Effects of jazz dance and concurrent training on psychological variables in menopausal women: A randomized controlled trial.

PURPOSE: To analyze the effect of two 16-week interventions with jazz dance and concurrent training compared to a control group on anxiety, depression, stress, mood, and the perspective of aging in menopausal women, after 1-month, post-intervention, and at the 6-month follow-up. METHODS: 70 post-menopausal women (53.19 ± 3.39 years) randomized into 3 groups:intervention group with Jazz Dance (JD); intervention group with Concurrent Training (CT), and Control Group (CG). Both interventions lasted 16 weeks, with 60-min classes, JD with a frequency of two weekly classes, and CT three times a week. The intensity of the JD was progressive and according to the frequency of beats per minute of the songs. In CT, the aerobic an initial intensity of 60% of HRmax, reaching 90%, and resistance the volume of sets and loads increased progressively throughout the intervention. Questionnaires related to symptoms of anxiety and depression (Hospital Anxiety and Depression Scale); stress (Perceived Stress Scale); mood (Brunel Mood Scale); and aging perspective (Sheppard Inventory) were applied. Intention-to-treat (ITT) and protocol adherence analysis were performed. RESULTS: In the protocol analysis, the JD showed improvements in anxiety and depressive symptoms after 1-month, which remained at the follow-up. The TC presented reduced anxiety and depressive symptoms after 16 weeks, which also remained at the follow-up. Considering stress, the CT showed improvements at all times and the JD post-intervention. As for mood, the CT presented reduced anger, mental confusion, and fatigue only after 1-month, and both exercise groups presented increased vigor at all times. CONCLUSION: Both interventions were beneficial, however dance showed immediate results for anxiety and depression, and concurrent training for stress. Considering mood, concurrent training was more effective for anger, mental confusion, and fatigue, while both interventions were effective for vigor. REGISTRATION: Brazilian Clinical Trials Registry (REBEC) RBR - 87ndrv.

Impact of air pollution on the health of the older adults during physical activity and sedentary behavior: A systematic review.

BACKGROUND: Air pollution, in addition to presenting health risks, can impact the practice of physical activity (PA) and sedentary behavior (SB) in older adults. This study analyzed the impact of air pollution on the health of older adults during PA and SB, through a systematic review. METHODS: A keyword and reference search was performed in PubMed, SCOPUS, SPORTDiscus, and Web of Science. Predetermined selection criteria included study designs: interventions or experiments, retrospective or prospective cohort studies, cross-sectional studies and case-control studies; population: older adults aged 60 years or older; exposures: specific air pollutants (particulate matter (PM), nitrogen dioxide (NO2), ozone (O3), carbon monoxide (CO), sulfur dioxide (SO2), black carbon (CN), ultrafine particles (PU), nitrogen oxides (NOx) and biomass fuels) indoors and outdoors; and outcomes: physical activity and/or sedentary behavior. RESULTS: The beneficial effects of PA were attenuated or harmed in 11 studies, showing negative impacts on the health of the older adults, mainly by PM2.5 pollutants. On the other hand, in 10 studies the effects of PA were greater than the negative effects of air pollutants, with a greater frequency in relation to PM2.5. In general, even the articles presenting controversial results suggest that practicing PA in polluted environments is more favorable to the health of older adults than remaining in SB. DISCUSSION AND CONCLUSIONS: On the one hand, air pollution negatively impacted the health of the older adults during PA practices, while on the other hand, PA can mitigate the negative effects of pollutants on the health of older adults during the practices. Evidence shows that practicing PA in environments with low concentrations of pollutants can provide gains and reduce health risks. Remaining in SB in environments with high levels of air pollution worsens the health of older adults.

Effects of Exercise in the Treatment of Alzheimer's Disease: An Umbrella Review of Systematic Reviews and Meta-Analyses.

The authors aimed to provide an overview of the evidence on the effects of exercise in people with Alzheimer's disease through a comprehensive review of the existing systematic reviews and meta-analyses. A literature search was performed in CINAHL, Cochrane Library, EMBASE, PubMed, SPORTDiscus, Scopus, and Web of Science databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The AMSTAR-2-Tool was used for the quality assessment. Twenty-three reviews fulfilled the criteria. Most of the reviews investigated the effects of aerobic exercise on Alzheimer's disease symptoms. The largest effects of exercise were seen in terms of improved cognition by multiple exercises. The majority of the reviews were rated as being of moderate quality and none were classified as having high quality. Exercise is an effective way to treat Alzheimer's disease symptoms and has a low incidence of related adverse events. As most reviews were evaluated as low-moderate quality, caution is needed in the interpretation of the results.

