Do soccer and Zumba exercise improve fitness and indicators of health among female hospital employees? A 12-week RCT

The Standard Error/Standard Deviation Mix-Up: Potential Impacts on Meta-Analyses in Sports Medicine

BACKGROUND

A recent review found that 45% of meta-analyses included statistical errors, of which, the most common was the calculation of effect sizes based on standard error (SE) rather than standard deviation (SD) [the SE/SD mix-up].

OBJECTIVES

The first aim of this study was to assess the impact of the SE/SD mix-up on the results of one highly cited meta-analysis. Our second aim was to identify one potential source of the SE/SD mix-up, by assessing how often SE is reported as a measure of sample variability in randomised controlled trials in sports medicine.

METHODS

We checked for potential SE/SD mix-ups in a 2015 meta-analysis of randomised controlled trials reporting the effects of recreational football interventions on aerobic fitness in adults. We corrected effect sizes affected by SE/SD mix-ups and re-analysed the data according to the original methodology. We compared pooled estimates of effect sizes from our re-analysis of corrected values with those of the original study. To assess how often SE was reported instead of SD as a measure of sample variance, we text mined results of randomised controlled trials from seven sports medicine journals and reported the proportion reporting of SE versus SD.

RESULTS

We identified potential SE/SD mix-ups in 9/16 effect sizes included in the meta-analysis describing the effects of football-based interventions versus non-exercise control. The published effect size was standardised mean difference (SMD) = 1.46 (95% confidence interval [CI] 0.91, 2.01). After correcting for SE/SD mix-ups, our re-analysis produced a smaller pooled estimate (SMD = 0.54 [95% CI 0.37, 0.71]). The original pooled estimate for trials comparing football versus running interventions was SMD = 0.68 (95% CI 0.06, 1.4). After correcting for SE/SD mix-ups and re-analysis, the effect was no longer statistically significant (SMD = 0.20 [95% CI - 0.10, 0.49)]). We found that 19.3% of randomised controlled trials reported SE rather than SD to describe sample variability. The relative frequency of the practice ranged from 0 to 25% across the seven journals sampled.

CONCLUSIONS

We found the SE/SD mix-up had inflated estimates for the effects of football on aerobic fitness. Meta-analysts should be vigilant to avoid miscalculating effect sizes. Authors, reviewers and editors should avoid and discourage (respectively) the practice of reporting SE as a measure of sample variability in sports medicine research.

A 3-Month Modified Basketball Exercise Program as a Health-Enhancing Sport Activity for Middle-Aged Individuals

Recreational team sports have received great acceptance lately, in different populations, indicating encouraging results in health-related quality of life. This study examined the efficacy of a 3-month basketball exercise program on selected indices of health (body mass-BM, body fat-BF, blood pressure-BP), functional capacity (flexibility of lower and upper limbs, balance), and physical fitness (maximum strength of lower limbs, trunk and handgrip, aerobic capacity) in middle-aged individuals. Forty middle-aged individuals (males and females; 40-55 years old) were randomly divided into (a) exercise (EG; n = 20) and (b) control groups (CG; n = 20). The EG followed a 3-month modified basketball exercise program (2 times/week; 24 training units), including different basketball drills with and without the ball (dribbling, passing, pivot, stops, etc.), to improve participants' health and physical fitness. Repeated measures ANOVA showed that the EG significantly increased their flexibility (17.23-74.88%; p < 0.001), static balance (44.76-54.69%; p < 0.001), and strength of lower limbs and trunk (11.67-13.13%; p < 0.001), while reducing BP (7.31-12%; p < 0.001), heart rate and RPE (5.30-34.37%; p < 0.001), and time during time-up-and-go test (-10.91%; p < 0.001). Handgrip strength, BM, and BF did not change following the program in the EG (p > 0.05). In the CG, the above variables remained stable. In conclusion, this program may be used to eliminate the detrimental effects of aging on health, functional capacity, and physical fitness parameters.

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.

The Effects of Zumba Fitness® on Respiratory Function and Body Composition Parameters: An Eight-Week Intervention in Healthy Inactive Women

BACKGROUND

Women are considered less active than men, and a sedentary lifestyle particularly affects middle-aged women and affects their overall health. Recommending group fitness programs that have a positive effect on women's overall health is an important strategy of any health policy. Thus, the purpose of this study was to investigate how the Zumba Fitness^® workout affects healthy inactive women's respiratory function and body composition.

METHODS

The research was conducted for eight weeks on a sample of 41 females aged 35 to 45 divided into two groups: experimental (21 subjects: age 38.52 ± 2.29) and control (20 subjects: age 39.45 ± 3.01). They were tested before, four weeks, and eight weeks after the intervention period. The respiratory functions were tested using spirometry and the body composition parameters by the Tanita body analyzer. The experimental group practiced Zumba Fitness^® three times per week for 60 min (24 training sessions in total). The control group was not physically active during the intervention period.

RESULTS

After the Zumba Fitness^® program, the experimental group showed a significant improvement in the following respiratory function parameters: forced expiratory volume in the first second (M = 4.02 ± 0.69; MD = 0.65, p = 0.01, ES = 0.14), vital capacity (M = 4.10 ± 0.65: MD = -0.63, p = 0.03, ES = 0.11) and lung age (M = 30.95 ± 10.30; MD = 8.52, p = 0.04, ES = 0.10). The body composition parameters were significantly decreased: body mass (M = 60.09 ± 7.57; MD = 6.32, p = 0.03, ES = 0.11), body mass index (M = 20.44 ± 2.63; MD = 2.61, p = 0.01, ES = 0.13) and fat mass (M = 16.07 ± 4.87; MD = 3.95, p = 0.03, ES = 0.11).

CONCLUSIONS

The results of the current study suggest that the Zumba Fitness^® workout is a beneficial exercise method not only for reducing body parameters but also for improving respiratory function in inactive women.

Does a 40-week Football and Zumba exercise intervention influence self-reported job satisfaction, work role functioning and sick leave among female hospital employees? A cluster-randomised controlled trial

This 40-week cluster-randomised controlled trial (RCT) examines the effects of football and Zumba on self-perceived job satisfaction, work role functioning and sick leave among Norwegian female hospital employees. Hundred-and-seven employees, mainly consisting of nurses (80%), were allocated into three groups; Football (FG), Zumba (ZG) and Control (CG). The exercise groups were offered two to three and one to two 1-h weekly sessions during the first 12 and last 28 weeks, respectively, with an actual weekly exercise frequency of 2.4 ± 0.5 and 0.9 ± 0.2 in FG and 2.3 ± 0.3 and 0.8 ± 0.2 in ZG. Outcome variables were measured at baseline, 12 and 40 weeks. In comparison to CG (4.8 days 95% CI 3.2-6.4), ZG (1.9 days, 95% CI 0.4-3.5) had a significant lower overall mean days of sickness absence during last sick leave period (-2.9 days, 95% CI -5.1 to -0.7, p = .011) which corresponded to a moderate effect size (d = 0.60). Between baseline (88.5%, 95% CI 84.3-92.6) and 12 weeks (93.8%, 95% CI 89.4-98.2), ZG showed significant within-group improvement in total score of the Work Role Functioning Questionnaire (WRFQ) (5.3%, 95% CI 0.6-10.1, p = .029), corresponding to a moderate effect size (d = 0.40). This study indicates that two to three 1-h weekly Zumba sessions can have a preventive effect on sick leave in female hospital employees.HighlightsParticipants in Zumba exercise organised by the workplace showed a significant lower number of sick leave days compared with the controls.Despite a correspondingly significant reduction in exercise adherence in both groups in the last 28 weeks, only FG showed tendencies for group improvement in job satisfaction and total WRFQ in this period.Workplace promotion of exercise and physical activity can thus be beneficial for both the workers and the organisation.

