RESUMEN
BACKGROUND: Preterm birth and low birthweight (LBW) might be associated with reduced physical fitness, although evidence remains inconclusive. OBJECTIVE: To examine the influence of preterm birth and LBW on physical fitness, as well as to assess whether variables such as gestational age, birthweight, or age at assessment moderate these effects. METHODS: PubMed, Scopus, and PsycINFO were systematically searched from inception to 7 December 2023 for case-control and cohort studies analyzing the association between preterm birth or LBW (or gestational age or birthweight as continuous variables) with at least one physical fitness-related outcome (i.e., cardiorespiratory fitness (CRF), muscle strength, flexibility, speed, agility). Random-effects meta-analysis and meta-regression models were used to estimate the pooled effect size, as well as to examine potential associations between the magnitude of the effect and gestational age, birthweight, or age at assessment. RESULTS: Fifty-two studies (n = 920,603 participants, average age ranging from 4.7 to 34.4 years) were included. Preterm birth was associated with reduced CRF (standardized mean difference (SMD) = -0.38, 95% confidence interval (CI) = -0.51 to -0.25) and muscle strength (SMD = -0.44, 95% CI = -0.79 to -0.08). LBW was associated with reduced CRF (SMD = -0.40, 95% CI = -0.64 to -0.17), muscle strength (SMD = -0.18, 95% CI = -0.24 to -0.13), flexibility (SMD = -0.11, 95% CI = -0.22 to -0.01), and agility (SMD = -0.99, 95% CI = -1.91 to -0.07). Meta-regression analyses showed that a lower gestational age or birthweight were associated with larger reductions in physical fitness, whereas no consistent association was found for the age at assessment. CONCLUSION: Both preterm birth and LBW seem associated with reduced physical fitness regardless of age, with larger reductions overall observed in individuals with lower gestational age or birthweight. These findings might support the implementation of preventive strategies (e.g., fitness monitoring and physical exercise interventions) in these populations through the life course. PROSPERO registration: CRD42021231845.
Asunto(s)
Capacidad Cardiovascular , Recién Nacido de Bajo Peso , Fuerza Muscular , Aptitud Física , Nacimiento Prematuro , Humanos , Edad Gestacional , Recién NacidoRESUMEN
Evidence suggests that preterm birth is associated with an impaired physical fitness later in life, but whether these effects are already visible since early childhood remains unknown. We aimed to compare the physical fitness of preterm preschoolers with that of children born at term. Children aged three to six years and born preterm (<35 weeks) were recruited from a Neonatal Intensive Care Unit, and children born at term (>37 weeks) were included as controls. A variety of physical fitness indicators (strength, cardiorespiratory fitness, agility, flexibility and balance) were assessed with the PREFIT battery and the adapted sit and reach test. Physical activity levels were measured through the PrePAQ questionnaire. A total of 98 preterm children (gestational age 32.4 ± 2.3 weeks, age 5.1 ± 0.8 years) and 74 controls (gestational age 39.9 ± 1.0 weeks, age 4.8 ± 0.9 years) were analysed. Despite no significant differences in physical activity levels (p > 0.05), preterm children showed an overall poorer physical fitness compared to controls. Specifically, preterm children had an impaired handgrip strength (-13.95%, p < 0.001), lower-limb muscle strength (-12.67%, p = 0.003), agility (-14.9%, p = 0.001), cardiorespiratory fitness (-12.73% p = 0.005) and flexibility (-17.04%, p = 0.001) compared to controls. An inverse dose-response association was observed between the level of prematurity and physical fitness, with very preterm children (gestational age ≤32 weeks) presenting the poorest fitness levels. In summary, prematurity seems to impair physical fitness since early childhood, which might support the need for promoting preventive strategies (e.g. fitness monitoring and applying exercise interventions).Highlights Preterm children present an impaired physical fitness compared with peers born at term since early childhood (3-6 years), as reflected by lower muscle strength, agility, flexibility and cardiorespiratory fitness.A greater impairment of physical fitness in observed in children born very preterm (≤32 weeks of gestation).These findings might support the implementation of preventive strategies (e.g. fitness monitoring and exercise training) in preterm children since early childhood.
Asunto(s)
Capacidad Cardiovascular , Nacimiento Prematuro , Niño , Femenino , Preescolar , Humanos , Recién Nacido , Fuerza de la Mano , Aptitud Física/fisiología , Ejercicio Físico/fisiología , Fuerza Muscular/fisiología , Capacidad Cardiovascular/fisiologíaRESUMEN
OBJECTIVES: School-based physical activity (PA) interventions have proven beneficial for improving cognitive performance and overall academic achievement, but their benefits on language skills remain unclear. We aimed to assess the effects of school-based PA interventions on language skills in children and adolescents. DESIGN: Systematic review with meta-analysis. METHODS: A systematic search was performed in PubMed, PsycINFO and Scopus until September 10th, 2022. We included randomized controlled trials (RCTs) that performed a school-based PA intervention in children/adolescents and that assessed language-related outcomes (i.e., reading, spelling, vocabulary, verbal fluency, comprehension and grammar) or language school grades. Random effect meta-analyses were conducted to pool study results. RESULTS: Thirty-one studies (18,651 participants) were finally included. Significant benefits were observed for reading (standardized mean difference [SMD]: 0.15; 95% confidence interval [CI]: 0.08, 0.22), vocabulary (SMD: 0.71; 95%CI: 0.44, 0.97), and comprehension (SMD: 0.24; 95%CI: 0.09, 0.40), with a non-significant trend (pâ¯=â¯0.083) also observed for language school grades (SMD: 0.40; 95%CI: -0.05, 0.86). No significant benefits were observed for spelling or verbal fluency (both pâ¯>â¯0.05), and no meta-analysis could be performed for grammar skills. No consistent differences were observed between integrated (i.e., performing PA along with the academic content) and non-integrated PA interventions (e.g., extra physical education lessons). CONCLUSIONS: School-based PA interventions appear as an effective strategy for improving different language-related skills, although further research is needed to determine how interventions' and participants' characteristics moderate these effects.
Asunto(s)
Ejercicio Físico , Instituciones Académicas , Niño , Adolescente , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Lenguaje , CogniciónRESUMEN
The present study aimed to analyze the relationship between obesity and different physical fitness markers with academic achievement in adolescents, as well as to check if the "Fat but Fit paradox" is applicable in this context. A total of 188 participants (83 boys) ranging from 12 to 18 years (14.51 ± 1.29 years) underwent a series of fitness tests, and were categorized as "fit" or "unfit" attending to their estimated cardiorespiratory fitness (above or below 42 and 35 ml·kg-1·min-1 for boys and girls, respectively). Participants were also categorized according to their body mass index as having overweight/obesity or not. A variety of fitness markers (i.e., cardiorespiratory fitness, lower-body power, sprint time, and flexibility) were positively associated with academic achievement (all p < 0.05), but no associations were found for upper-body power, upper-limb coordination or agility. Both being fit (ß = 0.652, 95% confidence interval: 0.001-1.302) and normoweight (ß = 1.085, 0.171-1.999) were positively associated with academic achievement. A higher academic achievement (p = 0.021) was found for fit and normoweight individuals compared to unfit and overweight/obese ones, but no differences were found for the remaining subgroups. These findings suggest that an optimal physical fitness might attenuate the negative consequences induced by obesity on academic achievement.