1 Introduction
2 Research Design and Methods
2.1 Literature Search
2.2 Inclusion Criteria
2.3 Measured Outcomes
2.4 Data Extraction
2.5 Study Quality
2.6 Statistical Analysis
3 Results
3.1 Literature Search
3.2 Characteristics of the Participants and Study Designs
Study (year) | Study design | MetS criteria | Medication | Group | Pre/post (n) | Sex (M/F) | Mean age (years) | Duration (weeks) | Intervention | Outcomes |
---|---|---|---|---|---|---|---|---|---|---|
Dynamic endurance training | ||||||||||
Dumortier et al. [14] (2003) | CT | WHO 1998 | No | Ex | 28/28 | 7/21 | 52 | 8 | F: 3×/week | MetS: WC, plasma glucose, HDL-C, TG |
Con | 11/11 | 4/7 | 53 | I: maximal lipid oxidation (defined by exercise calorimetry) | Other: \( {\dot{{V}}\text{O}}_{{ 2 {\text{peak}}}} \), WHR, BW, BMI, FM, FFM (PBF), plasma insulin, TC, LDL-C | |||||
T: 40 min | ||||||||||
T: aerobic continuous training (cycling) | ||||||||||
Watkins et al. [15] (2003) | RCT | Othera
| No | Ex | 21/14 | Both | NA | 26 | F: 3–4×/week | MetS: fasting glucose, SBP, DBP, HDL-C, TG |
Con | 11/11 | Both | NA | I: 70–85% HRres
| Other: \( {\dot{{V}}\text{O}}_{{ 2 {\text{peak}}}} \), BW, BMI, PBF, fasting insulin, TC, LDL-C | |||||
T: 55 min (10 min warm-up, 35 min at training intensity, 10 min cool-down) | ||||||||||
T: aerobic continuous training (cycling, walking, jogging) | ||||||||||
Gomes et al. [16] (2008) | CT | ATP III 2001 | Yes, except lipid medication | Ex | 18/18 | NA | 46 | 12 | F: 3×/week | MetS: WC, glucose, SBP, DBP, HDL-C, TG |
Con | 10/10 | NA | 46 | I: HR on anaerobic threshold, 10% below RCP | Other: BMI, TC, LDL-C, HR | |||||
T: 45 min | ||||||||||
T: aerobic continuous training (cycling) | ||||||||||
Irving et al. [17] (2008) | RCT | IDF 2005 | No | Ex 1 | 12/9 | 0/9 | 51 | 16 | F: 5×/week | MetS: WC, fasting glucose, SBP, DBP, HDL-C, TG |
Ex 2 | 15/11 | 0/11 | 51 | 16 | I: 2 sessions below lactate threshold (RPE 10–12) and 3 sessions between lactate threshold and \( {\dot{{V}}\text{O}}_{{ 2 {\text{peak}}}} \) (RPE 15–17) | Other: \( {\dot{{V}}\text{O}}_{{ 2 {\text{peak}}}} \), BW, BMI, FM, FFM (PBF) | ||||
Con | 9/9 | 0/9 | 51 | T: time depending on energy expenditure | ||||||
T: high-intensity aerobic continuous training (walking, running) | ||||||||||
F: 5×/week | MetS: WC, fasting glucose, SBP, DBP, HDL-C, TG | |||||||||
I: below lactate threshold (RPE 10–12) | Other: \( {\dot{{V}}\text{O}}_{{ 2 {\text{peak}}}} \), BW, BMI, FM, FFM (PBF) | |||||||||
T: time depending on energy expenditure | ||||||||||
T: low-intensity aerobic continuous training (walking, running) | ||||||||||
Tjønna et al. [18] (2008) | RCT | WHO 1998 | Yes | Ex 1 | 12/11 | 4/7 | 55 | 16 | F: 3×/week | MetS: WC, WHR, fasting glucose, insulin, SBP, DBP, HDL-C, TG |