Workplace exercise program in a hospital environment: an effective strategy for the promotion of employees physical and mental health. A randomized controlled study

PURPOSE

The demanding and exhausting working hours, as well as the bad and unsuitable working conditions that prevail in several hospitals, affect employees' physical and mental health. The purpose of this study was to examine the effectiveness of a daily 6-week supervised workplace exercise program on health indices, functional capacity, overall fitness, subjective vitality, and life satisfaction in health professionals.

METHODS

A randomized controlled study was used. 50 health professionals (40-55 years), working in a hospital environment, were divided into two groups: exercise (EG) and control group (CG). EG performed a 6-week supervised concurrent chair-based exercise program (stretching, strength, balance exercises, aerobic dance; 5 days/week, 30-40 min/day, 2 workouts/day lasted 15-20 min) in the hospital. Health indices (body composition, blood pressure, respiratory function), functional capacity (flexibility, balance), physical fitness (strength, cardiorespiratory fitness), subjective vitality, and life satisfaction were measured before and after the completion of the program. Additionally, after the completion of the program, EG participants' enjoyment was assessed.

RESULTS

EG significantly increased (p < 0.001) lean body mass and respiratory function (range of mean increase 3.5-4.5%, depending on the variable), functional capacity (range of mean increase 18-40%, depending on the variable), lower and upper libs maximal strength (range of mean increase 10-25%, depending on the variable), subjective vitality (41.3%) and life satisfaction (21.5%); while significantly decreased (p < 0.001) heart rate during submaximal test (- 14%), body fat and blood pressure (range of mean decrease - 3.5% to - 5.5%, depending on the variable). In CG, all the above variables did not change. Furthermore, a great percentage of employees (95%) reported high levels of enjoyment.

CONCLUSION

A workplace exercise program may be safely used for the promotion of employees' physical and mental health.

Football and Zumba Training in Female Hospital Staff: Effects after 12 and 40 Weeks on Self-Reported Health Status, Emotional Wellbeing, General Self-Efficacy and Sleep Problems

Background: This 40-weeks intervention study evaluates the effects on self-reported health status, emotional wellbeing, general self-efficacy and sleep problems among female hospital employees. Methods: 107 employees were cluster-randomized into three groups; football (FG), Zumba (ZG) and control (CG). Outcome measurements were conducted at baseline, 12 and 40 weeks. Weekly training frequencies in the first 12 and next 28 weeks were 2.4 ± 0.3 and 0.8 ± 0.2 in FG and 2.3 ± 0.3 and 0.9 ± 0.2 in ZG. Results: Compared to the CG, the ZG showed significant improvement in self-reported health status (p = 0.025), a reduced frequency of poor and restless sleep (on a 0–4 scale) (p = 0.004), as well as a tendency for reduction in the frequency of problems falling asleep (p = 0.055) and overall sleep problems (p = 0.051). Between baseline and 12 weeks, both the FG (p = 0.017) and the ZG (p = 0.017) showed within-group improvements in emotional wellbeing, whereas this improvement was maintained only in the ZG between baseline and 40 weeks (p = 0.002). The FG showed a significant within-group improvement in general self-efficacy (p = 0.012) between baseline and 12 weeks follow-up, with no such improvements in the other groups. Conclusion: The present findings revealed that a physical activity intervention with Zumba as well as football training may improve mental health and sleep outcomes in female hospital staff.

Integrated Nutritional Supports for Diabetic Patients During COVID-19 Infection: A Comprehensive Review

BACKGROUND

Diabetes mellitus is an endocrine metabolic disorder, which affects the major organs in human and comorbid with others. Besides, diabetic patients are more prone to various infectious diseases as well as COVID-19 sporadic infection which is a high risk for patients with diabetes mellitus. To combat these infections and comorbid situations, an integrated balanced nutritional supportive could help in maintaining sound health and increase immunity for prevention and management of such type of viral infections.

OBJECTIVES

While information regarding nutritional supports in COVID-19 pandemic in diabetic patients is not available, this review aimed to accumulate the evidence from previous publications where studied about nutrition-based supports or interventions for viral diseases with special emphasis on respiratory infections.

METHODS

For reviewing, searches are done for getting journal articles into Google Scholar, Pub Med/Medline, Database of Open Access Journal and Science Direct for relevant data and information.

RESULTS

Integrated nutritional supports of both macronutrients and micronutrients guidelines, including home-based physical exercise schedule, is summarized in this comprehensive review for possible prevention and management of diabetic patients in COVID-19 infections. The immuneboosting benefits of some vitamins, trace elements, nutraceuticals and probiotics in viral infections of diabetic patients are also included.

CONCLUSION

There is an urgent need for a healthy diet and integrated nutritional supports with home-based physical activities for diabetic patients during the self-isolation period of COVID-19 Infection.

Effectiveness of Workplace Exercise Interventions on Body Composition: A Systematic Review and Meta-Analysis

OBJECTIVE

The aim of this review was to analyze the effectiveness of workplace exercise interventions on body composition (BC).

DATA SOURCE

Studies published in PubMed, Scopus, SPORTDiscus, Web of Science, CINAHL and PsycINFO, from the earliest time point until 8 July 2020.

STUDY INCLUSION AND EXCLUSION CRITERIA

Inclusion criteria were worksite interventions, in adults, Randomized Controlled Trials (RCTs), real exercise practice, and measuring BC outcomes. Exclusion criteria were full-text non-available, abstract not in English, and exercise protocol missing.

DATA EXTRACTION

157 studies were retrieved and assessed for inclusion by 2 independent reviewers, who also used the Cochrane's Collaboration Tool to assess study quality and risk of bias.

DATA SYNTHESIS

We performed a meta-analysis to determine the effect size of the interventions on BC outcomes reported in at least 5 studies.

RESULTS

Twelve RCTs were included (n = 1270, 66% women), quality of studies being low to high (25% moderate, 67% high). Interventions achieved a statistically significant decrease in waist circumference (SMD = 0.24; 95% confidence interval (CI): 0.06 to 0.41; p = 0.008), total mass fat (SMD = 0.21; 95%CI: 0.00 to 0.41; p = 0.047), and body adiposity index (SMD = 0.20; 95%CI: 0.00 to 0.41; p = 0.049). No changes were observed in body weight (SMD = 0.08 95%CI: -0.02 to 0.18; p = 0.128). Additionally, muscle mass increased in interventions that included strength training. There were no adverse events reported.

CONCLUSION

The most effective workplace exercise interventions to improve BC combined supervised, moderate-intensity aerobic and strength training, for at least 4 months.

