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array:24 [ "pii" => "S2173578614000511" "issn" => "21735786" "doi" => "10.1016/j.acuroe.2014.03.008" "estado" => "S300" "fechaPublicacion" => "2014-11-01" "aid" => "618" "copyright" => "AEU" "copyrightAnyo" => "2013" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2014;38:589-93" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 255 "formatos" => array:3 [ "EPUB" => 10 "HTML" => 162 "PDF" => 83 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0210480614000217" "issn" => "02104806" "doi" => "10.1016/j.acuro.2013.10.013" "estado" => "S300" "fechaPublicacion" => "2014-11-01" "aid" => "618" "copyright" => "AEU" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2014;38:589-93" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 350 "formatos" => array:3 [ "EPUB" => 9 "HTML" => 214 "PDF" => 127 ] ] "es" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Artículo original</span>" "titulo" => "El entrenamiento en tapiz rodante a domicilio mejora la calidad seminal en adultos con diabetes de tipo 2" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "589" "paginaFinal" => "593" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Home-based treadmill training improved seminal quality in adults with type 2 diabetes" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Rosety-Rodriguez, J.M. Rosety, G. Fornieles, M.A. Rosety, A.J. Diaz, I. Rosety, A. Rodríguez-Pareja, F.J. Ordonez, S. Elosegui" "autores" => array:10 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Rosety-Rodriguez" ] 1 => array:2 [ "nombre" => "J.M." "apellidos" => "Rosety" ] 2 => array:2 [ "nombre" => "G." "apellidos" => "Fornieles" ] 3 => array:2 [ "nombre" => "M.A." "apellidos" => "Rosety" ] 4 => array:2 [ "nombre" => "A.J." "apellidos" => "Diaz" ] 5 => array:2 [ "nombre" => "I." "apellidos" => "Rosety" ] 6 => array:2 [ "nombre" => "A." "apellidos" => "Rodríguez-Pareja" ] 7 => array:2 [ "nombre" => "M." "apellidos" => "Rosety" ] 8 => array:2 [ "nombre" => "F.J." "apellidos" => "Ordonez" ] 9 => array:2 [ "nombre" => "S." 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Study of biochemical progression-free survival (new model; MRI D’Amico risk groups).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "R. Algarra, B. Zudaire, A. Tienza, J.M. Velis, A. Rincón, I. Pascual, J. Zudaire" "autores" => array:7 [ 0 => array:2 [ "nombre" => "R." "apellidos" => "Algarra" ] 1 => array:2 [ "nombre" => "B." "apellidos" => "Zudaire" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Tienza" ] 3 => array:2 [ "nombre" => "J.M." "apellidos" => "Velis" ] 4 => array:2 [ "nombre" => "A." "apellidos" => "Rincón" ] 5 => array:2 [ "nombre" => "I." "apellidos" => "Pascual" ] 6 => array:2 [ "nombre" => "J." 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Guerrero-Ramos, F. Villacampa-Aubá, E. Jiménez-Alcaide, L. García-González, I.A. Ospina-Galeano, F. de la Rosa-Kehrmann, A. Rodríguez-Antolín, J. Passas-Martínez, R. Díaz-González" "autores" => array:9 [ 0 => array:2 [ "nombre" => "F." "apellidos" => "Guerrero-Ramos" ] 1 => array:2 [ "nombre" => "F." "apellidos" => "Villacampa-Aubá" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Jiménez-Alcaide" ] 3 => array:2 [ "nombre" => "L." "apellidos" => "García-González" ] 4 => array:2 [ "nombre" => "I.A." "apellidos" => "Ospina-Galeano" ] 5 => array:2 [ "nombre" => "F." "apellidos" => "de la Rosa-Kehrmann" ] 6 => array:2 [ "nombre" => "A." "apellidos" => "Rodríguez-Antolín" ] 7 => array:2 [ "nombre" => "J." "apellidos" => "Passas-Martínez" ] 8 => array:2 [ "nombre" => "R." 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Rosety-Rodriguez, J.M. Rosety, G. Fornieles, M.A. Rosety, A.J. Diaz, I. Rosety, A. Rodríguez-Pareja, F.J. Ordonez, S. Elosegui" "autores" => array:10 [ 0 => array:4 [ "nombre" => "M." "apellidos" => "Rosety-Rodriguez" "email" => array:1 [ 0 => "manuel.rosetyrodriguez@uca.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "J.M." "apellidos" => "Rosety" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "G." "apellidos" => "Fornieles" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "M.A." "apellidos" => "Rosety" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 4 => array:3 [ "nombre" => "A.J." "apellidos" => "Diaz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "I." "apellidos" => "Rosety" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 6 => array:3 [ "nombre" => "A." "apellidos" => "Rodríguez-Pareja" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] ] 7 => array:3 [ "nombre" => "M." "apellidos" => "Rosety" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 8 => array:3 [ "nombre" => "F.J." "apellidos" => "Ordonez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">f</span>" "identificador" => "aff0030" ] ] ] 9 => array:3 [ "nombre" => "S." "apellidos" => "Elosegui" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">g</span>" "identificador" => "aff0035" ] ] ] ] "afiliaciones" => array:7 [ 0 => array:3 [ "entidad" => "Departamento de Medicina, Facultad de Medicina, Universidad de Cádiz, Cádiz, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departamento de Urología, Hospital Universitario Puerta del Mar, Cádiz, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Facultad de Ciencias del Deporte, Universidad de Cádiz, Cádiz, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Departamento de Anatomía Humana, Facultad de Medicina, Universidad de Cádiz, Cádiz, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Departamento de Ginecología, Hospital Universitario de Jerez, Cádiz, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Escuela de Medicina del Deporte, Universidad de Cádiz, Cádiz, Spain" "etiqueta" => "f" "identificador" => "aff0030" ] 6 => array:3 [ "entidad" => "Facultad de Medicina, Universidad de Cádiz, Cádiz, Spain" "etiqueta" => "g" "identificador" => "aff0035" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "El entrenamiento en tapiz rodante a domicilio mejora la calidad seminal en adultos con diabetes de tipo 2" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Previous studies have highlighted the prevalence of diabetes in a population of male partners of infertile couples.