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Supportive Care in Cancer : Official... Oct 2023High-intensity interval training (HIIT) is an appropriate training modality to improve endurance and therefore contributes to physical performance. This review... (Meta-Analysis)
Meta-Analysis Review
Effects of high-intensity interval training on functional performance and maximal oxygen uptake in comparison with moderate intensity continuous training in cancer patients: a systematic review and meta-analysis.
INTRODUCTION
High-intensity interval training (HIIT) is an appropriate training modality to improve endurance and therefore contributes to physical performance. This review investigates the effect of HIIT on functional performance in cancer patients. We reviewed the relative peak oxygen uptake (relV̇O) and meta-analytical compared HIIT with moderate intensity continuous training (MICT). Furthermore, we took various training parameters under consideration.
METHODS
A systematic literature search was conducted in Scopus, PubMed, and Cochrane Library databases. For the review, we included randomized controlled trials containing HIIT with cancer patients. From this, we filtered interventions with additional MICT for the meta-analysis. Outcomes of interest were various functional performance assessments and V̇O.
RESULTS
The research yielded 584 records which fit the inclusion criteria, of which 31 studies with n=1555 patients (57.4±8.6 years) could be included in the overall review and 8 studies in the meta-analysis (n=268, 59.11±5.11 years) regarding relV̇O. Different functional outcomes were found, of which walking distance (+8.63±6.91% meters in 6-min walk test) and mobility (+2.7cm in sit and reach test) improved significantly due to HIIT. In terms of relV̇O, the performance of cancer patients was improved by HIIT (10.68±6.48%) and MICT (7.4±4.29%). HIIT can be favored to increase relV̇O (SMD 0.37; 95% CI 0.09-0.65; I=0%; p=0.009). Effect sizes for relV̇O improvements correlate moderately with total training volume (Spearman's ρ=0.49; p=0.03), whereas percentage increases do not (Spearman's ρ=0.24; p=0.14).
CONCLUSION
Functional and physical outcomes were positively altered by different HIIT protocols and forms of implementation, whereas a tendency toward more effectiveness of HIIT vs. MICT was found for relV̇O. Future studies should include functional parameters more often, to finally allow a comparison between both training protocols in this regard.
Topics: Humans; High-Intensity Interval Training; Oxygen Consumption; Nutritional Status; Physical Functional Performance; Oxygen; Neoplasms
PubMed: 37851104
DOI: 10.1007/s00520-023-08103-9 -
Heart, Lung & Circulation Sep 2023Current pharmacological options for hypertrophic cardiomyopathy (HCM) are not disease-specific; while it treats symptoms, mavacamten targets the underlying pathology. We... (Review)
Review
BACKGROUND
Current pharmacological options for hypertrophic cardiomyopathy (HCM) are not disease-specific; while it treats symptoms, mavacamten targets the underlying pathology. We aim to assess the efficacy and safety of mavacamten, a first-in-class cardiac myosin inhibitor, in symptomatic obstructive HCM.
METHODS
This systematic review of the literature followed the PRISMA guidelines. Title/abstract and topics were searched using the following term: "mavacamten". The electronic research literature databases included the Cochrane Library, MedLine, and clinicaltrials.gov from July to August 2022. Primary efficacy endpoint was to assess clinical response at the end of treatment compared with baseline, defined as, at least one New York Heart Association (NYHA) class reduction. Two secondary endpoints from baseline were determined. The first was defined as improvement in mixed venous oxygen pressure (pVO). The second was defined as reduction of the post-exercise left ventricular outflow tract (LVOT) gradient.
RESULTS
We included in our analyses data from four studies that met our review eligibility criteria. There were three randomised placebo-controlled clinical trials and one non-randomised open-label clinical trial. All four studies showed a reduction in NYHA class from mavacamten use. Three out of four studies demonstrated >1 NYHA functional class improvement ranging from 34% to 80%, while only one study showed a smaller percentage of patients remaining at class 3. Three out of four studies measured pVO as an outcome, and all three studies noticed an increase in peak oxygen consumption after mavacamten treatment. Additionally, three out of four studies measured post-exercise LVOT gradient reduction as an outcome and all three found significant reduction in the post-exercise LVOT gradient after treatment. The most commonly observed adverse side effects were atrial fibrillation and decreased left ventricular ejection fraction, but all participants recovered without long-term sequelae and only one patient dropped out of the trial.
