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1.
Sports Med ; 54(7): 1835-1850, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38598150

RESUMEN

BACKGROUND: Growing evidence suggests that physical activity (PA) could improve cognitive performance in youths, but whether these effects occur from early childhood remains unclear. OBJECTIVE: To summarize evidence on the effects of PA interventions on cognitive performance in early childhood. METHODS: We performed a systematic search in PubMed, Scopus, Web of Science and PsycINFO (from inception to 6 September 2023) for randomized controlled trials assessing the effects of PA interventions (≥ 3 weeks) on cognitive-related outcomes in early childhood (3-6 years). We conducted a random-effects meta-analysis when five or more studies assessed a given outcome. The potential moderating role of participant (e.g., age) and intervention characteristics (e.g., duration, volume, intensity, cognitive engagement) was also assessed. RESULTS: We found a total of 24 studies (N = 3483 children) that were deemed to be of overall fair methodological quality. PA interventions were supervised and lasted between 3 and 24 weeks. The most common session duration was 30 min, with a frequency of two sessions per week. Pooled analyses revealed that PA interventions have positive effects on all analysed outcomes, including attention (standardized mean difference (SMD) = 0.49, 95% confidence interval (CI) 0.18-0.79, p = 0.002), inhibition (SMD = 0.45, 95% CI 0.06-0.84, p = 0.022), working memory (SMD = 0.50, 95% CI 0.18-0.82, p = 0.002), cognitive flexibility (SMD = 0.39, 0.15-0.62, p = 0.002) and vocabulary (SMD = 1.18, 0.19-2.16, p = 0.019). Sensitivity analyses confirmed the benefits in all cases except for inhibition (p = 0.062). No consistent differences were found relating to any moderator variable. CONCLUSIONS: Although further research is warranted, our findings suggest that PA interventions may improve cognitive performance in early childhood, particularly in the domains of attention, inhibition, working memory, cognitive flexibility and vocabulary. These findings might support the implementation of PA interventions from early childhood. PROSPERO REGISTRATION: CRD42021249319.


Asunto(s)
Cognición , Ejercicio Físico , Ensayos Clínicos Controlados Aleatorios como Asunto , Humanos , Preescolar , Niño , Atención , Desarrollo Infantil
2.
Sports Med ; 54(7): 1877-1906, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38647999

RESUMEN

BACKGROUND: Unsupervised exercise intervention (UNSUP) appears to be a practical and beneficial strategy for older adults, although its feasibility and effectiveness compared to supervised exercise intervention (SUP) remains unknown. We aimed to compare the safety, attendance/adherence rates, and effectiveness of SUP versus UNSUP on physical function and well-being outcomes in older adults. METHODS: A systematic search was conducted in PubMed, Web of Science, CINAHL, SPORTDiscus, and APA PsycINFO up to September 2022 for randomized controlled trials comparing SUP versus UNSUP in older adults (≥ 60 years). Safety and attendance/adherence rates were registered as indicators of feasibility, and meta-analyses were performed for physical function and well-being outcomes. Sub-analyses were performed for those studies that applied a similar intervention in both groups and for those studies where participants performed ≥ 66% of the sessions in the assigned condition. RESULTS: Thirty-four studies were included (n = 2830). No serious adverse events were reported, with similar attendance rates (81%) for both SUP and UNSUP. Compared with UNSUP, SUP induced significant higher benefits on knee extension strength (standardized mean difference (SMD) = 0.18, p = 0.002), sit-to-stand test (STS, SMD = 0.25, p = 0.050), timed-up-and-go test (TUG, SMD = 0.21, p = 0.035), usual gait speed (SMD = 0.29, p = 0.026), lean mass (mean difference = 1.05 kg, p < 0.001) and health-related quality of life (HRQoL, SMD = 0.21, p = 0.035), albeit only knee extension strength remained significant in sensitivity analyses. Sub-analyses revealed superior benefits of SUP on knee extension strength when only considering those studies that applied a similar intervention in both SUP and UNSUP groups. However, no significant benefits were found for the remaining outcomes. Beneficial effects of SUP over UNSUP were also observed for knee extension strength, STS, functional reach test, TUG, usual gait speed, lean mass, and HRQoL when separately analyzing those studies in which participants performed ≥ 66% of the sessions in the assigned condition. CONCLUSIONS: Current evidence suggests that both SUP and UNSUP programs are safe and could exert benefits on physical function and HRQoL. However, despite being associated with similar attendance rates, SUP might offer some additional benefits, although further high-quality research (i.e., accounting for confounding factors such as presence of supervised sessions in UNSUP or vice versa, as well as equating the exercise dose) is necessary to confirm these findings. PROSPERO REGISTRATION NUMBER: CRD42022326420.


