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Ageing Research Reviews May 2021Engaging in physical activity (PA) and avoiding sedentary behavior (SB) are important for healthy ageing with benefits including the mitigation of disability and... (Meta-Analysis)
Meta-Analysis Review
The association of objectively measured physical activity and sedentary behavior with skeletal muscle strength and muscle power in older adults: A systematic review and meta-analysis.
BACKGROUND
Engaging in physical activity (PA) and avoiding sedentary behavior (SB) are important for healthy ageing with benefits including the mitigation of disability and mortality. Whether benefits extend to key determinants of disability and mortality, namely muscle strength and muscle power, is unclear.
AIMS
This systematic review aimed to describe the association of objective measures of PA and SB with measures of skeletal muscle strength and muscle power in community-dwelling older adults.
METHODS
Six databases were searched from their inception to June 21, 2020 for articles reporting associations between objectively measured PA and SB and upper body or lower body muscle strength or muscle power in community dwelling adults aged 60 years and older. An overview of associations was visualized by effect direction heat maps, standardized effect sizes were estimated with albatross plots and summarized in box plots. Articles reporting adjusted standardized regression coefficients (β) were included in meta-analyses.
RESULTS
A total of 112 articles were included representing 43,796 individuals (range: 21 to 3726 per article) with a mean or median age from 61.0 to 88.0 years (mean 56.4 % female). Higher PA measures and lower SB were associated with better upper body muscle strength (hand grip strength), upper body muscle power (arm curl), lower body muscle strength, and lower body muscle power (chair stand test). Median standardized effect sizes were consistently larger for measures of PA and SB with lower compared to upper body muscle strength and muscle power. The meta-analyses of adjusted β coefficients confirmed the associations between total PA (TPA), moderate-to-vigorous PA (MVPA) and light PA (LPA) with hand grip strength (β = 0.041, β = 0.057, and β = 0.070, respectively, all p ≤ 0.001), and TPA and MVPA with chair stand test (β = 0.199 and β = 0.211, respectively, all p ≤ 0.001).
CONCLUSIONS
Higher PA and lower SB are associated with greater skeletal muscle strength and muscle power, particularly with the chair stand test.
Topics: Aged; Aged, 80 and over; Exercise; Female; Hand Strength; Humans; Male; Middle Aged; Muscle Strength; Muscle, Skeletal; Sedentary Behavior
PubMed: 33607291
DOI: 10.1016/j.arr.2021.101266 -
Chinese Journal of Traumatology =... 2015Heel pain is a very common foot disease. Varieties of names such as plantar fasciitis, jogger's heel, tennis heal, policeman's heel are used to describe it. Mechanical... (Review)
Review
Heel pain is a very common foot disease. Varieties of names such as plantar fasciitis, jogger's heel, tennis heal, policeman's heel are used to describe it. Mechanical factors are the most common etiology of heel pain. Common causes of hell pain includes: Plantar Fasciitis, Heel Spur, Sever's Disease, Heel bump, Achilles Tendinopathy, Heel neuritis, Heel bursitis. The diagnosis is mostly based on clinical examination. Normally, the location of the pain and the absence of associated symptoms indicating a systemic disease strongly suggest the diagnosis. Several therapies exist including rest, physical therapy, stretching, and change in footwear, arch supports, orthotics, night splints, anti-inflammatory agents, and surgery. Almost all patients respond to conservative nonsurgical therapy. Surgery is the last treatment option if all other treatments had failed. Rest, ice, massage, the use of correct exercise and complying with a doctor's advice all play important part in helping to recover from this hell pain condition, but getting good quality, suitable shoes with the appropriate amount of support for the whole foot is the most important.
Topics: Foot Diseases; Heel; Humans; Pain Management; Physical Examination
PubMed: 26643244
DOI: 10.1016/j.cjtee.2015.03.002 -
Nutrients Feb 2023The performance of male soccer players (MSP) depends on multiple factors such as body composition. The physical demands of modern soccer have changed, so the ideal body... (Meta-Analysis)
Meta-Analysis Review
The performance of male soccer players (MSP) depends on multiple factors such as body composition. The physical demands of modern soccer have changed, so the ideal body composition (BC) requirements must be adapted to the present. The aim of this systematic review and meta-analysis was to describe the anthropometric, BC, and somatotype characteristics of professional MSP and to compare the values reported according to the methods and equations used. We systematically searched Embase, PubMed, SPORTDiscus, and Web of Science following the PRISMA statement. Random-effects meta-analysis, a pooled summary of means, and 95% CI (method or equation) were calculated. Random models were used with the restricted maximum likelihood (REML) method. Seventy-four articles were included in the systematic review and seventy-three in the meta-analysis. After comparing the groups according to the assessment method (kinanthropometry, bioimpedance, and densitometry), significant differences were found in height, fat mass in kilograms, fat mass percentage, and fat-free mass in kilograms ( = 0.001; < 0.0001). Taking into account the equation used to calculate the fat mass percentage and ∑skinfolds, significant differences were observed in the data reported according to groups ( < 0.001). Despite the limitations, this study provides useful information that could help medical technical staff to properly assess the BC of professional MSP, providing a range of guidance values for the different BC.
