Physical exercise and synaptic protection in human and pre-clinical models of multiple sclerosis

In multiple sclerosis,only immunomodulato ry and immunosuppressive drugs are recognized as disease-modifying therapies.Howeve r,in recent years,several data from pre-clinical and clinical studies suggested a possible role of physical exe rcise as disease-modifying therapy in multiple sclerosis.Current evidence is sparse and often conflicting,and the mechanisms underlying the neuroprotective and antinflammatory role of exercise in multiple sclerosis have not been fully elucidated.Data,mainly derived from pre-clinical studies,suggest that exe rcise could enhance longterm potentiation and thus neuroplasticity,could reduce neuroinflammation and synaptopathy,and dampen astrogliosis and microgliosis.In humans,most trials focused on direct clinical and MRI outcomes,as investigating synaptic,neuroinflammato ry,and pathological changes is not straightfo rward compared to animal models.The present review analyzed current evidence and limitations in research concerning the potential disease-modifying therapy effects of exercise in multiple sclerosis in animal models and human studies.

Study on the Influence of New Media on College Students’ Physical Exercise Behavior

New media is becoming an important method to promote physical exercise,and it is also an essential factor affecting the physical exercise behavior of college students.This study takes the influence of new media sports information on college students’physical exercise behavior as the research objective.By using a questionnaire survey and mathematical statistics,545 college students in Shandong Province of China are selected as research samples.Based on the theory of new media exposure,fitness behavior theory,and self-efficacy theory,this study systematically discusses the influence and mechanism of new media exposure on the physical exercise behavior of college students in Shandong Province,so as to help college students improve their physical exercise behavior.

Physical exercise protects muscle from accelerated aging induced by high-salt intake and muscle CG2196(salt)gene overexpression in Drosophila

Aging decreases muscle mass,strength,and functional capacity.High-salt stress seems to promote muscle aging and decrease lifespan.However,exercise delays muscle aging and increases longevity,and it may protect muscle from rapid aging induced by high-salt intake(HSI),but the molecular mechanisms are poorly understood.In this study,the flies were fed a high-salt diet and trained to exercise.Muscle CG2196(salt)gene and dSir2 gene were over-expressed by building mef2-gal4/UAS system.The results showed that both physical exercise and muscle dSir2 gene overexpression prevented HSI-induced and muscle salt overexpression-induced accelerated age-related decline of climbing index,climbing endurance,muscle NAD^(+)level,SOD activity level,dSir2 expression,and dFOXO expression,and they also prevented HSI-induced and muscle salt overexpression-induced accelerated age-related increase in muscle ROS level,MDA level,and salt gene expression.Physical exercise improved lifespan decrease induced by HSI and muscle salt overexpression.Therefore,current results indicated that high-salt stress accelerated muscle aging by decreasing muscular NAD^(+)/dSir2/dFOXO pathway activity and increasing oxidative stress.Physical exercise protected muscle from accelerated aging induced by high-salt stress through activating muscle NAD^(+)/dSir2/dFOXO pathway and enhancing muscle oxidation resistance.The combination of exercise and muscle dSir2 overexpression had the best protective effect on muscle aging and lifespan in flies.

Who Benefits More from Physical Exercise?On the Relations between Personality,Physical Exercise,and Well-Being

Although employers believe that encouraging and supporting physical exercise activities by purchasing fitness equipment and building sports venues can improve employees’well-being,the utilization rate is rather low.Since most of the evidence of the well-being promotion in the workplace concentrated on the perspectives of organizational factors and psychosocial factors and focused on the reduction of the negative affect of well-being,it is still an open question whether physical exercise has benefits on both negative and positive affect of well-being and who benefits more from physical exercise.Thus,the purpose of this study is to investigate the impact of physical exercise on occupational well-being(job burnout and work engagement)and examine whether effectiveness depends on personality traits.Online questionnaires were distributed.The sample included 671 participants from different enterprises in China.Results showed that the effectiveness of physical exercise was also applicable to well-being in the workplace.Physical exercise was negatively correlated with job burnout and positively correlated with work engagement.The effectiveness was different among employees with different personality traits.Contrary to our expectation,individuals with neuroticism were more likely to improve their work engagement through physical exercise.Extroversion and conscientiousness weakened the benefits of physical exercise.Therefore,differences of effectiveness among different personality traits emphasize the need for a more personalized strategy in physical exercise interventions.

