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BACKGROUND & AIMS: Evidence on the association between nut consumption and depression is mainly based on cross-sectional studies. This study aims to analyse whether nut consumption is prospectively associated with the risk of depression in adults. METHODS: This study was conducted using the United Kingdom (UK) Biobank resource. Data from middle-aged and older UK adults who participated in this cohort between 2007-2012 (baseline) and 2013-2020 (follow-up) were analysed. Baseline information on nut consumption was obtained with the Oxford WebQ 24-h questionnaire. Depression, defined as a self-reported physician diagnosis of depression or antidepressant use, was assessed at baseline and follow-up. Hazard regression models estimating the predictive ability of nut consumption for the risk of developing depression were adjusted for sociodemographic, lifestyle, and health confounders. RESULTS: A total of 13,504 participants (mean age 57.5 ± 7.2 years, 50.7% female) free of depression at baseline were included in the analyses. After a mean follow-up of 5.3 ± 2.4 years, 1122 (8.3%) incident cases of depression were identified. Compared with no nut consumption, the daily consumption of >0 to 1 serving of 30 g of nuts was associated with a lower risk of depression (hazard ratio, HR = 0.83; 95% confidence interval, CI: 0.71-0.97) regardless of all potential confounders considered. In stratified analyses, a decreased risk of depression was more clearly observed in UK adults with adequate weight control, a healthy lifestyle, and better health status than in their counterparts (p < 0.05). CONCLUSIONS: Low-to-moderate nut consumption (>0 to 1 serving of 30 g/day) was associated with a 17% lower risk of depression during a 5.3-year follow-up compared with no nut consumption in a large sample of middle-aged and older UK adults. This protective association is enhanced in the absence of other known risk factors for depression.

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(1) Background: Heart failure (HF) with preserved ejection fraction (HFpEF) accounts for approximately 50% of all patients with HF. In the absence of pharmacological treatments that have been successful in reducing mortality or morbidity in this pathology, physical exercise is recognized as an important adjunct in the treatment of HF. Therefore, the objective of this study is to compare the efficacy of combined training and high intensity interval training (HIIT) on exercise capacity, diastolic function, endothelial function, and arterial stiffness in participants with HFpEF. (2) Methods: The ExIC-FEp study will be a single-blind, 3-arm, randomized clinical trial (RCT) conducted at the Health and Social Research Center of the University of Castilla-La Mancha. Participants with HFpEF will be randomly assigned (1:1:1) to the combined exercise, HIIT or control group to evaluate the efficacy of physical exercise programs on exercise capacity, diastolic function, endothelial function, and arterial stiffness. All participants will be examined at baseline, at three months and at six months. (3) Results: The findings of this study will be published in a peer-reviewed journal. (4) Conclusions: This RCT will represent a significant advance in the available scientific evidence on the efficacy of physical exercise in the treatment of HFpEF.

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INTRODUCTION: Physical activity interventions have been a proven effective means of preventing or treating overweight and obesity in children and adolescents. The results of these interventions in many cases are based on the determination of the effect they produce on anthropometric evaluations, which allow the calculation of health indices. However, the effects of physical activity interventions on anthropometric assessments in Chilean children and adolescents have not been systematized. The objective of this study is to provide a detailed protocol for a systematic review with meta-analysis that synthesizes the available evidence on the effect of physical activity interventions on anthropometric indicators and health indices in Chilean children and adolescents and identifies the field-based methods and health indices most used for body composition estimation. METHODS: This protocol was performed according to the PRISMA declaration. MEDLINE (PubMed), Web of Science, Scopus, and Scielo databases will be systematically searched. Eligible studies will include randomized controlled trials (RCTs), non-RCTs and pre-post studies. CONCLUSION: This systematic review and meta-analysis protocol is designed to provide up-to-date evidence that could significantly assist public health policy makers and implementers of physical activity interventions through evidence-based guidance and recommendations.