Choreographic Group-Based Fitness Classes Improve Cardiometabolic Health-Related Anthropometric Indices and Blood Lipids Profile in Overweight Sedentary Women

Background: Choreographic group-based fitness classes are the most common type of physical activity practiced by women, being a viable and sustainable strategy to improve general health. Thus, the aim of this study was to analyze the effect of a 16-week healthy lifestyle program, based on choreographic fitness classes, on cardiometabolic health-related anthropometric indices and metabolic blood profile among overweight sedentary women. Methods: A total of 50 overweight (Body Mass Index = 27.68 ± 1.19 kg/m2) middle-aged women (39.73 ± 7.41 years) were randomly assigned to an experimental exercise group based on structured choreographic fitness classes (CFC) with the Zumba Fitness program (3 days/week; 60 min/session) (CFC = 30) or a non-exercise control group (CG = 20). The anthropometric indices (waist circumference, waist-to-height ratio, a body shape index, conicity index, abdominal volume index, and body adiposity index), blood pressure, glycemia, and blood lipid profile [triglycerides (TG), total cholesterol, Low Density Lipoprotein (LDL), High Density Lipoprotein (HDL)] were evaluated pre- and post-intervention. Results: 40 participants competed the pre/post measures. Post-intervention, the CFC group (n = 25) presented a significant improvement in all anthropometric indices as well as in TG, HDL, and LDL as compared with the CG (n = 15). Conclusion: A 16-week healthy lifestyle program based on structured choreographic fitness classes with the Zumba Fitness program (3 days/week; 60 min/session) could significantly improve cardiometabolic health-related anthropometric indices and the blood lipid profile in overweight sedentary middle-aged women.

Zumba®, Fat Mass and Maximum Oxygen Consumption: A Systematic Review and Meta-Analysis

Background and objectives: Obesity or overweight is associated with many health risk factors and preventable mortality. Even people with normal weight and without history of obesity or overweight should avoid weight gain to reduce health risks factors. In this regard Latin aerobic dances involved in Zumba^® practice make this modality motivating for people. Apart from weight loss and VO2_peak benefits, Zumba practice is also interesting by the increase in adherence which can also avoid weight regain. The aim was to systematically review the scientific literature about the effects of any randomized intervention of Zumba^® practice on total fat mass (%) and maximum oxygen consumption (VO_2peak), besides establishing directions for the clinical practice. Evidence acquisition: Two systematic searches were conducted in two electronic databases following the PRISMA guidelines. The eligibility criteria were (a) outcomes: body mass or VO_2peak data including mean and standard deviation (SD) before and after Zumba^® intervention, (b) study design: randomized controlled trial (RCT) and (c) language: English. GRADE guidelines were used to assess the quality of evidence. A meta-analysis was performed to determine mean differences. Nine and four studies were selected for fat mass percentage and VO_2peak in the systematic review, respectively. However, only eight studies for fat mass percentage and three for VO_2peak could be included in the meta-analysis. Evidence synthesis: The overall standardized mean difference for fat mass was −0.25 with a 95% CI from −0.67 to 0.16 with a p-value of 0.69, with large heterogeneity. On the other hand, the overall effect size for VO_2peak was 0.53 (95% CI from 0.04 to 1.02 with a p-value of 0.03) with large heterogeneity. Conclusions: Based on the evidence, we cannot conclude that Zumba^® is effective at reducing body mass but it may improve VO_2peak. However, the limited number of studies that met the inclusion criteria makes it too early to reach a definite conclusion, so more research is needed.

Women-centred workplace health promotion interventions: a systematic review

AIM

To analyse workplace health promotion interventions implemented exclusively for the female population.

BACKGROUND

The differences in biological, psychological and social characteristics, as well as the type of work carried out by men and women, make it necessary for workplace health promotion to be specific for each group. This study focussed on working women.

INTRODUCTION

Workplace health promotion interventions are centred on increasing the well-being and health of the employees. Occupational health nurses play an essential role in the implementation of these interventions.

METHODS

A systematic review was carried out using the MEDLINE and Scopus databases, following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines.

RESULTS

Twelve articles met the inclusion criteria. Two lines of interventions were found: (1) promotion of breastfeeding (16.6%) and (2) promotion of physical activity and other healthy lifestyles (83.4%). The interventions studied underlined promoting breastfeeding, preventing a sedentary lifestyle, improving body composition, reducing cardiovascular risk, relieving premenstrual symptoms, time of breastfeeding after returning to work, and showing favourable results.

DISCUSSION

The lack of studies on the subject and the medium-to-low quality of the articles included in the review have made it difficult to analyse workplace health promotion interventions, making it necessary to continue research in this area.

CONCLUSION

There are very few occupational health promotion interventions targeting women (1.9%), and the majority of them focus on promoting physical activity. It is worrying that specific aspects of women's health are poorly addressed.

IMPLICATIONS FOR NURSING PRACTICE AND HEALTH POLICY

The work of the occupational nurse essentially is to guarantee the health of women in the workplace, being the key figure in the research and development of gender-related policies in the field of public health.

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.

The effect of workplace lifestyle programmes on diet, physical activity, and weight-related outcomes for working women: A systematic review using the TIDieR checklist

Physical activity and healthy diets are essential for the prevention of obesity and chronic disease that disparately impact women compared with men. Given the number of women engaged in the workforce, workplace interventions could improve lifestyle behaviours and health outcomes for women. This systematic review aimed to identify intervention characteristics of lifestyle programmes or organizational policy changes in the workplace associated with improved diet, physical activity, or weight-related outcomes for working women using the template for intervention description and replication (TIDieR) checklist. Seven databases were searched for controlled studies published up to March 2019 that included a workplace diet and/or physical activity intervention. From 5,318 identified records, 20 studies (23 articles and 26 intervention arms) were included. Data were extracted on diet, physical activity, weight-related outcomes, and TIDieR components. Findings indicated that group delivery may improve physical activity outcomes, and a high number of sessions may benefit weight-related outcomes for physical activity interventions. Mixed interventions that included tailoring and input from non-healthcare professionals may also enhance physical activity. In contrast, the role of mixed interventions in improving diet and weight-related outcomes was less clear. Overall, workplace health programmes were effective at improving lifestyle behaviours for working women.

Zumba Fitness and Women's Cardiovascular Health: A SYSTEMATIC REVIEW

PURPOSE

Zumba fitness (ZF) is a well-known exercise program involving dance and fitness. Despite its increasing popularity, no analysis has been conducted on studies focusing on the cardiovascular (CV) profile of women who performed this activity. The aim of this systematic review is to provide insights into the impact of ZF on women's CV health.

METHODS

Five clinical databases were searched. To be included, the articles had to include (1) women with or without CV risk factors (CVRF) and (2) CV-related outcomes resulting from a ZF program.

RESULTS

Ten studies (322 women; 181 healthy, 141 with CVRF) were included. In healthy women, low absolute effect sizes for maximal oxygen uptake ((Equation is included in full-text article.)O2max), anthropometric and body composition profile after 8 and 12 wk of ZF were found compared with nonparticipants. Moderate to large absolute effect sizes were recorded for (Equation is included in full-text article.)O2max and body composition following 40 wk of ZF. Findings proved promising but less consistent for ZF studies involving women with CVRF due to the absence of control groups.

CONCLUSIONS

Data describe ZF as feasible for healthy women and a promising fitness option for those with CVRF. Because of the low quality of the studies on women with CVRF and the overall small sample size along with discrepancies such as the average length of the studies on healthy women, cautious interpretation of the findings is recommended. Further investigations with a standardized design are needed to verify whether ZF may be considered as an alternative fitness option in primary prevention of CV disease in women.

