The benefit of Big Data and how to use them

It is well known that physical inactivity is a major health problem that needs to be addressed in many parts of the world and across different demographics. Europe is not any different: the Eurobarometer report (1) showed that participation in sport has flatlined in the past  years, with the only notable distinction of fitness and wellness facilities, which on average have shown a user increase.

The problem of physical inactivity is even more evident for elder demographics. As we age, our bodies take a little longer to repair themselves; moderate physical activity would keep our bodies fit and energetic, less prone to chronic conditions and diseases.

Some of the benefits associated to a balanced physical exercise (2) routine are:

• Boosted Immune Function. A healthy, strong body fights off infection and disease more easily and more quickly.
• Better Respiratory and Cardiovascular Function. Frequent physical activity lowers the risk of heart disease and reduces blood pressure.
• Stronger Bones. Exercise protects against bone loss. Higher bone density reduces the risk of osteoporosis and lowers the risk of falls and broken bones.
• Improved Gastrointestinal Function. Regular exercise helps boost the metabolism, promotes the efficient elimination of waste and encourages digestive health.
• Protection Against Chronic Conditions. Physical activity lowers the risk of developing serious conditions and can actually minimize some symptoms after certain conditions have already developed.

However, trendy, rigorous exercise regimens that younger generations participate in simply are not safe or realistic for many seniors. Therefore, the question of establishing a safe and age-related workout regimen that elderly people can not only adopt, but stick to for a prolonged period of time, becomes of paramount importance.

Through the collection with dedicated systems and the use of Big Data, it is possible to extrapolate important results and establish a workout pattern, thereby testing if elderly gym users can actually follow a customized training regimen, thus making them physically active citizens.

The importance of the right workout schedule: the PAHA project

A European project named PAHA (Promoting Physical Activity and Health in Ageing) was designed and executed to test the effectiveness of physical exercise for the elderly within fitness and wellness facilities. The project interested 7 EU countries — Finland, Germany, Greece, Hungary, Ireland, Portugal and the United Kingdom — and by special arrangement, in three fitness centers in Denmark, where three trial sessions of supervised exercise of 6 weeks duration were run, with around 15 participants at each session.

Through a supervised and structured exercise program for senior citizens (55 to 65 years old), the aim of PAHA was to convert self-reportedly inactive people into regular exercisers at a level that was beneficial to their health, supporting the EU Guidelines on Physical Activity.

The 6-week program included a high level of prebooked fully supervised training sessions with fitness staff who had previously completed additional training in active ageing and behavioural change. The content and intensity of the scheduled training programs were gently increased over the six-week period, following the different workout outcomes of the different users.  From the 669 people who took part in the project, 89 percent completed the full six weeks. Out of this number, 208 participants were tracked using Technogym Mywellness Key and had their data stored in the Technogym Mywellness Cloud database.

The end goal of this project was to establish a pattern between a training regimen fit for an elderly user and the continuation of said workout over time. In that regard, the project yielded remarkable results, especially in the case of tracked participants, who reported to have continued their physical activity routine three months after the project ended in 78 percent of the cases, thus establishing a positive motivational pattern between tracking results and continuing training.

How Big Data can change the wellness industry

The success of the project led Technogym to investigate further the role of Big Data in workout routines. When we decided to design this study we realized that there was limited data at the European level to investigate whether the volume and intensity of physical activity executed in health and wellness centers was compliant or exceeded the recommended level of physical activity suggested by international guidelines.

There were indeed some studies that reported the physical activity level of senior citizens,  but these were based on self-reported data and on a limited number of subjects. Considering that Technogym has established a cloud-based technology than can automatically track the exercise executed by members using connected devices, this solution was utilized to overcome the well-known problems related to self-reported data.

Thus, using a “big data approach,” we conducted a baseline descriptive analysis of  the “exercise behavior” on a large scale of a sample of European health and wellness centers.

Some interesting results at a glance

The results of the analysis came from data collected from a typical week of the past year, extracted from the Technogym MyWellness Cloud.

During the chosen week, clubs across 31 European countries automatically uploaded data on the wellness cloud through connected equipment. In the analysis, a total of 175,506 subjects were analyzed: 92,145 women and 83,361 men. The total number of analyzed training sessions was 349,568.

