Thèses sur le sujet « Didattica attiva »

Nella prima parte del mio elaborato ho voluto rilevare come a partire dalla seconda metà del Novecento il museo si sia modificato da semplice tempio, detentore di sapere, a museo-forum, con lo scopo di includere pubblici diversificati. Ho analizzato i cambiamenti avvenuti all’interno delle istituzioni culturali, in particolare quelli relativi ai nuovi mezzi di comunicazione e fruizione delle opere d’arte. Tra le varie novità si individua l’introduzione di una recente figura professionale a servizio del pubblico, il “mediatore culturale”. Si tratta di un ruolo che nasce nel contesto francese ma che si presentava già precedentemente, con funzioni simili e diciture differenti, nel mondo anglosassone e che attualmente si sta sviluppando anche nell’ambito culturale italiano. Per quanto riguarda l’Italia, attraverso una ricerca sul campo, ho analizzato le istituzioni culturali che utilizzano questa figura al loro interno individuando le funzioni che la caratterizzano e le sue principali peculiarità.

Nello scenario attuale, in cui le società sono soggette a rapidi cambiamenti nel tessuto culturale, economico, politico e sociale, il tema dell’Educazione alla cittadinanza attiva è divenuto sempre più centrale nella definizione degli obiettivi dei sistemi educativi in tutta Europa, a partire dalla proclamazione nel 2005 dell’Anno europeo della cittadinanza mediante l'educazione e come indicato nel Quadro strategico per la cooperazione europea nell’istruzione e nella formazione (ET2020). Questa urgenza è stata fondante per la costruzione del progetto di ricerca Erasmus+ STEP, Pedagogia della cittadinanza e formazione degli insegnanti: un’alleanza tra scuola e territorio, nella cornice del quale ho condotto parte della mia ricerca di dottorato. In seno al progetto STEP si è lavorato sui temi del vivere insieme, dell’educazione al Patrimonio e allo sviluppo sostenibile con la finalità di promuovere e rafforzare il dialogo e l’integrazione fra i diversi saperi disciplinari che incidono sulla formazione delle competenze di cittadinanza attiva, attraverso il coinvolgimento diretto di bambini e insegnanti in esperienze autenticamente rilevanti. Nella definizione del quadro teorico all’interno del quale si sono svolti gli studi di caso è stato fondamentale avviare una riflessione sui diversi modelli di Educazione alla cittadinanza esistenti e individuare le condizioni necessarie perché il contesto scolastico sia coerente con i valori di una società democratica. Il primo obiettivo dello studio di caso è stato indagare se e come contribuisca a sviluppare competenze di cittadinanza nei bambini della Scuola Primaria una Didattica della Storia che li veda attivi costruttori del proprio sapere, attraverso l’esplorazione del territorio culturale e sociale nel quale vivono e che li coinvolga in ricerche e discussioni in classe. Una particolare attenzione è stata rivolta al tema dello sviluppo del pensiero critico, che la letteratura indica come sottostimato e per monitorarlo si sono analizzate le conversazioni con i bambini durante tutto l’arco di sviluppo del progetto. La seconda domanda che ha guidato la ricerca è stata se e come un percorso di Ricerca-Formazione potesse favorire la costruzione di una comunità di pratica e promuovere negli insegnanti coinvolti nuovi saperi pedagogico-didattici, consapevolmente orientati allo sviluppo di competenze di cittadinanza nei bambini. In quest’ottica è stato previsto uno scambio continuo tra ricercatori e insegnanti con l’obiettivo di dare spazio agli insegnanti per condividere dubbi e difficoltà incontrati durante il percorso. Il secondo focus della ricerca è proprio la formazione insegnanti e l’individuazione di quali modelli di formazione possano produrre un’efficace riflessione sul senso del loro agire professionale e un conseguente miglioramento nelle loro progettazioni didattiche per orientarle alla promozione delle competenze di cittadinanza nei bambini. Si è indagato in particolare con lo studio di caso il modello della Ricerca-Formazione partendo dall’assunto che l’obiettivo della formazione debba essere lo sviluppo di un insegnante riflessivo e consapevole del proprio agire didattico e dell’importanza del processo di decodifica delle proprie rappresentazioni. La seconda parte della ricerca è dedicata appunto alle rappresentazioni dei futuri insegnanti sul significato dell’insegnamento della Storia e su eventuali connessioni con l’Educazione alla cittadinanza attiva. La volontà di condurre uno studio esplorativo, attraverso la somministrazione di questionari agli studenti di Scienze della Formazione Primaria su questo tema è nata dall’osservazione, durante l’analisi dei dati raccolti nello studio di caso, del ruolo cruciale rivestito dalla formazione insegnanti unitamente al fondamentale apporto che la decodifica delle proprie rappresentazioni può fornire allo sviluppo di professionisti riflessivi.
In the current scenario, where societies are changing rapidly in the cultural, economic, political and social context, the issue of Active Citizenship Education has become more and more crucial in defining the objectives of education systems all over Europe, starting with the proclamation in 2005 of the European Year of Citizenship through Education and as set out in the Strategic Framework for European Cooperation in Education and Training (ET2020). This urgency was the cornerstone of the construction of the Erasmus+ STEP research project, Citizenship education and teacher training: an alliance between school and territory, in which I carried out part of my doctoral research. Within the STEP project, work has been carried out on the themes of living together, heritage education and sustainable development with the aim of promoting and strengthening dialogue and integration between the various disciplines that can affect the development of active citizenship skills, through the direct involvement of children and teachers in genuinely relevant experiences. In defining the theoretical framework of the case studies, it was essential to start a reflection on the different existing models of Citizenship Education and to identify the required conditions to ensure that the school context is consistent with the values of a democratic society. The first objective of the case study was to investigate whether and how an History Education that involves them in research and discussion in the classroom can contribute to the development of citizenship skills in primary school children, seeing them as active builders of their own knowledge, through the exploration of the cultural and social territory where they live. Specific attention was paid to the theme of the development of critical thinking, which the literature indicates as underestimated and to monitor it, conversations with children were analyzed during the whole development of the project. The second question that guided the research was whether and how a path of Teacher Professional Development Research, built between school and territory, could foster the construction of a community of practice and promote in the teachers involved new pedagogical-didactic knowledge, consciously oriented to the development of citizenship skills in children. In this perspective, within the case study, a continuous exchange between researchers and teachers was established with the aim of giving space to teachers to share doubts and difficulties faced during the course. The second focus of the research is on teacher training and the identification of which training methods can produce an effective reflection on the meaning of their professional behavior and a consequent improvement in their didactic designs to orient them to the promotion of citizenship skills in children. Within the case study the model of Teacher Professional Development Research was particularly investigated, starting from the assumption that the objective of the training must be the development of a reflective teacher who is aware of his own didactic action and of the importance of the process of decoding his own representations. The second part of the research is dedicated to the representations of future teachers on the meaning of teaching History and on possible connections with Active Citizenship Education. The willingness to conduct an exploratory study, through the submission of questionnaires to students of the degree of Primary Education Science of on this topic was born from the observation, during the analysis of the data collected in the case study, of the crucial role played by teacher training together with the fundamental contribution that the decoding of their representations can provide to the development of reflective practitioners.

Nell’era dello sviluppo tecnologico, della globalizzazione e di contesti lavorativi sempre più interdisciplinari diviene importante, se non necessario, recuperare e approfondire quei modelli educativi che fanno della relazione il centro del processo di apprendimento al fine di formare studenti che siano in grado di dare un senso agli strumenti acquisiti piuttosto che esserne agenti passivi. Alla luce di questa necessità, il presente elaborato intende concentrarsi sull’innovazione della formazione universitaria nel particolare contesto della medical education italiana. Al fine di accompagnare i lettori nel progressivo avvicinamento a questo tema, l’articolazione dei capitoli procede dal generale al particolare. I lettori inizieranno il loro viaggio con la scoperta delle nuove teorie dell’apprendimento a cui sono associati innovativi metodi didattici, per poi incontrare le specifiche della nuova formazione universitaria influenzata da queste innovazioni ed infine il particolare mondo della formazione medica universitaria. Dopo aver acquisito una conoscenza del contesto innovativo all’interno del quale si sta muovendo la nuova formazione universitaria nel contesto medico, i lettori potranno procedere alla consultazione di due ricerche svolte all’interno di questo panorama pratico-teorico. Le ricerche sono presentate seguendo la struttura di articoli scientifici così da essere auto-consistenti. Alla luce della letteratura di riferimento gli obiettivi del primo studio sono: 1) tradurre, adattare e validare in italiano il Conceptions of Learning and Teaching (COLT) così che possa diventare uno strumento di promozione e monitoraggio in merito all’ implementazione di una didattica maggiormente student-centred nei diversi Atenei italiani ed 2) acquisire una prima rappresentazione campionaria in merito allo stato dell’arte dell’atteggiamento didattico dei docenti di diverse università italiane così da poter eventualmente implementare percorsi di formazione specifici rivolti ai docenti. Dal primo studio emerge che: 1) la versione italiana del questionario (COLT-IT) è composta da due sotto-scale (Teacher Centredness e Appreciation of Active Leraning) ciascuna di 5 items e 2) i docenti delle scuole di medicina italiane mostrano un atteggiamento maggiormente centrato sullo studente piuttosto che sul docente. In diretta continuità con il primo studio, la seconda ricerca ha lo scopo di 1) valutare la patient-centredness dei docenti di diverse scuole di medicina italiane e la presenza di eventuali differenze di genere e 2) la relazione statistica quantitativa tra le concezioni dei docenti sull’apprendimento/insegnamento (student-centred o teacher-centred) e la loro attitudine all’essere patient-centred o doctor-centred così da acquisire informazioni in merito alle variabili che potrebbero sostenere lo sviluppo di un atteggiamento centrato sul paziente degli studenti di medicina. Dal secondo studio emergono 1) delle differenze di genere nella patient centredness dei docenti, 2) un’associazione negativa tra l’atteggiamento centrato sul docente e le scale di Caring e Sharing e 3) un’associazione positiva tra l’atteggiamento centrato sullo studente e la scala del Caring. In conclusione, il presente elaborato permette di acquisire ulteriori evidenze scientifiche a sostegno dello sforzo nella promozione ed implementazione della didattica centrata sullo studente nelle scuole di medicina italiane.
In the era of technological development, globalization and increasingly interdisciplinary work contexts, it becomes important, if not necessary, to recover and deepen those educational models that make relationships the centre of the learning process in order to train students who are able to give a sense of the tools acquired rather than being passive agents. Considering this need, this paper intends to focus on the innovation of university education in the context of Italian medical education. In order to accompany readers in the progressive approach to this theme, the articulation of the chapters proceeds from the general to the particular. Readers will begin their journey with the discovery of new learning theories associated with innovative teaching methods, to then meet the specifics of the new university education influenced by these innovations and finally the specific world of university medical education. After acquiring a knowledge of the innovative context within which the new university training in the medical context is moving, readers will be able to consult two research studies carried out within this practical-theoretical panorama. Research is presented following the structure of scientific articles. In light of the relevant literature, the objectives of the first study are: 1) to translate, adapt and validate the Conceptions of Learning and Teaching (COLT) in Italian so that it can become a tool for promoting and monitoring the implementation of a more student-centered approach in the Italian universities and 2) to acquire a first representation of the state of the art of the teaching attitude of the teachers of different Italian universities so as to be able to eventually implement specific training courses aimed at teachers. The first study shows that: 1) the Italian version of the questionnaire (COLT-IT) is composed of two sub-scales (Teacher Centredness and Appreciation of Active Leraning) each of 5 items and 2) the teachers of the Italian medical schools show more student-centered rather than teacher-centered approach. In direct continuity with the first study, the second research aims to 1) evaluate the patient-centeredness of teachers from different Italian medical schools and the presence of any gender differences and 2) the quantitative statistical relationship between teachers' conceptions on learning / teaching (student-centered or teacher-centered) and their aptitude to be patient-centered or doctor-centered so as to acquire information about the variables that could support the development of medical students’ patient-centeredness. The second study reveals 1) gender differences in teachers' patient centeredness, 2) a negative association between teacher-centeredness and the Caring and Sharing scales, and 3) a positive association between student-centeredness and the Caring scale. In conclusion, this thesis allows to provide further scientific evidence to support the effort in the promotion and implementation of student-centered teaching in Italian medical schools.