Health-Related Physical Fitness Benefits in Sedentary Women Employees after an Exercise Intervention with Zumba Fitness®

Background: The protective properties of high physical fitness levels on health are manifest independently of age, sex, fatness, smoking, alcohol consumption, and other clinical factors. However, women are less active than men, which contributes to low physical fitness and a high risk of CVD. Thus, the objective of this study is to analyze the effect of two exercise interventions on health-related physical fitness in sedentary employed females. Methods: A total of 98 physically inactive adult women were randomly assigned to 3 study groups: the control group (CG) = 31, the endurance training group based on Zumba Fitness^® classes (ET; n = 39), and the concurrent training group that had an extra muscle-strengthening workout after the Zumba Fitness^® class (CnT; n = 28). Body composition (BMI, waist circumference), motor fitness (one-leg stand test), musculoskeletal fitness (shoulder–neck mobility, handgrip strength test, jump and reach test, and dynamic sit-up test), and cardiorespiratory fitness (2-km test and estimated VO₂ max) were assessed with the ALPHA-Fit test battery for adults. Results: Both interventions showed a significant improvement in the majority of health-related fitness and body composition variables/test (waist circumference: ET = −2.275 ± 0.95, p = 0.02, CnT = −2.550 ± 1.13, p = 0.03; one-stand leg test: ET = 13.532 ± 2.65, p < 0.001; CnT = 11.656 ± 2.88, p < 0.001; shoulder–neck mobility: ET = 1.757 ± 0.44, p < 0.001, CnT = 2.123 ± 0.47, p < 0.001; handgrip test: 0.274 ± 0.08, p < 0.001, CnT = 0.352 ± 0.08, p < 0.001; dynamic sit-up: ET = 1.769 ± 0.45, p < 0.001, CnT = −1.836 ± 0.49, p < 0.001; 2-km test time: −1.280 ± 0.25, p < 0.001, CnT = −1.808 ± 0.28, p < 0.001; estimated VO₂ max: ET = 1.306 ± 0.13, p < 0.001, CnT = 1.191 ± 0.15, p < 0.001). There were no significant differences after the intervention between the two exercise intervention groups. Conclusions: Exercise interventions based on Zumba fitness^® or Zumba fitness^® combined with an extra muscle-strengthening workout based on bodyweight training exercises are effective strategies to improve the health-related physical fitness in sedentary women employees.

Assessing the prevalence of meeting physical activity recommendations among U.S. healthcare workers: Data from the 2015 National Health Interview Survey

We examined the prevalence of U.S. healthcare workers who met the 2008 Physical Activity Guidelines for Americans (2008 Guidelines), and the relationships among meeting the 2008 Guidelines and health behaviors, musculoskeletal symptoms, and occupational- and workplace- factors. We estimated prevalence of meeting the 2008 Guidelines for aerobic and muscle-strengthening activity using data from the 2015 National Health Interview Survey. Among 1,502 U.S. healthcare workers, 56.2% met the recommended guideline for aerobic activity; 30.1% met the recommended guideline for muscle-strengthening activity; and 25.3% met both recommended guidelines. Adjusting for covariates, meeting the 2008 Guidelines was associated with no history of smoking, current alcohol consumption, type of occupation, occupational activities, and availability of a health promotion program at work. Our findings suggest multi-level approaches (combining individual and organizational level efforts) are needed.

Impact of a novel home-based exercise intervention on health indicators in inactive premenopausal women: a 12-week randomised controlled trial

PURPOSE

This study tested the hypothesis that a novel, audio-visual-directed, home-based exercise training intervention would be effective at improving cardiometabolic health and mental well-being in inactive premenopausal women.

METHODS

Twenty-four inactive premenopausal women (39 ± 10 years) were randomly assigned to an audio-visual-directed exercise training group (DVD; n = 12) or control group (CON; n = 12). During the 12-week intervention period, the DVD group performed thrice-weekly training sessions of 15 min. Training sessions comprised varying-intensity movements involving multiplanar whole-body accelerations and decelerations (average heart rate (HR) = 76 ± 3% HR_max). CON continued their habitual lifestyle with no physical exercise. A series of health markers were assessed prior to and following the intervention.

RESULTS

Following the DVD intervention, HDL cholesterol (pre: 1.83 ± 0.45, post: 1.94 ± 0.46 mmol/L) and mental well-being, assessed via the Warwick Edinburgh Mental Well-Being Scale, improved (P < 0.05). Conversely, [LDL cholesterol], [triglycerides], fasting [glucose], body composition and resting blood pressure and HR were unchanged following the DVD intervention (P > 0.05). There were no pre-post intervention changes in any of the outcome variables in the CON group (P > 0.05).

CONCLUSION

The present study suggests that a novel, audio-visual-directed exercise training intervention, consisting of varied-intensity movements interspersed with spinal and lower limb mobility and balance tasks, can improve [HDL cholesterol] and mental well-being in premenopausal women. Therefore, home-based, audio-visual-directed exercise training (45 min/week) appears to be a useful tool to initiate physical activity and improve aspects of health in previously inactive premenopausal women.

Lessons learned from community- and home-based physical activity programs: A narrative review of factors influencing women's participation in cardiac rehabilitation

BACKGROUND

Cardiovascular disease remains a leading cause of death in women. Despite the well-known benefits of cardiac rehabilitation, it remains underutilized, especially among women. Physical activity programs in the community, however, attract a large female population, suggesting that they overcome barriers to physical activity encountered by women. The characteristics of interventions that extend beyond the traditional cardiac rehabilitation model and promote physical activity merit examination.

OBJECTIVES

This narrative review aimed to: (a) summarize women's barriers to attend cardiac rehabilitation; (b) examine the characteristics of community- and home-based physical activity or lifestyle coaching interventions; and (c) discuss which barriers may be addressed by these alternative programs.

METHODS

Studies were included if they: (a) were published within the past 10 years; (b) included ≥70% women with a mean age ≥45 years; (c) implemented a community- or home-based physical activity intervention or a lifestyle education/behavioral coaching program; and (d) aimed to improve physical activity levels or physical function.

RESULTS

Most interventions reported high (≥70%) participation rates and significant increases in physical activity levels at follow-up; some improved physical function and/or cardiovascular disease risk factors. Community- and home-based interventions address women's cardiac rehabilitation barriers by: implementing appealing modes of physical activity (e.g. dancing, group-walking, technology-based balance exercises); adapting the program to meet participants' needs; offering flexible options regarding timing and setting (e.g. closer to home, the workplace or faith-based institutions); and promoting social interactions.

CONCLUSION

Cardiac rehabilitation can be enhanced by understanding the specific needs of women; novel elements such as program offerings, convenient settings and opportunities for socialization should be considered when designing cardiac rehabilitation programs.

Efficacy of theory-informed workplace physical activity interventions: a systematic literature review with meta-analyses

This review aimed to assess the efficacy of workplace physical activity interventions; compare the efficacy of those that were and were not informed by behaviour change theory, and outline the effectiveness of different intervention components. A search was undertaken in Medline, Embase, PsycINFO, Ovid Emcare (previously CINAHL) and SportDiscus. Randomised, non-randomised and cluster-controlled trials with objectively measured physical activity and/or measured or predicted maximal oxygen uptake (VO_2max) as outcomes were included in the review (83 papers from 79 trials). Random-effects meta-analyses of mean differences were undertaken. Workplace physical activity programmes demonstrated positive overall intervention effects for daily step counts (814.01 steps/day; CI: 446.36, 1181.67; p < 0.01; i² = 88%) and measured VO_2max (2.53 ml kg^-1 min^-1; CI: 1.69, 3.36; p < 0.01; i² = 0%) with no sub-group differences between theory- and non-theory informed interventions. Significant sub-group differences were present for predicted VO_2max (p < 0.01), with a positive intervention effect for non-theory informed studies (2.11 ml.kg^-1 min^-1; CI: 1.20, 3.02; p < 0.01; i² = 78%) but not theory-informed studies (-0.63 ml kg^-1 min^-1; CI: -1.55, 0.30; p = 0.18; i² = 0%). Longer-term follow-ups ranged from 24 weeks to 13 years, with significant positive effects for measured VO_2max (2.84 ml kg^-1 min^-1; CI: 1.41, 4.27; p < 0.01; i² = 0%). Effective intervention components included the combination of self-monitoring with a goal, and exercise sessions onsite or nearby. The findings of this review were limited by the number and quality of theory-informed studies presenting some outcomes, and confounding issues in complex interventions. Future researchers should consider rigorous testing of outcomes of theory-informed workplace physical activity interventions and incorporate longer follow-ups.

