Contribution of active commuting to and from school to device-measured physical activity levels in young people: A systematic review and meta-analysis.

OBJECTIVE: To analyze the contribution of active commuting to and from school (ACS) to device-measured light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) levels in young people aged 6 to 18 years old, as well as, in both trip directions (i.e., home-school, school-home). METHODS: This systematic review was conducted according to the PRISMA statement, and five different databases were used for the systematic search (PubMed, Web of Science, SPORTdiscuss, Cochrane Library, and National Transportation Library) using PECO strategy. RESULTS: A total of 14 studies met all the eligibility criteria, which compile 7127 participants. The overall ACS weighted LPA was 19.55 min (95% CI: 3.84-35.26; I2 = 99.9%, p < 0.001) and 68.74 min (95% CI: 6.09-131.39; z = 2.15, p = 0.030) during the home-school and school-home trips, respectively. For MVPA, the overall ACS weighted MVPA was 8.98 min (95% CI: 5.33-12.62; I2 = 99.95%, p < 0.001) during the home-school trip and 20.07 min (95% CI: 13.62-26.53; I2 = 99.62%, p < 0.001) during the school-home trip. CONCLUSION: ACS may contribute about 48% of the PA recommendations in young people on school days if both trip directions are actively performed. Therefore, future studies aimed at increasing daily PA levels in young population should focus on promoting students' ACS. PROSPERO registration number: CRD42020162004A.

Efficacy of school-based interventions for improving muscular fitness outcomes in children: A systematic review and meta-analysis.

The World Health Organization recommends that children should engage in an average of 60 min of moderate-to-vigorous physical activity (MVPA) per day and should perform activities that strengthen muscle and bone at least 3 days a week. Public health professionals as well as pediatric researchers have identified schools as a strategic place to promote muscular strength development. Thus, the aim of this systematic review and meta-analysis was to investigate the efficacy of school-based exercise interventions for improving muscular fitness (MF) in children. Searches were conducted in three databases. Eligible criteria were randomized and non-randomized controlled trials evaluating the effects of school-based exercise interventions on MF (i.e. muscular strength, muscular power, and local muscular endurance) in children under 13 years of age. Risk of bias by the National Institutes of Health tool was appraised, and pooled effect sizes (Hedges'g) were calculated using random-effects inverse-variance analyses. Seventeen studies enrolling 1653 children (28% girls were analyzed). Exercise interventions, mostly combined interventions targeting selected domains of MF, were associated with significant moderate increases in local muscular endurance (g = 0.65 95% CI, 0.13 to 1.17, p = 0.020; I2 = 85.0%) and muscular strength and muscular power (g = 0.33 95% CI, 0.16 to 0.51, p = 0.001; I2 = 59.3%), with higher effects using interventions with ≥3 sessions per week. Our findings indicate that school-based exercise that includes strength building exercises may improve MF in children and, consequently, prepare modern day youth for the demands of exercise and sport activities. HighlightsSchool-based muscle and bone strengthening exercises performed at least 3 days per week may serve to support the development of muscular fitness in girls and boysIntegrative interventions that include a variety of strength and conditioning activities seem to be a promising strategy to promote muscular fitness in school environmentFuture research should standardize assessment methods for use with children in the school context and should include interventions with girlsIt is of interest to a growing number of health care providers, fitness professionals and physical education teachers to encourage participation in well-designed muscle and bone strengthening exercises.

Testing the Mystic School Mobile Application to Promote Active Commuting to School in Spanish Adolescents: The PACO Study.

Active commuting to and/or from school (ACS) is an opportunity to increase daily physical activity (PA) levels in young people. Mobile-device interventions focused on promoting the practice of health-related PA can be more cost-effective than traditional interventions in this population. OBJECTIVE: To analyze the adolescents' opinion of the mobile application (app) Mystic School, which was designed to promote ACS in Spanish adolescents. METHODS: A total of 44 students (14-15 years old) from Granada and Jaén participated in the test of the Mystic School app during two phases: phase 1 (n = 10) for 2 weeks and phase 2 (n = 34) for 1 month. Each phase included an app presentation, a follow-up, and focus group sessions. The qualitative analysis was carried out through NVivo software. RESULTS: In phase 1, adolescents reported improvements in the design and functioning, such as the avatar movement, virtual steps utilities, and multiplayer function. These suggestions were included in phase 2. After phase 2, adolescents reported that it is important to add the possibility of playing without an Internet connection to the game, to include more competitive options, prizes, and to increase the difficulty of the levels. In both phases, problems with the step number counting remained. CONCLUSION: The Mystic School app can be a useful tool for the physical education teacher to integrate the content from this curriculum related to the promotion of PA, such as ACS.