School, as the main institution in terms of citizens education, is required to provide people with both theoretical knowledge and practical skills (how to live in the world). However, school community has to face an extremely complex and changing educational phase in which young people have to cope with a situation of great vulnerability, which often leads to antisocial behaviours, e.g. lack of interest, violent and destructive behaviours, drugs abuse, isolation, rejection of personal responsibilities and disconnection from educational services. School is therefore entrusted with an important educational task, as it is the place where prosocial behaviours are promoted and transversal competences are learnt, i.e. the competences which are not related to specific subjects and are necessary for people's personal development, active citizenship, social involvement and employment. The problem of antisocial behaviours, together with the commitment in the promotion of prosocial behaviours among school-age children, are nowadays topics of great interest for research. The analysis of literature regarding the study of the causes of prosocial and antisocial behaviours leads to focus on two crucial factors: empathy and caring climate. Most of researchers agree to say that empathy plays a key role in encouraging prosocial behaviours and curbing the antisocial ones, and also that both depend on the development and enhancement of people’s emphatic skills. In the same way, there is important evidence showing that the quality of relationships among people living at school has an important influence on antisocial and prosocial behaviours. This relationships system constitutes the school or class climate, the quality of which determines the sense of an atmosphere oriented towards people caring. Empathy and caring climate are supposed to be bound because, when someone has caring behaviours towards another person, a certain receptiveness is shown and people's needs are met. An interesting study and policy area, where empathy, positive relationships and prosocial behaviours are promoted, is Physical Education (PE), which is the most suitable context, both because of the possibility of creating plenty of relationship opportunities and because of a body-based communication. There are numerous studies emphasizing significant changes in empathy, caring climate and prosocial or antisocial behaviours thanks to specific PE programs. Moreover, numerous PE-based policies and response actions against antisocial behaviours are spreading internationally. One of the most noteworthy projects has been promoted recently by a partnership of international Agencies, such as WADA, UNESO and IOC, and has been developed by a group of European Universities belonging to the Association Internationale des Ecoles Superieures d'Education Physique (AIESEP), and has been coordinated by the University of Padua. The project provides the development of a toolkit to support teachers in promoting educational aspects such as fairness, equity, respect and inclusion through PE. This research includes the preparation and experimentation of an instructional design based on the above-mentioned Toolkit, the construction of which has been an integral part of the research project. The instructional design and, by extension, the Toolkit, are based on some effectiveness features highlighted in literature, which are mainly represented by a play-based learning and by the use of active learning strategies. The experimental phase of the research was conducted at a middle school in the province of Verona, involving 87 pupils from four second-year classes, divided into two experimental classes and two control classes. The experimental groups participated in a cycle of 11 workshops, taking place once or twice a week. The experimentation had three aims: (a) looking into the effectiveness and the impact of the intervention on empathy, caring climate and prosocial behaviours and on the construction of an equity concept related to the development of transversal competences; (b) analysing the validity and effectiveness of the instructional design based on the Toolkit; (c) assessing the methods, procedures and instrument which characterize this pilot projects, in order to support and improve the following research steps. The data were collected at baseline (T0), post-intervention (T1) and follow-up, and analysed combining a quantitative and qualitative approach. An intervention fidelity measuring instrument was also used. Analyses reveal a close connection between empathy, prosocial behaviours and sense of caring climate, although with a significant difference in gender considering the three measurement phases. Significant positive effects were highlighted regarding the intervention on empathy and prosocial behaviours, mainly in boys from the experimental groups. There was also a significant decrease in the prosocial behaviour assessment gap between pupils and teachers. By means of quantitative analyses, T1 shows a more complex and developed equity concept, closer to the definition of equity itself, compared to T0. The emerged codes and topics serve to identify the presence of critical thinking, argumentative, transfer and generalizing skills, and also to detect an increasing awareness of personal responsibility within a context of equity, in terms of respecting people's needs and feeling. The improvement in critical and reasoning skills seem to be connected to the changes in empathy, prosocial behaviour and caring climate, which has a weaker influence in an experimental group compared to control groups in T1. Validity and effectiveness analyses show numerous strong and weak points of the project: on one hand, it is viewed positively because of its flexibility and cross-curricularity, on the other hand, it was noticed that teachers have to be trained in order to work using active learning strategies. Finally, the project is becoming increasingly important in the advancement of research, as it aims at filling a relevant gap, which is highlighted in literature, and regards a generalized lack of validity and effects assessment in projects designed to develop educational aspects through PE and school sports.
La scuola, come prima responsabile dell'educazione dei cittadini, è oggi investita da una domanda che comprende, insieme, l'apprendimento e il saper stare al mondo. Tuttavia, la comunita'  scolastica si trova ad affrontare un paesaggio educativo estremamente complesso e mutevole di fronte al quale i giovani si trovano in una situazione di alta vulnerabilità che spesso sfocia in comportamenti antisociali: disinteresse, comportamenti violenti, abusi di sostanze, emarginazione, rifiuto di responsabilità personale e allontanamento dai servizi educativi. Alla scuola viene pertanto affidato un importante mandato educativo in quanto luogo per la promozione di comportamenti prosociali e l'apprendimento di quelle competenze trasversali, non direttamente riconducibili a specifici settori disciplinari, necessarie per la realizzazione e lo sviluppo personale, la cittadinanza attiva, l'inclusione sociale e l'occupazione. La problematica rappresentata dai comportamenti antisociali, insieme all'impegno nella promozione di comportamenti prosociali in eta' scolare, costituiscono oggi un prominente interesse di ricerca. L'analisi della letteratura riguardante lo studio delle determinanti dei comportamenti prosociali e antisociali porta ad individuare due elementi di rilevante importanza: la dimensione dell'empatia e la percezione di un clima di cura e benessere. E' largamente confermata l'ipotesi che l'empatia giochi un ruolo chiave nella messa in atto di comportamenti prosociali e nell'inibizione di quelli antisociali e che entrambi i comportamenti dipendano, a loro volta, dallo sviluppo e dal potenziamento delle capacita'  empatiche degli individui. Allo stesso modo, vi sono importanti evidenze che la qualita'  delle relazioni che intercorrono fra le persone che abitano la scuola influenzi in modo importante il manifestarsi di comportamenti antisociali e prosociali. Questo sistema di relazioni costituisce il clima scolastico, o di classe, la cui qualita'  determina la percezione di un clima orientato verso la cura e il benessere degli individui. La dimensione dell'empatia e la percezione del clima sembrano essere tra loro legate poiché, nel momento in cui si manifestano comportamenti di cura verso l'altro, viene dimostrata ricettivita'  ed accoglienza dei suoi bisogni. Un'interessante area di studio e di intervento per la promozione di empatia, relazioni positive e comportamenti prosociali e' rappresentata dall'educazione fisica (EF) in quanto contesto privilegiato, sia per il gran numero di opportunita'  relazionali che si possono attivare, sia per il coinvolgimento della dimensione corporea che veicola la comunicazione. Sono numerosi gli studi che hanno evidenziato significativi cambiamenti nell'empatia, nel clima di cura e nei comportamenti prosociali e antisociali attraverso specifici programmi di EF. A livello internazionale, inoltre, si stanno diffondendo numerose politiche ed azioni di intervento che utilizzano l'EF per contrastare la diffusione di comportamenti antisociali. Uno dei progetti di particolare rilievo e' stato recentemente promosso da una partnership di Agenzie internazionali, fra cui la WADA, l'UNESO e l'IOC, e sviluppato da un gruppo di università europee facenti parte dell'Association Internationale des coles Supèrieures d'Education Physique (AIESEP) e coordinato dall'Università di Padova. Il progetto prevedeva lo sviluppo di uno strumento (Toolkit) che supportasse gli insegnanti nella promozione di aspetti educativi legati alle dimensioni di fairness, equita' , rispetto ed inclusione attraverso l'EF. La presente ricerca comprende la preparazione e la sperimentazione di una progettazione didattica formulata sulla base del sopracitato Toolkit, la cui costruzione e' stata parte integrante del progetto di ricerca. La progettazione didattica e, per estensione, il Toolkit si basano su alcune caratteristiche di efficacia evidenziate in letteratura, che sono principalmente rappresentate da un approccio ludico all'apprendimento e dall'utilizzo di strategie di apprendimento attivo. La fase sperimentale della ricerca è stata condotta in una scuola secondaria di primo grado della provincia di Verona coinvolgendo 87 studenti di quattro classi seconde suddivise, a loro volta, in due classi sperimentali e due di controllo. Le classi sperimentali hanno partecipato ad un ciclo di 11 lezioni, con una frequenza di 1/2 incontri a settimana. La sperimentazione ha assunto il triplice scopo di: (a) indagare l'efficacia e l'impatto dell'intervento sull'empatia, sul clima di cura e benessere percepito, sui comportamenti prosociali e sulla costruzione del concetto di equita'  in relazione allo sviluppo di competenze trasversali; (b) analizzare la validita'  e la fattibilità della progettazione didattica attuata a partire dal Toolkit di riferimento; (c) valutare l'idoneita'  delle metodologie, delle procedure e degli strumenti caratterizzanti questo progetto pilota per supportare e migliorare i successivi passi di ricerca. I dati sono stati raccolti alla baseline (T0), al post-intervento (T1) e al follow-up (T2) ed analizzati utilizzando un approccio misto quantitativo-qualitativo. E' stato inoltre utilizzato uno strumento per la misurazione della fedelta'  dell'intervento. Dalle analisi e' emersa una stretta relazione fra l'empatia, i comportamenti prosociali e la percezione del clima di cura, evidenziando tuttavia una rilevante differenza di genere nei tre tempi di misurazione. Si sono evidenziati significativi effetti positivi dell'intervento sull'empatia e sui comportamenti prosociali, principalmente nei maschi delle classi sperimentali. Viene inoltre rilevata una significativa diminuzione della discrepanza di valutazione del comportamento prosociale fra allievi e insegnanti. Attraverso le analisi qualitative, emerge al T1 un concetto di equita'  maggiormente articolato e complesso rispetto al T0 e maggiormente aderente alla definizione stessa di equita' . I codici e i temi emersi consentono di identificare la presenza di capacita'  critiche, argomentative, di transfer e di generalizzazione, nonche' di rilevare una maggior consapevolezza della responsabilità personale nel rendere un contesto equo, rispettando bisogni ed emozioni altrui. Il miglioramento delle capacita'  critico-flessive sembra collegato ai cambiamenti rilevati nell'empatia, nel comportamento prosociale e nella percezione del clima di cura che, per una classe sperimentale, risulta minore rispetto alle classi controllo al T1. Le analisi di validita'  e fattibilita'  rilevano diversi punti di forza e criticita'  del progetto: se da una parte e' valutato positivamente per la sua flessibilità e cross-curricolarita' , dall'altra viene riconosciuta la necessità di formare il docente che vuole operare con metodologie di apprendimento attivo. Il progetto assume infine un'importanza strategica nell'avanzamento della ricerca poiche' tenta di colmare un rilevante gap, evidenziato in letteratura, che riguarda la diffusa mancanza di valutazione degli effetti e della validita'  dei progetti finalizzati allo sviluppo di aspetti educativi attraverso l'EF e lo sport scolastico.

Dopo un’ampia e dettagliata descrizione del mondo del nuoto paralimpico e dei protocolli di classificazione degli atleti per valutare attraverso test fisici e tecnici il grado di funzionalità fisica (Capitolo 1), si indagherà sul ruolo della pratica sportiva agonistica nel migliorare il benessere psicofisico percepito di atleti disabili (Capitolo 2). Successivamente si svilupperà un metodo di allenamento per atleti con sindrome del motoneurone superiore per la preparazione fisica di tre eventi internazionali di nuoto paralimpico. Nel corso della strutturazione dell’allenamento si è studiato e preso in considerazione le risposte fisiopatologiche all’allenamento tipiche di questa sindrome (Capitolo 3). Avendo chiarito nel precedente Capitolo le risposte fisiche indotte dal nuoto agonistico negli atleti affetti da sindrome del motoneurone superiore, si sperimenterà una strategia terapeutica al fine di migliorare la performance di nuoto in atleti paralimpici riducendo spasticità e clono, attraverso l’applicazione del Kinesio Taping che è una tecnica di taping innovativa basata sull'uso di un sottile nastro elastico incollato sulla pelle (Capitolo 4).

In the past, several studies investigated the circadian rhythm of different physiological variables associated to sport, the time-of-day effects on physical performance and the reciprocal relationship between sleep and physical activity but there is a scarce literature on how the chronotype could influence all these aspects. Therefore, the purposes of this Ph.D. thesis are: 1) to assess, with the use of actigraphy, the relationship between the three chronotypes and the circadian rhythm of activity levels and to determine whether sleep parameters respond differently with respect to the time (weekdays versus the weekend) in M-types, N-types and E-types; 2) to evaluate whether a linear regression formula using the MEQ score would predict the actigraphy-based acrophase in a young Italian population; 3) to investigate the effects of chronotype on psychophysiological responses (RPE, HR and walking time) to a submaximal self-paced walking task performed in two different times of day (08:30-09:00 vs 15:30-16:30). The results showed that: 1) the acrophases of the activity levels were significantly different in M- (14:32h), N- (15:42h) and E-types (16:53h) (p<0.001) while MESOR and amplitude were similar among chronotypes; there was also a significant interaction between the chronotype and sleep parameters: Sleep Efficiency of the E-types was poorer than that of the M- and N-types during weekdays (77.9% ± 7.0 versus 84.1% ± 4.9 and 84.1% ± 5.2) (p=0.005) but was similar to that measured in the M- and N-types during the weekend. 2) There was a significant linear relationship between MEQ and the Acrophase thus, enabling us to use the equation of the regression line to obtain predictions. The predictive equation resulted as follows: 1238.7-5.487*MEQ. The precision of the estimates was excellent and the r2 was 0.70, indicating that 70% of the variance in the acrophase was explained by MEQ. 3) It was found a significant interaction between chronotype and time of day. The post hoc analysis showed a significant difference for RPE in the morning session, with E-types reporting higher RPE compared with the M-types (14.33 ± 2.45 vs 12.00 ± 1.66) (p<0.01). This Ph.D. thesis highlights two key findings: 1) the chronotype influence the activity circadian rhythm and the sleep parameters suggesting that E-types accumulate a sleep deficit during weekdays, due to social and academic commitments and that they recover from this deficit during “free days” on the weekend; 2) the chronotype and the time of day when a physical task in undertaken can influence the RPE response.

Nella tesi vengono indicate le difficoltà della realtà italiana nel vendere il prodotto stadio al consumatore finale, portando esempi di successo esteri e proponendo delle iniziative per migliorare l'esperienza.

Nella stesura dell'elaborato finale ci si focalizza inizialmente sull'analisi del settore calcio e l'evoluzione che esso ha avuto nel tempo. Si passa poi ad analizzare più nello specifico il brand nelle società calcistiche, risorsa sempre più importante che le società devono saper sfruttare per avere successo anche al di fuori del rettangolo di gioco.

La tesi si articola in 3 parti: nella prima parte si tratta di cos'è un brand e di una serie di concetti ad esso collegati. Inoltre si inizia a trattare anche il ruolo del brand all'interno delle società sportive, in particolare all'interno delle società di calcio. Nella seconda parte si tratta invece il rebranding, ovvero di cosa si tratta e perché le aziende adottano tale strategia. Anche in questo caso, in un secondo momento, si prenderanno in considerazione le società di calcio (in particolare il Pordenone Calcio). Nella terza, e ultima, parte si studierà un modello matematico applicabile al Pordenone Calcio e si tireranno le somme.

It generally accepted that soccer is one of the most popular sports in the world. Thanks to technology development, a progressively increasing in studies about external load monitoring in soccer match and training were published. Currently, several are the systems available to simultaneously analyze movement patterns of many players during a soccer match, including video-based time motion analysis equipment and global positioning system (GPS) devices. However, the use of one of the first two methods depends on various factors linked to the strengths and weaknesses of each methodologies. As far as concern GPS technology, it has been demonstrated that GPS devices are reliable instruments for monitoring the true metabolic demands during intermittent or high-intensity exercises such as soccer activities. However, there are several concerns about the use of GPS device to assess the very high-speed bouts, short sprints and/or movements with many changes of direction, even more when the sample rate of the GPS device is low. Different studies have shown that reliability of GPS devices gradually decreases in relation to increasing number of changes of directions and accelerations and to reducing running distance. Thus, first aim of this thesis was to investigate the validity and accuracy of GPS technology with a sampling rate ≧10Hz in order to evaluate if it could produce better information on brief activities speed during short shuttle runs. Supporting by GPS technology, categories of movement described in relation to speed, acceleration or power thresholds, difference between playing position, analysis of fatigue during the match and physical demand in different soccer population (i.e adult versus young) have been analyzed during the training or game by researchers to better understand the workload imposed. Results obtained, in adult male players during a soccer match, identified in the high-intensity distance covered an important indicators of match physical performance. Instead, in youth players most information is available for players between 12 and 17 yr of age but, for very young players (<11 yr of age), data describing the activity profile during match play are limited and thus a less clear picture of the movement demands of these developing players is evident. Contrarily, information on match analysis about women’s soccer is relatively few and more confused if compared to those of men. Indeed, so far, there is not universally agreement upon standard velocity thresholds utilized to quantify the distances covered in different locomotor activities, especially for high-speed running and sprinting. However, just recently some studies have presented common recommendation that are now being adopted. Finally, it has been demonstrated that GPS technology could help to better evaluate the workload imposed by specific soccer training. In the last years, the methodology in soccer is changing and it became more difficult to check and program training in order to prevent injury. Not enough time is spent on physical conditioning without ball. Commonly, several technical and tactical exercises are considered the main activities during the soccer. The “modern” problem could be monitoring the global training load imposed from these type of training modalities. In this contest, the new available technologies could help coaches and sport scientists to better assessed the soccer training workload. Unfortunately, few studies investigated the relationship between GPS data and muscle fatigue after soccer-specific training sessions, and to our knowledge no data are available about the muscle impairments after different soccer training modalities and their relationship with external workload calculated using GPS devises. Therefore, the aims of this thesis were to describe the use of GPS technology in soccer. Four studies are developed in which the purposes were: 1) to evaluate the accuracy and inter-unit variability of a GPS device with a sampling rate of 20Hz for measuring mean and speed of shuttle runs; 2) to characterize match running performance of very young soccer players and evaluate the relationship between these data and physical capacities and technical skills; 3) to examine high-intensity distance covered during matches by elite female soccer players using different velocity thresholds and 4) to compare the decay in muscle performance after soccer-specific aerobic and traditional interval running training session.

In recent years, the interest in outcome measures has grown in the effort to improve quality of care and customer satisfaction. This thesis provides an overview of topics related to development and refinement of outcome measures and users' satisfaction measurement in Physical and Rehabilitation Medicine. The eight chapters - represented by original articles - are examples of the application of contemporary measurement approaches to some instruments commonly used in rehabilitation. These studies illustrate advances in measurement theory and methods that allow outcome indicators to be measured more accurately, including Rasch analysis. Their utility for researchers and clinicians are discussed. Chapter I focuses on the interpretation of the change scores of two common outcome measures for the upper limb: the Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH) and its short version (QuickDASH). In this work the minimal clinically important difference (MCID) was calculated by a triangulation of distribution and anchor-based approaches for these two questionnaires. The MCID thresholds represents the smallest improvement considered worthwhile by a patient, and thus increase the interpretability of score changes at individual level observed in the clinical setting. Assessing patient progress is an integral part of clinical practice, and meaningful threshold change values of outcome tools are essential for decision making regarding a patient‟s status and to facilitate the communication of results in a concise and comprehensible fashion. Among the different tools used for the assessment of musculoskeletal disorders of the lower limb, the Foot and Ankle Ability Measure (FAAM) showed good psychometrics properties. However, it has not yet been made a translation into Italian. Chapter II shows how to conduct a translation and cross-cultural adaptation of a questionnaire according to the international guidelines for the forward/backward translation. The activities od daily living (ADL) module of the Italian FAAM (FAAM-I/ADL) was translated and then validated with the classical test theory, taking into consideration internal consistency, reproducibility, sensitivity to change and validity. Chapter III presents an example of the test-retest reliability analysis and normative data collection of the the Functional Dexterity Test (FDT). Among the available tests for fine finger dexterity, it has been indicated as a valid instrument to measure outcome in different conditions. FDT scores were collected on a large sample of subjects (N=698) stratified by sex and age. These data could be used, for example, to improve the diagnostic capacity of this test. Chapters IV, V and VI report the complex process of validation through the Rasch analysis. In particular, the aim of Chapter IV and V was to perform the translation and cross-cultural adaptation into Italian and Arabic of the recently revised version of the Client Satisfaction with Device (CSD) module of the Orthotics and Prosthetics Users' Survey (OPUS), and then analyze its psychometric properties using factor and Rasch analyses. The need for validated versions of this instrument into Italian and Arabic is documented by the fact that information on patient satisfaction with orthosis (PSwO) is crucial for verifying and enhancing orthotic quality, for clinical decision making, and for improving patient's quality of life. The aim of the study included in Chapter VI was to perform a comprehensive analysis of the psychometric properties and dimensionality of the Italian version of the Upper Limb Functional Index (ULFI) using both Classical Test Theory and Rasch analysis. The last two chapters - VII and VIII - are systematic reviews of the literature. Chapter VII reports a literature search aimed at identifying which validated questionnaires are used to investigate PSwO in limb orthotics, and analyse their main fields of clinical application, the orthosis-related features analysed by the questionnaires, and the strength of their psychometric properties. Chapter VIII covers the topic of post-surgical scar assessment in rehabilitation. The study is a systematic review that provides a critical appraisal of the most used and clinimetrically sound outcome measures currently available for this topic.

