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Experimental Gerontology Jun 2022The muscle disease sarcopenia, which is characterised by a loss of muscle strength, muscle quantity, and physical performance, restricts mobility and independence in an... (Meta-Analysis)
Meta-Analysis Review
The muscle disease sarcopenia, which is characterised by a loss of muscle strength, muscle quantity, and physical performance, restricts mobility and independence in an ageing society. The aim of this systematic review and meta-analysis is to analyse the effects that long-term progressive resistance training interventions performed on weight machines have on sarcopenia (European Working Group on Sarcopenia in Older People) and how the interventions are composed. In total, 779 articles published between 2000 and 2020 were scanned (PubMed, Web of Science, CINAHL) and 14 randomised controlled trials were included within the review. Populations, interventions, control groups and outcomes were analysed. Subsequent meta-analysis (10 studies, 902 participants) revealed that the time needed in a chair-stand-test, as an indicator for leg strength, was predominantly reduced, whereas grip strength remained unchanged after the interventions. Data concerning the effects of machine-based progressive resistance training on muscle quantity were insufficient for meta-analysis. Physical performance measured by undergoing the Timed-Up-and-Go-test, gait speed test, Short Physical Performance Battery and 6 min-walk-test improved significantly as well. The quality of evidence (GRADE) in the analysed studies was low or moderate. In summary, machine-based progressive resistance training has the potential to reverse sarcopenia in the oldest old, as reflected by enhanced muscle strength and physical performance. The systematic review revealed promising initial results for muscle quantity.
Topics: Aged; Aged, 80 and over; Hand Strength; Humans; Muscle Strength; Muscle, Skeletal; Resistance Training; Sarcopenia
PubMed: 35318104
DOI: 10.1016/j.exger.2022.111767 -
British Journal of Sports Medicine Jul 2016To quantify age, sex, sport and training type-specific effects of resistance training on physical performance, and to characterise dose-response relationships of... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To quantify age, sex, sport and training type-specific effects of resistance training on physical performance, and to characterise dose-response relationships of resistance training parameters that could maximise gains in physical performance in youth athletes.
DESIGN
Systematic review and meta-analysis of intervention studies.
DATA SOURCES
Studies were identified by systematic literature search in the databases PubMed and Web of Science (1985-2015). Weighted mean standardised mean differences (SMDwm) were calculated using random-effects models.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
Only studies with an active control group were included if these investigated the effects of resistance training in youth athletes (6-18 years) and tested at least one physical performance measure.
RESULTS
43 studies met the inclusion criteria. Our analyses revealed moderate effects of resistance training on muscle strength and vertical jump performance (SMDwm 0.8-1.09), and small effects on linear sprint, agility and sport-specific performance (SMDwm 0.58-0.75). Effects were moderated by sex and resistance training type. Independently computed dose-response relationships for resistance training parameters revealed that a training period of >23 weeks, 5 sets/exercise, 6-8 repetitions/set, a training intensity of 80-89% of 1 repetition maximum (RM), and 3-4 min rest between sets were most effective to improve muscle strength (SMDwm 2.09-3.40).
SUMMARY/CONCLUSIONS
Resistance training is an effective method to enhance muscle strength and jump performance in youth athletes, moderated by sex and resistance training type. Dose-response relationships for key training parameters indicate that youth coaches should primarily implement resistance training programmes with fewer repetitions and higher intensities to improve physical performance measures of youth athletes.