Role of Sociodemographic Variables and the Mother's Active Behavior on Active Commuting to School in Children and Adolescents.

The main objective of the current study was to analyze how parents' sociodemographic characteristics, mode of commuting and physical activity (PA) act as indicators of active commuting to school (ACS) in their children and adolescents. A total of 684 paired parents (52.8% mothers) and their respective offspring (33.7% girls) were included. The participants self-reported their sociodemographic characteristics, mode of commuting, and PA. Logistic regression analyses were performed using a stepwise approach, including, as indicators, parental characteristics, mode of commuting and PA. The main outcome was child and adolescent ACS. The odds ratio (OR) and R2 of Nagelkerke were obtained for each step. Parental sociodemographic characteristics were greater indicators of child ACS than the parental mode of commuting and PA. In children, the greatest predictive variables of ACS explained 38% of the variance and were as follows: car availability (OR = 0.24), father's educational level (OR = 0.47), mother's educational level (OR = 1.95), mother's active commuting to work (OR = 4.52) and mother's salary/month (OR = 0.67). In adolescents, the greatest predictive variables of ACS explained 40% of the variance and were as follows: socioeconomic level (OR = 0.43) and father's active commuting (OR = 10.6). In conclusion, sociodemographic factors are better indicators of ACS than parents' physical activity and active commuting to work.

Supervised Exercise Immediately After Bariatric Surgery: the Study Protocol of the EFIBAR Randomized Controlled Trial.

BACKGROUND: Previous studies have investigated weight loss caused by exercise following bariatric surgery. However, in most cases, the training program is poorly reported; the exercise type, volume, and intensity are briefly mentioned; and the sample size, selection criteria, and follow-up time vary greatly across studies. PURPOSE: The EFIBAR study aims to investigate over 1 year the effects of a 16-week supervised exercise program, initiated immediately after bariatric surgery, on weight loss (primary outcome), body composition, cardiometabolic risk, physical fitness, and quality of life in patients with severe/extreme obesity. MATERIAL AND METHODS: The EFIBAR study is a parallel-group, superiority, randomized controlled trial (RCT), comprising 80 surgery patients. Half of the participants, randomly selected, perform a 16-week supervised exercise program, including both strength and aerobic training, starting immediately after the surgery (7-14 days). For each participant, all primary and secondary outcomes are measured at three different time points: (i) before the surgery, (ii) after the intervention (≈4 months), and (iii) 1 year after the surgery. CONCLUSION: The EFIBAR study will provide new insights into the multidimensional benefits of exercise in adults with severe/extreme obesity following bariatric surgery. TRIAL REGISTRATION: EFIBAR randomized controlled trial was prospectively registered at Clinicaltrials.gov (NCT03497546) on April 13, 2018.

A School-Based Randomized Controlled Trial to Promote Cycling to School in Adolescents: The PACO Study.

This manuscript describes the rationale and protocol of a school-based randomized controlled trial called "Cycling and Walk to School" (PACO, by its Spanish acronym) that aims to promote cycling to and from school and physical activity (PA) in adolescents. This study will examine the effects of this intervention in cycling and active commuting to and from school (ACS), PA and several ACS-related factors based on self-determination theory (SDT) and a social-ecological model (SEM). A total of 360 adolescents attending six high schools (three experimental and three control) from three Spanish cities will participate in this randomized controlled trial. The intervention (four cycling sessions; 1-2 h per session, one session per week) will be conducted by the research staff; the control group will continue their usual activities. PA levels will be measured by accelerometers, whereas ACS and the other study variables will be self-reported using questionnaires at baseline and post-intervention. The primary outcomes will be: rates of cycling to school, ACS and PA levels. In addition, SDT-related variables and individual, interpersonal, community, and environment variables relevant to ACS will be based on SEM. The findings will provide a comprehensive understanding of the short-term effects of this school-based intervention on cycling to school behaviour, ACS and PA levels in Spanish adolescents.

