1
|
Yu Y, Wang J, Xu J. Optimal dose and type of exercise to improve cognitive function in patients with mild cognitive impairment: a systematic review and network meta-analysis of RCTs. Front Psychiatry 2024; 15:1436499. [PMID: 39328348 PMCID: PMC11424528 DOI: 10.3389/fpsyt.2024.1436499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 08/22/2024] [Indexed: 09/28/2024] Open
Abstract
Background Mild cognitive impairment (MCI) represents a prodromal stage of dementia, characterized by cognitive decline exceeding that expected with normal aging. Exercise interventions have emerged as a promising approach to counter functional decline and enhance cognitive function in the elderly MCI population. However, the optimal exercise modalities and dosage (dose-response relationship) are understudied. Objective It aims to determine the most effective exercise modality for MCI patients by optimizing the dose-response relationship to ensure sufficient intensity to induce positive neurological adaptations. Methods A systematic search of electronic databases, including PubMed, Embase, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted from inception to April 15, 2024. Studies evaluating the efficacy of exercise interventions in MCI participants were included. Primary outcomes of interest are global cognition and executive function. Random-effects models will be utilized for both pairwise and network meta-analysis. Results Following the application of specific inclusion and exclusion criteria, a total of 42 articles, encompassing 2832 participants, were chosen for inclusion in a network meta-analysis. The findings revealed that multi-component exercise demonstrated superior efficacy in mitigating the deterioration of global cognition, as evidenced by standard mean differences (SMDs) of 1.09 (95% CI: 0.68 to 1.51) compared to passive controls. Additionally, multi-component exercise exhibited a significant impact on executive function, with SMDs of 2.50 (95% CI: 0.88 to 4.12) when contrasted with passive controls. Our research has demonstrated that sessions lasting 30 minutes, occurring 3-4 times per week, with interventions lasting 12-24 weeks and an intensity of 60-85% of maximum heart rate, yield higher effect sizes in improving global cognition. However, sessions lasting 30-61 minutes, with interventions lasting 25 weeks or longer, show greater effectiveness in enhancing executive function. Conclusion A network meta-analysis identified multi-component exercise as the most effective intervention for improving global cognitive and executive function in patients with mild cognitive impairment. Notably, moderate-intensity exercise performed at least three times weekly appears beneficial, with evidence suggesting shorter sessions and higher frequencies may optimize cognitive outcomes. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO, identifier CRD42024534922.
Collapse
Affiliation(s)
| | - Junjie Wang
- School of Sport and Health Sciences, Dalian University of Technology,
Dalian, China
| | | |
Collapse
|
2
|
Dong J, Wang D, Zhong S. Effects of different exercise types and cycles on pain and quality of life in breast cancer patients: A systematic review and network meta-analysis. PLoS One 2024; 19:e0300176. [PMID: 38959209 PMCID: PMC11221662 DOI: 10.1371/journal.pone.0300176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/22/2024] [Indexed: 07/05/2024] Open
Abstract
PURPOSE To determine the effect of different combinations of different exercise modalities with different training cycles on the improvement of quality of life and pain symptoms in breast cancer patients. METHODS The databases PubMed, Web of Science, Embase, and Scopus were searched through a computer network with a search deadline of 23 August 2023. Two researchers independently screened the literature, extracted data and performed methodological quality assessment of the included literature, and then performed the corresponding statistical analyses and graphing using stata17.0. RESULTS Thirty-six randomized control trial (RCT) studies involving 3003 participants and seven exercise modalities were included. Most of the exercise modalities improved patients' quality of life compared to usual care, with long-term aerobic combined with resistance exercise [SMD = 0.83,95% CI = 0.34,1.33,p = 0.001] and YOGA [SMD = 0.61,95% CI = 0.06,1.16,p = 0.029] treatments having a significant effect. For pain and fatigue-related outcome indicators, the treatment effect was not significant for all exercise modalities included in the analysis compared to the control group, but tended to be beneficial for patients. CONCLUSION Long-term aerobic combined with resistance exercise was the most effective in improving quality of life and fatigue status in breast cancer patients, and aerobic exercise was more effective in improving pain symptoms in breast cancer patients.