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Echevarria-Sánchez et al.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> found that patients with type 2 diabetes mellitus (T2DM) exhibited a low sperm progressive mobility that might be associated to subfertility. In a more detailed way, the highest percentage of sperm DNA damage because of oxidative stress seen in T2DM patients may be responsible for the poor embryonic development and pregnancy outcome in these individuals.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> In fact, oxidative stress is widely recognized as one of the major causes of male subfertility/infertility both in experimental<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> and human studies.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Fortunately, de Oliveira et al.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> have already demonstrated that a 12-week training program provided important upregulation in antioxidant enzymes and increased nitric oxide bioavailability, which may help minimize oxidative stress and the development of the chronic complications of T2DM. Therefore, this was the first study conducted to determine whether home-based training may improve seminal quality in adults with T2DM. A secondary objective was to assess its influence on antioxidant defense system in seminal plasma.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Participants</span><p id="par0015" class="elsevierStylePara elsevierViewall">A total of sixty adults with T2DM were recruited from the community for the current study. The characteristics of the participants at baseline are summarized in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. All the subjects met the following inclusion criteria: (1) young adults (25–40 years); (2) diagnosis of T2DM; (3) medical approval for physical activity participation. On the other hand, exclusion criteria were: (1) participation in a training program in the 6 months prior to their participation in the trial; (2) testicular varicocele, genital infection, and/or leukocytospermia; (3) previous surgery (e.g. vasectomy reversal, varicocele removal, etc.); (4) receiving medication and/or antioxidant consumption that may interfere with measured outcomes; (5) toxic habits (smoking and/or alcohol); (6) not completing at least 90% of the training sessions.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Participants were randomly allocated to the intervention (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>30) or control group (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>30) using a concealed method.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Home-based treadmill training</span><p id="par0025" class="elsevierStylePara elsevierViewall">Participants in the intervention group performed a 14-week, home-based, treadmill training program, 3 sessions per week, consisting of a warm-up (10–15<span class="elsevierStyleHsp" style=""></span>min), 40<span class="elsevierStyleHsp" style=""></span>min treadmill exercise at a work intensity of 55–70% of peak heart rate (increasing by 2.5% every two weeks) measured during a maximal treadmill test, and cooling-down (5–10<span class="elsevierStyleHsp" style=""></span>min). In order to ensure that the training workload was appropriate, all the participants from the intervention group wore a wireless wearable heart rate monitor (Sport Tester PE3000, Polar Electro, Kempele, Finland). Lastly, the control group included the age of 30, and the BMI matched adults with type 2 diabetes who did not take part in any training program.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Semen quality assessment</span><p id="par0030" class="elsevierStylePara elsevierViewall">Semen was collected after 3 days of sexual abstinence (intercourse or masturbation) by manual masturbation into a sterile container on site and examined within 30<span class="elsevierStyleHsp" style=""></span>min of ejaculation. Seminal assessment included semen volume (ml), sperm concentration (%), sperm motility (%), and normal morphologic features (%). All parameters were carried out according to the World Health Organization (WHO) guidelines.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> It should be pointed out that sperm concentration was determined by hemacytometer (Hauser Scientific Inc., Horsham, PA) whereas motility was assessed by a computer-aided semen analysis (CASA system, Microptic S.L., Spain).</p><p id="par0035" class="elsevierStylePara elsevierViewall">A fraction of each semen sample was used to determine antioxidants and lipoperoxidation levels. Seminal plasma was obtained after centrifugation at 3500<span class="elsevierStyleHsp" style=""></span>rpm for 15<span class="elsevierStyleHsp" style=""></span>minutes and it was loaded in the Eppendorf tubes (3<span class="elsevierStyleHsp" style=""></span>ml) and stored at −80<span class="elsevierStyleHsp" style=""></span>°C until analysis.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Total antioxidant status (TAS) in seminal plasma was determined by colorimetric method using Randox commercial kits on the Hitachi 902 Autoanalyzer. Total SOD activity was determined using pyrogallol as a substrate by the method of Marklund and Marklund.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> One Unit (U) of total SOD and CuZnSOD is defined as the amount of enzyme required to inhibit the rate of pyrogallol auto-oxidation by 50%.</p><p id="par0045" class="elsevierStylePara elsevierViewall">GPX activity was assayed by the subsequent oxidation of NADPH at 240<span class="elsevierStyleHsp" style=""></span>nm with t-butyl-hydro-peroxide as a substrate 21. GPX units (U/g protein) were defined as μmol NADPH oxidized/g protein.