Effects of 8-week of fitness classes on blood pressure, body composition, and physical fitness

BACKGROUND

Fitness activities such as indoor cycling (IC), Zumba® (ZU) and body pump (BP) are practiced by large segments of population. There are no studies showing which kind of fitness activity can produce more health benefits. The purpose of this study was to compare the effects of 8-week of IC, alone or combined with ZU (IC+ZU), or BP (IC+BP), on blood pressure, body composition, and physical fitness.

METHODS

Forty-eight participants were randomly assigned to four groups: IC, IC+ZU, IC+BP or control group (CG). Before and after 8-week of training, systolic (SBP) and diastolic blood pressure (DBP), fat, lean and bone mass, body circumferences, resting heart rate, aerobic fitness, limbs strength and vertical jump height (VJH) were assessed.

RESULTS

The IC and IC+ZU experienced significant decreases in SBP and DBP, which were significantly greater, compared to CG. Between-group comparisons showed greater decreases in body mass (BM) and body fat mass percentage (BFM) in IC compared to all groups, also significant differences were observed between IC+ZU and IC+B with CG. Decreases in neck, pectoral, waist and hip circumferences were found in IC, IC+ZU and IC+BP compared to CG. All experimental groups significantly increased 10RM leg press and leg flexion, VJH and VO2max compared to CG.

CONCLUSIONS

Fitness classes of IC, alone or combined with ZU or BP, are effective in reducing blood pressure and improving body composition and physical fitness. The IC is the most effective in reducing BM and BFM.

Effect of Two Choreographed Fitness Group-Workouts on the Body Composition, Cardiovascular and Metabolic Health of Sedentary Female Workers

Daily sedentary working hours contribute negatively to body composition, cardiovascular and metabolic health, especially in women, who are usually less active than men. The objective of this study was to analyze the effect of two trending choreographed fitness group-workouts on the body composition and cardiovascular and metabolic health of sedentary female workers. A total of 98 physically inactive and working women (38.9 ± 6.4 years of age) were randomly assigned to three study groups: Control group (CG) = 31, Zumba Fitness^® with three one-hour classes per week (ZF) = 39, and Zumba Fitness with 20 min of additional Bodyweight strength training (ZF + BW) = 28. Measurements included body composition, blood pressure, cardiovascular risk by the Framingham Heart Study tools (10 yr cardiovascular risk and vascular age) and a metabolic blood panel. Post-intervention, both choreographed fitness group-workouts reached a similar significant loss of fat mass (ZF = 2.805 ± 0.48, p < 0.0001; ZF + BW = 3.540 ± 0.04, p < 0.0001), an increase in muscle mass (ZF = 1.70 ± 0.581, p = 0.005; ZF + BW = 3.237 ± 0.657, p < 0.0001) and a decrease in SBP (ZF= 6.454 ± 1.70, p < 0.0001; ZF + BW = 4.12 ± 1.95, p = 0.039). Only the ZF group significantly improved the 10 yr cardiovascular risk (p = 0.032) and metabolic age (p = 0.0025) post-intervention. No significant improvement was observed in the metabolic panel for both choreographed fitness group-workouts. In conclusion, the ZF program generated improvements in cardiovascular and metabolic risk variables compared to ZF + BW or CG. Both choreographed fitness group-workouts contributed similarly to the improvement in systolic blood pressure, fat mass, muscle mass, and also engendered a great adherence to exercise.

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.

Obesity Prevention Worksite Wellness Interventions for Health Care Workers: A Narrative Review

Background: Health care workers face elevated risk of obesity due to their unique work requirements. The purpose of this systematic review was to present a narrative summary of the characteristics and effectiveness of worksite wellness programs focusing on preventing obesity among health care workers. Method: The databases Medline, CINAHL, Embase, PsycINFO, and PubMed were searched. Experimental and quasi-experimental studies published in English (between 2000 and 2018) that (a) were worksite interventions, (b) had intervention directed toward health care employees, and (c) reported weight-related outcomes were included. We excluded commercial weight loss studies. Two coders extracted data on the following: purpose, key study characteristics, design, type and dosage of intervention, outcome measure(s), attrition rate, and risk of bias. Results: Of the 51 studies included in this review, the majority (75%, n = 38) targeted diet and physical activity behaviors. The majority reported improved weight outcomes in favor of the intervention. Overall, moderate- to high-intensity behavioral strategies, using any mode of intervention delivery (phone, face-to-face, or Internet), delivered by a trained professional were effective in improving weight-related outcomes. Environmental strategies were effective in improving healthier habits. Self-directed strategies worked better for motivated employees. Discussion: Multicomponent interventions offered in health care settings may be successful in improving employee weight. Across study designs, several gaps in the reporting of intervention design, dosage, fidelity, and system-level outcomes were found. Conclusion/Applying research to practice: Occupational health professionals should continue to be creative in developing multicomponent interventions (combining behavioral/educational, environmental, and organizational support) and use evidence guidance frameworks/tools to design an intervention and report dosage outcomes.

Effects of Zumba® and Aquagym on Bone Mass in Inactive Middle-Aged Women

Background and objectives: Regular exercise may stimulate bone formation and reduce the loss of bone mass in premenopausal women. This study aims to evaluate the effect of high-impact physical activity (Zumba^®) and low-impact physical activity (Aquagym) on bone mass in inactive middle-aged women. Materials and methods: Fifty-five healthy inactive women (30⁻50 years old) were recruited in Spain in 2016 and were randomly allocated into one of three groups: High impact group (HIG: n = 15), low impact group (LIG: n = 12) and control group (CG: n = 28). HIG and LIG were recruited from Madrid and the CG from Toledo. HIG and LIG completed a 12-week intervention program with three 40' sessions per week of Zumba^® or Aquagym; respectively. Dual energy X-ray absorptiometry (DXA) measured bone mineral content (BMC) and areal bone mineral density (aBMD) at total body less head (TBLH), lumbar spine and right hip. Results: Post-intervention adjusted data showed no significant differences in BMC between any of the groups nor in aBMD between HIG and LIG. Interestingly; significant differences for the HIG vs. CG were found in the change in total hip aBMD (1.76% vs. -0.44%), femoral neck aBMD (1.80% vs. -2.71%), and intertrochanter aBMD (2.03% vs. -0.50%). Moreover, significant differences for the LIG vs. CG were also found in the change in femoral neck aBMD (-0.54% vs. -2.71%). Conclusions: The regular practice of Zumba^® and Aquagym might reduce the progressive deterioration of bone mass in inactive middle-aged women.

Strategies to improve the implementation of workplace-based policies or practices targeting tobacco, alcohol, diet, physical activity and obesity

BACKGROUND

Given the substantial period of time adults spend in their workplaces each day, these provide an opportune setting for interventions addressing modifiable behavioural risk factors for chronic disease. Previous reviews of trials of workplace-based interventions suggest they can be effective in modifying a range of risk factors including diet, physical activity, obesity, risky alcohol use and tobacco use. However, such interventions are often poorly implemented in workplaces, limiting their impact on employee health. Identifying strategies that are effective in improving the implementation of workplace-based interventions has the potential to improve their effects on health outcomes.

