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Background: Life expectancy free of cancer (LEFC) is a novel measure that considers both morbidity and mortality and could be a useful metric for disease surveillance and risk communication. We aimed to examine the association between physical activity and LEFC in British adults., Methods: This was a prospective cohort study of 292,559 apparently healthy UK Biobank participants (mean [SD] age, 56.0 [8.1] y, 51% women). Participants were categorized based on self-reported physical activity as "no activity" (0 min/wk), "insufficiently active" (10-599 metabolic equivalent-min/wk), "active" (600-1199 metabolic equivalent-min/wk), and "very active" (>1200 metabolic equivalent-min/wk). Hazard ratios from multistate models for transitions between 3 states (cancer-free, cancer diagnosis, and all-cause mortality) were used to calculate differences in predicted remaining LEFC across physical activity levels for men and women at ages 45 and 65 years., Results: During a median follow-up of 11.0 years, we recorded 13,143 cancer cases for men and 10,255 for women, and 6488 deaths for men and 3739 for women. At age 45, "insufficiently active," "active," and "very active" had a higher LEFC by 2.35, 2.46, and 2.76 years compared with "no activity," and by 1.44, 1.62, and 1.84 years at age 65. In women, the "insufficiently active," "active," and "very active" had a higher LEFC by 1.09, 1.42, and 1.59 years at age 45, and by 1.25, 1.54, and 1.71 years at age 65., Conclusions: Engaging in physical activity, even below recommended levels, appears to extend cancer-free years of life. Promoting physical activity is an important strategy for cancer prevention.

This systematic review aimed to analyse the literature on the effects of stretching exercise as a strategy to improve walking performance and balance in older adults. A literature search was performed in five databases up to October 2023 for randomized clinical trials addressing the effects of stretching exercise programs in older adults. The methodological quality was evaluated through the PEDro scale. A total of 29 studies were included. Methodological quality was good in 16 publications and fair in 13 investigations. Improvements on balance and walking ability following stretching programs were reported in different studies. The meta-analysis pooling 139 participants from 6 studies showed that stretching interventions increased gait speed in comparison with control groups that were not assigned to any exercise programs (standardized mean difference=0.56; 95 % confidence interval: 0.21, 0.90; I-squared = 0 %, p=0.520). These findings indicate potential benefits of stretching exercises to enhance walking ability in older adult population., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: This study aimed to systematically review the available evidence on the effects of boxing interventions on people with Parkinson disease., Methods: Four electronic databases were searched systematically from their inception until December 2023. The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database and Methodological Index for Non-Randomized Studies scales., Results: A total of 13 studies were included. Data synthesis indicated that participants who performed boxing programs did not have a significant effect in the polled data on functional mobility, balance, motor symptoms, gait and cardiorespiratory fitness Accordingly, for the effects of boxing on self-reported quality of life, the polled data showed a non-significant trend towards improving Hedges' g. Also, when the analysis was performed by comparing the experimental and control groups, the results remained non-significant., Conclusions: The evidence regarding the use of boxing as a program exercise for patients with Parkinson disease remains uncertain. Preliminary findings indicate that participation in boxing does not demonstrate a substantial impact on either physical or mental health outcomes., (© 2024 The Author(s). Published by IMR Press.)

Background: High adiposity and low physical activity are associated with cancer risk. Whether different amounts and intensities of physical activity can mitigate this association is unclear. We aimed to examine the independent and combined associations of adiposity and device-measured physical activity levels of different intensities with cancer incidence and mortality., Methods: This prospective cohort study included data from 70,747 UK Biobank participants (mean age 61.6 ± 7.9 years, 56.4% women) with wrist-worn accelerometer measurements of physical activity and without chronic diseases or mobility limitations. Physical activity exposures included min per week of light (LPA), moderate-to-vigorous (MVPA), and vigorous (VPA) intensity physical activity, along with total weekly volume. Body mass index (BMI) was calculated from anthropometric measurements. Participants were categorized into 9 groups based on joint tertiles of physical activity and BMI categories (normal weight, overweight, and obesity). Secondary analyses included adiposity using bio-impedance and waist circumference measurements. The outcome was incidence and death from cancer retrieved from national registries. Associations between adiposity, physical activity, and cancer hazard were calculated as subdistribution hazard ratios. A secondary analysis focused on cancer types strongly associated with physical activity., Results: We observed 2625 events (2572 non-fatal and 53 fatal) during a median follow-up of 6.1 years. Compared with the referent (normal weight and high physical activity), overweight and obesity were associated with a 6% to 36% higher cancer hazard across physical activity intensities. However, high MVPA and VPA (approximately 500 min and 32 min per week in the top tertiles, respectively) attenuated the hazard associated with overweight and obesity. Being normal weight was not associated with a higher cancer hazard regardless of physical activity level. The results were similar, although more pronounced, when modeling cancer types strongly associated with physical activity as the outcome., Conclusion: High MVPA and VPA levels may attenuate the association of overweight and obesity with cancer hazard, but maintaining a normal weight seems comparatively more important than physical activity to reduce the hazard. Maintaining a healthy body weight and engaging in physical activity is needed to minimize risk of some cancer types., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024. Production and hosting by Elsevier B.V.)