La ricerca ha per oggetto la formazione dei tecnici sportivi in Italia. Lo studio è articolato in tre parti: la prima descrive il Sistema Internazionale delle Qualifiche dei Tecnici Sportivi, la seconda analizza i percorsi formativi realizzate dalle Federazione Sportive Nazionali in Italia, mentre la terza parte presenta un’analisi comparativa dei percorsi per il rilascio delle qualifiche tecniche di maggior livello in sette diversi paesi. Il Sistema descritto nella prima parte è studiato attraverso l’analisi dei principali aspetti che lo caratterizzano, quali i diversi contesti operativi, le funzioni che i tecnici esercitano, i livelli di qualificazione, le conoscenze e competenze necessarie, le principali tipologie dell’apprendimento e le caratteristiche dei formatori. Nella seconda parte vengono analizzati i diversi percorsi formativi delle Federazioni Sportive italiane. Sono state analizzate 27 federazioni studiandone i seguenti elementi: l’articolazione in livelli della formazione, le metodologie ed i contenuti didattici, le modalità di valutazione, l’adesione allo SNaQ e le eventuali modifiche apportate; inoltre si è descritta la dimensione quantitativa dei tecnici per ciascuna federazione per i diversi livelli e si è descritto l’importante figura del responsabile della formazione federale. Nella terza parte si è condotta un’analisi comparativa della formazione riguardante la maggiore qualifica acquisibile in sette paesi diversi: Canada, Francia, Germania, Olanda, Svizzera, Nuova Zelanda e Italia. Si sono messi a confronto gli elementi principali dei percorsi, quali i prerequisiti di entrata, lo staff docente, la durata, i contenuti e le metodologie didattiche, i costi, le modalità di valutazione, etc. I risultati della ricerca dimostrano come sia cresciuta la considerazione che le funzioni del tecnico sportivo siano molto complesse ed articolate e dipendono in misura sempre crescente dal contesto operativo e che per questo, si rende necessaria una formazione più efficace che miri all’acquisizione di competenze. I percorsi formativi, nonostante gli enormi progressi degli ultimi anni dovuti al crescente numero di ricerche scientifiche del settore ed all’analisi delle migliori pratiche, sono ben lontani da dall’essere armonizzati, sia in campo nazionale (tra le diverse federazioni) che in campo internazionale (nei diversi paesi). Manca ancora un’efficace integrazione tra la formazione erogata dalle federazioni e la formazione realizzata dalle istituzioni accademiche. Si raccomandano quindi ulteriori studi in futuri progetti di ricerca che indaghino questo importante aspetto.
The research investigates the training of sport coaches in Italy. The study is divided into three parts: the first describes the International Sport Coaching Framework, the second analyses the training courses conducted by National Sports Federation in Italy, while the third part carries out a comparative analysis of the paths for obtaining sport coaches qualifications of higher level in seven different countries. The system described in the first part is studied through the analysis of the main aspects that characterize it, such as the different operational contexts, coach functions, levels of qualification, knowledge and skills, the main types of learning and the characteristics of coaches. The second part examines the various training courses of Italian Sports Federations. 27 federations were analysed by studying the following aspects: the articulation in levels of education, methodology and educational content, methods of assessment, adherence to and SNaQ changes; It also describes the quantitative dimension of coaches for each Federation for the different levels and describes the important figure of the Federal Responsible of coach education. In the third part has conducted a comparative analysis of the education of the higher qualification acquired in seven different countries: Canada, France, Germany, Holland, Swisterland, New Zealand and Italy. It has compared the main elements of the paths, such as entrance prerequisites, academic staff, the duration, content and teaching methods, costs, methods of evaluation, etc. Research results show that both grew up considering that the sports coach functions very complex and articulated and are increasingly operating context and that for this reason, it requires a more effective education aimed at the acquisition of skills and cempetences Training courses, despite the enormous progress in recent years due to the increasing number of scientific research in the sector and to the analysis of best practices, are far from being harmonized, both nationally (between the different federations) that internationally (in different countries). It still lacks an effective integration between the education provided by the federations and the education provided by academic institutions. Then further studies are recommended in future research projects that investigate this important aspect.

Attraverso la presente ricerca sono stati valutati, su un campione costituito da 204 soggetti di età compresa tra 45 e 88 anni, gli effetti neuromuscolari e quelli relativi alla mobilità articolare conseguenti alla pratica di diversi protocolli di fitness all’interno della palestra. Al tempo stesso sono stati valutati, attraverso due questionari, i benefici in termini di soddisfazione/benessere, ricercati ed attesi dal medesimo campione di soggetti con la tipologia di attività di fitness prescelta (questionario 1), e quelli sentiti come effettivamente conseguiti al termine dell’attività motoria praticata (questionario 2). In sostanza, con i predetti questionari si è cercato di indagare inizialmente i motivi che spingono le persone a frequentare la palestra ed i centri di fitness, piuttosto che praticare attività fisica all’aria aperta, come luoghi deputati non solo al raggiungimento di una forma fisica ideale, ma anche di un benessere psichico, verificando successivamente quanto i benefici sperati abbiano trovato effettiva realizzazione con la pratica di palestra. I dati acquisiti con i test motori e con i questionari somministrati, sono stati trattati statisticamente mediante analisi descrittiva, inferenziale ed altre analisi tipiche delle ricerche di mercato.

La tesi seguente prende in esame un argomento che, negli ultimi anni, è stato oggetto di numerose discussioni, contraddizioni e polemiche in ambito sportivo a livello internazionale: il calcio in Cina. Nonostante la Cina sia la prima potenza economica e sportiva al mondo, il calcio ha sempre rappresentato il suo punto debole. A partire dal 2010, però, il paese ha dato il via a un ambizioso progetto di rinascita e crescita calcistica che ha coinvolto l’intero sistema. La Cina si è posta l’obiettivo di entrare sia a livello di club, sia a livello di nazionale, nel calcio d’élite in un tempo di programmazione relativamente breve visto il livello attuale nel paese. Questa trattazione si focalizza principalmente su un repertorio terminografico italiano-cinese sul gioco del calcio, ma viene preceduta da una parte introduttiva dedicata alla conoscenza e all’esposizione dei suoi principali aspetti in Cina dal punto di vista storico, organizzativo ed economico, che ho deciso di suddividere in tre capitoli. Il primo capitolo di questo elaborato si apre con un excursus storico sulle origini del calcio in Cina prendendo in esame i suoi predecessori, lo Tsu chu e il Kemari. La digressione prosegue poi affrontando i principali eventi che hanno caratterizzato la storia moderna del calcio cinese: a partire dai successi di Lee Wai Tong, passando attraverso l’ingresso nella AFC, le vittorie del Liaoning in Asia, la disastrosa spedizione ai mondiali del 2002 sino ad arrivare alle Olimpiadi di Pechino del 2008. Il secondo capitolo è incentrato sull’analisi della struttura e dell’organizzazione delle federazioni calcistiche e delle competizioni da queste organizzate. In particolare, la Chinese Football Association (FCA), l'organo sportivo responsabile dell'amministrazione del calcio in Cina, così come della nazionale e delle competizioni per club, tra cui la Chinese Super League, il massimo torneo calcistico giocato in Cina. Attenzione particolare viene anche posta sulla Asian Football Confederation (AFC), l'organo amministrativo, organizzativo e di controllo del calcio asiatico a cui la FCA è affiliata dal 1974. Organizzatrice delle competizioni calcistiche in Asia, si occupa della gestione della AFC Asian Cup, il torneo calcistico che mette di fronte le sedici migliori Nazionali maschili asiatiche e dal 2007 anche l’Australia. Il terzo capitolo è dedicato al “Sogno Cinese”, il piano di rinnovamento economico che ha coinvolto anche il settore del calcio facendo parlare di un vero e proprio “sogno calcistico”. Dal 2010 la presenza della Cina sul suolo europeo si è fatta sempre più preponderante a causa degli ingenti investimenti che hanno toccato diversi aspetti: dall'acquisizione delle quote di maggioranza di squadre nei maggiori paesi europei a quelle di calciatori forti in cambio di ricchi stipendi. Un vero e proprio business che viene visto con preoccupazione nel nostro continente. Se da un lato la Cina punta a una rinascita facendo affidamento all’Europa, deve però fare i conti anche con i “problemi interni”. Non solo i cinesi per molto tempo hanno preferito altri sport al calcio, ma nell’ultimo decennio gli episodi di corruzione nel calcio cinese che hanno coinvolto giocatori, presidenti, arbitri e funzionari della federazione, hanno costretto il Governo a prendere importanti provvedimenti a riguardo. Nell’aprile 2016, la FCA ha quindi pubblicato il Piano 2016-2050 per lo sviluppo a medio e lungo termine del calcio cinese, il documento viene considerato il primo schedule e la prima roadmap per lo sviluppo del calcio in Cina con obiettivi concreti, tra cui la realizzazione di 20mila scuole di calcio con 50 milioni di praticanti. Il presidente Xi Jinping, grande appassionato di calcio, ha più volte espresso tre desideri per il suo futuro: il primo è quello di qualificarsi un’altra volta per i Mondiali di Calcio; il secondo è poterli ospitare; l’ultimo è vincere la Coppa del Mondo.

Nella presente trattazione si prenderà in esame la ginnastica artistica, una disciplina olimpica caratterizzata da forza, resistenza ma anche da grande creatività e stile. Il lavoro si articolerà in tre capitoli, la cui stesura è frutto dell’elaborazione di numerose fonti ottenute in seguito ad un’attenta ricerca. Si partirà con un primo capitolo principalmente introduttivo di questa attività sportiva in generale, analizzando brevemente le sue origini e la sua evoluzione nel tempo. In realtà, è necessario specificare che l’argomento storico non verrà trattato esclusivamente per la ginnastica in generale, bensì anche per raccontare dei fatti e dei protagonisti che hanno contribuito alla nascita della ginnastica agonistica, ossia il momento in cui allo spirito artistico e sportivo comincia ad affiancarsi quello competitivo, un cambiamento essenziale con cui cominciano a sorgere le prime gare che hanno costituito la base per la formazione di quelle odierne e delle loro regole. Si entrerà in dettaglio di tutti gli attrezzi di gara femminili e maschili, i quali saranno elencati e descritti singolarmente nelle loro funzioni e misure, ufficialmente dettate dalla Federazione Internazionale. A seguire, oltre alla descrizione degli attrezzi e degli esercizi, si parlerà in dettaglio delle competizioni e le loro regole, inerenti in particolare alla giuria e ai punteggi; nello specifico si parlerà dei due concorsi di gara di livello internazionale, ossia i Giochi Olimpici e i Campionati del Mondo. Si farà molta attenzione ai termini tecnici, in particolar modo verrà enunciata con molta chiarezza la differenza tra ginnastica artistica e ginnastica attrezzistica; allo stesso tempo si analizzerà il concetto di squadra di tale disciplina, molto diverso dalle altre, per l’importanza data all’aspetto individuale dell’atleta. In questo primo capitolo introduttivo, quindi, si parlerà delle caratteristiche generali e dunque di livello mondiale della disciplina presa in esame, non mancherà perciò un paragrafo dedicato alla Federazione Internazionale di Ginnastica (FIG) e al suo Programma Accademico. Tale Federazione è un organo fondamentale della ginnastica artistica di tutti i Paesi del mondo, è proprio da essa infatti che provengono tutte le decisioni inerenti ogni singolo aspetto che sarà enunciato in questo primo capitolo. Infine, questa prima parte si concluderà guardando più nel dettaglio uno degli eventi storici in cui la ginnastica artistica è stata protagonista, o ancora meglio un mezzo per il raggiungimento di scopi politici. Stiamo parlando di ciò che è passato alla storia come il boicottaggio dei Giochi di Mosca del 1980, un avvenimento che ha visto come protagonisti la Russia e gli Stati Uniti, questi ultimi all’epoca sotto il governo del presidente democratico Jimmy Carter; tale accaduto, di cui si descriveranno i dettagli nell’ultima parte del primo capitolo, influenzò la partecipazione ai Giochi di Mosca di quell’anno di diverse nazioni. In seguito ad un’introduzione degli aspetti mondiali della ginnastica artistica, si entrerà nel dettaglio di due tra le nazioni fondamentali per questa disciplina: L’Italia e la Cina. Il viaggio nella ginnastica di questi due paesi avrà inizio con il secondo capitolo in Italia; qui , innanzi tutto, si introdurrà la Federazione Ginnastica Italiana (FGI), organo essenziale di tale disciplina nel nostro paese, in particolar modo si parlerà della sua nascita e della sua evoluzione storica nel corso degli anni fino ad arrivare a quella che è al giorno d’oggi. Dunque si parlerà delle regole specifiche dettate da questo organo nazionale, riguardanti i diversi della ginnastica, tra cui uno fondamentale, quello delle competizioni ed in particolar modo delle categorie di gara femminili e maschili. Si racconteranno un po’ gli anni Sessanta, che hanno costituito per la disciplina italiana anni di grandi successi e trasformazioni.

Questa tesi vuole porsi l’obiettivo di presentare le vicende storiche che hanno portato alla nascita e alla diffusione del gioco della pallavolo in Cina concentrandosi principalmente sulla storia della nazionale femminile di pallavolo e sul suo personaggio simbolo, Jenny Lang Ping. Il primo capitolo è incentrato sulle tappe fondamentali della storia della pallavolo e della diffusione in Cina. Racconta la nascita della pallavolo moderna, il difficile processo di affermazione di questo sport in Cina negli anni sessanta fino alla realizzazione del sogno olimpico cinese degli anni ottanta. Il secondo capitolo si concentra sullo spirito della nazionale femminile che è passato alla storia come esempio di patriottismo nazionale, mentre il terzo capitolo ripercorre la bibliografia di Jenny Lang Ping. La seconda parte del trattato presenta un glossario italiano-cinese costituito da settanta schede terminografiche e bibliografiche di termini riguardanti il gioco della pallavolo.

Identification of innovative tools for the electromechanical evalutation of the neuro-muscular function in patients with altered motor control during daily-life activities and adapted physical activities
Identification of innovative tools for the electromechanical evalutation of the neuro-muscular function in patients with altered motor control during daily-life activities and adapted physical activities

This study investigated the effects induced by 8 weeks of two high-intensity interval training (HIIT) protocols, 10-20-30 and 30-30 concepts, characterized by significantly different train-ing volume and intensity, on physiological parameters, running performance, body composition and psychophysiological stress of recreational divided into two groups: the 10-20-30 group performed two 10-20-30 sessions/wk and one con-tinuous training (CT)/wk, whilst the 30-30 group performed two 30-30 sessions/wk and one CT session/wk. VO2max, 1 km time, maximal aerobic speed (MAS), and body composition were evaluated before and after intervention. Internal load was measured through rating of perceived exertion (RPE). Both groups significantly improved running performance (1 km time: p = 0.04; MAS: p = 0.000001), aerobic fitness (VO2max: p=0.000002) and body composition (lean mass (kg) p=0.0001; fat mass ( %) p = 0.00005). RPE resulted significantly lower in the 10-20-30 group than in 30-30 group (10-20-30: 13.36 ± 0.28; 30-30:15.55 ± 0.21; p = 0.0002). Thus, the 10-20-30 group improved physiological parameters, performance and body composition, similar to 30-30 with significantly lower RPE values. These results suggest that in recreational runners the 10-20-30 training is effective in improving aerobic fitness and performance, with a lower subjective perception of effort, thus enhancing individual compliance and adherence to the pre-scribed training program

Due to the fact that team sports such as football have a complex multidirectional and intermittent nature, an accurate planning of the training workload is needed in order to maximise the athletes’ performance during the matches and reduce their risk of injury. Despite the evaluation of external workloads during trainings and matches has become more and more easier thanks to the advent of the tracking system technologies such as Global Position System (GPS), the planning of the best training workloads aimed to obtain the higher performance during the matches and a lower risk of injury during sport stimuli, is still a very difficult challenge for sport scientists, athletic trainers and coaches. The application of machine learning approaches on sport sciences aims to solve this crucial issue. Hence, the combination between data and sport scientists’ peculiarities could maximize the information that can be obtained from the football training and match analysis. Thus, the aim of this thesis is to provide examples of the application of the machine learning approach on sport science. In particular, two studies are provided with the aim of detecting a pattern during in-season football training weeks and predicting injuries. For these studies, 23 elite football players were monitored in eighty in-season trainings by using a portable non-differential 10 Hz global position system (GPS) integrated with 100 Hz 3-D accelerometer, a 3-D gyroscope, and a 3-D digital, Northern Ireland compass (STATSports Viper). Information about non-traumatic injuries were also recorded by the club’s medical staff. In order to detect a pattern during the in-season training weeks and the injuries, Extra Tree Random Forest (ETRFC) and Decision Tree (DT) Classifier were computed, respectively. In the first study it was found that the in-season football trainings follow a sinusoidal model (i.e. zig-zag shape found in autocorrelation analysis) because their periodization is characterized by repeated short-term cycles which are constituted by two parts: the first one (i.e. trainings long before the match) is constituted by high training loads, and the second one (i.e. trainings close to the match) by low ones. This short-term structure appears to be a strategy useful both to facilitate the decay of accumulated fatigue from high training loads performed at the beginning of the cycle and to promote readiness for the following performance. As a matter of fact, a patter was detected through the in-season football training weeks by ETRFC. This machine learning process can accurately define the training loads to be performed in each training day to maintain higher performance throughout the season. Moreover, it was found that the most important features able to discriminate short-term training days are the distance covered above 20 W·kg-1, the acceleration above 2 m·s-2, the total distance and the distance covered above 25.5 W·Kg-1 and below 19.8Km·h-1. Thus, in accordance with the results found in this study, athletic trainers and coaches may use machine learning processes to define training loads with the aim of obtaining the best performance during all the season matches. Players’ training loads discrepancy in comparison with the ones defined by athletic trainers and coaches as the best ones to obtain enhancement in match performance, might be considered an index of individuals’ physical issue, which could induce injuries. As a matter of fact, in the second study presented in this thesis, it was found that it is possible to correctly predict 60.9% of the injuries by using the rules defined by DT classifier assessing training loads in a predictive window of 6-days. In particular, it was found that the number of injuries that the player suffered through the season, the total number of Acceleration above 2 m·s-2 and 3 m·s-2, and the distance in meters when the Metabolic Power (Energy Consumption per Kilogramme per second) is above the value of 25.5 W/Kg per minute, are the most important features able to predict injuries. Moreover, the football team analysed in this thesis should keep under control the discrepancy of these features when players return to the regular training because of the numerous fall-backs into injuries that have been recorded. Thus, this machine learning approach enables football teams to identify when their players should pay more attention during both trainings and matches in order to reduce the injury risk, while improving team strategy. In conclusion, Machine Learning processes could help athletic trainers and coaches with the coaching process. In particular, they could define which training loads could be useful to obtain enhancement in sport performance and to predict injuries. The diversities of coaching processes and physical characteristics of the football players in each team do not permit to make inferences on the football players’ population. Hence, these models should be built in each team in order to improve the accuracy of the machine learning processes.