Effects of Physical Exercise and Music Therapy on Cognitive Aspects in Tunisian Patients with Mild Alzheimer’s Type Dementia

Aim: The objective of this research is to highlight the effectiveness of physical exercise and music therapy in older patients with Alzheimer’s disease (AD). Methods: Patients with a mild level of AD were included in this study, divided into the therapy group (TG;N = 30, aged 68 ± 3.2 years) and the control group (CG;N=30, aged 65 ± 2.6 years). The therapy group was enrolled in an exercise-training program (walking, resistance and balance exercises) combined with musical therapy for 10 weeks (three sessions of 60 minutes per week). The Control group was instructed to follow their daily rhythm of life (e.g., rest, reading) under the same conditions. The intervention program was enrolled under the supervision of;one psychologist;a neurologist;two music therapists, and two physiotherapists, all belonging to the same hospital unit. After 10 weeks of participation in the combined program, cognitive parameters were improved in the therapy group measured with the Behavior Pathology in Alzheimer Disease (BEHAVE-AD), (p < 0.05) for activity disturbance, diurnal rhythm disturbances, anxieties and phobias, affective disturbance. The percentage range of improvements is 1.07% to 2.96%. Results: Our results demonstrate that physical exercise combined with music therapy improves cognitive function in patients with Alzheimer’s disease. Conclusions: Physical exercise and music therapy are beneficial combined treatments for improving life quality in older patients. This approach may be useful to help patients with a mild level of Alzheimer’s disease improve their behavioral and psychological parameters.

The Positive Effects of Physical Exercise on Mental Health Among Chinese Students Under Great Competitive Pressure

Under an environment full of competitive stress,students tend to form negative emotions,and the time for them to engage in physical exercise is greatly limited due to overwhelming academic tasks.Therefore,in this paper,we focus on acknowledging the purpose of physical exercise,and how physical exercise affects the mental health of students under stressful circumstances but not in the context of leisure.Questionnaire was distributed to participants with an average age of 20,to investigate their preference,frequency,and reason for exercising,and their attitude towards it.Our results showed that participants think that exercise can strengthen the body,relieve stress,improve fitness and interpersonal relationship regardless of their purpose such as interests,emotional necessity and even out of non-subjective ideas.In conclusion,physical exercise helped to improve students’mental health especially under great pressure and ultimately,it will enhance their academics and bring about the unity of mind and body.

Updated overview on interplay between physical exercise,neurotrophins,and cognitive function in humans

The many important benefits of physical exercise also encompass maintenance or improvement of cognitive functions. Among the variousmechanisms underlying the association between physical exercise and brain health, recent evidence attests that neurotrophin receptor signalingmay have an important role, because the activation of this pathway leads to growth and differentiation of new neurons and synapses, supportsaxonal and dendritic growth, fosters synaptic plasticity, and preserves survival of existing neurons. In this review of published evidence, we highlightthat a positive relationship exists between physical exercise and circulating brain-derived neurotrophic factor levels and that the postexercisevariation of this molecule is associated with improvement of neurocognitive functioning. Less clear evidence has instead been published forother neurotrophins, such as nerve growth factor, neurotrophin-3, and neurotrophin-4. Overall, promotion of adequate volumes and intensities ofphysical exercise (i.e., approximately 3 months of moderate-intensity aerobic exercise, with 2—3 sessions/week lasting not less than 30 min)may hence be regarded as an inexpensive and safe strategy for boosting brain-derived neurotrophic factor release, thus preserving or restoringcognitive functions.

Investigating Physical Exercise among Jordanians with Diabetes Mellitus

This study is aimed to investigate exercise behaviors (frequency and duration) among Jordanian diabetic patients, and their correlation with their physical characteristics and perceived exercise benefits and barriers, exercise self efficacy, and exercise planning. An exploratory descriptive design was utilized using the cross-sectional survey with self-reported questionnaires (Demographics, Charlson Comorbidity Index, Exercise Self-Efficacy Scale, Exercise Benefits and Barriers Scale, and Commitment to a Plan for Exercise Scale). A convenience sample of 115 Jordanians with diabetes mellitus was recruited from diabetes outpatient clinics. Participants reported an average number of 3.2 physical activities per week (average of 2.9 hours), with walking being the most common activity. Participant’s body mass index, comorbidity index, and exercise self-efficacy were correlated with both frequency and duration of exercise (r = -0.393, -0.286, 0.219 and -0.272, 0.383, 0.260, respectively). A predictive model of five predictors (age, BMI, CCI, exercise self efficacy, and perceived exercise barriers) that significantly predicted exercise duration (R2 = 0.34, F = 9.14, P < 0.000) was found. Diabetic patients were found to exercise less than optimum. Illness itself was not a cause of not exercising compared to lack of time and desire. Factors that can enhance or inhibit participants’ engagement in exercise should be included in designing tailored exercise educational programs.

