In the realm of fitness, three-month workout programs dominate the landscape. You’ve even seen plenty of them in our magazine over the years. Are they effective? Absolutely. But we’re going to let you in on an interesting secret: It doesn’t necessarily take 8 or 12 weeks to get your feet wet in the gym. Not that you’ll be a seasoned vet after four weeks, but if you can just get that first month under your belt, you’ll get yourself over the proverbial hump, where so many fail and give up, and set the stage for a lifetime of muscle gains.
A compound exercise is a move that incorporates multiple muscle groups, like lunges, deadlifts, and squats. It may also refer to two moves being strung together, like a bicep curl to a shoulder press. Compound exercises are efficient for increasing overall muscle mass and burning calories (because they require more effort to complete), as opposed to isolation exercises, which focus on working just one muscle group (like a bicep curl).

A systematic review evaluated 45 studies that examined the relationship between physical activity and cancer survivorship. According to the review, "[there] was consistent evidence from 27 observational studies that physical activity is associated with reduced all-cause, breast cancer–specific, and colon cancer–specific mortality. There is currently insufficient evidence regarding the association between physical activity and mortality for survivors of other cancers."[29] Although there is only limited scientific evidence on the subject, people with cancer cachexia are encouraged to engage in physical exercise.[30] Due to various factors, some individuals with cancer cachexia have a limited capacity for physical exercise.[31][32] Compliance with prescribed exercise is low in individuals with cachexia and clinical trials of exercise in this population often suffer from high drop-out rates.[31][32]

* If you're looking to control your weight, exercise is the least efficient way to do it. You'd have to run for hours to keep the cookies you ate from adding to your waistline. It's far more effective to not eat the cookies. Making fruits and vegetables a larger part of your diet will help crowd out the foods that don't offer much in the way of nutrition, and which add pounds that shouldn't be there. Also, as you build lean muscle tissue, your body will lessen its fatty tissue, and your shape will change. If you're overweight, you're not trying to lose weight, you're trying to lose fat. If your goal is to look and feel great, strength building exercise will accomplish this while making you fit in the process. Doing only aerobics will not.

In London, the Medical Officer of Thorpe Coombe maternity hospital approved and implemented the St Thomas method in 1940, presented as ‘Training for Childbirth - and After.’26 Wellcome Library [Internet]. Rodway H. Training for childbirth - and after (1940). 2015 Sep 24 [cited 2015 Oct 3]. Available from: http://wellcomelibrary.org/player/b16729006#?asi=0&ai=0. [Google Scholar] There was also interest from the USA, but this option did not materialize.29 Sydney Morning Herald [Internet]. Thomas BM: Obituary (1940). 2014 Oct 23 [cited 2015 Aug 30]. Available from: http://www.tiveyfamilytree.com/Barbara-Mortimer-Thomas-Death-Article-SMH-11-9-1940.htm. [Google Scholar]
With the right stimuli, bone density improves as well, says women’s health expert Belinda Beck, MD, an Arizona-based OB-GYN and researcher. In a recent study she conducted on postmenopausal women, Beck found that “even women with very low bone mass could tolerate the high loading required to increase bone mineral density as long as it was introduced gradually with close attention to technique.”
The Instructor – This is one of the most important factors of your exercise video. If you don’t like the instructor, it will eventually irritate you enough to stop using it. Look for instructors that motivate you to work harder and push harder not work to end the video so you don’t have to listen to them anymore. It’s a plus for the instructor to actually have a fitness background of some kind, which is both for your safety and to give you the knowledge that the video has legitimate foundations in real fitness rather than just being something they did on a whim or for celebrity endorsement.
The Russian twist is a type of exercise that is used to work the abdomen muscles by performing a twisting motion on the abdomen. This exercise is performed sitting on the floor with knees bent like in a "sit-up" position with the back typically kept off the floor at an angle of 45°. In this position, the extended arms are swung from one side to another in a twisting motion with or without weight.
Check your company's stock plan for the allowed methods and procedures. Once you do give notice to exercise with payment as required under your stock plan, it is unlikely that you can then change your decision to exercise or the exercise method, at least for tax purposes. This is illustrated by the case of Walter v. Commissioner, decided by the US Tax Court (TC Memo 2007-2, January 3, 2007). The employee attempted to change his original exercise instructions from a same-day sale to a cash exercise/hold. The Tax Court did not let him, holding that he had beneficial ownership of the stock when he initially exercised the options following the conditions under his stock plan.
