13 2022 1 AnnaleSKinesiologiae UDK / UDC 796.01:612 | Annales Kinesiologiae 13, 2022, 1, pp. 1–88 | ISSN 2232-2620 8, 2017, 1 A nnaleSK inesiologiae AnnaleSKinesiologiae UDK / UDC 796.01:612 | Annales Kinesiologiae 8, 2017, 1, pp. 1–64 | ISSN 2232-2620 AnnaleSKinesiologiae UDK / UDC 796.01:612 | Annales Kinesiologiae 13, 2022, 1, pp. 1–88 | ISSN 2232-2620 Koper 2022 ISSN 2232-2620 UDK/UDC 796.01:612 Volume 13, Year 2022, Number 1 ISSN (online ed.) 2335-4240 Editor in Chief / Glavni in odgovorni urednik: Rado Pišot Editors / Uredniki in urednice: Peter Čerče, Petra Dolenc, Mitja Gerževič, Mihaela Jurdana, Uroš Marušič, Cecil J. W. Meulenberg, Nina Mohorko, Armin Paravlić, Saša Pišot, Matej Plevnik, Boštjan Šimunič Editorial Board / Uredniški odbor: Guglielmo Antonutto (Ita), Bojan Borštner (Slo), Andrej Čretnik (Slo), Natale Gaspare de Santo (Ita), Nandu Goswami (Aut), Jay R. Hoffman (USA), Anita Hökelmann (Ger), Aleš Holobar (Slo), Peter Kokol (Slo), Stefano Lazzer (Ita), Zlatko Matjačić (Slo), Zoran Milanović (Srb), Ivana Milovanović (Srb), Jurij Planinšec (Slo), Pietro Enrico di Prampero (Ita), Carlo Reggiani (Ita), Vesna Štemberger (Slo), Matjaž Vogrin (Slo), Jernej Završnik (Slo), Milan Žvan (Slo) Technical Editors / Tehnični urednik in urednica: Peter Čerče, Language Editors / Lektorji in lektorice: Rick Harsch, Karry Close, Jezikovna Zadruga Soglasnik (an.), Nina Novak (sl.) Translation / Prevod: Petra Berlot Kužner (an./sl.) Graphic Design of the Cover / Oblikovanje naslovnice: Mateja Oblak Typesetting / Stavek: Alenka Obid Publisher / Izdajatelj: Science and Research Centre Koper, Annales ZRS / Znanstveno-raziskovalno središče Koper, Annales ZRS Journal secretary contact / Sedež: Annales Kinesiologiae, Science and Research Centre Koper, Garibaldijeva 1, SI-6000 Koper/Capodistria tel.: +386 5 663-77-00; fax: +386 5 663-77-10 E-mail: annaleskin@zrs-kp.si Home page: http://ojs.zrs-kp.si/index.php/AK Printing / Tisk: Grafika 3000 d.o.o. Quantity / Naklada: 250 copies per issue Financial support / Finančna podpora: The publishing of this journal is supported by the Foundation for Financing Sport Organisations in the Republic of Slovenia and the Slovenian Research Agency. Izdajo revije sofinancirata Fundacija za financiranje športnih organizacij v Republiki Sloveniji in Javna agencija za raziskovalno dejavnost Republike Slovenije. Journal abbreviation: Ann. Kinesiol. Annales Kinesiologiae is an international journal published twice a year. Annual subscriptions (2 issues in English language) are available for 25 eur, and a single issue is available for 15 eur. For students 20% discount applies upon presenting an international valid student ID. Subscription requests can be send to: annaleskin@zrs-kp.si TABLE OF CONTENTS Boštjan Šimunič: ...................................................................................................... Editorial Uvodnik Monika Jeruc Tanšek, Andrej Švent, Alan Kacin: ............................................... Effects of Inspiratory Muscle Training on Physical Performance During Backpack Carrying Učinki vadbe inspiratornih mišic na telesno zmogljivost med nošenjem nahrbtnika Nika Šuc, Blaž Lešnik: ........................................................................................... Body Mass Index Changes in Children and Adolescents With Intelectual Disability During the COVID-19 Pandemic Indeks telesne mase pri otrocih in mladostnikih z motnjo v duševnem razvoju med epidemijo covida-19 Mihaela Jurdana, Ana Tomažič, Boštjan Žvanut: ............................................... Fat Mass to Fat-Free Mass Ratio and Body Composition in Participants With Chronic Leg Problems Razmerje med maščobno maso in pusto mišično maso ter sestava telesa pri bolnikih s kroničnimi težavami spodnje okončine Edvard Kolar, Matej Tušak: ................................................................................... The Decision-Making Style Structure of Slovenian Sports Managers Struktura stilov odločanja slovenskih športnih menedžerjev REVIEWS AND REPORTS OCENE IN POROČILA Kaja Teraž, Rado Pišot: .......................................................................................... Report of 4th International SPE Balkan Ski Conference Poročilo s 4. Mednarodne konference SPE Balkan Ski Saša Pišot: ................................................................................................................ Having Fun While Learning - SKI EASY Snow Day Zabavno učenje smučanja – dnevi na snegu SKI EASY 1 5 23 35 47 77 79 Saša Pišot: ................................................................................................................ Report on the EASS & ISSA 2022 World Congress of Sport Sociology Poročilo s svetovnega kongresa sociologije športa EASS in ISSA 2022 Guidelines for authors .............................................................................................. Navodila avtorjem 83 85 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 1 EDITORIAL Excess body fat is a serious health risk leading to problems such as hypertension, elevated blood lipids (fats and cholesterol), diabetes mellitus type 2, cardiovascular disease, respiratory dysfunction and gallbladder disease. Individuals who accumulate a lot of visceral fat are at higher risk than those who are more likely to accumulate fat on their thighs and buttocks. These days, people are more concerned than ever about how much they weigh. Similarly, scientists propose a range of classification strategies based on body mass or composition, as is also evident in several publications in this issue of Annales Ki- nesiologiae. However, pure body mass or the body mass index is not an appropriate measure of health. For example, being thin does not necessarily mean that you have a lower health risk. In fact, the obsession with becoming thin often leads to serious eating disorders such as anorexia and bulimia. Being thin simply means weighing less than the recommended levels. It is important to distinguish between healthy leanness and unwanted thinness. There are also several important reasons to monitor body compo- sition: – To develop holistic physical fitness programs; – To monitor body mass change = body fat loss with muscle growth; – To provide a baseline for diet and the treatment of obesity; – To follow changes due to growth, development, maturation and ageing; – To individualise and optimise the performance of athletes. The simplest 2-component body composition models divide it into a fat component and a fat-free component, and not all fat is considered unhealthy. This is an important advance over body mass indexing. Essential fat is found in the bone marrow, heart, lungs, liver, spleen, kidneys, intestines, muscles and fat-rich tissues, while storage fat accumulates in the adipose tissue. In addition, storage fat is found around the internal organs and under the skin. Fat-free mass is the weight of your muscles, bones, liga- ments, tendons and internal organs, with essential fat subtracted. The search for methods to determine body composition went through several phases (with the methods of each phase labelled): (1) precision without biology (anthropo- metry); (2) biology without precision (dilution methods); (3) in search of precision (bioimpedance); and (4) in search of accuracy (dual-energy X-ray absorptiometry). As bioimpedance is a very affordable method with a high potential for error of < 4%, one should consider multiple standards for a valid evaluation: – Supine position with arms and legs abducted by 30 deg and 45 deg, respectively; – No eating for 12 hours and no drinking for 4 hours before the test; – No exercise within 12 hours of the test; – Urinate within 30 minutes of the test: – No alcohol consumption within 48 hours of the test – No diuretics within 7 days of the test. 2 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 These standards for valid bioimpedance assessment are difficult to achieve, and many authors simply ignore them. Nevertheless, body composition is an integral com- ponent of overall health and physical fitness that leads to important decision-making strategies for our health. On the other hand, dual-energy x-ray absorptiometry (DEXA or DXA) measures body fat, muscle and the total body bone mineral (TBBM) using two x-ray energies. DEXA is fast and has low radiation exposure. The analysis can be broken down into regional levels. While DEXA is the gold standard for measuring bone mineral density, it is also used to estimate total and regional body fat and lean mass. Therefore, I would like to point out to scientists that they need to be aware of the measurement standards to be followed and to choose state-of-the-art methods for valid results in order to ensure high-quality result interpretation. Boštjan Šimunič, Editor ANNALES KINESIOLOGIAE • 13 • 2022 • 1 3 UVODNIK Čezmerna telesna maščoba pomeni resno tveganje za zdravje, ki vodi v bolezni, kot so povišan krvni tlak, povišane vrednosti lipidov (maščob in holesterola) v krvi, sladkorna bolezen tipa 2, bolezni srca in ožilja, motnje v delovanju dihal in bolezni žolčnika. Posamezniki, ki si naberejo veliko visceralne maščobe, so bolj ogroženi kot tisti, ki si maščobo bolj nabirajo na stegnih in zadnjici. Danes se ljudje bolj kot kdaj koli prej ukvarjajo s tem, koliko tehtajo. Podobno tudi znanstveniki predlagajo različne strategije razvrščanja glede na telesno maso ali sestavo, kar je razvidno tudi iz več objav v tej številki revije Annales Kinesiologiae. Vendar samo telesna masa ali indeks telesne mase ni ustrezno merilo našega zdravja. Na primer, če ste vitki, to še ne pomeni, da je vaše tveganje za zdravje manjše. Pravza- prav obsedenost z vitkostjo pogosto vodi v resne motnje hranjenja, kot sta anoreksija in bulimija. Biti vitek preprosto pomeni tehtati manj, kot je priporočeno. Pomembno je ločiti med zdravo vitkostjo in neželeno vitkostjo. Je tudi več pomembnih razlogov za spremljanje telesne sestave: – za razvoj celostnih programov telesne pripravljenosti, – za spremljanje sprememb telesne mase = izguba telesne maščobe z rastjo mišic, – za zagotavljanje izhodišč za dieto in zdravljenje debelosti, – za spremljanje sprememb zaradi rasti, razvoja, transformacijskih procesov in staranja, – za individualizacijo in optimizacijo zmogljivosti športnikov. Najpreprostejši dvokomponentni modeli telesne sestave se delijo na maščobno in pusto komponento, pri čemer vsa maščoba ne velja za nezdravo. To je pomemben korak naprej v primerjavi z indeksom telesne mase. Zdravju koristno maščobo najdemo v ko- stnem mozgu, srcu, pljučih, jetrih, vranici, ledvicah, črevesju, mišicah in tkivih, bogatih z maščobo, medtem ko se maščoba kopiči predvsem tudi v visceralnem in podkožnem maščevju. Pusta masa je masa mišic, kosti, vezi, kit in notranjih organov, od katere je odšteta tudi zdravju koristna oziroma potrebna maščobna masa. Iskanje metod za določanje telesne sestave je potekalo v več fazah (s primeri najbolj razširjenih metod te faze): 1. natančnost brez biologije (antropometrija); 2. biologija brez natančnosti (metode presnavljanja snovi); 3. iskanje natančnosti (bioimpedanca) in 4. iskanje natančnosti (dvoenergijska rentgenska absorpciometrija). Ker je bioimpe- danca cenovno zelo dostopna metoda s potencialno nizko napako merjenja < 4 %, je treba za veljaven rezultat merjenja upoštevati več standardov: – ležeči položaj z abduciranimi rokami in nogami za 30 oziroma 45 stopinj, – 12 ur ne jesti in 4 ure pred testom ne piti, – brez vadbe 12 ur pred testom, – urinirati 30 minut pred testom, – ne uživati alkohola 48 ur pred testom, – ne jemati diuretikov 7 dni pred testom. 4 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Za veljavno oceno bioimpedance je namreč te standarde težko doseči, zato jih šte- vilni avtorji preprosto ne upoštevajo, čeprav je telesna sestava sestavni del splošnega zdravja in telesne pripravljenosti, ki vodi do pomembnih strategij odločanja o našem zdravju. Po drugi strani pa dvoenergijska rentgenska absorpciometrija (DEXA ali DXA) z dvema energijama rentgenskih žarkov meri telesno maščobo, mišice in kostno mineral- no gostoto celega telesa (TBBM). Metoda DEXA je hitra in pri njej je izpostavljenost sevanju majhna. Analizo je mogoče razdeliti na regionalna območja telesa. Čeprav je DEXA zlati standard za merjenje mineralne kostne gostote, se uporablja tudi za oceno skupne in regionalne telesne maščobe in puste mase. Zato bi rad opozoril znanstvenike, da se morajo zavedati merilnih standardov, ki jih je treba upoštevati, in ustrezno izbrati merilne metode za veljavno merjenje, da bi zagotovili visoko kakovost interpretacije rezultatov. Boštjan Šimunič, urednik ANNALES KINESIOLOGIAE • 13 • 2022 • 1 5 EFFECTS OF INSPIRATORY MUSCLE TRAINING ON PHYSICAL PERFORMANCE DURING BACKPACK CARRYING Monika JERUC TANŠEK1, Andrej ŠVENT2, Alan KACIN1 1 University of Ljubljana, Faculty of Health Sciences, Physiotherapy Department, Slovenia 2 Intact d.o.o., Slovenia Corresponding Author: Alan KACIN University of Ljubljana, Faculty of Health Sciences, Physiotherapy Department, Zdravstvena pot 5, 1000 Ljubljana, Slovenia Phone: +386 1 300 11 19 Email: alan.kacin@zf.uni-lj.si ABSTRACT Purpose: Restricting chest movement when carrying a loaded backpack reduces ef- ficiency and increases the work of the respiratory muscles. The aim of the present study was to investigate the effects of six weeks of inspiratory muscle training (IMT) on respira- tory muscle strength and endurance and on physical performance when carrying a load Methods: Twenty male (age: 32.2 ± 3.4 years) members of the Special Operati- ons Unit of the Slovenian Army volunteered to participate. The experimental group (n=10) trained their respiratory muscles for six weeks against an incremental inspi- ratory resistance with a breathing apparatus. The placebo group (n=10) performed the same IMT protocol but with a sham inspiratory resistance. Assessment of the su- bjects before and after IMT included measurements of the maximal inspiratory and expiratory pressures, heart rate measurements, and ratings of perceived physical and respiratory exertion before and after a 60-min walk test with a 25-kg backpack Results: After six weeks of IMT, the maximum inspiratory pressure measured before and after the 60-minute walk test increased significantly (p < 0.001) in the experi- mental group by 47 ± 13% and 58 ± 20%, respectively. Inspiratory fatigue was also significantly lower in the experimental group. No changes were observed in the he- art rate and the rating of perceived exertion during the walking test. In the placebo group, no significant changes were observed in the measured parameters after IMT. Original scientific article DOI: https://doi.org/10.35469/ak.2022.335 received: 2022-07-25 UDC: 796.015:612.2 6 Monika JERUC TANŠEK, Andrej ŠVENT, Alan KACIN: EFFECTS OF INSPIRATORY MUSCLE TRAINING ON PHYSICAL PERFORMANCE ..., 5–21 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Conclusion: Six weeks of IMT with progressive breathing resistance improves strength and reduces fatigue of the respiratory muscles. Individuals who perform tasks that requi- re them to carry a heavy backpack for extended periods of time may benefit from IMT. Keywords: load-carrying, respiratory muscle fatigue, respiratory muscle training, thoracic motion restriction. UČINKI VADBE INSPIRATORNIH MIŠIC NA TELESNO ZMOGLJIVOST MED NOŠENJEM NAHRBTNIKA IZVLEČEK Cilj: Omejitev gibanja prsnega koša med nošnjo obteženega nahrbtnika zmanjša učinkovitost in poveča delo dihalnih mišic. Cilj pričujoče študije je bil raziskati učinke šesttedenske vadbe inspiratornih mišic (VIM) na jakost in vzdržljivost dihalnih mišic ter telesno zmogljivost med prenašanjem bremena. Metode: Prostovoljno je sodelovalo 20 moških (starost: 32,2 ± 3,4 let) pripadnikov Enote za specialno delovanje Slovenske vojske. Eksperimentalna skupina (n=10) je šest tednov neprekinjeno vadila proti naraščajočemu uporu pri vdihu s posebno dihal- no napravo. Placebo skupina (n=10) je izvedla enak protokol VIM z napravo, vendar le z navideznim inspiratornim uporom. Začetno in končno testiranje preiskovancev je vključevalo meritve največjih inspiratornih in ekspiratornih tlakov, meritve frekvence srčnega utripa in oceno občutenja telesnega in dihalnega napora pred in po 60-minu- tnem testu hoje s 25-kg nahrbtnikom. Rezultati: Po šesttedenski VIM se je največji inspiratorni tlak izmerjen pred in po testu hoje pomembno (P < 0,001) povečal v eksperimentalni skupini, in sicer za 47 ± 13 % pred testom in za 58 ± 20 % po testu. Značilno se je zmanjšala tudi inspiratorna utrujenost v eksperimentalni skupini. Odziv frekvence srčnega utripa in ocena občute- nja napora med testom hoje se po VIM ni spremenila. V placebo skupini po VIM nismo opazili pomembnih sprememb v nobenem izmerjenem parametru. Zaključek: Šesttedenska VIM s progresivnim inspiratornim uporom izboljša jakost inspiratornih mišic in zmanjša njihovo utrudljivost. Tovrstna dihalna vadba ima lahko pozitivne učinke za ljudi med opravljanjem nalog, ki zahtevajo dolgotrajno nošenje težkega nahrbtnika. Ključne besede: prenašanje bremen, utrujenost dihalnih mišic, vadba dihalnih mi- šic, omejitev gibanja prsnega koša. 7 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Monika JERUC TANŠEK, Andrej ŠVENT, Alan KACIN: EFFECTS OF INSPIRATORY MUSCLE TRAINING ON PHYSICAL PERFORMANCE ..., 5–21 INTRODUCTION Carrying a load with a backpack is defined as the movement of a person with an additional mass on the trunk supported by shoulder straps (Knapik, Harman, Steelman & Graham, 2012). It is a common form of occupational physical activity, especially for soldiers, firefighters and rescue workers, as well as for various forms of sports and rec- reational activities. The load carried in a backpack restricts the movement of the chest and the amount of air a person can inhale, increasing the work of breathing (Dominelli, Sheel & Foster, 2012; Faghy & Brown, 2014b). In this case, the respiratory muscles are working outside the optimal limits of their length-tension curve (Romer & Polkey, 2008). Altered respiratory mechanics lead to accelerated fatigue of the respiratory mu- scles (Faghy & Brown, 2014a; Faghy & Brown, 2014b), which can reduce physical performance by reducing the blood flow to other skeletal muscles and increasing the perception of physical and respiratory effort (Dempsey, Romer, Rodman, Miller, & Smith, 2006; Harms, et al., 1997). The actual effect of carrying an extra load in a backpack on respiratory muscle function under different working conditions has not been studied in detail. Butcher, Jones, Eves and Petersen (2006) reported a significant reduction in the maximum air- way pressure in professional firefighters wearing a heavy backpack and a respiratory mask during both long-duration low-intensity physical activities and short-duration hi- gh-intensity physical activities. However, it is difficult to assess the individual effects of wearing a backpack and using a breathing mask because the mask itself increases the work of breathing (Eves, Jones & Petersen, 2005). In subjects of varying fitness levels, wearing a 25 kg backpack without a breathing mask has been shown to reduce the maximum inspiratory pressure (MIP) by 11% during 60 min walking (58% V̇O2max) on a treadmill and by a further 5% during subsequent high-intensity running (Faghy & Brown, 2014a; Faghy & Brown, 2014b; Faghy, Blacker & Brown, 2016). The physical training of members of military special forces includes both low- intensity activities (e.g. military patrols) and high-intensity activities (e.g. military interventions and combat operations) while wearing a backpack, so it might be use- ful to include respiratory muscle training in their training routine. By using special training aids and training programs, one can strengthen the inspiratory or expiratory respiratory muscles in isolation or both at the same time. Inspiratory muscle training (IMT) adds resistance to the inspiratory flow and primarily strengthens the inspira- tory muscles, especially the abdominal diaphragm, which creates an intrathoracic negative pressure during inspiration. IMT is commonly used to reduce respiratory effort during physical activity in elite athletes (HajGhanbari et al., 2013) and healthy individuals (Illi, Held, Frank & Spengler, 2012; Sales et al., 2016) as it significantly increases the strength of the inspiratory intercostal muscles, as well as the diaphragm (Verges, Lenherr, Haner, Schulz, & Spengler, 2007; Romer & Polkey, 2008). This has been shown to improve athletic performance (HajGhanbari et al., 2013), e.g. cycling (Romer, McConnell & Jones, 2002; Johnson, Sharpe & Brown, 2007; McConnell, 8 Monika JERUC TANŠEK, Andrej ŠVENT, Alan KACIN: EFFECTS OF INSPIRATORY MUSCLE TRAINING ON PHYSICAL PERFORMANCE ..., 5–21 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 2011), running (Tong et al., 2008), swimming (Yañez-Sepulveda et al., 2021) and rowing (Griffiths & McConnell, 2007). Respiratory muscle performance can be improved with various training protocols, most of which result in increased respiratory muscle strength and, to a lesser extent, improved muscle endurance (Fernández-Lázaro et al., 2021). IMT protocols vary and depend on the respiratory device used, the characteristics of the exerciser and the de- sired effects. In general, a minimum of four weeks of regular IMT, usually performed twice daily for at least 5 days per week at 50-70% of the maximum inspiratory pressure (MIP), is required for improvement in respiratory muscle strength (McConnell, 2013). Moderate- to high-intensity IMT (∼60% MIP) can increase maximal contraction velo- city and inspiratory muscle strength. Faghy & Brown (2016) reported that six weeks of IMT performed twice daily increased the maximal inspiratory pressure at rest by 31% and significantly attenuated the cardiovascular and perceptual responses to 60 minutes of walking with a 25-kg backpack at a steady pace, while improving perfor- mance by 8% during high-intensity timed runs. Because the relative intensity of their IMT protocol was kept constant at 50% of the maximal inspiratory muscle pressure, we hypothesize that even higher training effects can be achieved with a more progressive inspiratory resistance protocol. The progressivity of inspiratory resistance is likely to be of critical importance for training individuals with high levels of physical fitness, such as members of military special forces. The aim of our study was therefore to investigate the effects of six weeks of IMT with progressive breathing resistance in members of military special forces on respi- ratory muscle strength and endurance, heart rate response and the perception of effort when walking with a heavy backpack. METHODS We conducted a controlled prospective intervention study on a sample of members of the Special Unit of the Slovenian Army (SOU SA). The study was approved by the Medical Ethics Committee of the Republic of Slovenia (No. 0120-494/2017/7), the Ministry of Defence of the Republic of Slovenia and the General Staff of the Slovenian Army. Study Sample All the potential SOU SA candidates were first given important information regar- ding the purpose and procedure of the study. Twenty male (mean age: 32.2 ± 3.4 years, age range: 27-38 years) members of the SOU SA site completed a questionnaire on their general health and signed a declaration in which they volunteered to participate in the study. Exclusion criteria for the subjects were cardiovascular, respiratory or me- 9 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Monika JERUC TANŠEK, Andrej ŠVENT, Alan KACIN: EFFECTS OF INSPIRATORY MUSCLE TRAINING ON PHYSICAL PERFORMANCE ..., 5–21 tabolic diseases, a history of peripheral or central thromboembolism, radiculopathy or other peripheral neurological disorders of the lower limbs. Assessment of General Fitness The assessment of general physical fitness was based on regular military tests per- formed by the subjects in the three months prior to the start of the study. The tests included two minutes of push-ups, two minutes of abdominal crunches and a fast run of 3200 meters. The result achieved by the subject in each test task was converted into points using a motor test scoring system defined by gender and age categories (Ivšek & Pograjc, 2014). Study Design The twenty subjects were randomly divided by lot into two groups of equal size. The experimental group (EG) performed a six-week IMT program with a breathing device that provided a progressive increase in inspiratory resistance. The placebo group (PG) performed the same program with a device that did not add inspiratory resistance but had a virtual resistance regulator installed. Both groups were tested before and after the completion of the six-week IMT program, as described below. Tests and Measurements All the tests and measurements were carried out in the sports hall of Vojašnica Ed- varda Peperka, Moste-Polje Ljubljana. On the day of the test, the subjects ate a small meal two to three hours before the exercise and abstained from coffee or alcoholic beverages for at least 24 hours before the exercise. The subjects were familiarised with all the tests and measurement protocols before the first data collection. Heart Rate and Aerobic Capacity The subjects were placed in a stationary, semi-recumbent position on the exami- nation table for 10 minutes and their heart rate was measured using a monitor with a chest strap (Polar M430 POLAR Electro, Europe AG, Val-de-Travers, Switzerland). The Polar Fitness Test™, which assesses a person’s maximum oxygen consumption (V̇O2max) based on resting heart rate variability, gender, age, height, body weight and self- assessed physical activity level, was used to assess aerobic capacity. 