-
European Journal of Physical and... Oct 2019Fibromyalgia is a long-term condition that is associated with widespread pain and is recognized as one of the major common causes of disability. The standard clinical... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Fibromyalgia is a long-term condition that is associated with widespread pain and is recognized as one of the major common causes of disability. The standard clinical guidance for fibromyalgia includes both pharmacological and non-pharmacological interventions. In the latter, different interventions are implemented such as aerobic exercises, flexibility exercises, strength training, stretching and body awareness (BA) therapies. The aims of this review were to provide a summary of movement and BA therapies in patients with fibromyalgia and to compare the different therapies in relation to outcomes.
EVIDENCE ACQUISITION
The search strategy was undertaken using the following databases from inception to October 2018: PubMed, Cinahl, PEDro, PsychoInfo and The Cochrane Library. Articles were eligible if they were randomized controlled trials (RCTs) comparing movement and BA therapies with another intervention.
EVIDENCE SYNTHESIS
Two authors independently extracted data and assessed trial quality; 418 studies were found, twenty-two of which met the inclusion criteria. Pain symptom was improved with movement and BA therapies such as, affective self-awareness, t'ai chi, yoga, belly dance, strengthening program and Resseguier method. Forest plot analysis in short term confirms positive trend in favor of BA; however, a great heterogeneity was found between trials.
CONCLUSIONS
This systematic review and meta-analysis shows positive results in favor of movement and BA therapies as adjunct treatment to usual care in patients who suffer from fibromyalgia. Further work in identifying the mechanism of action by which BA therapies benefit outcomes should be undertaken.
Topics: Awareness; Disability Evaluation; Exercise; Exercise Therapy; Fibromyalgia; Humans; Muscle Stretching Exercises; Proprioception; Resistance Training; Surveys and Questionnaires
PubMed: 31106558
DOI: 10.23736/S1973-9087.19.05291-2 -
JAMA Network Open May 2022Strength training exercise is recommended for improving physical function in older adults. However, whether strength training (lifting and lowering weights under... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Strength training exercise is recommended for improving physical function in older adults. However, whether strength training (lifting and lowering weights under control) and power training (PT) (lifting weights fast and lowering under control) are associated with improved physical function in older adults is not clear.
OBJECTIVE
To evaluate whether PT vs traditional strength training is associated with physical function improvement in older adults.
DATA SOURCES
Systematic searches of MEDLINE, Embase, Cochrane Central, CINAHL, PsycInfo, PEDro, and SPORTDiscus were conducted from database inception to October 20, 2021.
STUDY SELECTION
Randomized clinical trials (RCTs) that compared strength training with instructions to move the weight as fast as possible in the lifting phase with traditional strength training in healthy, community-living older adults (age ≥60 years).
DATA EXTRACTION AND SYNTHESIS
Two authors independently selected trials, extracted data, assessed the risk of bias using the Cochrane risk-of-bias tool 2, and assessed the certainty of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation approach. Summary effect size measures were calculated using a multilevel random-effects model with cluster robust variance estimation and are reported as standardized mean differences (SMDs). Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline.
MAIN OUTCOMES AND MEASURES
Primary outcomes included physical function and self-reported physical function. Secondary outcomes included power, strength, muscle mass, walk speed, balance, and adverse effects.
RESULTS
A total of 20 RCTs enrolling 566 community-living older adults (mean [SD] age, 70.1 [4.8] years; 368 [65%] women) were included. For the primary outcomes, PT was associated with an improvement in physical function with low-certainty evidence in 13 RCTs (n = 383) (SMD, 0.30; 95% CI, 0.05-0.54) and self-reported function with low-certainty evidence in 3 RCTs (n = 85) (SMD, 0.38; 95% CI, -0.62 to 1.37). The evidence was downgraded by 2 levels for high risk of bias and imprecision for physical function and very serious imprecision for self-reported physical function.
