Open Access
Association of physical education with improvement of health-related physical fitness outcomes and fundamental motor skills among youths: a systematic review and meta-analysis
(American Medical Association (AMA), 2020-08-31) García Hermoso, Antonio; Alonso Martínez, Alicia; Ramírez Vélez, Robinson; Pérez Sousa, Miguel A.; Ramírez Campillo, Rodrigo; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
This systematic review and meta-analysis of 55 studies that included 37 563 youths revealed that cardiorespiratory fitness levels and change over approximately 1 year during youth were associated with lower risk of developing obesity and cardiometabolic disease later in life. These early associations detected from baseline to follow-up dissipated over time. The study suggests that prevention strategies that target youth cardiorespiratory fitness may be associated with improved health parameters in later life.
Open Access
Interindividual variability response to resistance and high-intensity interval training on blood pressure reduction in hypertensive older adults
(MDPI, 2025-01-16) Cano Montoya, Johnattan; Hurtado, Nicolas; Núñez Vergara, Carolina; Báez Vargas, Sebastián; Rojas-Vargas, Marcela; Martínez-Huenchullán, Sergio; Álvarez, Cristian ; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
Background: This study evaluated the effects of resistance training (RT) and high-intensity interval training (HIIT) on systolic (SBP) and diastolic blood pressure (DBP) in hypertensive older adults undergoing pharmacological therapy over four and eight weeks. We compared the efficacy of RT and HIIT in reducing non-responders (NRs) between weeks 4 and 8 and analyzed time-course adaptations in NRs and responders (Rs). Methods: Thirty-nine participants were randomized into RT-G (n = 13), HIIT-G (n = 13), or control (CG, n = 13) groups. RT utilized elastic bands, and HIIT involved cycle ergometers, with three weekly 30 min sessions for 8 weeks. SBP and DBP were measured before intervention and at weeks 4 and 8, respectively. Individual responses were classified as NRs or Rs using the Hopkins method (SDIR = √[SDExp2–SDCon2]). Time-course adaptations were evaluated. Results: Both the RT-G and HIIT-G reduced SBP at 8 weeks (RT-G: −13 mmHg; [ES: 1.12]; HIIT-G: −12 mmHg [ES: 0.8]; both p < 0.05). The proportion of NRs for SBP decreased from 46% to 38% in RT-G and 69% to 46% in HIIT-G. Rs showed a peak SBP reduction at 4 weeks (−14.7 and −25.5 mmHg), stabilizing by week 8 (−22.8 and −19.6 mmHg) in RT-G and HIIT-G, respectively. Conclusion: Eight weeks of RT and HIIT effectively reduced SBP and NR prevalence, with time-course adaptations favoring Rs.
Open Access
Grip strength moderates the association between anthropometric and body composition indicators and liver fat in youth with an excess of adiposity
(MDPI, 2018) Ramírez Vélez, Robinson; Izquierdo Redín, Mikel; Correa Bautista, Jorge Enrique; Tordecilla Sanders, Alejandra; Correa Rodríguez, María; Schmidt Río-Valle, Jacqueline; González Jiménez, Emilio; González Ruiz, Katherine; Ciencias de la Salud; Osasun Zientziak
Paediatric non-alcoholic fatty liver disease (NAFLD) is considered the most common early driver of chronic liver disease. The aim of this study was to examine whether grip strength moderates the association between anthropometric and body composition parameters and controlled attenuation parameter (CAP), an indicator of fat deposits in the liver, in children and adolescents with excess of adiposity. A total of 127 adolescents (67% girls) aged between 11 and 17, attending two public schools in Bogota (Colombia), who had an axiological evaluation of obesity were included in this study. A grip strength test was assessed as an indicator of muscular strength, and cardiorespiratory fitness by maximal oxygen uptake was assessed using the 20 m shuttle-run test. Waist circumference (WC), waist-to-height ratio (WHtR), fat mass, and visceral adipose tissue (VAT) (cm(3)) were included as anthropometric and body composition measures. CAP was determined with a FibroScan((R)) 502 Touch device (Echosens, Paris, France). The anthropometric and body composition parameters including WC, WHtR, fat mass, and VAT were positively associated with the CAP (range = 0.423 to 0.580), slightly reduced after being adjusted for handgrip strength/weight. The Johnson-Neyman technique revealed a significant inverse relationship between WC, WHtR, VAT, and CAP when grip strength normalized by body mass was above but not equal to or below 0.475 (8.1% of the sample), 0.469 (8.9% of the sample), and 0.470 (8.5% of the sample), respectively. In conclusion, grip strength adjusted by body mass, has a moderating effect on the association between anthropometric and body composition parameters (including WC, WHtR, and VAT) and CAP in in children and adolescents with excess of adiposity, suggesting the importance of promoting muscular strength during paediatric population in order to prevent NAFLD.
