Improving cardiorespiratory fitness (CRFit) in cancer patients is crucial to increase survivorship, promote health, and improve quality of life. High‐intensity training (HIT) has the potential to ...increase CRFit, perhaps better than other exercise modalities, but the extant evidence has yet to be fully explored. This systematic review and meta‐analysis aimed to evaluate the effects of HIT on CRFit in cancer patients and survivors and to identify the optimal characteristics of the interventions (eg, cancer type, intervention timing, exercise modality, intervention's duration, and the number of minutes of high‐intensity exercise in each session). The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed. A total of 31 articles (2515 participants) were included in the systematic review and 25 in the meta‐analyses. CRFit significantly improved with HIT in comparison with a control group (P < .00001, SMD = 0.44 and a 95% confidence interval from 0.25 to 0.64). The results obtained in the sub‐analysis were statistically significant except the comparison with the active group CRFit (P = .13). The results showed that higher effects could be achieved in: patients starting to exercise before treatment, interventions longer than eight weeks, programs including exclusively cardiovascular training and with a high‐intensity part of session duration of at least 20 minutes.
Objective
To evaluate the effects of 24‐week exergame intervention in the physical fitness of women with fibromyalgia in both single‐ and dual‐task conditions.
Design
Single‐blinded, randomized ...controlled trial.
Setting
University facilities.
Participants
Fifty‐five women with fibromyalgia, recruited from the local fibromyalgia association, were randomly assigned to one of the two groups: exercise group and control group.
Intervention
The exercise group completed 24 weeks of supervised and group‐based exergame protocol, divided into two sessions of 60 minutes. The intervention was focused on mobility, postural control, upper and lower limbs coordination, aerobic fitness, and strength.
Main outcome measures
The strength of the upper limbs was measured using the arm curl test. The mobility skill was assessed through the timed‐up and go test, and the flexibility of both upper and lower limbs was measured using the back scratch and the sit and reach tests, respectively.
Results
Fifty participants completed the study. In the single‐task condition, exergame intervention led to significantly higher effects in the arm curl test (P = 0.008), sit and reach test (P = 0.033), and timed‐up and go test (P = 0.021). Moreover, under dual‐task condition, exergames led to significant effects in all the physical fitness tests (arm curl test, timed‐up and go test, back scratch test, and sit and reach test) compared to the control group.
Conclusions
Exergame is an effective tool to improve the physical fitness in women with fibromyalgia under single or dual‐task conditions.
Falls can lead to severe health loss including death. Past research has shown that falls are an important cause of death and disability worldwide. The Global Burden of Disease Study 2017 (GBD 2017) ...provides a comprehensive assessment of morbidity and mortality from falls.
Estimates for mortality, years of life lost (YLLs), incidence, prevalence, years lived with disability (YLDs) and disability-adjusted life years (DALYs) were produced for 195 countries and territories from 1990 to 2017 for all ages using the GBD 2017 framework. Distributions of the bodily injury (eg, hip fracture) were estimated using hospital records.
Globally, the age-standardised incidence of falls was 2238 (1990-2532) per 100 000 in 2017, representing a decline of 3.7% (7.4 to 0.3) from 1990 to 2017. Age-standardised prevalence was 5186 (4622-5849) per 100 000 in 2017, representing a decline of 6.5% (7.6 to 5.4) from 1990 to 2017. Age-standardised mortality rate was 9.2 (8.5-9.8) per 100 000 which equated to 695 771 (644 927-741 720) deaths in 2017. Globally, falls resulted in 16 688 088 (15 101 897-17 636 830) YLLs, 19 252 699 (13 725 429-26 140 433) YLDs and 35 940 787 (30 185 695-42 903 289) DALYs across all ages. The most common injury sustained by fall victims is fracture of patella, tibia or fibula, or ankle. Globally, age-specific YLD rates increased with age.
This study shows that the burden of falls is substantial. Investing in further research, fall prevention strategies and access to care is critical.
Accessible Summary
What is known on the subject?
Attention‐deficit/hyperactivity disorder (ADHD) is characterized by problems of inattention and impulsive hyperactivity in children. Equine‐assisted ...activities and therapies (EAATs) have been used as alternative non‐pharmacological intervention option in patients with ADHD.
What does this paper adds to existing knowledge?
Nowadays, more studies of high methodological quality are needed to determine whether EAAT is an effective intervention for the treatment in children with ADHD.
What are the implications for practice?
Between 15 and 40 min of rising horses, 8–32 total sessions, for 4–32 weeks, seem to be beneficial to reduce the symptoms of ADHD.
