Football training improves cardiovascular health profile in sedentary, premenopausal hypertensive women

15 weeks of soccer training increases left ventricular mass and improves indices of left ventricular diastolic function in previously sedentary, mildly hypertensive, middle-aged women

PURPOSE

To investigate the impact of soccer training on cardiac adaptations in mildly hypertensive middle-aged women.

METHODS

Hypertensive premenopausal women (n = 41; age (mean ± SD): 44 ± 7 years; height: 166 ± 6 cm; weight: 78.6 ± 11.6 kg; body fat: 43.3 ± 5.2%) were randomized to soccer training (SOC, n = 21) or control (CON, n = 20). SOC performed three weekly training sessions for 15 weeks, whereas CON had no training or lifestyle changes during the same period. Cardiac structure and function were assessed by echocardiography pre-intervention and post-intervention.

RESULTS

Soccer training increased (P = 0.001) left ventricular mass index by 10% [95% CI 4; 15], while no changes occurred in CON (time × group interaction, P = 0.005). In addition, only SOC demonstrated a within-group increase (P = 0.01) of 8% [95% CI 2; 14] in left ventricular septum diameter. For markers of right ventricular remodelling, a within-group increase (P = 0.02) occurred for tricuspid annulus plane systolic excursion of 8% [95% CI 1; 14] in SOC only. Left atrial diameter index increased (P < 0.001) by 6% [95% CI 3; 10] after SOC, while it was unaffected in CON (time × group interaction, P = 0.02). For makers of diastolic function, SOC demonstrated a within-group increase (P = 0.02) in the average early diastolic mitral annulus velocity of 10% [95% CI 2; 19]. In addition, a reduction (P < 0.001) in mitral valve A velocity of - 19% [95% CI - 29; - 10] was observed following soccer training, which manifested in increased (P < 0.001) mitral valve E/A ratio of 34% [95% CI 16; 53] in SOC. No within-group changes were apparent in CON.

CONCLUSION

In sedentary, mildly hypertensive, middle-aged women, 15 weeks of soccer training increases left ventricular mass and left atrial diameter and improves indices of left ventricular diastolic function.

Health Benefits of Different Sports: a Systematic Review and Meta-Analysis of Longitudinal and Intervention Studies Including 2.6 Million Adult Participants

BACKGROUND

Several reviews have examined the health benefits of participation in specific sports, such as baseball, cricket, cross-country skiing, cycling, downhill skiing, football, golf, judo, rugby, running and swimming. However, new primary studies on the topic have recently been published, and the respective meta-analytic evidence needs to be updated.

OBJECTIVES

To systematically review, summarise and appraise evidence on physical health benefits of participation in different recreational sports.

METHODS

Searches for journal articles were conducted in PubMed/MEDLINE, Scopus, SpoLit, SPORTDiscus, Sports Medicine & Education Index and Web of Science. We included longitudinal and intervention studies investigating physical health outcomes associated with participation in a given sport among generally healthy adults without disability.

RESULTS

A total of 136 papers from 76 studies conducted among 2.6 million participants were included in the review. Our meta-analyses of available evidence found that: (1) cycling reduces the risk of coronary heart disease by 16% (pooled hazard ratio [HR] = 0.84; 95% confidence interval [CI]: 0.80, 0.89), all-cause mortality by 21% (HR = 0.79; 95% CI: 0.73, 0.84), cancer mortality by 10% (HR = 0.90; 95% CI: 0.85, 0.96) and cardiovascular mortality by 20% (HR = 0.80; 95% CI: 0.74, 0.86); (2) football has favourable effects on body composition, blood lipids, fasting blood glucose, blood pressure, cardiovascular function at rest, cardiorespiratory fitness and bone strength (p < 0.050); (3) handball has favourable effects on body composition and cardiorespiratory fitness (p < 0.050); (4) running reduces the risk of all-cause mortality by 23% (HR = 0.77; 95% CI: 0.70, 0.85), cancer mortality by 20% (HR = 0.80; 95% CI: 0.72, 0.89) and cardiovascular mortality by 27% (HR = 0.73; 95% CI: 0.57, 0.94) and improves body composition, cardiovascular function at rest and cardiorespiratory fitness (p < 0.010); and (5) swimming reduces the risk of all-cause mortality by 24% (HR = 0.76; 95% CI: 0.63, 0.92) and improves body composition and blood lipids (p < 0.010).

CONCLUSIONS

A range of physical health benefits are associated with participation in recreational cycling, football, handball, running and swimming. More studies are needed to enable meta-analyses of health benefits of participation in other sports. PROSPERO registration number CRD42021234839.

Health and performance effects of 12 weeks of small-sided street football training compared to grass football training in habitually active young men

PURPOSE

The purpose of the present study was to investigate the health and exercise performance effects of street football training on very small pitches surrounded by boards in young habitually active men in comparison to small-sided football training on grass.

METHODS

Thirty-nine habitually active men (30.7 ± 6.7 years, 90.9 ± 16.6 kg, 183.8 ± 4.5 cm, 39.6 ± 6.0 mL/min/kg) were randomly assigned to a street football training group (ST) or grass football group (GR) playing small-sided games for 70 min, 1.5 and 1.7 times per week for 12 weeks, respectively, or an inactive control group (CO). Intensity during training was measured using heart rate (HR) and GPS units. Pre- and post-intervention, a test battery was completed.

RESULTS

Mean HR (87.1 ± 5.0 vs. 84.0 ± 5.3%HRmax; P > 0.05) and percentage of training time above 90%HRmax (44 ± 28 vs. 34 ± 24%; P > 0.05) were not different between ST and GR. VO2max increased (P < 0.001) by 3.6[95% CI 1.8;5.4]mL/min/kg in GR with no significant change in ST or CO. HR during running at 8 km/h decreased (P < 0.001) by 14[10;17]bpm in ST and by 12[6;19]bpm in GR, with no change in CO. No changes were observed in blood pressure, resting HR, total body mass, lean body mass, whole-body bone mineral density, fasting blood glucose, HbA1c, plasma insulin, total cholesterol(C), LDL-C or HDL-C. Moreover, no changes were observed in Yo-Yo IE2 performance, 30-m sprint time, jump length or postural balance.

CONCLUSION

Small-sided street football training for 12 weeks with 1-2 weekly sessions led to improvements in submaximal exercise capacity only, whereas recreational grass football training confirmed previous positive effects on submaximal exercise capacity as well as cardiorespiratory fitness.

Long-term continuous exercise training counteracts the negative impact of the menopause transition on cardiometabolic health in hypertensive women - a 9-year RCT follow-up

PURPOSE

The study examined effects of 9-yrs of multicomponent exercise training during the menopause interval on cardiometabolic health in hypertensive women.

METHODS

Sedentary, middle-aged women (n = 25) with mild-to-moderate arterial hypertension were randomized into a soccer training (multicomponent exercise; EX; n = 12) or control group (CON; n = 13). EX took part in 1-h football training sessions, 1-3 times weekly, for a consecutive 9-years, totaling ∼800 training sessions, while CON did not take part in regular exercise training. 22 participants entered menopause during the intervention.

RESULTS

A time×group interaction effect (P = 0.04) of 8.5 mmHg in favour of EX was observed for changes in mean arterial pressure (MAP) (EX: -4.8 [-10.7;1.1] mmHg, CON +3.7 [-2.0;9.3] mmHg). Time×group interaction effects in favour of EX were also observed for total body weight (4.6 kg, P = 0.008, EX: +0.7 [-1.7;3.0] kg, CON: +5.3 [3.0;7.6] kg, total fat percentage (5.7%-points, P = 0.02; EX (-1.9 [-4.4;0.6] %-points; P = 0.13), CON +3.8 [1.4;6.2] %-points and for total cholesterol (1.2 mmol/l, P = 0.03, EX: -0.5 [-1.0;-0.1] mmol/l, CON: +0.7 [0.2;1.1] mmol/l. EX reduced (P = 0.02) plasma low-density lipoprotein cholesterol by -0.4 [-0.8;-0.1] mmol/l, whereas an increase (P = 0.01) of 0.4 [0.1;0.8] mmol/l occurred in CON (interaction. P < 0.001). A time×group interaction (P = 0.004) existed for changes in exercise capacity in favour of EX. Fasting glucose remained unchanged in EX and increased (P < 0.001) by 0.7 [0.4;1.0] mmol/l in CON (time×group interaction P = 0.02).

