Sport Injuries among Amateur Women and Young Intermediate Level Female Handball Players: A Preliminary Investigation.

Background and objectives: Handball is a popular sport among women whose practice can lead to marked health benefits but could also show a high injury risk. There is a lack of research on intermediate level female players. We aimed to identify the prevalence of sport injuries in amateur and young intermediate level female handball players and the potential influence of the sport category. Materials and Methods: A group of cadets, juvenile and senior female players of three handball clubs participating in the Spanish regional league were followed throughout the 2018-2019 season. Information on injuries and exposure was collected via questionnaires. Results: Out of 114 players (34 seniors, 33 juvenile and 47 cadets), 77 of them sustained at least one injury. Most of the injuries were either moderate or severe, regardless of the category. A total of 7.93, 5.93 and 4.16 injuries per 1000 h of exposure were registered in the senior, juvenile and cadet categories respectively. The risk of sustaining an injury was 2.14 times higher for senior players Confidence Interval (CI 95%: 1.51-3.03) and 1.92 higher for juvenile players (CI 95%: 1.32-2.78) when compared with cadets. Conclusions: Senior and young female handball athletes playing at an amateur and intermediate level, are exposed to a substantial risk of sustaining a moderate or severe injury. The players' category does not seem to have a great impact on the injury rate and on the characteristics of the sport injuries registered.

Is Stretching Exercise An Adequate Control Group in Clinical Trials Aimed at Improving Physical Fitness and Function of Older Adults? A Systematic Review and Meta-Analysis.

This study aimed to determine if stretching exercise can be implemented as an adequate control therapy in exercise randomized controlled trials aimed at improving physical fitness and physical function in older adults. Five electronic databases were systematically searched for randomized controlled trials focused in the physical fitness and function of older adults using stretching exercise as control group. The methodological quality was assessed and a meta-analysis was carried out. Sixteen studies were included, 13 in the meta-analysis. The methodological quality ranged from fair to good. The meta-analysis only in the controls resulted in significant improvements in different functional parameters related to walking, balance, knee flexion strength, or global physical function. The interventions, compared with the controls, significantly improved balance and knee strength parameters. Stretching exercise as control therapy in older people can lead to beneficial effects and could influence the interpretation of the effect size in the intervention groups.

Nordic walking for women with breast cancer: A systematic review.

Nordic walking (NW) seems to be an interesting rehabilitation strategy for women with breast cancer (BC). No review article that has synthesised and summarised the existing scientific evidence about the effect of NW on BC survivors has been published so far. A systematic review was conducted aimed at identifying the characteristics and methodological quality of the studies that have analysed the effects of NW on women with BC. The critical appraisal of the randomised controlled trials (RCTs) was retrieved from the Physiotherapy Evidence Database (PEDro). The methodological quality of the uncontrolled studies was evaluated by means of the Quality Assessment Tool for Before-After Studies with No Control Group. Nine investigations (four RCTs and five quasi-experimental studies) were included in the final analysis. The RCTs showed a fair methodological quality, while the quasi-experimental studies obtained a score ranging from "fair" to "poor". Judging from the findings of the analysed studies, NW had a significant and positive impact on a number of BC symptoms, including lymphedema, physical fitness, disability and morbid perceptions. No adverse effects were reported. However, due to the methodological limitations observed, further research is needed to confirm such findings.

Exercise Interventions for Improving Flexibility in People with Multiple Sclerosis: A Systematic Review and Meta-Analysis.

