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      Meta-Analyses of the Effects of Habitual Running on Indices of Health in Physically Inactive Adults

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          Abstract

          Background

          In order to implement running to promote physical activity, it is essential to quantify the extent to which running improves health.

          Objective

          The aim was to summarise the literature on the effects of endurance running on biomedical indices of health in physically inactive adults.

          Data Sources

          Electronic searches were conducted in October 2014 on PubMed, Embase, CINAHL, SPORTDiscus, PEDro, the Cochrane Library and LILACS, with no limits of date and language of publication.

          Study Selection

          Randomised controlled trials (with a minimum of 8 weeks of running training) that included physically inactive but healthy adults (18–65 years) were selected. The studies needed to compare intervention (i.e. endurance running) and control (i.e. no intervention) groups.

          Study Appraisal and Synthesis Methods

          Two authors evaluated study eligibility, extracted data, and assessed risk of bias; a third author resolved any uncertainties. Random-effects meta-analyses were performed to summarise the estimates for length of training and sex. A dose-response analysis was performed with random-effects meta-regression in order to investigate the relationship between running characteristics and effect sizes.

          Results

          After screening 22,380 records, 49 articles were included, of which 35 were used to combine data on ten biomedical indices of health. On average the running programs were composed of 3.7 ± 0.9 sessions/week, 2.3 ± 1.0 h/week, 14.4 ± 5.4 km/week, at 60–90 % of the maximum heart rate, and lasted 21.5 ± 16.8 weeks. After 1 year of training, running was effective in reducing body mass by 3.3 kg [95 % confidence interval (CI) 4.1–2.5], body fat by 2.7 % (95 % CI 5.1–0.2), resting heart rate by 6.7 min −1 (95 % CI 10.3–3.0) and triglycerides by 16.9 mg dl −1 (95 % CI 28.1–5.6). Also, running significantly increased maximal oxygen uptake ( VO 2max) by 7.1 ml min −1 kg −1 (95 % CI 5.0–9.1) and high-density lipoprotein (HDL) cholesterol by 3.3 mg dl −1 (95 % CI 1.2–5.4). No significant effect was found for lean body mass, body mass index, total cholesterol and low-density lipoprotein cholesterol after 1 year of training. In the dose-response analysis, larger effect sizes were found for longer length of training.

          Limitations

          It was only possible to combine the data of ten out the 161 outcome measures identified. Lack of information on training characteristics precluded a multivariate model in the dose-response analysis.

          Conclusions

          Endurance running was effective in providing substantial beneficial effects on body mass, body fat, resting heart rate, VO 2max, triglycerides and HDL cholesterol in physically inactive adults. The longer the length of training, the larger the achieved health benefits. Clinicians and health authorities can use this information to advise individuals to run, and to support policies towards investing in running programs.

          Electronic supplementary material

          The online version of this article (doi:10.1007/s40279-015-0359-y) contains supplementary material, which is available to authorized users.

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          Most cited references68

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          Dose response between physical activity and risk of coronary heart disease: a meta-analysis.

          No reviews have quantified the specific amounts of physical activity required for lower risks of coronary heart disease when assessing the dose-response relation. Instead, previous reviews have used qualitative estimates such as low, moderate, and high physical activity. We performed an aggregate data meta-analysis of epidemiological studies investigating physical activity and primary prevention of CHD. We included prospective cohort studies published in English since 1995. After reviewing 3194 abstracts, we included 33 studies. We used random-effects generalized least squares spline models for trend estimation to derive pooled dose-response estimates. Among the 33 studies, 9 allowed quantitative estimates of leisure-time physical activity. Individuals who engaged in the equivalent of 150 min/wk of moderate-intensity leisure-time physical activity (minimum amount, 2008 U.S. federal guidelines) had a 14% lower coronary heart disease risk (relative risk, 0.86; 95% confidence interval, 0.77 to 0.96) compared with those reporting no leisure-time physical activity. Those engaging in the equivalent of 300 min/wk of moderate-intensity leisure-time physical activity (2008 U.S. federal guidelines for additional benefits) had a 20% (relative risk, 0.80; 95% confidence interval, 0.74 to 0.88) lower risk. At higher levels of physical activity, relative risks were modestly lower. People who were physically active at levels lower than the minimum recommended amount also had significantly lower risk of coronary heart disease. There was a significant interaction by sex (P=0.03); the association was stronger among women than men. These findings provide quantitative data supporting US physical activity guidelines that stipulate that "some physical activity is better than none" and "additional benefits occur with more physical activity."
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            Physical activity and performance at school: a systematic review of the literature including a methodological quality assessment.

