Physical inactivity

Sedentary Behavior, Exercise, and Cardiovascular Health

Type of study: literature review

Number of citations: 1010

Year: 2019

Authors: C. Lavie, C. Ozemek, S. Carbone, P. Katzmarzyk, S. Blair

Journal: Circulation Research

Journal ranking: Q1

Key takeaways: Promoting physical activity and exercise training can help prevent chronic diseases, including cardiovascular disease, by improving cardiorespiratory fitness.

Abstract: Sedentary behavior and physical inactivity are among the leading modifiable risk factors worldwide for cardiovascular disease and all-cause mortality. The promotion of physical activity and exercise training (ET) leading to improved levels of cardiorespiratory fitness is needed in all age groups, race, and ethnicities and both sexes to prevent many chronic diseases, especially cardiovascular disease. In this state-of-the-art review, we discuss the negative impact of sedentary behavior and physical inactivity, as well as the beneficial effects of physical activity /ET and cardiorespiratory fitness for the prevention of chronic noncommunicable diseases, including cardiovascular disease. We review the prognostic utility of cardiorespiratory fitness compared with obesity and the metabolic syndrome, as well as the increase of physical activity /ET for patients with heart failure as a therapeutic strategy, and ET dosing. Greater efforts at preventing sedentary behavior and physical inactivity while promoting physical activity, ET, and cardiorespiratory fitness are needed throughout the healthcare system worldwide and particularly in the United States in which the burden of cardiometabolic diseases remains extremely high.

Physical Activity Over the Lifecourse and Cardiovascular Disease.

Type of study: literature review

Number of citations: 55

Year: 2023

Authors: A. S. Perry, Erin E. Dooley, H. Master, Nicole L. Spartano, E. Brittain, K. Pettee Gabriel

Journal: Circulation research

Journal ranking: Q1

Key takeaways: Physical activity throughout life can prevent cardiovascular disease and mitigate its related morbidity and death, but its levels have decreased over time.

Abstract: Despite improvements in cardiovascular care in recent decades, cardiovascular disease (CVD) remains a leading cause of death worldwide. At its core, CVD is a largely preventable disease with diligent risk factor management and early detection. As highlighted in the American Heart Association's Life's Essential 8, physical activity plays a central role in CVD prevention at an individual and population level. Despite pervasive knowledge of the numerous cardiovascular and noncardiovascular health benefits of physical activity, physical activity has steadily decreased over time and unfavorable changes in physical activity occur throughout people's lives. Here, we use a lifecourse framework to examine the evidence reporting on the association of physical activity with CVD. From in utero to older adults, we review and discuss the evidence detailing how physical activity may prevent incident CVD and mitigate CVD-related morbidity and death across all life stages.

Exercise benefits in cardiovascular diseases: from mechanisms to clinical implementation.

Type of study:

Number of citations: 107

Year: 2023

Authors: P. Valenzuela, L. Ruilope, A. Santos-Lozano, M. Wilhelm, N. Kränkel, C. Fiuza-Luces, A. Lucía

Journal: European heart journal

Journal ranking: Q1

Key takeaways: Regular physical activity and exercise can help prevent and manage cardiovascular diseases by improving metabolic health, reducing chronic inflammation, and promoting heart regeneration and protection.

Abstract: There is a pandemic of physical inactivity that appears to parallel the widespread prevalence of cardiovascular disease (CVD). Yet, regular physical activity (PA) and exercise can play an important role not only in primary cardiovascular prevention but also in secondary prevention. This review discusses some of the main cardiovascular effects of PA/exercise and the mechanisms involved, including a healthier metabolic milieu with attenuation of systemic chronic inflammation, as well as adaptations at the vascular (antiatherogenic effects) and heart tissue (myocardial regeneration and cardioprotection) levels. The current evidence for safe implementation of PA and exercise in patients with CVD is also summarized.

Exercise Effects On Cardiovascular Disease: From Basic Aspects To Clinical Evidence.

Type of study: literature review

Number of citations: 58

Year: 2021

Authors: F. Sanchis-Gomar, C. Lavie, Jorge Marín, C. Pérez-Quilis, T. Eijsvogels, J. O’Keefe, M. V. Perez, S. Blair

Journal: Cardiovascular research

Journal ranking: Q1

Key takeaways: Regular physical activity and exercise training reduce the risk of cardiovascular diseases and improve cardiorespiratory fitness, but most people lack sufficient levels for optimal health.

Abstract: Cardiovascular (CV) disease (CVD) remains the leading cause of major morbidity and CVD- and all-cause mortality in most of the world. It is now clear that regular physical activity (PA) and exercise training (ET) induces a wide range of direct and indirect physiologic adaptations and pleiotropic benefits for human general and CV health. Generally, higher levels of PA, ET, and cardiorespiratory fitness (CRF) are correlated with reduced risk of CVD, including myocardial infarction, CVD-related death, and all-cause mortality. Although exact details regarding the ideal doses of ET, including resistance and, especially, aerobic ET, as well as the potential adverse effects of extreme levels of ET, continue to be investigated, there is no question that most of the world's population have insufficient levels of PA/ET, and many also have lower than ideal levels of CRF. Therefore, assessment and promotion of PA, ET, and efforts to improve levels of CRF should be integrated into all health professionals' practices worldwide. In this state-of-the-art review, we discuss the exercise effects on many areas related to CVD, from basic aspects to clinical practice.

Exercise and Cardiovascular Health

Type of study:

Number of citations: 433

Year: 2003

Authors: J. Myers

Journal: Circulation

Journal ranking: Q1

Key takeaways: Regular physical activity is linked to reduced coronary heart disease risk, better overall health, and reduced mortality rates.

Abstract: Over the past 4 decades, numerous scientific reports have examined the relationships between physical activity, physical fitness, and cardiovascular health. Expert panels, convened by organizations such as the Centers for Disease Control and Prevention (CDC), the American College of Sports Medicine (ACSM), and the American Heart Association (AHA),1–3 along with the 1996 US Surgeon General’s Report on Physical Activity and Health,4 reinforced scientific evidence linking regular physical activity to various measures of cardiovascular health. The prevailing view in these reports is that more active or fit individuals tend to develop less coronary heart disease (CHD) than their sedentary counterparts. If CHD develops in active or fit individuals, it occurs at a later age and tends to be less severe. As many as 250 000 deaths per year in the United States are attributable to a lack of regular physical activity. In addition, studies that followed large groups of individuals for many years have documented the protective effects of physical activity for a number of noncardiovascular chronic diseases, such as non–insulin-dependent diabetes, hypertension, osteoporosis, and colon cancer.4 In contrast, we see a higher rate of cardiovascular events and a higher death rate in those individuals with low levels of physical fitness.1,4 Even midlife increases in physical activity, through change in occupation or recreational activities, are associated with a decrease in mortality.5 Despite this evidence, however, the vast majority of adults in the United States remains effectively sedentary; less than one-third of Americans meets the minimal recommendations for activity as outlined by the CDC, ACSM, and AHA expert panels. A sedentary lifestyle is one of the 5 major risk factors (along with high blood pressure, abnormal values for blood lipids, smoking, and obesity) for cardiovascular disease, as outlined by the AHA. Evidence from many scientific studies shows …

The effect of physical activity on mortality and cardiovascular disease in 130 000 people from 17 high-income, middle-income, and low-income countries: the PURE study

Type of study: non-rct observational study

Number of citations: 942

Year: 2017

Authors: S. Lear, Weihong Hu, S. Rangarajan, D. Gasevic, D. Leong, R. Iqbal, A. Casanova, S. Swaminathan, R. Anjana, Rajesh Kumar, A. Rosengren, Li Wei, Wang Yang, Chuangshi Wang, Huaxing Liu, S. Nair, R. Diaz, Hany Swidon, Rajeev Gupta, N. Mohammadifard, P. López-Jaramillo, A. Oguz, K. Zatońska, P. Serón, Á. Avezum, P. Poirier, K. Teo, S. Yusuf

Journal: The Lancet

Journal ranking: Q1

Key takeaways: Higher physical activity, including both recreational and non-recreational activities, is associated with lower mortality and cardiovascular disease risk in individuals from low-income, middle-income, and high-income countries.

Influence of Physical Activity on Hypertension and Cardiac Structure and Function

Type of study:

Number of citations: 203

Year: 2015

Authors: Sheila M. Hegde, S. Solomon

Journal: Current Hypertension Reports

Journal ranking: Q1

Key takeaways: Regular physical activity is associated with lower blood pressure, reduced cardiovascular risk, and improved cardiac remodeling, potentially preventing left ventricular hypertrophy in hypertensive patients.

Abstract: The global burden of hypertension is rising and accounts for substantial morbidity and mortality. Lifestyle factors such as diet and physical inactivity contribute to this burden, further highlighting the need for prevention efforts to curb this public health epidemic. Regular physical activity is associated with lower blood pressure, reduced cardiovascular risk, and cardiac remodeling. While exercise and hypertension can both be associated with the development of left ventricular hypertrophy (LVH), the cardiac remodeling from hypertension is pathologic with an associated increase in myocyte hypertrophy, fibrosis, and risk of heart failure and mortality, whereas LVH in athletes is generally non-pathologic and lacks the fibrosis seen in hypertension. In hypertensive patients, physical activity has been associated with paradoxical regression or prevention of LVH, suggesting a mechanism by which exercise can benefit hypertensive patients. Further studies are needed to better understand the mechanisms underlying the benefits of physical activity in the hypertensive heart.

Lack of leisure time physical activity and variations in cardiovascular mortality across US communities: a comprehensive county-level analysis (2011–2019)

Type of study: non-rct observational study

Number of citations: 2

Year: 2024

Authors: Shady Abohashem, Khurram Nasir, M. Munir, A. Sayed, Wesam Aldosoky, T. Abbasi, Erin D. Michos, Martha Gulati, Jamal S. Rana

Journal: British Journal of Sports Medicine

Journal ranking: Q1

Key takeaways: High prevalence of no leisure-time physical activity is associated with elevated cardiovascular mortality rates, particularly among middle-aged women and elderly non-Hispanic black individuals.

Abstract: Objectives To investigate the associations between county-level proportions of adults not engaging in leisure-time physical activity (no LTPA) and age-adjusted cardiovascular mortality (AACVM) rates in the overall US population and across demographics. Methods Analysing 2900 US counties from 2011 to 2019, we used the Centers for Disease Control and Prevention (CDC) databases to obtain annual AACVM rates. No LTPA data were sourced from the CDC’s Behavioural Risk Factor Surveillance System survey and county-specific rates were calculated using a validated multilevel regression and poststratification modelling approach. Multiple regression models assessed associations with county characteristics such as socioeconomic, environmental, clinical and healthcare access factors. Poisson generalised linear mixed models were employed to calculate incidence rate ratios (IRR) and additional yearly deaths (AYD) per 100 000 persons. Results Of 309.9 million residents in 2900 counties in 2011, 7.38 million (2.4%) cardiovascular deaths occurred by 2019. County attributes such as socioeconomic, environmental and clinical factors accounted for up to 65% (adjusted R2=0.65) of variance in no LTPA rates. No LTPA rates associated with higher AACVM across demographics, notably among middle-aged adults (standardised IRR: 1.06; 95% CI (1.04 to 1.07)), particularly women (1.09; 95% CI (1.07 to 1.12)). The highest AYDs were among elderly non-Hispanic black individuals (AYD=68/100 000). Conclusions Our study reveals a robust association between the high prevalence of no LTPA and elevated AACVM rates beyond other social determinants. The most at-risk groups were middle-aged women and elderly non-Hispanic black individuals. Further, county-level characteristics accounted for substantial variance in community LTPA rates. These results emphasise the need for targeted public health measures to boost physical activity, especially in high-risk communities, to reduce AACVM.

Cardiovascular Effects and Benefits of Exercise

Type of study:

Number of citations: 593

Year: 2018

Authors: Matthew A. Nystoriak, A. Bhatnagar

Journal: Frontiers in Cardiovascular Medicine

Journal ranking: Q2

Key takeaways: Regular physical activity, especially moderate levels, is beneficial for cardiovascular health, reducing cardiovascular disease risk and mortality.