Asunto(s)
Terapia por Ejercicio , Fuerza Muscular , Ensayos Clínicos Controlados Aleatorios como Asunto , Humanos , Anciano , Terapia por Ejercicio/métodos , Calidad de Vida , Persona de Mediana Edad , Rendimiento Físico Funcional , Cooperación del Paciente , Equilibrio Postural
3.
Lancet Healthy Longev ; 5(2): e108-e119, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38310891

RESUMEN

BACKGROUND: Physical behaviours (ie, physical activity and sedentary behaviour) might have a role in the development of sarcopenia, although the evidence is unclear. We aimed to explore the association of total and intensity-specific levels of physical activity and sedentary behaviour with sarcopenia and its components (ie, muscle mass, muscle strength, and physical performance) in older adults. METHODS: We conducted a systematic review and meta-analysis and searched MEDLINE (via PubMed), Scopus, and Web of Science from inception to July 26, 2022, for peer-reviewed, observational studies or baseline data from randomised clinical trials conducted in older adults (ie, individual age ≥60 years or mean age ≥65 years) and published in English that reported on the association of physical activity or sedentary behaviour or both with sarcopenia (or its determinants: muscle mass or strength, and physical performance). Physical activity and sedentary behaviour were measured by any method. The main outcome was sarcopenia, which could be diagnosed by any means. Estimates were extracted and pooled using Bayesian meta-analytic models and publication bias was assessed using the Egger's test. This study is registered with PROSPERO, CRD42022315865. FINDINGS: We identified 15 766 records, of which 124 studies (230 174 older adults; 121 301 [52·7%] were female and 108 873 [47·3%] were male) were included in the systematic review. 86 studies were subsequently included in the meta-analysis. Higher levels of total physical activity were inversely associated with sarcopenia both cross-sectionally (21 studies, n=59 572; odds ratio 0·49, 95% credible interval 0·37-0·62) and longitudinally (four studies, n=7545; 0·51, 0·27-0·94). A protective association was also identified for moderate-to-vigorous physical activity in cross-sectional research (five studies, n=6787; 0·85, 0·71-0·99), whereas no association was identified for the remaining physical behaviours (ie, steps, light physical activity, or sedentary behaviour). INTERPRETATION: Total and moderate-to-vigorous physical activity are inversely associated with sarcopenia. These findings might support the importance of moderate-to-vigorous, rather than light, intensity physical activity-based interventions to prevent sarcopenia. FUNDING: None. TRANSLATION: For the Spanish translation of the abstract see Supplementary Materials section.


Asunto(s)
Sarcopenia , Masculino , Humanos , Femenino , Anciano , Sarcopenia/epidemiología , Estudios Transversales , Teorema de Bayes , Fuerza Muscular/fisiología
4.
Scand J Med Sci Sports ; 34(1): e14557, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38268077

RESUMEN

OBJECTIVE: There is a growing prevalence of chronic kidney disease (CKD), a condition associated with a higher cardiovascular disease (CVD) risk. We assessed the association between self-reported physical activity (PA) and CKD and also studied whether PA attenuates CKD-associated CVD risk. METHODS: A cohort of Spanish adults (18-64 years) participated in this nationwide study. Participants were categorized at baseline as being either inactive (performing no PA), regularly, or insufficiently active (meeting or not, respectively, international PA recommendations) and were followed for up to 5 years. The presence of CKD (estimated glomerular filtration rate <60 mL/min/1.73 m2 ) and major CVD risk factors (diabetes, hypercholesterolemia, hypertension, obesity) was determined at baseline and at follow-up. RESULTS: 517 917 participants (44 ± 9 years, 67% male, CKD prevalence = 7%) were studied at baseline, with prospective analyses (median follow-up = 2 years, range = 2-5) in a subcohort of 264 581 individuals. Compared to physical inactivity, cross-sectional analyses at baseline showed that regular PA (odds ratio = 0.80; 95% confidence interval = 0.79-0.81), but not insufficient PA (1.02; 0.99-1.04) was associated with lower CKD prevalence. However, prospective analyses failed to confirm this association (p > 0.1). In turn, CKD was associated with a higher prevalence of hypertension (+3%) and diabetes (+5%) at baseline and with a greater incidence of hypertension at follow-up (+37%). Among those participants with CKD, regular PA was associated with a lower prevalence (-45% to -7%) and incidence (-38% to -4%) of all CVD risk factors. CONCLUSION: Although PA might not reduce incident CKD in the middle term (~2 years), it can attenuate the CVD risk linked to this condition.