Topics: Humans; Male; Soccer; Body Composition; Anthropometry; Somatotypes
PubMed: 36904159
DOI: 10.3390/nu15051160 -
Sports Health 2017Medial tibial stress syndrome (MTSS) is a common condition in active individuals and presents as diffuse pain along the posteromedial border of the tibia. (Meta-Analysis)
Meta-Analysis Review
CONTEXT
Medial tibial stress syndrome (MTSS) is a common condition in active individuals and presents as diffuse pain along the posteromedial border of the tibia.
OBJECTIVE
To use cross-sectional, case-control, and cohort studies to identify significant MTSS risk factors.
DATA SOURCES
Bibliographic databases (PubMed, Scopus, CINAHL, SPORTDiscus, EMBASE, EBM Reviews, PEDRo), grey literature, electronic search of full text of journals, manual review of reference lists, and automatically executed PubMed MTSS searches were utilized. All searches were conducted between 2011 and 2015.
STUDY SELECTION
Inclusion criteria were determined a priori and included original research with participants' pain diffuse, located in the posterior medial tibial region, and activity related.
STUDY DESIGN
Systematic review with meta-analysis.
LEVEL OF EVIDENCE
Level 4.
DATA EXTRACTION
Titles and abstracts were reviewed to eliminate citations that did not meet the criteria for inclusion. Study characteristics identified a priori were extracted for data analysis. Statistical heterogeneity was examined using the I index and Cochran Q test, and a random-effects model was used to calculate the meta-analysis when 2 or more studies examined a risk factor. Two authors independently assessed study quality.
RESULTS
Eighty-three articles met the inclusion criteria, and 22 articles included risk factor data. Of the 27 risk factors that were in 2 or more studies, 5 risk factors showed a significant pooled effect and low statistical heterogeneity, including female sex (odds ratio [OR], 2.35; CI, 1.58-3.50), increased weight (standardized mean difference [SMD], 0.24; CI, 0.03-0.45), higher navicular drop (SMD, 0.44; CI, 0.21-0.67), previous running injury (OR, 2.18; CI, 1.00-4.72), and greater hip external rotation with the hip in flexion (SMD, 0.44; CI, 0.23-0.65). The remaining risk factors had a nonsignificant pooled effect or significant pooled effect with high statistical heterogeneity.
CONCLUSION
Female sex, increased weight, higher navicular drop, previous running injury, and greater hip external rotation with the hip in flexion are risk factors for the development of MTSS.
Topics: Body Mass Index; Female; Gait; Hip; Humans; Male; Medial Tibial Stress Syndrome; Muscle Strength; Physical Conditioning, Human; Range of Motion, Articular; Risk Factors; Rotation; Running; Sex Factors
PubMed: 27729482
DOI: 10.1177/1941738116673299 -
Pediatric Emergency Care Sep 2020The aims of the study were to perform the first systematic review of pediatric syncope etiologies and to determine the most common diagnoses with credible intervals...
OBJECTIVES
The aims of the study were to perform the first systematic review of pediatric syncope etiologies and to determine the most common diagnoses with credible intervals (CredIs).
METHODS
Review was performed within Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines and used Embase, Scopus, PubMed, and the Cochrane Controlled Trial databases. The following inclusion criteria for the articles were used: minimum of 10 patients, standard definition of syncope used, subjects who were 21 years or younger, and subjects who were either a consecutive retrospective group or a prospective group. No restrictions were made regarding language of the studies, but an English abstract was required. The following information was collected: purpose of the study, definition of syncope, number of patients, patient age range, inclusion/exclusion criteria, and etiologies of syncope.
RESULTS
Of the 500 articles initially identified, 11 studies met the inclusion criteria and were the basis for this review. Three thousand seven hundred patients were included, ranging in age from 3 months to 21 years. The most common etiologies identified were vasovagal (52.2%; 95% CredI, 50.6-53.9), postural orthostatic tachycardia syndrome (13.1%; 95% CredI, 12.1-14.2), and cardiac causes (4.0%; 95% CredI, 3.39-4.65). A total of 18.3% (95% CredI, 17.0-19.5) of patients were found to have syncope of unknown cause.