Abstract: It is widely accepted that regular physical activity is beneficial for cardiovascular health. Frequent exercise is robustly associated with a decrease in cardiovascular mortality as well as the risk of developing cardiovascular disease. Physically active individuals have lower blood pressure, higher insulin sensitivity, and a more favorable plasma lipoprotein profile. Animal models of exercise show that repeated physical activity suppresses atherogenesis and increases the availability of vasodilatory mediators such as nitric oxide. Exercise has also been found to have beneficial effects on the heart. Acutely, exercise increases cardiac output and blood pressure, but individuals adapted to exercise show lower resting heart rate and cardiac hypertrophy. Both cardiac and vascular changes have been linked to a variety of changes in tissue metabolism and signaling, although our understanding of the contribution of the underlying mechanisms remains incomplete. Even though moderate levels of exercise have been found to be consistently associated with a reduction in cardiovascular disease risk, there is evidence to suggest that continuously high levels of exercise (e.g., marathon running) could have detrimental effects on cardiovascular health. Nevertheless, a specific dose response relationship between the extent and duration of exercise and the reduction in cardiovascular disease risk and mortality remains unclear. Further studies are needed to identify the mechanisms that impart cardiovascular benefits of exercise in order to develop more effective exercise regimens, test the interaction of exercise with diet, and develop pharmacological interventions for those unwilling or unable to exercise.

Combined effect of sedentary behavior and physical activity of different intensity on cardiovascular health

Type of study: systematic review

Number of citations: 0

Year: 2023

Authors:

Journal: Cardiovascular Therapy and Prevention

Journal ranking: Q3

Key takeaways: Switching from sedentary behavior to moderate-intensity physical activity can have a favorable effect on cardiovascular health.

Abstract: Sedentary behavior (SB) and low (insufficient) physical activity (LPA) are two complementary negative factors affecting cardiovascular health. Most of the current studies are devoted to the study of SB and physical activity (PA) of different intensity separately, while their combined effect has not been studied enough. The purpose was to analyze the literature on the assessment of combined SB+PA effect of different intensity on the general and cardiovascular health of a person. When preparing the review, a search was made for publications in the MedLine, Cochrane, Scopus databases, as well as electronic resources e-library, CyberLeninka and libraries of physical culture and sports universities in Russia for 2002-2022.Issues related to various SB+PA combinations and their effects on general and cardiovascular health are considered and discussed. The facts of the favorable effect of switching sedentary behavior on the same time moderate-intensity PA are presented. The presented data indicate the need for further study, taking into account the mutual substitution of SB and FA of different intensity.

Regular Exercise is Associated with a More Favorable Cardiovascular Risk Profile, Better Quality of Life, Less Depression and Less Psychological Stress

Type of study: non-rct observational study

Number of citations: 9

Year: 2022

Authors: Bastian Schrader, Anna-Maria Bünker, Charis Conradi, S. Lüders, B. Vaske, M. Koziolek, Hermann Haller, A. Elsässer, J. Schrader

Journal: International Journal of General Medicine

Journal ranking: Q2

Key takeaways: Regular exercise is associated with a more favorable cardiovascular risk profile, better quality of life, less depression, and less psychological stress, particularly for those at high levels of physical activity.

Abstract: Introduction It is well documented that insufficient physical activity (PA) contributes substantially to cardiovascular diseases. The number of physically active people in Germany is still too low. Methods In ELITE study in Germany, 4602 participants are regularly examined for cardiovascular risk factors (CVRF). The aim is to motivate participants to improve their CVRF through individual recommendations and regular follow-up. Here, the PA data are presented in correlation with CVRF at baseline. A feature of this presentation is that the usual CVRF but also the effects on psychosocial factors were recorded simultaneously. Results Participants were divided into 3 groups based on their PA: 1. frequent exercise (FE): daily to 2–3x per week (41.4%), 2. moderate exercise (ME): 1x/week to 2x/month (28.8%), 3. rarely exercise (RE): 1x/month to not at all (29.8%). Age did not differ in the 3 groups. The most common CVRF was arterial hypertension, which decreased significantly with an increase in PA. Diabetes, nicotine, and increased BMI were also significantly less frequent in group 1. Antihypertensives were taken less frequently in this group 1. Less physically active participants were significantly more likely to have 3 or more additional CVRF. While group 1 consumed more fruit (64%) and considerably less pork, in group 2 and 3 only 58.3% and 50.3% respectively included fruit in their diet. FE also had a favorable effect on stress, depression and general well-being, all of which were significantly better in group 1. Conclusion Results confirm the beneficial influences of exercise on known CVRF and on psychosocial parameters. The prevalence of several CVRF per person at low levels of sport is of particular concern, as these participants would benefit most. During a 5-year follow-up, participants will receive intensive education on the need to increase PA. It remains to be seen how successful the effort will be.

Mortality reduction with physical activity in patients with and without cardiovascular disease

Type of study: non-rct observational study

Number of citations: 216

Year: 2019

Authors: S. Jeong, Sun-Hwa Kim, Si‐Hyuck Kang, Hee-Jun Kim, C. Yoon, T. Youn, I. Chae

Journal: European Heart Journal

Journal ranking: Q1

Key takeaways: Physical activity reduces mortality risk more effectively in individuals with cardiovascular disease than in those without cardiovascular disease.

Abstract: Abstract Aims Physical activity has been shown to reduce mortality in a dose-response fashion. Current guidelines recommend 500–1000 metabolic equivalent task (MET)-min per week of regular physical activity. This study aimed to compare the impact of leisure-time physical activity on mortality in primary versus secondary cardiovascular prevention. Methods and results This study included a total of 131 558 and 310 240 subjects with and without cardiovascular disease (CVD), respectively, from a population-based cohort. Leisure-time physical activity was measured by self-report questionnaires. The study subjects were followed-up for a median of 5.9 years, and the main study outcome was all-cause mortality. There was an inverse relationship between the physical activity level and the mortality risk in both groups. The benefit in the secondary prevention group was shown to be greater than that in the primary prevention group: every 500 MET-min/week increase in physical activity resulted in a 14% and 7% risk reduction in mortality in the secondary and primary prevention groups, respectively (interaction P < 0.001). In addition, while individuals without CVD benefited the most between 1 and 500 MET-min/week of physical activity, the benefit in those with CVD continued above 500 − 1000 MET-min/week. The adjusted mortality risk of individuals with CVD who performed a high level of physical activity (≥1000 MET-min/week) was shown to be comparable to or lower than that of their counterparts without CVD. Conclusion Individuals with CVD may benefit from physical activity to a greater extent than do healthy subjects without CVD.

Cardiovascular responses to physical activity during work and leisure

Type of study: non-rct observational study

Number of citations: 16

Year: 2021

Authors: T. Quinn, C. Kline, E. Nagle, L. Radonovich, A. Alansare, Bethany Barone Gibbs

Journal: Occupational and Environmental Medicine

Journal ranking: Q1

Key takeaways: Workday physical activity increases cardiovascular load and lowers nocturnal HRV, supporting the physical activity health paradox hypothesis, while leisure time physical activity is protective.

Abstract: Objectives Recent evidence suggests that occupational physical activity (OPA) is associated with adverse cardiovascular health, whereas leisure time physical activity is protective. This study explored explanatory physiological mechanisms. Methods Nineteen males (68% white, age=46.6±7.9 years, body mass index=27.9±5.1 kg/m2) with high self-reported OPA wore activity (ActiGraph and activPAL) and heart rate (HR) monitors for 7 days and an ambulatory blood pressure (BP) monitor on one workday and one non-workday. Mixed effects models compared cardiovascular variables (24-hour, nocturnal, waking and non-work time HR and BP) and nocturnal HR variability (HRV) on workdays versus non-workdays. Additional models examined associations of daily activity (steps, light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA)) with cardiovascular variables. Workday by daily activity interactions were examined. Results 24-hour and waking HR and diastolic BP as well as non-work diastolic BP were significantly higher on workdays versus non-workdays (p<0.05 for all). However, no difference in systolic BP or nocturnal HR or BP was observed between work and non-workdays (p>0.05 for all). Low-frequency and high-frequency power indices of nocturnal HRV were lower on workdays (p<0.05 for both). Daily steps and LPA were positively associated with 24-hour and waking HR on work and non-workdays. Significant interactions suggested MVPA increases HR and lowers nocturnal HRV during workdays, with the opposite effect on non-workdays. Conclusions Cardiovascular load was higher on workdays versus non-workdays with no compensatory hypotensive response following workdays. Daily MVPA may differentially affect ambulatory cardiovascular load and nocturnal HRV on workdays versus non-workdays, supporting the physical activity health paradox hypothesis.

Time-Dependent Effects of Physical Activity on Cardiovascular Risk Factors in Adults: A Systematic Review

Type of study: systematic review

Number of citations: 16

Year: 2022

Authors: Hengxu Liu, Shiqi Liu, Kun Wang, Tingran Zhang, Lian Yin, Jiaqi Liang, Yi Yang, Jiong Luo

Journal: International Journal of Environmental Research and Public Health

Journal ranking: Q2

Key takeaways: Physical activity may have time-dependent effects on cardiovascular risk factors in adults, but more large-scale randomized controlled trials are needed to confirm this.

Abstract: Purpose: Physical activity is an important non-drug-related method to prevent and treat cardiovascular diseases, but how exercise duration affects the cardiovascular metabolic risk factors in adults remains uncertain. This review systematically examines the time-dependent effects of physical activity on cardiovascular risk factors in adults and aims to further the understanding of the temporal therapeutics of exercise. Methods: Following the PRISMA guidelines, the PubMed, Web of Science, EMBASE, and CNKI databases were systematically searched for relevant scientific studies from January 2000 to June 2022. Results: A total of 16 studies met the inclusion criteria and were included in the systematic review. The sample size ranged from 11–275 participants who were diagnosed with obesity, hypertension, diabetes mellitus type 2 (T2DM), and Coronary Heart Disease (CAD), while the subjects in four studies did not report any metabolic or cardiovascular disease. Four studies conducted trials of acute exercise interventions, while the remaining intervention periods ranged from 12 days to 12 weeks. The exercise interventions included aerobic training, resistance training, aerobic training that was combined with resistance training, compound exercise, and high-intensity interval exercise, and the training frequency varied from 2–5 times/week. Conclusions: Overall, this review found some evidence that the cardiovascular risk factors in adults may be time-dependent in response to physical activity. However, it is limited by the small sample size for each of the outcomes and several methodological issues, leading to poor comparability between studies. A randomized controlled trial with a larger sample size is supposed to be designed for the relevant population to completely test whether synchronizing the exercise time point in the day with the individual’s circadian rhythm can amplify the benefits of the exercise for improving cardiovascular health.

Physical Exercise and Selective Autophagy: Benefit and Risk on Cardiovascular Health

Type of study:

Number of citations: 96

Year: 2019

Authors: N. Wu, Haili Tian, Peijie Chen, Dan Wang, Jun Ren, Yingmei Zhang

Journal: Cells

Journal ranking: Q1

Key takeaways: Regular moderate-intensity physical exercise benefits cardiovascular health and reduces disease mortality, with selective autophagy playing a role in these benefits.

Abstract: Physical exercise promotes cardiorespiratory fitness, and is considered the mainstream of non-pharmacological therapies along with lifestyle modification for various chronic diseases, in particular cardiovascular diseases. Physical exercise may positively affect various cardiovascular risk factors including body weight, blood pressure, insulin sensitivity, lipid and glucose metabolism, heart function, endothelial function, and body fat composition. With the ever-rising prevalence of obesity and other types of metabolic diseases, as well as sedentary lifestyle, regular exercise of moderate intensity has been indicated to benefit cardiovascular health and reduce overall disease mortality. Exercise offers a wide cadre of favorable responses in the cardiovascular system such as improved dynamics of the cardiovascular system, reduced prevalence of coronary heart diseases and cardiomyopathies, enhanced cardiac reserve capacity, and autonomic regulation. Ample clinical and experimental evidence has indicated an emerging role for autophagy, a conservative catabolism process to degrade and recycle cellular organelles and nutrients, in exercise training-offered cardiovascular benefits. Regular physical exercise as a unique form of physiological stress is capable of triggering adaptation while autophagy in particular selective autophagy seems to be permissive to such cardiovascular adaptation. Here in this mini-review, we will summarize the role for autophagy in particular mitochondrial selective autophagy namely mitophagy in the benefit versus risk of physical exercise on cardiovascular function.

