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BACKGROUND AND OBJECTIVE: To revise and critically summarize the available scientific evidence regarding the effect of exercise on sleep quality in patients with chronic kidney disease (CKD). METHODS: A systematic review of randomized controlled trials (RCTs) and comparative studies was conducted, searching MEDLINE/PubMed, SPORTDiscus, and Scopus using keywords "Exercise", "Physical Activity", "Chronic Kidney Disease," and "Sleep". The methodological quality of included studies was assessed using the PEDRo and MINORS scales. RESULTS: A total of 8 RCTs and 3 comparative studies were included, showing a low (n = 1), fair (n = 7), and good (n = 3) methodological quality. Most of the studies included patients undergoing hemodialysis (HD) (n = 8). Self-reported sleep quality (n = 9), sleepiness (n = 2), and objective sleep status (n = 2) were the main outcomes analyzed. The most frequent exercise interventions included aerobic training (n = 7), resistance training (n = 2), or a combination of both (n = 4). Generally, exercise induced positive effects on the reported outcomes. Data synthesis indicated that participants who exercised obtained significant improvements on their self-reported sleep quality in comparison with those included in the control groups, with a mean difference in the Pittsburgh Sleep Quality Index of - 5.27 points (95% CI - 7.76, - 2.77; p < 0.001). CONCLUSION: Preliminary scientific evidence indicates that patients with CKD, especially those undergoing HD, report improvements in self-reported sleep quality after taking part in aerobic exercise programs, while combined training interventions yielded diverse findings. The effects of exercise on sleepiness and objective sleep status were backed by few studies with mixed results.
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Insuficiencia Renal Crónica , Entrenamiento de Fuerza , Humanos , Calidad de Vida , Calidad del Sueño , Somnolencia , Insuficiencia Renal Crónica/terapiaRESUMEN
INTRODUCTION AND HYPOTHESIS: Studies on the prevalence of urinary incontinence (UI) among CrossFit practitioners are on the rise. This systematic review with meta-analysis was aimed at determining the prevalence of UI among CrossFit practitioners. METHODS: A systematic review of the literature was performed by searching MEDLINE/PubMed, Scopus, and SPORTDiscus through January 2021. The search strategy included the keywords CrossFit, urine incontinence, exercise, high impact and pelvic floor dysfunction. The inclusion criterion was any study with a sample of CrossFit practitioners and results separated from the other fitness modalities analysed. The subjects were women with no restriction of age, parity, experience or frequency of training. Quality assessment of the studies included was conducted using the Oxford Centre of Evidence-Based Medicine scale and the Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies. RESULTS: Thirteen studies (6 comparative and 7 non-comparative) were included for the systematic review, all using a cross-sectional design. The level of evidence was 4, with their quality ranging from poor (n = 10) to fair (n = 3). A total of 4,823 women aged 18 to 71 were included, 91.0% participated in CrossFit, and 1,637 presented UI, which indicates a prevalence of 44.5%. Also, 55.3% and 40.7% presented mild or moderate UI respectively. Stress UI was the most common type reported (81.2%). CONCLUSIONS: The factors that increased the likelihood of UI were age, body mass index and parity. Exercises based on jumps were commonly associated with urine leakage. CrossFit practitioners presented higher UI than control groups.
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Incontinencia Urinaria de Esfuerzo , Incontinencia Urinaria , Embarazo , Femenino , Humanos , Masculino , Prevalencia , Estudios Transversales , Incontinencia Urinaria/epidemiología , Incontinencia Urinaria de Esfuerzo/epidemiología , Atletas , Encuestas y CuestionariosRESUMEN
This review aimed to systematically evaluate and meta-analyze the available data on the effects of Brain Gym (BG) on cognitive function in older people. Six electronic databases were searched systematically using: "Brain Gym" AND "elderly, "Brain Gym" AND "older people". The PEDro and MINORS scales were used to evaluate methodological quality. For the meta-analysis, inverse variance or generic inverse variance was used and heterogeneity was assessed with the Chi2 test and I2 test. Ten research studies with a high to low quality. Significant changes intra- and inter-group were observed for neurocognitive outcomes in the BG groups. Findings from the metaanalysis indicated changes in the BG groups, on cognitive function by means of the Mini-Mental State Examination, were not greater than those reported in the control/comparison groups. BG will not lead to improvements in cognitive function in people with and without cognitive impairment, supported by low to high evidence.
