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Journal of Sport and Health Science Jul 2024Impairments in hamstring strength, flexibility, and morphology have been associated with altered knee biomechanics, pain, and function. Determining the presence of these... (Meta-Analysis)
Meta-Analysis Review
There is more to the knee joint than just the quadriceps: A systematic review with meta-analysis and evidence gap map of hamstring strength, flexibility, and morphology in individuals with gradual-onset knee disorders.
BACKGROUND
Impairments in hamstring strength, flexibility, and morphology have been associated with altered knee biomechanics, pain, and function. Determining the presence of these impairments in individuals with gradual-onset knee disorders is important and may indicate targets for assessment and rehabilitation. This systematic review aimed to synthesize the literature to determine the presence of impairments in hamstring strength, flexibility, and morphology in individuals with gradual-onset knee disorders.
METHODS
Five databases (MEDLINE, Embase, CINAHL, SPORTDiscus, and Web of Science) were searched from inception to September 2022. Only studies comparing hamstring outcomes (e.g., strength, flexibility, and/or morphology) between individuals with gradual-onset knee disorders and their unaffected limbs or pain-free controls were included. Meta-analyses for each knee disorder were performed. Outcome-level certainty was assessed using the Grading of Recommendations Assessment, Development, and Evaluation, and evidence gap maps were created.
RESULTS
Seventy-nine studies across 4 different gradual-onset knee disorders (i.e., knee osteoarthritis (OA), patellofemoral pain (PFP), chondromalacia patellae, and patellar tendinopathy) were included. Individuals with knee OA presented with reduced hamstring strength compared to pain-free controls during isometric (standard mean difference (SMD) = -0.76, 95% confidence interval (95%CI) : -1.32 to -0.21) and concentric contractions (SMD = -0.97, 95%CI : -1.49 to -0.45). Individuals with PFP presented with reduced hamstring strength compared to pain-free controls during isometric (SMD = -0.48, 95%CI : -0.82 to -0.14), concentric (SMD = -1.07, 95%CI : -2.08 to -0.06), and eccentric contractions (SMD = -0.59, 95%CI : -0.97 to -0.21). No differences were observed in individuals with patellar tendinopathy. Individuals with PFP presented with reduced hamstring flexibility when compared to pain-free controls (SMD = -0.76, 95%CI : -1.15 to -0.36). Evidence gap maps identified insufficient evidence for chondromalacia patellae and hamstring morphology across all gradual-onset knee disorders.
CONCLUSION
Our findings suggest that assessing and targeting impairments in hamstring strength and flexibility during rehabilitation may be recommended for individuals with knee OA or PFP.
Topics: Humans; Muscle Strength; Hamstring Muscles; Knee Joint; Quadriceps Muscle; Osteoarthritis, Knee; Patellofemoral Pain Syndrome; Range of Motion, Articular; Biomechanical Phenomena; Chondromalacia Patellae; Evidence Gaps
PubMed: 37669706
DOI: 10.1016/j.jshs.2023.08.004 -
International Journal of Environmental... Feb 2023This review aimed to identify the effects of strength training programs on the physical fitness of Olympic combat sports (OCS) athletes. The systematic review included... (Review)
Review
This review aimed to identify the effects of strength training programs on the physical fitness of Olympic combat sports (OCS) athletes. The systematic review included peer-reviewed articles that incorporated interventions that included pre- and post-intervention physical fitness assessment. The search was performed in the SCOPUS, PubMed, and Web of Science databases between April and September 2022. PRISMA and the TESTEX checklist were used to select and assess the methodological quality of the studies. Twenty studies with 504 participants (428 males and 76 females) were included. Significant improvements were found in athletes' maximal dynamic and isometric strength, muscle power, flexibility, and balance. In addition, improvements in favor of the training groups in specific actions of judo, karate, fencing, and boxing were observed. In conclusion, interventions aimed at the development of muscle strength in OCS, specifically in judo, boxing, karate, wrestling, and fencing, proved to be beneficial at a physical fitness level, resulting in significant increases in favor of the training groups with OCS, which could be used by trainers and coaches to improve the physical performance of athletes.