Ready to take it to the next level? This workout with Chloe Bent is a full-length, 30-minute calorie burner that’s filled with dance moves that hit all the major muscle groups. After this dance routine, you’ll feel like your living room just became a stage. Take on this bodyweight routine at home when you need to spice up your cardio regimen. If you’re a beginner, don’t fret: This will be a great challenge for you.
Checkley, Müller, Alexander, and Pilates initiated their interests from a self-requirement to improve health or overcome functional loss. They subsequently used their bodies as a model to demonstrate their method’s effectiveness and encourage others. Despite their turn of the 20th century separation from the gymnasium ‘Physical Culture’ and new independence, all six MMB pioneers advocated their exercises as an adjunct to other sports and regular daily activity; Müller recommended running on the balls of the feet as an aerobic activity, Pilates worked with dancers, while Morris, who besides her dedication to dance and dancers’ health also published ‘Tennis by Simple Exercises’ in 1937 together with French tennis mega-star Suzanne Lenglen.60 Lenglen S, Morris M. Tennis by simple exercises. London: Heinemann; 1937. [Google Scholar]
Checkley, Müller, Alexander, and Pilates initiated their interests from a self-requirement to improve health or overcome functional loss. They subsequently used their bodies as a model to demonstrate their method’s effectiveness and encourage others. Despite their turn of the 20th century separation from the gymnasium ‘Physical Culture’ and new independence, all six MMB pioneers advocated their exercises as an adjunct to other sports and regular daily activity; Müller recommended running on the balls of the feet as an aerobic activity, Pilates worked with dancers, while Morris, who besides her dedication to dance and dancers’ health also published ‘Tennis by Simple Exercises’ in 1937 together with French tennis mega-star Suzanne Lenglen.60 Lenglen S, Morris M. Tennis by simple exercises. London: Heinemann; 1937. [Google Scholar]

Congratulations on your decision to make yourself a priority and commit to a regular workout routine. The addition of physical fitness into your life requires hard work, but yields great rewards. Now, which method should you choose? With the vast choice of fitness workout options available today, it can be overwhelming to know which one is right for you.
Bodyrock.tv is one of the forerunners in online fitness. This popular health and exercise blog is dedicated to weight loss, fitness, beauty, food, love and relationships. "Bodyrockers" find daily workouts that are either laid out with descriptions and pictures, or that are instructed in video format. All of the workouts can be done at home with minimal equipment.
The searches identified 80 studies, of which 11 met the inclusion criteria. In 5 studies, the diagnosis of RCIS was confirmed using an impingement test consisting of lidocaine injected into the subacromial space and elimination of pain with the impingement sign. Randomization methods were used in 6 studies, and blinded, independent examiners were involved in follow-up data collection in only 3 studies. Validated outcome measures were used in all studies. Follow-up was very good in 10 studies and was less than 90% in only 1 study. The specific exercise programs varied among studies. However, general treatment principles were identified among the different studies and included frequency, ROM, stretching or flexibility, strengthening, manual therapy (joint and/or soft tissue mobilizations), modalities, and others.

^ Jump up to: a b McKee AC, Daneshvar DH, Alvarez VE, Stein TD (January 2014). "The neuropathology of sport". Acta Neuropathol. 127 (1): 29–51. doi:10.1007/s00401-013-1230-6. PMC 4255282. PMID 24366527. The benefits of regular exercise, physical fitness and sports participation on cardiovascular and brain health are undeniable ... Exercise also enhances psychological health, reduces age-related loss of brain volume, improves cognition, reduces the risk of developing dementia, and impedes neurodegeneration.
Park further away. I know a lot of us have developed the (bad) habit of trying to get the parking spot absolutely closest to our destination—I know this because I have both cut-off and been cut-off by some aggressive drivers who really wanted to park 50 feet closer—but this is dumb. Spare yourself the road rage and do your body a favor by parking further away and getting in some extra walking.