Asunto(s)
Enfermedades Cardiovasculares , Diabetes Mellitus , Hipertensión , Insuficiencia Renal Crónica , Adulto , Humanos , Masculino , Femenino , Enfermedades Cardiovasculares/epidemiología , Estudios Transversales , Estudios Prospectivos , Factores de Riesgo , Factores de Riesgo de Enfermedad Cardiaca , Ejercicio Físico , Hipertensión/epidemiología , Insuficiencia Renal Crónica/epidemiología
5.
Scand J Med Sci Sports ; 34(1): e14479, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37632197

RESUMEN

BACKGROUND: There has been an increase in the number of studies examining the effect of acute and chronic physical activity on academic outcomes in children and adolescents in the last two decades. We aimed to systematically determine the acute effects of physical activity on academic outcomes in school-aged youth and to examine possible moderators. METHODS: We conducted a systematic search using PubMed, Web of Science, SPORTDiscus, and PsycINFO databases (from inception to 11th January 2023) for studies assessing the acute effects of physical activity on academic performance-related outcomes in school-aged youth. A univariate and multivariate meta-analysis was conducted based on a random-effects model with restricted maximum likelihood used to pool the academic outcomes results (Hedge's g). RESULTS: We included 11 articles (803 children and adolescents [range: 6-16 years]) in the systematic review. Overall, acute physical activity increased academic outcomes (Hedge's g = 0.35, 95% CI: 0.20-0.50). Multivariate meta-analyses revealed that physical activity increased academic performance in mathematics (Hedge's g = 0.29, 95% CI: 0.16-0.42) and language (Hedge's g = 0.28, 95% CI: 0.09-0.47). Only behavior change techniques (Hedge's g = 0.54, 95% CI, 0.18-0.90, p < 0.001) played a significant role in this relationship. CONCLUSIONS: A single bout of physical activity can improve academic outcomes in school-aged youth, which may serve as a complementary tool for the educational field. However, the observed heterogeneity in the results indicates that we should interpret the findings obtained with caution.


Asunto(s)
Rendimiento Académico , Ejercicio Físico , Niño , Adolescente , Humanos , Instituciones Académicas , Escolaridad , Organizaciones
6.
Lancet Healthy Longev ; 4(6): e247-e256, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-37182530

RESUMEN

BACKGROUND: Physical exercise is effective at attenuating ageing-related physical decline in general, but evidence of its benefits for older adults in residential care, who often have functional dependency, multimorbidity, and polypharmacy, is inconclusive. We aimed to establish the effects of exercise interventions on the physical function of this population. METHODS: For this systematic review and network meta-analysis, we searched PubMed, Web of Science, Cochrane Library, Rehabilitation & Sports Medicine Source, and SPORTDiscus to identify randomised controlled trials assessing the effects of exercise interventions (vs usual care) on physical function (ie, functional independence, physical performance, and other related measures, such as muscle strength, balance, or flexibility) in adults aged 60 years or older living in residential care. Relevant studies published in English or Spanish up to Jan 12, 2023, were included in the systematic review. The quality of studies was assessed using the Tool for the Assessment of Study Quality and Reporting in Exercise (TESTEX) score. A network meta-analysis was performed for physical function-related outcomes reported in at least ten studies, with subanalyses for specific intervention (ie, exercise type, training volume, and study duration) and participant (eg, having cognitive impairment or dementia, pre-frail or frail status, and being functionally dependent) characteristics. The study protocol was registered on PROSPERO (CRD42021247809). FINDINGS: 147 studies (11 609 participants, with mean ages ranging from 67 years [SD 9] to 92 years [2]) were included in the systematic review, and were rated as having overall good quality (median TESTEX score 9 [range 3-14]). In the meta-analysis (including 105 studies, n=7759 participants), exercise interventions were associated with significantly improved overall physical function, with a standardised mean difference [SMD] of 0·13 (95% credible interval [CrI] 0·04-0·21), which was confirmed in all analysed subpopulations. The strongest association was observed with 110-225 min per week of exercise, and the greatest improvements were observed with 170 min per week (SMD 0·36 [95% CrI 0·20-0·52]). No significant differences were found between exercise types. Subanalyses showed significant improvements for almost all analysed physical function-related outcomes (Barthel index, five-times sit-to-stand test, 30-s sit-to-stand test, knee extension, hand grip strength, bicep curl strength, Short Physical Performance Battery, 6-min walking test, walking speed, Berg balance scale, and sit-and-reach test). Large heterogeneity was found between and within studies in terms of population and intervention characteristics. INTERPRETATION: Exercise interventions are associated with improved physical function in older adults in residential care, and should, therefore, be routinely promoted in long-term care facilities. FUNDING: None. TRANSLATION: For the Spanish translation of the abstract see Supplementary Materials section.