Introduction
Attention‐deficit/hyperactivity disorder (ADHD) is a disorder characterized by problems of inattention and impulsive hyperactivity. Equine‐assisted activities and therapies (EAATs) have become an emerging non‐pharmacological intervention option in patients with ADHD.
Aim
To perform a systematic review of updated literature about EAAT in children with ADHD.
Method
A systematic review was performed until 28 November 2019, in four electronic databases: PubMed, Web of Science, Embase and Google Scholar. The inclusion criteria were as follows: (a) intervention programme, with pre‐ and post‐data, based on EAAT, (b) children with ADHD and (c) articles written in English.
Results
A total of 9 articles were found that meet the inclusion criteria. The evidence level was C for 7 studies and B for 2 studies. The level of conclusion was 3.
Discussion
There are few studies with high methodological quality, and there is a high heterogeneity in the variables included, what make that the level of evidence and conclusion are low.
Conclusion
There is no account with enough studies of high methodological quality to determine whether EAAT is an effective intervention for the treatment in children with ADHD.
This study aimed to compare the effects of two intervention programs, (1) high-intensity interval training (HIIT) and (2) moderate-intensity training (MIT), on anxiety, depression, stress, and ...resilience during the confinement caused by the coronavirus disease 2019 (COVID-19) in healthy adults.
A total of 67 adults who participated were randomly assigned to two groups: HIIT and MIT groups. The MIT group had to perform a home-based intervention based on aerobic exercises, whereas the HIIT group had to perform a home-based intervention based on HIIT exercises. The two groups (HIIT and MIT) had to complete the same physical exercise volume, 40 min per session (6 days per week) during the confinement period (6 weeks). Depression, anxiety, stress, and resilience were assessed before and after the intervention.
Results showed that HIIT and MIT significantly reduced the stress, anxiety, and depression as well as increase the resilience (
< 0.05). Moreover, the improvements obtained in the HIIT group seem to be greater than those of the MIT group in depression (
< 0.05).
HIIT and MIT decreased anxiety, stress, and depression as well as increased resilience during the COVID-19 confinement. In addition, the HIIT intervention seemed to be more beneficial to reduce depression than the MIT intervention.
The question of how games should be taught is still a controversial subject. There has been a growing number of studies on teaching games and coaching sports since the first publication of Bunker and ...Thorpe on Teaching Games for Understanding (TGfU). In this sense, the present systematic review and meta-analysis aimed to systematically review the scientific literature about the effects of technical and tactical approach interventions on skill execution and decision making, and to examine the influence of the teacher/coach management style. A systematic literature search was carried out in accordance with PRISMA guidelines in Web of Science (WOS), PubMed (Medline), Scopus, and SportDiscus electronic databases. A total of seven and six studies were deemed to meet the inclusion criteria for decision making and skill execution, respectively. Meta-analysis results showed that tactical interventions achieved significant improvements in decision making (effect size = 0.89 with 95% confidence interval (CI) from 0.12 to 1.65), but they did not show significant improvements in skill execution (effect size = 0.89 with 95% CI from -0.45 to 2.23) compared to technical approaches. However, the heterogeneity of interventions was large and the quality of evidence was low according to GRADE. In conclusion, tactical approaches are recommended to teach games and sports in order to develop technique, understanding, tactical knowledge, and decision making, which are demanded in game play. These findings could be useful for teachers and coaches to improve these aspects of their players and students.
Measuring muscle strength using isokinetic dynamometry allows evaluating and comparing normal and sick children, establishing recovery and rehabilitation goals, and quantitatively monitoring the ...course of a disease and the response to treatment. The purpose of this study was to carry out a systematic review and meta-analysis focusing on studies that examined the test-retest reliability of isokinetic knee strength measurements in children. This study is important because isokinetic dynamometry is the gold standard for evaluating muscle strength and it allows comparing muscle performance in children. The databases used were PubMed, Web of Science Scopus, and Embase (up to July 26, 2019). Only studies published in English were included in this review. All studies focused on the reliability of isokinetic knees in healthy children or those with cerebral palsy applied to dynamic contractions (concentric or eccentric) and provided measures of strength, reproducibility, ICC, peak torque, or SEM. We found a total of 143 abstracts and examined 94 articles to determine if they met the inclusion criteria. Finally, 10 articles were included in the systematic review and five studies (96 subjects) formed the meta-analysis sample, all of which focused on the reliability of isokinetic knees in the concentric mode. The CAT and QAREL scales were used to assess the quality of the included studies. The meta-analysis revealed high intra-class correlation coefficients (ICC) (0.84; p < 0.001; n = 96 subjects) in the flexion and excellent intra-class correlation coefficients (ICC 0.90; p < 0.001; n = 96 subjects) in the extension. Isokinetic dynamometry could be indicated as a method for measuring muscle strength training in children. However, the reviewed studies suggest some methodological issues in isokinetic tests, such as the rest days between testing and retesting, using the same speeds, protocols, and evaluators, and the performance of the subjects, so more research is required.
