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Cardiovascular Therapeutics 2022The purpose of this study is to compare the effects of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) on exercise capacity... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The purpose of this study is to compare the effects of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) on exercise capacity and several prognostic markers in patients with coronary artery disease (CAD) and heart failure (HF).
METHODS
This systematic review is registered on the INPLASY website (number: INPLASY202080112). We conducted a comprehensive search in eight databases of literature before September 13, 2019. Trials comparing HIIT and MICT in participants with CAD or HF aged 52-78 years were included. Exercise capacity (peak oxygen consumption (peak VO)) and prognostic markers, such as the anaerobic threshold (AT), minute ventilation/carbon dioxide production (VE/VCO) slope, left ventricular ejection fraction (LVEF), and prognostic value of the predicted VO max per cent (the predicted VO peak (%)) were examined.
RESULTS
A total of 15 studies were included comprising 664 patients, 50% of which were male, with an average age of 60.3 ± 13.2 years. For patients with CAD, HIIT significantly improved peak VO values (95% CI 0.7 to 2.11) compared with MICT, but peak VO values in patients with HF did not seem to change. For training lasting less than eight weeks, HIIT significantly improved peak VO values (95% CI 0.70 to 2.10), while HIIT lasting 12 weeks or longer resulted in a modestly increased peak VO value (95% CI 0.31 to 5.31). High-intensity interval training significantly increased the AT when compared with MICT (95% CI 0.50 to 1.48). High-intensity interval training also caused a moderate increase in LVEF (95% CI 0.55 to 5.71) but did not have a significant effect on the VE/VCO slope (95% CI -2.32 to 0.98) or the predicted VO peak (95% CI -2.54 to 9.59) compared with MICT.
CONCLUSIONS
High-intensity interval training is an effective therapy for improving peak VO values in patients with CAD. High-intensity interval training in the early stage (eight weeks or fewer) is superior to MICT. Finally, HIIT significantly improved prognostic markers, including the AT and LVEF in patients with CAD and HF.
Topics: Aged; Coronary Artery Disease; Exercise Tolerance; Female; Heart Failure; High-Intensity Interval Training; Humans; Male; Middle Aged; Oxygen Consumption; Prognosis; Stroke Volume; Ventricular Function, Left
PubMed: 35801132
DOI: 10.1155/2022/4273809 -
International Journal of Sports... Jun 2022This review aimed to determine (1) performance and training characteristics such as training intensity distribution (TID), volume, periodization, and methods in highly...
PURPOSE
This review aimed to determine (1) performance and training characteristics such as training intensity distribution (TID), volume, periodization, and methods in highly trained/elite distance runners and (2) differences in training volume and TID between event distances in highly trained/elite distance runners.
METHODS
A systematic review of the literature was carried out using the PubMed/MEDLINE, Scopus, and Web of Science databases.
RESULTS
Ten articles met the inclusion criteria. Highly trained/elite distance runners typically follow a pyramidal TID approach, characterized by a decreasing training volume from zone 1 (at or below speed at first ventilatory/lactate threshold [LT]) to zone 2 (between speeds associated with either both ventilatory thresholds or 2 and 4 mmol·L-1 LTs [vLT1 and vLT2, respectively]) and zone 3 (speed above vVT2/vLT2). Continuous-tempo runs or interval training sessions at vLT2 in zone 2 (ie, medium and long aerobic intervals) and those in zone 3 (ie, anaerobic or short-interval training) were both used at least once per week each in elite runners, and they were used to increase the number of either vLT2 or z3 sessions to adopt either a pyramidal or a polarized approach, respectively. More pyramidal- and polarized-oriented approaches were used by marathoners and 1500-m runners, respectively.
CONCLUSIONS
Highly trained and elite middle- and long-distance runners are encouraged to adopt a traditional periodization pattern with a hard day-easy day basis, consisting in a shift from a pyramidal TID used during the preparatory and precompetitive periods toward a polarized TID during the competitive period.