10 Monika JERUC TANŠEK, Andrej ŠVENT, Alan KACIN: EFFECTS OF INSPIRATORY MUSCLE TRAINING ON PHYSICAL PERFORMANCE ..., 5–21 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Respiratory Muscle Strength and Fatigue Measurements were taken using an inspiratory and expiratory MicroRPM® pressure measurement device (VYAIRE Medical Inc., Illinois, USA). Respiratory muscle strength was measured using the maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) in cm H2O (Faghy & Brown, 2016). The MIP measurement was derived from the residual volume (maximal expiration) and the MEP measurement of the total lung capacity (maximal inspiration). Each measurement was taken five times. The minimum and maximum values were excluded and the average of the remaining three measurements was calculated (McConnell, 2013). The respira- tory muscle fatigue was determined from the difference (∆) between the MIP and MEP values obtained before (pretest) and immediately after (posttest) the 60-minute walking test. Walking Test with a Backpack Before the 60-minute walking test, the subjects put on a military backpack (V2 Plus System, Tasmanian Tiger GmbH, Dasing, Germany) that was evenly filled with a 25-kg load. Each subject adjusted and fastened the straps of the backpack individu- ally before performing the test. The subjects completed the 60-minute walking test on a leveled Technogym Skillrun™ treadmill (Technogym, Cesena, Italy). Before they started walking, subjective ratings of overall perceived exertion (RPE) were assessed using the 15-item RPE scale and respiratory effort was assessed using the CR10 RPE scale (Borg, 1982). The heart rate was measured and recorded continuously during the test. The test began with a three-minute warm-up period so that the subjects gradually reached a target speed of 6.5 km/h, which they then maintained for 60 minutes (Faghy et al., 2016). Every ten minutes, the subjects rated the overall physical effort and respi- ratory effort. After completing the test, the subjects removed their backpacks, cooled down by walking slowly on a treadmill for 5 minutes, and then rested under control for another 20 minutes. Inspiratory Muscle Training Intervention The experimental group (n=10; EG) exercised with the POWERbreathe® (medium resistance) inspiratory muscle strengthening device (Powerbreathe International Ltd., Southam, UK) with an initial resistance of 60% MIP. The placebo group (n=10; PG) performed the same IMT program using the same respirator with the internal inspira- tory valve removed, minimizing the respiratory resistance. Every two weeks, the sub- jects’ MIP was measured again and inspiratory resistance was adjusted accordingly with an additional 10% increase to reach the final training target of 80% MIP. The MIP was reassessed in PG at the same time points and the breathing resistance was adjusted 11 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Monika JERUC TANŠEK, Andrej ŠVENT, Alan KACIN: EFFECTS OF INSPIRATORY MUSCLE TRAINING ON PHYSICAL PERFORMANCE ..., 5–21 virtually. All subjects performed 30 consecutive maximal breaths twice daily. Each maximal inspiration was followed by an active forced expiration to expiratory residual volume (McConnell, 2011). Both groups kept an exercise diary that encouraged them to perform IMT regularly; compliance with the program was checked weekly by the investigators The POWERbreathe® respirator works on the principle of suprathreshold inspiratory loading. This requires the subject to generate an inspiratory pressure that exceeds the pressure threshold set on the device in order to open the inspiratory valve. The inspiratory threshold is increased by tensioning the spring attached to the air valve of the device. The advantage of suprathreshold loading is that the increase in inspiratory resistance does not affect the actual airflow through the unit. Furthermore, the load re- sistance can be assessed objectively (McConnell 2011; McConnell, 2013). Statistical Analysis and Data Processing The normality of the data distribution was analyzed using the Shapiro-Wilk test, which showed the adequacy of the parametric tests. The effect of training was assessed by comparing the mean values of heart rate and maximum respiratory pressures me- asured at rest prior to the 60-minute walk test (pretest), before and after the six-week IMT period. The effect of IMT on fatigue during walking was assessed by comparing the heart rate and RPE at the end of the walking (posttest) and ∆ MIP and ∆ MEP. The means were compared using the independent samples t-test and the two-way factorial ANOVA (group × time) with repeated measures for the time factor. If the factor interac- tion was statistically significant, a pairwise comparison was performed using Tukey’s HSD post-hoc test. The threshold for statistical significance was set at p < 0.05 for all analyses. Results are presented as means ± standard deviations unless otherwise stated. RESULTS Subjects from EG and PG did not differ significantly in age, anthropometric charac- teristics, general physical fitness, and aerobic capacity. The detailed analysis of group characteristics is shown in Table 1. 12 Monika JERUC TANŠEK, Andrej ŠVENT, Alan KACIN: EFFECTS OF INSPIRATORY MUSCLE TRAINING ON PHYSICAL PERFORMANCE ..., 5–21 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Table 1: Comparison of the basic subjects’ characteristics across groups. EG PG p-value Age (years) 33.3 ± 4.1 31.2 ± 2.8 0.258 Body height (cm) 180.6 ± 7.4 179.3 ± 4.5 0.641 Body weight (kg) 85.7 ± 5.6 82.7 ± 5.6 0.246 BMI (kg/m2) 26.4 ± 2.3 25.6 ± 2.8 0.396 3200 m run (min) 13.3 ± 1.1 13.2 ± 1.1 0.843 Abdominal crunches (no./2 min) 87.3 ± 9.3 86.4 ± 9.0 0.843 Push-ups (no./2 min) 81.5 ± 7.2 79.4 ± 8.1 0.547 V̇O2max (ml/kg/min) 47.8 ± 3.08 49.3 ± 2. 79 0.485 EG – experimental group; PG – placebo group; BMI – body mass index; 2max – maximal pulmonary oxygen consumption Respiratory Muscle Strength The interaction of factors during the six-week IMT was significant (p < 0.001) for the pretest MIP. The pretest MIP increased significantly (p < 0.001) in the EG by 63 ± 15 cm H2O (47 ± 13%) after training. There was no significant change (p = 0.162) in the pretest MIP in the PG after training. The pretest MIP was significantly higher (p < 0.001) in the EG after training (Figure 1). The interaction of factors during the six weeks of IMT was significant (p < 0.001) for the posttest MIP. The posttest MIP increased significantly (p < 0.001) in the EG by 71 ± 20 cm H2O (58 ± 20%) after training. There was no significant change (p = 0.306) in the posttest MIP in the PG after training. The posttest MIP was significantly higher (p < 0.001) in the EG after training (Figure 2) 13 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Monika JERUC TANŠEK, Andrej ŠVENT, Alan KACIN: EFFECTS OF INSPIRATORY MUSCLE TRAINING ON PHYSICAL PERFORMANCE ..., 5–21 *** indicates the pretest to posttest difference in the EG at p < 0.001. ### indicates the difference between the groups at p < 0.001. Figure 1: Comparison of the mean (standard deviation) maximum inspiratory pressure (MIP) measured before the 60-minute walk test between the experimental group (EG) and the placebo group (PG) before and after the inspiratory muscle training program. *** indicates the pretest to posttest difference in the EG at p < 0.001. ### indicates the difference between the groups at p < 0.001. Figure 2: Comparison of the mean values (standard deviation) of the maximum inspira- tory pressure (MIP) measured after the 60-minute walk test between the experimental group (EG) and the placebo group (PG) before and after the inspiratory muscle train- ing program. EG before EG after PG before PG after EG before EG after PG before PG after 14 Monika JERUC TANŠEK, Andrej ŠVENT, Alan KACIN: EFFECTS OF INSPIRATORY MUSCLE TRAINING ON PHYSICAL PERFORMANCE ..., 5–21 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 The interaction of factors during six weeks of IMT was not significant for the pretest MIP (p = 0.556) and the posttest MIP (p = 0.279) (Figures 3 and 4). Figure 3: Comparison of the mean (standard deviation) maximum expiratory pressure (MEP) measured before the 60-minute walk test between the experimental group (EG) and the placebo group (PG) before and after the inspiratory respiratory muscle train- ing program. Figure 4: Comparison of the mean (standard deviation) maximum expiratory pressure (MEP) measured after the 60-minute walk test, between the experimental group (EG) and the placebo group (PG) before and after the inspiratory respiratory muscle train- ing program. EG before EG after PG before PG after EG before EG after PG before PG after 15 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Monika JERUC TANŠEK, Andrej ŠVENT, Alan KACIN: EFFECTS OF INSPIRATORY MUSCLE TRAINING ON PHYSICAL PERFORMANCE ..., 5–21 Respiratory Muscle Fatigue The interaction of factors during the six-week IMT was also significant (p < 0.001) for ∆ MIP during the 60-minute walk test. The ∆ MIP decreased (p < 0.01) from -12 ± 4 cmH2O before the training to -4 ± 4 cmH2O afterward. In contrast, the ∆ MIP in PG before (-12 ± 3 cmH2O) and after (-12 ± 4 cmH2O) the training was no different (p = 0.991). The ∆ MIP after IMT was significantly lower in EG (p < 0.001). The interaction of the factors for ∆ MEP during the 60-min walk test was also sig- nificant (p < 0.01). The ∆ MEP decreased from -15 ± 5 cmH2O before the training to -7 ± 5 cmH2O afterward. In contrast, the ∆ MIP in the PG before (-19 ± 7 cmH2O) and after (-16 ± 4 cmH2O) the training was no different (p = 0.549). The ∆ MEP after IMT was significantly lower in EG (p < 0.01). Heart Rate and Perceived Exertion The interaction of the factors during the six-week IMT was not significant for the heart rate (p = 0.215), respiratory effort (p = 0.327), and overall body exertion (p = 0.644) (Figure 5). 16 Monika JERUC TANŠEK, Andrej ŠVENT, Alan KACIN: EFFECTS OF INSPIRATORY MUSCLE TRAINING ON PHYSICAL PERFORMANCE ..., 5–21 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Figure 5. The mean (standard deviation) heart rate response (A) and ratings of overall body effort (B) and respiratory effort (C) during the 60-minute walk test before and after the six-week program of inspiratory muscle training for the experimental (EG) and placebo groups (PG). 17 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Monika JERUC TANŠEK, Andrej ŠVENT, Alan KACIN: EFFECTS OF INSPIRATORY MUSCLE TRAINING ON PHYSICAL PERFORMANCE ..., 5–21 DISCUSSION The main objective of the present study was to evaluate the effects of six weeks of IMT with progressive inspiratory resistance in members of military special forces on respiratory muscle strength and endurance, heart rate response and the perception of exertion when walking with a heavy backpack. The results show that the experimental group increased inspiratory muscle strength (MIP) by 47% as a result of the training, while there was no effect on the expiratory muscle strength (MEP). In addition, a si- gnificant reduction in inspiratory and expiratory fatigue during the 60-minute walk test with a 25-kg backpack was found in the experimental group, but this was not reflected in the RPE or HR values during the test. In contrast, there was no significant improve- ment in any of the measured physiological parameters in the placebo group. Thus, our results fully confirm the findings of the meta-analysis on the effects of IMT in various types of athletes (Karsten, Ribeiro, Esquivel & Matte, 2018) and highlight the impor- tance of the progressivity and specificity of breathing resistance for optimal training adaptation (McConnell, 2011). A direct comparison with the results of the methodologically most similar study by Faghy and Brown (2016) confirms our initial assumption that progressive inspira- tory resistance further enhances the effects of IMT. Indeed, Faghy and Brown (2016) achieved a 31% increase in MIP in the pretest and 19% in the posttest after six weeks of IMT in moderately physically fit healthy subjects, while our study achieved a 47% increase in MIP in the pretest and as much as 58% in the posttest in very physically fit subjects during the same training period. The training effect was substantially higher in our subjects despite their higher baseline level of physical fitness. IMT also had a positive effect on the endurance of the respiratory muscles of the experimental group. The initial inspiratory and, interestingly, expiratory fatigue indu- ced by the 60-minute walk test were reduced by 8 cmH2O. However, these changes were too small to reduce the subjective ratings of whole-body exertion or respiratory effort. Considering that the weight of a backpack is critical to respiratory fatigue under given exercise conditions, the weight of the backpack in our study appears to have been too low to cause noticeable respiratory fatigue and impair physical performance. Indeed, Dominelli, Sheel and Foster (2012) have shown that a backpack weighing less than 35 kg has no effect on respiratory mechanics and thus on the demand for respi- ratory effort during short periods of walking. Consistent with this, Shei, Chapman, Gruber & Mickleborough (2017) reported that six weeks of flow-resistive IMT impro- ved physical performance in recreational athletes but did not attenuate diaphragmatic fatigue during constant-load running to volitional exhaustion with a 10-kg backpack. Indeed, Faghy and Brown (2014a; 2014b) have shown that prolonged low-intensity physical activity with a backpack weighing less than 25 kg does not cause premature fatigue of the inspiratory respiratory muscles, although it does cause certain changes in the cardiovascular and metabolic responses and perceived physical exertion. They also highlight other factors that may mitigate premature inspiratory respiratory muscle fati- gue, namely previous regular exercise, male gender, higher body mass, higher skeletal 18 Monika JERUC TANŠEK, Andrej ŠVENT, Alan KACIN: EFFECTS OF INSPIRATORY MUSCLE TRAINING ON PHYSICAL PERFORMANCE ..., 5–21 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 muscle strength and higher aerobic capacity (Faghy & Brown, 2014a; Faghy & Brown, 2014b). All of these factors were present in our subjects, which most likely contributed to the low perceived respiratory muscle fatigue during the 60-minute walking test. Re- spiratory muscle fatigue due to the altered movement mechanics and excessive load on the chest when carrying a heavy backpack is clearly progressive (Butcher, et al., 2006; Faghy & Brown, 2014a; Faghy & Brown 2014b), so training-induced increases in re- spiratory muscle strength cannot completely prevent it. Wearing a backpack also requi- res a greater activity of the abdominal diaphragm to stabilize the thoracolumbar spine, which further accelerates diaphragm fatigue and worsens the mechanics and economy of breathing. It is therefore not surprising that IMT can also improve postural control when carrying loads and consequently reduce lower back pain (Janssens et al., 2015). The main limitation of our study protocol was that it failed to produce detectable changes in the heart rate and ratings of perceived physical and respiratory exertion be- tween the experimental and placebo groups. The most likely reason for this is that the intensity of the 60-minute walk test or the weight of the backpack was too low for the given population sample. To effectively stress the respiratory muscles, subjects must be exposed to a combination of prolonged moderate- to high-intensity physical activity while carrying a backpack weighing at least 25 kg. A two-stage testing protocol, such as that used by Faghy and Brown (2016), or a multi-stage protocol with progressive walking speeds and treadmill incline, such as that used by Armstrong, Ward, Lomax, Tipton, and House (2019), would most likely be more appropriate The recommended intensity of IMT is between 50 and 70 per cent of the MIP, exercise duration is up to 30 breathing cycles and exercise frequency is twice daily, every day per week (McConnell, 2013). To optimize the training protocol for the ne- eds of our study, we considered the basic principles of physical training: progressive overload and specificity. The progressivity of exercise overload is primarily achieved through incremental intensity (resistance), but increasing the time and frequency of exercise can have an additional effect. In our study, we only ensured the progressivity of the overload during the six-week training period by increasing intensity, i.e. by increasing the inspiratory resistance threshold on the respirator by 10% every two weeks. It could be that an additional modulation of the breathing exercise time, i.e. the number of breathing cycles, would further improve the training effect, especially the endurance of the inspiratory muscles. This should be tested in future studies. On the other hand, an additional increase in daily exercise frequency would not be feasi- ble in our subjects, as performing IMT twice a day, seven days a week, was already at the upper limit of their busy daily schedule. CONCLUSION The aim of this study was to determine whether six weeks of IMT could increase the strength and endurance of the respiratory muscles, thereby delaying their fatigue when carrying a backpack during physical activity. The IMT protocol used in previ- 19 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Monika JERUC TANŠEK, Andrej ŠVENT, Alan KACIN: EFFECTS OF INSPIRATORY MUSCLE TRAINING ON PHYSICAL PERFORMANCE ..., 5–21 ous studies was improved on by progressively increasing the inspiratory resistance to ensure a more optimal overload of the respiratory muscles. Our results show that MIT significantly increases inspiratory strength and reduces muscle fatigue during a 60-mi- nute walk with a 25-kg backpack. However, the positive changes in inspiratory pressure were not reflected in the perception of whole-body exertion and respiratory effort or in cardiovascular responses. Various groups of physically demanding occupations (e.g. military, firefighters, rescue workers, etc.), as well as people engaged in recreational activities that involve carrying heavy backpacks (hikers, alpinists, skiers, etc.), could benefit from MIT. Acknowledgments We would like to thank the Ministry of Defence of the Republic of Slovenia and the Slovenian Army for their support and logistical assistance in our study. Our special thanks go to the former Major General of the Slovenian Army Dr Andrej Osterman. We would also like to thank the management of Vojašnica Edvarda Peperka, Moste-Polje Ljubljana, for allowing us to use their sports hall for tests and measurements. Above all, we would like to thank all the test subjects who participated in the study, i.e. the members of the Special Operations Unit of the Slovenian army. REFERENCES Armstrong, N. C. D., Ward, A., Lomax, M., Tipton, M. J. & House, J. R. (2019) Wear- ing body armour and backpack loads increase the likelihood of expiratory flow limita- tion and respiratory muscle fatigue during marching. Ergonomics, 62(9), 1181–1192. https://doi.org/10.1080/00140139.2019.1629638. Borg, G. A. V. (1982). Psychophysical bases of perceived exertion. Medicine & Science in Sports & Exercise 14 (5), 377−381. https://doi.org/10.1249/00005768-198205000- 00012. Butcher, S. J., Jones, R. L., Eves, N. D., & Petersen, S. R. (2006). Work of breathing is increased during exercise with the self-contained breathing apparatus regulator. Ap- plied Physiology, Nutrition, and Metabolism 31(6), 693−701. https://doi.org/10.1139/ h06-073. Dempsey, J. A., Romer, L. M., Rodman, J., Miller, J., & Smith, C. (2006). Consequences of exercise-induced respiratory muscle work. Respiratory Physiology & Neurobiology, 151(2/3), 242–250. https://doi.org/10.1016/j.resp.2005.12.015. Dominelli, P. B., Sheel, A. W., & Foster G. E. (2012). Effect of carrying a weighted back- pack on lung mechanics during treadmill walking in healthy men. European Journal of Applied Physiology, 112(6), 2001–2012. https://doi.org/10.1007/s00421-011-2177-8. Eves, N. D., Jones, R. L., & Petersen, S. R. (2005). The influence of the self-contained breathing apparatus (SCBA) on ventilatory function and maximal exercise. Canadian Journal of Applied Physiology 30(5), 507−519. https://doi.org/10.1139/h05-137. 20 Monika JERUC TANŠEK, Andrej ŠVENT, Alan KACIN: EFFECTS OF INSPIRATORY MUSCLE TRAINING ON PHYSICAL PERFORMANCE ..., 5–21 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Faghy, M., Blacker, S., & Brown, P. I. (2016). Effects of load mass carried in a backpack upon respiratory muscle fatigue. European Journal of Sport Science, 16(8), 1032−1038. https://doi.org/10.1080/17461391.2016.1202326. Faghy, M. A., & Brown, P. I. (2014a). Preloaded time-trial to assess load carriage perfor- mance. Journal of Strength and Conditioning Research, 28(12), 3354–3362. https://doi. org/10.1519/JSC.0000000000000555. Faghy, M. A., & Brown, P. I. (2014b). Thoracic load carriage-induced respiratory mus- cle fatigue. European Journal of Applied Physiology, 114(5), 1085–1093. https://doi. org/10.1007/s00421-014-2839-4. Faghy, M. A., & Brown, P. I. (2016). Training the inspiratory muscles improves running performance when carrying a 25 kg thoracic load in a backpack. European Journal of Sport Science, 16(5), 585−594. https://doi.org/10.1080/17461391.2015.1071878. Fernández-Lázaro, D., Gallego-Gallego, D., Corchete, L. A., Fernández Zoppino, D., González-Bernal, J. J., García Gómez, B., & Mielgo-Ayuso, J. (2021). Inspiratory muscle training program using the PowerBreathe®: does it have ergogenic potential for respiratory and/or athletic performance? A systematic review with meta-analysis. In- ternational Journal of Environmental Research and Public Health, 18(13), 6703−6710. https://doi.org/10.3390/ijerph18136703. Griffiths, L. A., & McConnell, A. K. (2007). The influence of inspiratory and expiratory muscle training upon rowing performance. European Journal of Applied Physiology, 99(5), 457−466. https://doi.org/10.1007/s00421-006-0367-6. HajGhanbari, B., Yamabayashi, C., Buna, T. R., Coelho, J. D., Freedman, K. D., Mor- ton, T. A., ... Reid, W. D. (2013). Effects of respiratory muscle training on performance in athletes: a systematic review with meta-analyses. Journal of Strength and Condition- ing Research, 27(6), 1643−1663. https://doi.org/10.1519/JSC.0b013e318269f73f. Harms, C. A., Babcock, M. A., McClaran, S. R., Pegelow, D. F., Nickele, G. A., Nelson, W. B., Dempsey, J. A. (1997). Respiratory muscle work compromises leg blood flow during maximal exercise. Journal of Applied Physiology, 82(5), 1573–1583. https://doi. org/10.1152/jappl.1997.82.5.1573. Illi, S. K., Held, U., Frank, I., Spengler, C. M. (2012). Effect of respiratory muscle training on exercise performance in healthy individuals: a systematic review and meta-analysis. Sports Medicine 42(8), 707−724. https://doi.org/10.1007/BF03262290. Ivšek, C., & Pograjc, L. (2014). Priročnik splošne kondicijske priprave [General fitness training manual](pp. 6−64). Ljubljana: Center vojaških šol. Janssens, L., McConnell, A. K., Pijnenburg, M., Claeys, K., Goossens, N., Lysens, R., ... Brumagne, S. (2015). Inspiratory muscle training affects proprioceptive use and low back pain. Medicine & Science in Sports & Exercise 47(1), 12–19. https://doi. org/10.1249/MSS.0000000000000385. Johnson, M. A., Sharpe, G. R., & Brown, P. I. (2007). Inspiratory muscle training im- proves cycling time-trial performance and anaerobic work capacity but not critical pow- er. European Journal of Applied Physiology, 101(6), 761–770. https://doi.org/10.1007/ s00421-007-0551-3. Karsten, M., Ribeiro, G. S., Esquivel, M. S., & Matte, D. L. (2018). The effects of in- spiratory muscle training with linear workload devices on the sports performance and cardiopulmonary function of athletes: A systematic review and meta-analysis. Physical Therapy in Sport, 34, 92–104. https://doi.org/10.1016/j.ptsp.2018.09.004. 