International Journal of Environmental Research and Public Health

Research

11 pages, 776 KiB

Open AccessArticle

High Intensity Training Is an Effective Modality to Improve Long-Term Disability and Exercise Capacity in Chronic Nonspecific Low Back Pain: A Randomized Controlled Trial

by Jonas Verbrugghe, Dominique Hansen, Christophe Demoulin, Jeanine Verbunt, Nathalie Anne Roussel and Annick Timmermans

Int. J. Environ. Res. Public Health 2021, 18(20), 10779; https://doi.org/10.3390/ijerph182010779 - 14 Oct 2021

Cited by 13 | Viewed by 4657

Abstract

Previous research indicates that high intensity training (HIT) is a more effective exercise modality, as opposed to moderate intensity training (MIT), to improve disability and physical performance in persons with chronic nonspecific low back pain (CNSLBP). However, it is unclear how well benefits [...] Read more.

Previous research indicates that high intensity training (HIT) is a more effective exercise modality, as opposed to moderate intensity training (MIT), to improve disability and physical performance in persons with chronic nonspecific low back pain (CNSLBP). However, it is unclear how well benefits are maintained after intervention cessation. This study aimed to evaluate the long-term effectiveness of HIT on disability, pain intensity, patient-specific functioning, exercise capacity, and trunk muscle strength, and to compare the long-term effectiveness of HIT with MIT in persons with CNSLBP. Persons with CNSLBP (n = 35) who participated in a randomized controlled trial comparing effects of an HIT versus MIT intervention (24 sessions/12 weeks) were included for evaluation at baseline (PRE), directly after (POST), and six months after program finalization (FU) on disability, pain intensity, exercise capacity, patient-specific functioning, and trunk muscle strength. A general linear model was used to evaluate PRE-FU and POST-FU deltas of these outcome measures in each group (time effects) and differences between HIT and MIT (interaction effects). Ultimately, twenty-nine participants (mean age = 44.1 year) were analysed (HIT:16; MIT:13). Six participants were lost to follow-up. At FU, pain intensity, disability, and patient-specific functioning were maintained at the level of POST (which was significant from PRE, p < 0.05) in both groups. However, HIT led to a greater conservation of lowered disability and improved exercise capacity when compared with MIT (p < 0.05). HIT leads to a greater maintenance of lowered disability and improved exercise capacity when compared to MIT six months after cessation of a 12-week supervised exercise therapy intervention, in persons with CNSLBP. Full article

(This article belongs to the Special Issue Physical Activity, Physical Fitness, and Exercise Interventions for Preserving Human Health and Preventing and Treating Chronic Conditions across the Lifespan)

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9 pages, 503 KiB

Open AccessFeature PaperArticle

Examination of Construct Validity and Criterion-Related Validity of the German Motor Test in Egyptian Schoolchildren

by Osama Abdelkarim, Julian Fritsch, Darko Jekauc and Klaus Bös

Int. J. Environ. Res. Public Health 2021, 18(16), 8341; https://doi.org/10.3390/ijerph18168341 - 6 Aug 2021

Cited by 5 | Viewed by 2156

Abstract

Physical fitness is an indicator for children’s public health status. Therefore, the aim of this study was to examine the construct validity and the criterion-related validity of the German motor test (GMT) in Egyptian schoolchildren. A cross-sectional study was conducted with a total [...] Read more.

Physical fitness is an indicator for children’s public health status. Therefore, the aim of this study was to examine the construct validity and the criterion-related validity of the German motor test (GMT) in Egyptian schoolchildren. A cross-sectional study was conducted with a total of 931 children aged 6 to 11 years (age: 9.1 ± 1.7 years) with 484 (52%) males and 447 (48%) females in grades one to five in Assiut city. The children’s physical fitness data were collected using GMT. GMT is designed to measure five health-related physical fitness components including speed, strength, coordination, endurance, and flexibility of children aged 6 to 18 years. The anthropometric data were collected based on three indicators: body height, body weight, and BMI. A confirmatory factor analysis was conducted with IBM SPSS AMOS 26.0 using full-information maximum likelihood. The results indicated an adequate fit (χ² = 112.3, df = 20; p < 0.01; CFI = 0.956; RMSEA = 0.07). The χ²-statistic showed significant results, and the values for CFI and RMSEA showed a good fit. All loadings of the manifest variables on the first-order latent factors as well as loadings of the first-order latent factors on the second-order superordinate factor were significant. The results also showed strong construct validity in the components of conditioning abilities and moderate construct validity in the components of coordinative abilities. GMT proved to be a valid method and could be widely used on large-scale studies for health-related fitness monitoring in the Egyptian population. Full article

