Which Factor Is More Relevant to the Effectiveness of the Cognitive Intervention? A Meta-Analysis of Randomized Controlled Trials of Cognitive Training on Symptoms and Executive Function Behaviors of Children With Attention Deficit Hyperactivity Disorder

Objective: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by developmentally inappropriate inattention, hyperactivity, and impulsivity. Multiple cognitive training appeared to be more effective than working memory training, but the evidence remains insufficient, particularly for the subgroup symptoms and executive function behaviors at home. Further analysis of the impact of factors on the effectiveness would facilitate the development of cognitive training.Methods: We searched PubMed, Cochrane Library, Psyche, Embase, Chinese Biomedical Literature Database, CNKI, and Weifang Database, and included randomized controlled trials (RCTs) of children with ADHD undergoing cognitive intervention. Metaanalysis and univariate metaregression were performed by STATE. The risk of bias was assessed with the Cochrane risk of bias tool 2.0 by the two investigators separately. This study was registered with INPLASY, number INPLASY202140065.Results: We included 17 RCTs in the systematic review, with a combined 1,075 participants. For metaanalyses of both subgroups of ADHD symptoms and the executive function behaviors, the test of published bias failed to reach the p < 0.05 level. When all of the training are considered together, cognitive training can improve the presentation of inattention symptoms [SMD = −0.390, 95%CI (−0.675, −0.104)] and executive function behaviors (SMD = −0.319, 95%CI (−0.527, −0.111)]. In the subgroup analysis, the effects of working memory training on both presentations were not statistically significant. In contrast, the multiple cognitive training had significant effects on the presentation of inattention symptoms [SMD = −0.507, 95% CI (−0.722, −0.292)], hyperactivity/impulsivity [SMD = −0.305, 95% CI (−0.518, −0.09)], and the executive function behaviors [SMD = −0.499, 95%CI (−0.707, −0.290)]. In addition, metaregression analysis showed that only training frequency did significantly impact the symptoms of ADHD and the executive function behaviors.Conclusion: This study showed that improvements in symptoms and executive function behaviors were related to the domains of cognitive intervention. The findings suggest that multiple domains of cognitive training and moderate training frequency may have wider clinical benefits. All the above results highlight further research in refining the executive functions of children with ADHD and developing individually tailored cognitive intervention on homes based for children with vulnerable executive functions.Systematic Review Registration: [http://inplasy.com/], [INPLASY202140065].

Equal-Volume Strength Training With Different Training Frequencies Induces Similar Muscle Hypertrophy and Strength Improvement in Trained Participants

The main goal of the current study was to compare the effects of volume-equated training frequency on gains in muscle mass and strength. In addition, we aimed to investigate whether the effect of training frequency was affected by the complexity, concerning the degrees of freedom, of an exercise. Participants were randomized to a moderate training frequency group (two weekly sessions) or high training frequency group (four weekly sessions). Twenty-one participants (male: 11, female: 10, age: 25.9 ± 4.0) completed the 9-week whole-body progressive heavy resistance training intervention with moderate (n = 13) or high (n = 8) training frequency. Whole-body and regional changes in lean mass were measured using dual-energy x-ray absorptiometry, while the vastus lateralis thickness was measured by ultrasound. Changes in muscle strength were measured as one repetition maximum for squat, hack squat, bench press, and chest press. No differences between groups were observed for any of the measures of muscle growth or muscle strength. Muscle strength increased to a greater extent in hack squat and chest press than squat and bench press for both moderate (50 and 21% vs. 19 and 14%, respectively) and high-frequency groups (63 and 31% vs. 19 and 16%, respectively), with no differences between groups. These results suggest that training frequency is less decisive when weekly training volume is equated. Further, familiarity with an exercise seems to be of greater importance for strength adaptations than the complexity of the exercise.