CONCLUSIONS AND RELEVANCE
In this systematic review and meta-analysis, PT was associated with a modest improvement in physical function compared with traditional strength training in healthy, community-living older adults. However, high-quality, larger RCTs are required to draw more definitive conclusions.
Topics: Aged; Bias; Exercise; Female; Health Status; Humans; Male; Middle Aged; Resistance Training; Walking
PubMed: 35544136
DOI: 10.1001/jamanetworkopen.2022.11623 -
Journal of the American Medical... May 2021Virtual reality (VR) exergames are an innovative approach to promote older adults' mental health. VR exergames are active video games controlled by bodily movements in a... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Virtual reality (VR) exergames are an innovative approach to promote older adults' mental health. VR exergames are active video games controlled by bodily movements in a safe surrounding with advantages of physical activity engagement and interactions. The purpose of this study was to explore the effectiveness of VR exergames in improving older adults' cognition and ameliorating depressive outcome by a systematic review, meta-analysis, subgroup analysis, and meta-regression.
DESIGN
This is a systematic review and meta-analysis.
SETTING AND PARTICIPANTS
Adults over 60 years old.
METHODS
Four electronic databases, including PubMed, Embase, Medline, and Cochrane, were searched for related articles. After evaluation, 18 randomized control trials were selected for qualitative and quantitative synthesis.
RESULTS
The meta-analytical results found moderate effects of VR exergames on overall cognitive function and memory, and a large effect on depressive outcomes in older adults. Commercial VR games had more-significant and larger effects on depressive outcomes than exergames with VR devices. The meta-regression results revealed that the total intervention duration had a significant effect on depressive outcomes. A higher intervention duration had greater effects on depressive outcomes.
CONCLUSIONS AND IMPLICATIONS
This meta-analytical study suggests that VR exergames can provide potential positive influences on cognition, memory, and depression in older adult populations. VR exergames could be an interesting strategy for active aging and a good mental health status.
Topics: Aged; Cognition; Depression; Exercise; Humans; Middle Aged; Video Games; Virtual Reality
PubMed: 33812843
DOI: 10.1016/j.jamda.2021.03.009 -
Journal of Sport and Health Science Jul 2022The biomechanics of the trunk and lower limbs during walking and running gait are frequently assessed in individuals with low back pain (LBP). Despite substantial... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The biomechanics of the trunk and lower limbs during walking and running gait are frequently assessed in individuals with low back pain (LBP). Despite substantial research, it is still unclear whether consistent and generalizable changes in walking or running gait occur in association with LBP. The purpose of this systematic review was to identify whether there are differences in biomechanics during walking and running gait in individuals with acute and persistent LBP compared with back-healthy controls.
METHODS
A search was conducted in PubMed, CINAHL, SPORTDiscus, and PsycINFO in June 2019 and was repeated in December 2020. Studies were included if they reported biomechanical characteristics of individuals with and without LBP during steady-state or perturbed walking and running. Biomechanical data included spatiotemporal, kinematic, kinetic, and electromyography variables. The reporting quality and potential for bias of each study was assessed. Data were pooled where possible to compare the standardized mean differences (SMD) between back pain and back-healthy control groups.
RESULTS
Ninety-seven studies were included and reviewed. Two studies investigated acute pain and the rest investigated persistent pain. Nine studies investigated running gait. Of the studies, 20% had high reporting quality/low risk of bias. In comparison with back-healthy controls, individuals with persistent LBP walked slower (SMD = -0.59, 95% confidence interval (95%CI): -0.77 to -0.42)) and with shorter stride length (SMD = -0.38, 95%CI: -0.60 to -0.16). There were no differences in the amplitude of motion in the thoracic or lumbar spine, pelvis, or hips in individuals with LBP. During walking, coordination of motion between the thorax and the lumbar spine/pelvis was significantly more in-phase in the persistent LBP groups (SMD = -0.60, 95%CI: -0.90 to -0.30), and individuals with persistent LBP exhibited greater amplitude of activation in the paraspinal muscles (SMD = 0.52, 95%CI: 0.23-0.80). There were no consistent differences in running biomechanics between groups.