Topics: Adolescent; Athletes; Athletic Performance; Child; Female; Humans; Male; Muscle Strength; Resistance Training
PubMed: 26851290
DOI: 10.1136/bjsports-2015-095497 -
Topics in Spinal Cord Injury... 2018Physical therapists frequently use neuromuscular electrical stimulation (NMES) therapy in an effort to increase the voluntary strength of partially paralyzed muscles in... (Review)
Review
Physical therapists frequently use neuromuscular electrical stimulation (NMES) therapy in an effort to increase the voluntary strength of partially paralyzed muscles in people with spinal cord injury (SCI), but it is not clear whether this treatment is effective. To determine the effectiveness of NMES for increasing voluntary strength in the partially paralyzed muscles of people with SCI. A systematic review of scientific literature was conducted in MEDLINE, CINAHL, PEDro, ScienceDirect, and Embase. Inclusion criteria were randomized controlled trials and controlled trials that compared NMES aimed at increasing strength in partially paralyzed muscles versus placebo/nothing or versus a nonstrengthening intervention or versus any other type of strengthening intervention in adults with SCI. Five studies were included. Two studies found an increase in strength measured by peak force and manual muscle force test after an NMES protocol. One study found a between-group difference in favor of the NMES associated with progressive resistance training, and the other study showed an increase in the number of muscles improved by at least 1 degree of strength after NMES in combination with a cycle ergometer. The other 3 studies made several comparisons and found no differences between groups that received NMES and the controls. There is some suggestion that NMES increases voluntary strength in partially paralyzed muscle following SCI. However, there is no strong evidence to affirm the superiority of NMES over other treatment strategies used to gain strength in partially paralyzed muscles after SCI. These findings need replicating in large high-quality randomized controlled trials.
Topics: Electric Stimulation Therapy; Humans; Muscle Strength; Muscle, Skeletal; Resistance Training; Spinal Cord Injuries; Treatment Outcome
PubMed: 29434456
DOI: 10.1310/sci16-00048 -
Seminars in Arthritis and Rheumatism Aug 2017To analyze if exercise interventions for patients with knee osteoarthritis (OA) following the American College of Sports Medicine (ACSM) definition of muscle strength... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To analyze if exercise interventions for patients with knee osteoarthritis (OA) following the American College of Sports Medicine (ACSM) definition of muscle strength training differs from other types of exercise, and to analyze associations between changes in muscle strength, pain, and disability.
METHODS
A systematic search in 5 electronic databases was performed to identify randomized controlled trials comparing exercise interventions with no intervention in knee OA, and reporting changes in muscle strength and in pain or disability assessed as standardized mean differences (SMD) with 95% confidence intervals (95% CI). Interventions were categorized as ACSM interventions or not-ACSM interventions and compared using stratified random effects meta-analysis models. Associations between knee extensor strength gain and changes in pain/disability were assessed using meta-regression analyses.
RESULTS
The 45 eligible trials with 4699 participants and 56 comparisons (22 ACSM interventions) were included in this analysis. A statistically significant difference favoring the ACSM interventions with respect to knee extensor strength was found [SMD difference: 0.448 (95% CI: 0.091-0.805)]. No differences were observed regarding effects on pain and disability. The meta-regressions indicated that increases in knee extensor strength of 30-40% would be necessary for a likely concomitant beneficial effect on pain and disability, respectively.
CONCLUSION
Exercise interventions following the ACSM criteria for strength training provide superior outcomes in knee extensor strength but not in pain or disability. An increase of less than 30% in knee extensor strength is not likely to be clinically beneficial in terms of changes in pain and disability (PROSPERO: CRD42014015344).
Topics: Disability Evaluation; Exercise; Exercise Therapy; Female; Humans; Knee Joint; Male; Muscle Strength; Osteoarthritis, Knee; Pain Measurement; Randomized Controlled Trials as Topic
PubMed: 28438380
DOI: 10.1016/j.semarthrit.2017.03.007 -
Scientific Reports Sep 2022The effects and the prescription parameters of therapeutic exercise are not clear. For this reason, is needed to determine the effect of neuromuscular exercise on...