ABSTRACT Cardiorespiratory and Metabolic Response to Different Sinusoidal Work Rates Cardiorespiratory fitness is one of the most important health criteria in seemingly healthy individuals and nearly all patient populations. Alongside the traditional tests for cardiorespiratory functional evaluation, a test protocol was proposed based on the intensity of the exercise that varies according to a sine wave model. This approach engenders an incessantly fluctuating response in which the response to one cycle is repeated. Indeed, by the periodic occurrence of increasing and decreasing phases, an evaluation of the physiological response kinetic to similar work rate perturbations can be obtained in a single testing session. Sinusoidal protocol pattern depends on several factors: period (T), amplitude (AMP) and midpoint (MP), therefore, modulating one or all of these factors yield various responses of the heart-lung-muscle integrated system. So far, previous studies administered sine wave protocols to investigate changes in the physiological responses induced by changes in T, pedal frequency, or exercise intensity (below and above the lactate threshold). In particular, those studies focused on changes in the temporal responsiveness of the cardiorespiratory and metabolic parameters, measured as the time delay (TD, the latency between mechanical work rate and physiological responses). To date, no study has investigated the possible differences in the cardiorespiratory and metabolic kinetic induced by different sine waves AMP in two protocols sustained by the aerobic metabolism (exercise intensity below the critical power (CP)). Additionally, given that none of the previous studies has ever explored the influence of fatigue on sinusoidal responses, and considering that all the previously reported results were obtained by overlapping, rather than averaging, the analysis of each cycle, it is worth investigating if a cycle-by-cycle analysis may reveal any sign of fatigue with the cycle’s number progresses. Therefore, the aim of this study was two-folds: i) to assess the cardiorespiratory and metabolic response kinetic between two exhausting sinusoidal protocols differing in MP and AMP: 30CP-30 and 50CP-50, and ii) to compare the traditional data analysis approach with a cycle-by-cycle evaluation. In this latter, the possible impact of fatigue on the kinetics characteristics of cardiorespiratory and metabolic parameters will be explored. Ten active male (age: 25.7 ± 1.5 yrs; stature: 1.80 ± 0.06 m; body mass: 75.0 ± 2.7 kg; maximum oxygen uptake (V ̇_(O_2 max)): 3905±182 ml·min−1, CP: 216 ± 10 W) contributed to the study that was conducted in accordance with the Basic Principles of the Declaration of Helsinki. After determining individual V ̇_(O_2 max) and CP on a cycle ergometer, they randomly underwent two sinusoidal work rates (50CP-50: AMP= 50W, MP =CP-50W; 30CP-30: AMP= 30W, MP =CP-30W) with a period of 4 minutes, until exhaustion. Expiratory ventilation (V ̇_E), oxygen uptake (V ̇_(O_2 )), carbon dioxide output (V ̇_(CO_2 )), and heart rate (fH) responses were fitted by the sinewave function that minimized the residuals. AMP, MP and TD were assessed for all the physiological variables. The TD was determined for: i) peak (TD_MAX); ii) down-ward MP crossing (TD_DOWN); iii) nadir (TD_MIN); and iv) up-ward MP crossing (TD_UP) of all parameters for each cycle in 50CP-50 and 30CP-30. After examining the normality with Shapiro-Walk test, a two‐way ANOVA for repeated measures was applied to test the presence of differences between the two protocols and among cycles, taking the first cycle as the reference condition. To determine the presence of fatigue a regression analysis was also applied for exploring possible relationship between each variables and time. Lastly, a paired samples t-test also evaluated the differences between the traditional approach and the cycle-by-cycle analysis. Despite the lower AMP and higher MP values obtained on all the physiological parameters during 30CP-30 compared to 50CP-50, no difference was found in the TDs values in both protocols, regardless of which TD was considered. In some investigated variables, the impact of fatigue on AMP was dissimilar between the two protocols. Indeed, none of the physiological parameters showed any sign of fatigue in 30CP-30, while a significant increase in V ̇_E and V ̇_(CO_2 )was observed in 50CP-50. In regards to a possible impact of fatigue on MP, the V ̇_E, V ̇_(O_2 ) and V ̇_(CO_2 )responses remained steady, whereas a significant rise was observed in fH in both protocols. Refer to a possible effect of fatigue on TDs, no difference was found among cycles in both protocols.Taken together, these findings indicated that the respiratory and metabolic parameters responded similarly among all the cycles and were not influenced by the onset of fatigue. On the contrary, the fH showed a different response in the MP since the beginning of the protocol therefore, the traditional analysis ventures the lack of possible alterations in cardiac response. In conclusion, TDs of the cardiorespiratory and metabolic variables are not affected by the work rate intensity and oscillation AMP when the exercise is mostly aerobic (below CP). Additionally, a cycle-by-cycle analysis is recommended especially when the steadiness of all the cardiorespiratory and metabolic parameters cannot be ensured.

Introduzione: Durante una partita, le richieste di gioco per un giocatore di rugby dipendo dalla posizione in cui gioca. Gli avanti sono coinvolti più spesso in fasi statiche (mischie, raggruppamenti a terra e in piedi), mentre i tre quarti devono svolgere più frequentemente azioni dinamiche (sprintare, saltare, cambiare direzione). Sono queste richiese di gioco a determinare le caratteristiche antropometriche e fisiche richieste ad un giocatore per avere successo. Gli avanti sono più pesanti e forti, mentre i tre quarti sono più snelli e veloci. In generale, nonostante la letteratura riporti che giocatori più pesanti e pesanti siano favoriti ad essere selezionati per le competizioni internazionali, le informazioni sono limite per quanto riguarda giocatori italiani. Corporatura, forza, potenza e velocità possono essere efficacemente migliorate con un allenamento con sovraccarichi. Al momento però non vi sono informazioni definitive rispetto a quale sia la metodologia più efficace da impiegare quando si allenano degli atleti. Per esempio, l’efficacia dell’allenamento fino al cedimento muscolare (FAIL), che sembrava essere indispensabile per migliorare ipertrofia e forza muscolare, più recentemente è stata contestata poiché l’allenamento senza cedimento muscolare (NO-FAIL) è stato mostrato garantire superiori miglioramenti nei valori di forza e potenza degli atleti. Scopo: Lo scopo di questa tesi è duplice. Dapprima individuare quali caratteristiche siano perditrici della selezione per competizioni internazionali in giocatori italiani della categoria U20. In secondo luogo, quale tra FAIL e NO-FAIL, possa maggiormente migliorare le caratteristiche antropometriche e fisiche dei giocatori. Metodi: Per il primo scopo, è stata svolta un’analisi retrospettiva sulle caratteristiche fisiche e antropometriche, raccolte testando le variabili di 72 giocatori U20. È stata svolta un’analisi della varianza (ANOVA) a due vie, ponendo come fattori tra soggetti la posizione e la selezione per competizioni internazionali. La selezione è stata inoltre posta come variabile dipendente della regressione logistica. Per il secondo scopo, 16 giocatori di rugby amatoriali sono stati assegnati ad uno di due gruppi sperimentali (FAIL o NO-FAIL) e hanno svolto un programma di allenamento 11 contro sovraccarichi della durata di sette settimane. Le variabili antropometriche e fisiche sono state testate prima e dopo il programma sperimentale. Risultati: ANOVA non ha rilevato nessun effetto significativo per l’interazione. La massa corporea e la forza massimale degli arti inferiori sono risultate perditrici della selezione nei giocatori U20. Analizzando gli effect size, è stato possibile vedere che i giocatori del gruppo NO-FAIL sono migliorati maggiormente nella forza massimale degli arti inferiori, nell’altezza e potenza del salto verticale, nello sprint e nel cambio di direzione. Conclusioni: corporatura e forza massimale dei giocatori sono fondamentali per la selezione a livello internazionale nel rugby. L’allenamento con sovraccarichi FAIL comporta dei miglioramenti inferiori in queste variabili e quindi dovrebbe essere evitato. I preparatori atletici dovrebbero preferire l’uso di metodologie che consentano una maggior regolazione dell’intensità di allenamento, così da sfruttare i superiori miglioramenti di forza, potenza e velocità.
Introduction: Rugby union players must cope with diverse match demands depending on the playing position. Forwards (FWS) are more often engaged in static exertions (scrums, rucks, mauls) while backs (BKS) exhibition more dynamic actions (sprints, jumps, change of direction). These match demands dictate the anthropometrical and physical characteristics required to players to be successful. FWS are heavier and stronger, while BKS are leaner and faster. Despite the literature shows an overall advantage for stronger and heavier players to selection for international competition, limited data is present for Italian players. Body size, strength, power, and speed can be effectively improved by resistance training (RT). Yet, the debate is still open on the most effective RT modality for athletes. For instance, the efficacy of training to momentary muscular failure (FAIL), which seemed paramount towards increase muscle hypertrophy and strength, have recently been debated as RT not to failure (NO-FAIL) showed superior improvement in athletes’ strength and power. Aim: The aim of this thesis is two folds. First, which characteristics are predictor of selection for international competitions in Italian U20 players. Secondly, to assess the superior efficacy of either FAIL or NO-FAIL RT programs on improving players’ anthropometric and physical characteristics. Methods: For the first aim, anthropometric and physical characteristics, collected testing the variables of 72 U20 players, were retrospectively analyzed. Two-way analysis of variance, with selection for international tournaments and playing position as between subjects’ factors, was completed. Selection was also chosen as the dependent variable of multiple logistic regressions. For the second aim, 16 amateur rugby players were assigned to one of two groups (FAIL or NO-FAIL) and completed a seven weeks long RT program. Players’ anthropometric and physical variables were tested before and after the intervention. Results: ANOVA did not detect any significant interaction effects. The players’ body mass and lower body maximal strength resulted predictors of selection for U20 players. Analysis of the 13 effect sizes qualified that NO-FAIL RT allowed for superior improvements in lower body maximal strength and power, vertical jump height and power, linear sprint and change of direction. Conclusions: players’ body size and maximal strength are crucial for international selection in rugby. RT to FAIL elicits inferior improvements in these variables, and it should therefore be avoided. Strength and conditioning coaches should favor methods that allow for a better training intensity management in rugby players and exploit superior improvements in strength, power and speed.

The incidence of Type 1 Diabetes Mellitus (T1DM) is markedly growing in the past two decades. For the management of this disease, physical exercise has been recommended as a costeffective treatment throughout the global health system. The Non-Obese Diabetic (NOD) mouse represents a well-established experimental model analogous to human T1DM as it is characterized by a progressive autoimmune destruction of pancreatic β-cells. This thesis explored the uses of a mouse motorized treadmill to study the effects of exercise in NOD mice. Body mass, blood glucose level, immunological soluble factors, muscular performance and islets of Langerhans architecture were monitored during 12-week moderate-intensity endurance training in female NOD mice. After 12 weeks of training, no differences were registered as to diabetes incidence (50 vs 45%) and mean glycemia between sedentary controls and mice on exercise (190±34 vs 163±38 mg/dl, mean and SD). Exercise capacity dimished in the exercisingmice with respect to controls (work, distance, VO2max, p<.05). Preliminary data from a morphometric analysis of pancreata indicated the presence of larger infiltrates along with increased endocrine cellareas in the NOD exercising-mice. A higher infiltrate-to-islet ratio was observed in exercising-micewith respect to the controls. An exercise-induced weight loss was also detected. Among key anti- and pro-inflammatory cytokines: TNF-α, MIP-1β and IL-10 resulted to be lower at end of the training in the exercising animals with respect to pre-training values (1353±2 vs 1355±2.3; 984.6±12 vs 1001±37; 396±8.1 vs 407±27 MFI, respectively,p<.05) whereas IL-2P40 was higher in exercising-mice compared baseline (543±12 vs 539±15 MFI, p<.05). Further studies are needed to clarify the utility of the NOD mouse model to mimic and investigate the exercise effects in T1DM, immunomodulation and inflammation. Specifically, dose-response studies in which exercise will be administered to NOD mice at various levels of intensity will be necessary to determine the optimal regimen of physical exercise having clearcut preventive effects on the development of T1DM.

Electrical impedance tomography (EIT) is an imaging modality wherein the spatial map of conductivity and permittivity inside a medium is obtained from a set of surface electrical measurements. Electrodes are brought into contact with the surface of the object being imaged and a set of currents are applied and the corresponding voltages are measured. These voltages and currents are then used to estimate the electrical properties of the object using an image reconstruction algorithm which relies on an accurate model of the electrical interaction. The process of property estimation, called inverse problem, is highly nonlinear, ill-conditioned, and ill-posed. Reconstruction of the electrical properties distribution is an under-determined problem requiring a regularization method. The objective of this thesis was to develop a device for EIT imaging, which could be convenient, portable, inexpensive, noninvasive and easily programmable. A simple EIT system and its hardware parts has been developed. A belt with 32 electrodes in circular and planar geometry was built for two dimensional samples. The developed device provides current less than 1mA with frequencies higher than 60KHz. This are safe value for human body. The data processing was accomplished by utilizing a web site for the solution of EIT inverse-problem reconstruction. A series of images has been produced to evaluate the performance of the hardware developed. The difficulties in EIT image reconstruction, mainly due to the fact that the illposedness of the EIT reconstruction problem renders the solution sensitive to measurement errors and noise. Experiments have indicated that the EIT system can reconstruct resistive images of good contrast, with adequate robustness towards experimental fluctuations.

Type 2 diabetes mellitus (T2DM) is an extremely complex endocrine and metabolic disease, and the two major causes are impaired insulin secretion and increased insulin resistance in several organs and tissues. A non-human primate is an invaluable model for the study of human diseases due to their close genetic, anatomical and physiological similarities to humans. They are widely used in biomedical research aiming to elucidate the physiological and molecular mechanisms of different diseases, such as cardiovascular diseases, metabolic syndrome, age-related changes in metabolic parameters, obesity, T2DM, atherosclerosis etc. This entire project has different aims; the first is to confirm that baboons are a very suitable model for studying metabolic diseases such as cardiovascular diseases, metabolic syndrome, age-related changes in metabolic parameters, obesity etc, and confirm baboons as a model in a physical activity studies related to improving health and well-being. In fact, the first study was conducted to evaluate the SenseWear® Armband (SWA), a metabolic holter used in humans to estimate the resting and the total energy expenditure in baboon and verify his reliability to estimate energy expenditure during resting and different activities also in non-human primates. The second and more complex study was related to elucidate, at least in part, the effects of a continuous infusion of a medication for the treatment of T2DM (Exenatide) in a non-human primate, in a model with impaired β-cell function, reporting a insulin sensitizing effect in the Exenatide-treated group, an increase insulin sensitivity and β-cells function and decrease in total body weight. This type of research could be extremely valuable for helping to develop potential new treatments for T2DM. In conclusion, in the first study we demonstrated that the SWA is a reliable and simple method to estimate total energy expenditure (TEE) and resting energy expenditure (REE) in non-human primate, baboons, by placing it in the “metabolic jacket”. In the second study we found a powerful, direct, insulin sensitizing effect of EXE on normal glucose tolerant baboons. These studies provide novel solid basis for further clinical trials aimed at preserving and supporting subjects with diabetes or at high risk of developing it.

La ricerca mostra come la pratica delle regole contribuisca alla maturazione infantile, riconoscendo nell'ambito ludico-motorio una felice opportunità educativa. Il concetto di regola è stato affrontato nel suo orizzonte morale, anche attraverso l'accostamento ai più importati pensatori del mondo antico e moderno. Si è inoltre analizzato il modo in cui il riconoscimento della regola si sviluppa nel bambino durante la scuola primaria e come il gioco e lo sport possano contribuire alla crescita della persona. L’esperienza del laboratorio ludico-sportivo in contesti di vulnerabilità ( riferita al Progetto “L’Università Cattolica per i minori dell’Abruzzo” ) ha testimoniato come attraverso percorsi educativi mirati si possa contribuire alla maturazione del concetto di regola nel bambino.
The research shows how practice of rules contributes to child growth, admitting the sphere of game and movement as a lucky educational opportunity. The concept of rule has been faced in its moral aspect, also approaching the most important thinkers of ancient and modern world.Besides, the way the recognition of rule develops in the child during primary school has been analysed, and how game and sport can contribute to the growth of the person.The experience of “game and sport laboratory in vulnerable contexts” (regarding the project “Catholic University for children of Abruzzo”) has given evidence of how it is possible to contribute to the growth of the concept of rule in children through specific educational programme.

