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BMJ Open Diabetes Research & Care Mar 2022Type 2 diabetes mellitus (T2DM) accounts for approximately 90% of diabetes cases globally. Regular physical activity is regarded as one of the key components in T2DM... (Meta-Analysis)
Meta-Analysis Review
Effect of resistance training on HbA1c in adults with type 2 diabetes mellitus and the moderating effect of changes in muscular strength: a systematic review and meta-analysis.
Type 2 diabetes mellitus (T2DM) accounts for approximately 90% of diabetes cases globally. Regular physical activity is regarded as one of the key components in T2DM management. Aerobic exercise was traditionally recommended; however, there is a growing body of research examining the independent effect of resistance training (RT) on glycemic control. This systematic review and meta-analysis aimed to conduct an update on the effects of RT on glycosylated hemoglobin (HbA1c) in adults with T2DM and examine the moderating effects of training effect (ie, muscular strength improvements), risk of bias and intervention duration. Peer-reviewed articles published in English were searched across MEDLINE, Embase, CINAHL, Scopus and SPORTDiscus from database inception until January 19, 2021. Each online database was systematically searched for randomized controlled trials reporting on the effects of RT on HbA1c in individuals with T2DM. Twenty studies (n=1172) were included in the meta-analysis. RT significantly reduced HbA1c compared with controls (weighted mean difference=-0.39, 95% CI -0.60 to -0.18, p<0.001, I=69.20). Training effect significantly (p<0.05) moderated the results, with larger improvements in muscular strength leading to greater reductions in HbA1c (β=-0.99, CI -1.97 to -0.01). Intervention duration and risk of bias did not significantly moderate the effects. As a secondary analysis, this study found no significant differences in HbA1c when comparing RT and aerobic training (p=0.42). This study demonstrates that RT is an effective strategy to decrease HbA1c in individuals with T2DM. Importantly, RT interventions that had a larger training effect appeared more effective in reducing HbA1c, compared with interventions producing medium and small effects. CRD42020134046.
Topics: Adult; Diabetes Mellitus, Type 2; Exercise; Glycated Hemoglobin; Humans; Resistance Training
PubMed: 35273011
DOI: 10.1136/bmjdrc-2021-002595 -
Nursing Open Apr 2023To determine the effective exercise methods for different complications of breast cancer patients after surgery. (Meta-Analysis)
Meta-Analysis Review
AIM
To determine the effective exercise methods for different complications of breast cancer patients after surgery.
DESIGN
Systematic review and meta-analysis.
METHODS
A comprehensive electronic search was carried out with no time limit until May 2020. Studies must have been randomized controlled trials of patients after breast cancer surgery, without limit to the way of exercise. Literature quality was evaluated by the modified Jadad scale. The meta-analysis was conducted with CMA2.0 software.
RESULTS
Aerobic exercise reduced the intensity of the pain (MD = -1.043), improved shoulder flexion (MD = 3.398) and internal rotation range (MD = 3.868), lessened upper limb dysfunction (MD = -5.231) and improved muscle strength during flexion (MD = 1.076) and abduction (MD = 0.991). Shoulder elbow movement improved the range of shoulder external rotation (MD = 2.691) and reduced the incidence of arm lymphedema (RR = 0.343). Anti-resistance exercise also lessened upper limb dysfunction (MD = - 4.094).
Topics: Humans; Female; Exercise Therapy; Breast Neoplasms; Randomized Controlled Trials as Topic; Exercise; Upper Extremity
PubMed: 36451034
DOI: 10.1002/nop2.1518 -
Journal of Sport and Health Science Jan 2022Football is the most practised sport in the world and is associated with the risk of injuries in the players. Some studies have been published that identify injury... (Review)
Review
BACKGROUND
Football is the most practised sport in the world and is associated with the risk of injuries in the players. Some studies have been published that identify injury prevention programs, but there is no review of the full body of evidence on injury prevention programs for use by football coaches. The aim of this article was to carry out a systematic review of published studies on injury prevention programs for adult male footballers, identify points of common understanding and establish recommendations that should be considered in the design of injury prevention strategies.