CONCLUSIONS
Syncope is a common pediatric complaint. Most cases seen are a result of benign causes, with only a small percentage because of serious medical conditions. In addition, most syncopal episodes in the pediatric population are diagnosed clinically or with minimally invasive testing, emphasizing the importance of a detailed history and physical examination.
Topics: Child; Diagnosis, Differential; Humans; Medical History Taking; Physical Examination; Syncope
PubMed: 32530839
DOI: 10.1097/PEC.0000000000002149 -
Obesity Reviews : An Official Journal... May 2022To systematically review and analyze the effects of resistance-based exercise programs on body composition, regional adiposity, and body weight in individuals with... (Meta-Analysis)
Meta-Analysis Review
Resistance training effectiveness on body composition and body weight outcomes in individuals with overweight and obesity across the lifespan: A systematic review and meta-analysis.
To systematically review and analyze the effects of resistance-based exercise programs on body composition, regional adiposity, and body weight in individuals with overweight/obesity across the lifespan. Using PRISMA guidelines, randomized controlled trials were searched in nine electronic databases up to December 2020. Meta-analyses were performed using random-effects model. One-hundred sixteen articles describing 114 trials (n = 4184 participants) were included. Interventions involving resistance training and caloric restriction were the most effective for reducing body fat percentage (ES = -3.8%, 95% CI: -4.7 to -2.9%, p < 0.001) and whole-body fat mass (ES = -5.3 kg, 95% CI: -7.2 to -3.5 kg, p < 0.001) compared with groups without intervention. Significant results were also observed following combined resistance and aerobic exercise (ES = -2.3% and -1.4 kg, p < 0.001) and resistance training alone (ES = -1.6% and -1.0 kg, p < 0.001) compared with no training controls. Resistance training alone was the most effective for increasing lean mass compared with no training controls (ES = 0.8 kg, 95% CI: 0.6 to 1.0 kg, p < 0.001), whereas lean mass was maintained following interventions involving resistance training and caloric restriction (ES = ~ - 0.3 kg, p = 0.550-0.727). Results were consistently observed across age and sex groups (p = 0.001-0.011). Reductions in regional adiposity and body weight measures were also observed following combined resistance and aerobic exercise and programs including caloric restriction (p < 0.001). In conclusion, this study provides evidence that resistance-based exercise programs are effective and should be considered within any multicomponent therapy program when caloric restriction is utilized in individuals with overweight or obesity.
Topics: Body Composition; Body Mass Index; Body Weight; Humans; Longevity; Obesity; Overweight; Resistance Training
PubMed: 35191588
DOI: 10.1111/obr.13428 -
Chiropractic & Manual Therapies Dec 2022Clinicians rely on certain physical examination tests to diagnose and potentially grade ankle sprains and ankle instability. Diagnostic error and inaccurate prognosis...
INTRODUCTION
Clinicians rely on certain physical examination tests to diagnose and potentially grade ankle sprains and ankle instability. Diagnostic error and inaccurate prognosis may have important repercussions for clinical decision-making and patient outcomes. Therefore, it is important to recognize the diagnostic value of orthopaedic tests through understanding the reliability and validity of these tests.
OBJECTIVE
To systematically review and report evidence on the reliability and validity of orthopaedic tests for the diagnosis of ankle sprains and instability.
METHODS
PubMed, CINAHL, Scopus, and Cochrane databases were searched from inception to December 2021. In addition, the reference list of included studies, located systematic reviews, and orthopaedic textbooks were searched. All articles reporting reliability or validity of physical examination or orthopaedic tests to diagnose ankle instability or sprains were included. Methodological quality of the reliability and the validity studies was assessed with The Quality Appraisal for Reliability studies checklist and the Quality Assessment of Diagnostic Accuracy Studies-2 respectively. We identified the number of times the orthopaedic test was investigated and the validity and/or reliability of each test.
RESULTS
Overall, sixteen studies were included. Three studies assessed reliability, eight assessed validity, and five evaluated both. Overall, fifteen tests were evaluated, none demonstrated robust reliability and validity scores. The anterolateral talar palpation test reported the highest diagnostic accuracy. Further, the anterior drawer test, the anterolateral talar palpation, the reverse anterior lateral drawer test, and palpation of the anterior talofibular ligament reported the highest sensitivity. The highest specificity was attributed to the anterior drawer test, the anterolateral drawer test, the reverse anterior lateral drawer test, tenderness on palpation of the proximal fibular, and the squeeze test.