CONCLUSION

In conclusion, long-term multicomponent exercise training fully counteracts the detrimental effects of the menopause transition on cardiometabolic health in hypertensive women.

Dose-response effect of a recreational team handball-based exercise programme on cardiometabolic health and physical fitness in inactive middle-aged-to-elderly males - a randomised controlled trial

This study aimed at examining the dose-response of a recreational team handball (TH) exercise-based programme on cardiometabolic health and physical fitness in inactive middle-aged-to-elderly males without TH experience. Fifty-four inactive middle-aged-to-elderly men (67.5 ± 4.2 years; stature 168.8 ± 6.2 cm; body mass 78.4 ± 10.7 kg; fat mass 27.1 ± 5.3%; BMI 27.4 ± 2.9 kg/m2; VO2peak 27.3 ± 4.8 mL/min/kg) were randomised into three intervention groups performing 1 (TH1, n = 13), 2 (TH2, n = 15), or 3 (TH3, n = 12) 60-min weekly recreational TH-based training sessions, for 16 weeks, and a control group (CG, n = 14). A time x group interaction was observed for VO2peak, aerobic performance, fasting plasma insulin and body and fat mass (p ≤ 0.043) with TH3 showing the greatest overall effects. Post-intervention differences were observed in aerobic performance (TH3>CG, TH1 and TH2; TH2>CG), body mass (TH3>CG and TH1), fat mass (TH3>CG), VO2peak (TH3>CG) and plasma insulin (TH3>CG) (p ≤ 0.040). In conclusion, recreational TH performed for 60-min thrice and twice per week results in improved aerobic performance for middle-aged-to-elderly men. Moreover, it was observed that three weekly sessions were more effective in providing overall cardiometabolic benefits compared to training with a lower weekly frequency. ClinicalTrials.gov ID: NCT05295511.Trial registration: ClinicalTrials.gov identifier: NCT05295511.Highlights: We observed high intensities and fun levels during recreational TH, organised as formal and small-sided games, for middle-aged-to-elderly men during a 16-week period, independently of the number of weekly training sessions.Marked positive effects on aerobic performance and cardiometabolic health were observed in the intervention group that performed 3 weekly sessions.The study results indicate that recreational TH training with low frequency and volume results in some beneficial effects on cardiometabolic fitness and health for middle-aged-to-elderly men, but future studies with more participants or longer intervention periods are warranted to explore this possibility.

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.

Football training as a non-pharmacological treatment of the global aging population-A topical review

In the present topical mini-review, the beneficial impact of small-sided game football training for the increasing elderly global population is presented. As a multicomponent type of physical activity, football training executed on small pitched with 4-6 players in each team is targeting a myriad of physiological systems and causes positive adaptations of relevance for several non-communicable diseases, of which the incidence increases with advancing age. There is strong scientific evidence that this type of football training promotes cardiovascular, metabolic and musculo-skeletal health in elderly individuals. These positive adaptations can prevent cardiovascular disease, type 2 diabetes, sarcopenia and osteoporosis, and lower the risk of falls. Also, football training has been proven an efficient part of the treatment of several patient groups including men with prostate cancer and women after breast cancer. Finally, regular football training has an anti-inflammatory effect and may slow the biological aging. Overall, there is a growing body of evidence suggesting that recreational football training can promote health in the elderly.

The Effect of 12-Weeks Recreational Football (Soccer) for Health Intervention on Functional Movement in Older Adults

There is growing evidence that recreational football offers health benefits for older adults and an important pathway for physical activity for older adult groups. Despite anecdotal evidence that recreational football is beneficial for older adults, no empirical data are available to support this assertion. This study addressed this issue and examined the effects of a 12-week recreational football intervention on the functional fitness of older adults. Using a pre-post case-control design, thirteen males, aged 61-73 years (mean age ± SD = 66 ± 4 years) undertook a twice-weekly, 12-week recreational football for health intervention, and were matched with a control group, comprising thirteen males, aged 62-78 years (mean age ± SD = 66 ± 4 years) who maintained their typical exercise habits during the intervention period. Pre- and postintervention, participants underwent assessment of functional fitness, using the Rikli and Jones functional fitness battery as well as an assessment of body fatness, via bioelectrical impedance analysis and dominant handgrip strength using handgrip dynamometry. Results from a series of 2 (pre-post) X 2 (intervention vs. control) repeated-measures ANOVAs indicate significant pre-post X group interactions for the 30-second chair stand (p = 0.038, Pƞ² = 0.168), 8-foot timed up and go (p = 0.001, Pƞ² = 0.577) and 6 min walk test (p = 0.036, Pƞ² = 0.171). In all cases, performance improved significantly after the intervention for the football intervention group but not the control group. There were no significant differences in the 30 s arm curl test or dominant handgrip strength (p > 0.05). There was a non-significant trend (p = 0.07, Pƞ² = 0.127) towards a pre-post X group interaction for body fatness, showing a decreased percent body fat for the intervention group over the control group. The results of the present study demonstrate the utility of recreational football as a physical activity intervention in older adults to improve functional movement.

Effects of Low vs Moderate Dose of Recreational Football on Cardiovascular Risk Factors

This study aimed to compare the effectiveness of recreational football performed once (LOW) vs. twice (MOD) a week on cardiovascular risk factors in healthy, sedentary men. Body composition, resting blood pressure, blood lipid profile and maximal oxygen consumption (VO₂max) were measured at baseline, after a 12-week control and training period, using an interrupted time series study (study 1, n=18: n=8, LOW and n=10, MOD) nested in a randomised parallel trial (study 2, n=34: n=18 LOW and n=16 MOD). After the intervention in the study 1, LDL-Cholesterol (-12.3 mg•dL-¹ [-22.7 to -2.0]) and VO₂max (4.5 ml•kg-¹•min-¹ [1.2 to 7.8 ]) changed in LOW whereas differences were found in weight (-2.1 kg [-3.7 to -0.4]), BMI (-0.7 kg•m^-2 [-1.2 to -0.1]), total cholesterol (-22.2 mg•dL-¹ [-36.0 to -8.4]), no-HDL-cholesterol (-17.5 mg•dL-¹ [-30.5 to -4.5]), LDL-cholesterol (-14.9 mg•dL-¹ [-23.6 to -6.2]) and VO₂max (5.7 ml•kg-¹•min-¹ [2.8 to 8.6]) in MOD. Study 2 showed no evidence of differences between groups. Our results therefore, suggest positive health effects of recreational football even when performed at low frequency as it can happen in real context.

The Faroe Islands COVID-19 Recreational Football Study: Player-to-Player Distance, Body-to-Body Contact, Body-to-Ball Contact and Exercise Intensity during Various Types of Football Training for Both Genders and Various Age Groups

We determined player-to-player distance, body-to-ball contact, and exercise intensity during three training modalities in various football populations. 213 participants were recruited, ranging from 9-year-old boys to young men and 11-year-old girls to middle-aged women. All groups were analysed with video-filming and GPS-based Polar Pro monitors during three types of football training for 20 min, i.e., COVID-19-modified training (CMT) with >2-metre player-to-player distance, small-sided games (SSG), and simulated match-play with normal rules (SMP), in randomised order. Time spent in a danger zone (1.5 m) per-percent-infected-player (DZ PPIP) ranged from 0.015 to 0.279% of playing time. DZ PPIP for SSG was higher (P < 0.05) than CMT and SMP. The average number of contacts (within 1.5 m) with a potentially infected player ranged from 12 to 73 contacts/hour. SSG had more (P < 0.05) contacts than CMT and SMP, with SMP having a higher (P < 0.05) number of contacts than CMT. Time/contact ranged from 0.87 to 3.00 seconds for the groups. No player-to-player and body-to-ball touches were registered for CMT. Total player-to-player contacts were 264% higher (P < 0.05) in SSG than SMP, ranging from 80 to 170 and 25 to 56 touches, respectively. In all groups, a greater total distance was covered during SMP compared to CMT (38–114%; P < 0.05). All groups performed more high-intensity running (33–54%; P < 0.05) and had higher heart rates during SMP compared to CMT. Different types of football training all appear to exert a minor COVID-19 infection risk; however, COVID-19-modified training may be safer than small-sided game training, but also match-play. In contrast, exercise intensity is lower during COVID-19-modified training than match-play.