CONCLUSIONS
Mavacamten has a greater efficacy than placebo in the treatment of HCM. It also showed promising tolerability and efficacy profiles in the treatment of HCM in adults. The three endpoints used in the evaluation of studies were reduction in NYHA class, increase in pVO, and post-exercise LVOT gradient reduction. Mavacamten showed greater reduction in NYHA, larger effects on increase of pVO, and significant reduction of the LVOT gradient. Mavacamten was also found to be well tolerated, like the placebo. The side effect profile was limited for the majority of individuals taking mavacamten. In the future, authors recommended dose-optimisation studies, and studies that evaluate mavacamten both in comparison to, and in conjunction with other current treatments.
Topics: Adult; Humans; Cardiomyopathy, Hypertrophic; Heart; Stroke Volume; Ventricular Function, Left; Clinical Trials as Topic
PubMed: 37453852
DOI: 10.1016/j.hlc.2023.05.019 -
Archives of Physical Medicine and... Oct 2022To determine the effect of cardiac rehabilitation (CR) on changes in functional capacity among patients with cardiovascular disease (CVD) and a type 2 diabetes mellitus... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To determine the effect of cardiac rehabilitation (CR) on changes in functional capacity among patients with cardiovascular disease (CVD) and a type 2 diabetes mellitus (T2D) comorbidity compared with patients without T2D.
DATA SOURCES
A systematic review and meta-analysis of randomized controlled trials were completed using PubMed, Cumulative Index to Nursing and Allied Health, and Web of Science in January 2021.
STUDY SELECTION
Articles were included if they compared patients CR with T2D with those without T2D.
DATA EXTRACTION
The primary outcome variable was functional capacity change from pre- to post CR reported as maximum or peak oxygen consumption and peak metabolic equivalent (METs). Risk of bias was assessed using the Cochrane Risk of Bias Tool. A random-effects model subgroup meta-analysis was conducted. A diabetes comorbidity was selected for the subgroup analysis with patients with CVD having conditions reported as T2D or non-T2D.
DATA SYNTHESIS
Twelve studies with total sample of 15,672 patients were extracted. Average change in peak METs was 1.41±1.76 among non-T2D and 1.08±1.57 among T2D after CR. Change in functional capacity was significantly lower among patients with T2D (z value=2.14; g=-0.42; 95% CI, -0.86 to -0.01; P=.03).
CONCLUSIONS
Patients with CVD with T2D experience less robust improvements in functional capacity in response to CR compared with patients with CVD alone. A better understanding of the relationship between T2D and functional capacity vital step in informing exercise prescription in CR for patients with T2D and CVD. The lack of understanding the role of T2D onset and progression is a limitation to this study.
Topics: Cardiac Rehabilitation; Cardiovascular Diseases; Diabetes Mellitus, Type 2; Exercise Therapy; Humans
PubMed: 35259399
DOI: 10.1016/j.apmr.2022.01.167 -
International Journal of Sports... Apr 2018The aim of this study was to carry out a systematic review and meta-analysis of the effects of caffeine supplementation on physiological responses to submaximal... (Meta-Analysis)
Meta-Analysis Review
The aim of this study was to carry out a systematic review and meta-analysis of the effects of caffeine supplementation on physiological responses to submaximal exercise. A total of 26 studies met the inclusion criteria of adopting double-blind, randomized crossover designs that included a sustained (5-30 min) fixed-intensity bout of submaximal exercise (constrained to 60-85% maximal rate of oxygen consumption) using a standard caffeine dose of 3-6 mg·kg administered 30-90 min prior to exercise. Meta-analyses were completed using a random-effects model, and data are presented as raw mean difference (D) with associated 95% confidence limits (CLs). Relative to placebo, caffeine led to significant increases in submaximal measures of minute ventilation (D = 3.36 L·min; 95% CL, 1.63-5.08; P = .0001; n = 73), blood lactate (D = 0.69 mmol·L; 95% CL, 0.46-0.93; P < .00001; n = 208), and blood glucose (D = 0.42 mmol·L; 95% CL, 0.29-0.55; P < .00001; n = 129). In contrast, caffeine had a suppressive effect on ratings of perceived exertion (D = -0.8; 95% CL, -1.1 to -0.6; P < .00001; n = 147). Caffeine had no effect on measures of heart rate (P = .99; n = 207), respiratory exchange ratio (P = .18; n = 181), or oxygen consumption (P = .92; n = 203). The positive effects of caffeine supplementation on sustained high-intensity exercise performance are widely accepted, although the mechanisms to explain that response are currently unresolved. This meta-analysis has revealed clear effects of caffeine on various physiological responses during submaximal exercise, which may help explain its ergogenic action.