Leisure-time physical activity, occupational physical activity and the physical activity paradox in healthcare workers: A systematic overview of the literature.

Type of study: systematic review

Number of citations: 19

Year: 2023

Authors: Tanja I Janssen, C. Voelcker-Rehage

Journal: International journal of nursing studies

Journal ranking: Q1

Key takeaways: Occupational physical activity may negatively affect cardiovascular health in healthcare workers, while leisure-time physical activity is beneficial.

Physical activity and the heart: from well-established cardiovascular benefits to possible adverse effects.

Type of study: literature review

Number of citations: 7

Year: 2022

Authors: F. Zilio, Stefania Angela Di Fusco, M. Flori, Marco Malvezzi Caracciolo D'aquino, Luigi Pollarolo, Nadia Ingianni, F. Lucà, C. Riccio, M. Gulizia, D. Gabrielli, F. Oliva, F. Colivicchi

Journal: Trends in cardiovascular medicine

Journal ranking: Q1

Key takeaways: Physical activity reduces cardiovascular morbidity and mortality, but high-intensity exercise may counteract the benefits of moderate intensity levels, with some studies supporting a 'physical activity paradox'.

Cardiovascular reactivity, stress, and physical activity

Type of study: literature review

Number of citations: 272

Year: 2013

Authors: Chun-Jung Huang, H. Webb, Michael C. Zourdos, E. Acevedo

Journal: Frontiers in Physiology

Journal ranking: Q2

Key takeaways: Aerobic and resistance exercise can reduce cardiovascular responses to stress, potentially reducing the incidence of stroke and myocardial infarction.

Abstract: Psychological stress has been proposed as a major contributor to the progression of cardiovascular disease (CVD). Acute mental stress can activate the sympathetic-adrenal-medullary (SAM) axis, eliciting the release of catecholamines (NE and EPI) resulting in the elevation of heart rate (HR) and blood pressure (BP). Combined stress (psychological and physical) can exacerbate these cardiovascular responses, which may partially contribute to the elevated risk of CVD and increased proportionate mortality risks experienced by some occupations (e.g., firefighting and law enforcement). Studies have supported the benefits of physical activity on physiological and psychological health, including the cardiovascular response to acute stress. Aerobically trained individuals exhibit lower sympathetic nervous system (e.g., HR) reactivity and enhanced cardiovascular efficiency (e.g., lower vascular reactivity and decreased recovery time) in response to physical and/or psychological stress. In addition, resistance training has been demonstrated to attenuate cardiovascular responses and improve mental health. This review will examine stress-induced cardiovascular reactivity and plausible explanations for how exercise training and physical fitness (aerobic and resistance exercise) can attenuate cardiovascular responses to stress. This enhanced functionality may facilitate a reduction in the incidence of stroke and myocardial infarction. Finally, this review will also address the interaction of obesity and physical activity on cardiovascular reactivity and CVD.

Effects of physical activity on the cardiovascular system

Type of study: systematic review

Number of citations: 0

Year: 2024

Authors: Tomasz Gańko, Weronika Szafrańska, Weronika Kahan, Dominika Poborowska, Marta Wojaczek, Emilia Bąk, Jacek Fordymacki, Katarzyna Polańska, Oliwia Najjar

Journal: Quality in Sport

Journal ranking: brak

Key takeaways: Physical activity positively impacts cardiovascular function, allowing tailored training for patients with cardiovascular disease to safely improve their physical parameters.

Abstract: Introduction: It has been known for years that physical activity has a significant impact on human health and function. It is also inextricably linked to the cardiovascular system. It induces a number of positive changes in the cardiovascular system, both in the short term and in the long term. However, cardiovascular disease is the leading cause of death in Poland and patients affected by it constitute a very large group. In addition to appropriate pharmacotherapy, appropriately selected training and physical activity, the load and intensity of which will be planned individually for each patient, is also important. Aim of the study: The aim was to show how cardiovascular function changes during physical activity and what type of physical activity would be most appropriate in patients with cardiovascular disease. Materials and methods: The review is based on an analysis of scientific papers and materials collected from Pumbed, Google Scholar and other scientific articles using the keywords: physical activity, physical exertion, cardiovascular disease, training, cardiovascular primary and secondary prevention Conclusions: A number of changes in cardiovascular function occur during physical activity. Changes include: heart rate, blood pressure, stroke volume, cardiac output, arterio-venous difference and blood flow redistribution. By knowing how the above parameters change, we are able to offer patients with cardiovascular disease training at an appropriate frequency, intensity or load. With such tailored training, patients will be able to improve their physical parameters safely and without any concerns.

Effects of physical activity on sleep quality and wellbeing

Type of study: systematic review

Number of citations: 4

Year: 2024

Authors: S. Chrysant

Journal: Hospital Practice

Journal ranking: Q3

Key takeaways: Physical activity improves sleep onset, duration, and quality, potentially reducing the incidence of cardiovascular diseases and death.

Abstract: ABSTRACT Physical activity (PA) has pluripotential beneficial effects on body functions. These benefits include reduction in the incidence of cardiovascular disease (CVD), coronary heart disease (CHD), hypertension, type 2 diabetes mellitus (T2DM), and death. In addition to these effects, PA exerts significant beneficial effects on sleep onset, duration and quality, which add to its beneficial effects. In contrast, lack of sleep has been associated with increased incidence of CVD complications and death. In this regard, PA serves as a non-pharmacologic means for sleep improvement especially in older people, who frequently have difficulties in falling asleep. Regarding the timing of exercise and its effect on sleep, there has been no difference between morning and evening exercise on the onset and quality of sleep. With respect the beneficial cardiovascular effects of PA on sleep, there has been a debate among several investigators with some reporting significant beneficial effects of PA, and others reporting not significant beneficial effects. In order to get a better perspective on the effects of PA on quality of sleep, and its cardiovascular beneficial effects, a Medline search of the English literature was conducted between 2017 and 2023 using the terms exercise, sleep, cardiovascular disease, death and 36 pertinent papers were selected (Figure 1). The findings from these papers together with collateral literature will be discussed in this review.

Reduced physical activity in young and older adults: metabolic and musculoskeletal implications

Type of study: non-rct experimental

Number of citations: 192

Year: 2019

Authors: Kelly A. Bowden Davies, Sam Pickles, Victoria S. Sprung, G. Kemp, U. Alam, D. Moore, A. Tahrani, D. Cuthbertson

Journal: Therapeutic Advances in Endocrinology and Metabolism

Journal ranking: Q1

Key takeaways: Short-term physical inactivity can negatively impact metabolic and musculoskeletal health, particularly in individuals at high risk of type 2 diabetes or elderly with sarcopenia or osteoporosis.

Abstract: Background: Although the health benefits of regular physical activity and exercise are well established and have been incorporated into national public health recommendations, there is a relative lack of understanding pertaining to the harmful effects of physical inactivity. Experimental paradigms including complete immobilization and bed rest are not physiologically representative of sedentary living. A useful ‘real-world’ approach to contextualize the physiology of societal downward shifts in physical activity patterns is that of short-term daily step reduction. Results: Step-reduction studies have largely focused on musculoskeletal and metabolic health parameters, providing relevant disease models for metabolic syndrome, type 2 diabetes (T2D), nonalcoholic fatty liver disease (NAFLD), sarcopenia and osteopenia/osteoporosis. In untrained individuals, even a short-term reduction in physical activity has a significant impact on skeletal muscle protein and carbohydrate metabolism, causing anabolic resistance and peripheral insulin resistance, respectively. From a metabolic perspective, short-term inactivity-induced peripheral insulin resistance in skeletal muscle and adipose tissue, with consequent liver triglyceride accumulation, leads to hepatic insulin resistance and a characteristic dyslipidaemia. Concomitantly, various inactivity-related factors contribute to a decline in function; a reduction in cardiorespiratory fitness, muscle mass and muscle strength. Conclusions: Physical inactivity maybe particularly deleterious in certain patient populations, such as those at high risk of T2D or in the elderly, considering concomitant sarcopenia or osteoporosis. The effects of short-term physical inactivity (with step reduction) are reversible on resumption of habitual physical activity in younger people, but less so in older adults. Nutritional interventions and resistance training offer potential strategies to prevent these deleterious metabolic and musculoskeletal effects. Impact: Individuals at high risk of/with cardiometabolic disease and older adults may be more prone to these acute periods of inactivity due to acute illness or hospitalization. Understanding the risks is paramount to implementing countermeasures.

Musculoskeletal exercise: Its role in promoting health and longevity.

Type of study:

Number of citations: 53

Year: 2023

Authors: G. D’Onofrio, J. Kirschner, H. Prather, D. Goldman, A. Rozanski

Journal: Progress in cardiovascular diseases

Journal ranking: Q1

Key takeaways: Resistance training can improve health and longevity by increasing muscle strength, mass, balance, metabolic rate, bone density, reduce body fat, and enhance cognitive function and psychological well-being.

Association of physical activity, cardiorespiratory fitness, grip strength, and grip strength asymmetry with incident musculoskeletal disorders in 406,080 White adults.

Type of study: non-rct observational study

Number of citations: 0

Year: 2025

Authors: Yuexin Yu, Yulong Tang, Xiangnan Li, Zixin Hu, Li Jin, Jiucun Wang, Shuai Jiang, Hui Zhang, Jing Liu

Journal: Journal of sport and health science

Journal ranking: Q1

Key takeaways: Low levels of physical activity, cardiorespiratory fitness, grip strength, and grip strength asymmetry increase the risk of musculoskeletal disorders, while improved fitness can help offset this risk.

Associations between pain and physical activity among older adults

Type of study: non-rct observational study

Number of citations: 42

Year: 2022

Authors: N. Niederstrasser, N. Attridge

Journal: PLoS ONE

Journal ranking: Q1

Key takeaways: High levels of physical activity in older adults are associated with a reduced risk of musculoskeletal pain, while low wealth, being female, and being overweight or obese are risk factors.

Abstract: Objectives Chronic pain is a significant societal problem and pain complaints are one of the main causes of work absenteeism and emergency room visits. Physical activity has been associated with reduced risk of suffering from musculoskeletal pain complaints, but the exact relationship in an older adult sample is not known. Methods Participants self-reported their physical activity level and whether they were often troubled by bone, joint, or muscle pain. Logistic regression analyses revealed the nature of the relationship between musculoskeletal pain and physical activity cross-sectionally and longitudinally over the course of 10 years. Data were taken from the English Longitudinal Study of Ageing, comprising of 5802 individuals residing in England aged 50 or older. Results Only high levels of physical activity were associated with a reduced risk of suffering from musculoskeletal pain compared to a sedentary lifestyle longitudinally. In addition, having low wealth, being female, and being overweight or obese were found to be risk factors for suffering from musculoskeletal pain. Conclusions The development of interventions aimed at alleviating and preventing musculoskeletal pain complaints might benefit from incorporating physical activity programs, weight loss, and aspects addressing wealth inequality to maximise their efficacy.

The association between physical activity and musculoskeletal disorders—a cross-sectional study of teachers

Type of study: non-rct observational study

Number of citations: 10

Year: 2023

Authors: M. Grabara

Journal: PeerJ

Journal ranking: Q1

Key takeaways: Teachers in Poland meet the WHO recommendation for moderate-intensity physical activity, but women are less likely to engage in vigorous and high-vigorous physical activity than men.