THE ADAPTABLE CHANGE OF THE FUNCTION OF T LYMPHOCYTES FOR PHYSICAL EXERCISE WITH OXYGEN

Objective To find out the possible regularity and mechanism of the adaptable change of human be- ing T lymphocytes for physical exercise with oxygen and bring the original data for the Movement of All People Im- proving their Health. Methods We selected 16 untrained female students in university and let them had the same amount of exercise for 8 weeks. After that, we collected the cycle blood at the time point or before exercise, the end of exercise and 1 hour after exercise at the end or the 0,first, 2 nd, 4 nd, 6 nd and 8 nd week respectively, so as to de- termine its stimuli index (SI) by MTT method. Results In the different time sect, such as the early stage or exer- cise, quiet condition,as soon as the end of exercise and 1 hour after exercise, we found that the SI were obviousIy low- er than that or normal (P<0.05),especially in the time sect of the end or exercise. Continuing to 4 weeks,the func- tion of T lymphocytes restored gradualy and it lasted to the 8th week, the SI in quiet condition and 1 hour after exer- cise had restored to normal (P>0.05),but in the end or exercise, it still was low,however. the extent of the cases se- lected was in a condition or acute excitability. Conclusion As the bodies adapting to the exercise, the function of T lymphocytes restored slowly and the rate increased faster and faster.

Physical Exercise as Treatment for Type 2 Diabetes Distal Symmetric Polyneuropathy: A Systematic Review of Randomized and Controlled Studies

Pharmaceuticals targeting the pathogenesis of diabetic distal symmetric polyneuropathy have all failed in clinical trials, limiting recourse to palliative treatments. The American Diabetes Association regards the effectiveness of glycemic control and lifestyle modification therapies on diabetic neuropathies as inconclusive. The objective of this research was to determine if and how physical exercise influences distal symmetric polyneuropathic severity in type 2 diabetes patients. Embase, MEDLINE, and Google Scholar were searched to collect randomized and controlled studies published between January 1, 2012 and April 20, 2020. Titles had to mention diabetes, physical exercise of any type or lifestyle interventions in general, and neuropathy. Abstracts had to indicate satisfaction of PICOS criteria, whereas full-text reviews had to be fully confirmatory. Extracted data was thematically synthesized based primarily on relationships between exercise interventions and effects on distal symmetric polyneuropathic severity outcomes in type 2 diabetes patients. Qualitative analysis scoring criteria objectively mirrored PICO except for the bias and limitation score component, which assessed common markers of validity for randomized trials (as specified in the PRISMA statement). Database searches yielded 379 unique records, 15 of which passed eligibility screening. Thematic synthesis supported exercise as an ameliorative treatment of type 2 diabetes distal symmetric polyneuropathy through improved Michigan Diabetic Neuropathy Scores and increased sural sensory nerve conduction velocity, though efficacy may be limited by neuropathic severity. This is the first systematic review to acquire these results, and to do so within the context of neuropathic severity. This review protocol is registered on PROSPERO (CRD42020181211) at https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020181211

Physical Exercise and Gene p53—A Mini Review

Cancer is a global problem that in addition to physical, emotional and physiological causes economic and social impacts. The p53 gene is a tumor suppressor gene found in many malignant and benign tumors;this has the primary function of keeping cells at rest after damaging to DNA. The p53 acts in the maintenance of cellular homeostasis, mainly through autophagy, playing a role in cell cycle arrest, when necessary, thus avoiding mutated DNA replication. When in the oncogenic environment in many cases it is mutated, losing much of its efficiency allowing tumor development. Studies show that exercise can in the regular part of its pro-autophagic function even in the oncology setting. Stimuli of moderate-intensity aerobic and predominance of submaximal seem to trigger the protective function of p53 in various cancer settings. Among the many changes that these pathology triggers were the objective of this mini review is to relate the changes that exercise generates in p53 protein functions and their possible influence on tumor cells.

