Cochrane Library Cochrane Database of Systematic Reviews Exercise prior to influenza vaccination for limiting influenza incidence and its related complications in adults (Review) Grande AJ, Reid H, Thomas EE, Nunan D, Foster C Grande AJ, Reid H, Thomas EE, Nunan D, Foster C. Exercise prior to influenza vaccination for limiting influenza incidence and its related complications in adults. Cochrane Database of Systematic Reviews 2016, Issue 8. Art. No.: CD011857. DOI: 10.1002/14651858.CD011857.pub2. www.cochranelibrary.com Exercise prior to influenza vaccination for limiting influenza incidence and its related complications in adults (Review) Copyright © 2016 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Cochrane Trusted evidence. Informed decisions. Library Better health. Cochrane Database of Systematic Reviews T A B L E O F C O N T E N T S HEADER......................................................................................................................................................................................................... 1 ABSTRACT..................................................................................................................................................................................................... 1 PLAIN LANGUAGE SUMMARY....................................................................................................................................................................... 2 SUMMARY OF FINDINGS.............................................................................................................................................................................. 4 BACKGROUND.............................................................................................................................................................................................. 6 OBJECTIVES.................................................................................................................................................................................................. 6 METHODS..................................................................................................................................................................................................... 6 RESULTS........................................................................................................................................................................................................ 8 Figure 1.................................................................................................................................................................................................. 9 Figure 2.................................................................................................................................................................................................. 10 Figure 3.................................................................................................................................................................................................. 11 DISCUSSION.................................................................................................................................................................................................. 13 AUTHORS' CONCLUSIONS........................................................................................................................................................................... 14 ACKNOWLEDGEMENTS................................................................................................................................................................................ 14 REFERENCES................................................................................................................................................................................................ 15 CHARACTERISTICS OF STUDIES.................................................................................................................................................................. 17 DATA AND ANALYSES.................................................................................................................................................................................... 27 Analysis 1.1. Comparison 1 Exercise versus no exercise prior to influenza vaccination, Outcome 1 Blood parameters- Antibody 28 titre - Follow-up over time................................................................................................................................................................... Analysis 1.2. Comparison 1 Exercise versus no exercise prior to influenza vaccination, Outcome 2 Blood parameters - Antibody 29 titre - Timing of vaccination................................................................................................................................................................. Analysis 1.3. Comparison 1 Exercise versus no exercise prior to influenza vaccination, Outcome 3 Blood parameters - Antibody 30 titre - Type of exercise.......................................................................................................................................................................... ADDITIONAL TABLES.................................................................................................................................................................................... 31 APPENDICES................................................................................................................................................................................................. 34 CONTRIBUTIONS OF AUTHORS................................................................................................................................................................... 38 DECLARATIONS OF INTEREST..................................................................................................................................................................... 38 SOURCES OF SUPPORT............................................................................................................................................................................... 38 DIFFERENCES BETWEEN PROTOCOL AND REVIEW.................................................................................................................................... 38 INDEX TERMS............................................................................................................................................................................................... 38 Exercise prior to influenza vaccination for limiting influenza incidence and its related complications in adults (Review) i Copyright © 2016 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Cochrane Trusted evidence. Informed decisions. Library Better health. Cochrane Database of Systematic Reviews [Intervention Review] Exercise prior to influenza vaccination for limiting influenza incidence and its related complications in adults Antonio Jose Grande1, Hamish Reid2, Emma E Thomas2, David Nunan3, Charles Foster4 1Laboratory of Evidence-Based Practice, Universidade do Extremo Sul Catarinense, Criciuma, Brazil. 2British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention, NuCield Department of Population Health, University of Oxford, Oxford, UK. 3NuCield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. 4British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention, NuCield Department of Population Health, University of Oxford, Oxford, UK Contact address: Antonio Jose Grande, Laboratory of Evidence-Based Practice, Universidade do Extremo Sul Catarinense, Av. Universitária, 1105, Predio S, LABEPI, Criciuma, Santa Catarina, 88806-000, Brazil. [email protected]. Editorial group: Cochrane Acute Respiratory Infections Group Publication status and date: New, published in Issue 8, 2016. Citation: Grande AJ, Reid H, Thomas EE, Nunan D, Foster C. Exercise prior to influenza vaccination for limiting influenza incidence and its related complications in adults. Cochrane Database of Systematic Reviews 2016, Issue 8. Art. No.: CD011857. DOI: 10.1002/14651858.CD011857.pub2. Copyright © 2016 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. A B S T R A C T Background Influenza is an infectious virus affecting both humans and animals. In humans, symptoms present as fever, cough, sore throat, runny nose, headache, muscle and joint pain, and malaise. The epidemiological profile of influenza is influenced by multiple factors, including transmissibility of the virus and the susceptibility of the population. Annually, influenza is estimated to infect 5% to 10% of adults, with higher rates in winter seasons in countries with seasonal variation. Exercise could be an intervention to enhance immune response and limit influenza incidence and its related complications. Objectives To assess the efficacy and safety of short and long-term exercise prior to influenza vaccination in enhancing influenza prevention in adults. Search methods We searched CENTRAL (2015, Issue 11), which contains the Cochrane Acute Respiratory Infections Group's Specialised Register, MEDLINE (1966 to 3 November 2015), Embase (1974 to 3 November 2015), CINAHL (1981 to 3 November 2015), LILACS (Latin American and Caribbean Health Sciences, 1982 to 3 November 2015), PEDro (1980 to 3 November 2015), SPORTDiscus (1985 to 3 November