Background: To revise and critically summarize the available scientific evidence regarding the effect of exercise on sleep quality in people with diabetes., Methods: Three electronic databases (MEDLINE/PubMed, PEDro Database and Scopus) were searched systematically from their inception until February 2024. The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database and Quality Assessment Tool for Before-After Studies with No Control Group scales., Results: A total of 7 randomized controlled trials and 3 single-arm studies were included. Most of the studies included patients with type 2 diabetes (n = 8). Self-reported sleep quality (n = 9) and objective sleep status (n = 1) were the main outcomes analysed. A variety of training programs were assessed over durations ranging from 4 to 16 weeks in the studies included. Data from eleven interventions demonstrated a significant improvement in self-reported sleep quality among patients with type 2 diabetes (Hedges' g -1.45; 95% CI -2.6; -0.29, p = 0.005). However, data synthesis indicated that participants who exercised did not obtain significant improvements on their self-reported sleep quality compared to those in the control groups (Hedges' g 1.40; 95% CI -1.36; 4.18, p = 0.111)., Conclusions: Preliminary evidence suggests that exercise can be prescribed to manage self-reported sleep quality in this population, although its effects may not surpass those of usual care., Competing Interests: Declarations. Ethical approval: This article does not contain any studies with human participants or animals performed by any of the authors. Conflict of interest: All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Physical activity and sedentary time are associated with multiple health outcomes, and benefits also extend to those living with chronic conditions. These observations are primarily based on data from studies in which self-reported data assessed physical activity. Recent data where physical activity and sedentary time are measured with devices suggest that the dose-response association between device-measured physical activity and risk of incident diseases and mortality is greater and observed at lower levels of physical activity than indicated by self-reported data., (Published under Open Access CC-BY-NC-BD 4.0. https://creativecommons.org/licenses/by-nc-nd/4.0/.)

This study aims to review the scientific evidence regarding the effects of table tennis practice on children and adolescents. Studies were searched in three electronic databases (PubMed, Scopus, and SportDiscus) from their inception up to May 2024. The methodological quality of the included studies was assessed using the 10-point Physiotherapy Evidence Database (PEDro) and Methodological Index for Non-Randomized Studies (MINORS). A total of twelve studies were examined, with interventions involving children with intellectual disabilities, ADHD, DCD, ASD, and typically developing children. A variety of training programs were assessed over durations ranging from 6 weeks to 1 year in the studies included. Table tennis was shown to positively impact various domains, including executive function, motor skills, visual perception, graphomotor function, gross motor skills, coordination capacity, behavioral inhibition, and social behavior. Nonetheless, it is imperative to expand the number of studies on children and adolescents with diverse conditions to more comprehensively evaluate the benefits of table tennis for each specific condition.

(1) Background: This study explores the potential energy expenditure associated with participation in after-school sports activities among primary school children. (2) Methods: The study involved 129 children age (11.35 ± 0.55 years) recruited from eight different public after-school sport programs. (3) Results: Data analyses revealed significant differences between the eight sports in total calories per session, calories per minute, and METs ( p < 0.05). All sports showed higher energy expenditure compared to chess ( p < 0.05), with soccer and rugby exhibiting the highest energy expenditure per session. Team sports showed elevated energy consumption per session ( p < 0.01, r > 0.30), calories per minute ( p = 0.01, r > 0.40), and METs ( p < 0.01, r > 0.40) in comparison with individual sports. (4) Conclusions: These findings enhance our understanding of the energy expenditure observed in primary school children following various after-school sports activities. The results indicate that team sports, in particular, are pivotal in elevating physical activity levels, thereby playing an essential role in fostering healthier lifestyles among children.