METHODS
PubMed and EMBASE databases were used to identify relevant published articles using the following keywords: "soccer" AND "injury" AND "prevention".
RESULTS
A total of 2512 studies were identified initially, but only 11 studies met the inclusion criteria, and their outcomes are presented. Results revealed that injury prevention programs in football have focused on strength training, proprioceptive training, multicomponent programs (balance, core stability, and functional strength and mobility), and warm-up programs.
CONCLUSION
Based on results from the studies analyzed, football players can lower the incidence of match and training injuries by participating in dynamic warm-up programs that include preventive exercises before games or during training sessions, and by adding strength, balance, and mobility training to the training sessions.
Topics: Adult; Humans; Male; Athletic Injuries; Exercise; Soccer; Warm-Up Exercise
PubMed: 33188962
DOI: 10.1016/j.jshs.2020.11.003 -
Sleep Medicine Reviews Feb 2020Sleep is crucial to children's health and development. Reduced physical activity and increased screen time adversely impact older children's sleep, but little is known... (Meta-Analysis)
Meta-Analysis
Sleep is crucial to children's health and development. Reduced physical activity and increased screen time adversely impact older children's sleep, but little is known about these associations in children under 5 y. This systematic review examined the association between screen time/movement behaviors (sedentary behavior, physical activity) and sleep outcomes in infants (0-1 y); toddlers (1-2 y); and preschoolers (3-4 y). Evidence was selected according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and synthesized using vote counting based on the direction of association. Quality assessment and a Grading of Recommendations, Assessment, Development and Evaluation was performed, stratified according to child age, exposure and outcome measure. Thirty-one papers were included. Results indicate that screen time is associated with poorer sleep outcomes in infants, toddlers and preschoolers. Meta-analysis confirmed these unfavorable associations in infants and toddlers but not preschoolers. For movement behaviors results were mixed, though physical activity and outdoor play in particular were favorably associated with most sleep outcomes in toddlers and preschoolers. Overall, quality of evidence was very low, with strongest evidence for daily/evening screen time use in toddlers and preschoolers. Although high-quality experimental evidence is required, our findings should prompt parents, clinicians and educators to encourage sleep-promoting behaviors (e.g., less evening screen time) in the under 5s.
Topics: Age Factors; Child, Preschool; Exercise; Humans; Infant; Infant, Newborn; Screen Time; Sedentary Behavior; Sleep
PubMed: 31778942
DOI: 10.1016/j.smrv.2019.101226 -
Sports Medicine (Auckland, N.Z.) Jul 2022Weightlifting training (WLT) is commonly used to improve strength, power and speed in athletes. However, to date, WLT studies have either not compared training effects... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Weightlifting training (WLT) is commonly used to improve strength, power and speed in athletes. However, to date, WLT studies have either not compared training effects against those of other training methods, or been limited by small sample sizes, which are issues that can be resolved by pooling studies in a meta-analysis. Therefore, the objective of this systematic review with meta-analysis was to evaluate the effects of WLT compared with traditional resistance training (TRT), plyometric training (PLYO) and/or control (CON) on strength, power and speed.
METHODS
The systematic review included peer-reviewed articles that employed a WLT intervention, a comparison group (i.e. TRT, PLYO, CON), and a measure of strength, power and/or speed. Means and standard deviations of outcomes were converted to Hedges' g effect sizes using an inverse variance random-effects model to generate a weighted mean effect size (ES).