21 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Monika JERUC TANŠEK, Andrej ŠVENT, Alan KACIN: EFFECTS OF INSPIRATORY MUSCLE TRAINING ON PHYSICAL PERFORMANCE ..., 5–21 Knapik, J., Harman, E. A., Steelman, R. A., & Graham, B. S. (2012). A systema- tic review of the effects of physical training on load carriage performance. Journal of Strength and Conditioning Research, 26(2), 585–597. https://doi.org/10.1519/ JSC.0b013e3182429853. McConnell A. K. (2011). Breathe strong perform better. USA. Human Kinetics. McConnell, A. K. (2013). Respiratory muscle training: theory and practice. Edinburgh, Churchill Livingstone: Elsevier. Romer, L. M., McConnell, A. K., & Jones, D. A. (2002). Inspiratory muscle fatigue in trained cyclists: Effects of inspiratory muscle training. Medicine & Science in Sports & Exercise 34(5), 785–792. https://doi.org/10.1097/00005768-200205000-00010. Romer, L. M., & Polkey, M. I. (2008). Exercise-induced respiratory muscle fatigue: im- plications for performance. Journal of Applied Physiology, 104(3), 879–888. https://doi. org/10.1152/japplphysiol.01157.2007. Sales, A. T., Fregonezi, G. A., Ramsook, A. H., Guenette, J. A., Lima, I. N., & Reid, W. D. (2016). Respiratory muscle endurance after training in athletes and non-athletes: a systematic review and meta-analysis. Physical Therapy in Sport, 17(January), 76–86. https://doi.org/10.1016/j.ptsp.2015.08.001. Shei, R. J., Chapman, R. F., Gruber, A. H., Mickleborough, T. D. (2017). Respiratory effects of thoracic load carriage exercise and inspiratory muscle training as a strategy to optimize respiratory muscle performance with load carriage. Springer Science Reviews, 5(1-2), 49−64. https://doi.org/10.1007/s40362-017-0046-5. Tong, T. K., Fu, F. H., Chung, P., Eston, R., Lu, K., Quach, B., … So, R. (2008). The effect of inspiratory muscle training on high-intensity, intermittent running performance to exhaustion. Applied Physiology, Nutrition, and Metabolism, 33(4), 671−681. https:// doi.org/10.1139/H08-050. Verges, S., Lenherr, O., Haner, A. C., Schulz, C., & Spengler, C. M. (2007). Increased fatigue resistance of respiratory muscles during exercise after respiratory muscle endur- ance training. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 292(3), R1246–R1253. https://doi.org/10.1152/ajpregu.00409.2006. Yañez-Sepulveda, R., Alvear-Ordenes, I., Tapia-Guajardo, A., Verdugo-Marchese, H., Cristi-Montero, C., & Tuesta, M. (2021). Inspiratory muscle training improves the swimming performance of competitive young male sprint swimmers. The Journal of Sports Medicine and Physical Fitness, 61(10),1348−1353. https://doi.org/10.23736/ S0022-4707.21.11769-4. ANNALES KINESIOLOGIAE • 13 • 2022 • 1 23 Original scientific article DOI: https://doi.org/10.35469/ak.2022.308 received: 2021-11-30 UDC: 613.25-053.2-056.34: 616-036.21 BODY MASS INDEX CHANGES IN CHILDREN AND ADOLESCENTS WITH INTELECTUAL DISABILITY DURING THE COVID-19 PANDEMIC Nika ŠUC1, Blaž LEŠNIK2 1 Center Janez Levec Ljubljana, Slovenia 2 Faculty of Sport, University of Ljubljana, Slovenia Corresponding author: Nika ŠUC Center Janez Levec Ljubljana, Karlovška 18, 1000 Ljubljana, Slovenia Tel.: +386 41 805 033 E-mail: nika_suc@yahoo.com ABSTRACT Introduction: Intellectual disability (ID) is a generalized neurodevelopmental dis- order characterized by significantly impaired intellectual and adaptive functioning. Body mass index (BMI) is a value derived from the mass (weight) and height of a per- son. Due to the COVID-19 pandemic, there was a lockdown of all schools and other daily sport activities. Methods: We measured the height and weight of 100 children and adolescents with intellectual disabilities. The measurements were taken in September 2020 and then six months later, in March 2021. The calculated BMI was transformed into age- and sex-standardized values (zBMI). Mean BMI and zBMI were compared over time and between sexes using a paired t-test and two-way mixed analysis of variance (ANOVA). The effect size was estimated using Cohen’s d. Results: On average across all groups, BMI increased by 0.5kg/m2 in the studied period. The increase in mean BMI was statistically significant for both groups of girls; the difference between girls and boys in BMI increase was marginally statistically sig- nificant. The analysis of zBMI confirmed that the observed changes were likely not simply a consequence of maturation. Discussion: One effect of the COVID-19 pandemic and restrictions related to it was the increase in BMI values in children and youth. With our results, we can relate this data also to the population with ID. Although we have provided intervention programs and encouraged pupils and their parents to be more physically active during lockdown, 24 Nika ŠUC, Blaž LEŠNIK: BODY MASS INDEX CHANGES IN CHILDREN AND ADOLESCENTS WITH INTELECTUAL DISABILITY ..., 23–33 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 the importance of school and after-school activities regarding physical fitness status is clearly evident. Keywords: body mass index, youth with intellectual disability, COVID-19 pandemic INDEKS TELESNE MASE PRI OTROCIH IN MLADOSTNIKIH Z MOTNJO V DUŠEVNEM RAZVOJU MED EPIDEMIJO COVIDA-19 IZVLEČEK Uvod: Motnja v duševnem razvoju je motnja, za katero je značilna pomembna ome- jitev tako intelektualnega delovanja kot prilagojenega vedenja, ki se kaže v pojmovnih, socialnih in praktičnih spretnostih prilagajanja. Indeks telesne mase (ITM) je antropo- loška mera, ki je definirana kot telesna masa v kilogramih, deljena s kvadratom telesne višine v metrih. V času pandemije COVID-19 je bilo uvedeno popolno zaprtje šol in ostalih dnevnih prostočasnih aktivnosti. Metode: Septembra 2020 in ponovno marca 2021 smo izmerili maso in višino 100 mladostnikov z motnjo v duševnem razvoju,. Izračunane vrednosti ITM smo pretvorili v standardizirane (zITM) glede na starost in spol. Za primerjavo povprečja ITM in zITM med skupinami in skozi čas, smo uporabili test t in analizo variance, velikost učinka pa smo ocenili s Cohenovim d. Rezultati: V povprečju se je ITM zvišal za 0,5 kg/m2. Povečanje ITM je bilo statistič- no značilno pri obeh skupinah deklet; razlika med deklicami in dečki v povečanju pov- prečnega ITM je bila mejno statistično značilna. Analiza zITM je pokazala, da opažene spremembe po vsej verjetnosti niso bile zgolj posledica telesnega razvoja. Razprava: Ena izmed posledic pandemije in restrikcij povezanih z njo, je tudi zvi- šanje ITM pri otrocih in mladostnikih. Z našimi rezultati lahko pokažemo, da se je ITM zvišal tudi pri osebah z motnjami v duševnem razvoju. Kljub interventnim programom med zaprtjem šol in spodbujanju učencev in staršev k večji aktivnosti, lahko vidimo kako pomembne so šolske in obšolske dejavnosti za razvoj in ohranjanje normalne telesne teže. Ključne besede: indeks telesne mase, mladostniki z motnjo v duševnem razvoju, pandemija COVID-19 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 25 Nika ŠUC, Blaž LEŠNIK: BODY MASS INDEX CHANGES IN CHILDREN AND ADOLESCENTS WITH INTELECTUAL DISABILITY ..., 23–33 INTRODUCTION Intellectual disability affects about 1% of the population, and of those about 85% have mild intellectual disability (Schalock, Luckasson, & Tasse, 2021). Males are more likely to be diagnosed with intellectual disabilities than females. Intellectual disability is identified by problems in both intellectual and adaptive functioning (Schaepper, Hau- ser, & Kagadkar 2021). A full-scale IQ score of around 70 to 75 indicates a significant limitation in intellectual functioning. However, the IQ score must be interpreted in the context of the person’s difficulties regarding general mental abilities. Three areas of adaptive functioning are considered: Conceptual – language, reading, writing, math, re- asoning, knowledge, and memory; Social – empathy, social judgment, communication skills, the ability to follow rules and the ability to make and keep friendships; Practical – independence in areas such as personal care, job responsibilities, managing money, recreation, and organizing school and work tasks (Golubović, Maksimović, Golubović, & Glumbić, 2012). Adaptive functioning is assessed through standardized measures with the individual and interviews with others, such as family members, teachers, and caregivers. Intellectual disability is identified as mild (most people with intellectual disability are in this category), moderate or severe. The symptoms of intellectual disa- bility begin during childhood; delays in language or motor skills may be seen by the age of two, but mild levels of intellectual disability may not be identified until school-going age. Intellectual disability can be associated with a genetic syndrome, such as Down syndrome or Fragile X syndrome; it may develop following an illness such as menin- gitis, whooping cough or measles; it may result from head trauma during childhood; or it may result from exposure to toxins such as lead or mercury. Other factors that may contribute to intellectual disability include brain malformation, maternal disease, environmental influences (alcohol, drugs, or other toxins), labor- and delivery-related events, infection during pregnancy, and problems at birth. Individuals with intellectual disabilities are at higher risk for health disparities including being overweight and obe- se; however, little is known at the population level about the BMI status of children and youth with intellectual disabilities (Lloyd, Foley, & Temple, 2014). The body mass index (BMI) is defined as the body mass divided by the square of the body height (expressed in kg/m2). It is a convenient rule-of-thumb to broadly categorize a person as underweight, normal weight, overweight, or obese based on tissue mass (muscle, fat, and bone) and height. Major adult BMI classifications are underweight (under 18.5kg/m2), normal weight (18.5 to 24.9), overweight (25 to 29.9), and obese (30 or more). When used to predict an individual’s health, rather than as a statistical measurement for groups, the BMI has limitations that can make it less useful than some of the alternatives, especially when applied to individuals with abdominal obesity, short stature, or unusually high muscle mass (Temple, Foley, & Lloyd, 2014). People with BMIs under 20 and over 25 have been associated with higher all-cause mortality, with the risk increasing with distance from the 20–25 range. BMI is used differently for chil- dren. It is calculated in the same way as for adults but then compared to typical values for other children of the same age. Instead of comparison against fixed thresholds for 26 Nika ŠUC, Blaž LEŠNIK: BODY MASS INDEX CHANGES IN CHILDREN AND ADOLESCENTS WITH INTELECTUAL DISABILITY ..., 23–33 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 underweight and overweight, the BMI is compared against the percentiles for children of the same sex and age (Ptomey et al., 2020). A BMI that is less than the 5th percentile is considered underweight and above the 95th percentile is considered obese. Children with a BMI between the 85th and 95th percentile are considered overweight. Obesity is a major health concern due to its increasing prevalence, particularly in people with intellectual disabilities. There has been a marked increase in the proportion of adults who were obese, from 13.2% in 1993 to 26.0% in 2013 for men, and from 16.4% to 23.8% for women (Health & Social Care Information Centre, March 2015). This is a cause of significant concern as obesity in turn increases the attributable risk for diabetes, cancer, and cardiovascular disease (Guh et al., 2009). Another cross-sectional study suggested a higher prevalence of obesity in people with intellectual disabilities when compared with the general population. The gender ratio showed that 39.3% of women and 27.8% of men with intellectual disability were obese compared to 25.1% of women and 22.7% of men in the general population (Melville et al., 2008). The coronavirus disease 2019 (COVID-19) has an impact on physical activity (PA) behaviors worldwide. People around the world stayed at home and self-isolated, due to the lockdown policy. Although a lockdown is considered essential and the best rec- ommendation for preventing the spread of the disease, it may create new challenges. Staying at home for a prolonged period can lead to disturbing consequences, such as weight gain, social isolation and may also cause a reduction in PA levels. The decrease in PA levels may be especially apparent among active individuals habitually practic- ing sports. Diminished PA resulting from home isolation may worsen a wide range of health conditions, including chronic ones, such as cardiac and metabolic diseases as well as infectious diseases, due to negative immune-modulation even without substan- tial weight gain. Therefore, maintaining an active lifestyle at home, including mainly PA, is extremely important for the general population’s health, especially for people with additional risk factors, including older adults, during the quarantine (Dor-Haim, Katzburg, Revach, Levine, & Barak, 2021). In relation to the facts outlined above, the aim of our observational study was to estimate the impact of COVID-19 and associated lockdown policy on the BMI of chil- dren and adolescents with intellectual disabilities in Slovenia. METHODS We measured the height and weight of 100 children and adolescents with moderate intellectual disability. They constituted a convenience sample of students of a special education center where the first author works. The sample consisted of 23 girls aged 6–14 years, 19 girls aged 15–26 years, 32 boys aged 6–14 years, and 28 boys aged 15–26 years. The measurements were performed by the first author in September 2020 and then after six months, in March 2021, as part of regular physical education lessons. In the period between both measurements, the school was closed for 10 weeks due to the ANNALES KINESIOLOGIAE • 13 • 2022 • 1 27 Nika ŠUC, Blaž LEŠNIK: BODY MASS INDEX CHANGES IN CHILDREN AND ADOLESCENTS WITH INTELECTUAL DISABILITY ..., 23–33 COVID-19 pandemic. We calculated the BMI of all participants in both periods, and standardized the values based on age (in months) and sex, thus obtaining zBMI values according to WHO guidelines (World Health Organization, 2007). For the 17 partici- pants aged 20 to 26 years, the standards for 19-year-olds were used (which are practi- cally identical to those for adults). The differences in mean BMI increase according to sex and age group were tested using a two-way analysis of variance (ANOVA). Mean BMI and zBMI were compared between the two measurements using a paired t-test within each group and the pooled sample. The effect size was estimated using Cohen’s d. No a priori statistical power analysis or sample size estimation was performed. The study was approved by the Committee for Ethical Issues in the Field of Sport of the Faculty of Sport, University of Ljubljana (no. 12/2022). RESULTS On average across all groups, BMI increased by 0.5 kg/m2 in the studied period. Descriptive statistics, results of paired t-tests and effect sizes for BMI and zBMI incre- ase are reported in Table 1. The increase in mean BMI was statistically significant for both groups of girls, mar- ginally statistically significant for the younger boys and not statistically significant for older boys. ANOVA showed that the difference between girls and boys in BMI increase was marginally statistically significant (p=0.070 for the effect of gender); the effect of age group on mean BMI increase was not statistically significant (p=0.319), nor was there a statistically significant interaction (p=0.929). For the increase in zBMI, none of the effects was statistically significant (p=0.167 for gender, p=0.814 for age group, p=0.301 for interaction). These findings are illustrated in Figure 1. 28 Nika ŠUC, Blaž LEŠNIK: BODY MASS INDEX CHANGES IN CHILDREN AND ADOLESCENTS WITH INTELECTUAL DISABILITY ..., 23–33 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Ta bl e 1: D es cr ip tiv e st at is tic s, re su lts o f p ai re d t-t es ts , e ffe ct s iz e es tim at es a nd e st im at es o f r el at iv e BM I a nd z BM I i nc re as e in th e st ud ie d pe ri od . B M I Se pt em be r 20 20 M ar ch 2 02 1 re la tiv e ch an ge of m ea n m ed ia n re la tiv e ch an ge G ro up n M ea n SD M ea n SD p (t -t es t) d (9 5% C I) G ir ls 6 -1 4 y 21 20 .4 6. 2 21 .3 7. 1 0. 00 7 0. 65 (1 .1 2, 0 .1 7) +4 .4 % +3 .4 % G ir ls 1 5- 26 y 19 28 .0 7. 1 28 .6 6. 6 0. 00 7 0. 69 (1 .1 9, 0 .1 8) +2 .3 % +1 .9 % B oy s 6 -1 4 y 32 20 .6 5. 1 21 .0 4. 8 0. 05 6 0. 35 (- 0. 01 , 0 .7 1) +2 .1 % +0 .8 % B oy s 1 5- 26 y 28 23 .7 5. 2 23 .9 4. 9 0. 41 5 0. 16 (- 0. 22 , 0 .5 3) +0 .8 % +1 .3 % zB M I Se pt em be r 20 20 M ar ch 2 02 1 re la tiv e ch an ge of m ea n m ed ia n re la tiv e ch an ge G ro up n M ea n SD M ea n SD p (t -t es t) d (9 5% C I) G ir ls 6 -1 4 y 21 0. 72 1. 64 0. 80 1. 75 0. 36 9 0. 20 (- 0. 23 , 0 .6 3) +1 0. 3% +1 0, 4% G ir ls 1 5- 26 y 19 1. 46 1. 54 1. 62 1. 37 0. 00 6 0. 71 (0 .2 0, 1 .2 1) +1 1. 2% +1 1, 0% B oy s 6 -1 4 y 32 1. 25 1. 94 1. 30 1. 83 0. 49 8 0. 12 (- 0. 23 , 0 .4 7) +4 .0 % -8 ,5 % B oy s 1 5- 26 y 28 0. 52 1. 35 0. 52 1. 35 0. 91 5 -0 .0 2 (- 0. 39 , 0 .3 5) -1 .1 % +2 ,2 % N ot es : n – sa m pl e si ze ; S D – st an da rd d ev ia tio n; C I – c on fid en ce in te rv al ANNALES KINESIOLOGIAE • 13 • 2022 • 1 29 Nika ŠUC, Blaž LEŠNIK: BODY MASS INDEX CHANGES IN CHILDREN AND ADOLESCENTS WITH INTELECTUAL DISABILITY ..., 23–33 Figure 1: Mean BMI (top panel) and zBMI (bottom panel) change (with a 95% confi- dence interval, CI) from September to March according to sex and age group. Because the groups did not differ statistically significantly in mean zBMI change, we analyzed the mean zBMI change between the two time points for the pooled sample. It was marginally statistically significant (p=0.075). Hence, the confidence interval for the estimated effect size contained zero, but very close to the lower limit (d=0.18, 95% CI -0.02 to 0.38), and the distribution of within-participant changes contained both positive and negative values, with the majority being positive (Figure 2). Overall, the mean within-participant increase in zBMI was 0.06. 30 Nika ŠUC, Blaž LEŠNIK: BODY MASS INDEX CHANGES IN CHILDREN AND ADOLESCENTS WITH INTELECTUAL DISABILITY ..., 23–33 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Figure 2: Mean BMI (top panel) and zBMI (bottom panel) change (with a 95% confi- dence interval, CI) from September to March according to sex and age group. DISCUSSION AND CONCLUSION Our data show that during the studied period, which included a 10-week lockdown, BMI in pupils with intellectual disabilities tended to increase on average more than what would be expected due to maturation alone. As expected, the average BMI of the pupils was higher than in their counterparts in the general population in the beginning (the starting mean zBMI values were positive), but this was more pronounced at the end of the studied period. In general, the effect seemed to be somewhat larger in girls than boys (and likely absent among the oldest boys). Although we had online sports classes, supported and encouraged families to lead an active lifestyle and pupils returned to school much earlier than the majority popula- tion, there was still an increase in BMI in six months in all four groups. We assume that not only the school lockdown but also the general lockdown had an impact on increased BMI. There were a lot fewer possibilities for indoor and outdoor activities and there were no after-school activities, such as the Special Olympics program and training ses- sions, in which the population with intellectual disabilities is highly engaged (Lloyd, Temple, & Foley, 2012). Studies related to the Slovenian SLOfit program suggest that the general fitness of the majority population dropped by 17% on average in almost all measurements of the SLOfit program. Part of those are also height and weight, and the BMI has increased in children and youth during the pandemic limitations on schools, sports programs and other social-life activities (Recek, 2020). Studies show that the intervention programs ANNALES KINESIOLOGIAE • 13 • 2022 • 1 31 Nika ŠUC, Blaž LEŠNIK: BODY MASS INDEX CHANGES IN CHILDREN AND ADOLESCENTS WITH INTELECTUAL DISABILITY ..., 23–33 provided during lockdown were excellent; we had online classes, professional recom- mendations, TV and online classes, etc., to encourage pupils to be as active as possible and maintain their physical fitness. Although all the programs were successful in terms of time spent outside and being active, there was a lack of moderate-to-vigorous physi- cal activity (MVPA). Studies suggest that most of the MVPA is performed in the school environment (Morrison, Meh, Sember, Starc, & Jurak, 2021). BMI status is a signifi- cant indicator of health, and these findings suggest that being overweight and obesity are significant health concerns for children and youth with intellectual disabilities. It is critical that health professionals increase health promotion efforts, including physical activity and healthy eating behaviors for children and youth with intellectual disabili- ties. We assume that the lockdown resulted in a reduction in physical activity below the minimum recommendations of health organizations, which is in line with other studies that showed a decline in physical activity levels during closure times (Chen et al., 2020, Balanzá-Martinez, Atienza-Carbonell, Kapczinski, & De Boni, 2020). The study sug- gests that pandemics such as the current pandemic pose unique health issues caused by the requirements to stay at home, leading to a reduction in physical activity, among all people and especially among physically active individuals habitually practicing sports (Ravalli, & Musumeci 2020). Although a lockdown may be required to mitigate a pandemic, it also generates new health challenges. Staying at home for a prolonged period of time may increase sedentary habits and decrease physical activity levels that may lead to disturbing con- sequences such as an increased risk of worsening health conditions (including chronic ones), weight gain, insufficient sunlight exposure, social isolation, and poor metabolic health. A US study found that the COVID-19 pandemic period was associated with an excess increase in BMI of 0.24kg/m2 per year more than in the previous pre-pandemic period, even when controlling for socioeconomic status, race and ethnicity, baseline BMI category, and type of BMI ascertainment. Our findings validate the predictions of many scholars that weight increases among children because of the cumulative ef- fects of anticipated decreases in physical activity and increases in sedentary behavior, screen time, and high-calorie diets among children during the pandemic (Knapp et al, 2022). Altogether, sedentary behavior and low levels of physical activity can have ad- verse effects on a person’s overall well-being and quality of life (Laron, & Goldwag, 2020). Several authors followed children and youth and their development during the pandemic; most of the findings report an increased BMI (Woolford et al., 2021). After such devastating results of so many studies, the health program and school prevention programs should increase the level of physical activity, promote a healthy and active life style and try to rebalance the current situation of increased BMI of youth after all the restrictions. We must not forget to also include pupils with intellectual disabilities, as they are even more affected by staying at home with even less social life and oppor- tunities to be active and lead a healthy lifestyle. The main limitation of our study is that we do not have strictly comparable data on how the 10-week lockdown affected the majority population in this age group. In addition, we only measured height, weight, and BMI, but we did not compare other 32 Nika ŠUC, Blaž LEŠNIK: BODY MASS INDEX CHANGES IN CHILDREN AND ADOLESCENTS WITH INTELECTUAL DISABILITY ..., 23–33 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 potentially relevant indicators such as skinfold or general fitness level of the target population. ACKNOWLEDGEMENTS We are grateful to colleagues at the Center Janez Levec Ljubljana for their contribu- tion to this work; not only for help with the measurements, but also for doing a great job teaching online during school lockdowns and encouraging students and their parents to be physically active as much as possible. We thank prof. Gaj Vidmar, PhD, for help with the statistical analysis. REFERENCES Balanzá-Martínez, V., Atienza-Carbonell, B., Kapczinski, F. & De Boni, R. B. (2020). Lifestyle behaviours during the COVID-19 - time to connect. Acta Psychiatrica Scandi- navica,141(5), 399–400. https://doi.org/10.1111/acps.13177. Chen, P., Mao, L., Nassis, G. P., Harmer, P., Ainsworth, B. E., & Li, F. (2020). Coronavi- rus disease (COVID-19): the need to maintain regular physical activity while taking pre- cautions. Journal of Sport and Health Science, 9(2), 103–104. https://doi.org/10.1016/j. jshs.2020.02.001. Dor-Haim, H., Katzburg, S., Revach, P., Levine, H., & Barak, S. (2021). The impact of COVID-19 