OBJECTIVES

To assess the effects of strategies for improving the implementation of workplace-based policies or practices targeting diet, physical activity, obesity, tobacco use and alcohol use.Secondary objectives were to assess the impact of such strategies on employee health behaviours, including dietary intake, physical activity, weight status, and alcohol and tobacco use; evaluate their cost-effectiveness; and identify any unintended adverse effects of implementation strategies on workplaces or workplace staff.

SEARCH METHODS

We searched the following electronic databases on 31 August 2017: CENTRAL; MEDLINE; MEDLINE In Process; the Campbell Library; PsycINFO; Education Resource Information Center (ERIC); Cumulative Index to Nursing and Allied Health Literature (CINAHL); and Scopus. We also handsearched all publications between August 2012 and September 2017 in two speciality journals: Implementation Science and Journal of Translational Behavioral Medicine. We conducted searches up to September 2017 in Dissertations and Theses, the WHO International Clinical Trials Registry Platform, and the US National Institutes of Health Registry. We screened the reference lists of included trials and contacted authors to identify other potentially relevant trials. We also consulted experts in the field to identify other relevant research.

SELECTION CRITERIA

Implementation strategies were defined as strategies specifically employed to improve the implementation of health interventions into routine practice within specific settings. We included any trial with a parallel control group (randomised or non-randomised) and conducted at any scale that compared strategies to support implementation of workplace policies or practices targeting diet, physical activity, obesity, risky alcohol use or tobacco use versus no intervention (i.e. wait-list, usual practice or minimal support control) or another implementation strategy. Implementation strategies could include those identified by the Effective Practice and Organisation of Care (EPOC) taxonomy such as quality improvement initiatives and education and training, as well as other strategies. Implementation interventions could target policies or practices directly instituted in the workplace environment, as well as workplace-instituted efforts encouraging the use of external health promotion services (e.g. gym membership subsidies).

DATA COLLECTION AND ANALYSIS

Review authors working in pairs independently performed citation screening, data extraction and 'Risk of bias' assessment, resolving disagreements via consensus or a third reviewer. We narratively synthesised findings for all included trials by first describing trial characteristics, participants, interventions and outcomes. We then described the effect size of the outcome measure for policy or practice implementation. We performed meta-analysis of implementation outcomes for trials of comparable design and outcome.

MAIN RESULTS

We included six trials, four of which took place in the USA. Four trials employed randomised controlled trial (RCT) designs. Trials were conducted in workplaces from the manufacturing, industrial and services-based sectors. The sample sizes of workplaces ranged from 12 to 114. Workplace policies and practices targeted included: healthy catering policies; point-of-purchase nutrition labelling; environmental supports for healthy eating and physical activity; tobacco control policies; weight management programmes; and adherence to guidelines for staff health promotion. All implementation interventions utilised multiple implementation strategies, the most common of which were educational meetings, tailored interventions and local consensus processes. Four trials compared an implementation strategy intervention with a no intervention control, one trial compared different implementation interventions, and one three-arm trial compared two implementation strategies with each other and a control. Four trials reported a single implementation outcome, whilst the other two reported multiple outcomes. Investigators assessed outcomes using surveys, audits and environmental observations. We judged most trials to be at high risk of performance and detection bias and at unclear risk of reporting and attrition bias.Of the five trials comparing implementation strategies with a no intervention control, pooled analysis was possible for three RCTs reporting continuous score-based measures of implementation outcomes. The meta-analysis found no difference in standardised effects (standardised mean difference (SMD) -0.01, 95% CI -0.32 to 0.30; 164 participants; 3 studies; low certainty evidence), suggesting no benefit of implementation support in improving policy or practice implementation, relative to control. Findings for other continuous or dichotomous implementation outcomes reported across these five trials were mixed. For the two non-randomised trials examining comparative effectiveness, both reported improvements in implementation, favouring the more intensive implementation group (very low certainty evidence). Three trials examined the impact of implementation strategies on employee health behaviours, reporting mixed effects for diet and weight status (very low certainty evidence) and no effect for physical activity (very low certainty evidence) or tobacco use (low certainty evidence). One trial reported an increase in absolute workplace costs for health promotion in the implementation group (low certainty evidence). None of the included trials assessed adverse consequences. Limitations of the review included the small number of trials identified and the lack of consistent terminology applied in the implementation science field, which may have resulted in us overlooking potentially relevant trials in the search.

AUTHORS' CONCLUSIONS

Available evidence regarding the effectiveness of implementation strategies for improving implementation of health-promoting policies and practices in the workplace setting is sparse and inconsistent. Low certainty evidence suggests that such strategies may make little or no difference on measures of implementation fidelity or different employee health behaviour outcomes. It is also unclear if such strategies are cost-effective or have potential unintended adverse consequences. The limited number of trials identified suggests implementation research in the workplace setting is in its infancy, warranting further research to guide evidence translation in this setting.

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.

Towards co-designing active ageing strategies: A qualitative study to develop a meaningful physical activity typology for later life

BACKGROUND

Physical activity levels decline in later life despite the known benefits for physical, cognitive and mental health. Older people find it difficult to meet activity targets; therefore, more realistic and meaningful strategies are needed. We aimed to develop a typology of older people's motivations and lifelong habits of being active as a starting point to co-designing active ageing strategies in a workshop.

METHODS

We conducted semi-structured interviews with 27 participants aged 65-80 in Norfolk, UK, and participant observation with 17 of them. At a workshop with 13 study participants and 6 government and civil society representatives, we invited reflections on preliminary findings.

RESULTS

Three types were developed. "Exercisers" had engaged in sport and exercise throughout their life but experienced physical ill health and limitations as barriers. "Out-and-about-ers" pursued social engagement and a variety of interests but experienced biographical disruption through retirement and loss of companions that limited social activities in later life. A final type characterized people who preferred "sedentary/solitary" activities. A workshop elicited suggestions for new strategies relating to these types that addressed people's specific motivations. An example was to combine social engagement and physical activity in "dog-parent"-walking schemes to link people through shared responsibility for a dog.

CONCLUSIONS

We suggest that these potential strategies map more closely onto the everyday life-worlds in which public health might seek to intervene than common physical activity interventions. Most notably, this means a more differentiated understanding of barriers, and acknowledging that intellectual, social or solitary pursuits can include incidental physical activity.

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.

Perceptions of a Peer Modeling Workplace Physical Activity Intervention for Women

A workplace physical activity (PA) study tested a novel use of peers to deliver the intervention. Peer models provided vicarious experience for living physically active lifestyles to a group of inactive women. The purpose of this study was to describe participants' perceptions of the peer modeling intervention. Nine women from the intervention group ( n = 26) participated in a 90-minute focus group. Qualitative description using thematic analysis was used to identify themes from the focus group transcript. Two themes about the intervention were "I am left wanting more" and "focus on food." Two themes about the peer models were "real people" and "it is doable." Focus group participants perceived the peer modeling PA intervention favorably; however, they desired more attention to healthy eating and more time with peer models. Replication of the study accounting for themes identified by focus group participants is needed to strengthen the peer modeling intervention.

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.

Bone mineral density in lifelong trained male football players compared with young and elderly untrained men

PURPOSE

The purpose of the present controlled cross-sectional study was to investigate proximal femur and whole-body bone mineral density (BMD), as well as bone turnover profile, in lifelong trained elderly male football players and young elite football players compared with untrained age-matched men.

