Can high-intensity interval training improve physical and mental health outcomes? A meta-review of 33 systematic reviews across the lifespan

A systematic review and meta-analysis of the effectiveness of high-intensity interval training for physical fitness in university students

BACKGROUND

Extensive research has demonstrated the effectiveness of high-intensity interval training (HIIT) in children and adults; however, evidence specific to university students remains limited. This study aimed to evaluate the effects of HIIT on promoting physical health in university students and to identify potential factors influencing intervention outcomes.

METHOD

A systematic search was conducted across five electronic databases (Web of Science, Scopus, PubMed, SportDiscus, and MEDLINE) up to December 2024 using Boolean operators and keywords related to HIIT and university students.

INCLUSION CRITERIA

(1) Experimental studies; (2) Physical-related outcomes; (3) Intervention duration of at least 3 weeks; (4) Meets the definition of high-intensity activity; (5) Participants are general university students. A meta-analysis was conducted using RevMan 5.4 software, comparing intervention and control groups. Effect sizes were calculated using Cohen's d, and heterogeneity was assessed with the I² statistic. Subgroup analyses were performed based on intervention duration and rest interval duration.

RESULTS

Results showed that HIIT significantly reduced BMI, body fat percentage, waist-to-hip ratio, and heart rate, while significantly improving VO2max and muscle strength in university students. Interventions lasting longer than eight weeks demonstrated greater improvements in muscle strength compared to those lasting eight weeks or less. However, there are no significant differences in rest interval across any of the groups. Notably, HIIT also has positive effects on agility and speed with varying effect sizes.

CONCLUSION

The unique characteristics of university students make HIIT a time-efficient and effective intervention strategy for this population. Future studies should consider the specific needs of the university environment, incorporating the latest technological advancements and developing tailored intervention strategies that align with students' preferences.

Customizing intense interval exercise training prescription using the "frequency, intensity, time, and type of exercise" (FITT) principle

Intense interval exercise training induces various physiological and metabolic adaptations related to performance and health. For designing a program, the F.I.T.T. principle, referring to frequency, intensity, time, and type of exercise, can be used to manipulate the level of physiological stress in the body, leading to various adaptations. Modifying these four parameters results in a wide range of interval protocols that are safe and effective for different populations including athletes and individuals with chronic diseases. In this review, we present how the manipulation of the F.I.T.T. components can alter the acute and chronic cardiorespiratory, metabolic, perceptual, and affective responses and adaptations to intense interval exercise training. From this evidence, it appears that the duration of the exercise bout and recovery interval are critical parameters for the manipulation of almost all acute responses, enabling periodization of intense interval exercise training, and promoting optimal adaptations and exercise adherence. In addition, a considerable level of adaptations may be achieved with training frequencies as low as once or twice per week and with lower than maximal intensities, adding to the feasibility of this exercise mode. Overall, by varying these parameters, the design of an intense interval exercise training program can be tailored according to the needs and abilities of each individual, and an optimized training prescription may be achieved.

Efficacy of high-intensity interval training in individuals with type 2 diabetes mellitus: An umbrella review of systematic reviews and meta-analyses

High-intensity interval training (HIIT) has gained attention as a potentially effective alternative to traditional exercise modalities for individuals with type 2 diabetes mellitus (T2DM). Previous studies have evaluated this exercise strategy with various regimens, comparator groups and outcomes, limiting the generalisability of findings. We performed a novel umbrella review to generate an up-to-date synthesis of the available evidence regarding the effect of HIIT on glycaemic control and other clinically relevant cardiometabolic health outcomes in individuals with T2DM, as compared with traditional moderate-intensity continuous training (MICT) and/or non-exercise control (CON). This umbrella review followed the Preferred Reporting Items for Overviews of Reviews guideline. Seven databases were searched until August 2024. Systematic reviews with meta-analyses comparing HIIT with MICT and/or CON were included. Literature search, data extraction and methodological quality assessment (A MeaSurement Tool to Assess systematic Reviews 2 [AMSTAR-2]) were conducted independently by two reviewers. Ten systematic reviews with meta-analyses, encompassing 76 primary studies and 2954 unique participants, met the inclusion criteria. The data indicated that HIIT significantly improves glycosylated haemoglobin and cardiorespiratory fitness compared with CON (weighted mean difference [WMD]: -0.83% to -0.39% and 3.35-6.38 mL/kg/min) and MICT (WMD: -0.37% to -0.07% and 1.68-4.12 mL/kg/min) in individuals with T2DM. HIIT is also effective in improving other glycaemic parameters, including fasting blood glucose, fasting blood insulin and HOMA-IR. Improvement in body composition, lipid profiles and blood pressure has also been observed following HIIT. Most systematic reviews received moderate to low AMSTAR-2 score. This umbrella review supports HIIT as an efficacious exercise strategy for improving glycaemic control and certain relevant cardiometabolic health outcomes in individuals with T2DM. Our findings offer a comprehensive basis that may potentially contribute to informing physical activity recommendations for incorporating HIIT into T2DM management strategies.

LIVING - protocol for a pragmatic randomized controlled trial investigating the effect of three different levels of diabetes self-management programs

BACKGROUND

In Denmark, Type 2 Diabetes (T2D) care includes diabetes self-management programs (DSMPs) delivered by municipalities. Following a successful pilot study, a DSMP was expanded to include a digital platform and flexible educational materials. While exercise therapy is recognized as essential in T2D management, high-quality studies on DSMPs incorporating exercise are limited. This trial assesses the (cost)effectiveness of three interventions with escalating intensity, hypothesizing that higher intensity enhances diabetes management competence and reduces complication risk.

METHODS/DESIGN

A pragmatic randomized controlled trial will assess three different DSMP interventions in six Danish municipalities acting as trial sites. Each site will implement one of three versions of Lev Livet: a short version (SLL), a full version (FLL), or the full version with high intensity exercise (FLL + H). At each site, 48 participants will be randomly assigned (2:1) to intervention or control groups. Primary outcome is perceived competence in diabetes (questionnaire). Other outcomes measure physical activity level (accelerometer),HbA1c, disease progression, physical function, and self-reported metrics. The trial is approved by the Danish National Center for Ethics (case no 1-10-72-107-23) and registered at ClinicalTrials.gov (NCT06091501).

DISCUSSION

The LIVING trial has the potential to establish whether the Lev Livet program is effective and cost effective and how it can be implemented in municipalities. By analyzing dose-response relationships, the trial may refine intervention frequency and intensity, improve diabetes management, and inform both national and international guidelines for accessible, effective diabetes care.

The impact of high-intensity interval training on insulin sensitivity and quality of life in women with overweight polycystic ovary syndrome

BackgroundPolycystic ovary syndrome (PCOS) is a prevalent endocrine disorder in women of reproductive age, characterized by menstrual irregularities, hyperandrogenism, and polycystic ovaries. Insulin resistance is central to its pathophysiology, contributing to metabolic disturbances and increased cardiometabolic risks. High-Intensity Interval Training (HIIT) has emerged as a promising intervention to improve metabolic health.ObjectiveThis study aimed to investigate the specific effects of HIIT on insulin sensitivity, body composition, metabolic profile, and quality of life in women with overweight PCOS.MethodsA retrospective analysis was conducted on 107 female patients with overweight PCOS who were divided into two groups: the Regular Interval Training Group (n = 54) and the HIIT Group (n = 53). Baseline data, including insulin sensitivity, glucose metabolism, body composition, metabolic profile, and quality of life, were measured and compared between the two groups.ResultsThe HIIT Group demonstrated significantly improved insulin sensitivity, reduced fasting glucose levels, lower HOMA-IR index, lower body fat percentage, decreased waist and hip circumferences, improved favorable changes in metabolic profile, and significant improvements in quality of life compared to the Regular Interval Training Group. These findings suggest that HIIT led to beneficial outcomes across various metabolic and clinical parameters in women with overweight PCOS.ConclusionThe findings of this study highlight the potential of personalized exercise prescriptions, such as HIIT, in optimizing health outcomes in women with overweight PCOS. The observed improvements in insulin sensitivity, body composition, metabolic profile, and quality of life underscore the promising role of HIIT in addressing the multifaceted implications of PCOS and its associated metabolic and reproductive implications.

Effectiveness of high-intensity interval training in rehabilitation nursing for mild-to-moderate stable COPD patients: a randomized controlled clinical trial

OBJECTIVE

The current study was conducted to explore the clinical impact of high-intensity interval training (HIIT) in rehabilitation nursing on improving cardiopulmonary function and exercise capacity in COPD patients.

METHODS

A total of thirty-one COPD patients underwent HIIT, while an equal number underwent moderate-intensity continuous training (MICT) were included in this randomized controlled clinical study. The randomization method used was stratified block randomization, stratified by center. During the 6 months follow-up period, the clinical data, including cardiopulmonary exercise testing (CPET) results, cardiopulmonary function index, quality of life, and follow-up outcomes, were collected before and after the interventions. The therapeutic effects of the two groups were compared.

RESULTS

After the intervention, the HIIT group exhibited significantly higher peak power, exercise test duration, anaerobic threshold, peak oxygen uptake, peak ventilation, FEV1/FVC ratio, FEV1% of expected value, LVEF (%), and SF-36 scores compared to the MICT group (P < 0.05). Moreover, LVEDD was significantly lower in the HIIT group compared to the MICT group (P < 0.05). At the 6-month follow-up, the incidence of COPD acute exacerbation in the HIIT group was significantly lower than in the MICT group (P < 0.05).

CONCLUSION

Implementation of HIIT in rehabilitation nursing effectively improved cardiopulmonary function and exercise capacity in COPD patients during clinical treatment, highlighting its promising application potential.

TRIAL REGISTRATION

This study was previously registered at Chinese Clinical Trial Registry (Date 11/05/2022 Number ChiCTR2200059764).

