Are crohn’s disease patients limited in sport practise? An ultraendurance case–control study response

The aim of this study was to analyze the psychophysiological response of a Crohn’s Disease patient in an ultra-endurance event. The psychophysiological responses of a Crohn’s Disease and nonCrohn’s Disease participant were analysed before during and after an 8 h ultra-endurance running event. Result...

Full description

Autores:
Tornero Aguilera, José Francisco
Sánchez-Molina, Joaquín
Parraca, Jose A.
Morais, Ana
Clemente-Suárez, Vicente Javier
Tipo de recurso:
Article of investigation
Fecha de publicación:
2022
Institución:
Corporación Universidad de la Costa
Repositorio:
REDICUC - Repositorio CUC
Idioma:
eng
OAI Identifier:
oai:repositorio.cuc.edu.co:11323/10729
Acceso en línea:
https://hdl.handle.net/11323/10729
https://repositorio.cuc.edu.co/
Palabra clave:
Sport
Exercise
Disease
HRV
Autonomic modulation
Rights
openAccess
License
Atribución 4.0 Internacional (CC BY 4.0)
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oai_identifier_str oai:repositorio.cuc.edu.co:11323/10729
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network_name_str REDICUC - Repositorio CUC
repository_id_str
dc.title.eng.fl_str_mv Are crohn’s disease patients limited in sport practise? An ultraendurance case–control study response
title Are crohn’s disease patients limited in sport practise? An ultraendurance case–control study response
spellingShingle Are crohn’s disease patients limited in sport practise? An ultraendurance case–control study response
Sport
Exercise
Disease
HRV
Autonomic modulation
title_short Are crohn’s disease patients limited in sport practise? An ultraendurance case–control study response
title_full Are crohn’s disease patients limited in sport practise? An ultraendurance case–control study response
title_fullStr Are crohn’s disease patients limited in sport practise? An ultraendurance case–control study response
title_full_unstemmed Are crohn’s disease patients limited in sport practise? An ultraendurance case–control study response
title_sort Are crohn’s disease patients limited in sport practise? An ultraendurance case–control study response
dc.creator.fl_str_mv Tornero Aguilera, José Francisco
Sánchez-Molina, Joaquín
Parraca, Jose A.
Morais, Ana
Clemente-Suárez, Vicente Javier
dc.contributor.author.none.fl_str_mv Tornero Aguilera, José Francisco
Sánchez-Molina, Joaquín
Parraca, Jose A.
Morais, Ana
Clemente-Suárez, Vicente Javier
dc.subject.proposal.eng.fl_str_mv Sport
Exercise
Disease
HRV
Autonomic modulation
topic Sport
Exercise
Disease
HRV
Autonomic modulation
description The aim of this study was to analyze the psychophysiological response of a Crohn’s Disease patient in an ultra-endurance event. The psychophysiological responses of a Crohn’s Disease and nonCrohn’s Disease participant were analysed before during and after an 8 h ultra-endurance running event. Results showed how Crohn’s patient presented a similar psychophysiological response than non-Crohn’s participant in the ultra-endurance event, except for a higher pre- and post-event sympathetic modulation, lower event sympathetic tone, and lower event body temperature. This study could contribute to improving physical activity recommendations for persons with Crohn’s Disease and open a new research line for an improved understanding of psychophysiological modifications of Crohn’s Disease patients during exercise.
publishDate 2022
dc.date.issued.none.fl_str_mv 2022
dc.date.accessioned.none.fl_str_mv 2024-02-19T17:03:20Z
dc.date.available.none.fl_str_mv 2024-02-19T17:03:20Z
dc.type.spa.fl_str_mv Artículo de revista
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dc.type.content.spa.fl_str_mv Text
dc.type.driver.spa.fl_str_mv info:eu-repo/semantics/article
dc.type.redcol.spa.fl_str_mv http://purl.org/redcol/resource_type/ART
dc.type.version.spa.fl_str_mv info:eu-repo/semantics/publishedVersion
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dc.identifier.citation.spa.fl_str_mv Tornero-Aguilera, J.F.; Sánchez-Molina, J.; Parraca, J.A.; Morais, A.; Clemente-Suárez, V.J. Are Crohn’s Disease Patients Limited in Sport Practise? An UltraEndurance Case–Control Study Response. Int. J. Environ. Res. Public Health 2022, 19, 10007. https://doi.org/10.3390/ ijerph191610007
dc.identifier.issn.spa.fl_str_mv 1661-7827
dc.identifier.uri.none.fl_str_mv https://hdl.handle.net/11323/10729
dc.identifier.doi.none.fl_str_mv 10.3390/ ijerph191610007
dc.identifier.eissn.spa.fl_str_mv 1660-4601
dc.identifier.instname.spa.fl_str_mv Corporación Universidad de la Costa
dc.identifier.reponame.spa.fl_str_mv REDICUC – Repositorio CUC
dc.identifier.repourl.spa.fl_str_mv https://repositorio.cuc.edu.co/
identifier_str_mv Tornero-Aguilera, J.F.; Sánchez-Molina, J.; Parraca, J.A.; Morais, A.; Clemente-Suárez, V.J. Are Crohn’s Disease Patients Limited in Sport Practise? An UltraEndurance Case–Control Study Response. Int. J. Environ. Res. Public Health 2022, 19, 10007. https://doi.org/10.3390/ ijerph191610007
1661-7827
10.3390/ ijerph191610007
1660-4601
Corporación Universidad de la Costa
REDICUC – Repositorio CUC
url https://hdl.handle.net/11323/10729
https://repositorio.cuc.edu.co/
dc.language.iso.spa.fl_str_mv eng
language eng
dc.relation.ispartofjournal.spa.fl_str_mv International Journal of Environmental Research and Public Health
dc.relation.references.spa.fl_str_mv 1. Baumgart, D.C.; Sandborn, W.J. Crohn’s disease. Lancet 2020, 380, 1590–1605. [CrossRef]
2. Burisch, J.; Jess, T.; Martinato, M.; Lakatos, P.L.; On Behalf of ECCO-EpiCom. The burden of inflammatory bowel disease in Europe. J. Crohn’s Colitis 2013, 7, 322–337. [CrossRef] [PubMed]