Effects of air pollution on health: A mapping review of systematic reviews and meta-analyses.

BACKGROUND: There has been a notable increase in knowledge production on air pollution and human health. OBJECTIVE: To analyze the state of the art on the effects of air pollution on human health through a mapping review of existing systematic reviews and meta-analyses (SRs and MAs). METHODS: The systematic mapping review was based on the recommendations for this type of scientific approach in environmental sciences. The search was performed using PubMed, Web of Science, Scopus, Cinahl, and Cochrane Library databases, from their inception through June 2020. RESULTS: Among 3401 studies screened, 240 SRs and MAs satisfied the inclusion criteria. Five research questions were answered. There has been an overall progressive increase in publications since 2014. The majority of the SRs and MAs were carried out by researchers from institutions in China, the US, the UK, and Italy. Most studies performed a meta-analysis (161). In general, the reviews support the association of air pollution and health outcomes, and analyzed the effects of outdoor air pollution. The most commonly investigated health outcome type was the respiratory (mainly asthma and COPD), followed by cardiovascular outcomes (mainly stroke). Particulate matter (with a diameter of 2.5 µm (PM2.5) and 10 µm (PM10) or less) and nitrogen dioxide (NO2) were the most widely investigated pollutants in the reviews. The general population was the most common sample in the reviews, followed by children, and adults. The majority of the reviews investigated health outcomes of respiratory diseases in children, as well as cardiovascular diseases in all ages. Combining health outcomes and air pollutants, PM2.5 was included in a higher number of reviews in eight health outcomes, mainly cardiovascular diseases. DISCUSSION: The majority of SRs and MAs showed that air pollution has harmful effects on health, with a focus on respiratory and cardiovascular outcomes. Future studies should extend the analysis to psychological and social aspects influenced by air pollution.

Effects of exercise in people with haemophilia: An umbrella review of systematic reviews and meta-analyses.

INTRODUCTION: There is considerable evidence to indicate that exercise can have a positive impact on the treatment of people with haemophilia (PWH). However, there is a requirement for in-depth and comprehensive studies. AIM: This study aimed to analyse the evidence regarding the effects of exercise in PWH through an umbrella review of existing systematic reviews and meta-analyses. The secondary objective was to analyse the quality of the evidence. METHODS: This umbrella review followed the PRISMA guidelines and was documented in the PROSPERO registry (CRD42019140785). We searched the PubMed, Web of Science, SPORTDiscus, Scopus, CINAHL and Cochrane Library databases. The methodological quality of the systematic reviews was assessed using AMSTAR 2. RESULTS: Out of a total of 1030 systematic reviews, 10 fulfilled the criteria. Only one study was classified as high quality, and half of the selected studies were classified as low or critically low quality according to AMSTAR 2. Furthermore, most reviews investigated the effects of strength training and aquatic training, with positive results associated with low adverse events. Range of motion, strength and pain were the most investigated variables. All reviews showed overlapping studies. CONCLUSION: Exercise is an effective way to treat haemophilia and has a low incidence of related adverse events. However, caution is needed in the interpretation of the results due to half of the selected reviews showed low or critically low quality and only one have high quality.

Indoor air quality of environments used for physical exercise and sports practice: Systematic review.