Competing Interests: DD reports funding from the National Health and Medical Research Council, New South Wales Health, and the Ian Potter Foundation. DS reports funding from the US National Institutes of Health and the Forest Park Foundation, royalties from Human Kinetics, consulting fees from the National Institute of Public Health of Mexico and Washington University in St Louis, lecture honoraria from Washington University in St Louis, and travel support from the National Institute of Public Health, Mexico. All other authors declare no competing interests.

Objective: We aimed to analyze and summarize the available scientific evidence on the benefits of Nordic walking for people with chronic pain and fatigue., Literature Survey: This systematic review adhered to PRISMA guidelines and conducted a comprehensive search across five databases using the PICO strategy., Methodology: Inclusion criteria encompassed randomized trials evaluating Nordic walking for pain and fatigue. Two authors independently screened studies, extracted data, and assessed methodological quality using the PEDro scale., Synthesis: A total of 14 studies were included, with sample sizes ranging from 20 to 136 participants. The methodological quality of the included studies varied from fair (five studies) to good (nine studies). The interventions consisted of supervised Nordic walking sessions lasting 6 to 24 weeks, with a frequency of 2 to 4 days per week and duration of 25 to 75 min. The results of this review suggest that Nordic walking had beneficial effects in six of the eight studies that analyzed participant fatigue. However, Nordic walking did not show greater beneficial effects on fatigue than walking (two studies) or than not performing physical activity (one study). Additionally, six of the nine studies that examined the effects of Nordic walking on participants' perceptions of pain showed beneficial results. However, five studies that compared Nordic walking with control groups did not find any significant inter-group differences on pain., Conclusions: Based on our findings, Nordic walking exercise programs provide a potentially efficient method for alleviating pain and fatigue in people with chronic conditions. Its straightforwardness and ease of learning make it accessible to a broad spectrum of participants, which can result in higher adherence rates and lasting positive effects.

Body dissatisfaction is commonly associated with rhythmic gymnastics (RG) practice, but limited research exists on the prevalence of this issue among recreational level practitioners. This study examines body image dissatisfaction among young girls practicing RG recreationally. A total of 88 girls between six and eleven years of age, who participate in RG as an extracurricular activity, were measured and completed the Stunkard pictogram. To create a control group, 88 girls who did not practice RG were also recruited and matched to the gymnasts by age. Results revealed that the mean body mass index values in both groups were within the normal weight range. The mean score for body dissatisfaction was similar between the two groups, with slightly positive values (RG = 0.94; CG = 1.06). The Mann-Whitney U test showed that there was no significant difference in the ratings of actual body size, ideal body size, and body dissatisfaction between the RG and control groups. These findings suggest that practicing RG at a young age is not associated with body dissatisfaction among girls.

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.

Purpose: This study aimed to quantify the dose-response association and the minimal effective dose of leisure-time physical activity (PA) to prevent mortality and cardiovascular disease in adults with type 2 diabetes., Methods: Cross-country comparison of 2 prospective cohort studies including 14,913 and 17,457 population-based adults with type 2 diabetes from the UK and China. Baseline leisure-time PA was self-reported and categorized by metabolic equivalent hours per week (MET-h/week) according to World Health Organization recommendations: none, below recommendation (>0-7.49 MET-h/week); at recommended level (7.5-14.9 MET-h/week); above recommendation (≥15 MET-h/week). Mortality and cardiovascular disease data were obtained from national registries., Results: During a median follow-up of 12.4 and 9.7 years, in the UK and China cohorts, repectively, higher levels of leisure-time PA were inversely associated with all-cause (1571 and 2351 events) and cardiovascular mortality (392 and 1060 events), mostly consistent with a linear dose-response relationship. PA below, at, and above recommendations, compared with no activity, yielded all-cause mortality hazard ratios of 0.94 (95% confidence interval (95%CI): 0.79-1.12), 0.90 (95%CI: 0.74-1.10), and 0.85 (95%CI: 0.70-1.02) in British adults and 0.87 (95%CI: 0.68-1.10), 0.88 (95%CI: 0.74-1.03), and 0.77 (95%CI: 0.70-0.85) in Chinese adults. Associations with cardiovascular mortality were more pronounced in British adults (0.80 (95%CI: 0.58-1.11), 0.75 (95%CI: 0.52-1.09), and 0.69 (95%CI: 0.48-0.97)) but less pronounced in Chinese adults (1.06 (95%CI: 0.76-1.47), 1.01 (95%CI: 0.80-1.28), and 0.79 (95%CI: 0.69-0.92)). PA at recommended levels was not associated with lower rates of major adverse cardiovascular events (2345 and 4458 events)., Conclusion: Leisure-time PA at the recommended levels was not convincingly associated with lower mortality and had no association with risk of major adverse cardiovascular events in British or Chinese adults with type 2 diabetes. Leisure-time PA above current recommendations may be needed to prevent cardiovascular disease and premature mortality in adults with type 2 diabetes., (Copyright © 2024. Production and hosting by Elsevier B.V.)