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OBJECTIVES: This systematic review and meta-analysis synthesizes the evidence on prospective bidirectional associations between sleep-related problems (SRP) and chronic musculoskeletal pain (CMP). METHODS: A literature search for cohort studies available in the PubMed, Scopus, Web of Science, PsycINFO and Cochrane Library databases as of 19 July 2022 was performed. Pooled odds ratios and effect sizes were calculated through random effects meta-analysis. Subgroup and meta-regression analyses were performed to explore differences by follow-up time, proportion of each sex and mean age. The Meta-analysis Of Observational Studies in Epidemiology guidelines were strictly followed. RESULTS: Twenty studies with a total of 208 190 adults (aged 34.4-71.7 years) were included, with 17 of them being used in the meta-analysis. Individuals with SRP at baseline had a 1.79-fold higher incidence (odds ratio [OR] = 1.79; 95% CI: 1.55, 2.08; I2 = 84.7%; P < 0.001) and a 2.04-fold higher persistence (OR = 2.04; 95% CI: 1.42, 2.94; I2 = 88.5%; P < 0.005) of CMP than those without SRP. In the subgroup analysis of the association between SRP and CMP, the longer the follow-up time of the studies, the higher the heterogeneity between them. In the corresponding meta-regression, no significant effect was observed for follow-up time, sex proportion or age. Individuals with CMP at baseline had a 2.02-fold higher incidence of SRP (OR = 2.02; 95% CI: 1.62, 2.53; I2 = 90.0%; P < 0.001) than those without CMP. CONCLUSION: This study provides robust evidence concerning the longitudinal association between SRP and incidence-persistence of CMP in adults. In addition, the available prospective studies support the existence of a bidirectional relationship between CMP and SRP. PROSPERO REGISTRATION NUMBER: CRD42020212360.

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BACKGROUND: The positive influence of most types of exercise has been reported repeatedly, but what the most effective exercise approaches are for improving health-related quality of life (HRQoL) in people with cancer remains unknown. The aim of this systematic review and network meta-analysis was to synthesize the evidence from intervention studies to assess the effects of different types of exercise on HRQoL during and after cancer treatment. METHODS: MEDLINE, SPORTDiscus, the Cochrane Library, Web of Science, and Scopus were searched for randomized controlled trials aimed at testing the effects of exercise interventions meant to improve HRQoL in people with cancer. Separate analyses were conducted for HRQoL as measured by general and cancer-specific questionnaires. We also evaluated whether the effects of exercise were different during and after cancer treatment in both the physical and mental HRQoL domains. RESULTS: In total, 93 studies involving 7435 people with cancer were included. Network effect size estimates comparing exercise intervention vs. usual care were significant for combined exercise (0.35, 95% confidence interval (95%CI): 0.14-0.56) for HRQoL as measured by general questionnaires, and for combined (0.31, 95%CI: 0.13-0.48), mind-body exercise (0.54, 95%CI: 0.18-0.89), and walking (0.39, 95%CI: 0.04-0.74) for HRQoL as measured by cancer-specific questionnaires. CONCLUSION: Exercise programs combining aerobic and resistance training can be recommended to improve HRQoL during and after cancer treatment. The scarcity and heterogeneity of these studies prevents us from making recommendations about other exercise modalities due to insufficient evidence.

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Background/objective: Uruguay was enrolled in the fourth edition of the Global Matrix on physical activity-related indicators in children and adolescents with the aim of producing its second Report Card and analyses on the ten core indicators. Methods: A harmonized development process proposed by the Active Healthy Kids Global Alliance was followed. The best available scientific and grey literature was systematically searched for all the indicators included in the Report Card (Overall Physical Activity, Organized Sport Participation, Active Play, Active Transportation, Sedentary Behavior, Physical Fitness, Family and Peers, School, Community and Environment, and Government). A grading scale ranging from A to F was used. A new approach was used to grade the Government indicator according to the Active Healthy Kids Global Alliance guidance. Results: New information was identified and 7 out of 10 indicators were graded, while there were 3 out of 10 indicators with incomplete information to be graded. An gender-based analysis was included in this second Report Card, providing separate grades for 5 of the indicators [girls/boys]: Overall Physical Activity [F/F], Organized Sport Participation [F/D], Active Transportation [C/C], Sedentary Behavior [D+/D+], and Community and Environment [D+/C-]. The comparison between 2018 and 2022 analysis showed a decrease in Overall Physical Activity and Organized Sport Participation, while the sources of influence School and Government obtained a higher grade in comparison with the previous Report Card. Conclusion: Uruguay has developed its second version of the Report Card on physical activity-related indicators in children and adolescents. The gender analysis showed inequalities between girls and boys. In summary, behavioral indicators have decreased while sources of influence have risen along the time.