Background and objectives: People with multiple sclerosis (MS) often experience limitations in joint range of motion, which is linked to spasticity and continued inactivity. Low flexibility levels in this population have been linked to postural problems and muscular pain. Therefore, the purpose of this study was to conduct a systematic review and a meta-analysis aimed at identifying the characteristics and methodological quality of investigations studying the effects of exercise interventions on the flexibility levels of people with MS. Materials and Methods: Three electronic databases (MEDLINE/PubMed, SPORTDiscus and Scopus) were systematically searched up to May 2019 for intervention studies focused on the effects of exercise on the flexibility levels of people with MS. A meta-analysis, including randomized controlled trials (RCT), which reported information regarding the effects of exercise on flexibility, was also conducted. The methodological quality of included studies was assessed using the Physiotherapy Evidence Database, and the Quality Assessment Tool for Before-After Studies, with no control group. The quality of the information reported, regarding the programs conducted, was assessed by means of the Consensus on Exercise Reporting Template (CERT) scale. Results: Seven studies, four RCTs and three uncontrolled investigations were finally selected. The methodological quality of the RCTs was considered "poor" in one study, and "good" and "excellent" in two studies and one investigation, respectively. The three uncontrolled studies showed a methodological quality between "fair" and "poor". Following the CERT scale, four studies were graded as "high" and three as "low". Findings from the meta-analysis indicated no significant effects on hamstring flexibility, or the range of motion in the hips, knees or ankles. Conclusions: There is preliminary evidence from individual studies which indicates that people with MS can improve their lower limb flexibility following participation in physical exercise programs, but the meta-analysis did not confirm these findings.

Mortality of Spanish soccer referees and coaches: a retrospective cohort study.

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.

The Omni Scale Is Not Suitable for Assessing Self-Perceived Exertion during Physical Activity in Preschoolers.

INTRODUCTION: We aimed to identify the utility, reliability, and validity of an adapted version of the OMNI self-perceived exertion (PE) rating scale in preschoolers. POPULATION AND METHODS: Firstly, 50 (mean age ± standard deviation [SD] = 5.3 ± 0.5 years, 40% girls) performed a cardiorespiratory fitness (CRF) test twice, with a one-week interval between assessments, and rated their PE either individually or in groups. Secondly, 69 children (mean age ± SD = 4.5 ± 0.5 years, 49% girls) performed two CRF tests, separated by a one-week interval, twice and rated their self-PE. Thirdly, the heart rate (HR) of 147 children (mean age ± SD = 5.0 ± 0.6 years, 47% girls) were compared against self-rated PE after finishing the CRF test. RESULTS: Self-assessed PE differed when the scale was administered individually (e.g., 82% rated PE with 10) or in groups (42% rated PE with 10). The scale showed poor test-retest reliability (ICC:0.314-0.031). No significant associations were found between the HR and PE ratings. CONCLUSIONS: An adapted version of the OMNI scale was found not suitable for assessing self-PE in preschoolers.

Aquatic exercise for people with intellectual disabilities: findings from a systematic review.

Background: There is a need for promoting exercise practice among people with intellectual disabilities (ID). Aquatic exercise (AE) could be a viable option in this regard. Objective: To identify and critically analyze the best available evidence concerning the effects of AE in the physical and mental health of people with ID. Methods: A systematic review of randomized controlled trials (RCTs) and comparative studies was performed after searching within several databases up to March 2021. Results: A total of 4 RCTs and 3 comparative studies were found. Their methodological quality ranged from high to low. Aquatic interventions had positive effects on cardiorespiratory, muscular fitness and balance. Mixed effects were seen on parameters related to obesity and cognition. Scant information regarding feasibility and intervention fidelity was provided. In general, interventions details were not discussed in deep. Conclusion: Preliminary evidence shows that aquatic exercise can be prescribed to people with ID in order to improve their physical health. The impact of aquatic exercise on motor skills, cognitive function and mental health remains unclear. Further research on this topic should provide a detailed description of the interventions carried out, including information on the feasibility and intervention fidelity.

Upper versus lower body resistance exercise with elastic bands: effects on cognitive and physical function of institutionalized older adults.