Objective: To examine the joint associations between physical activity and abdominal obesity with the risk of cardiovascular disease (CVD) events., Methods: We included 70 830 UK Biobank participants (mean age±SD=61.6 ± 7.9 years; 56.4% women) with physical activity measured by wrist-worn accelerometers and without major chronic diseases. Participants were jointly categorised into six groups based on their physical activity level (tertiles of total volume and specific intensity levels) and presence or absence of abdominal obesity based on measured waist circumference. Associations with incident CVD (fatal and non-fatal events) were determined using proportional subdistribution hazard models with multivariable adjustment., Results: After excluding events during the first 2 years of follow-up, participants were followed for a median of 6.8 years, during which 2795 CVD events were recorded. Compared with the low abdominal adiposity and highest tertile of physical activity, abdominal obesity was associated with higher risk of incident CVD, especially in those with low levels of vigorous-intensity physical activity (HR 1.42, 95% CI 1.22 to 1.64). Approximately 500 min per week of moderate-to-vigorous intensity and approximately 30-35 min of vigorous-intensity physical activity offset the association of abdominal obesity and the risk of having a CVD event., Conclusion: Physical activity equivalent to approximately 30-35 min of vigorous intensity per week appears to offset the association between abdominal obesity and incident CVD. About 15 times more physical activity of at least moderate intensity is needed to achieve similar results., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Physical activity is consistently associated with reduced mortality, decreased risk for non-communicable diseases, and improved mental health in observational studies. Randomized controlled trials and observational Mendelian randomization studies support causal links between physical activity and health outcomes. However, the scarcity of evidence from randomized controlled trials, along with their inherent challenges like exposure contrasts, healthy volunteer biases, loss to follow-up, and limited real-world dose-response data, warrants a comprehensive approach. This review advocates synthesizing insights from diverse study designs to better understand the causal relationship between physical activity, mortality risk, and other health outcomes. Additionally, it summarizes recent research since the publication of current physical activity recommendations. Novel observational studies utilizing device-measured physical activity underscore the importance of every minute of activity and suggest that all intensity levels confer health benefits, with vigorous-intensity potentially requiring lower volumes for substantial benefits. Future guidelines, informed by device-measured physical activity studies, may offer refined age-specific recommendations, emphasize vigorous-intensity physical activity, and include daily step counts as a simple, easily assessable metric using commercial wearables., Competing Interests: Competing interests The authors declare that they have no competing interests., (Copyright © 2023. Production and hosting by Elsevier B.V.)