(This article belongs to the Special Issue Physical Activity, Physical Fitness, and Exercise Interventions for Preserving Human Health and Preventing and Treating Chronic Conditions across the Lifespan)

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11 pages, 2494 KiB

Open AccessArticle

Relative Handgrip Strength as Marker of Cardiometabolic Risk in Women with Systemic Lupus Erythematosus

by Sergio Sola-Rodríguez, José Antonio Vargas-Hitos, Blanca Gavilán-Carrera, Antonio Rosales-Castillo, José Mario Sabio, Alba Hernández-Martínez, Elena Martínez-Rosales, Norberto Ortego-Centeno and Alberto Soriano-Maldonado

Int. J. Environ. Res. Public Health 2021, 18(9), 4630; https://doi.org/10.3390/ijerph18094630 - 27 Apr 2021

Cited by 4 | Viewed by 2918

Abstract

This study aimed to examine the association of relative handgrip strength (rHGS) with cardiometabolic disease risk factors in women with systemic lupus erythematosus (SLE). Methods: Seventy-seven women with SLE (mean age 43.2, SD 13.8) and clinical stability during the previous six months were [...] Read more.

This study aimed to examine the association of relative handgrip strength (rHGS) with cardiometabolic disease risk factors in women with systemic lupus erythematosus (SLE). Methods: Seventy-seven women with SLE (mean age 43.2, SD 13.8) and clinical stability during the previous six months were included. Handgrip strength was assessed with a digital dynamometer and rHGS was defined as absolute handgrip strength (aHGS) divided by body mass index (BMI). We measured blood pressure, markers of lipid and glucose metabolism, inflammation (high sensitivity C-reactive protein [hs-CRP]), arterial stiffness (pulse wave velocity [PWV]), and renal function. A clustered cardiometabolic risk index (z-score) was computed. Results: Pearson′s bivariate correlations revealed that higher rHGS was associated with lower systolic blood pressure (SBP), triglycerides, hs-CRP, PWV, and lower clustered cardiometabolic risk (r_range = from −0.43 to −0.23; all p < 0.05). Multivariable linear regression analyses adjusted for age, disease activity (SLEDAI), and accrual damage (SDI) confirmed these results (all p < 0.05) except for triglycerides. Conclusions: The findings suggest that higher rHGS is significantly associated with lower cardiometabolic risk in women with SLE. Full article

(This article belongs to the Special Issue Physical Activity, Physical Fitness, and Exercise Interventions for Preserving Human Health and Preventing and Treating Chronic Conditions across the Lifespan)

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14 pages, 1813 KiB

Open AccessArticle

The Combined Effects of Obesity and Cardiorespiratory Fitness Are Associated with Response Inhibition: An ERP Study

by Lin Chi, Chiao-Ling Hung, Chi-Yen Lin, Tai-Fen Song, Chien-Heng Chu, Yu-Kai Chang and Chenglin Zhou

Int. J. Environ. Res. Public Health 2021, 18(7), 3429; https://doi.org/10.3390/ijerph18073429 - 25 Mar 2021

Cited by 7 | Viewed by 2881

Abstract

Obesity and cardiorespiratory fitness exhibit negative and positive impacts, respectively, on executive function. Nevertheless, the combined effects of these two factors on executive function remain unclear. This study investigated the combined effects of obesity and cardiorespiratory fitness on response inhibition of executive function [...] Read more.