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Encéfalo , Disfunción Cognitiva , Humanos , Anciano , Cognición , Ejercicio FísicoRESUMEN
BACKGROUND: Studies suggest that physical exercise lead to improvements in the psychosocial dimension, associated comorbidities as well as to a higher quality of life (QoL) in people with epilepsy. However, there is a need to provide evidence-based guidelines for its prescription. Therefore, this review aimed to systematically evaluate and meta-analyze the available data on the potential effects of physical exercise training programs in people with epilepsy. METHODS: Four electronic databases (MEDLINE/PubMed, PEDro, SPORTDiscuss and Scopus) were searched systematically from their inception until April 2022 for randomized controlled trials (RCTs), comparative studies and non-controlled studies that provided information regarding the effects of physical exercise training programs on people with epilepsy. The studies' methodological quality assessment was performed using the PEDro, the MINORS and the Quality Assessment Tool for Before-After Studies with No Control Group scales. For the meta-analysis, inverse variance or generic inverse variance was use to report mean difference or standardized mean difference for continuous data and their 95% confidence intervals (CI). Heterogeneity was assessed with the Chi-squared test and I2 test. RESULTS: After removing duplicated studies, 82 results were retrieved by the literature search and 14 were eligible for full text search. Finally, 14 studies with a methodological quality ranging from good to low quality met the inclusion criteria. Totally, 331 people with epilepsy were evaluated. Significant changes between preand post-intervention results in the exercise intervention groups were observed for QoL, fitness level, psycho-affective and neurocognitive outcomes. Findings from the meta-analysis indicated that moderate exercise led to a non-significant decrease (p = 0.08, Chi-squared test) in seizure frequency (SMD 0.33 95% CI 0.04; 0.70), while a significant effect of exercise was observed on QoL with a mean improvement of 4.72 percentage points (95% CI 0.58; 8.86, p = 0.03). CONCLUSION: Improvements on QoL, fitness level, psycho-affective and neurocognitive outcomes can be achieved through exercise training in people with epilepsy. Altogether, the findings suggest that people with epilepsy can benefit from exercising.
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Epilepsia , Terapia por Ejercicio , Humanos , Terapia por Ejercicio/métodos , Ejercicio Físico , Calidad de Vida , Modalidades de Fisioterapia , Epilepsia/terapiaRESUMEN
We analyzed whether male Spanish elite soccer players live longer than the general population. Secondly, we compared their mortality with a cohort of soccer players who continued working as soccer elite coaches after retirement. Using age and calendar-date adjusted life tables, we analyzed the mortality hazard ratio of 1333 Spanish male players born before 1950, and who played in elite leagues from 1939, compared with the Spanish population. Using Cox proportional hazards model we compared their mortality with a cohort of 413 players who continued as coaches. Players showed significantly lower mortality than the general population, but this advantage decreased with advanced age, disappearing after 80 years. Coaches showed a similar pattern. Comparing players versus coaches, date of birth and years as professional were associated with survival, but debut age and player position were not. Unadjusted median survival time was 79.81 years (IQR 72.37-85.19) for players and 81.8 years (IQR 74.55-86.73) for coaches. Kaplan-Meier estimator adjusted for covariables showed no difference between cohorts (p=0.254). In conclusion, former Spanish male players showed lower mortality than the general population, but this effect disappeared after 80 years of age. Continuing their career as coaches after retirement from playing did not confer major benefits.