Topics: Adult; Blood Glucose; Caffeine; Exercise; Heart Rate; Humans; Lactic Acid; Oxygen Consumption; Perception; Physical Exertion; Pulmonary Gas Exchange
PubMed: 28872376
DOI: 10.1123/ijspp.2017-0312 -
Critical Care Medicine Feb 2020RBC transfusions can increase oxygen availability to the tissues, but studies have provided conflicting results. The objectives of this study were, therefore, to... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
RBC transfusions can increase oxygen availability to the tissues, but studies have provided conflicting results. The objectives of this study were, therefore, to evaluate, using systematic review and meta-analysis, the effects of transfusion on hemodynamic/oxygenation variables in patients without acute bleeding.
DATA SOURCES
PubMed, Scopus, Cochrane Database of Systematic Reviews, and Embase from inception until June 30, 2019.
STUDY SELECTION
All articles that reported values of prespecified hemodynamic or oxygenation variables before and after RBC transfusion.
DATA EXTRACTION
Publication year, number of patients, number of transfusions and the type of population studied, hemodynamic and oxygenation data (heart rate, cardiac index, mixed venous oxygen saturation or central venous oxygen saturation, oxygen delivery index, oxygen consumption index, oxygen extraction ratio, arteriovenous oxygen difference and arterial blood lactate) before and after transfusion. We performed a meta-analysis for each variable for which there were sufficient data to estimate mean differences. We also performed subgroup analyses comparing septic with nonseptic patients.
DATA SYNTHESIS
We retrieved 6,420 studies; 33 met the inclusion criteria, 14 of which were in patients with sepsis. In the meta-analysis, the estimated mean differences and 95% CIs comparing the periods before and after transfusion were -0.0 L/min/m (-0.1 to 0.1 L/min/m) (p = 0.86) for cardiac index; -1.8 beats/min (-3.7 to 0.1 beats/min) (p = 0.06) for heart rate; 96.8 mL/min/m (71.1-122.5 mL/min/m) (p < 0.01) for oxygen delivery index; 2.9% (2.2-3.5%) (p < 0.01) for mixed venous oxygen saturation or central venous oxygen saturation; -3.7% (-4.4% to -3.0%) (p < 0.01) for oxygen extraction ratio; and 4.9 mL/min/m (0.9-9.0 mL/min/m) (p = 0.02) for oxygen consumption index. The estimated mean difference for oxygen consumption index in the patients with sepsis was 8.4 mL/min/m (2.3-14.5 mL/min/m; p = 0.01).
CONCLUSIONS
Transfusion was not associated with a decrease in mean cardiac output or mean heart rate. The increase in mean oxygen delivery following transfusion was associated with an increase in mean oxygen consumption after transfusion, especially in patients with sepsis.
Topics: Erythrocyte Transfusion; Hemodynamics; Humans; Oxygen
PubMed: 31939794
DOI: 10.1097/CCM.0000000000004115 -
Journal of Gastrointestinal Surgery :... Nov 2020Cardiopulmonary exercise testing (CPX) can objectively measure fitness and oxygen uptake at anaerobic threshold. The relationship between fitness and postoperative... (Review)
Review
BACKGROUND
Cardiopulmonary exercise testing (CPX) can objectively measure fitness and oxygen uptake at anaerobic threshold. The relationship between fitness and postoperative outcomes after upper gastro-intestinal surgery is unclear. The aim of the present review is to assess the prognostic ability of CPX in predicting postoperative outcome associated with oesophagogastric surgery.
METHODS
Relevant studies were identified through a systematic search of EMBASE, Medline, CINAHL, Cochrane Library, and Web of Science to July 2019. The eligibility criteria for studies included prognostic studies of upper gastro-intestinal surgery among adult populations using a preoperative CPX and measurement of postoperative outcome (mortality or morbidity or length of stay). Risk of bias was assessed using the QUIPS Quality in Prognostic Studies validated tool.
RESULTS
Thirteen papers with a total of 1735 participants were included in data extraction. A total of 7 studies examined the association between CPX variables and postoperative mortality. Patients undergoing gastro-intestinal surgery with lower anaerobic threshold values were found to have an increased risk of postoperative mortality. Similarly, a lower rate of oxygen consumption was found to be associated with higher mortality. There was conflicting evidence regarding the association between CPX variables and postoperative morbidity. The evidence did not demonstrate any association between preoperative CPX variables and hospital length of stay.