Association between Exercise and Blood Pressure in Hypertensive Residents: A Meta-Analysis

BACKGROUND

Exercise is recommended as an effective lifestyle behaviour for adults to prevent and treat hypertension. In this study, a randomized-effect meta-analysis was used to analyse the influence of exercise interventions on blood pressure in patients with hypertension.

METHODS

Candidate papers were retrieved from PubMed, Web of Science, Embase, and Cochrane Library electronic databases, and 46 studies were finally included and analysed.

RESULTS

It was shown that preplanned walking (systolic blood pressure (SBP): WMD (weighted mean difference) = -5.94, 95% CI: -8.57, -3.30; diastolic blood pressure (DBP): WMD = -2.66, 95% CI: -3.66, -1.67), yoga (SBP: WMD = -5.09, 95% CI: -9.28, -0.89; DBP: WMD = -3.06, 95% CI: -5.16, -0.96), aquatic sports (SBP WMD = -7.53, 95% CI: -11.40, -3.65; DBP: WMD = -5.35, 95% CI: -9.00, -1.69), and football (SBP: WMD = -6.06, 95% CI: -9.30, -2.82; DBP: WMD = -5.55, 95% CI: -8.98, -2.13) had significant effects on blood pressure reduction. However, Tai Chi (SBP: WMD = -8.31, 95% CI: -20.39, 3.77; DBP: WMD = -3.05, 95% CI: -6.96, 0.87) and Qigong (SBP: WMD = -4.34, 95% CI: -13.5, 4.82; DBP: WMD = -3.44, 95% CI: -7.89, 1.01) did not significantly reduce blood pressure. The heterogeneity of the meta-analysis was high.

CONCLUSION

Walking, yoga, aquatic sports, and football were feasible and independent lifestyle interventions, and they were effective options for treating hypertension. More scientifically designed randomized controlled trials are needed in the future to further compare different forms of exercise for the treatment of hypertension.

Effects of recreational sports and combined training on blood pressure and glycated hemoglobin in middle-aged and older adults: A systematic review with meta-analysis

BACKGROUND

Combined resistance and aerobic training (CT) is the most suitable form of exercise training to simultaneously improve strength and cardiometabolic profile in middle-aged and older adults. Recreational sports (RS) emerge as an alternative to CT to improve these outcomes. We performed a meta-analysis on the effects of RS and CT on systolic blood pressure (SBP), diastolic blood pressure (DBP) and glycated hemoglobin (HbA1c) in middle-aged and older adults and to compare these exercise interventions to a non-exercising control group (CON).

METHODS

Search was conducted using the databases at PubMed, COCHRANE and SciELO between July and August 2020. Studies that included men and women aged ≥45 years, healthy or with values for SBP ≥130 mmHg or DBP ≥80 mmHg or with type 2 diabetes and performed RS or CT versus CON.

RESULTS

From 6017 records, 27 studies were included (9 RS and 18 CT). The analysis included 1411 participants with 55 ± 8 years. RS and CT were associated with reductions in SBP (RS: -7.2 mmHg, P = 0.03; CT: -3.6 mmHg, P < 0.001) and DBP (RS: -3.6 mmHg, P = 0.02; CT: -3.1 mmHg, P < 0.001) versus CON. Only CT was associated with a reduction in HbA1c versus CON (-0.47%; P < 0.001).

CONCLUSIONS

RS and CT are effective exercise interventions to improve BP in middle-aged and older adults. CT seems to be an excellent strategy to reduce HbA1c, and future studies are necessary to confirm the effectiveness of RS to improve HbA1c.

Effects of Small-Sided Soccer Games on Physical Fitness, Physiological Responses, and Health Indices in Untrained Individuals and Clinical Populations: A Systematic Review

BACKGROUND

Small-sided soccer games (SSSG) are a specific exercise regime with two small teams playing against each other on a relatively small pitch. There is evidence from original research that SSSG exposure provides performance and health benefits for untrained adults.

OBJECTIVES

The aim of this systematic review was to summarize recent evidence on the acute and long-term effects of SSSG on physical fitness, physiological responses, and health indices in healthy untrained individuals and clinical populations.

METHODS

This systematic literature search was conducted in four electronic databases (PubMed, Web of Science, SPORTDiscus) from inception until June 2019. The following key terms (and synonyms searched for by the MeSH database) were included and combined using the operators "AND", "OR", "NOT": ((soccer OR football) AND ("soccer training" OR "football training" OR "soccer game*" OR "small-sided soccer game*") AND ("physical fitness" OR "physiological adaptation*" OR "physiological response*" OR health OR "body weight" OR "body mass" OR "body fat" OR "bone composition" OR "blood pressure")). The search syntax initially identified 1145 records. After screening for titles, abstracts, and full texts, 41 studies remained that examined the acute (7 studies) and long-term effects (34 studies) of SSSG-based training on physical fitness, physiological responses, and selected alth indices in healthy untrained individuals and clinical populations.

RESULTS

No training-related injuries were reported in the 41 acute and long-term SSSG studies. Typically, a single session of SSSG lasted 12-20 min (e.g., 3 × 4 min with 3 min rest or 5 × 4 min with 4 min rest) involving 4-12 players (2 vs. 2 to 6 vs. 6) at an intensity ≥ 80% of HR_max. Following single SSSG session, high cardiovascular and metabolic demands were observed. Specifically, based on the outcomes, the seven acute studies reported average heart rates (HR) ≥ 80% of HR_max (165-175 bpm) and mean blood lactate concentrations exceeding 5 mmol/l (4.5-5.9 mmol/l) after single SSSG sessions. Based on the results of 34 studies (20 with healthy untrained, 10 with unhealthy individuals, and 4 with individuals with obesity), SSSG training lasted between 12 and 16 weeks and was performed 2-3 times per week. SSSG had positive long-term effects on physical fitness (e.g., Yo-Yo IR1 performance), physiological responses including maximal oxygen uptake (VO_2max) [+ 7 to 16%], and many health-related markers such as blood pressure (reductions in systolic [- 7.5%] and diastolic [- 10.3%] blood pressure), body composition (decreased fat mass [- 2 to - 5%]), and improved indices of bone health (bone mineral density: [+ 5 to 13%]; bone mineral content: [+ 4 to 5%]), and metabolic (LDL-cholesterol [- 15%] as well as cardiac function (left-ventricular internal diastolic diameter [+ 8%], end diastolic volume [+ 21%], left-ventricular mass index [+ 18%], and left-ventricular ejection fraction [+ 8%]). Irrespective of age or sex, these health benefits were observed in both, untrained individuals and clinical populations.

CONCLUSIONS

In conclusion, findings from this systematic review suggest that acute SSSG may elicit high cardiovascular and metabolic demands in untrained healthy adults and clinical populations. Moreover, this type of exercise is safe with positive long-term effects on physical fitness and health indices. Future studies are needed examining the long-term effects on physical fitness and physiological adaptations of different types of SSSG training (e.g., 3 vs. 3; 6 vs. 6) in comparison to continuous or interval training in different cohorts.

Effects of the Small-Sided Soccer Games on Blood Pressure in Untrained Hypertensive Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

This systematic review with meta-analysis was conducted to assess the effects of small-sided games (SSGs)-based programs on the systolic and diastolic blood pressure of untrained hypertensive adults. The data sources utilized were Web of Science, Scopus, SPORTDiscus, and PubMed. The eligibility criteria were: (i) randomized controlled trials including a control group and an intervention group exclusively using soccer SSGs; (ii) intervention and control groups including an untrained hypertensive adult population; (iii) articles written in English; and (iv) only full-text and original articles. The database search initially identified 241 titles. From those, five articles were eligible for the systematic review and meta-analysis. The included randomized controlled studies involved five individual experimental groups and 88 participants, and 68 participants in the five control groups. The results showed a large and beneficial effect of SSG on systolic (ES = 1.69; 95% CI = 0.71 to 2.66; p = 0.001; I² = 85.2%; Egger’s test p = 0.101) and diastolic blood pressure (ES = 2.25; 95% CI = 1.44 to 3.06; p < 0.001; I² = 74.8%; Egger’s test p = 0.118) when compared to the control groups. The findings of the current systematic review and meta-analysis revealed consistent beneficial effects of recreational soccer SSGs on untrained men and women from the hypertensive population, although high levels of heterogeneity.

