[Association between transtheoretical model and physical activity in patients with hypertension]. / Modelo transteórico y su asociación con la actividad física en pacientes con hipertensión arterial.

OBJECTIVE: To identify the association between the transtheoretical model (TTM) and physical activity (PA) carried out in free time in patients with arterial hypertension in the central region of Mexico. DESIGN: Comparative cross-sectional study. SITE: The study was carried out in the Family Medicine Unit No.1 (UFM1) of the Mexican Social Security Institute in Aguascalientes, Mexico. PARTICIPANTS: Four hundred thirty-five adults aged 40 to 70 with arterial hypertension who attended the outpatient clinic at UFM1 were included. INTERVENTIONS: The Global Physical Activity Questionnaire and the Stages of Change algorithm from the TTM were applied. MAIN MEASUREMENTS: A descriptive, bivariate analysis and ordinal logistic regression were performed to evaluate the association between TTM stages and PA. RESULTS: As patients progress through the stages of change, their weekly PA increased. Individuals in the action, maintenance and consolidation stages were significantly more likely to perform higher levels of exercise: 20 times more likely in the action stage with an ordinal odds ratio (OR) of 20.07 (CI95%: 10,52-38,25), 24 times more in the maintenance stage with OR 24 (CI95%: 12,79-47,63) and 40 times more in the consolidation stage with OR 40,35 (IC95%: 19,25-84,59). CONCLUSIONS: The strong association between the stages of change and PA reveals the importance of applying the TTM to achieve success in programs to promote healthy habits by designing strategies that suit each subject.

ß-Endorphins are not responsible for delayed gastric emptying of digestible solids after exercise in professional cyclists. A preliminary study.

OBJECTIVE: It has been reported that professional cyclists had an accelerated solid gastric emptying which decreased by increasing the exercise intensity. That could be explained by a predominance of stress-dependent motility inhibitors such gastrointestinal hormones, neurotransmitters and or the predominance of the gastric inhibitory vagal motor circuit. The aim of this preliminary study was to evaluate the role of ß-endorphins, inhibitors of gastric motility, in these findings. METHODS: Gastric emptying of solids marked with Tc99 while resting and plasmatic levels of ß-endorphins were evaluated in 27 healthy controls and 19 professional cyclists (day 1). Besides, gastric emptying of solids was also assessed in cyclists when they reached 50% (day 1) and 75% (day 2) of the maximum oxygen consumption (low and high, respectively), during exercise on the cycle-ergometer. The third day, naloxone was administered in cyclists in order to block the ß-endorphins receptors and gastric emptying was measured when they reached 75% of the maximum oxygen consumption. RESULTS: Basal ß-endorphin levels were lower in cyclists vs controls (p<0.05) and they increased with the exercise intensity (p<0.001). There were no significant differences in gastric emptying of solids with or without naloxone when 75% of the maximum oxygen consumption was reached. CONCLUSIONS: The inhibitory effect of the exercise in the gastric emptying of solids does not seem to be secondary to the action of ß-endorphins, that leaves the gastric inhibitory vagal motor circuit a more likely predominant role.

[Practical recommendations on physical exercise during pregnancy based on the main clinical practice guidelines]. / Recomendaciones prácticas sobre ejercicio físico durante el embarazo basadas en las principales guías de práctica clínica.

The main guidelines for physical activity/exercise during pregnancy recommend that all pregnant women without medical or obstetric contraindications remain physically active during pregnancy, in order to achieve health benefits and, at the same time, reduce the possibility of complications during pregnancy. The objective of this article was to extract the practical recommendations on physical exercise during pregnancy, of interest to the primary care physician, from the clinical practice guidelines of three international societies of Obstetrics and Gynecology of recognized prestige and great international influence on this subject, two of them pioneers in the elaboration of this type of recommendations: the American College of Obstetrics and Gynecology and the Society of Obstetricians and Gynaecologists of Canada; and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, together with the one published by the Spanish Society of Gynecology and Obstetrics.