lockdown on physical activity and weight gain among active adult po- pulation in Israel: a cross-sectional study. BMC Public Health 21, 1521. https://doi. org/10.1186/s12889-021-11523-z. Golubović, Š., Maksimović, J., Golubović, B., & Glumbić, N. (2012). Effects of exercise on physical fitness in children with intellectual disability. Research in Developmental Disabilities, 33 (2), 608–614. https://doi.org/10.1016/j.ridd.2011.11.003. Guh, D. P., Zhang, W., Bansback, N., Amarsi, Z., Birmingham, C. L. & Anis, A. H. (2009). The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health, 25(9), 88. https://doi.org/10.1186/1471- 2458-9-88. Health & Social Care Information Centre (2015). Statistics on Obesity, Physical Acti- vity and Diet. Retrieved from https://files.digital.nhs.uk/publicationimport/pub16xxx/ pub16988/obes-phys-acti-diet-eng-2015.pdf. Knapp E. A., Dong, Y., Dunlop, A. L., Aschner, J. L., Stanford, J. B., Hartert, T., … & Chandran, A. (2022). Changes in BMI During the Covid-19 Pandemic. Pediatrics, 150 (3). https://doi.org/10.1542/peds.2022-056552. Laron, M. & Goldwag, R. G. (2020). Health Behaviors during the COVID-19 Pandemic – Preliminary Findings. Retrieved from https://brookdale.jdc.org.il/en/publication/israeli- -household-health-behaviors-corona/. Lloyd, M., Temple V. A. & Foley J. T. (2012). International BMI comparison of children and youth with intellectual disabilities participating in Special Olympics. Research in De- velopmental Disabilities, 33(6), 1708–1714. https://doi.org/10.1016/j.ridd.2012.04.014. ANNALES KINESIOLOGIAE • 13 • 2022 • 1 33 Nika ŠUC, Blaž LEŠNIK: BODY MASS INDEX CHANGES IN CHILDREN AND ADOLESCENTS WITH INTELECTUAL DISABILITY ..., 23–33 Lloyd, M., Foley, J. T., & Temple, V. A. (2014). Body mass index of children and youth with an intellectual disability by country economic status. Preventive Medicine, 69, 197–201. https://doi.org/10.1016/j.ypmed.2014.10.010. Melville, C. A., Cooper, S. A., Morrison, J., Allan, L., Smiley, E. & Williamson, A. (2008), The prevalence and determinants of obesity in adults with intellectual disabiliti- es. Journal of Applied Research in Intellectual Disabilities, 21(5), 425–437. https://doi. org/10.1111/j.1468-3148.2007.00412.x. Morrison, S. A., Meh, K., Sember, V., Starc, G., Jurak, G. (2021). The effect of Pan- demic Movement Restriction Policies on Children’s Physical Fitness, Activity, Screen Time and Sleep. Frontiers in Public Health, 9(785679), 1–12. https://doi.org/10.3389/ fpubh.2021.785679. Ptomey, L. T., Walpitage, D. L., Mohseni, M., Dreyer Gillette, M. L., Davis, A. M., Forseth, B., … Waitman, L. R. (2020). Weight status and associated comorbidities in children and adults with Down syndrome, autism spectrum disorder and intellectual and developmental disabilities. Journal of Intellectual Disability Research, 64(9), 725–737. https://doi.org/10.1111/jir.12767. Ravalli, S. & Musumeci, G. (2020). Coronavirus outbreak in Italy: physiological benefits of home-based exercise during pandemic. Journal of Functional Morphology and Kine- siology 5(2), 1–6. https://doi.org/10.3390/jfmk5020031. Recek, T. (2020). Dr. Gregor Starc: „Otrokom smo vzeli gibanje. Tretjina otrok je nazado- vala v gibalnih sposobnostih, najbolj pa v vzdržljivosti in koordinaciji“ [Interview Gre- gor Starc, PhD: „We have taken movement away from children. A third of children have regressed in their motor skills, but most of all in their endurance and coordination“]. Večer, 73, 3.10.2020. Retrieved from https://www.vecer.com/slovenija/intervju-dr-gre- gor-starc-otrokom-smo-vzeli-gibanje-tretjina-otrok-je-nazadovala-v-gibalnih-sposob- nostih-najbolj-pa-v-vzdrzljivosti-in-koordinaciji-10223072. Schaepper, M. A., Hauser, M., & Kagadkar, F. (2021). What is Intellectual Disability? American Psychiatric Association. Retrieved from: https://www.psychiatry.org/patients- families/intellectual-disability/what-is-intellectual-disability. Schalock, R. L., Luckasson, R. & Tasse, M. J. (2021). Intellectual Disability: Definition, Diagnosis, Classification and Systems of Supports, 12th Edition. American Association on Intellectual and Developmental Disabilities. Temple, V. A., Foley, J. T., & Lloyd, M. (2014). Body mass index of adults with intellec- tual disability participating in Special Olympics by world region. Journal of Intellectual Disability Research, 58(3), 277–284. https://doi.org/10.1111/jir.12011. Woolford, S. J., Sidell, M., Li, X., Else, V., Young, D. R., Resnicow, K., & Koebnick, C. (2021). Changes in Body Mass Index among children and adolescents during the CO- VID-19 pandemic. JAMA. Oct 12; 326(14): 1434–1436. https://doi.org/10.1001/ jama.2021.15036. World Health Organization (2007). BMI-for-age (5-19 years). Retrieved from https:// www.who.int/tools/growth-reference-data-for-5to19-years/indicators/bmi-for-age. ANNALES KINESIOLOGIAE • 13 • 2022 • 1 35 Original scientific article DOI: https://doi.org/10.35469/ak.2022.344 received: 2022-09-15 UDC: 612-053.9 FAT MASS TO FAT-FREE MASS RATIO AND BODY COMPOSITION IN PARTICIPANTS WITH CHRONIC LEG PROBLEMS Mihaela JURDANA1, Ana TOMAŽIČ1, Boštjan ŽVANUT1 1 University of Primorska, Faculty of Health Sciences, Izola, Slovenia Corresponding Author: Boštjan ŽVANUT University of Primorska, Faculty of Health Sciences, Izola, Polje 42, SI-6310 Izola, Slovenia Phone: +386 5 662 64 60; Fax: +386 5 662 64 80 E-mail: bostjan.zvanut@fvz.upr.si ABSTRACT Background & aim: Low fat-free mass (FFM) or high fat mass (FM) in older adults are abnormal body composition phenotypes associated with morbidity. The dual bur- den of excessive FM and low FFM may lead to a higher risk of cardiovascular and other diseases and disability and lower physical performance compared with individu- als with normal body composition or low FFM or high FM alone. Both conditions lead to poorer health and can be identified by a high FM/FFM ratio. Because few studies have examined the effects of abnormal body composition using the FM/FFM ratio, the aim of this study is to determine the FM/FFM values by gender in patients with knee and hip pathologies and compare them with body composition parameters. This condi- tion is important when surgery is required because abnormal body composition leads to an increase in infections and other postoperative complications. Methods: A total of 93 participants aged 64.71 ± 7.71 years in women and 65.9 ± 9.9 years in men with a body mass index (BMI) ≥25 kg/m2 were recruited from the Val- doltra Orthopaedic Hospital (Ankaran, Slovenia). The waist circumference (WC) and anthropometric data (BMI), as well as body composition data (FM, FFM, % of body water, estimated by bioelectrical impedance - BIA) were measured. In addition, the body composition phenotypes (FM/FFM ratio) were calculated. Results: The FM/FFM index was higher in females. The female group with FM/ FFM (0.68) and those with a higher FM/FFM (0.92) correlated positively with WC. Male participants were excluded for further analysis because only two males had FM/ FFM > 0.80. The FM/FFM of the remaining male participants was 0.53 ± 0.09. 36 Mihaela JURDANA, Ana TOMAŽIČ, Boštjan ŽVANUT: FAT MASS TO FAT-FREE MASS RATIO AND BODY COMPOSITION ..., 35–45 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Conclusions: FM/FFM provide information on patient body composition and iden- tify individuals at risk of body composition abnormalities in women only. Keywords: Fat-mass, fat-free mass, waist circumference, older adults, knee, hip. RAZMERJE MED MAŠČOBNO MASO IN PUSTO MIŠIČNO MASO TER SESTAVA TELESA PRI BOLNIKIH S KRONIČNIMI TEŽAVAMI SPODNJE OKONČINE IZVLEČEK Izhodišča: Zmanjšan delež puste mišične mase (FFM) ali povečan delež maščevja (FM) vodi pri starejših odraslih do sprememb v telesni sestavi, ki odstopajo od me- jnih vrednosti, kar je povezano z obolevnostjo. Sočasna prisotnost povečane FM in zmanjšane FFM lahko v primerjavi s posamezniki z normalno telesno sestavo ali samo z nizko FFM ali visoko FM poveča tveganje za razvoj srčno-žilnih in drugih bolezni, invalidnost in nižjo telesno zmogljivost. Oba dejavnika poslabšata zdravstveno stanje posameznika, ki ga lahko identificiramo s pomočjo povečanega razmerja FM/FFM. Zato je namen te raziskave določiti vrednosti FM/FFM pri preiskovancih s patologijo kolena in kolka ter jih primerjati s parametri telesne sestave. Poznavanje vrednosti FM/FFM je ključnega pomena v primerih, ko je potreben operativni poseg, saj telesna sestava, ki odstopa od mejnih vrednosti vodi do večjega tveganja za razvoj poopera- tivnih zapletov. Metode: V raziskavo je bilo vključenih 93 preiskovancev iz Ortopedske bolnišnice Valdoltra (Ankaran, Slovenija), starih 64,71 ± 7,71 let (ženske) in 65,9 ± 9,9 let (moški) z indeksom telesne mase (ITM) ≥25 kg/m2, napotenih na ortopedsko specialistično obravnavo. Izmerjeni so bili antropometrija (ITM), obseg pasu (WC) ter telesna ses- tava (FM, FFM, % telesne vode, ocenjeni z bioeletrično impedančno analizo-BIA). S pomočjo indeksa FM/FFM so bili določeni fenotipi telesne sestave. Rezultati: Indeks FM/FFM je bil višji pri ženskah. Tako skupina žensk s FM/FFM (0,68), kot skupina z višjim FM/FFM (0,92) sta pozitivno korelirali z obsegom pasu. Ker sta imela samo dva moška FM/FFM >0,80 smo moške preiskovance iz nadaljnje analize izključili. FM/FFM preostalih moških preiskovancev je znašal 0,53 ± 0,09. Zaključek: Razmerje FM/FFM nam poda pomembno informacijo o značilnostih pacientove telesne sestave ter pomaga identificirati bolnike, pri katerih obstaja tveg- anje za spremenjeno telesno sestavo. V naši študiji smo s pomočjo indeksa ugotovili, pomembne značilnosti v spremembi telesne sestave pri preiskovankah ženskega spola. Ključne besede: maščobna masa, pusta mišična masa, obseg pasu, starejši odrasli, koleno, kolk. 37 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Mihaela JURDANA, Ana TOMAŽIČ, Boštjan ŽVANUT: FAT MASS TO FAT-FREE MASS RATIO AND BODY COMPOSITION ..., 35–45 INTRODUCTION The ageing of the population and the rise in obesity prevalence worldwide are the two major risk factors for non-communicable diseases, including degenerative diseas- es, sarcopenia, frailty, increased morbidity and mortality, with negative implications for the public health system (Merchant et al., 2021). Elevated body mass index (BMI), waist circumference (WC), and/or waist-to-hip ratio are commonly used to define obe- sity. BMI needs to be interpreted with caution in older adults as loss of physiological body height may lead to over-interpretation and lack of correlation with the percentage of body fat, the distribution of fat, or body composition (Batsis et al., 2016). Addition- ally, BMI has a limited ability to distinguish between muscle mass and fat accumulation and does not provide information on body composition (Prado et al., 2012). Therefore, a better understanding of body composition may require more specific measurements, such as fat mass (FM) and fat free mass (FFM), which can be obtained by bioelectri- cal impedance analysis (BIA) (Prado et al., 2012). The fat mass to fat-free mass ratio (FM/FFM) is an integrated metabolic index for assessing body composition, which evaluates the combined effect of the ratio between FM and FFM (Godziuk, Woodhouse, Prado, & Forhan, 2020; Rugila et al., 2022) In other words, FM/FFM indicates whether the amount of FM is adequate for the amount of FFM in an individual. Theoretically, higher values of the ratio indicate a less favorable balance between FM and FFM, and a high FM/FFM ratio already has negative effects on physical abilities and contributes to morbidity and mortality in many patients (Prado et al., 2012). Despite these clinical associations previously found with FM/FFM in chronic disease, this ratio has not been studied in patients with chronic knee or hip pain. The clinical impact of higher versus lower FM/FFM in these patients requires increased attention due to the accelerated loss of FFM associated with pain, mobility limitations and obesity-related inflammation (Godziuk et al., 2020). In addition, a loss of muscle mass is associated with prolonged hospital stays, infections, and other complications and disability (Prado et al., 2012). Thus, the aim of this study is to determine the FM/FFM values and compare the body composition of patients with higher and lower FM/FFM values by gender. Screen- ing of this ratio may be important in order to identify patients with abnormal body composition, especially if surgery is indicated, to avoid complications after surgery. Our hypothesis is that higher FM/FFM values in these individuals are associated with abnormalities in body composition. 38 Mihaela JURDANA, Ana TOMAŽIČ, Boštjan ŽVANUT: FAT MASS TO FAT-FREE MASS RATIO AND BODY COMPOSITION ..., 35–45 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 METHODS Study Design In this cross-sectional study, 93 participants (Caucasian origin), women with a mean age of 64.71 ± 7.71 years and men with a mean age of 65.90 ± 9.90 years with knee and hip problems, referred to an orthopedist for further diagnosis, were recruited at the Valdoltra Orthopaedic Hospital (Ankaran, Slovenia), excluding participants with cancer and acute illness, patients with pacemakers, and patients with a BMI ≤ 25 kg/m2. Participants were examined in 2019 in the departments of the mentioned institution and underwent anthropometric measurement and body composition analysis. The National Medical Ethics Committee of Slovenia (code 0120-557/2017/4) ap- proved the study. All the participants were fully informed about the procedures before written informed consent was obtained. Anthropometric Data At the study site, body height, body mass and WC were measured according to a standardized protocol. All the measurements were taken between 7 and 8 am after fast- ing overnight. The body height (cm) of the subjects was measured to the nearest 0.1 cm while standing, without shoes, using a Leicester Height Measure (Invicta Plastics Lim- ited, Oadby, England). The body mass (kg) of the participants wearing light clothing without shoes was measured with an accuracy of 0.1 kg. The WC (cm) was measured in the standing position halfway between the costal arch and the iliac crest with a non- stretchable tape measure. The BMI (kg/m2) was calculated using the formula body mass (kg) / body height (m2). Body Composition Measurements FM (kg) and FFM (kg) were estimated by bioelectrical impedance analysis (BIA) using the Tanita BC 418MA (Tanita Corporation, Arlington Heights, IL) and the data was analyzed with the software provided by the manufacturer. The FM to FFM ratio (FM/FFM) was calculated as an index of obesity combined with sarcopenia and the fol- lowing cut-off values were used (Biolo et al., 2015; Prado et al., 2012): FM/FFM ratio < 0.40 for metabolically healthy obese individuals in whom the increase in FM was minor compared to that in FFM; FM/FFM ratios between 0.40 and 0.80 for obese phenotypes in whom FM predominated FFM, but FFM is still adequately maintained; FM/FFM ratios > 0.80 for obese phenotypes with sarcopenia in whom FM was increased and FFM was reduced. 39 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Mihaela JURDANA, Ana TOMAŽIČ, Boštjan ŽVANUT: FAT MASS TO FAT-FREE MASS RATIO AND BODY COMPOSITION ..., 35–45 Statistics Statistical analyses were performed using IBM SPSS ver. 26. Univariate data analysis was performed by calculating the frequencies and percentages for qualitative variables, mean and/or median, standard deviation (SD) were calculated for quantita- tive variables. To assess the normality of the distribution, Kolmogorov-Smironov and Shaphiro-Wilk tests were performed. Normality was additionally assessed by evaluat- ing the histogram, skewness, and kurtosis. The independent sample t-test was used to determine the statistically significant differences between the two groups because the variables in both groups followed the normal distribution. The Pearson’s correlation coefficient was calculated to determine the association between normally distributed variables. RESULTS The participant characteristics are shown in Table 1. The female and male partici- pants were comparable in age and BMI. Male participants had higher body mass, % body water, FFM and WC whereas FM and the FM/FFM ratio were higher in females. We excluded male participants from further analysis because only two men had FM/FFM > 0.80 (1.0 ± 0.13); the FM/FFM of the remaining male participants was 0.53 ± 0.09. Table 1. General characteristics of the participants Parameters Men n=37 (45.8%) Women n = 56 (54.2%) Age [years] 64.71 ± 7.71 65.90 ± 9.90 Anthropometric measurements Body mass [kg] 93.2 ± 16.0 78.9 ± 12.9 Body height [cm] 172 ± 7 160 ±7 WC [cm] 109 ± 14 101 ± 11 BMI [kg/m²] 31.4 ± 4.8 30.8 ± 5.0 Body composition measurements FFM [kg] 59.7 ± 7.1 43.3 ± 4.6 Body water [%] 48.7 ± 3.2 41.1 ± 2.9 FM [kg] 30.4 ± 10.6 43.3 ±4.6 FM/FFM 0.50 ± 0.16 0.75 ± 0.15 Legend: All the values are mean ±SD, BMI - body mass index, WC - waist circumference, FM - fat mass, FFM - fat free mass, FM/FFM ratio - ratio between fat mass and fat free mass 40 Mihaela JURDANA, Ana TOMAŽIČ, Boštjan ŽVANUT: FAT MASS TO FAT-FREE MASS RATIO AND BODY COMPOSITION ..., 35–45 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Therefore, we divided the females into two groups based on the cut-off values for the FM/FFM ratio: FM/FFM between 0.40 and 0.80 and FM/FFM ≥ 0.80 (Table 2). Table 2. Body composition data in women with medium and higher FM/FFM (0.4 < FM/FFM < 0.8 and FM/FFM ≥ 0.8). FM/FFM 0.4 < FM/FFM < 0.8 FM/FFM ≥ 0.8 Independent sample t-test (p)Parameters (n=41) (n=15) Cohen d Age [years] 66.62 ± 9.82 65.85 ± 9.55 .704 Body mass [kg] 72.33 ± 8.11 91.31 ± 11.12 < .001 -2.112 Body height [cm] 159.05 ± 6.94 160.53 ± 7.58 .318 WC [cm] 97.07 ± 7.93 110.18 ± 9.07 < .001 -1.581 BMI [kg/m²] 28.66 ± 3.32 35.56 ± 4.79 < .001 -1.837 Body water [%] 42.38 ± 2.18 38.13 ± 1.76 < .001 2.044 FM [%] 38.95 ± 3.34 46.28 ± 2.68 < .001 -2.304 FM [kg] 28.3 ± 4.9 42.4 ±7.0 < .001 -2.481 FFM [kg] 41.63 ± 3.61 46.31 ± 4.63 < .001 -1.200 FM/FFM ratio .68 ± .09 .92 ± .11 < .001 -2.511 Legend: All values are mean ± SD, BMI - body mass index, WC - waist circumference, FM - fat mass, FFM - fat free mass, FM/FFM ratio - ratio between fat mass and fat free mass Forty-one of the women were classified in the obesity phenotype group: FM/FFM ratio (0.68 ± 0.09), while fifteen women had an obesity phenotype combined with a low FFM: FM/FFM ratio (0.92 ± 0.11). In addition, women with a higher FM/FFM ratio (≥ 0.8) exhibited significantly greater body mass, BMI, WC, FFM and FM and a sig- nificantly lower % of body water when compared to the group with a lower FM/FFM. Pearson’s correlation analysis revealed a significant, positive correlation in both groups between FM/FFM and BMI (overall: r = 0.742, p < 0.01; for 0.4 < FM/FFM < 0.8: r = 0.659, p < 0.01; for FM/FFM ≥ 0.8: r = 0.676, p < 0.01, Figure 1a) and WC (over- all: r = 0.768, p < 0.01; for 0.4 < FM/FFM < 0.8: r = 0.741, p < 0.01; FM/FFM ≥ 0.8: r = 0.542, p < 0.01, Figure 1b). In addition, a significant, negative correlation was identified between FM/FFM and % of body water (overall: r = - 0.907, p <0.01; for 0.4 < FM/FFM < 0.8: r = - 0.869, p < 0.01; for FM/FFM ≥ 0.8: r= - 0.874, p <0.01, Figure 1c). 41 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Mihaela JURDANA, Ana TOMAŽIČ, Boštjan ŽVANUT: FAT MASS TO FAT-FREE MASS RATIO AND BODY COMPOSITION ..., 35–45 Figures 1a, 1b: Scatter diagrams of the FM/FFM ratio and BMI (a) and WC (b). a) b) 42 Mihaela JURDANA, Ana TOMAŽIČ, Boštjan ŽVANUT: FAT MASS TO FAT-FREE MASS RATIO AND BODY COMPOSITION ..., 35–45 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 DISCUSSION In this cross-sectional study, the majority of the participants with hip or knee joint problems and associated leg pain were obese with normal FFM, while obesity associ- ated with lower FFM was only found in women. A higher FM/FFM (> 0.8) is signifi- cantly associated with worse body composition parameters (body mass, BMI, WC, FM, FFM) in female patients. The ageing process in the increasing population of older adults is associated with an increase in chronic health conditions and a high prevalence of functional limitations and disabilities associated with a decrease in muscle mass and strength (Delmonico & Beck, 2017). In addition, obese adults have greater skeletal muscle mass than normal body mass adults of the same age and sex, as we confirmed in this study. These dif- ferences are the result of muscle anabolism induced by the loading effect of the higher body mass in obesity (Biolo et al., 2015; Morse & Soeldner, 1964). In our study, the FM/FFM ratio in both female groups correlated strongly and posi- tively with WC. The WC is a surrogate marker for assessing the risk of visceral/ab- dominal fat accumulation (Ma et al., 2021). The association between abdominal fat and muscle mass loss is explained by several mechanisms. Abdominal obesity is character- ized by systemic inflammation, oxidative stress and insulin resistance, which affect muscle proteolysis and inhibit protein synthesis (Biolo et al., 2015). Adipose tissue is actively involved in metabolic regulation and secretes pro-inflammatory cytokines such Figure 1c: Scatter diagrams of the % of body water. c) 43 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Mihaela JURDANA, Ana TOMAŽIČ, Boštjan ŽVANUT: FAT MASS TO FAT-FREE MASS RATIO AND BODY COMPOSITION ..., 35–45 as interleukin-6 (IL -6) and tumor necrosis factor-α (TNF-α), as well as the hormone leptin. The pro-inflammatory cytokines have effects on the brain, liver, and pancreas, which control appetite, carbohydrate and fat metabolism, and energy balance (Dhawan & Sharma, 2020; Roubenoff, 2000). The increase in FM and the accompanying release of pro-inflammatory cytokines lead to insulin resistance, which reduces the normal ana- bolic effect of insulin on amino acid transport in muscle (Kim et al., 2000). In addition, there is evidence that leptin reduces growth hormone secretion, suppressing another important anabolic stimulus (Obradovic et al., 2021). In addition, there are a number of explanations for the association between body fat, muscle mass and musculoskeletal pain, including the upregulation of pro-inflammatory cytokines released by adipose tissue (Younger, Kapphahn, Brennan, Sullivan & Ste- fanick, 2016). Inflammation triggered by pro-inflammatory cytokines is known to be associated with physical pain, particularly in women (Walsh et al., 2018). In addition, a higher FM/FFM is a determinant factor of physical inactivity (Rugila et al., 2022). Ac- cording to the FM/FFM ratio, obese women in this study had predominantly more fat mass and less muscle mass. This could be a result of the different distribution of body fat between the sexes (Prado et al., 2012). Physical activity became more difficult in this condition and their habitual level decreased further. The FM/FFM ratio may help reinforce the notion that body composition is a more informative measure of risk for musculoskeletal pain and immobility (Walsh et al., 2018). Taken together, these find- ings support the hypothesis that a higher FM/FFM ratio (> 0.8) may associate obesity with an additional decrease of FFM due to immobility and inflammation. This could be important information for sarcopenia screening in participants scheduled for surgery to avoid complications. This study should be considered in light of certain limitations. First, the study in- cluded a relatively small sample size. Second, there is a lack of additional measure- ments of inflammatory markers and muscle function, which would certainly be of inter- est. Finally, this study is cross-sectional. CONCLUSIONS A higher value of the FM/FFM ratio, studied for the first time in participants with chronic knee or hip pain, was significantly associated with abdominal obesity and is useful for identifying individuals at risk of body composition abnormalities. The clini- cal implications of an FM/FFM > 0.8 in these participants require increased attention, as accelerated loss of FFM and complications may occur if surgery is indicated. Acknowledgements We thank the participants for their time and the entire staff of the Valdoltra Ortho- paedic Hospital, Slovenia. 