Effects of football fitness training on lymphedema and upper-extremity function in women after treatment for breast cancer: a randomized trial

BACKGROUND

Breast cancer survivors are encouraged to be physically active. A recent review suggests that football training is an effective exercise modality for women across the lifespan, positively influencing health variables such as strength, fitness and social well-being. However, football is a contact sport, potentially posing an increased risk of trauma-related injury. Against this backdrop, breast cancer survivors are advised to avoid trauma or injury to the affected or at-risk arm in order to protect against lymphedema onset or exacerbation. The aim of this study was therefore to evaluate the feasibility and safety of Football Fitness training in relation to lymphedema and upper-extremity function after treatment for breast cancer.

MATERIAL AND METHODS

Sixty-eight women aged 18-75 years, who had received surgery for stage I-III breast cancer and completed (neo) adjuvant chemotherapy and/or radiotherapy within five years, were randomized (2:1) to a Football Fitness group (FFG, n = 46) or a control group (CON, n = 22) for twelve months. Secondary analyses using linear mixed models were performed to assess changes in upper-body morbidity, specifically arm lymphedema (inter-arm volume % difference, dual energy X-ray absorptiometry; extracellular fluid (L-Dex), bioimpedance spectroscopy), self-reported breast and arm symptoms (EORTC breast cancer-specific questionnaire (BR23) and upper-extremity function (DASH questionnaire) at baseline, six- and twelve-month follow-up.

RESULTS

We observed similar point prevalent cases of lymphedema between groups at all time points, irrespective of measurement method. At the six-month post-baseline assessment, reductions in L-Dex (extracellular fluid) were found in FFG versus CON. These significant findings were not maintained at the twelve-month assessment. No difference between groups was observed for inter-limb volume difference %, nor any of the remaining outcomes.

CONCLUSION

While superiority of Football Fitness was not observed, the results support that participation in Football Fitness training is feasible and suggests no negative effects on breast cancer-specific upper-body morbidity, including lymphedema.

TRIAL REGISTRATION

The trial was registered at ClinicalTrials.gov. NCT03284567.

Effects of a 4 week touch rugby and self-paced interval running intervention on health markers in active young men

Background

Modified team sport activity has been proposed as effective exercise modality for promoting markers of health that are comparable or greater than continuous forms of activity. However, research using modified team sports is currently limited to sedentary populations using 2–3 sessions across a minimum of 8 weeks.

Aim

To investigate the effects of a 4-week touch rugby and self-paced interval running intervention on a range of health markers in active men.

Methods

Sixteen participants (age 26.4 ± 6.4 years) were matched for age, demographic and physical activity before completing a single touch rugby (n = 8) or running (n = 8) session per week for 4 weeks. Measures of systolic and diastolic blood pressure, resting heart rate (RHR), body composition and biochemical status were recorded pre- and post-intervention.

Results

ANCOVA analysis revealed between-group differences for impedance (P = 0.027), fat mass (P = 0.008), percentage body fat (P = 0.008) and fat-free mass (P = 0.002), with greater changes after touch rugby. Systolic blood pressure decreased for both groups with greater reductions observed after touch rugby (P = 0.002). No between-group difference was observed for RHR, interleukin-6 or C-reactive protein (P > 0.05). Contrasting internal, external and perceptual loads were observed.

Conclusion

The results of this study suggest that a single session of touch rugby over a 4-week period elicited greater improvements in body composition and SBP than self-paced running, with both being equally beneficial for improving RHR, diastolic blood pressure and inflammatory status in active young men.

Effects of a 16-week recreational team handball intervention on aerobic performance and cardiometabolic fitness markers in postmenopausal women: A randomized controlled trial

BACKGROUND

Postmenopausal women have an elevated risk of developing cardiovascular diseases, which can be counteracted by conventional exercise regimes or recreational football. Less is known about the impact of exercise programmes based on other team sports. Thus, we examined the effects of recreational team handball on aerobic performance, cardiorespiratory fitness and cardiometabolic health in untrained postmenopausal women.

METHODS

Sixty-seven participants (age 68 ± 6 years, stature 157 ± 6 cm, body mass 67 ± 10 kg, fat mass 37 ± 7%, VO_2peak 25.2 ± 3.6 mL/min/kg, Yo-Yo intermittent endurance level 1 test performance (YYIE1) 230 ± 103 m) with no previous experience of team handball were randomly allocated to either a team handball (THG, n = 41) or a control (CG, n = 26) group. THG performed 2-3 60-min training sessions per week for 16 weeks. YYIE1 performance and cardiometabolic markers were evaluated at baseline and post-intervention.

RESULTS

Average attendance during recreational team handball training was 1.9 ± 0.4 sessions per week, with mean heart rates of 76 ± 6%HR_max and 18 ± 9 min (44 ± 20% of total time) played at HR > 80%HR_max. A between-group effect was observed for YYIE1 performance, with a more pronounced improvement in aerobic exercise performance in THG compared to CG (70 ± 62 vs 15 ± 44%; p < 0.001). Within-group improvements (p < 0.05) were observed for THG with regard to VO_2peak (7 ± 10%), incremental treadmill test time to exhaustion (TTE) (11 ± 14%), total cholesterol (-3 ± 9%) and low-density lipoprotein cholesterol (-2 ± 14%), with no significant changes in CG except an increase (p < 0.05) in TTE. Post-intervention values were higher for THG vs CG for YYIE1 performance (88%; 406 ± 216 vs 216 ± 75 m) and VO_2peak (10%; 27.5 ± 3.8 vs 24.9 ± 3.6 mL/min/kg).

CONCLUSIONS

Recreational team handball can be used to obtain moderate-to-vigorous aerobic intensities, and just 2 weekly 60-min team handball training sessions for 16 weeks can result in improvements in aerobic performance and in markers of cardiorespiratory fitness in postmenopausal women with no previous experience of the sport.

Recreational football is medicine against non-communicable diseases: A systematic review

The purpose of this research was to conduct a systematic review of published articles related to the effect of recreational football on non-communicable diseases. A systematic review of Web of Science, SPORTDiscus, MEDLINE, and PubMed databases was performed according to PRISMA guidelines. Only empirical studies were included. There were no restrictions on the types of study design eligible for inclusion. The primary outcome measures result from the potential effects of recreational football on non-communicable diseases (eg, blood pressure, bone density, LDL cholesterol, and fat mass). A total of 44 articles met the inclusion criteria and were included. Recreational football is shown to: (a) decrease blood pressure and resting heart rate, improve cardiac structure and functioning, as well as increase maximal oxygen uptake in both sexes; (b) reduce cholesterol and triglycerides levels, increase insulin sensitivity, and have a positive impact on glycemic control; (c) improve bone mineralization, increase both bone mineral density and content, as well as acting as a stimulus for osteogenesis; and (d) be clearly beneficial for bone health, while slightly beneficial for body composition, muscle strength, and maximal oxygen uptake in adults with prostate cancer. The present systematic review demonstrated the benefits of recreational football practice on non-communicable diseases related to cardiovascular and bone health, body composition, type 2 diabetes, and prostate cancer. The effectiveness of recreational football on the aforementioned diseases may be related to age and gender; however, further research is required.

Gender-dependent evaluation of football as medicine for prediabetes

PURPOSE

Training intensity and health effects of football were investigated gender specifically in individuals with prediabetes.

METHODS

Participants with prediabetes (age 60 ± 6 years) were randomised into a football and dietary advice group (FD-men n = 13 and FD-women n = 14) or a dietary advice only group (D-men n = 12 and D-women n = 11). FD performed football training (twice/week for 16 weeks), while both groups received dietary advice. Body composition, bone variables, blood pressure, blood lipid profile and peak oxygen uptake (VO2peak) were determined pre- and post-intervention.

RESULTS

Mean heart rate during football training was 79 ± 2 and 80 ± 3% HRmax for FD-men and FD-women, respectively, with peak heart rate values of 96 ± 1 and 97 ± 2% HRmax, with no gender differences. VO2peak increased more (P < 0.05) in FD-men and FD-women than in D-men and D-women. However, relative delta change in VO2peak was 21 ± 14% in FD-women, which was greater (P < 0.05) than in FD-men (11 ± 12%). Reduction in SBP and DBP, respectively, was similar in FD-men (- 10.8 ± 13.0 and - 7.3 ± 11.8 mmHg) and FD-women (- 11.3 ± 11.0 and - 7.1 ± 6.2 mmHg), with within-gender differences for men. Total plasma cholesterol and LDL cholesterol decreased (P < 0.05) by - 0.7 ± 1.1 and - 0.5 ± 0.9 mmol L-1, respectively, in FD-women and - 0.2 ± 0.4 and - 0.2 ± 0.3 mmol L-1 in FD-men, with no significant gender differences (P = 0.08). Body fat content was lowered (P < 0.05) by 3 and 4%-points in FD-men and FD-women, respectively.