Topics: Humans; Lactic Acid; Oxygen Consumption; Physical Endurance; Running
PubMed: 35418513
DOI: 10.1123/ijspp.2021-0435 -
Nutrients Jun 2022Nutritional ergogenic aids (NEAs) are substances included within the group of sports supplements. Although they are widely consumed by athletes, evidence-based analysis... (Meta-Analysis)
Meta-Analysis Review
Nutritional ergogenic aids (NEAs) are substances included within the group of sports supplements. Although they are widely consumed by athletes, evidence-based analysis is required to support training outcomes or competitive performance in specific disciplines. Combat sports have a predominant use of anaerobic metabolism as a source of energy, reaching peak exertion or sustained effort for very short periods of time. In this context, the use of certain NEAs could help athletes to improve their performance in those specific combat skills (i.e., the number of attacks, throws and hits; jump height; and grip strength, among others) as well as in general physical aspects (time to exhaustion [TTE], power, fatigue perception, heart rate, use of anaerobic metabolism, etc.). Medline/PubMed, Scopus and EBSCO were searched from their inception to May 2022 for randomised controlled trials (RCTs). Out of 677 articles found, 55 met the predefined inclusion criteria. Among all the studied NEAs, caffeine (5-10 mg/kg) showed strong evidence for its use in combat sports to enhance the use of glycolytic pathways for energy production during high-intensity actions due to a greater production of and tolerance to blood lactate levels. In this regard, abilities including the number of attacks, reaction time, handgrip strength, power and TTE, among others, were improved. Buffering supplements such as sodium bicarbonate, sodium citrate and beta-alanine may have a promising role in high and intermittent exertion during combat, but more studies are needed in grappling combat sports to confirm their efficacy during sustained isometric exertion. Other NEAs, including creatine, beetroot juice or glycerol, need further investigation to strengthen the evidence for performance enhancement in combat sports. Caffeine is the only NEA that has shown strong evidence for performance enhancement in combat sports.
Topics: Athletes; Athletic Performance; Caffeine; Dietary Supplements; Humans; Performance-Enhancing Substances; Sports Nutritional Physiological Phenomena
PubMed: 35807770
DOI: 10.3390/nu14132588 -
Nutrients Jun 2020Rowing is a high-intensity sport requiring a high level of aerobic and anaerobic capacity. Although good nutrition is essential for successful performance in a rowing... (Meta-Analysis)
Meta-Analysis
Rowing is a high-intensity sport requiring a high level of aerobic and anaerobic capacity. Although good nutrition is essential for successful performance in a rowing competition, its significance is not sufficiently established. This review aimed to provide nutritional strategies to optimize performance and recovery in rowing athletes based on a literature review. Following the guidelines given in the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA), we performed web searches using online databases (Pubmed, Web of Science, Wiley Online Library, ACS Publications, and SciFinder). Typically, a rowing competition involves a 6-8-min high-intensity exercise on a 2000-m course. The energy required for the exercise is supplied by muscle-stored glycogens, which are derived from carbohydrates. Therefore, rowing athletes can plan their carbohydrate consumption based on the intensity, duration, and type of training they undergo. For effective and safe performance enhancement, rowing athletes can take supplements such as β-alanine, caffeine, β-hydroxy-β-methylbutyric acid (HMB), and beetroot juice (nitrate). An athlete may consume carbohydrate-rich foods or use a carbohydrate mouth rinse. Recovery nutrition is also very important to minimize the risk of injury or unexplained underperformance syndrome (UUPS) from overuse. It must take into account refueling (carbohydrate), rehydration (fluid), and repair (protein). As lightweight rowing athletes often attempt acute weight loss by limiting food and fluid intake to qualify for a competition, they require personalized nutritional strategies and plans based on factors such as their goals and environment. Training and competition performance can be maximized by including nutritional strategies in training plans.
