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European Journal of Surgical Oncology :... Oct 2023This systematic review aimed to appraise the current available evidence regarding the effects of exercise prehabilitation and rehabilitation on perceived health-related... (Review)
Review
Effects of exercise prehabilitation and/or rehabilitation on health-related quality of life and fatigue in patients with non-small cell lung cancer undergoing surgery: A systematic review.
BACKGROUND
This systematic review aimed to appraise the current available evidence regarding the effects of exercise prehabilitation and rehabilitation on perceived health-related quality of life (HRQoL) and fatigue in patients undergoing surgery for non-small cell lung cancer (NSCLC).
METHODS
Studies were selected according to Cochrane guidelines and assessed for methodological quality and therapeutic quality (the international CONsensus on Therapeutic Exercise aNd Training (i-CONTENT)). Eligible studies included patients with NSCLC performing exercise prehabilitation and/or rehabilitation and postoperative HRQoL and fatigue up to 90-days postoperatively.
RESULTS
Thirteen studies were included. Exercise prehabilitation and rehabilitation significantly improved postoperative HRQoL in almost half of the studies (47%), although none of the studies demonstrated a decrease in fatigue. Methodological quality and therapeutic quality were poor in respectively 62% and 69% of the studies.
CONCLUSION
There was an inconsistent effect of exercise prehabilitation and exercise rehabilitation on improving HRQoL in patients with NSCLC undergoing surgery, with no effect on fatigue. Due to the low methodological and therapeutic quality of included studies, it was not possible to identify the most effective training program content to improve HRQoL and reduce fatigue. It is recommended to investigate the impact of a high therapeutic qualified exercise prehabilitation and exercise rehabilitation on HRQoL and fatigue in larger studies.
Topics: Humans; Carcinoma, Non-Small-Cell Lung; Quality of Life; Preoperative Exercise; Lung Neoplasms; Fatigue
PubMed: 37301638
DOI: 10.1016/j.ejso.2023.04.008 -
Physical Medicine and Rehabilitation... May 2024Stroke remains a top contributor to long-term disability in the United States and substantially limits a person's physical activity. Decreased cardiovascular capacity is... (Review)
Review
Stroke remains a top contributor to long-term disability in the United States and substantially limits a person's physical activity. Decreased cardiovascular capacity is a major contributing factor to activity limitations and is a significant health concern. Addressing the cardiovascular capacity of stroke survivors as part of poststroke management results in significant improvements in their endurance, functional recovery, and medical outcomes such as all-cause rehospitalization and mortality. Incorporation of a structured approach similar to the cardiac rehabilitation program, including aerobic exercise and risk factor education, can lead to improved cardiovascular function, health benefits, and quality of life in stroke survivors.
Topics: Humans; Cardiac Rehabilitation; Stroke Rehabilitation; Quality of Life; Stroke; Exercise; Exercise Therapy
PubMed: 38514223
DOI: 10.1016/j.pmr.2023.06.007 -
Arquivos Brasileiros de Cardiologia 2023Although the Talk Test (TT) is a reliable and low-cost test, its use for aerobic exercise prescription is still limited.
BACKGROUND
Although the Talk Test (TT) is a reliable and low-cost test, its use for aerobic exercise prescription is still limited.
OBJECTIVE
To analyze the heart rate (HR) in the stages of the TT and at the peak of the 6-minute walk test (6MWT) as a parameter to prescribe aerobic exercise compared with HR at the first and second ventilatory thresholds (VT1 and VT2) of cardiopulmonary exercise test (CPET).
METHODS
Individuals with cardiovascular disease attended three assessment days: 1) anamnesis and CPET; 2) 6MWT; and 3) TT. One-way repeated measures ANOVA or Friedman's test were used to compare HR at VT1 and VT2 with HR at TT stages: last positive (TT+), first equivocal (TT±), and negative (TT-), and at the peak of the 6MWT. Pearson's or Spearman's test assessed correlations between HR at VTs, TT stages, and 6MWT. Statistical significance was set at 5%.
RESULTS
The study included 22 cardiac patients (13 men, 61 ± 8 years). HR at VT1 was similar to HR at TT+ (p = 0.987) and TT± (p = 0.154), and moderately correlated with TT+ (r = 0.479, p = 0.024). HR at VT2 was similar to TT- (p = 0.383), with a strong correlation (r = 0.757, p < 0.001). HR at the peak of the 6MWT was significantly different from HR at TT+, TT±, and VT1 (p = 0.001, p = 0.005, and p < 0.001, respectively) but similar to TT- (p = 0.68).
