Objective
This study aimed to provide, through an umbrella review, an overview of the effect of single exercise interventions during pregnancy on gestational diabetes mellitus (GDM) and hypertensive ...disorders of pregnancy (HDP). Also, to update the current evidence through an updated meta‐analysis.
Design
Umbrella review.
Setting
PubMed, EMBASE, Web of Science, Cochrane database of systematic reviews, Epistemonikos, SPORTDiscus, Clinicaltrials.gov, and PROSPERO register were searched from the database inception until August 2021.
Population
Peer‐reviewed systematic reviews and meta‐analyses of randomised controlled trials (RCTs) and RCTs samples.
Methods
Random‐effects model was used to calculate relative risk with 95% confidence interval in the updated meta‐analysis. The reference category was the groups that received usual prenatal care. AMSTAR 2 and the Cochrane Collaboration tool were used to assess the quality and GRADE approach was used to assess the overall certainly of evidence.
Main outcome measures
GDM and HDP relative risk.
Results
Twenty‐three systematic reviews and meta‐analyses; and 63 RCTs were included. Single exercise interventions reduced the incidence of GDM and HDP in most systematic reviews and meta‐analyses. Moreover, exercise interventions during pregnancy decrease the incidence of developing GDM and GH, particularly when they are supervised, have a low to moderate intensity level, and are initiated during the first trimester of pregnancy.
Conclusion
Based on the findings, obstetric and physical exercise professionals could recommend exercise interventions during pregnancy as an effective strategy to improve maternal outcomes.
This systematic review and meta‐analysis aimed to assess the efficacy and safety of risdiplam on motor and respiratory function in spinal muscular atrophy (SMA). We systematically searched Medline, ...Scopus, Web of Science, and the Cochrane Library from inception to March 2023. We included pre‐post studies that determined the effect of risdiplam on the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP‐INTEND), the 32‐item Motor Function Measure (MFM32), the Revised Upper Limb Module (RULM), the Hammersmith Functional Motor Scale – Expanded (HFMSE), respiratory function, and the proportion of risdiplam‐related adverse events in a population with SMA (phenotypes 1 and 2/3). Meta‐analyses were also performed where possible. Eleven studies were included. After 12 months of treatment, 57% of participants with SMA1 achieved a CHOP‐INTEND score ≥ 40 points, and more than half were able to feed orally and had head control. In SMA2/3, MFM32, RULM, and HFMSE increased by 2.09 (1.17, 3.01), 1.73 (1.25, 2.20), and 1.00 (0.40, 1.59) points, respectively. Efficacy on respiratory function in SMA2/3 was inconsistent. Finally, 16% of participants experienced adverse events, but serious adverse events could not be quantified due to a lack of cases. The limited available evidence suggests that risdiplam is an effective and safe drug for the treatment of SMA. In addition, long‐term clinical benefit may be partly determined by the stage of disease at which treatment is initiated.
Resilience refers to the process by which individuals use the ability to cope with challenges to successfully adapt to adverse situations, inclining towards the future and hope. The main aim of this ...study was to analyze the relation between resilience, personality traits, and hopelessness. Furthermore, we conducted comparisons between two age groups: young and older adults. The sample comprised 439 Spanish participants (66.7% women; M = 43.73, SD = 26.41; age range = 18–98 years). The Connor–Davidson Resilience Scale, NEO‐Five Factor Inventory, and Beck Hopelessness Scale were used to measure the main study variables. The results revealed a negative relation between resilience and neuroticism, and a positive association with the other personality traits. Additionally, levels of resilience were found to be negatively related to hopelessness. The group of older adults showed significantly lower resilience levels than the young adults, although age was not a significant predictor of resilience. Neuroticism, extraversion, openness, and hopelessness were the only predictors of resilience for the current study. This work contributes to the study of resilience and related factors, by attempting to understand the role of resilience and resistance to risk and how individuals tackle challenges over time, with important implications for mental health.
Background
There is inconsistent evidence about the effect of physical activity on the prevention and treatment of depression during the postnatal period. The aim of this meta‐analysis was to ...determine the effect of physical activity interventions during pregnancy and the postpartum period for controlling postpartum depressive symptoms.
Methods
We systematically searched Cochrane Library Plus, Science Direct, EMBASE, CINAHL, PubMed, Web of Science, and Scopus, from January 1990 to May 2016, for randomized or nonrandomized controlled trials addressing the effect of physical activity on postpartum depression. The inverse variance‐weighted method was used to compute pooled estimates of effect size and respective 95% confidence intervals (95% CI) for physical activity intervention on postpartum depression. Subgroup analyses were performed comparing women with and without postpartum depressive symptoms according to specific scales measuring this construct. Meta‐regression and sensitivity analysis were computed to evaluate heterogeneity.