Obesity and cardiorespiratory fitness exhibit negative and positive impacts, respectively, on executive function. Nevertheless, the combined effects of these two factors on executive function remain unclear. This study investigated the combined effects of obesity and cardiorespiratory fitness on response inhibition of executive function from both behavioral and neuroelectric perspectives. Ninety-six young adults aged between 18 and 25 years were recruited and assigned into four groups: the high cardiorespiratory fitness with normal weight (NH), high cardiorespiratory fitness with obesity (OH), low cardiorespiratory fitness with normal weight (NL), and low cardiorespiratory fitness with obesity (OL) groups. The stop-signal task and its induced P3 component of event-related potentials was utilized to index response inhibition. The participants with higher cardiorespiratory fitness (i.e., the NH and OH groups) demonstrated better behavioral performance (i.e., shorter response times and higher accuracy levels), as well as shorter stop-signal response times and larger P3 amplitudes than their counterparts with low cardiorespiratory fitness (i.e., the NL and OL groups). The study provides first-hand evidence of the substantial effects of cardiorespiratory fitness on the response inhibition, including evidence that the detrimental effects of obesity might be overcome by high cardiorespiratory fitness. Full article

(This article belongs to the Special Issue Physical Activity, Physical Fitness, and Exercise Interventions for Preserving Human Health and Preventing and Treating Chronic Conditions across the Lifespan)

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17 pages, 951 KiB

Open AccessArticle

Effects of an African Circle Dance Programme on Internally Displaced Persons with Depressive Symptoms: A Quasi-Experimental Study

by Dauda Salihu, Eliza M. L. Wong and Rick Y. C. Kwan

Int. J. Environ. Res. Public Health 2021, 18(2), 843; https://doi.org/10.3390/ijerph18020843 - 19 Jan 2021

Cited by 10 | Viewed by 4733

Abstract

Background: Internally Displaced Persons (IDPs) are people who have been forced to flee their homes due to disasters. Depressive symptoms, at over 31–67%, are prevalent in IDPs in Africa. Despite the evidence for the benefits of the promotion of dance interventions on [...] Read more.

Background: Internally Displaced Persons (IDPs) are people who have been forced to flee their homes due to disasters. Depressive symptoms, at over 31–67%, are prevalent in IDPs in Africa. Despite the evidence for the benefits of the promotion of dance interventions on psychological health, supporting information is needed to outline the benefits of an African Circle Dance (ACD) intervention for IDPs in Africa. Methods: A quasi-experimental design (pre-/post-test) was employed. Two IDP camps were randomized into the intervention group (psychoeducation and ACD intervention) and the control group (psychoeducation). Adults aged ≥18 years, living in an IDP camp, able to perform brisk walking, and who scored ≥10 on a depressive symptoms subscale were recruited. The intervention group received an 8-week ACD dance intervention and two 1-h psychoeducation sessions on stress management; the controls only received the psychoeducation sessions. Outcomes were depressive symptoms, stress, and anxiety. Data were collected at baseline (T0), immediately after the intervention at week 8 (T1), and at week 12 (T2) at the post-intervention and follow-up session. A generalized estimating equation was used to test the effects of the ACD intervention, with a 0.05 significance level. Results: 198 IDPs completed the study (n_control = 98; n_intervention = 100). The intervention group reported significantly greater improvements in depressive symptoms (v = 0.33, p < 0.001) and stress (v = 0.15, 0.008) than did the control group. Conclusions: ACD could be a valuable complementary intervention in health promotion but more research is needed. Full article

(This article belongs to the Special Issue Physical Activity, Physical Fitness, and Exercise Interventions for Preserving Human Health and Preventing and Treating Chronic Conditions across the Lifespan)

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14 pages, 801 KiB

Open AccessArticle

Heart Rate Variability in Women with Systemic Lupus Erythematosus: Association with Health-Related Parameters and Effects of Aerobic Exercise

by Elena Martínez-Rosales, Sergio Sola-Rodríguez, José Antonio Vargas-Hitos, Blanca Gavilán-Carrera, Antonio Rosales-Castillo, Alba Hernández-Martínez, Enrique G. Artero, José Mario Sabio and Alberto Soriano-Maldonado

Int. J. Environ. Res. Public Health 2020, 17(24), 9501; https://doi.org/10.3390/ijerph17249501 - 18 Dec 2020

Cited by 7 | Viewed by 3792

Abstract

Abnormal heart rate variability (HRV) has been observed in patients with systemic lupus erythematosus (SLE). In a combined cross-sectional and interventional study approach, we investigated the association of HRV with inflammation and oxidative stress markers, patient-reported outcomes, and the effect of 12 weeks [...] Read more.