The average session/week attendance at the centre was 1.92 for women and 2.07 for men. The average intensity per session, expressed in Metabolic Equivalents, the ratio of the rate at which a person expends energy to the person's mass, while performing some specific physical activity, was 5.78 ± 1.82 for women and 6.01 ± 2.11 for men.

The average weekly duration expressed in minutes was 113.2 ± 81.2 for women and 124.2 ± 89.5 for men. Minutes accumulated during the exercise sessions were divided into Aerobic (women 32.6 ± 16.8; men 32.7 ± 18.3), Resistance (women 27.6 ± 16.9; men 32.1 ± 18.8), Flexibility (women 3.32 ± 3.26; men 3.38 ± 3.12) and Body Weight Exercises (women 22.8 ± 20.9; men 17.9 ± 17.0).

Let’s discuss the results

The results of this preliminary descriptive analysis show that in health and wellness centers both men and women far exceeded the World Health Organization minimum recommended dose of physical activity to be considered moderately active.

Both aerobic, resistance and body weight exercises were well represented in duration, whilst very little time was devoted to stretching.

References

1. Special Eurobarometer 472: Sport and physical activity Report. December 2017. Directorate-General for Communication. March 2018.

2. American College of Sports Medicine, Chodzko-Zaijko WJ, Proctor DN, Fiatarone Singh MA, et al. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Med Sci Sports Exerc. 2009 Jul;41(7):1510-30.

Author:
Dr. Silvano Zanuso is Scientific Research & Communication Manager at Technogym and visiting professor at the University of Coventry (UK). Dr. Zanuso’s primary scientific and research interest is on the effects of physical activity and exercise in those with metabolic disorders, and he publishes regularly on this and other topics in recognized scientific and clinical journals. Dr. Zanuso has been a consultant for health promotion for different governments and public institutions, and he has held conferences and educational programs in more than twenty countries.

I am an avid hiker. I don’t travel long distances to hike, the Sandia Mountains are located on the east side of Albuquerque and I can enjoy myriad trails year round.  I know, many places don’t have mountains to hike it, but this isn’t about hiking per se, more about noticing your surroundings while getting a great all over workout.  It’s about learning to focus on your surroundings, breathe deeply and learning to live in the moment, meditating without sitting.

 

It’s about learning to focus on your surroundings, breathe deeply and learning to live in the moment, meditating without sitting.

Walking out the front door is easy.  Put on a pair of shoes and go!  I will attempt to talk about how to meditate while working out.  As you start to walk notice your surroundings, each yard is different, people are walking their dogs, different cars go by, the ever changing cloud patterns…  Walk at different speeds, find hills, include a jog once in awhile.  Take time to think about what your body is doing.  Focus on your breath.  Try slow deep breaths through the nose, try faster deeper breaths, not too fast, through your mouth.  As you settle into a pattern and focus on your breath your walk becomes meditative.  Breathe in, breathe out…  In time you become aware of every step, every breath, every blade of grass, every tree, every cloud. 

Even a cardio workout at the gym can be meditative.  You step onto the elliptical trainer, set your time, resistance and incline, and you start to move.  Right, left, right, left, breathe deep, find a cadence.  If you listen to music you can keep time with the beat.  Try breathing in time with your feet, every right and left is one breath, or slow it down to every two or three revolutions.  Follow the cadence of someone next to you while you look out the window and admire the clouds.  The focus is on the breath.

As I hike I try to stay in the moment.  I listen to each breath, hear each footstep as it lands on the ground and notice each twig I break as I look at the vegetation that has changed from green and lush to sparse and dry in the winter months, and back to green in the spring and summer  I can hike the same trail ten times in three months and see something different each time.  The world is amazing - pay attention to everything!

I teach my students and clients to be mindful and present.  We work on breath, focus and mindfulness.  Of course we work on strength, cardio, nutrition and general fitness too but our lifeline is our breath, we need to focus to be present and enjoy our life, and mindfulness is just plain good karma.  It can take a lifetime to learn to master, but with daily practice we can achieve the things we want and enjoy every moment.  Learning to meditate teaches us patience and calmness.  This patience and calmness can help us in many aspects of our life. 

You don’t need mountains to walk.  Head out the front door and breathe in the day.