Impact of Probiotic Supplementation and High-Intensity Interval Training on Primary Dysmenorrhea: A Double-Blind, Randomized Controlled Trial Investigating Inflammation and Hormonal Modulation

Background: Dysmenorrhea, categorized as primary (PD) or secondary (SD), significantly affects females during their reproductive years, impairing quality of life, performance, and social relationships. Alongside medical treatment, exercise and probiotics are complementary measures for managing PD and promoting health. This study examined the impact of probiotic supplementation and high-intensity interval training (HIIT) on PD severity, physiological modulation, and physical fitness. Methods: Participants, recruited according to the primary dysmenorrhea criteria, were divided into non-PD (control) and PD groups, with the PD group further classified into dysmenorrhea (Dysmen), dysmenorrhea with probiotics (DysmenPro), dysmenorrhea with exercise (DysmenEx), and dysmenorrhea with both (DysmenExPro). Interventions included 10 weeks of HIIT and probiotics. Pre- and post-intervention assessments included questionnaires on premenstrual and menstrual symptoms, physical fitness evaluations, and blood sample analyses for biochemical, hormonal, and prostaglandin levels. Results: HIIT significantly reduced premenstrual symptoms, menstrual distress, and pain severity, likely due to hormone (estradiol, prolactin, progesterone, cortisol) modulation and decreased inflammation (high-sensitivity C-reactive protein, PGE2, PGF2α). Cardiovascular endurance and explosive strength showed improvement through high-intensity interval training (HIIT), whereas probiotics had no significant effect on these aspects of physical fitness. While probiotics reduced premenstrual and menstrual distress symptoms, they had no notable impact on pain, inflammation, or hormone levels. Dysmenorrhea-related discomforts were correlated significantly with inflammation and hormones. Conclusions: The intervention strategy involving probiotics and HIIT exercise may be utilized as an alternative and complementary treatment to alleviate PD symptoms. Furthermore, this strategy could also be incorporated into educational health plans to promote women's health and potentially prevent gynecological disorders in the adolescent population.

Effects of high-intensity interval training on sleep disturbances associated with posttraumatic stress disorder

Sleep disturbances are common in individuals with posttraumatic stress disorder. Exercise interventions are a promising approach in the treatment of sleep disorders, but little is known about the efficacy of exercise interventions for sleep disturbances associated with posttraumatic stress disorder. A total of 40 individuals with posttraumatic stress disorder were randomized to six sessions of either high-intensity interval training or low-to-moderate-intensity training, administered within 12 days. Sleep quality was assessed over 24 days from baseline to post with the Pittsburgh Sleep Quality Index, a sleep log, and a waist-worn actigraphy. Analyses revealed that, regardless of group allocation, Pittsburgh Sleep Quality Index score improved significantly by 2.28 points for high-intensity interval training and 1.70 points for low-to-moderate-intensity training (d = 0.56 for high-intensity interval training; 0.49 for low-to-moderate-intensity training) over time, while there were no significant changes in any sleep log or actigraphy measure. Analysis of a subsample of those affected by clinically significant sleep disturbances (n = 24) revealed a significant time effect with no difference between exercise interventions: Pittsburgh Sleep Quality Index improved significantly by 2.65 points for high-intensity interval training and 2.89 points for low-to-moderate-intensity training (d = 0.53 for high-intensity interval training; 0.88 for low-to-moderate-intensity training), and actigraphy measure of wake after sleep onset was reduced significantly by 14.39 minutes for high-intensity interval training and 6.96 minutes for low-to-moderate-intensity training (d = 0.47 for high-intensity interval training; 0.11 for low-to-moderate-intensity training) from baseline to post. In our pilot study, we found an improvement in sleep quality from pre- to post-assessment. There were no significant differences between exercise groups. Further studies are needed to investigate whether the found time effects reflect the exercise intervention or unrelated factors.

Feasibility and efficacy of adding high-intensity interval training to a multidisciplinary lifestyle intervention in children with obesity-a randomized controlled trial

BACKGROUND

Multidisciplinary lifestyle interventions for children with obesity in Denmark often include recommendations regarding physical activity, but no structured exercise program. We hypothesized that adding high-intensity interval training (HIIT) to a multidisciplinary lifestyle intervention would improve BMI z-score (primary outcome), waist circumference, blood pressure, and health-related quality of life (HRQOL).

METHODS

This randomized controlled trial included 173 children and adolescents with obesity. Participants were allocated to 12-months lifestyle intervention (N = 83), or 12-month lifestyle intervention accompanied by a 12-week HIIT program (N = 90). HIIT consisted of three weekly sessions and included activities eliciting intensities >85% of maximal heart rate.

RESULTS

Attendance rate for the 3-months HIIT intervention was 68.0 ± 23.2%. Dropout was lower in HIIT compared to control at three months (7.8% vs. 20.5%) and 12 months (26.5% vs 48.2%). Changes in BMI z-score did not differ between HIIT and control at 3 months (Mean Difference (MD): 0.01, 95% confidence interval (CI): -0.09; 0.12, P = 0.82) or 12 months (MD: 0.06, CI: -0.07;0.19, P = 0.34). Across randomization, BMI z-score was reduced by 0.11 (CI: 0.17; 0.06, P < 0.01) at 3 months and 0.20 (CI: 0.26;0.14, P < 0.01) at 12 months. At 3 months, HIIT experienced a greater increase in HRQOL of 2.73 (CI: 0.01;5.44, P = 0.05) in PedsQL Child total-score and 3.85 (CI: 0.96; 6.74, P < 0.01) in psychosocial health-score compared to control. At 12 months, PedsQL Child physical-score was reduced by 6.89 (CI: 10.97; 2.83, P < 0.01) in HIIT compared to control. No group differences or changes over time were found for waist circumference or blood pressure.

CONCLUSION

Adding a 12-week HIIT program did not further augment the positive effects of a 12-month lifestyle intervention on BMI z-score. Adding HIIT improved HRQOL after 3 months, but reduced HRQOL at 12 months. Implementation of HIIT in community-based settings was feasible and showed positive effects on adherence to the lifestyle intervention.

5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2025

The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, an interprofessional expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.

The Effect of High-Intensity Interval Training (HIIT) on Brain-Derived Neurotrophic Factor Levels (BNDF): A Systematic Review

BACKGROUND/OBJECTIVES

High-intensity interval training (HIIT) alternates short periods of intense exercise with recovery, effectively enhancing cardiorespiratory fitness, endurance, and strength in various populations. Concurrently, brain-derived neurotrophic factor (BDNF) supports neuronal resilience and activity-dependent plasticity, which are vital for learning and memory. This study aims to systematically review changes in BDNF levels in response to HIIT, with three primary objectives: evaluating the benefits of HIIT for BDNF modulation, assessing methodological quality and the risk of bias in reviewed studies, and identifying patterns in BDNF response based on HIIT protocols and population characteristics.

METHODS

Comprehensive database searches were conducted in PubMed and SPORTDiscus to identify relevant studies published up to April 2024. Given the diversity in study designs and outcomes, a narrative synthesis was performed rather than a meta-analysis. Bias was evaluated using visualization tools such as RobVis, and the review was conducted by a single researcher, which may limit its comprehensiveness.

RESULTS

Twelve studies met the inclusion criteria, with most indicating significant increases in BDNF levels post-HIIT, suggesting HIIT's potential to enhance neuroplasticity and cognitive functions. However, variations in BDNF responses were observed across different HIIT protocols and study populations. Some studies reported decreases or no change in BDNF levels, reflecting the complex regulation of BDNF influenced by factors such as exercise intensity, duration, and individual variability.

CONCLUSIONS

HIIT shows promise as an intervention for increasing BDNF levels, with potential benefits for brain health and cognitive function. These findings underscore the need for further research to confirm the optimal conditions under which HIIT can effectively enhance neurological outcomes. Future studies should explore standardized HIIT protocols and the long-term impact of HIIT on BDNF and neuroplasticity.

Enhancing Adolescent Physical Fitness and Well-Being: A School-Based High-Intensity Interval Training Program

Background: The aim of this study is to investigate the effects of a school-based high-intensity interval training (HIIT) program on quality of life and physical fitness in adolescents. Methods: The study included 60 male adolescents (16.2 ± 0.6 years), randomly assigned to one of two groups: the HIIT group (n = 30) and the control group (CG, n = 30). Participants completed the KIDSCREEN-27 questionnaire to evaluate quality of life and physical fitness tests, including vertical jump, repetitive strength, agility, and flexibility. The experimental program consisted of a 12-week intervention integrated into the warm-up phase of regular physical education (PE) classes. Each PE class lasted 45 min, with the HIIT regimen occupying 10 min of the warm-up phase. The HIIT sessions followed a Tabata-style structure, performed twice weekly. A two-way ANOVA with repeated measures assessed group and time interaction effects. Results: The results revealed changes in physical well-being following the HIIT intervention (p = 0.01) compared to the control group (p = 0.42). The results of the two-way ANOVA with repeated measures revealed interaction effects between group and time for the various fitness tests, countermovement jump (p = 0.04), 4 × 10 m agility test (p = 0.02), medicine ball throw test (p = 0.04), and sit-ups (30 s) (p = 0.01). Conclusions: This study highlights the effectiveness of school-based HIIT in significantly enhancing physical well-being and physical fitness among adolescents.

The effects of high-intensity interval training and moderate-intensity continuous training on patients underwent Coronary Artery Bypass Graft surgery; a systematic review

OBJECTIVES

To our knowledge, there is no clear consensus on a definitive cardiac rehabilitation method for patients undergoing Coronary Artery Bypass Graft (CABG). We conducted this systematic review to compare and evaluate the effects of two of the most frequent cardiac rehabilitation modalities, high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT), on cardiopulmonary variables.

METHODS

We carried out a systematic search of the databases PubMed, Web of Science, Embase, Scopus, and Google Scholar. Following the removal of duplicate results, the original search yielded 385 citations. We identified four randomized clinical trials after reviewing titles, abstracts, and potential full-text studies. We utilized the Cochrane Risk of Bias Tool (RoB2) to assess the risk of bias.

RESULTS

We included four randomized clinical trials involving 143 people. All trials included individuals who had CABG and completed HIIT or MICT sessions for at least four weeks. The findings indicated that HIIT programs may improve functional capacity, heart rate variability indices, and blood pressure management while lowering brain natriuretic peptide (BNP1-32) and N-terminal pro-b-type natriuretic peptide (NT-proBNP1-76) levels.