CONCLUSION
There is moderate-to-strong evidence that individuals with persistent LBP demonstrate differences in walking gait compared to back-healthy controls.
Topics: Biomechanical Phenomena; Gait; Humans; Low Back Pain; Running; Walking
PubMed: 35151908
DOI: 10.1016/j.jshs.2022.02.001 -
Journal of Neuroengineering and... Nov 2021Physical training (PT, e.g., Tai Chi and strength training) has been demonstrated to improve balance control and prevent falls. Recently, exergame intervention (EI) has... (Meta-Analysis)
Meta-Analysis Review
Comparison between the effects of exergame intervention and traditional physical training on improving balance and fall prevention in healthy older adults: a systematic review and meta-analysis.
OBJECTIVE
Physical training (PT, e.g., Tai Chi and strength training) has been demonstrated to improve balance control and prevent falls. Recently, exergame intervention (EI) has emerged to prevent falls by enhancing both physical and cognitive functions in older adults. Therefore, we aim to quantitatively assess and compare the effects of PT and EI on the performance of balance control and fall prevention in healthy older adults via meta-analysis.
METHODS
A search strategy based on the PICOS principle was used to find the publication in the databases of PubMed, EMBASE, Web of Science, Cochrane Library, and MEDLINE. The quality and risk of bias in the studies were independently assessed by two researchers.
RESULTS
Twenty studies consisting of 845 participants were included. Results suggested that as compared to PT, EI induced greater improvement in postural control (sway path length, SMD = - 0.66, 95% CI - 0.91 to - 0.41, P < 0.001, I = 0%; sway speed, SMD = - 0.49, 95% CI - 0.71 to - 0.27, P < 0.001, I = 42%) and dynamic balance (SMD = - 0.19, 95% CI - 0.35 to - 0.03, P = 0.02, I = 0%) in healthy older adults. The EI with 90-119 min/week for more than 8-week significantly reduced falls. Subgroup analyses revealed that exergames, which were designed by the two principles of repeatedly performing diversified tasks and gradually increase the difficulty of the task, induced significant effects in improving balance control and falls prevention respectively (P = 0.03, P = 0.009). In addition, intervention that combines EI and PT induced significant improvement in postural control (P = 0.003).
CONCLUSION
The exergame intervention, especially the combination of EI and PT, is a promising strategy to improve balance control and reduce falls in healthy older adults. Future studies with rigorous design, larger sample size, and follow-up assessments are needed to further assess the effectiveness of diverse exergame interventions in fall prevention and to quantify the "dose-effect" relationship, as well as the carry-over effect of such intervention, which will ultimately help optimize the rehabilitative strategies to improve balance control and prevent falls.
Topics: Aged; Exercise; Exergaming; Humans; Postural Balance; Resistance Training
PubMed: 34819097
DOI: 10.1186/s12984-021-00917-0 -
International Journal of Environmental... Oct 2022Constraint-induced movement therapy (CIMT) has been delivered in the stroke population to improve lower-extremity functions. However, its efficacy on prime components of... (Meta-Analysis)
Meta-Analysis Review
Constraint-induced movement therapy (CIMT) has been delivered in the stroke population to improve lower-extremity functions. However, its efficacy on prime components of functional ambulation, such as gait speed, balance, and cardiovascular outcomes, is ambiguous. The present review aims to delineate the effect of various lower-extremity CIMT (LECIMT) protocols on gait speed, balance, and cardiovascular outcomes. Material and methods: The databases used to collect relevant articles were EBSCO, PubMed, PEDro, Science Direct, Scopus, MEDLINE, CINAHL, and Web of Science. For this analysis, clinical trials involving stroke populations in different stages of recovery, >18 years old, and treated with LECIMT were considered. Only ten studies were included in this review, as they fulfilled the inclusion criteria. The effect of CIMT on gait speed and balance outcomes was accomplished using a random or fixed-effect model. CIMT, when compared to controlled interventions, showed superior or similar effects. The effect of LECIMT on gait speed and balance were non-significant, with mean differences (SMDs) of 0.13 and 4.94 and at 95% confidence intervals (Cis) of (-0.18-0.44) and (-2.48-12.37), respectively. In this meta-analysis, we observed that despite the fact that several trials claimed the efficacy of LECIMT in improving lower-extremity functions, gait speed and balance did not demonstrate a significant effect size favoring LECIMT. Therefore, CIMT treatment protocols should consider the patient's functional requirements, cardinal principles of CIMT, and cardiorespiratory parameters.