Ex 2 | 10/8 | 4/4 | 52 | 16 | I: 10 min warm-up 70% HRpeak, 4 × 4 min 90% HRpeak and 3 × 3 min 70% HRpeak, 5 min min cool-down | Other \( {\dot{{V}}\text{O}}_{{ 2 {\text{peak}}}} \), BW, BMI | ||||
Con | 10/9 | 5/4 | 50 | T: 40 min | ||||||
T: aerobic interval training (walking, running uphill) | ||||||||||
F: 3×/week | MetS: WC, fasting glucose, SBP, DBP, HDL-C, TG | |||||||||
I: 70% HRpeak
| Other: \( {\dot{{V}}\text{O}}_{{ 2 {\text{peak}}}} \), WHR, BW, BMI, insulin | |||||||||
T: 47 min | ||||||||||
T: aerobic continuous training (walking, running uphill) | ||||||||||
Balducci et al. [20] (2010) | RCT | IDF 2005 | Yes | Ex 1 | 20/18 | 12/8 | 64 | 52 | F: 2×/week | MetS: WC, SBP, DBP, HDL-C, TG |
Con | 20/20 | 11/9 | 61 | I: 70-80% \( {\dot{{V}}\text{O}}_{{ 2 {\text{peak}}}} \)
| ||||||
T: 60 min | Other: \( {\dot{{V}}\text{O}}_{{ 2 {\text{peak}}}} \), BW, BMI, PBF, TC, LDL-C, HbA1c, HOMA-index | |||||||||
T: aerobic continuous training (walking, jogging, cycling) | ||||||||||
Stensvold et al. [21] (2010) | RCT | IDF 2005 | Yes | Ex 1 | 11/11 | Both | 50 | 12 | F: 3×/week | MetS: WC, glucose, SBP, DBP, HDL-C, TG |
Con | 11/11 | Both | 47 | I: 10 min warm-up 70% HRpeak, 4 × 4 min 90–95% HRpeak and 4 × 3 min 70% HRpeak, 5 min cool-down | Other: \( {\dot{{V}}\text{O}}_{{ 2 {\text{peak}}}} \), BW, BMI, FM, FFM (PBF), TC, HbA1c
| |||||
T: 43 min | ||||||||||
T: aerobic interval training (walking, running) | ||||||||||
Dynamic resistance training | ||||||||||
Stensvold et al. [21] (2010) | RCT | IDF 2005 | Yes | Ex 2 | 11/10 | Both | 51 | 12 | F: 3×/week (2 × programme 1, 1 × programme 2) | MetS: WC, glucose, SBP, DBP, HDL-C, TG |
Con | 11/11 | Both | 47 | I: warm-up 2 sets, 15–20 repetitions, 40–50% 1RM, week 1: 60% 1RM; from week 2 on: 3 sets, 8–12 repetitions, 80% 1RM | Other: \( {\dot{{V}}\text{O}}_{{ 2 {\text{peak}}}} \), BW, BMI, FM, FFM (PBF), TC, HbA1c
| |||||
T: programme 1: 40 min; programme 2: 50 min | ||||||||||
T: dynamic resistance training, programme 1: 3 exercises; programme 2: 5 exercises | ||||||||||
Combined intervention: dynamic endurance + dynamic resistance training | ||||||||||
Balducci et al. [20] (2010) | RCT | IDF 2005 | Yes | Ex 2 | 22/20 | 14/8 | 61 | 52 | F: 2×/week | MetS: WC, SBP, DBP, HDL-C, TG |
Con | 20/20 | 11/9 | 61 | I: aerobic endurance training 70–80% \( {\dot{{V}}\text{O}}_{{ 2 {\text{max}}}} \) dynamic resistance training 80% 1RM | Other: \( {\dot{{V}}\text{O}}_{{ 2 {\text{peak}}}} \), BW, BMI, PBF, TC, LDL-C, HbA1C, HOMA-index | |||||
T: aerobic endurance training 40 min dynamic resistance training 20 min | ||||||||||
T: aerobic continuous training (walking, jogging, cycling) dynamic resistance training (4 exercises) | ||||||||||