Abstract: Purpose Combined with insufficient physical activity (PA) prolonged and improperly performed sedentary work can lead to musculoskeletal disorders (MSDs). The aim of this study was (I) to evaluate the self-reported level of PA and the prevalence of MSDs in male and female teachers, and (II) to investigate the association between PA and MSDs in teachers in Polish primary and secondary schools. Methods The study included 254 teachers from primary and secondary schools from Upper Silesia, Poland, excluding physical education teachers. The level of PA was assessed using the Seven-Day Physical Activity Recall (SDPAR). A standardized Nordic Musculoskeletal Questionnaire (NMQ) was used to assess the prevalence of MSDs. Results A similar percentage of female (80%) and male (90%) teachers met the WHO recommendations on moderate-intensity PA. The recommendations on performing vigorous-intensity PA were met by significantly (p = 0.002) less female than male teachers (50% and 75% respectively). Lower back disorders during the last 12 months and the last 7 days (57% and 45%, respectively) were the most commonly reported MSDs by teachers, followed by neck (53%, 40%), upper back (39%, 28%), and knee disorders (37%, 26%). The highest pain intensity was experienced by the teachers in the lower back and neck. Teachers with a greater number of MSDs were less likely to engage in vigorous-intensity PA and total PA than those with fewer painful areas of the body. Pain intensity in the neck, knees, upper- and lower back, and wrists/hands was negatively related to moderate and total PA. BMI negatively correlated with total PA, moderate-intensity PA vigorous-intensity PA, and high vigorous-intensity PA. Conclusions The study revealed the association between PA and MSDs in studied teachers. The most of the studied teachers met the WHO recommendation, and women were less likely to perform vigorous and high-vigorous PA than men. The lower back and neck disorders were the most common among the teachers.

Exercise and physical health: musculoskeletal health and functional capabilities.

Type of study:

Number of citations: 121

Year: 1995

Authors: I. Vuori

Journal: Research quarterly for exercise and sport

Journal ranking: Q1

Key takeaways: Regular lifelong physical activity is essential for enhancing musculoskeletal health and functions, with benefits gained even from moderate exercise intensity.

Abstract: An adequately functioning musculoskeletal system is a key factor for functional capacity, independence, and good quality of life. Impaired functional capacity and degenerative diseases of the musculoskeletal organs are one of the most prevalent and increasing sources of morbidity and suffering. Physical activity positively influences most structural components of the musculoskeletal system that are related to functional capabilities and the risk of degenerative diseases. Physical activity also has the potential to postpone or prevent prevalent musculoskeletal disorders, such as mechanical low back pain, neck and shoulder pain, and osteoporosis and related fractures. Exercise can contribute to the rehabilitation of musculoskeletal disorders and recovery from orthopedic surgery. A substantial part of the age-related decline in functional capabilities is not due to aging per se but to decreased and insufficient physical activity. Physical activity has great potential to favorably influence both the normal and pathological structures, functions, and processes. Musculoskeletal benefits of physical activity can be attained by people of all ages and with various diseases. This potential is substantial because many benefits are gained by activity which is moderate in amount and intensity. Scientific evidence is sufficient to recommend regular lifelong physical activity as part of a healthy lifestyle for everyone in order to enhance musculoskeletal health and functions for individual and population levels. However, several important issues regarding the effects, effectiveness, feasibility, and safety of exercise to improve various aspects of musculoskeletal health and functional capabilities need further research.

Musculoskeletal system problems in office workers: relationship of physical activity levels and quality of life

Type of study: non-rct observational study

Number of citations: 9

Year: 2022

Authors: Harun İkiz, E. Ergin

Journal: International Journal of Occupational Safety and Ergonomics

Journal ranking: Q2

Key takeaways: High prevalence of musculoskeletal disorders in office workers is linked to low physical activity levels, suggesting the need for training and exercises to prevent these issues and improve their quality of life.

Abstract: Objectives. This study aimed to determine the relationship between musculoskeletal problems in office workers and their physical activity levels and quality of life. Methods. A questionnaire form, the quality of life scale (SF-36) and the international physical activity questionnaire (IPAQ) were used. Group differences were compared post hoc (Bonferroni) and non-parametrically (Mann–Whitney U test, etc.). Results. Among the participants, 81.7% experienced pain in at least one body area. Back pain was experienced most frequently at a rate of 54.8%, followed by neck and shoulder pain, respectively. According to the participants’ physical activity levels, 58.5% (n = 141) were active, 37.3% (n = 90) were less active and 4.1% (n = 10) were very active. There was a significant relationship between the prevalence of musculoskeletal disorders (MSDs) among the participants and the participants’ age, educational status, income status, regular exercise status, duration of computer use, eye complaints, complaints in the wrists and ergonomic chair use. Conclusion. The prevalence of MSDs was determined to be high in the office workers, while their levels of physical activity were found low. Training and exercises are needed to prevent MSDs in office workers and improve their levels of physical activity and quality of life.

EFFECTS OF PHYSICAL ACTIVITY LEVEL AND SEDENTARY BEHAVIOR ON THE MUSCULOSKELETAL SYSTEM IN YOUNG ADULTS

Type of study:

Number of citations: 0

Year: 2024

Authors: H. Telli, Filiz Özel Çakır

Journal: Genel Tıp Dergisi

Journal ranking: brak

Key takeaways: Higher physical activity levels in males and lower inactive and insufficiently active levels in females are associated with reduced musculoskeletal pain, posture, muscle shortness, and trunk muscle endurance in young adults aged 18-35.

Abstract: Aim: The aim of this study is to investigate the relationship between the level of physical activity and sedentary behavior in young adults aged 18-35 and to evaluate the effects of this relationship on musculoskeletal pain, posture, muscle shortness, and trunk muscle endurance. Methods: In this cross-sectional descriptive study, conducted at the Faculty of Health Sciences of a university between March 2018 and August 2018, 219 students were included. Data were obtained by using the case report form which determines the demographic characteristics and sedentary behavior of the students, The International Physical Activity Index - short form, posture analysis form, muscle shortness evaluation form, and trunk muscle endurance evaluation form. Results: In the study, 66.2% of patients were female and 33.8% were male. In the evaluation of physical activity level, the ratio of highly active individuals in males, and inactive and insufficiently active individuals in females was significantly higher (p

Impact of Physical Activity in Cardiovascular and Musculoskeletal Health: Can Motion Be Medicine?

Type of study: systematic review

Number of citations: 49

Year: 2017

Authors: Gannon L Curtis, M. Chughtai, A. Khlopas, J. Newman, Rafay Khan, Shervin Shaffiy, A. Nadhim, A. Bhave

Journal: Journal of Clinical Medicine Research

Journal ranking: Q2

Key takeaways: Physical activity may decrease cardiovascular disease and improve osteoarthritis symptoms, but excessive activity may increase OA risk, so physicians should advise patients to exercise in moderation.

Abstract: Physical activity is a well-known therapeutic tool for various types of medical conditions, including vasculopathic diseases such as coronary artery disease, stroke, type 2 diabetes, and obesity. Additionally, increased physical activity has been proposed as a therapy to improve musculoskeletal health; however, there are conflicting reports about physical activity potentially leading to degenerative musculoskeletal disease, especially osteoarthritis (OA). Additionally, although physical activity is known to have its benefits, it is unclear as to what amount of physical activity is the most advantageous. Too much, as well as not enough exercise can have negative consequences. This could impact how physicians advise their patients about exercise intensity. Multiple studies have evaluated the effect of physical activity on various aspects of health. However, there is a paucity of systematic studies which review cardiovascular and musculoskeletal health as outcomes. Therefore, the purpose of this review was to assess how physical activity impacts these aspects of health. Specifically, we evaluated the effect of various levels of physical activity on: 1) cardiovascular and 2) musculoskeletal health. The review revealed that physical activity may decrease cardiovascular disease and improve OA symptoms, and therefore, motion can be considered a “medicine”. However, because heavy activity can potentially lead to increased OA risk, physicians should advise their patients that excessive activity can also potentially impact their health negatively, and should be done in moderation, until further study.

SP0084 Why physical activity exercise works

Type of study:

Number of citations: 0

Year: 2018

Authors: M. Iversen

Journal: Annals of the Rheumatic Diseases

Journal ranking: Q1

Key takeaways: Physical activity and exercise have positive health effects for various systems, making it a key component of symptom management for individuals with musculoskeletal disorders.

Abstract: Pain, inflammation, and decreased physical function are consequences of musculoskeletal disorders (MSDs), limiting patients’ daily activities and restricting their participation in society. Physical activity and exercise have positive health effects for the circulatory, digestive, endocrine, excretory, immune, integumentary, muscular, nervous, respiratory and skeletal systems. Given the benefits of physical activity and exercise, physical activity is a primary component of symptom management for individuals with musculoskeletal disorders. This presentation will review the short- and long-term effects of physical activity and exercise in general and specifically, for individuals with musculoskeletal disorders, with a focus on the cardiovascular, immune and musculoskeletal systems. Disclosure of Interest None declared

Investigating the Impact of Prolonged Sitting and Lack of Physical Activity on the Musculoskeletal Health of School Students

Type of study:

Number of citations: 0

Year: 2024

Authors: Swati Tiwari, Sonu Sangate, Shreya Kanojiya, Mohasina naz, Ashwin Patidar, Monu Sangate, Mayuri Prajapat, Manisha Saste, Aadila Siddiqui, Riya Sahu, Vedika Tiwari, Ayushi Brahme, Jitendra Solanki

Journal: International Journal For Multidisciplinary Research

Journal ranking: brak

Key takeaways: Prolonged sitting and insufficient physical activity in school students can negatively impact their musculoskeletal health, leading to conditions like poor posture, back pain, and reduced physical fitness.

Abstract: Background Prolonged sitting and lack of physical activity have become very common issues among school students due to increased screen time and academic schedules. These sedentary behaviors can adversely affect musculoskeletal health, leading to conditions such as poor posture, back pain, and reduced physical fitness. Understanding these impacts is crucial for developing effective interventions to promote healthier lifestyles among these groups. Aims This study aims to investigate the effects of prolonged sitting and insufficient physical activity on the musculoskeletal health of school students. The objectives include identifying common musculoskeletal problems, analysing the correlation between sedentary behaviors and these issues Setting The research was conducted in various schools, encompassing a diverse population of students aged 12-17 years. The schools were selected to represent different socio-economic backgrounds and geographical locations to ensure a comprehensive analysis. Design A mixed-methods approach was employed, combining quantitative surveys and qualitative interviews. The quantitative component involved the administration of structured questionnaires to gather data on students' sitting habits, physical activity levels, and musculoskeletal complaints. The qualitative component included in-depth interviews with selected students, teachers, and health professionals to gain deeper insights into the causes and effects of sedentary behaviors.

Association between physical activity and musculoskeletal pain: an analysis of international data from the ASAP survey

Type of study: non-rct observational study

Number of citations: 12

Year: 2022

Authors: H. Rhim, A. Tenforde, Lisa Mohr, K. Hollander, L. Vogt, D. Groneberg, J. Wilke

Journal: BMJ Open

Journal ranking: Q1

Key takeaways: A dose of 300-450 minutes of physical activity per week is associated with lower odds of musculoskeletal pain in six body locations, while excessive doses may increase pain in certain locations.