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BACKGROUND & AIMS: Only a few studies have assessed the association between a proinflammatory diet and the risk of depression in older adults, and they have rendered weak results. The present study analysed the association between the Dietary Inflammatory Index (DII) and incident self-reported diagnosis or symptoms of depression in two cohorts of community-dwelling older adults in Spain. METHODS: We used data from the Seniors-ENRICA-I (SE-I) and Seniors-ENRICA-II (SE-II) cohorts. In both cohorts, the baseline DII was calculated from habitual food consumption estimated with a validated computer-based diet history. The incidence of both physician self-reported diagnosis of depression and mild-to-major depressive symptoms (≥3 on the 10-item Geriatric Depression Scale) was analysed. Logistic regression models were adjusted for the main potential confounders, such as sociodemographics, lifestyles, and comorbidities. The results of both cohorts were pooled using a random effects model. RESULTS: Among the 1627 participants in SE-I (mean age 71.5 ± 5.5 y, 53.1% women) and the 1579 in SE-II (mean age 71.4 ± 4.2, 46.7% women), 86 (5.3%) and 140 (8.9%) incident cases of depression were identified after a mean 3.2-y and 2.3-y follow-up, respectively. The fully adjusted odds ratio (95% confidence interval) of incident depression for the highest (the highest proinflammatory diet) versus the lowest quartile of DII was 2.76 (1.25-6.08, p-for-trend = 0.005) in the SE-I, 1.90 (1.04-3.40, p-for-trend = 0.005) in the SE-II and 2.07 (1.01-3.13) in the pooled cohorts. The results were consistent across strata defined by sex, age, physical activity, loneliness/poor social network, and morbidity. CONCLUSIONS: A proinflammatory dietary pattern is associated with depression risk in older adults. Future research should evaluate whether reducing the inflammatory component of diet leads to reduced depression symptoms in this population.

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Background: The first Uruguay's Report Card in 2018 based on the Global Matrix initiative showed the lack of information on physical activity in children and adolescents. This study mapped and examined the available evidence on physical activity-related indicators based on Uruguay's 2022 Report Card. Methods: The scoping review was reported using the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews extension for Scoping Reviews guidelines. A comprehensive literature search was performed for the period between 2018 and 2021, including electronic databases (PubMed, Web of Science, LILACS, Scielo, and Latindex), gray literature (Google Scholar, open access thesis, relevant websites of State-agencies and International Organizations), national and regional relevant journals, and reference lists of key texts. Two researchers independently conducted both the selection and data-charting process. Data items from each paper were charted based on the Population, Concept, and Context elements reflected in the objective of the review. A narrative synthesis and network plots were conducted to summarize the evidence. Results: A total of 20 papers were included in this review, consisting of four peer-reviewed scientific papers, three bachelor's theses, four official documents of State-agencies, four Government reports, of which three included national surveys, and five laws. Strengths, weaknesses, and knowledge gaps were identified from the available evidence. We synthesized main challenges such as publishing scientific studies, establishing cross-national and cross-sectoral collaborations in research projects, generating high-quality data, reporting information on social inequality indicators that influence equitable distribution, or increasing access to public information. Our results support early emerging and growth research on this topic. However, despite existing papers on physical activity-related indicators in Uruguayan youths, the lack of high-quality evidence remains clear. Conclusion: The findings of this scoping review provide the best available evidence for identifying and overcoming the challenges of physical activity-related indicators research in Uruguay. The methodological framework used could be useful for countries involved in future editions of the Global Matrix initiative. Systematic review registration: Open Science Framework, https://osf.io/hstbd/.