Objective: The aim of this study was to determine dose-response associations, including the minimal effective level, between leisure-time physical activity and risk of incident neuropathy, nephropathy, and retinopathy., Research Design and Methods: This cohort study included 18,092 individuals with type 2 diabetes from the UK Biobank. Self-reported leisure-time physical activity was converted into MET-hours per week. Participants were categorized into no physical activity (0 MET-h/week), below recommendations (0-7.49 MET-h/week), at recommendations (7.5-14.9 MET-h/week), and above recommendations (≥15 MET-h/week). Microvascular complications were identified from hospital inpatient records using diagnosis codes. We used Cox proportional hazards regression analysis to calculate adjusted hazard ratios (aHRs) and restricted cubic splines to identify the minimal effective level of physical activity., Results: During a median follow-up of 12.1 years, 672 individuals (3.7%) were diagnosed with neuropathy, 1,839 (10.2%) with nephropathy, and 2,099 (11.7%) with retinopathy. Any level of physical activity was associated with a lower risk of neuropathy and nephropathy but not retinopathy. Compared with those reporting no physical activity, the aHR of neuropathy was 0.71 (95% CI 0.53, 0.90) below recommendations, 0.73 (0.56, 0.96) at recommendations, and 0.67 (0.52, 0.87) above recommendations. Corresponding aHRs for nephropathy were 0.79 (0.68, 0.92), 0.80 (0.67, 0.95), and 0.80 (0.68, 0.95). The association with retinopathy was weaker, with aHRs of 0.91 (0.78, 1.06), 0.91 (0.77, 1.08), and 0.98 (0.84, 1.15), respectively., Conclusions: Any level of leisure-time physical activity was associated with a lower risk of neuropathy and nephropathy but not retinopathy in individuals with type 2 diabetes. For both neuropathy and nephropathy, the minimal effective physical activity level may correspond to <1.5 h of walking per week., (© 2023 by the American Diabetes Association.)

Background: How the association between adiposity and the risk of death changes with age, and which is the optimal level of adiposity to reduce mortality in older ages, is still not completely understood. We aimed to ascertain the age-specific risks of mortality associated with different measures of adiposity., Methods: This was a prospective UK Biobank cohort study. Participants were categorized based on five different adiposity and body composition metrics. We explored the age-varying associations between body composition indices and all-cause mortality from 45 to 85 years of age at follow-up using hazard ratios (HR) from flexible parametric survival models with multivariable adjustment and age as timescale. Participants were followed from baseline (2006-2010) through 31 March 2020., Results: We included 369,752 participants (mean baseline age = 56.3 ± 8.1 years; range 38.9-73.7 years; 54.1% women) and 10,660 deaths during a median follow-up of 11.4 years. Associations between body mass index and mortality were similar when using the fat mass index in magnitude and shape. Compared to participants with normal weight, overweight was not associated with the risk of death regardless of age and the adiposity measure used. Participants with obesity class I showed an HR of 1.20 (95% confidence interval [CI]: 1.08, 1.33) and 1.14 (95%CI: 0.98, 1.30) at ages 60 and 80, respectively, and participants with obesity class II an HR about 1.55 across all age. More attenuated associations with higher age were found in individuals with the highest obesity using the fat mass index. Very high lean mass was associated with an increased risk of mortality in those aged 55-75 years (HR about 1.20 across all ages)., Conclusion: Obesity should be prevented at any age. Attenuated associations with older age were observed only among the individuals with the highest obesity, but the risk remained higher compared to normal-weight participants. Lean mass did not reduce mortality risk at any age., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)

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.

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.

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., (© 2022 John Wiley & Sons Ltd.)

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.

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., (© 2022. The Author(s).)

Background: The feasibility and reliability of the Functional Movement Screen (FMS) battery for predicting injury risk have been widely studied in athletic, military, public service and healthy populations. However, scant research has been carried out in people with disabilities. This study aimed at identifying the feasibility and reliability of the FMS battery when administered to adults with intellectual disability (ID)., Methods: Adults from a residential and day care centre over 18 years of age, diagnosed with ID and able to follow simple instructions, were included in the study. All participants with behavioural or health problems that prevented the completion of the FMS battery were excluded. All exercises were video recorded to assure proper scoring. Three assessors (one trained and two novices) scored each of the FMS subtests performed separately from the videos. Feasibility was based on completion rates. Reliability of the composite test scores was analysed using intraclass correlation coefficients (ICCs)., Results: A total of 30 people with ID (mean age: 35.5 ± 7.12 years; 33.3% women) completed all assessments. The battery showed to be feasible, although difficulties when performing two of the subtests were observed among those with moderate and severe ID. Mean total scores from the three assessors ranged from 7.83 to 8.90. An inverse trend was observed indicating that the higher the ID level, the lower the total FMS score. Test-retest reliability was good for the trained assessor (ICC = 0.89) and mostly moderate for both novice assessors (ICC range: 0.60 to 0.76). Moderate to good inter-rater reliability was observed (ICC range: 0.65 to 0.80)., Conclusion: The FMS battery is a reliable tool that can be performed by people with ID, albeit with certain difficulties, especially in those with moderate to severe impairment. The battery does not seem to be useful for identifying people with ID at risk of suffering a sport injury. Adequately powered, well-designed studies are required to determine if the FMS battery is appropriate for identifying changes in functional performance in this population., (© 2022 The Authors. Journal of Intellectual Disability Research published by MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.)

