people with neurodegenerative conditions. Antonio’s objective is not only to promote the physical, emotional, and social advantages of TT but also to scientifically support its efficacy in aiding brain functionality.

Understanding the concept of neuroplasticity, the brain’s ability to form new cells and connections through proper training, Antonio aims to utilize TT as a tool to enhance the cognitive abilities of those with neurodegenerative conditions. The NeuroPongTM Project has taken root in various locations in the United States, collaborating with medical institutions and Memory Care centers.

Expanding the project globally, Antonio brought it to Italy in collaboration with the Mondino Foundation and the ASD TT 2009 Association. A research protocol on the benefits of TT for individuals with MS was established, involving local medical professionals and TT enthusiasts. Dr. Barbera’s collaboration with the International Table Tennis Federation (ITTF) Foundation further underscores the scientific backing of his project.

Presenting his findings at the first World Congress TT4 Health Congress in Crete, Greece, organized by the ITTF Foundation, Antonio showed the positive effects of TT on individuals living with PD. Another protocol focusing on participants with AD is set to commence in Colorado.

The NeuroPongTM Project aspires to engage more European locations, fostering collaboration between healthcare providers, TT clubs, and local communities to promote the holistic benefits of this remarkable sport.

Empowering Healthy Aging

he World Health Organization (WHO) has published a comprehensive toolkit aimed at catalyzing action to promote physical activity among older adults. This initiative is part of a broader series designed to assist countries in crafting and executing policies to increase population participation in physical activity. Aligned with the Global Action Plan on Physical Activity (GAPPA) 2018–2030 and the ACTIVE technical package, this toolkit focuses on interventions that can be delivered through primary health and community care services. Its strategic design also supports the objectives of the UN Decade of Healthy Ageing (2021–2030).

The development of this toolkit was a collaborative endeavor, drawing upon the collective wisdom and expertise of global leaders in health, ageing, and physical activity. It consolidates evidence-based strategies aimed at enhancing physical activity among older adults, with a range of case study examples of what this could look like in practice.

At its core, this toolkit seeks to empower nations to proactively address the challenges posed by an ageing demographic. By fostering physical activity among older adults, countries can positively impact health outcomes, enhance quality of life and physical function, and mitigate the burden of chronic disease. The toolkit provides a roadmap for policymakers, healthcare professionals, and community leaders to design, implement, and evaluate interventions tailored to the unique needs of their ageing populations.

The toolkit details three key activities needed to support and promote physical activity among older people: 1. educating and encouraging – communicating why physical activity is important; 2. engaging and supporting – ensuring physical activity programmes and services meet the needs of older people; 3. enabling every day – ensuring that environments where older people live, work and socialise support physical activity.

The toolkit describes five enabling factors that underpin effective and sustainable provision of physical activity opportunities for older people. These include: 1. governance, leadership and finance; 2. advocacy; 3. partnerships and community links; 4. training; 5. monitoring and evaluation.

To members of the International Society for Physical Activity and Health (ISPAH), we see this toolkit as a catalyst for furthering your commitment to global physical activity promotion. We hope you will embrace the insights provided to inform your advocacy efforts, guide your research pursuits, and strengthen collaborative initiatives. By integrating these evidence-based strategies into your work, you are pivotal in contributing to the realisation of GAPPA’s objectives and the broader vision of fostering active and healthy ageing worldwide.

This toolkit supports a future where older adults can not only live longer but live in better health. It provides the tools, the guidance, and the inspiration to pave the way for positive change, redefining what it means to age with grace, health, and vibrancy. As we share this resource with the global community, let us all commit to championing the cause of healthy ageing, confident in our collective ability to create a world where older age brings vitality, resilience, and the joy of physical activity.

To explore the toolkit and access additional resources, visit the WHO website or ISPAH website.

The main goal is living to be and not to have

“Living to be or living to have are two existential modes based on opposing ideas. Living to be is what Sinner, Bagnaia, and their companions have demonstrated, striving to be the best version of themselves to achieve their ultimate goals. Living to have is the hallmark of those who seek possession, whether it be things or people, and when this deep-seated need isn’t fulfilled, it transforms frustration into destructive anger towards loved ones, as the murderer of Giulia Cecchettin did. As her sister Elena wrote, he ‘was not educated about consent, respect, and freedom of choice.’

To Have or to Be is the title of a book by Erich Fromm published in 1976, which described, with these two words, two opposing ways of living. The approach to everyday life based on ‘having’ characterizes those who have a possessive relationship with their world, aiming to seize things and people. Their motto is summarized in the phrase: ‘I am what I possess.’ The existential mode of those who live according to the ‘being’ approach stands in opposition, defining themselves by their actions, encapsulated in the phrase: ‘I am what I do.’ Following this mode, daily experience is never the same, and the present contains the past and anticipates the future.