Despite the importance of the spike jump in volleyball and the high number of female athletes at high level, movement analyses of the volleyball spike jump were mainly conducted in male players. Potential sex-dependent differences were marginally considered in the scientific literature and practical training. The few studies that tackled this problem can, due to limitations, only hint on the existence of sex differences in essential movement characteristics. Investigations on factors that determine performance in females are also lacking; frequently, performance determinants found in males were assumed to be identical in female players. Consequently, sex-specific training measures to improve technical movement characteristics in the volleyball spike jump are not common. The purpose of this dissertation was 1) to investigate sex-specific differences in movement characteristics, 2) to identify performance determinants in females, and 3) to implement and assess a specific technical training to enhance volleyball spike jump performance in female players. One female and one male team (n1=15, n2=15) competing in the highest Austrian division were recorded via 12 Vicon MX-13 (250 Hz) cameras, two AMTI force plates (2000 Hz), and surface electromyography (2000 Hz) in 5 lower limb muscles. They performed volleyball spike jumps striking a stationary ball and the data was assessed to identify sex differences and performance determinants in females. Based on these findings, a specific six-week training intervention was derived and implemented for female players (n=12). Kinematic and kinetic data were obtained during three measurement sessions with six weeks between the sessions to allow for a comparison between control and intervention phase. Significant (p<.05) sex differences were documented in approach, arm and torso usage, neuromuscular activation pattern, range of motion and acceleration distances, and the strategy to convert horizontal into vertical velocity. Correlation and regression analyses revealed that a majority of these variables affected jump height in females. A subsequent technical-coordinative training intervention that specifically focused on the relevant movement characteristics improved jump height by 11.9% during the competitive season. The intervention resulted in beneficial adaptations in all measured movement characteristics that were not strictly related to strength and power abilities. The sex differences corroborated that technical patterns identified on the basis of a sample that consists of males only cannot be assumed to be identical in females without any further investigation. The second study showed that several characteristics where differences have been found affected spike jump performance in female players. Therefore, they should not be ignored and, instead, addressed in specific training measures. The training intervention study reported positive effects of such approach. The training measure applied in this study showed to effectively enhance female spike jump performance at high level in a short amount of time. However, this training approach requires biomechanical understanding of performance determinants from the coach and specific adaptations to the target group.

Metformin (METF), historical antihyperglycemic drug, is a likely candidate for lifespan extension, treatment and prevention of sedentariness damages, insulin resistance and obesity. Skeletal muscle is a highly adaptable tissue, capable to increase its mass in response to exercise and to regenerate new fibrils after damage. Aims of this work were to investigate METF ability to prevent sedentariness injury and enhance skeletal muscle function. Sedentary 12-weeks old C57BL/6 mice were treated with METF (250 mg/kg per day, in drinking water) for 60 days. METF role on skeletal muscle differentiation was studied in vitro using murine C2C12 myoblasts. Muscular performance evaluation revealed that METF enhanced mice physical performance. Tissues analysis indicated that in liver METF increased AMPK and CAMKII signaling, while inactivated ERKs, principal kinases involved in hepatic stress conditions. In skeletal muscle, METF activated AKT, key kinase in skeletal muscle maintenance. In in vitro studies, Immunofluorescence and Western blot analysis showed that METF did not modify the C2C12 proliferation capacity, while positively influenced the differentiation process and myotube maturation. Together, our novel results suggest that METF may have a positive action not only on the promotion of healthy aging but also on the prevention of sedentariness damages.

This thesis adds to the knowledge of potential factors causing muscle fatigue during high-intensity exercise lasting few minutes and provides a new insight on how manipulation of exercise training may affect the regulation of some key transport proteins involved in fatigue development, and how these adaptations are related to changes in exercise performance. Study I showed that performance during an intense exercise bout corresponding to ~130% of V&O2-max was more depressed when preceded by previous fatiguing exercise lasting ~3 min or ~2 h compared to previous exhaustive exercise lasting ~30 s. These results suggest that muscle fatigue during intense dynamic exercise can occur for different reasons and that muscle CP is not likely to be a critical factor. Muscle pH may play a contributing role, but it does not seem to cause fatigue, whereas muscle glycogen could be of importance if it is low. Contraction-induced loss of cellular K+ could be a major cause of muscle fatigue during intense exercise lasting ~2 min in duration. However, it appears not to be the K+ ion that causes fatigue, but more likely the concurrent depolarization of the membrane potential. In Study II it was demonstrated that an alteration from regular endurance training to intense intermittent training in humans resulted in improved performance during short-duration exhaustive and repeated intense exercise. These improvements were associated with higher expression of muscle Na+,K+ pump α1 subunit and NHE1, as well as elevated capillary density and relative number of FTx fibres. After the intense training period there was a lowered venous K+ accumulation during and in recovery from intense exercise, whereas the amount of some subunits of the Na+,K+ pump were related to performance variables. Together, these findings support a role for the Na+,K+pump in the control of K+ homeostasis and in the development of fatigue during repeated intense exercise. Furthermore V&O2-max, endurance performance and oxidative enzyme activity remained unaltered despite the dramatic reduction in training volume, suggesting that very intense exercise training also in fit subjects is a powerful stimulus for the maintenance of oxidative capacity.

Nitric oxide (NO) is a signaling molecule that influences different aspects of the cellular homeostasis and regulates several physiological processes. It is normally produced endogenously starting from aminoacid L-arginine but recent evidences suggest that it can be also increased through the ingestion of food rich in inorganic nitrate (mainly green leafy vegetables and beetroot). Indeed, ingested inorganic nitrate (NO3-), after been absorbed, can be converted in the oral cavity to nitrite (NO2-) and be finally reduced into NO in the blood. This alternative NO3- - NO2- - NO pathway seems facilitated in condition of low O2 availability (ischemia and hypoxia) and low pH. In the last 10 years, several studies have been conducted to investigate the effects of dietary NO3- supplementation on skeletal muscle function, since NO regulates microvascular blood flow, muscle contractile proprieties, glucose homeostasis, intracellular calcium handling, and mitochondrial respiration. Dietary NO3- supplementation is likely to elicit a positive outcome when testing endurance exercise capacity in healthy subjects and enhance exercise tolerance in patients. However, there are still unresolved questions about the mechanisms utilized by inorganic NO3- to affect skeletal muscle functions, the possible potentiating effect of hypoxic conditions and the effectiveness of this intervention in other disease populations. My PhD projects tried to address some of these questions. The first study aimed to examine the effects of increased NO bioavailability on contraction economy. One of the most interesting effects of dietary NO3- supplementation is the reduction of muscle O2 consumption (V ̇O_2) at a given exercise intensity, since the V ̇O_2 requested to carry out a specific exercise is generally a fixed amount regardless of sex, age and training status of the subject involved in the exercise. A lower V ̇O_2 during moderate intensity exercise has been demonstrated both in healthy subjects and disease patients after dietary NO3- supplementation. The mechanistic basis is not clear yet, and this effect has been related to reduced ATP cost of contraction and/or an enhanced mitochondrial coupling efficiency. In our study, we evaluated skeletal muscle contraction economy following NO2- infusion in hypoxic condition. Contractions of the in-vivo isolated canine muscle were obtained by direct nerve stimulation. Muscle blood flow was kept constantly high by pump-perfusion. O2 consumption during exercise was assessed directly by Fick method. Mitochondrial respiration rates were evaluated by high-resolution respirometry from muscle biopsies. In hypoxic conditions, but in the presence of constant and normal convective O2 delivery, NO2- infusion did not affect canine skeletal muscle oxidative metabolism. These evidences suggest that the effects of increased NO availability on muscle contraction efficiency in hypoxia, if present, are likely not attributable to changes in mitochondrial respiratory efficiency. The second study aimed to investigate the effects of increased NO bioavailability on the physiological responses to exercise after prolonged permanence at altitude. Data from Tibetan population living at altitude from generations suggest that changes in NO bioavailability may contribute to hypoxia acclimatization and their enhanced exercise efficiency. Moreover, recent studies have demonstrated that NO3- supplementation can limit exercise impairment following exposure to acute hypoxia. However, it is not known if Caucasian subjects exposed to several days of hypobaric hypoxia can benefits from increased NO bioavailability. Thus, we investigated the ergogenic effects of dietary NO3- supplementation on exercise performance at different intensities during a prolonged permanence at altitude. Cycling and arm-cranking exercises were performed in order to test possible different effects of NO3- supplementation in relation to a different muscle fibers recruitment pattern. Dietary NO3- supplementation reduced O2 cost during moderate-intensity exercise both in cycling and arm-cranking. In cycle-ergometer exercise this effect was dependent from aerobic fitness level of the subjects, in accordance to previous results obtained in normoxia. Moreover, dietary NO3- supplementation enhanced severe-intensity exercise tolerance, suggesting that dietary NO3- supplementation can be a valid ergogenic aid to counteract exercise intolerance at altitude. Finally, in the third study we evaluated the possible ergogenic effects of dietary NO3- supplementation in obese subjects. Literature shows that NO3- can exert significant positive effects on exercise tolerance and, as a consequence, quality of life of patients with an impaired skeletal muscle oxidative metabolism such as chronic heart failure, chronic obstructive pulmonary diseases and peripheral arterial disease patients. Obese patients are characterized by a higher O2 cost of exercise, and therefore a reduced exercise tolerance during constant work-rate exercise compared with healthy subjects. We evaluated the effects of beetroot juice (BR, rich in NO3-) supplementation on the main physiological variables associated with exercise tolerance in obese adolescents. We observed a significant increase in plasma NO3- concentration after BR supplementation. The O2 cost of moderate-intensity exercise was not different in BR condition versus placebo, whereas, during severe-intensity exercise, signs of a reduced amplitude of the O2 uptake slow component were observed in BR, in association with a significantly longer time to exhaustion. Thus, exercise intolerance of obese adolescents, at least at severe-intensity, can be attenuated by short-term dietary NO3- supplementation. This intervention can be a useful aid to counteract early fatigue and reduced physical activity in this at-risk population. Overall, the studies carried out during my PhD extend the current knowledge about dietary NO3- supplementation on physiological responses to exercise, starting from a mechanistic investigation in isolated canine muscle up to the evaluation of the ergogenic benefits of this intervention on exercise tolerance in obese adolescents.

Definire in modo sempre più approfondito i modelli di prestazione della ginnastica aerobica è presupposto fondamentale per fornire indicazioni utili per ottimizzarne l’allenamento. Non essendo ancora incluso tra le discipline olimpiche, questo sport tecnico-combinatorio, subisce continue modifiche del Codice dei Punteggi che provocano evoluzioni del modello di prestazione. Partendo da studi precedenti sono state confrontate caratteristiche morfologiche e meccanico-muscolari degli atleti di elite. Sono state effettuate valutazioni posturali globali ed analitiche, è stato valutato l’equilibrio ed alcuni salti tecnici nelle loro espressioni di forza e di controllo. Dieci atleti italiani della squadra nazionale senior di ginnastica aerobica (cinque maschi e cinque femmine) e nove atleti della squadra nazionale junior (tutti di sesso femminile) con sei atleti senior (tre maschi e tre femmine) e due atleti junior (di sesso femminile) utilizzati come campione di controllo, hanno preso parte allo studio. Dopo aver firmato il consenso informato è stato chiesto loro di sottoporsi ad una valutazione posturale globale utilizzando lo Squat Test e ad una valutazione posturale analitica utilizzando il Sit & Reach Test ed altre manovre di allungamento guidato per la flessibilità di alcuni distretti muscolari. L’equilibrio statico e le caratteristiche meccaniche di due salti tecnici sono stati valutati con la Force Platform del Muscle-Lab Bosco System, l’equilibrio dinamico con il Delos Postural System e la forza esplosiva è stata indagata utilizzando lo Squat Jump bipodalico e monopodalico, il Counter Mouvement Jump sia a braccia libere che a braccia bloccate utilizzando la Pedana quattro jump. L’analisi dei dati mostra che le caratteristiche morfologiche così come i valori di forza esplosiva e di riuso di energia elastica degli atleti di elite sono rimasti invariati negli anni. La valutazione posturale globale ha evidenziato problemi di varismo/valgismo, pronazione dei piedi e iperlordosi soprattutto nei gruppi di alto livello. La valutazione posturale analitica ha mostrato un’ottima flessibilità in tutti i gruppi esaminati. Dai test di equilibrio è emerso che gli atleti di alto livello hanno una migliore capacità di recuperare la condizione di stabilità e in particolare i maschi lo fanno utilizzando di preferenza il sistema vestibolare mentre le femmine prediligono il sistema propriocettivo. Gli atleti di alto livello imprimono nei salti tecnici una forza che va dal 60% al 80% della loro forza max mentre il campione di controllo arriva fino al 97% dimostrando che la tecnica e la coordinazione incidono sul costo muscolare. Confrontando i dati di forza esplosiva di questa ricerca con gli studi precedenti viene confermato che i cambiamenti nei regolamenti di questa disciplina sportiva poco incidono sugli aspetti muscolari mentre incidono prevalentemente sugli aspetti metabolici della prestazione.
Ever more detailed definitions of aerobic gymnastics performance models are fundamental for providing useful information in order to optimise training programmes. As it not yet an Olympic discipline, this technical-combinatory sport undergoes continuous changes to its Scoring System, causing changes to the performance model. Taking previous studies as a starting point, the morphological and mechanical-muscular properties of elite gymnasts were compared. Global and analytical postural evaluations were carried out, and the testing of equilibrium and some technical jumps, measuring force and control, was performed. Ten Italian gymnasts from the senior aerobic gymnastics national team (five males and five females) and nine gymnasts from the junior national team (all female), with six senior gymnasts (three males and three females) and two junior gymnasts (female) used as a control sample, took part in the study. After signing an informed consent form, gymnasts were asked to undergo a global postural appraisal using the Squat Test and an analytical postural test using the Sit & Reach Test and other guided stretching movements for the flexibility of some muscular districts. Static equilibrium and the mechanical properties of two technical jumps were evaluated using the Muscle-Lab Bosco System Force Platform, dynamic equilibrium was tested with the Delos Postural System and explosiveness was tested using the bipodalic and monopodalic Squat Jump, the Counter Movement Jump with free arms and hands on hips using the quattro jump force plate. The analysis of acquired data shows that morphological properties as well as values for explosiveness and the reuse of elastic energy for elite gymnasts have remained unchanged over the years. The global postural appraisal highlighted the problems of varus/valgus, pronation of the feet and hyperlordosis, especially among elite groups. The analytical postural evaluation showed excellent flexibility in all the groups examined. Equilibrium tests showed that elite gymnasts have a greater capacity to regain stability, in particular males regain stability using more the vestibular system, while females favour the proprioceptor system. Elite gymnasts use a force for technical jumps that ranges from 60 to 80% of their max. force, while the percentage for the control sample was 97%, demonstrating that technique and coordination impact on muscular cost. Comparing data on explosiveness from this research with previous studies, it is confirmed that changes to the rules of this sporting discipline have little bearing on muscular aspects, while they chiefly impact metabolic aspects of performance.

Lo scopo di questo studio è stato quello di quantificare l'affidabilità della frequenza cardiaca (HR), come parametro utile per valutare le condizioni di recupero di mezzofondisti e velocisti, durante un Interval Training (IT). Sono stati studiati ventidue atleti sottoposti a due diverse sessioni di IT: al 80% e 120% della soglia anaerobica (SA). Durante entrambe le sessioni abbiamo misurato HR, consumo di ossigeno (VO₂), produzione di anidride carbonica (VCO₂), ventilazione polmonare (Ve), mediante un analizzatore portatile di gas. Inoltre, è stato calcolato l'eccesso di produzione di anidride carbonica (CO₂excess) per verificare l'ipotesi che la deriva cardiaca, che si è verificata durante il recupero tra le ripetizioni di IT, fosse collegata ad uno stato di acidosi lattica. La deriva cardiaca è avvenuta in entrambi i gruppi ad entrambe le intensità lavorative, mentre CO₂excess, VO₂ e Ve non si sono modificati. Sulla base della nostra ricerca, l'utilizzo della HR come parametro di valutazione del recupero metabolico appare impreciso e fuorviante ed in definitiva non idoneo per la gestione del recupero nell’allenamento. ----------------------------------------------------------------------------------------------------------------------------The aim of this study was to quantify the reliability of heart rate (HR) monitoring to assess recovery status, after moderate and high-intensity exercise, in prolonged sprint and middle distance running specialties of athletics. Twenty-two runners underwent two different sessions of interval training: at 80% and 120% of anaerobic threshold (AT). Throughout both sessions we measured HR, oxygen uptake (VO₂), carbon dioxide production (VCO₂), pulmonary ventilation (Ve), by means a portable gas analyzer. The excess in carbon dioxide production (CO₂excess) was also measured to test the hypothesis that a cardiac drift, that occurred during recovery between repetitions of interval training, was related to lactic acidosis. The heart rate charts in both groups of athletes and with respect to the two workloads showed a progressive increase of the same during recovery periods, while CO2excess as well as VO₂ and Ve were not modified. On the basis of our research, the use of HR as a parameter of evaluation of the established recovery is inaccurate and unfit for training.