CONCLUSION

Gender-mixed football training combined with dietary advice causes broad-spectrum health effects for men and women with prediabetes, with minor gender-specific differences. Thus, the intensity and training-induced effects of football training are also high for elderly women with prediabetes.

The Game of Life soccer program: Effect on skills, physical fitness and mobility in persons with intellectual disability and autism spectrum disorder

BACKGROUND

Soccer is the world's most popular sport. The present authors evaluated the effect of the Game of Life (GOL) soccer initiative on soccer skills, fitness and mobility of adults with intellectual disability (ID) and autism spectrum disorder (ASD).

METHODS

The programme is comprised of once-weekly sessions.

OUTCOMES

soccer skills, fitness and mobility. Effectiveness was evaluated using within-/between-group analyses (e.g. effect size, ES).

RESULTS

Fifty adults with intellectual disability and 19 with ASD (age = 31.80 ± 10.11) participated in this study. From pre-test to post-test, the intellectual disability group improved their soccer skills (ES = 0.437); physical fitness-the intellectual disability group presented trivial ESs, whereas the ASD group showed moderate-to-large ESs; Mobility-only the ASD group presented a significant improvement (ES=-0.435), and the intellectual disability group presented better ability in most outcomes in pre- and post-tests.

CONCLUSION

The findings indicated differences in entry-level performance and training impact between the two groups. This should be considered when developing training programmes for soccer players.

Cardiometabolic Risk Reduction Through Recreational Group Sport Interventions in Adults: A Systematic Review and Meta-analysis

OBJECTIVE

To estimate the pooled effects of community-based, recreational-level group sports on cardiometabolic risk factors and fitness parameters among adults.

PARTICIPANTS AND METHODS

We systematically searched PubMed, EMBASE, PsychINFO, CINAHL, and Web of Science electronic databases for English-language articles reporting the effectiveness of recreational-level group sports published between January 1, 1965, and January 17, 2017. We extracted baseline and end of intervention means for cardiometabolic and fitness parameters. Random- or fixed-effects meta-analyses were used to obtain pooled before and after change in outcome means within intervention participants and between groups.

RESULTS

From 2491 screened titles, 23 publications were included (902 participants; mean ± SD age, 46.6±11.7 years), comprising 21 soccer and 2 rugby interventions. Intervention participants achieved larger improvements (mean [95% CI]) compared with control subjects in weight (-1.44 kg [-1.79 to -1.08 kg]), body mass index (-0.88 kg/m² [-1.73 to -0.03 kg/m²]), waist circumference (-0.77 cm [-1.21 to -0.33 cm]), body fat (-1.8% [-3.12% to -0.49%]), total cholesterol level (-0.33 mmol/L [-0.53 to -0.13 mmol/L]), low-density lipoprotein cholesterol level (-0.35 mmol/L [-0.54 to -0.15 mmol/L]), systolic blood pressure (-5.71 mm Hg [-7.98 to -3.44 mm Hg]), diastolic blood pressure (-3.36 mm Hg [-4.93 to -1.78 mm Hg]), maximum oxygen consumption (3.93 mL/min per kg [2.96-4.91 mL/min]), and resting heart rate (-5.51 beats/min [-7.37 to -3.66 beats/min]). Most studies (16) were classified as high quality, and we found no evidence of publication bias.

CONCLUSION

We found significant cardiometabolic and fitness improvements following group sport participation, primarily recreational soccer. These findings suggest that group sport interventions are promising strategies for reducing cardiometabolic risk in adults.

Recreational soccer as sport medicine for middle-aged and older adults: a systematic review

Background

Strategies to prevent or attenuate the age-related decline in physical and physiological function and reduce chronic disease risk factors are of clinical importance.

Objective

To examine the health benefits of recreational soccer in middle-aged and older adults.

Design

Systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Data sources

All available records up until 9 June 2017 in PubMed, Web of Science, SPORTDiscus, MEDLINE, Embase, CINAHL Plus, PsycINFO and Cochrane Library databases.

Eligibility criteria for selecting studies

All randomised trials with or without a control group (randomised controlled trials or randomised uncontrolled trials) and non-randomised controlled trials that used recreational soccer, which includes small-sided soccer games, as the sole or principal intervention, and reported relevant effects in untrained/sedentary, healthy or unhealthy adults aged 40 years and above were included.

Results

Five trials described in 13 articles were included, which scored 6–9 out of 12 points on the modified Delphi quality rating scale. The duration was from 12 to 52 weeks, with various frequencies, volumes and game formats performed both outdoors and indoors with men and women. The trials indicate that recreational soccer may result in improvement in cardiovascular function, body composition and functional ability, although no significant changes were observed in postural balance.

Conclusion

Recreational soccer should be considered an alternative exercise modality for untrained, healthy or unhealthy middle-aged and older adults of both sexes to maintain an active lifestyle and mitigate a wide array of physical and physiological age-related changes.

The Yo-Yo Intermittent Tests: A Systematic Review and Structured Compendium of Test Results

Background: Although Yo-Yo intermittent tests are frequently used in a variety of sports and research studies to determine physical fitness, no structured reference exists for comparison and rating of test results. This systematic review of the most common Yo-Yo tests aimed to provide reference values for test results by statistical aggregation of published data.

Methods: A systematic literature search for articles published until August 2017 was performed in MEDLINE, Web of Science, SPORTDiscus and Google Scholar. Original reports on healthy females and males ≥16 years were eligible for the analysis. Sub-maximal test versions and the Yo-Yo Intermittent Recovery Level 1 Children's test (YYIR1C) were not included.

Results: 248 studies with 9,440 participants were included in the structured analysis. The Yo-Yo test types most frequently used were the Yo-Yo Intermittent Recovery Level 1 (YYIR1, 57.7%), the Yo-Yo Intermittent Recovery Level 2 (YYIR2, 28.0%), the Yo-Yo Intermittent Endurance Level 2 (YYIE2, 11.4%), and the Yo-Yo Intermittent Endurance Level 1 (YYIE1, 2.9%) test. For each separate test, reference values (global means and percentiles) for sports at different levels and both genders were calculated.

Conclusions: Our analysis provides evidence that Yo-Yo intermittent tests reference values differ with respect to the type and level of sport performed.The presented results may be used by practitioners, trainers and athletes to rate Yo-Yo intermittent test performance levels and monitor training effects.

Football training improves metabolic and cardiovascular health status in 55- to 70-year-old women and men with prediabetes

We examined the effects of 16 weeks of football training and dietary advice on blood glucose control and health status in 55- to 70-year-old women and men with prediabetes. Fifty participants with prediabetes (age; 61 ± 6 years, BMI; 29.6 ± 4.7; VO_2max 22.3 ± 5.7 mL·min^-1 ·kg^-1 ) were randomized into a football and dietary advice group (F+D; n = 27) and a dietary advice group (D; n = 23). F+D performed football training (twice weekly 30- to 60-minutes sessions) and received dietary advice, while D only received dietary advice. An oral glucose tolerance test (OGTT) was completed pre and post the 16-week period. Body composition, blood pressure, and maximal oxygen uptake (VO_2max ) were additionally measured. Both groups demonstrated a decrement (P < .05) in fasting blood glucose (-0.4 ± 0.5 mmol·L^-1 ) and lowered blood glucose throughout OGTT. F+D displayed lower values than D (P < .05) after 60 minutes (9.0 ± 2.7 vs 10.6 ± 2.9 mmol·L^-1 ) and 120 minutes (5.7 ± 1.6 vs 7.5 ± 2.4 mmol·L^-1 ). VO_2max increased by 14% in F+D, with a higher (P < .05) change score than in D (2%). Mean arterial pressure declined more (P < .05) in F+D than in D (-8 ± 9 vs -4 ± 11 mm Hg). Fat loss was greater (P < .05) in F+D than in D (-3.4 ± 2.8 vs -1.2 ± 2.0 kg), and the increase in lean body mass was also greater (P < .05) in F+D than in D (0.7 ± 1.5 vs -0.3 ± 1.6 kg). In conclusion, football training combined with dietary advice has broad-spectrum effects on metabolic and cardiovascular health profile with greater overall effects than professional dietary advice per se for 55- to 70-year-old women and men with prediabetes.