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
Effect of a multicomponent intervention with tele-rehabilitation and the Vivifrail© exercise programme on functional capacity after hip fracture: study protocol for the ActiveFLS randomized controlled trial
(MDPI, 2023) Cedeño Veloz, Bernardo Abel; Casadamon-Munarriz, Irache; Rodríguez-García, Alba; Lozano Vicario, Lucía; Zambom Ferraresi, Fabrício; Gonzalo Lázaro, María; Hidalgo Ovejero, Ángel; Izquierdo Redín, Mikel; Martínez Velilla, Nicolás; Ciencias de la Salud; Osasun Zientziak
Introduction: Hip fractures are the most common fracture leading to hospitalization and are associated with high costs, mortality rates and functional decline. Although several guidelines exist for preventing new fractures and promoting functional recovery, they tend to focus on osteoporosis treatment and do not take into account the complexity of frailty in older adults and geriatric syndromes, which are important factors in individuals at risk of suffering from frailty fractures. Moreover, most health systems are fragmented and are incapable of providing appropriate management for frail and vulnerable individuals who are at risk of experiencing fragility fractures. Multicomponent interventions and physical exercise using tele-rehabilitation could play a role in the management of hip fracture recovery. However, the effectiveness of exercise prescription and its combination with a comprehensive geriatric assessment (CGA) is still unclear. Methods: This randomized clinical trial will be conducted at the Hospital Universitario de Navarra (Pamplona, Spain). A total of 174 older adults who have suffered a hip fracture and fulfil the criteria for inclusion will be randomly allocated to either the intervention group or the control group. The intervention group will receive a multicomponent intervention consisting of individualized home-based exercise using the @ctive hip app for three months, followed by nine months of exercise using Vivifrail. Additionally, the intervention group will receive nutrition intervention, osteoporosis treatment, polypharmacy adjustment and evaluation of patient mood, cognitive impairment and fear of falling. The control group will receive standard outpatient care according to local guidelines. This research aims to evaluate the impact of the intervention on primary outcome measures, which include changes in functional status during the study period based on the Short Physical Performance Battery. Discussion: The findings of this study will offer valuable insights into the efficacy of a comprehensive approach that considers the complexity of frailty in older adults and geriatric syndromes, which are important factors in individuals at risk of suffering from frailty fractures. This study’s findings will contribute to the creation of more effective strategies tailored to the requirements of these at-risk groups.
Metadata only
A más ejercicio, menos enfermedades y gasto en farmacia. ¿A qué esperamos?
(2013) Izquierdo Redín, Mikel; Rodríguez Mañas, Leocadio; Rodríguez Artalejo, Fernando; Andradas Aragonés, Elena; Gorostiaga Ayestarán, Esteban; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa; Parlamento de Navarra
Recientemente, un grupo de investigadores españoles ha publicado un estudio que muestra una reducción significativa en el número de visitas a los centros de salud de las personas que participaron en un programa de ejercicio físico, en comparación con el número de visitas de una población físicamente inactiva. También se ha observado un gran ahorro en el costo sanitario y en la prevención de nuevas enfermedades asociadas al sedentarismo. El ejercicio, comparado con el gasto en medicamentos, tiene un bajo coste y apenas efectos adversos. Sin embargo, a pesar de la abrumadora evidencia científica de que la actividad física mejora la salud de la población, sus efectos no están aún social ni políticamente reconocidos. ¿A qué se espera para la prescripción del ejercicio físico como una medicina? ¿Cuándo se recetará la práctica de ejercicio físico dos días a la semana en la prevención y tratamiento de enfermedades cardiovasculares y otras enfermedades crónicas como el declive de la capacidad funcional? ¿Por qué no se prescribe el entrenamiento de fuerza muscular en el tratamiento y prevención de la discapacidad de personas mayores consideradas frágiles o en pacientes con diabetes tipo II? ¿Cuándo se abordarán profundos cambios para que nuestros hijos realicen más ejercicio físico desde primaria? Parece que queda mucho por hacer, pero las posibilidades del ejercicio físico como la nueva píldora del siglo XXI son realmente estimulantes.