In these days, the enthusiasm these young champions have stirred around their achievements and the consequent massive public exposure they’ve received are examples of the strong need for identification that everyone, adults and youth alike, harbors towards young, positive figures who convey spontaneity through their actions, despite performing at an exceptional level. The country needs examples to look up to, especially because these young champions are not alone; alongside them are many others, men and women, who work or study, equally talented, living with an existential mode centered on ‘being,’ yet they lack the visibility of our young champions. These winning youngsters shed light on these lifestyles centered on self-realization and a sense of belonging. The message is clear: even if you’re a talent, you can’t win alone. As Michael Jordan said, ‘One man can be a crucial ingredient on a team, but one man cannot make a team.’

Sinner and Bagnaia don’t feel alone; they’re aware they’ve grown thanks to the team—that’s how champions flourish. Emanuela Audisio rightly says that while discussing ‘immature, violent, ill-equipped Italian kids, not accustomed to defeats, frustrations, lacking respect,’ perhaps attention should also be given to this aspect of sports. Let’s talk about how these youngsters have grown, who their mentors have been, how they’ve learned from mistakes, and how they’ve developed a team mentality even in individual sports. Let’s discuss and get to know all those other young individuals, and there are many, boys and girls, whose stories don’t make it to the media, who aren’t famous but pursue personal goals of self-realization that are important to them. Let’s give them a voice too. Otherwise, a narrative of this youth as insecure, spoiled, and enslaved by social media will continue to spread.”

Make your dreams come true

Effects of exercise on cognitive functions

Zhang M, Jia J, Yang Y, Zhang L, Wang X. Effects of exercise interventions on cognitive functions in healthy populations: A systematic review and meta-analysis. Ageing Res Rev. 2023 Nov 3;92:102116.

American College of Sports Medicine (ACSM) indicate that several exercise variables should be assessed when considering exercise prescriptions to improve the cognitive health of the brain; they proposed the FITT-VP principle as a reference, defined as:

  • exercise frequency (how often)
  • intensity (difficulty)
  • time (duration of each bout of exercise)
  • type (of exercise)
  • volume (total amount of exercise per intervention)
  • progression (change in difficulty in an exercise program over intervention time)
There is dearth of studies that have simultaneously considered:
  • whether chronic exercise interventions may affect various cognitive functions of individuals in the general population from childhood to adulthood and into older age
  • how each of exercise variables further moderating this relationship
  • in healthy populations of children and youths (ages 6–17 years old), adults (ages 18–60 years old), and elderly adults (ages >60 years)
The analysis of exercise type indicated that all exercise types had significant effects on cognition.
  • For exercise duration, moderate and long exercise durations (p < 0.001) both had significant effects on cognition.
  • Low and moderate exercise frequency both had significant effects on cognition.
  • Some of the assessed cognitive domains benefited positively from exercise interventions. Specifically, global cognition (p<0.001), executive function (p = 0.01), and memory (p = 0.01) showed statistically significant differences compared to the control groups, whereas no statistical significance was found for attention (p = 0.14) and information processing.
  • Global cognition needs aerobic exercise, moderate duration,, moderate frequency, moderate intensity.
  • Executive function need resistance exercise, low frequency and moderate length intervention.
  • Memory requires mind-body exercise, moderate duration, moderate frequency, high-intensity exercise and moderate intervention length.
  • Attention and information processing need low-intensity and moderate frequency exercise.
  • Global cognition, executive function, and memory performances were significantly improved in older participants.

Physical activity may improve autism deficits

Gehricke, J.-G., Chan, J., Farmer, J.G., Fenning, R.M., Steinberg-Epstein, R., Misra, M., Parker, R.A., & Neumeyer, A.M. (2020). Physical activity rates in children and adolescents with autism spectrum disorder compared to the general population. Research in Autism Spectrum Disorders.

Physical activity may improve symptoms and skill deficits associated with autism spectrum disorder (ASD).

The objective of this study was to compare the reported frequency of physical activity and covariates in a large sample of children with ASD with children of similar age from the general population. The sample with ASD was derived from the Autism Treatment Network Registry Call Back Assessment (n = 611), and the general population data were derived from the National Survey of Children’s Health (NSCH) (n = 71,811). In addition, demographic, child, and family (parent) factors were examined in relation to frequency of recent physical activity in children with ASD.

Among males in the 6-11 year-old age group, those with ASD participated in physical activity less often (p <0.001) than those in the NSCH general population. Specifically, 33 % of boys 6-11 years old in the NSCH group vs. only 17 % in the RCBA group 6-11 years old engaged in some physical activity every day, while 4 % of boys in the NSCH group vs. 18 % in the RCBA group engaged in no physical activity whatsoever. A similar effect was seen across other age groups and in females but was not statistically significant.

The demographic, child, and family characteristics associated with physical activity in children and adolescents with ASD included ethnicity in females, DSM-IV ASD diagnosis, IQ, and PAM-13 total score in females.

Parents and caregivers are encouraged to find suitable physical activity programs for children with ASD. This may be especially important for 6-11 year-old boys with ASD who engage in significantly less physical activity than their peers in the general population.

Is it a benefit for young to have sports organized by adults?

We know that almost all young people under 18 (90.6%) practice sports in sports facilities, therefore in situations organized for them by sports clubs and ultimately by adults. Consequently, the time in which young people organize themselves autonomously is very limited, if not absent.