RESULTS
Sixteen studies were included in the analysis, comprising 427 participants. Data indicated that when compared with TRT, WLT resulted in greater improvements in weightlifting load lifted (4 studies, p = 0.02, g = 1.35; 95% CI 0.20-2.51) and countermovement jump (CMJ) height (9 studies, p = 0.00, g = 0.95; 95% CI 0.04-1.87). There was also a large effect in terms of linear sprint speed (4 studies, p = 0.13, g = 1.04; 95% CI - 0.03 to 2.39) and change of direction speed (CODS) (2 studies, p = 0.36, g = 1.21; 95% CI - 1.41 to 3.83); however, this was not significant. Interpretation of these findings should acknowledge the high heterogeneity across the included studies and potential risk of bias. WLT and PLYO resulted in similar improvements in speed, power and strength as demonstrated by negligible to moderate, non-significant effects in favour of WLT for improvements in linear sprint speed (4 studies, p = 0.35, g = 0.20; 95% CI - 0.23 to 0.63), CODS (3 studies, p = 0.52, g = 0.17; 95% CI - 0.35 to 0.68), CMJ (6 studies, p = 0.09, g = 0.31; 95% CI - 0.05 to 0.67), squat jump performance (5 studies, p = 0.08, g = 0.34; 95% CI - 0.04 to 0.73) and strength (4 studies, p = 0.20, g = 0.69; 95% CI - 0.37 to 1.75).
CONCLUSION
Overall, these findings support the notion that if the training goal is to improve strength, power and speed, supplementary weightlifting training may be advantageous for athletic development. Whilst WLT and PLYO may result in similar improvements, WLT can elicit additional benefits above that of TRT, resulting in greater improvements in weightlifting and jumping performance.
Topics: Athletes; Athletic Performance; Humans; Muscle Strength; Plyometric Exercise; Resistance Training; Weight Lifting
PubMed: 35025093
DOI: 10.1007/s40279-021-01627-2 -
The Cochrane Database of Systematic... Sep 2022Improving mobility outcomes after hip fracture is key to recovery. Possible strategies include gait training, exercise and muscle stimulation. This is an update of a... (Review)
Review
BACKGROUND
Improving mobility outcomes after hip fracture is key to recovery. Possible strategies include gait training, exercise and muscle stimulation. This is an update of a Cochrane Review last published in 2011.
OBJECTIVES
To evaluate the effects (benefits and harms) of interventions aimed at improving mobility and physical functioning after hip fracture surgery in adults.
SEARCH METHODS
We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, CINAHL, trial registers and reference lists, to March 2021.
SELECTION CRITERIA
All randomised or quasi-randomised trials assessing mobility strategies after hip fracture surgery. Eligible strategies aimed to improve mobility and included care programmes, exercise (gait, balance and functional training, resistance/strength training, endurance, flexibility, three-dimensional (3D) exercise and general physical activity) or muscle stimulation. Intervention was compared with usual care (in-hospital) or with usual care, no intervention, sham exercise or social visit (post-hospital).
DATA COLLECTION AND ANALYSIS
Members of the review author team independently selected trials for inclusion, assessed risk of bias and extracted data. We used standard methodological procedures expected by Cochrane. We used the assessment time point closest to four months for in-hospital studies, and the time point closest to the end of the intervention for post-hospital studies. Critical outcomes were mobility, walking speed, functioning, health-related quality of life, mortality, adverse effects and return to living at pre-fracture residence.