CONCLUSION
Studies report an association between CPX variables and postoperative mortality; however, there is conflicting evidence regarding the association between CPX variables and postoperative morbidity.
Topics: Adult; Digestive System Surgical Procedures; Exercise Test; Humans; Morbidity; Postoperative Complications
PubMed: 32632727
DOI: 10.1007/s11605-020-04696-2 -
Training Periodization, Intensity Distribution, and Volume in Trained Cyclists: A Systematic Review.International Journal of Sports... Feb 2023A well-planned periodized approach endeavors to allow road cyclists to achieve peak performance when their most important competitions are held.
UNLABELLED
A well-planned periodized approach endeavors to allow road cyclists to achieve peak performance when their most important competitions are held.
PURPOSE
To identify the main characteristics of periodization models and physiological parameters of trained road cyclists as described by discernable training intensity distribution (TID), volume, and periodization models.
METHODS
The electronic databases Scopus, PubMed, and Web of Science were searched using a comprehensive list of relevant terms. Studies that investigated the effect of the periodization of training in cyclists and described training load (volume, TID) and periodization details were included in the systematic review.
RESULTS
Seven studies met the inclusion criteria. Block periodization (characterized by employment of highly concentrated training workload phases) ranged between 1- and 8-week blocks of high-, medium-, or low-intensity training. Training volume ranged from 8.75 to 11.68 h·wk-1 and both pyramidal and polarized TID were used. Traditional periodization (characterized by a first period of high-volume/low-intensity training, before reducing volume and increasing the proportion of high-intensity training) was characterized by a cyclic progressive increase in training load, the training volume ranged from 7.5 to 10.76 h·wk-1, and pyramidal TID was used. Block periodization improved maximum oxygen uptake (VO2max), peak aerobic power, lactate, and ventilatory thresholds, while traditional periodization improved VO2max, peak aerobic power, and lactate thresholds. In addition, a day-by-day programming approach improved VO2max and ventilatory thresholds.
CONCLUSIONS
No evidence is currently available favoring a specific periodization model during 8 to 12 weeks in trained road cyclists. However, few studies have examined seasonal impact of different periodization models in a systematic way.
Topics: Humans; Athletic Performance; Oxygen Consumption; Oxygen; Lactic Acid; Bibliometrics
PubMed: 36640771
DOI: 10.1123/ijspp.2022-0302 -
PloS One 2023There is widespread agreement about the key role of hemoglobin for oxygen transport. Both observational and interventional studies have examined the relationship between... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
There is widespread agreement about the key role of hemoglobin for oxygen transport. Both observational and interventional studies have examined the relationship between hemoglobin levels and maximal oxygen uptake ([Formula: see text]) in humans. However, there exists considerable variability in the scientific literature regarding the potential relationship between hemoglobin and [Formula: see text]. Thus, we aimed to provide a comprehensive analysis of the diverse literature and examine the relationship between hemoglobin levels (hemoglobin concentration and mass) and [Formula: see text] (absolute and relative [Formula: see text]) among both observational and interventional studies.
METHODS
A systematic search was performed on December 6th, 2021. The study procedures and reporting of findings followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Article selection and data abstraction were performed in duplicate by two independent reviewers. Primary outcomes were hemoglobin levels and [Formula: see text] values (absolute and relative). For observational studies, meta-regression models were performed to examine the relationship between hemoglobin levels and [Formula: see text] values. For interventional studies, meta-analysis models were performed to determine the change in [Formula: see text] values (standard paired difference) associated with interventions designed to modify hemoglobin levels or [Formula: see text]. Meta-regression models were then performed to determine the relationship between a change in hemoglobin levels and the change in [Formula: see text] values.
RESULTS
Data from 384 studies (226 observational studies and 158 interventional studies) were examined. For observational data, there was a positive association between absolute [Formula: see text] and hemoglobin levels (hemoglobin concentration, hemoglobin mass, and hematocrit (P<0.001 for all)). Prespecified subgroup analyses demonstrated no apparent sex-related differences among these relationships. For interventional data, there was a positive association between the change of absolute [Formula: see text] (standard paired difference) and the change in hemoglobin levels (hemoglobin concentration (P<0.0001) and hemoglobin mass (P = 0.006)).
CONCLUSION
These findings suggest that [Formula: see text] values are closely associated with hemoglobin levels among both observational and interventional studies. Although our findings suggest a lack of sex differences in these relationships, there were limited studies incorporating females or stratifying results by biological sex.