CONCLUSION

Given the findings, it appeared that supervised high-intensity exercise regimens could be more useful to patients. Following the surgery, HIIT therapy improves exercise capacity, the autonomic nervous system, volume overload, and blood pressure regulation.

Effects of acute rope skipping exercises of different exercise modes on cognitive function in 9-10-year-old children

To explore the effects of acute high-intensity interval rope skipping exercise and acute moderate-intensity continuous rope skipping exercise on cognitive function in 9-10-year-old children, this study aims to inform the selection of appropriate jump rope methods for cognitive training in physical activities. A total of 60 students from two classes of fourth grade in a primary school were selected as research subjects. After matching according to gender, they were randomly divided into HIIT group, MICT group and control group. The Digit Span Test (DST), Attention Network Test (ANT) and Stroop Color Word Test were conducted three days before the intervention and 5 min after the intervention. During the intervention, the HIIT group performed a high-intensity intermittent rope skipping exercise (required fast jumping with feet together, practice for 1 min and rest for 1 min, jump continuously for 5 groups, and the exercise intensity is ≥ 85% of the maximum heart rate), while the MICT group performed a moderate-intensity continuous rope skipping exercise (required to medium jumping with feet together, jump continuously for 5 min, and the exercise intensity is 60-80% of the maximum heart rate), and the control group rests in place. After the intervention, both HIIT and MICT groups showed increased DST total scores, improved executive control network efficiency, and faster inhibitory control response speeds, with no significant changes in accuracy. The HIIT group also exhibited increased orienting network efficiency and no significant changes in accuracy. Acute rope skipping exercises using HIIT and MICT methods can improve the working memory, executive control network efficiency and inhibitory control ability of children aged 9-10 years old. Additionally, conducting acute rope skipping exercises using HIIT method can also enhance their orienting network efficiency.

Efficacy of Interval Training in Improving Body Composition and Adiposity in Apparently Healthy Adults: An Umbrella Review with Meta-Analysis

BACKGROUND

Although the efficacy of interval training for improving body composition has been summarized in an increasing number of systematic reviews in recent years, discrepancies in review findings and conclusions have been observed.

OBJECTIVE

This study aims to synthesize the available evidence on the efficacy of interval training compared with moderate-intensity continuous training (MICT) and nonexercise control (CON) in reducing body adiposity in apparently healthy adults.

METHODS

An umbrella review with meta-analysis was performed. A systematic search was conducted in seven databases (MEDLINE, EMBASE, Cochrane Database, CINAHL, Scopus, SPORTDiscus, and Web of Science) up to October 2023. Systematic reviews with meta-analyses of randomized controlled trials (RCTs) comparing interval training and MICT/CON were included. Literature selection, data extraction, and methodological quality assessment (AMSTAR-2) were conducted independently by two reviewers. Meta-analyses were performed using a random-effects model. Subgroup analyses were conducted based on the type of interval training [high-intensity interval training (HIIT) and sprint interval training (SIT)], intervention duration, body mass index, exercise modality, and volume of HIIT protocols.

RESULTS

Sixteen systematic reviews, including 79 RCTs and 2474 unique participants, met the inclusion criteria. Most systematic reviews had a critically low (n = 6) or low (n = 6) AMSTAR-2 score. Interval training demonstrated significantly greater reductions in total body fat percent (BF%) compared with MICT [weighted mean difference (WMD) of - 0.77%; 95% confidence interval (CI) - 1.12 to - 0.32%] and CON (WMD of - 1.50%; 95% CI - 2.40 to - 0.58%). Significant reductions in fat mass, visceral adipose tissue, subcutaneous abdominal fat, and android abdominal fat were also observed following interval training compared to CON. Subgroup analyses indicated that both HIIT and SIT resulted in superior BF% loss than MICT. These benefits appeared to be more prominent in individuals with overweight/obesity and longer duration interventions (≥ 12 weeks), as well as in protocols using cycling as a modality and low-volume HIIT (i.e., < 15 min of high-intensity exercise per session).

CONCLUSIONS

This novel umbrella review with large-scale meta-analysis provides an updated synthesis of evidence with implications for physical activity guideline recommendations. The findings support interval training as a viable exercise strategy for reducing adiposity in the general population.

Effects of aerobic training on cardiopulmonary fitness in patients with long COVID-19: a randomized controlled trial

BACKGROUND

Long COVID-19 is characterized by systemic deterioration of the entire body, leading to significant physical and mental disorders. Exercise training has the potential to improve persistent symptoms and cardiopulmonary functions.

METHOD

This was a single-center, randomized, controlled trial. Twenty-four patients aged 18 to 75 years who had a history of SARS-CoV-2 infection and long COVID symptoms. Patients were randomly allocated in a 1:1 ratio to receive either a 4-week exercise training program or an attention control group. The training group participated in 12 supervised aerobic sessions on a cycling ergometer over 4 weeks. The outcomes were to assess the impact of a 4-week aerobic exercise on the persistent symptoms and cardiopulmonary fitness, the surrogate endpoints of COVID-19 recovery and cardiopulmonary health.

RESULTS

After the 4-week intervention, significant reductions were observed in the total number of symptoms in the training group. Specifically, 67.8% of patients in the training group exhibited reduced or completely resolved symptoms, in comparison to 16.7% in the control group (P = 0.013). After adjusting for gender, significant improvements in the training group were observed for exercise time (Pgroup*time = 0.028), maximum load (Pgroup*time = 0.01), and peak VO2 (Pgroup*time = 0.001), as well as O2 pulse (Pgroup*time = 0.042) and maximum heart rate (Pgroup*time = 0.007). The score of Short Form-12, depression, anxiety, perceived stress, and insomnia did not show significant changes between groups (Pgroup*time > 0.05).

CONCLUSION

A supervised aerobic training program has the potential to alleviate persistent symptoms and improve exercise tolerance in patients with long COVID-19. Further research is necessary to confirm these effects in a large population. This intervention could be easily implemented in non-hospital settings, potentially benefiting a broader range of individuals.

TRIAL REGISTRATION NUMBER

ClinicalTrials.gov NCT05961462. Registered on July 25, 2023.

Effects of High-Intensity Interval Training on the Parameters Related to Physical Fitness and Health of Older Adults: A Systematic Review and Meta-Analysis

BACKGROUND

As a novel and time-efficient exercise form, high-intensity interval training (HIIT) has shown great potential in improving health-related physical fitness among diverse populations. However, empirical evidence on its efficacy among the elderly has not been well summarized. This systematic review and meta-analysis aimed to determine the effect of HIIT interventions on the parameters related to physical fitness and health of older adults, including resting heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), cardiorespiratory fitness (CRF), body mass index (BMI), body fat percent (BF%), waist circumference (WC), muscular endurance (ME), muscular strength (MS), muscular power (MP), balance and flexibility, compared to non-exercise and other-exercise (e.g., moderate-intensity continuous training, resistance training) conditions.

METHODS

Literature published from January 2000 to May 2023 was collected through extensive searches across eight databases and relevant review papers. Randomized controlled trials (RCTs) featuring a minimum 2-week exercise intervention for older adults (≥ 60 years) were included. The pooled effect size of Hedges'g was estimated using random-effects models in R. Meta-regression was performed for both categorical (health status, duration of training programme, and frequency) and continuous moderators (mean age, male rate, and attrition rate).

RESULTS

Forty-four eligible RCTs with 1863 participants (52.1% female; 60.5-81.2 years) were included in the quantitative analysis. Compared to non-exercise condition, HIIT significantly improved resting HR (g = -0.36, 95%CI = [-0.67, -0.05], P = 0.032), SBP (g = -0.29, 95%CI = [-0.54, -0.03], P = 0.008), CRF (g = 0.77, 95%CI = [0.51, 1.04], P < 0.001), BF% (g = -0.26, 95%CI = [-0.41, -0.11], P = 0.006), MS (g = 0.47, 95%CI = [0.23, 0.71], P = 0.004), ME (g = 0.65, 95%CI = [0.10, 1.19], P = 0.036), and balance (e.g., timed-up-and-go) (g = -0.79, 95%CI = [-1.19, -0.40], P = 0.035). Compared to other-exercise condition, HIIT significantly improved resting HR (g = -0.11, 95%CI = [-0.21, -0.01], P = 0.029), SBP (g = -0.14, 95%CI = [-0.28, -0.01], P = 0.038), and CRF (g = 0.23, 95%CI = [0.07, 0.38], P = 0.008). No significant difference was found between HIIT and non-exercise condition for DBP, BMI and WC, as well as between HIIT and other-exercise condition for DBP, BMI, BF%, WC, ME, and balance (all P > 0.05). Meta-regression indicated that mean age moderated the HIIT effect on resting HR (b = -0.02, P = 0.014; HIIT vs. other-exercise condition) and SBP (b = 0.03, P = 0.048; HIIT vs. non-exercise), and attrition rate moderated the effect on CRF (b = 0.03, P = 0.007; HIIT vs. non-exercise).

CONCLUSION

This study supports the efficacy of HIIT in improving resting HR, SBP, CRF, BF%, MS, ME and balance among older adults. More empirical evidence is needed to determine the efficacy of HIIT for MP and flexibility in this population.

TRIAL REGISTRATION

PROSPERO CRD42022316246.