BACKGROUND: Systematic reviews have the potential to contribute substantially to environmental health and risk assessment. OBJECTIVE: This study aimed to investigate indoor air quality of environments used for physical exercise and sports practice through a systematic review. METHODS: The systematic review followed the PRISMA guidelines and was recorded in the PROSPERO registry (CRD42016036057). The search was performed using the SciELO, Science Direct, Scopus, LILACS, MEDLINE via PubMed, and SPORTDiscus databases, from their inception through April 2017. The search terms used in the databases were {air pollution" OR "air pollutants" OR "air quality"} AND {"physical exercise" OR "physical activity" OR "sport"}. The results of selected studies were divided into 5 categories for analysis: monitoring of air quality in the environment according to international guidelines, indoor-to-outdoor ratio (I/O), air quality during physical exercise, impact of air quality on health, and interventions to improve indoor air quality. RESULTS: Among 1281 studies screened, 34 satisfied the inclusion criteria. The monitoring of pollutants was conducted in 20 studies. CO and NO2 were the most investigated pollutants, and guidelines were discussed in most studies. The I/O ratio was investigated in 12 studies, of which 9 showed a higher concentration of some pollutants in indoor rather than outdoor environments. Among the 34 studies selected, only 7 investigated the impact of indoor air pollution on human health. The population in most of these studies consisted of hockey players. CONCLUSION: Most studies conducted monitoring of pollutants in indoor environments used for physical exercise and sports practice. The earliest studies were conducted in ice skating rinks and the most recent evaluated gymnasiums, fitness centers, and sports centers. The CO, particulate matter, and NO2 concentrations were the most investigated and have the longest history of investigation. These pollutants were within the limits established by guidelines in most studies. Studies that examined the association between air quality documented the adverse effects of pollution. There is a need for more studies focused on the relationship between pollution and health.

Scientific production on indoor air quality of environments used for physical exercise and sports practice: Bibliometric analysis.

INTRODUCTION: In order to minimize adverse health effects and increase the benefits of physical activity, it is important to systematize indoor air quality study in environments used for physical exercise and sports. OBJECTIVES: To investigate and analyze the scientific production related to indoor air quality of environments used for physical exercise and sports practice through a bibliometric analysis. METHODS: The databases Scielo, Science Direct, Scopus, Lilacs, Medline via Pubmed, and SportDiscus were searched from their inception to March 2016. Bibliometric analysis was performed for authors, institutions, countries, and collaborative networks, in relation to publication year, theme, citation network, funding agency, and analysis of titles and keywords of publications. Country, area, and impact factor of the journals were analyzed. RESULTS: Of 1281 studies screened, 34 satisfied the inclusion criteria. The first publication occurred in 1975. An increase in publications was observed in the last 15 years. Most of the studies were performed by researchers in the USA, followed by Portugal and Italy. Seventeen different scientific journals have published studies on the subject, and most are in the area of Environmental Sciences. It was noted that the categories of author keywords associated with "Pollutants," "Sport Environment," and "Physical Exercise" were the most commonly used in most studies. A total of 68% of the studies had at least one funding agency, and 81% of studies published in the last decade had funding. CONCLUSIONS: Our results demonstrate that there is recent exponential growth, driven in the last decade by researchers in environmental science from European institutions.

Risk factors for running-related injuries: An umbrella systematic review.

PURPOSE: This umbrella systematic review (SR) of SRs and meta-analysis seeks to comprehensively synthesize existing literature to identify and consolidate the diverse range of risk factors contributing to running-related injuries (RRIs). METHODS: Systematic searches were conducted on June 28, 2023, across Web of Science, SPORTDiscus, Scopus, PubMed, and Cochrane Library. We included SRs, whether accompanied by meta-analyses or not, that focused on investigating risk factors for RRIs within observational studies. The methodological quality of the SRs was evaluated using the Assessing the Methodological Quality of Systematic Reviews II. To assess the extent of overlap across reviews, the corrected covered area metric was calculated. RESULTS: From 1509 records retrieved, 13 SRs were included. The degree of overlap between SRs was low (4%), and quality varied from critically low (n = 8) to low (n = 5). Two hundred seven outcomes assessed in 148 primary studies were identified as being associated with the occurrence of RRIs. The effect sizes of the associations for which risk measures were reported (n = 131) were classified as large (n = 30, 23%), medium (n = 38, 29%), small (n = 48, 37%) or no effect (n = 15, 11%). Running/training characteristics, health and lifestyle factors, along with morphological and biomechanical aspects, exhibit large effect sizes in increasing the risk for RRIs. CONCLUSION: Drawing from the outcomes of the low-quality SRs and associations with large effect sizes, our findings indicate that running/training characteristics and health and lifestyle factors, as well as morphological and biomechanical aspects, are all implicated in elevating the risk of RRIs, emphasizing the multifactorial basis of injury incidence in running. Given the low quality and heterogeneity of SR, individual findings warrant cautious interpretation.