3. Pedersen, B.K.; Saltin, B. Evidence for prescribing exercise as therapy in chronic disease. Scand. J. Med. Sci. Sports 2006, 16, 3–63. [CrossRef] [PubMed]
4. Roberts, C.K.; Barnard, R.J. Effects of exercise and diet on chronic disease. J. Appl. Physiol. 2005, 98, 3–30. [CrossRef] [PubMed]
5. Pérez, C.A. Prescription of physical exercise in Crohn’s disease. J. Crowns Colitis 2009, 3, 225–231. [CrossRef] [PubMed]
6. Lykouras, D.; Karkoulias, K.; Triantos, C. Physical exercise in patients with inflammatory bowel disease. J. Crohn’s Colitis 2017, 11, 1024. [CrossRef] [PubMed]
7. Reboredo, M.M.; Pinheiro, B.V.; Chebli, J.M.F. Physical exercise programs in patients with inflammatory bowel disease. J. Crohn’s Colitis 2017, 11, 1286. [CrossRef]
8. D’Incà, R.; Varnier, M.; Mestriner, C.; Martines, D.; D’Odorico, A.; Sturniolo, G.C. Effect of moderate exercise on Crohn’s disease patients in remission. Ital. J. Gastroenterol. Hepatol. 1999, 31, 205–210.
9. Ng, V.; Millard, W.; Lebrun, C.; Howard, J. Low-intensity exercise improves quality of life in patients with Crohn’s disease. Clin. J. Sport Med. 2007, 17, 384–388. [CrossRef]
10. Robinson, R.J.; Krzywicki, T.; Almond, L.; al-Azzawi, F.; Abrams, K.; Iqbal, S.J.; Mayberry, J.F. Effect of a low-impact exercise program on bone mineral density in Crohn’s disease: A randomized controlled trial. Gastroenterology 1998, 115, 36–41. [CrossRef]
11. Tew, G.A.; Leighton, D.; Carpenter, R.; Anderson, S.; Langmead, L.; Ramage, J.; Faulkner, J.; Coleman, E.; Fairhurst, C.; Seed, M.; et al. High-intensity interval training and moderate-intensity continuous training in adults with Crohn’s disease: A pilot randomised controlled trial. BMC Gastroenterol. 2019, 19, 19. [CrossRef]
12. Fragala, M.S.; Kraemer, W.J.; Denegar, C.R.; Maresh, C.M.; Mastro, A.M.; Volek, J.S. Neuroendocrine-immune interactions and responses to exercise. Sports Med. 2011, 41, 621–639. [CrossRef]
13. Awick, E.A.; Ehlers, D.K.; Aguiñaga, S.; Daugherty, A.M.; Kramer, A.F.; McAuley, E. Effects of a randomized exercise trial on physical activity, psychological distress and quality of life in older adults. Gen. Hosp. Psychiatry 2017, 49, 44–50. [CrossRef]
14. Chan, D.; Robbins, H.; Rogers, S.; Clark, S.; Poullis, A. Inflammatory bowel disease and exercise: Results of a Crohn’s and Colitis UK survey. Frontline Gastroenterol. 2014, 5, 44–48. [CrossRef]
15. Belinchón-deMiguel, P.; Clemente-Suárez, V.J. Nutrition, hydration and ergogenic aids strategies in ultraendurance mountain events. J. Sports Med. Phys. Fitness 2019, 59, 791. [CrossRef]
16. Costa, R.J.S.; Snipe, R.M.J.; Kitic, C.M.; Gibson, P.R. Systematic review: Exercise-induced gastrointestinal syndrome—implications for health and intestinal disease. Aliment. Pharmacol. Ther. 2017, 46, 246–265. [CrossRef]
17. Sánchez-Molina, J.; Tronero-Aguilera, J.F.; Clemente-Suárez, V.J. Psychophysiological respond in a swimming ultra-endurance event. J. Sports Med. Phys. Fit. 2020, 61, 140–145. [CrossRef]
18. Santos, S.; Parraca, J.A.; Fernandes, O.; Villafaina, S.; Clemente-Suarez, V.J.; Melo, F. The Effect of Expertise during Simulated Flight Emergencies on the Autonomic Response and Operative Performance in Military Pilots. Int. J. Environ. Res. Public Health 2020, 19, 9141. [CrossRef]
19. Borg, G. Perceived exertion as an indicator of somatic stress. Scand. J. Rehabil. Med. 1970, 2, 92–98.
20. Clemente-Suárez, V.J.; Delgado-Moreno, R.; González, B.; Ortega, J.; Ramos-Campo, D.J. Amateur endurance triathletes’ performance is improved independently of volume or intensity based training. Physiol. Behav. 2018, S0031-9384, 30182–30183. [CrossRef]
21. Armstrong, L.E.; Soto, J.A.H.; Hacker, F.T.; Casa, D.J.; Kavouras, S.; Maresh, C.M. Urinary indices during dehydration, exercise and rehydratation. Occup. Health Ind. Med. 1998, 8, 345–355.
22. Hormeño-Holgado, A.J.; Clemente-Suárez, V.J. Psychophysiological monitorization in a special operation selection course. J. Med. Syst. 2019, 43, 47. [CrossRef]
23. Suarez, V.; Campo, D.; Gonzalez-Rave, J. Modifications to body composition after running an alpine marathon: Brief clinical report. Int. Sport J. 2011, 12, 133–140.
24. Taxonera, C.; Barreiro-de-Acosta, M.; Bastida, G.; Martinez-Gonzalez, J.; Merino, O.; García-Sánchez, V.; Gisbert, J.P.; MarínJiménez, I.; López-Serrano, P.; Gómez-García, M.; et al. Outcomes of medical and surgical therapy for entero-urinary fistulas in Crohn’s disease. J. Crohn’s Colitis 2016, 10, 657–662. [CrossRef]
25. Scozzari, G.; Arezzo, A.; Morino, M. Enterovesical fistulas: Diagnosis and management. Tech. Coloproctol. 2010, 14, 293–300. [CrossRef]
26. Chlíbková, D.; Rosemann, T.; Posch, L.; Matoušek, R.; Knechtle, B. Pre-and post-race hydration status in hyponatremic and non-hyponatremic ultra-endurance athletes. Chin. J. Physiol. 2016, 59, 173–183. [CrossRef]
27. Wiroth, J.B.; Filippi, J.; Schneider, M.; Al-Jaouni, R.; Horvais, N.; Gavarry, O.; Bermon, S.; Hébuterne, X. Muscle performance in patients with Crohn’s disease in clinical remission. Inflamm. Bowel Dis. 2005, 11, 296–303. [CrossRef]
28. Clemente-Suárez, V.J. Psychophysiological response and energy balance during a 14-h ultraendurance mountain running event. Appl. Physiol. Nutr. Metab. 2015, 40, 269–273. [CrossRef]
29. Belinchón-deMiguel, P.; Clemente-Suárez, V.J. Psychophysiological, body composition, biomechanical and autonomic modulation analysis procedures in an ultraendurance mountain race. J. Med. Syst. 2018, 42, 32. [CrossRef]
30. Sousa, C.V.; Nikolaidis, P.T.; Clemente-Suárez, V.J.; Rosemann, T.; Knechtle, B. Pacing and performance analysis of the World’s Fastest Female Ultra-Triathlete in 5x and 10x Ironman. Int. J. Environ. Res. Public Health 2020, 17, 1543. [CrossRef]
