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Effects of Resistance and Endurance Training Alone or Combined on Hormonal Adaptations and Cytokines in Healthy Children and Adolescents: A Systematic Review and Meta-analysis
Umeå University, Faculty of Social Sciences, Umeå School of Sport Sciences. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Sports Medicine.ORCID iD: 0000-0002-6488-0663
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Sports Medicine. Winternet, Boden, Sweden.ORCID iD: 0000-0002-2339-6381
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.ORCID iD: 0000-0002-0726-7029
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2022 (English)In: Sports Medicine - Open, ISSN 2199-1170, Vol. 8, no 1, article id 81Article, review/survey (Refereed) Published
Abstract [en]

Background: No previous systematic review has quantitatively compared the effects of resistance training, endurance training, or concurrent training on hormonal adaptations in children and adolescents. Objective was to examine the effects of exercise training and training type on hormonal adaptations in children and adolescents.

Methods: A systematic literature search was conducted in the following databases: PubMed, Web of Science, and EBSCO. Eligibility criteria were: population: healthy youth population sample (mean age < 18 years); intervention: resistance training, endurance training, or concurrent training (> 4 weeks duration); comparison: control group; outcome: pre- and post-levels of hormones and cytokines; and study design: randomized and non-randomized controlled trials. We used a random-effect model for the meta-analysis. The raw mean difference in hormones from baseline to post-intervention was presented alongside 95% confidence intervals (CI). Further, the certainty of evidence quality and the risk of bias were assessed.

Results: A total of 3689 records were identified, of which 14 studies were eligible for inclusion. Most studies examined adolescents with fewer studies on children (age < 12 years, N = 5 studies) and females (N = 2 studies). Nine exercise training programs used endurance training, five studies used resistance training, and no eligible study used concurrent training. The meta-analysis showed no significant effect of exercise training on testosterone (MD = 0.84 nmol/L), cortisol (MD = − 17.4 nmol/L), or SHBG (MD = − 5.58 nmol/L). Subgroup analysis showed that resistance training significantly increased testosterone levels after training (MD = 3.42 nmol/L) which was not observed after endurance training (MD = − 0.01 nmol/L). No other outcome differed between training types. Exercise training resulted in small and non-significant changes in GH (MD = 0.48 ng/mL, p = 0.06) and IGF-I (MD = − 22.90 ng/mL, p = 0.07). GH response to endurance training may be age-dependent and evident in adolescents (MD = 0.59 ng/mL, p = 0.04) but not when children and adolescents are pooled (MD = 0.48 ng/mL, p = 0.06). Limited evidence exists to conclude on IL-6 and TNF-α effects of exercise training. Assessments of GRADE domains (risk of bias, consistency, directness, or precision of the findings) revealed serious weaknesses with most of the included outcomes (hormones and cytokines).

Conclusions: This systematic review suggests that exercise training has small effects on hormonal concentrations in children and adolescents. Changes in testosterone concentrations with training are evident after resistance training but not endurance training. GH's response to training may be affected by maturation and evident in adolescents but not children. Further high-quality, robust training studies on the effect of resistance training, endurance training, and concurrent training are warranted to compare their training-specific effects.

Place, publisher, year, edition, pages
Springer, 2022. Vol. 8, no 1, article id 81
Keywords [en]
Cortisol, GH, IGF-I, IL-6, Pediatric, SHBG, Testosterone, TNF-α
National Category
Sport and Fitness Sciences
Identifiers
URN: urn:nbn:se:umu:diva-197785DOI: 10.1186/s40798-022-00471-6ISI: 000814259800001PubMedID: 35727479Scopus ID: 2-s2.0-85132812161OAI: oai:DiVA.org:umu-197785DiVA, id: diva2:1681164
Available from: 2022-07-06 Created: 2022-07-06 Last updated: 2025-02-11Bibliographically approved
In thesis
1. Physical activity in children and effects of maturation on exercise: with reference to training, biomarkers, anthropometrical factors, and methods
Open this publication in new window or tab >>Physical activity in children and effects of maturation on exercise: with reference to training, biomarkers, anthropometrical factors, and methods
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Fysisk aktivitet och effekter av biologisk mognad hos barn : med hänvisning till träning, biomarkörer, antropometriska faktorer och metoder
Abstract [en]