Topics: Humans; Male; Female; Oxygen Consumption; Oxygen
PubMed: 37824583
DOI: 10.1371/journal.pone.0292835 -
Journal of Strength and Conditioning... Dec 2023Doma, K, Matoso, B, Protzen, G, Singh, U, and Boullosa, D. The repeated bout effect of multiarticular exercises on muscle damage markers and physical performances: a... (Meta-Analysis)
Meta-Analysis
Doma, K, Matoso, B, Protzen, G, Singh, U, and Boullosa, D. The repeated bout effect of multiarticular exercises on muscle damage markers and physical performances: a systematic review and meta-analyses. J Strength Cond Res 37(12): 2504-2515, 2023-This systematic review and meta-analysis compared muscle damage markers and physical performance measures between 2 bouts of multiarticular exercises and determined whether intensity and volume of muscle-damaging exercises affected the outcomes. The eligibility criteria consisted of (a) healthy male and female adults; (b) multiarticular exercises to cause muscle damage across 2 bouts; (c) outcome measures were compared at 24-48 hours after the first and second bouts of muscle-damaging exercise; (d) at least one of the following outcome measures: creatine kinase (CK), delayed onset of muscle soreness (DOMS), muscle strength, and running economy. Study appraisal was conducted using the Kmet tool, whereas forest plots were derived to calculate standardized mean differences (SMDs) and statistical significance and alpha set a 0.05. After screening, 20 studies were included. The levels of DOMS and CK were significantly greater during the first bout when compared with the second bout at T24 and T48 (p < 0.001; SMD = 0.51-1.23). Muscular strength and vertical jump performance were significantly lower during the first bout compared with the second bout at T24 and T48 (p ≤ 0.05; SMD = -0.27 to -0.40), whereas oxygen consumption and rating of perceived exertion were significantly greater during the first bout at T24 and T48 (p < 0.05; SMD = 0.28-0.65) during running economy protocols. The meta-analyses were unaffected by changes in intensity and volume of muscle-damaging exercises between bouts. Multiarticular exercises exhibited a repeated bout effect, suggesting that a single bout of commonly performed exercises involving eccentric contractions may provide protection against exercise-induced muscle damage for subsequent bouts.
Topics: Adult; Humans; Male; Female; Muscle, Skeletal; Exercise; Myalgia; Running; Creatine Kinase; Physical Functional Performance; Muscle Contraction
PubMed: 38015738
DOI: 10.1519/JSC.0000000000004628 -
Rheumatology (Oxford, England) Nov 2023JIA is the most common type of arthritis in children and adolescents, causing joint damage, chronic pain and disability. Deconditioning is also prevalent in patients... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
JIA is the most common type of arthritis in children and adolescents, causing joint damage, chronic pain and disability. Deconditioning is also prevalent in patients with JIA due to both inactivity and the disease progression, resulting in reduced cardiorespiratory fitness (CRF). We aimed to evaluate CRF of patients with JIA compared with healthy controls.
METHODS
This is a systematic review and meta-analysis of studies using cardiopulmonary exercise testing (CPET) to examine differences in determinants of CRF between patients with JIA vs healthy controls. The primary outcome was peak oxygen uptake (VO2peak). Literature search involved PubMed, Web of Science and Scopus databases, manual search of article references and grey literature. Quality assessment was undertaken with Newcastle-Ottawa Scale.
RESULTS
From 480 literature records initially retrieved, eight studies (538 participants) were included in final meta-analysis. VO2peak was significantly lower in patients with JIA compared with controls [weighted mean difference (WMD): -5.95 ml/kg/min (95% CI -9.26, -2.65)]. Exercise duration and VO2peak (% predicted) were found to be significantly impaired in patients with JIA compared with controls [standardized mean difference: -0.67 (95% CI -1.04, -0.29) and WMD: -11.31% (95% CI -20.09, -2.53), respectively], while no significant differences were found in maximum heart rate.
CONCLUSION
VO2peak and other CPET variables were lower in patients with JIA compared with controls, indicating reduced CRF in the former. Overall, exercise programs for patients with JIA should be promoted as part of their treatment to improve physical fitness and reduce muscle atrophy.
PROSPERO REGISTRATION
CRD42022380833.
Topics: Child; Adolescent; Humans; Exercise Test; Cardiorespiratory Fitness; Arthritis, Juvenile; Oxygen Consumption; Exercise
PubMed: 37280055
DOI: 10.1093/rheumatology/kead272