[Barriers and facilitators of the EfiKroniK exercise program for people with chronic diseases in Primary Care]. / Barreras y facilitadores del programa de ejercicio EfiKroniK para pacientes con enfermedad crónica en atención primaria.

OBJECTIVE: Explore patients' perceptions during a supervised exercise program and detect the barriers and facilitators that influence exercise adherence after the supervision period. DESIGN: A qualitative observational study with three focus groups as the main data collection technique was conducted. SITE: Primary Health centers of Bizkaia. PARTICIPANTS: Out of the 175 randomized patients in the hybrid effectiveness-implementation trial, a sample of 19 patients from the intervention group were included in the qualitative study (12 advanced-stage onco-haematological patients and seven with severe mental disorders). METHODS: Content analysis of the generated transcripts was performed by combining a deductive approach, based on the domains of the PRACTIS theoretical framework, and an inductive one, based on the postulates of the Grounded Theory. RESULTS: The data analysis showed that participants were satisfied with the EfiKroniK program and that the main identified benefits were discovery of the benefits of physical exercise, the psychological and emotional management of the disease, the benefits from peer communication and emotional support, and the break from routine of their illness. Participants decreased the levels of physical exercise at the end of the supervision6 due to the confluence of several barriers. CONCLUSION: A supervised exercise program carried out in Primary Care contributed to the improvement of the quality of life as well as the emotional and social well-being of patients with advanced-stage diseases. Our study identified potential barriers and facilitators associated with exercise participation and its continuity, however, it is necessary to encourage inter-sectoral coordination within the socio-health system to promote integrated and continuous care for chronic patients.

[Benefits of a community physical exercise program prescribed from primary care for perimenopausal/menopausal women]. / Beneficios de un programa de ejercicio físico comunitario prescrito desde Atención Primaria en la salud de mujeres perimenopáusicas/menopaúsicas.

OBJECTIVE: To measure the benefits of a physical exercise program in a community, through the modifications in quality of life, and perimenopausal-menopausal women physical condition. SETTING: The participants were recruited in PC consultations from two health centers in Molina de Segura (Murcia). PARTICIPANTS: Women between 40 and 70 years old, or under 40 of age diagnosed with early menopause. DESIGN: Quasi-experimental study, non-randomized, controlled, open and single-center with 2 parallel branches to study. INTERVENTION: Experimental group: ACTIVA Bone Health Program for six months. CONTROL: inactive. MAIN MEASUREMENTS IN BOTH GROUPS: The SF 36 questionnaire was used to measure the Quality of life. PHYSICAL CONDITION: Aerobic condition, flexibility, balance and strength measured with the mile, flamenco, flexibility box tests, and throwing the medicine ball, respectively. Physical activity level through the GPPAQ Questionnaire. Sociodemographic variables were collected and the adherence to the program was measured. RESULTS: The quality of life improved in the intervention group compared to the control group, except «Body Pain¼ dimension (p = 0.412). As regards the intragroup level, all dimensions showed significant improvement except both «Physical Function¼ (p = 0.263) and «Body Pain¼ (p = 0.136). The physical capacities that benefited most were aerobic fitness, strength and balance. CONCLUSIONS: The Active Bone Health Physical Exercise Program piloting showed benefits on participants' physical and mental quality of life. In addition, it has been shown that performing a specific physical exercise for premenopausal-menopausal women improves their physical condition.

[Effect of physical exercise on Alzheimer's disease. A sistematic review]. / Efecto del ejercicio físico en la enfermedad de Alzheimer. Una revisión sistemática.

