The physiologic benefits of optimizing cardiorespiratory fitness and physical activity - From the cell to systems level in a post-pandemic world.

Cardiovascular (CV) disease (CVD) is a leading cause of premature death and hospitalization which places a significant strain on health services and economies around the World. Evidence from decades of empirical and observational research demonstrates clear associations between physical activity (PA) and cardiorespiratory fitness (CRF) which can offset the risk of mortality and increase life expectancy and the quality of life in patients. Whilst well documented, the narrative of increased CRF remained pertinent during the coronavirus disease 2019 (COVID-19) pandemic, where individuals with lower levels of CRF had more than double the risk of dying from COVID-19 compared to those with a moderate or high CRF. The need to better understand the mechanisms associated with COVID-19 and those that continue to be affected with persistent symptoms following infection (Long COVID), and CV health is key if we are to be able to effectively target the use of CRF and PA to improve the lives of those suffering its afflictions. Whilst there is a long way to go to optimise PA and CRF for improved health at a population level, particularly in a post-pandemic world, increasing the understanding using a cellular-to-systems approach, we hope to provide further insight into the benefits of engaging in PA.

Effects of exercise programs on cardiovascular responses in individuals with down syndrome: A systematic review and meta-analysis.

The purpose of this study is to conduct a systematic review and meta-analysis of exercise interventions designed to improve cardiovascular responses in individuals with DS. A search for relevant articles was conducted on seven electronic databases: PubMed, PEDro, Google Scholar, Scopus, WOS, MEDLINE, and SPORT Discus. An electronic search was conducted on October 15, 2022, without applying any year constraints. The studies were chosen based on a predetermined set of inclusion and exclusion criteria. The methodology of the study was evaluated using the PEDro scale, and data analyses were conducted using the CMA v3 random effects model. In total, 625 articles were reviewed, and data from 10 randomized controlled trials (RCTs) involving DS were used in this meta-analysis. The results showed that exercise programs were effective in increasing VO2peak (ml. kg -1min-1) (ES: 0.69; 95 % confidence interval [CI], 0.27-1.12; P: 0.001), time to exhaustion (ES: 0.83; CI, 0.31-1.35, P: 0.001), and VEpeak (ES: 0.76; CI, 0.32-1.20; P: 0.001). No changes were found for HRpeak (ES: 0.3; CI, -0.02-0.63, P: 0.07), VO2peak (ml·min-1) (ES: 0.45; CI, -0.01-0.92; P: 0.06), or RER (ES: 0.45; CI, -0.09-0.98, P: 0.10). No adverse effects were reported in any of the studies. In this meta-analysis and comprehensive review, exercise interventions may improve cardiovascular responses in DS; however, the association wasn't consistent across trials. RCTs with precise intervention criteria, large sample sizes, and long-term follow-up are needed in the future to demonstrate the benefits of exercise on cardiovascular responses in people with DS.