Topics: Athletes; Athletic Performance; Caffeine; Dietary Carbohydrates; Dietary Supplements; Energy Metabolism; Female; Fluid Therapy; Glycogen; Humans; Male; Muscle, Skeletal; Nitrates; Nutritional Physiological Phenomena; Nutritional Requirements; Physical Conditioning, Human; Water Sports; beta-Alanine
PubMed: 32516908
DOI: 10.3390/nu12061685 -
Nutrients May 2020Intermittent fasting (IF) has been studied in athletes during Ramadan and in those willing to decrease adiposity while maintaining or increasing lean body mass. The... (Meta-Analysis)
Meta-Analysis
Intermittent fasting (IF) has been studied in athletes during Ramadan and in those willing to decrease adiposity while maintaining or increasing lean body mass. The purpose of this systematic review was to summarize the effects of IF on performance outcomes. We searched peer-reviewed articles in the following databases: PubMed, Web of Science and Sport Discus (up to December 2019). Studies were selected if they included samples of adults (≥18 years), had an experimental or observational design, investigated IF (Ramadan and time-restricted feeding (TRF)), and included performance outcomes. Meta-analytical procedures were conducted when feasible. Twenty-eight articles met the eligibility criteria. Findings indicated that maximum oxygen uptake is significantly enhanced with TRF protocols (SMD = 1.32, 0.001), but reduced with Ramadan intermittent fasting (Ramadan IF; SMD = -2.20, < 0.001). Additional effects of IF may be observed in body composition (body mass and fat mass). Non-significant effects were observed for muscle strength and anaerobic capacity. While Ramadan IF may lead to impairments in aerobic capacity, TRF may be effective for improving it. As there are few studies per performance outcome, more research is needed to move the field forward.
Topics: Adolescent; Adult; Athletes; Athletic Performance; Body Composition; Exercise Tolerance; Fasting; Female; Humans; Islam; Male; Oxygen Consumption; Young Adult
PubMed: 32408718
DOI: 10.3390/nu12051390 -
Journal of Clinical Medicine Mar 2023Aspiration pneumonia is increasingly recognised as a common condition. While antibiotics covering anaerobes are thought to be necessary based on old studies reporting... (Review)
Review
INTRODUCTION
Aspiration pneumonia is increasingly recognised as a common condition. While antibiotics covering anaerobes are thought to be necessary based on old studies reporting anaerobes as causative organisms, recent studies suggest that it may not necessarily benefit prognosis, or even be harmful. Clinical practice should be based on current data reflecting the shift in causative bacteria. The aim of this review was to investigate whether anaerobic coverage is recommended in the treatment of aspiration pneumonia.
METHODS
A systematic review and meta-analysis of studies comparing antibiotics with and without anaerobic coverage in the treatment of aspiration pneumonia was performed. The main outcome studied was mortality. Additional outcomes were resolution of pneumonia, development of resistant bacteria, length of stay, recurrence, and adverse effects. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed.
RESULTS
From an initial 2523 publications, one randomised control trial and two observational studies were selected. The studies did not show a clear benefit of anaerobic coverage. Upon meta-analysis, there was no benefit of anaerobic coverage in improving mortality (Odds ratio 1.23, 95% CI 0.67-2.25). Studies reporting resolution of pneumonia, length of hospital stay, recurrence of pneumonia, and adverse effects showed no benefit of anaerobic coverage. The development of resistant bacteria was not discussed in these studies.
CONCLUSION
In the current review, there are insufficient data to assess the necessity of anaerobic coverage in the antibiotic treatment of aspiration pneumonia. Further studies are needed to determine which cases require anaerobic coverage, if any.
PubMed: 36902779
DOI: 10.3390/jcm12051992 -
The Cochrane Database of Systematic... Aug 2021Children and adolescents diagnosed with cancer are at high risk of experiencing severe side effects from cancer treatment, many of which are amenable to physical... (Review)
Review
BACKGROUND
Children and adolescents diagnosed with cancer are at high risk of experiencing severe side effects from cancer treatment, many of which are amenable to physical therapy. These side effects can negatively impact a child's quality of life and ability to participate in daily activities (e.g. play and attendance at school). Researchers have evaluated physical therapy interventions in children with cancer and childhood cancer survivors. However, factors such as small sample sizes, varying intervention protocols and differences in cancer types among trials make it difficult to draw conclusions about efficacy.