Morbid Obesity: A Review on the Reasons for Impediments to Physical Exercises and Social Activities

Morbid obesity is regarded as a disease due to excess body weight, causing a silence of life as a whole and entailing the most varied disabilities for the person, such as: physical, social, psychological, affective, etc. It represents cases of “public health”, thereby involving competent bodies in the development of solutions that encompass various medical specialties and other health fields, in addition to influencing the mind of these people, causing depression that, due to metabolic involvement, can evolve to the death of the individual. The participation of multidisciplinary health focuses on weight loss, freely and spontaneously, or on the indication of bariatric surgery. We know how difficult it is to lose weight. In order to achieve successful procedures, we recommend the “Obese Workshop” or pre- and post-surgical follow-ups close to the patients, with a view to avoiding recurrences or the “accordion effect” (very common), which can interfere with the Body Mass Index (BMI). Everyone, males and females, complained of tiredness and the impossibility of any physical exercise, even the lightest and simplest to be performed, in addition to the fact that they cannot attend gyms and are unable to open a simple door handle.

The relationship between physical exercise and subjective well-being in Chinese college students: the mediating role of psychological resilience and the moderating role of peer influence

Objective:To explore the influence of physical exercise,psychological resilience,and peer influence on subjective well-being,and then build a model of moderated mediation.Methods:Physical Activity Rating,Connor Davision Resilience Scale,Peer Influence Scale,and Index of Well-Being were used.This paper investigated 790 undergraduates.Results:(1)Physical exercise has a significant positive predictive effect on subjective well-being(β=0.43,P<0.001);(2)Psychological resilience plays a part in mediating the relationship between physical exercise and subjective well-being.The mediating effect value is 0.18;(3)The relationship between physical exercise and psychological resilience moderated by the peer influence.Compared with the low peer influence(β simple=0.01,t=0.06,P>0.05),physical exercise has a stronger positive predictive effect on psychological resilience in college students with high peer influence(β simple=0.87,t=2.07,P<0.05).Conclusion:Physical exercise affects college students'subjective well-being through psychological resilience,and peer influence moderates the mediating effect of psychological resilience.

Roles and molecular mechanisms of physical exercise in cancer prevention and treatment

Exercise can enhance motivation to change lifestyle behaviors,improve aerobic fitness,improve physical function,control fatigue,and enhance quality of life.Studies have demonstrated the benefits to be gained from physical exercise,highlighting the importance of popularizing the concept of physical exercise for individuals and making professional exercise-treatment programs available to patients with cancer.However,the correlation between physical exercise and carcinogenesis is easily overlooked,and exercise interventions are not routinely provided to patients with cancer,especially those with advanced cancer.In this article,we present a literature review of the effects of exercise on cancer development and progression and give recent evidence for the type of exercise best suited for different types of cancer and in different disease stages.Moreover,the molecular mechanisms about regulating metabolism and systemic immune function in cancer are summarized and discussed.In conclusion,physical exercise should be considered as an important intervention for preventing and treating cancer and its complications.

Physical exercise suppresses hepatocellular carcinoma progression by alleviating hypoxia and attenuating cancer stemness through the Akt/GSK-3β/β-catenin pathway

