Journal of Rehabilitation Medicine 51-7 | Page 6

Effect of different levels of exercise on telomere length 475 subgroup analysis demonstrated that longer telomere length was not found in individuals who engaged in aerobic exercise (MD 0.07; 95% CI –0.02, 0.17; p = 0.14). Total search reslut In addition, longer telomere length 6,763 was positively correlated with exer- 2,651 duplicates removed cise in both sexes (MD 0.11; 95% CI 4,112 titles 0.02, 0.21; p = 0.02 for males; MD and abstracts Common reasons for exclusion: 0.20; 95% CI 0.02, 0.37; p = 0.03 for screened -not analyze the association females). Longer telomere length was between physical exercise and telomere lenght also found in individuals <65 years 71 full texts -non-English or Chinese study of age (MD 0.25; 95% CI 0.09, 0.40; screened p = 0.002), but not in elderly indivi- Reasons for exclusion: duals (MD 0.11; 95% CI –0.09, 0.31; -cannot provide sufficient data (n=25) p = 0. 27). Subgroup analysis also -sample number 1<100 (n=10) 11 eligible -conference abstract (n=12) demonstrated a positive relationship papers -review (n=13) in all tissue sources and study types. Fig. 1. Search results and study selection. However, longer telomere length was not significant in active people of Included studies European descent (MD 0.07; 95% CI –0.01, 0.16; p = 0.09), or in the PCR group (MD 0.12; The characteristics of the included studies, invol- 95% CI –0.01, 0.25; p = 0.07). ving 19,292 participants, are summarized in Table I. Telomere length in these studies was determined using quantitative polyme- rase chain reaction (q-PCR), telomere restriction fragment (TRF) methodology, and Southern blot using leukocytes and peripheral blood mononuclear cells. Quality evaluation revealed that one study achieved the maximum score of 9, while the score for the remainder of the studies was > 7. The definition of mode- rate and robust physical exercise in the included studies varied. The intensity of robust exercise was defined as > 2.5 me- tabolic equivalent tasks (MET) h/week, while the definition of moderate exercise Fig. 2. Meta-analysis of the association between telomere length and exercise. 95% CI: 95% confidence interval; SD: standard deviation. ranged from 1 to 22.5 MET h/week. Embase 3,923 CINAHL (EBSCO) 134 SPORDiscus (EBSCD) 49 Ovid (medline) 2,629 Other source 28 Pooled results Active individuals were significantly associated with longer telomere length, with a mean difference (MD) of 0.15; 95% CI 0.05, 0.24; I 2  = 99%)(Fig. 2). Analysis also revealed that both robust and moderate exercise could significantly increase telomere length (MD 0.08; 95% CI 0.04, 0.12; I 2  = 99% (Fig. 3) and MD 0.07; 95% CI 0.03, 0.11; I 2  = 100% (Fig. 4), respectively. Details of the subgroup analysis are summarized in Table SI. The Fig. 3. Meta-analysis of the association between telomere length and robust exercise. 95% CI: 95% confidence interval; SD: standard deviation. J Rehabil Med 51, 2019