Effects of Supplementation with Omega-3 and Omega-6 Polyunsaturated Fatty Acids and Antioxidant Vitamins, Combined with High-Intensity Functional Training, on Exercise Performance and Body Composition: A Randomized, Double-Blind, Placebo-Controlled Trial

The aim of this study was to investigate the effects of a supplement rich in ω-3 and ω-6 polyunsaturated fatty acids (PUFAs) and antioxidant vitamins on physical performance and body composition following a period of high-intensity functional training (HIFT). Nineteen healthy young adults (nine males, ten females) underwent an 8-week HIFT program (3 days·week-1) where they were randomized 1:1 into either the supplement group (SG)-n = 10, receiving a 20 mL daily dose of a dietary cocktail formula (Neuroaspis™ PLP10) containing a mixture of ω-3 and ω-6 PUFAs (12,150 mg), vitamin A (0.6 mg), vitamin E (22 mg), and γ-tocopherol (760 mg)-or the placebo group (PG)-n = 9, receiving a 20 mL daily dose of virgin olive oil. Body composition, cardiorespiratory fitness, muscle strength, and muscle endurance were assessed before and after the training period. Body mass did not change, but muscle mass increased by 1.7 ± 1.9% or 0.40 ± 0.53 kg in the SG (p = 0.021) and decreased by 1.2 ± 1.6% or 0.28 ± 0.43 kg (p = 0.097) in the PG, compared with baseline. VO2max, vertical jump, squat 1RM, bench press 1RM, and muscle endurance increased similarly in both groups. The effects of HIFT on physical performance parameters, muscle damage, and inflammation indices were not affected by the supplementation. In conclusion, HIFT combined with high doses of ω-3 and ω-6 PUFAs and antioxidant vitamins resulted in a small but significant increase in muscle mass and fat reduction compared with HIFT alone.

Effects and neural mechanisms of different physical activity on major depressive disorder based on cerebral multimodality monitoring: a narrative review

Major depressive disorder (MDD) is currently the most common psychiatric disorder in the world. It characterized by a high incidence of disease with the symptoms like depressed mood, slowed thinking, and reduced cognitive function. Without timely intervention, there is a 20-30% risk of conversion to treatment-resistant depression (TRD) and a high burden for the patient, family and society. Numerous studies have shown that physical activity (PA) is a non-pharmacological treatment that can significantly improve the mental status of patients with MDD and has positive effects on cognitive function, sleep status, and brain plasticity. However, the physiological and psychological effects of different types of PA on individuals vary, and the dosage profile of PA in improving symptoms in patients with MDD has not been elucidated. In most current studies of MDD, PA can be categorized as continuous endurance training (ECT), explosive interval training (EIT), resistance strength training (RST), and mind-body training (MBT), and the effects on patients' depressive symptoms, cognitive function, and sleep varied. Therefore, the present study was based on a narrative review and included a large number of existing studies to investigate the characteristics and differences in the effects of different PA interventions on MDD. The study also investigated the characteristics and differences of different PA interventions in MDD, and explained the neural mechanisms through the results of multimodal brain function monitoring, including the intracranial environment and brain structure. It aims to provide exercise prescription and theoretical reference for future research in neuroscience and clinical intervention in MDD.

Investigating the Alcohol Effects on the Response to Strenuous Exercise Training: Protocol for a Multidisciplinary Intervention Study in Young Healthy Adults-The BEER-HIIT Study

High-intensity interval training (HIIT) is a time-efficient strategy to improve fitness and performance. Whereas the multiple and negative effects of high intake of alcohol have been widely studied, the effect of moderate alcohol doses after exercise is not clear, and it is currently under debate. For that, a total of 80 young healthy adults are studied and allocated into 5 groups, each including 16 participants. Four groups follow a HIIT program, while the fifth group is a control non-training group. The training groups will be randomized according to the characteristics of the ingested beverage (alcohol beer, beer 0.0%, sparkling water, or ethanol). The effects of HIIT on several aspects of physical performance and mental health in young healthy adults are evaluated, also the concomitant effect of daily and moderate alcohol consumption. The novelty of this study lies in the continuous measurement of the psychological parameters associated with carrying out a highly demanding training program in conjunction with alcohol consumption in moderate quantities, reflecting real-life conditions.

Dragon boat exercise reshapes the temporal-spatial dynamics of the brain

Although exercise training has been shown to enhance neurological function, there is a shortage of research on how exercise training affects the temporal-spatial synchronization properties of functional networks, which are crucial to the neurological system. This study recruited 23 professional and 24 amateur dragon boat racers to perform simulated paddling on ergometers while recording EEG. The spatiotemporal dynamics of the brain were analyzed using microstates and omega complexity. Temporal dynamics results showed that microstate D, which is associated with attentional networks, appeared significantly altered, with significantly higher duration, occurrence, and coverage in the professional group than in the amateur group. The transition probabilities of microstate D exhibited a similar pattern. The spatial dynamics results showed the professional group had lower brain complexity than the amateur group, with a significant decrease in omega complexity in the α (8-12 Hz) and β (13-30 Hz) bands. Dragon boat training may strengthen the attentive network and reduce the complexity of the brain. This study provides evidence that dragon boat exercise improves the efficiency of the cerebral functional networks on a spatiotemporal scale.

Home Anxiety Assessment and Influencing Factors among Adolescent Athletes in Yantai City

OBJECTIVE

To understand the prevalence of home-related anxiety among adolescent athletes during the novel coronavirus pandemic and to ascertain the factors influencing this anxiety.

METHODS

We employed cluster sampling to select 1150 adolescent athletes (aged 8-18 years) from six sports training schools in Yantai City, Shandong Province. Mental health status was assessed and recorded. Chi-square tests and multivariable logistic regression were used to analyze the factors contributing to athletes' anxiety.

RESULTS

The survey revealed a COVID-19 infection rate of 38.23% (437 individuals) with an anxiety score of 40.98 ± 8.20 and an anxiety detection rate of 11.29% (129 individuals) during the COVID-19 epidemic. Female athletes exhibited a higher anxiety rate of 14.40% compared to 8.40% in male athletes. Multivariate analysis identified female gender as a risk factor for anxiety (OR = 1.64), while participation in aquatics emerged as a protective factor (OR = 0.24, 95% CI: 1.08-2.48). Professional training duration exceeding three years increased anxiety risk (OR = 3.05, 95% CI: 1.67-5.58), as did not seeking help during difficulties (OR = 2.59, 95% CI: 1.33-5.01). Interestingly, parental care was linked to increased anxiety risk (OR = 2.44, 95% CI 1.34-4.44), while care from friends was protective (OR = 0.60, 95% CI: 0.36-1.01), which was possibly due to the pressure associated with parental expectations.

CONCLUSIONS

Adolescent athletes, particularly females and those with extended training durations, exhibit a heightened susceptibility to anxiety. This study also highlights that athletes who proactively seek assistance during challenging situations tend to experience lower anxiety levels. Additionally, a lack of COVID-19 infection and the involvement of concerned parents contribute to reduced anxiety among these young athletes.

Impact of Aerobic High-Intensity Interval Training Intervention and Mediterranean Diet Recommendations on Health-Related Quality of Life and Lifestyle Modification in Post-Myocardial Infarction Patients: Results From the INTERFARCT Surveys

This study aims to determine the impact of 2 (low vs high volume) high-intensity interval training (HIIT) programs with Mediterranean diet (MedDiet) recommendations on health-related quality of life (HRQoL) and lifestyle modification, and to examine the relationships between the changes in anxiety and depression with HRQoL and lifestyle variables after myocardial infarction (MI). Participants (n = 80) were randomized to attention control or one of the two supervised HIIT groups (2 d/weeks). Surveys before and after intervention (16 weeks): HRQoL (SF-36), anxiety and depression (HADS), MedDiet adherence (MEDAS), and physical activity (PA) and sedentary behavior (SB) levels. After intervention, there were improvements (P < .05) in HRQoL, HADS scores, and MedDiet adherence, with higher PA level in both HIIT groups with no between-HIIT group differences. The HADS score decline correlated (P < .05) with both the increase in physical component of SF-36 (r = .42), the overall metabolic expenditure (r = .26), and adherence to the MedDiet (r = .24), and the reduction in the SB (r = .35). HIIT exercise intervention with MedDiet recommendations improved HRQoL, along with reduced anxiety and depression symptoms, and a healthier lifestyle after MI. Better mental health was related to higher values of PA and MedDiet adherence.

Systematic Review and Meta-analysis of Exercise Interventions for Psychotic Disorders: The Impact of Exercise Intensity, Mindfulness Components, and Other Moderators on Symptoms, Functioning, and Cardiometabolic Health

BACKGROUND AND HYPOTHESIS

Exercise therapy has been shown to be an effective complementary treatment for patients with psychotic disorders. However, the specific impacts of different training modalities remain poorly understood. This article aims to quantitatively review the moderating influence of different exercise modalities, hypothesizing that higher exercise intensity as well as utilization of mindfulness-based exercise (MBE) components, will improve intervention outcomes.

STUDY DESIGN

PubMed, Web of Science, and PsycINFO were searched from 2010 to March 2022 for randomized controlled trials investigating exercise interventions in patients with psychotic disorders (preregistration: https://doi.org/10.17605/OSF.IO/J8QNS). Outcomes considered were positive/negative symptoms, Positive and Negative Syndrome Scale (PANSS) General Psychopathology/Total scores, depressive symptoms, psychosocial functioning, quality of life, cardiorespiratory fitness, and body mass index. Separate meta-analyses, including moderator analyses, were performed to evaluate the moderating influence of different training modalities.

STUDY RESULTS

Of 6653 studies, 40 (n = 2111 patients) were included in the meta-analysis. The effects of moderate-intensity exercise exceed low-intensity approaches for PANSS Total scores (P = .02) and depressive symptoms (P = .04). The presence of MBE components was associated with improvements in positive symptoms (P = .04) and PANSS General Psychopathology subscores (P = .04) but also with higher error and between-study heterogeneity. Our analysis also shows improved intervention effects on depression in younger patients (P = .012) and improved psychosocial functioning scores following more frequent sessions (P < .01).

CONCLUSIONS

A minimum of moderate intensity should be considered. More frequent training sessions per week also seem to be beneficial. While adding mindfulness elements is promising, it increases heterogeneity and requires caution in terms of generalization.

