-
Cureus Sep 2023Using the guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), this meta-analysis (MA) tried to figure out how well creatine... (Review)
Review
Using the guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), this meta-analysis (MA) tried to figure out how well creatine (Cr) improves metabolic performance. We searched Google Scholar, PubMed, and the Cochrane Library to identify relevant randomized clinical trials (RCTs) exploring the various effects of Cr across different age groups compared to a placebo (PLA). We also investigated the synergistic effects of combining other supplements with Cr. In order to emphasize the different ways and sports where Cr has been used in the past years, we found from the selected articles that Cr demonstrated a more pronounced effect during aerobic or anaerobic exercise compared to PLA groups in the studies. Furthermore, in sports that demand significant cumulative energy, such as long-distance races, biking, or triathlons, athletes have observed performance enhancements with Cr supplementation. We also stipulate that Cr enhances resistance training in people over 50 years old and that adding other training supplements, such as β-hydroxy β-methylbutyrate (HMB), synergistically improves training outcomes when combined with Cr. The current MA was based on a thorough analysis of 10 separate studies. When these results were added together, we found that taking Cr supplements demonstrated statistically significant benefits over PLA. In conclusion, the present MA has found evidence that Cr has positive effects on metabolic outcomes for people who consume it.
PubMed: 37720119
DOI: 10.7759/cureus.45282 -
Frontiers in Public Health 2023To present a systematic review of randomized controlled trials which summarizes the effects of community-based resistance, balance, and multi-component exercise... (Review)
Review
OBJECTIVE
To present a systematic review of randomized controlled trials which summarizes the effects of community-based resistance, balance, and multi-component exercise interventions on the parameters of functional ability (e.g., lower extremities muscle strength, balance performance and mobility).
METHODS
This PROSPERO-registered systematic review (registration no. CRD42023434808) followed the PRISMA guidelines. Literature search was conducted in Cochrane, Embase, Ovid Medline, PEDro, Pubmed, Science Direct, Scopus and Web of Science. We included RCTs that investigated the following interventions: lower extremity strengthening, balance and multi-component exercise interventions on ambulatory community-dwelling adults aged ≥65 years.
RESULTS
Lower extremity strengthening exercises revealed significant effects on the strength of lower extremity, balance outcomes and mobility. Balance exercises reduce the rate of injurious falls, improve static, dynamic and reactive balance, lower extremity strength as well as mobility. Multi-component exercise training reduces medically-attended injurious falls and fallers, incidence of falls, fall-related emergency department visits as well as improves mobility, balance, and lower extremity strength.
CONCLUSION
Physical exercises are effective in improving the components of balance, lower extremity strength, mobility, and reducing falls and fall-related injuries. Further research on fall prevention in low-income countries as well as for older adults in vulnerable context is needed.
Topics: Humans; Aged; Accidental Falls; Independent Living; Exercise Therapy; Activities of Daily Living; Emergency Service, Hospital
PubMed: 37601180
DOI: 10.3389/fpubh.2023.1209319 -
Journal of Clinical Medicine Sep 2023Previous systematic review and meta-analysis indicates that rehabilitation within a week of intensive care unit (ICU) admission benefits physical function in critically... (Review)
Review
Previous systematic review and meta-analysis indicates that rehabilitation within a week of intensive care unit (ICU) admission benefits physical function in critically ill patients. This updated systematic review and meta-analysis aim to clarify effects of initiating rehabilitation within 72 h of ICU admission on long-term physical, cognitive, and mental health. We systematically searched the MEDLINE, Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi for randomized controlled trials (RCTs) between April 2019 and November 2022 to add to the previous review. Two investigators independently selected and extracted data. Pooled effect estimates for muscle strength, cognitive function, mental health after discharge, and adverse events were calculated. Evidence certainty was assessed via Grading of Recommendations, Assessment, Development, and Evaluations. Eleven RCTs were included in the meta-analysis. Early rehabilitation may improve muscle strength (three trials; standard mean difference [SMD], 0.16; 95% confidence interval [CI], -0.04-0.36) and cognitive function (two trials; SMD, 0.54; 95% CI, -0.13-1.20). Contrastingly, early mobilization showed limited impact on mental health or adverse events. In summary, initiating rehabilitation for critically ill patients within 72 h may improve physical and cognitive function to prevent post-intensive care syndrome without increasing adverse events. The effect on mental function remains uncertain.
PubMed: 37762829
DOI: 10.3390/jcm12185888 -
Journal of Athletic Training Nov 2023To critically assess the literature focused on strength training of the intrinsic foot muscles (IFMs) and resulting improvements in foot function. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To critically assess the literature focused on strength training of the intrinsic foot muscles (IFMs) and resulting improvements in foot function.