Active commuting to school among 36,781 Spanish children and adolescents: A temporal trend study.

This study examines trends in the rates of active commuting to school (ACS) in Spanish children (n = 18 343; 8.93 ± 1.68) and adolescents (n = 18 438; 14.11 ± 1.58) aged 6-18 years from 2010 to 2017. Given the study period included the economic crisis in Spain (2008-2013), the second aim of this study was to compare ACS rates during and after the economic crisis. Data were obtained from 28 studies conducted across Spain. The overall trends in ACS were evaluated using multilevel logistic regression analysis. Among Spanish children and adolescents, the rates of ACS to school ranged around 60% between 2010 and 2017. The rates of ACS in Spanish youth did not change significantly during the 2010-2017 period, except a sporadic increase in the rate of ACS in adolescents in 2012-2013. No significant association between the ACS and the economic crisis time period in youth was found. As conclusion, the ACS remains stable in Spain during the last decade, which is a promising result regarding the evidenced decreasing trend in many countries. Further educational and policy strategies are important to continue promoting this behavior in children and adolescents in the long term.

Feasibility and reliability of the Spanish version of the Youth Activity Profile questionnaire (YAP-Spain) in children and adolescents.

Considerable public health efforts across the globe have focused on promoting physical activity (PA) and minimizing sedentary behaviour (SB) in youths. However, it is important to have valid, reliable and feasible methods to assess these behaviours in youths. The purpose of this study was to analyse the feasibility and reliability of the Spanish version of the previously validated Youth Activity Profile questionnaire (YAP) in children and adolescents. The YAP-S is a 15-item self-report instrument designed to capture PA and SB in youths. A total of 604 children (5-12 years old) and 346 adolescents (12-17 years old) filled out the questionnaire twice (14 days apart). Feasibility was evaluated through required time and number of misunderstood questions by participants. The test-retest reliability was examined using the weighted kappa coefficient (κ) and intraclass correlation coefficient. The average time to complete the questionnaire was 28.85 ± 14.28 and 12.24 ± 9.84 minutes in children and adolescents, respectively. No misunderstanding of questions was reported. The questionnaire showed an adequate reliability for activity at school, out-of-school and sedentary behaviours (k = 0.61-0.77; ICC = 0.77-0.89) in children and adolescents. The YAP-S might be considered a feasible and reliable questionnaire for assessing PA and SB in Spanish children and adolescents.

Psychometric Characteristics of a Commuting-to-School Behaviour Questionnaire for Families.

The purposes of this study were: (a) to describe the patterns of modes of commuting to school (children) and to work (parents) separated by gender and age, (b) to validate the questions on children's mode of commuting to and from school according to their parents, and (c) to analyse the reliability of a family questionnaire focused on commuting to school behaviours. A total of 611 parents (mean age: 43.28 ± 6.25 years old) from Granada (Spain) completed "Family commuting-to-school behaviour" questionnaire in two sessions separated by 14 days, (2016 and 2018). The validation between family and children's questions was assessed using the Kappa and Spearman correlation coefficients, and the test-retest reliability within the family questions was assessed using the Kappa and the weighted Kappa. The children's modes of commuting to school (mean age: 11.44 ± 2.77 years old) were mainly passive (57.7% to school) while parents' modes of commuting to work were mainly active (71.6%). The validity of the mode of commuting was significant with high Kappa and Spearman coefficients. The test-retest reliability presented a good agreement for the mode of commuting to school in children, distance and time to school, and the mode of commuting to work in parents, while the questions on acceptable distance to walk or cycle to school showed a moderate to good agreement. The "Family commuting-to-school behaviour" questionnaire could be a useful tool to assess the mode of commuting of children, distance and time to school for researchers and practitioners.

Are the Parents' and Their Children's Physical Activity and Mode of Commuting Associated? Analysis by Gender and Age Group.