31. Magro, D.O.; Cazzo, E.; Kotze, P.; Vasques, A.C.J.; Martinez, C.A.R.; Chaim, E.A.; Geloneze, B.; Pareja, J.C.; Coy, C.S.R. Glucose Metabolism Parameters and Post-Prandial GLP-1 and GLP-2 Release Largely Vary in Several Distinct Situations: A Controlled Comparison Among Individuals with Crohn’s Disease and Individuals with Obesity Before and After Bariatric Surgery. Obes. Surg. 2018, 28, 378–388. [CrossRef] [PubMed]
32. Oray, M.; Abu Samra, K.; Ebrahimiadib, N.; Meese, H.; Foster, C.S. Long-term side effects of glucocorticoids. Expert Opin. Drug Saf. 2016, 15, 457–465. [CrossRef] [PubMed]
33. American Diabetes Association. Children and Adolescents: Standards of Medical Care in Diabetes—2018. Diabetes Care 2018, 41 (Suppl. S1), S126–S136.
34. Phillips, S.; Green, H.J.; Tarnopolsky, M.A.; Heigenhauser, G.J.; Grant, S.M. Progressive effect of endurance training on metabolic adaptations in working skeletal muscle. Am. J. Physiol. Endoc. M 1996, 270, E265–E272. [CrossRef]
35. Romanovsky, A.A. Skin temperature: Its role in thermoregulation. Acta Physiol. 2014, 210, 498–507. [CrossRef]
36. Herborn, K.A.; Graves, J.L.; Jerem, P.; Evans, N.P.; Nager, R.; McCafferty, D.J.; McKeegan, D.E. Skin temperature reveals the intensity of acute stress. Physiol. Behav. 2015, 152, 225–230. [CrossRef]
37. Sánchez-Molina, J.; Robles-Pérez, J.J.; Clemente-Suárez, V.J. Psychophysiological and specific fine motor skill modifications in a checkpoint action. J. Med. Syst. 2019, 43, 90. [CrossRef]
38. Rüst, C.A.; Knechtle, B.; Knechtle, P.; Wirth, A.; Rosemann, T. Body mass change and ultraendurance performance: A decrease in body mass is associated with an increased running speed in male 100-km ultramarathoners. J. Strength Cond. Res. 2012, 26, 1505–1516. [CrossRef]
39. Armstrong, L.E.; Casa, D.J.; Emmanuel, H.; Ganio, M.S.; Klau, J.F.; Lee, E.C.; Maresh, C.M.; McDermott, B.P.; Stearns, R.L.; Vingren, J.L.; et al. Nutritional, physiological, and perceptual responses during a summer ultraendurance cycling event. J. Strength Cond. Res. 2012, 26, 307–318. [CrossRef]
40. Cheuvront, S.N.; Haymes, E.M. Thermoregulation and marathon running. Sports Med. 2001, 31, 743–762. [CrossRef]
41. Prinsloo, G.E.; Rauch, H.G.; Derman, W.E. A brief review and clinical application of heart rate variability biofeedback in sports, exercise, and rehabilitation medicine. Phys. Sportsmed. 2014, 42, 88–99. [CrossRef]
42. Hottenrott, K.; Hoos, O.; Esperer, H.D. Heart rate variability and physical exercise. Current status. Herz 2006, 31, 544–552. [CrossRef]
43. Roldas, G.; Pedrel Carballido, C.; Capdevila, L.; Villegas García, J. Variabilidad de la frecuencia cardíaca: Concepto, medidas y relación con aspectos clínicos (I). Arch. Med. Deporte 2008, 123, 41–47.
44. Aubert, A.E.; Seps, B.; Beckers, F. Heart rate variability in athletes. Sports Med. 2003, 33, 889–919. [CrossRef]
45. Bustamante-Sánchez, Á.; Clemente-Suárez, V.J. Psychophysiological Response to Disorientation Training in Different Aircraft Pilots. Appl. Psychophysiol. Biofeedback 2020, 45, 241–247. [CrossRef]
46. Bustamante-Sánchez, Á.; Tornero-Aguilera, J.F.; Fernández-Elías, V.E.; Hormeno-Holgado, A.J.; Dalamitros, A.A.; ClementeSuárez, V.J. Effect of Stress on Autonomic and Cardiovascular Systems in Military Population: A Systematic Review. Cardiol. Res. Pract. 2020, 2020, 7986249. [CrossRef]
47. Czaplinski, A.; Yen, A.A.; Appel, S.H. Forced vital capacity (FVC) as an indicator of survival and disease progression in an ALS clinic population. J. Neurol. Neurosurg. Psychiatry 2006, 77, 390–392. [CrossRef] [PubMed]
48. Veqar, Z.; Imtiyaz, S. Vibration Therapy in Management of Delayed Onset Muscle Soreness (DOMS). J. Clin. Diagn. Res. 2014, 8, LE01–LE04. [CrossRef]
49. Ward, S.; Pearce, A.J.; Pietrosimone, B.; Bennell, K.; Clark, R.; Bryant, A.L. Neuromuscular deficits after peripheral joint injury: A neurophysiological hypothesis. Muscle Nerve 2015, 51, 327–332. [CrossRef]
50. Gil-Cabrera, J.; Tornero Aguilera, J.F.; Sanchez-Tena, M.A.; Alvarez-Peregrina, C.; Valbuena-Iglesias, C.; Clemente-Suárez, V.J. Aviation-associated spatial disorientation and incidence of visual illusions survey in military pilots. Int. J. Aerosp. Psychol. 2021, 31, 17–24. [CrossRef]
51. Clemente-Suárez, V.J.; Robles-Pérez, J.J. Mechanical, physical, and physiological analysis of symmetrical and asymmetrical combat. J. Strength Cond. Res. 2013, 27, 2420–2426. [CrossRef] [PubMed]
52. Sánchez-Molina, J.; Robles-Pérez, J.J.; Clemente-Suárez, V.J. Psychophysiological and fine motor skill differences of elite and non-elite soldiers in an urban combat simulation. Mil. Psychol. 2019, 31, 425–432. [CrossRef]
53. Vicente-Rodriguez, M.; Clemente-Suárez, V.J. Psychophysiological anxiety response of a rescue helicopter crew in a crane rescue manoeuvre. BMJ Mil. Health 2020, 167, 413–417. [CrossRef] [PubMed]
54. Hormeño-Holgado, A.J.; Clemente-Suárez, V.J. Effect of different combat jet manoeuvres in the psychophysiological response of professional pilots. Physiol. Behav. 2019, 208, 112559. [CrossRef]
55. Clemente-Suárez, V.J.; Robles-Pérez, J.J.; Herrera-Mendoza, K.; Herrera-Tapias, B.; Fernández-Lucas, J. Psychophysiological response and fine motor skills in high-altitude parachute jumps. High Alt. Med. Biol. 2017, 18, 392–399. [CrossRef]
56. Delgado-Moreno, R.; Robles-Pérez, J.J.; Clemente-Suárez, V.J. Combat stress decreases memory of warfighters in action. J. Med. Syst. 2017, 41, 124. [CrossRef]
57. Delgado-Moreno, R.; Robles-Pérez, J.J.; Aznar-Laín, S.; Clemente-Suárez, V.J. Effect of experience and psychophysiological modification by combat stress in soldier’s memory. J. Med. Syst. 2019, 43, 150. [CrossRef]