In extreme instances, over-exercising induces serious performance loss. Unaccustomed overexertion of muscles leads to rhabdomyolysis (damage to muscle) most often seen in new army recruits.[88] Another danger is overtraining, in which the intensity or volume of training exceeds the body's capacity to recover between bouts. One result of detrimental overtraining is suppressed immune function, with an increased incidence of upper respiratory tract infection (URTI). An increased incidence of URTIs is also associated with high volume/intensity training, as well as with excessive exercise (EE), such as in a marathon.[89] Marathon training requires the runner to build their intensity week to week which makes them more susceptible to injury the more they increase their mileage. A study shows that in the last 10–15 years up to 90% of marathon runners have suffered a physical injury from their training.[90]
The second aim of this study was to describe the isokinetic muscle fatigue induced by high intensity OLDE and its recovery. Firstly, the absence of isometric KF MVC torque decrease confirms that our exercise only solicits the knee extensors and does not involve the knee flexors. Secondly, EMG RMS measured during KE MVCs shortly after exhaustion and during the recovery period was not altered by high intensity OLDE, confirming the results of a previous study [8]. Therefore, as a decrease in knee extensors force production capacity can be observed without concomitant changes in EMG signal, our data combined with the data of a previous study [8] suggest that EMG signal cannot be used to investigate dynamic exercise-induced muscle fatigue. The lack of changes in EMG signal is likely to be caused by a potentiation of the maximal evoked muscular wave (M-wave) induced by high intensity OLDE [8]. Finally, according to our hypothesis, isokinetic KE MVC torque quickly recovered and plateaued after exhaustion (within ~ 30 s at 60 and 100 deg/s, and within ~ 50 s at 140 deg/s). This quick recovery in torque production capacity is likely to be associated with recovery in both central and peripheral fatigue. This assumption is supported by one previous study in our laboratory demonstrating that not only peripheral and central fatigue, but also cortical and spinal excitability recovered shortly after exhaustion [8]. Froyd et al. [32] also demonstrated a significant recovery in skeletal muscle function within 1–2 minutes after completion of a one-leg isokinetic time trial performed at high intensity. Taking all together, these results demonstrate that to fully appreciate the extent of neuromuscular alterations induced by high intensity dynamic exercise, assessment of muscle fatigue must be performed within 30 s of cessation of the exercise.
In addition to determining the optimal position from which to initiate an exercise based on the patient's related impairments and level of pain, exercise dosage and progression are important aspects of a rehabilitation program. Intervention details, such as number of repetitions and sets, exercise order, and work-to-rest ratios, should be tailored to each patient based on his or her specific needs. The proposed protocol does not describe a method to determine the initial exercise intensity or the criteria for modification or progression. Using a criterion-based method to determine the initial intensity and progression would individualize these guidelines of the exercise program. In their randomized controlled trial designed to address the effectiveness of exercises to treat RCIS, Lombardi et al6 used a 6-repetition maximum load to establish the starting intensity of strengthening exercises. They6 also recommended a reevaluation every 2 weeks to make necessary adjustments to exercise intensity. Although we do not know whether the 6-repetition maximum-load criteria used in their study is optimal, it is an excellent example of a criterion-based method to determine initial exercise intensity and progression. Future research on exercise for the treatment of RCIS should include criterion-based methods to determine the optimal exercise dosage and progression.
How to: Keep your feet shoulder-width apart and your back straight. Bend your knees and lower your rear as if you were sitting down in a chair. Your weight should be evenly distributed on 3 points of your feet -- heel, outaside ball, inside ball -- that form a triangle. Your knees won't stay in line with your ankles that way, but there will be less strain on other parts of your body.  Add dumbbells once you can do 12 reps with good form.
HIIT stands for high-intensity interval training. “This refers to tough quick, intense bursts of exercise, followed by short recovery periods. This type of training gets and keeps your heart rate up,” explains Laferrara, while also (typically) decreasing the overall amount of time you spend training. This workout is great for burning fat because the intense intervals help kick-start the process known as excess post-exercise oxygen consumption (AKA the “afterburn effect”), which helps you burn more calories even after you stop working out as your body has to work harder and take in more oxygen to return to its resting state.
Individuals can increase fitness following increases in physical activity levels.[15] Increases in muscle size from resistance training is primarily determined by diet and testosterone.[16] This genetic variation in improvement from training is one of the key physiological differences between elite athletes and the larger population.[17][18] Studies have shown that exercising in middle age leads to better physical ability later in life.[19]
I purchased Insanity a few years back and only lasted for 3-4 workouts. The workouts were too difficult for me and although I enjoyed it, I just failed to commit to it. Fast forward to July of this year..... I am not even sure why I attempted it again, but I am glad I did. First things first; this program is physically challenging to the point that I would recommend anyone going into it be cleared by their doctor BEFORE starting. Seeing a physician after you've injured yourself is the equivalent of closing the barn after the horses got out! There, it's been said. Now on to my review of this product.
