Acute physical exercise may affect cardiac autonomic modulation hours or even days during the recovery phase. Although sleep is an essential recovery period, the information on nocturnal autonomic modulation indicated by heart rate variability (HRV) after different exercises is mostly lacking. Therefore, this study investigated the effects of exercise intensity and duration on nocturnal HR, HRV, HR, and HRV-based relaxation, as well as on actigraphic and subjective sleep quality. Fourteen healthy male subjects (age 36 ± 4 years, maximal oxygen uptake 49 ± 4 ml/kg/min) performed five different running exercises on separate occasions starting at 6 p.m. with HR guidance at home. The effect of intensity was studied with 30 min of exercises at intensities corresponding to HR level at 45% (easy), 60% (moderate) and 75% (vigorous) of their maximal oxygen uptake. The effect of duration was studied with 30, 60, and 90 min of moderate exercises. Increased exercise intensity elevated nocturnal HR compared to control day (p < 0.001), but it did not affect nocturnal HRV. Nocturnal HR was greater after the day with 90- than 30- or 60-min exercises (p < 0.01) or control day (p < 0.001). Nocturnal HRV was lower after the 90-min exercise day compared to control day (p < 0.01). Neither exercise intensity nor duration had any impact on actigraphic or subjective sleep quality. The results suggest that increased exercise intensity and/or duration cause delayed recovery of nocturnal cardiac autonomic modulation, although long exercise duration was needed to induce changes in nocturnal HRV. Increased exercise intensity or duration does not seem to disrupt sleep quality.

SUMMARY Sleep is the most important period for recovery from daily load. Regular physical activity enhances overall sleep quality, but the effects of acute exercise on sleep are not well defined. In sleep hygiene recommendations, intensive exercising is not suggested within the last 3 h before bed time, but this recommendation has not been adequately tested experimentally. Therefore, the effects of vigorous late-night exercise on sleep were examined by measuring polysomnographic, actigraphic and subjective sleep quality, as well as cardiac autonomic activity. Eleven (seven men, four women) physically fit young adults (VO 2max 54 ± 8 mLAEkg )1 AEmin )1 , age 26 ± 3 years) were monitored in a sleep laboratory twice in a counterbalanced order: (1) after vigorous late-night exercise; and (2) after a control day without exercise. The incremental cycle ergometer exercise until voluntary exhaustion started at 21:00 ± 00:28 hours, lasted for 35 ± 3 min, and ended 2:13 ± 00:19 hours before bed time. The proportion of non-rapid eye movement sleep was greater after the exercise day than the control day (P < 0.01), while no differences were seen in actigraphic or subjective sleep quality. During the whole sleep, no differences were found in heart rate (HR) variability, whereas HR was higher after the exercise day than the control day (54 ± 7 versus 51 ± 7, P < 0.01), and especially during the first three sleeping hours. The results indicate that vigorous late-night exercise does not disturb sleep quality. However, it may have effects on cardiac autonomic control of heart during the first sleeping hours.k e y w o r d s actigraphy, heart rate variability, polysomnography, recovery, subjective sleep quality

Objectives: The aim of this study is to evaluate the effects of multicomponent rehabilitation on physical activity, sedentary behavior, and mobility in older people recently discharged from hospital. Design: Randomized controlled trial. Setting: Home and community. Participants: Community-dwelling people aged ⩾60 years recovering from a lower limb or back musculoskeletal injury, surgery, or disorder were recruited from local health center hospitals and randomly assigned into an intervention ( n = 59) or a control (standard care, n = 58) group. Intervention: The six-month intervention consisted of a motivational interview, goal attainment process, guidance for safe walking, a progressive home exercise program, physical activity counseling, and standard care. Measurements: Physical activity and sedentary time were assessed using an accelerometer and a single question. Mobility was evaluated with the Short Physical Performance Battery, self-reported use of a walking aid, and ability to negotiate stairs and walk outdoors. Intervention effects were analyzed with generalized estimating equations. Results: Daily physical activity was 127 ± 78 minutes/day and 121 ± 70 at baseline and 167 ± 81 and 164 ± 72 at six months in the intervention and control group, respectively; mean difference of 3.4 minutes (95% confidence interval (CI) = −20.3 to 27.1). In addition, no significant between-group differences were shown in physical performance. Conclusion: The rehabilitation program was not superior to standard care for increasing physical activity or improving physical performance. Mobility-limited older people who had recently returned home from hospital would have needed a longer and more frequently monitored comprehensive geriatric intervention.

This study provides new knowledge about the factor structure of the 12-item General Health Questionnaire (GHQ-12; D. Goldberg, 1972) through the application of confirmatory factor analysis to longitudinal data, thereby enabling investigation of the factor structure, its invariance across time, and the rank-order stability of the factors. Two community-based longitudinal adult samples with 1-year (n = 640) and 6-year (n = 330) follow-up times were studied. As a result, the correlated 3-factor model (i.e., Anxiety/Depression, Social Dysfunction, and Loss of Confidence) showed a better fit with both samples than the alternative models. The correlated 3-factor structure was also relatively invariant across time in both samples, indicating that the scale has good construct validity. The rank-order stabilities of the factors were low across time, which suggests that the GHQ-12 measures temporal mental state.