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Atletas/estadística & datos numéricos , Esperanza de Vida/tendencias , Tutoría/estadística & datos numéricos , Fútbol/estadística & datos numéricos , Factores de Edad , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Humanos , Masculino , Modelos de Riesgos Proporcionales , Jubilación , Estudios Retrospectivos , EspañaRESUMEN
There is evidence that elite soccer players live longer than general population, but there is no information on soccer coaches and referees. We aimed to analyze the longevity of both professionals, comparing them with soccer players and with general population. In this retrospective cohort study, a total of 328 male Spanish soccer coaches, 287 referees, and 1230 soccer players, all born before 1950, were divided in two cohorts, matched 2:1 with coaches and referees. We compared the survival of the cohorts with the Kaplan-Meier estimator and significance with the log-rank test. We calculated hazard ratios of death for coaches and referees compared with male Spanish general population of the same period. Differences in survival among cohorts were found, but they did not reach statistical significance. The estimated median survival time was 80.1 years (95% CI 77.7-82.4) for referees, 78 years (95% CI 76.6-79.3) for coaches, 78.8 years (95% CI 77.6-80) for referees matched with players, and 76.6 years (95% CI 75.3-77.9) for coaches matched with players. Both coaches and referees had lower mortality than general population, but this advantage disappeared after 80 years of age. We found no differences in longevity among Spanish elite soccer referees, coaches and players born before 1950. Both coaches and referees had lower mortality than general population, but this advantage disappeared after 80 years of age.
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Fútbol , Humanos , Masculino , Estudios Retrospectivos , LongevidadRESUMEN
OBJECTIVE: Self-perception questionnaires are considered a useful alternative to assess the level of physical fitness (PF) of a specific population. However, very few questionnaires of this type have been validated in the Spanish population. The aim of this study was to identify the reliability and validity of the Perceived Physical Fitness Scale (PPFS) in Spanish students. METHODS: After a back-translation process, the PPFS questionnaire was administered twice to 722 students (primary school, n=207; secondary school, n=515) to determine its reliability. To identify its convergent validity, the International Fitness Scale (IFIS) was administered, as well as a set of PF field-based tests from the Eurofit battery. The questionnaire internal consistency, reliability and convergent validity of the questionnaire were assessed by means of the Cronbach's alpha, intraclass correlation coefficient and Pearson corelation coefficient. RESULTS: The internal consistency of the PPFS was accurate among Primary (α=0.702) and good among Secondary (α=0.888) students., Reliability was poor among Primary (ICC=0.490; 95% CI [0.298-0.665]) and good among Secondary (ICC=0.797; 95% CI [0.760-0.829]) students. The PPFS showed significant associations with PF levels assessed by means of the Eurofit (Primary; r=0.421; p<0.001 / Secondary; r=0.533; p<0.001) and with the IFIS scale (Primary; r=0.356; p<0.001 / Secondary r=0.792; p<0.001). CONCLUSIONS: The Spanish adapted version of the PPFS questionnaire shows good reliability and acceptable convergent validity when used as a tool to assess PF among secondary school students. Its poor reliability, together with the weak association demonstrated against the IFIS scale among primary school students discourages the PPFS use at this educational level.
OBJETIVO: Los cuestionarios de autopercepción se consideran una alternativa útil para valorar el nivel de condición física (CF) de una población. Sin embargo, existen muy pocos cuestionarios de este tipo que hayan sido validados en población española. En este estudio se planteó identificar la fiabilidad y validez del cuestionario Perceived Physical Fitness Scale (PPFS) en escolares españoles. METODOS: Tras un proceso de retrotraducción, se administró el cuestionario PPFS en dos momentos a 722 estudiantes (Primaria, n=207; Secundaria, n=515) para determinar su fiabilidad. Para identificar su validez convergente, se administró la Escala Internacional de Aptitud Física (IFIS) y pruebas de campo de valoración de la CF extraídas de la batería Eurofit. La consistencia interna, la fiabilidad y la validez convergente del cuestionario fueron testadas mediante el alpha de Cronbach, el coeficiente de correlación intraclase y el coeficiente de Pearson. RESULTADOS: La consistencia interna del PPFS fue aceptable en Primaria (α=0,702) y buena en Secundaria (α=0,888), mientras que la fiabilidad fue pobre en Primaria (CCI=0,490; IC 95% [0,298-0,665]) y buena en Secundaria (CCI=0,797; IC 95% [0,760-0,829]). El PPFS mostró asociaciones estadísticamente significativas con la CF valorada a través de la Eurofit (Primaria; r=0,421; p<0,001 / Secundaria; r=0,533; p<0,001) y con la escala IFIS (Primaria; r=0,356; p<0,001 / Secundaria r=0,792; p<0,001). CONCLUSIONES: La versión adaptada al castellano del cuestionario PPFS muestra una buena fiabilidad y una adecuada validez convergente a la hora de ser empleada como herramienta de valoración de la propia condición física entre el alumnado de Secundaria. La pobre fiabilidad y débil asociación demostrada con la escala IFIS entre el alumnado de Primaria desaconseja su uso en este nivel educativo.