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Physical fitness</span><p id="par0050" class="elsevierStylePara elsevierViewall">Participants performed a continuous maximal incremental test, using the standard Bruce treadmill protocol, until exhaustion in the laboratory of Sports Medicine. Gas exchange data were collected throughout the test using a breath-by-breath metabolic system. The EKG was continuously recorded using a 12 lead stress analysis system. In this respect, the criterion we used to determine the VO<span class="elsevierStyleInf">2</span> max was the maximal O<span class="elsevierStyleInf">2</span> value at plateau despite increasing workload (<2<span class="elsevierStyleHsp" style=""></span>ml/kg/min increase in VO<span class="elsevierStyleInf">2</span> between progressive stages). Furthermore, it should be pointed out that all participants underwent a pre-training period in the laboratory to be familiarized with the correct use of the treadmill.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Body composition</span><p id="par0055" class="elsevierStylePara elsevierViewall">Fat mass percentage was assessed by bioelectrical impedance analysis BIA (MC-180, Tanita Ltd., UK). Participants were requested not to perform moderate or vigorous exercise for 24<span class="elsevierStyleHsp" style=""></span>h prior to testing as well as to abstain from eating or drinking for two hours before testing. Moreover, they were asked to urinate immediately prior to data collection.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Nutritional intake record</span><p id="par0060" class="elsevierStylePara elsevierViewall">To control the potential confounding effect of diet, participants included in intervention and control groups recorded their nutritional intake for 3 consecutive days (2 weekdays and 1 weekend day). It should be pointed out that participants were instructed about completion of the nutritional protocol. No significant difference was found between the intervention and control groups when assessing mean daily vitamin intake both at baseline (10.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.6 vs. 9.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.2<span class="elsevierStyleHsp" style=""></span>mg/d vitamin E <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.411; 83.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>20.4 vs. 80.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>19.7<span class="elsevierStyleHsp" style=""></span>mg/d vitamin C <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.620) and at the end of the intervention program (10.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.5 vs. 10.2<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.0<span class="elsevierStyleHsp" style=""></span>mg/d vitamin E <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.716; 85.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>21.6 vs. 82.9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>20.9<span class="elsevierStyleHsp" style=""></span>mg/d vitamin C <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.328).</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Ethics and statistics</span><p id="par0065" class="elsevierStylePara elsevierViewall">This research has been conducted in full accordance with ethical principles, including the World Medical Association Declaration of Helsinki (version, 2002). Participants gave their written informed consent prior to study participation. Furthermore, this protocol was approved by an Institutional Ethics Committee.</p><p id="par0070" class="elsevierStylePara elsevierViewall">The results were expressed as a mean (SD). Given the limited sample size, the Shapiro–Wilk test was used to assess whether the data were normally distributed. To compare the mean values, repeated one-way analysis of variance (ANOVA), with post hoc Bonferroni correction to account for multiple tests, were used. Lastly, Pearson's correlation coefficient (<span class="elsevierStyleItalic">r</span>) was used to determine potential associations among tested parameters. The significance of the changes observed was ascertained to be <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05.</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Results</span><p id="par0075" class="elsevierStylePara elsevierViewall">The home-based treadmill training significantly increased VO<span class="elsevierStyleInf">2</span> max (34.7<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.1 vs. 38.2<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.9<span class="elsevierStyleHsp" style=""></span>ml/kg/min; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.018; <span class="elsevierStyleItalic">d</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.71) suggesting an improvement of physical fitness. Similarly, it significantly reduced fat mass percentage (30.3<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.8 vs. 29.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.4%; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.0376; <span class="elsevierStyleItalic">d</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.64).