MAIN RESULTS
We included 40 randomised controlled trials (RCTs) with 4059 participants from 17 countries. On average, participants were 80 years old and 80% were women. The median number of study participants was 81 and all trials had unclear or high risk of bias for one or more domains. Most trials excluded people with cognitive impairment (70%), immobility and/or medical conditions affecting mobility (72%). In-hospital setting, mobility strategy versus control Eighteen trials (1433 participants) compared mobility strategies with control (usual care) in hospitals. Overall, such strategies may lead to a moderate, clinically-meaningful increase in mobility (standardised mean difference (SMD) 0.53, 95% confidence interval (CI) 0.10 to 0.96; 7 studies, 507 participants; low-certainty evidence) and a small, clinically meaningful improvement in walking speed (CI crosses zero so does not rule out a lack of effect (SMD 0.16, 95% CI -0.05 to 0.37; 6 studies, 360 participants; moderate-certainty evidence). Mobility strategies may make little or no difference to short-term (risk ratio (RR) 1.06, 95% CI 0.48 to 2.30; 6 studies, 489 participants; low-certainty evidence) or long-term mortality (RR 1.22, 95% CI 0.48 to 3.12; 2 studies, 133 participants; low-certainty evidence), adverse events measured by hospital re-admission (RR 0.70, 95% CI 0.44 to 1.11; 4 studies, 322 participants; low-certainty evidence), or return to pre-fracture residence (RR 1.07, 95% CI 0.73 to 1.56; 2 studies, 240 participants; low-certainty evidence). We are uncertain whether mobility strategies improve functioning or health-related quality of life as the certainty of evidence was very low. Gait, balance and functional training probably causes a moderate improvement in mobility (SMD 0.57, 95% CI 0.07 to 1.06; 6 studies, 463 participants; moderate-certainty evidence). There was little or no difference in effects on mobility for resistance training. No studies of other types of exercise or electrical stimulation reported mobility outcomes. Post-hospital setting, mobility strategy versus control Twenty-two trials (2626 participants) compared mobility strategies with control (usual care, no intervention, sham exercise or social visit) in the post-hospital setting. Mobility strategies lead to a small, clinically meaningful increase in mobility (SMD 0.32, 95% CI 0.11 to 0.54; 7 studies, 761 participants; high-certainty evidence) and a small, clinically meaningful improvement in walking speed compared to control (SMD 0.16, 95% CI 0.04 to 0.29; 14 studies, 1067 participants; high-certainty evidence). Mobility strategies lead to a small, non-clinically meaningful increase in functioning (SMD 0.23, 95% CI 0.10 to 0.36; 9 studies, 936 participants; high-certainty evidence), and probably lead to a slight increase in quality of life that may not be clinically meaningful (SMD 0.14, 95% CI -0.00 to 0.29; 10 studies, 785 participants; moderate-certainty evidence). Mobility strategies probably make little or no difference to short-term mortality (RR 1.01, 95% CI 0.49 to 2.06; 8 studies, 737 participants; moderate-certainty evidence). Mobility strategies may make little or no difference to long-term mortality (RR 0.73, 95% CI 0.39 to 1.37; 4 studies, 588 participants; low-certainty evidence) or adverse events measured by hospital re-admission (95% CI includes a large reduction and large increase, RR 0.86, 95% CI 0.52 to 1.42; 2 studies, 206 participants; low-certainty evidence). Training involving gait, balance and functional exercise leads to a small, clinically meaningful increase in mobility (SMD 0.20, 95% CI 0.05 to 0.36; 5 studies, 621 participants; high-certainty evidence), while training classified as being primarily resistance or strength exercise may lead to a clinically meaningful increase in mobility measured using distance walked in six minutes (mean difference (MD) 55.65, 95% CI 28.58 to 82.72; 3 studies, 198 participants; low-certainty evidence). Training involving multiple intervention components probably leads to a substantial, clinically meaningful increase in mobility (SMD 0.94, 95% CI 0.53 to 1.34; 2 studies, 104 participants; moderate-certainty evidence). We are uncertain of the effect of aerobic training on mobility (very low-certainty evidence). No studies of other types of exercise or electrical stimulation reported mobility outcomes.
AUTHORS' CONCLUSIONS
Interventions targeting improvement in mobility after hip fracture may cause clinically meaningful improvement in mobility and walking speed in hospital and post-hospital settings, compared with conventional care. Interventions that include training of gait, balance and functional tasks are particularly effective. There was little or no between-group difference in the number of adverse events reported. Future trials should include long-term follow-up and economic outcomes, determine the relative impact of different types of exercise and establish effectiveness in emerging economies.
Topics: Aged, 80 and over; Exercise; Exercise Therapy; Female; Hip Fractures; Humans; Male; Randomized Controlled Trials as Topic; Resistance Training; Walking
PubMed: 36070134
DOI: 10.1002/14651858.CD001704.pub5 -
Sports Medicine (Auckland, N.Z.) Nov 2016Gross motor competence confers health benefits, but levels in children and adolescents are low. While interventions can improve gross motor competence, it remains... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Gross motor competence confers health benefits, but levels in children and adolescents are low. While interventions can improve gross motor competence, it remains unclear which correlates should be targeted to ensure interventions are most effective, and for whom targeted and tailored interventions should be developed.
