Open Access
Validation and application of two new core stability tests in professional football
(MDPI, 2020) Etxaleku, Saioa; Izquierdo Redín, Mikel; Bikandi Latxaga, Eder; García Arroyo, Jaime; Setuain Chourraut, Igor; Ciencias de la Salud; Osasun Zientziak
The purpose of the first study was to validate two newly proposed core stability tests; Prone Plank test (PPT) and Closed Kinetic Chain test (CCT), for evaluating the strength of the body core. Subsequently, these tests were employed in a longitudinal prospective study implementing a core stability training program with a professional Spanish football team. For the validation study, 22 physically active men (Tegner Scale 6-7) performed three trials of the PPT and CCT tests in two different testing sessions separated by one week. In the longitudinal study, 13 male professional football players were equally evaluated (PPT and CCT) before and after the competitive session in which they completed a core training program. Intra-/intersession, and intertester, reliability was analyzed. PPT and CCT demonstrated excellent to good test-retest reliability and acceptable error measurement (ICCs for intratester and intrasession reliability ranged from 0.77 to 0.94 for the PPT, and 0.8-0.9 for the CCT) in all but one of the testing conditions (female tester for CCT test; ICC = 0.38). Significant improvements on core strength were found from pre to post evaluation in both the PPT (p < 0.01) and CCT (p < 0.01) after the implementation of a core training program in professional football players.
Open Access
Benefits of aquatic exercise in adults with and without chronic disease: a systematic review with meta-analysis
(Wiley, 2021) Faíl, Luís Brandão; Marinho, Daniel; Marques, Elisa A.; Costa, Mário J.; Santos, Catarina C.; Marqués, Mário C.; Izquierdo Redín, Mikel; Neiva, Henrique P.; Ciencias de la Salud; Osasun Zientziak
Aquatic exercise is being increasingly recommended for healthy individuals as well as people with some special health conditions. A systematic review with meta-analysis was performed to synthesize and analyze data on the effects of water-based training (WT) programs on health status and physical fitness of healthy adults and adults with diseases to develop useful recommendations for health and sports professionals. We searched three databases (PubMed, Web of Science, and Scopus) up to June 2021 for randomized trials that examined WT in adults. A total of 62 studies were included, of which 26 involved only healthy individuals and 36 focused on adults with chronic diseases. In the healthy group, the effects of WT on strength, balance, and cardiorespiratory fitness were beneficial, indicating the usefulness of performing WT for at least 12 weeks (2–3x/ week, 46–65 min/session). Among adults with diseases, improvements were observed in patients with fibromyalgia (in balance and cardiorespiratory fitness), bone diseases (pain, balance, flexibility, and strength), coronary artery disease (strength and anthropometry), hypertension (quality of life), stroke (quality of life), diabetes (balance and quality of life), multiple sclerosis (quality of life and balance), and Parkinson's disease (pain, gait, cardiorespiratory fitness, and quality of life). Research is required to determine the effects of WT on patients with heart disease, especially coronary artery disease. In adults with chronic disease, benefits in physical fitness and/or other health-related measures were mainly observed after 8–16 weeks of training. WT is an effective physical activity when the intention is to enhance health and physical fitness in healthy adults and adults with chronic diseases.