Stensvold et al. [21] (2010) | RCT | IDF 2005 | Yes | Ex 3 | 10/9 | Both | 53 | 12 | F: 3×/week (2 × aerobic endurance training, 1 × dynamic resistance training) | MetS: WC, glucose, SBP, DBP, HDL-C, TG |
Con | 11/11 | Both | 47 | I: aerobic endurance training 10 min warm-up 70% HRpeak, 4 × 4 min 90–95% HRpeak and 4 × 3 min 70% HRpeak, 5 min cool-down dynamic resistance training warm-up 2 sets, 15–20 repetitions, 40–50% 1RM, week 1: 60% 1RM; from week 2 on: 3 sets, 8–12 repetitions, 80% 1RM | Other: \( {\dot{{V}}\text{O}}_{{ 2 {\text{peak}}}} \), BW, BMI, FM, FFM (PBF), TC, HbA1c
| |||||
T: aerobic endurance training 43 min dynamic resistance training 40 min | ||||||||||
T: aerobic interval training (walking, running) dynamic resistance training (3 exercises) |
Study (year) | Eligibility criteria | Randomly allocated | Allocated concealed | Similar baseline values | Blinding of assessors | Key outcomes in 85% of included subjects | Intent to treat | Between-group statistical comparison | Point + variability measure | Total PEDro score |
---|---|---|---|---|---|---|---|---|---|---|
Dumortier et al. [14] (2003) | 1 | 0 | 0 | 1 | 0 | 1 | 1 | 1 | 1 | 6 |
Watkins et al. [15] (2003) | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 1 | 1 | 5 |
Gomes et al. [16] (2008) | 1 | 0 | 0 | 1 | 0 | 1 | 1 | 1 | 1 | 6 |
Irving et al. [17] (2008) | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 1 | 1 | 5 |
Tjønna et al. [18] (2008) | 1 | 1 | 0 | 1 | 0 | 1 | 0 | 1 | 1 | 6 |
Balducci et al. [20] (2010) | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 8 |
Stensvold et al. [21] (2010) | 1 | 1 | 1 | 1 | 0 | 1 | 0 | 1 | 1 | 7 |
3.3 Primary Outcomes: Effect of Exercise on Cardiovascular Risk Factors Associated with the Metabolic Syndrome
3.4 Secondary Outcomes: Effect of Dynamic Endurance Exercise on Other Cardiovascular Risk Factors
Outcome | Mean baseline value | Mean effect | 95% CI | Significance | Interventions (n) | Heterogeneity I² (%) | Model used |
---|---|---|---|---|---|---|---|
Blood lipids | |||||||
LDL-C (mmol/L) | 3.34 | −0.38 | −0.75, −0.01 | p = 0.05 | 4 | 60 | RE |
TC (mmol/L) | 5.55 | −0.53 | −0.64, −0.42 | p < 0.001 | 5 | 23 | FE |
Anthropometric characteristics | |||||||
Weight (kg) | 92.06 | −3.51 | −5.40, −1.61 | p < 0.001 | 8 | 0 | FE |
BMI (kg/m²) | 32.18 | −1.65 | −2.81, −0.48 | p < 0.01 | 9 | 0 | FE |
FM (kg) | 38.73 | −1.92 | −6.41, +2.57 | NS | 4 | 0 | FE |
Glucose/insulin parameters | |||||||
Plasma insulin (mmol/L) | 18.68 | −0.98 | −4.51 to +2.56 | NS | 4 | 0 | FE |
Other secondary outcomes | |||||||
\( {\dot{V}{O}}_{{ 2 {\text{peak}}}} \) (mL/kg/min) | 26.61 | +5.86 | +3.03, +8.69 | p < 0.001 | 8 | 58 | RE |