 

Author: Mindy Caplan ACSM-EP is a New Mexico-based Fitness Instructor, Personal Trainer, Wellness/Lifestyle Coach, and Yoga Instructor.

Disclaimer: Opinions expressed in the Certification Blog are the authors’ and do not necessarily reflect positions of ACSM.

2018 was another great year for Current Sports Medicine Reports (CSMR) as we continued to publish timely, peer-reviewed, clinically relevant information that is useful for busy sports medicine and primary care providers. The journal saw two big changes in 2018; 1) it went from publishing bimonthly (six issues annually) to publishing monthly (12 issues annually) and 2) Shawn F. Kane, MD, FACSM, assumed the role of editor-in-chief from William O. Roberts, MD, MS, FACSM, who led the journal for eight strong years. Each edition of CSMR contains a combination of section articles and case reports from one of our 12 topical sections, a special communication, an invited commentary that covers a variety of emerging and interesting topics, and a few rotating columns. Five times per year CSMR highlights sports medicine clinicians who are involved in the journal and the college. 2018 also marked the second year of our partnership with the International Federation of Sports Medicine (FIMS), helping CSMR expand its international focus on sports medicine.

The most frequently viewed article in 2018 was “Exercise is Medicine for Concussion,” written by John J. Leddy, MD, et al. and covered the emerging role for sub-maximal exercise in the treatment of concussions. For years the standard of care for a patient with a concussion could be described as cocoon therapy with the patient staying in a dark room and not exerting themselves until they were totally asymptomatic and had recovered. Dr. Leddy and his team have challenged this dogma and through multiple studies have shown that sub-maximal is highly beneficial in the recovery of concussions. 

The article most accessed through the journal website was “Energy Drinks:  A Contemporary Issues Paper,” written by John P. Higgins, MD, MBA, M.PHIL, FACSM; Kavita Babu, MD; Patricia A. Deuster, PhD, MPH, FACSM; and Jane Shearer, PhD. The consumption of energy drinks continues to rise, and we are learning more and more about their potentially negative consequences. This paper gives clinicians excellent information to better discuss the negative impacts of these products with our patients. This article also was our most mentioned across our various social media platforms and in the mainstream news media.

2019 looks to be another great year as CSMR strives to continue to publish articles that continue to make a difference in clinical practice. Planned content for 2019 looks to include the following topics

• Developing Physician Leaders
• Fighting in Ice Hockey
• Injury Prevention
• Concussion Subtypes
• Ketogenic Diets
• Dogs as Motivation for Physical Activity and Health

We hope you enjoy our content as much as our team enjoys putting it together. If there are topics or authors you would like to see published in CSMR please contact us via email.

Most Read Articles Published in 2018

Exercise is Medicine for Concussion

Pediatric Inactivity Triad: A Risky PIT 

Multiple Sclerosis and Exercise: A Literature Review

Energy Availability, Macronutrient Intake, and Nutritional Supplementation for Improving Exercise Performance in Endurance Athletes

Energy Drinks: A Contemporary Issues Paper

Sports Drinks on the Edge of a New Era

The Application of Blood Flow Restriction: Lessons From the Laboratory

Interval Training for Cardiometabolic Health: Why Such a HIIT? 

Female Athlete Issues for the Team Physician: A Consensus Statement - 2017 Update 

Nutritional Supplements for the Treatment and Prevention of Sports-Related Concussion - Omega 3 Fatty Acids: Evidence Still Lacking? 

Physical Effects of Anabolic-androgenic Steroids in Healthy Exercising Adults: A Systematic Review and Meta-analysis

Core Muscle Injuries in Athletes 

Sacroiliac Joint Dysfunction in the Athlete: Diagnosis and Management

Conversation Starters: Highest Altmetric Attention Score

Altmetric calculates a score based on the online attention an article receives. The score is calculated based on two main sources of online attention: social media and mainstream news media. 

Energy Drinks: A Contemporary Issues Paper

Zurich to Berlin—“Where” Are We Now with the Concussion in Sport Group?

Exercise is Medicine for Concussion

Energy Availability, Macronutrient Intake, and Nutritional Supplementation for Improving Exercise Performance in Endurance Athletes

Optimal Running Dose and Cardiovascular Risk

Pediatric Inactivity Triad: A Risky PIT 

The Application of Blood Flow Restriction: Lessons From the Laboratory

Interval Training for Cardiometabolic Health: Why Such a HIIT? 