CONCLUSIONS
HR at TT+ and TT- reflect HR at VT1 and VT2, respectively, differently from 6MWT, which was similar only to VT2. TT may be an objective test to assist aerobic exercise prescription in cardiac rehabilitation.
Topics: Male; Humans; Walk Test; Cardiac Rehabilitation; Heart Rate; Exercise; Exercise Therapy; Exercise Test; Oxygen Consumption
PubMed: 37820173
DOI: 10.36660/abc.20230086 -
Physiotherapy Research International :... Oct 2023There has been a growing interest in demonstrating the health benefits of exercise among people with epilepsy in recent years. Although exercise is recommended for...
BACKGROUND
There has been a growing interest in demonstrating the health benefits of exercise among people with epilepsy in recent years. Although exercise is recommended for people with epilepsy, there is uncertainty concerning the effects of yoga and aerobic exercise on multiple health outcomes in epilepsy.
PURPOSE
The aim of this trial was to examine the effects of yoga and aerobic exercise training on physical activity, seizure frequency, health-related physical fitness, mental, emotional, and psychological health status, and quality of life.
METHODS
This study was designed as a single-center, 8-week, randomized controlled trial in a three-arm parallel group. Participants will be randomly allocated to yoga, aerobic exercise, or wait-list control groups. The primary outcome is physical activity/sedentary behavior measured by the ActiGraph GT9X accelerometer and seizure frequency. Secondary outcomes include functional capacity, lower extremity strength, balance, body composition, waist and hip circumference, cognition, depression, anxiety, perceived stress, fatigue, sleep quality, and quality of life. The outcomes will be evaluated at baseline and at 8 weeks of follow-up.
IMPLICATIONS OF PHYSIOTHERAPY PRACTICE
This study is the first randomized controlled trial comparing the effects of yoga and aerobic exercise among people with epilepsy. The findings of this study could provide important information about the effects of yoga and aerobic exercise training on a variety of health conditions in people with epilepsy.
TRIAL REGISTRATION
ClinicalTrials.gov identifier: NCT05066880, registered October 4, 2021.
Topics: Humans; Yoga; Quality of Life; Exercise; Seizures; Epilepsy; Randomized Controlled Trials as Topic
PubMed: 37151132
DOI: 10.1002/pri.2013 -
Developmental Medicine and Child... Oct 2023To investigate the efficacy of aerobic exercise on the functioning (participation, activities, and body functions and structures) and quality of life (QoL) of children... (Meta-Analysis)
Meta-Analysis Review
AIM
To investigate the efficacy of aerobic exercise on the functioning (participation, activities, and body functions and structures) and quality of life (QoL) of children and adolescents with cerebral palsy (CP).
METHOD
A systematic review with meta-analysis was performed. A comprehensive search of articles was performed using the electronic databases Embase, PubMed, PEDro, and CINAHL. Methodological quality and certainty of evidence were evaluated with the PEDro and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) scales respectively. The effects of aerobic exercise on functioning were assessed using meta-analytic techniques. However, given the broad nature of outcomes related to functioning and QoL, different instruments can be used to measure them; this made it impossible to synthesize results in a meta-analysis for some of the outcomes.
RESULTS
Fifteen randomized controlled trials with 414 participants with CP were included. Analysis of the methodological quality of the studies revealed a low risk of bias. The effect of aerobic exercise compared to usual care or other interventions was significant for aerobic capacity (standardized mean difference [SMD] = 0.81; 95% confidence interval [CI] = 0.16-1.47; p < 0.002; I = 68%), gross motor function (SMD = 0.70; 95% = CI 0.21-1.19; p = 0.005; I = 49%), mobility (SMD = 0.53; 95% CI = 0.05-1.05; p = 0.03; I = 27%), balance, and participation (SMD = 0.74; 95% CI = 0.10-1.39; p = 0.02; I = 0%). Aerobic exercise was not effective for muscle strength, spasticity, gait parameters, and QoL (p > 0.05). The certainty of evidence for most comparisons was moderate to low.
INTERPRETATION
This review provides the most up-to-date evidence on the efficacy of aerobic exercise on the functioning and QoL of children and adolescents with CP.
WHAT THIS PAPER ADDS
Aerobic exercise improves gross motor function but not gait parameters in cerebral palsy (CP). It improves participation but not quality of life in children and adolescents with CP. It is more effective than usual care or other interventions in improving mobility, aerobic capacity, and balance in CP. It is no more effective than usual care or other interventions in improving muscle strength and spasticity.
Topics: Humans; Child; Adolescent; Quality of Life; Cerebral Palsy; Exercise; Muscle Strength; Muscle Spasticity
PubMed: 36895173
DOI: 10.1111/dmcn.15570 -
Scandinavian Journal of Medicine &... Oct 2023It is assumed that people with multiple sclerosis (MS) who participate in programs of physical exercise improve their physical fitness. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
It is assumed that people with multiple sclerosis (MS) who participate in programs of physical exercise improve their physical fitness.
