Aerobic training protects cardiac function during advancing age : A meta-analysis of four decades of controlled studies
- Authors: Beaumont, Alexander , Grace, Fergal , Richards, Joanna , Campbell, Amy , Sculthorpe, Nicholas
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 49, no. 2 (2019), p. 199-219
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- Description: Background: In contrast to younger athletes, there is comparatively less literature examining cardiac structure and function in older athletes. However, a progressive accumulation of studies during the past four decades offers a body of literature worthy of systematic scrutiny. Objectives: We conducted a systematic review, meta-analysis and meta-regression of controlled echocardiography studies comparing left ventricular (LV) structure and function in aerobically trained older athletes (> 45 years) with age-matched untrained controls, in addition to investigating the influence of chronological age. Methods: Electronic databases were searched from inception to January 2018 before conducting a random-effects meta-analysis to calculate pooled differences in means, effect size and 95% confidence intervals (CIs). Study heterogeneity was reported using Cochran’s Q and I2 statistic. Results: Overall, 32 studies (644 athletes; 582 controls) were included. Athletes had greater LV end-diastolic diameter (3.65 mm, 95% CI 2.66–4.64), interventricular septal thickness (1.23 mm, 95% CI 0.85–1.60), posterior wall thickness (1.20 mm, 95% CI 0.83–1.56), LV mass (72 g, 95% CI 46–98), LV mass index (28.17 g·m2, 95% CI 19.84–36.49) and stroke volume (13.59 mL, 95% CI 7.20–19.98) (all p < 0.01). Athletes had superior global diastolic function [ratio of early (E) to late (A) mitral inflow velocity (E/A) 0.18, 95% CI 0.13–0.24, p < 0.01; ratio of early (e′) to late (a′) diastolic annular tissue velocity (e′/a′) 0.23, 95% CI 0.06–0.40, p = 0.01], lower A (−8.20 cm·s−1, 95% CI −11.90 to −4.51, p < 0.01) and a′ (−0.72 cm·s−1, 95% CI −1.31 to −0.12, p = 0.02), and more rapid e′ (0.96 cm·s−1, 95% CI 0.05–1.86, p = 0.04). Meta-regression for chronological age identified that athlete–control differences, in the main, are maintained during advancing age. Conclusions: Athletic older men have larger cardiac dimensions and enjoy more favourable cardiac function than healthy, non-athletic counterparts. Notably, the athlete groups maintain these effects during chronological ageing. © 2018, The Author(s).
Exercise interventions for the prevention and treatment of groin pain and injury in athletes : A critical and systematic review
- Authors: Charlton, Paula , Drew, Michael , Mentiplay, Benjamin , Grimaldi, Alison , Clark, Ross
- Date: 2017
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 47, no. 10 (2017), p. 2011-2026
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- Description: Background: Groin injury is a common musculoskeletal complaint for athletes competing in a variety of sports. The extent to which exercise interventions incorporating external load are an appropriate option for the treatment and prevention of groin injury in athletes is not yet clear. Objectives: The aim of this review was to describe and evaluate exercise therapy interventions and outcomes for the treatment and prevention of groin injury with specific attention to application of external load. Data Sources: The databases Medline, PubMed, SPORTDiscus, Web of Science, and Cochrane were searched on 18 April 2016. Study Eligibility Criteria: This review was registered as PROSPERO CRD42016037752 and a systematic search was conducted with the following inclusion criteria: any study design evaluating exercise interventions for the prevention or treatment of groin pain in athletes. Data Analysis: Two independent authors screened search results, performed data extraction, assessed risk of bias using the modified Downs and Black appraisal tool and determined strength and level of evidence. Reporting standards for exercise interventions were assessed using the Consensus for Exercise Reporting Template (CERT). Results: A total of 1320 titles were identified with 14 studies satisfying the inclusion criteria, four (29%) of which demonstrated low risk of bias. Ten (71%) studies utilised external load as a component of the exercise intervention. Reporting standards for exercise intervention scores ranged from 0 to 63%. Conclusion: There is limited evidence from level 2 and 3 studies indicating exercise therapy may reduce the incidence and hazard risk of sustaining a groin injury in athletes. There is strong evidence from level 4 studies indicating exercise therapy is beneficial as a treatment for groin injury in athletes in terms of symptom remission, return to sport and recurrence outcomes. However, there are limited studies with low risk of bias, and exercise interventions for the treatment of groin injury are poorly described. © 2017, Springer International Publishing Switzerland.