Abstract: Objective To explore the association of physical activity (PA) with musculoskeletal pain (MSK pain). Design Cross-sectional study Setting 14 countries (Argentina, Australia, Austria, Brazil, Chile, France, Germany, Italy, the Netherlands, Singapore, South Africa, Spain, Switzerland and the USA). Participants Individuals aged 18 or older. Primary and secondary outcome measures PA volumes were assessed with an adapted version of the Nordic Physical Activity Questionnaire-short. Prevalence of MSK pain was captured by means of a 20-item checklist of body locations. Based on the WHO recommendation on PA, participants were classified as non-compliers (0–150 min/week), compliers (150–300 min/week), double compliers (300–450 min/week), triple compliers (450–600 min/week), quadruple compliers (600–750 min/week), quintuple compliers (750–900 min/week) and top compliers (more than 900 min/week). Multivariate logistic regression was used to obtain adjusted ORs of the association between PA and MSK pain for each body location, correcting for age, sex, employment status and depression risk. Results A total of 13 741 participants completed the survey. Compared with non-compliers, compliers had smaller odds of MSK pain in one location (thoracic pain, OR 0.77, 95% CI 0.64 to 0.93). Double compliance was associated with reduced pain occurrence in six locations (elbow, OR 0.70, 95% CI 0.50 to 0.98; forearm, OR 0.63, 95% CI 0.40 to 0.99; wrist, OR 0.74, 95% CI 0.57 to 0.98; hand, OR 0.57, 95% CI 0.40 to 0.79; fingers, OR 0.72, 95% CI 0.52 to 0.99; abdomen, OR 0.61, 95% CI 0.41 to 0.91). Triple to top compliance was also linked with lower odds of MSK pain (five locations in triple compliance, three in quadruple compliance, two in quintuple compliance, three in top compliance), but, at the same time, presented increased odds of MSK pain in some of the other locations. Conclusion A dose of 300–450 min WHO-equivalent PA/week was associated with lower odds of MSK pain in six body locations. On the other hand, excessive doses of PA were associated with higher odds of pain in certain body locations.

The Role of Physical Exercise in Chronic Musculoskeletal Pain: Best Medicine—A Narrative Review

Type of study: literature review

Number of citations: 23

Year: 2024

Authors: H. de la Corte-Rodriguez, J. M. Román-Belmonte, Cristina Resino-Luís, Jorge Madrid-Gonzalez, E. C. Rodríguez-Merchán

Journal: Healthcare

Journal ranking: brak

Key takeaways: Physical exercise is an effective, inexpensive, and safe treatment for chronic musculoskeletal pain, improving sleep quality, daily living, and quality of life without adverse effects.

Abstract: The aim of this paper is to provide a narrative review of the effects of physical exercise in the treatment of chronic musculoskeletal pain. Physical inactivity and sedentary behavior are associated with chronic musculoskeletal pain and can aggravate it. For the management of musculoskeletal pain, physical exercise is an effective, cheap, and safe therapeutic option, given that it does not produce the adverse effects of pharmacological treatments or invasive techniques. In addition to its analgesic capacity, physical exercise has an effect on other pain-related areas, such as sleep quality, activities of daily living, quality of life, physical function, and emotion. In general, even during periods of acute pain, maintaining a minimum level of physical activity can be beneficial. Programs that combine several of the various exercise modalities (aerobic, strengthening, flexibility, and balance), known as multicomponent exercise, can be more effective and better adapted to clinical conditions. For chronic pain, the greatest benefits typically occur with programs performed at light-to-moderate intensity and at a frequency of two to three times per week for at least 4 weeks. Exercise programs should be tailored to the specific needs of each patient based on clinical guidelines and World Health Organization recommendations. Given that adherence to physical exercise is a major problem, it is important to empower patients and facilitate lifestyle change. There is strong evidence of the analgesic effect of physical exercise in multiple pathologies, such as in osteoarthritis, chronic low back pain, rheumatoid arthritis, and fibromyalgia.

Many physiotherapists lack preparedness to prescribe physical activity and exercise to people with musculoskeletal pain: A multi-national survey.

Type of study: non-rct observational study

Number of citations: 47

Year: 2021

Authors: C. Barton, M. King, B. Dascombe, N. Taylor, D. de Oliveira Silva, S. Holden, A. Goff, K. Takarangi, N. Shields

Journal: Physical therapy in sport : official journal of the Association of Chartered Physiotherapists in Sports Medicine

Journal ranking: Q1

Key takeaways: Many physiotherapists lack knowledge and training to effectively prescribe aerobic exercise and resistance training for people with musculoskeletal pain.

Motivation toward physical activity in patients with chronic musculoskeletal disorders: a meta-analysis of the efficacy of behavioural interventions

Type of study: meta-analysis

Number of citations: 4

Year: 2024

Authors: Matthieu Haas, Julie Boiché, Guillaume Chevance, Christophe Latrille, Mathis Brusseau, A. Courbis, Arnaud Dupeyron

Journal: Scientific Reports

Journal ranking: Q1

Key takeaways: Behavioral interventions can positively impact physical activity motivation in patients with chronic musculoskeletal disorders, particularly reducing fear of movement.

Physical activity levels of individuals with chronic musculoskeletal disorders: Their relationship with barriers and facilitators.

Type of study: non-rct observational study

Number of citations: 3

Year: 2023

Authors: Ayse Sevim Kalın, Yesim Kurtais Aytur

Journal: Musculoskeletal care

Journal ranking: Q1

Key takeaways: Individuals with chronic musculoskeletal disorders have low physical activity levels, with barriers such as fatigue, pain, and lack of motivation being major obstacles, while facilitators include desire to be in good health, enjoy exercise, and maintain fitness.

Abstract: BACKGROUND Individuals with chronic musculoskeletal disorders (MSD) often avoid physical activity (PA) and exercise although these are the key factors in managing their condition and pain. OBJECTIVES To determine the PA levels of individuals with chronic MSD and their relationship with barriers and facilitators. DESIGN Three hundred and five subjects with five MSD groups; fibromyalgia, myofascial pain, osteoarthritis, periarticular regional pain and degenerative spine problems were included in the study. The visual analogue scale was used to assess pain, the Hospital Anxiety and Depression Scale to assess emotional impact, and the Nottingham Health Profile (NHP) to assess quality of life. PA levels were categorised by the International Physical Activity Questionnaire-Short Form. Perceived barriers and facilitators for PA/exercise were determined by questionnaire. RESULTS 66 (21.6%) were male, 239 (78.4%) were female. 196 (64.3%) of the subjects were physically inactive, 94 (31.1%) low-active, and 15 (4.6%) sufficiently active. The most frequently reported barriers for PA/exercise were fatigue/feeling too tired (72.1%), pain (66.2%), and lack of motivation/willingness (54.4%). The most frequently reported facilitators were the desire to be in good health (72.8%), enjoying exercise (59.7%), and the desire to keep fit and lose weight (59%). CONCLUSION The level of PA in individuals with MSD was quite low. Identifying the underlying causes of PA is important since PA/exercise is beneficial for musculoskeletal health. Yet, barriers and facilitators for PA were revealed for this study population. Identifying and understanding these barriers and facilitators would facilitate the individualised PA/exercise programs for both clinical practice and research.

Physical-work ability and chronic musculoskeletal complaints are related to leisure-time physical activity: Cross-sectional study among manual workers aged 50–70 years

Type of study: non-rct observational study

Number of citations: 11

Year: 2019

Authors: K. L. Norheim, A. Samani, Jakob Hjort Bønløkke, Ø. Omland, P. Madeleine

Journal: Scandinavian Journal of Public Health

Journal ranking: Q1

Key takeaways: High-intensity leisure-time physical activity for 3-4 hours per week is associated with greater physical-work ability and lower odds of chronic musculoskeletal complaints in the knees among manual workers aged 50-70 years.

Abstract: Aims: To investigate the associations between both high- and low-intensity leisure-time physical activity on physical-work ability and chronic musculoskeletal complaints among manual workers aged 50–70 years. Methods: In this cross-sectional study, 1763 manual workers (mean age 57.1, SD ± 4.7 years) replied to questions about leisure-time physical activity, physical-work ability, chronic musculoskeletal complaints as well as health and lifestyle factors. Ordinal and binomial logistic regression models were constructed to assess the influence of the duration of both low- and high-intensity physical activity on physical-work ability and chronic musculoskeletal complaints, respectively. Models were adjusted for gender, age, smoking, alcohol intake, body mass index, physical-work demand, work experience, chronic disease and, regarding physical-work ability, also for chronic musculoskeletal complaints. Results: A statistically significant association between greater physical-work ability and high-intensity physical activity was found for workers engaged in 3–4 h/wk and ⩾ 5 h/wk (OR 1.59, 95% CI 1.15–2.19 and OR 1.56, 95% CI 1.10–2.22, respectively). For both high- and low-intensity physical activity, a duration of 3–4 h/wk was associated with lower odds of reporting chronic musculoskeletal complaints in the knees (OR 0.65, 95% CI 0.42–1.00 and OR 0.61, 95% CI 0.38–0.99, respectively). Conclusions: Engaging in ⩾ 3 h/wk of high-intensity leisure-time physical activity was associated with greater physical-work ability among manual workers aged 50–70 years. Both high- and low-intensity physical activity related to lower odds of having chronic musculoskeletal complaints in the knees.

Reducing the global burden of musculoskeletal conditions

Type of study:

Number of citations: 336

Year: 2018

Authors: A. Briggs, A. Woolf, K. Dreinhöfer, N. Homb, D. Hoy, D. Kopansky-Giles, K. Åkesson, L. March

Journal: Bulletin of the World Health Organization

Journal ranking: Q1

Key takeaways: Musculoskeletal health is crucial for maintaining economic, social, and functional independence, and reducing the impact of chronic diseases like cardiovascular and respiratory diseases.

Abstract: Musculoskeletal conditions include more than 150 diagnoses that affect the locomotor system. These conditions are characterized by pain and reduced physical function, often leading to significant mental health decline, increased risk of developing other chronic health conditions and increased all-cause mortality.1 Many musculoskeletal conditions share risk factors common to other chronic health conditions, such as obesity, poor nutrition and a sedentary lifestyle. Musculoskeletal conditions account for the greatest proportion of persistent pain across geographies and ages.2 Back and neck pain, osteoarthritis, rheumatoid arthritis and fractures are among the most disabling musculoskeletal conditions and pose major threats to healthy ageing by limiting physical and mental capacities and functional ability. Although the prevalence of major musculoskeletal conditions increases with age, they are not just conditions of older age. Regional pain conditions, low back and neck pain, musculoskeletal injury sequelae and inflammatory arthritides commonly affect children, adolescents and middle-aged people during their formative and peak income-earning years, establishing trajectories of decline in intrinsic capacity in later years. While point prevalence estimates vary with respect to age and musculoskeletal condition, approximately one in three people worldwide live with a chronic, painful musculoskeletal condition. Notably, recent data suggest that one in two adult Americans live with a musculoskeletal condition, a prevalence comparable to that of cardiovascular and chronic respiratory diseases combined, which cost 213 billion United States dollars in 2011 (or 1.4% of gross domestic product).3 Data from lowand middle-income countries are fewer, yet comparable.4 Musculoskeletal health is critical for human function, enabling mobility, dexterity and the ability to work and actively participate in all aspects of life. Musculoskeletal health is therefore essential for maintaining economic, social and functional independence, as well as human capital across the life course. Impaired musculoskeletal health is responsible for the greatest loss of productive life years in the workforce compared with other noncommunicable diseases,5 commonly resulting in early retirement and reduced financial security. In subsistence communities and lowand middle-income economies, impaired musculoskeletal health has profound consequences on an individual’s ability to participate in social roles and in the prosperity of communities.4

Bone Health and Physical Activity - The Complex Mechanism.

Type of study:

Number of citations: 1

Year: 2024

Authors: Alicja Nowak, M. Ogurkowska

Journal: Aging and disease

Journal ranking: Q1

Key takeaways: Physical activity plays a crucial role in maintaining bone health, with optimal exercise intensity, duration, and frequency needed to maintain bone homeostasis and avoid fractures.

Abstract: This review summarizes the mechanism and role of physical activity in maintaining the proper functioning of the musculoskeletal system. Bone adaptation to the mechanical environment occurs in skeletal regions subjected to the greatest stresses resulting from the nature of exercise, however, there is a varied response of bone tissue to mechanical loads depending on its material and structural properties (trabecular and cortical). The regulation of bone tissue metabolism during physical exercise is influenced by factors associated with mechanical stress (gravitational forces, impact loading, and muscular contractions) as well as by systemic mechanisms (hormones, myokines, cytokines). The presence of insulin receptors and glucose transporters in osteoblasts indicates that these cells consume large amounts of glucose. Therefore, when energy demand during physical activity increases, nutritional factors play an important role in bone response. On the other hand, the musculoskeletal system participates in the regulation of energy metabolism. To maintain bone homeostasis, an optimized form of physical activity should be used (e.g. intensity, duration, training session frequency). The complexity of factors modulating the sensitivity of bones to mechanical stimuli causes the results of physical training are age- and sex-dependent. Moreover, when selecting exercises to improve bone health, it is important to take into account metabolic and musculoskeletal system conditions. In addition, exercise should be safe and adapted to the health and fitness level so as not to increase the risk of fractures. Participation in regular physical activity should continue after the training program to maintain bone mass.