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.

Background: Efforts to synthesise existing knowledge concerning the effects of exercise interventions on obesity (i.e. changes in body weight and composition) have been made, but scientific evidence in this matter is still limited. This systematic review and meta-analysis aims to identify and critically analyse the best available evidence regarding the use of physical exercise as a strategy to attenuate obesity through its effects on adiposity-related anthropometric parameters in people with intellectual disability (ID)., Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a literature search was performed using PubMed, Scopus, SPORTDiscus, CINAHL and the Cochrane Library through specific keywords up to July 2020. The search adhered to the population, intervention, comparison and outcome strategy. Randomised controlled trials addressing the effects of the exercise intervention on adiposity-related anthropometric parameters (body mass index, waist circumference, waist-hip ratio, fat percentage or body weight) in children, adolescents and adults with ID were included. The methodological quality of the studies found was evaluated through the PEDro scale., Results: A total of nine investigations with children and/or adolescents (10-19 years) and 10 investigations with adults (18-70 years) were selected, mostly experiencing mild and moderate ID. Methodological quality was fair in 13 of these publications, good in five and excellent in one. Seventeen trials reported comparable baseline and post-intervention data for the intervention and control groups and were included in the meta-analysis. In nine studies, the intervention group performed a cardiovascular training programme. Five papers described a combined training programme. Two trials executed whole-body vibration training programmes, and one publication proposed balance training as the primary intervention. According to the meta-analysis results, the reviewed studies proposed exercise modalities that, in comparison with the activities performed by the participants' in the respective control groups, did not have a greater impact on the variables assessed., Conclusions: While physical exercise can contribute to adiposity-related anthropometric parameters in people with mild and moderate ID, these findings show that exercise alone is not sufficient to manage obesity in this population. Multicomponent interventions appear to be the best choice when they incorporate dietary deficit, physical activity increase and behaviour change strategies. Finding the most effective modality of physical exercise can only aid weight loss interventions. Future research would benefit from comparing the effects of different exercise modalities within the framework of a multicomponent weight management intervention., (© 2022 The Authors. Journal of Intellectual Disability Research published by MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.)

Background: The aim of the study was to identify the reliability and validity of the SAPF questionnaire and the Stunkard rating scale in determining self-perceived physical appearance and the degree of body dissatisfaction in a group of elderly Spanish people., Methods: Both instruments were adapted to Spanish people and were administered twice to a group of 86 elderly people. Their reliability and validity were assessed by means of the intraclass correlation coefficient (ICC), Cronbach's alpha and Spearman's rho coefficient, from the physical fitness level of the participants and their body mass index (BMI). ANOVA test was carried out to compare the variables with normal distribution., Results: The questionnaire and the Stunkard rating scale showed a good test-retest reliability (ICC=0.78 and ICC=0.8, respectively). SAPF and fitness level showed a significant, albeit weak, association (rho=0.424), while the association between self-perception of body composition and BMI was moderately strong (rho=0.727). The self-perceived physical appearance of 59.5% of the sample was acknowledged to be normal, 11.4% perceived it as bad and 29.1% as good. Only 27.1% were satisfied with their body image, while the other participants showed a desire to lose the equivalent weight of one (47.06%), two (22.35%) or three or more (3.5%) points in the Stunkard scale., Conclusion: The versions of both instruments adapted to Spanish persons showed reliability and validity, and showed that it was possible to determine that a large part of the sample was dissatisfied with their body image. BMI had a significant influence in this regard.

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 I 2 statistic. Fixed-effect or random-effects models were applied to obtain the pooled results in the case of low (I 2 < 30%) or high (I 2 > 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., (Copyright © 2021. Published by Elsevier B.V.)