DATA SOURCES
A search of electronic databases (PubMed, CINAHL, Scopus, and SPORTDiscus) was completed between January 2000 and March 2022.
STUDY SELECTION
Randomized control trials with an outcome of interest and at least 2 weeks of IFM exercise intervention were included. Outcomes of interest were broadly divided into 5 categories of foot posture (navicular drop and Foot Posture Index), namely: balance, strength, patient-reported outcomes, sensory function, and motor performance. The PEDro scale was used to assess the methodologic quality of the included studies with 2 independent reviewers rating each study. Studies with a PEDro score greater than 4/10 were included.
DATA EXTRACTION
Data extracted by 2 independent reviewers were design, participant characteristics, inclusion and exclusion criteria, type of intervention, outcomes, and primary results. We performed a random-effects meta-analysis to analyze the difference between intervention and control groups for each outcome when at least 2 studies were available. Standardized mean differences (SMDs) describe effect sizes with 95% CIs (SMD ranges). When the CI crossed zero, the effect was not significant.
DATA SYNTHESIS
Thirteen studies were included, and IFM exercise interventions were associated with decreasing navicular drop (SMD range = 0.37, 1.83) and Foot Posture Index (SMD range = 1.03, 1.69) and improving balance (SMD range = 0.18, 1.86), strength (SMD range = 0.06, 1.52), and patient-reported outcomes for disability (SMD range = 0.12, 1.00), with pooled effect sizes favoring the IFM intervention over the control. The IFM exercises were not superior (SMD range = -0.15, 0.66) for reducing pain. We could not perform a meta-analysis for sensory function and motor performance, as only 1 study was available for each outcome; however, these results supported the use of IFM strength training.
CONCLUSIONS
Strength training of the IFMs was helpful for patients in improving foot and ankle outcomes.
Topics: Humans; Exercise; Lower Extremity; Exercise Therapy; Muscle, Skeletal; Resistance Training
PubMed: 35724360
DOI: 10.4085/1062-6050-0162.22 -
Nutrients Aug 2023Sarcopenia is an age-related disease characterized by loss of muscle strength, mass and performance. Malnutrition contributes to sarcopenia pathogenesis. The aim of this... (Review)
Review
The Role of Nutrition in the Treatment of Sarcopenia in Old Patients: From Restoration of Mitochondrial Activity to Improvement of Muscle Performance, a Systematic Review.
Sarcopenia is an age-related disease characterized by loss of muscle strength, mass and performance. Malnutrition contributes to sarcopenia pathogenesis. The aim of this systematic review is to analyze existing evidence on the efficacy of nutritional supplementation on muscle and mitochondrial health among sarcopenic or malnourished older adults. We included randomized controlled trials (RCTs) assessing the effect of branched-chain amino acid (BCAA), vitamin D and/or omega-3 polyunsaturated fatty acid (PUFA) on muscle mass, strength and performance and/or on mitochondrial activity and redox state in older sarcopenic and/or malnourished adults. The literature search was on MEDLINE, Embase and Cochrane Central, restricted to articles published in the last 10 years (2012-2022). Twelve RCTs with a total of 1337 subjects were included. BCAA with vitamin D significantly ameliorates appendicular muscle mass (4 RCTs), hand grip strength (4 RCTs), gait speed (3 RCTs), short physical performance battery (3 RCTs) or chair stand test (3 RCTs) among six out of nine RCTs. BCAA alone (2 RCTs) or PUFA (1 RCT) were not effective in improving muscle health. Mitochondrial function was significantly improved by the administration of BCAA alone (1 RCT) or in association with vitamin D (1 RCT). In conclusion, BCAA in association with vitamin D may be useful in the treatment of sarcopenia and boost mitochondrial bioenergetic and redox activity. PROSPERO CRD42022332288.