Soccer is a team sport that requires prolonged high-intensity intermittent exercise. Physical aspects of match performance have changed a lot in the last forty years; for example total distance has increased from 7000-8000 m in the seventies to 10000-11000 m reported in recent investigations. Nowadays, during the match, players change activity on average every 5 seconds and perform approximately 1300 actions, with 200 of these being completed at high-intensity. In addition, the game involves other intense actions such as decelerations, kicking, dribbling, and tackling. All of these efforts exacerbate the physical strain imposed on the players and contribute to making football highly physiologically demanding. Furthermore, soccer players that compete at high level perform up to 70 matches during a single season. During the second half of a match, the total distance and high-intensity running decline markedly, with the amount of high-intensity running 20% to 40% lower in the last 15 min of the game compared with the initial 15-min period. A greater decrement in running is observed when more activity is performed in the first half. Furthermore, in the 5-min period following the most demanding 5-min of the game, the distance covered at high intensity is reduced by 6% to 12% compared with the game average. Collectively, these results indicate that players experience fatigue toward the end of a match and temporarily during a game. Accordingly, both single and repeated-sprint test performances are impaired after a high-intensity period during as well as at the end of the game. Fatigue may also have a negative impact on passing precision, with the less fit players showing a more pronounced deterioration in technical performance. Furthermore, maximal strength and jumping ability are also both reduced immediately after a match. The time required for a full recovery of these qualities in male players may be very long (> 72 h) (permanent fatigue). However, there is limited information regarding recovery time in high level athletes. In literature, fatigue can be defined as an acute impairment of performance that includes both an increase in the perceived of the effort necessary to exert a desired force or power and/or reduction in the ability to exert maximal force or power. It has been demonstrated that the neuromuscular mechanisms that contribute to performance impairment differ according to the contraction mode, exercise intensity and the duration. Fatigue can be classified as central when the origin is proximal and/or peripheral when the origin is distal to the neuromuscular junction. However, to date, no studies have quantified the relative contribution of central and peripheral factors in determining fatigue in soccer. Peripheral skeletal muscle function can be determined using electrical stimulations and classified as high-frequency and low-frequency (or long-lasting fatigue). Long-lasting fatigue can be evaluated using tetanic nerve stimulations at different frequencies (low- to high-frequency force ratio). Nonetheless, tetanic nerve stimulations are very painful, and their usability is limited. Paired stimulations have been proposed as a surrogate of the stimulation trains, and recent research demonstrates the validity of this method to quantify muscle fatigue induced by eccentric exercise. In chapter 2, a study was conducted to determine the extent to which neuromuscular fatigue occurs in high-level professional soccer players. In addition to this, we aimed to examine recovery after a match and to examine its relationship with central and peripheral fatigue indicators. Maximal voluntary contraction (MVC), sprint and passing abilities, muscle soreness, maximal voluntary activation, EMG activity, and evoked quadriceps contractile properties (using different electrical stimulations) were determined before, immediately after, and at 24 and 48 h after the match in 20 male professional players. Immediately after a game, fatigue was evident from the reduction in MVC and sprint performance (-11%, P < 0.001 and -3%, P < 0.001, respectively) as well as increased muscle soreness (P < 0.001) compared with baseline. However, short-passing ability was seen to be preserved. This was observed alongside maximal voluntary activation and EMG activity being reduced by 8% (P < 0.001) and 12% (P = 0.001), respectively. M-wave characteristics were unchanged, whereas quadriceps mechanical responses to single and paired stimulations at 10 Hz resulted significantly reduced (peak torque = -8%, P < 0.001 and -9%, P < 0.001). Despite the observation of a partial recovery 24 h after the game, all variables returned to baseline values 48 h after the match. In high-level professional players, the fatigue induced by a soccer match occurs to a lesser extent than in lower level athletes and appears to be recovered in a faster fashion. Match-related fatigue is determined by a combination of central and peripheral factors. A relationship exists between central fatigue indicators, MVC and sprint performance decrements, whereas muscle soreness appears to be linked to peripheral fatigue indicators, in particular to mechanical responses at low-frequency stimulations. In chapter 3, a study was conducted to determine the possible relationship between match related fatigue and goal scoring. Some preliminary observations indicate that goal scoring increases over time during the game; however, these preliminary results were obtained analyzing minor soccer leagues and/or using a limited amount of matches. The aim of this study was to examine the goal scoring patterns in four major European leagues (English Premier League, French Football Ligue 1, Italian Serie A and Spanish Football Liga) across three consecutive seasons (2008–09, 2009–10 and 2010–11). Chi square analysis revealed a significantly (P < 0.001) higher goal scoring frequency in the second half (55.1 %) compared to the first half (44.9 %). With 15-min interval analysis highlighting a significant (P < 0.001) upward trend in the number of goals scored as time progressed (13.7, 15.1, 16.2, 17.7, 17.2 and 20.2 %, for 0–15, 15–30, 30–45, 45–60, 60–75 and 75–90 intervals respectively). The main finding of the present study is that, in the four major European soccer leagues investigated, the amount of goals scored is greater in the second half, with the scoring rate being highest in the last 15-min of a match. Fatigue occurring during the game may play a role; however, fatigue alone cannot explain the differences. The state of the games result and the reduced time available for scoring are other potential contributing factors to the increased goal scoring patterns observed in the latter stages of the game. Repeated-sprint ability (RSA) is defined by the ability to perform several sprints interspersed with brief recovery periods. RSA is an essential component of many team sports like soccer and is deemed to be an important determinant of physical performance. Several studies have been carried out to establish the physiological determinants of RSA and to investigate the fatigue mechanisms related to this particular form of exercise in order to improve performance. However, no study to date has investigated the high- and low-frequency fatigue induced in more than one muscle group involved during fatiguing RSA exercise. In chapter 4, a study was presented aimed to investigate peripheral fatigue in Knee Extensor (KE) and Plantar Flexor (PF) muscles RSA cycling and running tests. Both RSA tests consisted of 5 x 6 s sprints and peripheral fatigue was quantified using diverse electrical stimulations (from a single stimulus to paired stimulations at 100 Hz). The main findings were that RSA cycling induced higher decrements in peak torque (PT), maximal rate of torque development and relaxation of KE compared with running (PT decrements at different stimulation frequencies: -39% to -53% cycling vs -16% to -39% running, P < 0.049). The PT ratios of KE measured using several low- and high-frequency stimulations did not highlight differences in low-frequency fatigue induced by the two exercise modes. On the contrary, no major differences were noted in PT decrements of PF (P > 0.231). However, the higher decrements of some PT ratios of the PF (10/100 Hz, 20/50 Hz and 20/100 Hz) confirmed the presence of low-frequency fatigue following RSA cycling. Subjects also reported significantly higher values for RPE leg following RSA cycling (8.2 vs 7.3 respectively, P = 0.018) despite no differences in blood lactate, hydrogen ions and bicarbonates concentrations (P > 0.467). The higher level of peripheral fatigue induced by RSA cycling may be partially related to longer fractional duration of muscle contraction phases which can limit local blood flow. The discrepancies in neuromuscular fatigue between KE and PF can be partially explained by differences in muscle fibre composition and/or muscle contributions during RSA tests. A number of studies have determined the reproducibility of peripheral muscle contractile properties at rest reporting good values of coefficient of variation. Only one study has assessed the reliability of the quadriceps contractile properties in a fatigued state. This was achieved using a sustained (2 minutes) maximal isometric contraction. However, this form of exercise is far from specific for the majority of sporting performances. In order to use electrical stimulations as a tool to determine the extent of peripheral muscle fatigue experienced by athletes it is necessary to carry out methodological studies that establish the reliability of peripheral muscle fatigue measures caused by a specific exercise. For these reasons, in chapter 5 a reliability study was conducted to determine the reproducibility of peripheral fatigue induced in knee extensors by high-intensity intermittent running test (HIT). The reliability of the assessment of peripheral fatigue was established in ten amateur soccer players (age: 18 ± 1, height: 178 ± 5 cm, weight: 68 ± 8 kg). Transcutaneous electrical stimulations before and after HIT determined knee extensors muscle contractile properties on three separate occasions (T1, T2 and T3), each separated by 7 days. No significant differences were noted for any of the parameters measured (P = 0.101). The ICC values for peak torque (PT) varied from moderate to high, with the exception of PT at 10 Hz calculated comparing T2 vs T1 (range PRE = 0.78 - 0.92; POST = 0.76 - 0.97). The ICC derived from PT percentage decrements data were all low, with the exception of PT decrements at 1 Hz calculated comparing T3 vs T2 (ICC = 0.85, moderate). The TE for all contractile parameters obtained using 1 Hz and 100 Hz electrical stimulations were below 10%, including some that demonstrated a TE lower than 5%. Muscle contractile properties determined using 10 Hz stimulations showed a higher level of TE (range: 3.2 - 15.1%). Similar results were obtained for maximal rate of torque development and torque relaxation. From the results of this study it can be concluded that muscle contractile properties express a good level of reliability in baseline and post-exercise measures following familiarization. In chapter 6, seasonal variations in peripheral neuromuscular fatigue induced by HIT were established in two groups of professional soccer players: eleven adult players (age: 23 ± 3, height: 181 ± 4 cm, weight: 78 ± 6 kg) and twelve young players (age: 17 ± 1, height: 181 ± 4 cm, weight: 71 ± 5 kg). Transcutaneous electrical stimulations before (PRE) and after (POST) HIT determined knee extensors muscle contractile properties on four separate occasions during a season (before the preparation period Test 1, after the preparation period Test 2, in the mid of competitive period Test 3 and towards the end of the competitive period Test 4). Muscle contractile properties at rest were partially reduced during the competitive period both in adult and young professional players (reduction of PRE maximal rate of torque development at 1 Hz (P < 0.024) and the same parameter at 10 Hz (P < 0.022)). Analysis of POST parameters, confirmed the reduction of the high-frequency fatigue levels during the competitive period for adult players (higher values of POST peak torque at 100 Hz (P = 0.006) and POST maximal rate of torque relaxation at 100 Hz, P = 0.009). Furthermore, in young players, the reduction of both high-frequency fatigue and low-frequency fatigue were evident (POST maximal rate of torque development at 100 Hz (P = 0.035), POST maximal rate of torque relaxation at 100 Hz (P = 0.009), POST peak torque at 10 Hz (P = 0.038) and POST 10/100 Hz ratio (P = 0.012). Considering percentage decrements, several parameters confirm the presence of lower level high-frequency and low-frequency peripheral fatigue both in adult and young players during the competitive period. These results suggest that it is possible to use the assessment of muscle contractile properties to monitor soccer players physical condition. In conclusion, fatigue in soccer is determined by a combination of central and peripheral factors. Central fatigue is evident immediately after and in the hours of recovery following a match (permanent fatigue). While peripheral fatigue is more evident considering some aspects of soccer performance characterized by short high-intensity periods (temporary fatigue). Peripheral fatigue include both high-frequency and low-frequency fatigue with the latter being more evident in young players. Training interventions and strategies applied to improve performance levels should take these aspects into consideration.

Circa il 20.9% dei bambini e adolescenti italiani sono in sovrappeso e il 9,8% sono obesi in particolare in Molise il 24,9% sono in sovrappeso e il 15,8% obesi. L’obesità può persistere, con molta probabilità, in età adulta, con rischi elevati di comorbidità a livello sia somatico sia mentale, stigmatizzazione con problemi psico-sociali. Data la gravità delle conseguenze per la salute è necessario trovare dei trattamenti, possibilmente non farmacologici, efficaci. Il valore di uno stile di vita attivo e dell’esercizio per perdere peso è oramai universalmente riconosciuto. Recentemente la ricerca scientifica raccomanda l’allenamento basato sulla resistenza muscolare per ridurre l’obesità in bambini adolescenti e in sovrappeso, in quanto il lavoro progressivo ad alta intensità riduce l’adiposità, aumentando la massa muscolare che è associata al miglioramento della sensibilità all’insulina. Lo scopo dello studio è stato quello di trovare il programma di allenamento ottimale raccomandabile per gli adolescenti in sovrappeso ed obesi, con l’obiettivo di ridurre l’adiposità aumentando la massa magra. Lo studio ha proposto una nuova combinazione di protocolli di allenamento disegnato con una prima fase di potenziamento muscolare (Resistance Training-RT), a moderata ed alta intensità strutturato al fine di preparare i soggetti ad una seconda fase di lavoro di tipo aerobico. L’allenamento Aerobico (AT) rappresenta il programma maggiormente utilizzato per la diminuzione della massa corporea attraverso un aumento della spesa energetica. Il problema è che l’allenamento aerobico non ha una grande sostenibilità per soggetti in sovrappeso ed obesi, data l’alta richiesta energetica da un punto fisico e fisiologico. Inoltre, nel momento in cui i soggetti sovrappeso ed obesi si mettono a confronto con i loro pari normopeso, se effettuano esercizi di tipo aerobico estensivi prolungati non solo hanno delle prestazioni molto inferiori ma si sentono sotto il costante giudizio negativo dei loro pari. Quarantacinque adolescenti sovrappeso, reclutati nelle scuole medie della provincia di Campobasso, sono stati arruolati per lo studio. Sono stati sottoposti a diversi protocolli di attività fisica articolati in due fasi: nella prima fase, della durata di 16 settimane, il primo gruppo ha svolto un protocollo di resistenza a moderata intensità mentre, il secondo gruppo ha svolto lavoro di resistenza muscolare ad alta intensità, il terzo gruppo ha svolto allenamento di tipo aerobico. Nella seconda fase, della durata di 6 settimane, tutti e tre i gruppi hanno svolto allenamento di tipo aerobico. Alla fine dello studio, trascorse 12 settimane dalla fase sperimentale, è stato effettuato un follow-up su tutti i soggetti dello studio. Differenze significative sono emerse tra i dati di composizione corporea relativamente ai comparti di massa magra (F 2.76 = 6.254; p =0.003; η2 = 0.141) e grassa (F 2.76 = 5.843; p = 0.004; η2 = 0.133), e nei Fitness tests (p<0.01), ma solo per i gruppi che hanno effettuato nella prima fase di sperimentazione un allenamento orientato alla resistenza muscolare. Nel terzo gruppo non si evincono modificazioni significative della composizione corporea. I valori di VO2 max sono significativamente migliorati in tutti e tre gruppi (p<0.05) ma nei gruppi di RT sono significativamente più elevati di quelli di AT (F 2.38 = 4.264; p = 0.021; η2 = 0.183). L’aderenza al programma di esercizio è stata in media del 94% per i due gruppi RT mentre, per il gruppo AT è stata dell’83%. I risultati del chi2 mostrano differenze significative tra i tre gruppi relativamente alla tendenza a continuare l’attività fisica dopo la fine della sperimentazione (chi2 value = 6.73; p = 0.035). I risultati indicano che il protocollo proposto può essere un trattamento efficace per questa popolazione e gli effetti positivi vengono mantenuti dopo 12 settimane di follow-up. Questa proposta di attività fisica è risultata gradita e soddisfacente ai partecipanti e ciò può avere influenzato l’adozione di uno stile di vita più attivo.
About 20.9% of the children and adolescents in Italy are overweight and 9.8 % are obese, in particular in Molise 24.9% are overweight and 15.8% who are affected by obesity. The non pharmacological treatment of children and adolescents with these problems remains an important matter for health-care policy. The childhood obesity will persist into adulthood, the elevated risks of somatic and mental co-morbidity, stigmatization and the psychosocial impairment that caused high health-care are all reasons why effective treatments are needed to be found. The efficacy of Physical activity for weight loss is well recognized and regular exercise behaviors have been widely recommended. In the last decades, resistance training (RT) has been recommended for children and adolescents, if it is applied with appropriate techniques and correctly supervised High-intensity progressive RT leads to reduction in adiposity and metabolic risk in normal-weight and overweight children, increasing the muscle mass, which has been associated with improved insulin sensitivity. Considering that continuity of physical activity is a necessary condition for long-term maintenance of weight loss, it is essential that the dose, mode and intensity should be appropriate and enjoyable to this target group. Aim of the present study was to find the optimal exercise program to be recommended in reducing adiposity and promoting long-term physical activity adherence in a sample of overweight adolescents. This study proposed a new combination of training protocols for overweight adolescents, designed with a first phase of RT, Moderate Resistance Training (MRT) and High Resistance Training (HRT), that prepares the subjects to the successive second phase of Aerobic Training (AT). The results were compared to those of AT, performed in both the first and the second phases. AT represents the widely used type of physical training for correction of excessive body mass by increasing the energy expenditure. The problem is that this kind of training does not have a great sustainability for overweight subjects, given the higher physical and physiological demands. Moreover AT does not provide the best chance to compete with slimmer peers. Forty-five overweight adolescents were randomly divided into three exercise groups, to perform two phases of physical activity as follows: in the first phase, the first group performed a 16-week moderate-intensity RT, the second group performed a 16-week high-intensity RT, and the third group performed a 16-week AT; in the second phase, all groups performed a 6-week AT. Anthropometric body composition and fitness measures were considered as outcome measures. After the second protocol, both RT groups showed a significant improvement in percentage of fat mass (F 2.76 = 5.843; p = 0.004; η2 = 0.133) and free fat mass (F 2.76 = 6.254; p =0.003; η2 = 0.141), Flamingo Balance Test (F 2.76 = 32.597; p < 0.001; η2 = 0.462), Sit and Reach Test (F 2,76 = 9.678; p < 0.001; η2 = 0.203), Shuttle Test (F 2.76 = 7.988; p = 0.001; η2 = 0.174), Abdominal Curl Test (F 2.76 = 8.477; p < 0.001; η2 = 0.182). The VO2 max values of the RT groups were significantly higher than those of the AT group (F 2.38 = 4.264; p = 0.021; η2 = 0.183). The rate of adherence to exercise was an average of 94% in both RT groups, whereas in the AT group, it was 83%. The results of the chi-squared test showed significant differences among the three groups relative to participation in physical activity after the end of the intervention (chi2value = 6.73; p = 0.035). The present study provides preliminary evidence that moderate-to-intense RT, followed by AT, can be an effective treatment for overweight adolescents, and the positive effects are maintained even after 12 weeks of follow-up. It is possible that protocol has been enjoyable and satisfying for this population and has influenced the adaption of active behaviours. These findings represent advancement in the theory-based physical activity intervention for overweight adolescents.