Objective:Physical exercise,a common non-drug intervention,is an important strategy in cancer treatment,including hepatocellular carcinoma(HCC).However,the mechanism remains largely unknown.Due to the importance of hypoxia and cancer stemness in the development of HCC,the present study investigated whether the anti-HCC effect of physical exercise is related to its suppression on hypoxia and cancer stemness.Methods:A physical exercise intervention of swimming(30 min/d,5 d/week,for 4 weeks)was administered to BALB/c nude mice bearing subcutaneous human HCC tumor.The anti-HCC effect of swimming was assessed in vivo by tumor weight monitoring,hematoxylin and eosin(HE)staining,and immunohistochemistry(IHC)detection of proliferating cell nuclear antigen(PCNA)and Ki67.The expression of stemness transcription factors,including Nanog homeobox(NANOG),octamer-binding transcription factor 4(OCT-4),v-Myc avian myelocytomatosis viral oncogene homolog(C-MYC)and hypoxia-inducible factor-1a(HIF-1a),was detected using real-time reverse transcription polymerase chain reaction.A hypoxia probe was used to explore the intratumoral hypoxia status.Western blot was used to detect the expression of HIF-1a and proteins related to protein kinase B(Akt)/glycogen synthase kinase-3β(GSK-3β)/β-catenin signaling pathway.The IHC analysis of platelet endothelial cell adhesion molecule-1(CD31),and the immunofluorescence co-location of CD31 and desmin were used to analyze tumor blood perfusion.SMMC-7721 cells were treated with nude mice serum.The inhibition effect on cancer stemness in vitro was detected using suspension sphere experiments and the expression of stemness transcription factors.The hypoxia status was inferred by measuring the protein and mRNA levels of HIF-1a.Further,the expression of proteins related to Akt/GSK-3β/β-catenin signaling pathway was detected.Results:Swimming significantly reduced the body weight and tumor weight in nude mice bearing HCC tumor.HE staining and IHC results showed a lower necrotic area ratio as well as fewer PCNA or Ki67 positive cells in mice receiving the swimming intervention.Swimming potently alleviated the intratumoral hypoxia,attenuated the cancer stemness,and inhibited the Akt/GSK-3β/β-catenin signaling pathway.Additionally,the desmin+/CD31+ratio,rather than the number of CD31+vessels,was significantly increased in swimming-treated mice.In vitro experiments showed that treating cells with the serum from the swimming intervention mice significantly reduced the formation of SMMC-7721 cell suspension sphere,as well as the m RNA expression level of stemness transcription factors.Consistent with the in vivo results,HIF-1a and Akt/GSK-3β/β-catenin signaling pathway were also inhibited in cells treated with serum from swimming group.Conclusion:Swimming alleviated hypoxia and attenuated cancer stemness in HCC,through suppression of the Akt/GSK-3β/β-catenin signaling pathway.The alleviation of intratumoral hypoxia was related to the increase in blood perfusion in the tumor.

Sport and physical exercise in sustainable mental health care of common mental disorders:Lessons from the COVID-19 pandemic

The large-scale disruptions to physical activity during the coronavirus pandemic have been found to be a leading predictor of common mental disorders.In addition,regular physical exercise has been found to alleviate anxiety,sadness and depression during the pandemic.These findings,together with numerous studies published before the pandemic on the effects of physical activity on mental health,should be considered in the provision of mental health care following the pandemic.Cross-sectional research has revealed that all types of exercise and sport are associated with a reduced mental health burden.Therefore,the effectiveness of exercise and sport participation in sustainable mental health care as well as the causal relationship between exercise,psychosocial health and common mental disorders merit further investigation.Physical activity and sport,with their global accessibility,significant and clinically meaningful efficacy as well as virtual absence of adverse effects,offer a promising option for the promotion of mental health,including the prevention and treatment of common mental disorders.Physical exercise and sport are likely to become valuable public mental health resources in the future.

Non-coding RNAs in exercise immunology:A systematic review

Regular physical exercise has been recognized as a potent modulator of immune function,with its effects including enhanced immune surveillance,reduced inflammation,and improved overall health.While strong evidence exists that physical exercise affects the specific expression and activity of non-coding RNAs(ncRNAs)also involved in immune system regulation,heterogeneity in individual study designs and analyzed exercise protocols exists,and a condensed list of functional,exercise-dependent ncRNAs with known targets in the immune system is missing from the literature.A systematic review and qualitative analysis was used to identify and categorize ncRNAs participating in immune modulation by physical exercise.Two combined approaches were used:(a)a systematic literature search for“ncRNA and exercise immunology”,(b)and a database search for microRNAs(miRNAs)(miRTarBase and DIANA-Tarbase v8)aligned with known target genes in the immune system based on the Reactome database,combined with a systematic literature search for“ncRNA and exercise”.Literature searches were based on PubMed,Web of Science,and SPORTDiscus;and miRNA databases were filtered for targets validated by in vitro experimental data.Studies were eligible if they reported on exercise-based interventions in healthy humans.After duplicate removal,95 studies were included reporting on 164 miRNAs,which were used for the qualitative synthesis.Six studies reporting on long-noncoding RNAs(lncRNAs)or circular RNAs were also identified.Results were analyzed using ordering tables that included exercise modality(endurance/resistance exercise),acute or chronic interventions,as well as the consistency in reported change between studies.Evaluation criteria were defined as“validated”with 100%of3 independent studies showing identical direction of regulation,“plausible”(≥80%),or“suggestive”(≥70%).For resistance exercise,upregulation of miR-206 was validated while downregulation of miR-133a appeared plausible.For endurance exercise,15 miRNAs were categorized as validated,with 12 miRNAs being consistently elevated and 3 miRNAs being downregulated,most of them after acute exercise training.In conclusion,our approach provides evidence that miRNAs play a major role in exercise-induced effects on the innate and adaptive immune system by targeting different pathways affecting immune cell distribution,function,and trafficking as well as production of(anti-)inflammatory cytokines.miRNAs miR-15,miR-29c,miR-30a,miR-142/3,miR-181a,and miR-338 emerged as key players in mediating the immunomodulatory effects of exercise predominantly after acute bouts of endurance exercise.