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Resumen: Introducción: la medición precisa de la actividad física (AF) es clave para analizar su asociación con resultados de salud. Sin embargo, en Uruguay no existen estudios que comparen diferentes métodos para determinar la AF en adultos. El objetivo de este estudio fue analizar la confiabilidad del Cuestionario Internacional de Actividad Física (IPAQ) en estudiantes universitarios uruguayos y evaluar su validez concurrente en comparación con la AF basada en dispositivos. Método: 54 estudiantes universitarios de educación física completaron el IPAQ (versión larga) en dos ocasiones con 7 días de diferencia y utilizaron acelerómetros GeneActiv durante ese período. La confiabilidad se evaluó a través del Coeficiente de Correlación Intraclase (ICC) y se utilizó el análisis de Bland-Altman para determinar la validez concurrente. Resultados: todos los dominios de AF mostraron niveles moderados de ICC. El transporte (ICC = 0,64), el tiempo libre (ICC = 0,58), y la AF total (ICC = 0,53) fueron los dominios con niveles moderados más altos. El total de minutos de AF evaluados a través del IPAQ en las dos ocasiones reportó un promedio de 773 minutos de diferencia (IC 95% 362,88-1.184,01). La diferencia de minutos de AF entre la evaluación con el IPAQ y con los acelerómetros es de 752 minutos (IC 95% 418,05-1.087.16). Conclusiones: el IPAQ sobreestima la AF respecto al acelerómetro en estudiantes universitarios uruguayos, sin embargo fue más confiable al considerar dominios de transporte y tiempo libre para los participantes que reportaron realizar un promedio menor a 400 minutos de AF semanal.

Summary: Introduction: precise measurement of physical activity (PA) is key to analyze its association with health results. However, there are no studies in Uruguay comparing the different methods to determine PA in adults. The study aims to analyze the reliability of the International Physical Activity Questionnaire (IPAQ) in Uruguayan university students and to assess its validity by comparing it to device-based monitoring PA. Method: 54 Physical Education university students completed the IPAQ (long version) on 2 occasions with a 7 day difference using GeneActive accelerometers during that period. Reliability was assessed with the Intraclass Correlation Coefficient (ICC) and the Bland-Altman analysis was used to determine concurrent validity. Results: all PA domains evidenced moderate ICC levels. Transport (ICC= 0.64), free time (ICC= 0.58) and total PA (ICC= 0.53) were the domains with the highest moderate levels. The total number of minutes of PA assessed by IPAQ reported an average of a 773 minutes difference (CI 95%: 362.88; 1184.01). Difference of PA in minutes, considering the assessment with the IPAQ and the accelerometers is 752 minutes (CI 95%: 418.05; 1087.16). Conclusions: the IPAQ overestimates the PA when compared to the accelerometer in Uruguayan university students. However, it was more reliable when considering the transport and free time domains for participants who reported an average physical activity under 400 minutes per week.

Resumo: Introdução: a mensuração precisa da atividade física (AF) é fundamental para analisar sua associação com desfechos de saúde. No entanto, no Uruguai não existem estudos que comparem diferentes métodos para determinar a AF em adultos. Objetivo: analisar a confiabilidade do Questionário Internacional de Atividade Física (IPAQ) em estudantes universitários uruguaios e avaliar sua validade concorrente em comparação com a AF baseada em dispositivos. Método: 54 estudantes universitários de Educação Física preencheram o IPAQ (versão longa) em 2 ocasiões com 7 dias de intervalo e usaram acelerômetros GeneActiv durante esse período. A confiabilidade foi avaliada por meio do Coeficiente de Correlação Intraclasse (ICC) e a análise de Bland-Altman foi utilizada para determinar a validade concorrente. Resultados: todos os domínios da AF apresentaram níveis moderados de ICC. Transporte (ICC = 0,64), tempo livre (ICC = 0,58) e AF total (ICC = 0,53) foram os domínios com os níveis moderados mais altos. O total de minutos de AF avaliados pelo IPAQ em ambas as ocasiões apresentou diferença média de 773 minutos (IC 95%: 362,88; 1184,01). A diferença em minutos de AF entre a avaliação com o IPAQ e com os acelerômetros é de 752 minutos (IC 95%: 418,05; 1087,16). Conclusões: o IPAQ superestima a AF em relação ao acelerômetro em universitários uruguaios, porém, foi mais confiável ao considerar os domínios transporte e tempo livre para participantes que relataram realizar em média menos de 400 minutos de AF por semana.