58. Tornero-Aguilera, J.F.; Clemente-Suárez, V.J. Effect of experience, equipment and fire actions in psychophysiological response and memory of soldiers in actual underground operations. Int. J. Psychophysiol. 2018, 128, 40–46. [CrossRef]
59. Belinchón-Demiguel, P.; Tornero-Aguilera, J.F.; Dalamitros, A.; Nikolaidis, P.T.; Rosemann, T.; Knechtle, B.; Clemente-Suárez, V.J. Multidisciplinary analysis of differences between finisher and non-finisher ultra-endurance mountain athletes. Front. Physiol. 2019, 10, 1507. [CrossRef]
60. Belinchón-Demiguel, P.; Ruisoto, P.; Knechtle, B.; Nikolaidis, P.T.; Herrera-Tapias, B.; Clemente-Suárez, V.J. Predictors of Athlete’s Performance in Ultra-Endurance Mountain Races. Int. J. Environ. Res. Public Health 2021, 18, 956. [CrossRef]
61. Belinchón-Demiguel, P.; Ruisoto-Palomera, P.; Clemente-Suárez, V.J. Psychophysiological Stress Response of a Paralympic Athlete During an Ultra-Endurance Event. A Case Study. J. Med. Syst. 2019, 43, 70. [CrossRef] [PubMed]
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spelling Atribución 4.0 Internacional (CC BY 4.0)© 2022 by the authors. Licensee MDPI, Basel, Switzerland.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Tornero Aguilera, José FranciscoSánchez-Molina, JoaquínParraca, Jose A.Morais, AnaClemente-Suárez, Vicente Javier2024-02-19T17:03:20Z2024-02-19T17:03:20Z2022Tornero-Aguilera, J.F.; Sánchez-Molina, J.; Parraca, J.A.; Morais, A.; Clemente-Suárez, V.J. Are Crohn’s Disease Patients Limited in Sport Practise? An UltraEndurance Case–Control Study Response. Int. J. Environ. Res. Public Health 2022, 19, 10007. https://doi.org/10.3390/ ijerph1916100071661-7827https://hdl.handle.net/11323/1072910.3390/ ijerph1916100071660-4601Corporación Universidad de la CostaREDICUC – Repositorio CUChttps://repositorio.cuc.edu.co/The aim of this study was to analyze the psychophysiological response of a Crohn’s Disease patient in an ultra-endurance event. The psychophysiological responses of a Crohn’s Disease and nonCrohn’s Disease participant were analysed before during and after an 8 h ultra-endurance running event. Results showed how Crohn’s patient presented a similar psychophysiological response than non-Crohn’s participant in the ultra-endurance event, except for a higher pre- and post-event sympathetic modulation, lower event sympathetic tone, and lower event body temperature. This study could contribute to improving physical activity recommendations for persons with Crohn’s Disease and open a new research line for an improved understanding of psychophysiological modifications of Crohn’s Disease patients during exercise.10 páginasapplication/pdfengMultidisciplinary Digital Publishing Institute (MDPI)Switzerlandhttps://www.mdpi.com/1660-4601/19/16/10007Are crohn’s disease patients limited in sport practise? An ultraendurance case–control study responseArtículo de revistahttp://purl.org/coar/resource_type/c_2df8fbb1Textinfo:eu-repo/semantics/articlehttp://purl.org/redcol/resource_type/ARTinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/version/c_970fb48d4fbd8a85International Journal of Environmental Research and Public Health1. Baumgart, D.C.; Sandborn, W.J. Crohn’s disease. Lancet 2020, 380, 1590–1605. [CrossRef]2. Burisch, J.; Jess, T.; Martinato, M.; Lakatos, P.L.; On Behalf of ECCO-EpiCom. The burden of inflammatory bowel disease in Europe. J. Crohn’s Colitis 2013, 7, 322–337. [CrossRef] [PubMed]3. Pedersen, B.K.; Saltin, B. Evidence for prescribing exercise as therapy in chronic disease. Scand. J. Med. Sci. Sports 2006, 16, 3–63. [CrossRef] [PubMed]4. Roberts, C.K.; Barnard, R.J. Effects of exercise and diet on chronic disease. J. Appl. Physiol. 2005, 98, 3–30. [CrossRef] [PubMed]5. Pérez, C.A. Prescription of physical exercise in Crohn’s disease. J. Crowns Colitis 2009, 3, 225–231. [CrossRef] [PubMed]6. Lykouras, D.; Karkoulias, K.; Triantos, C. Physical exercise in patients with inflammatory bowel disease. J. Crohn’s Colitis 2017, 11, 1024. [CrossRef] [PubMed]7. Reboredo, M.M.; Pinheiro, B.V.; Chebli, J.M.F. Physical exercise programs in patients with inflammatory bowel disease. J. Crohn’s Colitis 2017, 11, 1286. [CrossRef]8. D’Incà, R.; Varnier, M.; Mestriner, C.; Martines, D.; D’Odorico, A.; Sturniolo, G.C. Effect of moderate exercise on Crohn’s disease patients in remission. Ital. J. Gastroenterol. Hepatol. 1999, 31, 205–210.9. Ng, V.; Millard, W.; Lebrun, C.; Howard, J. Low-intensity exercise improves quality of life in patients with Crohn’s disease. Clin. J. Sport Med. 2007, 17, 384–388. [CrossRef]10. Robinson, R.J.; Krzywicki, T.; Almond, L.; al-Azzawi, F.; Abrams, K.; Iqbal, S.J.; Mayberry, J.F. Effect of a low-impact exercise program on bone mineral density in Crohn’s disease: A randomized controlled trial. Gastroenterology 1998, 115, 36–41. [CrossRef]11. Tew, G.A.; Leighton, D.; Carpenter, R.; Anderson, S.; Langmead, L.; Ramage, J.; Faulkner, J.; Coleman, E.; Fairhurst, C.; Seed, M.; et al. High-intensity interval training and moderate-intensity continuous training in adults with Crohn’s disease: A pilot randomised controlled trial. BMC Gastroenterol. 2019, 19, 19. [CrossRef]12. Fragala, M.S.; Kraemer, W.J.; Denegar, C.R.; Maresh, C.M.; Mastro, A.M.; Volek, J.S. Neuroendocrine-immune interactions and responses to exercise. Sports Med. 2011, 41, 621–639. [CrossRef]13. Awick, E.A.; Ehlers, D.K.; Aguiñaga, S.; Daugherty, A.M.; Kramer, A.F.; McAuley, E. Effects of a randomized exercise trial on physical activity, psychological distress and quality of life in older adults. Gen. Hosp. Psychiatry 2017, 49, 44–50. [CrossRef]14. Chan, D.; Robbins, H.; Rogers, S.; Clark, S.; Poullis, A. Inflammatory bowel disease and exercise: Results of a Crohn’s and Colitis UK survey. Frontline Gastroenterol. 