[The inadequate physical activity as risk factor of non-communicable diseases].

Type of study: literature review

Number of citations: 0

Year: 2024

Authors: K. Amlaev, K. Dahkilgova, L. Blinkova, V. Mazharov

Journal: Problemy sotsial'noi gigieny, zdravookhraneniia i istorii meditsiny

Journal ranking: brak

Key takeaways: Inadequate physical activity is a significant risk factor for developing non-communicable diseases, including obesity, musculoskeletal diseases, diabetes mellitus II, and chronic cardiovascular diseases.

Abstract: The article presents brief review of impact of inadequate physical activity on development of non-communicable diseases. The low physical activity is among top five most significant factors of premature death and is the cause of more than 20% of cases of diabetes mellitus II and chronic cardiovascular diseases. The article considers mode of assessing intensity of physical activity based on using metabolic equivalent. The effect of hypodynamia on development of obesity, diseases of musculoskeletal system, diabetes mellitus II, cardio-vascular and oncological diseases is considered. The relationship between inadequate physical activity and population mental health is considered too.

Physical exercise, mental health problems, and suicide attempts in university students

Type of study: non-rct observational study

Number of citations: 203

Year: 2020

Authors: Michael Grasdalsmoen, H. Eriksen, K. Lønning, Borge Sivertsen

Journal: BMC Psychiatry

Journal ranking: Q1

Key takeaways: Regular physical exercise is positively associated with mental health problems and suicidality in college students, with higher levels of exercise being associated with reduced self-harm and suicide attempts.

Abstract: Abstract Background Physical inactivity and mental health problems are both major public health concerns worldwide. Although several studies have demonstrated the health benefits of regular physical exercise, few epidemiological studies have investigated the nature of the association between different aspects of physical exercise and mental health, and little is known regarding the possible link to suicidality. Study aim To examine the association between frequency, intensity, and duration of physical exercise and mental health problems, and to explore whether low levels of physical activity is related to self-harm and suicide attempts among college and university students. Methods We employed data from the SHoT2018-study, a national health survey for higher education in Norway, in which 50,054 students aged 18–35 years participated. Physical exercise was assessed with three questions (frequency, intensity, and duration). Mental health problems were assessed with both a screening tool assessing psychological distress (Hopkins Symptom Checklist-25; HSCL-25) and self-reported depressive disorder (using a pre-defined list of conditions). Suicide attempts and self-harm were assessed with two items from the Adult Psychiatric Morbidity Survey. Results Physical exercise was negatively associated with all measures of mental health problems and suicidality in a dose-response manner. The strongest effect-sizes were observed for frequency of physical exercise. Women with low levels of physical activity had a near three-fold increased odds of both scoring high on the HSCL-25, and self-reported depression, compared to women exercising almost every day. Even stronger effect-sizes were observed for men (ORs ranging from 3.5 to 4.8). Also, physical exercise duration and intensity were significantly associated with mental health problems, but with generally smaller ORs. Similarly, graded associations were also observed when examining the link to self-harm and suicide attempts (ORs ranging from 1.9 to 2.5). Conclusion Given the demonstrated dose-response association between inactivity and both poor mental health, self-harm, and suicidal attempt, there is a need to facilitate college students to become more physically active. This is a shared responsibility that resides both on a political level and on the post-secondary institutions. The cross-sectional nature of the study means that one should be careful to draw firm conclusion about the direction of causality.

Poor physical activity as a risk factor for mental health disorders

Type of study:

Number of citations: 1

Year: 2021

Authors: B. Stubbs

Journal: European Journal of Public Health

Journal ranking: Q1

Key takeaways: Higher levels of physical activity are associated with a reduced risk of mental health disorders, contributing to healthy aging, improved sleep, and preserved cognition across the lifespan.

Abstract: Rates of common mental disorders appear to be increasing among both adolescent and adult population affecting life quality and expectancy. Availability of the treatments il limited to a large portion of the global population thus new approaches toward the prevention and treatment of mental illnesses need to emerge in order to reduce the global and growing burden of these conditions. A great body of evidence has linked both the onset and symptoms of various mental disorders to lifestyle factors such as physical activity and diet. Given their modifiable nature, there has been an increasing interest in the implementation of physical activity in the prevention and adjunctive treatment among people with mental illnesses. Robust evidence indicates that physical activity may in fact, by influencing a range of biological and psychosocial processes, contribute to healthy aging, improve sleep and preserve cognition across the lifespan as well as affect associated with mental disorders serious physical health comorbidities including cardiovascular disease, metabolic risk factors such as adiposity and premature mortality. The plausible effects of physical activity toward mental health may be at least partially explained by its potential in modulating hippocampal neurogenesis and synaptic plasticity. Finally, higher levels of physical activity have been consistently associated with a reduced risk of both affective and cognitive disorders.

Physical activity and sleep quality in relation to mental health among college students

Type of study: non-rct observational study

Number of citations: 230

Year: 2019

Authors: A. Ghrouz, M. Noohu, Md Dilshad Manzar, D. Warren Spence, Ahmed S. Bahammam, S. Pandi‑Perumal

Journal: Sleep and Breathing

Journal ranking: Q1

Key takeaways: Higher physical activity levels and better sleep quality are significantly associated with improved mental health among Indian college students.

Abstract: ObjectiveTo examine the associations and interactive effects of physical activity and sleep quality on mental health among Indian college students.MethodA cross-sectional study was conducted among Indian college students. The sociodemographic data and body mass index were obtained from a convenience sample of 617 college students, age range from 18 to 30 years, including both genders (314 men, 51%). All participants completed three questionnaires: the Hospital Anxiety and Depression Scale, the International Physical Activity Questionnaire-Short Form, and the Pittsburgh Sleep Quality Index. Questionnaires were evaluated to ascertain the subjects’ mental health level, physical activity level, and sleep quality. Analyses were conducted with binary logistic regression models.ResultThe mean (± S.D.) anxiety and depression scores were 9.3 ± 4.4 and 7.4 ± 2.5 respectively, with anxiety and depression scores ranging from 0 to 20 and 0–17, respectively.The prevalence of anxiety (30%) was more than that of depression (18%). Out of the total participants, 51% reported having low physical activity levels, and 51% had poor sleep quality. Odds ratio calculations indicated that the participants physical activity levels (moderate and high) were significantly and inversely associated with scores for anxiety (OR = 0.16 and 0.96; p = 0.001) and for depression (OR = 0.11 and 0.96; p = 0.001).The poor sleep quality was significantly positively associated with anxiety (OR = 1.38) and depression OR = 1.58 (p = 0.001).ConclusionMental health problems are common among both male and female college students. Significant associations were found between physical activity levels and sleep quality with mental health.

Physical activity improves mental health

Type of study: non-rct observational study

Number of citations: 10

Year: 2019

Authors: D. Wasserman

Journal: Acta Paediatrica

Journal ranking: Q1

Key takeaways: Adolescents with sufficient physical activity and reduced sedentary behavior are less likely to experience suicidal behavior and have better mental health.

Abstract: An important article from the public health point of view on how lifestyles influence the mental health of adolescents by Khan et al. (1), published in this issue of Acta Paediatrica, shows in a cross-sectional design on a representative sample of adolescents from Bangladesh comprising 2989 students, with a mean age of 14.20 0.99, that suicidal behaviour is associated with insufficient physical activity (PA) and prolonged sedentary behaviour (SB). These findings are consistent with the results published in other studies (2). The PA definition was based on the WHO guideline of 60 minutes or more per day of PA and SB was defined as three or more hours per day. In the Saving and Empowering Young Lives in Europe (SEYLE) study from 11 European countries (3) using similar definitions on a sample of 12 395 adolescents, with a mean age of 14.91 0.90 years, it was shown that 29% of adolescents, who were identified for high-use of internet/TV/video games by spending at least 5 hours per day watching TV, playing video games or surfing the internet for reasons not related to school or work, along with demonstrated SB and reduced sleep, had a high prevalence of suicide attempts (5.9% in comparison with 6.7% in Khan et al.’s Bangladesh study), as well as high levels of subthreshold depression (33.2%) and depression (13.4%) (4). In another article from the SEYLE study (5), a direct association of PA with depressive symptoms, anxiety and well-being was investigated in adolescents with three PA levels categorised as: Most Active pupils (60 minutes + activity on 8–14 days) with a subgroup who reported daily PA; Somewhat Active (60 minutes + activity on 4-7 days in the past 14 days); and Least Active (60 minutes + activity on 0-3 days in the past 14 days). The data showed that only 17.9% of European boys and 10.7% of European girls reached sufficient levels recommended by the WHO of 60 minutes of PA every day. In the Least Active group, there were significantly more girls than boys (34.3% vs 21.2%), and there were significantly more boys than girls (47.7% vs 31.4%) in the Most Active group. Overall, McMahon et al. (5), using the SEYLE data on 11 110 adolescents, showed that PA was negatively correlated with both depressive symptoms and anxiety, and positively correlated with well-being. More frequent PA increased well-being and decreased levels of depressed symptoms and anxiety, for both boys and girls. The results also suggested that increasing activity in the Least Active adolescent group resulted in improvements in well-being, which was clinically meaningful. Those findings are consistent with studies reported elsewhere of children and adolescents in a review by Biddle and Asare (6), as well as with previous studies on adults (7). Longitudinal reports on the association between PA and changes in well-being (8) provides further support for the results found in the crosssectional studies done in Bangladesh (1) and Europe (3). Furthermore, the SEYLE study (5) showed that the lowest levels of anxiety and depression, and the highest levels of well-being were demonstrated among pupils participating in team sports. However, for the boys, participating in any sport, both individual and team, was associated with more positive mental health outcomes on all three measures – anxiety, depression and well-being. This is very important from the public mental health perspective, as it is well known that boys, and also men for that matter, are difficult to motivate and to secure compliance in the pharmacological and psychological treatments of depression and anxiety. There are several explanations for the role of the association between PA and depression, and other mental health problems. The engagement, especially in team sports activities, can lead to better confidence and the development of positive interactions and relationships. On the other hand, there is also the possibility that depression may negatively influence patterns of PA as several symptoms could hinder the involvement in such activities. Since approximately 80% of adolescents worldwide do not achieve 60 minutes + of moderate to vigorous activity each day (9), school-based interventions with the goal of promoting well-being and positive mental health should include frequent PA in the daily school events e.g. during school breaks and in the classroom, as well as engagement in sports after the school day. Emphasising the role of healthy lifestyles, like PA (5) and sufficient sleep (10), for positive mental health should be a focus for parental education and awareness should be increased on the population level.

Physical activity and mental health in children and adolescents: a review of reviews

Type of study: systematic review

Number of citations: 1993

Year: 2011

Authors: S. Biddle, Mavis Asare

Journal: British Journal of Sports Medicine

Journal ranking: Q1

Key takeaways: Physical activity in young people may have small to moderate benefits on mental health, while sedentary screen time is associated with poorer mental health.