</p><p id="par0080" class="elsevierStylePara elsevierViewall">Regarding seminal quality analysis, sperm concentration (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.029; <span class="elsevierStyleItalic">d</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.61) and the percentages of total sperm motility (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.006; <span class="elsevierStyleItalic">d</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.21) and normal spermatozoa (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.018; <span class="elsevierStyleItalic">d</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.10) were significantly improved in the intervention group. These results are listed in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>. Furthermore, after the completion of the training program, seminal TAS (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.024; <span class="elsevierStyleItalic">d</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.90) and GPX activity (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.012; <span class="elsevierStyleItalic">d</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.08) were significantly increased. These results are summarized in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Lastly, significant correlations were found between seminal antioxidant defenses and seminal quality parameters. In this respect, a positive significant correlation was found between TAS and percentages of sperm motility (<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.040; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.0292) and normal morphology (<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.037; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.0354).</p><p id="par0090" class="elsevierStylePara elsevierViewall">On the other hand, no significant changes in any of the measured variables were found in the control group (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). Furthermore, it should be also pointed out that neither sports-related injuries nor withdrawals from the program were reported during the entire study period.</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Discussion</span><p id="par0095" class="elsevierStylePara elsevierViewall">As was hypothesized, treadmill training improved seminal quality in sedentary adults with T2DM. Similarly, Gaskins et al.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> demonstrated that higher moderate-to-vigorous activity and less TV watching were significantly associated with higher total sperm count and sperm concentration in young healthy men. However, it should be pointed out when designing a training protocol that depending on sport modality and/or intensity, physical activity may impact negatively on sperm quality. In this respect, bicycling ≥5<span class="elsevierStyleHsp" style=""></span>h/wk was associated with lower sperm concentration and motility.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> Similarly, long-term strenuous treadmill exercises (80%VO<span class="elsevierStyleInf">2</span> max) have a deleterious effect on reproduction.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">Accumulated evidence indicates that oxidative stress can be a primary cause of male subfertility/infertility.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> In this line, another striking feature of the present study was that treadmill training significantly increased seminal TAS, by a significant improvement of GPX activity. Consistent with previous studies,<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> our results also suggested that seminal plasma TAS had a significant positive correlation with percentages of sperm motility and normal morphology.</p><p id="par0105" class="elsevierStylePara elsevierViewall">Regarding body composition, Bener et al.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> reported that patients having a BMI >30 were found to have a three-fold increased risk of infertility. Accordingly, it was important to note that the current treadmill training improved body composition by reducing fat mass percentage in patients with T2DM. This is of particular interest given that Goulis and Tarlatzis<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> found the excess adipose tissue resulted in increased conversion of testosterone to estradiol, which may finally impair testicular function.</p><p id="par0110" class="elsevierStylePara elsevierViewall">The current study has some limitations that should be considered. The small sample size may limit the generalization of the results. Furthermore, sexual hormone evaluations were not included. Another major weakness was the relatively short duration of the exercise intervention in that there was no follow-up to determine whether the positive effects induced by treadmill training were maintained. Therefore, there is a clear need for long-term studies to determine whether correction of seminal quality improves the outcomes of live birth and pregnancy rate in this group.</p><p id="par0115" class="elsevierStylePara elsevierViewall">On the other hand, regarding the strengths of the present trail, the excellent adherence rate suggested that the training program was effective and easy to follow-up. This was of particular interest given that it may finally give them the confidence to continue exercising after the trial finishes. In fact, several authors have recommended home-based exercise programs to maintain the beneficial effects obtained during previous supervised training programs.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">In conclusion, a 14-week home-based treadmill training improved seminal quality in young adults with T2DM. A secondary finding was that the seminal antioxidant defense system significantly increased after being exercised.