BACKGROUND: Some studies have reported a positive parent-child association between physical activity (PA), but few have examined the difference in these associations concerning both genders. The objective of this study was to establish the association between moderate to vigorous physical activity (MVPA) and mode of commuting (MC) of the parents with their children by gender and age group. METHODS: This cross-sectional study included 686 mothers and fathers (43.4 ± 6.5 years old) and their children (children 9.7 ± 1.7 y. and adolescents 14.0 ± 1.7 y.). Each participant completed a questionnaire on PA and MC. Chi-square test, odds ratio for categorical variables, and lineal regressions for continuous variables were used to examine the parent-child associations. RESULTS: An inverse association was found between fathers-children in the weekend MVPA in children and between mothers-adolescents in out-of-school and weekend MVPA. An inverse association was found in MVPA between mothers-girls, and the different parents' MC to work was positively associated with the MC to school in children and adolescents except for the association AC parents-adolescents. The AC was mainly associated between mothers and girls and boys. CONCLUSIONS: A weak association in parent-child MVPA but a strong association in MC between parent-child was found.

Prevalence of Injuries in Exercise Programs Based on Crossfit®, Cross Training and High-Intensity Functional Training Methodologies: A Systematic Review.

Current literature shows studies that question the safety of the practices carried out in high-intensity training modalities such as CrossFit®, Cross Training or High-Intensity Functional Training, which may lead to a greater risk in the prevalence of injuries. The aim of this study was to analyze in detail the prevalence of injuries occurring in training based on the CrossFit®, Cross Training or High-Intensity Functional Training modalities, through a systematic review, as well as evaluating the methodological quality of the included studies. We used the recommendations of the PRISMA protocol. For the quality analysis of the studies, we applied the tool proposed by the National Institute of Health (United States). The areas that mainly present a higher risk of injury during CrossFit, Cross Training or High-Intensity Functional Training practices are shoulders, knees and back. Additionally, 11 of the 12 included studies displayed a poor methodological quality according to the quality tool used.

Objective Measures to Assess Active Commuting Physical Activity to School in Young People: A Systematic Review Protocol and Practical Considerations.

There are no systematic reviews that have identified the existing studies assessing active commuting physical activity (PA) to and from (to/from) school using objective measures, as well as the contribution of both walking and cycling to/from school to PA levels. To fill this gap in the literature, this systematic review will aim (a) to identify existing studies that assess active commuting PA to/from school with objective measures in young people and to examine the contribution of walking and cycling to/from school to PA levels, and (b) to propose an appropriate methodology and practical considerations to assess active commuting PA to/from school based on the studies identified. The review protocol was registered in PROSPERO (CRD42020162004). We will conduct a systematic search up to 2020 in five databases: PubMed, Web of Science, SPORTdiscuss, Cochrane Library, and National Transportation Library. Both the risk of bias and the quality of the identified studies will be evaluated through different instruments according to the design of each study. This systematic review will help to choose the most appropriate objective measures to assess active commuting PA to/from school and to promote walking and cycling to/from school to increase PA levels.

Metabolic Syndrome and Its Associated Factors in Older Adults: A Secondary Analysis of SABE Colombia in 2015.

Background: Understanding the metabolic syndrome (MetS) prevalence at the national level is important to develop effective programs and strategies to prevent and control MetS. This study aimed to analyze the prevalence of MetS according to gender and aging stage, and its association with potential factors in older individuals ≥60 years of age in Colombia. Methods: The data for this study came from a secondary cross-sectional, nationally representative SABE study Survey on Health, Well-Being, and Aging in Colombia, 2015. A total of 1637 participants (60.7% women, 70.5 ± 7.9 years) from 86 Colombian municipalities participated. A structured questionnaire was used to collect data on socio-demography, lifestyle, and self-report medical conditions. Measurements included anthropometric (weight, waist circumference, body mass index), sarcopenia "proxy" status (calf circumference) handgrip strength levels, high-density lipoprotein cholesterol, triglycerides, fasting glucose, and blood pressure. Univariate and multiple regression models were established as part of the main analysis. Results: Using the harmonized Joint Scientific Statement criteria, MetS was present in 54.9% of the study population, with a higher prevalence among females than males (59.8% vs. 47.3%). Individuals who were cigarette smokers (odds ratio [OR] = 1.5; 95% confidence interval [CI] = 1.0-2.4; P = 0.034), female gender (OR = 1.3; 95% CI = 1.0-1.8; P = 0.020), and sarcopenia "proxy" (OR = 1.6; 95% CI = 1.0-2.5; P = 0.026) were more likely to have a higher prevalence estimate of MetS, after controlling for relevant covariates. Conclusions: Overall prevalence of MetS among older adults in Colombia is high. Smoking, female gender, and sarcopenia "proxy" status are associated with MetS. These results suggested that MetS is still a serious public burden in Colombia, and screening for promotion of healthy lifestyle and nutrition counseling should be offered routinely in old age.