44 Mihaela JURDANA, Ana TOMAŽIČ, Boštjan ŽVANUT: FAT MASS TO FAT-FREE MASS RATIO AND BODY COMPOSITION ..., 35–45 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 REFERENCES Batsis, J. A., Mackenzie, T. A., Bartels, S. J., Sahakyan, K. R., Somers, V. K., & Lopez- Jimenez, F. (2016). Diagnostic accuracy of body mass index to identify obesity in older adults: NHANES 1999–2004. International Journal of Obesity, 40(5), 761–767. https:// doi.org/10.1038/ijo.2015.243. Biolo, G., Di Girolamo, F. G., Breglia, A., Chiuc, M., Baglio, V., Vinci, P., … Situlin, R. (2015). Inverse relationship between “a body shape index” (ABSI) and fat-free mass in women and men: Insights into mechanisms of sarcopenic obesity. Clinical Nutrition, 34(2), 323–327. https://doi.org/10.1016/j.clnu.2014.03.015. Delmonico, M. J., & Beck, D. T. (2017). The current understanding of sarcopenia: emerg- ing tools and interventional possibilities. American Journal of Lifestyle Medicine, 11(2), 167–181. https://doi.org/10.1177/1559827615594343. Dhawan, D., & Sharma, S. (2020). Abdominal obesity, adipokines and non-communicable diseases. The Journal of Steroid Biochemistry and Molecular Biology, 203, 105737. https://doi.org/10.1016/j.jsbmb.2020.105737. Godziuk, K., Woodhouse, L. J., Prado, C. M., & Forhan, M. (2020). Clinical screen- ing and identification of sarcopenic obesity in adults with advanced knee osteoarthritis. Clinical Nutrition ESPEN, 40, 340–348. https://doi.org/10.1016/j.clnesp.2020.08.005. Kim, J. Y., Nolte, L. A., Hansen, P. A., Han, D. H., Ferguson, K., Thompson, P. A., & Hol- loszy, J. O. (2000). High-fat diet-induced muscle insulin resistance: Relationship to vis- ceral fat mass. American Journal of Physiology. Regulatory, Integrative and Comparative Physiology, 279(6), R2057–2065. https://doi.org/10.1152/ajpregu.2000.279.6.R2057. Ma, S., Xi, B., Yang, L., Sun, J., Zhao, M., & Bovet, P. (2021). Trends in the prevalence of overweight, obesity, and abdominal obesity among Chinese adults between 1993 and 2015. International Journal of Obesity, 45(2), 427–437. https://doi.org/10.1038/s41366- 020-00698-x. Merchant, R. A., Seetharaman, S., Au, L., Wong, M. W. K., Wong, B. L. L., Tan, L. F., … Morley, J. E. (2021). Relationship of fat mass index and fat free mass index with body mass index and association with function, cognition and sarcopenia in pre- frail older adults. Frontiers in Endocrinology, 12, 765415. https://doi.org/10.3389/fen- do.2021.765415. Morse, W. I., & Soeldner, J. S. (1964). The non-adipose body mass of obese women: Evi- dence of increased muscularity. Canadian Medical Association Journal, 90(12), 723–725. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1922508/. Obradovic, M., Sudar-Milovanovic, E., Soskic, S., Essack, M., Arya, S., Stewart, A. J., … Isenovic, E. R. (2021). Leptin and obesity: Role and clinical implication. Frontiers in Endocrinology, 12, 585887. https://doi.org/10.3389/fendo.2021.585887. Prado, C. M. M., Wells, J. C. K., Smith, S. R., Stephan, B. C. M., & Siervo, M. (2012). Sarcopenic obesity: A critical appraisal of the current evidence. Clinical Nutrition, 31(5), 583–601. https://doi.org/10.1016/j.clnu.2012.06.010. Roubenoff, R. (2000). Sarcopenia and its implications for the elderly. European Journal of Clinical Nutrition, 54(3), S40–S47. https://doi.org/10.1038/sj.ejcn.1601024. Rugila, D. F., Oliveira, J. M., Machado, F. V. C., Correia, N. S., Puzzi, V. C., Passos, N. F. P., … Furlanetto, K. C. (2022). Fat mass to fat-free mass ratio and its associations 45 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Mihaela JURDANA, Ana TOMAŽIČ, Boštjan ŽVANUT: FAT MASS TO FAT-FREE MASS RATIO AND BODY COMPOSITION ..., 35–45 with clinical characteristics in asthma. Heart & Lung: The Journal of Critical Care, 56, 154–160. https://doi.org/10.1016/j.hrtlng.2022.07.006. Walsh, T. P., Arnold, J. B., Evans, A. M., Yaxley, A., Damarell, R. A., & Shanahan, E. M. (2018). The association between body fat and musculoskeletal pain: A system- atic review and meta-analysis. BMC Musculoskeletal Disorders, 19(1), 233. https://doi. org/10.1186/s12891-018-2137-0. Younger, J., Kapphahn, K., Brennan, K., Sullivan, S. D., & Stefanick, M. L. (2016). Association of leptin with body pain in women. Journal of Women’s Health, 25(7), 752–760. https://doi.org/10.1089/jwh.2015.5509. ANNALES KINESIOLOGIAE • 13 • 2022 • 1 47 Original scientific article DOI: https://doi.org/10.35469/ak.2022.365 received: 2022-11-24 UDC: 796.062:005.7 THE DECISION-MAKING STYLE STRUCTURE OF SLOVENIAN SPORTS MANAGERS Edvard KOLAR1, Matej TUŠAK2 1 University of Maribor, Faculty of Organizational Science, Slovenia 2 University of Ljubljana, Faculty of Sport, Slovenia Corresponding author: Edvard KOLAR University of Maribor, Faculty of Organizational Science, Kidričeva cesta 55A, 4000 Kranj Phone: +386 41 376 381 E-mail: edvard.kolar@guest.um.si ABSTRACT Purpose: Decisions that we make are always burdened with consequences, which are the inevitable result of our decision-making. The decision-making style (DMS) is the way in which managers acquire, process and use information in decision-making processes. The goals of the present research are to define the factor structure of DMS for a sample of Slovenian sports managers and to determine the characteristics of their DMS structure. Methods: 80 managers of Slovenian sports organizations filled in an anonymous internet survey. The DMS was measured with the use of the General Decision-Ma- king Style Inventory (GDMS), which was translated into the Slovenian language. The GDMS questionnaire measures five different decision-making styles: rational, intuitive, dependent, avoidant and spontaneous. The factor analysis (FA) method was used to test the assumption about the structure of the DMS. The internal consistency was measured using Cronbach’s alpha coefficient. The Pearson correlation coefficient was used to study the relationship between the DMS. Results: After three successive implementations of FA, we developed an optimized DMS model with 20 items confirming that when making decisions, sports managers use a combination of all five DMS. Slovenian sports managers mostly use the rational and dependent DMS, indicating that they are mostly rational decision-makers. We also recognized the correlation between the rational and the dependent style, but since the structure of the DMS in our sample is dominated by the rational DMS, we could con- clude that this is a dependent-rational DMS, where mangers seek advice, opinions and knowledge from colleagues when making decisions to increasing their rationality. 48 Edvard KOLAR, Matej TUŠAK: DECISION-MAKING STYLE STRUCTURE OF SLOVENIAN SPORTS MANAGERS , 47–73 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Conclusions: We can conclude that the recognized average structure of the DMS is functional and healthy; furthermore, Slovenian sports managers are on average rati- onal decision-makers who, due to the specific organizational characteristics of sports organizations, look for confirmation and opinions on future decisions in the broader environment of the organizations’ stakeholders. Keywords: Slovenian sports managers, decision-making styles, structure. STRUKTURA STILOV ODLOČANJA SLOVENSKIH ŠPORTNIH MENEDŽERJEV IZVLEČEK Namen: Odločitve, ki jih sprejemamo, so vedno obremenjene s posledicami, ki so neizogiben rezultat našega odločanja. Stil odločanja (DMS) je način, na katerega me- nedžerji pridobivajo, obdelujejo in uporabljajo informacije v procesih odločanja. Cilja te raziskave sta opredelitev faktorske strukture DMS na vzorcu slovenskih športnih me- nedžerjev in opredelitev značilnosti strukture njihovih stilov. Metode: 80 menedžerjev slovenskih športnih organizacij je izpolnilo anonimno spletno anketo. DMS je bil merjen z uporabo splošnega vprašalnika stilov odločanja (GDMS), ki je bil preveden v slovenski jezik. Vprašalnik GDMS meri pet različnih stilov odločanja: racionalnega, intuitivnega, odvisnega, izogibajočega in spontanega. Za preverjanje predpostavke o strukturi DMS je bila uporabljena metoda faktorske analize (FA). Notranja konsistentnost je bila preverjena s Cronbachovim koeficientom. Pearsonov korelacijski koeficient je bil uporabljen za proučevanje povezanosti med stili odločanja. Rezultati: Po treh zaporednih izvedbah FA smo razvili optimiziran model stilov od- ločanja z 20 postavkami vprašalnika, ki potrjuje, da športni menedžerji pri odločanju uporabljajo kombinacijo vseh petih stilov odločanja. Večinoma uporabljajo racionalni in odvisni stil, kar kaže, da so večinoma racionalni odločevalci. Ugotovljena je bila tudi korelacija med racionalnim in odvisnim stilom, ker pa v strukturi našega vzorca prevladuje racionalni stil, bi lahko sklepali, da gre za odvisno-racionalni stil odloča- nja, v okviru katerega menedžerji pri sprejemanju odločitev iščejo nasvete, mnenja in znanje pri sodelavcih zaradi povečanja racionalnosti svojih odločitev. Zaključek: Ugotovili smo, da je ugotovljena povprečna struktura stilov odločanja funkcionalna in zdrava. Slovenski športni menedžerji so v povprečju racionalni od- ločevalci, ki zaradi posebnih organizacijskih značilnosti športnih organizacij iščejo potrditev in mnenja o prihodnjih odločitvah v širšem okolju deležnikov organizacije. Ključne besede: slovenski športni menedžerji, stili odločanja, struktura. ANNALES KINESIOLOGIAE • 13 • 2022 • 1 49 Edvard KOLAR, Matej TUŠAK: DECISION-MAKING STYLE STRUCTURE OF SLOVENIAN SPORTS MANAGERS , 47–73 INTRODUCTION Decision-making is a process resulting in a decision (Tomić, 2007). “Decisions are an essential part of our lives, both in the work environment and outside of it. Decisions are made by those who are responsible for choosing between two or more options,” (Heller & Hindle, 2001). A decision, as a result of a decision-making process, can be defined as “a judgment or choice between two or more options that develops from an infinite number of situations, from solving a problem to taking action in a certain di- rection,” (Heller & Hindle, 2001). Bohanec (2012) writes that a decision is a conscious and irreversible sharing of resources with the aim of achieving the desired goals. The decisions we make are always burdened with consequences, which are inevitable re- sults of our decision-making. Therefore, it is particularly important how we decide on matters (or problems). The decisions we make define our past and significantly design our future. Deci- sions made by managers about a company define the company’s past performance, its current market, economic and social position and its future place in the industry, national economy and global environment. The essence of the managerial function is the coordination of technically divided work and the implementation of the joint work tasks of the association with the help of others; i.e., delegating and solving problems that arise, or making decisions. Thus, we could define the content of management work as coordination and delegation (responsibilities, duties and powers), while the method of managerial work is decision-making (Kolar & Jurak, 2014). Because of this, mana- gers are often called decision-makers (Daft, 2010). The results of their decisions are reflected in the growth, prosperity or collapse of the organizations they deal with (Daft, 2008). Simon (1960) wrote that decision-making and management are synonymous terms. The general idea of the decision maker is an individual who evaluates and cho- oses between possible decisions. When solving problems, decision-makers are faced with situations representing a gap between the desired (the goal of the decision) and the actual state (initial state); in order to bridge this gap, they perform intellectual (co- gnitive) activities, while the future steps that need to be taken are unknown (Klein & Methlie, 1992). Every decision refers to an object, and the reason for its adoption is a certain purpose, which manifests itself as an intended change of that object in favour of the one who makes the decision (Rozman & Kovač, 2012). A fundamental condition for ensuring the success and efficiency of n organization is that the managers at all levels of management make valid decisions. Simon (1987) claims that it is highly unlikely to find two types of managers (at least not good managers) who can be classified as making decisions solely based on intuition or making decisions solely based on rational/analytical techniques. It is more likely that we will find a range of combinations or the related use of intuition and rational-analytical techniques in decision-making processes. Rowe, Boulgarides and McGrath (1984) point out that the decision-making style reflects the way a person uses information to make decisions. Avsec (2012) accordingly stated that, despite the fact that the nature of the problem and situational factors play an important role in decision- 50 Edvard KOLAR, Matej TUŠAK: DECISION-MAKING STYLE STRUCTURE OF SLOVENIAN SPORTS MANAGERS , 47–73 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 -making, we can assume that, regardless of the decision-making problem, individuals differ in the frequency of use of individual decision-making styles. Remenova and Jan- kelova (2019) state that the decision-making style can be understood as the result of a cognitive process that leads to the choice of solutions from among several alternatives. The authors also note that managers generally use a combination of at least two de- cision-making styles, varying based on the characteristics and weight of the decision problem. Driver (1979) defined decision-making styles as learned patterns of response that people use when making decisions. The decision-making style is therefore the way managers acquire, process and use information in decision-making processes. This is a set of qualitative indicators that manifest themselves within the decision-making pro- cess in the form of a decision-making style and represent a typical method of enforcing decisions. Managers’ decision-making styles significantly contribute to their individual performance and thus to the performance of organizations (Abdelsalam, Daeoud & ElKadi, 2013); therefore, as pointed out by Rowe and Boulgarides (1992), they need to be measured, because decision-making styles should form the backbone of effective de- cision-making. Knowledge of decision-making styles and their use in the management structure directly contributes to increasing the competitive advantage of organizations (Remenova & Jankelova, 2019) and can also represent one of the main sources of risk for the successful operation of organizations. Several authors have worked on defining decision-making styles. It is typical of research in the field of decision-making styles that in addition to defining the styles, authors often build different models and constructs, including a varying number of decision-making styles, as well as different inventories for determining the dominant styles of individual subjects (Harren, 1979; Rowe & Mason, 1987; Hunt, Krzystofiak, Meindl, & Yousry, 1989; Scott & Bruce 1995; Nygren, 2000). Berisha, Pula and Kra- sniqi (2018), based on a review of a large number of studies, concluded that one of the most frequently used and validated questionnaires for discovering decision-making styles is the General Decision-Making Style Inventory (GDMS) developed by Scott and Bruce (1995). Scott and Bruce (1995) defined decision-making styles as a learned response or behavioural pattern of an individual who is faced with a decision-making situation. They claimed that it is not a personality trait, but rather a tendency to react in a specific way in a decision-making situation, whereby the characteristics of the situa- tion itself can have a significant influence. The authors also stated that individual styles are not mutually exclusive and that individuals do not rely exclusively on one decision- -making style. The results of their study showed that individuals use a combination of decision-making styles when making important decisions. Based on the questionnaire, which contained 37 items and was used on the initial sample of subjects (military of- ficers), with the use of factor analysis, the authors discovered a structure based on five factors (decision-making styles) and then reduced the questionnaire to 25 items. In the subsequent steps of the analysis, the questionnaire was tested with the use of the factor analysis method (the principal axes method with varimax factor rotation) on the remaining three different samples. The results of the study showed that the structure of the decision-making styles consists of five styles and that the questionnaire can be used ANNALES KINESIOLOGIAE • 13 • 2022 • 1 51 Edvard KOLAR, Matej TUŠAK: DECISION-MAKING STYLE STRUCTURE OF SLOVENIAN SPORTS MANAGERS , 47–73 regardless of the decision-making context or situation (Scott & Bruce, 1995). The five decision-making styles included in the GDMS inventory are defined as (Thunholm, 2004; Faletič & Avsec, 2013): – rational style: characteristic of people who search for information in detail and comprehensively and logically evaluate all the alternatives. They mainly focus on logic, order and the systematic analysis of information; – intuitive style: characteristic of those who pay a lot of attention to details in the information flow and, instead of systematically searching and processing information, mainly consider their feelings about whether a certain decision is correct or not; – dependent style: characteristic of people who seek advice, support and confirma- tion from others before making an important decision; – spontaneous style: characteristic of those who have a sense of urgency and thus a desire to complete the decision-making process as soon as possible and make a decision; – avoidant style; characteristic of people who want to avoid making a decision whenever possible. In various studies on samples from different countries, numerous authors (Loo, 2000; Thunholm, 2004; Spicer & Sadler-Smith, 2005; Gambetti, Fabbri, Bensi & To- netti, 2008; Curşeu & Schruijer; 2012; Erenda, Meško & Bukovec; 2014; Bavoľár & Orosová, 2015; Alacreu-Crespo et al., 2019) have confirmed the validity (using factor analysis) and reliability (using Cronbach’s alpha coefficient) of the GDMS inventory as suggested by Scott and Bruce (1995). In the aforementioned preliminary research, the authors tested the validity of the five-factor structure of decision-making styles on samples of managers, various profiles of students, the general population, military officers and others. In the present study, we will determine the factor structure of decision-making styles using a sample of Slovenian sports managers. Sports managers usually work in the specific environment of non-profit sports organizations, which in terms of legal, structural and procedural characteristics, are significantly different to for-profit organizations (companies). One of the important characteristics of sports organizations is that they are interest-type associations, in which the interests of different stakeholders are in constant conflict (Tavčar & Trunk Širca, 2002). Participants in sports organizations are individuals (offi- cials, coaches and athletes), groups (professional and other) and associations (societies and clubs), all with their own interests and with the possibility of significantly acting and influencing the operation of the organization. Furthermore, in non-profit sports or- ganizations, it is necessary to deal with a large number of volunteers (Santos, Batista & Carvalho, 2022) and to generate and obtain financial resources from a large number of different sources (sponsorships, donations, national and local budgets, sales of products and services, etc.). Finally, a “unique” governmental-managerial process is established in non-profit sports organizations; they are led by a committee of elected volunteers (governmental organizational function) who form very sensitive relations with profes- sional (management) staff (Young, 1998; Kolar & Jurak, 2014). 52 Edvard KOLAR, Matej TUŠAK: DECISION-MAKING STYLE STRUCTURE OF SLOVENIAN SPORTS MANAGERS , 47–73 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 All of the aforementioned specifics of the structure and operation of non-profit sports organizations have a significant impact on the management and decision-ma- king processes in these types of organizations and thus probably on the structure of the decision-making styles of the sports managers. The goals of the present research are to define the factor structure of decision-making styles using a sample of Slovenian sports managers and to determine the characteristics of their structure of decision-making styles. According to the described structural and operational differences in the functio- ning of non-profit sports organizations, we can define the hypothesis that in the struc- ture of decision-making styles of the sample of managers in our research, the depen- dent decision-making style will be more emphasized than the intuitive and spontaneous style, which enables faster and quick decisions. We assume that sports managers have to coordinate decisions with much more diverse stakeholder interests than is typical for for-profit organizations (companies). METHODS Participants The sample consisted of 80 managers of Slovenian sports organizations, which is more than the minimum requirement for executing the factor analysis (de Winter, Dodou & Wieringa, 2009, Andrew, Pedersen & McEvoy, 2010). The average age of the subjects was 47.5±10.6 years and the average work experience as a manager was 15.61±9.7 years. The upper age limit was 68 years, whereas the lower age limit was 28 years. The most experienced manager had 40 years and the least experienced 1 year of work experience. The sample consisted of 56 men (70%) and 24 women (30%). The sample is comparable to samples of sports managers by other authors (Barros & Lucas, 2001; Case & Branch, 2003; Retar, Plevnik & Kolar, 2013). The Slovenian Olympic Committee sent the managers of Slovenian sports organizations an invitation to parti- cipate in the study and to fill in an anonymous internet survey. The invitation was sent three times at one-month intervals. All the subjects participated in the study voluntarily and without any compensation. Instrument The decision-making style was measured with the use of the General Decision- -Making Style Inventory – GDMS (Scott & Bruce, 1995), which was translated into the Slovenian language. The GDMS questionnaire measures five different decision- -making styles: rational, intuitive, dependent, avoidant and spontaneous. The questio- nnaire consists of 25 items (5 for each decision-making style) ranging on a five-point Likert scale from strongly disagree (1) to strongly agree (5). The total score of all five decision-making styles was obtained by adding the item score of the decision-making ANNALES KINESIOLOGIAE • 13 • 2022 • 1 53 Edvard KOLAR, Matej TUŠAK: DECISION-MAKING STYLE STRUCTURE OF SLOVENIAN SPORTS MANAGERS , 47–73 style and the score ranges from 5 to 25. GDMS scales have previously shown good psychometric characteristics (Scott & Bruce, 1995; Loo, 2000; Thunholm, 2004; Spi- cer & Sadler-Smith, 2005; Gambetti, et. al, 2008; Curşeu & Schruijer; 2012; Avsec, 2012; Erenda, et al.; 2014; Bavoľár & Orosová, 2015; Alacreu-Crespo, et. al, 2019). In this study, the alpha coefficients of the scales ranged between 0.572 (spontaneous) and 0.814 (avoidant). The Cronbach’s alpha for the whole GDMS is 0.69, which is a good indicator of internal consistency. The Slovenian version of the GDSM inventory has already been used and validated in several research projects and using different samples in Slovenia (Avsec, 2012; Faletič & Avsec, 2013; Erenda, et al.; 2014); in the present study, general information questions about gender, age, experiences in management, level of education and field of education were added. Statistical Analysis Statistical data processing was carried out using the Statistical Package for the Soci- al Sciences 29 (IBM SPSS Inc., Armonk, NY, USA). The factor analysis method – Prin- cipal Component Factoring (PCF) and varimax rotation of factors – was used to test the assumption about the structure of decision-making styles (Scott & Bruce, 1995). Factor extraction was carried out with the use of Kaiser-Guttman’s criterion (Eigenvalue > 1). Before applying the factor analysis (FA), the data adequacy was tested with the Keiser- -Meyer-Olkin Measure of Sampling Adequacy (KMO) and Bartlett’s test of sphericity. Values of the KMO test above 0.6 indicate that the analyzed data is suitable for the use of FA (Tabachnick & Fidell, 2007). Bartlett’s test must show significant differences at a risk level of less than 5% (p < 0.05), showing that the correlation matrix is not uniform and that the observed variables are related to a certain extent. The internal consistency of the overall scale and subscales was measured using Cronbach’s alpha coefficient. Pearson correlation coefficient was used to study the relationship between the GDMS’ styles. RESULTS Table 1 shows descriptive statistics for five decision-making styles. The average values of the individual decision-making style use (Mean/Value) were calculated from the original model of items assigned to an individual decision-making style (Scott & Bruce, 1995). The average share of the individual decision-making style use (Mean/% of maximum) in relation to the maximum possible total value of the sum of items origi- nally dedicated to the individual decision-making style (maximum = 25) was calculated for each decision-making style. 