Sports Drinks on the Edge of a New Era

Football Team Rhabdomyolysis: The Pain Beats the Gain and the Coach Is to Blame


ACSM Professional Members who are physicians have an electronic subscription to Current Sports Medicine Reports, as well as additional ACSM journals Medicine & Science in Sports & Exercise®, Exercise and Sport Sciences Reviews and the Translational Journal of the American College of Sports Medicine. Further, members receive discounts on ACSM certification exams, meeting and conference registrations, ACSM continuing education credits and more. Learn more and join today! 

Shawn F. Kane, MD, FACSM, graduated from Gettysburg College with a BS in Biology and was commissioned a second lieutenant in the U.S. Army. He attended medical school at the F. Edward Hebert School of Medicine at the Uniformed Services University of the Health Sciences (USUHS) and graduated in 1995. He completed his internship and residency in Family Medicine at Womack Army Medical Center at Fort Bragg, NC, and his Sports Medicine Fellowship at Fort Belvoir, VA. He retired from the U.S. Army in 2018 after having served almost his entire career in the U.S. Army Special Operations Community, including 12 deployments in support of combat operations. He currently serves as an associate professor and physician at the University of North Carolina Chapel Hill Family Medicine Center. He has been a member of ACSM since 1993 and currently serves as the editor-in-chief for Current Sports Medicine Reports.

Scientific findings emerge constantly, and a field of study can change rapidly. As such, it is important to ACSM that our official statements are as current and accurate as possible. Historically, the Position Stand (PS) has been ACSM’s most authoritative “official” statement. Our PS span a variety of research and clinical topics and provide a scientific summary and guidance to our members and the general public.

Unfortunately, many of our PS are now quite old and in need of updating. We are often asked, “When will the position stand be updated?” This has been a complex issue for ACSM to tackle. ACSM’s desire to maintain its leadership in providing highly influential scientific statements for the fields of exercise science and sport medicine has prompted us to thoughtfully consider how we develop a PS. Ensuring that we are using gold-standard methodology and evidence-based procedures has been a priority. As a result, we have new protocols for the development of PS that standardize the process and improve transparency, accuracy, and consistency in the reporting of methodology and results.

In addition, the ACSM Pronouncements Committee (Michael Deschenes, PhD, FACSM, Chair) recognized the limitation of relying so heavily on the use of the PS as our primary means to communicate these scientific summaries. Thus, the committee developed four additional “official statements” of the college: Umbrella Review, Expert Consensus, Contemporary Issues and Call to Action. Consequently, the college now has several mechanisms, in addition to the PS, to release an official stance. Other prominent organizations use a similar approach, publishing a variety of types of statements that have different development protocols and different purposes. This structure will give ACSM greater flexibility to comment, take a stance, and update existing documents in a well-timed manner. We are happy to report that the answer to the question, “When will the position stand be updated?” is soon.

In fact, thanks to the work of the Pronouncements Committee, in the very near future you will start to see many of these older PS updated with current and emerging scientific and clinical content. During 2018, the Pronouncements Committee used a multi-step process to conduct a thorough review of the existing PS.

First, Web of Science was used to gather metrics on each PS to determine how often it is being cited and/or downloaded. Additional citation information and altmetric scores were obtained from the publisher. Next, the committee invited content experts to review the papers to provide their thoughts and recommendations as to whether the paper’s content was current or outdated, whether the paper should be updated and, if updated, what format the update should take. In addition, they were asked to comment on the perceived urgency of a needed update. When possible, members of the original PS writing group participated in the review process. Finally, the committee members discussed the reviewers’ comments and recommendations and considered a variety of additional factors (e.g., age of the paper, interest of the topic to our members, whether the topic remains “core” to ACSM’s mission, the existence of current statements on the topic by other organizations).

With this review completed, work to update these papers will begin shortly. Several of the older PS will be updated with a new PS. However, several other PS were identified as needing a quicker update than can be achieved via a new PS. Thus, several of those papers will be updated with Expert Consensus Statements. Similarly, other PS will be updated with Umbrella Reviews or Call to Action statements.