Feasibility and Reliability of a Questionnaire to Assess the Mode, Frequency, Distance and Time of Commuting to and from School: The PACO Study.

Active commuting to and from school has several health implications. Self-reporting is the most common assessment tool, but there is a high heterogeneity of questionnaires in the scientific literature. The purpose of this study was to analyse the feasibility and reliability of the Spanish "New Version of Mode and Frequency of Commuting To and From School" questionnaire in children and adolescents. A total of 635 children (5-12 years old) and 362 adolescents (12-18 years old) filled out the questionnaire twice (14 days apart). Feasibility was evaluated using an observational checklist. The test-retest reliability of the "New Version of Mode and Frequency of Commuting To and From School" questionnaire and the distance and time to school were examined using the kappa and weight kappa coefficient (κ). No misunderstanding of questions was reported. The time to complete the questionnaire was 15 ± 3.62 and 9 ± 2.26 min for children and adolescents, respectively. The questionnaire showed substantial and almost perfect kappa coefficients for the overall six items (k = 0.61-0.94) in children and adolescents. The "New Version of Mode and Frequency of Commuting To and From School" questionnaire is a feasible and reliable questionnaire in Spanish children and adolescents.

School-Based Interventions for Promoting Physical Activity Using Games and Gamification: A Systematic Review Protocol.

Games and/or gamification seem to be a promising area for educational and health research. These strategies are being increasingly used for improving health indicators, even in educational settings; however, there is little information about these terms within the school to promote physical activity (PA). OBJECTIVE: the aim of this study is to describe a systematic review protocol of school-based interventions for promoting PA in pre-schoolers, children, and adolescent students using games and gamification. METHODS: This review protocol is registered in International prospective register of systematic reviews (PROSPERO) (CRD42019123521). Scientific databases include PubMed, Web of Science, SportDiscus, Cochrane Library, ERIC, and PsycINFO. A standardized procedure will be executed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol (PRISMA-P) checklist for conducting systematic review protocols and the PICOS (Population, Interventions, Comparators, Outcomes, and Study design) tool to address an appropriate search strategy. Detailed information will be extracted, including a quantitative assessment using effect sizes to compare the interventions and a qualitative assessment using the Evaluation of Public Health Practice Projects (EPHPP) tool. CONCLUSION: This systematic review protocol contributes to establishing future systematic reviews using games and gamification strategies in school settings in order to examine their effect on PA outcomes among youth. Additionally, an update and clarification on the different terms in the school context have been included.

Dance Fitness Classes Improve the Health-Related Quality of Life in Sedentary Women.

This study aims to analyze the effect of two dance-focused and choreographic fitness classes on Health-Related Quality of Life (HRQoL) in sedentary worker women. Methods: 65 sedentary middle-aged worker women (38 ± 7.3 years old) completed a 16-week intervention randomly assigned to: (1) dance fitness group based on Zumba Fitness classes (DF group, n = 25)], (2) dance fitness + functional strength training group (DFFT group, n = 20), and (3) control group (n = 20). HRQoL was assessed by the 36-Item Short-Form Health-Survey (SF-36), which evaluates 8 dimensions of health [General Health (GH), Physical Functioning (PF), Social Functioning (SF), Physical Role (PR), Emotional Role (ER), Bodily Pain (BP), Vitality (V), and Mental Health (MH)] scored from 0 (worst) to 100 (best health status). Results: The control group statistically differed from both exercise groups in PF and PR, and from the DF group in SF and MH showing a lower score. No statistical differences were observed between exercise groups post-intervention, except in V. DF group showed increases in GH, PF, SF, V, PR, and MH post-intervention. Conclusion: A 16-week dance fitness intervention based on Zumba Fitness classes generates notable improvements in a wide range of HRQoL dimensions in sedentary middle-aged worker women, especially in V, PR and MH dimensions.

Health-Related Physical Fitness Benefits in Sedentary Women Employees after an Exercise Intervention with Zumba Fitness®.

