Open Access
Tailored exercise is safe and beneficial for acutely hospitalised older adults with COPD
(European Respiratory Society, 2020) Martínez Velilla, Nicolás; Valenzuela, Pedro L.; Zambom Ferraresi, Fabrício; López Sáez de Asteasu, Mikel; Ramírez Vélez, Robinson; García Hermoso, Antonio; Lucía, Alejandro; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
Open Access
Ideal cardiovascular health status and health-related quality of life in adolescents: the labmed physical activity study
(Sao Paulo Pediatric Society, 2021) Agostinis-Sobrinho, César; Werneck, André de Oliveira; Kievišienė, Justina; Moreira, Carla; Ramírez Vélez, Robinson; Ciencias de la Salud; Osasun Zientziak
Objective: Adolescent's ideal cardiovascular health index (ICVH) seems to be an important indicator of youth's lifestyles and cardiometabolic health with potential positive consequences for their Health-Related Quality of Life (HRQoL). The purpose of this study was to examine the associations between the ICVH index and HRQoL in adolescents. Methods: This was a cross-sectional study based on secondary analyses from the LabMed Physical Activity Study (n=407 adolescents, 53% girls). ICVH, as defined by the American Heart Association, was determined as meeting ideal behaviors (physical activity, body mass index, smoking status, and diet intake) and health factors (blood pressure, total glucose, and cholesterol). HRQoL was measured with the Kidscreen-10 self-report questionnaire. Results: Analysis of covariance (ANCOVA) showed a significant association between the accumulation of ideal cardiovascular health metrics and HRQoL (F(4,403)=4.160; p=0.003). In addition, the higher the number of ideal health behaviors accumulated, the higher the mean values of HRQoL (p-value for trend=0.001), after adjustments for age, sex, socioeconomic status and pubertal stage. Conclusions: ICVH index was positively associated with HRQoL in adolescents. Ideal health behaviors metrics seem to have a stronger association with HRQoL than the ideal health factors metrics in adolescents.
Open Access
Evaluación de los dominios de la actividad física y los componentes de la condición física en niños de 4-5 años en un centro de salud
(Lúa Ediciones 3.0, 2023) Legarra Gorgoñón, Gaizka; García Alonso, Yesenia; Ramírez Vélez, Robinson; Erice Echegaray, Blanca; Moreno González, Paula; Izquierdo Redín, Mikel; Alonso Martínez, Alicia; Ciencias de la Salud; Osasun Zientziak
Introducción: la falta de actividad física y el sedentarismo en niños se asocia con una mayor adiposidad, bajo nivel de aptitud cardiovascular y riesgo de enfermedades cardiovasculares. Sin embargo, cumplir con las recomendaciones de actividad física se relaciona con mejoras en la salud mental, disminución de la ansiedad y depresión, así como adopción de hábitos saludables. Objetivos: evaluar la relación entre los diferentes dominios de la actividad física y del sedentarismo, medidos de forma objetiva, y los componentes de la condición física en niños españoles de 4 y 5 años. Población y métodos: estudio transversal dentro del proyecto 'Observatorio y programa de intervención de ejercicio físico y estilos de vida en familia para niños y niñas de 4 a 5 años en Atención Primaria' (https://observatorioactividadfisica.es). La condición física se evaluó con la batería PREFIT y la cantidad e intensidad de actividad física mediante un acelerómetro tri-axial GENEActiv durante 7 días consecutivos las 24 horas del día. Resultados: la muestra evaluada fue de 70 niños (38 niños y 32 niñas) con una media (intervalo de confianza [IC] del 95%) de 4,83 años. No se observaron diferencias significativas en la condición física entre niños y niñas. Los niños realizaron una actividad física de mayor intensidad y tiempo que las niñas. Además, se encontró una fuerte relación significativa entre los componentes de la condición física y los dominios de la actividad física. Conclusiones: estos hallazgos resaltan la importancia de promover estilos de vida activos desde temprana edad y la necesidad de programas de entrenamiento estructurado para reducir el sedentarismo y mejorar la condición física en esta población.