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RESUMEN: El objetivo de esta revisión fue conocer la influencia del entrenamiento muscular inspiratorio (EMI) sobre la capacidad aeróbica y la fuerza muscular inspiratoria (FMI) en pacientes con insuficiencia cardíaca (IC). Realizamos una revisión de revisiones sistemáticas en PubMed y Web of Science hasta agosto de 2019. Se identificaron un total de 2053 artículos, de los cuales 4 se seleccionaron para esta revisión. Se utilizó la herramienta 'Assessment of Multiple Systematic Reviews 2' (AMSTAR-2) para evaluar la calidad de los estudios. En los estudios incluidos se examinaron un total de 10 intervenciones diferentes con 250 pacientes (rango edad media= 53-76 años). Todos los estudios presentaron nivel de confianza alto (AMSTAR-2). El EMI presentó mejoras significativas sobre la capacidad aeróbica (test de la marcha de 6 minutos: 46.66-71.04 metros; p<0.05 y VO2pico: 2.59-2.65 mL/kg-1/min-1; p<0.01) y la FMI (presión inspiratoria máxima: 16.57-23.36 cmH2O, p<0.05) en comparación al grupo control. Programas de intervención de EMI con una duración de 12 semanas reportaron mayores mejorías sobre la capacidad aeróbica y la FMI en comparación a programas de intervención de menor duración. El EMI es un tratamiento importante y necesario en la rehabilitación cardíaca de pacientes con IC. Son necesarios más estudios que analicen los efectos de diferentes rangos en las características del EMI.

ABSTRACT: The aim of this review was to understand the influence of inspiratory muscle training (IMT) on aerobic capacity and inspiratory muscle strength (IMS) in patients with heart failure (HF). We conducted a review of systematic reviews in PubMed and Web of Science up to August 2019. A total of 2053 articles were identified, of which 4 were selected for this review. The 'Assessment of Multiple Systematic Reviews 2' (AMSTAR-2) tool was used to assess the quality of the studies. In the included studies, a total of 10 different interventions with 250 patients (mean age range = 53-76 years) were examined. All the studies presented high confidence level (AMSTAR-2). IMT showed significant improvements in aerobic capacity (6-minute walk test: 46.66-71.04 meters; p<0.05 and VO2peak: 2.59-2.65 mL/kg-1/min-1; p<0.01) and IMS (maximal inspiratory pressure: 16.57-23.36 cmH2O, p<0.05) in this population compared to the control group and IMF in this population. IMT intervention programs lasting 12 weeks reported greater improvements in aerobic capacity and IMS compared to shorter intervention programs. IMT is an important and necessary treatment in cardiac rehabilitation of patients with HF. More studies are needed to analyze the effects of different ranges of the IMT characteristics.

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RESUMEN El objetivo de este estudio fue conocer la influencia de programas de ejercicio físico y sus características de prescripción (frecuencia, intensidad, tipo y tiempo) sobre variables de la rehabilitación cardíaca en pacientes con enfermedad coronaria y/o infarto de miocardio. Realizamos una revisión de revisiones sistemáticas y metaanálisis en PubMed y Web of Science, con artículos publicados hasta el 1 de febrero de 2020. Se identificaron un total de 3902 artículos, de los cuales se seleccionaron 19. Se utilizó 'A Measurement Tool to Assess Systematic Reviews 2' para evaluar la calidad de los estudios incluidos. Dieciséis estudios poseían una calidad moderada-alta. Programas de ejercicio físico (i.e. entrenamiento de fuerza, entrenamiento por intervalos de alta intensidad, entrenamiento continuo de moderada intensidad y taichí) resultaron beneficiosos en la rehabilitación cardíaca de pacientes con enfermedad de las arterias coronarias y/o infarto de miocardio. Además, se encontró evidencia sobre los mejores rangos de las características de prescripción del entrenamiento para dos programas de ejercicio físico.

ABSTRACT The aim of this study was to determine the influence of exercise programs and how they are prescribed (frequency, intensity, type and time) on the variables of cardiac rehabilitation in patients with coronary artery disease or myocardial infarction. We conducted a review of systematic reviews and meta-analyses through a search in PubMed y Web of Science of the articles published until February 1, 2020. Of 3902 articles identified, 19 were selected. The quality of the studies included was evaluated with A Measurement Tool to Assess Systematic Reviews 2. The quality of the studies was moderate-high. Exercise programs (strength training, high-intensity interval training, moderate intensity continuous training and Tai Chi) were beneficial for cardiac rehabilitation of patients with coronary artery disease or myocardial infarction. We present evidence of the best way of prescribing two exercise training programs.