PURPOSE: To compare the effects of upper versus the lower-body resistance exercise on cognitive and physical functions of institutionalized older people. METHODS: This was a non-randomized multi-center comparative and crossover study (clincialtrials.gov code NCT03831373). Two experimental groups performed a 12-week intervention of resistance exercises with low-intensity elastic bands, one program focused on exercises of the upper body (n = 20, mean age 87.6 ± 6.4 years, 75% women) and the other on the lower body (n = 29, mean age 81.4 ± 7.7 years, 55% women). Following 12 weeks of detraining, the groups performed the other intervention. After another 12 weeks, a follow-up assessment was carried. The control group (n = 19, mean age 81.3 ± 9.5, 68% women) performed a full body stretching exercise program in both phases. Before and after each period, cognitive and physical function was assessed by standardized test (Mini-Mental State Examination, Trail Making test and Phototest; Timed Up and Go, Back Scratch, Chair Sit and Reach and had grip strength, respectively). Intention-to-treat and per-protocol analyses were carried. RESULTS: After the first intervention, significant improvements (p < 0.05) were observed in the cognitive function in both experimental groups, and in the hand grip strength in the group that performed lower-body exercise. After the second phase, all groups showed improvements in lower-body and shoulder flexibility and a significant worsening in hand grip strength. The lower-body exercise group showed a worsening in cognitive function, and the upper-body group in functional mobility and dynamic balance. CONCLUSIONS: Resistance exercise with elastic bands showed beneficial effects on cognitive function and functional independence in institutionalized older adults. While upper body exercises seemed to be more effective on cognitive function, lower limb exercises showed better results on physical function parameters.

Systematic review and meta-analysis of randomised controlled trials on the effects of yoga in people with Parkinson's disease.

PURPOSE: Yoga may be a beneficial treatment for people with Parkinson's disease (PD). However, no studies have critically reviewed and meta-analyzed the scientific evidence for yoga's benefits regarding motor and non-motor symptoms. The purpose of this study was to conduct a systematic review and meta-analysis on the effectiveness of yoga as a rehabilitation strategy for PD. MATERIALS AND METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a literature search was performed using MEDLINE/PubMed, PEDro, SPORTDiscus, and Scopus. Studies addressing any concepts on the impact of yoga intervention on physical and psychological outcomes in people with PD were included. RESULTS: Fourteen RCTs were selected, with heterogeneous protocols and outcomes measures. Yoga interventions were safe and well-accepted for patients with mild to moderate PD. The descriptive analysis indicated that its practice might provide both physical and psychological benefits. Preliminary evidence showed that yoga has comparable or superior efficacy to exercise. A subsequent meta-analysis on five RCTs detected that yoga was more effective than passive control in ameliorating motor symptoms. CONCLUSIONS: Yoga appears to be a promising rehabilitative therapy for individuals with PD. Recommendations are proposed for future studies.IMPLICATIONS FOR REHABILITATIONYoga is a safe and feasible therapy for people with mild to moderate PD.Yoga practice positively impacts physical and mental health in this population.When compared to exercise, yoga showed to have similar or even greater effects.

Effects of Nordic walking in people with Parkinson's disease: A systematic review and meta-analysis.

Nordic walking (NW) may be a beneficial treatment for people with Parkinson's disease (PD). Since high-quality research has been published on the effects of NW on people with PD by now, an actualised and comprehensive, in-depth review is recommended to guide practitioners in prescribing this exercise modality. The purpose of this study was to conduct a systematic review and meta-analysis on the effectiveness of NW as a rehabilitation strategy for PD. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a literature search was performed using Pubmed, SportDiscus and Scopus up to May 2021. Randomised controlled trials (RCTs) addressing the impact of a NW intervention on any outcomes in people with PD were included. The critical appraisal of the RCTs was retrieved from the Physiotherapy Evidence Database (PEDro) or evaluated using the PEDro scale. The Cochrane Collaboration's risk of bias tool was also employed. The review was not registered a priori on any database and a review protocol was not published. Twelve studies were included in the review. The investigations were mostly good-to-fair methodological quality, and risk of bias was acceptable. None of the reported statistically significant benefits of NW were clinically meaningful, except for walking ability. Although adherence to NW programs was good, some adverse effects derived from its practice were informed. The practice of Nordic Walking does not lead to clinically significant changes in global motor impairment, functional mobility, balance and physical fitness in patients with PD. This therapy seems to improve walking ability and quality of life, although further research in this latter outcome is needed.

[Estimación del aumento global del tiempo de sedentarismo durante los confinamientos de la COVID-19: una revisión sistemática y un metanálisis.] / Estimating the global increase in sedentary time during COVID-19 lockdowns: a systematic review and meta-analysis.