Open Access
Tracking of physical fitness levels from childhood and adolescence to adulthood: a systematic review and meta-analysis
(AME Publishing, 2022) García Hermoso, Antonio; Izquierdo Redín, Mikel; Ramírez Vélez, Robinson; Ciencias de la Salud; Osasun Zientziak
Background: prospective and large studies indicate that high physical fitness levels during young are beneficial for health during adulthood. The aim of the study was to investigate the tracking of physical fitness components from childhood and/or adolescence to adulthood. Methods: two authors systematically searched MEDLINE and Web of Science electronic databases for relevant articles. Studies with apparently healthy youth aged 6-18 years who track their physical fitness to adulthood were included. Our study carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Correlation coefficients (r) were used as effect size. Random-effects models were used to estimate the pooled effect size. Correlation coefficients were interpreted as follows: <0.30 low stability, 0.30 to 0.60 moderate stability, and >0.60 high stability. Risk of bias of each study was determined by The Quality Assessment Tool for Observational Cohort and Cross-sectional Studies. Results: twenty-one prospective studies were included in the meta-analysis (n=6,197 participants at follow-up, 47.4% women). The mean length of follow-up was 20.8 years. Overall, cardiorespiratory fitness (r=0.38; 95% CI: 0.29-0.48; I2=92.7%), muscular strength (r=0.51; 95% CI: 0.43-0.59; I2=87.9%), and muscular endurance (r=0.50; 95% CI: 0.36-0.86; I2=94.5%) show moderate tracking from childhood and/or adolescence to adulthood, independent of test used and length of follow-up. This moderate tracking was slightly stronger in women than in men and from adolescence compared to childhood. Trunk flexibility component, assessed with the sit and reach test, exhibits high stability (r=0.69; 95% CI: 0.58-0.81; I2=92.9%). Interestingly, meta-regression analysis shows positive association between correlation coefficient for flexibility and the length of follow-up (β =0.017; 95% CI: 0.012-0.021). Discussion: although the current study found inconsistency between results, the findings suggest that acquiring high physical fitness levels should be targeted already from childhood and adolescence given that low levels of fitness in adulthood are related with several chronic diseases and mortality.
Open Access
Resistance training and clinical status in patients with postdischarge symptoms after COVID-19: protocol for a randomized controlled crossover trial 'The EXER-COVID Crossover Study'.
(BMC, 2022) Ramírez Vélez, Robinson; Oteiza Olaso, Julio; Casas Fernández de Tejerina, Juan Manuel; García Alonso, Nora; Legarra Gorgoñón, Gaizka; Oscoz Ochandorena, Sergio; Arasanz Esteban, Hugo; García Alonso, Yesenia; Correa Rodríguez, María; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
Background: physical exercise induces a coordinated response of multiple organ systems, including the immune system. In fact, it has been proposed that physical exercise may modulate the immune system. However, the potential effect of an exercise program on COVID-19 survivors has not been investigated. Thus, the aim of this study is to evaluate the modifications in immunological parameters, physical condition, inflammatory profile, and perceived persistent symptoms after 6 weeks of supervised resistance training (RT), in addition to the standard care on the clinical status of patients with persistent COVID-19 symptoms. The objective of this protocol is to describe the scientific rationale in detail and to provide information about the study procedures. Methods/design: a total of 100 patients with postdischarge symptoms after COVID-19 will be randomly allocated into either a group receiving standard care (control group) or a group performing a multicomponent exercise program two times a week over a period of 6 weeks. The main hypothesis is that a 6-week multicomponent exercise program (EXER-COVID Crossover Study) will improve the immunological and inflammatory profile, physical condition, and persistent perceived symptoms (fatigue/tiredness, musculoskeletal pain, and shortness of breath) in patients with postdischarge symptoms after COVID-19. Discussion: our results will provide insights into the effects of a multicomponent exercise program on immunological parameters, physical condition, inflammatory profile, and persistent perceived symptoms in patients with postdischarge symptoms after COVID-19. Information obtained by this study will inform future guidelines on the exercise training rehabilitation of patients with postdischarge symptoms after COVID-19.
Open Access
Association of cardiorespiratory fitness levels during youth with health risk later in life: a systematic review and meta-analysis.