Topics: Adolescent; Humans; Physical Therapy Modalities; Stroke; Stroke Rehabilitation; Walking; Walking Speed
PubMed: 36232103
DOI: 10.3390/ijerph191912809 -
Scientific Reports Jul 2022The effects and the prescription parameters of therapeutic exercise are not clear. For this reason, is needed to determine the effect of therapeutic exercises on the... (Meta-Analysis)
Meta-Analysis
The effects and the prescription parameters of therapeutic exercise are not clear. For this reason, is needed to determine the effect of therapeutic exercises on the motor function of children with Down Syndrome (DS) aged 0 to 3 years. The present study is systematic review and meta-analysis of effectiveness outcomes in this population: gait, balance, motor development, fine motor skills, and executive functions. The databases of PubMed, PEDro, EMBASE, SCIELO, Lilacs, Cochrane library were searched from January to December 2019. We recruited Randomized Controlled Trials (RCTs) which met the inclusion criteria in our study. Six studies and 151 participants were included. Two types of therapeutic exercises, aerobic and neuromuscular, were identified. Both types of exercise were effective in improving outcomes. There were no differences between the modes of application of the exercise. No differences were identified between the treadmill and the physiotherapy plan for the reduction of the time to reach independent walking, Mean Difference (MD) 46.79, 95% Confidence Interval (IC) (- 32.60, 126.19), nor for the increase in walking speed MD 0.10 IC (- 0.02, 0.21) m/s. This study suggests that aerobic exercise therapy has a potentially effective role to promote the gait and motor development of children with DS aged 0 to 3 years when it is applied using a treadmill with a frequency of 5 days, a duration of 6-8 min, and an intensity of between 0.2 and 0.5 m/s. Studies with less heterogeneity and larger sample sizes are required.
Topics: Child; Down Syndrome; Exercise; Exercise Therapy; Gait; Humans; Randomized Controlled Trials as Topic; Walking Speed
PubMed: 35906275
DOI: 10.1038/s41598-022-16332-x -
Journal of Sports Science & Medicine Sep 2023Static stretching can increase the range of motion of a joint. Muscle-tendon unit stiffness (MTS) is potentially one of the main factors that influences the change in... (Meta-Analysis)
Meta-Analysis Review
Static stretching can increase the range of motion of a joint. Muscle-tendon unit stiffness (MTS) is potentially one of the main factors that influences the change in the range of motion after static stretching. However, to date, the effects of acute and long-term static stretching on MTS are not well understood. The purpose of this meta-analysis was to investigate the effects of acute and long-term static stretching training on MTS, in young healthy participants. PubMed, Web of Science, and EBSCO published before January 6, 2023, were searched and finally, 17 papers were included in the meta-analysis. Main meta-analysis was performed with a random-effect model and subgroup analyses, which included comparisons of sex (male vs. mixed sex and female) and muscle (hamstrings vs. plantar flexors) were also performed. Furthermore, a meta-regression was conducted to examine the effect of total stretching duration on MTS. For acute static stretching, the result of the meta-analysis showed a moderate decrease in MTS (effect size = -0.772, Z = -2.374, 95% confidence interval = -1.409 - -0.325, p = 0.018, I = 79.098). For long-term static stretching, there is no significant change in MTS (effect size = -0.608, Z = -1.761, 95% CI = -1.284 - 0.069, p = 0.078, I = 83.061). Subgroup analyses revealed no significant differences between sex (long-term, p = 0.209) or muscle (acute, p =0.295; long-term, p = 0.427). Moreover, there was a significant relationship between total stretching duration and MTS in acute static stretching (p = 0.011, R2 = 0.28), but not in long-term stretching (p = 0.085, R < 0.01). Whilst MTS decreased after acute static stretching, only a tendency of a decrease was seen after long-term stretching.