Asunto(s)
Ejercicio Físico , Fuerza de la Mano , Anciano , Humanos , Ejercicio Físico/fisiología , Terapia por Ejercicio/métodos , Fuerza Muscular/fisiología , Metaanálisis en Red , Ensayos Clínicos Controlados Aleatorios como Asunto , Anciano de 80 o más Años
7.
World J Pediatr ; 19(8): 727-740, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37154861

RESUMEN

BACKGROUND: Advances in cancer treatments, particularly the development of radiation therapy, have led to improvements in survival outcomes in children with brain tumors. However, radiation therapy is associated with significant long-term neurocognitive morbidity. The present systematic review and meta-analysis aimed to compare the neurocognitive outcomes of children and adolescents with brain tumors treated with photon radiation (XRT) or proton therapy (PBRT). METHODS: A systematic search was conducted (PubMed, Embase, Cochrane, and Web of Science from inception until 02/01/2022) for studies comparing the neurocognitive outcomes of children and adolescents with brain tumors treated with XRT vs. PBRT. The pooled mean differences (expressed as Z scores) were calculated using a random effects method for those endpoints analyzed by a minimum of three studies. RESULTS: Totally 10 studies (n = 630 patients, average age range: 1-20 years) met the inclusion criteria. Patients who had received PBRT achieved significantly higher scores (difference in Z scores ranging from 0.29-0.75, all P < 0.05 and significant in sensitivity analyses) after treatment than those who had received XRT for most analyzed neurocognitive outcomes (i.e., intelligence quotient, verbal comprehension and perceptual reasoning indices, visual motor integration, and verbal memory). No robust significant differences (P > 0.05 in main analyses or sensitivity analyses) were found for nonverbal memory, verbal working memory and working memory index, processing speed index, or focused attention. CONCLUSIONS: Pediatric brain tumor patients who receive PBRT achieve significantly higher scores on most neurocognitive outcomes than those who receive XRT. Larger studies with long-term follow-ups are needed to confirm these results.


Asunto(s)
Neoplasias Encefálicas , Terapia de Protones , Niño , Adolescente , Humanos , Lactante , Preescolar , Adulto Joven , Adulto , Protones , Neoplasias Encefálicas/radioterapia , Neoplasias Encefálicas/patología , Terapia de Protones/efectos adversos , Terapia de Protones/métodos
8.
Eur J Sport Sci ; 23(6): 1028-1035, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35603835

RESUMEN

We analysed the association between self-reported sleep characteristics and the prevalence of major cardiovascular disease (CVD) risk factors attending to the potential effect of physical activity (PA) and weight status. A large cohort of Spanish workers (n = 527,662; 32% female, 44 ± 9yrs) participated in this cross-sectional study. We assessed participants' self-reported indicators of sleep quantity (short [<6 h/d], normal [6-9 h/d] or long [>9 h/d]) and quality (unrestful or restful, and difficulties or not falling asleep) as well as the presence of major CVD risk factors (diabetes, hypertension and hypercholesterolemia); and categorised participants based on PA ("inactive", "insufficiently active" or "regularly active") and weight status (normal weight, overweight or obesity). Impairments in any sleep quantity or quality indicator, respectively, were significantly (p < 0.05) associated with the prevalence of at least one CVD risk factor. Yet, being physically active and having normal weight markedly attenuated these associations. Thus, individuals with poor sleep quantity or quality but who were physically active and had normal weight showed no different risk of hypertension or diabetes than those with normal sleep characteristics, albeit the former still presented a higher risk of hypercholesterolemia if they reported short sleep (+5% vs. normal duration, p = 0.047), unrestful sleep (+9% vs. restful, p < 0.001) or having difficulties to fall asleep (+48% vs. no difficulties, p < 0.001). The present findings support the need for maintaining optimal PA levels and weight status in order to minimise the CVD risk associated with poor sleep quantity or quality.HighlightsBoth sleep quantity and quality are associated with the prevalence of hypertension, diabetes, and hypercholesterolemia.Being physically active and having normal weight markedly reduces the cardiovascular risk associated with poor sleep quantity/quality.Having poor sleep quantity/quality while being also inactive and overweight/obese predisposes to a higher cardiovascular risk.


