Objective To evaluate systematic reviews of randomised controlled trials (RCTs) on the effects of exercise on general cognition, memory and executive function across all populations and ages. Methods Systematic reviews and meta-analyses of RCTs evaluating the effects of exercise on general cognition, memory and executive function were eligible. Data extraction and risk of bias scoring were conducted in duplicate. The A MeaSurement Tool to Assess systematic Reviews (AMSTAR-2) was used to assess the risk of bias. Effect sizes were pooled using random effects models and reported as standardised mean differences (SMD). Subgroup analyses were conducted for participant and intervention characteristics. General cognition, memory and executive function. Data sources CINAHL, The Cochrane Library, Embase, MEDLINE via OVID, Emcare, ProQuest Central, ProQuest Nursing and Allied Health Source, PsycINFO, Scopus, Sport Discus and Web of Science. Results 133 systematic reviews (2,724 RCTs and 258 279 participants) were included. Exercise significantly improved general cognition (SMD=0.42), memory (SMD=0.26) and executive function (SMD=0.24). Memory and executive function improvements from exercise were greater for children and adolescents than for adults and older adults. Those with attention-deficit/hyperactivity disorder exhibited greater improvement in executive function than other populations. Effects were generally larger for low- and moderate-intensity interventions. Shorter interventions (1–3 months) and exergames (video games that require physical movement) had the largest effects on general cognition and memory. Findings remained statistically significant after excluding reviews rated as low and critically low quality. Conclusions These findings provide strong evidence that exercise, even light intensity, benefits general cognition, memory and executive function across all populations, reinforcing exercise as an essential, inclusive recommendation for optimising cognitive health. Trial registration number PROSPERO ID: CRD42023468991.

Bennett, H and Slattery, F. Effects of blood flow restriction training on aerobic capacity and performance: A systematic review. J Strength Cond Res 33(2): 572–583, 2019—Blood flow restriction (BFR) is a novel training method that can elicit training adaptations at low training intensities. Recent research has aimed to determine the effect of aerobic exercise with BFR on aerobic fitness and performance, with conflicting results. This review aimed to systematically identify and assess studies that have combined BFR with aerobic exercise in humans, establishing its effect on aerobic fitness and performance. Five databases (Medline, Web of Science, SPORTDiscus, CINHAL, and ScienceDirect) were searched. Two authors independently conducted all searches and reviewed all abstracts, determining article suitability. The Quality Assessment Tool for Quantitative Studies was used to assess risk of bias in each study. Fourteen studies were included for analysis. Blood flow restriction aerobic exercise increased measures of aerobic fitness and performance in younger adults when using occlusion pressures ≥130 mm Hg. In older adults, measures of aerobic performance improved; however, measures of aerobic fitness remained unchanged. These findings must be interpreted with caution because methodological limitations were present in all trials. Short-term BFR aerobic exercise seems to offer a valid method of improving aerobic performance and fitness in healthy adults when using occlusion pressures ≥130 mm Hg. Conversely, it seems to strictly enhance aerobic performance in older adults without impacting aerobic fitness, potentially suggesting different mechanisms of adaptation between older and younger individuals. Despite methodological limitations, BFR aerobic exercise seems to have applications in scenarios where high-intensity aerobic exercise is not appropriate, although more high-quality research is needed to further demonstrate this.