Background: Regular physical activity during childhood and adolescence can positively affect overall cardiometabolic health, fundamental motor skill development, bone density, quality of life, and psychological well-being. Research on physical activity in children is growing continuously, and one area is focused on assessing children's physical activity. Advances in wearable technology have provided more reliable tools for assessing physical activity, particularly in young children. These wearables must be calibrated to age-specific groups, body positions, and epoch times. Furthermore, muscle strength is an important health indicator in children; however, little is known about how muscle strength is influenced by age, maturity, hormones, and cytokines in pediatric populations. This thesis aimed to examine methods to estimate physical activity in children, understand which factors are associated with muscular strength in trained male children, and increase our understanding of how exercise-related hormones and proinflammatory cytokines (IL-6 and TNF-α) adapt to acute and long-term training. 

Methods: This thesis included four studies. Paper I aimed to calibrate two accelerometer devices, MotionWatch 8 (MW8) and ActiGraph GT3X ( GT3X), worn on the hip and wrist (n = 30), and to develop age-specific cut-offs for physical activity intensities in 3-year-old children. Paper II was a cross-sectional study that examined the associations of muscular strength measures with anthropometric factors, chronological age, maturation, and training experience in trained prepubertal and pubertal males (n = 41). Another aim of Paper II was to examine whether a handgrip strength test can predict the total muscle strength assessed with whole-body free-weight exercises. Paper III was an intervention study that examined acute hormonal and cytokine responses to free-weight resistance training in trained prepubertal and pubertal male children (n = 41). Paper IV was a systematic review and meta-analysis that assessed the evidence of the effects of exercise training and training type on hormone and cytokine adaptations in children and adolescents. 

Results: There was a strong correlation between MW8 and the GT3X device (counts/30 s) at both hip and wrist levels (Paper I). The devices' cut-off scores for physical activity levels were classified with outstanding and excellent accuracy (Paper I). The cross-sectional study showed that muscular strength tests in trained male children are mostly associated with anthropometric factors, which differ depending on the exercise test chosen (Paper II). Furthermore, the handgrip strength test was strongly associated with total muscle strength in trained male children (Paper II). A single resistance training session induced greater acute post-exercise testosterone and IGF-I levels in pubertal children than in prepubertal male children (Paper III). Post-exercise IL-6 levels were significantly increased only in the prepubertal group. Lastly, the systematic review and meta-analysis showed that long-term exercise training had a small effect on resting hormonal concentrations. Resistance training, but not endurance training, increased resting testosterone levels in healthy children and adolescents (Paper IV). 

Conclusions: Measuring and classifying physical activity levels in preschoolers can be achieved accurately using MW8 or the GT3X device (Paper I). Another finding was that anthropometric measures such as body mass and fat-free mass are important factors associated with muscle strength, and they may be used to scale muscle strength scores to provide a fair interpretation across children of different body sizes (Paper II). A simple handgrip strength test could be a quick and effective screening tool for practitioners and researchers to estimate total muscle strength in trained male children (Paper II). Furthermore, pubertal children were stronger than prepubertal children and had greater post-exercise IGF-I and testosterone responses following a single resistance training session (Paper III). Finally, the systematic review and meta-analysis suggested that exercise training had a small effect on hormonal concentrations in healthy children and adolescents (Paper IV). 

Place, publisher, year, edition, pages
Umeå: Umeå University, 2024. p. 94
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 2335
Keywords
Growth, maturation, accelerometers, actigraphy, hormones, cytokines, resistance training
National Category
Sport and Fitness Sciences
Research subject
Sports Medicine
Identifiers
urn:nbn:se:umu:diva-233054 (URN)9789180705288 (ISBN)9789180705295 (ISBN)
Public defence
2025-01-17, Aula Biologica, Biologihuset, Umeå, 09:00 (English)
Opponent
Supervisors
Available from: 2024-12-20 Created: 2024-12-18 Last updated: 2025-02-11Bibliographically approved

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Jansson, DanielLindberg, Ann-SofieLundberg, ElenaDomellöf, MagnusTheos, Apostolos

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