(American Medical Association, 2020-08-31) García Hermoso, Antonio; Ramírez Vélez, Robinson; García Alonso, Yesenia; Alonso Martínez, Alicia; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Importance Although the associations between cardiorespiratory fitness (CRF) and health in adults are well understood, to date, no systematic review has quantitatively examined the association between CRF during youth and health parameters later in life. Objectives To examine the prospective association between CRF in childhood and adolescence and future health status and to assess whether changes in CRF are associated with future health status at least 1 year later. Data Sources For this systematic review and meta-analysis, MEDLINE, Embase, and SPORTDiscus electronic databases were searched for relevant articles published from database inception to January 30, 2020. Study Selection The following inclusion criteria were used: CRF measured using a validated test and assessed at baseline and/or its change from baseline to the end of follow-up, healthy population with a mean age of 3 to 18 years at baseline, and prospective cohort design with a follow-up period of at least 1 year. Data Extraction and Synthesis Data were processed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Random-effects models were used to estimate the pooled effect size. Main Outcomes and Measures Anthropometric and adiposity measurements and cardiometabolic health parameters. Results Fifty-five studies were included with a total of 37 563 youths (46% female). Weak-moderate associations were found between CRF at baseline and body mass index (r = –0.11; 95% CI, –0.18 to –0.04; I2 = 59.03), waist circumference (r = –0.29; 95% CI, –0.42 to –0.14; I2 = 69.42), skinfold thickness (r = –0.34; 95% CI, –0.41 to –0.26; I2 = 83.87), obesity (r = –0.15; 95% CI, –0.23 to –0.06; I2 = 86.75), total cholesterol level (r = –0.12; 95% CI, –0.19 to –0.05; I2 = 75.81), high-density lipoprotein cholesterol (HDL-C) level (r = 0.11; 95% CI, 0.05-0.18; I2 = 69.06), total cholesterol to HDL-C ratio (r = –0.19; 95% CI, –0.26 to –0.13; I2 = 67.07), triglyceride levels (r = –0.10; 95% CI, –0.18 to –0.02; I2 = 73.43), homeostasis model assessment for insulin resistance (r = –0.12; 95% CI, –0.18 to –0.06; I2 = 68.26), fasting insulin level (r = –0.07; 95% CI, –0.11 to –0.03; I2 = 0), and cardiometabolic risk (r = –0.18; 95% CI, –0.29 to –0.07; I2 = 90.61) at follow-up. Meta-regression analyses found that early associations in waist circumference (β = 0.014; 95% CI, 0.002-0.026), skinfold thickness (β = 0.006; 95% CI, 0.002-0.011), HDL-C level (β = −0.006; 95% CI, −0.011 to −0.001), triglyceride levels (β = 0.009; 95% CI, 0.004-0.014), and cardiometabolic risk (β = 0.007; 95% CI, 0.003-0.011) from baseline to follow-up dissipated over time. Weak-moderate associations were found between change in CRF and body mass index (r = –0.17; 95% CI, –0.24 to –0.11; I2 = 39.65), skinfold thickness (r = –0.36; 95% CI, –0.58 to –0.09; I2 = 96.84), obesity (r = –0.21; 95% CI, –0.35 to –0.06; I2 = 91.08), HDL-C level (r = 0.05; 95% CI, 0.02-0.08; I2 = 0), low-density lipoprotein cholesterol level (r = –0.06; 95% CI, –0.11 to –0.01; I2 = 58.94), and cardiometabolic risk (r = –0.08; 95% CI, –0.15 to –0.02; I2 = 69.53) later in life. Conclusions and Relevance This study suggests that early intervention and prevention strategies that target youth CRF may be associated with maintaining health parameters in later life.