Collapse
Affiliation(s)
- Jin Dong
- Physical Education Institute, Shanxi University, Taiyuan, China
| | - Desheng Wang
- Physical Education Institute, Shanxi University, Taiyuan, China
| | - Shuai Zhong
- Department of Rehabilitation Medicine, Dazhou Central Hospital, Dazhou, China
| |
Collapse
|
3
|
Han B, Zhang P, Zhao H, Zhang X, Gao H, Dong J, Zeng L, Pi P, Pei J. Effects of exercise interventions on quality of life in patients with breast cancer: A systematic review and network meta-analysis. Psychooncology 2024; 33:e6370. [PMID: 38937093 DOI: 10.1002/pon.6370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 06/15/2024] [Accepted: 06/20/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVE To compare and rank the effectiveness of four primary categories of exercise modalities (aerobic, resistance, mind-body, and combined exercise [CE]) in improving the Quality of life (QoL) of women with breast cancer in a network meta-analysis (NMA). METHODS Articles published in English and indexed in the PubMed (MEDLINE), EBSCO, Web of Science, SPORTDiscus, The Cochrane Library, Google Scholar, PsycINFO, EMBASE, and CINAHL Plus databases were identified from inception to 12 October 2023. Studies that met the eligibility criteria were assessed for risk of bias. A frequentist NMA was conducted to appraise the efficacy of different exercise types. RESULTS This study included 56 studies with 3904 participants. Aerobic, mind-body, and combined exercises effectively improved QoL compared to controls. The surface under the cumulative ranking curve (SUCRA) indicated that CE best improved patients' QoL (SUCRA = 96.7%). Analysis of the secondary outcomes suggests that exercise reduced patients' depression (standardized mean difference [SMD] = -0.38, 95% confidence interval [CI] = -0.70 to -0.06, p < 0.001; I2 = 79%) and anxiety (SMD = -0.50, 95% CI = -0.69 to -0.31, p < 0.001; I2 = 27.4%) but did not affect self-esteem. CONCLUSION All exercise types but resistance were effective in improving the QoL of women with breast cancer, CE (the combination of aerobic and resistance exercise) had the highest likelihood of being optimal for improving QoL.
Collapse
Affiliation(s)
- Bing Han
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Peizhen Zhang
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Haojie Zhao
- School of Physical Education, Shandong University, Jinan, China
| | - Xiaojie Zhang
- School of Physical Education, Shandong University, Jinan, China
| | - Hongyue Gao
- School of Chemistry and Chemical Engineering, Shandong University, Jinan, China
| | - Jiating Dong
- School of Translation Studies, Shandong University, Weihai, China
| | - Liqing Zeng
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Peng Pi
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Jiayi Pei
- School of Physical Education, Shandong University, Jinan, China
| |
Collapse
|
4
|
Li L, Li X, Huang Y, Li H, Li C, Ma Y, Zhang J, Peng F, Lyu S. An RCT META analysis based on the effect of tai chi exercise therapy on the outcome of elderly patients with moderate-to-severe sleep disorders-A systematic review study. Heliyon 2024; 10:e24085. [PMID: 38293413 PMCID: PMC10826669 DOI: 10.1016/j.heliyon.2024.e24085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 12/16/2023] [Accepted: 01/03/2024] [Indexed: 02/01/2024] Open
Abstract
Background According to statistics, about one-fifth of the world's elderly people suffer from sleep disorders, and the problem of sleep disorders in the elderly is extremely serious, and this problem is one of the important causes of chronic diseases such as hypertension, hyperlipidemia, diabetes mellitus, and coronary heart disease in the elderly. The positive effect of Tai Chi exercise therapy on sleep problems has been confirmed, but at present, the effect of the specific duration of Tai Chi exercise on the improvement of elderly people with moderate to severe sleep disorders varies. Objective META analysis was used to investigate and find that long-term Tai Chi exercise therapy has the best effect on improving sleep in elderly patients with moderate to severe sleep disorders. Methods: META analysis was performed using Revman 5.3 after searching Web of science, Pubmed, Scopus, The Cochroae Library, OVID, CBM, CNKI, VIP, and other databases, and then filtering and extracting. Results A total of seven papers were included. Meta-analysis showed that tai chi exercise was more effective in improving sleep problems in elderly patients with sleep disorders compared to the control group, and the difference was significant. This was demonstrated by a decrease in the global Pittsburgh Sleep Quality Index (PSQI) score [SMD = -0.66, 95 % CI (-0.91, -0.41), P < 0.00001], as well as its subdomains of subjective sleep quality [SMD = -0.79, 95 % CI (-1.06, -0.52), P < 0.00001], sleep latency [SMD = -0.80, 95 % CI (-1.21, -0.40), P < 0.00001], sleep duration [SMD = -0.38, 95 % CI (-0.72, -0.04), P = 0.03], habitual sleep efficiency [SMD = -0.58, 95 % CI (-0.84, -0.31), P < 