Effects of Exercise Intervention on Health-Related Physical Fitness and Blood Pressure in Preschool Children: A Systemat

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SYSTEMATIC REVIEW

Effects of Exercise Intervention on Health‑Related Physical Fitness and Blood Pressure in Preschool Children: A Systematic Review and Meta‑Analysis of Randomized Controlled Trials Antonio García‑Hermoso1,2   · Alicia M. Alonso‑Martinez3 · Robinson Ramírez‑Vélez1,3 · Mikel Izquierdo1,3

© Springer Nature Switzerland AG 2019

Abstract Background  No previous systematic review has quantitatively examined the effect of physical exercise interventions on health-related physical fitness and blood pressure in children younger than 6 years old. Objective  To evaluate the effects of exercise interventions on health-related physical fitness (i.e., physical fitness components and body composition) and blood pressure in preschoolers. Methods  We searched four databases. Only randomized controlled trials (RCTs), evaluating the effectiveness of exercise intervention on weight-related outcomes, blood pressure, and physical fitness components in preschoolers (1–5.99 years old) were included. The effect sizes were reported as Hedges’ g using random-effects models. Results  A total of 19 RCTs were included. Exercise interventions favored reductions in body mass index (g = − 0.17; 95% confidence interval [CI], − 0.31 to − 0.03), waist circumference (g = − 0.25; 95% CI − 0.47 to − 0.03), and body fat percentage (g = − 0.31; 95% CI − 0.60 to − 0.23); as well as improvement in cardiorespiratory fitness (g = 0.25; 95% CI 0.08–0.42), muscular strength (g = 0.25; 95% CI 0.09–0.40), and speed–agility (g = − 0.51; 95% CI − 0.78 to − 0.24). Blood pressure was not reduced. The subgroup analysis revealed that physical exercise alone favored larger reductions in body mass index and waist circumference compared with physical exercise combined with another intervention. Also, changes in cardiorespiratory fitness, lower-body muscular strength and speed–agility were associated with larger decreases in body composition. Conclusion  Physical exercise whether combined or not with additional intervention has a small effect on both body weight and physical fitness in preschoolers. Also, it seems that interventions to prevent obesity should be directed towards improving physical fitness of preschoolers.

1 Introduction The early years are a critical period for physical, social and cognitive development [1] and for establishing healthy behavior patterns, which may persist into childhood [2] and adulthood [3]. While the evidence for the early years * Antonio García‑Hermoso [email protected] 1



Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Navarra, Spain

2



Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile, USACH, Santiago, Chile

3

Department of Health Sciences, Public University of Navarra, CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Pamplona, Navarra, Spain



is relatively new, a growing body of research suggests that regular physical activity participation in presc