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The intensity paradox: A systematic review and meta-analysis of its impact on the cardiorespiratory fitness of older adults
University of Agder, Kristiansand, Norway.ORCID iD: 0009-0003-7815-4915
University of Agder, Kristiansand, Norway.
University of Birmingham, Birmingham, United Kingdom.ORCID iD: 0009-0001-3928-2135
University of Birmingham, Birmingham, United Kingdom.ORCID iD: 0000-0002-8713-2457
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2024 (English)In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 34, no 2, article id e14573Article, review/survey (Refereed) Published
Abstract [en]

Aim: The present systematic review and meta-analysis aimed to compare the effect of moderate- versus high-intensity aerobic exercise on cardiorespiratory fitness (CRF) in older adults, taking into account the volume of exercise completed. Methods: The databases MEDLINE (Ovid), EMBASE (Ovid), and CENTRAL (Cochrane Library) were searched to identify randomized controlled trials (RCTs). Two reviewers extracted data and assessed bias. Comprehensive Meta-Analysis software calculated overall effect size, intensity differences, and performed meta-regression analyses using pre-to-post intervention or change scores of peak oxygen uptake (V̇O2peak). The review included 23 RCTs with 1332 older adults (intervention group: n = 932; control group: n = 400), divided into moderate-intensity (435 older adults) and high-intensity (476 older adults) groups. Results: Meta-regression analysis showed a moderate, but not significant, relationship between exercise intensity and improvements in V̇O2peak after accounting for the completed exercise volume (β = 0.31, 95% CI = [−0.04; 0.67]). Additionally, studies comparing moderate- versus high-intensity revealed a small, but not significant, effect in favor of high-intensity (Hedges' g = 0.20, 95% CI = [−0.02; 0.41]). Finally, no significant differences in V̇O2peak improvements were found across exercise groups employing various methods, modalities, and intensity monitoring strategies. Conclusion: Findings challenge the notion that high-intensity exercise is inherently superior and indicate that regular aerobic exercise, irrespective of the specific approach and intensity, provides the primary benefits to CRF in older adults. Future RCTs should prioritize valid and reliable methodologies for monitoring and reporting exercise volume and adherence among older adults. © 2024 The Authors. Scandinavian Journal of Medicine & Science In Sports published by John Wiley & Sons Ltd.

Place, publisher, year, edition, pages
Chichester: John Wiley & Sons, 2024. Vol. 34, no 2, article id e14573
Keywords [en]
adherence, aerobic exercise, aging, health, HIIT, individuality, public health, V̇O2peak
National Category
Geriatrics
Research subject
Health Innovation, M4HP
Identifiers
URN: urn:nbn:se:hh:diva-52742DOI: 10.1111/sms.14573PubMedID: 38389140Scopus ID: 2-s2.0-85184175153OAI: oai:DiVA.org:hh-52742DiVA, id: diva2:1840486
Available from: 2024-02-23 Created: 2024-02-23 Last updated: 2024-04-19Bibliographically approved

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Ivarsson, Andreas

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