Open Access
Effects of order and sequence of resistance and endurance training on body fat in elementary school-aged girls
(Termedia Publishing, 2017) Alves, Ana R.; Marta, Carlos C.; Neiva, Henrique P.; Izquierdo Redín, Mikel; Marqués, Mário C.; Ciencias de la Salud; Osasun Zientziak
The purpose of this study was to analyse the effects of order and sequence of concurrent resistance and endurance training on body fat percentage (BFP) in a large sample of elementary school-aged girls. One hundred and twenty-six healthy girls, aged 10-11 years (10.95 ± 0.48 years), were randomly assigned to six groups to perform different training protocols per week for 8 weeks: Resistance-only (R), Endurance-only (E), Concurrent Distinct Endurance-Resistance (CDER), Concurrent Parallel Endurance-Resistance (CPER), Concurrent Parallel Resistance-Endurance (CPRE), and a Control group (C). In R and E, the subjects performed single sessions of resistance or endurance exercises, respectively (two days per week). In CDER, resistance-endurance training was performed on different days each week (four days per week). CPER and CPRE performed single-session combined endurance-resistance training or combined resistance-endurance training, respectively, each week (two days per week). After an 8-week training period, BFP decreased in all experimental groups (CPER: 13.3%, p< 0.05; CPRE: 13.8%, p<0.001; E: 1.9%, p>0.05; R: 5.0%, p>0.05; and CDER: 5.6%, p>0.05). However, a significant difference was found in CPER and CPRE when compared to CDER, E, and R, indicating that training sequence may influence BFP. All programmes were effective, but CPER and CPRE obtained better results for BFP than CDER, E, or R. The effects of concurrent resistance and endurance training on body fat percentage can be mediated by order and sequence of exercise. These results provide insight into optimization of school-based fat loss exercise programmes in childhood.
Open Access
Inter-individual variability in responses to 7 weeks of plyometric jump training in male youth soccer players
(Frontiers Media, 2018) Ramírez Campillo, Rodrigo; Álvarez, Cristian; Gentil, Paulo; Alonso Martínez, Alicia; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
The purpose of this study was to compare the inter-individual variability in the effects of plyometric jump training (PJT) on measures of physical fitness (sprint time, change of direction speed, countermovement jump, 20- and 40-cm drop jump reactive strength index, multiple five bounds distance, maximal kicking distance, and 2.4-km time trial) in youth soccer players who completed a PJT program versus players who completed soccer training only. In a single-blinded study, participants aged between 10 and 16 years were randomly divided into a PJT group (n = 38) and a control group (n = 38). The experimental group participated in a PJT program twice weekly for 7 weeks, whereas the control group continued with their regular soccer training sessions. Between-group differences were examined using a Mann–Whitney U test. Nonresponders where defined as individuals who failed to demonstrate any beneficial change that was greater than two times the typical error of measurement from zero. The results indicated that the mean group improvement for all physical fitness measures was greater (p < 0.05) in the PJT group (Δ = 0.4 to 23.3%; ES = 0.04 to 0.58) than in the control group (Δ = 0.1 to 3.8%; ES = 0.02 to 0.35). In addition, a significantly greater (p < 0.05) number of responders across all dependent variables was observed in the PJT group (from 4 up to 33 responders) than in the control group (from 0 up to 9 responders). In conclusion, compared to soccer training only, PJT induced greater physical fitness improvements in youth soccer players, with a greater number of responders for all the physical fitness tests related to jumping, speed, change of direction speed, endurance, and kicking technical ability.
