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Good hamstring flexibility(HF) is crucial for sports performance and health, with injuries having an economic impact on healthcare and sports teams. Therefore, our objectives were to estimate the effect of neurodynamic techniques on HF and to compare the effect of these techniques with static stretching. We systematically searched the Cochrane, MEDLINE(via PubMed), Scopus, Web of Science and Sportdiscus databases for RCTs comparing neurodynamic interventions with control intervention or with static stretching exercises for HF in adults with limited HF. We conducted a random-effects meta-analysis with subgroup analyses according to the type of comparison group(control group or static stretching exercises) and total number of sessions. Furthermore, to reflect the variation in genuine therapy effects in different scenarios, including future patients, we calculated a 95% prediction interval(prI). Thirteen trials were included, involving 624 participants. Pooled results showed a significant improvement in HF for immediate (SMD = 1.01, 95% CI: 0.44 to 1.59) and short-term effects (SMD = 1.21, 95% CI: 0.90 to 1.52). Subgroup analyses by type of comparison group showed that these techniques are more effective than the control group in the immediate and short term and than static stretching in the short term. Analyses by total sessions showed a significant increase in HF with a treatment of 1, 3, 10 and 12 sessions. Neurodynamic techniques improve HF immediately and in the short term. Subgroup analyses by type of comparison group showed that these techniques are more effective than static stretching in the short term.

Background The use of standing desks may reduce sedentary behavior and, in turn, improve other health and academic outcomes. However, the evidence is sparse among university settings. The aim of this scoping review was to identify and map evidence for the effects of standing desk interventions on sedentary behavior and physical, mental, and academic outcomes in university students, as well as instructors and students’ perceptions of this type of equipment in the classroom. Methods A scoping review was conducted in accordance with the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review guidelines. PubMed, Web of Science, Scopus, PsycINFO, PubPsych and ERIC databases were searched for qualitative and quantitative studies from their inception to 2024. Narrative synthesis and network plots were used to summarize the available evidence. Results Seventeen studies involving 2886 university students and 163 instructors were included. Fourteen studies were experimental and three were cross-sectional. In seven studies standing desks improved movement patterns (sitting and standing time in the classroom) and in four studies improved mental health outcomes (anxiety, mood, stress, and positive or negative feelings). Four studies analyzed pain and discomfort, one found significant improvements and three found mixed results. Eleven studies analyzed academic and classroom outcomes and seven found significant improvements in the standing desks group and five did not. Additionally, the use of standing desks was accepted and positively perceived by students in ten studies and by instructors in two. Conclusions The implementation of standing desks at university settings could be a behavioral intervention for improving movement patterns and mental health. However, the extant evidence is sparse; further long-term, high-quality trials are needed to draw robust conclusions.

Background The concept of early vascular aging (EVA) represents a potentially beneficial model for future research into the pathophysiological mechanisms underlying the early manifestations of cardiovascular disease. For this reason, the aims of this study were to verify by confirmatory factor analysis the concept of EVA on a single factor based on vascular, clinical and biochemical parameters in a healthy adult population and to develop a statistical model to estimate the EVA index from variables collected in a dataset to classify patients into different cardiovascular risk groups: healthy vascular aging (HVA) and EVA. Methods The EVasCu study, a cross-sectional study, was based on data obtained from 390 healthy adults. To examine the construct validity of a single-factor model to measure accelerated vascular aging, different models including vascular, clinical and biochemical parameters were examined. In addition, unsupervised clustering techniques (using both K-means and hierarchical methods) were used to identify groups of patients sharing similar characteristics in terms of the analysed variables to classify patients into different cardiovascular risk groups: HVA and EVA. Results Our data show that a single-factor model including pulse pressure, glycated hemoglobin A1c, pulse wave velocity and advanced glycation end products shows the best construct validity for the EVA index . The optimal value of the risk groups to separate patients is K = 2 (HVA and EVA). Conclusions The EVA index proved to be an adequate model to classify patients into different cardiovascular risk groups, which could be valuable in guiding future preventive and therapeutic interventions.

Background: Type 2 diabetes mellitus (T2DM) is related to increased inflammatory processes. The effects of resistance exercise on inflammatory biomarkers in T2DM are controversial. Our purpose was to determine the effectiveness of resistance exercise on inflammatory biomarkers in patients diagnosed with T2DM.Methods: We searched four databases until September 2021. We included randomized clinical trials (RCTs) of the effects of resistance exercise on inflammatory biomarkers (C-reactive protein [CRP], tumor necrosis factor alpha, interleukin-6, and interleukin-10) in patients with T2DM. A random effects meta-analysis was conducted to determine the standardized mean difference (SMD) and the raw mean difference (MD) for CRP.Results: Thirteen RCTs were included in the review, and 11 in the meta-analysis for CRP. Lower CRP levels were observed when resistance exercise was compared with the control groups (SMD=–0.20; 95% confidence interval [CI], –0.37 to –0.02). When conducting the MD meta-analysis, resistance exercise showed a significant decrease in CRP of –0.59 mg/dL (95% CI, –0.88 to –0.30); otherwise, in the control groups, the CRP values increased 0.19 mg/dL (95% CI, 0.17 to 0.21).Conclusion: Evidence supports resistance exercise as an effective strategy to manage systemic inflammation by decreasing CRP levels in patients with T2DM. The evidence is still inconclusive for other inflammatory biomarkers.