2014, 5, 44–48. [CrossRef]15. Belinchón-deMiguel, P.; Clemente-Suárez, V.J. Nutrition, hydration and ergogenic aids strategies in ultraendurance mountain events. J. Sports Med. Phys. Fitness 2019, 59, 791. [CrossRef]16. Costa, R.J.S.; Snipe, R.M.J.; Kitic, C.M.; Gibson, P.R. Systematic review: Exercise-induced gastrointestinal syndrome—implications for health and intestinal disease. Aliment. Pharmacol. Ther. 2017, 46, 246–265. [CrossRef]17. Sánchez-Molina, J.; Tronero-Aguilera, J.F.; Clemente-Suárez, V.J. Psychophysiological respond in a swimming ultra-endurance event. J. Sports Med. Phys. Fit. 2020, 61, 140–145. [CrossRef]18. Santos, S.; Parraca, J.A.; Fernandes, O.; Villafaina, S.; Clemente-Suarez, V.J.; Melo, F. The Effect of Expertise during Simulated Flight Emergencies on the Autonomic Response and Operative Performance in Military Pilots. Int. J. Environ. Res. Public Health 2020, 19, 9141. [CrossRef]19. Borg, G. Perceived exertion as an indicator of somatic stress. Scand. J. Rehabil. Med. 1970, 2, 92–98.20. Clemente-Suárez, V.J.; Delgado-Moreno, R.; González, B.; Ortega, J.; Ramos-Campo, D.J. Amateur endurance triathletes’ performance is improved independently of volume or intensity based training. Physiol. Behav. 2018, S0031-9384, 30182–30183. [CrossRef]21. Armstrong, L.E.; Soto, J.A.H.; Hacker, F.T.; Casa, D.J.; Kavouras, S.; Maresh, C.M. Urinary indices during dehydration, exercise and rehydratation. Occup. Health Ind. Med. 1998, 8, 345–355.22. Hormeño-Holgado, A.J.; Clemente-Suárez, V.J. Psychophysiological monitorization in a special operation selection course. J. Med. Syst. 2019, 43, 47. [CrossRef]23. Suarez, V.; Campo, D.; Gonzalez-Rave, J. Modifications to body composition after running an alpine marathon: Brief clinical report. Int. Sport J. 2011, 12, 133–140.24. Taxonera, C.; Barreiro-de-Acosta, M.; Bastida, G.; Martinez-Gonzalez, J.; Merino, O.; García-Sánchez, V.; Gisbert, J.P.; MarínJiménez, I.; López-Serrano, P.; Gómez-García, M.; et al. Outcomes of medical and surgical therapy for entero-urinary fistulas in Crohn’s disease. J. Crohn’s Colitis 2016, 10, 657–662. [CrossRef]25. Scozzari, G.; Arezzo, A.; Morino, M. Enterovesical fistulas: Diagnosis and management. Tech. Coloproctol. 2010, 14, 293–300. [CrossRef]26. Chlíbková, D.; Rosemann, T.; Posch, L.; Matoušek, R.; Knechtle, B. Pre-and post-race hydration status in hyponatremic and non-hyponatremic ultra-endurance athletes. Chin. J. Physiol. 2016, 59, 173–183. [CrossRef]27. Wiroth, J.B.; Filippi, J.; Schneider, M.; Al-Jaouni, R.; Horvais, N.; Gavarry, O.; Bermon, S.; Hébuterne, X. Muscle performance in patients with Crohn’s disease in clinical remission. Inflamm. Bowel Dis. 2005, 11, 296–303. [CrossRef]28. Clemente-Suárez, V.J. Psychophysiological response and energy balance during a 14-h ultraendurance mountain running event. Appl. Physiol. Nutr. Metab. 2015, 40, 269–273. [CrossRef]29. Belinchón-deMiguel, P.; Clemente-Suárez, V.J. Psychophysiological, body composition, biomechanical and autonomic modulation analysis procedures in an ultraendurance mountain race. J. Med. Syst. 2018, 42, 32. [CrossRef]30. Sousa, C.V.; Nikolaidis, P.T.; Clemente-Suárez, V.J.; Rosemann, T.; Knechtle, B. Pacing and performance analysis of the World’s Fastest Female Ultra-Triathlete in 5x and 10x Ironman. Int. J. Environ. Res. Public Health 2020, 17, 1543. [CrossRef]31. Magro, D.O.; Cazzo, E.; Kotze, P.; Vasques, A.C.J.; Martinez, C.A.R.; Chaim, E.A.; Geloneze, B.; Pareja, J.C.; Coy, C.S.R. Glucose Metabolism Parameters and Post-Prandial GLP-1 and GLP-2 Release Largely Vary in Several Distinct Situations: A Controlled Comparison Among Individuals with Crohn’s Disease and Individuals with Obesity Before and After Bariatric Surgery. Obes. Surg. 2018, 28, 378–388. [CrossRef] [PubMed]32. Oray, M.; Abu Samra, K.; Ebrahimiadib, N.; Meese, H.; Foster, C.S. Long-term side effects of glucocorticoids. Expert Opin. Drug Saf. 2016, 15, 457–465. [CrossRef] [PubMed]33. American Diabetes Association. Children and Adolescents: Standards of Medical Care in Diabetes—2018. Diabetes Care 2018, 41 (Suppl. S1), S126–S136.34. Phillips, S.; Green, H.J.; Tarnopolsky, M.A.; Heigenhauser, G.J.; Grant, S.M. Progressive effect of endurance training on metabolic adaptations in working skeletal muscle. Am. J. Physiol. Endoc. M 1996, 270, E265–E272. [CrossRef]35. Romanovsky, A.A. Skin temperature: Its role in thermoregulation. Acta Physiol. 2014, 210, 498–507. [CrossRef]36. Herborn, K.A.; Graves, J.L.; Jerem, P.; Evans, N.P.; Nager, R.; McCafferty, D.J.; McKeegan, D.E. Skin temperature reveals the intensity of acute stress. Physiol. Behav. 2015, 152, 225–230. [CrossRef]37. Sánchez-Molina, J.; Robles-Pérez, J.J.; Clemente-Suárez, V.J. Psychophysiological and specific fine motor skill modifications in a checkpoint action. J. Med. Syst. 2019, 43, 90. [CrossRef]38. Rüst, C.A.; Knechtle, B.; Knechtle, P.; Wirth, A.; Rosemann, T. Body mass change and ultraendurance performance: A decrease in body mass is associated with an increased running speed in male 100-km ultramarathoners. J. Strength Cond. Res. 2012, 26, 1505–1516. [CrossRef]39. Armstrong, L.E.; Casa, D.J.; Emmanuel, H.; Ganio, M.S.; Klau, J.F.; Lee, E.C.; Maresh, C.M.; McDermott, B.P.; Stearns, R.L.; Vingren, J.L.; et al. Nutritional, physiological, and perceptual responses during a summer ultraendurance cycling event. J. Strength Cond. Res. 2012, 26, 307–318. [CrossRef]40. Cheuvront, S.N.; Haymes, E.M. Thermoregulation and marathon running. Sports Med. 2001, 31, 743–762. [CrossRef]41. Prinsloo, G.E.; Rauch, H.G.; Derman, W.E. A brief review and clinical application of heart rate variability biofeedback in sports, exercise, and rehabilitation medicine. Phys. Sportsmed. 