Asunto(s)
Enfermedades Cardiovasculares , Diabetes Mellitus , Hipercolesterolemia , Hipertensión , Humanos , Femenino , Masculino , Sobrepeso/epidemiología , Sobrepeso/complicaciones , Autoinforme , Hipercolesterolemia/epidemiología , Hipercolesterolemia/complicaciones , Factores de Riesgo , Estudios Transversales , Hipertensión/epidemiología , Hipertensión/complicaciones , Obesidad/epidemiología , Diabetes Mellitus/epidemiología , Sueño , Ejercicio Físico , Enfermedades Cardiovasculares/epidemiología
10.
Support Care Cancer ; 30(7): 6287-6297, 2022 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-35471614

RESUMEN

PURPOSE: The strict lockdown implemented due the COVID-19 pandemic is generating a great impact on wellbeing and health-related quality of life (HRQoL) in people with cancer. We aimed to evaluate the efficacy and feasibility of an online home-based exercise intervention performed during a lockdown period analysing its effects on body composition, physical fitness, and HRQoL in breast cancer survivors. METHODS: Fifteen women with breast cancer receiving hormonal therapy (55.5 ± 6.7 years) were included in the study. The exercise intervention consisted of two weekly sessions of remotely supervised functional training (60 min per day) and two weekly sessions of unsupervised aerobic training (20-30 min/session; 60-85% of maximum heart rate) for a total of 16 weeks. DXA absorptiometry was used for the assessment of body composition. Functional assessment included cardiorespiratory fitness (CRF) by Rockport walking test, upper and lower body strength (grip strength, arm curl test, and chair stand test), walking speed (brisk walking test), and agility (8-foot up-and-go test). The HRQoL was evaluated with the QLQ-BR23 questionnaire. The adherence to the intervention was measured as the percentage of online classes attended. RESULTS: Rate of adherence for the online exercise intervention was 90 ± 17%. The exercise intervention induced significant (p < 0.05) improvements in physical fitness: CRF (+ 9%), right arm and lower limb strength (+ 10% and + 18%, respectively) and lower limbs lean mass (+ 2% and + 3.5% for left and right leg, respectively). CONCLUSION: This feasibility study suggests that an online home-based exercise intervention during COVID-19 lockdown could improve physical fitness and body composition in breast cancer survivors even in a context of heightened concern for future health.


Asunto(s)
Neoplasias de la Mama , COVID-19 , Supervivientes de Cáncer , Control de Enfermedades Transmisibles , Terapia por Ejercicio , Estudios de Factibilidad , Femenino , Humanos , Fuerza Muscular/fisiología , Pandemias , Calidad de Vida
11.
Sports Med Open ; 8(1): 36, 2022 Mar 04.
Artículo en Inglés | MEDLINE | ID: mdl-35244811

RESUMEN

BACKGROUND: Exercise training can positively impact the immune system and particularly natural killer (NK) cells, at least in healthy people. This effect would be of relevance in the context of cancer given the prominent role of these cells in antitumor immunity. In this systematic review and meta-analysis, we aimed to summarize current evidence on the effects of exercise training on the levels and function of NK cells in cancer survivors (i.e., from the time of diagnosis until the end of life). METHODS: Relevant articles were searched in PubMed, Scopus, Web of Science and Cochrane Central Register of Controlled Trials (until January 11, 2022). Randomized controlled trials (RCT) of exercise training (i.e., non-acute) interventions vs usual care conducted in cancer survivors and assessing NK number and/or cytotoxic activity (NKCA) before and upon completion of the intervention were included. Methodological quality of the studies was assessed with the PEDro scale, and results were meta-analyzed using a random effects (Dersimoian and Laird) model. RESULTS: Thirteen RCT including 459 participants (mean age ranging 11-63 years) met the inclusion criteria. Methodological quality of the studies was overall fair (median PEDro score = 5 out of 10). There was heterogeneity across studies regarding cancer types (breast cancer, non-small cell lung cancer and other solid tumors), treatment (e.g., receiving vs having received chemotherapy), exercise modes (aerobic or resistance exercise, Tai Chi, Yoga) and duration (2-24 weeks). No consistent effects were observed for NK number in blood (mean difference [MD]: 1.47, 95% confidence interval [CI] - 0.35 to 3.29, p = 0.113) or NKCA as assessed in vitro (MD: - 0.02, 95%CI - 0.17 to 0.14, p = 0.834). However, mixed results existed across studies, and some could not be meta-analyzed due to lack of information or methodological heterogeneity. CONCLUSIONS: Current evidence does not support a significant effect of exercise training intervention on NK cells in blood or on their 'static response' (as assessed in vitro) in cancer survivors. Several methodological issues and research gaps are highlighted in this review, which should be considered in future studies to draw definite conclusions on this topic.