The effects and the prescription parameters of therapeutic exercise are not clear. For this reason, is needed to determine the effect of neuromuscular exercise on balance, muscle strength and flexibility specifying the parameters and characteristics of effective interventions in children between 6 and 12 years and adolescent between 13 and 18 years with Down Syndrome. The present study is a systematic review of effectiveness outcomes balance, muscle strength and flexibility in this population. The databases of PubMed, PEDro, EMBASE, SCIELO, Lilacs, Cochrane library were searched from May to December 2021. We recruited randomized controlled trials (RCTs) which met the inclusion criteria in our study. Ten studies were included. The interventions included mechanotherapy, vibration, and use of different unstable surfaces. The exercise frequency ranged from 3 to 5 days a week, and the duration of each session was between six and 15 min. The frequency was between two and three times a week for 6 and 12 weeks and the intensity were between 60 and 80% of maximal voluntary contraction. Neuromuscular exercise in different modes of application was associated with increases in chest and lower limb muscle strength mean 8.51, CI [2.35-14.67] kg and (21.54 [1.64, 41.43]) kg. Balance also improved when the mode of application was isokinetic training and core stability exercises (- 0.20 [- 0.29, - 0.12]) evaluated with stability index. Neuromuscular exercise appears to be effective for the improvement of both lower limb and chest muscle strength and balance in children over 8 years. No evidence was found in children under 8 years.
Topics: Adolescent; Child; Down Syndrome; Exercise; Exercise Therapy; Humans; Muscle Strength; Muscle, Skeletal; Randomized Controlled Trials as Topic
PubMed: 36056081
DOI: 10.1038/s41598-022-19086-8 -
Sports Medicine (Auckland, N.Z.) Dec 2015Resistance training (RT) is an intervention frequently used to improve muscle strength and morphology in old age. However, evidence-based, dose-response relationships... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Resistance training (RT) is an intervention frequently used to improve muscle strength and morphology in old age. However, evidence-based, dose-response relationships regarding specific RT variables (e.g., training period, frequency, intensity, volume) are unclear in healthy old adults.
OBJECTIVES
The aims of this systematic review and meta-analysis were to determine the general effects of RT on measures of muscle strength and morphology and to provide dose-response relationships of RT variables through an analysis of randomized controlled trials (RCTs) that could improve muscle strength and morphology in healthy old adults.
DATA SOURCES
A computerized, systematic literature search was performed in the electronic databases PubMed, Web of Science, and The Cochrane Library from January 1984 up to June 2015 to identify all RCTs related to RT in healthy old adults.
STUDY ELIGIBILITY CRITERIA
The initial search identified 506 studies, with a final yield of 25 studies. Only RCTs that examined the effects of RT in adults with a mean age of 65 and older were included. The 25 studies quantified at least one measure of muscle strength or morphology and sufficiently described training variables (e.g., training period, frequency, volume, intensity).
STUDY APPRAISAL AND SYNTHESIS METHODS
We quantified the overall effects of RT on measures of muscle strength and morphology by computing weighted between-subject standardized mean differences (SMDbs) between intervention and control groups. We analyzed the data for the main outcomes of one-repetition maximum (1RM), maximum voluntary contraction under isometric conditions (MVC), and muscle morphology (i.e., cross-sectional area or volume or thickness of muscles) and assessed the methodological study quality by Physiotherapy Evidence Database (PEDro) scale. Heterogeneity between studies was assessed using I2 and χ2 statistics. A random effects meta-regression was calculated to explain the influence of key training variables on the effectiveness of RT in terms of muscle strength and morphology. For meta-regression, training variables were divided into the following subcategories: volume, intensity, and rest. In addition to meta-regression, dose-response relationships were calculated independently for single training variables (e.g., training frequency).