Water Polo Performance Classification Based on the Functional Test for Agility Performance: A Long-Term Training Tool

Background: Water polo is an open-skilled team sport in which agility is important. Objective: This study aimed to propose a water polo player classification based on the Functional Test for Agility Performance. Methods: A total of 78 male water polo players of different competition levels (7.7% regional, 52.5% national and 39.7% international), years of training (6.7 ± 4.5; 2-25 years), weekly training frequency (6.1 ± 2.1; 2-12) and age (18.1 ± 4.3; 12-36) were evaluated in the Functional Test for Agility Performance. Hierarchical Cluster Analysis was used in five levels to classify water polo player performance. Results: The players were classified based on the Functional Test for Agility Performance as excellent (≤ 3.22 s), very good (3.23-4.48 s); good (4.49-4.76 s); under development (4.77-5.11 s) and learning (≥ 5.12 s). Age, years of training, and weekly training frequency showed a decreasing trend from Gr1 to Gr4. Athletes at the international level ranked primarily in the best performing groups (Gr1 and Gr2, n = 30), the ones at the national level in the intermediate groups (Gr2, Gr3 and Gr4; n = 41), with a higher concentration in Gr2, and those at regional level mainly in Gr4 (n = 4). Conclusion: This classification proposal is expected to be useful as a tool to evaluate the training of athletes of different competition levels as well as to follow up on water polo athletes in long-term training.

Effects of Different 16-Week Exercise Interventions on Bone Mineral Density of Sedentary Older Women

Multicomponent exercise that includes both resistance and aerobic training is recommended to prevent loss of bone mineral density (BMD) in postmenopausal women. However, optimal training frequency has not been determined. Sixty-three non-osteoporotic sedentary women ages 60y and older were randomized to one of three exercise groups for sixteen weeks: 1) one resistance and one aerobic session per week, 2) two resistance and two aerobic sessions per week, or 3) three resistance and three aerobic sessions per week. Resistance exercise included supervised sessions on weight machines, and aerobic exercise was treadmill walking. BMD of the hip and lumbar spine (L1-L4) was assessed by dual energy X-ray absorptiometry (Prodigy, GE Medical Systems Lunar, Madison, WI, software version 6.10.029), and z scores were calculated from a reference population adjusted for age and sex. Among the total cohort with BMD measurements at week 16 (n=58; 83% white), z scores improved for the trochanter, Ward’s triangle, total hip, L1 and L4. Within-group comparisons showed improvement at the trochanter, total hip, and L1 for group 2 only, while only group 1 demonstrated an increase at L4 (p<0.05 for all). However, no time-by-group interactions were observed. Sixteen weeks of combined resistance and aerobic training is effective for improving BMD of older adult women. Results suggest training frequency of two sessions per week may be optimal. Postmenopausal women should be encouraged to do aerobic exercise such as walking plus resistance training at least once weekly to prevent osteoporosis.

Compatibility of Concurrent Aerobic and Strength Training for Skeletal Muscle Size and Function: An Updated Systematic Review and Meta-Analysis

Background Both athletes and recreational exercisers often perform relatively high volumes of aerobic and strength training simultaneously. However, the compatibility of these two distinct training modes remains unclear. Objective This systematic review assessed the compatibility of concurrent aerobic and strength training compared with strength training alone, in terms of adaptations in muscle function (maximal and explosive strength) and muscle mass. Subgroup analyses were conducted to examine the influence of training modality, training type, exercise order, training frequency, age, and training status. Methods A systematic literature search was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. PubMed/MEDLINE, ISI Web of Science, Embase, CINAHL, SPORTDiscus, and Scopus were systematically searched (12 August 2020, updated on 15 March 2021). Eligibility criteria were as follows. Population: healthy adults of any sex and age; Intervention: supervised concurrent aerobic and strength training for at least 4 weeks; Comparison: identical strength training prescription, with no aerobic training; Outcome: maximal strength, explosive strength, and muscle hypertrophy. Results A total of 43 studies were included. The estimated standardised mean differences (SMD) based on the random-effects model were − 0.06 (95% confidence interval [CI] − 0.20 to 0.09; p = 0.446), − 0.28 (95% CI − 0.48 to − 0.08; p = 0.007), and − 0.01 (95% CI − 0.16 to 0.18; p = 0.919) for maximal strength, explosive strength, and muscle hypertrophy, respectively. Attenuation of explosive strength was more pronounced when concurrent training was performed within the same session (p = 0.043) than when sessions were separated by at least 3 h (p > 0.05). No significant effects were found for the other moderators, i.e. type of aerobic training (cycling vs. running), frequency of concurrent training (> 5 vs. < 5 weekly sessions), training status (untrained vs. active), and mean age (< 40 vs. > 40 years). Conclusion Concurrent aerobic and strength training does not compromise muscle hypertrophy and maximal strength development. However, explosive strength gains may be attenuated, especially when aerobic and strength training are performed in the same session. These results appeared to be independent of the type of aerobic training, frequency of concurrent training, training status, and age. PROSPERO: CRD42020203777.