OBJECTIVE: Las estrategias restrictivas de movilidad derivadas de la pandemia por COVID-19 podrían afectar negativamente al estado de salud de la población debido a la disminución de los niveles de actividad física. El objetivo de este estudio es estimar el aumento del tiempo de sedentarismo durante los confinamientos en comparación con la situación anterior al brote de COVID-19 en muestras de población adulta de diferentes países del mundo. METHODS: Se realizó una búsqueda sistemática en tres bases de datos electrónicas, hasta el 27 de febrero de 2021, de estudios que informaran sobre el tiempo total de sedentarismo antes y durante los confinamientos por COVID-19 utilizando una herramienta validada. Se realizó un metanálisis utilizando modelos de efectos aleatorios para calcular las diferencias de medias ponderadas en el tiempo sedentario diario total antes y durante los confinamientos. El análisis se repitió estratificado y comparando por sexo. RESULTS: Se incluyeron 20 estudios, con una calidad metodológica buena (n=15) y regular (n=5). Para el metanálisis se agruparon los datos de 18 estudios, con 47.245 participantes. Los confinamientos por COVID-19 en todo el mundo condujeron a un aumento medio ponderado de 2,40 horas diarias en el tiempo total de comportamiento sedentario (intervalo de confianza del 95%: 1,95; 2,85). El análisis estratificado y comparativo por sexo en 8 estudios indicó un aumento similar para mujeres (n=20.455) y hombres (n=11.825). CONCLUSIONS: El tiempo total de sedentarismo diario aumentó en 2,40 horas en todo el mundo durante los confinamientos en comparación con la situación anterior al brote de COVID-19, sin diferencias significativas entre sexos.

OBJETIVO: This study aimed to estimate the increase in sedentary time during the lockdowns compared to the situation before the COVID-19 outbreak in adult population samples from different countries worldwide. METODOS: We systematically searched three electronic databases until 27th February 2021 for studies reporting data on total sedentary time before and during COVID-19 lockdowns using a validated tool. We performed a meta-analysis using random-effects models to calculate weighted mean differences in total daily sedentary time before and during the lockdowns. The analysis was repeated stratified and compared by sex. RESULTADOS: We included 20 studies, with a good (n=15) and fair (n=5) methodological quality. We pooled for meta-analysis the data from 18 studies, comprising 47,245 participants. The COVID-19 lockdowns across the globe led to a weighted mean increase of 2.40 hours per day in total sedentary behavior time (95% confidence interval: 1.95; 2.85). The stratified and comparative analysis by sex in 8 studies indicated a similar increase for women (n=20,455) and men (n=11,825). CONCLUSIONES: Total daily sedentary time increased by 2.40 hours worldwide during the lockdowns compared to the situation before the COVID-19 outbreak, with no significant difference between sexes.

Associations between Self-Perceived and Desired Health-Related Physical Fitness in Spanish Children.

Health-related physical fitness (HRPF) has emerged as an important marker of health among children. It is usually defined as a multidimensional construct consisting of cardiorespiratory endurance; muscular strength and endurance; and flexibility. Currently, health policies are aimed at getting children to increase their HRPF levels. Understanding the relationship between the perceived and the desired levels of fitness can be important to avoid the abandoning of physical activity practice. We analyzed the associations between the self-perceived and the desired health-related physical fitness. A modified version of the self-perceived HRPF questionnaire was completed by 330 children (148 girls, mean age: 10.78 ± 0.67 years, and 182 boys, mean age: 10.82 ± 0.61 years). Fitness was measured through tests selected from the Eurofit battery. The questions regarding desired HRPF showed moderate internal consistency (Cronbach's α: 0.671) and good test-retest reliability (ICC: 0.761). In general, children shared a desire to improve their self-perceived HRPF. Those who perceived themselves as already being fit were the ones who showed the strongest desire for achieving higher HRPF levels.

Fitness, Fatness, and Mortality in Men and Women From the UK Biobank: Prospective Cohort Study.