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INTRODUCTION: Physical 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 ANALYSIS: This 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 DISSEMINATION: This 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 NUMBER: CRD42020189892.

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El objetivo de esta revisión fue comparar la influencia del entrenamiento aeróbico y de fuerza combinados (EAFC) con el entrenamiento aeróbico (EA) sobre capacidad aeróbica, fuerza muscular y otras variables relevantes en la rehabilitación cardíaca (RC) de pacientes con enfermedad de las arterias coronaria (EAC). Realizamos una revisión de revisiones sistemáticas y meta análisis en PubMed hasta el 27 de abril de 2019. Se identificaron un total de 30 artículos y se seleccionaron finalmente 3 estudios para esta revisión. La calidad general de los estudios incluidos fue moderada (AMSTAR-2). El EAFC presentó mayores mejorías en comparación al EA sobre capacidad aeróbica, composición corporal y fuerza muscular en pacientes adultos (rango de edad media: 45-73 años) con EAC. Esta revisión agrega evidencia adicional que el EAFC presenta mejoras clínicamente significativas sobre capacidad aeróbica y fuerza muscular en comparación al EA. Son necesarios más estudios que permitan establecer conclusiones consistentes de los efectos del EAFC en comparación al EA sobre calidad de vida. Además, son necesarios más estudios que analicen diferentes protocolos del EAFC y que permitan establecer su prescripción más eficiente en la RC de esta población.

The objective of this review was to compare the influence of combined aerobic and strength training (EAFC) with aerobic training (EA) on aerobic capacity, muscle strength and other relevant variables in cardiac rehabilitation (RC) of patients with coronary artery disease (EAC). We conducted a review of systematic reviews and meta-analyzes in PubMed up to 27 April 2019. A total of 30 articles were identified and 3 studies were finally selected for this review. The overall quality of the included studies was moderate (AMSTAR-2). EAFC showed greater improvements compared to EA on aerobic capacity, body composition and muscle strength in adult patients (mean age range: 45-73 years) with EAC. This review adds additional evidence that EAFC presents clinically significant improvements in aerobic capacity and muscular strength compared to EA. More studies are needed to establish consistent conclusions about the effects of EAFC compared to EA on quality of life. In addition, more studies are needed to analyze different protocols of the EAFC and to establish their most efficient prescription in CR of this population.

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Introducción. Personas con insuficiencia cardíaca (IC) encuentran afectadas su calidad de vida, capacidad funcional y función cardíaca. Objetivo. Comparar la influencia del entrenamiento de fuerza (EF) versus un grupo control (GC) respecto de variables de la rehabilitación cardíaca (RC) en pacientes con IC. Método. Se llevó a cabo una revisión de meta-análisis y revisiones sistemáticas en PubMed y Web of Science hasta marzo de 2020. Se identificaron un total de 545 artículos, entre los cuales se seleccionaron cinco para esta revisión. Se utilizó la herramienta 'Assessment of Multiple Systematic Reviews 2' (AMSTAR-2) para evaluar la calidad metodológica de los estudios. Resultados. En los estudios incluidos se identificaron un total de 13 intervenciones diferentes con 329 pacientes (rango de edad media = 48-77 años) con IC y fracción de eyección del ventrículo izquierdo reducida. Un estudio presentó nivel de confianza alto y cuatro estudios presentaron nivel de confianza moderado (AMSTAR-2). El EF indujo mejoras significativas en la calidad de vida, la capacidad aeróbica, la frecuencia cardíaca pico y la fuerza muscular en comparación al GC. No se encontraron diferencias significativas en la fracción de eyección del ventrículo izquierdo ni en el volumen diastólico final ventricular izquierdo. Conclusiones. El EF es una intervención de ejercicio adecuada y necesaria en la RC de pacientes con IC. Son necesarios estudios que analicen los efectos del EF según características del entrenamiento, edad, severidad de la IC y tratamiento farmacológico.