            To describe the prospective relationship between physical activity and academic performance. Prospective studies were identified from searches in PubMed, PsycINFO, Cochrane Central, and Sportdiscus from 1990 through 2010. We screened the titles and abstracts for eligibility, rated the methodological quality of the studies, and extracted data. Studies had to report at least 1 physical activity or physical fitness measurement during childhood or adolescence. Studies had to report at least 1 academic performance or cognition measure during childhood or adolescence. We identified 10 observational and 4 intervention studies. The quality score of the studies ranged from 22% to 75%. Two studies were scored as high quality. Methodological quality scores were particularly low for the reliability and validity of the measurement instruments. Based on the results of the best-evidence synthesis, we found evidence of a significant longitudinal positive relationship between physical activity and academic performance. Participation in physical activity is positively related to academic performance in children. Because we found only 2 high-quality studies, future high-quality studies are needed to confirm our findings. These studies should thoroughly examine the dose-response relationship between physical activity and academic performance as well as explanatory mechanisms for this relationship.
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              What are the Main Running-Related Musculoskeletal Injuries?

              Background Musculoskeletal injuries occur frequently in runners and despite many studies about running injuries conducted over the past decades it is not clear in the literature what are the main running-related musculoskeletal injuries (RRMIs). Objective The aim of this study is to systematically review studies on the incidence and prevalence of the main specific RRMIs. Methods An electronic database search was conducted using EMBASE (1947 to October 2011), MEDLINE (1966 to October 2011), SPORTDiscus™ (1975 to October 2011), the Latin American and Caribbean Center on Health Sciences Information (LILACS) [1982 to October 2011] and the Scientific Electronic Library Online (SciELO) [1998 to October 2011] with no limits of date or language of publication. Articles that described the incidence or prevalence rates of RRMIs were considered eligible. Studies that reported only the type of injury, anatomical region or incomplete data that precluded interpretation of the incidence or prevalence rates of RRMIs were excluded. We extracted data regarding bibliometric characteristics, study design, description of the population of runners, RRMI definition, how the data of RRMIs were collected and the name of each RRMI with their rates of incidence or prevalence. Separate analysis for ultra-marathoners was performed. Among 2924 potentially eligible titles, eight studies (pooled n = 3500 runners) were considered eligible for the review. In general, the articles had moderate risk of bias and only one fulfilled less than half of the quality criteria established. Results A total of 28 RRMIs were found and the main general RRMIs were medial tibial stress syndrome (incidence ranging from 13.6% to 20.0%; prevalence of 9.5%), Achilles tendinopathy (incidence ranging from 9.1% to 10.9%; prevalence ranging from 6.2% to 9.5%) and plantar fasciitis (incidence ranging from 4.5% to 10.0%; prevalence ranging from 5.2% to 17.5%). The main ultra-marathon RRMIs were Achilles tendinopathy (prevalence ranging from 2.0% to 18.5%) and patellofemoral syndrome (prevalence ranging from 7.4% to 15.6%). Conclusion This systematic review provides evidence that medial tibia stress syndrome, Achilles tendinopathy and plantar fasciitis were the main general RRMIs, while Achilles tendinopathy and patellofemoral syndrome were the most common RRMIs for runners who participated in ultra-marathon races.
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                Author and article information

                Contributors
                l.hespanhol@outlook.com
                pillayjd@dut.ac.za
                w.vanmechelen@vumc.nl
                +31 20444969 , e.verhagen@vumc.nl
                Journal
                Sports Med
                Sports Med
                Sports Medicine (Auckland, N.z.)
                Springer International Publishing (Cham )
                0112-1642
                1179-2035
                16 July 2015
                16 July 2015
                2015
                : 45
                : 10
                : 1455-1468
                Affiliations
                [ ]Department of Public and Occupational Health and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
                [ ]Department of Basic Medical Sciences, Durban University of Technology, PO Box 1334, Durban, 4001 South Africa
                Author information
                http://orcid.org/0000-0001-9227-8234
                Article
                359
                10.1007/s40279-015-0359-y
                4579257
                26178328
                fc0bca46-001c-4163-b7bf-5e3830ad202f
                © The Author(s) 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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                © Springer International Publishing Switzerland 2015

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