2014, 42, 88–99. [CrossRef]42. Hottenrott, K.; Hoos, O.; Esperer, H.D. Heart rate variability and physical exercise. Current status. Herz 2006, 31, 544–552. [CrossRef]43. Roldas, G.; Pedrel Carballido, C.; Capdevila, L.; Villegas García, J. Variabilidad de la frecuencia cardíaca: Concepto, medidas y relación con aspectos clínicos (I). Arch. Med. Deporte 2008, 123, 41–47.44. Aubert, A.E.; Seps, B.; Beckers, F. Heart rate variability in athletes. Sports Med. 2003, 33, 889–919. [CrossRef]45. Bustamante-Sánchez, Á.; Clemente-Suárez, V.J. Psychophysiological Response to Disorientation Training in Different Aircraft Pilots. Appl. Psychophysiol. Biofeedback 2020, 45, 241–247. [CrossRef]46. Bustamante-Sánchez, Á.; Tornero-Aguilera, J.F.; Fernández-Elías, V.E.; Hormeno-Holgado, A.J.; Dalamitros, A.A.; ClementeSuárez, V.J. Effect of Stress on Autonomic and Cardiovascular Systems in Military Population: A Systematic Review. Cardiol. Res. Pract. 2020, 2020, 7986249. [CrossRef]47. Czaplinski, A.; Yen, A.A.; Appel, S.H. Forced vital capacity (FVC) as an indicator of survival and disease progression in an ALS clinic population. J. Neurol. Neurosurg. Psychiatry 2006, 77, 390–392. [CrossRef] [PubMed]48. Veqar, Z.; Imtiyaz, S. Vibration Therapy in Management of Delayed Onset Muscle Soreness (DOMS). J. Clin. Diagn. Res. 2014, 8, LE01–LE04. [CrossRef]49. Ward, S.; Pearce, A.J.; Pietrosimone, B.; Bennell, K.; Clark, R.; Bryant, A.L. Neuromuscular deficits after peripheral joint injury: A neurophysiological hypothesis. Muscle Nerve 2015, 51, 327–332. [CrossRef]50. Gil-Cabrera, J.; Tornero Aguilera, J.F.; Sanchez-Tena, M.A.; Alvarez-Peregrina, C.; Valbuena-Iglesias, C.; Clemente-Suárez, V.J. Aviation-associated spatial disorientation and incidence of visual illusions survey in military pilots. Int. J. Aerosp. Psychol. 2021, 31, 17–24. [CrossRef]51. Clemente-Suárez, V.J.; Robles-Pérez, J.J. Mechanical, physical, and physiological analysis of symmetrical and asymmetrical combat. J. Strength Cond. Res. 2013, 27, 2420–2426. [CrossRef] [PubMed]52. Sánchez-Molina, J.; Robles-Pérez, J.J.; Clemente-Suárez, V.J. Psychophysiological and fine motor skill differences of elite and non-elite soldiers in an urban combat simulation. Mil. Psychol. 2019, 31, 425–432. [CrossRef]53. Vicente-Rodriguez, M.; Clemente-Suárez, V.J. Psychophysiological anxiety response of a rescue helicopter crew in a crane rescue manoeuvre. BMJ Mil. Health 2020, 167, 413–417. [CrossRef] [PubMed]54. Hormeño-Holgado, A.J.; Clemente-Suárez, V.J. Effect of different combat jet manoeuvres in the psychophysiological response of professional pilots. Physiol. Behav. 2019, 208, 112559. [CrossRef]55. Clemente-Suárez, V.J.; Robles-Pérez, J.J.; Herrera-Mendoza, K.; Herrera-Tapias, B.; Fernández-Lucas, J. Psychophysiological response and fine motor skills in high-altitude parachute jumps. High Alt. Med. Biol. 2017, 18, 392–399. [CrossRef]56. Delgado-Moreno, R.; Robles-Pérez, J.J.; Clemente-Suárez, V.J. Combat stress decreases memory of warfighters in action. J. Med. Syst. 2017, 41, 124. [CrossRef]57. Delgado-Moreno, R.; Robles-Pérez, J.J.; Aznar-Laín, S.; Clemente-Suárez, V.J. Effect of experience and psychophysiological modification by combat stress in soldier’s memory. J. Med. Syst. 2019, 43, 150. [CrossRef]58. Tornero-Aguilera, J.F.; Clemente-Suárez, V.J. Effect of experience, equipment and fire actions in psychophysiological response and memory of soldiers in actual underground operations. Int. J. Psychophysiol. 2018, 128, 40–46. [CrossRef]59. Belinchón-Demiguel, P.; Tornero-Aguilera, J.F.; Dalamitros, A.; Nikolaidis, P.T.; Rosemann, T.; Knechtle, B.; Clemente-Suárez, V.J. Multidisciplinary analysis of differences between finisher and non-finisher ultra-endurance mountain athletes. Front. Physiol. 2019, 10, 1507. [CrossRef]60. Belinchón-Demiguel, P.; Ruisoto, P.; Knechtle, B.; Nikolaidis, P.T.; Herrera-Tapias, B.; Clemente-Suárez, V.J. Predictors of Athlete’s Performance in Ultra-Endurance Mountain Races. Int. J. Environ. Res. Public Health 2021, 18, 956. [CrossRef]61. Belinchón-Demiguel, P.; Ruisoto-Palomera, P.; Clemente-Suárez, V.J. Psychophysiological Stress Response of a Paralympic Athlete During an Ultra-Endurance Event. A Case Study. J. Med. Syst. 2019, 43, 70. [CrossRef] [PubMed]101619SportExerciseDiseaseHRVAutonomic modulationPublicationORIGINALAre Crohn’s Disease Patients Limited in Sport Practise.pdfAre Crohn’s Disease Patients Limited in Sport Practise.pdfArtículoapplication/pdf954728https://repositorio.cuc.edu.co/bitstreams/53a10a6f-9da6-4407-85cf-b89ce6b57268/downloaddf1f6d7d0e1dd2199842825c325098cfMD51LICENSElicense.txtlicense.txttext/plain; charset=utf-814828https://repositorio.cuc.edu.co/bitstreams/ce65332b-0d67-4414-bbb3-1e046022bf4e/download2f9959eaf5b71fae44bbf9ec84150c7aMD52TEXTAre Crohn’s Disease Patients Limited in Sport Practise.pdf.txtAre Crohn’s Disease Patients Limited in Sport Practise.pdf.txtExtracted texttext/plain45817https://repositorio.cuc.edu.co/bitstreams/5399e264-b872-4cd2-986c-d71e032ca702/download9eb62836a9d4275f7a296fb8a75e268aMD53THUMBNAILAre Crohn’s Disease Patients Limited in Sport Practise.pdf.jpgAre Crohn’s Disease Patients Limited in Sport Practise.pdf.jpgGenerated Thumbnailimage/jpeg15765https://repositorio.cuc.edu.co/bitstreams/438df9a1-b7be-48b8-86d9-db6453e48018/download72aebe0dd61993156095f0db5f606c83MD5411323/10729oai:repositorio.cuc.edu.co:11323/107292024-09-17 14:12:40.506https://creativecommons.org/licenses/by/4.0/© 2022 by the authors. 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ada en las Obras Colectivas.