54 Edvard KOLAR, Matej TUŠAK: DECISION-MAKING STYLE STRUCTURE OF SLOVENIAN SPORTS MANAGERS , 47–73 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Table 1: Descriptive statistics and internal consistency of decision-making styles. Variable Po ss ib le r an g A ct ua l r an ge Mean St an da rd D ev ia tio n Sk ew ne ss K ur to si s C ro nb ac h α Va lu e % o f m ax im um DMS Rational 5–25 15–25 21.35 85.40% 2.081 -0.283 0.885 0.777 DMS Intuitive 5–25 7–21 15.30 61.20% 3.235 -0.537 0.024 0.667 DMS Dependent 5–25 10–23 17.53 70.10% 3.027 -0.211 -0.365 0.694 DMS Avoidant 5–25 5–18 9.21 36.85% 3.129 0.439 -0.508 0.814 DMS Spontaneous 5–25 6–20 12.80 51.20% 2.558 0.122 -0.044 0.572 Key: DMS Rational = rational style; DMS Intuitive = intuitive style; DMS Dependent = dependent style; DMS Avoidant = avoidant style; DMS Spontaneous = spontaneous style. The structure of the decision-making styles (Table 1) revealed that Slovenian sports managers on average most often use the rational and dependent decision-making styles. These are followed by the intuitive and spontaneous decision-making styles whereas sports managers in Slovenia are least likely to use the avoidant decision-making style. Similar results on the structure of decision-making styles in different samples (middle managers, teachers, students, military officers and engineers) were also found by other authors (Scott & Bruce, 1995; Hariri, Monypenny & Prideaux, 2014; Ghazi & Hu, 2016; Berisha, et al., 2018; Krasniqi, Berisha & Pula, 2019). The internal consisten- cy, calculated using Cronbach’s alpha coefficient, was 0.686 for the overall scale and between 0.572 (DMS Spontaneous) and 0.814 (DSM Avoidant) for the five subscales. The reliability coefficient of the questionnaire items for the spontaneous style can be assessed as sufficient, while the other coefficients indicate moderate to robust internal consistency (Taber, 2018). Before applying FA, the Kaiser-Meyer-Olkin (KMO) test and Bartlett’s test of sphe- ricity (Table 2) were carried out to evaluate the factorability. The KMO measure of sampling adequacy was 0.689 (the required minimum is above 0.6) and the significance of Bartlett’s test of sphericity was 0.000 (p < 0.01). The results of both tests show that the studied sample is suitable for performing FA. ANNALES KINESIOLOGIAE • 13 • 2022 • 1 55 Edvard KOLAR, Matej TUŠAK: DECISION-MAKING STYLE STRUCTURE OF SLOVENIAN SPORTS MANAGERS , 47–73 Table 2: The Kaiser-Meyer-Olkin (KMO) test and Bartlett’s test of sphericity. KMO and Bartlett‘s Test Kaiser-Meyer-Olkin Measure of Sampling Adequacy. 0,689 Bartlett‘s Test of Sphericity Approx. Chi-Square 824.326 df 300 Sig. 0.000 The structure of the decision-making styles of Slovenian sports managers was ve- rified by FA using the method of principal components with varimax rotation (Table 3). The FA procedure based on Kaiser-Guttman’s criterion extracted seven (7) factors, which cumulatively explain 66.65% of the total variance. Table 3 shows a scree plot diagram with the factor eigenvalue curve bend at the fifth factor, meaning that a five- -factor solution corresponds to the basic GDMS model and could also be considered a valid result of the FA (Scott & Bruce, 1995; Spicer & Sadler-Smith, 2005). Thus, the rotated solution with five factors explains 54.57% of the total variance of the observed variables. Table 4 shows the factor structure and factor loadings of the items included in the GDMS inventory, which were obtained by the orthogonal rotation of the factors using the varimax method. It can be observed that all the items measuring a rational decision- -making style (DMSRAT1 to DMSRAT5) from the original model are related to the first factor (factor loadings from 0.637 to 0.725). The first factor explains 13.91% of the total variance of the rotated solution (Table 3) and can be named the “rational style”. The second factor is associated with four items measuring the avoidant style (DMSA- VO2, 3, 4 and 5) and one of the spontaneous decision-making style items (DMSSPO2). The projections of avoidant style items on the second factor are high (factor loadings from 0.663 to 0.876), while the projection of the DMSSPO2 on the same factor is very low (0.382). Therefore, the second factor can be named the “avoidant style”, explaining 13.61% of the total space of the rotated solution (Table 3). The third factor (Table 4) is explained with three items measuring the intuitive decision-making style (DMSINT1, 2 and 5). Projections of items on this factor are very high for all three items (factor loadings from 0.797 to 0.871). The third factor explains 10.61% of the total variance of the rotated solution (Table 3) and can be named the “intuitive style”. The fourth factor is explained with four dependent decision-making style variables (DMSDEP1, 2, 3 and 4) with relatively high projections on the factor (factor loadings from 0.636 to 0.788). The fourth factor explains 8.90% of the total variance (Table 3) and can be named the “dependent style”. The fifth factor is explained with only two items, both belonging to the spontaneous decision-making style (DMSSPO1 and 3). Their projections on the factor are high (factor loadings 0.735 and 0.801). The fifth factor explains 7.54% of the total variance of the rotated solution (Table 3) and can be named the “spontaneous style”. The sixth factor of the rotated solution is explained with four variables, which, in 56 Edvard KOLAR, Matej TUŠAK: DECISION-MAKING STYLE STRUCTURE OF SLOVENIAN SPORTS MANAGERS , 47–73 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Total Variance Explained C om po ne nt Initial Eigenvalues Extraction Sums of Squared Loadings Rotation Sums of Squared Loadings To ta l % o f V ar ia nc e C um ul at iv e % To ta l % o f V ar ia nc e C um ul at iv e % To ta l % o f V ar ia nc e C um ul at iv e % 1 5.022 20.087 20.087 5.022 20.087 20.087 3.479 13.917 13.917 2 3.451 13.803 33.890 3.451 13.803 33.890 3.403 13.612 27.529 3 2.943 11.774 45.664 2.943 11.774 45.664 2.654 10.615 38.144 4 1.704 6.816 52.480 1.704 6.816 52.480 2.226 8.903 47.048 5 1.347 5.389 57.869 1.347 5.389 57.869 1.884 7.538 54.586 6 1.155 4.621 62.490 1.155 4.621 62.490 1.628 6.511 61.097 7 1.039 4.155 66.645 1.039 4.155 66.645 1.387 5.549 66.645 8 0.915 3.662 70.307 9 0.860 3.441 73.748 10 0.813 3.253 77.001 11 0.700 2.799 79.800 12 0.634 2.537 82.336 13 0.620 2.481 84.817 14 0.572 2.287 87.104 15 0.471 1.886 88.990 16 0.429 1.716 90.705 17 0.398 1.594 92.299 18 0.367 1.467 93.765 19 0.329 1.318 95.083 20 0.300 1.200 96.283 21 0.267 1.068 97.351 22 0.215 0.859 98.211 23 0.171 0.683 98.894 24 0.164 0.656 99.550 25 0.112 0.450 100.000 Table 3: FA of the original GDMS inventory with 25 items. ANNALES KINESIOLOGIAE • 13 • 2022 • 1 57 Edvard KOLAR, Matej TUŠAK: DECISION-MAKING STYLE STRUCTURE OF SLOVENIAN SPORTS MANAGERS , 47–73 Table 4: Factor structure and factor loadings of the 25 items of the GDMS inventory. Rotated Component Matrixa Component 1 2 3 4 5 6 7 DMSRAT3 0.725 DMSRAT5 0,716 DMSRAT4 0.714 DMSRAT1 0.670 DMSRAT2 0.637 DMSAVO3 0.876 DMSAVO2 0.769 DMSAVO5 0.760 DMSAVO4 0.663 DMSSPO2 0.382 DMSINT2 0.871 DMSINT5 0.821 DMSINT1 0.797 DMSDEP1 0.788 DMSDEP4 0.679 DMSDEP3 0.671 DMSDEP2 0.636 DMSSPO3 0.801 DMSSPO1 0.735 DMSDEP5 0.613 DMSINT4 0.563 DMSAVO1 0.479 DMSSPO4 0.373 DMSINT3 0.746 DMSSPO5 0.662 Notes: DMSRAT1-5 = rational style items 1 to 5; DMSINT1 – 5 = intuitive style items 1 to 5; DMSDEP1 – 5 = dependent style item 1 to 5; DMSAVO1-5 = avoidant style items 1 to 5; DMSSPO1 – 5 = spontaneous style items 1 to 5. 58 Edvard KOLAR, Matej TUŠAK: DECISION-MAKING STYLE STRUCTURE OF SLOVENIAN SPORTS MANAGERS , 47–73 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 the original GDMS inventory model, are classified as different decision-making styles. With the exception of the rational style variables, all the other decision-making styles are related to this sixth factor. Projections of individual items in the sixth factor are lower than for the first five factors (factor loadings from 0.373 to 0.613). The sixth fac- tor explains 6.51% of the total variance of the rotated solution (Table 3) and can be na- med the “non-rational style” or “descriptive style”, as the variables associated with this factor measure all the decision-making styles from the original model with the excep- tion of the rational style. Items explaining this decision-making style deviate from the rational or normative model of decision-making, assuming that the decision-maker is entirely rational and fully follows the decision-making process. Observing this aspect, these items primarily belong to the descriptive rather than rational decision-making styles (Bohanec, 2001). The seventh factor is explained with two variables belonging to the intuitive and spontaneous decision-making styles. The projection of both variables in the seventh factor is relatively high (DMSINT3 = 0.746 and DMSSPO = 0.662) with the factor explaining 5.55% of the total variance (Table 3). The association of these two variables in the same factor is not surprising, as different authors have found statisti- cally significant correlations between the intuitive and spontaneous decision-making styles (Scott & Bruce, 1995; Thunholm, 2004; Spicer & Sadler-Smith, 2005; Wood, 2012; Verma, Rangnekar & Barua, 2012; Curşeu & Schruijer, 2012; Faletič & Avsec, 2013; Reyna, Ortiz & Revilla, 2014; Hariri, et al., 2014; Bavoľár & Orosová 2015; Berisha, et al., 2018; Geisler & Allwood, 2018). Based on this, it can be concluded that both styles have the same cognitive structure in the background, which could be named the intuitive-experiential cognitive style (Sagiv, Amit, Ein-Gar & Arieli, 2013; Alacreu- -Crespo, et. al, 2019). As Thunholm (2004) states, the spontaneous decision-making style could also be named the high-speed intuitive style due to the urgency of the deci- sion-making process. As a result, we have named the seventh factor the “high-speed” decision-making style. Since the scree plot diagram analysis revealed that it is possible to interpret the factor structure with only five factors (Table 3) and as the sixth and se- venth factors are unclear, we further checked how the variables are projected within the five-factor structure of the decision-making styles of sports managers. Table 5 shows the five-factor structure of the decision-making styles of Slovenian sports managers. The factor structure with a limited number of extracted factors (five) explains 57.87% of the total variance – 8.78% less than the full seven-factor model. This structure is also characterized by higher eigenvalues of all five extracted factors; also, a larger part of the total variance is explained than for the five factors within the seven-factor model (+ 3.30%). Eight items are projected onto the first factor, which explains 15.67% of the total variance. All the items measuring the avoidant decision- -making style in the original GDMS inventory are related to this factor (factor loadings 0.489 and 0.832). Furthermore, two variables measuring the spontaneous decision-ma- king style (DMSSPO4 = 0.541 and DMSSPO2 = 0.489) and a single variable mea- suring the dependent decision-making style (DMSDEP5 = 0.658) are also related to the first factor. In contrast, within the seven-factor solution, the variables DMSDEP5 and DMSSPO4 were connected to the sixth factor (non-rational style) and the variable ANNALES KINESIOLOGIAE • 13 • 2022 • 1 59 Edvard KOLAR, Matej TUŠAK: DECISION-MAKING STYLE STRUCTURE OF SLOVENIAN SPORTS MANAGERS , 47–73 Table 5: Factor structure and factor loadings with a limited number of extracted factors. Rotated Component Matrixa Component 1 2 3 4 5 DMSAVO5 0.832 DMSAVO3 0.808 DMSAVO2 0.752 DMSDEP5 0.658 DMSAVO1 0.619 DMSSPO4 0.541 DMSAVO4 0.495 DMSSPO2 0.489 DMSRAT3 0.742 DMSRAT5 0.693 DMSRAT4 0.678 DMSRAT1 0.664 DMSRAT2 0.659 DMSINT2 0.858 DMSINT1 0.817 DMSINT5 0.788 DMSINT4 0.566 DMSDEP1 0.793 DMSDEP2 0.627 DMSDEP3 0.564 DMSDEP4 0.503 0.556 DMSSPO3 0.774 DMSSPO1 0.687 DMSINT3 0.686 DMSSPO5 0.435 Eigenvalues 3.918 3.436 2.762 2.335 2.017 % of Variance 15.672 13.744 11.048 9.339 8.066 60 Edvard KOLAR, Matej TUŠAK: DECISION-MAKING STYLE STRUCTURE OF SLOVENIAN SPORTS MANAGERS , 47–73 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 DMSSPO2 was connected with the lowest projection to the second factor (avoidant style). As the first factor includes all five variables measuring the avoidant style (DMSA- VO1 - 5), as well as a variable from a seven-factor model structure with a projection on the avoidant style factor (Table 4) and two variables with a projection on the sixth factor (non-rational style), it can be named the “avoidant style”. The second factor is explained with five items measuring the rational decision-making style (DMSRAT1 - 5). The projections of items on this factor are high for all five items (factor loadings from 0.659 to 0.742). The second factor explains 13.74% of the total variance and can be named the “rational style”. The third factor is explained with four items measuring the intuitive decision-making style (DMSINT1, 2, 4 and 5). The projections of items on this factor are moderate to very high (factor loadings from 0.566 to 0.858). The third factor explains 11.05% of the total variance and can be named the “intuitive style”. The fourth factor is, as in the seven-factor model, explained with four dependent decision- -making style variables (DMSDEP1, 2, 3 and 4). Projections of items on this factor are moderate to high (factor loadings from 0.556 to 0.793); the fourth factor explains 9.34% of the total variance and can be named the “dependent style”. The fifth factor is a combination of the fifth (spontaneous style) and seventh (high-speed style) factors from the seven-factor model structure. This factor is explained with three variables measuring the spontaneous decision-making style in the original model (DMSSPO1, 3 and 5) and a variable measuring intuitive style (DMSINT3), together explaining 8.07% of the total variance of the studied space. With the exception of the variable DMSSPO5, which has a slightly lower projection on the fifth factor (0.435), other variables have high projections (factor loadings from 0.686 to 0.774). The fifth factor is named the “spontaneous style”. In this way, the developed five-factor decision-making styles structure model forms individual factors or decision-making styles more clearly and, at the same time, establi- shes the same structure as the original GDMS inventory (Scott & Bruce, 1995), which was confirmed by other authors (Loo, 2000; Thunholm, 2004; Spicer & Sadler-Smith, 2005; Gambetti, et al., 2008; Curşeu & Schruijer; 2012; Avsec, 2012; Erenda, Meško & Bukovec; 2014; Bavoľár & Orosová, 2015; Alacreu-Crespo, et. al, 2019). Regardless of the increased clarity of the five-factor structure model, some variables are nevertheless distributed outside the predicted decision-making styles. Some other authors have also faced a similar problem with different samples; they named the variables that were not distributed among the factors in accordance with the intended model as “problematic items”. One such item, which in the resulting five-factor structure (Table 5), was not projected onto the factors in accordance with the original model, is DMSDEP5 (I like to have someone to steer me in the right direction when I am faced with important de- cisions) (Baiocco, Laghi, D´alesio, Gurrieri & Di Chiacchio, 2007; Fischer, Soyez & Gurtner, 2015; del Campo, Pauser, Steiner & Vetschera, 2016). This particular item did not project onto a dependent style factor in either seven-factor or five-factor structure models. Two further variables were also not projected onto a spontaneous style factor in either of the two models; namely, DMSSPO4 (I often make impulsive decisions) ANNALES KINESIOLOGIAE • 13 • 2022 • 1 61 Edvard KOLAR, Matej TUŠAK: DECISION-MAKING STYLE STRUCTURE OF SLOVENIAN SPORTS MANAGERS , 47–73 and DMSSPO2 (I often make decisions on the spur of the moment) (Fischer, et al., 2015). In the continuation of the present study, we designed the “optimized structure model” by removing the mentioned variables from the structure of the decision-making styles of Slovenian sports managers. In order to balance the number of items for each decision-making style (four items per style), we also removed the variables that, in the five-factor structure model (Table 5), had the smallest projections on the avoidant style factor (DMSAVO4 - I generally make important decisions at the last minute) and the rational style factor (DMSRAT2 - I make decisions in a logical and systematic way). Both of these variables have also been characterized as problematic by other authors (Baiocco, et. al, 2007; Fischer, et al., 2015). Based on previous projections of the vari- able DMSINT3 (I generally make decisions that feel right to me) onto the high-speed (Table 4) and spontaneous (Table 5) styles, we assumed that in the continuation of the research, this variable would also have a high projection on the spontaneous decision- -making style. Table 6: Descriptive statistics and internal consistency of the optimized structure model of decision-making styles. Va ri ab le Po ss ib le r an g A ct ua l r an ge Mean St an da rd D ev ia tio n Sk ew ne ss K ur to si s C ro nb ac h α Va lu e % o f m ax im um DMS Rational 5–20 12–20 17.03 85.13% 1.736 -0.203 0.630 0.740 DMS Intuitive 5–20 4–18 12.43 62.13% 2.997 -0.591 0.258 0.775 DMS Dependent 5–20 9–20 15.28 76.38% 2.648 -0.087 -0.520 0.705 DMS Avoidant 5–20 4–14 7.18 35.88% 2.540 0.403 -0.706 0.814 DMS Spontaneous 5–20 5–17 12.56 62.81% 2.609 -0.575 0.051 0.609 Table 6 reveals no changes in the order of the average use of individual decision- -making styles, between the optimized structural model of the decision-making styles of Slovenian sports managers (20 items; 4 items per decision-making style) and the original GDMS inventory model (25 items, 5 items per decision-making style). The internal consistency, calculated using Cronbach’s alpha coefficient, was 0.637 for 62 Edvard KOLAR, Matej TUŠAK: DECISION-MAKING STYLE STRUCTURE OF SLOVENIAN SPORTS MANAGERS , 47–73 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 the overall scale and between 0.609 (DMS Spontaneous) and 0.814 (DSM Avoidant) for the five subscales. The reliability coefficients for the intuitive (DMS Intuitive α = 0.775), dependent (DMS Dependent α = 0.705) and spontaneous (DMS Spontaneous α = 0.609) subscales were higher in comparison to the original model, whilst the reli- ability coefficient was slightly lower for the rational style subscale (DMS Rational α = 0.740) and equal for the avoidant decision-making style subscale. The KMO measure of sampling adequacy was 0.646 (the required minimum is above 0.6) and the signifi- cance of Bartlett’s test of sphericity was 0.000 (p < 0.01) (Table 7). The results of both tests show that the studied sample is suitable for performing FA. Table 7: The Kaiser-Meyer-Olkin (KMO) test and Bartlett’s test of sphericity for the optimized model. KMO and Bartlett‘s Test Kaiser-Meyer-Olkin Measure of Sampling Adequacy 0.646 Bartlett‘s Test of Sphericity Approx. Chi-Square 592.612 df 190 Sig. 0.000 The optimized structure with 20 items of the decision-making styles of Slovenian sports managers was verified by FA using the method of principal components with varimax rotation (Table 8). The FA procedure, based on Kaiser-Guttman’s criterion, extracted five (5) factors that cumulatively explained 61.60% of the total variance, which is 3.73% more than in the five-factor structure of the original GDMS Inventory with 25 items (Table 5). Table 9 shows the factor structure and factor loadings of the 20 items included in the optimized model inventory, obtained by the orthogonal rotation of the factors using the varimax method. Four avoidant style variables (DMSAVO1, 2, 3 and 5) are associated with the first factor (factor loadings from 0.618 to 0.859), together explaining 14.39% of the total variance (Table 8). This first factor can be named the “avoidant style”. The second factor is explained with four items measuring the intuitive decision-making style (DMSINT1, 2, 4 and 5). The projections of items on this factor are very high for three items (factor loadings from 0.803 to 0.856) and moderate for DMSINT4 (0.569). The second factor explains 13.45% of the total variance and can be named the “intuitive style”. The third factor is explained with four items measuring the rational decision-ma- king style (DMSRAT1, 3, 4 and 5). The projections of items on this factor are high for all four items (factor loadings from 0.661 to 0.754). The third factor explains 13.29% of the total variance and can be named the “rational style”. Four variables measuring ANNALES KINESIOLOGIAE • 13 • 2022 • 1 63 Edvard KOLAR, Matej TUŠAK: DECISION-MAKING STYLE STRUCTURE OF SLOVENIAN SPORTS MANAGERS , 47–73 Table 8: FA of the optimized structure model inventory with 20 items. Total Variance Explained C om po ne nt Initial Eigenvalues Extraction Sums of Squared Loadings Rotation Sums of Squared Loadings To ta l % o f Va ri an ce C um ul at iv e % To ta l % o f Va ri an ce C um ul at iv e % To ta l % o f Va ri an ce C um ul at iv e % 1 3.547 17.735 17.735 3.547 17.735 17.735 2.878 14.388 14.388 2 3.129 15.646 33.380 3.129 15.646 33.380 2.689 13.446 27.834 3 2.785 13.925 47.305 2.785 13.925 47.305 2.658 13.288 41.121 4 1.577 7.887 55.192 1.577 7.887 55.192 2.188 10.942 52.063 5 1.282 6.408 61.600 1.282 6.408 61.600 1.907 9.536 61.600 6 0.984 4.920 66.519 7 0.882 4.409 70.928 8 0.809 4.044 74.972 9 0.798 3.988 78.961 10 0.658 3.289 82.250 11 0.624 3.119 85.369 12 0.580 2.901 88.271 13 0.509 2.543 90.813 14 0.374 1.871 92.684 15 0.326 1.632 94.317 16 0.307 1.536 95.852 17 0.261 1.306 97.158 18 0.238 1.190 98.348 19 0.208 1.040 99.388 20 0.122 0.612 100.000 64 Edvard KOLAR, Matej TUŠAK: DECISION-MAKING STYLE STRUCTURE OF SLOVENIAN SPORTS MANAGERS , 47–73 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Table 9: Factor structure and factor loadings of the optimized model inventory with 20 items. Rotated Component Matrixa Component 1 2 3 4 5 DMSAVO3 0.859 DMSAVO5 0.833 DMSAVO2 0.828 DMSAVO1 0.618 DMSINT2 0.856 DMSINT1 0.811 DMSINT5 0.803 DMSINT4 0.569 DMSRAT3 0.754 DMSRAT5 0.732 DMSRAT4 0.716 DMSRAT1 0.661 DMSDEP1 0.812 DMSDEP3 0.635 DMSDEP2 0.594 DMSDEP4 0.581 DMSSPO3 0.790 DMSINT3 0.705 DMSSPO1 0.677 DMSSPO5 0.433 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 65 Edvard KOLAR, Matej TUŠAK: DECISION-MAKING STYLE STRUCTURE OF SLOVENIAN SPORTS MANAGERS , 47–73 the dependent decision-making style have a projection on the fourth factor. The projec- tions of the variables on this factor range from moderate for the variables DMSDEP4 (0.581), DMSDEP2 (0.594) and DMSDEP3 (0.635) to very high for the variable DM- SDEP1 (0.812). The fourth factor explains 10.94% of the total variance and can be named the “dependent style”. The fifth factor combines three variables measuring the spontaneous decision-making style (DMSSPO1, 3 and 5) and a variable measuring the intuitive style (DMSINT3); this factor is identical to the fifth factor extracted in a five-factor structure with 25 items (Table 5). With the exception of the variable DMS- SPO5, which has a low but still satisfactory projection onto this factor (0.433), the other variables have high projections (factor loadings from 0.677 to 0.790). The fifth factor explains 9.54% of the total variance. Table 10: Correlations between the decision-making styles in the optimized structure model inventory with 20 items. Correlations DMS Rational DMS Intuitive DMS Dependent DMS Avoidant DMS Spontaneous DMS Rational 1 DMS Intuitive -0.143 1 DMS Dependent .348** 0.012 1 DMS Avoidant -0.211 0.020 0.175 1 DMS Spontaneous -0.087 .278* -0.036 -0.025 1 Notes: * p < 0.05; ** p < 0.01. Table 10 shows the correlations between the extracted factors within the optimized model of the decision-making styles of Slovenian sports managers. Correlation analysis showed that the rational and dependent decision-making styles are statistically signifi- cantly related at a 1% risk level. A statistically significant association at a 5% risk level was also found between the intuitive and spontaneous decision-making styles. Similar conclusions were also reached by other authors (Scott & Bruce, 1995; Thunholm, 2004; Spicer & Sadler-Smith, 2005; Baiocco, Laghi & Alessio, 2009; Wood, 2012; Verma, et al., 2012; Curşeu & Schruijer, 2012; Faletič & Avsec, 2013; Reyna, et. al., 2014; Hariri, et al., 2014; Bavoľár & Orosová 2015; Berisha, et al., 2018; Geisler & Allwood, 2018). These findings are consistent with the expectations; namely, both types of connections are characterized by the same cognitive style in the background, defining the manife- station of the aforementioned styles. Thus, the rational and dependent decision-making styles have a background in the rational-analytical cognitive style, while the intuitive 66 Edvard KOLAR, Matej TUŠAK: DECISION-MAKING STYLE STRUCTURE OF SLOVENIAN SPORTS MANAGERS , 47–73 