Open Access
Effect of high-intensity interval training on body composition, cardiorespiratory fitness, blood pressure, and substrate utilization during exercise among prehypertensive and hypertensive patients with excessive adiposity
(Frontiers Media, 2020) Delgado Floody, Pedro; Izquierdo Redín, Mikel; Ramírez Vélez, Robinson; Caamaño Navarrete, Felipe; Moris, Roberto; Jerez Mayorga, Daniel; Andrade, David C.; Álvarez, Cristian; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Regular exercise training is a recognized lifestyle strategy to lower resting blood pressure (BP), but little is known about substrate metabolism in population with high BP. Thus, the purpose of this study was to investigate the effects of 16-weeks of HIIT on body composition, BP, cardiorespiratory fitness by (Formula presented.) O2max, and substrate utilization during exercise among prehypertensive and hypertensive patients with excessive adiposity. We also aimed to test the potential association between changes in cardiorespiratory fitness, substrate utilization during exercise and BP. Forty-two physically inactive overweight/obese participants participated in 16-weeks of HIIT intervention. The HIIT frequency was three times a week (work ratio 1:2:10, for interval cycling: rest period: repeated times; 80–100% of the maximum heart rate). Groups were distributed based on their baseline BP: HIIT-hypertensive (H-HTN: age 47.7 ± 12.0 years; body mass index [BMI] 30.3 ± 5.5 kg/m2; systolic [SBP]/diastolic BP [DBP] 151.6 ± 10/81.9 ± 4.2 mmHg), HIIT-pre-hypertensive (H-PreHTN: age 37.6 ± 12.0 years; BMI 31.9 ± 5.3 kg/m2; SBP/DBP 134.4 ± 3.2/74.9 ± 7.0 mmHg), and a normotensive control group (H-CG: age 40.7 ± 11.0 years; BMI 29.5 ± 4.2 kg/m2; SBP/DBP 117.0 ± 6.2/72.4 ± 4.1 mmHg). Anthropometry/body composition, BP, and metabolic substrate utilization during exercise (fat [FATox], carbohydrate [CHOox] oxidation, respiratory exchange ratio [RER], and (Formula presented.) O2max), were measured before and after the 16-week HIIT intervention. Adjusted mixed linear models revealed a significant improved in (Formula presented.) O2max were + 3.34 in the H-CG, + 3.63 in the H-PreHTN, and + 5.92 mL⋅kg–1⋅min–1, in the H-HTN group, however, the Time × Group interaction were not significant (p = 0.083). All the exercise types induced similar decreases on SBP (−8.70) in the H-HTN, (−7.14) in the H-CG, and (−5.11) mmHg in the H-PreHTN, as well as DBP levels (−5.43) mmHg in H-CG group (p = 0.032 vs. H-HTN group). At 16-week, no significant correlations were noted for the changes of blood pressure, cardiorespiratory fitness or exercise metabolism substrates outcomes. In conclusion, our results suggest that a 16-week HIIT-intervention improved (Formula presented.) O2max and blood pressure BP, but these changes are independent of substrate utilization during exercise in normotensive and hypertensive participants with excessive adiposity.
Open Access
Effects of a multicomponent exercise program in older adults with non-small-cell lung cancer during adjuvant/palliative treatment: an intervention study
(MDPI, 2020) Rosero Rosero, Ilem Dayana; Ramírez Vélez, Robinson; Martínez Velilla, Nicolás; Cedeño Veloz, Bernardo Abel; Morilla Ruiz, Idoia; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Clinical intervention studies support the efficacy and safety of exercise programs as a treatment modality for non-small-cell lung cancer (NSCLC) during adjuvant/palliative treatment, but the effectiveness of real-world oncogeriatric services is yet to be established. We aimed to examine the effects of a 10-week structured and individualized multicomponent exercise program on physical/cognitive functioning and mental wellness in elderly patients with NSCLC under adjuvant therapy or palliative treatment. A non-randomized, opportunistic control, longitudinal-design trial was conducted on 26 patients with NSCLC stage I-IV. Of 34 eligible participants, 21 were allocated into two groups: (i) control group (n = 7) received usual medical care; and (ii) intervention group (n =19) received multicomponent program sessions, including endurance, strength, balance, coordination and stretching exercises. Tests included the Short Physical Performance Battery (SPPB), 5-m habitual Gait Velocity Test (GVT), Timed Up & Go Test (TUG), 6-Min Walk Test (6MWT), independence of activities in daily living (IADL), muscular performance, cognitive function, and quality of life, which were measured at baseline and after 10weeks of the program. Results revealed a significant groupxtime interaction for SPPB (p = 0.004), 5-m GVT (p = 0.036), TUG (p = 0.007), and muscular performance (chest and leg power; p < 0.001). Similarly, significant changes were observed between groups for cognitive functioning (p = 0.021) and quality of life for EUROQoL 5D (p = 0.006). Our findings confirm that a multicomponent exercise program improves measures of physical/cognitive functioning and quality of life in the elderly with NSCLC under adjuvant therapy or palliative treatment. This is an interesting and important study that adds to our current body of knowledge on the safety of exercise interventions, especially in the elderly with solid tumors.