</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflict of interest</span><p id="par0125" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:2 [ "identificador" => "xres378199" "titulo" => array:5 [ 0 => "Abstract" 1 => "Objective" 2 => "Materials and methods" 3 => "Results" 4 => "Conclusions" ] ] 1 => array:2 [ "identificador" => "xpalclavsec357251" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres378198" "titulo" => array:5 [ 0 => "Resumen" 1 => "Objetivo" 2 => "Material y método" 3 => "Resultados" 4 => "Conclusiones" ] ] 3 => array:2 [ "identificador" => "xpalclavsec357252" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Materials and methods" "secciones" => array:7 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Participants" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Home-based treadmill training" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Semen quality assessment" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Physical fitness" ] 4 => array:2 [ "identificador" => "sec0035" "titulo" => "Body composition" ] 5 => array:2 [ "identificador" => "sec0040" "titulo" => "Nutritional intake record" ] 6 => array:2 [ "identificador" => "sec0045" "titulo" => "Ethics and statistics" ] ] ] 6 => array:2 [ "identificador" => "sec0050" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0055" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0060" "titulo" => "Conflict of interest" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2013-09-16" "fechaAceptado" => "2013-10-11" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec357251" "palabras" => array:4 [ 0 => "Type 2 diabetes mellitus" 1 => "Exercise" 2 => "Semen" 3 => "Antioxidant defense system" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec357252" "palabras" => array:4 [ 0 => "Diabetes mellitus tipo 2" 1 => "Ejercicio" 2 => "Semen" 3 => "Defensas antioxidantes" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">This was the first study conducted to determine the influence of home-based treadmill training on seminal quality in adults with type 2 diabetes.</p> <span class="elsevierStyleSectionTitle" id="sect0015">Materials and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Sixty sedentary adults with type 2 diabetes volunteered for the current study. Thirty were randomly allocated to the intervention group and performed a 14-week, home-based, treadmill training program, 3 sessions per week, consisting of a warm-up (10–15<span class="elsevierStyleHsp" style=""></span>min), 40<span class="elsevierStyleHsp" style=""></span>min treadmill exercise at a work intensity of 55–70% of peak heart rate (increasing by 2.5% each two weeks) measured during a maximal treadmill test, and cooling-down (5–10<span class="elsevierStyleHsp" style=""></span>min). The control group included the age of 30, and BMI matched adults with type 2 diabetes who did not take part in any training program. Seminal quality analysis included semen volume, sperm concentration, motility and normal morphologic features. Furthermore, total antioxidant status (TAS) and glutathione peroxidase (GPX) activity were assessed in seminal plasma. This protocol was approved by an Institutional Ethics Committee.</p> <span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The home-based treadmill training significantly increased sperm concentration as well as percentages of total sperm motility and normal spermatozoa. Furthermore, TAS and GPX activity were increased after the completion of the training program. No significant changes in any of the measured variables were found in the control group.</p> <span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Home-based treadmill training improved seminal quality in adults with type 2 diabetes. A secondary finding was that seminal antioxidant defense system was significantly increased after being exercised.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El presente estudio se diseñó para determinar la influencia de un programa de entrenamiento domiciliario en la calidad seminal de adultos con diabetes tipo 2.</p> <span class="elsevierStyleSectionTitle" id="sect0040">Material y método</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Participaron un total de 60 adultos varones con diagnóstico de diabetes tipo 2 distribuidos aleatoriamente en un grupo intervención (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>30) y otro control (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>30). Los participantes incluidos en el grupo de intervención desarrollaron un programa de entrenamiento domiciliario en tapiz rodante de 14 semanas, 3 sesiones/semana de 40<span class="elsevierStyleHsp" style=""></span>min a una intensidad del 55-70% FCmáx (incrementando un 2,5% cada 2 semanas). Los parámetros de calidad seminal ensayados fueron: volumen, concentración y porcentaje de movilidad y morfología normal. Asimismo se estudió el nivel de defensas antioxidantes en plasma seminal. Nuestro protocolo fue aprobado por un comité de ética institucional.</p> <span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Tras completar el programa de entrenamiento se observó un incremento significativo de la concentración espermática, así como de los porcentajes de movilidad y de morfología normal. Paralelamente, se observó un incremento del estatus total antioxidante en el plasma seminal. No se observaron cambios significativos en ninguna de las variables ensayadas en el grupo control.</p> <span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El programa de entrenamiento mejoró la calidad seminal en pacientes con diabetes tipo 2. Este hallazgo podría explicarse por una mejora de las defensas antioxidantes seminales inducida por el ejercicio.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0025">Please cite this article as: Rosety-Rodriguez M, Rosety JM, Fornieles G, Rosety MA, Diaz AJ, Rosety I, et al. El entrenamiento en tapiz rodante a domicilio mejora la calidad seminal en adultos con diabetes de tipo 2. Actas Urol Esp. 2014;38:589–593.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Note</span>: Results expressed as mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>sd.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Intervention \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Control \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span> value \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age (years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36.2<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35.7<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">>0.05 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Fat mass (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30.3<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.7<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.6vs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">>0.05 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HbA1c (5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">>0.05 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Fitness (ml/kg/min) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34.7<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33.9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">>0.05 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab575303.