Background Cardiorespiratory fitness may moderate the association between obesity and all-cause mortality (ie, the "fat-but-fit" hypothesis), but unaddressed sources of bias are a concern. Methods and Results Cardiorespiratory fitness was estimated as watts per kilogram from a submaximal bicycle test in 77 169 men and women from the UK Biobank cohort and combined with World Health Organization standard body mass index categories, yielding 9 unique fitness-fatness combinations. We also formed fitness-fatness combinations based on bioimpedance as a direct measure of body composition. All-cause mortality was ascertained from death registries. Multivariable-adjusted Cox regression models were used to estimate hazard ratios and 95% CIs. We examined the association between fitness-fatness combinations and all-cause mortality in models with progressively more conservative approaches for accounting for reverse causation, misclassification of body composition, and confounding. Over a median follow-up of 7.7 years, 1731 participants died. In our base model, unfit men and women had higher risk of premature mortality irrespective of levels of adiposity, compared with the normal weight-fit reference. This pattern was attenuated but maintained with more conservative approaches in men, but not in women. In analysis stratified by sex and excluding individuals with prevalent major chronic disease and short follow-up and using direct measures of body composition, mortality risk was 1.78 (95% CI, 1.17-2.71) times higher in unfit-obese men but not higher in obese-fit men (0.94 [95% CI, 0.60-1.48]). In contrast, there was no increased risk in obese-unfit women (1.09 [95% CI, 0.44-1.05]) as compared with the reference. Conclusions Cardiorespiratory fitness modified the association between obesity and mortality in men, but this pattern appeared susceptible to biases in women.

Effectiveness of equine-assisted therapies for improving health outcomes in people with multiple sclerosis: A systematic review and meta-analysis.

BACKGROUND: Scientific evidence has shown that equine-assisted therapies (EAT) lead to improvements in the physical function and the quality of life (QoL) of people with disabilities through the practice of hippotherapy or therapeutic riding (TR). There is a need to confirm whether people with multiple sclerosis (PwMS) can also benefit from its practice. This review aimed to systematically evaluate and meta-analyze the available data on the potential health benefits of EAT in PwMS. METHODS: Four electronic databases (MEDLINE/PubMed, Web of Science, SPORTDiscus, and Scopus) were searched systematically from their inception until June 2021 for randomized controlled trials (RCTs) and comparative studies that provided information regarding the effects of EAT on PwMS. The studies' methodological quality assessment was performed using the PEDro and the MINORS scales. For the meta-analysis, heterogeneity across studies was quantified using the I2 statistic. Fixed-effect or random-effects models were applied to obtain the pooled results in the case of low (I2 < 30%) or high (I2 > 30%) heterogeneity values, respectively. Standardized mean differences (SMD) and 95% confidence intervals (CIs) were calculated to assess the change in each outcome. RESULTS: After removing duplicated studies, 234 results were retrieved by the literature search and 11 were eligible for full text search. Finally, 9 studies with a methodological quality ranging from good to low quality met the inclusion criteria. Six of them focused on hippotherapy and 4 of them were included in the quantitative analysis. Totally, 225 PwMS patients were evaluated. Findings from the meta-analysis indicated that this therapy improved static (SMD = 0.42; 95% CI: 0.05, 0.78) but not dynamic balance (SMD = 0.51; 95% CI: -0.04, 1.06), while significant benefits were observed on the patients' QoL (SMD = 0.37; 95% CI: 0.00, 0.73). Hippotherapy showed effectiveness for reducing self-perceived fatigue (SMD = 0.70; 95% CI: 0.33, 1.07), while TR showed mixed effects on balance and QoL. CONCLUSION: The actual evidence on the effectiveness of EAT in PwMS is mainly limited to hippotherapy. This rehabilitation approach seems to have beneficial effects on static balance, QoL and fatigue, but not directly on gait and dynamic balance. Altogether, the findings suggest that hippotherapy could be incorporated as a complementary therapy when developing comprehensive care plans for PwMS.

Physical Activity and Mortality Across Levels of Adiposity: A Prospective Cohort Study From the UK Biobank.