OBJECTIVE
The aim of this network meta-analysis (NMA) was to analyze the effect of different types of exercise on muscular fitness and cardiorespiratory fitness (CRF) among people with MS and to determine the best type of exercise according to disease severity.
METHODS
MEDLINE, the Physiotherapy Evidence Database, the Cochrane Library, SPORTDiscus, Scopus, and Web of Science were searched from inception to April 2022 to identify randomized controlled trials (RCTs) concerning the effect of physical exercise on fitness in people with MS. We ranked the types of physical exercise by calculating the surface under the cumulative ranking (SUCRA).
RESULTS
We included 72 RCTs involving 2543 MS patients in this NMA. A ranking of five types of physical exercise (aerobic, resistance, combined [aerobic and resistance], sensorimotor training, and mind-body exercises) was achieved. Combined and resistance training had the highest effect sizes (0.94, 95% CI 0.47, 1.41, and 0.93, 95% CI 0.57, 1.29, respectively) and the highest SUCRA (86.2% and 87.0%, respectively) for muscular fitness. The highest effect size (0.66, 95% CI 0.34, 0.99) and SUCRA (86.9%) for CRF was for aerobic exercise.
CONCLUSIONS
Combined and resistance training seem to be the most effective exercises to improve muscular fitness and aerobic exercise for CRF in people with MS.
Topics: Humans; Network Meta-Analysis; Exercise; Exercise Therapy; Physical Fitness; Multiple Sclerosis
PubMed: 37226414
DOI: 10.1111/sms.14407 -
Hypertension Research : Official... Feb 2024We aimed to evaluate the dose-dependent effects of aerobic exercise on systolic (SBP) and diastolic blood pressure (DBP) and haemodynamic factors in adults with... (Meta-Analysis)
Meta-Analysis Review
We aimed to evaluate the dose-dependent effects of aerobic exercise on systolic (SBP) and diastolic blood pressure (DBP) and haemodynamic factors in adults with hypertension. PubMed, Scopus, and Web of Science were searched to April 2022 for randomized trials of aerobic exercise in adults with hypertension. We conducted a random-effects meta-analysis to estimate mean differences (MDs) and 95%CIs for each 30 min/week increase in aerobic exercise. The certainty of evidence was rated using the GRADE approach. The analysis of 34 trials with 1787 participants indicated that each 30 min/week aerobic exercise reduced SBP by 1.78 mmHg (95%CI: -2.22 to -1.33; n = 34, GRADE=low), DBP by 1.23 mmHg (95%CI: -1.53 to -0.93; n = 34, GRADE=moderate), resting heart rate (MD = -1.08 bpm, 95%CI: -1.46 to -0.71; n = 23, GRADE=low), and mean arterial pressure (MD = -1.37 mmHg, 95%CI: -1.80 to -0.93; n = 9, GRADE = low). A nonlinear dose-dependent decrement was seen on SBP and DBP, with the greatest decrement at 150 min/week (MD = -7.23 mmHg, 95%CI: -9.08 to -5.39 for SBP and -5.58 mmHg, 95%CI: -6.90 to -4.27 for DBP). Aerobic exercise can lead to a large and clinically important reduction in blood pressure in a dose-dependent manner, with the greatest reduction at 150 min/week. The dose-dependent effects of aerobic exercise on systolic and diastolic blood pressure and haemodynamic factors in adults with hypertension.
Topics: Adult; Humans; Blood Pressure; Randomized Controlled Trials as Topic; Hypertension; Exercise
PubMed: 37872373
DOI: 10.1038/s41440-023-01467-9 -
Clinical Breast Cancer Aug 2023Current anticancer treatments for breast cancer (BC) may cause cardiotoxicity. This study aimed to investigate the effectiveness of aerobic exercise in mitigating... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Current anticancer treatments for breast cancer (BC) may cause cardiotoxicity. This study aimed to investigate the effectiveness of aerobic exercise in mitigating cardiotoxicity caused by BC therapy.
MATERIALS AND METHODS
PubMed, Embase, Cochrane Library, Web of Science, and the Physiotherapy Evidence Database were searched until February 7, 2023. Clinical trials investigating the effectiveness of exercise training, including aerobic exercise, in BC patients receiving treatments that could cause cardiotoxicity were eligible. Outcome measures included cardiorespiratory fitness (CRF) (peak oxygen consumption, VOpeak), left ventricular ejection fraction, and peak oxygen pulse. Intergroup differences were determined by standard mean differences (SMD) and 95% confidence intervals (CIs). Trial sequential analysis (TSA) was utilized to ensure whether the current evidence was conclusive.