Effect of a 26-month floorball training on male elderly's cardiovascular fitness, glucose control, body composition, and functional capacity

BACKGROUND

Floorball training offers a motivating and socially stimulating team activity for older adults, and 12 weeks of floorball training twice a week among men aged 65-76 years have been shown to have positive effects on a number of physiological parameters important for health. However, the effect of long-term participation in floorball training among male elderly has not been investigated. The aim of the present study was to examine the effect of 26-month self-organized regular participation in floorball training on cardiovascular fitness, body composition, blood lipids, glucose control, and physical function among recreationally active men aged 66-78 years.

METHODS

After completing a 12-week randomized and controlled intervention with floorball and petanque training in the autumn 2014 or spring 2015, 15 subjects chose to participate in floorball training (floorball group, FG), whereas 16 subjects resumed their usual lifestyle (control group, CG). FG took part in self-organized floorball training 1.7 sessions of 40 min/week, and CG continued their normal recreationally active lifestyle during a 26-month follow-up period. At baseline and after the follow-up period subjects were tested for cardiovascular fitness, glucose control (resting blood samples), body composition dual-energy X-ray absorptiometry (DXA-scanning), and functional capacity.

RESULTS

In FG, the decline in maximal oxygen uptake (VO_2max) during the follow-up period was lower (242 ± 379 mL/min, p = 0.01), blood glycosylated hemoglobin (HbA1c) increased less (-1.6 ± 2.9 mmol/L, p = 0.02), and leg bone mineral density increased more (0.03 ± 0.05 g/cm², p = 0.02) than those in CG. The effects on body mass, total lean body mass, fat mass, blood lipids, and physical function were similar in FG and CG.

CONCLUSION

Approximately twice weekly floorball sessions with 40 min/session over 26-month appear to reduce age-related decline in cardiovascular fitness and glucose control and improve leg bone mineral density, suggesting that long-term participation in floorball training can be considered as a health-enhancing activity in recreationally active male elderly.

Effects of soccer training on health-related physical fitness measures in male adolescents

PURPOSE

The aims of this study were to (1) investigate the health-related physical fitness profile of untrained adolescent boys in comparison to adolescent soccer players, (2) determine the intensity and enjoyment of 6 v 6 and 4 v 4 small-sided games, and (3) evaluate the health-related effects of a short-period of soccer training in the untrained group.

METHODS

Forty-one adolescent boys (untrained, n = 24: age = 15.9 ± 0.6 years; trained, n = 17: age = 15.7 ± 0.7 years) were recruited. For Purpose 1, the players (n = 17) and the untrained (n = 24) boys were tested for speed, jumping power, postural balance, flexibility, and aerobic capacity. After baseline testing, Purposes 2 and 3 were addressed by randomly assigning the untrained boys to either a soccer-training group (small-sided games, 2 sessions per week for 8 weeks) or to a control group, followed by identical retesting.

RESULTS

At baseline, physical fitness was higher (p < 0.001) in trained players than in untrained for aerobic fitness, sprinting, jumping power, and postural balance. Small-sided games using 6 v 6 or 4 v 4 elicited similar heart rate (HR) (mean:  ~ 85% peak heart rate, HR_peak), rate of perceived exertion, and enjoyment responses. Over 8 weeks, the between-group analysis revealed that soccer training had a large beneficial effect on postural balance (45%) when compared with control group with unclear effects on other fitness parameters.

CONCLUSION

Adolescent soccer players had markedly higher physical fitness compared with untrained adolescents. Small-sided soccer games practiced by untrained adolescents elicited high exercise intensity. While 8 weeks of twice-weekly soccer training sessions induced significant improvement in postural balance, the short duration of the study was not sufficient to result in between-group differences in sprint and jump performance or aerobic fitness.

Broad-spectrum physical fitness benefits of recreational football: a systematic review and meta-analysis

BACKGROUND

A previous meta-analysis showed that maximal oxygen uptake increased by 3.51 mL/kg/min (95% CI 3.07 to 4.15) during a recreational football programme of 3-6 months in comparison with continuous moderate-intensity running, strength training or a passive control group. In addition, narrative reviews have demonstrated beneficial effects of recreational football on physical fitness and health status.

OBJECTIVE

The purpose of this systematic review and meta-analysis was to evaluate the magnitude of effects of recreational football on blood pressure, body composition, lipid profile and muscular fitness with reference to age, gender and health status.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

MEDLINE, PubMed, SPORTDiscus, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Google Scholar were searched prior to 1 February 2017. In addition, Google Scholar alerts were set up in January 2012 to identify potential papers with the following key terms: recreational football, recreational soccer, street football and street soccer.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Randomised and matched controlled trials with participants allocated to a recreational football group or any other type of exercises or passive control group were included. Training programmes had to last at least 2 weeks to meet the inclusion criteria. The primary outcome measures were blood pressure, resting heart rate, body composition, muscular fitness, and blood lipids and glucose tolerance. A total of 31 papers met the inclusion criteria and were included.

RESULTS

The effect of recreational football on systolic blood pressure (SBP) versus no-exercise controls was most likely extremely largely beneficial (effect size (ES)=4.20 mm Hg; 95% CI 1.87 to 6.53). In addition, a most likely very large beneficial (ES=3.89 mm Hg; 95% CI 2.33 to 5.44) effect was observed for diastolic blood pressure (DBP), when compared with non-active groups. Furthermore, a most likely extremely large beneficial effect was shown for SBP and DBP in participants with mild hypertension (11 and 7 mm Hg decrease, respectively) and participants with prehypertension (10 and 7 mm Hg decrease, respectively). Meta-analysis of recreational football determined the impact on resting heart rate as most likely extremely largely beneficial (ES=6.03 beats/min; 95% CI 4.43 to 7.64) when compared with non-active groups. The observed recreational football effect on fat mass was most likely largely beneficial (ES=1.72 kg; 95% CI 0.86 to 2.58) and the effect on countermovement jump (CMJ) performance was most likely very largely beneficial (ES=2.27 cm; 95% CI 1.29 to 3.25) when compared with non-active groups. Possibly beneficial decreases were found in low-density lipoprotein levels (ES=0.21 mmol/L; 95% CI 0.06 to 0.36). Possibly largely beneficial effect was observed for DBP in comparison with continuous running training. Small harmful and unclear results were noted for SBP, fat and lean body mass, body mass index, as well as muscular fitness when compared with running and Zumba training.

CONCLUSION

The present meta-analysis demonstrated multiple broad-spectrum benefits of recreational football on health-related physical fitness compared with no-exercise controls, including improvements in blood pressure, resting heart rate, fat mass, low-density lipoprotein cholesterol and CMJ performance. Additionally, recreational football is efficient and effective as Zumba and continuous running exercise regimens with highlighted social, motivational and competitive components.

Sex and Gender Differences in Prevention of Type 2 Diabetes

Lifestyle intervention programs are effective in the prevention of type 2 diabetes mellitus (T2DM) in high risk populations. However, most studies only give limited information about the influence of sex and/or gender effectiveness of these interventions. So far, similar outcome was reported for diabetes progression and weight loss. Nevertheless, long-term data on cardiovascular outcome are sparse but favoring women regarding all-cause and cardiovascular mortality. In both men and women, sex hormone imbalances and reproductive disorders are associated with a higher risk of T2DM development. Diabetes prevention approaches are reported for polycystic ovary syndrome, gestational diabetes mellitus, and erectile dysfunction and are presented in this review. In the surgical treatment options for morbid obese patients, sex and gender differences are present. Choices and preferences of adherence to lifestyle and pharmacological interventions, expectations, treatment effects, and complications are influenced by sex or gender. In general, bariatric surgery is performed more often in women seeking medical/surgical help to lose weight. Men are older and have higher comorbidities and mortality rates and worse follow-up outcome after bariatric surgery. A more gender-sensitive clinical approach, as well as consideration of ethnicity may improve quality of life and increase health and life expectancy in men and women with a high risk for subsequent progression to T2DM.