Results
Twelve studies were included in the meta‐analysis. Effect size for the relationship between physical activity interventions during pregnancy and the postpartum period on postpartum depressive symptoms was 0.41 (95% CI 0.28‐0.54). Heterogeneity was I2 = 33.1% (P = .117). When subgroup analyses were done, pooled effect sizes were 0.67 (95% CI 0.44‐0.90) for mothers who met postpartum depressive symptoms criteria at baseline based on specific scales, and 0.29 (95% CI 0.14‐0.45) for mothers who did not meet those depressive symptoms criteria at baseline.
Conclusion
Physical exercise during pregnancy and the postpartum period is a safe strategy to achieve better psychological well‐being and to reduce postpartum depressive symptoms.
Objectives
The two aims of this systematic review and meta‐analysis were to (1) analyze the effect of exercise on chemotherapy‐induced peripheral neuropathy (CIPN) severity and (2) determine the best ...type of exercise for the management of CIPN.
Methods
We systematically searched the MEDLINE, WOS, Sportdiscus, Scopus, and Cochrane databases from inception to December 2020 for experimental studies addressing the effect of exercise on CIPN severity, as measured by symptom severity (SSS) and peripheral deep sensitivity (PDS). The DerSimonian and Laird method was used to compute pooled estimates of the standardized mean differences (SMDs) and its respective 95% confidence intervals (CIs). Subgroup analyses were performed based on the types of exercise and the frequency and length of the interventions.
Results
Thirteen studies were included in this meta‐analysis. In the analyses comparing exercise interventions versus controls, there was an improvement in the SSS (SMD = −0.21; 95% CI: −0.40 to −0.01; %change: −20.34%) and the PDS (SMD = 0.49; 95% CI: 0.06 to 0.91; %change: 31.64%) in favor of the intervention group. In the pre–post analyses, there was an improvement in the SSS (SMD = −0.72; 95% CI: −1.10 to −0.34; %change: −15.65%) and the PDS (SMD = 0.47; 95% CI: 0.15 to 0.79; %change:18.98%).
Conclusions
This meta‐analysis provides an overview of the evidence supporting exercise as a suitable intervention to reduce the severity of CIPN by reducing the severity of the symptoms and the peripheral deep sensitivity among patients with cancer or cancer survivors. Furthermore, sensoriomotor training and mind–body exercises appear to be more effective in reducing symptom severity, and active nerve‐specific exercises and mind–body exercises seem to be more effective in improving peripheral deep sensitivity.
Background
High‐intensity interval training (HIIT) has emerged as an alternative training method to increase brain‐derived neurotrophic factor (BDNF) levels, a crucial molecule involved in plastic ...brain changes. Its effect compared to moderate‐intensity continuous training (MICT) is controversial. We aimed to estimate, and to comparatively evaluate, the acute and chronic effects on peripheral BDNF levels after a HIIT, MICT intervention or a control condition in adults.
Methods
The CINAHL, Cochrane, PubMed, PEDro, Scopus, SPORTDiscus, and Web of Science databases were searched for randomized controlled trials (RCTs) from inception to June 30, 2023. A network meta‐analysis was performed to assess the acute and chronic effects of HIIT versus control condition, HIIT versus MICT and MICT versus control condition on BDNF levels. Pooled standardized mean differences (SMDs) and their 95% confidence intervals (95% CIs) were calculated for RCTs using a random‐effects model.
Results
A total of 22 RCTs were selected for the systematic review, with 656 participants (aged 20.4–79 years, 34.0% females) and 20 were selected for the network meta‐analysis. Network SMD estimates were significant for HIIT versus control condition (1.49, 95% CI: 0.61, 2.38) and MICT versus control condition (1.08, 95% CI: 0.04, 2.12) for acutely BDNF increase. However, pairwise comparisons only resulted in a significant effect for HIIT versus control condition.
Conclusions
HIIT is the best training modality for acutely increasing peripheral BDNF levels in adults. HIIT may effectively increase BDNF levels in the long term.
Aim
To analyse, in schoolchildren, the relationship between daily steps with metabolic parameters; and to examine whether this association is mediated by cardiorespiratory‐fitness (CRF).
Methods
A ...cross‐sectional analysis of baseline data from a feasibility trial was performed in children from two primary schools in Cuenca, Spain. Daily steps were measured using the Xiaomi MI Band 3. Lipid and glycaemic profiles were analysed from blood samples. CRF was assessed using the 20‐m shuttle run test. ANCOVA models were used to test the mean differences by daily steps quartiles. Mediation analyses were conducted to examine whether CRF mediates the association between daily steps and lipid and glycaemic parameters.
Results
A total of 159 schoolchildren (aged 9–12 years, 53% female) were included in the analysis. Schoolchildren in the highest daily steps quartiles (>10 000 steps) showed significantly lower triglycerides and insulin levels (p = 0.004 and 0.002, respectively). This association did not remain after controlling for CRF. In mediation analyses, a significant indirect effect was observed through CRF in the relationship between daily steps with triglycerides and insulin.