12.
Eur J Clin Invest ; 52(5): e13738, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-34958676

RESUMEN

BACKGROUND: Sleep is known to affect cardiovascular health, but some controversy exists on the independent association between different sleep characteristics (duration, restfulness, difficulties falling asleep) and specific risk factors for cardiovascular disease (CVD). We aimed to assess the association between self-reported sleep characteristics and the likelihood of major CVD risk factors. METHODS: Totally, 521,364 Spanish workers (32% female, 44 ± 9 years [18-64]) insured by an occupational risk prevention company participated in this nationwide cross-sectional study. Participants' sleep was considered 'poor' if they reported having ≥1 of the following conditions: excessively short (<6 h/d) or long (>9 h/d) sleep, unrestful sleep, or difficulties to fall asleep. We assessed the independent association between aforementioned sleep characteristics and the prevalence of hypertension, diabetes, hypercholesterolaemia, obesity and physical inactivity. RESULTS: Poor sleep (reported by 33% of participants) was associated with a higher likelihood of presenting all CVD risk factors individually, particularly physical inactivity (which prevalence was ~3-fold higher in the poor sleep group compared with participants reporting no sleep abnormality). In separate analyses, all the different sleep characteristics were associated with the likelihood of ≥2 CVD risk factors. Participants with optimal sleep, normal sleep duration, no difficulties falling sleep and restful sleep showed a lower total CVD risk score than their peers with poor sleep, short sleep duration, difficulties falling sleep and unrestful sleep, respectively (all p < .001). CONCLUSIONS: Poor sleep was associated with a higher likelihood of presenting major CVD risk factors. These findings might support the importance of monitoring and improving sleep patterns for primary CVD prevention.


Asunto(s)
Enfermedades Cardiovasculares , Adulto , Enfermedades Cardiovasculares/epidemiología , Estudios Transversales , Femenino , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Masculino , Factores de Riesgo , Autoinforme , Sueño
14.
Sports Med ; 52(4): 835-846, 2022 04.
Artículo en Inglés | MEDLINE | ID: mdl-34674184

RESUMEN

BACKGROUND: Professional athletes seem to have a lower overall mortality risk than the general population, but controversy exists about whether athletes in sports associated with repetitive head impacts have a higher risk of mortality from neurodegenerative diseases. OBJECTIVE: We aimed to determine the risk of mortality from neurodegenerative diseases in sports associated with repeated head impacts compared with the general population or compared with athletes with no such exposure. METHODS: We conducted a systematic review with meta-analysis, systematically searching PubMed, Web of Science, Scopus, and SPORTDiscus (since inception to 14 May 2021) for studies comparing the risk of death from neurodegenerative disease in athletes participating in contact sports in which their heads recurrently receive blows from the bodies of other participants or from a ball versus a control group or dataset representing the general population. RESULTS: Six moderate- to high-quality retrospective studies including data from 41,699 athletes participating in contact sports (boxing, basketball, ice hockey, American Football and soccer) met all inclusion criteria to be included in the systematic review. Of these, three studies (N = 37,065 male professional soccer players) could be meta-analysed. Despite no differences in the risk of all-cause (p = 0.138), cardiovascular (p = 0.085) and cancer-related mortality (p = 0.136), soccer players presented with a significantly higher mortality risk from motor neuron disease (standard mortality rate 8.43; 95% confidence interval 3.07-23.13; p < 0.001). CONCLUSIONS: Although more research is needed (particularly in other contact sports and with neurodegenerative disease as the cause of death), preliminary evidence suggests that participation in professional soccer might increase the risk of mortality from motor neuron disease compared with the general population. The present findings highlight the need for the design of preventive measures and for adequate neuropsychological monitoring in these athletes. PROSPERO REGISTRATION: CRD42020195647.


Asunto(s)
Conmoción Encefálica , Fútbol Americano , Hockey , Enfermedades Neurodegenerativas , Fútbol , Atletas , Conmoción Encefálica/epidemiología , Femenino , Humanos , Masculino , Enfermedades Neurodegenerativas/complicaciones , Estudios Retrospectivos , Fútbol/psicología
16.
Ageing Res Rev ; 72: 101479, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34601135

RESUMEN

AIMS: To assess the potential multi-domain benefits of exercise interventions on patients with Alzheimer's disease (AD), as well as to determine the specific effects of different exercise modalities (aerobic, strength, or combined training). METHODS: A systematic search was conducted in PubMed and Web of Science until March 2021 for randomized controlled trials assessing the effect of exercise interventions (compared with no exercise) on patients with AD. Outcomes included cognitive function (mini-mental state examination [MMSE] test), physical function (e.g., 6-minute walking test [6MWT]), functional independence (Barthel index), and neuropsychiatric symptoms (Neuropsychiatric Inventory [NPI]). A random-effects meta-analysis was conducted. RESULTS: 28 studies (total n = 1337 participants, average age 79-90 years) were included in the systematic review, of which 21 could be meta-analyzed. Although considerable heterogeneity was found, exercise interventions induced several significant benefits, including in Barthel index (n = 147 patients, mean difference [MD]=8.36 points, 95% confidence interval [CI]=0.63-16.09), 6MWT (n = 369, MD=84 m, 95% CI=44-133)), and NPI (n = 263, MD=-4.4 points, 95% CI=-8.42 to -0.38). Benefits were also found in the MMSE test, albeit significance was only reached for aerobic exercise (n = 187, MD=2.31 points, 95% CI 0.45-4.27). CONCLUSIONS: Exercise interventions appear to exert multi-domain benefits in patients with AD.


