Open Access
Effects of exercise training on glycaemic control in youths with type 1 diabetes: a systematic review and meta-analysis of randomised controlled trials
(Taylor & Francis, 2022) García Hermoso, Antonio; Ezzatvar, Yasmin; Huerta Uribe, Nidia; Alonso Martínez, Alicia; Chueca-Guindulain, María J.; Berrade-Zubiri, Sara; Izquierdo Redín, Mikel; Ramírez Vélez, Robinson; Ciencias de la Salud; Osasun Zientziak
The aim of the study is to evaluate whether exercise interventions are associated with improved glycaemic control in children and adolescents with type 1 diabetes mellitus (T1DM), and to examine its relationship with the characteristics of the intervention (i.e. type, intensity, length, and duration of the sessions). Eligible criteria were randomised controlled trials of youth aged 6– 18 years with T1DM, participating in an exercise-based intervention where glycaemic control is measured (i.e. glycated haemoglobin [HbA1c]). Pooled effect sizes (Hedges’g) were calculated using random-effects inverse-variance analyses. Fourteen studies enrolling 509 patients were analysed. Effect size was expressed as Hedges’ g to correct for possible small sample bias. Overall, HbA1c levels in the exercise group (g = –0.38 95% confidence interval [CI], –0.66 to –0.11; mean difference [MD] = –0.62%) were reduced compared with the control group. Concurrent training (g = –0.63 95%CI, –1.05 to –0.21), high-intensity exercise (g = –0.43 95%CI, –0.83 to –0.03), interventions ≥24 weeks (g = –0.92 95%CI, –1.44 to –0.40), and sessions ≥60 minutes (g = –0.71 95%CI, –1.05 to –0.08) showed larger changes (MD = –0.66% to 1.30%). In conclusion, our study suggests that programmes longer than 24 weeks with at least 60 min/session of high-intensity concurrent exercise may serve as a supportive therapy to metabolic control in youth with T1DM.
Open Access
Effect of a gamified family-based exercise intervention on adherence to 24-hour movement behavior recommendations in preschool children: single-center pragmatic trial
(JMIR Publications, 2025-03-04) Legarra Gorgoñón, Gaizka; García Alonso, Yesenia; Ramírez Vélez, Robinson; Alonso Martínez, Loreto; Izquierdo Redín, Mikel; Alonso Martínez, Alicia; Ciencias de la Salud; Osasun Zientziak; Ciencias humanas y de la educación; Giza eta Hezkuntza Zientziak; Gobierno de Navarra / Nafarroako Gobernua
Background: Adherence to 24-hour movement behavior recommendations, including physical activity (PA), sedentary time, and sleep, is essential for the healthy development of preschool children. Gamified family-based interventions have shown the potential to improve adherence to these guidelines, but evidence of their effectiveness among children is limited. Objective: This study aimed to evaluate the effectiveness of a gamified family-based exercise intervention in promoting adherence to 24-hour movement behavior recommendations among preschool-aged children. Methods: This 12-week study is a single-center, pragmatic randomized controlled trial that included 80 preschool children (56% boys) and their families, who were randomly assigned to either the gamification group (n=40) or the control group (n=40). The “3, 2, 1 Move on Study” incorporates family-oriented physical activities and gamification techniques to increase PA domains, reduce sedentary behavior, and improve sleep patterns. The primary outcome was to increase moderate to vigorous PA (MVPA) by 5 minutes/day, as measured by accelerometer at follow-up. Accelerometer-determined daily time spent (PA domains, sedentary behavior, and sleep), physical fitness (cardiorespiratory, speed-agility, muscular, physical fitness z-score), basic motor competencies (self-movement and object movement), and executive function (memory, cognitive flexibility, and inhibitory control) were also included as secondary outcomes. Results: The 71 participants included in the per-protocol analyses (32 girls, 45%; 39 boys, 55%) had a mean (SD) age of 5.0 (0.5) years. Change in MVPA per day after the intervention (12 weeks) increased in both groups by +25.3 (SD 24.6) minutes/day in the gamification group and +10.0 (SD 31.4) minutes/day in the routine care group, but no significant between-group differences were observed (8.62, 95% CI –5.72 to 22.95 minutes/day, ηp2=.025; P=.23). The analysis of secondary outcomes showed significant between-group mean differences in the change in physical behaviors derived from the accelerometers from baseline to follow-up of 26.44 (95% CI 8.93 to 43.94) minutes/day in favor of light PA (ηp2=.138; P=.01) and 30.88 (95% CI 4.36 to 57.41) minutes/day in favor of total PA, which corresponds to a large effect size (ηp2=.087; P=.02). Likewise, the gamification group substantially increased their score in standing long jump and physical fitness z-score from baseline (P<.05). Conclusions: In the “3, 2, 1 Move on Study,” a gamified intervention showed a modest but relevant increase in MVPA and other domains of 24-hour movement behavior among preschool-aged children. Therefore, gamified family-based interventions may provide a viable alternative to improve adherence to 24-hour movement behavior recommendations.
Open Access
High muscular fitness has a powerful protective cardiometabolic effect in adults: influence of weight status
(BioMed Central, 2016) Ramírez Vélez, Robinson; Correa Bautista, Jorge Enrique; Lobelo, Felipe; Izquierdo Redín, Mikel; Alonso Martínez, Alicia; Rodríguez Rodríguez, Fernando; Cristi Montero, Carlos; Ciencias de la Salud; Osasun Zientziak
Background: Low levels of muscular fitness (MF) are recognized as an important marker of nutritional status and a predictor of metabolic complications, cardiovascular disease and death, however, the relationship between MF, body mass index (BMI) and the subsequent cardiometabolic protective effects has been less studied among Latin American populations. This study identified an association between MF and the cardiometabolic risk score index (CMRSI) and the lipid-metabolic cardiovascular risk index (LMCRI) in a wide sample of university students grouped according to their BMI. Methods: Six thousand ninety five healthy males (29.6 ± 11.7 year-old) participated in the study. Absolute strength was measured using a T.K.K. analogue dynamometer (handgrip), and the participant’s strength was then calculated relative to their body mass (MF/BM). The LMCRI was derived from the levels of triglycerides, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), and glucose levels in a blood sample. The CMRSI was calculated by summing the standardized residuals (z-score) for waist circumference, total cholesterol, LDL-c, triglycerides, HDL-c, and median blood pressure. Subjects were divided into six subgroups according to BMI (normal vs. overweight/obese) and MF/BM tertiles (unfit, average, fit). Results: The group of participants with low and moderate levels of MF/BM showed higher CMRSI values independent of BMI (P < 0.001). The group with normal BMI and high MF/BM had the highest levels of cardiometabolic protection. All overweight/obese BMI groups had significantly higher LMCRI values independent of the level of MF/BM (P < 0.001). Conclusions: Participants with high MF/BM showed reduced cardiometabolic risk, which increased significantly when they were within normal parameters.

Alonso Martínez, Alicia

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