RESULTS
Sixteen trials involving 876 participants were included. Aerobic exercise significantly improved CRF measured by VOpeak in mL/kg/min (SMD 1.79, 95% CI 0.99-2.59) when compared to usual care. This result was confirmed through TSA. Subgroup analyses revealed that aerobic exercise given during BC therapy significantly improved VOpeak (SMD 1.84, 95% CI 0.74-2.94). Exercise prescriptions at a frequency of up to 3 times per week, an intensity of moderate to vigorous, and a >30-minute session length also improved VOpeak.
CONCLUSION
Aerobic exercise is effective in improving CRF when compared to usual care. Exercise performed up to 3 times per week, at a moderate-to-vigorous intensity, and having a session length >30 minutes is considered effective. Future high-quality research is needed to determine the effectiveness of exercise intervention in preventing cardiotoxicity caused by BC therapy.
Topics: Humans; Female; Breast Neoplasms; Cardiotoxicity; Feasibility Studies; Stroke Volume; Ventricular Function, Left; Exercise
PubMed: 37286435
DOI: 10.1016/j.clbc.2023.04.010 -
The Journal of Sports Medicine and... Jul 2023Gestational diabetes mellitus (GDM) and gestational hypertension (GH) are the most common pregnancy complications, predisposing to adverse pregnancy outcomes and being a... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Gestational diabetes mellitus (GDM) and gestational hypertension (GH) are the most common pregnancy complications, predisposing to adverse pregnancy outcomes and being a major cause of maternal morbidity and mortality, often associated with significantly higher health risks for the mother and her offspring. The aim of this study was to systematically evaluate the effects of aerobic exercise performed during pregnancy on GDM, GH, and pregnancy outcomes.
EVIDENCE ACQUISITION
The databases PubMed, EMbase, Web of Science, China Knowledge Network, Wan fang, and Wipu were searched for clinical randomized controlled trials of exercise interventions on GDM, GH, and pregnancy outcomes, and data were analyzed and systematically evaluated using RevMan 5.3 according to the inclusion and exclusion criteria.
EVIDENCE SYNTHESIS
Meta-analysis showed that, in terms of pregnancy complications, aerobic exercise intervention reduced the incidence of maternal GDM better than the control group, with a statistically significant difference (OR=0.39, 95% CI: 0.30, 0.50, P<0.00001); aerobic exercise intervention reduced the incidence of maternal GH better than the control group, with a statistically significant difference (OR=0.38, 95% CI: 0.27, 0.54, P<0.00001).
CONCLUSIONS
The results in pregnancy suggest that aerobic exercise is advantageous for pregnant women, as it reduces the incidence of GDM and GH and improves the incidence of adverse pregnancy outcomes to a certain extent.
Topics: Humans; Pregnancy; Female; Diabetes, Gestational; Exercise; Pregnancy Complications; Hypertension; China
PubMed: 37067246
DOI: 10.23736/S0022-4707.23.14578-6 -
Experimental Physiology Dec 2023The human gastrointestinal microbiota and its unique metabolites regulate a diverse array of physiological processes with substantial implications for human health and... (Review)
Review
The human gastrointestinal microbiota and its unique metabolites regulate a diverse array of physiological processes with substantial implications for human health and performance. Chronic exercise training positively modulates the gut microbiota and its metabolic output. The benefits of chronic exercise for the gut microbiota may be influenced by acute changes in microbial community structure and function that follow a single exercise bout (i.e., acute exercise). Thus, an improved understanding of changes in the gut microbiota that occur with acute exercise could aid in the development of evidence-based exercise training strategies to target the gut microbiota more effectively. In this review, we provide a comprehensive summary of the existing literature on the acute and very short-term (<3 weeks) exercise responses of the gut microbiota and faecal metabolites in humans. We conclude by highlighting gaps in the literature and providing recommendations for future research in this area. NEW FINDINGS: What is the topic of this review? The chronic benefits of exercise for the gut microbiota are likely influenced by acute changes in microbial community structure and function that follow a single exercise bout. This review provides a summary of the existing literature on acute exercise responses of the gut microbiota and its metabolic output in humans. What advances does it highlight? Acute aerobic exercise appears to have limited effects on diversity of the gut microbiota, variable effects on specific microbial taxa, and numerous effects on the metabolic activity of gut microbes with possible implications for host health and performance.
Topics: Humans; Gastrointestinal Microbiome; Exercise; Feces
PubMed: 37702557
DOI: 10.1113/EP091446