METHODS

One hundred and forty healthy, non-smoking men participated in the study, including lifelong trained football players (FTE, n = 35) aged 65-80 years, elite football players (FTY, n = 35) aged 18-30 years, as well as untrained age-matched elderly (UE, n = 35) and young (UY, n = 35) men. All participants underwent a regional dual-energy X-ray Absorptiometry (DXA) scan of the proximal femur and a whole-body DXA scan to determine BMD. From a resting blood sample, the bone turnover markers (BTMs) osteocalcin, carboxy-terminal type-1 collagen crosslinks (CTX-1), procollagen type-1 amino-terminal propeptide (P1NP), and sclerostin were measured.

RESULTS

FTE had 7.3%-12.9% higher (p < 0.05) BMD of the femoral neck, wards, shaft, and total proximal femur in both legs compared to UE, and 9.3%-9.7% higher (p < 0.05) BMD in femoral trochanter in both legs compared to UY. FTY had 24.3%-37.4% higher (p < 0.001) BMD in all femoral regions and total proximal femur in both legs compared to UY. The whole-body DXA scan confirmed these results, with FTE showing similar whole-body BMD and 7.9% higher (p < 0.05) leg BMD compared to UY, and with FTY having 9.6% higher (p < 0.001) whole-body BMD and 18.2% higher (p < 0.001) leg BMD compared to UY. The plasma concentration of osteocalcin, CTX-1, and P1NP were 29%, 53%, and 52% higher (p < 0.01), respectively, in FTY compared to UY.

CONCLUSION

BMD of the proximal femur and whole-body BMD are markedly higher in lifelong trained male football players aged 65-80 years and young elite football players aged 18-30 years compared to age-matched untrained men. Elderly football players even show higher BMD in femoral trochanter and leg BMD than untrained young despite an age difference of 47 years.

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.

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.

Team Sport in the Workplace? A RE-AIM Process Evaluation of 'Changing the Game'

Background

The workplace is a priority setting to promote health. Team sports can be an effective way to promote both physical and social health. This study evaluated the potential enablers and barriers for outcomes of a workplace team sports intervention programme ‘Changing the Game’ (CTG). This study was conducted in a FTSE 100 services organisation. This process evaluation was conducted using the RE-AIM framework.

Methods

A mixed methods approach was used. Data were collected from the participants in the intervention group prior to, during and at the end of the intervention using interviews (n = 12), a focus group (n = 5), and questionnaires (n = 17). Organisational documentation was collected, and a research diary was recorded by the lead author. The evidence collected was triangulated to examine the reach, efficacy, adoption, implementation and maintenance of the programme. Data was assessed through template analysis, and questionnaire data were analysed using multiple regression and a series of univariate ANOVAs.

Results

CTG improved VO₂ Max, interpersonal communication, and physical activity behaviour (efficacy) over 12-weeks. This may be attributed to the supportive approach adopted within the design and delivery of the programme (implementation). Individual and organisational factors challenged the adoption and maintenance of the intervention. The recruitment and communication strategy limited the number of employees the programme could reach.

Conclusion

The process evaluation suggests addressing the culture within workplaces may better support the reach, adoption and maintenance of workplace team sport programmes. Future research should consider investigating and applying these findings across a range of industries and sectors.

It's Time to Start Changing the Game: A 12-Week Workplace Team Sport Intervention Study

BACKGROUND

A 12-week multi-team sport programme was provided to employees of a large services organisation and conducted in workplaces. This programme was used to investigate the short-term effect of regular sports team participation on individual employee and organisational health.

METHODS

A large services organisation participated in this study. Two regional worksites of office workers were assigned as the team sport (intervention) (n = 28 participants) or control (n = 20 participants) groups. The team sport sessions were underpinned by psychological behaviour change theory and consisted of weekly 1-h team sport sessions for 12 weeks. Measures of aerobic fitness, physical activity behaviour, group cohesion, interaction and communication, psychological wellbeing, health, anthropometrics and workplace experiences were recorded pre- and post-intervention. Data were analysed using a series of mixed ANOVAs.

RESULTS

After 12 weeks significant improvements were observed in VO2 max (+ 4.5 ± 5.8 ml/min kg, P < .002, η 2p = .182), interpersonal communication within teams (+ 3%, P < .042, η 2p = .087) and mean weekly physical activity duration (+ 154.74', P < .002, η 2p = .071) in the intervention group. A significant (P < .012, η 2p = .130) effect on body composition was observed in the intervention group.

CONCLUSIONS

Participation in team sport may be an effective method to improve the aerobic fitness and physical activity behaviour of employees, and promote interpersonal communication between colleagues. Individual health outcomes and social interactions have the capacity to influence the health of the organisation. The extent of which these findings are replicable across a scope of organisations should be examined objectively over the long term.

What are the Facilitators and Obstacles to Participation in Workplace Team Sport? A Qualitative Study

Working age adults are failing to meet physical activity recommendations. Inactive behaviours are increasing costs for diminished individual and organisational health. The workplace is a priority setting to promote physical activity, however there is a lack of evidence about why some employees choose to participate in novel workplace activities, such as team sport, whilst others do not. The aim of this study was to explore the complexity of facilitators and obstacles associated with participation in workplace team sport. Twenty-nine semi-structured face-to-face and telephone interviews were conducted with office workers (58% female) (36 ± 7.71) from manufacturing, public services, and educational services. Data was analysed through template analysis. Five sub-level (i.e., intrapersonal, interpersonal, organisational, community and societal influences) facilitate participation or create obstacles for participants. Participants were challenged by a lack of competence, self-efficacy, negative sporting ideals and amotivation. Unhealthy competition, an unstable work-life balance and unsupportive colleagues created obstacles to participation. An unsupportive organisation and workplace culture placed demands on workplace champions, funding, facilities and communication. Healthy competitions, high perceptions of competence and self-efficacy, and being motivated autonomously enabled participation. Further, relatedness and social support created a physical activity culture where flexible working was encouraged and team sport was promoted in accessible locations within the organisation. Researchers should consider accounting for complexity of these influences. A participatory approach may tailor interventions to individual organisations and the employees that work within them. Interventions whereby autonomy, competence and relatedness are supported are recommended. This may be achieved by adapting sports and training workplace champions.

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.

Short Duration Small Sided Football and to a Lesser Extent Whole Body Vibration Exercise Induce Acute Changes in Markers of Bone Turnover

We aimed to study whether short-duration vibration exercise or football sessions of two different durations acutely changed plasma markers of bone turnover and muscle strain. Inactive premenopausal women (n = 56) were randomized to complete a single bout of short (FG15) or long duration (FG60) small sided football or low magnitude whole body vibration training (VIB). Procollagen type 1 amino-terminal propeptide (P1NP) was increased during exercise for FG15 (51.6 ± 23.0 to 56.5 ± 22.5 μg·L⁻¹, mean ± SD, P < 0.05) and FG60 (42.6 ± 11.8 to 50.2 ± 12.8 μg·L⁻¹, P < 0.05) but not for VIB (38.8 ± 15.1 to 36.6 ± 14.7 μg·L⁻¹, P > 0.05). An increase in osteocalcin was observed 48 h after exercise (P < 0.05), which did not differ between exercise groups. C-terminal telopeptide of type 1 collagen was not affected by exercise. Blood lactate concentration increased during exercise for FG15 (0.6 ± 0.2 to 3.4 ± 1.2 mM) and FG60 (0.6 ± 0.2 to 3.3 ± 2.0 mM), but not for VIB (0.6 ± 0.2 to 0.8 ± 0.4 mM) (P < 0.05). Plasma creatine kinase increased by 55 ± 63% and 137 ± 119% 48 h after FG15 and FG60 (P < 0.05), but not after VIB (26 ± 54%, NS). In contrast to the minor elevation in osteocalcin in response to a single session of vibration exercise, both short and longer durations of small sided football acutely increased plasma P1NP, osteocalcin, and creatine kinase. This may contribute to favorable effects of chronic training on musculoskeletal health.