Topics: Female; Male; Humans; Muscle Stretching Exercises; Tendons; Muscles; Hamstring Muscles
PubMed: 37711702
DOI: 10.52082/jssm.2023.465 -
Frontiers in Public Health 2022As brain function declines and cognitive ability declines, the benefits of resistance exercise to the brain of older people are gradually gaining attention.
BACKGROUND
As brain function declines and cognitive ability declines, the benefits of resistance exercise to the brain of older people are gradually gaining attention.
OBJECTIVE
The purpose of this review is to explore the mechanism and relationship between physiological factors such as vascular and neuronal degeneration and cognitive decline, and to categorize the differences in the effects of an acute and chronic resistance exercise intervention on cognitive function in healthy elderly people and the possible regulators of cognitive effects.
METHODS
Using PubMed, Elsevier, Web of Science, X-MOL, CNKI, and Taiwan academic literature database, the research papers published in relevant journals at home and abroad until April 2022 were searched with Chinese and English keywords such as Resistance exercise, the elderly, hippocampus, memory performance, neurons, cognitive function. Pedro scale was used to check the quality of various documents, and the relevant research documents were obtained with the resistance exercise elements as the main axis for comprehensive analysis.
RESULTS AND CONCLUSION
(1) Resistance exercise can have a beneficial effect on the brain function of the elderly through blood flow changes, stimulate nerve conduction substances and endocrine metabolism, promote cerebrovascular regeneration and gray matter volume of the brain, and prevent or delay the cognitive function degradation such as memory and attention of the elderly; (2) Acute resistance can temporarily stimulate hormone secretion and significantly improve the effect of short-term memory test, but it has little effect on the cognitive performance of the elderly; (3) Moderate-high intensity resistance exercise (50-80%1RM, 1-3 times/week, 2-3 groups/time) lasting for at least 6 months is more prominent for the improvement of cognitive function of the elderly, while the parameters such as resistance exercise intensity, exercise amount, duration, evaluation test time and differences of subjects may have different degrees of influence on cognitive benefits.
Topics: Humans; Aged; Resistance Training; Exercise; Health Status; Cognition; Taiwan
PubMed: 36483263
DOI: 10.3389/fpubh.2022.1013734 -
Neuroscience and Biobehavioral Reviews Jul 2023The difficulty in assessing FOG and the variety of existing cues, hamper to determine which cueing modality should be applied and which FOG-related aspect should be... (Meta-Analysis)
Meta-Analysis Review
The difficulty in assessing FOG and the variety of existing cues, hamper to determine which cueing modality should be applied and which FOG-related aspect should be targeted to reach personalized treatments for FOG. This systematic review aimed to highlight: i) whether cues could reduce FOG and improve FOG-related gait parameters, ii) which cues are the most effective, iii) whether medication state (ON-OFF) affects cues-related results. Thirty-three repeated measure design studies assessing cueing effectiveness were included and subdivided according to gait tasks (gait initiation, walking, turning) and to the medication state. Main results reveal that: preparatory phase of gait initiation benefit from visual and auditory cues; spatio-temporal parameters (e.g., step and stride length) are improved by visual cues during walking; turning time and step time variability are reduced by applying auditory and visual cues. Some findings on the potential benefits of cueing on FOG and FOG gait-related parameters were found. Questions remain about which are the best behavioral strategies according to FOG features and PD clinical characteristics.
Topics: Humans; Parkinson Disease; Cues; Gait Disorders, Neurologic; Gait; Walking
PubMed: 37086934
DOI: 10.1016/j.neubiorev.2023.105189