OBJECTIVE: The objective of this review is to analyze through a the scientific evidence about the effects of physical activity in patients with Alzheimer's disease (AD) as a preventive and non-pharmacological treatment. DESIGN: Systematic review. DATA SOURCES: We have identified articles from Pubmed, Science Direct, Medline and Scopus databases, with the keywords Alzheimer, Exercise, Neuroimaging, MRI, PET y Physical Activity. Selected articles: We included those studies that evaluated the effects of physical activity on Alzheimer's disease and those which also included magnetic resonance imaging or positron emission tomography with Pittsburg Compound B marker (PiB) analyzing brain atrophy or increase of the beta-amyloid deposit respectively. We excluded studies including other types of dementia, different of AD. We also excluded articles which not included neuroimaging tests, single cases or non-English language articles. DATA EXTRACTION: The PRISMA quality scale was used for the critical lecture of the studies. The researchers independently assessed the articles and the discrepancies were resolved by consensus. RESULTS: We identified 75 articles, of which 23 were finally included in the review. CONCLUSIONS: Most of the studies included do not allow us to know the impact of physical exercise on cognition and the cerebral structural-functional changes in patients at risk of developing AD or in patients who already have the disease. Without being able to rule out a possible beneficial effect, more studies are needed with a better design and methodological rigor that allows a better known about this association.

[Moderate exercise and intake of either high or low glycemic index carbohydrates in sedentary women]. / Ejercicio moderado y consumo de alimentos de alto y bajo índice glucémico en mujeres sedentarias.

OBJECTIVE: To analyze changes in blood glucose, insulin and triglyceride concentrations in relation to a moderate aerobic exercise in sedentary women of different body weight, exposed to either a high or low glycemic index carbohydrates diet. DISEñO: Cross-over type. SITE: Research was performed in the Exercise Physiology Laboratory at Facultad de Ciencias de la Cultura Física, Universidad Autónoma de Chihuahua, México. PARTICIPANTS: Twenty-six young sedentary women who did not exercise in the last year participated in the study. Four of adequate weight (AW) and 2 with obesity (OB) were excluded for not consuming the suggested carbohydrates (1gr/kg of weight) nor completed the programed exercise. There were n=10 in each group (AW/OB). INTERVENTION: Two treatments of 55minutes of aerobic exercise each were applied one day after consuming either high or low glycemic index carbohydrates. MAIN MEASUREMENTS: Plasmatic glucose, insulin, and triglycerides were determined before and after the scheduled exercise. RESULTS: Glucose, insulin, and triglycerides were higher in OB than in AW at baseline. Glucose was normalized in OB from 5.8±0.35 to 5.3±0.23 mmol/L (P=.001), only by eating foods with low glycemic index; triglycerides increased from 139.5±66.0 to 150.8±67.2mg/dl (P=.004) at the end of the exercise, after consumption of low glycemic index carbohydrates. CONCLUSION: Elevation of triglycerides secondary to exercise after consumption of low glycemic index seems to indicate an increase of lipid oxidation in OB.

Effects training in hypoxia on cardiometabolic parameters in obese people: A systematic review of randomized controlled trial.

OBJECTIVE: The aim of the present review is to evaluate effects of intermittent hypoxia and exercise therapy in cardiometabolic parameters on adult obese people. DATABASE: Three well-known databases were selected: EMBASE, MEDLINE and Web of Science. Studies selection: Inclusion criteria were: (a) human healthy overweight or obese adults, (b) study randomized controlled trial, (c) original experimental study, (d) English languages and (e) therapy with intermittent hypoxia and exercise. DESIGN: The assessment of the methodological quality of each study was based upon the risk of bias (PEDro scale) and level of evidence (CBO Guidelines). DATA EXTRACTION: five articles clearly met inclusion criteria and were reviewed to data extraction. RESULTS: In the hypoxia groups, weight, body mass index, waist circumference, waist-hip ratio, fat mass and lean mass improved in at least two studies in comparison with the baseline. Systolic blood pressure improved in one study. The lipid profile and the aerobic capacity were not reduced significantly. CONCLUSIONS: Results suggest that combined hypoxia with exercise may help to improve cardiometabolic parameters in obese people.

[Detection of the largest population susceptible to prescription of a program of exercises in Primary Care to prevent frailty]. / Detección de la población mayor susceptible de prescripción de un programa de ejercicios en Atención Primaria para prevenir la fragilidad.