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Aptitud Física , Estudiantes , Humanos , Psicometría , Reproducibilidad de los Resultados , España , Encuestas y CuestionariosRESUMEN
BACKGROUND: Students spend a high number of hours being seated while at school. In order to find the correct adjustment between school furniture and the anthropometric characteristics, specific knowledge and tools are necessary. OBJECTIVE: The objective of the study is to evaluate the accuracy and reliability of the measurers with different instruments, as well as contrast the differences between the values that were obtained by the different examiners. METHODS: Measurements were taken independently by one expert examiner and two inexperienced teachers from the school. They used a measuring tape, a segmometer and an anthropometer for the anthropometric measurements. The statistical tests conducted: Kolmogorov-Smirnov test, Intraclass Correlation Coefficient, Bland and Altman method, Standard Error of Measurement, Technical Error of Measurement and relative TEM with a level of significance of ρ ≤ 0.05. RESULTS: A total of 108 students (8.87±1.67 years; 40.7% girls) participated in the study. The non-expert measurers had good accuracy and reliability, but they far exceeded the error percentages of the expert, obtaining the worst results in the shoulder measurement. The instrument with the lowest affinity between the inexperienced measurers was the anthropometer. CONCLUSIONS: In order to assign furniture in the schools, the experts should continue using the anthropometer. The inexperienced measurers can use more accessible instruments in the school environment such as a measuring tape and segmometer.
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Diseño Interior y Mobiliario , Instituciones Académicas , Femenino , Humanos , Masculino , Reproducibilidad de los Resultados , Antropometría/métodos , EstudiantesRESUMEN
Scientific evidence regarding whether intellectually gifted children show similar physical activity habits and physical fitness levels in comparison to typically developed children, is inconclusive. This is in part due to the scant research that has directly compared both groups of people. In this study, physical activity prevalence, self-perceived and objectively assessed physical fitness levels, and body image were assessed in a sample of 74 intellectually gifted children (mean age 11.6 ± 1.2 years). Seventy-four non-gifted children matched by age and sex were selected as a comparison cohort. Results indicated that both groups showed similar self-perceived and objectively assessed fitness levels. Physical activity habits were also similar, although significant differences were observed indicating that intellectually gifted girls were less active in comparison with non-gifted girls. Both cohorts perceived their body image accurately, although intellectually gifted children were much more satisfied with their physical appearance.
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OBJECTIVE: Stressful situations may have a negative effect on population's mental health, including impaired sleep quality. Thus, we analysed the effect on sleep during the confinement due to the COVID-19 outbreak, in a Galicia population sample, measuring subjective sleep satisfaction, and insomnia intensity and incidence. METHODS: Through an adapted questionnaire from the Cuestionario Oviedo de Sueño, distributed telematically and printed, using a convenience sampling in Galicia, we compared sleep situation, before and during the first two weeks of confinement for COVID-19. We compared the results of the questionnaire before and during confinement with the Wilcoxon signed-rank test and McNemar's test. RESULTS: In 451 analysed subjects, there was about half point decrease in sleep satisfaction (in a 1 to 7 scale), three points increase in insomnia score (9 to 45 scale) and an increase from 23.1 to 36.3% in the insomnia incidence (p<0.001 for all the comparisons). There existed less affectation in the insomnia incidence in elderly above 65 years (from 21.7 to 26.1%, p=1) and in subjects that telecommuted (unchanged 28.1% incidence, p=1). In a post-hoc analysis of a health workers subgroup, sleep affectation was similar to that of others workers. CONCLUSIONS: Confinement situation in COVID-19 outbreak context in our environment has caused important alterations in the population's sleep quality, increasing the symptoms and incidence of insomnia.