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 and spontaneous decision-making styles have a background in the intuitive-experiential cognitive style (Sagiv et. al, 2013; Alacreu-Crespo et al., 2019). DISCUSSION The decision-making style focuses attention on how an individual obtains, uses and interprets information. Thunholm (2004) defined a decision-making style as a response pattern that an individual shows when faced with a decision problem. This response pattern depends on the decision situation, the decision problem and the decision maker. Faletič and Avsec (2013) stated that although the nature of the problem and the situati- onal factors play an important role in decision-making, we can assume that individuals differ in the frequency of using individual decision-making styles regardless of the decision-making problem. Managers’ decision-making styles contribute significantly to their individual performance and thus to the performance of organizations (Abdel- salam, Dawoud & ElKadi, 2013); therefore, as pointed out by Rowe and Boulgarides (1992), they need to be measured, because decision-making styles should form the backbone of effective decision-making. The present study deals with determining the structure of the decision-making styles of Slovenian sports managers. The GDMS Inventory (Scott & Bruce, 1995) with a five- -factor structure was used to measure decision-making styles. After three successive implementations of FA using the method of principal components with the orthogonal rotation of factors using the varimax method, we developed a five-factor model of decision-making styles with 20 items. The results and a comparison of the individual obtained models are presented in Table 11. Table 11 shows the basic characteristics of all three studied factor models. In all three models, the first five extracted factors form the original structure of the model de- veloped by Scott and Bruce (1995), which was confirmed by the authors earlier menti- oned. The developed optimized structure model inventory includes 20 items measuring the avoidant, intuitive, rational, dependent and spontaneous decision-making styles. This model has relatively good internal consistency, both at the level of the entire mo- del and at the level of the individual decision-making styles. Individual factors also explain the variance of the space of decision-making styles in a more balanced way compared to the other two models with 25 items. Another advantage of the developed optimized model is the balanced number of items measuring the individual decision- -making styles, allowing us to determine a clearer structure of decision-making styles, both at the level of the individual decision-maker and at the level of the entire sample. In all three factor models, the rational, avoidant and dependent styles showed the gre- atest stability of the structure of the included items. The stability of the intuitive style was relatively good, while the spontaneous style scale proved to be very unstable and problematic (Fischer et. al, 2015). Based on the optimized structure model inventory, we calculated the structure of the decision-making styles of Slovenian sports managers (Table 6), confirming that when ANNALES KINESIOLOGIAE • 13 • 2022 • 1 67 Edvard KOLAR, Matej TUŠAK: DECISION-MAKING STYLE STRUCTURE OF SLOVENIAN SPORTS MANAGERS , 47–73 Ta bl e 11 : B as ic c ha ra ct er is tic s o f a ll th re e fa ct or m od el s o f t he d ec is io n- m ak in g st yl e st ru ct ur e of S lo ve ni an sp or ts m an ag er s. Solution 7- fa ct or s s ol ut io n 5- fa kt or so lu tio n O pt im iz ed st ru ct ur e m od el in ve nt or y (2 5 ite m s) (2 5 ite m s) (2 0 ite m s) % o f va ri an ce 66 .6 45 % 57 .8 69 % 61 .6 00 % Extracted factors (decion-making styles) Factor name No of items % of variance α Factor name No of items % of variance α Factor name No of items % of variance α R at io na l s ty le 5 13 .9 2% 0. 77 7 Av oi da nt st yl e 8 15 .6 7% 0. 82 8 Av oi da nt st yl e 4 14 .3 9% 0. 81 4 Av oi da nt st yl e 5 13 .6 1% 0. 81 0 R at io na l st yl e 5 13 .7 4% 0. 77 7 In tu iti ve st yl e 4 13 .4 5% 0. 77 5 In tu iti ve st yl e 3 10 .6 1% 0. 82 4 In tu iti ve st yl e 4 11 .0 5% 0. 77 5 R at io na l st yl e 4 13 .2 9% 0. 74 0 D ep en de nt st yl e 4 8. 90 % 0. 70 5 D ep en de nt st yl e 4 9. 34 % 0. 70 5 D ep en de nt st yl e 4 10 .9 4% 0. 70 5 Sp on ta ne ou s st yl e 2 7. 54 % 0. 69 7 Sp on ta ne ou s st yl e 4 8. 07 % 0. 60 9 Sp on ta ne ou s st yl e 4 9. 54 % 0. 60 9 N on -r at io na l st yl e 4 6. 51 % 0. 60 2 H ig h sp ee d st yl e 2 5. 55 % 0. 41 3 68 Edvard KOLAR, Matej TUŠAK: DECISION-MAKING STYLE STRUCTURE OF SLOVENIAN SPORTS MANAGERS , 47–73 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 making decisions, sports managers use a combination of all five decision-making styles (Scott & Bruce, 1995; Thunholm, 2004; Avsec, 2012; Faletič & Avsec, 2013). Slove- nian sports managers mostly use the rational (Atilgan & Kaplan, 2022) and dependent decision-making styles, indicating that they are mostly rational decision-makers. Rati- onal decision-makers characteristically follow a decision-making process involving the critical evaluation of evidence and a structured process that requires time and conscious effort before making and implementing decisions (Fitzgerald, Mohammed & Kremer, 2017). Rational and intuitive decision-making styles are defined as functional decision- -making styles, the use of which leads to various positive outcomes (Faletič & Avsec, 2013; Alacreu-Crespo, et. al, 2019). In contrast to a number of other studies, in our sample, the dependent decision-making style emerged as the second most used style (Spicer & Sadler-Smith, 2005; Curşeu & Schruijer, 2012; Erenda, Meško & Bukovec, 2014; Alacreu-Crespo et al., 2019; El Othman et. al, 2020). The dependent decision- -making style has a statistically significant positive correlation with emotional (seeking moral support) and instrumental social support (seeking advice, help and information from others). Connection with both aspects of support indicates that individuals who predominantly use the dependent decision-making style, seek support within their envi- ronment for the decision-making processes (Alacreu-Crespo et al., 2019). However, it has to be emphasized that the dependent style is not necessarily dysfunctional, as it also correlates with positive outcomes when it is defined on the basis of behaviour, such as seeking advice and support and not shifting responsibility to others (Faletič & Avsec, 2013; Fischer et. al, 2015). Frequent use of the dependent decision-making style in Slovenian sports managers is probably related to specific characteristics for this type of organization (Young, 1998; Kolar & Jurak, 2014). Sports managers mostly work in in- terest-type associations, where the interests of various participants and stakeholders (at- hletes, volunteers, employees, associations, the state, local communities, sponsors, etc.) overlap or are even in conflict. Managers need to constantly coordinate and consider all these interests in the decision-making processes in order to achieve the organization’s strategic and operational goals (Parent, 2010). In these organizations, there is also a “unique” governmental-managerial process, led by a committee of elected volunteers (governmental organizational function) who form very sensitive relations with the pro- fessional (management) staff (Young, 1998; Kikulis, Slack & Hinings, 1995). When re- gulating this process, the managers are in a subordinate position, as they are appointed by the governmental function and therefore need to act in accordance with the interests of the government. In order to avoid a conflict between the managerial and governmen- tal structures, the managers depend on the opinions, directions and decisions of the government, otherwise the negative consequences would mostly be reflected on the managers. The structure of decision-making styles also shows that sports managers use an intuitive and spontaneous decision-making style to a lesser extent, which means that they are less likely to make decisions quickly, unconsciously and based on experience (Simon, 1987; Epstein, 1994; Kahneman, 2003; Dane & Pratt, 2007). This is probably also related to the aforementioned specifics of this type of organization. Sports mana- gers use an avoidant decision-making style least often or to a negligible extent, which ANNALES KINESIOLOGIAE • 13 • 2022 • 1 69 Edvard KOLAR, Matej TUŠAK: DECISION-MAKING STYLE STRUCTURE OF SLOVENIAN SPORTS MANAGERS , 47–73 is good, because this decision-making style is defined as pathological and dysfunctional and, as such, does not lead to decisions (Mitchell, Shepherd & Sharfman, 2011; Faletič & Avsec, 2013). Finally, it is necessary to mention the recognized connection between the rational and the dependent styles, which are together also classified as a non-functional deci- sion-making style. Since the structure of the decision-making styles in our sample is dominated by the rational decision-making style, we could conclude that this forms a dependent-rational decision-making style, which can be characterized as functional (Faletič & Avsec, 2013; Fischer et. al, 2015). It is typical for such decision-makers to seek advice, opinions and knowledge from colleagues when making decisions, thus using the dependent style and increasing the rationality of their decisions (Vroom, 2003; Khasawneh, Alomari & Abu-tineh, 2011). Such an understanding is in accor- dance with the theory of extended rationality (Secchi, 2010), where a decision-maker reduces the influence of the limitations of rationality, which arise from an individual’s abilities to acquire and process information (Simon, 1976). CONCLUSION The decision-making process of managers has an important impact on the deve- lopment and growth of sports organizations; therefore, the knowledge of the way mana- gers make decisions is very important. In the present study, we found that the structure of the decision-making styles of Slovenian sports managers is formed as a combina- tion of five decision-making styles, with the rational and dependent decision-making styles being predominant. We can conclude that the recognized average structure of decision-making styles is functional and healthy; furthermore, Slovenian sports mana- gers are, on average, rational decision-makers who, due to the specific organizational characteristics of sports organizations, look for confirmation and opinions on future decisions in the broader environment of the organizations’ stakeholders. This study also developed an instrument for measuring the decision-making styles of sports managers, which assumes a five-factor structure of decision-making styles and is consistent with the GDSM Inventory developed and proposed by Scott and Bruce (1995). By using the questionnaire, it is possible to predict the behaviour of individual decision-makers in decision-making situations, which can be an important tool when choosing a manager for an individual sports organization or placing them in the overall organizational struc- ture of a sports organization. Limitations of the Study There are some limitations that should be considered for a more valid understanding of the results obtained. The participants completed the questionnaire online and this may have influenced the results. The study could be improved with a larger sample, 70 Edvard KOLAR, Matej TUŠAK: DECISION-MAKING STYLE STRUCTURE OF SLOVENIAN SPORTS MANAGERS , 47–73 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 which means that we need to be careful when generalizing the results to the entire po- pulation of sports managers. REFERENCES Abdelsalam, H. M., Dawoud, R. H. & ElKadi, H. A. (2013). An examination of the decision-making styles of egyptian managers. In S. Saeed, M. A. Khan & R. Ahmad (Eds.), Business Strategies and Approaches for Effective Engineering Management (pp. 219-236). USA, Pennsylvania, Hershey: Business Science Reference. https://doi. org/10.4018/978-1-4666-3658-3.ch013. Alacreu-Crespo, A., Fuentes, M.C., Abad-Tortosa, D., Cano-Lopez, I., Gonzalez, E. & Serrano, M.A. (2019). Spanish validation of General Decision-Making Style sca- le: Sex invariance, sex differences and relationship with personality and coping style. Judgment and Decision Making, 14(6), 739-751. Retrieved from https://sjdm.org/ journal/19/190621a/jdm190621a.pdf Andrew, P.S.D., Pedersen, P.M. & McEvoy, C.D. (2010). Research Methods and Design in Sport Management. USA, Champaign, IL: Human Kinetics. Atılgan, D., & Kaplan, T. (2022). Investigation of the relationship among crisis manage- ment, decision-making and self-confidence based on sports managers in Turkey. Journal of Sport Sciences Researches, 7(1), 49-67. Avsec, A. (2012). Do emotionally intelligent individuals use more adaptive decision-mak- ing styles? Studia Psychologica, 54(3), 209-219. Baiocco, R., Laghi, F., D’Alessio, M., Guerrieri, G., & Di Chiacchio, C. (2007). Gli stili nella presa di decisione in adolescenza: quale rilevanza nella pratica orientativa. Psico- logia dell’educazione e formazione, 9(1), 67-98. Baiocco, R., Laghi, F. & D’Alessio, M. (2009). Decision-making style among adolescents: Relationship with sensation seeking and locus of control. Journal of Adolescence, 32, 963-976. Barros, C., & Lucas, J. (2001). Sports managers and subsidies. European Sport Manage- ment Quarterly, 1(2), 112-123. Bavoľár, J. & Orosová, O. (2015). Decision-making styles and their associations with de- cision-making competencies and mental health. Judgment and Decision Making, 10(1), 115-122. Berisha, G., Pula, J. S. & Krasniqi, B. (2018). Convergent validity of two decision mak- ing style measures. Journal of Dynamic Decision Making, 4(1), 1-8. Bohanec, M. (2001). What is Decision Support? https://www.researchgate.net/publication/ 248421433_What_is_Decision_Support Bohanec, M. (2012). Odločanje in modeli. Ljubljana: DMFA – založništvo. Case, R., & Branch, J. (2003). A Study to Examine the Job Competencies of Sport Facility Managers. International Sports Journal, 7(2), 25. Curşeu, P.L. & Schruijer, S.G.L. (2012). Decision Style and Rationality: An Analysis of Predictive Validity of the General Decision-Making Style Inventory. Educational and Psychological Measurement, 72(6), 1053-1062. Daft, L.R. (2008). Organization Theory and Design (10th Edition). USA, Ohio: South- Western Cengage Learning. ANNALES KINESIOLOGIAE • 13 • 2022 • 1 71 Edvard KOLAR, Matej TUŠAK: DECISION-MAKING STYLE STRUCTURE OF SLOVENIAN SPORTS MANAGERS , 47–73 Daft, L.R. (2010). Management (9th Edition). USA, Ohio: South-Western Cengage Learning. Dane, E.I., & Pratt, M.G. (2007). Exploring intuition and its role in managerial decision- making. Academy of Management Review, 32(1), 33-54. de Winter, J.C.F, Dodou, D. & Wieringa, P.A. (2009). Exploratory Factor Analysis Small Sample Sizes. Multivariate Behaviour Research, 44(2), 147-181. del Campo, C., Pauser, S., Steiner, E., & Vetschera, R. (2016). Decision making styles and the use of heuristics in decision making. Journal of Business Economics, 86(4), 389–412. https://doi.org/10.1007/s11573-016-0811-y Driver, M. J. (1979). Individual decision-making and creativity. V S. Kerr (Ur.), Organiza- tional behavior. USA, Ohio, Columbus: Grid Publishing. El Othman, R., El Othman, R., Hallit, R., Obeid, S. & Hallit, S. (2020). Personality traits, emotional intelligence and decision-making styles in Lebanese universities medi- cal students. BMC Psychology 8(46), 1-14. https://doi.org/10.1186/s40359-020-00406- 4 Epstein, S. (1994). Integration of cognitive and the psychodynamic unconscious. American Psychologist, 49(8), 709-724. Erenda, I., Meško, M. & Bukovec, B. (2014). Intuitive decision-making and leadership competencies of managers in Slovenian automotive industry. Journal of Universal Ex- cellence, 3(2), 87-101. Faletič, L. in Avsec, A. (2013). Stili odločanja kot napovednik psihičnega blagostanja. An- thropos, 3-4(231-232), 129-149. Fischer, S., Soyez, K. & Gurtner, S. (2015). Adapting Scott and Bruce’s General Decision- Making Style Inventory to Patient Decision Making in Provider Choice. Medical Deci- sion Making, 35(4), 525-532. Fitzgerald, D.R., Mohammed, S. & Kremer, G.O. (2017). Differences in the way we de- cide: The effect of decision style diversity on process conflict in design teams. Personal- ity and Individual Differences, 104, 339–344. Gambetti, E., Fabbri, M. Bensi, L. & Tonetti, L. (2008). A contribution to the Italian validation of General Decision-Style Inventory. Personality and Individual Differences, 44(4), 842-852. Geisler, M. & Allwood, C.M. (2018). Relating Decision-Making Styles to Social Orienta- tion and Time Approach. Journal of Behavioral Decision Making, 31, 415-429. Ghazi, A.M.A. & Hu, W. (2016). Impact of Individual Decision-Making Styles on Market- ing Information System Based Decision-Making: An Empirical Study of Saudi Arabia Manufacturing Firms. Journal of International Business Research and Marketing, 1(3), 27-39. Hariri, H., Monypenny, R. & Prideaux, M. (2014). Leadership styles and decision-mak- ing styles in an Indonesian school context. School Leadership and Management, 34(3), 284-298. Harren, V.A. (1979). A model of career decision-making for college students. Journal of Vocational Behavior, 14, 119–133. Heller, R. & Hindle, T. (2001). Veliki poslovni priročnik. Ljubljana: Založba Mladinska knjiga. Hunt, R.G., Krzystofiak, F.J., Meindl, J.R. & Yousry, A.M. (1989). Cognitive style and decision making. Organizational Behavior and Human Decision Processes, 44, 436-453. Kahneman, D. (2003). A Perspective on Judgment and Choice. American Psychologist, 58(9), 697–720. 72 Edvard KOLAR, Matej TUŠAK: DECISION-MAKING STYLE STRUCTURE OF SLOVENIAN SPORTS MANAGERS , 47–73 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Khasawneh, S., Alomati, A & Abu-tineh, A. (2011). Decision-Making Styles of Depart- ment Chairs at Public Jordanian Universities: A high-expectancy workforce. Tertiary Education and Management, 17(4), 309-318. Kikulis, L.M., Slack, T. & Hinings, B. (1995). Does decision making make a difference? Patterns of change within Canadian national sport organizations. Journal of Sport Man- agement, 9(3), 273-299. Klein, M. in Mathlie, L.B. (1992). Expert Systems, A Decision Support Approach. (With applications in management and finance). England, Wokingham: Addison-Wesley Com- pany Ltd. Kolar, E. & Jurak, G. (2014). Strateški management športnih organizacij. Koper: Znanst- veno-raziskovalno središče, Univerzitetna založba Annales. Krasniqi, B.A., Berisha, G. & Pula, J.S. (2019). Does decision-making style predict man- agers’ entrepreneurial intentions? Journal of Global Entrepreneurship Research, 9(68), 1-15. Loo, R. (2000). A psychometric evaluation of the General Decision-Making Style Inven- tory. Personality and Individual Differences, 29(5), 895-905. Mitchell, J.R., Shepherd, D.A. & Sharfman, M.P. (2011). Erratic Strategic Decisions: When and Why Managers are Inconsistent in Strategic Decision Making. Strategic Management Journal, 32, 683-704. Nygren, T.E. (2000). Development of a measure of decision making styles to predict per- formance in a dynamic J/DM task. Paper presented at the 41st Psychonomic Society Meetings, New Orleans, LA. Parent, M. M. (2010). Decision Making in Major Sport Events Over Time: Parameters, Drivers, and Strategies. Journal of Sport Management, 24(3), 291-318. https://doi. org/10.1123/ jsm. 24.3.291 Remenova, K. & Jankelova, N. (2019). How Successfully can Decision-Making Style Pre- dict the Orientation toward Well- or Ill-Structured Decision-Making Problems. Journal of Competitiveness, 11(1), 99–115. Retar, I., Plevnik, M., & Kolar, E. (2013). Key competences of Slovenian sport managers. Annales kinesiologiae, 4(2), 81-94. Reyna, C., Ortiz, M.V. & Revilla, R.G. (2014). Exploratory structural equation modelling of general decision-making style inventory. Revista de Psicologia, 23(1), 33-39. Rowe, A.J., & Mason, O.R. (1987). Managing with style: A guide to understanding, assess- ing, and improving decision making. San Francisco, California: Jossey-Bass. Rowe, A.J. & Boulgarides, J.D. (1992). Managerial decision making: A guide to success- ful business decisions. USA, New York: McMillan. Rowe, A. J., Boulgarides, J. D., & McGrath, M. R. (1984). Managerial decision making. USA, Chicago, IL: Science research associates. Rozman, R. & Kovač, J. (2012). Management. Ljubljana: Založba GV. Sagiv, L., Amit, A. Ein-Gar, D. & Arieli, S. (2014). Not All Great Minds Think Alike: Systematic and Intuitive Cognitive Style. Journal of Personality, 82(5), 402-417. Santos, J.M., Batista, P. & Carvalho, M.J. (2022). Framing sport managers profile: A systematic review of the literature between 2000 and 2019. Sport TK-EuroAmerican Journal of Sport Sciences, 11 (Article 24). Scott, S.G. & Bruce, R.A. (1995). Decision-making style: the development and assessment of a new measure. Educational and Psychological Measurement, 55(5), 818–831. ANNALES KINESIOLOGIAE • 13 • 2022 • 1 73 Edvard KOLAR, Matej TUŠAK: DECISION-MAKING STYLE STRUCTURE OF SLOVENIAN SPORTS MANAGERS , 47–73 Secchi, D. (2010). Extendable Rationality. Understanding Decision Making in Organiza- tions. USA, New York: Springer Publishing. Simon, H.A. (1960). The New Science of Management Decision. USA, New York: Ameri- can Book – Stratford Press, Inc. Simon, H.A. (1976). From substantive to procedural rationality. V S. J. Latsis (Ed.), Meth- od and Appraisal in Economics (str. 129-148). USA, New York: Cambridge University Press. Simon, H.A. (1987). Making management decision: The role of intuition and emotion. Academy of Management Executive, 1, 57-64. Spicer, D.P. & Sadler-Smith, E. (2005). An examination of the general decision making style questionnaire in two UK samples. Journal of Managerial Psychology, 20(2),137- 149. Tabachnick, B. G. & Fidell, L.S. (2007). Using multivariate statistics (5th edition). Bos- ton: Pearson Education. Taber, K.S. (2018). The Use of Cronbach’s Alpha When Developing and Reporting Re- search Instruments in Science Education. Research in Science Education, 48, 1273- 1296. Tavčar, M. & Trunk Širca, N. (2002). Na poti k učeči se organizaciji. Ljubljana: Visoka šola za management v Kopru in Šola za ravnatelje Ljubljana. Thunholm, P. (2004). Decision-making style: Habit, style or both? Personality and Indi- vidual Differences, 36, 931–944. Tomić, M. (2007). Sportski menadžment. Beograd: Fakultet sporta i fizičkog vaspitanja. Verma, N., Rangnekar, S. & Barua, M.K. (2012). Decision making style of executives in India. The Journal of Sri Krishna Research & Educational Consortium, 3(4), 38-49. Vroom, V.H. (2003). Educating managers for decision-making and leadership. Manage- ment Decision, 41(10), 968–978. Wood, N.L. (2012). Individual differences in decision-making styles as predictors of good decision making. (Master Thesis). Bowling Green: [N.L. Wood]. Young, D. R. (1998). Nonprofit Management Studies in the United States: The state of the Art. European Journal for Sport Management, 5(2), 30–44. REPORTS AND REVIEWS POROČILA IN OCENE ANNALES KINESIOLOGIAE • 13 • 2022 • 1 77 REPORTS AND REVIEWS/POROČILA IN OCENE, 77–84 REPORT OF 4th INTERNATIONAL SPE BALKAN SKI CONFERENCE Pamporovo ski resort, Bulgaria, 13–17 March 2022 After two successful conferences – one in Kopaonik, Serbia, and the other in Ja- horina, Bosnia and Herzegovina – the third international SPE Balkan Ski Conference in Rogla, Slovenia, was cancelled because of the pandemic. The fourth international conference was organised in Bulgaria, at the Pamporovo ski resort. The conference was hosted by the Association of Bulgarian Ski Instructors – the Bulgarian Ski School, in cooperation with the Science and Research Centre Koper (ZRS Koper), Slovenia, the Faculty of Sport and Physical Education of the University of Niš, Serbia, and the Ski Instructors Association (SITAS) of Slovenia. The high level of the scientific conference was set by renowned experts in the field of alpine skiing and snowboarding, which was then reinforced by the members of the demo groups on the snow. In the afternoon, we heard renowned speakers such as Dieter Bubeck, PhD (Germany), Prof. Erich Muller (Austria), Prof. Lana Ružić (Croatia), Prof. Matej Supej (Slovenia), Ron Kipp, PhD (USA), Asa Tugetam, PhD (Sweden) and many others. In more than thirty scientific papers, the participants presented the main idea of the conference, “Science, Practice and Education”, and the main theme “Fun and safety in contemporary skiing − the new role of ski instructors/trainers in winter sports and society”. The abstracts published on this occasion present the latest perspec- tives on the sensitive areas of safety and injuries, preparation, and the development of ski technique, as well as modern possibilities and approaches in the methodology and didactics of teaching skiing. The morning workshops on the snow enriched the theory and were led by members of the demo teams from the participating Balkan countries (from Bosnia and Herzego- vina, Bulgaria, Romania, Serbia and Slovenia). The morning workshops gave the par- ticipants the opportunity to deepen their theoretical knowledge through practical work. Another important event in the conference was the “Demo Team Show”, where the au- dience could admire the perfected skiing techniques of the demo teams of the national ski schools. The honorary members such as the Slovenian ski legend Bojan Križaj and Bulgarian Olympic gold medallist Ekaterina Dafovska added to the value of the event. Despite the spring-like days in March, the sunny conditions did not affect the con- ditions on the slopes. The beautiful weather and perfectly groomed slopes further con- tributed to the excellent conference. The next big event will take place in the upcoming winter season of 2023, with the INTERSKI Congress in the Levi Ski Resort, Finland, where the 5th SPE Balkan Ski Conference, which will be held at the Predeal Ski Resort in Romania, will also be announced and promoted to the biggest snow sports society in the world. Kaja Teraž and Rado Pišot 78 REPORTS AND REVIEWS/POROČILA IN OCENE, 77–84 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 POROČILO S 4. MEDNARODNE KONFERENCE SPE BALKAN SKI Smučarski center Pamporovo, Bolgarija, 13.