Effects of recreational football on women's fitness and health: adaptations and mechanisms

The review describes the fitness and health effects of recreational football in women aged 18-65 years. The review documents that 2 × 1 h of recreational football training for 12-16 weeks causes marked improvements in maximal oxygen uptake (5-15%) and myocardial function in women. Moreover, mean arterial blood pressure was shown to decrease by 2-5 mmHg in normotensive women and 6-8 mmHg in hypertensive women. This review also show that short-term (< 4 months) and medium-term (4-16 months) recreational football training has major beneficial impact on metabolic health profile in women, with fat losses of 1-3 kg and improvements in blood lipid profile. Lastly, 2 × 1 h per week of recreational football training for women elevates lower extremity bone mineralisation by 1-5% and whole-body bone mineralization by 1-2% within 4-12-month interventions. These training adaptations are related to the high heart rates, high number of fast runs, and multiple changes of direction and speed occurring during recreational football training for untrained women. In conclusion, regular small-sided football training for women is an intense and versatile type of training that combines elements of high-intensity interval training (HIIT), endurance training and strength training, thereby providing optimal stimuli for cardiovascular, metabolic and musculoskeletal fitness. Recreational football, therefore, seems to be an effective tool for prevention and treatment of lifestyle diseases in young and middle-aged women, including hypertension, type 2 diabetes and osteopenia. Future research should elucidate effects of football training for elderly women, and as treatment and rehabilitation of breast cancer patients and other women patient groups.

Muscle ion transporters and antioxidative proteins have different adaptive potential in arm than in leg skeletal muscle with exercise training

It was evaluated whether upper‐body compared to lower‐body musculature exhibits a different phenotype in relation to capacity for handling reactive oxygen species (ROS), H⁺, La⁻, Na⁺, K⁺ and also whether it differs in adaptive potential to exercise training. Eighty‐three sedentary premenopausal women aged 45 ± 6 years (mean ± SD) were randomized into a high‐intensity intermittent swimming group (HIS, n = 21), a moderate‐intensity swimming group (MOS, n = 21), a soccer group (SOC, n = 21), or a control group (CON, n = 20). Intervention groups completed three weekly training sessions for 15 weeks, and pre‐ and postintervention biopsies were obtained from deltoideus and vastus lateralis muscle. Before training, monocarboxylate transporter 4 (MCT4), Na⁺/K⁺ pump α₂, and superoxide dismutase 2 (SOD2) expressions were lower (P < 0.05) in m. deltoideus than in m. vastus lateralis, whereas deltoid had higher (P < 0.05) Na⁺/H⁺ exchanger 1 (NHE1) expression. As a result of training, Na⁺/K⁺ pump α₂ isoform expression was elevated only in deltoideus muscle, while upregulation (P < 0.05) of the α₁ and β₁ subunits, phospholemman (FXYD1), NHE1, and superoxide dismutase 1 expression occurred exclusively in vastus lateralis muscle. The increased (P < 0.05) expression of MCT4 and SOD2 in deltoid muscle after HIS and vastus lateralis muscle after SOC were similar. In conclusion, arm musculature displays lower basal ROS, La⁻, K⁺ handling capability but higher Na⁺‐dependent H⁺ extrusion capacity than leg musculature. Training‐induced changes in the ion‐transporting and antioxidant proteins clearly differed between muscle groups.

Blood pressure, heart rate and perceived enjoyment after small-sided soccer games and repeated sprint in untrained healthy adolescents

The purpose of this study was to examine systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR), rating of perceived exertion (RPE) and perceived enjoyment responses to a repeated-sprint training session (RST) compared to a small-sided soccer game session (SSG) in untrained adolescents. Twelve healthy post-pubertal adolescent males (age 15.8±0.6 years, body mass 59.1±3.7 kg, height 1.7±0.1m) performed RST and SSG sessions in a randomized and counterbalanced order. Blood pressure and HR were measured at rest and at 10, 20 and 30 minutes after interventions, and RPE and enjoyment were assessed. RST and SSG elicited similar exercise HR (74.0% vs. 73.7% of HR peak during RST and SSG respectively, P>0.05). There was no significant change in SBP or DBP after the 2 interventions (all P>0.05, ES<0.5) with a trend to a decrease in SBP after SSG at 30 min after intervention (moderate effect, ES=0.6). Pearson’s correlation analysis revealed a significant and large correlation between baseline BP values and magnitude of decline after both RST and SSG. Heart rate during recovery was higher compared with baseline at all times after both sessions (all P<0.05), with HR values significantly lower after SSG versus RST at 30 min after interventions (82.3±3.2 versus 92.4±3.2 beats/min, respectively, P=0.04). RPE was significantly lower (P=0.02, ES=1.1) after SSG than after RST, without significant differences in enjoyment. In conclusion, repeated sprint and small-sided games elicited similar exercise intensity without a significant difference in perceived enjoyment. Post-exercise hypotension after the two forms of training may depend on resting BP of subjects.

Broad-spectrum health improvements with one year of soccer training in inactive mildly hypertensive middle-aged women

The study tested the hypothesis that long-term soccer training has positive impact on cardiovascular profile, body composition, bone health, and physical capacity in inactive, pre-menopausal women with mild hypertension. The study applied a randomized controlled design in which physically inactive middle-aged women were separated into a soccer training group (n=19; SOC) and a control group (n=12; CON). SOC performed 128±29 (±SD) one-h small-sided soccer training sessions over one year. Blood pressure, body composition, blood lipid profile, and fitness level were determined pre- and post-intervention. Over one year, mean arterial pressure decreased more in SOC than in CON (-5±7 vs +4±5 mmHg; P<.05). Total-body fat mass decreased more (P<.05) in SOC than in CON (-2.5±2.5 vs +0.6±3.2 kg; P<.05), while the change scores for lean body mass were not significantly different in SOC (2.6±2.7 kg) compared to CON (1.1±1.9 kg, P=.09). Over one year, change scores in whole-body bone mineral density (0.004±0.032 vs -0.019±0.026 g·cm² ) as well as bone mineral content (30±70 vs -39±113 g) were positive in SOC compared to CON (P<.05). Post-intervention plasma triglycerides decreased more (-0.1±0.7 vs +0.2±0.2 mmol·L^-1 ) and HDL cholesterol increased more (0.2±0.7 vs -0.2±0.2 mmol·L^-1 ) in SOC than in CON (P<.05). Yo-Yo intermittent endurance level 1 (122±105 vs 2±21%) and 20-m sprint performance (6±6 vs -1±2%) increased more (P<.05) in SOC than in CON. In conclusion, long-term soccer training resulted in broad-spectrum improvements in the health profile of untrained, pre-menopausal women with mild hypertension, including cardiovascular, metabolic, and musculo-skeletal benefits.

Low-volume high-intensity swim training is superior to high-volume low-intensity training in relation to insulin sensitivity and glucose control in inactive middle-aged women

PURPOSE

We tested the hypothesis that low-volume high-intensity swimming has a larger impact on insulin sensitivity and glucose control than high-volume low-intensity swimming in inactive premenopausal women with mild hypertension.

METHODS

Sixty-two untrained premenopausal women were randomised to an inactive control (n = 20; CON), a high-intensity low-volume (n = 21; HIT) or a low-intensity high-volume (n = 21; LIT) training group. During the 15-week intervention period, HIT performed 3 weekly 6-10 × 30-s all-out swimming intervals (average heart rate (HR) = 86 ± 3 % HRmax) interspersed by 2-min recovery periods and LIT swam continuously for 1 h at low intensity (average HR = 73 ± 3 % HRmax). Fasting blood samples were taken and an oral glucose tolerance test (OGTT) was conducted pre- and post-intervention.

RESULTS

After HIT, resting plasma [insulin] was lowered (17 ± 34 %; P < 0.05) but remained similar after LIT and CON. Following HIT, 60-min OGTT plasma [insulin] and [glucose] was lowered (24 ± 30 % and 10 ± 16 %; P < 0.05) but remained similar after LIT and CON. Total area under the curve for plasma [glucose] was lower (P < 0.05) after HIT than LIT (660 ± 141 vs. 860 ± 325 mmol min L(-1)). Insulin sensitivity (HOMA-IR) had increased (P < 0.05) by 22 ± 34 % after HIT, with no significant change after LIT or CON, respectively. Plasma soluble intracellular cell adhesion molecule 1 was lowered (P < 0.05) by 4 ± 8 and 3 ± 9 % after HIT and CON, respectively, while plasma soluble vascular cell adhesion molecule 1 had decreased (P < 0.05) by 8 ± 23 % after HIT only.