0.0001], sleep disturbance [SMD = -0.51, 95 % CI (-0.78, -0.25), P = 0.00001] and daytime dysfunction [SMD = -0.33, 95 % CI (-0.59, -0.07), P = 0.01]. Improvement was also observed in the Epworth Sleepiness Scale (ESS) and Insomnia Severity Index Scale (ISI). The results showed that the optimal duration and frequency of Tai Chi exercise therapy for improving moderately severe elderly patients with sleep disorders was long-term. Conclusion This study systematically assessed the efficacy of Tai Chi exercise therapy for elderly patients with moderate-to-severe sleep disorders. Through a meta-analysis of relevant randomized controlled trials (RCTs), it aims to determine the effectiveness of Tai Chi exercise in improving sleep quality in elderly patients with moderate-to-severe sleep disorders, as well as to compare its effects with those of traditional treatments; to analyze the safety of Tai Chi exercise for this patient population and assess its feasibility as a non-pharmacological therapy; and to fill the research gaps and provide more comprehensive and systematic evidence support. This study provides a practical approach to reducing the risk of medication side effects in older adults with sleep disorders and offers a potentially effective non-pharmacological treatment option, especially for those who are unable or unwilling to use medication. Tai chi exercise may not only improve sleep, but also improve coordination, muscle strength, balance, and reduce stress and anxiety in older adults. It also helps older adults socialize and enhances their social connections and emotional support. This study suggests that community centers or activity centers for the elderly can organize tai chi classes to promote the participation of older adults, and can be used as a scientific exercise rehabilitation tool in clinical treatment, incorporating tai chi practice into daily life, such as tai chi practice at a fixed time every day or every week, which not only helps to improve the sleep disorders of older adults, but also improves their overall quality of life.
Collapse
Affiliation(s)
- Lujia Li
- School of Physical Education and Exercise, Beijing Normal University, Beijing 100875, China
| | - Xiaozheng Li
- Department of Psychiatric, Tianjin Anding Hospital, No. 13 Liulin Road, Hexi District, China
| | - Yuerong Huang
- School of Physical Education and Exercise, Beijing Normal University, Beijing 100875, China
| | - Haojie Li
- School of Physical Education and Exercise, Beijing Normal University, Beijing 100875, China
| | - Cuihan Li
- School of Physical Education and Exercise, Beijing Normal University, Beijing 100875, China
| | - Yuxin Ma
- School of Physical Education and Exercise, Beijing Normal University, Beijing 100875, China
| | - Jianwei Zhang
- School of Physical Education and Exercise, Beijing Normal University, Beijing 100875, China
| | - Fang Peng
- Leisure and Health Teaching and Research Department, Department of Physical Education, Hainan Medical College, China
| | - Shaojun Lyu
- School of Physical Education and Exercise, Beijing Normal University, Beijing 100875, China
| |
Collapse
|
5
|
Zhou J, Dai Y, Fu J, Yan C, Yu DG, Yi T. Dual-Step Controlled Release of Berberine Hydrochloride from the Trans-Scale Hybrids of Nanofibers and Microparticles. Biomolecules 2023; 13:1011. [PMID: 37371591 DOI: 10.3390/biom13061011] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
In this nano era, nanomaterials and nanostructures are popular in developing novel functional materials. However, the combinations of materials at micro and macro scales can open new routes for developing novel trans-scale products with improved or even new functional performances. In this work, a brand-new hybrid, containing both nanofibers and microparticles, was fabricated using a sequential electrohydrodynamic atomization (EHDA) process. Firstly, the microparticles loaded with drug (berberine hydrochloride, BH) molecules in the cellulose acetate (CA) were fabricated using a solution electrospraying process. Later, these microparticles were suspended into a co-dissolved solution that contained BH and a hydrophilic polymer (polypyrrolidone, PVP) and were co-electrospun into the nanofiber/microparticle hybrids. The EHDA processes were recorded, and the resultant trans-scale products showed a typical hybrid topography, with microparticles distributed all over the nanofibers, which was demonstrated by SEM assessments. FTIR and XRD demonstrated that the components within the hybrids were presented in an amorphous state and had fine compatibility with each other. In vitro dissolution tests verified that the hybrids were able to provide the designed dual-step drug release profiles, a combination of the fast release step of BH from the hydrophilic PVP nanofibers through an erosion mechanism and the sustained release step of BH from the insoluble CA microparticles via a typical Fickian diffusion mechanism. The present protocols pave a new way for developing trans-scale functional materials.