RESULTS
RT improved muscle strength substantially (mean SMDbs = 1.57; 25 studies), but had small effects on measures of muscle morphology (mean SMDbs = 0.42; nine studies). Specifically, RT produced large effects in both 1RM of upper (mean SMDbs = 1.61; 11 studies) and lower (mean SMDbs = 1.76; 19 studies) extremities and a medium effect in MVC of lower (mean SMDbs = 0.76; four studies) extremities. Results of the meta-regression revealed that the variables "training period" (p = 0.04) and "intensity" (p < 0.01) as well as "total time under tension" (p < 0.01) had significant effects on muscle strength, with the largest effect sizes for the longest training periods (mean SMDbs = 2.34; 50-53 weeks), intensities of 70-79% of the 1RM (mean SMDbs = 1.89), and total time under tension of 6.0 s (mean SMDbs = 3.61). A tendency towards significance was found for rest in between sets (p = 0.06), with 60 s showing the largest effect on muscle strength (mean SMDbs = 4.68; two studies). We also determined the independent effects of the remaining training variables on muscle strength. The following independently computed training variables are most effective in improving measures of muscle strength: a training frequency of two sessions per week (mean SMDbs = 2.13), a training volume of two to three sets per exercise (mean SMDbs = 2.99), seven to nine repetitions per set (mean SMDbs = 1.98), and a rest of 4.0 s between repetitions (SMDbs = 3.72). With regard to measures of muscle morphology, the small number of identified studies allowed us to calculate meta-regression for the subcategory training volume only. No single training volume variable significantly predicted RT effects on measures of muscle morphology. Additional training variables were independently computed to detect the largest effect for the single training variable. A training period of 50-53 weeks, a training frequency of three sessions per week, a training volume of two to three sets per exercise, seven to nine repetitions per set, a training intensity from 51 to 69% of the 1RM, a total time under tension of 6.0 s, a rest of 120 s between sets, and a rest of 2.5 s between repetitions turned out to be most effective.
LIMITATIONS
The current results must be interpreted with caution because of the poor overall methodological study quality (mean PEDro score 4.6 points) and the considerable large heterogeneity (I2) = 80%, χ2 = 163.1, df = 32, p < 0.01) for muscle strength. In terms of muscle morphology, our search identified nine studies only, which is why we consider our findings preliminary. While we were able to determine a dose-response relationship based on specific individual training variables with respect to muscle strength and morphology, it was not possible to ascertain any potential interactions between these variables. We recognize the limitation that the results may not represent one general dose-response relationship.
CONCLUSIONS
This systematic literature review and meta-analysis confirmed the effectiveness of RT on specific measures of upper and lower extremity muscle strength and muscle morphology in healthy old adults. In addition, we were able to extract dose-response relationships for key training variables (i.e., volume, intensity, rest), informing clinicians and practitioners to design effective RTs for muscle strength and morphology. Training period, intensity, time under tension, and rest in between sets play an important role in improving muscle strength and morphology and should be implemented in exercise training programs targeting healthy old adults. Still, further research is needed to reveal optimal dose-response relationships following RT in healthy as well as mobility limited and/or frail old adults.
Topics: Aged; Aged, 80 and over; Humans; Muscle Strength; Muscle, Skeletal; Resistance Training; Time Factors
PubMed: 26420238
DOI: 10.1007/s40279-015-0385-9 -
Journal of Strength and Conditioning... May 2020Roberts, BM, Nuckols, G, and Krieger, JW. Sex differences in resistance training: A systematic review and meta-analysis. J Strength Cond Res 34(5): 1448-1460, 2020-The... (Meta-Analysis)
Meta-Analysis
Roberts, BM, Nuckols, G, and Krieger, JW. Sex differences in resistance training: A systematic review and meta-analysis. J Strength Cond Res 34(5): 1448-1460, 2020-The purpose of this study was to determine whether there are different responses to resistance training for strength or hypertrophy in young to middle-aged males and females using the same resistance training protocol. The protocol was pre-registered with PROSPERO (CRD42018094276). Meta-analyses were performed using robust variance random effects modeling for multilevel data structures, with adjustments for small samples using package robumeta in R. Statistical significance was set at P < 0.05. The analysis of hypertrophy comprised 12 outcomes from 10 studies with no significant difference between males and females (effect size [ES] = 0.07 ± 0.06; P = 0.31; I = 0). The analysis of upper-body strength comprised 19 outcomes from 17 studies with a significant effect favoring females (ES = -0.60 ± 0.16; P = 0.002; I = 72.1). The analysis of lower-body strength comprised 23 outcomes from 23 studies with no significant difference between sexes (ES = -0.21 ± 0.16; P = 0.20; I = 74.7). We found that males and females adapted to resistance training with similar effect sizes for hypertrophy and lower-body strength, but females had a larger effect for relative upper-body strength. Given the moderate effect size favoring females in the upper-body strength analysis, it is possible that untrained females display a higher capacity to increase upper-body strength than males. Further research is required to clarify why this difference occurs only in the upper body and whether the differences are due to neural, muscular, motor learning, or are an artifact of the short duration of studies included.