b.	Distribuir copias o fonogramas de las Obras, exhibirlas públicamente, ejecutarlas públicamente y/o ponerlas a disposición pública, incluyéndolas como incorporadas en Obras Colectivas, según corresponda.

c.	Distribuir copias de las Obras Derivadas que se generen, exhibirlas públicamente, ejecutarlas públicamente y/o ponerlas a disposición pública.
Los derechos mencionados anteriormente pueden ser ejercidos en todos los medios y formatos, actualmente conocidos o que se inventen en el futuro. Los derechos antes mencionados incluyen el derecho a realizar dichas modificaciones en la medida que sean técnicamente necesarias para ejercer los derechos en otro medio o formatos, pero de otra manera usted no está autorizado para realizar obras derivadas. Todos los derechos no otorgados expresamente por el Licenciante quedan por este medio reservados, incluyendo pero sin limitarse a aquellos que se mencionan en las secciones 4(d) y 4(e).

4. Restricciones.
La licencia otorgada en la anterior Sección 3 está expresamente sujeta y limitada por las siguientes restricciones:

a.	Usted puede distribuir, exhibir públicamente, ejecutar públicamente, o poner a disposición pública la Obra sólo bajo las condiciones de esta Licencia, y Usted debe incluir una copia de esta licencia o del Identificador Universal de Recursos de la misma con cada copia de la Obra que distribuya, exhiba públicamente, ejecute públicamente o ponga a disposición pública. No es posible ofrecer o imponer ninguna condición sobre la Obra que altere o limite las condiciones de esta Licencia o el ejercicio de los derechos de los destinatarios otorgados en este documento. No es posible sublicenciar la Obra. Usted debe mantener intactos todos los avisos que hagan referencia a esta Licencia y a la cláusula de limitación de garantías. Usted no puede distribuir, exhibir públicamente, ejecutar públicamente, o poner a disposición pública la Obra con alguna medida tecnológica que controle el acceso o la utilización de ella de una forma que sea inconsistente con las condiciones de esta Licencia. Lo anterior se aplica a la Obra incorporada a una Obra Colectiva, pero esto no exige que la Obra Colectiva aparte de la obra misma quede sujeta a las condiciones de esta Licencia. Si Usted crea una Obra Colectiva, previo aviso de cualquier Licenciante debe, en la medida de lo posible, eliminar de la Obra Colectiva cualquier referencia a dicho Licenciante o al Autor Original, según lo solicitado por el Licenciante y conforme lo exige la cláusula 4(c).

b.	Usted no puede ejercer ninguno de los derechos que le han sido otorgados en la Sección 3 precedente de modo que estén principalmente destinados o directamente dirigidos a conseguir un provecho comercial o una compensación monetaria privada. El intercambio de la Obra por otras obras protegidas por derechos de autor, ya sea a través de un sistema para compartir archivos digitales (digital file-sharing) o de cualquier otra manera no será considerado como estar destinado principalmente o dirigido directamente a conseguir un provecho comercial o una compensación monetaria privada, siempre que no se realice un pago mediante una compensación monetaria en relación con el intercambio de obras protegidas por el derecho de autor.

c.	Si usted distribuye, exhibe públicamente, ejecuta públicamente o ejecuta públicamente en forma digital la Obra o cualquier Obra Derivada u Obra Colectiva, Usted debe mantener intacta toda la información de derecho de autor de la Obra y proporcionar, de forma razonable según el medio o manera que Usted esté utilizando: (i) el nombre del Autor Original si está provisto (o seudónimo, si fuere aplicable), y/o (ii) el nombre de la parte o las partes que el Autor Original y/o el Licenciante hubieren designado para la atribución (v.g., un instituto patrocinador, editorial, publicación) en la información de los derechos de autor del Licenciante, términos de servicios o de otras formas razonables; el título de la Obra si está provisto; en la medida de lo razonablemente factible y, si está provisto, el Identificador Uniforme de Recursos (Uniform Resource Identifier) que el Licenciante especifica para ser asociado con la Obra, salvo que tal URI no se refiera a la nota sobre los derechos de autor o a la información sobre el licenciamiento de la Obra; y en el caso de una Obra Derivada, atribuir el crédito identificando el uso de la Obra en la Obra Derivada (v.g., "Traducción Francesa de la Obra del Autor Original," o "Guión Cinematográfico basado en la Obra original del Autor Original"). Tal crédito puede ser implementado de cualquier forma razonable; en el caso, sin embargo, de Obras Derivadas u Obras Colectivas, tal crédito aparecerá, como mínimo, donde aparece el crédito de cualquier otro autor comparable y de una manera, al menos, tan destacada como el crédito de otro autor comparable.