OBJETIVO: Las situaciones de estrés pueden tener repercusiones sobre la salud mental de la población, que pueden incluir alteraciones en la calidad del sueño. Por ello analizamos el efecto sobre el sueño durante el confinamiento por la pandemia del COVID-19 en una muestra de población española, midiendo la satisfacción subjetiva con el sueño, y la intensidad e incidencia de insomnio. METODOS: Mediante un cuestionario adaptado a partir del Cuestionario Oviedo de Sueño, distribuido de forma telemática e impresa, a través de un muestreo de conveniencia en Galicia, se comparó la situación del sueño en la población, antes y durante los primeros quince días del confinamiento por el COVID-19. La comparación de los resultados del cuestionario antes y durante el confinamiento se realizó con la prueba de rangos con signo de Wilcoxon y el test de McNemar. RESULTADOS: En los 451 sujetos analizados, se encontró una disminución de medio punto en la satisfacción del sueño (en una escala de 1 a 7), un incremento de tres puntos en la puntuación de insomnio (escala de 9 a 45) y un incremento del 23,1 al 36,3% en la incidencia de insomnio (p<0,001 para todas las comparaciones). Existió menor afectación en la incidencia de insomnio en los mayores de 65 años (pasó del 21,7 al 26,1%, p=1), y en los sujetos que se encontraban realizando teletrabajo (se mantuvo en el 28,1%, p=1). En un análisis post-hoc de un subgrupo de personal sanitario, la afectación del sueño fue similar a la de otros trabajadores. CONCLUSIONES: La situación de confinamiento en el contexto de la pandemia del COVID-19 en nuestro entorno ha provocado alteraciones importantes en la calidad del sueño de la población, incrementando los síntomas y la incidencia de insomnio.
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COVID-19/prevención & control , Distanciamiento Físico , Cuarentena/psicología , Trastornos del Inicio y del Mantenimiento del Sueño/etiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , COVID-19/epidemiología , COVID-19/psicología , Estudios Transversales , Brotes de Enfermedades , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Satisfacción Personal , Factores de Riesgo , Índice de Severidad de la Enfermedad , Sueño , Trastornos del Inicio y del Mantenimiento del Sueño/diagnóstico , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , España/epidemiología , Estrés Psicológico/diagnóstico , Estrés Psicológico/epidemiología , Estrés Psicológico/etiología , Adulto JovenRESUMEN
PURPOSE: This research was aimed at evaluating the effects of a five-month detraining period on the functional fitness level of a group of non-institutionalized and active older adults after taking part in a multi-component training program. A secondary aim was to determine how usual physical activity (PA) levels vary due to cessation of the program. METHODS: We tested sixty-five older people (mean age: 77.1 ± 6.2; 83% women) during the final week of an 8-month multi-component training program and during the first week after its resumption (five months later). We used the senior fitness test and the Minnesota Questionnaire to assess their functional fitness and their PA levels respectively. RESULTS: We observed a significant worsening of lower-limb strength (p = 0.008), shoulder range of motion (p = 0.004), and dynamic balance (p < 0.001) once the detraining period was completed. There was a slight downward trend in the remaining functional fitness dimensions, and there were significant differences when comparing the amount of PA estimated at pre-detraining and post-detraining (5155 ± 2258 vs 3937 ± 2087 MET-min·wk-1; p < 0.001). Older adults classified as very active showed a non-significant trend to smaller decreases in functional fitness once the detraining period was over, in comparison with those considered active. CONCLUSIONS: Active older people who regularly participated in a multicomponent training program showed a significant reduction in their strength, range of motion, and dynamic balance levels after a five-month detraining period. Self-reported PA decreased significantly during this time frame. Effective strategies are needed to increase PA levels in older people when systematic training programs are temporarily interrupted.