Open Access
Twenty-four-hour movement guidelines during middle adolescence and their association with glucose outcomes and type 2 diabetes mellitus in adulthood
(Elsevier, 2022) García Hermoso, Antonio; López Gil, José Francisco; Ezzatvar, Yasmin; Ramírez Vélez, Robinson; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
Background: The aim of the present study was to determine the association between adherence to the 24-h movement guidelines during middle adolescence and glucose outcomes (glycated hemoglobin and fasting glucose) and type 2 diabetes mellitus (T2DM) in adulthood, 14 and 22 years later. Methods: We analyzed data from apparently healthy adolescents aged 12-18 years who participated in Waves I and II (1994-1996, n = 14,738), Wave IV (2008-2009, n = 8913), and Wave V (2016-2018, n = 3457) of the National Longitudinal Study of Adolescent to Adult Health (Add Health) in the United States. Physical activity, screen time, and sleep duration were measured using questionnaires, and the 24-h guidelines were defined as: 5 or more times moderate-to-vigorous physical activity per week, ≤2 h per day of screen time, and sleeping 8-10 h per day and or night. Capillary and venous whole blood was collected and analyzed to determine glycated hemoglobin and fasting glucose for Waves IV and V, respectively. Results: Only 2.1% of the adolescents met all the 3 guidelines, and 37.8% met none of them. In both waves IV and V, adolescents who met physical activity and screen time guidelines had lower odds of T2DM in adulthood than those who did not meet any of these guidelines (Wave IV; prevalence ratio (PR) = 0.57, 95%CI: 0.21-0.89; Wave V: PR = 0.43, 95%CI: 0.32-0.74). Only for Wave V did adolescents who met all three guidelines have lower odds of T2DM at follow-up compared with those who did not meet any of these guidelines (PR = 0.47, 95%CI: 0.24-0.91). Also, for each increase in meeting one of the 24-h recommendations, the odds of T2DM decreased by 18% (PR = 0.82, 95%CI: 0.61-0.99) and 15% (PR = 0.85, 95%CI: 0.65-0.98) in adulthood for Waves IV and V, respectively. Conclusion: Promoting all 24-h movement guidelines in adolescence, especially physical activity and screen time, is important for lowering the potential risk of T2DM in adulthood.
Open Access
Effects of a postoperative program in patients with shoulder stiffness following arthroscopic rotator cuff repair
(SAGE, 2022) Gutiérrez Espinoza, Héctor; Araya-Quintanilla, Felipe; Pinto Concha, Sebastián; Sepúlveda Loyola, Walter; Ramírez Vélez, Robinson; Fuentes Contreras, Jorge; Ciencias de la Salud; Osasun Zientziak
Background: The most common complication in the surgery for rotator cuff (RC) tears is postoperative shoulder stiffness. The evidence for the postoperative treatment of this condition is scarce. This study assessed the effects of a postoperative program at the onset of shoulder stiffness following arthroscopic RC repair. Methods: A single-group pre- and post-test design was included. Participants performed a 6-week program. Primary outcomes were shoulder and upper limb function assessed with the Constant–Murley and Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaires, respectively. Secondary outcomes included pain intensity at rest and during movement with the visual analog scale (VAS), and shoulder range of motion assessed with a goniometer. Results: A total of 115 adult males were included. The intervention produced a positive effect on the Constant–Murley (+35.6 points, p<0.001) and DASH questionnaire (−26.2 points, p=0.005); VAS at rest (−2.8 cm, p<0.001); VAS at movement (−2.7 cm, p<0.001); and shoulder ROMs. Conclusion: The program showed clinically and statistically significant benefits in most of the functional outcomes in the study participants.