Background: The protective properties of high physical fitness levels on health are manifest independently of age, sex, fatness, smoking, alcohol consumption, and other clinical factors. However, women are less active than men, which contributes to low physical fitness and a high risk of CVD. Thus, the objective of this study is to analyze the effect of two exercise interventions on health-related physical fitness in sedentary employed females. Methods: A total of 98 physically inactive adult women were randomly assigned to 3 study groups: the control group (CG) = 31, the endurance training group based on Zumba Fitness® classes (ET; n = 39), and the concurrent training group that had an extra muscle-strengthening workout after the Zumba Fitness® class (CnT; n = 28). Body composition (BMI, waist circumference), motor fitness (one-leg stand test), musculoskeletal fitness (shoulder-neck mobility, handgrip strength test, jump and reach test, and dynamic sit-up test), and cardiorespiratory fitness (2-km test and estimated VO2 max) were assessed with the ALPHA-Fit test battery for adults. Results: Both interventions showed a significant improvement in the majority of health-related fitness and body composition variables/test (waist circumference: ET = -2.275 ± 0.95, p = 0.02, CnT = -2.550 ± 1.13, p = 0.03; one-stand leg test: ET = 13.532 ± 2.65, p < 0.001; CnT = 11.656 ± 2.88, p < 0.001; shoulder-neck mobility: ET = 1.757 ± 0.44, p < 0.001, CnT = 2.123 ± 0.47, p < 0.001; handgrip test: 0.274 ± 0.08, p < 0.001, CnT = 0.352 ± 0.08, p < 0.001; dynamic sit-up: ET = 1.769 ± 0.45, p < 0.001, CnT = -1.836 ± 0.49, p < 0.001; 2-km test time: -1.280 ± 0.25, p < 0.001, CnT = -1.808 ± 0.28, p < 0.001; estimated VO2 max: ET = 1.306 ± 0.13, p < 0.001, CnT = 1.191 ± 0.15, p < 0.001). There were no significant differences after the intervention between the two exercise intervention groups. Conclusions: Exercise interventions based on Zumba fitness® or Zumba fitness® combined with an extra muscle-strengthening workout based on bodyweight training exercises are effective strategies to improve the health-related physical fitness in sedentary women employees.

Physical Exercise following bariatric surgery in women with Morbid obesity: Study protocol clinical trial (SPIRIT compliant).

BACKGROUND: Severe and morbid obesity are increasing globally, particularly in women. As BMI increases, the likelihood of anovulation is higher. The primary aim of the EMOVAR clinical trial is to examine, over the short (16 weeks) and medium (12 months) term, the effects of a supervised physical exercise program (focused primarily on aerobic and resistance training) on ovarian function in women with severe/morbid obesity who have undergone bariatric surgery. Secondary objectives are to examine the effects of the intervention on chronic inflammation, insulin resistance, arterial stiffness, physical fitness, and health-related quality of life. METHODS: This is a randomized controlled trial in which ∼40 female bariatric surgery patients, aged between 18 and 45 years old, will be included. Participants assigned to the experimental group will perform a total of 48 sessions of supervised concurrent (strength and aerobic) training (3 sessions/week, 60 min/session) spread over 16 weeks. Patients assigned to the control group will receive lifestyle recommendations. Outcomes will be assessed at baseline, week 16 (i.e., after the exercise intervention) and 12 months after surgery. The primary outcome is ovarian function using the Sex-Hormone Binding Globuline, measured in serum. Secondary outcomes are serum levels of anti-mullerian hormone, TSH, T4, FSH, LH, estradiol, prolactine, and free androgen index, as well as oocyte count, the diameters of both ovaries, endometrial thickness, and uterine arterial pulsatility index (obtained from a transvaginal ultrasound), the duration of menstrual bleeding and menstrual cycle duration (obtained by personal interview) and hirsutism (Ferriman Gallwey Scale). Other secondary outcomes include serum markers of chronic inflammation and insulin resistance (i.e., C-reactive protein, interleukin 6, tumor necrosis factor-alpha, leptin, glomerular sedimentation rate, glucose, insulin and the HOMA-IR), arterial stiffness, systolic, diastolic and mean blood pressure, body composition, and total weight loss. Physical fitness (including cardiorespiratory fitness, muscular strength, and flexibility), health-related quality of life (SF-36 v2) and sexual function (Female Sexual Function Index) will also be measured. DISCUSSION: This study will provide, for the first time, relevant information on the effects of exercise training on ovarian function and underlying mechanisms in severe/morbid obese women following bariatric surgery. TRIAL REGISTRATION NUMBER: ISRCTN registry (ISRCTN27697878).