AIM: Identify the population over 70 year's old treated in primary care who should participate in a physical exercise program to prevent frailty. Analyze the concordance among 2criteria to select the beneficiary population of the program. DESIGN: Population-based cross-sectional study. SETTINGS: Primary Care. PARTICIPANTS: Elderly over 70 years old, living in the Peñagrande neighborhood (Fuencarral district of Madrid) from the Peñagrande cohort, who accepted to participate in 2015 (n = 332). MAIN MEASUREMENTS: The main variable of the study is the need for exercise prescription in people over 70 years old at the Primary Care setting. It was identified through 2different definitions: Prefrail (1-2 of 5 Fried criteria) and Independent individuals with physical performance limited, defined by Consensus on frailty and falls prevention among the elderly (independent and with a total SPPB score <10). RESULTS: The 63,8% of participants (n = 196) need exercise prescription based on criteria defined by Fried and/or the consensus for prevention of frailty and falls in the elderly. In 82 cases the 2criteria were met, 80 were prefrail with normal physical performance and 34 were robust with a limited physical performance. The concordance among both criteria is weak (kappa index 0, 27). CONCLUSION: Almost 2thirds of the elderly have some kind of functional limitation. The criteria of the consensus document to prevent frailty detect half of the pre-frail individuals in the community.

Dietary program and physical activity impact on biochemical markers in patients with type 2 diabetes: A systematic review.

OBJECTIVES: Evaluate the effectiveness of the implementation of independently or combined dietary and physical activity programs on the blood glucose values and lipid profile in patients with type 2 diabetes, including participants aged 60 years and over. DESIGN: Systematic review. DATA SOURCE: PubMed/Medline database, with language restrictions. Papers published between 2010 and 2016 were included. STUDY SELECTION: A total of 30 randomised controlled trials were included that focused on physical activity and dietary interventions in patients with type 2 diabetes mellitus and include participants aged 60 years and over. RESULTS: The selected articles have shown that the implementation of physical activity programs (aerobic, resistance, flexibility and combined exercises), and programs based on a higher intake of vegetables, grains, legumes, fruits, unsaturated fatty acids, as well as consumption of foods with low glycaemic index, calorie restriction, intake of probiotics, vitamin D supplementation and educational sessions about diabetes improves blood glucose levels, as well as the lipid profile, in patients with type 2 diabetes. CONCLUSIONS: Physical activity and dietary programs are fundamental in the treatment and metabolic control of type 2 diabetes mellitus.

Effects of an Ai Chi fall prevention programme for patients with Parkinson's disease.

INTRODUCTION: One of the main symptoms of Parkinson's disease is the high incidence of falls occurring due to the decline of both static and dynamic balance. The aim of this study is to determine the effect of an Ai Chi programme designed to prevent falls in patients with Parkinson's disease by improving both functional independence and perception of physical pain. METHODS: Fifteen patients diagnosed with Parkinson's disease (Hoehn and Yahr stages 1-3) participated in a 10-week Ai Chi programme consisting of 30 to 45-minute aquatic exercise sessions twice a week. The assessment measures used in this study were the pain visual analogue scale (VAS), the Tinetti gait and balance assessment tool, and the Timed Get up and Go test. RESULTS: The results were calculated by applying the Friedman test to 3 related measurements: patients at baseline, at post-treatment (at the end of the 10 week programme) and after one month of follow-up. The data obtained showed a significant improvement (p <.001) in scores for pain perception, balance, and gait function after the treatment programme. Furthermore, patients continued to show significant improvements and the benefits remained at the one-month follow-up visit. CONCLUSION: Ai Chi is a promising and feasible aquatic treatment for improving pain perception, balance, and functional capacity in patients diagnosed with mild or moderate Parkinson's disease.

Is physical exercise harmful to liver transplantation recipients? Review of literature.