d.	Para evitar toda confusión, el Licenciante aclara que, cuando la obra es una composición musical:

i.	Regalías por interpretación y ejecución bajo licencias generales. El Licenciante se reserva el derecho exclusivo de autorizar la ejecución pública o la ejecución pública digital de la obra y de recolectar, sea individualmente o a través de una sociedad de gestión colectiva de derechos de autor y derechos conexos (por ejemplo, SAYCO), las regalías por la ejecución pública o por la ejecución pública digital de la obra (por ejemplo Webcast) licenciada bajo licencias generales, si la interpretación o ejecución de la obra está primordialmente orientada por o dirigida a la obtención de una ventaja comercial o una compensación monetaria privada.

ii.	Regalías por Fonogramas. El Licenciante se reserva el derecho exclusivo de recolectar, individualmente o a través de una sociedad de gestión colectiva de derechos de autor y derechos conexos (por ejemplo, los consagrados por la SAYCO), una agencia de derechos musicales o algún agente designado, las regalías por cualquier fonograma que Usted cree a partir de la obra (“versión cover”) y distribuya, en los términos del régimen de derechos de autor, si la creación o distribución de esa versión cover está primordialmente destinada o dirigida a obtener una ventaja comercial o una compensación monetaria privada.

e.	Gestión de Derechos de Autor sobre Interpretaciones y Ejecuciones Digitales (WebCasting). Para evitar toda confusión, el Licenciante aclara que, cuando la obra sea un fonograma, el Licenciante se reserva el derecho exclusivo de autorizar la ejecución pública digital de la obra (por ejemplo, webcast) y de recolectar, individualmente o a través de una sociedad de gestión colectiva de derechos de autor y derechos conexos (por ejemplo, ACINPRO), las regalías por la ejecución pública digital de la obra (por ejemplo, webcast), sujeta a las disposiciones aplicables del régimen de Derecho de Autor, si esta ejecución pública digital está primordialmente dirigida a obtener una ventaja comercial o una compensación monetaria privada.

5. Representaciones, Garantías y Limitaciones de Responsabilidad.
A MENOS QUE LAS PARTES LO ACORDARAN DE OTRA FORMA POR ESCRITO, EL LICENCIANTE OFRECE LA OBRA (EN EL ESTADO EN EL QUE SE ENCUENTRA) “TAL CUAL”, SIN BRINDAR GARANTÍAS DE CLASE ALGUNA RESPECTO DE LA OBRA, YA SEA EXPRESA, IMPLÍCITA, LEGAL O CUALQUIERA OTRA, INCLUYENDO, SIN LIMITARSE A ELLAS, GARANTÍAS DE TITULARIDAD, COMERCIABILIDAD, ADAPTABILIDAD O ADECUACIÓN A PROPÓSITO DETERMINADO, AUSENCIA DE INFRACCIÓN, DE AUSENCIA DE DEFECTOS LATENTES O DE OTRO TIPO, O LA PRESENCIA O AUSENCIA DE ERRORES, SEAN O NO DESCUBRIBLES (PUEDAN O NO SER ESTOS DESCUBIERTOS). ALGUNAS JURISDICCIONES NO PERMITEN LA EXCLUSIÓN DE GARANTÍAS IMPLÍCITAS, EN CUYO CASO ESTA EXCLUSIÓN PUEDE NO APLICARSE A USTED.

6. Limitación de responsabilidad.
A MENOS QUE LO EXIJA EXPRESAMENTE LA LEY APLICABLE, EL LICENCIANTE NO SERÁ RESPONSABLE ANTE USTED POR DAÑO ALGUNO, SEA POR RESPONSABILIDAD EXTRACONTRACTUAL, PRECONTRACTUAL O CONTRACTUAL, OBJETIVA O SUBJETIVA, SE TRATE DE DAÑOS MORALES O PATRIMONIALES, DIRECTOS O INDIRECTOS, PREVISTOS O IMPREVISTOS PRODUCIDOS POR EL USO DE ESTA LICENCIA O DE LA OBRA, AUN CUANDO EL LICENCIANTE HAYA SIDO ADVERTIDO DE LA POSIBILIDAD DE DICHOS DAÑOS. ALGUNAS LEYES NO PERMITEN LA EXCLUSIÓN DE CIERTA RESPONSABILIDAD, EN CUYO CASO ESTA EXCLUSIÓN PUEDE NO APLICARSE A USTED.

7. Término.

a.	Esta Licencia y los derechos otorgados en virtud de ella terminarán automáticamente si Usted infringe alguna condición establecida en ella. Sin embargo, los individuos o entidades que han recibido Obras Derivadas o Colectivas de Usted de conformidad con esta Licencia, no verán terminadas sus licencias, siempre que estos individuos o entidades sigan cumpliendo íntegramente las condiciones de estas licencias. Las Secciones 1, 2, 5, 6, 7, y 8 subsistirán a cualquier terminación de esta Licencia.

b.	Sujeta a las condiciones y términos anteriores, la licencia otorgada aquí es perpetua (durante el período de vigencia de los derechos de autor de la obra). No obstante lo anterior, el Licenciante se reserva el derecho a publicar y/o estrenar la Obra bajo condiciones de licencia diferentes o a dejar de distribuirla en los términos de esta Licencia en cualquier momento; en el entendido, sin embargo, que esa elección no servirá para revocar esta licencia o que deba ser otorgada , bajo los términos de esta licencia), y esta licencia continuará en pleno vigor y efecto a menos que sea terminada como se expresa atrás. La Licencia revocada continuará siendo plenamente vigente y efectiva si no se le da término en las condiciones indicadas anteriormente.

8. Varios.

a.	Cada vez que Usted distribuya o ponga a disposición pública la Obra o una Obra Colectiva, el Licenciante ofrecerá al destinatario una licencia en los mismos términos y condiciones que la licencia otorgada a Usted bajo esta Licencia.

b.	Si alguna disposición de esta Licencia resulta invalidada o no exigible, según la legislación vigente, esto no afectará ni la validez ni la aplicabilidad del resto de condiciones de esta Licencia y, sin acción adicional por parte de los sujetos de este acuerdo, aquélla se entenderá reformada lo mínimo necesario para hacer que dicha disposición sea válida y exigible.

c.	Ningún término o disposición de esta Licencia se estimará renunciada y ninguna violación de ella será consentida a menos que esa renuncia o consentimiento sea otorgado por escrito y firmado por la parte que renuncie o consienta.

d.	Esta Licencia refleja el acuerdo pleno entre las partes respecto a la Obra aquí licenciada. No hay arreglos, acuerdos o declaraciones respecto a la Obra que no estén especificados en este documento. El Licenciante no se verá limitado por ninguna disposición adicional que pueda surgir en alguna comunicación emanada de Usted. Esta Licencia no puede ser modificada sin el consentimiento mutuo por escrito del Licenciante y Usted.


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