Effects of high-intensity interval training on depressive and anxiety symptoms in healthy individuals: A systematic review and meta-analysis of randomized clinical trials

Although evidence regarding the effects of high-intensity interval training (HIIT) on mental health has increased in recent years, there is still no consensus regarding the effects of HIIT on the symptoms of depression and anxiety in a healthy population. Therefore, this systematic review aimed to investigate the effects of HIIT on depressive and/or anxiety symptoms in healthy individuals. The following four databases were searched: PubMed, Scopus, Embase, and PsycINFO. Only randomized clinical trials (RCTs) were included. We performed a random-effects meta-analysis based on standardized mean difference (SMD). The risk of bias was assessed using the RoB 2.0 tool, and the certainty of the evidence was evaluated based on recommendations GRADE. Eight RCTs evaluating 471 participants (81% female) were considered eligible for inclusion. The results of the meta-analysis showed that HIIT-based interventions had no significant effect on reducing anxiety (SMD = -0.17; 95% CI: -0.53, 0.19; p = 0.27) and depressive symptoms (SMD = -0.38; 95% CI: -1.06, 0.30; p = 0.17) compared with the passive control group. In conclusion, HIIT does not improve symptoms of depression and anxiety in healthy individuals. This finding is based on evidence of very low certainty. Therefore, the evidence is still not consistent enough to support HIIT as a viable strategy to reduce both outcomes because of the limited number of included studies and the overall quality of evidence.

High-intensity interval training enhances mRNA expression of IGF1Ea in rat Achilles tendon

High-intensity interval training (HIIT) reportedly enhances the functional properties of the musculoskeletal system. However, the effects of HIIT on tendons remain unclear. Sixteen male rats were randomly assigned to the control (Con) or HIIT group (n = 8 in each group). Rats in the HIIT group executed the HIIT program consisting of 2.5 min treadmill running and 4.5 min rests between the bouts, 5 days per week for 9 weeks. Running speed, number of sets, and inclination were incrementally increased during the training period. Histological analysis revealed no apparent morphological changes in the extracellular matrix structure or nuclei of tenocytes between the groups. Real-time reverse transcription polymerase chain reaction analysis revealed that Igf1Ea mRNA expression was enhanced in the HIIT group. Furthermore, Igfbp5 mRNA expression tended to be higher in the HIIT group. The 9-week HIIT program enhanced tenogenic Igf1Ea mRNA expression.

The effect of high-intensity intermittent and moderate-intensity continuous exercises on neurobiological markers and cognitive performance

BACKGROUND

The effects of exercise on cognitive functions and general brain health have been increasingly studied. Such studies conducted among athletes are very important to understanding the effects of different exercise methods on biochemical parameters and cognitive performance. The present study aimed to compare the neuroprotective effects of high-intensity interval exercise (HIIE) and moderate-intensity continuous exercise (MICE) based on biochemical parameters and cognitive performance in athletes.

METHODS

A total of twenty-eight elite male boxing athletes aged > 18 years, with at least eight years of training experience, who successfully achieved national and international levels were included in this study. The elite athletes participating in the study were aged 24.43 ± 4.72 years, 14.45 ± 5.89 years of training experience, had a body weight of 74.64 ± 7.82 kg, and had a height of 177 ± 7.15 cm. Athletes who consumed any stimulants during the testing or supplementation phase, nutritional supplements, or steroids that may have affected hormone levels or sports performance in the last three months were excluded from this study. Venous blood samples were obtained, and cognitive performance tests (Stroop tests) were applied (i) immediately after high-intensity intermittent exercise (HIIE), (ii) one hour after HIIE, (iii) immediately after moderate-intensity continuous exercise (MICE), and (iv) one hour after MICE. Serum BDNF, S100B, and NSE levels were measured after each session.

RESULTS

Serum BDNF levels were significantly (F = 2.142, P < 0.001, ηp 2 = 0.589) greater in the HIIE group (5.65 ± 1.79 ng/mL) than in the control group (1.24 ± 0.54 ng/mL) and MICE group (3.38 ± 1.29 ng/mL) for the samples obtained immediately after exercise. Serum S100B levels were significantly (F = 3.427, P < 0.001, ηp 2 = 0.427) greater in the HIIE group (71.92 ± 23.05 ng/L) than in the control group (47.39 ± 15.78 ng/L), however there was no significant difference between the HIIE and MICE groups (59.62 ± 28.90 ng/L) in the samples obtained immediately after exercise. Serum NSE levels were significantly (F = 1.475, P < 0.001, ηp 2 = 0.312) greater in the HIIE group (14.57 ± 2.52 ng/mL) than in the control group (9.51 ± 3.44 ng/ML mL), however there was no significant difference between the HIIE and MICE groups (59.62 ± 28.90 ng/L) in the samples obtained immediately after exercise. Compared with control groups, both HIIE and MICE improved cognitive performance demonstrated by the Stroop test results. Again, HIIE was superior to MICE in terms of Stroop task reaction time and error rate (incongruent task) scores.

CONCLUSION

HIIE and MICE have favorable effects on improving cognitive performance and neuroprotection in an athlete population. HIIE is considered to be superior to MICE in improving neuroprotection and cognitive performance. Our study has remarkable results demonstrating the benefits of HIIT on neuroprotection and cognitive performance. HIIE is recommended instead of MICE, especially in sports where cognitive performance is more important.

Is Frequency of Practice of Different Types of Physical Activity Associated with Health and a Healthy Lifestyle at Different Ages?

Physical activity (PA) has been shown to be related to physical and mental health. Yet there are few studies on how the frequency of PA relates to health and a healthy lifestyle. We aimed to investigate how the frequency of different PAs is associated with the following health indicators: body mass index (BMI), substance consumption, physical health, and mental health. We focused on three types of PA: (1) medium- to high-intensity aerobic exercise; (2) low- to medium-intensity relaxing exercise; and (3) outdoor leisure PA. A total of 9617 volunteers, aged 19 to 81, participated in the study. The relationships between the frequencies of the three types of PA and health-related and sociodemographic factors were analyzed using multinomial logistic regression. We found that women more frequently engaged in PA type 2, and men in types 1 and 3. A higher frequency of PA was associated with lower BMI and less or no smoking behavior; higher education (PAs 1 and 3); higher age (PAs 2 and 3); better physical health (PAs 1 and 3); and better mental health (PA 3). In conclusion, higher frequency of different PAs was significantly associated with better physical and mental health, less smoking, higher age, and a higher level of education.

Is dancing an effective intervention for fat loss? A systematic review and meta-analysis of dance interventions on body composition

OBJECTIVE

The systematic review aimed to review the research on the effects of dance interventions, relative to normal lifestyles, on body composition in people with overweight and obesity.

METHODS

7 databases were searched from their inception to 3 July 2023 for studies with dance interventions and normal lifestyles groups. Only studies investigating dance interventions in people with overweight and obesity(body mass index (BMI)>24kg/m2 and percent fat mass (Fat(%)) abnormal(male>20%, female>25%)) were included in the meta-analysis. There were no restrictions on dance forms.

RESULTS

654 studies were identified from the databases, and 10 studies were evaluated to be eligible. The meta-analysis revealed that compared to normal lifestyles dance had meaningful improvements in body mass(BM), BMI, waist circumference(WC), Fat(%), and fat mass(Fat(kg)). No significant differences were found in the waist-to-hip ratio(WHR).

CONCLUSIONS

Dance is effective on fat loss in people with overweight and obesity, and has a significant improvement on body composition and morphology. For its high efficiency and greater sense of enjoyment, dance can be a beneficial exercise intervention for fat loss.

Cardiorespiratory Fitness and Performance Adaptations to High-Intensity Interval Training: Are There Differences Between Men and Women? A Systematic Review with Meta-Analyses

BACKGROUND

It is important to consider biological sex as a variable that might influence exercise adaptation in order to optimize exercise prescription for men and women.

OBJECTIVE

The aim of this study was to quantify the impact of biological sex on maximal oxygen uptake ([Formula: see text]O2max) and performance outcomes after high-intensity interval training (HIIT).

METHODS

A systematic search and review was conducted by two independent reviewers up to 8 September 2022 using MEDLINE, SPORTDiscus, and Sports Medicine & Education Index in ProQuest. Trials including healthy adults were included if they presented data for or compared male and female [Formula: see text]O2max or performance outcomes in response to HIIT. Performance outcomes included measures of exercise performance and concurrently measured physiological adaptations. Where appropriate, a random-effects, pre-post meta-analysis was undertaken. Data were sub-grouped for men and women, baseline training level, mean age, intervention type, and intervention length. Heterogeneity was assessed using Chi2, Cochran's Q, and Higgins I2 and sensitivity analyses, where required. Study quality was assessed using the Newcastle-Ottawa Scale and publication bias was assessed through visual inspection of funnel plots.

RESULTS

Thirty-three references from 28 trials were included in the review (n = 965; 462 women and 503 men). Meta-analyses included 19 studies for [Formula: see text]O2max, eight for peak power output from [Formula: see text]O2max testing (PPO), and five for threshold power (powerAT). Meta-analyses revealed similar increases in [Formula: see text]O2max in women (g = 0.57; 95% CI 0.44-0.69) and men (g = 0.57; 95% CI 0.42-0.72), and powerAT in women (g = 0.38; 95% CI 0.13-0.64) and men (g = 0.38; 95% CI 0.11-0.64). Raw mean differences for change in [Formula: see text]O2max were Δ 0.32 L·min-1 and 3.50 mL·kg-1·min-1 in men, versus Δ 0.20 L·min-1 and 3.34 mL·kg-1·min-1 for women. No significant sex differences were present for the primary analysis of any outcome. After sub-grouping, significant differences were present for PPO where the effect size was higher for well-trained women (g = 0.37) compared with well-trained men (g = 0.17), and for [Formula: see text]O2max where interventions with a duration of 4 weeks or less had significantly smaller effect sizes compared with those longer than 4 weeks (p < 0.001). Unweighted mean percentage change in [Formula: see text]O2max, PPO, and powerAT across studies was 11.16 ± 7.39%, 11.16 ± 5.99%, and 8.07 ± 6.55% for women, and 10.90 ± 5.75%, 8.22 ± 5.09%, and 7.09 ± 7.17% for men, respectively. Significant heterogeneity was present for both [Formula: see text]O2max and PPO (I2, range: 62.06-78.80%). Sub-grouping by baseline training status and intervention length decreased heterogeneity in most groups. A qualitative synthesis of other outcomes indicated similar improvements in fitness and performance for men and women with some evidence suggesting differences in the mechanisms of adaptation.