Asunto(s)
Enfermedad de Alzheimer , Anciano , Anciano de 80 o más Años , Enfermedad de Alzheimer/terapia , Cognición , Ejercicio Físico , Terapia por Ejercicio , Humanos , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto
17.
Scand J Med Sci Sports ; 31(12): 2241-2248, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34416791

RESUMEN

OBJECTIVE: To determine the risk of mortality from mental disorders and suicide in professional sports associated with repeated head impacts. METHODS: A systematic search was performed in PubMed, Web of Science, Scopus, and SPORTDiscus (since inception to June 8, 2021) to find studies comparing the incidence of mortality from mental disorders or suicide in former or active professional athletes of sports characterized by repeated head impacts vs athletes with no such exposure or the general non-athletic population. RESULTS: Seven retrospective studies of moderate-to-high quality that included data from boxers and from basketball, ice hockey, soccer, and National Football League (NFL) players, respectively (total = 27 477 athletes, 100% male) met all inclusion criteria. Former male NFL players (n = 13 217) had a lower risk of mortality from mental disorders (standard mortality rate [SMR] = 0.30; 0.12-0.77; p = 0.012) and suicide (SMR = 0.54; 0.37-0.78; p < 0.001) than the general population. This finding was also corroborated in male soccer players (n = 13,065; SMR = 0.55; 0.46-0.67; p < 0.001). Male athletes participating in sports associated with repeated head impacts (n = 18,606) had also a lower risk of all-cause, cardiovascular disease (CVD), and cancer mortality (all p < 0.01) than the general population. CONCLUSIONS: Participation of male athletes in American football or soccer at the professional level might confer a certain protective effect against mortality from mental disorders or suicide, besides its association with a lower risk of all-cause, CVD, or cancer-related mortality.


Asunto(s)
Fútbol Americano/psicología , Trastornos Mentales/mortalidad , Fútbol/psicología , Suicidio/estadística & datos numéricos , Baloncesto/lesiones , Baloncesto/psicología , Boxeo/lesiones , Boxeo/psicología , Conmoción Encefálica/epidemiología , Enfermedades Cardiovasculares/mortalidad , Causas de Muerte , Conducta Competitiva/fisiología , Fútbol Americano/lesiones , Hockey/lesiones , Hockey/psicología , Humanos , Incidencia , Masculino , Neoplasias/mortalidad , Estudios Retrospectivos , Fútbol/lesiones , Estados Unidos/epidemiología
18.
Neurosci Biobehav Rev ; 128: 394-405, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34087277

RESUMEN

Neurodegenerative disorders are associated with reduced levels of brain-derived neurotrophic factor (BDNF). We aimed to assess the effect of exercise interventions on plasma BDNF levels in individuals with neurodegenerative disorders. Eighteen randomized controlled trials (RCT) assessing the effects of exercise interventions versus no exercise on plasma BDNF levels in individuals with neurodegenerative disorders (i.e., multiple sclerosis, Parkinson's disease, mild cognitive impairment [MCI] and Alzheimer's disease) were included. Overall, exercise interventions induced a significant increase in plasma BDNF levels (SMD=2.22, 95% CI=1.33-3.12, p<0.001; 18 studies), which was separately confirmed for multiple sclerosis (SMD= 2.40, 95% CI= 1.30-3.50, p<0.001; 10 studies) and Parkinson's disease (SMD= 10.00, 95% CI= 2.48-17.51, p=0.009; 3 studies), with a non-significant trend also observed for MCI (SMD= 1.07, 95% CI= -0.14-2.28, p=0.080; 4 studies). BDNF levels significantly increased regardless of exercise type (p<0.001, p=0.003 and p=0.020 for combined, aerobic and resistance exercise, respectively), weekly exercise volume (p<0.001 for both ≥150 and <150 min/week) and intervention length (p<0.001 for both interventions of ≥12 and <12 weeks). In conclusion, physical exercise interventions increase plasma BDNF levels in individuals with neurodegenerative disorders. PROSPERO registration number: CRD42020199459.