Abnormal heart rate variability (HRV) has been observed in patients with systemic lupus erythematosus (SLE). In a combined cross-sectional and interventional study approach, we investigated the association of HRV with inflammation and oxidative stress markers, patient-reported outcomes, and the effect of 12 weeks of aerobic exercise in HRV. Fifty-five women with SLE (mean age 43.5 ± 14.0 years) were assigned to either aerobic exercise (n = 26) or usual care (n = 29) in a non-randomized trial. HRV was assessed using a heart rate monitor during 10 min, inflammatory and oxidative stress markers were obtained, psychological stress (Perceived Stress Scale), sleep quality (Pittsburg Sleep Quality Index), fatigue (Multidimensional Fatigue Inventory), depressive symptoms (Beck Depression Inventory), and quality of life (36-item Short-Form Health Survey) were also assessed. Low frequency to high frequency power (LFHF) ratio was associated with physical fatigue (p = 0.019). Sample entropy was inversely associated with high-sensitivity C-reactive protein (p = 0.014) and myeloperoxidase (p = 0.007). There were no significant between-group differences in the changes in HRV derived parameters after the exercise intervention. High-sensitivity C-reactive protein and myeloperoxidase were negatively related to sample entropy and physical fatigue was positively related to LFHF ratio. However, an exercise intervention of 12 weeks of aerobic training did not produce any changes in HRV derived parameters in women with SLE in comparison to a control group. Full article

(This article belongs to the Special Issue Physical Activity, Physical Fitness, and Exercise Interventions for Preserving Human Health and Preventing and Treating Chronic Conditions across the Lifespan)

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10 pages, 316 KiB

Open AccessArticle

Associations between Health-Related Physical Fitness and Cardiovascular Disease Risk Factors in Overweight and Obese University Staff

by Jiangang Chen, Yuan Zhou, Xinliang Pan, Xiaolong Li, Jiamin Long, Hui Zhang and Jing Zhang

Int. J. Environ. Res. Public Health 2020, 17(23), 9031; https://doi.org/10.3390/ijerph17239031 - 3 Dec 2020

Cited by 8 | Viewed by 2613

Abstract

Purpose: This cross-sectional study examined the associations between health-related physical fitness (HPF) and cardiovascular disease (CVD) risk factors in overweight and obese university staff. Methods: A total of 340 university staff (109 women, mean age 43.1 ± 9.7 years) with overweight (n [...] Read more.

Purpose: This cross-sectional study examined the associations between health-related physical fitness (HPF) and cardiovascular disease (CVD) risk factors in overweight and obese university staff. Methods: A total of 340 university staff (109 women, mean age 43.1 ± 9.7 years) with overweight (n = 284) and obesity (n = 56) were included. The HPF indicators included skeletal muscle mass index (SMI), body fat percentage (BFP), grip strength (GS), sit-and-reach test (SRT), and vital capacity index (VCI). CVD risk factors were measured, including uric acid (UA), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and glucose (GLU). Results: BFP, SMI, and GS were positively associated with UA level (β = 0.239, β = 0.159, β = 0.139, p < 0.05). BFP was positively associated with TG and TG/HDL-C levels (β = 0.421, β = 0.259, p < 0.05). GS was positively associated with HDL-C level (β = 0.244, p < 0.05). SRT was negatively associated with GLU level (β = −0.130, p < 0.05). Conclusions: In overweight and obese university staff, body composition, muscle strength, and flexibility were associated with CVD risk factors. An HPF test may be a practical nonmedical method to assess CVD risk. Full article

(This article belongs to the Special Issue Physical Activity, Physical Fitness, and Exercise Interventions for Preserving Human Health and Preventing and Treating Chronic Conditions across the Lifespan)

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Graphical abstract

11 pages, 658 KiB

Open AccessArticle

Is Weight Gain Inevitable for Patients Trying to Quit Smoking as Part of Cardiac Rehabilitation?

by Ahmad Salman and Patrick Doherty

Int. J. Environ. Res. Public Health 2020, 17(22), 8565; https://doi.org/10.3390/ijerph17228565 - 18 Nov 2020

Cited by 2 | Viewed by 2129

Abstract

The literature is uncertain about the extent to which those who attend cardiac rehabilitation (CR) gain weight while trying to quit smoking. This study aimed to determine the extent of CR-based smoking cessation provision and whether CR, as delivered in routine practice, is [...] Read more.