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Anthropometric, biochemical and fitness status of adults with type 2 diabetes enrolled in the intervention and control groups at baseline.</p>" ] ] 1 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Note</span>: Results expressed as mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>sd. Volume: semen volume expressed as ml; Count: Sperm concentration expressed as 106<span class="elsevierStyleHsp" style=""></span>ml<span class="elsevierStyleSup">−1</span>; sperm motility and normal morphology expressed as percentage (%).</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Intervention group</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Control group</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cohen's <span class="elsevierStyleItalic">d</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Pre-test \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Post-test \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Baseline \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Final \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Volume \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.96<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.82 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.08<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.86 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.90<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.86 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.92<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.90 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.18 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Count \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">58.6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">62.2<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>6.3<a class="elsevierStyleCrossRefs" href="#tblfn0005"><span class="elsevierStyleSup">a,b</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57.9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>6.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">58.2<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>6.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.61 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Motility \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57.1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">63.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5.8<a class="elsevierStyleCrossRefs" href="#tblfn0005"><span class="elsevierStyleSup">a,b</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">56.0<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">56.3<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>6.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.21 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Morphology \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">46.1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">51.2<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5.0<a class="elsevierStyleCrossRefs" href="#tblfn0005"><span class="elsevierStyleSup">a,b</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45.9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.10 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab575302.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005"><span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05 vs. pre-test.</p>" ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "<p class="elsevierStyleNotepara" id="npar0010"><span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05 vs. final.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Characteristics of the standard seminal fluid evaluation in adults with type 2 diabetes allocated in the intervention and the control group.</p>" ] ] 2 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Note</span>: TAS, total antioxidant status expressed as mmol/l; GPX, glutathione peroxidase expressed as 10<span class="elsevierStyleSup">−3</span><span class="elsevierStyleHsp" style=""></span>U/g protein.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Exercising group</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Control group</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cohen's <span class="elsevierStyleItalic">d</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Pre-test \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Post-test \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Baseline \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Final \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">TAS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.41<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.53 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.89<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.46 <a class="elsevierStyleCrossRefs" href="#tblfn0015"><span class="elsevierStyleSup">a,b</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.32<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.58 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.36<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.90 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">GPX \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.77<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.66 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n 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