This is a lift that builds full-body power and tests the ability to move quickly. HOW TO DO IT: Start with the bar on the ground. Place your hands on the bar -- a little outside of your shins -- with the bar touching your mid shin. You should keep your weight on your heels with your chest big and pull the bar up like a deadlift, while driving the knees back so that the bar path stays perpendicular to the floor and you stay over the bar. This utilizes your hip hinge and activates your posterior chain. Once the bar passes the knees, you jump up (you may not actually leave the ground, but you should feel like you’re trying to) and shrug so that the bar comes as high as possible. The next step is for you to get under the bar or “catch” it as quickly as possible by squatting under the bar and changing the hand position underneath the bar, putting the body into a front squat position with the bar resting on the shoulders. You then stand the bar up. MUSCLES USED: Glutes, quads, hamstring, calves, shoulders, core and traps.

^ Jump up to: a b Cooney GM, Dwan K, Greig CA, Lawlor DA, Rimer J, Waugh FR, McMurdo M, Mead GE (September 2013). "Exercise for depression". Cochrane Database Syst. Rev. 9 (9): CD004366. doi:10.1002/14651858.CD004366.pub6. PMID 24026850. Exercise is moderately more effective than a control intervention for reducing symptoms of depression, but analysis of methodologically robust trials only shows a smaller effect in favour of exercise. When compared to psychological or pharmacological therapies, exercise appears to be no more effective, though this conclusion is based on a few small trials.


I must confess: the title of this section is misleading, because while most of us associate the first home workouts with fitness icons Jane Fonda and Richard Simmons, they were not the first ones to bring workouts inside our homes. In fact, before there were VHS tapes, before there were even televised workouts, there were the audio-only vinyl record workouts, nicknamed vinylcise.
The physical benefits of Pilates include an increase in muscle strength and tone without creating bulk. The increase in deep core muscle strength helps to make your abdominal muscles look tight and toned. It also improves your flexibility and posture, which can decrease your chances of injuring yourself. Pilates is also effective in easing chronic lower back pain and preventing future back pain and injuries.
A simple example of an eccentric contraction is to hold something in your hand with your elbow bent. Slowly allow your elbow to straighten out while holding the weight.  You can visualize your bicep muscle lengthening as you are holding the weight while you are slowly straightening your elbow.  This is an eccentric contraction or eccentric loading of your bicep muscle.
The squat is performed by squatting down with a weight held across the upper back under neck and standing up straight again. This is a compound exercise that also involves the glutes (buttocks) and, to a lesser extent, the hamstrings, calves, and the lower back. Lifting belts are sometimes used to help support the lower back. The freeweight squat is one of 'The Big Three' powerlifting exercises, along with the deadlift and the bench press.[2]
Jump up ^ Hubal MJ, Gordish-Dressman H, Thompson PD, Price TB, Hoffman EP, Angelopoulos TJ, Gordon PM, Moyna NM, Pescatello LS, Visich PS, Zoeller RF, Seip RL, Clarkson PM; Gordish-Dressman; Thompson; Price; Hoffman; Angelopoulos; Gordon; Moyna; Pescatello; Visich; Zoeller; Seip; Clarkson (June 2005). "Variability in muscle size and strength gain after unilateral resistance training". Medicine & Science in Sports & Exercise. 37 (6): 964–972. PMID 15947721.
Your body has that whole breathing thing on lock, but there's more than one way to inhale and exhale and some require extra work from the abs. "Kapalabhati breathing engages the transverse abdominis to push out the breath," says Allison Candelaria, owner of Soul Yoga in Oklahoma City. Here's how to do it: Sit tall, then strongly and quickly pull your navel toward your spine. Then release your ab muscles, forcing you to exhale. Work up to doing that 20 times, inhaling and letting your belly expand between each "pump." (This belly bonfire breathing technique can also help you fire up your body anywhere, anytime.)