Open Access
Acute effects of high intensity, resistance, or combined protocol on the increase of level of neurotrophic factors in physically inactive overweight adults: the brainfit study
(Frontiers Media, 2018) Domínguez Sánchez, María Andrea; Bustos Cruz, Rosa H.; Velasco Orjuela, Gina P.; Quintero, Andrea P.; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
The purpose of this study was to compare the neurotrophic factor response following one session of high-intensity exercise, resistance training or both in a cohort of physically inactive overweight adults aged 18–30 years old. A randomized, parallel-group clinical trial of 51 men (23.6 ± 3.5 years; 83.5 ± 7.8 kg; 28.0 ± 1.9 kg/m2) who are physically inactive (i.e., < 150 min of moderate-intensity exercise per week or IPAQ score of <600 MET min/week for >6 months) and are either abdominally obese (waist circumference ≥90 cm) or have a body mass index, BMI ≥25 and ≤ 30 kg/m2 were randomized to the following four exercise protocols: high-intensity exercise (4 × 4 min intervals at 85–95% maximum heart rate [HRmax] interspersed with 4 min of recovery at 75–85% HRmax) (n = 14), resistance training (12–15 repetitions per set, at 50–70% of one repetition maximum with 60 s of recovery) (n = 12), combined high-intensity and resistance exercise (n = 13), or non-exercising control (n = 12). The plasma levels of neurotrophin-3 (NT-3), neurotrophin-4 (also known as neurotrophin 4/5; NT-4 or NT-4/5), and brain-derived neurotrophic factor (BDNF) were determined before (pre-exercise) and 1-min post-exercise for each protocol session. Resistance training induced significant increases in NT-3 (+39.6 ng/mL [95% CI, 2.5–76.6; p = 0.004], and NT-4/5 (+1.3 ng/mL [95% CI, 0.3–2.3; p = 0.014]), respectively. Additionally, combined training results in favorable effects on BDNF (+22.0, 95% CI, 2.6–41.5; p = 0.029) and NT-3 (+32.9 ng/mL [95% CI, 12.3–53.4; p = 0.004]), respectively. The regression analysis revealed a significant positive relationship between changes in BDNF levels and changes in NT-4/5 levels from baseline to immediate post-exercise in the combined training group (R2 = 0.345, p = 0.034) but not the other intervention groups. The findings indicate that acute resistance training and combined exercise increase neurotrophic factors in physically inactive overweight adults. Further studies are required to determine the biological importance of changes in neurotrophic responses in overweight men and chronic effects of these exercise protocols.
Open Access
Concurrent training and detraining: the influence of different aerobic intensities
(Lippincott, Williams & Wilkins, 2020) Sousa, António C.; Neiva, Henrique P.; Gil, Maria H.; Izquierdo Redín, Mikel; Rodríguez Rosell, David; Ciencias de la Salud; Osasun Zientziak
The aim of this study was to verify the effects of different aerobic intensities combined with the same resistance training on strength and aerobic performances. Thirty-nine men were randomly assigned to a low-intensity group (LIG), moderate-intensity group (MIG), high-intensity group (HIG), and a control group. The training program consisted of full squat, jumps, sprints, and running at 80% (LIG), 90% (MIG), or 100% (HIG) of the maximal aerobic speed for 16-20 minutes. The training period lasted for 8 weeks, followed by 4 weeks of detraining. Evaluations included 20-m sprints (0-10 m: T10; 0-20 m: T20), shuttle run, countermovement jump (CMJ), and strength (1RM(est)) in full squat. There were significant improvements from pre-training to post-training in T10 (LIG: 4%; MIG: 5%; HIG: 2%), T20 (3%; 4%; 2%), CMJ (9%; 10%; 7%), 1RM(est) (13%; 7%; 8%), and oxygen uptake (V?o(2)max; 10%; 11%; 10%). Comparing the changes between the experimental groups, 1RM(est)gains were significantly higher in the LIG than HIG (5%) or MIG (6%). Furthermore, there was a tendency for higher gains in LIG and MIG compared with HIG, with 'possibly' or 'likely' positive effects in T10, T20, and CMJ. Detraining resulted in performance decrements, but minimal losses were found for V?o(2)max in LIG (-1%). Concurrent training seems to be beneficial for strength and aerobic development regardless of the aerobic training intensity. However, choosing lower intensities can lead to increased strength and is recommended when the cardiorespiratory gains should be maintained for longer.