The literature is uncertain about the extent to which those who attend cardiac rehabilitation (CR) gain weight while trying to quit smoking. This study aimed to determine the extent of CR-based smoking cessation provision and whether CR, as delivered in routine practice, is associated with helping patients quit smoking and avoid weight gain. Data from the UK National Audit of Cardiac Rehabilitation database, between April 2013 and March 2016, were used. Smoking status is categorised as smokers and quitters assessed by patient self-report. Outcomes included body weight, blood pressure, depression, and physical activity. A multiple linear regression model was constructed to understand the effect of continuing smoking or quitting smoking on CR outcomes. CR outcome scores were adjusted by the baseline CR score for each characteristic. An e-survey collected information about the smoking cessation support offered to patients attending CR. A total of 2052 smokers (58.59 ± 10.49 years, 73.6% male) and 1238 quitters (57.63 ± 10.36 years, 75.8% male) were analysed. Overall, 92.6% of CR programmes in the United Kingdom (UK) offer smoking cessation support for CR attenders. Quitting smoking during CR was associated with a mean increase in body weight of 0.4 kg, which is much less than seen in systematic reviews. Quitters who attended CR also had better improvements in physical activity status and psychosocial health measures than smokers. As delivered in routine practice, CR programmes in the UK adhere to the guideline recommendations for smoking cessation interventions, help patients quit smoking, and avoid weight gain on completion of CR. Full article

(This article belongs to the Special Issue Physical Activity, Physical Fitness, and Exercise Interventions for Preserving Human Health and Preventing and Treating Chronic Conditions across the Lifespan)

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Review

Jump to: Research, Other

27 pages, 7155 KiB

Open AccessReview

Characteristics of Physical Exercise Programs for Older Adults in Latin America: A Systematic Review of Randomized Controlled Trials

by Eduardo Vásquez-Araneda, Rodrigo Ignacio Solís-Vivanco, Sandra Mahecha-Matsudo, Rafael Zapata-Lamana and Igor Cigarroa

Int. J. Environ. Res. Public Health 2021, 18(6), 2812; https://doi.org/10.3390/ijerph18062812 - 10 Mar 2021

Cited by 4 | Viewed by 4633

Abstract

Aim: To characterize physical exercise programs for older adults in Latin America. Methods: This review was conducted in accordance with the PRISMA statement. A search for randomized controlled trials (RCTs) published between the years 2015 and 2020 was performed in the Scopus, MedLine [...] Read more.

Aim: To characterize physical exercise programs for older adults in Latin America. Methods: This review was conducted in accordance with the PRISMA statement. A search for randomized controlled trials (RCTs) published between the years 2015 and 2020 was performed in the Scopus, MedLine and SciELO databases. Results: A total of 101 RCTs were included. A large percentage of the studies had an unclear risk of bias in the items: selection, performance, detection and attribution. Furthermore, a heterogeneous level of compliance was observed in the CERT items. A total sample of 5013 older adults (79% women) was included. 97% of the studies included older adults between 60–70 years, presenting an adherence to the interventions of 86%. The studies were mainly carried out in older adults with cardiometabolic diseases. Only 44% of the studies detailed information regarding the place of intervention; of these studies, 61% developed their interventions in university facilities. The interventions were mainly based on therapeutic physical exercise (89% of the articles), with a duration of 2–6 months (95% of the articles) and a frequency of 2–3 times a week (95% of the articles) with sessions of 30–60 min (94% of the articles) led by sports science professionals (51% of the articles). The components of physical fitness that were exercised the most were muscular strength (77% of the articles) and cardiorespiratory fitness (47% of the articles). Furthermore, only 48% of the studies included a warm-up stage and 34% of the studies included a cool-down stage. Conclusions: This systematic review characterized the physical exercise programs in older adults in Latin America, as well the most frequently used outcome measures and instruments, by summarizing available evidence derived from RCTs. The results will be useful for prescribing future physical exercise programs in older adults. Full article

(This article belongs to the Special Issue Physical Activity, Physical Fitness, and Exercise Interventions for Preserving Human Health and Preventing and Treating Chronic Conditions across the Lifespan)

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13 pages, 668 KiB

Open AccessReview

Isokinetic Trunk Strength in Acute Low Back Pain Patients Compared to Healthy Subjects: A Systematic Review

by Waleska Reyes-Ferrada, Luis Chirosa-Rios, Angela Rodriguez-Perea, Daniel Jerez-Mayorga and Ignacio Chirosa-Rios

Int. J. Environ. Res. Public Health 2021, 18(5), 2576; https://doi.org/10.3390/ijerph18052576 - 4 Mar 2021

Cited by 12 | Viewed by 3337

Abstract

Background: The purpose of this systematic review was to: (I) determine the quality of evidence from studies assessing trunk isokinetic strength in subjects with acute low back pain (ALBP) compared to healthy subjects and (II) establish reference values of isokinetic trunk strength in [...] Read more.