Get your shoulders looking svelte with hand/arm raises. Riggins says here’s how to do them: Raise your hand over head; hand is at a 90-degree angle to the body as if you’re doing shoulder press with no weights. Put your hands up and raise over head; raise up to sky and bring back down. Keep repeating for 30 seconds. We know it sounds too easy, but you’ll feel it start to burn about 20 seconds in!
Several exercises from Week 1 are carried over to Week 2, but one move is added to each bodypart routine—with the exception of abs—so you can train all muscle groups more completely from multiple angles. Chest, for example, includes two exercises: One is a compound movement (dumbbell bench press) that involves multiple joints (both the shoulder and elbow) to work the largest amount of muscle possible, and the other is an isolation exercise (dumbbell flye) that involves only one joint (shoulder) and targets the pecs to a greater extent. (When doing presses for chest, the deltoids and triceps are involved to a degree, meaning presses don’t isolate the pecs as much as flyes do.)
Most of the literature agrees that FO, NFO and OTS must be viewed on a continuum with a disturbance, an adaptation and finally a maladaptation of the hypothalamic–pituitary–adrenal axis (HPA), resulting in an altered hormonal response to intense training and competition.3,–,12 When investigating hormonal markers of training adaptation, it is important to target specific hormones for their information potential and to synchronise their sampling in accordance with their response patterns.
But too much rest may do more harm than good. Once prescribed almost universally for back pain, illness, and discomfort of all kinds, bed rest has been shown in studies to be associated with loss of strength and endurance, changes in soft tissue, bone loss, joint disease, high blood pressure, and weakening of the cardiovascular system. It’s one reason falls are a danger for people over 80: The resulting injuries may heal, but the health complications from staying in bed for weeks can be irreversible.
Hormonal responses to the two exercise bouts are presented in fig 4A–D. Visual inspection led to the conclusion that there are no differences in relative cortisol response between the NFO and the OTS group. ACTH, PRL and GH responses are higher in the NFO group compared with the OTS group, especially in the second exercise bout. However, the SE of GH in the NFO group was probably too large to draw clear conclusions. Indeed, the main effect of group gave an F ratio of F1,7=1.4 for GH. For ACTH and PRL, F ratios were F1,7=5.1 and F1,6=14.7, both significant at p<0.05, confirming larger responses for the NFO group. Visual inspection led to the conclusion that this larger response was much more pronounced after the second exercise bout. Indeed, parametric results pointed in the direction of an interaction effect between test and group for ACTH and PRL (F1,7=4.1; p=0.084; F1,6=4.0; p=0.092).
Jump up ^ Olsen CM (December 2011). "Natural rewards, neuroplasticity, and non-drug addictions". Neuropharmacology. 61 (7): 1109–1122. doi:10.1016/j.neuropharm.2011.03.010. PMC 3139704. PMID 21459101. Similar to environmental enrichment, studies have found that exercise reduces self-administration and relapse to drugs of abuse (Cosgrove et al., 2002; Zlebnik et al., 2010). There is also some evidence that these preclinical findings translate to human populations, as exercise reduces withdrawal symptoms and relapse in abstinent smokers (Daniel et al., 2006; Prochaska et al., 2008), and one drug recovery program has seen success in participants that train for and compete in a marathon as part of the program (Butler, 2005). ... In humans, the role of dopamine signaling in incentive-sensitization processes has recently been highlighted by the observation of a dopamine dysregulation syndrome in some patients taking dopaminergic drugs. This syndrome is characterized by a medication-induced increase in (or compulsive) engagement in non-drug rewards such as gambling, shopping, or sex (Evans et al., 2006; Aiken, 2007; Lader, 2008).
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Other strength training equipment. This includes weight stacks (plates with cables and pulleys), flexible bands, and flexible rods. Fichera says flexible bands are good for beginners, especially since they come with instructions. But he doesn't recommend them for long-term use; your muscles will likely adapt to the resistance and need more of a challenge.

There’s a simple way to get your body back in fat-blasting mode: Temporarily ditch your go-to moves. "When you change up your workout, your body works harder because it’s in unfamiliar territory," explains Amy Dixon, a Santa Monica, California–based trainer and exercise physiologist. "That’s what causes it to burn more calories and build more muscle."