Topics: Adult; Female; Humans; Hypertrophy; Male; Middle Aged; Muscle Strength; Muscle, Skeletal; Resistance Training; Sex Characteristics; Time Factors; Young Adult
PubMed: 32218059
DOI: 10.1519/JSC.0000000000003521 -
Disability and Rehabilitation Apr 2018This study systematically review and meta-analyse the effectiveness of inspiratory muscle training (IMT) to reduce postoperative pulmonary complications (PPC) and length... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
This study systematically review and meta-analyse the effectiveness of inspiratory muscle training (IMT) to reduce postoperative pulmonary complications (PPC) and length of hospital stay (LOS), both in the preoperative and/or postoperative periods of cardiac, pulmonary, and abdominal surgical patients. Sensitive analysis was performed to examine which patients benefit more from IMT according to methodological features (quality of studies and sample size), patient's characteristics (pulmonary risk stratification, age, and body mass index), type of surgery, period of training, and training protocols (training doses and level of supervision).
METHODS
The literature search was made in the electronic databases PubMed®, EBSCO, Web of Science, PEDro and Scopus. Only randomized controlled trials were included. Data extraction, quality assessment and meta-analysis were performed.
RESULTS
We included 17 randomized controlled trials in the systematic review, of which, 12 were included for the PPC meta-analysis and 11 for the LOS meta-analysis. IMT significantly reduced the risk of PPC (Risk Ratio (RR) = 0.50, 95%CI: 0.39, 0.64, I=0.0%), and a decrease in LOS (Mean Difference = -1.41, 95%CI: -2.07, -0.75, I = 0.0%).
CONCLUSION
IMT is effective to reduce PPC and LOS in patients undergoing surgery. Implications for Rehabilitation Physiotherapy interventions with inspiratory muscle training (IMT) are effective to reduce postoperative pulmonary complications (PPC) and length of hospital stay (LOS) after major surgery, and should start preoperatively. Rehabilitation with IMT is beneficial at all ages and risk levels, but older and high-risk patients benefit more, as well as pulmonary surgery patients. IMT is more effective if it is supervised, and prescription target at least two-week period, sessions with more than 15 minutes, with imposed load increment, and adding other exercise modes.
Topics: Abdomen; Breathing Exercises; Humans; Length of Stay; Muscle Strength; Postoperative Care; Postoperative Complications; Preoperative Care; Respiratory Muscles; Thoracic Surgical Procedures
PubMed: 28093920
DOI: 10.1080/09638288.2016.1277396 -
BMC Geriatrics Nov 2021Health-promoting interventions are important for preventing frailty and sarcopenia in older adults. However, there is limited evidence that nutritional interventions... (Meta-Analysis)
Meta-Analysis
Does the combination of resistance training and a nutritional intervention have a synergic effect on muscle mass, strength, and physical function in older adults? A systematic review and meta-analysis.
BACKGROUND
Health-promoting interventions are important for preventing frailty and sarcopenia in older adults. However, there is limited evidence that nutritional interventions yield additional effects when combined with resistance training. This systematic review and meta-analysis aimed to compare the effectiveness of nutritional interventions with resistance training and that of resistance training alone.
METHODS
Randomized controlled trials published in peer-reviewed journals prior to July 2020 were retrieved from databases and other sources. The articles were screened according to the inclusion and exclusion criteria. The methodological quality of the included studies was assessed using Cochrane's risk of bias tool 2. A meta-analysis was performed using the RevMan 5.4 program and STATA 16 program.