CONCLUSIONS

These findings suggest that low-volume high-intensity intermittent swimming is an effective and time-efficient training strategy for improving insulin sensitivity, glucose control and biomarkers of vascular function in inactive, middle-aged mildly hypertensive women.

The impact of badminton on health markers in untrained females

The purpose of the study was to examine the health effects of 8 weeks of recreational badminton in untrained women. Participants were matched for maximal oxygen uptake (V̇O_2max) and body fat percentage and assigned to either a badminton (n = 14), running (n = 14) or control group (n = 8). Assessments were conducted pre- and post-intervention with physiological, anthropometric, motivation to exercise and physical self-esteem data collected. Post-intervention, V̇O_2max increased (P < 0.05) by 16% and 14% in the badminton and running groups, respectively, and time to exhaustion increased (P < 0.05) by 19% for both interventions. Maximal power output was increased (P < 0.05) by 13% in the badminton group only. Blood pressure, resting heart rate and heart rate during submaximal running were lower (P < 0.05) in both interventions. Perceptions of physical conditioning increased (P < 0.05) in both interventions. There were increases (P < 0.05) in enjoyment and ill health motives in the running group only, whilst affiliation motives were higher (P < 0.05) for the badminton group only. Findings suggest that badminton should be considered a strategy to improving the health and well-being of untrained females who are currently not meeting physical activity guidelines.

Evaluating a Nationwide Recreational Football Intervention: Recruitment, Attendance, Adherence, Exercise Intensity, and Health Effects

The present study evaluated a nationwide exercise intervention with Football Fitness in a small-scale society. In all, 741 adult participants (20–72 yrs) were successfully recruited for Football Fitness training in local football clubs, corresponding to 2.1% of the adult population. A preintervention test battery including resting heart rate (RHR), blood pressure, and body mass measurements along with performance tests (Yo-Yo Intermittent Endurance level 1 (Yo-Yo IE1), the Arrowhead Agility Test, and the Flamingo Balance Test) were performed (n = 502). Training attendance (n = 310) was 1.6 ± 0.2 sessions per week (range: 0.6–2.9), corresponding to 28.8 ± 1.0 sessions during the 18 wk intervention period. After 18 wks mean arterial pressure (MAP) was −2.7 ± 0.7 mmHg lower (P < 0.05; n = 151) with even greater (P < 0.05) reductions for those with baseline MAP values >99 mmHg (−5.6 ± 1.5 mmHg; n = 50). RHR was lowered (P < 0.05) by 6 bpm after intervention (77 ± 1 to 71 ± 1 bpm). Yo-Yo IE1 performance increased by 41% (540 ± 27 to 752 ± 45 m), while agility and postural balance were improved (P < 0.05) by ~6 and ~45%, respectively. In conclusion, Football Fitness was shown to be a successful health-promoting nationwide training intervention for adult participants with an extraordinary recruitment, a high attendance rate, moderate adherence, high exercise intensity, and marked benefits in cardiovascular health profile and fitness.

Effects of recreational soccer on physical fitness and health indices in sedentary healthy and unhealthy subjects

Recreational soccer (RS) is becoming a popular alternative to the classical continuous exercise mode used for the improvement of cardiovascular and metabolic fitness in untrained people. The objective of this paper was to conduct a detailed systematic review of the literature, identifying the physiological responses to RS and the training effects of RS on aerobic fitness and health in untrained healthy individuals and clinical patients. PubMed, Google Scholar and ScienceDirect databases were searched using terms related to recreational soccer. Inclusion criteria were randomized controlled trials (RCT) that assessed acute physiological responses to RS or the training effects of RS on physical fitness and health in sedentary, untrained subjects of any age or health status. All studies were assessed for methodological quality using the PEDro scale. Thirty-five articles met the inclusion criteria; seven examined the acute response to RS, and 28 assessed training effects. Clear evidence was found that RS had positive effects on many health-related indices and variables, including VO₂max (gains of 7-16%), blood pressure (reductions of 6-13 mmHg), body composition (decreased fat mass and improved indices of bone health), and metabolic and cardiac function. These positive effects were observed in both healthy individuals and clinical patients, irrespective of age or sex. Although this review provides clear evidence of the positive effects of RS on health, most studies had limitations of methodology (an average PEDro score < 6). Furthermore, many of the training studies were from a small number of research groups. Future studies should be extended to other countries and institutions to ensure generality of the results. Regular RS training leads to significant cardiovascular and muscular adaptations and gains of health both in sedentary individuals and clinical patients at all ages, suggesting that RS is a potentially highly motivational method to enhance population health.

Health-Related Physical Fitness in Healthy Untrained Men: Effects on VO2max, Jump Performance and Flexibility of Soccer and Moderate-Intensity Continuous Running

The purpose of this study was to determine the effects of recreational soccer (SOC) compared to moderate-intensity continuous running (RUN) on all health-related physical fitness components in healthy untrained men. Sixty-nine participants were recruited and randomly assigned to one of three groups, of which sixty-four completed the study: a soccer training group (SOC; n = 20, 34±4 (means±SD) years, 78.1±8.3 kg, 179±4 cm); a running group (RUN; n = 21, 32±4 years, 78.0±5.5 kg, 179±7 cm); or a passive control group (CON; n = 23, 30±3 years, 76.6±12.0 kg, 178±8 cm). The training intervention lasted 12 weeks and consisted of three 60-min sessions per week. All participants were tested for each of the following physical fitness components: maximal aerobic power, minute ventilation, maximal heart rate, squat jump (SJ), countermovement jump with arm swing (CMJ), sit-and-reach flexibility, and body composition. Over the 12 weeks, VO2max relative to body weight increased more (p<0.05) in SOC (24.2%, ES = 1.20) and RUN (21.5%, ES = 1.17) than in CON (-5.0%, ES = -0.24), partly due to large changes in body mass (-5.9, -5.7 and +2.6 kg, p<0.05 for SOC, RUN and CON, respectively). Over the 12 weeks, SJ and CMJ performance increased more (p<0.05) in SOC (14.8 and 12.1%, ES = 1.08 and 0.81) than in RUN (3.3 and 3.0%, ES = 0.23 and 0.19) and CON (0.3 and 0.2%), while flexibility also increased more (p<0.05) in SOC (94%, ES = 0.97) than in RUN and CON (0-2%). In conclusion, untrained men displayed marked improvements in maximal aerobic power after 12 weeks of soccer training and moderate-intensity running, partly due to large decreases in body mass. Additionally soccer training induced pronounced positive effects on jump performance and flexibility, making soccer an effective broad-spectrum fitness training intervention.

Oxidative capacity and glycogen content increase more in arm than leg muscle in sedentary women after intense training

The hypothesis that the adaptive capacity is higher in human upper- than lower-body skeletal muscle was tested. Furthermore, the hypothesis that more pronounced adaptations in upper-body musculature can be achieved by "low-volume high-intensity" compared with "high-volume low-intensity" exercise training was evaluated. A group of sedentary premenopausal women aged 45 ± 6 yr (± SD) with expected high adaptive potential in both upper- and lower-extremity muscle groups participated. After random allocation to high-intensity swimming (HIS, n = 21), moderate-intensity swimming (MOS, n = 21), soccer (SOC, n = 21) or a nontraining control group (CON, n = 20), the training groups completed three workouts per week for 15 wk. Resting muscle biopsies were obtained from the vastus lateralis muscle and deltoideus muscle before and after the intervention. After the training intervention, a larger (P < 0.05) increase existed in deltoideus muscle of the HIS group compared with vastus lateralis muscle of the SOC group for citrate synthase maximal activity (95 ± 89 vs. 27 ± 34%), citrate synthase protein expression (100 ± 29 vs. 31 ± 44%), 3-hydroxyacyl-CoA dehydrogenase maximal activity (35 ± 43 vs. 3 ± 25%), muscle glycogen content (63 ± 76 vs. 20 ± 51%), and expression of mitochondrial complex II, III, and IV. Additionally, HIS caused higher (P < 0.05) increases than MOS in deltoideus muscle citrate synthase maximal activity, citrate synthase protein expression, and muscle glycogen content. In conclusion, the deltoideus muscle has a higher adaptive potential than the vastus lateralis muscle in sedentary women, and "high-intensity low-volume" training is a more efficient regime than "low-intensity high-volume" training for increasing the aerobic capacity of the deltoideus muscle.