Abstract: Objective To synthesise reviews investigating physical activity and depression, anxiety, self-esteem and cognitive functioning in children and adolescents and to assess the association between sedentary behaviour and mental health by performing a brief review. Methods Searches were performed in 2010. Inclusion criteria specified review articles reporting chronic physical activity and at least one mental health outcome that included depression, anxiety/stress, self-esteem and cognitive functioning in children or adolescents. Results Four review articles reported evidence concerning depression, four for anxiety, three for self-esteem and seven for cognitive functioning. Nine primary studies assessed associations between sedentary behaviour and mental health. Physical activity has potentially beneficial effects for reduced depression, but the evidence base is limited. Intervention designs are low in quality, and many reviews include cross-sectional studies. Physical activity interventions have been shown to have a small beneficial effect for reduced anxiety, but the evidence base is limited. Physical activity can lead to improvements in self-esteem, at least in the short term. However, there is a paucity of good quality research. Reviews on physical activity and cognitive functioning have provided evidence that routine physical activity can be associated with improved cognitive performance and academic achievement, but these associations are usually small and inconsistent. Primary studies showed consistent negative associations between mental health and sedentary behaviour. Conclusions Association between physical activity and mental health in young people is evident, but research designs are often weak and effects are small to moderate. Evidence shows small but consistent associations between sedentary screen time and poorer mental health.

Role of Physical Activity on Mental Health and Well-Being: A Review

Type of study: literature review

Number of citations: 310

Year: 2023

Authors: Aditya Mahindru, Pradeep S Patil, V. Agrawal

Journal: Cureus

Journal ranking: brak

Key takeaways: Regular physical activity improves mental health, mood, and quality of life, with potential benefits for managing substance cravings and treating psychotic symptoms.

Abstract: In addition to the apparent physical health benefits, physical activity also affects mental health positively. Physically inactive individuals have been reported to have higher rates of morbidity and healthcare expenditures. Commonly, exercise therapy is recommended to combat these challenges and preserve mental wellness. According to empirical investigations, physical activity is positively associated with certain mental health traits. In nonclinical investigations, the most significant effects of physical exercise have been on self-concept and body image. An attempt to review the current understanding of the physiological and psychological mechanisms by which exercise improves mental health is presented in this review article. Regular physical activity improves the functioning of the hypothalamus-pituitary-adrenal axis. Depression and anxiety appear to be influenced by physical exercise, but to a smaller extent in the population than in clinical patients. Numerous hypotheses attempt to explain the connection between physical fitness and mental wellness. Physical activity was shown to help with sleep and improve various psychiatric disorders. Exercise in general is associated with a better mood and improved quality of life. Physical exercise and yoga may help in the management of cravings for substances, especially in people who may not have access to other forms of therapy. Evidence suggests that increased physical activity can help attenuate some psychotic symptoms and treat medical comorbidities that accompany psychotic disorders. The dearth of literature in the Indian context also indicated that more research was needed to evaluate and implement interventions for physical activity tailored to the Indian context.

Domain-Specific Physical Activity and Mental Health: A Meta-analysis.

Type of study: meta-analysis

Number of citations: 514

Year: 2017

Authors: R. White, Mark Babic, P. Parker, D. Lubans, T. Astell‐Burt, C. Lonsdale

Journal: American journal of preventive medicine

Journal ranking: Q1

Key takeaways: The domain in which physical activity occurs influences the relationship between physical activity and mental health, with work-related physical activity being positively associated with mental ill-health.

Physical activity and prevention of mental health complications: An umbrella review

Type of study: systematic review

Number of citations: 32

Year: 2024

Authors: M. Rahmati, San Lee, D. Yon, S. Lee, Raphael Udeh, Mark McEvoy, Hans Oh, L. Butler, H. Keyes, Y. Barnett, Ai Koyanagi, J. Shin, Lee Smith

Journal: Neuroscience & Biobehavioral Reviews

Journal ranking: Q1

Key takeaways: Higher physical activity levels are significantly associated with reduced risk of depression and anxiety disorders, emphasizing the importance of promoting physical activity in mental health interventions.

Physical Activity and Mental Health in Undergraduate Students

Type of study: non-rct observational study

Number of citations: 53

Year: 2022

Authors: G. Rodríguez-Romo, Jorge Acebes-Sánchez, Sonia García-Merino, María Garrido-Muñoz, Cecilia Blanco-García, I. Diez-Vega

Journal: International Journal of Environmental Research and Public Health

Journal ranking: Q2

Key takeaways: Higher levels of physical activity in undergraduate students, particularly leisure time and commuting, are associated with better mental health, while only moderate levels of occupational physical activity are beneficial.

Abstract: Most research support positive relationships between physical activity and mental health. However, possible moderating variables of these relationships have also been identified, such as age, gender, level of physical activity, and the scope of physical activity. This study aimed to analyze the relationships between physical activity and mental health levels in undergraduate students, assessing whether these associations can change depending on the level of physical activity (low, medium, or high) and the setting (occupational, commuting, or leisure time physical activity) in which it was performed. A descriptive and cross-sectional study was conducted. The sample comprised 847 undergraduate students. Physical activity and mental health were measured by the Global Physical Activity Questionnaire (GPAQv2) and the General Health Questionnaire (GHQ-12). We found relationships between students’ physical activity level and their mental health status. The higher the total physical activity, the better their mental health scores. High levels of commuting and leisure time physical activity is also associated with better mental health, while only moderate levels of occupational physical activity are associated with better mental health status. Regarding the possible associations between physical activity and vulnerability to mental health problems, with the fully adjusted regression model, leisure time and occupational physical activity remain protective of a poor state of mental health. Leisure time physical activity, performed at a high level, and moderate occupational physical activity seems to be the best combination of physical activity to reduce students’ vulnerability to potential mental health problems.

Associations of physical activity with positive mental health: A population-based study

Type of study: non-rct observational study

Number of citations: 76

Year: 2020

Authors: N. Tamminen, J. Reinikainen, K. Appelqvist-Schmidlechner, K. Borodulin, T. Mäki-Opas, Pia Solin

Journal: Mental Health and Physical Activity

Journal ranking: Q1

Key takeaways: Increased physical activity, particularly in leisure time and commuting, is strongly associated with better mental health, emphasizing the importance of physical activity for overall well-being.

The relationship of physical activity to mental health: A 2015 behavioral risk factor surveillance system data analysis.

Type of study: non-rct observational study

Number of citations: 30

Year: 2019

Authors: Noemi Fluetsch, Carly Levy, Lindsay A. Tallon

Journal: Journal of affective disorders

Journal ranking: Q1

Key takeaways: Higher physical activity levels are associated with fewer self-reported days of poor mental health, with aerobic exercise being more beneficial than muscle strengthening exercises.

Physical activity and mental health in children and adolescents: An updated review of reviews and an analysis of causality

Type of study: systematic review

Number of citations: 817

Year: 2019

Authors: S. Biddle, Simone Ciaccioni, G. Thomas, I. Vergeer

Journal: Psychology of Sport and Exercise

Journal ranking: Q1

Key takeaways: Physical activity in children and adolescents is associated with better cognitive health and performance, with the strongest evidence for cognitive functioning and partial evidence for depression.

Physical activity and mental health: evidence is growing

Type of study:

Number of citations: 185

Year: 2016

Authors: S. Biddle

Journal: World Psychiatry

Journal ranking: Q1

Key takeaways: Physical activity, ranging from light to moderate-vigorous, positively impacts mental health, including mood, self-esteem, cognitive function, and depression, with varying preferences for activity types.

Abstract: Physical activity should be viewed as a continuum ranging from virtually no movement at all (e.g., sedentary behaviour or sitting time) through light physical activity (e.g., light ambulation) to moderate‐to‐vigorous physical activity, MVPA (e.g., exercise, playing sports, cycling to work). While it is often MVPA and “exercise” that are considered to be associated with better mental health, we should not rule out the positive changes that can occur from lower down the continuum. It is also important to note that people have widely varying preferences for the types of activity they wish to engage in. Some of the mental health benefits may be associated with doing something people “want to” and enjoy. We should not be too prescriptive, therefore, concerning the types of activity we recommend for mental health. In the expanding literature on physical activity and mental health, researchers have addressed the effects of both single bouts and programs of physical activity. In addition, a wide variety of psychological outcomes have been studied, including effects on mood, self‐esteem, cognitive functioning and decline, depression, and quality of life. “Exercise makes you feel good” is a common assumption and refers to often‐reported psychological effects of single bouts of physical activity, such as walking or structured exercise. While mood enhancement has been well documented, this can be dependent on the intensity of exercise undertaken. While more moderate levels often lead to the reporting of pleasure and positive mood, more intense forms of exercise may lead to displeasure, although such feelings will subside with time after exercise1. Such findings have implications for promoting physical activity. If we want more people to lead physically active lives, it may be better to avoid very high levels of exercise intensity. It is often believed that physical activity, such as sport, can boost self‐esteem. However, the nature of participation will affect whether self‐esteem is elevated or even decreased. It is likely that changes in global self‐esteem through physical activity will be from changes in aspects of the physical self, including improvements in skills and competence, body image, and physical fitness. Indeed, the association between physical activity and global self‐esteem is small (meta‐analytic effect size d=0.23)2, but at the level of physical self‐worth or even body image these associations would expect to increase. The argument that physical activity can positively affect cognitive functioning is a powerful one. This has been used to advocate for more physical activity in schools, as well as in older adults to ameliorate or prevent cognitive decline. A meta‐analysis of randomized controlled trials (RCTs) examining exercise training studies in adults aged 55‐80 years found that exercise was associated with enhanced cognitive functioning, especially for tasks involving more complex executive functioning3. A meta‐analysis of prospective studies found that baseline measures of physical activity predicted the risk of overall dementia and Alzheimer's disease4: the most active groups showed a 28% risk reduction for dementia and 45% risk reduction for Alzheimer's disease compared to the least active. Dishman et al5 assessed whether it is possible to state that there is a causal link between physical activity and cognitive decline. They used the five factors of strength of association, temporal sequencing, consistency, dose‐response, and plausibility. It was concluded that there is increasing evidence suggestive of a causal link between physical activity and reduced risk of cognitive decline. However, there is a great deal of research still needed to increase our confidence that this conclusion is robust. The most widely studied area of physical activity and mental health is that concerning depression. This has been researched as a transient sub‐clinical mood effect or in populations with, or at risk of, clinical depression. For example, Dishman et al5 reported 20‐33% lower odds of depression for active groups in prospective cohort studies. While the evidence has nearly always been suggestive of beneficial effects of physical activity on depression, media coverage, or the promotion of findings by journals, has sometimes been less positive. For example, the BMJ headline in 2001 suggested that exercise was not effective for the treatment of depression. This was based on a meta‐analysis of 14 studies6. Yet, the meta‐analysis showed a large effect size (−1.1) for exercise compared to no‐treatment. The authors stated that the effectiveness of exercise in reducing symptoms of depression “cannot be determined because of lack of good quality research on clinical populations with adequate follow up”. However, the results were similar to other therapies for depression. The results of the TREAD trial7 also led to media‐reported doubt about exercise for depression. This was a two‐arm RCT with both arms receiving usual general practitioner care for depression and the intervention arm also having additional sessions with a physical activity counsellor. Both groups had decreased depression scores over time, but there was no advantage to the physical activity intervention arm. The authors noted that “clinicians and policy makers should alert people with depression that advice to increase physical activity will not increase their chances of recovery from depression”. This conclusion, however, may be misguided, because there was no waitlist or a no‐treatment control group to compare to. Physical activity has been used in interventions designed to reduce alcohol and other drug dependence and enhance smoking cessation. While the evidence is complex, it does support a role for physical activity in populations who often have low fitness or comorbidities such as depression. In addition, there is extensive evidence linking physical activity with improved sleep outcomes8. Strong compulsions to exercise, sometimes referred to as exercise “addiction” or “dependence” have been noted in psychiatry9. Exercise dependence is characterized by a frequency of at least one exercise session per day, a stereotypical daily or weekly pattern of exercise, recognition of exercise being compulsive, and of withdrawal symptoms if there is an interruption to the normal routine, and reinstatement of the normal pattern within one or two days of a stoppage. The population prevalence of exercise dependence, however, is likely to be very low. To sum up, physical activity is a major health behaviour strongly recommended for the prevention and treatment of several non‐communicable diseases. The behaviour itself is multi‐faceted and may comprise less sitting, more light‐intensity activity, as well as traditional MVPA. The evidence concerning mental health effects is extensive, but still growing. Associations are clear, but more needs to be known about clinical effectiveness for some population groups and conditions, as well as on the underlying causal mechanisms responsible for what ancient societies have always been aware of, i.e., that “movement is good for you” and sloth is associated with poor mental and physical health. Stuart Biddle Institute of Sport, Exercise & Active Living, Victoria University, Melbourne, Australia

Physical activity and mental health: the association between exercise and mood.