Liver transplantation is a treatment that significantly improves the patients' quality of life. However, we should be more ambitious and seek an improvement in their fitness through training protocols allowing them to fully return to daily activities. English and Spanish-language articles on PubMed and the Cochrane Library were searched untill 2014. Articles were reviewed by 2 of the authors to determine if they were suitable for inclusion. It is shown a compilation of studies that included patients who have participated in aerobic, strength, or both combined training programs, without implying a risk for the graft function. There is a lack of studies with high scientific evidence that stablish a proper exercise program methodology, supervised by specialists in physical activity and sports.

[Prevalence of performing and prescribing physical exercise in patients diagnosed with anxiety and depression]. / Prevalencia de realización y prescripción de ejercicio físico en pacientes diagnosticados de ansiedad y depresión.

OBJECTIVE: To estimate the prevalence of physical exercise practice in patients diagnosed with anxiety and/or depression. DESIGN: Cross-sectional, observational study. LOCATION: Sabugo and la Magdalena primary care centers in Avilés. PARTICIPANTS: Patients aged 18 to 75 years diagnosed with anxiety and/or depression, consumers of psychoactive drugs in the three months previous to the realization of the study. We selected 376 patients by simple random sampling stratified by health center, making them a telephone survey. MAIN MEASUREMENTS: Age, sex, physical exercise realization, type and duration of exercise, diagnosis of anxiety and/or depression, exercise prescription, prescriber health personnel and use of psychotropic medication. RESULTS: 294 participants (78.19% of selected) with a mean age of 55.33 years (55.32±12.53 SD) and 78.2% were female. 60.9% were diagnosed with anxiety, 59.5% with depression and 20.4% both diagnoses. 62.9% used antidepressants, benzodiazepines 76.9% and 39.79% both treatments. 58.5% (95%CI: 52.70-64.31) performed exercise of which 44.77% did it 3-5 times/week. The mean duration was 1.24h each time (95%CI: 0.53-1.96). The physical exercise was prescribed to the 59.18% (95%CI: 53.39-64.97); 90.23% by the family physician, 63.22% primary care nurse, 17.24% psychiatrist and 5.17% psychologist. The adherence to the prescription was 59.77% (95%CI: 52.20-67.34). CONCLUSIONS: The percentage of anxious and/or depressed patients who practiced exercise is similar to the general population but should be higher. The exercise prescription by health personnel is insufficient.

[Applying the Theory of Planned Behavior: Which factors influence on doing physical exercise?]. / Aplicando la Teoría de la Conducta Planeada: ¿qué factores influyen en la realización de ejercicio físico?

OBJECTIVES: The purpose of this study was analyzed the influence of attitude, subjective norm, and Perceived behavioral control (PBC) on intention of doing physical exercise in a group of people. DESIGN: Cross-sectional and observational study. LOCATION: Questionnaire was applied to general population in the province of Alicante PARTICIPANTS: 679 people who practiced physical exercise in the province of Alicante. MAIN MEASUREMENTS: It was applied a questionnaire measuring the components of the Theory of Plan Behavior model (TPB). RESULTS: Results showed that variables of the model (TPB) had good fit to the data. Moreover, subjective norm and perceived behavioural control had a significant impact on intention and the three variables explained 61% of its variance. CONCLUSIONS: Findings supported the important role of TPB in the context of physical exercise. Perceived behavioral control was the strongest predictor of intention to practice physical exercise. A possible intervention might lead to implement programs focused in increasing control perception of people to engage in physical exercise.

[Evaluation of a supervised physical exercise program in sedentary patients over 65 years with type 2 diabetes mellitus]. / Evaluación de un programa de ejercicio físico supervisado en pacientes sedentarios mayores de 65 años con diabetes mellitus tipo 2.