RESULTS
A total of 22 studies were included in the meta-analysis. The results of the meta-analysis showed no significant differences between groups in muscle mass, muscle strength, or physical functional performance. In the subgroup analysis regarding the types of nutritional interventions, creatine showed significant effects on lean body mass (n = 4, MD 2.61, 95% CI 0.51 to 4.72). Regarding the other subgroup analyses, there were no significant differences in appendicular skeletal muscle mass (p = .43), hand grip strength (p = .73), knee extension strength (p = .09), chair stand test results (p = .31), or timed up-and-go test results (p = .31). In the meta-regression, moderators such as the mean age of subjects and duration of interventions were not associated with outcome variables.
CONCLUSIONS
This meta-analysis showed that nutritional interventions with resistance training have no additional effect on body composition, muscle strength, or physical function. Only creatine showed synergistic effects with resistance training on muscle mass.
TRIAL REGISTRATION
CRD42021224843 .
Topics: Aged; Hand Strength; Humans; Muscle Strength; Muscle, Skeletal; Muscles; Resistance Training; Sarcopenia
PubMed: 34772342
DOI: 10.1186/s12877-021-02491-5 -
PloS One 2021Rheumatoid arthritis(RA) and osteoarthritis(OA) patients showed systemic manifestations that may lead to a reduction in muscle strength, muscle mass and, consequently,...
The effects of resistance training with blood flow restriction on muscle strength, muscle hypertrophy and functionality in patients with osteoarthritis and rheumatoid arthritis: A systematic review with meta-analysis.
INTRODUCTION
Rheumatoid arthritis(RA) and osteoarthritis(OA) patients showed systemic manifestations that may lead to a reduction in muscle strength, muscle mass and, consequently, to a reduction in functionality. On the other hand, moderate intensity resistance training(MIRT) and high intensity resistance training(HIRT) are able to improve muscle strength and muscle mass in RA and OA without affecting the disease course. However, due to the articular manifestations caused by these diseases, these patients may present intolerance to MIRT or HIRT. Thus, the low intensity resistance training combined with blood flow restriction(LIRTBFR) may be a new training strategy for these populations.
OBJECTIVE
To perform a systematic review with meta-analysis to verify the effects of LIRTBFR on muscle strength, muscle mass and functionality in RA and OA patients.
MATERIALS AND METHODS
A systematic review with meta-analysis of randomized clinical trials(RCTs), published in English, between 1957-2021, was conducted using MEDLINE(PubMed), Embase and Cochrane Library. The methodological quality was assessed using Physiotherapy Evidence Database scale. The risk of bias was assessed using RoB2.0. Mean difference(MD) or standardized mean difference(SMD) and 95% confidence intervals(CI) were pooled using a random-effects model. A P<0.05 was considered statistically significant.
RESULTS
Five RCTs were included. We found no significant differences in the effects between LIRTBFR, MIRT and HIRT on muscle strength, which was assessed by tests of quadriceps strength(SMD = -0.01[-0.57, 0.54], P = 0.96; I² = 58%) and functionality measured by tests with patterns similar to walking(SMD = -0.04[-0.39, 0.31], P = 0.82; I² = 0%). Compared to HIRT, muscle mass gain after LIRTBFR was reported to be similar. When comparing LIRTBFR with low intensity resistance training without blood flow restriction(LIRT), the effect LIRTBFR was reported to be higher on muscle strength, which was evaluated by the knee extension test.
CONCLUSION
LIRTBFR appears to be a promising strategy for gains in muscle strength, muscle mass and functionality in a predominant sample of RA and OA women.
Topics: Arthritis, Rheumatoid; Blood Flow Restriction Therapy; Hemodynamics; Humans; Hypertrophy; Muscle Strength; Resistance Training
PubMed: 34758045
DOI: 10.1371/journal.pone.0259574