Exploring the relationship between Total Athleticism score and CrossFit® Open Performance in amateur athletes: single measure involving body fat percentage, aerobic capacity, muscle power and local muscle endurance.

There has been an increasing interest among CrossFit® coaches and practitioners in identifying indicators of sport performance. This study aimed to examine the correlation between anthropometric measures, cardiorespiratory capacity, power, local muscle endurance, and total athleticism score, with performance in the CrossFit® Open 2021. Fourteen male volunteers (aged 30.3 ± 5.8 years) participated in the study and underwent a series of tests on separate weeks. These tests included assessments of body fat percentage (subcutaneous adipose thickness measured at seven sites), maximal oxygen consumption (2 km test in rowing ergometer), muscle power (one repetition maximum in power clean), and muscle endurance (Tibana test, which included the conclusion of four distinct rounds of work). These results were used to calculate the total score of athleticism, which was then compared to the participants performance during the CrossFit® Open 2021. The athletes presented an average of body fat (8.6 ± 2.0%), maximal oxygen consumption (53.3 ± 2.4 mL. (kg.min)-1), 2km row time (07:00 ± 00:21 mm:ss), 1-Repetition maximum in power clean (125.2 ± 21.2 kg) and Tibana test performance (281.0 ± 35.9 repetitions). Interestingly, the top five athletes with the highest scores also achieved the highest z-scores in the CrossFit® Open 2021. Conversely, the four athletes with the lowest TSA score had the lowest z-scores in the CrossFit® Open. Moreover, almost perfect correlation (r = 0.91; p<0.01) was found between the total athleticism score and z-scores in the CrossFit® Open 2021. The total score may be a single measure and holistic indication of athleticism level in CrossFit®. Furthermore, coaches can potentially apply this useful tool for monitoring athletic performance and designing training sessions that address specific areas of CrossFit® performance.

Effects of Air Pollution on the Health of Older Adults during Physical Activities: Mapping Review.

Atmospheric pollutants present environmental threats to health and have been investigated in different environments, such as highways, squares, parks, and gyms. These environments are frequented by older adults, who are considered fragile to the harmful impacts of pollution present in the air. The aim was to analyze the state of the art on the effects of air pollution on the health of older adults during physical activities (PAs) through a mapping review. The search was performed in PubMed, Web of Science, Scopus, and Cinahl databases until June 2022. Of the 10,109 studies initially identified, 58 met the inclusion criteria. The most investigated health outcome was cardiovascular disease, followed by respiratory outcomes. Particulate matter (PM2.5 and PM10), nitrogen dioxide (NO2), and ozone (O3) were the most investigated pollutants. Of the 75 health outcomes investigated, in 29, air pollution had harmful effects on the health of the older adults during the practice of PA, more frequently in cardiovascular diseases. In 25 outcomes, the beneficial effects of PA to the health of the older adults remained, despite exposure to high and low concentrations of pollutants, most often in terms of mental disorders. We conclude that poor air quality is a harmful factor for the health of older adults during the practice of PAs, more frequently in cardiovascular and respiratory diseases. On the other hand, for mental-health-related outcomes (depression and cognition), in most studies, the beneficial effects of PA in older adults were maintained, even after exposure to pollutants.

Effects of resistance training on sleep of patients with fibromyalgia: A systematic review.

This study investigated the effects of resistance training (RT) on the sleep quality of patients with fibromyalgia (FM), through a systematic review. The search was carried out in the PubMed, Embase, Scopus, and Web of Science databases. Initially, 148 studies were found, of which six were included for qualitative analysis. Four studies showed significant improvement in sleep after RT. Compared to other exercise modalities, RT proved to be superior to flexibility training and equivalent to aerobic exercise. Interventions lasted from 4 to 21 weeks, the weekly frequency ranged from two to three times, and the intensity ranged from 40% to 80% 1RM, with exercises for the major muscle groups. RT is an intervention that can be used to treat FM, however, more studies are needed to verify its effectiveness in improving sleep.

Mental health of older people in social isolation: the role of physical activity at home during the COVID-19 pandemic.