OBJECTIVE: To analyze whether an exercise program can modify glycated hemoglobin (HbA1c), blood pressure (BP), body mass index (BMI), lipids, cardiovascular risk profile (CVR), self-perceived health status (SHS), and pharmaceutical expenditure (PE). DESIGN: A randomized, single blind, controlled trial. INTERVENTION: program of supervised aerobic physical exercise. Analysis by intention to treat. LOCATION: Primary Care: 2 rural health areas. Health Area of Navalmoral. Cáceres. Extremadura. Spain. PARTICIPANTS: 100 type 2 diabetic patients, aged 65 to 80 years, sedentary. Distribution: 50% control group (CG) and 50% intervention group (IG). Abandoned 12%. INTERVENTION: monitored aerobic exercise: 40minutes, 2 days/week, 3 months. KEY MEASURES: HbA1c, BP, BMI, lipid, CVR, SHS, PE. Complications during exercise. RESULTS: There were post-intervention differences between groups in HbA1c, BP, BMI, cholesterol and SHS. In the IG, there was a significant decrease in; HbA1c: 0.2±0.4% (95% CI: 0.1 to 0.3), systolic BP: 11.8±8.5mmHg (95% CI: 5.1 to 11.9), BMI: 0.5±1 (95% CI: 0.2 to 0.8), total cholesterol: 14±28.2mg/dl (95% CI: 5.9 to 22.2), LDL: 18.3±28.2mg/dl 95% CI: 10.2 to 26.3), CVR: 6.7±7.7% (95% CI: 4.5 to 8.9), PE: 3.9±10.2 € (95% CI: 0.9 to 6.8), and an increase in SHS; 4.7±5.7 (95% CI: 3 to 6.3). CONCLUSIONS: In diabetics over 65 years, a program of monitored aerobic exercise, of easy implementation, improves HbA1c, BP, cholesterol, CVR, PE, and SHS.

[Medical recommendations from primary care on physical exercise in the postpartum]. / Recomendaciones médicas desde atención primaria sobre ejercicio físico en el posparto.

There is evidence that demonstrates the benefits of practicing physical activity/exercise for the mother after childbirth. However, this postpartum period (PP) is often a missed opportunity in a lifetime for women to start or resume physical exercise and get the great benefits that it can bring them. The objective of this article was to analyze the benefits of physical exercise during PP; the prescription of physical exercise; recommendations on when to resume your practice; barriers and facilitators; physical exercise during breastfeeding; as well as its role in the most frequent illnesses and discomforts in this period, always keeping in mind that the work of the primary care doctor is essential to motivate and encourage women to perform physical exercise in the PP.

Planetary health diet versus usual diet in adolescents. How do food and physical activity influence academic performance?

Introduction: Objective: to analyze the relationship of the similarity of planetary health diet and habitual diet with the practice of physical activity on the academic performance of adolescent high school students by gender. Method: 877 adolescents were evaluated. The diet is reviewed through the 24-hour reminder. Physical activity was classified according to type of activity, frequency, duration, and intensity using the APALQ questionnaire. The caloric intake of adolescents was compared with the proposal of the EAT-LANCET commission, and the relationship between physical activity and diet with academic performance was again established. Results: Mexican adolescents do not comply with the proposal of a planetary health diet. No relationship was found between physical activity and academic performance. On the other hand, animal proteins rich in fats are consumed doubly according to the recommendation; these and whole grains, both are inversely related to better academic performance. Conclusions: Mexican adolescents are far from consuming a planetary health diet. Physical activity was not related to academic performance, but there is an inverse relationship between fat-rich animal proteins and whole grains in relation to subjects that contribute to academic performance, which suggests that a healthy diet such as the planetary diet proposal could have an impact on environmental sustainability and favorably impact the academic performance of adolescents.