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Objectives: This study compared the influence of subtalar axis position on foot behavior in a closed kinetic chain in older and younger adults. Methods: The sample included 50 older adults and a control group of 50 younger adults. The variables were initially analyzed for both feet together, and were later analyzed separately, comparing each foot (right and left) between groups. Range of motion was assessed by validated goniometric procedures: the position of subtalar axis was evaluated by the palpation technique, while the Foot Posture Index was used to assess behavior in a closed kinetic chain. Student's t-test / Mann-Whitney test compared the main variables according to sample distribution, while Student's t-test / Wilcoxon test was used for paired samples. A standardized Haberman residuals test was also used to determine the connection between the position of subtalar joint axis and the Foot Posture Index. Results: Data from the right and left feet were similar for all variables. The older group had reduced mobility in the ankle and first metatarsophalangeal joint (5.42º [SD (Standard Deviation), 4.49] and 76.12º [SD, 19.24], respectively) with statistically significant values, (p <0.001), as measured by the Mann-Whitney test for the ankle joint and the t-Sutdent test for the first metatarsophalangeal joint, while the younger group had normal values (11.46º [SD, 6.49] and 97.17º [SD, 13.65], respectively)(p < 0.001). The difference in subtalar axis position was not significant (p = 0.788), with more internal deviations in both groups. There was a significant difference in Foot Posture Index (p = 0.006, by applying the chi-square test), with the normal position more prevalent in the older group and the prone position more prevalent in the younger group. Conclusions: Regarding internal deviations in the subtalar joint axis, the older group had a higher frequency of feet in the normal position, while the younger group had a higher frequency of feet in the prone position which, in this case, agrees with the rotational balance theory. For the normal axis position, a higher frequency of normal position was found in both groups. Regarding external deviations of the subtalar joint axis, neither group followed the pattern expected in rotational balance theory. The most consistent connection in the older group was between external axis position and supine foot position, whereas in the younger group it was between normal axis position and normal foot position.
Objetivos: Este estudo comparou a influência da posição do eixo subtalar no comportamento do pé em cadeia cinética fechada em idosos e adultos jovens. Metodologia: O grupo amostral incluiu 50 idosos e o grupo controle, 50 adultos jovens. As variáveis foram estudadas inicialmente para ambos os pés e comparadas entre os grupos, sendo posteriormente analisadas separadamente, comparando-se cada pé (direito e esquerdo) entre os grupos. A amplitude de movimento articular foi avaliada por procedimentos goniométricos validados; a posição do eixo subtalar foi avaliada pela técnica de palpação; o Foot Posture Index foi utilizado para avaliar o comportamento do pé em uma cadeia cinética fechada. O teste t de Student/teste de Mann-Whitney comparou as principais variáveis de acordo com a distribuição amostral, enquanto o teste t de Student/teste de Wilcoxon foi utilizado para amostras emparelhadas. O teste de resíduais ajustados de Haberman padronizado foi usado para a relação entre a posição do eixo da subtalar e o Foot Posture Index. Resultados: Os dados dos pés direito e esquerdo foram semelhantes para todas as variáveis. O grupo mais velho apresentou mobilidade reduzida no tornozelo e na primeira articulação metatarsofalângica (5,42 [desvio padrão DP, 4,49] e 76,12 [DP, 19,24] graus, respectivamente), enquanto o grupo mais jovem apresentou valores normais (11,46 [DP, 6,49] e 97,17 [DP, 13,65], respetivamente) com valores estatisticamente significativos, (p <0,001), aferidos pelo teste de Mann-Whitney para a articulação do tornozelo e pelo teste t-Sutdent para a primeira articulação metatarsofalângica. A diferença na posição do eixo subtalar não foi significativa (p = 0,788, pela aplicação do teste de Qui-quadrado), com mais desvios internos em ambos os grupos. O Foot Posture Index diferiu significativamente entre os grupos (p = 0,006 pela aplicação do teste de Qui-quadrado), sendo a postura normal mais prevalente no grupo mais velho e a postura pronada mais prevalente no grupo mais jovem. Conclusões: Em relação aos desvios internos do eixo da articulação subtalar, o grupo mais velho apresentou maior frequência de pés na postura normal, enquanto o mais jovem apresentou maior frequência de pés pronados, o que, neste caso, corrobora a teoria do equilíbrio rotacional. Na posição normal do eixo, foi encontrada maior frequência de pés com postura normal em ambos os grupos. Em relação aos desvios externos do eixo da articulação subtalar, nenhum dos grupos seguiu o padrão esperado na teoria do equilíbrio rotacional. A relação mais consistente no grupo mais velho foi entre a posição do eixo externo e a posutra supinada do pé, enquanto no grupo mais jovem se deu entre a posição normal do eixo e a postura normal do pé