The practice of sports organized and managed by adults can offer numerous advantages to young people, such as learning rules, teamwork, physical development, and guidance from experienced coaches. However, it is equally important that young people have the opportunity to participate in autonomous and self-managed sports experiences.

Here are some points to consider as food for thought for the sports world, which then requires on-field sense of responsibility, decision-making skills, and autonomy:

  1. Development of leadership and autonomy - Allowing young people to organize and manage sports activities on their own can promote the development of their decision-making, leadership, and problem-solving skills. This type of experience helps them become more independent and take initiative.
  2. Creativity and entrepreneurial spirit - Self-management of sports can promote creativity and innovation among young people, encouraging them to develop new ways to practice a sport or organize sports events.
  3. Flexibility and adaptability - Working autonomously in sports teaches young people to be flexible and adaptable to changing situations, improving their problem-solving and adaptability skills.
  4. Balance between structure and freedom -BIt is important to find a balance between adult organization and young people’s self-management in sports. Both experiences have their advantages, and the ideal could be a mix of the structure offered by adults and the autonomy granted to young people.
  5. Inclusion and diversity - Self-management could promote greater inclusion and diversity in sports activities, allowing a variety of people to participate based on their needs and interests.
  6. Fosters responsibility - Self-management in sports teaches young people to be responsible for their actions and decisions. They learn to manage their time, take responsibility, and fulfill commitments within the sports context.
  7. Boosts self-confidence - When young people autonomously manage sports activities, they can experience success through their own efforts and work. This contributes to boosting self-confidence and a positive perception of their abilities.
  8. Promotes collaborative spirit - Collaborating among peers in managing sports activities fosters the development of closer social relationships. It creates an environment where young people learn to work together, negotiate, resolve conflicts, and make group decisions.
  9. Encourages creativity and innovation - Self-management offers the freedom to experiment with new ideas and methods in the sports field. This freedom stimulates creativity and innovation, encouraging young people to think originally and adopt unconventional solutions.
  10. Provides a sense of belonging and identity - When young people are actively involved in managing sports activities, they develop a sense of belonging and identity with the group. This sense of belonging can increase motivation and enthusiasm in practicing sports.

In conclusion, while sports organized and managed by adults offer a solid structure and professional guidance, allowing young people to take initiative and autonomously manage some sports activities can significantly contribute to the development of their individual, social, and decision-making skills. Finding a balance between these two approaches can be extremely advantageous for their overall development.

The need to have a routine: the Phelps tape

Michael Phelps, one of the greatest swimmers in history, was known for his intense preparation and routine before competitions. His pre-race routine, often referred to as “watching the tape,” was a ritual that contributed to his concentration and optimal mental state for competing at the highest level.

This practice involved several steps:

Isolation - Phelps sought a quiet corner free from distractions. He often withdrew to a secluded area, away from the hustle and bustle of the main event, to completely focus on his performance.

Headphones and music - He wore headphones and listened to his personal playlist. Music helped him relax and focus his mind on his upcoming races.

Visualization - He closed his eyes and mentally imagined himself swimming the perfect race. He visualized every aspect of his performance, imagining every stroke, turn, and movement in the water. This visualization practice helped him mentally prepare and adopt a winning mindset.

Focus on headphones - By concentrating on the music, rhythm, and lyrics of the songs, Phelps found a way to block out external distractions and entirely focus on his upcoming performances.

This ritual was part of Phelps’ mental approach to competition. It allowed him to enter an optimal mental state, minimizing stress and maximizing his concentration, enabling him to excel in his races.

What a coach must know

A coach must know more than just the simple technique of their sport for several reasons:

Complete development of athletes - Knowledge limited to just the sport’s technique might not be sufficient to maximize athletes’ potential. Coaches must understand psychology, nutrition, physical preparation, and other aspects influencing athletes’ performances to provide comprehensive support and optimize their abilities.

Management of mental aspects - Sports involve not only physical ability but also the mind. Coaches must be capable of handling psychological aspects such as motivation, confidence, concentration, and stress management, all of which can significantly impact athletes’ performances.

Injury prevention - Understanding biomechanics, proper training, and recovery strategies is essential to prevent injuries and promote athletes’ health. A coach who only knows the technique might not identify injury risks correctly or suggest methodologies to prevent them.

Team building and leadership - Knowledge solely about the technique might not be enough to create a positive team environment or develop leadership skills. Coaches need to understand how to manage group dynamics, resolve conflicts, and foster cohesion to form an effective team.

Adaptability and innovation - In the sports world, strategies and tactics can evolve rapidly. Coaches must be flexible and able to adapt to changes by integrating new training methods, technologies, and approaches to remain competitive.

In conclusion, while knowledge of the sport’s technique is fundamental, a coach aiming for success and to maximize athletes’ performance must possess broad and diversified knowledge beyond mere sports technique. Integrating insights into psychological, physical, nutritional, and team management aspects is crucial in providing comprehensive support to athletes.”