Open Access
Effects of physical exercise on metabolic syndrome in psychotic disorders: a systematic review with meta-analysis of randomized controlled trials
(Cambridge University Press, 2025-07-18) Ancín Osés, Arantxa; Izquierdo Redín, Mikel; Cuesta, Manuel J.; López Sáez de Asteasu, Mikel; Ciencias de la Salud; Osasun Zientziak
Background. Physical exercise improves mental and physical health of individuals with severe mental illness (SMI); however, its impact on metabolic syndrome remains unclear. Aims. To evaluate the effects of exercise interventions on metabolic syndrome components in individuals with SMI and explore interactions between exercise and antipsychotic medications on metabolic outcomes. Methods. Following PRISMA guidelines, we systematically searched PubMed, CINAHL, Web of Science, and APA PsycINFO through October 10, 2023, for randomized controlled trials (RCTs) assessing the effects of exercise on waist circumference, blood pressure, glucose, triglycerides, and HDL cholesterol in SMI. Risk of bias was evaluated using the Cochrane RoB-2 tool. Data were pooled using random-effects models in Comprehensive Meta-Analysis and JASP. Results. Ten RCTs (N = 773; mean age 39.9 ± 7.36 years; 38.7% female; 71.5% schizophrenia spectrum disorders) met inclusion criteria. Pooled analyses revealed no significant effects of exercise on waist circumference (SMD = 0.206, 95% CI [-0.118, 0.530], p = 0.171), systolic blood pressure (SMD = 0.194, 95% CI [-0.115, 0.504], p = 0.219), diastolic blood pressure (SMD = -0.21, 95% CI [-0.854, 0.434], p = 0.522), HDL (SMD = 0.157, 95% CI [-0.36, 0.674], p = 0.551), triglycerides (SMD = -0.041, 95% CI [-0.461, 0.38], p = 0.849), or glucose (SMD = -0.071, 95% CI [-0.213, 0.071], p = 0.326). Heterogeneity was moderate to high. Conclusions. Exercise interventions did not significantly improve metabolic syndrome components in SMI. Future trials must prioritize tailored regimens, adjunctive therapies, and rigorous control of medication effects.
Open Access
Normative values for the short physical performance battery (SPPB) and their association with anthropometric variables in older Colombian adults. The SABE Study, 2015
(Frontiers Media, 2020) Ramírez Vélez, Robinson; Rincón Pabón, David; García Hermoso, Antonio; Zambom Ferraresi, Fabrício; López Sáez de Asteasu, Mikel; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Background: The short physical performance battery (SPPB) is a physical performance test of lower extremity function designed for non-disabled older adults. We aimed to establish reference values for community-dwelling Colombian adults aged 60 years or older in terms of (1) the total score; (2) the three subtest scores (walking speed, standing balance performance, and five times sit-to-stand test); and (3) the time to complete the five times sit-to-stand test, s and the walking speed test. Additionally, we sought to explore how much of the variance in the SPPB subtest scores could be explained by anthropometric variables (age, body mass, height, body mass index, and calf circumference). Methods: Participants were men and women aged 60 years or older who participated in the Health and Well-being and Aging Survey in Colombia, 2015. A sample of 4,211 participants (57.3% women) completed the SPPB test, and their anthropometric variables were evaluated. Age-specific percentiles were calculated using the LMS method (3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles). Results: The mean SPPB total score for the entire sample was 8.73 (2.0) points. On average, the total SPPB score was 0.85 points greater in men than in women (p < 0.001). Significant sex differences were observed in all three age groups tested (60–69, 70–79, and 80+ years). In the full sample, our findings suggested that age, body mass, height, body mass index, and calf circumference are significant contributors to walking speed (p < 0.001) after controlling for confounding factors, including ethnicity, socioeconomic status, and urbanicity. Conclusions: Percentile values are of interest to identify target populations for primary prevention and to estimate the proportion of high or low values for SPPB measures in community-dwelling Colombians aged at least 60 years.
