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Physical activity, exercise, and immune function.

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Jeffrey A Woods. 2005. Physical activity, exercise, and immune function.. https://doi.org/10.1016/j.bbi.2005.04.007

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Effects of exercise training on cardiac performance, exercise capacity and quality of life in patients with heart failure: a meta-analysis.

BACKGROUND: Despite major advances in pharmacological treatment of chronic heart failure (CHF), a number of patients still suffer from dyspnoea, fatigue, diminished exercise capacity and poor quality of life. It is in this context that exercise training is being intensively evaluated for any additional benefit in the treatment of CHF. AIMS: To determine the effect of exercise training in patients with CHF on cardiac performance, exercise capacity and health-related quality of life. A meta-analysis was performed to obtain this goal. METHODS AND RESULTS: After including 35 randomised controlled trials, the methodological quality of each study was assessed, summary effect sizes (SESs) and the concomitant 95% confidence intervals (95% CI) were calculated for each outcome. Quantitative analysis showed statistically significant SESs, at rest, for diastolic blood pressure and end-diastolic volume. During maximal exercise, significant SESs were found for systolic blood pressure, heart rate, cardiac output, peak oxygen uptake, anaerobic threshold and 6-min walking test. The Minnesota Living with Heart Failure Questionnaire improved by an average of 9.7 points. CONCLUSIONS: Exercise training has clinically important effects on exercise capacity and HRQL, and may have small positive effects on cardiac performance during exercise.

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Exercise or other physical activity for preventing pre-eclampsia and its complications.

BACKGROUND: The association between an increase in regular physical activity and a reduction in the risk of hypertension is well documented for non-pregnant people. It has been suggested that exercise may help prevent pre-eclampsia and its complications. Possible adverse effects of increased physical activity during pregnancy, particularly on the risk of preterm birth and fetal growth restriction, are unclear. It is, therefore, important to assess whether exercise reduces the risk of pre-eclampsia and its complications and, if so, whether these benefits outweigh the risks. OBJECTIVES: To assess the effects of exercise, or increased physical activity, on prevention of pre-eclampsia and its complications. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group Trials Register (December 2005), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2005, Issue 1), and EMBASE (2002 to February 2005). SELECTION CRITERIA: Studies were included if these were randomised trials evaluating the effects of exercise or increased physical activity during pregnancy for women at risk of pre-eclampsia. DATA COLLECTION AND ANALYSIS: Two review authors independently selected trials for inclusion and extracted data. Data were entered on Review Manager software for analysis, and double checked for accuracy. MAIN RESULTS: Two small, good quality trials (45 women) were included. Both compared moderate intensity regular aerobic exercise with maintenance of normal physical activity during pregnancy. The confidence intervals were wide and crossed the line of no effect for all reported outcomes including pre-eclampsia (relative risk 0.31, 95% confidence interval 0.01 to 7.09). AUTHORS' CONCLUSIONS: There is insufficient evidence for reliable conclusions about the effects of exercise on prevention of pre-eclampsia and its complications.

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