You may notice that the titles and focus of these updates vary slightly from the original PS. Nonetheless, the goal is to provide a timely update with current information that extends the conclusions of the original PS. The Pronouncements Committee has prioritized the order of these updates and work will begin in the first quarter of 2019.

Finally, of note, the recent update of the acsm.org website provides greater flexibility to retain our older papers (e.g., archive), while also directing viewers to updates and current content. You can find that content here. Stay tuned as the college works to update these seminal and highly influential papers.

Lynette L. Craft, Ph.D., FACSM completed her Ph.D. in Kinesiology at Michigan State University and post-doctoral training in Health Psychology at Boston University School of Medicine. She currently serves as the ACSM Chief Science Officer.

ACSM’s Health & Fitness Journal® strives to provide health and fitness professionals with accurate, unbiased and authoritative practical information that will enhance their day to day work with clients and patients. Beginning in 1997, the journal has published six issues per year that cover a wide variety of exercise, nutrition and other topics that are of interest to the health and fitness industry. Additionally, each issue of the journal provides continuing education credit opportunities. Each issue consists of special columns written by the journal’s associate editors and two to six feature articles that have gone through a peer review process.

Since 2015 the September/October issue of ACSM’s Health & Fitness Journal® has focused on a specific theme (weight loss, resistance training, and behavior change). In 2018 the journal published two themed issues with the September/October publication a special issue on nutrition followed by special fitness trends issue in November/December that highlighted ACSM’s Worldwide Survey of Fitness Trends.

In 2018 the journal published 23 feature articles and a total of 38 columns penned by the journal’s associate editors. The relative interest in these 61 articles can be quantified by comparing the numbers of times the online version of the article is viewed and/or referred to through social media platforms and the mainstream news media.

The most accessed article through the journal website was a feature article written by Joel E. Williams, MPH, Ph.D.; Brian Helsel, M.S., CSCS; Bryce Nelson, M.D., Ph.D.; and Ransome Eke, M.D., MPH, Ph.D. titled “Exercise Considerations for Type 1 and Type 2 Diabetes.” With the incidence of diabetes continuing to increase throughout the world this article was timely and presented important considerations that health and professionals must be aware of when working with these populations. The authors provide a number of practical application strategies that fitness professionals can utilize with clients and patients.

The most popular paper referred to by social media platforms and mainstream media was our annual “Worldwide Survey of Fitness Trends for 2019” penned by Walter R. Thompson, Ph.D., FACSM. The 13^th annual survey conducted by Dr. Thompson continued the tradition of the article being one of the most referred to articles published in the journal. This year’s survey was the basis of a special trends issue that featured a number of the top trends and compared U.S. survey results with those collected in China and Spain.

Outlook for 2019

The articles and columns to be published in 2019 will continue to present topics and associated practical applications that will be of interest to health and fitness professionals and supportive of their work with clients and patients. The planned content will once again include two themed issues:

• September/October: Combating Physical Inactivity
• November/December: Special Trends Issue with an expanded international focus

Upcoming 2019 feature articles will include topics on aquatic exercise/water-based training, children and youth, connecting healthcare and fitness professionals, resistance training, lifestyle medicine and more. We appreciate each health and fitness professional that has submitted their work for publication in the journal and encourage you to consider sharing your expertise with our readers. If you are interested in submitting an article to ACSM’s Health & Fitness Journal®, details on how to write and submit a feature article can be found on the website.

Additionally, our exceptional associate editor team will continue to provide quality practical health and fitness information through their respective columns:

Column	Author	Description
Fitness Focus	Grace T. DeSimone, BA	A clip and distribute article that health and fitness professionals can give to clients/patients.
Take Ten	James A. Peterson, Ph.D., FACSM	Ten specific insights into a pertinent health and fitness topic.
Wouldn’t You Like to Know	Barbara A. Bushman, Ph.D., FACSM	A practical review focused on answering a specific question based on a topic of interest to health and fitness professionals.
A Nutritionist’s View	Stella L. Volpe, Ph.D., R.D., LDN, FACSM	A concise column that covers a hot topic in nutrition.
The Legal Aspects	Anthony A. Abbott, Ph.D., Ed.D., FACSM, FNSCA	An important column that addresses legal issues that affect the health and fitness professional.
Business Edge	Jennifer L. Bacon, M.S.	A practical column that covers relevant business-related topics that affect the health and fitness professional.
Research Bites	Mary M. Yoke, Ph.D., M.A., FACSM	Translates three or four pertinent research articles into information that the health and fitness practitioner can use.
Worksite Health Promotion	Nico P. Pronk, Ph.D., FACSM, FAWHP	This thoughtful column covers all aspects of employee wellness in the context of the worksite.
Do It Right	Peter Ronai, MS, FACSM	Each column illustrates a specific resistance training exercise with photos and videos and explains how to correctly teach the activity.
Health & Fitness A to Z	Gary Liguori, Ph.D., FACSM	Reviews an important topic from its inception to today and where it may be headed in the future.
Enhancing Your Behavioral Tool Kit	Janet Buckworth, Ph.D., FACSM	Provides insights into behavioral change and coaching strategies health and fitness professionals can utilize with their clients/patients.
ACSM Certification	Yuri Feito, Ph.D., MPH, FACSM	For 2019 this column will focus on presenting case studies that will provide insight into working with clients/patients from the initial referral forward.
Celebrate Success	Dixie Stanforth, Ph.D., FACSM	An inspirational column that highlights real-world, positive change that is happening in many communities through individuals, organizations, and/or improved public policy.
Clinical Applications	Kristi M. King, Ph.D., CHES	Covers the clinical aspects of the health and fitness profession.
Medical Report	Written by various clinicians	Provides practical medical information the health and fitness professional needs to know.

Columns shown in blue publish in each issue of the journal. Columns in purple publish in the January/February, May/June and September/October issues. Columns in green publish in the March/April, July/August and November/December issues.

Most Read Articles of 2018

Exercise Considerations for Type 1 and Type 2 Diabetes

Targeting Abdominal Obesity Through the Diet: What Does the Evidence Say?

Lifestyle Modifications to Promote Healthy Blood Pressure *associate editor column, Wouldn’t You Like to Know?

The Evolution of Exercise-Associated Muscle Cramp Research *associate editor column, Health & Fitness A to Z

The Four Social Media Apps That Rule Digital Fitness Marketing and How Best to Use Them

Behavioral Strategies, Including Exercise, for Addressing Insomnia

Developing the P (for Progression) in FITT-VP Exercise Prescription *associate editor column, Wouldn’t You Like to Know?

Food with Benefits: Gain the Competitive Edge With a “Food-First” Approach

Twelve (Plus One) Thoughts from Our Nutrition-Themed Issue *editor column

Shareable Resource: What to Eat Before, During and After Exercise *associate editor column, Fitness Focus

Conversation Starters: Highest Altmetric Attention Score

Altmetric calculates a score based on the on-line attention an article receives. The score is calculated based on two primary sources of on-line attention: social media and mainstream news media.

Worldwide Survey of Fitness Trends for 2019

Interval Training for Cardiometabolic and Brain Health 

Physical Inactivity in Youth: Can Exercise Deficit Disorder Alter the Way We View Preventative Care? 

Targeting Abdominal Obesity Through the Diet: What Does the Evidence Say? 

Stimulant-Containing Energy Drinks: What You Need to Know

Biology of Aging: Identified Drivers and Interventions for Optimal Healthspan

Gluten-Free Diets and Exercise Performance *associate editor column, A Nutritionist’s View

Developing the P (for Progressions) in a FITT-VP Exercise Prescription *associate editor column, Wouldn’t You Like to Know?

Food With Benefits: Gain the Competitive Edge with a "Food-First" Approach

The Evolution of Exercise-Associated Muscle Cramp Research *associate editor column, Health & Fitness A to Z

ACSM Alliance of Health and Fitness Members receive each issue of ACSM's Health & Fitness Journal® in both print and digital formats. Additionally, Alliance members receive discounts on ACSM Certification exams, continuing education credits, the ACSM health & Fitness Summit and consumer products. Learn more and join today!

Brad A. Roy, Ph.D., FACSM, is an administrator/executive director at Kalispell Regional Medical Center. He is responsible for The Summit Medical Fitness Center, a 114,800 sq ft medical fitness center located in Kalispell, Montana, and a number of other hospital departments. He is the editor-in-chief of ACSM’s Health & Fitness Journal®.