Exercise improves arterial stiffness in children and adolescents

1. In this systematic review and network meta-analysis, resistance training, high-intensity interval training (HIIT), and aerobic exercise interventions were superior to controls in reducing arterial stiffness in children and adolescents.

2. However, sensorimotor training did not show a benefit in reducing arterial stiffness compared to controls.

Evidence Rating Level: 1 (Excellent)

Arterial stiffness (AS) is an important variable as it is an early marker of atherosclerotic cardiovascular disease (ACVD). In the adult population, exercise has been shown to reduce AS. However, this has yet to be comprehensively evaluated in pediatric populations. As a result, the objective of the present systematic review and network meta-analysis was to evaluate the effectiveness of various exercise modalities in reducing AS in pediatric patients.

Of 2414 identified records, 14 (n=1003 participants) studies were included from various databases from 2015-2022. Studies were included if they evaluated the effects of exercise on pulse wave velocity (PWV) in both children and adolescents. Studies were excluded if they only reported the acute effects of exercise on PWV, or if they included adult populations. The review was performed using PRISMA guidelines, Meta-analyses statement extension for NMA guidelines, and the Cochrane Handbook for Systematic Reviews of Interventions recommendations. The risk of bias was assessed using the Cochrane Collaboration’s tool for assessing risk of bias. Statistical analyses were performed using meta-regression and subgroup analyses. The primary outcome was the reduction in AS measured by PWV.

The results demonstrated that the most effective exercise intervention for reducing AS was aerobic exercise. However, for pediatric patients with a higher cardiometabolic risk, high-intensity interval training (HIIT) was more effective at reducing AS. Sensorimotor training was the only intervention that had no effect on AS. Despite these results, the study was limited by the different instruments used to measure PWV, which may have influenced the overall effect size of the intervention. Nonetheless, the present study demonstrated the potential role for exercise to mitigate the development of AVCD at an early age.

Click to read the study in British Journal of Sports Medicine

Image: PD

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