LIMITATIONS AND RISK OF BIAS

Publication bias is unlikely to have significantly influenced results for [Formula: see text]O2max or powerAT, but the meta-analysis of PPO could have benefitted from additional study data to strengthen results. The overlap in age categories and sensitivity of the analysis limits the accuracy of the results of the sub-grouping by age.

CONCLUSIONS

Findings indicated no sex-specific differences for any fitness or performance outcomes. Baseline training status and intervention length accounted for most variability in outcomes. PROSPERO registration number: CRD42021272615.

Effects of combined training or moderate intensity continuous training during a 3-week multidisciplinary body weight reduction program on cardiorespiratory fitness, body composition, and substrate oxidation rate in adolescents with obesity

This study aimed to investigate the effects of combined training (COMB, a combination of moderate-intensity continuous training-MICT and high-intensity interval training-HIIT) vs. continuous MICT administered during a 3-week in-hospital body weight reduction program (BWRP) on body composition, physical capacities, and substrate oxidation in adolescents with obesity. The 3-week in-hospital BWRP entailed moderate energy restriction, nutritional education, psychological counseling, and two different protocols of physical exercise. Twenty-one male adolescents with obesity (mean age: 16.1 ± 1.5 years; mean body mass index [BMI] 37.8 ± 4.5 kg m-2) participated in this randomized control trial study (n:10 for COMB, n:11 MICT), attending ~ 30 training sessions. The COMB group performed 3 repetitions of 2 min at 95% of peak oxygen uptake (V'O2 peak) (e.g., HIIT ≤ 20%), followed by 30 min at 60% of V'O2 peak (e.g., MICT ≥ 80%). Body composition, V'O2 peak, basal metabolic rate (BMR), energy expenditure, and substrate oxidation rate were measured during the first week (W0) and at the end of three weeks of training (W3). The two training programs were equivalent in caloric expenditure. At W3, body mass (BM) and fat mass (FM) decreased significantly in both groups, although the decrease in BM was significantly greater in the MICT group than in the COMB group (BM: - 5.0 ± 1.2 vs. - 8.4 ± 1.5, P < 0.05; FM: - 4.3 ± 3.0 vs. - 4.2 ± 1.9 kg, P < 0.05). V'O2 peak increased only in the COMB by a mean of 0.28 ± 0.22 L min-1 (P < 0.05). The maximal fat oxidation rate (MFO) increased only in the COMB group by 0.04 ± 0.03 g min-1 (P < 0.05). COMB training represents a viable alternative to MICT for improving anthropometric characteristics, physical capacities, and MFO in adolescents with obesity during a 3-week in-hospital BWRP.

The Impact of a Single Supervised Exercise Session in the Third Trimester of Pregnancy on the Physical Activity Levels of Pregnant Women-A Pilot Study

BACKGROUND

Despite the numerous beneficial effects of physical exercise during pregnancy, the levels of physical activity remain low. The aim of the study is to investigate the impact of a single supervised physical exercise session on the overall physical activity levels of pregnant women.

METHODS

During the third trimester, pregnant women attending our outpatient clinic were requested to assess their physical activity levels using the International Physical Activity Questionnaire (IPAQ). Additionally, they were invited to participate in a supervised 30 min mild-moderate-intensity aerobic exercise session (stationary bike ergometer) under the guidance of medical personnel. Subsequently, physical activity levels were reevaluated at the time of delivery.

RESULTS

Prior to the intervention, 3 out of 50 (6%) women engaged in mild-moderate physical activity for 150 min per week, while 20 out of 50 (40%) women participated in mild-moderate activity for 15-30 min, twice a week. Following the intervention, these percentages increased to 10 out of 50 (20%) and 31 out of 50 (62%), respectively (p < 0.05).

CONCLUSIONS

This pilot study suggests that a single exercise session supervised by medical personnel may significantly improve the low physical activity levels observed in pregnant women.

The Efficacy and Feasibility of a High Intensity Interval Training Program to Improve Cardiorespiratory Fitness in Truck Drivers: The Fit 2 Drive Cluster Controlled Pilot Study

OBJECTIVE

This cluster-controlled pilot study assessed the efficacy and feasibility of "Fit 2 Drive," a depot-delivered, high-intensity interval training (HIIT) program to improve the cardiorespiratory fitness (CRF) of truck drivers.

METHODS

Companies of local delivery drivers (44 men; mean [SD] age = 50.5 [9.8] years; Brisbane, Australia) were assigned to "Fit 2 Drive" (4 clusters; 27 drivers; 1 × 4 minutes supervised to self-managed HIIT, 3 times a week, 12 weeks) or a control (5 clusters; 17 drivers). Analyses assessed between group changes in CRF (VO 2peak ), HIIT session attendance, and delivery costs.

RESULTS

Driver clusters allocated to "Fit 2 Drive" significantly improved CRF compared to a control (mean difference of 3.6 mL·kg -1 ·min -1 ; P < 0.019; 95% confidence interval = 0.7-6.5 mL·kg -1 ·min -1 ). Drivers who completed the program attended 70% of sessions (25/36) with delivery costs averaging $710 AUD per driver.

CONCLUSIONS

The findings support the efficacy and feasibility of Fit 2 Drive but also highlight challenges for in-person delivery at scale.

Mental, physical, and phychophysiological responses to FFP2/N95 face mask during HIIT in active women

Training systems based on high-intensity interval training (HIIT) have experienced great influence in recent years within the context of exercise and sport. This study aims to provide insight on whether the immediate outcomes (e.g., central and peripheral acute responses) may be intensified or attenuated when a HIIT protocol is performed using a FFP2/N95 face mask in active healthy adult women. In other words, it strives to provide new findings relative to the use of face masks as a potential performance enhancing tool. In the current study, the same training session was carried out on two occasions under different conditions (i.e., with FFP2/N95 and without FFP2/N95) in a cross-over experimental design. The following study variables were assessed before and after the HIIT in both sessions: Lactate, cortisol, alpha-amylase, selective attention, countermovement jump (CMJ), and power output. Additionally, central and peripheral Rates of Perceived Exertion (RPE) were assessed before and during the HIIT. This study makes novel contributions to prior research, showing that the use of FFP2/N95 face mask (vs. no mask) yielded higher alpha-amylase, selective attention, and peripheral RPE scores. No significant differences were found for lactate, cortisol, CMJ, and power output. Interestingly, central RPE scores were significantly lower under FFP2/N95 face mask (vs. no mask) condition. The main suggestion in light of these results is that researchers and practitioners should consider potential peripheral and central responses to training stimuli when using FFP2/N95 face masks.

Effectiveness of physical activity interventions for improving depression, anxiety and distress: an overview of systematic reviews

OBJECTIVE

To synthesise the evidence on the effects of physical activity on symptoms of depression, anxiety and psychological distress in adult populations.

DESIGN

Umbrella review.

DATA SOURCES

Twelve electronic databases were searched for eligible studies published from inception to 1 January 2022.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Systematic reviews with meta-analyses of randomised controlled trials designed to increase physical activity in an adult population and that assessed depression, anxiety or psychological distress were eligible. Study selection was undertaken in duplicate by two independent reviewers.

RESULTS

Ninety-seven reviews (1039 trials and 128 119 participants) were included. Populations included healthy adults, people with mental health disorders and people with various chronic diseases. Most reviews (n=77) had a critically low A MeaSurement Tool to Assess systematic Reviews score. Physical activity had medium effects on depression (median effect size=-0.43, IQR=-0.66 to -0.27), anxiety (median effect size=-0.42, IQR=-0.66 to -0.26) and psychological distress (effect size=-0.60, 95% CI -0.78 to -0.42), compared with usual care across all populations. The largest benefits were seen in people with depression, HIV and kidney disease, in pregnant and postpartum women, and in healthy individuals. Higher intensity physical activity was associated with greater improvements in symptoms. Effectiveness of physical activity interventions diminished with longer duration interventions.

CONCLUSION AND RELEVANCE

Physical activity is highly beneficial for improving symptoms of depression, anxiety and distress across a wide range of adult populations, including the general population, people with diagnosed mental health disorders and people with chronic disease. Physical activity should be a mainstay approach in the management of depression, anxiety and psychological distress.

PROSPERO REGISTRATION NUMBER

CRD42021292710.

Observational longitudinal association between waking movement behaviours and psychological distress among adolescents using isotemporal analysis: DADOS study

This study aimed to examine the impact of reallocating time spent in waking movement behaviours at baseline on indicators of psychological distress at 24-month follow-up using isotemporal substitution regression models among a sample of Spanish adolescents. The DADOS (Deporte, ADOlescencia y Salud) study is a 3-year longitudinal observational research project carried out between years 2015-2017. The analyses included 197 adolescents (91 girls) aged 13.9 ± 0.3 years at baseline. Waking movement behaviours were assessed by a wrist-worn GENEActiv triaxial accelerometer and expressed as minutes/day of light physical activity (LPA), moderate-vigorous physical activity (MVPA) and time spent in sedentary behaviour (SB). The Behaviour Assessment System for Children and Adolescents (level 3 for adolescents) was used to assess psychological distress indicators (i.e., anxiety, social stress, and risk of depression). Results showed significant associations only for girls. The substitution of 10 min/day of SB or LPA at baseline with 10 min/day of MVPA was associated with lower levels of anxiety (both p ≤ 0.01) and social stress (both p < 0.05) at follow-up. The substitution of 10 min/day of SB with 10 min/day of LPA was associated with higher levels of anxiety at follow-up (p = 0.01). These findings highlight the need of specific physical activity recommendations for mental health paying special attention to sex-differences.