Conclusion
Children who daily accumulate more than 10 000 steps have better lipid and metabolic profile, and CRF mediated their relationship in schoolchildren.
This study examined the association between key components of physical fitness with inhibition and cognitive flexibility in preschoolers.
This was a cross-sectional study of 362 Spanish preschoolers. ...The key components of physical fitness and executive functioning were measured.
The partial correlation controlling for body mass index and family socioeconomic status showed that inhibition was positively related to cardiorespiratory fitness. No association was found between muscular strength (i.e., standing long jump and dynamometry) and speed/agility with inhibition or between physical fitness components and cognitive flexibility. The inhibition mean scores were significantly higher in preschoolers with higher cardiorespiratory than in their peers who were in lower categories, after adjustments were made for confounders. Additionally, the results showed that cardiorespiratory fitness was a significant predictor of inhibition, but for cognitive flexibility, age was the only significant predictor.
Our data suggest that cardiorespiratory fitness is associated with inhibition in preschoolers. Likewise, our results also suggest that cognitive flexibility is an executive function that is more dependent on changes associated with age at this development stage. These findings are important for supporting initiatives that aimed at stimulating healthy brain development, and promote the improvement of cardiorespiratory fitness at early ages.
The aim of this study was to assess the effectiveness of a high‐intensity interval training (HIIT) intervention based on playground games (MOVI‐daFit!) on improvements in adiposity, physical fitness, ...and cardiometabolic risk factors in schoolchildren. A cluster‐randomized controlled trial (RCT) was performed that included 562 schoolchildren (9–11 years) from 10 schools in Cuenca, Spain. The intervention consisted of four 60‐min sessions per week in the school setting. Analyses were conducted on the intention‐to‐treat basis. Changes in physical fitness parameters (cardiorespiratory fitness: main outcome), body composition, blood pressure, and biochemical cardiometabolic risk parameters were analyzed using both mixed linear and logistic regression models, controlling for baseline covariates, Tanner stages, health dietary score index, body mass index, and cluster factor school. In boys, no significant differences in any outcome measure were noted except for the standing long jump test (10.13 cm; 95% CI 2.94 to 17.32; p = 0.006) between the intervention group (IG) and the control group (CG). Improvements in mean arterial pressure (−1.68 mmHg; 95% CI −3.28 to −0.08; p = 0.039), the triglyceride/HDL‐c ratio (−0.36 mg/dl; 95% CI −0.59 to −0.13; p = 0.002), C‐reactive protein (−0.23 mg/L; 95% CI −0.43 to −0.03), VO2max (1.44 ml/kg/min; 95% CI 0.52 to 2.36, p = 0.002), 20‐m shuttle run test (3.64 laps; 95% CI 0.51 to 6.78), and standing long jump test (7.04 cm; 95% CI 1.21 to 12.87; p = 0.018) were observed in girls in the IG compared with those in the CG. Body composition parameters did not change significantly in either boys or girls. Additionally, children with lower fitness levels obtained greater improvements than children with higher fitness levels. In conclusion, MOVI‐daFit! may represent a good strategy for incorporating HIIT into playground games, although its implementation may need to be improved to extend the benefits to children and enhance its adherence.
Background
Research has suggested the beneficial effects of physical activity (PA) on academic achievement (AA). However, the mechanisms underlying this influence remain unclear. Some proposed ...mechanisms include physiological, cognitive, psychological, and behavioral paths. This study aimed to analyze mediators between PA and AA in children and adolescents.
Methods
Systematic search in Medline, SPORTDiscuss, PsycInfo, Scopus, and Web of Science for observational and experimental studies, published up to March 2021.
Results
Twenty‐eight studies (75237 participants, aged 4–16) were included. The designs of these studies were: 21 studies cross‐sectional, 5 longitudinal, and 2 experimental. Eight out of nine studies analyzing fitness as a mediator reported positive results, and one reported null finding. Adiposity was a significant mediator in one study, in two only in girls, and two reported null results. Cognition as a mediator was supported by four studies, whereas two reported null results. Regarding mental well‐being, 10 out of 14 studies reported positive effects, and one out of five behavioral studies found positive results. Although studies were too sparse to draw conclusions, overall, the results indicated that self‐esteem, self‐image, self‐efficacy, stress, and health behaviors might be potential mediators in the relationship between PA and AA. All studies were rated as medium‐high quality.
Conclusion
Overall, the available evidence seems to suggest that cardiorespiratory fitness, cognition, mental well‐being, and exercise‐related behaviors play some role as mediators of the relationship between PA and AA. However, the cross‐sectional nature of most of the reviewed studies prevents us from making any statement in terms of causal paths. Thus, well‐designed follow‐up and randomized controlled studies aimed not only to tests the effect of PA in AA, but also to examine the influence of mediators are required.
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