Introduction. People with heart failure (HF) find their quality of life, functional capacity and cardiac function affected. Objective. To compare the influence of strength training (ST) versus a control group (CG) on cardiac rehabilitation (CR) variables in patients with HF. Method. A review of meta-analyses and systematic reviews was conducted in PubMed and Web of Science up to March 2020. A total of 545 articles were identified, from which five were selected for this review. The Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) tool was used to assess the methodological quality of the studies. Results. A total of 13 different interventions with 329 patients (mean age range = 48-77 years) with HF and reduced left ventricular ejection fraction were identified in the included studies. One study had a high confidence level and 4 studies had a moderate confidence level (AMSTAR-2). EF induced significant improvements in quality of life, aerobic capacity, peak heart rate, and muscle strength compared to CG. No significant differences were found in left ventricular ejection fraction or left ventricular end-diastolic volume. Conclusions. EF is an appropriate and necessary exercise intervention in CR in patients with HF. Studies are needed to analyze the effects of EF according to training characteristics, age, HF severity and pharmacological treatment.

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Resumen El objetivo de esta revisión fue comparar la influencia del entrenamiento por intervalos de alta intensidad (HIIT) con el entrenamiento continuo de moderada intensidad (MICT) sobre la capacidad aeróbica y otras variables relevantes en pacientes con enfermedad de las arterias coronarias (EAC). Realizamos una revisión de estudios sistemáticos y metaanálisis en PubMed hasta el 04 de junio de 2019. Se identificaron un total de 22 artículos, de los cuales 6 se seleccionaron finalmente para esta revisión. La calidad metodológica se evaluó utilizando la herramienta 'Assessment of Multiple Systematic Reviews 2' (AMSTAR-2). Todos los estudios analizaron los efectos del HIIT y MICT en pacientes adultos (rango edad media: 52-76 años). La calidad general de los estudios incluidos fue moderada-alta (AMSTAR-2). El HIIT presentó mayores mejorías sobre el consumo de oxígeno pico y la frecuencia cardíaca pico en comparación al MICT. Esta revisión agrega evidencia adicional que el HIIT presenta mejoras clínicamente significativas sobre la capacidad aeróbica en comparación al MICT. Son necesarios más estudios que permitan establecer conclusiones consistentes de los efectos del HIIT y MICT sobre otras variables relevantes.

Abstract The aim of this review was to compare the influence of high-intensity interval training (HIIT) with moderate-intensity continuous training (MICT) on aerobic capacity and other relevant variables in patients with coronary artery disease (EAC). We reviewed the systematic studies and meta-analysis in PubMed up to June 4th, 2019. A total of 22 articles were identified, of which 6 were selected for this review. The methodological quality was evaluated using the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) tool. The studies selected analyzed HIIT and MICT effects in adult patients (average ages ranging between 52-76). The overall quality of the included studies was moderate-high (AMSTAR-2). HIIT showed greater improvements over peak oxygen consumption and peak heart rate compared to MICT. This review adds further evidence that HIIT presents clinically significant improvements in aerobic capacity compared to MICT. Further studies are needed to establish consistent conclusions about the effects of HIIT and MICT on other relevant variables.

Resumo O objetivo desta revisão foi comparar a influência do treinamento intervalado de alta intensidade (HIIT) com o treinamento contínuo de intensidade moderada (MICT) na capacidade aeróbica e em outras variáveis relevantes em pacientes com doença arterial coronariana (DAC). Realizamos uma revisão de estudos sistemáticos e metanálise no PubMed até 4 de junho de 2019. Foram identificados 22 artigos, dos quais 6 foram finalmente selecionados para esta revisão. A qualidade metodológica foi avaliada usando a ferramenta 'Assessment of Multiple Systematic Reviews 2' (AMSTAR-2). Todos os estudos analisaram os efeitos de HIIT e MICT em pacientes adultos (faixa etária: 52-76 anos). A qualidade geral dos estudos incluídos foi moderadamente alta (AMSTAR-2). O HIIT mostrou uma maior melhora no pico de consumo de oxigênio e no pico de frequência cardíaca em comparação com o MICT. Esta revisão aporta evidências de que o HIIT apresenta melhorias clinicamente significativas na capacidade aeróbica em comparação com o MICT. Mais estudos são necessários para estabelecer conclusões consistentes dos efeitos do HIIT e MICT em outras variáveis relevantes.

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