High-intensity interval training versus moderate-intensity continuous training on patient quality of life in cardiovascular disease: a systematic review and meta-analysis

This systematic review and meta-analysis aimed to compare the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on the quality of life (QOL) and mental health (MH) of patients with cardiovascular disease (CVDs). Web of Science, Medline, Embase, Cochrane (CENTRAL), CINAHL, China National Knowledge Infrastructure, Wanfang, and China Science and Technology Journal databases were searched from their date of establishment to July, 2023. A total of 5798 articles were screened, of which 25 were included according to the eligibility criteria. The weighted mean difference (WMD) and standardized mean difference (SMD) were used to analyze data from the same and different indicator categories, respectively. The fixed-effects model (FE) or random-effects model (RE) combined data based on the between-study heterogeneity. There were no statistically significant differences regarding QOL, physical component summary (PCS), mental component summary (MCS), and MH, including depression and anxiety levels, between the HIIT and MICT groups [SMD = 0.21, 95% confidence interval (CI)  - 0.18-0.61, Z = 1.06, P = 0.290; SMD = 0.10, 95% CI  - 0.03-0.23, Z = 1.52, P = 0.128; SMD = 0.07, 95% CI  - 0.05-0.20, Z = 1.13, P = 0.25; SMD = - 0.08, 95% CI  - 0.40-0.25, Z = - 0.46, P = 0.646; WMD = 0.14. 95% CI  - 0.56-0.84, Z = 0.39, P = 0.694, respectively]. HIIT significantly improved PCS in the coronary artery disease (CAD) population subgroup relative to MICT. HIIT was also significantly superior to MICT for physical role, vitality, and social function. We conclude that HIIT and MICT have similar effects on QOL and MH in patients with CVD, while HIIT is favorable for improving patients' self-perceived physiological functioning based on their status and social adjustment, and this effect is more significant in patients with CAD.

Training effects of set- and repetition-interval rest time on recumbent-boxing exercise: Could virtual reality improve further?

This study examined the influence of set-interval and repetition-interval rest time of virtual reality (VR) boxing game in supine-lying posture. Fifty healthy middle-aged adults were randomly assigned into VR and non-VR groups to perform six different exercise protocols with varying set-interval and repetition-interval rest times (S0R0, S0R1/3, S0R2/3, S40R0, S40R1/3, and S40R2/3). Analysis on the non-VR group showed significant differences between exercise protocols for average heart rate (p < 0.001), maximum ventilation volume (p < 0.001), respiratory quotient (p < 0.001), oxygen pulse (p < 0.001), and excess post-exercise oxygen consumption (EPOC) (p = 0.003). VR appeared to have no further improvement on physical training effects in middle-aged adults, while the participants reported negative experience that might be associated with the over-exertion. Future study might need to explore game design elements that can accommodate high-exertion exercises.

Preventative interventions that target cardiovascular dysfunction in children and young people: a systematic review of their effectiveness and an investigation of sexual dimorphism

Given that cardiovascular diseases remain a primary cause of mortality and morbidity, there is a need to consider preventative strategies to improve vascular function from early in life. The aims of this study were therefore to investigate which interventions may improve endothelial function, intima media thickness and arterial stiffness in children and young people and to assess whether these interventions differ in boys and girls. A systematic literature search of Science Direct, Pubmed, Google Scholar and the Cochrane Library by two independent reviewers was performed to source articles. Inclusion criteria were any studies including any child ≤18 years of age receiving an intervention, which measured vascular function other than blood pressure. Exclusion criteria were studies assessing children with chronic medical conditions. A total of 72 studies were identified, which met the inclusion criteria. A measurable change in outcome was more likely to be reported in studies investigating endothelial function (p = 0.03). Interventions which improved vascular function included physical activity and dietary programmes. Under 10% of studies considered sex differences. In conclusion, school-based physical activity interventions are most likely to result in improvements in vascular function. Endothelial function may be the first variable of vascular function to change secondary to an intervention. Standardisation of reporting of differences between the sexes is essential to be able to ensure interventions are equally effective for boys and girls.

Pulmonary rehabilitation and physical interventions

Pulmonary rehabilitation has established a status of evidence-based therapy for patients with symptomatic COPD in the stable phase and after acute exacerbations. Rehabilitation should have the possibility of including different disciplines and be offered in several formats and lines of healthcare. This review focusses on the cornerstone intervention, exercise training, and how training interventions can be adapted to the limitations of patients. These adaptations may lead to altered cardiovascular or muscular training effects and/or may improve movement efficiency. Optimising pharmacotherapy (not the focus of this review) and oxygen supplements, whole-body low- and high-intensity training or interval training, and resistance (or neuromuscular electrical stimulation) training are important training modalities for these patients in order to accommodate cardiovascular and ventilatory impairments. Inspiratory muscle training and whole-body vibration may also be worthwhile interventions in selected patients. Patients with stable but symptomatic COPD, those who have suffered exacerbations and patients waiting for or who have received lung volume reduction or lung transplantation are good candidates. The future surely holds promise to further personalise exercise training interventions and to tailor the format of rehabilitation to the individual patient's needs and preferences.

Comparative effectiveness of school-based exercise interventions on physical fitness in children and adolescents: a systematic review and network meta-analysis

Background

Schools provide a favorable setting for health education, however, the most effective school-based exercise mode for improving physical fitness remains unclear. This network meta-analysis was designed to assess and rank the comparative efficacy of six exercise modalities on physical fitness indicators in a school-based setting.

Methods

An online search of the Web of Science, PubMed, SPORTDiscus, and Scopus databases was conducted. Randomized and quasi-randomized controlled trials were considered. Outcomes included measures of anthropometry and body composition, muscular fitness, and cardiorespiratory fitness. Data were pooled with a random effects model using the frequentist framework.

Results

A total of 66 studies with 8,578 participants (48% girls) were included. High-intensity interval training was the most effective intervention reducing body mass index (mean difference (MD) = -0.60 kg·m^-2, 95% confidence interval (95%CI) = -1.04 to -0.15, p = 0.009), elevating VO_2max (MD = 3.59 mL·kg^-1·min^-1, 95% CI = 2.45 to 4.74, p < 0.001), and 20-meter sprint performance (MD = -0.35 s, 95% CI = -0.55 to -0.14, p = 0.001). Aerobic training had the highest probability of reducing waist circumference (standardized mean difference (SMD) = -0.60, 95% CI = -0.88 to -0.32, p < 0.001). Active video games emerged as a promising modality for improving countermovement jump (MD = 2.43 cm, 95% CI = 0.06 to 4.80, p = 0.041) and shuttle running performance (SMD = 0.86, 95% CI = 0.29 to 1.43, p = 0.003). Strength training was the best exercise mode for improving standing long jump performance (SMD = 1.03, 95% CI = 0.07 to 1.98, p = 0.035) while combined training was rated the first for decreasing body fat percent (MD = -2.56%, 95% CI = -4.73 to -0.40, p = 0.022) and increasing push-up repetitions (SMD = 3.59, 95% CI = 0.81 to 6.37, p = 0.012).

Conclusion

School-based exercise interventions have multiple effects on physical fitness. The findings of this study will help to inform physical education teachers and coaches how best to deliver exercise programs in a school setting. Since the study was limited by the original research, the conclusions will require further verification using high-quality randomized controlled trials.

Systematic Review Registration

PROSPERO, Identifier: CRD42023401963.

"I just had the feeling that the interval training is more beneficial": young adults' subjective experiences of physical fitness and the role of training modes

Objective

Compelling evidence has shown that high-intensity interval training (HIIT) is associated with substantial increases in physical fitness. However, little is known about whether and how individuals experience these adaptations over time. The purpose of this study is, therefore, to explore how physically inactive young adults subjectively experience physical fitness and its development as they start to exercise and how these experiences relate to different intensity domains (i.e., moderate and severe) as well as to training modes [i.e., HIIT and moderate intensity continuous training (MICT)] and their sequential administration (i.e., HIIT-MICT and MICT-HIIT).

Methods

Thirty-one inactive participants completed a 15-week two-period sequential exercise intervention in which they first trained for six weeks in a HIIT or a MICT group and subsequently switched training modes. Interviews using the biographical mapping method were conducted at the end of the intervention to assess participants' exercise- and fitness-related experiences over the past weeks. To assess experiential patterns, we conducted a reflexive thematic analysis.

Results

We developed three themes that represent the temporal and processual character of starting to exercise after a prolonged period of inactivity: (1) Inactive young adults are not all the same when starting to exercise; (2) Developing physical fitness is a multi-faceted and individual experience; and (3) Feeling physically fit (or not) fosters large-scale effects.

Conclusion

Our results show that, in retrospect, participants mostly deemed HIIT to be more effective than MICT. Our findings also emphasize that physical fitness is a complex and subjective experience that manifests in various ways over time. The idiosyncrasy of physical fitness experiences reiterates the necessity for individually tailored exercise prescriptions instead of one-size-fits-all approaches.

A longitudinal study of lifestyle behaviours in emerging adulthood and risk for symptoms of depression, anxiety, and stress

BACKGROUND

Little research has examined how lifestyle behaviours cluster together to contribute to mental health outcomes. The current study aimed to identify latent classes of emerging adult lifestyle behaviours (diet, physical activity, sedentary time, smoking, alcohol, cannabis, and other drug use) at age 20 years and their associations with depression, anxiety, and stress symptoms at age 22 and 27 years.

METHODS

Participants were 616 emerging adults enrolled in the Raine Study. Lifestyle classes at baseline were identified using latent class analysis. Longitudinal associations between latent class membership and risk of depression, anxiety, and stress symptoms were examined using logistic regression models.

RESULTS

Three lifestyle classes were identified: Class 1 (healthier pattern, n = 399 [64.8 %]), Class 2 (predominantly female, high substance-use, low physical activity pattern, n = 121 [19.6 %]), and Class 3 (predominantly male, high substance-use, poor diet pattern, n = 96 [15.6 %]). Following adjustment, Class 2 were at a higher risk of depression, anxiety, and stress symptoms at age 22 years, and a higher risk of anxiety and stress symptoms at age 27 years, compared to Class 1.

LIMITATIONS

This study was limited by reliance on self-report data, lack of available indicators for parental socioeconomic status, and some measurement inconsistencies across variables. Adherence to lifestyle clusters over time was not assessed.

CONCLUSIONS

Latent classes of lifestyle behaviours were identified among emerging adults, and differences in mental health outcomes were found among the classes at two prospective time points. Future research and prevention strategies for common mental disorders should target emerging adults and focus on lifestyle patterns.