Topics: Male; Female; Humans; Resistance Training; Physical Fitness; Martial Arts; Wrestling; Athletes; Muscle Strength
PubMed: 36834211
DOI: 10.3390/ijerph20043516 -
Alternative Therapies in Health and... 2015Physical inactivity is commonly observed among individuals aged ≥ 60 y. Identified barriers to sedentary older adults beginning activity include low self-efficacy,... (Review)
Review
BACKGROUND
Physical inactivity is commonly observed among individuals aged ≥ 60 y. Identified barriers to sedentary older adults beginning activity include low self-efficacy, pre-existing medical conditions, physical limitations, time constraints, and culture. Dancing has the potential to be an attractive physical activity that can be adjusted to fit a target population's age, physical limitations, and culture.
OBJECTIVES
This review examined the benefits to physical health of dance interventions among older adults.
METHODS
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search using the PubMed database was conducted. Eighteen studies met the inclusion and exclusion criteria and were analyzed for type of intervention, the study's design, participants' demographics, and outcomes, including attrition.
RESULTS
The 18 articles reported on studies conducted in North America, South America, Europe, and Asia. Of the styles of dancing, 6 studies used ballroom, 5 used contemporary, 4 used cultural, 1 used pop, and 2 used jazz. Two studies targeted older adults with pre-existing medical conditions. The average age of participants ranged from 52-87 y. Researchers used a variety of measures to assess effectiveness: (1) 3 of 5 (60%) that used measures to assess flexibility showed significant positive results; (2) 23 of 28 (82%) that used measures of muscular strength and endurance showed significant positive changes; (3) 8 of 9 (89%) that used measures of balance showed significant positive changes; (4) 8 of 10 (80%) that used measures of cognitive ability showed significant positive changes; and (5) the one that measured cardiovascular endurance showed significant positive changes. Only 6 studies reported participation, and they found low attrition.
CONCLUSIONS
The findings suggest that dance, regardless of its style, can significantly improve muscular strength and endurance, balance, and other aspects of functional fitness in older adults. Future researchers may want to analyze the effects of dance on mental health and explore ways to make this intervention attractive to both genders. Standardizing outcome measures for dance would facilitate meta-analysis.
Topics: Accidental Falls; Aged; Aged, 80 and over; Dance Therapy; Dancing; Exercise; Female; Health Behavior; Humans; Male; Middle Aged; Motor Skills; Muscle Strength; Postural Balance; Psychomotor Performance
PubMed: 26393993
DOI: No ID Found -
Gerontology 2019Handgrip strength measurements are feasible with older adults and a reliable indicator for vitality, physical function, and several risk factors in the ageing process.... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Handgrip strength measurements are feasible with older adults and a reliable indicator for vitality, physical function, and several risk factors in the ageing process. Interventions with exercise training induce a variety of strength, balance, and endurance improvements. The pooled transfer effects of exercise training on handgrip strength has not been investigated to date. Thus, the objective of this meta-analytical review is to examine the effects of different exercise training on handgrip strength in healthy community-dwelling older adults of 60 years or older.
METHODS
The literature search was conducted in three databases (PubMed, Web of Science, SPORTDiscus) using the following search terms with Boolean conjunctions: (hand grip* OR grip strength OR grip power) AND (sport* OR train* OR exercis* OR strength OR intervention OR endurance OR resistance OR balance OR aerob*) AND (old* OR elder* OR senior*). Non-randomized and randomized controlled trials with an exercise training and handgrip strength as the outcome parameter were screened. Study quality was independently assessed by two researchers using the PEDro scale. Comparison of handgrip strength between the intervention and control groups was conducted by using the hedges g (including adjustment for small sample sizes), calculating standardized mean differences (SMDs). A random effects inverse-variance model was applied for statistical analysis.
RESULTS
Twenty-four trials (mean PEDro score 5.8 ± 0.9) with a total of 3,018 participants (mean age 73.3 ± 6.0 years) were included. Small but significant effects (p < 0.001) on handgrip strength were observed (SMD 0.28, 95% CI 0.13-0.44). Study heterogeneity (I2 56%) and the funnel shape for publication bias analyses were acceptable.
CONCLUSIONS
Meaningful but small transfer effects of a multitude of different training approaches on handgrip strength occurred in healthy community-dwelling older adults. Handgrip strength cannot clearly be recommended to assess general functional performance for all kinds of exercise programs, whereas task-specific training and multimodal training modes seem to provide an appropriate stimulus to also improve handgrip strength.
