Cardiovascular diseases cause 17 million deaths annually worldwide, of which hypertension is responsible for 9.4 million and a 7% burden of disease. High blood pressure is responsible for 45% of deaths from heart disease and 51% of deaths from stroke. The aim of this systematic review and meta-analysis was to quantify the effect of isometric resistance training on systolic, diastolic, and mean arterial blood pressure (SBP, DBP, and MAP, respectively) values in normotensive adult participants. This study was registered with the PROSPERO database. Eligible studies were identified after performing a systematic search within the following databases: PubMed, Scielo, BioMed Central, Clinical Trials, EMBASE, Cochrane Central Register of Controlled Trials, and EBSCO. Randomized controlled trials that categorized participants as normotensive according to the guidelines of the American Heart Association and the American College of Cardiology were included. Systematic review with meta-analysis. Level 1. Data related to participant characteristics, exercise programs, level of evidence, risk of bias, Consensus on Exercise Reporting Template, and outcomes of interest were systematically reviewed independently by 2 authors. A total of 6 randomized controlled trials were included. The following reductions in blood pressure (compared with the control group) were generated by isometric resistance training: SBP (mean difference [MD], −2.83 mm Hg; 95% CI, −3.95 to −1.72; P < 0.00001), DBP (MD, −2.73; 95% CI, −4.23 to −1.24; P = 0.0003), and MAP (MD, −3.07; 95% CI, −5.24 to −0.90; P = 0.005). It appears that isometric resistance training reduces SBP, DBP, and MAP in normotensive young adults in a statistically significant and clinically relevant manner. This type of exercise could be considered effective in preventing arterial hypertension.

The objective of this study was to assess the benefits and potential risks associated with different physical exercise modalities for managing symptoms in adults with major depressive disorder who were not receiving second-generation antidepressants or cognitive behavioral therapy. A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted. The search included multiple databases: Medline, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, PsycInfo, Web of Science, Clinical Trials repository, gray literature, and manual search. No language restrictions were applied. Eligible studies involved RCTs of adults with major depressive disorder who were not on antidepressants or receiving psychological therapy, comparing various exercise modalities with second-generation antidepressants or cognitive behavioral therapy, body-mind exercise, or no exercise interventions. Nine RCTs involving 678 adults were analyzed. The pooled results indicated a small clinical effect favoring exercise in reducing depressive symptoms, although the difference was not statistically significant (SMD = 0.27, 95% CI [− 0.58, 0.04], P = 0.09). Subgroup analyses suggested that intervention duration, frequency, intensity, supervision, age, overweight/obesity status, and diagnosis of depression could influence treatment outcomes. A sensitivity analysis was conducted for studies with controls without exercise interventions and a low risk of bias in the domains related to the randomization process and deviations from the intended interventions. The results showed that there are no statistically significant differences when interventions are compared with medication and body-mind exercise (p = 0.12, I² = 78%). Furthermore, the analysis showed a moderate effect size favoring exercise, but no statistically significant difference between groups (p = 0.05), with high heterogeneity (I² = 85%). The evidence quality was generally low to very low, and methodological limitations compromised the certainty of the findings. Adverse events associated with exercise were manageable. The study emphasizes the need for well-designed RCTs to provide clearer insights into the potential benefits of exercise in managing major depressive disorder symptoms. Caution is warranted in interpreting these results due to the limitations of the included studies.Systematic review registration: PROSPERO CRD42022356741.

This randomized controlled trial compared flywheel-based resistance training with traditional resistance training on depressive symptoms in sedentary older women. Twenty-nine women aged ≥60 years without clinical depression were randomized (blocks of 2 and 4) to flywheel (n = 14) or traditional resistance training (n = 15) for 8 weeks (six exercises, twice weekly) at the Federal University of Viçosa, Brazil. Flywheel devices provide inertial resistance and eccentric overload by storing and releasing kinetic energy. Depressive symptoms were the primary outcome. Allocation was concealed with sealed envelopes; outcome assessors and the principal investigator were blinded. Twenty-eight participants completed the protocol; one dropout in the traditional group required multiple imputation. Adjusted depressive symptom scores were 2.7 ± 2.7 in the flywheel group (↓2.5 points) and 2.0 ± 2.8 in the traditional group (↓2.0 points), with no between-group difference (p = 0.193). The effect size was small (ηp² = 0.03) and statistical power was low (1-β = 0.25). All adverse events were mild (grade 1); no serious events occurred. Both flywheel and traditional resistance training showed potential to reduce depressive symptoms in sedentary older women. Larger trials are warranted. ClinicalTrials.gov NCT05910632.

Background The objective was to identify the benefits and harms of different physical exercise modalities in the symptomatology of major depressive disorder in adults without usual treatment. Methods We conducted a systematic review and meta-analysis of randomized controlled trials. Medline (via Ovid), Cochrane Central Register of Controlled Trials (CENTRAL), Embase, PsycInfo, Web of Science, Clinical Trials repository, gray literature, and manual search were searched from inception to November 2022 for relevant studies without language restriction. The following inclusion criteria were used for studies to determine their eligibility: randomized controlled trials (RCTs) in adults diagnosed with major depressive disorder who did not consume antidepressant medication or attended psychological therapy, with or without the presence of chronic communicable or non-communicable diseases, that compared physical exercise modalities with usual therapy, body-mind exercise or did not exercise. We excluded randomized controlled trials in development with pregnant women and adults with other mental health disorders such as bipolar disorder and anxiety. The risk of bias and quality of evidence were assessed using the Cochrane Risk of Bias II Tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE), respectively. The main outcome was depressive symptoms measured using validated depression scales after the intervention. Results The nine RCTs included 678 adults (211 men 31.12% and 467 women 68.88%) between 20 and 72 years old. The pooled standardized mean difference (SMD) of the 7 trials (12 interventions), calculated using the random effects model, was − 0.27 (95% CI [-0.58, 0.04) P = 0.09, indicating a small clinical effect in favor of exercise on the instruments scores that assess depressive symptoms, I² = 76%. Sensitivity analyzes showed a moderate effect size, compared to primary outcomes, in favor of physical exercise: − 0.58 [-1.15, -0.01]. They even showed statistical significance: (P = 0.05); I² = 85%. Subgroup analyzes demonstrated that the intervention (i.e., < 12 weeks duration, frequency 5 per 150 minutes per week, at high intensity and with supervision) and characteristics (i.e., less than 50 years of age, overweight and obese, and diagnosis of depression) could influence the overall effect of treatment. Discussion We found low- to very low-quality evidence supporting the effect of physical exercise, compared with usual therapy, body mind exercise or doing nothing, on symptoms of major depressive disorder. Physical exercise is safe, although it produces adverse events that can be easily controlled. We downgraded the certainty of the evidence due to methodological limitations, inconsistency and imprecision. These are preliminary results, well-designed and reported randomized controlled trials are required.

Resumos de trabalhos apresentados no III Simpósio Internacional de Fisiologia do Exercício e Saúde, 24 e 25 de maio de 2024, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brasil