Topics: Humans; Aged; Sarcopenia; Muscles; Nutritional Status; Malnutrition; Vitamin D; Vitamins; Amino Acids, Branched-Chain; Mitochondria
PubMed: 37686735
DOI: 10.3390/nu15173703 -
Journal of Strength and Conditioning... Jul 2024Ramos-Campo, DJ, Benito-Peinado, PJ, Caravaca, LA, Rojo-Tirado, MA, and Rubio-Arias, JÁ. Efficacy of split versus full-body resistance training on strength and muscle... (Meta-Analysis)
Meta-Analysis
Ramos-Campo, DJ, Benito-Peinado, PJ, Caravaca, LA, Rojo-Tirado, MA, and Rubio-Arias, JÁ. Efficacy of split versus full-body resistance training on strength and muscle growth: a systematic review with meta-analysis. J Strength Cond Res 38(7): 1330-1340, 2024-No previous study has systematically compared the effect of 2 resistance training routines commonly used to increase muscle mass and strength (i.e., split [Sp] and full-body [FB] routines). Our objective was to conduct a systematic review and meta-analysis following PRISMA guidelines to compare the effects on strength gains and muscle growth in healthy adults. 14 studies (392 subjects) that compared Sp and FB routines in terms of strength adaptations and muscle growth were included. Regarding the effects of the Sp or FB routine on both bench press and lower limbs strength, the magnitude of the change produced by both routines was similar (bench press: mean difference [MD] = 1.19; [-1.28, 3.65]; p = 0.34; k = 14; lower limb: MD = 2.47; [-2.11, 7.05]; p = 0.29; k = 14). Concerning the effect of the Sp vs. FB routine on muscle growth, similar effects were observed after both routines in the cross-sectional area of the elbow extensors (MD = 0.30; [-2.65, 3.24]; p = 0.84; k = 4), elbow flexors (MD = 0.17; [-2.54, 2.88]; p = 0.91; k = 5), vastus lateralis (MD = -0.08; [-1.82, 1.66]; p = 0.93; k = 5), or lean body mass (MD = -0.07; [-1.59, 1.44]; p = 0.92; k = 6). In conclusion, the present systematic review and meta-analysis provides solid evidence that the use of Sp or FB routines within a resistance training program does not significantly impact either strength gains or muscle hypertrophy when volume is equated. Consequently, individuals are free to confidently select a resistance training routine based on their personal preferences.
Topics: Humans; Resistance Training; Muscle Strength; Muscle, Skeletal; Lower Extremity; Muscle Development
PubMed: 38595233
DOI: 10.1519/JSC.0000000000004774 -
Sports Medicine (Auckland, N.Z.) Dec 2023Protein supplements are important to maintain optimum health and physical performance, particularly in athletes and active individuals to repair and rebuild their...
Effect of Soy Protein Supplementation on Muscle Adaptations, Metabolic and Antioxidant Status, Hormonal Response, and Exercise Performance of Active Individuals and Athletes: A Systematic Review of Randomised Controlled Trials.
BACKGROUND
Protein supplements are important to maintain optimum health and physical performance, particularly in athletes and active individuals to repair and rebuild their skeletal muscles and connective tissues. Soy protein (SP) has gained popularity in recent years as an alternative to animal proteins.
OBJECTIVES
This systematic review evaluates the evidence from randomised controlled clinical trials of the effects of SP supplementation in active individuals and athletes in terms of muscle adaptations, metabolic and antioxidant status, hormonal response and exercise performance. It also explores the differences in SP supplementation effects in comparison to whey protein.
METHODS
A systematic search was conducted in PubMed, Embase and Web of Science, as well as a manual search in Google Scholar and EBSCO, on 27 June 2023. Randomised controlled trials that evaluated the applications of SPs supplementation on sports and athletic-related outcomes that are linked with exercise performance, adaptations and biomarkers in athletes and physically active adolescents and young adults (14 to 39 years old) were included, otherwise, studies were excluded. The risk of bias was assessed according to Cochrane's revised risk of bias tool.
RESULTS
A total of 19 eligible original research articles were included that investigated the effect of SP supplementation on muscle adaptations (n = 9), metabolic and antioxidant status (n = 6), hormonal response (n = 6) and exercise performance (n = 6). Some studies investigated more than one effect. SP was found to provide identical increases in lean mass compared to whey in some studies. SP consumption promoted the reduction of exercise-induced metabolic/blood circulating biomarkers such as triglycerides, uric acid and lactate. Better antioxidant capacity against oxidative stress has been seen with respect to whey protein in long-term studies. Some studies reported testosterone and cortisol fluctuations related to SP; however, more research is required. All studies on SP and endurance performance suggested the potential beneficial effects of SP supplementation (10-53.3 g) on exercise performance by improving high-intensity and high-speed running performance, enhancing maximal cardiac output, delaying fatigue and improving isometric muscle strength, improving endurance in recreational cyclists, increasing running velocity and decreasing accumulated lactate levels; however, studies determining the efficacy of soy protein on VOmax provided conflicted results.
