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Additional File 2: Characteristics and echocardiographic measures of participants born very preterm/with extremely low birthweight by cohort

Additional File 1: Flow chart of the study population

Every year, approximately 15 million infants worldwide (11% of all newborns) are born preterm (

Objective: To evaluate the effects and safety of exercise training, and to determine the most effective exercise intervention for people with Duchenne muscular dystrophy. Exercise training was compared with no training, placebo or alternative exercise training. Primary outcomes were functioning and health-related quality of life. Secondary outcomes were muscular strength, endurance and lung function. Data sources: A systematic literature search was conducted in Medline, EMBASE, CINAHL, Cochrane Central, PEDro and Scopus. Study selection and data extraction: Screening, data extraction, risk of bias and quality assessment were carried out. Risk of bias was assessed using the Cochrane Collaborations risk of bias tools. The certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation. Data synthesis: Twelve studies with 282 participants were included. A narrative synthesis showed limited or no improvements in functioning compared with controls. Health-related quality of life was assessed in only 1 study. A meta-analysis showed a significant difference in muscular strength and endurance in favour of exercise training compared with no training and placebo. However, the certainty of evidence was very low. Conclusion: Exercise training may be beneficial in Duchenne muscular dystrophy, but the evidence remains uncertain. Further research is needed on exercise training to promote functioning and health-related quality of life in Duchenne muscular dystrophy. Lay abstract The aim of this study was to examine the effects of all types of exercise training compared with no training, placebo or alternative exercise training programmes in people with Duchenne muscular dystrophy. The primary outcomes were functioning and health-related quality of life. Secondary outcomes were muscular strength and endurance. A further aim was to evaluate safety and, if possible, to find the most effective exercise training intervention. This review investigates existing research on this topic. The results have been systematically gathered and analysed, to give a broader view of what effect exercise training may have for people with Duchenne muscular dystrophy. The results suggest that exercise training preserves functioning, and benefits muscular strength and endurance. The study was not able to identify the best type of exercise training and prescriptions to use in Duchenne muscular dystrophy. The validity of the results was reduced by the low number of studies included, the low quality of the studies, and diversity in both the interventions and outcome measures used. The results should therefore be interpreted with caution.

Objectives: To compare physical activity and body composition in a cohort of children born extremely preterm/extremely low birth weight (EP/ELBW) with term-born (TB) controls. Methods: A regional cohort of children born during 1999–2000 at gestational age

Background: Survival after extremely preterm (EP) birth has increased considerably during the last three decades. The lifetime respiratory prospects for survivors are unknown. Aim: To study long-term respiratory health following EP birth, here defined as being born before or at 28 weeks of pregnancy, or with a birth weight less than 1001 gram. Methods: Three population-based cohorts born EP (EPB) in 1982-1985, 1991-1992, or 1999-2000, and individually matched term-born control subjects (TB) underwent clinical examinations, comprehensive tests of pulmonary function (PF) and surveys of respiratory symptoms. The first cohort was examined at 18 and 25 years of age, the second at 11 and 18 years of age, and the third at 11 years of age. Results: Symptoms of lung disease resolved during the age span studied, but variables of bronchial airflow were lower in the EPB than the TB group, and most marked in subgroups with neonatal bronchopulmonary dysplasia (BPD). Airflow limitations tracked in parallel in EPB and TB groups through puberty (11-18 years) and into early adult life (18-25 years), with no relative improvement or deterioration. At 25 years of age, significant bronchial obstruction, resistance, and hyperresponsiveness were observed, and subgroups had pulmonary hyperinflation. Children born EP in 1999- 2000 had less airflow limitation and less pulmonary hyperinflation compared to children born similarly preterm in 1991-1992, particularly those with a history of BPD. Improvements were statistically related to increased use of antenatal corticosteroids and treatment with surfactant in the 1999-2000 cohort. Conclusions and implications: EP birth was associated with persistent bronchial obstruction and hyperresponsiveness from childhood to adulthood, with no indications of catch-up growth or early onset deterioration compared to TB subjects. Failing to reach peak predicted PF at early adulthood, combined with possible prospects of steeper age-related declines, suggest a potential for early onset chronic obstructive pulmonary disease (COPD) in subgroups. Less impairment among the most recently born 1999-2000 cohort indicates that better treatment not only improves survival but also respiratory outcome. Studies of these issues are few, hampering our understanding of long-term outcomes and ability to propose explanatory mechanisms.