Training frequency for educating schoolchildren in basic life support: very brief 4-month rolling-refreshers versus annual retraining—a 2-year prospective longitudinal trial

ObjectiveTo compare the effectiveness of 4-month rolling-refreshers and annual retraining in basic life support (BLS) on a sample of schoolchildren.DesignProspective longitudinal trial.Setting and participantsFour hundred and seventy-two schoolchildren (8–12 years old).InterventionsSchoolchildren were instructed in BLS and then split into the following three groups: control group (CG), standard group (SG) and rolling-refresher group (RRG). Their BLS skills were assessed within 1 week (T1) and 2 years later (T2). Moreover, CG did not receive any additional training; SG received one 50 min retraining session 1 year later; RRG participated in very brief (5 min) rolling-refreshers that were carried out every 4 months.Primary and secondary outcomesHands-on skills of BLS sequence and cardiopulmonary resuscitation.ResultsBLS sequence performance was similar in all groups at T1, but SG and RRG followed the steps of the protocol in more proportion than CG at T2. When compared at T2, RRG showed higher proficiency than SG in checking safety, checking response, opening the airway and alerting emergency medical services. In addition, although the mean resuscitation quality was low in all groups, RRG participants reached a higher percentage of global quality cardiopulmonary resuscitation (CG: 16.4±24.1; SG: 25.3±28.8; RRG: 29.9%±29.4%), with a higher percentage of correct chest compressions by depth (CG: 3.9±11.8; SG: 10.8±22.7; RRG: 15.5±26.1 mm).ConclusionsIn 8-to-12-year-old schoolchildren, although annual 50 min retraining sessions help to maintain BLS performance, 4-month very brief rolling-refreshers were shown to be even more effective. Thus, we recommend implementing baseline BLS training at schools, with subsequently brief rolling-refreshers.

The Effect of Aerobic Exercise Training Frequency on Arterial Stiffness in a Hyperglycemic State in Middle-Aged and Elderly Females

The frequency of aerobic exercise training in reducing the increase in arterial stiffness during acute hyperglycemia, a risk factor for cardiovascular disease, is unknown. The aim of the study was to determine the aerobic exercise training frequency on arterial stiffness in a hyperglycemic state in middle-aged and elderly females. Twenty healthy elderly people were randomly assigned to a two-times-a-week (T2, n = 10) and four-times-a-week (T4, n = 10) exercise group. All participants exercised for 35 min per session, which consisted of jogging exercises with a heart rate intensity of 65%. Brachial-ankle (ba), and heart-brachial (hb) pulse wave velocity (PWV) were measured before, 4 and 8 weeks after intervention; before the oral ingestion of 75-g of glucose; and 30, 60, and 90 min after ingestion. The baPWV before and 4 weeks after the intervention increased in both groups (p < 0.05), but only increased 8 weeks after intervention in the T2 group. hbPWV was unchanged before, 4 and 8 weeks after intervention in both groups. These findings show that frequent aerobic exercise suppresses the increase in arterial stiffness following glucose intake. The results of this study can be used to support the implementation of exercise programs for middle-aged and elderly patients.