OBJECTIVE: To examine the combined and stratified associations of physical activity and adiposity measures, modelled as body mass index (BMI), abdominal adiposity (waist circumference), and body fat percentage (BF) with all-cause mortality. PATIENTS AND METHODS: Using the UK Biobank cohort, we extracted quintiles of self-reported weekly physical activity. Categories of measured BMI, waist circumference, and BF were generated. Joint associations between physical activity-adiposity categories and mortality were examined using Cox proportional hazards models adjusted for demographic, behavioral, and clinical covariates. Physical activity-mortality associations were also examined within adiposity strata. Participants were followed from baseline (2006 to 2010) through January 31, 2018. RESULTS: A total of 295,917 participants (median follow-up, 8.9 years, during which 6684 deaths occurred) were included. High physical activity was associated with lower risk of premature mortality in all strata of adiposity except for those with BMI ≥35 kg/m2. Highest risk (HR, 1.54; 95% CI; 1.33 to 1.79) was observed in individuals with low physical activity and high BF as compared with the high physical activity-low BF referent. High physical activity attenuated the risk of high adiposity when using BF (HR, 1.24; 95% CI; 1.04 to 1.49), but the association was weaker with BMI (HR, 1.45; 95% CI; 1.21 to 1.73). Physical activity also attenuated the association between mortality and high waist circumference. CONCLUSION: Low physical activity and adiposity were both associated with a higher risk of premature mortality, but high physical activity attenuated the increased risk with adiposity irrespective of adiposity metric, except in those with a BMI ≥35 kg/m2.

Stair climbing and mortality: a prospective cohort study from the UK Biobank.

BACKGROUND: Regular stair climbing has the potential to lower the risk of premature death, but current evidence is scarce. We aimed to examine whether daily stair climbing is associated with lower risk of all-cause, cancer, and cardiovascular disease (CVD) mortality. METHODS: Using the UK Biobank cohort, we extracted information of self-reported daily flights of stairs climbed at home, categorized as none, 1 to 5, 6 to 10, 11 to 15, and ≥16 flights per day. Associations between flights of stair climbed per day and mortality were examined as hazard ratios (HRs) from Cox proportional hazards models adjusted for demographic, clinical, and behavioural covariates including time spent in other physical activities. We calculated the restricted mean survival time as an absolute measure of association. The risk of residual confounding was examined using propensity score matching and by using lung cancer as negative control outcome. Participants were followed from baseline (2006-2010) through 31 March 2020. RESULTS: A total of 280 423 participants (median follow-up 11.1 years, during which 9445 deaths occurred) were included. Compared with not climbing any stairs, climbing more than five flights of stairs at home per day was associated with lower risk of premature mortality. The lowest risk was found for those climbing 6-10 flights per day: 0.91; 95% confidence interval (CI): 0.85, 0.98, translated to approximately 44 to 55 days of additional survival. A similar pattern was found after applying propensity score matching and for cancer mortality (6-10 flights per day HR: 0.88; 95% CI: 0.80, 0.97), but not for CVD mortality (6-10 flights per day HR: 1.08; 95% CI: 0.91, 1.29). The association between stair climbing and lung cancer was similar to that of all-cause mortality. CONCLUSIONS: Climbing more than five flights of stairs at home per day was associated with a lower risk of all-cause and cancer mortality, but not CVD mortality, compared with those who did not take the stairs. The magnitude of the association was small and appeared susceptible to residual confounding. It is unlikely that at-home stair climbing is sufficient physical activity stimuli to lower the risk of premature mortality.

Effects of exercise on the physical fitness and functionality of people with amputations: Systematic review and meta-analysis.

STUDY DESIGN: systematic review and meta-analysis. BACKGROUND: Despite existing scientific evidence alluding to the positive effects of physical exercise on people with amputations, there is a lack of consistency between the results of past studies. OBJECTIVE: To identify if people with amputations taking part in an exercise training programme can benefit from improvements in their health status as measured by changes in their physiological fitness and functionality levels. METHODS: A systematic review and meta-analysis of randomized controlled trials (RCTs) were performed after searching within several databases up to October 2019. RESULTS: Ten RCTs with satisfactory methodological quality were found. Five RCTs were pooled in the meta-analysis. Exercise programmes with a combination of activities were most commonly delivered. Exercise had positive effects on aerobic and muscular fitness parameters. Findings from the meta-analysis indicated that exercise improved distance walked but did not have a significant impact on functional mobility or self-reported functional capacity. CONCLUSION: Combined exercise of muscular endurance and functional physical exercise appear to have greater positive effects on cardiorespiratory fitness, muscular fitness and functionality levels in adult prosthesis users with unilateral lower limb amputation. Future studies should include different profiles of patients with amputations that are poorly represented in the current scientific literature.