Asunto(s)
Disfunción Cognitiva , Enfermedades Neurodegenerativas , Factor Neurotrófico Derivado del Encéfalo , Ejercicio Físico , Humanos , Enfermedades Neurodegenerativas/terapia , Ensayos Clínicos Controlados Aleatorios como Asunto
19.
Ageing Res Rev ; 69: 101368, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-34022464

RESUMEN

BACKGROUND: We aimed to summarize evidence on the safety, adherence and effectiveness of home-based resistance training (UHBRT) for improving health-related endpoints in community-dwelling older adults. METHODS: Randomized controlled trials of UHBRT in older adults (≥60yrs) were included after a systematic search (PubMed, CINAHL, PsycInfo, SPORTDiscus, Web of Science, MEDLINE, Cochrane Central Register of Controlled Trials) until 02/19/2021. Adverse events and adherence rates were assessed as indicators of feasibility. Other endpoints included physical (muscle strength, muscle power, balance, physical performance) and mental-related measures (cognition, quality of life [QoL]) as well as other health-related variables (body composition, physical activity levels, falls). RESULTS: 21 studies (N = 4,053) were included. No major adverse events were reported, with adherence averaging 67 % (range 47-97 %). UHBRT significantly improved lower-limb muscle strength (Hedges' g = 0.33; 95 % confidence interval [CI] = 0.11-0.57), muscle power measured through the sit-to-stand test (g = 0.44; 95 %CI = 0.06-0.84), and balance (assessed with the postural sway, g = 0.32; 95 %CI = 0.16-0.49). No benefits were found for other strength indices (handgrip strength), balance (single leg stance and functional reach test), physical performance (walking speed, TUG and SPPB), QoL, nor for the risk or rate of falls (all p > 0.05, g<0.61). No meta-analysis could be performed for the remaining endpoints. CONCLUSIONS: Although efforts are needed to increase adherence, preliminary evidence suggests that UHBRT can be safe and modestly effective for improving some measures of lower-limb muscle strength, balance, and muscle power in community-dwelling older adults. However, no benefits were found for other physical fitness measures, QoL or falls. More evidence is therefore needed to draw definite conclusions.


Asunto(s)
Calidad de Vida , Entrenamiento de Fuerza , Anciano , Terapia por Ejercicio , Fuerza de la Mano , Humanos , Vida Independiente , Fuerza Muscular , Equilibrio Postural , Ensayos Clínicos Controlados Aleatorios como Asunto
20.
Exerc Immunol Rev ; 27: 125-141, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33965896

RESUMEN

BACKGROUND: Regular exercise, particularly moderate-intensity continuous training (MICT), can improve immune function. Natural killer (NK) cells, a subset of lymphocytes that react to infections, are the most responsive innate immune cells to exercise, but the mechanisms underlying this are poorly understood. A type of exercise training that is gaining popularity in recent years is high-intensity interval training (HIIT), but how it affects NK cells is largely unknown. In fact, intense exercise has been traditionally viewed as a potential stressor to immune homeostasis. The purpose of this study was to determine in healthy, previously untrained adults (N=8 [3 male; 40±6 years]) the effects of an intervention consisting of 4-week MICT followed by 4-week HIIT on NK cells as compared with a pre-training (baseline) state. METHODS: Participants were studied at three time points: baseline, mid-intervention (after MICT), and post-intervention (after HIIT). Main assessments included cytotoxicity assays, flow-cytometry analysis of NK cell surface markers, and interrogation of the cellular proteome using a systems biology approach. RESULTS: A significant time effect was found for NK cell cytotoxicity (p<0.001), which was increased ~10-fold at both midand post-intervention versus baseline. No significant intervention effect was found for NK surface receptor expression, except for CXCR3 determined as mean fluorescence intensity (p=0.044, although with no significant differences in post hoc pairwise comparisons). The proteins showing a higher differential expression (Log2 fold-change > 10 and false discovery rate [FDR] q-value < 0.001) were COP9 signalosome subunit 3 (COPS3), DnaJ heat shock protein family member B11 (DNAJB11), histidyl-TRNA synthetase 1 (HARS), NIMA related kinase 9 (NEK9), nucleoporin 88 (NUP88), phosphoinositide-3-kinase regulatory subunit 1 (PIK3R1), regulator of chromosome condensation 2 (RCC2), TAO kinase 3 (TAOK3), transducin beta like 2 (TBL2), and ring finger protein 40 (RNF40). All were upregulated at mid-intervention compared with baseline, with the exception of HARS, which was downregulated. Four enriched pathways (FDR p<25%) were found: two related to transmembrane transport and cellular composition (downregulated at mid-intervention vs baseline), and two related to oxidation- reduction reactions (regulated at post-intervention versus baseline). CONCLUSION: A progressive exercise intervention of MICT followed by HIIT induces a remarkable improvement in NK function compared with the untrained state, although at the mechanistic level the pathways involved seem to differ over time during the intervention.


Asunto(s)
Entrenamiento de Intervalos de Alta Intensidad , Células Asesinas Naturales/inmunología , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proteómica , Biología de Sistemas
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