OBJECTIVE
The aim of this systematic review was to identify the potential correlates of gross motor competence in typically developing children and adolescents (aged 3-18 years) using an ecological approach.
METHODS
Motor competence was defined as gross motor skill competency, encompassing fundamental movement skills and motor coordination, but excluding motor fitness. Studies needed to assess a summary score of at least one aspect of motor competence (i.e., object control, locomotor, stability, or motor coordination). A structured electronic literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Six electronic databases (CINAHL Complete, ERIC, MEDLINE Complete, PsycINFO, Scopus and SPORTDiscus with Full Text) were searched from 1994 to 5 August 2014. Meta-analyses were conducted to determine the relationship between potential correlates and motor competency if at least three individual studies investigated the same correlate and also reported standardized regression coefficients.
RESULTS
A total of 59 studies were identified from 22 different countries, published between 1995 and 2014. Studies reflected the full range of age groups. The most examined correlates were biological and demographic factors. Age (increasing) was a correlate of children's motor competence. Weight status (healthy), sex (male) and socioeconomic background (higher) were consistent correlates for certain aspects of motor competence only. Physical activity and sport participation constituted the majority of investigations in the behavioral attributes and skills category. Whilst we found physical activity to be a positive correlate of skill composite and motor coordination, we also found indeterminate evidence for physical activity being a correlate of object control or locomotor skill competence. Few studies investigated cognitive, emotional and psychological factors, cultural and social factors or physical environment factors as correlates of motor competence.
CONCLUSION
This systematic review is the first that has investigated correlates of gross motor competence in children and adolescents. A strength is that we categorized correlates according to the specific ways motor competence has been defined and operationalized (object control, motor coordination, etc.), which enables us to have an understanding of what correlates assist what types of motor competence. Indeed our findings do suggest that evidence for some correlates differs according to how motor competence is operationalized.
Topics: Adolescent; Body Weight; Child; Child, Preschool; Exercise; Humans; Male; Motor Skills; Movement; Physical Fitness
PubMed: 26894274
DOI: 10.1007/s40279-016-0495-z -
Journal of Sport and Health Science Mar 2021Acute ankle injury causes damage to joint mechanoreceptors and deafferentation and contributes to proprioception deficits in patients with chronic ankle instability... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Acute ankle injury causes damage to joint mechanoreceptors and deafferentation and contributes to proprioception deficits in patients with chronic ankle instability (CAI). We aimed to explore whether deficits of proprioception, including kinesthesia and joint position sense (JPS), exist in patients with CAI when compared with the uninjured contralateral side and healthy people. We hypothesized that proprioception deficits did exist in patients with CAI and that the deficits varied by test methodologies.
METHODS
The study was a systematic review and meta-analysis. We identified studies that compared kinesthesia or JPS in patients with CAI with the uninjured contralateral side or with healthy controls. Meta-analyses were conducted for the studies with similar test procedures, and narrative syntheses were undertaken for the rest.
RESULTS
A total of 7731 studies were identified, of which 30 were included for review. A total of 21 studies were eligible for meta-analysis. Compared with the contralateral side, patients with CAI had ankle kinesthesia deficits in inversion and plantarflexion, with a standardized mean difference (SMD) of 0.41 and 0.92, respectively, and active and passive JPS deficits in inversion (SMD = 0.92 and 0.72, respectively). Compared with healthy people, patients with CAI had ankle kinesthesia deficits in inversion and eversion (SMD = 0.64 and 0.76, respectively), and active JPS deficits in inversion and eversion (SMD = 1.00 and 4.82, respectively). Proprioception deficits in the knee and shoulder of patients with CAI were not statistically significant.
CONCLUSION
Proprioception, including both kinesthesia and JPS, of the injured ankle of patients with CAI was impaired, compared with the uninjured contralateral limbs and healthy people. Proprioception varied depending on different movement directions and test methodologies. The use of more detailed measurements of proprioception and interventions for restoring the deficits are recommended in the clinical management of CAI.