Collapse
Affiliation(s)
- Jianfeng Zhou
- School of Materials and Chemistry, University of Shanghai for Science and Technology, Shanghai 200093, China
| | - Yelin Dai
- Wenqi Middle School, East Jiangchuan Road 980, Shanghai 200240, China
- High School Affiliated to Fudan University, Qingpu Campus, Longpu Road 500, Shanghai 201700, China
| | - Junhao Fu
- School of Materials and Chemistry, University of Shanghai for Science and Technology, Shanghai 200093, China
| | - Chao Yan
- School of Materials and Chemistry, University of Shanghai for Science and Technology, Shanghai 200093, China
| | - Deng-Guang Yu
- School of Materials and Chemistry, University of Shanghai for Science and Technology, Shanghai 200093, China
| | - Tao Yi
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macau 999078, China
| |
Collapse
|
6
|
Chen X, Li J, Chen C, Zhang Y, Zhang S, Zhang Y, Zhou L, Hu X. Effects of exercise interventions on cancer-related fatigue and quality of life among cancer patients: a meta-analysis. BMC Nurs 2023; 22:200. [PMID: 37312185 DOI: 10.1186/s12912-023-01363-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 05/31/2023] [Indexed: 06/15/2023] Open
Abstract
PURPOSE In this study, exercise interventions were evaluated for their effects on cancer-related fatigue (CRF) and quality of life (QoL) among cancer patients. DESIGN A meta-analysis was performed. METHODS We systematically searched the PubMed/Medline, Web of Science, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, and CINAHL databases, and gray literature sources including the Virginia Henderson International Nursing Library and Google Scholar. This study only included randomized controlled trials (RCTs) examining how exercise interventions affect CRF and QoL among cancer patients. Based on the Cochrane Risk-of-Bias Assessment Tool, version 2 (RoB 2) and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, the methodological quality of the included studies was evaluated. In addition, standardized mean differences (SMDs) and 95% confidence intervals (CIs) were applied to assess the intervention effect with respect to CRF and QoL. Data analysis was performed using Review Manager (version 5.4). RESULTS There were a total of 1573 participants in the 28 included articles. According to the meta-analysis, CRF (SMD = -0.35, 95% CI: -0.63 to -0.07, p = 0.01) and QoL (SMD = 0.36, 95% CI: 0.20 to 0.53, p < 0.01) were positively affected by exercise interventions. Subgroup analyses revealed considerable improvements in CRF (SMD = -0.54, 95% CI: -1.00 to -0.09, p = 0.02) and QoL (SMD = 0.38, 95% CI: 0.16 to 0.59, p < 0.01) from aerobic exercise. An intervention duration less than 12 weeks had a better effect on CRF (SMD = -0.80, 95% CI: -1.43 to -0.17, p = 0.01) and QoL (SMD = 0.53, 95% CI: 0.21 to 0.85, p < 0.01), and three times per week was the most effective frequency in improving QoL (SMD = 0.69, 95% CI: 0.28 to 1.11, p < 0.01). Exercise intervention was more successful in improving CRF (SMD = -0.66, 95% CI: -1.10 to -0.21, p < 0.01) and QoL (SMD=-0.50, 95% CI: 0.23 to 0.78, p < 0.01) in female cancer patients. Sensitivity analyses showed that the pooled outcomes were reliable and stable. CONCLUSION Exercise interventions are a workable approach to improve CRF and QoL among cancer patients. An aerobic exercise intervention of less than 12 weeks might be most effective in improving CRF and QoL, and three times per week might be the most appropriate frequency. Exercise might have a more positive effect on improving CRF and QoL in female cancer patients. Additionally, a larger number of high-quality RCTs should be conducted to further confirm the efficacy of exercise interventions on CRF and QoL among cancer patients. REGISTRATION NUMBER CRD42022351137.