Roles of physical exercise in neurodegeneration:reversal of epigenetic clock

The epigenetic clock is defned by the DNA methylation(DNAm)level and has been extensively applied to distinguish biological age from chronological age.Aging-related neurodegeneration is associated with epigenetic alteration,which determines the status of diseases.In recent years,extensive research has shown that physical exercise(PE)can afect the DNAm level,implying a reversal of the epigenetic clock in neurodegeneration.PE also regulates brain plas‑ticity,neuroinfammation,and molecular signaling cascades associated with epigenetics.This review summarizes the efects of PE on neurodegenerative diseases via both general and disease-specifc DNAm mechanisms,and discusses epigenetic modifcations that alleviate the pathological symptoms of these diseases.This may lead to probing of the underpinnings of neurodegenerative disorders and provide valuable therapeutic references for cognitive and motor dysfunction.

Physical exercise and COVID-19 pandemic in PubMed:Two months of dynamics and one year of original scientific production

Our aim was to conduct a narrative review about physical exercise and Corona Virus Disease 2019(COVID-19).A literature search was completed crossing the keywords“COVID-19”and“physical exercise”,for a narrative re-view,and physical activity(PA),physical exercise,physical training,sport,physical fitness,for a systematic re-view;search strategy(Randomized Controlled Trial,in the last 1 year,English).The first search date was closed on 04/26/2020 and 06/26/2020.This strategy was chosen to assess the dynamics of scientific information production for the pandemic.In two months,an increase of 76%,from 12(19.4%)to 50(80.64%)COVID-19 articles(n=62,100%)was found.The main types of articles published were editorial articles(16.13%,n=10 of 62 articles)and commentary(9.68%,n=6 of 62 articles).The most frequent country of origin of the scientific production was the United States(12.90%,n=8 of 62 articles),the United Kingdom(12.90%,n=8 of 62 arti-cles),and Brazil(11.29%,n=7 of 62 articles).However,in 2020,there were only 2 relevant randomized controlled trials on the COVID-19 topic in the context of physical exercise.Scientific information production shows the concern of the PA science community to bring a solution to the increase in physical inactivity generated by the COVID-19 pandemic.Our findings show the dynamics of scientific production on the COVID-19,in a situation so unique such as a pandemic,denotes that the practice of PA is essential to improve and/or maintain physical and mental health.

Prevalence of Achilles tendinopathy in physical exercise:A systematic review and meta-analysis

This comprehensive systematic review and meta-analysis assessed the prevalence of Achilles tendinopathy(AT)in physical exercise(PE).Specifically,we estimate the overall risk of AT in physical exercise and compare sportspecific estimates of AT risk.PubMed,Web of Science,Cochrane Library,and SPORTDiscus were searched before the 1st of October 2021.Random-effects,subgroup analysis,sensitivity analysis and meta-regressions were conducted,involving 16 publications.This meta-analysis found that the overall prevalence of AT was 0.06(95%CI,0.04–0.07).The prevalence of Achilles tendon rupture was 0.03(95%CI,0.02–0.05).Subgroup analysis showed that the prevalence of AT increased with age,the highest among the group aged over 45(0.08;95%CI,0.04–0.11),and the lowest among the group under 18 years old(0.02;95%CI,0.01–0.03).The gymnastics and ball games had the highest prevalence of AT,at(0.17;95%CI,0.14–0.20)and(0.06;95%CI,0.02–0.11),respectively.The prevalence of AT in athletes(0.06;95%CI,0.04–0.08)was higher than that of amateur exercisers(0.04;95%CI,0.02–0.06)and there was no difference in the prevalence of AT between males and females.There are differences in the prevalence of AT in different ages,sport events and characteristics of participants.This systematic review and meta-analysis suggested that it was necessary to pay more attention to AT in people who were older or engaged in gymnastics.