Depression and anxiety are prevalent and rising in children and adolescents, prompting interest in exercise as a potential therapeutic intervention. The aim of this systematic umbrella review and meta-meta-analysis (a meta-analysis of meta-analyses) was to evaluate the effects of exercise on depression and anxiety symptoms in children and adolescents and to identify the most promising exercise-based approaches. This systematic umbrella review was preregistered (PROSPERO ID: CRD42024533558) and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Preferred Reporting Items for Overviews of Reviews (PRIOR) guidelines. A search of 11 databases identified systematic reviews and meta-analyses of randomized controlled trials (RCTs) evaluating the effects of exercise (aerobic, resistance, mind-body exercise) on depression and anxiety symptoms in children and adolescents. Risk of bias was assessed using the A MeaSurement Tool to Assess systematic Reviews (AMSTAR-2) tool, and certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. Meta-analyses were conducted to combine effect sizes, using random effects models. Subgroup analyses were performed to examine participant and intervention characteristics. A total of 21 systematic reviews (n = 375 RCTs, n = 38,117 participants 5-18 years of age) were included. Participants included those with various clinical conditions, including depression, psychosocial disorders, obesity, and cancer, as well as healthy individuals. The pooled analysis found moderate effect sizes favoring exercise for symptoms of depression (standardized mean difference [SMD] = -0.45, 95% CI = -0.59 to -0.31, I² = 71.37%, p < .01, 180 RCTs, n = 34,490 participants) and anxiety (SMD = -0.39, 95% CI = -0.61 to -0.17, I² = 68.1%, p < .01, n = 55 RCTs, n = 24,797 participants). Mixed exercise modes and moderate-intensity exercise had the largest effects on depression, whereas resistance exercise was most effective for symptoms of anxiety. Interventions that were <12 weeks were more effective for depression compared with those that were ≥12 weeks. Benefits were generally consistent across populations. The certainty of evidence was moderate for depression and low to moderate for anxiety. This meta-meta-analysis finds that exercise reduces depression and anxiety symptoms in children and adolescents. These results suggest that structured exercise programs should be considered as part of comprehensive care approaches. This study reviewed evidence from 21 review articles, consisting of 375 randomized controlled trials involving over 38,000 children and adolescents, to examine the effects of exercise on symptoms of anxiety and depression. Results show that exercise significantly reduces symptoms of depression and anxiety, with moderate-intensity and resistance exercises being particularly effective. Shorter interventions (less than 12 weeks) had greater benefits for depression. These results highlight the potential of structured exercise programs as a valuable tool for improving youth mental health. • Clinicians should consider incorporating structured exercise programs, particularly moderate-intensity and resistance training, as part of a comprehensive approach to managing depression and anxiety in children and adolescents. • Shorter exercise interventions (<12 weeks) may provide greater benefits for depression and could be a practical starting point for integrating exercise into treatment plans. • Given the broad effectiveness of exercise across various populations, healthcare providers can recommend physical activity interventions regardless of a child's clinical condition, tailoring programs to individual needs and preferences. Effectiveness of physical activity in improving depression and anxiety in children and adolescents: a systematic umbrella review; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024533558.

Breast cancer (BC) patients undergoing chemotherapy are at risk of developing cancer therapy-related cardiac dysfunction (CTRCD). Exercise has been proposed to prevent CTRCD; however, its effectiveness remains unclear. The aim of this systematic review was to establish the effect of exercise on global longitudinal strain (GLS) and left ventricular ejection fraction (LVEF) in BC patients undergoing chemotherapy, to determine if exercise can prevent the development of CTRCD. Four databases (Medline, Scopus, eMbase, SPORTDiscus) were searched. Studies were eligible for inclusion if they measured GLS or LVEF prior to and following an exercise intervention of any length in BC patients undergoing chemotherapy and were published in English from 2000 onwards. Risk of bias was evaluated using the QUADAS-2 tool. Of the 398 studies screened, eight were eligible. Changes were similar in exercising (EX) and non-exercising (CON) groups for GLS (EX: pre: −19.6 ± 0.4, post: −20.1 ± 1.0, CON: pre: −20.0 ± 0.4, post: −20.1 ± 1) and LVEF (EX: pre: 58.5 ± 4.1%, post: 58.6 ± 2%, CON: pre: 56.6 ± 4.2%, post: 55.6 ± 4.6%). Exercise maintained or improved peak oxygen uptake (VO₂peak) during chemotherapy, while declines were observed in non-exercising groups. The included studies were limited by methodological deficiencies. The ability of exercise to prevent CTRCD is unclear. However, exercise positively impacts cardiorespiratory fitness in BC patients undergoing chemotherapy. Future research must address the methodological limitations of current research to understand the true effect of exercise in the prevention of CTRCD.

Bennett, H, Davison, K, Arnold, J, Slattery, F, Martin, M, and Norton, K. Multicomponent musculoskeletal movement assessment tools: a systematic review and critical appraisal of their development and applicability to professional practice. J Strength Cond Res 31(10): 2903–2919, 2017—Multicomponent movement assessment tools have become commonplace to measure movement quality, proposing to indicate injury risk and performance capabilities. Despite popular use, there has been no attempt to compare the components of each tool reported in the literature, the processes in which they were developed, or the underpinning rationale for their included content. As such, the objective of this systematic review was to provide a comprehensive summary of current movement assessment tools and appraise the evidence supporting their development. A systematic literature search was performed using PRISMA guidelines to identify multicomponent movement assessment tools. Commonalities between tools and the evidence provided to support the content of each tool was identified. Each tool underwent critical appraisal to identify the rigor in which it was developed, and its applicability to professional practice. Eleven tools were identified, of which 5 provided evidence to support their content as assessments of movement quality. One assessment tool (Soccer Injury Movement Screen [SIMS]) received an overall score of above 65% on critical appraisal, with a further 2 tools (Movement Competency Screen [MCS] and modified 4 movement screen [M4-MS]) scoring above 60%. Only the MCS provided clear justification for its developmental process. The remaining 8 tools scored between 40 and 60%. On appraisal, the MCS, M4-MS, and SIMS seem to provide the most practical value for assessing movement quality as they provide the strongest reports of developmental rigor and an identifiable evidence base. In addition, considering the evidence provided, these tools may have the strongest potential for identifying performance capabilities and guiding exercise prescription in athletic and sport-specific populations.