Intermittent high-intensity exercise for pre- to established hypertension: A systematic review and meta-analysis

OBJECTIVE

To determine the impact of intermittent high-intensity exercise training ([IHIE], including high-intensity interval training [HIIT] and recreational team sports [RTS]) on systolic (SBP) and diastolic blood pressure (DBP) in adults with pre- to established arterial hypertension.

DATA SOURCES

MEDLINE, Cochrane Library, Embase, and SPORTDiscus.

ELIGIBILITY CRITERIA

Randomized controlled trials (RCTs) comparing the impact of IHIE on BP versus a non-exercise control.

DATA COLLECTION AND ANALYSIS

Two authors independently conducted all procedures. Mean differences were calculated using random-effects model. The certainty of the evidence was assessed with GRADE.

RESULTS

Twenty-seven RCTs (18 HIIT and 9 RTS) were analyzed, with median duration of 12 weeks. Participants' (n = 946) median age was 46 years. Overall, IHIE decreased SBP (-3.29 mmHg; 95% CI: -5.19, -1.39) and DBP (-2.62 mmHg; 95% CI: -3.79, -1.44) compared to the control group. IHIE elicited higher decreases in office SBP and DBP of hypertensive subjects (SBP: -7.13 mmHg, [95% CI: -10.12, -4.15]; DBP: -5.81 mmHg, [95% CI: -7.94, -3.69]) than pre-hypertensive (SBP: -2.14 mmHg, [95% CI: -4.36, -0.08]; DBP: -1.83 mmHg, [95% CI: -2.99, -0.67]). No significant differences were found between HIIT (SBP: -2.12 mmHg, [95% CI: -4.78, -0.54]; DBP: -1.89 mmHg, [95% CI: -3.32, -0.48]) and RTS (SBP: -4.18 mmHg, [95% CI: -7.19, -2.43]; DBP: -4.04 mmHg, [95% CI: -6.00, -2.09]). These findings present low/very low certainty of evidence. No adverse cardiovascular events were reported.

CONCLUSIONS

IHIE appears to be safe and to promote substantial decreases in BP, particularly in patients with hypertension. However, the certainty of evidence was low/very low.

PROTOCOL

CRD42020163575.

Importance of immunometabolic markers for the classification of patients with major depressive disorder using machine learning

BACKGROUND

Although there is scientific evidence of the presence of immunometabolic alterations in major depression, not all patients present them. Recent studies point to the association between an inflammatory phenotype and certain clinical symptoms in patients with depression. The objective of our study was to classify major depression disorder patients using supervised learning algorithms or machine learning, based on immunometabolic and oxidative stress biomarkers and lifestyle habits.

METHODS

Taking into account a series of inflammatory and oxidative stress biomarkers (C-reactive protein (CRP), tumor necrosis factor (TNF), 4-hydroxynonenal (HNE) and glutathione), metabolic risk markers (blood pressure, waist circumference and glucose, triglyceride and cholesterol levels) and lifestyle habits of the participants (physical activity, smoking and alcohol consumption), a study was carried out using machine learning in a sample of 171 participants, 91 patients with depression (71.42% women, mean age = 50.64) and 80 healthy subjects (67.50% women, mean age = 49.12). The algorithm used was the support vector machine, performing cross validation, by which the subdivision of the sample in training (70%) and test (30%) was carried out in order to estimate the precision of the model. The prediction of belonging to the patient group (MDD patients versus control subjects), melancholic type (melancholic versus non-melancholic patients) or resistant depression group (treatment-resistant versus non-treatment-resistant) was based on the importance of each of the immunometabolic and lifestyle variables.

RESULTS

With the application of the algorithm, controls versus patients, such as patients with melancholic symptoms versus non-melancholic symptoms, and resistant versus non-resistant symptoms in the test phase were optimally classified. The variables that showed greater importance, according to the results of the area under the ROC curve, for the discrimination between healthy subjects and patients with depression were current alcohol consumption (AUC = 0.62), TNF-α levels (AUC = 0.61), glutathione redox status (AUC = 0.60) and the performance of both moderate (AUC = 0.59) and vigorous physical exercise (AUC = 0.58). On the other hand, the most important variables for classifying melancholic patients in relation to lifestyle habits were past (AUC = 0.65) and current (AUC = 0.60) tobacco habit, as well as walking routinely (AUC = 0.59) and in relation to immunometabolic markers were the levels of CRP (AUC = 0.62) and glucose (AUC = 0.58). In the analysis of the importance of the variables for the classification of treatment-resistant patients versus non-resistant patients, the systolic blood pressure (SBP) variable was shown to be the most relevant (AUC = 0.67). Other immunometabolic variables were also among the most important such as TNF-α (AUC = 0.65) and waist circumference (AUC = 0.64). In this case, sex (AUC = 0.59) was also relevant along with alcohol (AUC = 0.58) and tobacco (AUC = 0.56) consumption.

CONCLUSIONS

The results obtained in our study show that it is possible to predict the diagnosis of depression and its clinical typology from immunometabolic markers and lifestyle habits, using machine learning techniques. The use of this type of methodology could facilitate the identification of patients at risk of presenting depression and could be very useful for managing clinical heterogeneity.

Acute effect of high-intensity interval training versus moderate-intensity continuous training on appetite perception: A systematic review and meta-analysis

Interval training protocols have gained popularity over the years, but their impact on appetite sensation compared to officially recommended training method, moderate intensity continuous training (MICT) is not well understood. Thus, this systematic review and meta-analysis aimed to compare a single session of high intensity interval training (HIIT) including sprint interval training (SIT) with MICT on appetite perception measured by the visual analog scale (VAS). After searching up articles published up to September 2021, 13 randomized controlled studies were included in the meta-analysis. Outcomes of meta-analysis demonstrated that both acute sessions of HIIT/SIT and MICT suppressed appetite compared to no-exercise control groups immediately post exercise but there were no significant effects 30-90 min post exercise or in AUC values, indicating a transient effect of exercise on appetite sensations. Moreover, differences in appetite sensations between HIIT/SIT and MICT were negligible immediately post exercise, but HIIT/SIT suppressed hunger (MD = -6.347 [-12.054, -0.639], p = 0.029) to a greater extent than MICT 30- to 90-min post exercise, while there was a lack of consistency other VAS subscales of appetite. More studies that address the impact of exercising timing, nutrient compositions of energy intake (energy intake (EI)) and differences in participants' characteristics and long-term studies analyzing chronic effects are needed to comprehensively examine the differences between HIIT/SIT and MICT on appetite and EI. SYSTEMATIC REVIEW REGISTRATION: [https://www.crd.york.ac.uk/PROSPERO], Identifier [CRD42021284898].

Impact of high-intensity interval training on tendon related gene expression in rat Achilles tendon

Immobilization or aging associated with limited physical activity can lead to the functional deterioration of tendons, which has become an important public health concern. Therefore, growing research is focused on the effect of exercise training on preserving tendon function. Exercise training subjects muscles and tendons to repeated mechanical stress, and in vitro studies have revealed that repetitive mechanical loading stimulates tendon cell responses to changes in the extracellular matrix and functional properties of the tendon. However, although several types of exercise training have been shown to be effective in preserving tendon function, no studies have investigated the impact of high-intensity interval training (HIIT), which involves composing short bouts of exercise with high-power output. Here, we determined whether the HIIT program enhanced tenogenic progressions by measuring the mRNA expression in rat Achilles tendons. Sixteen rats were randomly assigned into either a sedentary control group (Con, n = 8) or an HIIT group (n = 8). Rats in the HIIT group performed the program with treadmill running; the training volume was incremental (running speed, number of sets, and inclination), and training was conducted 5 days per week for 9 weeks. The rats in the HIIT group exhibited a marked decrease in the body weight and different types of fat weights, and a marked increase in different types of muscle weights. Real-time reverse transcription polymerase chain reaction analysis revealed that mRNA expressions of tendon-related genes Tnxb, Opn, and Tgfb1 were upregulated in the HIIT group compared to that in the Con group. Cross-links in mRNA expressions of collagen-related Dcn and Fmod in the HIIT group tended to be higher than in those Con group. These results suggest that HIIT induces initiation of tenogenic progression and stimulation of cross-link formation between collagen fibrils in rat Achilles tendons.

High-intensity interval training improves the outcomes of patients with chronic obstructive pulmonary disease: A meta-analysis of randomized controlled trials

BACKGROUND

Pulmonary exercise is an important part in the treatment of chronic obstructive pulmonary disease (COPD). We aimed to evaluate the effects and safety of high-intensity interval training (HIIT) in patients with COPD, to provide insights to the COPD treatment and care.

METHODS

Two investigators searched PubMed, Medline, Embase, web of Science, Cochrane library, China National Knowledge Infrastructure (CNKI), Wanfang, and Weipu databases up to Sept 15, 2022 for randomized controlled trials (RCTs) on the effects and safety of HIIT for COPD patients. RevMan5.3 software was used for statistical analysis.

RESULTS

A total of 20 RCTs involving 962 COPD patients were finally included. 514 patients underwent HIIT interventions. Meta-analysis showed that HIIT increased the peak oxygen consumption (SMD = 0.30, 95%CI:0.14-0.46), peak minute ventilation (SMD = 0.26, 95%CI: 0.05-0.47), peak work rate (SMD = 0.34, 95%CI: 0.17-0.51), 6-min walking distance (SMD = 0.39, 95%CI: 0.23-0.55) in COPD patients (all P < 0.05). HIIT improved the quality of life (SMD = 0.30, 95%CI: 0.06-0.54) and reduced the dyspnea (SMD = -0.27, 95%CI: -0.51∼-0.03) in COPD patients (all P < 0.05). There were no significant differences in the forced expiratory volume in 1 s/forced vital capacity (SMD = 0.28, 95%CI: -0.01-0.56) and St. George's Respiratory Questionnaire score (SMD = -0.35, 95%CI: -0.73-0.03) between HIIT and control group (all P > 0.05). There was no publication bias analyzed by the Egger test and funnel plots (all P > 0.05).

CONCLUSIONS

HIIT may be beneficial to improve the pulmonary function, exercise capacity and quality of life of patients with COPD, which is worthy of clinical promotion for COPD treatment and care.