A healthy diet and high health-related physical fitness levels may be part of an overall healthy lifestyle. The relationship between adherence to the Mediterranean diet and physical fitness levels has been analyzed in several studies. However, no studies have synthesized evidence on this relationship throughout adulthood. Moreover, in addition to the overall Mediterranean dietary pattern, the associations of individual components of the Mediterranean diet with physical fitness indicators are also unclear. This protocol for a systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis for Protocols statement and the Cochrane Collaboration Handbook. Systematic literature searches will be performed in the MEDLINE (PubMed), Scopus, Web of Science, SPORTDiscus and Cochrane CENTRAL databases to identify studies published up to 31 January 2022. The inclusion criteria will comprise observational studies and randomized controlled trials reporting the associations between adherence to the Mediterranean diet and physical fitness levels on general healthy or unhealthy adults ([greater than or equal to]18 years). When at least five studies addressing the same outcome are available, meta-analysis will be carried out to estimate the standardized mean difference of physical fitness according to the adherence to Mediterranean diet. Subgroup analyses will be performed according to the characteristics of the population, the individual dietary components of the Mediterranean diet and physical fitness parameters as long as there are sufficient studies.

IntroductionPhysical fitness (PF) is an important indicator of health in children and adolescents. Internationally, test batteries have been used to assess overall PF. In Latin America, however, while PF has been widely measured, there is no accepted test battery, making it difficult to monitor and/or compare the PF levels of Latin children. The aim of this study, therefore, is to systematically review and potentially meta-analyse the peer-reviewed literature regarding the assessment of PF in Latin American children and adolescents.Methods and analysisThis systematic review and meta-analysis will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols statement. The systematic literature search will be performed in MEDLINE, Scopus, SciELO, EMBASE, Cochrane Library, Web of Science, SPORTDiscus, LILACS and Latindex (Spanish) to locate articles published up to April 2021. Eligible studies will include both descriptive and analytic study designs. Meta-analyses are planned for sufficiently homogeneous PF outcomes with regard to statistical and methodological characteristics. Narrative syntheses are planned for PF outcomes that are considered to be too heterogeneous. The statistical program STATA V.15 will be used for meta-analyses, with subgroup analyses performed according to the characteristics of included studies.Ethics and disseminationThis systematic review and meta-analysis protocol is designed to provide updated evidence on the PF of Latin American children and adolescents. Findings from this review may be useful for teachers, researchers and other professionals responsible for paediatric fitness and health promotion/surveillance. The results will be disseminated through peer-reviewed scientific publications, conferences, educational talks and infographics.PROSPERO registration numberCRD42020189892.

Depressive and anxiety symptoms are associated with a greater likelihood of disordered eating behaviors (DEBs), but the role of sex in these associations is unclear. Objectives: The aim of this study was to analyze the associations between depression, anxiety, and DEBs in a sample of Spanish university students. Methods: Depression was assessed with the Beck Depression Inventory-II (BDI-II), anxiety with the Generalized Anxiety Disorder (GAD-7) instrument, and DEBs with the Sick, Control, One stone, Fat, Food (SCOFF) questionnaire. Statistical analyses included generalized linear regression models adjusted for sociodemographic, body composition, and lifestyle covariates as the main confounders. Results: Among the 453 students analyzed (71.5% female), the frequencies of mild-to-severe depression, mild-to-severe anxiety, and of DEBs were higher in the females (42.0%, 77.5%, and 32.7%, respectively) than in the males (24.0%, 52.7%, and 20.2%, respectively). The results of the adjusted GLMs were similar for both the sexes, indicating higher estimated marginal means of the SCOFF total score and greater odds of DEBs among those with mild-to-severe depression or anxiety than among those without these conditions. Conclusions: Depression and anxiety symptoms are cross-sectionally associated with DEBs in Spanish university students of both sexes. Future prospective studies are needed to examine the direction of these associations separately for females and males.