Open Access
Effects of multicomponent exercise training on the intrinsic capacity in frail older adults: review of clinical trials
(Universidade Estadual Paulista, 2022) Mello, Alexandre; Izquierdo Redín, Mikel; Teodoro, Juliana Lopes; Lusa Cadore, Eduardo; Ciencias de la Salud; Osasun Zientziak
Aim: To review the effects of multicomponent exercise training on the domains of the intrinsic capacity of physically frail older adults: locomotion, vitality, cognition, psychological outcomes, and sensory function. Methods: The search for the studies was carried out in the MEDLINE, Cochrane CENTRAL, and PEDro databases, along with manual search, delimiting the period of publication as the last 10 years. The initial search identified 338 studies and 18 among them were analyzed qualitatively. Results: From the analysis of the included studies, great variability was evidenced between the intervention protocols, as well as between the results. As for the effectiveness of multicomponent exercise training, it has been shown to induce a positive effect on most of the analyzed outcomes. Conclusion: In summary, the present review suggests that multicomponent physical training can be effective to improve aspects of locomotion, cognition, and psychological aspects in frail older populations. Nevertheless, more studies are needed to specify the time needed to achieve such adaptations, the magnitude of these adaptations, and the design of the most appropriate training program for each outcome related to intrinsic capabilities.
Open Access
The influence of ACE ID and ACTN3 R577X polymorphisms on lower-extremity function in older women in response to high-speed power training
(BioMed Central, 2013) Pereira, Ana; Costa, Aldo M.; Leitão, José C.; Monteiro, António M.; Izquierdo Redín, Mikel; Silva, António J.; Bastos, Estela; Marqués, Mário C.; Ciencias de la Salud; Osasun Zientziak
Background: We studied the influence of the ACE I/D and ACTN3 R577X polymorphisms (single or combined) on lower-extremity function in older women in response to high-speed power training. Methods: One hundred and thirty-nine healthy older Caucasian women participated in this study (age: 65.5 ± 8.2 years, body mass: 67.0 ± 10.0 kg and height: 1.57 ± 0.06 m). Walking speed (S10) performance and functional capacity assessed by the “get-up and go” (GUG) mobility test were measured at baseline (T1) and after a consecutive 12-week period of high-speed power training (40-75% of one repetition maximum in arm and leg extensor exercises; 3 sets 4–12 reps, and two power exercises for upper and lower extremity). Genomic DNA was extracted from blood samples, and genotyping analyses were performed by PCR methods. Genotype distributions between groups were compared by Chi-Square test and the gains in physical performance were analyzed by two-way, repeated-measures ANOVA. Results: There were no significant differences between genotype groups in men or women for adjusted baseline phenotypes (P > 0.05). ACE I/D and ACTN3 polymorphisms showed a significant interaction genotype-training only in S10 (P = 0.012 and P = 0.044, respectively) and not in the GUG test (P = 0.311 and P = 0.477, respectively). Analyses of the combined effects between genotypes showed no other significant differences in all phenotypes (P < 0.05) at baseline. However, in response to high-speed power training, a significant interaction on walking speed (P = 0.048) was observed between the “power” (ACTN3 RR + RX & ACE DD) versus “non-power” muscularity-oriented genotypes (ACTN3 XX & ACE II + ID)]. Conclusions: Thus, ACE I/D and ACTN3 R577X polymorphisms are likely candidates in the modulation of exercise-related gait speed phenotype in older women but not a significant influence in mobility traits.