The COVID-19 pandemic involves a new coronavirus characterized by a respiratory disease resulting from an infection with severe acute respiratory syndrome by coronavirus 2 (SARS-CoV-2). The severity and fatality of COVID-19 are directly related to age and immunocompromised states, with older adults making up the vast majority of cases. The elderly with a higher risk of serious complications due to COVID-19 and deaths are also the group most susceptible to the damage of social isolation, impacting on mental health, resulting in a more sedentary lifestyle, and health problems due to several causes, implying need for greater attention, care and protection. Physical activity has shown excellent results for mental health, being used in different treatments and populations, when considering the elderly, one of the ways to mitigate this impact on mental health is the practice of physical activity. Here, we discuss the impacts of social isolation on mental health and the role of physical activity and exercise in the homes of the elderly as a way to protect the spread of other diseases from all causes during the COVID-19 pandemic period. To this end, we discuss some possibilities that can be used by the elderly in the period of social isolation, to the point of remaining active within their homes.

Correction to: Do the benefits of exercise in indoor and outdoor environments during the COVID­19 pandemic outweigh the risks of infection?

[This corrects the article DOI: 10.1007/s11332-020-00673-z.].

Psychological variables of CrossFit participants: a systematic review.

Objective: This study aimed to review the existing literature concerning the psychological variables of CrossFit participants. Methodology: This review followed the PRISMA guidelines and was documented in the PROSPERO registry (CRD42018091177). Six electronic databases (SCOPUS, PubMed, SPORTDiscus, Web of Science, EMBASE, and Cochrane) were searched from their inception through July 2020. The methodological quality of the studies was assessed. Results: Thirty-four studies met the inclusion criteria. We observed an increase in satisfaction, clinical addiction, and enjoyment among participants related to exercise, social improvement, and high intrinsic motivation to participate for the purpose of enjoyment, challenge, and affiliation. Perceptions of effort were high among CrossFit participants. Some studies found that the reaction time was impaired after the CrossFit session, whereas others found no changes in mental health, self-esteem, and well-being after training. Conclusion: Adherence and maintenance of the practice of CrossFit are related to psychological variables such as motivation and satisfaction of basic psychological needs. CrossFit participants demonstrated high perception of effort, intrinsic motivation, and reasons for practice such as enjoyment, challenge, and affiliation. The quality assessment demonstrated the need for more detail in the methods section of future investigations. Additional high-quality studies are needed to investigate the effects of CrossFit training on the mental health of participants.

An Exploratory Pilot Study on Choking Episodes in Archery.

The aim of our study is to test the fit of an explanatory model of the frequency of the phenomenon of choking under pressure in archers, focusing on both the individual components (anxiety, coping styles, and decentralization) and environmental components (perception of coach assistance). 115 competitive athletes including 72 males (62.6%) and 43 females (37.4%) participated in the study, with average age of 39 years (±15.47). Participants reported personal data and completed measures of self-consciousness, anxiety, coping styles, and decentering. The ruminative component of concern was found to be the factor directly influencing the frequency of choking episodes in performance. Two significant mediations of personal coping style were also identified on the effects of anxiety on brooding thinking and on the athlete's ability to decentralize. The latter personal self-regulative component has been shown to be able to strongly limit the frequency of choking under pressure. Finally, among the environmental components, a further facilitating influence for the athlete resulted in the perception of being supported by the coach. The results therefore suggest that the athlete in choking should not face alone the hard upcoming period, but should preferably be supported with an articulated program focused on the cognitive remodeling of disturbing thoughts, on the strengthening of the capacity of decentralization, on the enhancement of the relationship of support and trust with the coach.

Perception of Risk, Self-Efficacy and Social Trust during the Diffusion of Covid-19 in Italy.

The Coronavirus pandemic has affected the lives of people all over the world. The perception of risk and people's consequent behaviour during a pandemic are very complex and are affected by multiple cultural and psychological factors. The aim of this study was to investigate the change in risk perception, perceived self-efficacy and the perceived trust in the behaviour of others, the decisions of health authorities and government provisions, as well as the variation of self-restraint behaviours during the spread of the Covid-19 epidemic in Italy. We used a convenience sample of 707 university students (Mage = 22.99; SD = 4.01) from a central area of Italy. Participants freely joined the research by answering an online questionnaire between February and March 2020. Three time intervals defined by the progressive containment measures implemented by the Italian Government were considered. Main outcome measures were the Generalized Self-Efficacy Scale, the Risk Perception Index, the Index of Self-restraint Behaviours, and Institutional and Interpersonal Trust Measures. Results confirmed that significant changes in the time progression have occurred in the perception of risk, in the perception of individual self-efficacy, in the value attributed to social responsibility, in interpersonal trust and in trust in health authorities. The study also identified the participants' personality traits and locus of control as predictors (positive and negative) of perceived self-efficacy and tested a mediation model of trust on the effect of risk perception on self-restraint intentions.