My favorites are all free, though you can subscribe for more features to most of them as well. But free works just fine. They’re all available on iOS and Android (except for one). They’re all built around the science-based concept of high-intensity circuit training using body weight, so you don’t need any fancy equipment. I’ve done these in hotel rooms, my office, parks, and even in a quiet corner at the airport waiting to get on a plane.
Burpees: One of the most dreaded moves in fitness, burpees make up a cornerstone of CrossFit workouts. Starting from standing, athletes bend down and plant their hands, kick back into a plank position, and perform a push-up. The legs are then brought back in, and the movement culminates with a slight jump up and hands clapped overhead. (The feet have to leave the ground for it to count!) Now repeat 100 times, just for funsies.
It's hard to pinpoint the first time exercise appeared visually on-screen—meaning on film or video, something that you could see, as opposed to hear—but one of the earliest is the 1928 film Exercise: A Film Lesson in Health and Hygiene. It isn't exactly instructional, but features a bunch of boy scouts showing off some rather bizarre group exercise routines. Check out the bit that starts around 1:22, where they ride each other like human chariots. Anyhow, this film is significant in that its primary purpose is to display and broadcast forms of exercise to an audience, and it seems to be the first to have done so.
Time course of normalized EMG RMS for all muscles was analyzed with fully repeated measures 3 (session) x 10 (time: from 10 to 100% of time to exhaustion) ANOVA. Fully repeated measures 3 (session) x 11 (time: warm-up and from 10 to 100% of time to exhaustion) ANOVAs were used to analyze the time course of leg RPE, leg muscle pain, heart rate and cadence. Significant effect of time was explored with planned comparison (10% vs other time points, 100% vs other time points) adjusted with Holm-Bonferonni correction.
Physiological, psychological and EMG responses to the time to exhaustion tests are presented Figs 4 and 5. Leg RPE (Fig 4A), leg muscle pain (Fig 4B) and heart rate (HR, Fig 4C) increased over time (all P < 0.001). Cadence during the time to exhaustion decreased over time (P < 0.001). Planned comparisons for these aforementioned parameters are presented Fig 5. EMG RMS of the VL (Fig 5A), VM (Fig 5B), RF (Fig 5C) and the sum of these muscles (Fig 5D) increased over time (all P < 0.001). Planned comparisons for EMG parameters are presented Fig 5. Blood lactate concentration increased (from 1.3 ± 0.5 to 6.0 ± 1.1 mmol/L, P < 0.001) and blood glucose concentration decreased (from 5.3 ± 0.5 to 4.4 ± 0.3 mmol/L, P = 0.001) over time.
Natural movement-harmonizing exercises and stretches have likely been practiced since the beginning of mankind. Forms of non-strenuous rhythmical functional movements were used for three main purposes: To manage and prevent musculoskeletal disorders, to maintain a naturally healthy body and mind, and to enhance athletic performance. Around the turn of the 20th century, at least six independent Western modern mind–body (MMB) methods emerged simultaneously. This phenomenon occurred during the same era in which Einstein, Picasso, Freud, and Stravinsky also broke away from dominating and restrictive establishment controls, subsequently freeing their fields. The cultural changes and personal emancipation that MMB pioneers brought to the exercise world were no less dramatic, yet significantly less documented.
Raphael AJ. Natural childbirth in twentieth century England; PhD thesis. London: Queen Mary University of London; 2010.  In the sub-continent, Vaughan was amazed that mostly affluent women suffered physically and mentally from childbirth, while poor women typically gave birth with relative ease. She explained that the active indigenous Indian lifestyle and regular exercises that maintain a functional pelvic anatomy were abandoned by the affluent.27 Vaughan K. The shape of the pelvic brim as the determining factor in childbirth. BMJ. 1931;2(3698):939–41.10.1136/bmj.2.3698.939[Crossref], [PubMed] [Google Scholar] Vaughan also observed that traditional Indian women, who covered their entire body with garments, were at risk of medical dangers including osteopenia due to sunlight deprivation.28 Vaughan KO. The purdah system and its effect on motherhood. Cambridge: W. Heffer & Sons Limited; 1928. [Google Scholar]
Limitation of the Study. One potential limit of the present study undoubtedly regards the limited number of subjects involved in the study and the operating loss of the control group. Unfortunately, too many participants of the latter did not satisfy the requirements during the study, thus impeding a comparative statistical approach. Further studies are therefore needed to confirm our conclusions, in particular with a larger sample and control group.
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