Aim: Considering that sympathetic activation is induced by exercise, it is reasonable to assume that hemodynamic adjustments to exercise act in opposition to those elicited by the diving response. However, cardiovascular measurements have never been performed during underwater dynamic apnoea (DA), and this hypothesis remains speculative. Methods: Data concerning heart rate (HR), stroke volume (SV) and cardiac output (CO) during static apnoea (SA) and DA were collected from 12 elite divers by means of an impedance cardiograph adapted to the underwater environment. Mean arterial pressure (MBP), systemic vascular resistance (SVR) and arterial oxygen saturation (SaO2) were also assessed. Five trials were performed by the divers: head-out immersion during normal breathing (test A); 3 min of SA immersed at the surface (B) and at 3 m depth (C); DA till exhaustion immersed at the surface (D) and at 3 m depth (E). Results: Both B and C conditions led to bradycardia (_17%) compared to A and also induced a decrement in SV (_8%) and in CO (_25%), while MBP was maintained because of an increase in SVR. A significant MBP increment (+11%) was detected only during tests D and E, when a SaO2 drop was also present, whereas HR, SV and CO remained unchanged. Conclusion: We concluded that typical diving response was present only during SA, while sympathetic activation was induced by exercise during DA, which partially obscured the effects of the diving response.

The knowledge that inactivity during childhood predisposes youngsters to a variety of negative outcomes (e.g. lack of socialization, poor emotional aspects, worsening psychological well-being and cognitive abilities, health risks, etc.), in combination with research indicating that many children are not enough physically active, has stimulated interest in better understanding children's physical activity determinants. It is necessary to identify the social, psychological, biological, and developmental factors that contribute to the differences in children's behaviours. A complex arrangement of determinants seems to be involved, and several social, educational and cultural factors clearly impact children’s physical activity and sport involvement. Demographic/biological, psychological, behavioural, social/cultural and environmental variables have been reported as associated with children’s physical activity. The family represent an all-encompassing ecology for development. As a starting point, the family constitutes an important initial element of socialization influence for children because they spend, prior to adolescence, the majority of their free-time within the context of the family. Parents have also been found to influence physical activity behaviours of their offspring. Several forms of parental influence have been suggested in the literature: direct modelling, encouragement, support, involvement, restriction or facilitation of physical activity and beliefs on physical activity. The factors most frequently investigated are related to parental role modeling, social support and parental belief systems. In particular, parental support has been found to be positively related to physical activity level of children, and active parents (especially fathers) were more likely to have active children. Generally, interventions to promote children’s physical activity mostly focused directly on children than on parents (e.g. one more hour of physical education per week). To design effective strategies to increase children’s physical activity, a clear understanding of how parents influence their children's behaviours is required. The scientific literature related to physical activity parenting is still limited. Studies reported inconsistent, and mostly null, findings, and types of parental support have not been systematically evaluated yet. The challenge of health education and sport pedagogy in promoting children regular physical activity is linked with the identification of multiple theory-based factors that influence physical activity behaviours. For these reasons it has been decided to carried out a research that investigates parental correlates with an ecological approach, in order to taking into account personal, cultural and environmental factors, using objective data and valid measurements. It has been carried out a comparative study in order to investigate the phenomenon of physical activity parenting in different cultural and national policies context. Italy and Germany have been chosen because of their similarity and differences. It is possible to identify three major objectives of the research: - To examine the roles of supportive social environments (parents’ role) and physical environments on children’s active living, with an ecological approach; - To compare Italian and German children’s physical activity habits; - To investigate what variables are strongly associated with higher rates of physical activity participation. A group of 4th grade children and both their parents participated in the research. Participants filled in a package of questionnaires and a subgroup of the total number of participants wore a tri-axial accelerometer for 7 consecutive days, in order to register physical activity quantity. The investigated individual variables were children self-report physical activity, enjoyment during physical activity, importance of physical activity, perceived parental support, perceived parents’ physical activity level and children self-efficacy. Parents reported answers on importance of physical activity, support, quantity of physical activity and enjoyment. The findings confirmed scientific literature evidence and further sustain the notion that parental support is a key element in shaping physical activity levels in school-aged children. Moreover it is of relevance to compare results of different countries and cultural context. Further research is needed to combine quantitative and qualitative data to better understand physical activity parenting. Moreover, sport pedagogy research should focus on the implementation of educational programs among parents about their role in the socialization of children’s physical activity behaviours abstrakt Deutsch Es ist bekannt, dass Inaktivität im Kindesalter zu unterschiedlichen negativen Auswirkungen, wie zum Beispiel mangelnde Sozialisation, dürftige emotionale Fähigkeiten, schlechtes psychologisches Wohlbefinden und schlechte kognitive Fähigkeiten, Gesundheitsgefährdung etc. im Jugendalter führen kann. Dieses Wissen, und Forschungsergebnisse die zeigen, dass viele Kinder nicht ausreichend körperlich aktiv sind, hat das Interesse angeregt die Faktoren von körperlicher Aktivität im Kindheitsalter besser verstehen zu wollen. Es ist daher notwendig, die sozialen, psychologischen, biologischen und entwicklungsbedingten Faktoren zu identifizieren, die zu unterschiedlichen Verhalten bei Kindern führen. Ein komplexes Arrangement von Determinanten scheint dabei beteiligt zu sein, und einige soziale, bildungsrelevante und kulturelle Faktoren beeinflussen eindeutig die körperliche Aktivität und das Sportengagement von Kindern. Es wurde gezeigt, dass demographische/biologische, psychologische, verhaltensbezogene, soziale/kulturelle und umweltbedingte Variablen mit der körperlichen Aktivität von Kindern zusammenhängen. Die Familie spielt dabei eine all-umfassende Rolle für die Entwicklung. Sie stellt einen wichtigen Einfluss in der Sozialisation des Kindes dar, da dieses -vor der Adoleszenz – den Großteil seiner Freizeit mit der Familie verbringt. Es wurde auch herausgefunden, dass Eltern das Verhalten ihrer Kinder im Hinblick auf körperliche Aktivität beeinflussen. Verschiedene Formen elterlichen Einflusses wurden in der Literatur herausgestellt: Vorbildfunktion, Ermunterung, Unterstützung, Beteiligung, Verbot oder Förderung. Die am häufigsten untersuchten Faktoren betreffen die elterliche Vorbildfunktion, soziale Unterstützung und Überzeugung der Eltern. Die Daten zeigen, dass insbesondere die elterliche Unterstützung in positivem Zusammenhang mit dem Aktivitätslevel von Kindern steht, und dass Kinder aktiver Eltern (besonders aktiver Väter) mit einer höheren Wahrscheinlichkeit selbst aktiv sind. Im Allgemeinen bezogen sich die Interventionen zur Förderung der körperlichen Aktivität meist auf Kinder und nicht auf ihre Eltern (zum Beispiel eine Stunde Sportunterricht pro Woche). Um effektive Strategien zur Förderung körperlicher Aktivität zu entwickeln muss ein klares Verständnis über den Einfluss von Eltern auf das Verhalten ihrer Kinder vorliegen. Die wissenschaftliche Literatur, die sich auf die körperliche Aktivität von Eltern bezieht ist jedoch begrenzt. Die Ergebnisse der durchgeführten Studien sind widersprüchlich und/oder nichtig und unterschiedliche Arten von elterlicher Unterstützung wurden bisher nicht systematisch evaluiert. Die Herausforderung für Gesundheitserziehung und Sportpädagogik Kinder regelmäßig in körperlicher Aktivität zu fördern ist mit der Identifikation von mehreren theoriegestützten Faktoren verbunden, die körperliche Aktivität beeinflussen. Aus diesen Gründen wurde entschieden eine Studie durchzuführen, die elterliche Korrelationen mit einem ökologischen Ansatz untersucht, um so persönliche, kulturelle und Umweltbedingungen zu berücksichtigen. Hierzu wurden objektive Daten erhoben und valide Messinstrumente eingesetzt. Es wurde eine Vergleichsstudie durchgeführt um das Phänomen der Erziehung zu körperlicher Aktivität in unterschiedlichen Kulturkreisen und unterschiedlicher nationaler Politik zu erfassen. Italien und Deutschland wurden aufgrund ihrer Ähnlichkeit und Unterschiedlichkeit ausgesucht. Drei Hauptziele der Studie können heraus gestellt werden. Es soll(en) -die Rolle des unterstützenden sozialen Umfelds (die Rolle der Eltern) und der physischen Umwelt auf den aktiven Lebensstil von Kindern, mit Hilfe eines ökologischen Ansatzes untersucht werden. -die Gewohnheiten in Italien und Deutschland im Hinblick auf körperliche Aktivität verglichen werden. -untersucht werden, welche Variablen mit einer stärkeren Beteiligung an körperlicher Aktivität zusammenhängen. An der Studie nahmen Viertklässler und ihre beiden Elternteile teil. Alle Teilnehmer füllten Fragebögen aus und ein Teil der Gruppe trug an sieben aufeinanderfolgenden Tagen einen Akzelerometer, um das Ausmaß ihrer körperlichen Aktivität zu erfassen. Die untersuchten individuellen Variablen waren die von den Kindern selbst eingeschätzte körperliche Aktivität, ihre Freude daran, der Stellenwert der körperlichen Aktivität für sie, die wahrgenommene Unterstützung der Eltern, die körperliche Aktivität der Eltern und das Selbstvertrauen der Kinder. Die Eltern beantworteten Fragen über die Bedeutung von körperlicher Aktivität für sie, ihre Unterstützung, ihr Ausmaß der körperlichen Aktivität und ihre Freude daran. Die Ergebnisse bestätigen bereits vorhandene wissenschaftliche Literatur und stärken die Annahme, dass elterliche Unterstützung ein entscheidender Erfolgsfaktor für die Entwicklung von körperlicher Aktivität bei Schulkindern ist. Darüber hinaus ist es wichtig die Ergebnisse unterschiedlicher Länder und kultureller Kreise zu vergleichen. Um die Erziehung zu körperlicher Aktivität besser zu verstehen ist Forschung von Nöten, die qualitative und quantitative Ansätze vereint. Vielmehr sollte die Sportpädagogik ihre Forschung auf die Implementation von Erziehungsprogrammen für Eltern lenken, und ihre Rolle in der Sozialisation des Kindes im Hinblick auf seine körperliche Aktivität untersuchen
Contrastare la sedentarietà promuovendo l'€™adozione di uno stile di vita attivo nella popolazione infantile continua ad essere un problema di grande rilevanza pubblica. La conoscenza che l'inattività durante l'infanzia predispone i giovani ad una varietà di esiti negativi (nell'€™ambito della socializzazione, dell'€™emotività, per il benessere psicologico e le capacità cognitive, rischi per la salute, ecc), in combinazione con le evidenze che indicano che molti bambini non sono abbastanza attivi, ha stimolato l'interesse per lo studio delle determinanti dell'attività fisica dei bambini. E' necessario individuare i fattori sociali, psicologici, biologici e di sviluppo che contribuiscono alle differenze nei comportamenti dei bambini. Un complesso sistema di determinanti sembra essere coinvolto e diversi fattori sociali, educativi e culturali sembrano chiaramente influenzare l'attività fisica dei bambini e il loro coinvolgimento in attività sportive. Inoltre, aspetti di tipo demografico/biologico, psicologico, comportamentale, sociale/culturale e ambientale sono risultati essere correlati con l'attività fisica dei bambini. Tra questi, la famiglia rappresenta un fattore fondamentale per lo sviluppo complessivo del bambino. Come punto di partenza, la famiglia costituisce un importante elemento di socializzazione per i bambini perchè passano la maggior parte del loro tempo libero nel contesto familiare. In letteratura vi sono molte evidenze che riportano l’esistenza di correlazioni positive tra il livello di attività fisica dei bambini e quello dei loro genitori, abbracciando l'€™ipotesi di un modeling diretto del comportamento. Inoltre, anche il supporto e il sistema di valori dei genitori sembrano influire sulle abitudini di movimento dei figli, così come l'€™incoraggiamento, il sostegno, la partecipazione, la restrizione o la facilitazione di attività fisica e le credenze sull'attività fisica. Tra questi, i fattori che sono stati studiati più frequentemente sono il modeling, il supporto e i sistemi di credenze e valori dei genitori. In particolare, è stato rilevato che il supporto dei genitori correla positivamente con il livello di attività fisica di bambini, e che genitori attivi (soprattutto padri) hanno più probabilità di avere bambini attivi. In generale, gli interventi per promuovere l'attività fisica dei bambini hanno come focus per lo più direttamente i bambini (ad esempio, un'ora in più di educazione fisica a settimana). Tuttavia, per progettare strategie efficaci per aumentare l'attività fisica dei bambini, è necessaria una chiara comprensione di come i genitori influenzano il comportamento dei loro figli. La letteratura scientifica relativa al parenting in attività fisica è ancora limitata. Alcuni studi riportato risultati inconsistenti, e il tipo di supporto dei genitori non è ancora stato valutato sistematicamente. La sfida che si pone nel campo dell'€educazione alla salute e della pedagogia dello sport nel promuovere una regolare attività fisica dei bambini è collegata con l'individuazione di molteplici fattori che influenzano i comportamenti di attività fisica. Per queste ragioni è stato deciso di condurre una ricerca con un approccio ecologico, che indagasse il parenting in attività fisica e al fine di valutare possibili fattori personali, culturali e ambientali, utilizzando anche dati oggettivi. E' stato effettuato uno studio comparativo al fine di indagare il fenomeno del parenting in attività fisica in diversi contesti culturali. Per questo motivo sono stati scelti due paesi Europei, Italia e Germania, per le loro somiglianze e differenze. E' possibile individuare tre obiettivi principali della ricerca: - esaminare il ruolo di supporto dei genitori e degli ambienti fisici per l'™attività fisica dei bambini, con un approccio ecologico; - confrontare la situazione italiana e tedesca sulle abitudini di attività fisica dei bambini; - studiare quali variabili sono fortemente associate a più alti tassi di partecipazione all'attività fisica. Un gruppo di bambini della classe quarta della scuola primaria ed entrambi i loro genitori hanno partecipato alla ricerca. I partecipanti hanno compilato un pacchetto di questionari e un sottogruppo del numero totale di partecipanti ha indossato un accelerometro triassiale per 7 giorni consecutivi, al fine di registrare la quantità di attività fisica. Le singole variabili sono state per i bambini l'€™attività fisica, l'€™enjoyment durante l'attività fisica, l'importanza dell'attività fisica, il sostegno percepito dei genitori, la percezione del livello di attività fisica dei genitori e la self-efficacy. I genitori hanno riportato risposte sull'€™importanza che danno all'attività fisica, la frequenza di supporto ai figli, la quantità di attività fisica e l'€™enjoyment. I risultati hanno confermato le evidenze scientifiche e sostengono l'idea che il supporto dei genitori sia un elemento chiave nella definizione dei livelli di attività fisica nei bambini in età scolare. Inoltre è stato rilevante confrontare i risultati di due diversi paesi e contesti culturali per mettere in luce le differenze anche ambientali. Sono necessarie ulteriori ricerche che prevedano la raccolta di dati qualitativi oltre che qualitativi per comprendere meglio il parenting in attività fisica. Inoltre, la ricerca nella pedagogia dello sport dovrebbe concentrarsi sulla realizzazione di programmi educativi per i genitori circa il loro ruolo nella socializzazione dei comportamenti di attività fisica dei bambini

A subject specific forward dynamic 3-actuator torque-driven model of the human musculoskeletal system was created, based on measure- ments of individual subject characteristics. The goal was to simu- late a common strength exercise: squat jump with and without extra load. Hip, knee and ankle resultant net torques were modeled from experimental data. Elastic components were not considered. Two models were created for each joint, and then implemented into sim- ulations. Subsequently they were compared to each other to estab- lished which one best matched actual performances. By analyzing kinematic and kinetic experimental data at the instant of the toe-off, it was shown that accurate joint torque models implemented in a sim- ple computer simulation could reproduce squat jumps. The model that best matched actual jumps was used to optimize jump height performance with and without extra load. A linear decreasing of the jump height was found as the load increased. The load at which the model would not be able to take-off was predicted. In addition, joint and global power outputs for different extra load conditions were es- timated. It seemed that global power output probably suffered from a slight inaccuracy of simulated vertical ground reaction forces. It was concluded that a computational approach combined with exper- imental data, is an original way to conduct research in strength and conditioning training. It would help coaches, athletes and scientists to better understand human performances. This investigation is the first step in a wider project aiming to evaluate the advantages of the individual subject approach for understanding strength exercise tasks.