Topics: Exercise; Hand Strength; Humans
PubMed: 31499496
DOI: 10.1159/000501203 -
BMC Musculoskeletal Disorders Oct 2019Globally, low back pain (LBP) is one of the greatest causes of disability. In people with LBP, dysfunction of muscles such as the gluteus medius have been demonstrated...
INTRODUCTION
Globally, low back pain (LBP) is one of the greatest causes of disability. In people with LBP, dysfunction of muscles such as the gluteus medius have been demonstrated to increase spinal loading and reduce spinal stability. Differences in gluteus medius function have been reported in those with LBP compared to those without, although this has only been reported in individual studies. The aim of this systematic review was to determine if adults with a history, or current LBP, demonstrate differences in measures of gluteus medius function when compared to adults without LBP.
METHODS
MEDLINE, EMBASE, AMED, PsycINFO, PubMED, Pro Quest Database, CINAHL and SPORTDiscus were searched from inception until December 2018 for published journal articles and conference abstracts. No language restrictions were applied. Only case-control studies with participants 18 years and over were included. Participants could have had any type and duration of LBP. Studies could have assessed gluteus medius function with any quantifiable clinical assessment or measurement tool, with the participant non-weight bearing or weight bearing, and during static or dynamic activity. Quality appraisal and data extraction were independently performed by two authors.
RESULTS
The 24 included articles involved 1088 participants with LBP and 998 without LBP. The gluteus medius muscle in participants with LBP tended to demonstrate reduced strength and more trigger points compared to the gluteus medius muscle of those without LBP. The level of activity, fatigability, time to activate, time to peak activation, cross sectional area, and muscle thickness showed unclear results. Meta-analysis was not performed due to the heterogeneity of included studies.
CONCLUSION
Clinically, the findings from this systematic review should be considered when assessing and managing patients with LBP. Future studies that clearly define the type and duration of LBP, and prospectively assess gluteus medius muscle function in those with and without LBP are needed.
TRIAL REGISTRATION
PROSPERO ( CRD42017076773 ).
Topics: Buttocks; Humans; Low Back Pain; Muscle Strength; Muscle, Skeletal
PubMed: 31638962
DOI: 10.1186/s12891-019-2833-4 -
Nutrients Apr 2023Sarcopenia is a progressive and frequent syndrome among older adults highly related to physical inactivity and malnutrition. Nowadays, it is considered a pathology that... (Review)
Review
Sarcopenia is a progressive and frequent syndrome among older adults highly related to physical inactivity and malnutrition. Nowadays, it is considered a pathology that triggers multiple health complications associated with the loss of muscle mass, strength, autonomy, and quality of life. The objective of the present systematic review was to evaluate the effect of exercise programs combined with dietary supplementation on body composition as the primary outcome. This systematic review was carried out in accordance with the elements considered for planning a systematic review by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and the search was performed in the Scopus, EBSCO, and PubMed databases for the last 10 years. A total of 16 studies met the inclusion criteria and were included in this systematic review. Regular resistance exercise together with daily essential amino acids or whey protein and vitamin D supplementation improve the maintenance or gains in appendiceal/skeletal muscle mass and total lean mass in sarcopenic older adults. The data suggest a synergistic effect not only on the primary outcome, but also on other variables such as strength, speed, stability, and other indicators of quality of life. This systematic review was registered in PROSPERO, ID: CRD42022344284.
Topics: Humans; Aged; Sarcopenia; Muscle Strength; Quality of Life; Dietary Supplements; Body Composition; Resistance Training; Diet; Muscle, Skeletal
PubMed: 37111217
DOI: 10.3390/nu15081998 -
Journal of Physiotherapy Jan 2018Does physical exercise training improve physical function and quality of life in people with cognitive impairment and dementia? Which training protocols improve physical... (Meta-Analysis)
Meta-Analysis
QUESTION
Does physical exercise training improve physical function and quality of life in people with cognitive impairment and dementia? Which training protocols improve physical function and quality of life? How do cognitive impairment and other patient characteristics influence the outcomes of exercise training?
DESIGN
Systematic review with meta-analysis of randomised trials.