Open Access
Safety and effectiveness of long-term exercise interventions in older adults: a systematic review and meta-analysis of randomized controlled trials
(Springer, 2020-02-04) García Hermoso, Antonio; Ramírez Vélez, Robinson; López Sáez de Asteasu, Mikel; Martínez Velilla, Nicolás; Zambom Ferraresi, Fabrício; Valenzuela, Pedro L.; Lucía, Alejandro; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
Background Physical exercise is benefcial to reduce the risk of several conditions associated with advanced age, but to our knowledge, no previous study has examined the association of long-term exercise interventions (≥1 year) with the occurrence of dropouts due to health issues and mortality, or the efectiveness of physical exercise versus usual primary care interventions on health-related outcomes in older adults (≥ 65 years old). Objective To analyze the safety and efectiveness of long-term exercise interventions in older adults. Methods We conducted a systematic review with meta-analysis examining the association of long-term exercise interventions (≥1 year) with dropouts from the corresponding study due to health issues and mortality (primary endpoint), and the efects of these interventions on health-related outcomes (falls and fall-associated injuries, fractures, physical function, quality of life, and cognition) (secondary endpoints). Results Ninety-three RCTs and six secondary studies met the inclusion criteria and were included in the analyses (n=28,523 participants, mean age 74.2 years). No diferences were found between the exercise and control groups for the risk of dropouts due to health issues (RR=1.05, 95% CI 0.95–1.17) or mortality (RR=0.93, 95% CI 0.83–1.04), although a lower mortality risk was observed in the former group when separately analyzing clinical populations (RR=0.67, 95% CI 0.48–0.95). Exercise signifcantly reduced the number of falls and fall-associated injuries, and improved physical function and cognition. These results seemed independent of participants’ baseline characteristics (age, physical function, and cognitive status) and exercise frequency. Conclusions Long-term exercise training does not overall infuence the risk of dropouts due to health issues or mortality in older adults, and results in a reduced mortality risk in clinical populations. Moreover, exercise reduces the number of falls and fall-associated injuries, and improves physical function and cognition in this population.
Open Access
Acute and time-course changes in hemodynamic and physical performance parameters following single and multiple resistance training sets in cognitively impaired individuals: a randomized crossover study
(Elsevier, 2025-01-23) Fonseca, Nuno; Esteves, Dulce; Marques, Diogo Luís ; Faíl, Luís Brandão; Sousa, Tiago ; Pamplona Pinto, Mafalda ; Neiva, Henrique P.; Izquierdo Redín, Mikel; Marqués, Mário C.; Ciencias de la Salud; Osasun Zientziak
This study analyzed the acute and time-course changes following one resistance training (RT) set (1SET) and three sets (3SET) on hemodynamic and physical performance parameters in individuals with different cognitive impairment levels. Thirty-nine individuals (22 women and 17 men aged 80 ± 9 years) grouped by cognitive impairment (mild [MILD], moderate [MOD], and severe [SEV]) randomly performed two protocols, each separated by one week, of 1SET or 3SET of 10 repetitions. Before (PRE), immediately (POST), and 72 h after (POST72) protocols, the participants performed the following measurements: systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), 1-kg medicine ball throw (MBT) distance, five-repetition sit-to-stand (STS) time, and handgrip strength (HGS). A three-way ANOVA with repeated measures revealed no significant differences between 1SET and 3SET on SBP, DBP, HR, STS, MBT, and HGS in any group at any time (all p ¿ 0.05). SEV increased SBP and HR from PRE to POST and decreased STS time after 3SET. From POST to POST72, all groups decreased SBP after both protocols, and SEV improved STS time after 3SET and HGS following both protocols. Furthermore, from PRE to POST72, MILD decreased SBP, while SEV improved HGS following 1SET and STS time following 3SET. These findings demonstrate that single and multiple sets cause acute hemodynamic changes, with a tendency to reduce SBP within 72 h. Additionally, individuals with worse cognitive function showed greater adaptive responses over time in physical performance, with 1SET improving HGS and 3SET enhancing STS performance. Trial registration: ClinicalTrials.gov ID: NCT06185010