Background Heart diseases, particularly heart failure, significantly impact patient quality of life and mortality rates. Functional capacity assessment is vital for predicting prognosis and risk in these patients. While the cardiopulmonary exercise test is considered the gold standard, the 6-minute walk test has emerged as a more accessible alternative. However, the screening accuracy and optimal cut-off points of the 6-minute walk test for detecting severely reduced functional capacity in cardiac pathologies, including heart failure with preserved ejection fraction, are unclear. The study aimed to analyse the diagnostic accuracy of the 6-minute walk test for detecting reduced functional capacity, defined as VO 2max  < 14 ml/kg/min, compared with the cardiopulmonary exercise test in participants with heart failure with preserved ejection fraction using data from the “Ejercicio en Insuficiencia Cardiaca con Fracción de Eyección Preservada” (ExIC-FEp) trial; and to compare these results with previous studies investigating the screening accuracy for assessing functional capacity of the 6-minute walk test in participants with other chronic cardiac pathologies through a meta-analysis. Results The ExIC-FEp trial involved 22 participants with heart failure with preserved ejection fraction, who were not treated with beta-blockers, using the cardiopulmonary exercise test, specifically VO 2max, as the reference test. The 6-minute walk test had a sensitivity of 70%, a specificity of 80%, and an area under the curve of 76% in the ExIC-FEp trial. Five studies were included in the meta-analysis showing a sensitivity of 79%, a specificity of 78%, and an area under the curve of 85%. Conclusion In conclusion, the 6-minute walk test holds promise as a screening tool for assessing functional capacity in heart failure with preserved ejection fraction and chronic heart diseases, with a VO 2max  < 14 ml/kg/min as a reference point. It demonstrates moderate to good screening accuracy. However, the screening accuracy and optimal cut-off points of the 6-minute walk test for detecting severely reduced functional capacity, regardless of aetiology, are unclear. Trial Registration NCT05726474. Registered 16 February 2023, https://clinicaltrials.gov/study/NCT05726474 . Key Points • The 6-minute walk test (6MWT) shows promise as a screening tool for assessing functional capacity in participants with heart failure with preserved ejection fraction (HFpEF) and other chronic cardiac pathologies. • The screening accuracy of the 6MWT was analysed in comparison to the gold standard cardiopulmonary exercise test (CPET) in participants with HFpEF from the ExIC-FEp trial. The 6MWT demonstrated a sensitivity of 70%, specificity of 80%, and an area under the curve (AUC) of 76%. • A meta-analysis comparing the screening accuracy of the 6MWT for detecting severely reduced functional capacity across various cardiac pathologies revealed consistent results. The pooled estimates showed a sensitivity of 79%, a specificity of 78%, and an AUC of 85%. • The 6MWT offers a cost-effective and easily implementable alternative to the CPET for assessing functional capacity. Its moderate to good screening accuracy and widespread availability make it a valuable screening tool in the screening evaluation of participants with HFpEF and other chronic cardiac pathologies.

Introduction and objective: The constant practice of physical activity contributes to obtaining adequate values of physical fitness and body composition, which brings benefits to people's health. Even though scientific evidence exposes the health effects of physical activity, the adult population has a low prevalence of exercise due to lack of time, lack of sports venues, factors that increase in university students due to academic demands. One tool that could be useful in removing barriers to not practicing physical activity may be immersive virtual reality, as evidence suggests that it can be a tool that promotes the practice of physical activity, so the objective of this randomized controlled trial protocol is to evaluate the impact of a physical exercise program performed through immersive virtual reality on physical fitness and body composition in a university population. Methodology: An intervention group (n=18) and a control group (n=18) will be randomly selected. The intervention group will execute a physical exercise program through immersive virtual reality for 12 weeks. All participants will be evaluated at the beginning and end of the intervention to determine the effect of the program on physical fitness and body composition. Conclusions: This randomized controlled trial will provide information on the effect of physical exercise through virtual reality on the variables studied.

The main objective of this study was to estimate the association between nut consumption and body composition-related measures and to examine whether this relationship is mediated by cardiorespiratory fitness (CRF) and the muscle strength index (MSI) in young adults. A cross-sectional study involving college students (n = 354) aged 18–30 years from a Spanish public university was conducted. Body composition and fitness components were assessed using standard methods. Nut consumption was evaluated using a Food-Frequency Questionnaire. ANCOVA models were used to assess the mean differences in physical fitness and body composition by nut consumption categories. Hayes’s PROCESS macro was applied for mediation and interaction analyses adjusted for the main confounders. Young adults with high nut consumption (≥5 portions of 30 g/week) showed significantly higher values of physical fitness components and fat-free mass and lower values of adiposity-related measures than their peers in the lowest categories of nut consumption (˂1 portion/week) (p < 0.05). No significant interaction between CRF and nut consumption on body composition was found. In the mediation analysis, CRF and MSI acted as full mediators of the relationship of nut consumption with fat-free mass and waist circumference/height index. Otherwise, CRF and MSI partially mediated the relationship between nut consumption and body mass index and percent of fat mass. Finally, nut consumption, per se, does not appear to have a significant impact on body composition indicators because these associations have been shown to be partially (for BMI and %BF) or entirely (for ratio WC/height and fat-free mass) explained by CRF and MSI.