Psychotic disorders are among the chronic diseases with a major impact on the life of those affected, because of related disabilities, stigma and the difficulties involving family members and care services. Statistics report that 1.7% of the Italian population requires every year at least one treatment to mental health services: at least one-fifth of these treatments, is due to psychotic disorders. The therapeutic intervention is typically structured with a multidisciplinary approach to meet the different needs of these people: it involves the use of psychopharmacological therapies associated with psychotherapeutic, educational and rehabilitative treatment. In the last years research has shown that physical activity (PA) can positively influence the treatment of psychotic disorders. Compared to the general population, in fact, people suffering for severe mental illness have higher levels of overweight and obesity and present higher possibilities of developing chronic diseases such as type 2 diabetes, cardiovascular disease and metabolic syndrome. Moreover, these disorders are associated with higher levels of physical inactivity and lower levels of quality of life than the general population. Regular PA, on the other hand, improves lipid profiles, helps to regulate body composition and glucose metabolism, reduces blood pressure, increases fitness levels and has also positive effects on mood and anxiety levels. The main obstacles that these people encounter in adhering to regular PA programs are primarily related to the pathology and and to theirs socio-economic conditions. The side effects of antipsychotic drugs, the lack of motivation, poor concentration and difficulty in accessing the proposed activity, contribute to limit the exercise capacity of these persons and hinder their participation in regular PA programs long-lasting. Literature highlighted the importance and usefulness of educational interventions to support treatment compliance, helping people who suffer from psychotic disorders to deal with their disease and the correlated risks. Moreover, educational intervention are necessary to promote the insight of illness and to involve patients in tailored care. In addition, increasing evidence underline the crucial role of health professionals in health promotion interventions, that affect very significantly the healthy behaviors and physical habits of people with psychotic disorders. These observations are theoretically supported especially by Deci and Ryan in the theory of self-determination and by Hagger and Chatzisarantis in Trans-Contextual Model. The authors have shown that contextual factors such as social support, self-efficacy, autonomy, competence, social skills and the role of significant others are of fundamental importance in determining the motivation of people of being physically active. Even the enjoyment, defined as an emotional response positive sports experience, which reflects the general feelings of pleasure, satisfaction and fun, is considered one of the main determinants of adherence AF, as it is able to influence the will to begin and to maintain a program of regular exercise. Based on these findings, the research took into consideration some virtuous experiences operating in our country, offering regular PA programs as an integral part of the therapeutic treatments for users of psychiatric services. The purpose was to bring out the opinions of health professionals involved in regular PA programs with the users of psychiatric services, to highlight the benefits, barriers and facilitators of PA proposals. For this purpose it was decided to adopt a blended approach: participants completed a package of questionnaires which investigated the amount of PA, motivation, enjoyment, self-efficacy and quality of life reported by the participants. Therefore, a comparison was made between the two groups of participants on the basis of the variables examined. Moreover, four focus groups have been carried out, with health professionals involved in the study. They were asked to tell their personal experiences in PA with users of psychiatric services, highlighting the faced difficulties, the greatest benefits for users and the most important elements that can facilitate the implementation of PA proposals and to increasing their effectiveness. The results of the research are in line with literature. The content-analysis of focus groups, moreover, highlighted important data in support of the central role of the health care workers, in supporting users of the psychiatric services, to take part in the activities concerning health promotion. Results showed the need of a specific preparation, for these people, especially in what concern motivational processes and the management of strategies to promote active lifestyles. Finally, the statements reported by the health care workers confirmed and enriched the evidences about the utility of PA programs within the rehabilitative paths for people with severe mental disorders. They highlighted, in particular, the need to promote these initiatives making them an integral part of the therapeutic treatments. Moreover, it was highlighted the need to work on the network of contacts between the realities that promote these initiatives; health care workers underlined also the growing need for collaboration with local institutions at different levels, to promote and support the debate on this topic; finally they stressed that it is important to increase more effective PA proposals with the aim to respond to the needs of the users of psychiatric services.
I disturbi psicotici cronici si collocano tra le patologie a più alto impatto sulla qualità della vita di chi ne è affetto: per la disabilità che comportano, per lo stigma sociale cui è soggetto chi ne soffre e per le difficoltà che coinvolgono i familiari e i servizi assistenziali. Si stima che l’1.7% della popolazione italiana richieda almeno un trattamento all’anno ai servizi di salute mentale territoriale: di questi, almeno un quinto è a causa di disturbi psicotici. L’intervento terapeutico in genere prevede l'uso di terapie psicofarmacologiche associate a trattamenti psicoterapeutici, educativi e riabilitativi multidisciplinari, tra i quali assume sempre maggiore rilevanza l’attività fisica (AF). La ricerca ha infatti messo in evidenza come essa possa influenzare positivamente il trattamento dei disturbi psicotici, che sono fortemente associati a sovrappeso ed obesità e ad un elevato rischio di sviluppare patologie croniche come diabete di tipo 2, malattie cardiovascolari e sindrome metabolica. Inoltre questi disturbi sono associati a maggiori livelli di sedentarietà e a minori livelli di qualità della vita rispetto alla popolazione generale. L’AF regolare, per contro, migliora i profili lipidici, la composizione corporea e il metabolismo del glucosio, diminuisce la pressione arteriosa e ha effetti positivi sull’umore e sui livelli d’ansia. Gli ostacoli principali che queste persone incontrano nell’aderire a programmi di AF regolare sono collegati principalmente alla patologia e alle condizioni socioeconomiche ad essa correlate. Gli effetti collaterali dei farmaci antipsicotici, la mancanza di motivazione, la scarsa concentrazione e la difficoltà ad accedere a proposte di attività, limitano le capacità e le possibilità d’esercizio di queste persone e ostacolano la partecipazione a programmi di AF regolare in modo duraturo. La letteratura ha messo in evidenza l’importanza e l’utilità d’interventi educativi che aiutino le persone che soffrono per questi disturbi a prendere consapevolezza della malattia e a conoscerne i rischi correlati, per cercare di migliorare l’aderenza alle cure. Inoltre, crescenti evidenze sottolineano il ruolo fondamentale degli operatori sanitari negli interventi di promozione della salute, che influenzano in modo molto significativo i comportamenti salutari e le abitudini motorie di queste persone. Queste osservazioni trovano un supporto teorico in particolare in quanto affermato da Deci e Ryan nella Teoria dell’autodeterminazione e da Hagger e Chatzisarantis nel Modello Trans-Contestuale. Gli autori hanno dimostrato come fattori contestuali quali il supporto sociale, l’autoefficacia, l’autonomia, la competenza, le capacità relazionali e il ruolo degli altri significativi risultino fondamentali nel determinare la motivazione delle persone nei confronti dell’AF. Anche l’enjoyment, definito come una risposta emotiva positiva all’esperienza sportiva, che riflette sensazioni generali di piacere, gradimento e divertimento, viene considerato tra le principali determinanti dell’aderenza all’AF, in quanto è in grado d’influenzare la volontà di iniziare e di mantenere un programma di esercizio regolare e duraturo. Sulla base di queste evidenze la ricerca ha voluto prendere in esame alcune esperienze virtuose del territorio nazionale, che propongono l’AF come parte integrante del trattamento terapeutico per gli utenti dei servizi psichiatrici territoriali. Lo scopo è stato quello di far emergere il parere di operatori sanitari coinvolti in programmi regolari di AF con gli utenti, per mettere in evidenza benefici, barriere e facilitatori dell’AF proposta. A tale scopo è stato scelto di adottare un metodo misto: i partecipanti hanno compilato un pacchetto di questionari con i quali sono state indagate la quantità di AF svolta, la motivazione, l’enjoyment, l’auto-efficacia e la qualità della vita riportate dai partecipanti. É stato quindi realizzato un confronto tra i due gruppi di partecipanti sulla base delle variabili prese in esame. Inoltre sono stati realizzati quattro focus group, ai quali hanno preso parte gli operatori sanitari coinvolti nello studio. Agli operatori è stato chiesto di raccontare le loro personali esperienze nell’ambito dell’AF con gli utenti, mettendo in luce le difficoltà che incontrano, i maggiori benefici per gli utenti e gli elementi più rilevanti per facilitare la realizzazione delle proposte ed incrementarne l’efficacia. I risultati si pongono in linea con quanto già evidenziato dalla letteratura. Dall’analisi dei focus, in particolare, sono emersi dati importanti a sostegno della centralità del ruolo dell’operatore sanitario, nel supportare costantemente gli utenti nelle attività proposte che riguardano la promozione della salute. Inoltre è emersa la necessità di una preparazione specifica, per queste persone, soprattutto nell’ambito dei processi motivazionali e nella gestione delle strategie per promuovere stili di vita attivi. Infine le testimonianze degli operatori hanno confermato e arricchito le evidenze a sostegno dell’utilità dell’AF all’interno dei percorsi riabilitativi degli utenti con gravi disturbi psichiatrici. È stata messa in luce, in particolar modo, la necessità di promuovere queste iniziative e di renderle parte integrante dei trattamenti terapeutici. Non di meno, è stata evidenziata la necessità di lavorare sulla rete di contatti tra le realtà che promuovo queste iniziative ma soprattutto l’esigenza crescente di collaborazione con gli enti del territorio a livello locale, regionale e nazionale, per promuovere e sostenere il confronto sull’argomento e sviluppare proposte d’intervento sempre più efficaci e rispondenti alle esigenze degli utenti.

Wearable sensor continues to advance in flexible electronics, smart materials, and low-power computing thanks to recent technological advances, on hardware and software, have allowed to monitor biomechanical and physiological parameters and to tracker movement during daily physical activity. This system is nowadays applied in wellness and health. Currently, medical and sport field are experiencing a rapidly growing interest in wearable device technology for the monitoring and stored data in real-time, about motion activities, biometric and health parameters. Physiological and biomechanical information, i.e. heart rate, blood pressure, breathing rate, body temperature, blood saturation and cardiac electrical activity (ECG) and movement, are used in medical field to assess cardiovascular and pulmonary engage and in sport field to assess, mainly, external work and internal work i.e. energy expenditure, an important parameter used to quantify physical activity intensity level, because high physical activity levels achieved weekly are an important factor correlated to health and wellness, and it is inversely proportional to cardiovascular, dysmetabolic and obesity illness risk. There are many tools (accelerometer and pedometer), and algorithms used, as well as, different is the accuracy of the measurements. Therefore, the purpose of this narrative review is to summarize: the main wearable devices and algorithms reported in literature, with relative validity and reliability, to assess physical activity levels (PAL) and predict indirect energy expenditure (IEE).
Il sensore indossabile continua a progredire nell'elettronica flessibile, nei materiali intelligenti e nell'informatica a bassa potenza grazie ai recenti progressi tecnologici, su hardware e software, che hanno consentito di monitorare i parametri biomeccanici e fisiologici e registrare i movimenti durante l'attività fisica quotidiana. Questo sistema è oggi applicato nel campo del benessere e della salute, con il settore medico e sportivo che stanno riscontrando un interesse in rapida crescita per queste tecnologie, utilizzate per monitorare dati in tempo reale, sulle attività di movimento, sui parametri biometrici e sui parametri di salute. Le informazioni fisiologiche e biomeccaniche come frequenza cardiaca, pressione sanguigna, frequenza respiratoria, temperatura corporea, saturazione sanguigna e attività elettrica cardiaca (ECG) e movimento sono utilizzate in campo medico per valutare l'impegno cardiovascolare e polmonare, mentre in campo sportivo sono utilizzate per valutare principalmente il lavoro esterno ed interno. Per valutare il lavoro interno viene utilizzato il dispendio energetico come parametro utile a quantificare il livello di intensità dell'AF svolta. Attualmente, ci sono sensori come accelerometri e pedometri integrati a dispositivi indossabili, che sono utilizzati per la stima della SE indiretta durante l’esercizio fisico, con differenze di precisione nella stima per i diversi modelli e tipologie. Pertanto, lo scopo di questa rassegna narrativa è riassumere: i principali dispositivi indossabili e algoritmi di correlazione riportati in letteratura, con relativa validità e affidabilità, utilizzati per valutare rispettivamente i livelli di AF raggiunti e la stima della SE indiretta. Ricerca della letteratura: La revisione della letteratura è stata eseguita nella primavera e nell'estate 2020 utilizzando i seguenti motori di ricerca Google Scholar, PubMed con i seguenti termini: dispositivo indossabile, spesa energetica, attività fisica, algoritmo. Articoli in inglese e revisioni sono state incluse e pubblicate negli ultimi 8 anni (2013-2021). Per i criteri di inclusione nella ricerca, sono stati scelti articoli che contenevano studi con i dispositivi indossabili come pedometri e accelerometri utilizzati in protocolli di esercizio durante l’attività fisica.

The ischemic preconditioning (IP) is a protective phenomenon against cell injury induced by infarction. Furthermore, muscle IP has been found capable of improving exercise performance in laboratory testing. This investigation aimed at verifying the hypothesis that IP improved performance during self-paced exercise (SPE) in the field. 11 healthy male well trained runners performed three randomly assigned 5000 m self-paced running test in a regular athletic track. One was the reference (RT) test, while the others where performed after muscle IP (IPT) and a control sham test (ST). Average speed was measured during each test. Moreover, mean values of heart rate (HR), oxygen uptake (VO2), aerobic energy cost (AEC), and blood lactate (BLa) after race were gathered. We found that none of the studied variables were affected neither by IPT nor by ST with respect to the RT test. In detail, speed was on average 4.78±0.49, 4.84±0.85, and 4.53±0.38 m·s-1 for the RT, the ST, and the IPT test respectively. HR was 176.4±8.8, 173.8±5.4, and 175.4±5.8 bpm. VO2 was 3.5±0.69, 3.74±0.85, and 3.62±1.19 l·min-1. AEC was 1.04±0.15, 1.08±0.1, and 1.09±0.15 kcal·kg-1·km-1. Finally, BLa after races reached a level of 12.85±3.54, 11.88±4.74, and 12.82±3.6 mmol·l-1. Findings of the present investigation indicate that ischemic preconditioning is not capable to ameliorate performance during self paced exercise in the field. These results are in contrast to what previously found in the laboratory setting.

Background Obesity is a chronic multifactorial pathology caused by environmental, behavioral and genetics factors, with negative impact on general health, quality of life, and increased risk to fall into disability and morbidity. Non-surgical management of obesity consisted on a multicomponent approach, including behavioral therapy, pharmacotherapies, and lifestyle change to reduce the energy intake with diet, and increase physical activity. Because few patients achieved an important weight loss with lifestyle change, many undergo to bariatric surgery. Materials and methods This study is divided into two phases. In the first phase, the aim is to evaluate functional capacity of patients with obesity before and after sleeve gastrectomy to analyzed changes of maximal oxygen consumption, muscular strength, static balance, level of physical activity and quality of life. In the second phase, the aim is to analyze the effect of 1 month supervised physical exercise protocol performed 6 months after surgery. One hundred and seventy-nine patients with obesity were recruited and valuated 1 month before and 6 months after sleeve gastrectomy. Physical functioning evaluation consisted on: cardiopulmonary capacity, muscle strength, static balance, level of physical activity, and quality of life. After surgery, 28 patients were recruited for a 10-sessions of supervised physical exercise protocol. Results As expected, after surgery were recorded significant reduction of body weight, body mass index and waist circumference. Absolute muscular strength of upper and lower limb decreased, while strength adjusted by body weight increased significantly. Static balance improved in females, while males tend to worsen their balance control. Also quality of life and level of physical activity increased after surgery. After physical exercise protocol, patients improved muscular strength, dynamic balance, and flexibility capacities. Conclusion After sleeve gastrectomy, patients with obesity improved their functional capacity, increased the time dedicated to physical activity, and improved quality of life. Even if the weight loss was detected mainly by surgery, physical activity is strongly recommended to avoid muscle mass reduction and to improve quality of life.

Alterations in muscle mitochondrial function have been implicated in the pathogenesis of numerous metabolic disorders, including insulin resistance, type 2 diabetes, obesity, and the deleterious effects of aging. However, the precise role for mitochondrial function in these processes remains to be established. In vivo 31P Magnetic Resonance Spectroscopy (31P-MRS) is an effective technique that permits the non-invasive investigation of skeletal muscle metabolism and transgenic mice are a novel tool for examining the effects of specific genes on mitochondrial function. Combining these two approaches would be a powerful methodology for studying mitochondrial function but its implementation has been limited due to the small volume of muscle from which the MR signal can be obtained and the requirement that the region of interest (ROI) must remain still for the entire duration of these lengthy studies. A new MR-compatible experimental set-up was developed to perform these experiments under low-dose anesthesia to minimize movement with constant physiological monitoring to ensure that the animal remained viable throughout the study. The unidirectional flux of ATP synthesis (Pi → ATP) was measured using 31P saturation-transfer MRS in two different transgenic mouse models overexpressing PGC-1α or UCP3. While PGC-1α has been shown to be a potent promoter of mitochondrial biogenesis and fiber-type remodelling, UCP3 seems to play a critical role in regulating mitochondrial activity, but, whether this might be its primary role is still a matter of debate. The rates of ATP production (VATP) were 19% lower in UCP3 +/+ mice with respect to their wild-type (WT) littermates (P=0.02) accompanied by a significant increase in energy expenditure and food intake, confirming a contributing role played by this protein in regulating mitochondrial energy production. In PGC-1α +/+ mice, VATP was increased in mice fed a regular chow (by 50%, P<0.01) or a high fat diet (by 58%, P<0.001) with respect to wild-type littermate mice, with no significant difference in energy expenditure, food intake or locomotor activity. In the mouse model overexpressing PGC-1α, higher rates of VATP suggest enhanced efficiency in ATP production. This thesis has demonstrated that 31P-MRS can successfully be applied to the investigation of muscle mitochondrial function in transgenic mice in vivo.