Effect of Two Choreographed Fitness Group-Workouts on the Body Composition, Cardiovascular and Metabolic Health of Sedentary Female Workers.

Daily sedentary working hours contribute negatively to body composition, cardiovascular and metabolic health, especially in women, who are usually less active than men. The objective of this study was to analyze the effect of two trending choreographed fitness group-workouts on the body composition and cardiovascular and metabolic health of sedentary female workers. A total of 98 physically inactive and working women (38.9 ± 6.4 years of age) were randomly assigned to three study groups: Control group (CG) = 31, Zumba Fitness® with three one-hour classes per week (ZF) = 39, and Zumba Fitness with 20 minutes of additional Bodyweight strength training (ZF + BW) = 28. Measurements included body composition, blood pressure, cardiovascular risk by the Framingham Heart Study tools (10 yr cardiovascular risk and vascular age) and a metabolic blood panel. Post-intervention, both choreographed fitness group-workouts reached a similar significant loss of fat mass (ZF = 2.805 ± 0.48, p < 0.0001; ZF + BW = 3.540 ± 0.04, p < 0.0001), an increase in muscle mass (ZF = 1.70 ± 0.581, p = 0.005; ZF + BW = 3.237 ± 0.657, p < 0.0001) and a decrease in SBP (ZF= 6.454 ± 1.70, p < 0.0001; ZF + BW = 4.12 ± 1.95, p = 0.039). Only the ZF group significantly improved the 10 yr cardiovascular risk (p = 0.032) and metabolic age (p = 0.0025) post-intervention. No significant improvement was observed in the metabolic panel for both choreographed fitness group-workouts. In conclusion, the ZF program generated improvements in cardiovascular and metabolic risk variables compared to ZF + BW or CG. Both choreographed fitness group-workouts contributed similarly to the improvement in systolic blood pressure, fat mass, muscle mass, and also engendered a great adherence to exercise.

Supervised exercise following bariatric surgery in morbid obese adults: CERT-based exercise study protocol of the EFIBAR randomised controlled trial.

BACKGROUND: There is increasing evidence of weight regain in patients after bariatric surgery (BS), generally occurring from 12 to 24 months postoperatively. Postoperative exercise has been suggested to ad long-term weight maintenance and to improve physical function in BS patients. However, there are a limited number of intervention studies investigating the possible benefits of exercise in this population. The aim of the current report is to provide a comprehensive CERT (Consensus on Exercise Reporting Template)-based description of the rationale and details of the exercise programme implemented in the EFIBAR Study (Ejercicio FÍsico tras cirugía BARiátrica), a randomised controlled trial investigating the effects of a 16-week supervised concurrent (aerobic and strength) exercise intervention program on weight loss (primary outcome), body composition, cardiometabolic risk, physical fitness, physical activity and quality of life (secondary outcomes) in patients with severe/morbid obesity following bariatric surgery. METHODS: A total of 80 BS patients [60-80% expected women, aged 18 to 60 years, body mass index (BMI) ≥ 40 kg/m2 or ≥ 35 kg/m2 with comorbid conditions)] will be enrolled in the EFIBAR Randomized Control Trial (RCT). Participants allocated in the exercise group (n = 40) will undertake a 16-week supervised concurrent (strength and aerobic) exercise programme (three sessions/week, 60 min/session), starting 7 to 14 days after surgery. The rationale of the exercise programme will be described following the CERT criteria detailing the 16 key items. The study has been reviewed and approved by the Ethics Committee of the Torrecárdenas University Hospital (Almería, Spain) (ref. N° 76/2016). DISCUSSION: The present study details the exercise programme of the EFIBAR RCT, which may serve: 1) exercise professionals who would like to implement an evidence-based exercise programme for BS patients, and 2) as an example of the application of the CERT criteria. TRIAL REGISTRATION: The trial was prospectively registered at Clinicaltrials.gov NCT03497546 on April 13, 2018.