Introducción: Objetivo: analizar la relación de la similitud entre la dieta de salud planetaria y la dieta habitual con la práctica de actividad física sobre el rendimiento académico en adolescentes estudiantes de secundaria por género. Método: se evaluaron 877 adolescentes. La dieta se revisó a través del recordatorio de 24 horas. Se clasificó la actividad física según el tipo de actividad, frecuencia, duración e intensidad con el cuestionario APALQ. Se comparó la ingesta calórica de los adolescentes con la propuesta por la comisión EAT-LANCET y se establecieron relaciones entre la actividad física y la dieta con el rendimiento académico. Resultados: los adolescentes mexicanos no cumplen con la propuesta de una dieta de salud planetaria. No se encontró relación entre la actividad física y el rendimiento académico. Por otro lado, las proteínas animales ricas en grasas se consumen doblemente de acuerdo con la recomendación; estas y los cereales integrales, ambos se relacionan inversamente con un mejor rendimiento académico. Conclusiones: los adolescentes mexicanos están lejos de consumir una dieta planetaria saludable. La actividad física no se relacionó con el rendimiento académico, pero sí existe una relación inversa entre las proteínas animales ricas en grasas y los cereales integrales con relación a materias que contribuyen con el rendimiento académico, lo que sugiere que una alimentación saludable como la propuesta de la dieta planetaria podría tener impacto sobre la sostenibilidad ambiental e impactar favorablemente en el rendimiento académico de los adolescentes.

Effects of different lower limb strengthening protocols on muscle activity, strength and power in sedentary and physically inactive subjects: a systematic review.

Introduction: The purpose of this systematic review was: a) to determine the quality of evidence from studies assessing the effects of different lower limb strengthening protocols on muscle activity, strength, and power in sedentary and/or physically inactive subjects; and b) to determine the effectiveness of lower extremity strengthening protocols on muscle activity, strength, and power in sedentary and/or physically inactive subjects. Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statements were followed using keywords associated with strength training, lower limb, sedentary, and physical inactivity. Four databases were used: Medline via PubMed, Web of Science, Scopus and SPORTDiscus. Methodological quality was assessed using the PEDro scale. A total of 164 articles were retrieved, six included in this review. Four studies were classified as fair methodological quality, and two were considered of good methodological quality. Due to the heterogeneity in methodological aspects and the limited number of articles including the variables under study, it was not possible to establish a measure of effectiveness of lower limb strengthening protocols on muscle activity, strength, or power. In conclusion, strength training in the lower limb seems to improve the levels of strength, power, and muscular activity in sedentary subjects. However, due to the limited number of articles, methodological variability, and training methods used, it is necessary to conduct new studies that control these variables.

Introducción: El propósito de esta revisión sistemática fue: a) determinar la calidad de la evidencia de los estudios que evaluaron los efectos de diferentes protocolos de fortalecimiento de miembros inferiores sobre la actividad, la fuerza y la potencia muscular en sujetos sedentarios y/o físicamente inactivos; y b) determinar la efectividad de los protocolos de fortalecimiento sobre la actividad, fuerza y potencia muscular de miembros inferiores en sujetos sedentarios y/o físicamente inactivos. Se siguieron los criterios PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyse) utilizando palabras clave asociadas con el entrenamiento de fuerza, extremidades inferiores, sedentarismo e inactividad física. Se revisaron cuatro bases de datos: Medline vía PubMed, Web of Science, Scopus y SPORTDiscus. La calidad metodológica se evaluó mediante la escala PEDro. Se recuperaron 164 artículos en total, seis incluidos en esta revisión. Cuatro estudios se clasificaron como de calidad metodológica regular y dos se consideraron de buena calidad metodológica. Debido a la heterogeneidad en los aspectos metodológicos y al escaso número de artículos que incluyeron las variables en estudio, no fue posible establecer una medida de efectividad de los protocolos de fortalecimiento de miembros inferiores sobre la actividad, la fuerza o la potencia muscular. En conclusión, el entrenamiento de fuerza en el miembro inferior parece mejorar los niveles de fuerza, potencia y actividad muscular en sujetos sedentarios. No obstante, debido al número limitado de artículos, la variabilidad metodológica y los métodos de entrenamiento utilizados, es necesario realizar nuevos estudios que controlen estas variables.

[Review of nutrition and hydration in relation to physical exercise during pregnancy]. / Revisión de la nutrición e hidratación con relación al ejercicio físico en el embarazo.