Background: The purpose of this systematic review was to: (I) determine the quality of evidence from studies assessing trunk isokinetic strength in subjects with acute low back pain (ALBP) compared to healthy subjects and (II) establish reference values of isokinetic trunk strength in subjects with ALBP. Methodology: Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statements were followed using keywords associated with trunk, strength and low back pain. Four databases were used: PubMed, Web of Science, Scopus and SPORTDiscus. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS). Results: A total of 1604 articles were retrieved, four included in this review. All were evaluated as high risk of bias (Rob). Due to the high Rob and the diversity of protocols, instruments and variables used, it was not possible to determine reference values for subjects with ALBP, we can only establish a range of flexion peak torque (PT) between 175.1 and 89.7 Nm at 60°/s and between 185 and 81.5 Nm at 120°/s, and for extension PT between 240.0 and 91.5 Nm at 60°/s and between 217.5 and 69.2 Nm at 120°/s in subjects with ALBP. Conclusions: Due to the low quality of the evidence and the diversity of protocols used when measuring trunk isokinetic strength, it is necessary to carry out new high-quality research to establish reference values of trunk strength in subjects with ALBP. Full article

(This article belongs to the Special Issue Physical Activity, Physical Fitness, and Exercise Interventions for Preserving Human Health and Preventing and Treating Chronic Conditions across the Lifespan)

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Other

Jump to: Research, Review

18 pages, 2542 KiB

Open AccessSystematic Review

The Effects of Martial Arts on Cancer-Related Fatigue and Quality of Life in Cancer Patients: An Up-to-Date Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials

by Daniel Sur, Shanthi Sabarimurugan and Shailesh Advani

Int. J. Environ. Res. Public Health 2021, 18(11), 6116; https://doi.org/10.3390/ijerph18116116 - 6 Jun 2021

Cited by 4 | Viewed by 3868

Abstract

Background: To evaluate and synthesize the existing evidence of the effects of practicing martial arts by cancer patients and cancer survivors in relation to overall quality of life (QoL) and cancer-related fatigue (CRF). Methods: Randomized controlled trials (RCTs) from 1 January 2000 to [...] Read more.

Background: To evaluate and synthesize the existing evidence of the effects of practicing martial arts by cancer patients and cancer survivors in relation to overall quality of life (QoL) and cancer-related fatigue (CRF). Methods: Randomized controlled trials (RCTs) from 1 January 2000 to 5 November 2020 investigating the impact of martial arts were compared with any control intervention for overall QoL and CRF among cancer patients and survivors. Publication quality and risk of bias were assessed using the Cochrane handbook of systematic reviews. Results: According to the electronic search, 17 RCTs were retrieved including 1103 cancer patients. Martial arts significantly improved social function, compared to that in the control group (SMD = −0.88, 95% CI: −1.36, −0.39; p = 0.0004). Moreover, martial arts significantly improved functioning, compared to the control group (SMD = 0.68, 95% CI: 0.39–0.96; p < 0.00001). Martial arts significantly reduced CRF, compared to that in the control group (SMD = −0.51, 95% CI: −0.80, −0.22; p = 0.0005, I2 > 95%). Conclusions: The results of our systematic review and meta-analysis reveal that the effects of practicing martial arts on CRF and QoL in cancer patients and survivors are inconclusive. Some potential effects were seen for social function and CRF, although the results were inconsistent across different measurement methods. There is a need for larger and more homogeneous clinical trials encompassing different cancer types and specific martial arts disciplines to make more extensive and definitive cancer- and symptom-specific recommendations. Full article

(This article belongs to the Special Issue Physical Activity, Physical Fitness, and Exercise Interventions for Preserving Human Health and Preventing and Treating Chronic Conditions across the Lifespan)

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