–17. marec 2022 Po dveh uspešnih konferencah na Kopaoniku v Srbiji ter Jahorini v Bosni in Her- cegovini je bila tretja mednarodna balkanska smučarska konferenca SPE na Rogli v Sloveniji zaradi pandemije odpovedana. Četrta mednarodna konferenca je bila organi- zirana v Bolgariji, v smučarskem središču Pamporovo. Konferenco je gostilo Združe- nje bolgarskih učiteljev smučanja – Bolgarska šola smučanja – v soorganizaciji z Znan- stveno-raziskovalnim središčem Koper (ZRS Koper), Slovenija, Fakulteto za šport in telesno vzgojo Univerze v Nišu, Srbija, in Združenjem učiteljev smučanja (ZUTS) Slovenije. Visoko raven znanstvene konference so postavili priznani strokovnjaki s področja alpskega smučanja in deskanja na snegu, ki so jo nato podkrepili člani demo skupin na snegu. V popoldanskih urah smo prisluhnili priznanim predavateljem, kot so dr. Dieter Bubeck (Nemčija), prof. dr. Erich Muller (Avstrija), prof. dr. Lana Ružić (Hrva- ška), prof. Matej Supej (Slovenija), dr. Ron Kipp (ZDA), dr. Asa Tugetam (Švedska) in številni drugi. V več kot tridesetih znanstvenih prispevkih so udeleženci predstavili glavno idejo konference Znanost, praksa in izobraževanje in glavno temo konference Zabava in varnost v sodobnem smučanju – nova vloga smučarskih učiteljev/trenerjev v zimskih športih in družbi. Ob tej priložnosti objavljeni povzetki predstavljajo najno- vejše poglede na občutljiva področja varnosti in poškodb, priprave in razvoja smučar- ske tehnike ter sodobne možnosti in pristope v metodologiji in didaktiki poučevanja smučanja. Dopoldanske delavnice na snegu so obogatile predstavljeno teorijo, vodili pa so jih člani demo ekip iz sodelujočih balkanskih držav (demo ekipe iz Bosne in Hercegovi- ne, Bolgarije, Romunije, Srbije in Slovenije). Dopoldanske delavnice so udeležencem omogočile, da so teoretično znanje poglobili s praktičnim delom na snegu. Pomemben dogodek konference je bil tudi „Demo Team Show“, na katerem je občinstvo lahko občudovalo dovršeno tehniko smučanja demo ekip nacionalnih smučarskih šol. Častna člana, kot sta slovenska smučarska legenda Bojan Križaj in bolgarska olimpijska prva- kinja Ekaterina Dafovska, sta še povečala pomembnost dogodka. Kljub spomladanskim marčevskim dnevom sončno vreme ni vplivalo na razmere na smučiščih. Lepo vreme in odlično urejene proge so še dodatno prispevali k odlični konferenci. Naslednji veliki dogodek bo potekal v prihajajoči zimski sezoni 2023, in sicer kon- gres INTERSKI v smučarskem središču Levi na Finskem, kjer bo najavljena tudi 5. balkanska smučarska konferenca SPE, ki bo potekala v smučarskem središču Predeal v Romuniji, in promovirana v največjem društvu za snežne športe na svetu. Kaja Teraž in Rado Pišot ANNALES KINESIOLOGIAE • 13 • 2022 • 1 79 REPORTS AND REVIEWS/POROČILA IN OCENE, 77–84 HAVING FUN WHILE LEARNING - SKI EASY SNOW DAY 1st SKI EASY Multiplier SPORT EVENT, Pamporovo, Bulgaria, 14–16 March 2022 Despite the difficult situation caused by Covid- 19 measures, the project ERASMUS + Sport - cooperation “SKI EASY - EASY (Educational, Accessible, Simple, Youthful) Approach to Skills Acquisition in Skiing” has successfully pursued the implementation of its objectives. One of the important outcomes is the implementation of multiplier sport events known as the SKI EASY SNOW DAY. The main idea of the SKI EASY SNOW DAY is to promote the SKI EASY teaching module and to enable children – ski beginners from 6–9 years old, especially those coming from deprived social and economic environments – to experience an exciting snow day and try to take their first steps on ski. For that purpose, the Elan ski manu- facturer prepared and adapted special skis (using U-Flex technology) and ski boots for children that enable easier turns on slopes and more fun when learning how to ski. In short, the SKI EASY SNOW DAY enables deprived children from lower socio- economic environments who do not have the opportunity to experience skiing to get a 80 REPORTS AND REVIEWS/POROČILA IN OCENE, 77–84 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 taste of this beautiful experience with professional ski instructors with the help of the SKI EASY MOBAPP application. The 2022 SKI EASY Snow Day Pamporovo was the first of three planned mul- tiplier sport events and was organized by a Bulgarian ski school. It took place at the Pamporovo ski resort which offers suitable conditions for the event and was divided in two parts. On the first day, a workshop was held by SKI EASY project partners with Bulgarian ski school instructors to get acquainted with the SKI EASY teaching model. The following two days were devoted to ski lessons for beginners. Despite the pro- blems of viral illnesses and the COVID-19 pandemic, we managed to have two very nice and unforgettable days with the children. There was a very good response from the ski instructors, coaches and other snow sport experts, participants of the 3rd SPE Balkan Ski Conference, who were invited to observe the implementation of the SKI EASY teaching model. The SKI EASY project also addresses the aspect of sustainability, as the 300 pairs of skis will remain with the eight project partners in order to be able to organize further ski days and ski teaching courses after the end of the project according to the developed unified SKI EASY teaching model. In 2023 another two SKI EASY SNOW DAYS will be held in Kopaonik, Serbia and Innsbruck, Austria. Saša Pišot, Project coordinator ANNALES KINESIOLOGIAE • 13 • 2022 • 1 81 REPORTS AND REVIEWS/POROČILA IN OCENE, 77–84 ZABAVNO UČENJE SMUČANJA – DNEVI NA SNEGU SKI EASY 1. interaktivni športni dogodek SKI EASY, Pamporovo, Bolgarija, 14.–16. marec 2022 Projekt ERASMUS + šport „EASY (izobraževalen, dostopen, preprost, mladosten) pristop k usvajanju veščin pri učenju smučanja«)“ je kljub težkim razmeram zaradi ukrepov covida-19 uspešno uresničil zastavljene cilje. Eden od pomembnih rezultatov je izvedba interaktivnih športnih dogodkov, imenovanih dan na snegu SKI EASY. Glavni zamisli dneva na snegu SKI EASY sta promocija učnega modula SKI EASY in omogočanje otrokom začetnikom, starim od 6 do 9 let, zlasti tistim, ki prihajajo iz socialno in ekonomsko šibkih družin, da doživijo razburljiv dan na snegu in poskusijo 82 REPORTS AND REVIEWS/POROČILA IN OCENE, 77–84 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 narediti prve korake na smučeh. V ta namen je proizvajalec smuči Elan pripravil poseb- ne smuči s tehnologijo U-Flex in smučarske čevlje, ki omogočajo lažje zavoje in več zabave pri učenju smučanja. Dan na snegu SKI EASY omogoča otrokom, ki nimajo priložnosti, da s pomočjo dostopne opreme, profesionalnih učiteljev in zabavne mobilne aplikacije SKI EASY doživijo čudovito izkušnjo usvajanja smučarskega znanja. Dan na snegu SKI EASY, ki ga je organizirala bolgarska šola smučanja, je bil prvi od treh načrtovanih interaktivnih športnih dogodkov, saj smučarsko središče Pampo- rovo ponuja primerne pogoje za dogodek, ki je bil razdeljen na dva dela. Prvi dan so partnerji projekta SKI EASY organizirali delavnico za učitelje bolgarske nacionalne smučarske šole, na kateri so se ti seznanili z modelom SKI EASY. Preostala dneva sta bila namenjena učenju smučanja otrok začetnikov. Kljub težavam z virusnimi obolenji in epidemijo covida-19 nam je uspelo pripraviti lepa in nepozabna dneva za otroke iz bližnjega mesta. Lahko se pohvalimo tudi z dobrim odzivom učiteljev smučanja – ude- ležencev 3. SPE konference Balkan SKI, ki so bili povabljeni, da si ogledajo izvajanje modela poučevanja SKI EASY. S projektom SKI EASY zagotavljamo tudi trajnost, saj bo 300 parov smučarske opreme pri osmih projektnih partnerjih namenjenih za organizacijo smučarskih dni in tečajev smučanja po enotnem učnem modelu SKI EASY tudi po končanem projektu. Leta 2023 bosta izvedena še dva smučarska dogodka – dneva na snegu SKI EASY na Kopaoniku v Srbiji in v Innsbrucku v Avstriji. Saša Pišot, koordinatorica projekta ANNALES KINESIOLOGIAE • 13 • 2022 • 1 83 REPORTS AND REVIEWS/POROČILA IN OCENE, 77–84 REPORT ON THE EASS & ISSA 2022 WORLD CONGRESS OF SPORT SOCIOLOGY Tübingen, Germany, 7–10 June 2022 After two years of online conferences and uncertain times, the EASS (European Association of Sociology of Sports) and ISSA (International Sociology of Sport Asso- ciation) have joined forces to organise a joint World Congress of Sociology of Sport with the working title: Why Sociology Matters? The Role of Sociology of Sport in Interdisciplinary Research. Scholars from around the world pondered the question of why sociology and its very special relationship to society is hardly noticed. Sociology seems to have a reputa- tion problem, not only in the public and political contexts, but also in scientific research networks. The aim of this congress was therefore to provide a clearer insight into the complex descriptions of reality and to reveal the contradictions and inconsistencies in the common sense and everyday constructions that target the field of sport. The organiser of the congress was the University of Tübingen, together with the Institute of Sports Science of the University of Tübingen. At the three-day event, 230 papers were presented by over 350 authors in 10 sessions. Among the papers, the topics of depression and the deviant behaviour of elite athletes and coaches, and the impact of COVID-19 measures on sport participation and sport policy issues were the main topics of interest. The main key lectures: 1. Addressed the novelties in European football and its organisation in lectures presented by prof. Mark Turner, PhD (Against the European Super League: Re- ading this critical juncture for English and European football) and prof. David Webber PhD (Rewriting the future: Alternatives to ‘the present’ (and presence of) capitalist realism in elite European football) 2. Opened up new questions in the field of sport impact on the local community with the lectures: (Re)configuring for sport, volunteerism and the civil society landscape: Toward sustainable communities and capacity building in a post- -Olympic metropolis by prof. Niki Koutrou and prof. Geoffrey Kohe, Recipro- cation and Responsibility – “Giving Back” to Children and Youth in Community Organizations by prof. Christine Dallaire and Steph MacKay. The conference gave the expected impetus for further cooperation between rese- archers and their institutions, so we are looking forward to the next, 19th EASS Con- ference in 2023 with the working title: Transitioning Sport, Transitioning European Societies to be held in Budapest, Hungary on 30 May––2 June 2023. Saša Pišot 84 REPORTS AND REVIEWS/POROČILA IN OCENE, 77–84 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 POROČILO S SVETOVNEGA KONGRESA SOCIOLOGIJE ŠPORTA EASS IN ISSA 2022 Tübingen, Nemčija, 7.–10. junij 2022 Po dveh letih spletnih konferenc in negotovih razmerah v času covida-19 sta EASS (Evropsko združenje za sociologijo športa) in ISSA (Mednarodno združenje za socio- logijo športa) združila moči in organizirala skupni svetovni kongres sociologije športa z delovnim naslovom Zakaj je sociologija pomembna? Vloga sociologije športa v in- terdisciplinarnem raziskovanju. Udeleženci z vsega sveta so razmišljali, zakaj sta sociologija in njen posebni odnos do družbe premalo opazna, saj se zdi, da ima sociologija težave z ugledom, ne le v jav- nem in političnem kontekstu, temveč tudi v znanstveno-raziskovalnih mrežah. Glavni namen tega kongresa je bil zato spodbuditi jasnejši vpogled v opise resničnosti, pro- tislovij in morebitnih nedoslednosti, ki se kažejo v »zdravo razumskih« in vsakdanjih konstrukcijah na področju športa. Organizator kongresa je bila univerza v Tübingenu skupaj z inštitutom za znanosti o športu univerze v Tübingenu. Na tridnevnem dogodku je več kot 350 avtorjev v desetih sekcijah predstavilo več kot 230 prispevkov. Med referati so bile v ospredju predvsem teme depresije, deviantnega vedenja vrhunskih športnikov in trenerjev in vpliv ukrepov za zajezitev covida-19 na participacijo v športu in pereča politična vprašanja s področja športa. Glavna vabljena predavanja so: 1. obravnavala novosti v evropskem nogometu in njegovi organizaciji, ki sta jih predstavila prof. dr. Mark Turner – Proti evropski superligi: (Kritičen trenutek za angleški in evropski nogomet) – in prof. David Webber – Rewriting the futu- re: alternativa »sedanjosti« (in prisotnosti) kapitalističnega realizma v elitnem evropskem nogometu; 2. odpirala nova vprašanja na področju vpliva športa in politik na lokalno skupnost s predavanji prof. Niki Koutroua in prof. Geoffreya Koheja – (Re)configuring for sport, volunteerism and the civil society landscape: Na poti k trajnostnim skupnostim in krepitvi zmogljivosti v post-olimpijski metropoli – ter predava- njem Reciprocation and Responsibility – »Giving Back« to Children and Youth in Community Organizations, ki sta ga pripravila prof. Christine Dallaire in Steph MacKay. Konferenca je pričakovano spodbudila nadaljnje sodelovanje med raziskovalci in njihovimi institucijami, zato se že veselimo naslednje, 19. konference EASS 2023 z delovnim naslovom Transitioning Sport, transitioning European societies, ki bo od 30. maja do 2. junija 2023 potekala v Budimpešti. Saša Pišot ANNALES KINESIOLOGIAE • 13 • 2022 • 1 85 GUIDELINES FOR AUTHORS, 85–88 GUIDELINES FOR AUTHORS 1. Aim and scope of the journal: Annales Kinesiologiae is an international interdisciplinary journal covering kinesiology and its related areas. It combines fields and topics directed towards the study and research of human movement, physical activity, exercise and sport in the context of human life style and influences of specific environments. The journal publishes original scientific articles, review articles, technical notes and reports. 2. General policy of Annales Kinesiologiae Annales Kinesiologiae pursues the multi-disciplinary aims and nature of Kinesiology with the main goal to promote high standards of scientific research. a) Reviewing: Each manuscript, meeting the technical standards and falling within the aims and scope of the journal, will be subjected to a double-blind peer-review by two reviewers. Authors can propose up to two reviewers for revision of their work and also up to two reviewers they would like to avoid. The referees are chosen by the Editors. Assessments by the referees will be presented anonymously to the author and will be returned to the author for correction. The corrected copy of the manuscript, with the list of corrections on a separate page, should be returned to the responsible Editor. b) Permissions: Authors wishing to include figures, tables, or text passages that have been published elsewhere, are required to obtain permission from the copyright owner(s) and to include evidence that such permission has been granted when submitting their manuscript. Any material received without such evidence it will be assumed that the authors hold the copyright. c) Copyright agreement: Submitting the article through the OJS (Open Journal System), the corresponding author will be asked to accept the terms of the copyright agreement. The aforementioned agreement is effective if and when the article submitted to be published in Annales Kinesiologiae is accepted. 3. Manuscript preparation a) Language and style: The language of Annales Kinesiologiae is USA English. The authors are responsible for the language, grammar, and style of the manuscript, which need to meet the criteria defined in the guidelines for authors. Manuscripts are required to follow a scientific style style. The journal will be printed in grayscale. b) The length of the manuscript should not exceed 36,000 characters (excluding spaces). Text formatting: It is required to use the automatic page numbering function to number the pages. Times New Roman font size 12 is recommended, with double spacing between lines. Use the table function, not spreadsheets, to make tables. Use an equation editor for equations. Finally, all lines need to be number, were the first line of a pages is assigned line number 1. c) Miscellaneous: Whenever possible, use the SI units (Système international d’unités). 86 GUIDELINES FOR AUTHORS, 85–88 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 d) The title page should include the title of the article (no more than 85 characters, including spaces), full names of the author(s) and affiliations (institution name and address) of each author; linked to each author using superscript numbers, as well as the corresponding author’s full name, telephone, and e-mail address. e) The authors are obliged to prepare two abstracts – one short abstract in English and one (translated) in Slovene language. For foreign authors translation of the abstract into Slovene will be provided. The content of the abstract should be structured into the following sections: purpose, methods, results, and conclusions. It should only contain the information that appears in the main text, and should not contain reference to figures, tables and citations published in the main text. The abstract is limited to 250 words. f) Under the abstract a maximum of 6 appropriate Keywords shall be given in English and in Slovene. For foreign authors the translation of the key words into Slovene will be provided. g) The main text should include the following sections: Introduction, Methods, Results, Discussion, Conclusions, Acknowledgement (optional), and References. Individual parts of the text can form sub-sections. h) Each table should be submitted on a separate page in a Word document after the Reference section. Tables should be double-spaced. Each table shall have a brief caption; explanatory matter should be in the footnotes below the table. Abbreviations used in the tables must be consistent with those used in the main text and figures. Definitions of symbols should be listed in the order of appearance, determined by reading horizontally across the table and should be identified by standard symbols. All tables should be numbered consecutively Table 1, etc. The preferred location of the table in the main text should be indicated preferably in a style as follows: *** Table 1 somewhere here ***. i). Captions are required for all figures and shall appear on a separate manuscript page, under the table captions. Each figure should be saved as a separate file without captions and named as Figure 1, etc. Files should be submitted in *.tif or *.jpg format. The minimum figure dimensions should be 17x20 cm and a resolution of at least 300 dpi. Combinations of photo and line art should be saved at 600–900 dpi. Text (symbols, letters, and numbers) should be between 8 and 12 points, with consistent spacing and alignment. Font type may be Serif (Times Roman) or Sans Serif (Arial). Any extra white or black space surrounding the image should be cropped. Ensure that participant-identifying information (i.e., faces, names, or any other identifying features) should be omitted. Each figure should be saved as a separate file without captions and named as Figure 1, etc. The preferred location of the figure in the main text should be indicated preferably in a style as follows: *** Figure 1 somewhere here ***. ANNALES KINESIOLOGIAE • 13 • 2022 • 1 87 GUIDELINES FOR AUTHORS, 85–88 j) References The journal uses the Harvard reference system (Publication Manual of the American Psycho- logical Association, 6th ed., 2010), see also: https://www.apastyle.org). The list of references should only include work cited in the main text and being published or accepted for publication. Personal communications and unpublished works should only be mentioned in the text. Referen- ces should be complete and contain up to seven authors. If the author is unknown, start with the title of the work. If you are citing work that is in print but has not yet been published, state all the data and instead of the publication year write „in print“. Reference list entries should be alphabetized by the last name of the first author of each work. Titles of references written in languages other than English should be additionally translated into English and enclosed within square brackets. Full titles of journals are required (no abbreviati- ons). Where available, DOI numbers should be provided in the form of a resolvable URL https:// doi.org/10.1037/rmh0000008. Examples of reference citation in the text One author: This research spans many disciplines (Enoka, 1994) or Enoka (1994) had con- cluded... Two authors: This result was later contradicted (Greene & Roberts, 2005) or Greene and Roberts (2005) pointed out... Three to six authors: a) first citation: Šimunič, Pišot and Rittweger (2009) had found... or (Šimunič, Pišot & Rit- tweger, 2009) b) Second citation: Šimunič et al. (2009) or (Šimunič et al., 2009) Seven or more authors: Only the first author is cited: Di Prampero et al. (2008) or (Di Prampero et al., 2008). Several authors for the same statement with separation by using a semicolon: (Biolo et al., 2008; Plazar & Pišot, 2009) Examples of reference list: The style of referencing should follow the examples below: Books Latash, M. L. (2008). Neurophysiologic basis of movement. Campaign (USA): Human Ki- netic. Journal articles Marušič, U., Meeusen, R., Pišot, R., & Kavcic, V. (2014). The brain in micro- and hyper- gravity : the effects of changing gravity on the brain electrocortical activity. European journal of sport science, 14(8), 813–822. https://doi.org/10.1080/17461391.2014.908959 88 GUIDELINES FOR AUTHORS, 85–88 ANNALES KINESIOLOGIAE • 13 • 2022 • 1 Šimunič, B., Koren, K., Rittweger, J., Lazzer, S., Reggiani, C., Rejc, E., … Degens, H. (2019). Tensiomyography detects early hallmarks of bed-rest-induced atrophy before changes in muscle architecture. Journal of applied physiology, 126(4), 815–822. https://doi.org/10.1152/ japplphysiol.00880.2018 Book chapters Šimunič, B., Pišot, R., Mekjavić, I. B., Kounalakis, S. N. & Eiken, O. (2008). Orthostatic intolerance after microgravity exposures. In R. Pišot, I. B. Mekjavić, & B. Šimunič (Eds.), The effects of simulated weightlessness on the human organism (pp. 71–78). Koper: University of Primorska, Scientific and research centre of Koper, Publishing house Annales. Rossi, T., & Cassidy, T. (in press). Teachers’ knowledge and knowledgeable teachers in physical education. In C. Hardy, & M. Mawer (Eds.), Learning and teaching in physical educati- on. London (UK): Falmer Press. Conference proceeding contributions Volmut, T., Dolenc, P., Šetina, T., Pišot, R. & Šimunič, B. (2008). Objectively measures physical activity in girls and boys before and after long summer vacations. In V. Štemberger, R. Pišot, & K. Rupret (Eds.) Proceedings of 5th International Symposium A Child in Motion “The physical education related to the qualitative education” (pp. 496–501). Koper: University of Primorska, Faculty of Education Koper, Science and research centre of Koper; Ljubljana: University of Ljubljana, Faculty of Education. Škof, B., Cecić Erpić, S., Zabukovec, V., & Boben, D. (2002). Pupils‘ attitudes toward endurance sports activities. In D. Prot, & F. Prot (Eds.), Kinesiology – new perspectives, 3rd International scientific conference (pp. 137–140), Opatija: University of Zagreb, Faculty of Ki- nesiology. 4. Manuscript submission The article should be submitted via online Open Journal Systems application, which is open source journal management and publishing software at http://ojs.zrs-kp.si/index.php/AK/ about/submissions. All the communication process with authors proceeds via Open Journal System and e-mail. 5. For additional information regarding article publication, please do not hesitate to contact the secretary of Annales Kinesiologiae. ISSN 1318-0185ISSN 2232-2620 A nnaleSK inesiologiae