Introduction: Studies on nutritional recommendations for pregnant women who exercise are scarce. The objective of this article is not to focus on the diet of pregnant women as a whole, but to review those aspects of it that may be related to physical exercise. To this end, the nutritional and hydration recommendations contained in the main clinical practice guides on physical exercise during pregnancy are collected, including the first Spanish guides. Likewise, the energy requirements required by pregnant women who perform physical exercise during pregnancy for adequate gestational weight gain are addressed, aspects related to macronutrients in the aforementioned population group, and two specific topics, such as nutritional needs in the adolescent who practices physical exercise during pregnancy and eating disorders in pregnant athletes It is concluded by stating that pregnant women who exercise regularly should eat a varied and balanced diet, such as the Mediterranean diet, avoid long periods of fasting to avoid the appearance of hypoglycemia and maintain adequate fluid intake before, during and after physical exercise. Pregnant adolescents who engage in physical exercise require nutritional supervision to achieve adequate gestational weight gain. The pregnant athlete with an eating disorder has a higher risk of complications during pregnancy and childbirth, gynecological, fetal and neonatal, and, therefore, requires close monitoring by specialists in maternal-fetal medicine.

Introducción: Los estudios sobre recomendaciones nutricionales para la embarazada que realiza ejercicio físico son escasos. El objetivo de este artículo no es centrarnos en la dieta de la embarazada de forma global, sino revisar aquellos aspectos de la misma que pueden tener relación con el ejercicio físico. Para ello, se recogen las recomendaciones nutricionales y sobre hidratación contenidas en las principales guías de práctica clínica sobre ejercicio físico durante el embarazo, incluyendo las primeras guías españolas. Así mismo, se abordan los requerimientos energéticos que precisan las gestantes que realizan ejercicio físico durante el embarazo para una ganancia de peso gestacional adecuada, aspectos relacionados con los macronutrientes en el citado grupo de población, y dos temas específicos, como son las necesidades nutricionales en la adolescente que practica ejercicio físico durante su embarazo y los trastornos de la conducta alimentaria en deportistas embarazadas. Se concluye afirmando que las embarazadas que realizan ejercicio físico de forma regular deben llevar una dieta variada y equilibrada, como es la dieta mediterránea, eludir períodos largos de ayuno para evitar la aparición de hipoglucemias y mantener una adecuada ingesta de líquidos antes, durante y después del ejercicio físico. Las adolescentes embarazadas que realizan ejercicio físico requieren una supervisión nutricional para que alcancen una ganancia de peso gestacional adecuada. La deportista embarazada con un trastorno de la conducta alimentaria tiene un mayor riesgo de complicaciones durante el embarazo y parto, ginecológicas, fetales y neonatales, y, por tanto, requiere un estrecho seguimiento por especialistas en medicina maternofetal.

Time dedicated to physical activity among medical residents: are there differences based on gender or specialty type?

INTRODUCTION: Physical activity (PA) is associated with positive health outcomes such as prevention of chronic diseases, psychological well-being and improved work performance. Medical residents are subjected to sleep deprivation, extended work schedule and high burnout prevalence. These conditions may lead to the neglect of personal health and the restriction of time dedicated to PA. The objective of the present study was to analyze the time dedicated to PA of medical residents, comparing women vs men residents and surgical vs clinical residents. METHODS: It is a cross-sectional study performed in a Spanish third-level university hospital. All medical residents from our institution were invited to voluntarily participate in the study answering a web-based questionnaire on June 2022. Data regarding demographics, residency and PA practice was recorded. RESULTS: The response rate was 20.73% (114/550). The 32.5% of the residents considered themselves to be physically inactive and mean time dedicated to PA in a regular week was 3.62 ±â€¯2.22 h. Men residents dedicated more time to PA than women residents (4.23 ±â€¯2.42 h vs 3.14 ±â€¯1.95 h, p = 0.012) and surgical residents dedicated more time than clinical residents (4.33 ±â€¯2.36 h vs 3.23 ±â€¯2.05 h, p = 0.01). CONCLUSIONS: One third of the medical residents consider themself physically inactive. Women and clinical residents practice PA less time than men and surgical residents. Efforts should be made to encourage PA among residents, especially in women and non-surgeons.