Local Muscle Endurance and Strength Had Strong Relationship with CrossFit® Open 2020 in Amateur Athletes.

This study analyzed the relationship between anthropometric measures, cardiorespiratory capacity, strength, power, and local muscle endurance with performance in the CrossFit® Open 2020. For this, 17 volunteers (6 women) (29.0 ± 7.2 years) completed, on separate weeks, tests for body composition (dual-energy X-ray absorptiometry), maximal oxygen consumption (2 km row test), muscle strength (one repetition maximum (1 RM) back and front squat, isometric peak torque), muscle power (1 RM snatch and clean and jerk) and muscle endurance (Tibana test), which were compared with performance during the CrossFit® Open 2020. Specific tests of localized muscular endurance and muscle strength had the strongest relationship with performance in the CrossFit® Open 2020. On the other hand, the percentage of fat and cardiorespiratory capacity were not significantly correlated with CrossFit® Open 2020 workout performance. Coaches and practitioners should therefore utilize these findings to assess physical fitness and organize the distribution of the training session based on less developed physical needs, in order to ensure an appropriate physiological adaptation for a given competition.

Daily submicron particle doses received by populations living in different low- and middle-income countries.

In the present study, the daily dose in terms of particle surface area received by citizens living in different low- and middle-income countries, characterized by different lifestyles, habits, and climates, was evaluated. The level of exposure to submicron particles and the dose received by the populations of Accra (Ghana), Cairo (Egypt), Florianopolis (Brazil), and Nur-Sultan (Kazakhstan) were analyzed. A direct exposure assessment approach was adopted to measure the submicron particle concentration levels of volunteers at a personal scale during their daily activities. Non-smoking adult volunteers performing non-industrial jobs were considered. Exposure data were combined with time-activity pattern data (characteristic of each population) and the inhalation rates to estimate the daily dose in terms of particle surface area. The received dose of the populations under investigation varied from 450 mm2 (Florianopolis, Brazil) to 1300 mm2 (Cairo, Egypt). This work highlights the different contributions of the microenvironments to the daily dose with respect to high-income western populations. It was evident that the contribution of the Cooking & Eating microenvironment to the total exposure (which was previously proven to be one of the main exposure routes for western populations) was only 8%-14% for low- and middle-income populations. In contrast, significant contributions were estimated for Outdoor day and Transport microenvironments (up to 20% for Cairo, Egypt) and the Sleeping & Resting microenvironment (up to 28% for Accra, Ghana), highlighting the effects of different site-specific lifestyles (e.g. time-activity patterns), habits, socioeconomic conditions, climates, and outdoor air quality.

What we already know about the effects of exercise in patients with fibromyalgia: An umbrella review.

We aimed to analyze the evidence on the effects of physical exercise in patients with fibromyalgia (FM) and to assess the characteristics of published studies, especially the quality of the evidence, through an umbrella review. This umbrella review followed the PRISMA guidelines and was documented in the PROSPERO registry (CRD42017075687). We searched the PubMed, Web of Science, SportDiscus, Scopus, Cinahl, and Cochrane Library databases. The methodological quality of systematic reviews was assessed using AMSTAR 2. We only selected systematic reviews (with or without meta-analyses) investigating the effects of any type of physical exercise in patients with FM syndrome. Thirty-seven systematic reviews (total = 477) fulfilled the criteria. Most studies were rated as being of low or moderate quality. A variety of exercises were used as treatment for FM symptoms, with positive results. Most of the reviews investigated the effects of aerobic exercise and strength training. No serious adverse events were reported. The largest effects of exercise were seen in terms of improved pain intensity and quality of life. Altogether, exercise may be an effective treatment for FM symptoms. Thus, aerobic exercise and strength training are effective programs for the treatment of FM. By summarizing the findings and effect sizes of the reviewed studies, we observed that the evidence for improvement of pain level and quality of life was the strongest. The results have potential to influence evidence-based practice. Future studies should analyze the long-term effects of exercise.