CONCLUSION
Overall, the diagnostic accuracy, reliability, and validity of physical examination tests for the assessment of ankle instability were limited. Physical examination tests should not be used in isolation, but rather in combination with the clinical history to diagnose an ankle sprain. Preliminary evidence suggests that the overall validity of physical examination for the ankle may be better if conducted five days after the injury rather than within 48 h of injury.
Topics: Humans; Ankle; Reproducibility of Results; Ankle Joint; Physical Examination; Joint Instability; Ankle Injuries
PubMed: 36536446
DOI: 10.1186/s12998-022-00470-0 -
Systematic Reviews Jun 2019Understanding the effects of gait speed on biomechanical variables is fundamental for a proper evaluation of alterations in gait, since pathological individuals tend to... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Understanding the effects of gait speed on biomechanical variables is fundamental for a proper evaluation of alterations in gait, since pathological individuals tend to walk slower than healthy controls. Therefore, the aim of the study was to perform a systematic review of the effects of gait speed on spatiotemporal parameters, joint kinematics, joint kinetics, and ground reaction forces in healthy children, young adults, and older adults.
METHODS
A systematic electronic search was performed on PubMed, Embase, and Web of Science databases to identify studies published between 1980 and 2019. A modified Quality Index was applied to assess methodological quality, and effect sizes with 95% confidence intervals were calculated as the standardized mean differences. For the meta-analyses, a fixed or random effect model and the statistical heterogeneity were calculated using the I index.
RESULTS
Twenty original full-length studies were included in the final analyses with a total of 587 healthy individuals evaluated, of which four studies analyzed the gait pattern of 227 children, 16 studies of 310 young adults, and three studies of 59 older adults. In general, gait speed affected the amplitude of spatiotemporal gait parameters, joint kinematics, joint kinetics, and ground reaction forces with a decrease at slow speeds and increase at fast speeds in relation to the comfortable speed. Specifically, moderate-to-large effect sizes were found for each age group and speed: children (slow, - 3.61 to 0.59; fast, - 1.05 to 2.97), young adults (slow, - 3.56 to 4.06; fast, - 4.28 to 4.38), and older adults (slow, - 1.76 to 0.52; fast, - 0.29 to 1.43).
CONCLUSIONS
This review identified that speed affected the gait patterns of different populations with respect to the amplitude of spatiotemporal parameters, joint kinematics, joint kinetics, and ground reaction forces. Specifically, most of the values analyzed decreased at slower speeds and increased at faster speeds. Therefore, the effects of speed on gait patterns should also be considered when comparing the gait analysis of pathological individuals with normal or control ones.
Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Biomechanical Phenomena; Child; Child, Preschool; Gait; Gait Analysis; Humans; Middle Aged; Walking; Walking Speed; Young Adult
PubMed: 31248456
DOI: 10.1186/s13643-019-1063-z -
American Journal of Obstetrics and... Nov 2018Myofascial pain is characterized by the presence of trigger points, tenderness to palpation, and local or referred pain, and commonly involves the pelvic floor muscles...
BACKGROUND
Myofascial pain is characterized by the presence of trigger points, tenderness to palpation, and local or referred pain, and commonly involves the pelvic floor muscles in men and women. Pelvic floor myofascial pain in the absence of local or referred pain has also been observed in patients with lower urinary tract symptoms, and we have found that many patients report an improvement in these symptoms after receiving myofascial-targeted pelvic floor physical therapy.
OBJECTIVE
We sought to systematically review the literature for examination techniques used to assess pelvic floor myofascial pain in women.
STUDY DESIGN
We performed a systematic literature search using strategies for the concepts of pelvic floor disorders, myofascial pain, and diagnosis in Ovid MEDLINE 1946-, Embase 1947-, Scopus 1960-, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects, and Cochrane Database of Systematic Reviews. Articles were screened by 3 authors and included if they contained a description of a pelvic myofascial physical examination.
RESULTS
In all, 55 studies met our inclusion criteria. Overall, examination components varied significantly among the included studies and were frequently undefined. A consensus examination guideline was developed based on the available data and includes use of a single digit (62%, 34/55) to perform transvaginal palpation (75%, 41/55) of the levator ani (87%, 48/55) and obturator internus (45%, 25/55) muscles with a patient-reported scale to assess the level of pain to palpation (51%, 28/55).