This systematic review aimed to identify and summarize the reliability and validity of the questionnaires that have been designed for assessing self-perceived physical fitness (PF) in elderly people. Three electronic databases (MEDLINE/PubMed, SPORTDiscuss and Scopus) were searched systematically from their inception until March 2021 in order to find investigations that provided information on the reliability and/or validity of questionnaires used for identifying self-perceived PF in this population. Nine studies fulfilled these criteria, and seven questionnaires were found, five of them being specifically designed for the elderly. Concurrent validity was mostly obtained by correlating the items of the questionnaires with PF field-based tests, and poor to moderately strong associations were obtained. Test-retest reliability was informed in five questionnaires, and high values were generally observed. The SRFit questionnaire showed the best rates of concurrent validity and test-retest reliability, although these results were partially affected by the mean age of the sample. The lack of a rigorous methodological approach when designing these questionnaires detected in this review, asks for further studies using quantitative and qualitative approaches in order to create more solid and valid measurement tools., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Exercise performed at home could be a useful therapy for people with chronic kidney disease. This systematic review and meta-analysis aimed at describing the characteristics, main findings, methodological quality, and adherence rate reported in the existent randomized controlled trials that have provided information regarding the impact of home-based exercise programs on people with chronic kidney disease., Methods: Electronic databases (MEDLINE/PubMed, SPORTDiscus, Scopus, and CENTRAL) were searched up to April 2021, using the keywords: "Exercise"; "Home"; "Kidney Disease." Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was adopted. Jadad scale and Cochrane's tool were used to assess the methodological quality and risk of bias., Results: Out of the 14 studies finally selected, 11 were included in the meta-analysis and most presented high methodological quality. The meta-analysis showed significant effects of home-based exercise on fitness and quality of life, but a little impact on renal function. Although exercise performed at home was mostly feasible and safe, adherence was not high and a considerable number of dropouts were observed., Conclusion: Home-based exercise has positive effects on the fitness' level and on the quality of life on people with chronic kidney disease. Future studies are needed to identify whether exercise performed at home is a better physical therapy option than center-based exercise.

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.

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., Competing Interests: The authors declare that they have no conflict of interest, (Thieme. All rights reserved.)

Objective: The purpose of this study was to analyze the validity and provide normative values for the three-min shuttle run test in Spanish preschoolers., Methods: A total of 497 children (mean age 4.83±0.57 years; 47.8% girls) performed the three-min shuttle run test. Posttest body mass index and heart rate values were taken as internal validity indicators., Results: Age- and sex-specific percentiles for cardiorespiratory fitness were provided. Boys performed better than girls in the test. A significant association was observed between the total distance covered and heart rate (p=0.002). No correlation was found between body mass index and the test score, although the total distance covered by normal weight and obese children was significantly different (296.9 versus. 271.3 m; p=0.013)., Conclusions: This study provides age- and sex-specific cardiorespiratory fitness normative values for the three-min shuttle run test when performed by Spanish preschoolers. This test is an interesting option when the lack of resources limits the measurement of cardiorespiratory fitness in the preschool setting.

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., Competing Interests: The authors declare that there is no conflict of interest., (© The British Society of Developmental Disabilities 2021.)

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., (© 2021 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of Society on Sarcopenia, Cachexia and Wasting Disorders.)

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.

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., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 López-Valenciano, Suárez-Iglesias, Sanchez-Lastra and Ayán.)

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., Competing Interests: Declaration of competing interest The authors declare that there is no conflict of interest, (Copyright © 2020 Elsevier Inc. All rights reserved.)

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/m 2 . 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/m 2 ., (Copyright © 2020 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.)

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.

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.

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.

Background: The promotion of physical activity among imprisoned people is a public health strategy that could help to improve the health status of this collective. This systematic review is aimed at reviewing the scientific evidence regarding the effects of exercise training programs performed by inmates., Methods: A systematic search for randomized controlled trials aimed at identifying the characteristics and effects of prison-based exercise training programs on imprisoned people was carried through MEDLINE, SPORTDiscus, and Scopus., Results: A total of 11 randomized controlled studies were selected, and the methodological quality of these was acceptable according to the Downs and Black scale. The proposed interventions were mainly based on the performance of aerobic or combined exercise training programs. Generally, the participants were healthy men who were imprisoned for at least 2 months and up to 15 years. Ten out of the 11 studies reported significant changes on physical and mental health-related variables, after the intervention took place., Conclusion: These findings suggest that prison-based exercise programs constitute a feasible and useful strategy for improving the physical and mental health status of prisoners.