Type of study: literature review

Number of citations: 633

Year: 2005

Authors: M. A. Peluso, L. G. D. Guerra de Andrade

Journal: Clinics

Journal ranking: Q2

Key takeaways: Physical activity can improve mood and prevent depressive and anxiety disorders, but excessive exercise and overtraining syndrome can also negatively impact mental health.

Abstract: Physical activity is an important public health tool used in the treatment and prevention of various physical diseases, as well as in the treatment of some psychiatric diseases such as depressive and anxiety disorders. However, studies have shown that in addition to its beneficial effects, physical activity can also be associated with impaired mental health, being related to disturbances like 'excessive exercise' and 'overtraining syndrome'. Although the number of reports of the effects of physical activity on mental health is steadily increasing, these studies have not yet identified the mechanisms involved in the benefits and dangers to mental health associated with exercise. This article reviews the information available regarding the relationship between physical activity and mental health, specifically addressing the association between exercise and mood.

Relationship between physical activity and individual mental health after traumatic events: a systematic review

Type of study: systematic review

Number of citations: 26

Year: 2023

Authors: Zhifeng Wang, Bing Jiang, Xingtong Wang, Zhixiang Li, Dongxu Wang, Haihong Xue, Dongmei Wang

Journal: European Journal of Psychotraumatology

Journal ranking: Q1

Key takeaways: Higher levels of physical activity are positively correlated with mental resilience and well-being after traumatic events, and can be used to improve mental health after such events.

Abstract: ABSTRACT Background: Traumatic events can cause social tension, anxiety, panic and other psychological crises, and can even cause post-traumatic stress disorder (PTSD) and suicide. Physical activity has a good role in promoting mental health, and has a great application prospect in individual psychological intervention after traumatic events. However, no systematic review of the relationship between physical activity and individual mental health after traumatic events affecting many people has been published so far, which makes it impossible for people to understand the research status in this field from a holistic perspective. Objective: This review explores the relationship between physical activity and individual psychology, physiology, subjective quality of life and well-being after traumatic events, so as to provide some valuable clues or enlightenment for individual psychological intervention after traumatic events. Method: Relevant literature was searched in five databases, summarised, sorted and studied. Results: Thirty-three study papers were included in this review, the main study findings include: (1) Physical activity is positively correlated with individual mental resilience and subjective well-being after traumatic events, and negatively correlated with anxiety, depression, tension and PTSD. (2) Individuals with higher levels of physical activity have better mental health status after traumatic events than those who do not regularly engage in physical activity. (3) Physical activity can promote sleep quality, self-efficacy, subjective quality of life and various physiological functions of those experiencing traumatic events. (4) Physical activity (including exercise) is regarded as one of the preferred nursing measures to buffer against mental stress and maintain physical and mental health for those experiencing traumatic events. Conclusion: The level of physical activity is positively correlated with individual physical and mental health before and after traumatic events. Physical activity can be used as one of the effective measures to improve individual mental health after traumatic events.

Role of Physical Activity and Sedentary Behavior in the Mental Health of Preschoolers, Children and Adolescents: A Systematic Review and Meta-Analysis

Type of study: meta-analysis

Number of citations: 842

Year: 2019

Authors: M. Rodriguez-Ayllon, C. Cadenas-Sánchez, F. Estévez-López, N. E. Muñoz, J. Mora-Gonzalez, J. Migueles, P. Molina-García, H. Henriksson, Alejandra Mena-Molina, V. Martínez-Vizcaíno, A. Catena, M. Löf, K. Erickson, D. Lubans, F. Ortega, I. Esteban‐Cornejo

Journal: Sports Medicine

Journal ranking: Q1

Key takeaways: Physical activity interventions can improve adolescents' mental health, and promoting physical activity while reducing sedentary behavior may protect mental health in children and adolescents.

Abstract: BackgroundEvidence suggests that participation in physical activity may support young people’s current and future mental health. Although previous reviews have examined the relationship between physical activity and a range of mental health outcomes in children and adolescents, due to the large increase in published studies there is a need for an update and quantitative synthesis of effects.ObjectivesThe objectives of this study were to determine the effect of physical activity interventions on mental health outcomes by conducting a systematic review and meta-analysis, and to systematically synthesize the observational evidence (both longitudinal and cross-sectional studies) regarding the associations between physical activity and sedentary behavior and mental health in preschoolers (2–5 years of age), children (6–11 years of age) and adolescents (12–18 years of age).MethodsA systematic search of the PubMed and Web of Science electronic databases was performed from January 2013 to April 2018, by two independent researchers. Meta-analyses were performed to examine the effect of physical activity on mental health outcomes in randomized controlled trials (RCTs) and non-RCTs (i.e. quasi-experimental studies). A narrative synthesis of observational studies was conducted. Studies were included if they included physical activity or sedentary behavior data and at least one psychological ill-being (i.e. depression, anxiety, stress or negative affect) or psychological well-being (i.e. self-esteem, self-concept, self-efficacy, self-image, positive affect, optimism, happiness and satisfaction with life) outcome in preschoolers, children or adolescents.ResultsA total of 114 original articles met all the eligibility criteria and were included in the review (4 RCTs, 14 non-RCTs, 28 prospective longitudinal studies and 68 cross-sectional studies). Of the 18 intervention studies, 12 (3 RCTs and 9 non-RCTs) were included in the meta-analysis. There was a small but significant overall effect of physical activity on mental health in children and adolescents aged 6–18 years (effect size 0.173, 95% confidence interval 0.106–0.239, p < 0.001, percentage of total variability attributed to between-study heterogeneity [I^2] = 11.3%). When the analyses were performed separately for children and adolescents, the results were significant for adolescents but not for children. Longitudinal and cross-sectional studies demonstrated significant associations between physical activity and lower levels of psychological ill-being (i.e. depression, stress, negative affect, and total psychological distress) and greater psychological well-being (i.e. self-image, satisfaction with life and happiness, and psychological well-being). Furthermore, significant associations were found between greater amounts of sedentary behavior and both increased psychological ill-being (i.e. depression) and lower psychological well-being (i.e. satisfaction with life and happiness) in children and adolescents. Evidence on preschoolers was nearly non-existent.ConclusionsFindings from the meta-analysis suggest that physical activity interventions can improve adolescents’ mental health, but additional studies are needed to confirm the effects of physical activity on children’s mental health. Findings from observational studies suggest that promoting physical activity and decreasing sedentary behavior might protect mental health in children and adolescents. PROSPERO Registration Number: CRD42017060373.

Up for Debate: Does Regular Physical Activity Really Improve Mental Health?

Type of study:

Number of citations: 2

Year: 2024

Authors: Eduardo E. Bustamante, Angelique G. Brellenthin, David R Brown, Patrick J O'Connor

Journal: Medicine & Science in Sports & Exercise

Journal ranking: Q1

Key takeaways: Regular physical activity is associated with less depression and anxiety, but the mechanisms and effects for those without mental disorders are unclear.

Abstract: ABSTRACT Physical activity is frequently touted as beneficial for mental health. This article, based on a 2023 ACSM colloquium, highlights key strengths and limitations of the evidence regarding physical activity and mental health from three perspectives: epidemiological studies, randomized controlled trial experiments, and investigations that explicitly consider the potential role that contextual factors, such as the social climate in which physical activity is completed, can play in physical activity–mental health interactions. A large body of epidemiological evidence supports that regular leisure time physical activity is associated with less depression and anxiety. Higher amounts of physical activity are often associated with fewer depressive symptoms, but there may be a dose–response point where for some people more is not better but can plateau or even worsen. Epidemiological evidence is emerging but currently inadequate to support associations between mental health and occupational, transportation/active commuting, or domestic/household physical activity types. A large body of randomized controlled trials, typically small, short duration and conducted with samples biased toward middle-to-higher socioeconomic status Whites, supports that the adoption of regular exercise improves aspects of mental health; however, the mechanisms are unclear and for those without mental disorders the mean effects are small. Mental health benefits of exercise may be partially a placebo response or result from contextual factors surrounding exercise programs. A small body of evidence supports that contextual elements, such as the program implementation quality and social environment, can influence the mental health outcomes associated with physical activity programs, but the evidence is currently inadequate to identify which contextual variables have consistent moderate or larger effects. Greater progress will be made in this area when research designs are expanded to include consideration of the potential influence of contextual factors on relationships between physical activity and mental health.

The influence of physical activity on mental well-being

Type of study: systematic review

Number of citations: 1260

Year: 1999

Authors: K. Fox

Journal: Public Health Nutrition

Journal ranking: Q2

Key takeaways: Moderate regular exercise effectively treats depression and anxiety, improves mood states, and enhances overall mental well-being in the general population.

Abstract: Abstract Objective: The case for exercise and health has primarily been made on its impact on diseases such coronary heart disease, obesity and diabetes. However, there is a very high cost attributed to mental disorders and illness and in the last 15 years there has been increasing research into the role of exercise a) in the treatment of mental health, and b) in improving mental well-being in the general population. There are now several hundred studies and over 30 narrative or meta-analytic reviews of research in this field. These have summarised the potential for exercise as a therapy for clinical or subclinical depression or anxiety, and the use of physical activity as a means of upgrading life quality through enhanced self-esteem, improved mood states, reduced state and trait anxiety, resilience to stress, or improved sleep. The purpose of this paper is to a) provide an updated view of this literature within the context of public health promotion and b) investigate evidence for physical activity and dietary interactions affecting mental well-being. Design: Narrative review and summary. Conclusions: Sufficient evidence now exists for the effectiveness of exercise in the treatment of clinical depression. Additionally, exercise has a moderate reducing effect on state and trait anxiety and can improve physical self-perceptions and in some cases global self-esteem. Also there is now good evidence that aerobic and resistance exercise enhances mood states, and weaker evidence that exercise can improve cognitive function (primarily assessed by reaction time) in older adults. Conversely, there is little evidence to suggest that exercise addiction is identifiable in no more than a very small percentage of exercisers. Together, this body of research suggests that moderate regular exercise should be considered as a viable means of treating depression and anxiety and improving mental well-being in the general public.

Is physical activity in natural environments better for mental health than physical activity in other environments?

Type of study: non-rct experimental

Number of citations: 414

Year: 2013

Authors: R. Mitchell

Journal: Social science & medicine

Journal ranking: Q1

Key takeaways: Physical activity in natural environments is associated with a lower risk of poor mental health compared to physical activity in non-natural environments.

The relation of physical activity and exercise to mental health.

Type of study: literature review

Number of citations: 549

Year: 1985

Authors: Taylor Cb, Sallis Jf, R. Needle

Journal: Public health reports

Journal ranking: Q1

Key takeaways: Physical activity and exercise may alleviate mild to moderate depression symptoms, improve self-image, social skills, cognitive functioning, reduce anxiety, and alter coronary-prone behavior.

Abstract: Mental disorders are of major public health significance. It has been claimed that vigorous physical activity has positive effects on mental health in both clinical and nonclinical populations. This paper reviews the evidence for this claim and provides recommendations for future studies. The strongest evidence suggests that physical activity and exercise probably alleviate some symptoms associated with mild to moderate depression. The evidence also suggests that physical activity and exercise might provide a beneficial adjunct for alcoholism and substance abuse programs; improve self-image, social skills, and cognitive functioning; reduce the symptoms of anxiety; and alter aspects of coronary-prone (Type A) behavior and physiological response to stressors. The effects of physical activity and exercise on mental disorders, such as schizophrenia, and other aspects of mental health are not known. Negative psychological effects from exercise have also been reported. Recommendations for further research on the effects of physical activity and exercise on mental health are made.