Collapse
Affiliation(s)
- Xiaoli Chen
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, PR China
| | - Juejin Li
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, PR China
| | - Chongcheng Chen
- Department of Nephrology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, PR China
| | - Yalin Zhang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, PR China
| | - Shu Zhang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, PR China
| | - Yun Zhang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, PR China
| | - Lin Zhou
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, PR China
| | - Xiaolin Hu
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, PR China.
| |
Collapse
|
7
|
Liu H, Dai Y, Li J, Liu P, Zhou W, Yu DG, Ge R. Fast and convenient delivery of fluidextracts liquorice through electrospun core-shell nanohybrids. Front Bioeng Biotechnol 2023; 11:1172133. [PMID: 37091339 PMCID: PMC10117974 DOI: 10.3389/fbioe.2023.1172133] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 03/31/2023] [Indexed: 04/09/2023] Open
Abstract
Introduction: As an interdisciplinary field, drug delivery relies on the developments of modern science and technology. Correspondingly, how to upgrade the traditional dosage forms for a more efficacious, safer, and convenient drug delivery poses a continuous challenge to researchers. Methods, results and discussion: In this study, a proof-of-concept demonstration was conducted to convert a popular traditional liquid dosage form (a commercial oral compound solution prepared from an intermediate licorice fluidextract) into a solid dosage form. The oral commercial solution was successfully encapsulated into the core-shell nanohybrids, and the ethanol in the oral solution was removed. The SEM and TEM evaluations showed that the prepared nanofibers had linear morphologies without any discerned spindles or beads and an obvious core-shell nanostructure. The FTIR and XRD results verified that the active ingredients in the commercial solution were compatible with the polymeric matrices and were presented in the core section in an amorphous state. Three different types of methods were developed, and the fast dissolution of the electrospun core-shell nanofibers was verified. Conclusion: Coaxial electrospinning can act as a nano pharmaceutical technique to upgrade the traditional oral solution into fast-dissolving solid drug delivery films to retain the advantages of the liquid dosage forms and the solid dosage forms.
Collapse
Affiliation(s)
- Hang Liu
- School of Materials and Chemistry, University of Shanghai for Science and Technology, Shanghai, China
| | - Yelin Dai
- Wenqi Middle School, Shanghai, China
- Qingpu Campus, High School Affiliated to Fudan University, Shanghai, China
| | - Jia Li
- Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Ping Liu
- The Base of Achievement Transformation, Shidong Hospital Affiliated to University of Shanghai for Science and Technology, Shanghai, China
- Institute of Orthopaedic Basic and Clinical Transformation, University of Shanghai for Science and Technology, Shanghai, China
| | - Wenhui Zhou
- School of Materials and Chemistry, University of Shanghai for Science and Technology, Shanghai, China
| | - Deng-Guang Yu
- School of Materials and Chemistry, University of Shanghai for Science and Technology, Shanghai, China
| | - Ruiliang Ge
- Department of Outpatient, The Third Affiliated Hospital, Naval Medical University, Shanghai, China
| |
Collapse
|
8
|
Fiuza-Luces C, Valenzuela PL, Santos-Lozano A, Ruiz-Casado A, Lucia A. Exercise and quality of life in cancer. JOURNAL OF SPORT AND HEALTH SCIENCE 2023:S2095-2546(23)00001-7. [PMID: 36621566 PMCID: PMC10362481 DOI: 10.1016/j.jshs.2023.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Affiliation(s)
- Carmen Fiuza-Luces
- Physical Activity and Health Research Group (PaHerg), Research Institute of Hospital 12 de Octubre ('i+12'), Madrid 28041, Spain.
| | - Pedro L Valenzuela
- Physical Activity and Health Research Group (PaHerg), Research Institute of Hospital 12 de Octubre ('i+12'), Madrid 28041, Spain; Department of Systems Biology, University of Alcalá, Madrid 28871, Spain
| | - Alejandro Santos-Lozano
- i+HeALTH Research Group, Department of Health Sciences, European University Miguel de Cervantes, Valladolid 47012, Spain
| | - Ana Ruiz-Casado
- Department of Medical Oncology, Hospital Universitario Puerta de Hierro Majadahonda, Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Madrid 28220, Spain
| | - Alejandro Lucia
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid 28670, Spain
| |
Collapse
|