CONCLUSION
Physical examination methods to evaluate pelvic musculature for presence of myofascial pain varied significantly and were often undefined. Given the known role of pelvic floor myofascial pain in chronic pelvic pain and link between pelvic floor myofascial pain and lower urinary tract symptoms, physicians should be trained to evaluate for pelvic floor myofascial pain as part of their physical examination in patients presenting with these symptoms. Therefore, the development and standardization of a reliable and reproducible examination is needed.
Topics: Female; Humans; MEDLINE; Myofascial Pain Syndromes; Pain Measurement; Palpation; Pelvic Floor; Physical Examination; Urologic Diseases
PubMed: 29959930
DOI: 10.1016/j.ajog.2018.06.014 -
JAMA Network Open Mar 2022There are concerns that low- and no-calorie sweetened beverages (LNCSBs) do not have established benefits, with major dietary guidelines recommending the use of water... (Meta-Analysis)
Meta-Analysis
Association of Low- and No-Calorie Sweetened Beverages as a Replacement for Sugar-Sweetened Beverages With Body Weight and Cardiometabolic Risk: A Systematic Review and Meta-analysis.
IMPORTANCE
There are concerns that low- and no-calorie sweetened beverages (LNCSBs) do not have established benefits, with major dietary guidelines recommending the use of water and not LNCSBs to replace sugar-sweetened beverages (SSBs). Whether LNCSB as a substitute can yield similar improvements in cardiometabolic risk factors vs water in their intended substitution for SSBs is unclear.
OBJECTIVE
To assess the association of LNCSBs (using 3 prespecified substitutions of LNCSBs for SSBs, water for SSBs, and LNCSBs for water) with body weight and cardiometabolic risk factors in adults with and without diabetes.
DATA SOURCES
Medline, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception through December 26, 2021.
STUDY SELECTION
Randomized clinical trials (RCTs) with at least 2 weeks of interventions comparing LNCSBs, SSBs, and/or water were included.
DATA EXTRACTION AND SYNTHESIS
Data were extracted and risk of bias was assessed by 2 independent reviewers. A network meta-analysis was performed with data expressed as mean difference (MD) or standardized mean difference (SMD) with 95% CIs. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) system was used to assess the certainty of the evidence.
MAIN OUTCOMES AND MEASURES
The primary outcome was body weight. Secondary outcomes were other measures of adiposity, glycemic control, blood lipids, blood pressure, measures of nonalcoholic fatty liver disease, and uric acid.
RESULTS
A total of 17 RCTs with 24 trial comparisons were included, involving 1733 adults (mean [SD] age, 33.1 [6.6] years; 1341 women [77.4%]) with overweight or obesity who were at risk for or had diabetes. Overall, LNCSBs were a substitute for SSBs in 12 RCTs (n = 601 participants), water was a substitute for SSBs in 3 RCTs (n = 429), and LNCSBs were a substitute for water in 9 RCTs (n = 974). Substitution of LNCSBs for SSBs was associated with reduced body weight (MD, -1.06 kg; 95% CI, -1.71 to -0.41 kg), body mass index (MD, -0.32; 95% CI, -0.58 to -0.07), percentage of body fat (MD, -0.60%; 95% CI, -1.03% to -0.18%), and intrahepatocellular lipid (SMD, -0.42; 95% CI, -0.70 to -0.14). Substituting water for SSBs was not associated with any outcome. There was also no association found between substituting LNCSBs for water with any outcome except glycated hemoglobin A1c (MD, 0.21%; 95% CI, 0.02% to 0.40%) and systolic blood pressure (MD, -2.63 mm Hg; 95% CI, -4.71 to -0.55 mm Hg). The certainty of the evidence was moderate (substitution of LNCSBs for SSBs) and low (substitutions of water for SSBs and LNCSBs for water) for body weight and was generally moderate for all other outcomes across all substitutions.
CONCLUSIONS AND RELEVANCE
This systematic review and meta-analysis found that using LNCSBs as an intended substitute for SSBs was associated with small improvements in body weight and cardiometabolic risk factors without evidence of harm and had a similar direction of benefit as water substitution. The evidence supports the use of LNCSBs as an alternative replacement strategy for SSBs over the moderate term in adults with overweight or obesity who are at risk for or have diabetes.
Topics: Adult; Body Weight; Cardiovascular Diseases; Diabetes Mellitus; Female; Humans; Male; Obesity; Overweight; Sugar-Sweetened Beverages; Water
PubMed: 35285920
DOI: 10.1001/jamanetworkopen.2022.2092