Hematological detraining-related changes among elderly individuals with high blood pressure.

AIM: The aim of the present study was to compare the effects of detraining on physical performance, blood pressure, biologic and anthropometric variables of hypertensive elderly individuals, grouped by two levels of previous physical activity. METHODS: A total of 87 elderly individuals (70 to 93 years old) with systolic/diastolic blood pressure levels above 120/80 mmHg who participated during 18 non-consecutive months in 2 years in physical exercise programs offered in northern Portugal communities were included in the study. Tests were performed before and after three months of no exercise. Attendance to the exercise sessions, hematological markers, cardiorespiratory function, and anthropometric variables were assessed. The results were analyzed according to the fulfillment of the WHO recommendations on moderate physical activity (at least 150 minutes/week). RESULTS: Weight, total cholesterol, and glucose were influenced by the amount of physical activity performed previously to the detraining period. After the detraining period, the total cholesterol, glucose, insulin, and weight had significant differences influenced by the amount of physical activity previously performed (p<0.05). CONCLUSIONS: The number of minutes per week of aerobic and resistance exercise training over 18 non-consecutive months was not a significant determinant factor in the development of hypertension during the three months of detraining.

Impact of COVID-19 Pandemic on University Students' Physical Activity Levels: An Early Systematic Review.

Purpose: This systematic review aimed to analyze the impact that the COVID-19 lockdown had on the amount of physical activity performed by university students. Materials and Methods: A systematic electronic search for studies providing information regarding physical activity levels pre and during COVID-19 pandemic in university students was performed up to 20th October 2020 in the databases Cochrane Library, PubMed, SPORTDiscus, and Web of Science. The risk of bias of external validity quality of included studies was assessed by means of those the Newcastle-Ottawa Scale (NOS). The quality of the evidence for main outcomes was graded using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results and Conclusions: A total of 10 studies were selected. Physical activity levels were assessed by means of questionnaires (10 studies) and accelerometer (1 study). Risk of bias was regarded as low and high in six and four investigations, respectively. The quality of evidence was downgraded to low. A significant reduction of physical activity levels were observed in 9 studies. Compared to pre-lockdown values, five studies showed a reduction of light/mild physical activity (walking) between 32.5 and 365.5%, while seven studies revealed a reduction of high/vigorous physical activity between 2.9 and 52.8%. Walking, moderate, vigorous, and total physical activity levels have been reduced during the COVID-19 pandemic confinements in university students of different countries. Despite of the reductions, those who met the current minimum PA recommendations before the lockdown generally met the recommendations also during the confinements.

Nordic Walking for Overweight and Obese People: A Systematic Review and Meta-Analysis.

BACKGROUND: Nordic walking (NW) is a potentially beneficial exercise strategy for overweight and obese people. To date, no reviews have synthesized the existing scientific evidence regarding the effects of NW on this population. This systematic review and meta-analysis aimed to identify the characteristics, methodological quality, and results of the investigations that have studied the effects of NW in overweight and obese individuals. METHODS: Six electronic databases were searched up to June 2019 for studies that examined the effects of NW on people with a body mass index ≥ 25 kg/m2. The methodological quality of the included randomized controlled trials was retrieved from the physiotherapy evidence database or evaluated using the physiotherapy evidence database scale. RESULTS: Twelve studies were included in the review. The investigations were mostly good-to-fair methodological quality. NW groups had a significant improvement on parameters such as fasting plasma glucose, abdominal adiposity, and body fat compared with the baseline, but no significant improvements were found when compared with control groups. CONCLUSIONS: NW can potentially lead to improvements in parameters related to major health outcomes in overweight and obese people. The lack of control for confounding variables in the analyzed studies prevents further elaboration on its potential benefits.