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.

Health Benefits of Zumba Fitness Training: A Systematic Review

OBJECTIVE

As an alternative to the traditional approach to physical exercise, new kinds of organized physical activity have been developed designed to engage large segments of the population. Among these, Zumba fitness is extremely popular, with a growing number of participants. This article aims to summarize and analyze the body of evidence on the effects of Zumba fitness interventions on physical function, fitness, and wellbeing. TYPE: Systematic review.

LITERATURE SURVEY

Keyword "Zumba" was identified as term for the literature research in MEDLINE, Scopus, Bandolier, PEDro, and Web of Science. Only studies published in peer-reviewed journals written in English language were considered.

METHODOLOGY

Eleven manuscripts were classified as eligible with 586 total participants, ranging in age from 18 to 65 years. After a quality appraisal, we classified 4 studies as high-quality investigations and 7 as low quality. Results were summarized in several domains: "anthropometric parameters and body composition," "hormonal and metabolic profiles," "aerobic and cardiovascular performance," "muscular fitness parameters," and "quality of life, pain score and physical activity questionnaire."

SYNTHESIS

Results from this systematic review indicated that Zumba fitness could be considered an effective type of physical activity able to improve aerobic capacity. Small but positive benefits were noted for reducing body weight and other body measurements. Furthermore, other effects, including psychological and social benefits on quality of life, were found after Zumba fitness interventions. Otherwise, limited evidence described positive effects on muscular strength and flexibility.

CONCLUSIONS

Zumba fitness could be considered an effective type of physical activity able to improve aerobic capacity. Limited evidence described positive effects on muscular strength and flexibility.

LEVEL OF EVIDENCE

II.

Is Recreational Soccer Effective for Improving VO2max A Systematic Review and Meta-Analysis

Background

Soccer is the most popular sport worldwide, with a long history and currently more than 500 million active participants, of whom 300 million are registered football club members. On the basis of scientific findings showing positive fitness and health effects of recreational soccer, FIFA (Fédération Internationale de Football Association) introduced the slogan “Playing football for 45 min twice a week—best prevention of non-communicable diseases” in 2010.

Objective

The objective of this paper was to perform a systematic review and meta-analysis of the literature to determine the effects of recreational soccer on maximal oxygen uptake (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$\end{document}V˙O2max).

Methods

Six electronic databases (MEDLINE, PubMed, SPORTDiscus, Web of Science, CINAHL and Google Scholar) were searched for original research articles. A manual search was performed to cover the areas of recreational soccer, recreational physical activity, recreational small-sided games and \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$\end{document}V˙O2max using the following key terms, either singly or in combination: recreational small-sided games, recreational football, recreational soccer, street football, street soccer, effect, maximal oxygen uptake, peak oxygen uptake, cardiorespiratory fitness, \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$\end{document}V˙O2max. The inclusion criteria were divided into four sections: type of study, type of participants, type of interventions and type of outcome measures. Probabilistic magnitude-based inferences for meta-analysed effects were based on standardised thresholds for small, moderate and large changes (0.2, 0.6 and 1.2, respectively) derived from between-subject standard deviations for baseline fitness.

Results

Seventeen studies met the inclusion criteria and were included in the systematic review and meta-analysis. Mean differences showed that \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$\end{document}V˙O2max increased by 3.51 mL/kg/min (95 % CI 3.07–4.15) over a recreational soccer training programme in comparison with other training models. The meta-analysed effects of recreational soccer on \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$\end{document}V˙O2max compared with the controls of no exercise, continuous running and strength training were most likely largely beneficial [effect size (ES) = 1.46; 95 % confidence interval (CI) 0.91, 2.01; I² = 88.35 %], most likely moderately beneficial (ES = 0.68; 95 % CI 0.06, 1.29; I² = 69.13 %) and most likely moderately beneficial (ES = 1.08; 95 % CI −0.25, 2.42; I² = 71.06 %), respectively. In men and women, the meta-analysed effect was most likely largely beneficial for men (ES = 1.22) and most likely moderately beneficial for women (ES = 0.96) compared with the controls. After 12 weeks of recreational soccer with an intensity of 78–84 % maximal heart rate (HR_max), healthy untrained men improved their \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$\end{document}V˙O2max by 8–13 %, while untrained elderly participants improved their \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$\end{document}V˙O2max by 15–18 %. Soccer training for 12–70 weeks in healthy women resulted in an improvement in \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$\end{document}V˙O2max of 5–16 %. Significant improvements in \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$\end{document}V˙O2max have been observed in patients with diabetes mellitus, hypertension and prostate cancer.

Conclusion

Recreational soccer produces large improvements in \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$\end{document}V˙O2max compared to strength training and no exercise, regardless of the age, sex and health status of the participants. Furthermore, recreational soccer is better than continuous endurance running, albeit the additional effect is moderate. This kind of physical activity has great potential for enhancing aerobic fitness, and for preventing and treating non-communicable diseases, and is ideal for addressing lack of motivation, a key component in physical (in)activity.

Salsa dance and Zumba fitness: Acute responses during community-based classes

BACKGROUND

Research interest in both partnered Latin dance and non-partnered Latin-themed aerobic dance has increased in recent years, likely a result of the gaining popularity of these types of instructor-led group classes among the mainstream dance and fitness audiences; however, the efficacy of these activities for the purposes of health promotion currently remains unclear. The purpose of this study was to simultaneously assess the physiological responses and psychological experiences during salsa dance and Zumba fitness in a community sample of physically inactive women.

METHODS

Twenty-four participants, aged 22-56 years, visited the laboratory to perform a graded exercise test for determination of maximal oxygen uptake and maximal heart rate. The participants then attended 2 partnered salsa dance and 2 non-partnered Zumba fitness classes each in a counterbalanced order over a 2-week period. The 1-h classes were taught by certified instructors in established venues in the Royal Borough of Kingston and the surrounding communities of London, UK. Physiological data were collected using a wrist-worn ActiGraph wGT3X+ accelerometer with accompanying heart rate monitor and were processed using previously validated dance-specific techniques. Psychological experiences were measured via the Subjective Exercise Experiences Scale.

RESULTS

There was a significantly higher (p < 0.001) total time spent in moderate-to-vigorous physical activity (51.2 ± 3.1 vs. 32.6 ± 5.9 min), total energy expenditure (411 ± 66 vs. 210 ± 46 kcal), and total step count (6773 ± 556 vs. 4108 ± 781 steps) during Zumba fitness when compared to salsa dance. Significant pre- to post-class improvements in positive well-being (p < 0.01, partial η ² = 0.41) and psychological distress (p < 0.001, partial η ² = 0.72) were simultaneously observed for both salsa dance and Zumba fitness.

CONCLUSION

The acute responses to classes of partnered Latin dance and non-partnered Latin-themed aerobic dance suggest that in physically inactive women participation is indeed efficacious in terms of community-based physical activity and psychosocial health promotion.