PARTICIPANTS
People with mild cognitive impairment or dementia as the primary diagnosis.
INTERVENTION
Physical exercise.
OUTCOME MEASURES
Strength, flexibility, gait, balance, mobility, walking endurance, dual-task ability, activities of daily living, quality of life, and falls.
RESULTS
Forty-three clinical trials (n=3988) were included. According to the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) system, the meta-analyses revealed strong evidence in support of using supervised exercise training to improve the results of 30-second sit-to-stand test (MD 2.1 repetitions, 95% CI 0.3 to 3.9), step length (MD 5cm, 95% CI 2 to 8), Berg Balance Scale (MD 3.6 points, 95% CI 0.3 to 7.0), functional reach (3.9cm, 95% CI 2.2 to 5.5), Timed Up and Go test (-1second, 95% CI -2 to 0), walking speed (0.13m/s, 95% CI 0.03 to 0.24), and 6-minute walk test (50m, 95% CI 18 to 81) in individuals with mild cognitive impairment or dementia. Weak evidence supported the use of exercise in improving flexibility and Barthel Index performance. Weak evidence suggested that non-specific exercise did not improve dual-tasking ability or activity level. Strong evidence indicated that exercise did not improve quality of life in this population. The effect of exercise on falls remained inconclusive. Poorer physical function was a determinant of better response to exercise training, but cognitive performance did not have an impact.
CONCLUSION
People with various levels of cognitive impairment can benefit from supervised multi-modal exercise for about 60minutes a day, 2 to 3days a week to improve physical function. [Lam FMH , Huang MZ, Liao LR, Chung RCK, Kwok TCY, Pang MYC (2018) Physical exercise improves strength, balance, mobility, and endurance in people with cognitive impairment and dementia: a systematic review. Journal of Physiotherapy 64: 4-15].
Topics: Accidental Falls; Activities of Daily Living; Cognitive Dysfunction; Dementia; Exercise; Humans; Mobility Limitation; Muscle Strength; Physical Endurance; Postural Balance; Quality of Life
PubMed: 29289581
DOI: 10.1016/j.jphys.2017.12.001 -
Journal of Athletic Training May 2020To determine the effects of an eccentric hamstrings strength-training program, performed for at least 4 weeks by healthy adults, on muscle architecture and eccentric... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To determine the effects of an eccentric hamstrings strength-training program, performed for at least 4 weeks by healthy adults, on muscle architecture and eccentric strength.
DATA SOURCES
A systematic search was performed up to October 2018 in the following electronic databases: PubMed, PEDro, CINAHL and SPORTDiscus. Combinations of the following search terms were used: , , , , , , , , , , and .
STUDY SELECTION
Included articles were randomized controlled trials that allowed comparisons between isolated eccentric strength training of the biceps femoris muscle and other programs.
DATA EXTRACTION
Data from the included studies were extracted by 2 independent reviewers. These data included the study design, participant characteristics, inclusion and exclusion criteria of clinical studies, exercise and intervention characteristics, outcome measures, and the main results of the study. When meta-analysis was possible, we performed quantitative analysis. Ten randomized controlled trials were included.
DATA SYNTHESIS
Limited to moderate evidence indicated that eccentric strength training was associated with an increase in fascicle length (mean difference [MD] = 1.97; 95% confidence interval [CI] = 1.48, 2.46), an increase in muscle thickness (MD = 0.10; 95% CI = 0.06, 0.13), and a decrease in pennation angle (MD = 2.36; 95% CI = 1.61, 3.11). Conflicted to moderate evidence indicated that eccentric hamstrings strength was increased after eccentric strength training compared with concentric strength training (standardized mean difference [SMD] = 1.06; 95% CI = 0.26, 1.86), usual level of activity (SMD = 2.72; 95% CI = 1.68, 3.77), and static stretching (SMD = 0.39; 95% CI = -0.97, 1.75).
CONCLUSIONS
In healthy adults, an eccentric strength-training program produced architectural adaptations on the long head of the biceps femoris muscle and increased eccentric hamstrings strength.
Topics: Adaptation, Physiological; Adult; Athletic Injuries; Hamstring Muscles; Humans; Muscle Strength; Resistance Training
PubMed: 32216654
DOI: 10.4085/1062-6050-194-19 -
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