Open Access
Effectiveness of a multicomponent exercise training program for the management of delirium in hospitalized older adults using near-infrared spectroscopy as a biomarker of brain perfusion: study protocol for a randomized controlled trial
(Frontiers Media, 2022) Lozano Vicario, Lucía; Zambom Ferraresi, Fabíola; Zambom Ferraresi, Fabrício; Casa Marín, Antón de la; Ollo Martínez, Iranzu; López Sáez de Asteasu, Mikel; Cedeño Veloz, Bernardo Abel; Fernández Irigoyen, Joaquín; Santamaría Martínez, Enrique; Romero Ortuno, Román; Izquierdo Redín, Mikel; Martínez Velilla, Nicolás; Ciencias de la Salud; Osasun Zientziak
Delirium is an important cause of morbidity and mortality in older adults admitted to hospital. Multicomponent interventions targeting delirium risk factors, including physical exercise and mobilization, have been shown to reduce delirium incidence by 30–40% in acute care settings. However, little is known about its role in the evolution of delirium, once established. This study is a randomized clinical trial conducted in the Acute Geriatric Unit of Hospital Universitario de Navarra (Pamplona, Spain). Hospitalized patients with delirium who meet the inclusion criteria will be randomly assigned to the intervention or the control group. The intervention will consist of a multicomponent exercise training program, which will be composed of supervised progressive resistance and strength exercise over 3 consecutive days. Functional Near-Infrared Spectroscopy (NIRS) will be used for assessing cerebral and muscle tissue blood flow. The objective is to assess the effectiveness of this intervention in modifying the following primary outcomes: duration and severity of delirium and functional status. This study will contribute to determine the effectiveness of physical exercise in the management of delirium. It will be the first study to evaluate the impact of a multicomponent intervention based on physical exercise in the evolution of delirium.
Open Access
Factor structure of the 10-item CES-D scale among patients with persistent COVID-19
(Wiley, 2022) Ramírez Vélez, Robinson; Olabarrieta Landa, Laiene; Rivera, Diego; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
The presence of persistent coronavirus disease 2019 (COVID-19) might beassociated with significant levels of psychological distress that would meet thethreshold for clinical relevance. The Center for Epidemiologic Studies DepressionScale (CES-D) version 10 has been widely used in assessing psychological distressamong general and clinical populations from different cultural backgrounds. To ourknowledge, however, researchers have not yet validated these findings amongpatients with persistent COVID-19. A cross-sectional validation study wasconducted with 100 patients from the EXER-COVID project (69.8% women;mean (±standard deviation) ages: 47.4 ± 9.5 years). Confirmatory factor analyses(CFAs) were performed on the 10-item CES-D to test four model fits: (a)unidimensional model, (b) two-factor correlated model, (c) three-factor correlatedmodel, and (d) second-order factor model. The diagonal-weighted least-squares estimator was used, as it is commonly applied to latent variable modelswith ordered categorical variables. The reliability indices of the 10-item CES-D in patients with persistent COVID-19 were as follows: depressive affect factor(α=0.82Ord;ω=0.78u−cat), somatic retardation factor (α=0.78Ord;ω=0.56u−cat),and positive affect factor (α=0.56Ord;ω=0.55u−cat). The second‐order model fitshowed good Omega reliability (ω=0.87ho). Regarding CFAs, the unidimensional‐factor model shows poor goodness of fit, especially residuals analysis (root meansquare error of approximation [RMSEA] = 0.081 [95% confidence interval,CI = 0.040–0.119]; standardized root mean square residual [SRMR] = 0.101). The two‐factor correlated model, three‐factor correlated model, and second‐order factormodel showed adequate goodness of fit, and theχ2difference test (∆X2) did not show significant differences between the goodness of fit for these models(∆X= 4.11282;p= 0.127). Several indices showed a good fit with the three‐factor correlated model: goodness‐of‐fit index = 0.974, comparative fit index = 0.990,relative noncentrality index = 0.990, and incremental fit index = 0.990, which were all above 0.95, the traditional cut‐off establishing adequate fit. On the other hand RMSEA = 0.049 (95% CI = 0.000–0.095), where an RMSEA < 0.06–0.08 indicates anadequate fit. Item loadings on the factors were statistically significant (λ≥0.449j;p's < 0.001), indicating that the items loaded correctly on the corresponding factors and the relationship between factors (φ≥0.382;p's≤0.001. To our knowledge, thisis the first study to provide validity and reliability to 10‐item CES‐D in a persistentCOVID‐19 Spanish patient sample. The validation and reliability of this shortscreening tool allow us to increase the chance of obtaining complete data in aparticular patient profile with increased fatigue and brain fog that limit patients' capacity to complete questionnaires.