Background: Childhood obesity has negative impact on heart-rate variability (HRV) and, thereby, on the cardiovascular health of children and adolescents. Thus, physical-exercise interventions were ...proposed to increase HRV. The present systematic review aims to provide an up-to-date analysis of research on the effect of physical-exercise interventions on HRV in obese children and adolescents. Methods: An electronic search of the literature was performed, and 10 articles were included. PRISMA guideline methodology was employed. Results: Physical-exercise interventions predominantly involved aerobic training; however, alternative training programs, including judo or recreational soccer, were found. The duration of intervention ranged from 6 to 24 weeks, with a training frequency of between 2 and 7 times per week. The duration of sessions typically ranged from 40 to 60 min. Conclusions: Results of the included articles indicated that physical-exercise intervention increased the HRV and thereby the autonomic modulation of obese children and adolescents. This is significant, as HRV is associated with cardiovascular health. Such physical-exercise interventions are crucial to reduce weight and improve cardiovascular health in children and adolescents, thereby achieving a sustainable future.
A number of previous investigations have been designed to determine the effect of acute caffeine intake on the rate of fat oxidation during exercise. However, these investigations have shown ...contradictory results due to the differences in the exercise protocols used or the co-ingestion of caffeine with other substances. Hence, to date, there is no consensus about the effect of caffeine on fat oxidation during exercise. The purpose of this study was to conduct a systematic review followed by a meta-analysis to establish the effect of acute intake of caffeine (ranging from 2 to 7 mg/kg of body mass) on the rate of fat oxidation during exercise. A total of 19 studies published between 1978 and 2020 were included, all of which employed crossover experimental designs in which the ingestion of caffeine was compared to a placebo. Studies were selected if the exercise intensity was consistent in the caffeine and placebo trials and if these were preceded by a fasting protocol. A subsequent meta-analysis was performed using the random effects model to calculate the standardized mean difference (SMD). The meta-analysis revealed that caffeine significantly (
= 0.008) increased the fat oxidation rate (SMD = 0.73; 95% CI = 0.19 to 1.27). This increment was consistent with a significant (
= 0.04) reduction of the respiratory exchange ratio (SMD = -0.33; 95% CI = -0.65 to -0.01) and a significant (
= 0.049) increase in the oxygen uptake (SMD = 0.23; 95% CI = 0.01 to 0.44). The results also showed that there was a dose-response effect of caffeine on the fat oxidation rate, indicating that more than 3.0 mg/kg is necessary to obtain a statistically significant effect of this stimulant on fat oxidation during exercise. Additionally, the ability of caffeine to enhance fat oxidation during exercise was higher in sedentary or untrained individuals than in trained and recreational athletes. In conclusion, pre-exercise intake of a moderate dose of caffeine may effectively increase fat utilization during aerobic exercise of submaximal intensity performed after a fasting period. However, the fitness level of the participant may modulate the magnitude of the effect of caffeine on fat oxidation during exercise.
Abstract
Cancer and associated medical treatments affect patients' health-related quality of life (HRQoL) by decreasing functional dimensions of physical, social, cognitive, and emotional well-being, ...while increasing short and late-term symptoms. Exercise, however, is demonstrated to be a useful therapy to improve cancer patients' and survivors’ HRQoL, yet the effectiveness of high-intensity training (HIT) exercise is uncertain. This systematic review and meta-analysis aimed to analyse the effects of HIT on HRQoL dimensions in cancer patients and survivors as well as evaluate the optimal prescription of HIT. The search followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA) and examined Web of Science and PubMed (Medline) databases. Data were analysed utilizing Review Manager Software. Twenty-two articles were included in the systematic review and 17 in the meta-analysis. Results showed HIT improved global quality of life, physical functioning, role functioning, social functioning, cognitive functioning, fatigue, pain, dyspnea, and insomnia, compared to an inactive control group, yet no differences were found between HIT and low to moderate-intensity exercise interventions. Particular improvements in HRQoL were observed during cancer treatment and with a training duration of more than eight weeks, a frequency of 2 days/week, and a volume of at least 120 min/week, including 15 min or more of HIT. Our findings whilst encouraging, highlight the infancy of the extant evidence base for the role of HIT in the HRQoL of cancer patients and survivors.
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