Topics: Ankle Injuries; Ankle Joint; Bias; Chronic Disease; Humans; Joint Instability; Kinesthesis; Knee Joint; Movement; Proprioception; Sensation Disorders; Shoulder Joint
PubMed: 33017672
DOI: 10.1016/j.jshs.2020.09.014 -
PloS One 2017The bench press exercise (BP) plays an important role in recreational and professional training, in which muscle activity is an important multifactorial phenomenon. The... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The bench press exercise (BP) plays an important role in recreational and professional training, in which muscle activity is an important multifactorial phenomenon. The objective of this paper is to systematically review electromyography (EMG) studies performed on the barbell BP exercise to answer the following research questions: Which muscles show the greatest activity during the flat BP? Which changes in muscle activity are related to specific conditions under which the BP movement is performed?
STRATEGY
PubMed, Scopus, Web of Science and Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library were searched through June 10, 2016. A combination of the following search terms was used: bench press, chest press, board press, test, measure, assessment, dynamometer, kinematics and biomechanics. Only original, full-text articles were considered.
RESULTS
The search process resulted in 14 relevant studies that were included in the discussion. The triceps brachii (TB) and pectoralis major (PM) muscles were found to have similar activity during the BP, which was significantly higher than the activity of the anterior deltoid. During the BP movement, muscle activity changes with exercise intensity, velocity of movement, fatigue, mental focus, movement phase and stability conditions, such as bar vibration or unstable surfaces. Under these circumstances, TB is the most common object of activity change.
CONCLUSIONS
PM and TB EMG activity is more dominant and shows greater EMG amplitude than anterior deltoid during the BP. There are six factors that can influence muscle activity during the BP; however, the most important factor is exercise intensity, which interacts with all other factors. The research on muscle activity in the BP has several unresolved areas, such as clearly and strongly defined guidelines to perform EMG measurements (e.g., how to elaborate with surface EMG limits) or guidelines for the use of exact muscle models.
Topics: Electromyography; Exercise; Humans; Muscle Contraction; Muscle, Skeletal; Psychomotor Performance
PubMed: 28170449
DOI: 10.1371/journal.pone.0171632 -
Journal of Sports Science & Medicine Dec 2021The objectives of this systematic review were to summarize and evaluate the effectiveness of strength and conditioning trainings on front crawl swimming, starts and... (Review)
Review
The objectives of this systematic review were to summarize and evaluate the effectiveness of strength and conditioning trainings on front crawl swimming, starts and turns performance with relevant biomechanical parameters. Four online databases including PudMed, ESCSOhost, Web of Science and SPORTDiscus were searched according to different combination of keywords. 954 articles were extracted from databases, and ultimately 15 articles were included in this study after removal of duplicate and articles screening according to inclusion and exclusion criteria. Meta-analyses were adopted when appropriate and Egger's regression symmetry was adopted to assess the publication bias and the results were presented with forest plots and funnel plots respectively. Fifteen articles studied the effects of strength and resistance, core, and plyometric trainings. The quality of the investigation was assessed by the checklist developed by Downs and Black. Most of the investigations found out that training programs were beneficial to front crawl sprinting swimming performance, stroke biomechanics, force, and muscle strength. First, strength and resistance trainings and core trainings were effective on sprinting performance enhancement. Second, resistance trainings were found to have positive effects on stroke rate. Plyometric trainings were beneficial to start performance, while there was no sufficient evidence for confirming the positive improvement on turn biomechanical, also overall swimming performance, after weeks of plyometric trainings. Strength and Conditioning trainings are suggested to implement in regular training regime regarding to the positive effects on swimming performance, including starts, turns and front crawl swim, and relevant biomechanical parameters, instead of swimming training only. Further research with higher quality is recommended to conduct and more investigations on the training effects to other stroke styles are also suggested.
Topics: Biomechanical Phenomena; Humans; Muscle Strength; Plyometric Exercise; Resistance Training; Swimming
PubMed: 35321128
DOI: 10.52082/jssm.2021.564