CONCLUSION
It is possible to recommend SP to athletes and active individuals in place of conventional protein supplements by assessing their dosage and effectiveness in relation to different types of training. SP may enhance lean mass compared with other protein sources, enhance the antioxidant status, and reduce oxidative stress. SP supplementation had an inconsistent effect on testosterone and cortisol levels. SP supplementation may be beneficial, especially after muscle damage, high-intensity/high-speed or repeated bouts of strenuous exercise.
Topics: Adolescent; Adult; Humans; Young Adult; Antioxidants; Athletes; Biomarkers; Dietary Supplements; Hydrocortisone; Lactates; Muscle, Skeletal; Soybean Proteins; Testosterone; Whey Proteins; Randomized Controlled Trials as Topic
PubMed: 37603200
DOI: 10.1007/s40279-023-01899-w -
Sports Medicine (Auckland, N.Z.) Jan 2024Resistance exercise training is widely used by general and athletic populations to increase skeletal muscle hypertrophy, power and strength. Endogenous sex hormones... (Meta-Analysis)
Meta-Analysis
The Effect of Hormonal Contraceptive Use on Skeletal Muscle Hypertrophy, Power and Strength Adaptations to Resistance Exercise Training: A Systematic Review and Multilevel Meta-analysis.
BACKGROUND
Resistance exercise training is widely used by general and athletic populations to increase skeletal muscle hypertrophy, power and strength. Endogenous sex hormones influence various bodily functions, including possibly exercise performance, and may influence adaptive changes in response to exercise training. Hormonal contraceptive (HC) use modulates the profile of endogenous sex hormones, and therefore, there is increasing interest in the impact, if any, of HC use on adaptive responses to resistance exercise training.
OBJECTIVE
Our aim is to provide a quantitative synthesis of the effect of HC use on skeletal muscle hypertrophy, power and strength adaptations in response to resistance exercise training.
METHODS
A systematic review with meta-analysis was conducted on experimental studies which directly compared skeletal muscle hypertrophy, power and strength adaptations following resistance exercise training in hormonal contraceptive users and non-users conducted before July 2023. The search using the online databases PUBMED, SPORTDiscus, Web of Science, Embase and other supplementary search strategies yielded 4669 articles, with 8 articles (54 effects and 325 participants) meeting the inclusion criteria. The methodological quality of the included studies was assessed using the "Tool for the assessment of study quality and reporting in exercise".
RESULTS
All included studies investigated the influence of oral contraceptive pills (OCP), with no study including participants using other forms of HC. The articles were analysed using a meta-analytic multilevel maximum likelihood estimator model. The results indicate that OCP use does not have a significant effect on hypertrophy [0.01, 95% confidence interval (CI) [- 0.11, 0.13], t = 0.14, p = 0.90), power (- 0.04, 95% CI [- 0.93, 0.84], t = - 0.29, p = 0.80) or strength (0.10, 95% CI [- 0.08, 0.28], t = 1.48, p = 0.20).
DISCUSSION
Based on the present analysis, there is no evidence-based rationale to advocate for or against the use of OCPs in females partaking in resistance exercise training to increase hypertrophy, power and/or strength. Rather, an individualised approach considering an individual's response to OCPs, their reasons for use and menstrual cycle history may be more appropriate.
REGISTRATION
The review protocol was registered on PROSPERO (ID number and hyperlink: CRD42022365677).
Topics: Female; Humans; Contraceptives, Oral; Gonadal Steroid Hormones; Hypertrophy; Muscle Strength; Muscle, Skeletal; Resistance Training
PubMed: 37755666
DOI: 10.1007/s40279-023-01911-3 -
Critical Care Medicine Oct 2023Neuromuscular electrical stimulation (NMES) is used in the rehabilitation of patients with critical illness. However, it is unclear whether NMES prevents ICU-acquired... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Neuromuscular electrical stimulation (NMES) is used in the rehabilitation of patients with critical illness. However, it is unclear whether NMES prevents ICU-acquired weakness (ICU-AW). For this purpose, we conducted an updated systematic review and meta-analysis.
DATA SOURCES
We searched the MEDLINE, Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi databases from April 2019 to November 2022 to identify new randomized controlled trials to the previous meta-analysis.
STUDY SELECTION
We systematically searched the literature for all randomized controlled trials on the effect of NMES in patients with critical illness.
DATA EXTRACTION
Two authors independently selected the studies and extracted data. They calculated the pooled effect estimates associated with the occurrence of ICU-AW and adverse events as primary outcomes and muscle mass change, muscle strength, length of ICU stay, mortality, and quality of life as secondary outcomes. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach.
DATA SYNTHESIS
Overall, eight studies were added to the previous 10 studies. Evidence suggests that the use of NMES reduces the occurrence of ICU-AW (six trials; risk ratio [RR], 0.48; 95% CI, 0.32-0.72); however, NMES may have little to no effect on pricking sensation in patients (eight trials; RR, 6.87; 95% CI, 0.84-56.50). NMES is likely to reduce the change in muscle mass (four trials; mean difference, -10.01; 95% CI, -15.54 to -4.48) and may increase muscle strength (six trials; standardized mean difference, 0.43; 95% CI, 0.19-0.68). Further, NMES may result in little to no difference in the length of ICU stay, and the evidence is uncertain about the effect on mortality and quality of life.
CONCLUSIONS
This updated meta-analysis revealed that the use of NMES may result in a lower occurrence of ICU-AW in patients with critical illness, but its use may have little to no effect on pricking sensation in patients.
Topics: Humans; Quality of Life; Critical Illness; Randomized Controlled Trials as Topic; Electric Stimulation Therapy; Electric Stimulation
PubMed: 37232695
DOI: 10.1097/CCM.0000000000005941 -
Sports Medicine (Auckland, N.Z.) Apr 2024Running economy is defined as the energy demand at submaximal running speed, a key determinant of overall running performance. Strength training can improve running... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Running economy is defined as the energy demand at submaximal running speed, a key determinant of overall running performance. Strength training can improve running economy, although the magnitude of its effect may depend on factors such as the strength training method and the speed at which running economy is assessed.
AIM
To compare the effect of different strength training methods (e.g., high loads, plyometric, combined methods) on the running economy in middle- and long-distance runners, over different running speeds, through a systematic review with meta-analysis.
METHODS
A systematic search was conducted across several electronic databases including Web of Science, PubMed, SPORTDiscus, and SCOPUS. Using different keywords and Boolean operators for the search, all articles indexed up to November 2022 were considered for inclusion. In addition, the PICOS criteria were applied: Population: middle- and long-distance runners, without restriction on sex or training/competitive level; Intervention: application of a strength training method for ≥ 3 weeks (i.e., high loads (≥ 80% of one repetition maximum); submaximal loads [40-79% of one repetition maximum); plyometric; isometric; combined methods (i.e., two or more methods); Comparator: control group that performed endurance running training but did not receive strength training or received it with low loads (< 40% of one repetition maximum); Outcome: running economy, measured before and after a strength training intervention programme; Study design: randomized and non-randomized controlled studies. Certainty of evidence was assessed with the GRADE approach. A three-level random-effects meta-analysis and moderator analysis were performed using R software (version 4.2.1).
RESULTS
The certainty of the evidence was found to be moderate for high load training, submaximal load training, plyometric training and isometric training methods and low for combined methods. The studies included 195 moderately trained, 272 well trained, and 185 highly trained athletes. The strength training programmes were between 6 and 24 weeks' duration, with one to four sessions executed per week. The high load and combined methods induced small (ES = - 0.266, p = 0.039) and moderate (ES = - 0.426, p = 0.018) improvements in running economy at speeds from 8.64 to 17.85 km/h and 10.00 to 14.45 km/h, respectively. Plyometric training improved running economy at speeds ≤ 12.00 km/h (small effect, ES = - 0.307, p = 0.028, β = 0.470, p = 0.017). Compared to control groups, no improvement in running economy (assessed speed: 10.00 to 15.28 and 9.75 to 16.00 km/h, respectively) was noted after either submaximal or isometric strength training (all, p > 0.131). The moderator analyses showed that running speed (β = - 0.117, p = 0.027) and VOmax (β = - 0.040, p = 0.020) modulated the effect of high load strength training on running economy (i.e., greater improvements at higher speeds and higher VOmax).
CONCLUSIONS
Compared to a control condition, strength training with high loads, plyometric training, and a combination of strength training methods may improve running economy in middle- and long-distance runners. Other methods such as submaximal load training and isometric strength training seem less effective to improve running economy in this population. Of note, the data derived from this systematic review suggest that although both high load training and plyometric training may improve running economy, plyometric training might be effective at lower speeds (i.e., ≤ 12.00 km/h) and high load strength training might be particularly effective in improving running economy (i) in athletes with a high VOmax, and (ii) at high running speeds.
PROTOCOL REGISTRATION
The original protocol was registered ( https://osf.io/gyeku ) at the Open Science Framework.
Topics: Humans; Resistance Training; Running; Athletic Performance; Plyometric Exercise; Physical Endurance; Muscle Strength
PubMed: 38165636
DOI: 10.1007/s40279-023-01978-y