OBJECTIVES
The primary aim of this review was to evaluate the efficacy of physical therapy interventions - with a specific focus on symptom relief and compensation of therapy-related side effects - on the quality of life of children and adolescents diagnosed with cancer. Participants must be between the ages of 0 and 19 years at the time of the physical therapy intervention study. The intervention may occur prior to, during or following cancer treatment. The intervention must be compared to a control group of children receiving standard care, no physical therapy intervention or a comparison intervention. We have excluded general physical exercise studies where the primary aim was to improve physical fitness through aerobic, anaerobic, resistance exercise or combined physical exercise training regimens (i.e. combined aerobic and resistance exercise regimens). We have also intended to record the occurrence of any adverse effects resulting from physical therapy interventions. The secondary aims were to evaluate the efficacy of physical therapy on impairments of pain, peripheral neuropathy, balance, gait, functional abilities and mobility, motor function and performance, range of motion, strength and fatigue.
SEARCH METHODS
We searched CENTRAL, MEDLINE, Embase, CINAHL, PEDro, ongoing trial registries, conference proceedings and the reference lists of relevant studies and reviews in March 2020. We also contacted oncology rehabilitation researchers working in paediatrics in March 2020 to identify additional studies.
SELECTION CRITERIA
The review included randomised controlled trials (RCTs), cross-over trials, and controlled clinical trials (CCTs) that compared the effects of physical therapy interventions to a control group, and involved children and adolescents diagnosed with cancer between the ages of 0 and 19 years at the time of the intervention. We excluded studies examining general physical exercise interventions where the primary aim was to improve physical fitness through aerobic exercise, resistance exercise or combined physical exercise training regimens (i.e. combined aerobic and resistance exercise regimens).
DATA COLLECTION AND ANALYSIS
We used standard methodological procedures expected by Cochrane.
MAIN RESULTS
We found no RCTs, cross-over trials or CCTs comparing the effects of physical therapy interventions with a focus on symptom relief and compensation of therapy-related side effects for children and adolescents between the ages of 0 and 19 years.
AUTHORS' CONCLUSIONS
Results demonstrate that the evidence to date is inadequate to inform clinical practice. Recommendations for future research include the need for large-scale, high-quality designs that examine: (1) paediatric populations with same cancer types; (2) similar intervention protocols; (3) long-term outcomes; (4) physical therapy interventions (e.g. electrophysical modalities and sensory interventions); and (5) outcomes commonly impaired in children with cancer (e.g. peripheral neuropathy and gait deficits).
Topics: Adolescent; Adult; Child; Child, Preschool; Exercise; Exercise Therapy; Humans; Infant; Infant, Newborn; Neoplasms; Physical Fitness; Physical Therapy Modalities; Quality of Life; Young Adult
PubMed: 34343340
DOI: 10.1002/14651858.CD012924.pub2 -
Sports Medicine (Auckland, N.Z.) Nov 2022Sleep loss may influence subsequent physical performance. Quantifying the impact of sleep loss on physical performance is critical for individuals involved in athletic... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Sleep loss may influence subsequent physical performance. Quantifying the impact of sleep loss on physical performance is critical for individuals involved in athletic pursuits.
DESIGN
Systematic review and meta-analysis.
SEARCH AND INCLUSION
Studies were identified via the Web of Science, Scopus, and PsycINFO online databases. Investigations measuring exercise performance under 'control' (i.e., normal sleep, > 6 h in any 24 h period) and 'intervention' (i.e., sleep loss, ≤ 6 h sleep in any 24 h period) conditions were included. Performance tasks were classified into different exercise categories (anaerobic power, speed/power endurance, high-intensity interval exercise (HIIE), strength, endurance, strength-endurance, and skill). Multi-level random-effects meta-analyses and meta-regression analyses were conducted, including subgroup analyses to explore the influence of sleep-loss protocol (e.g., deprivation, restriction, early [delayed sleep onset] and late restriction [earlier than normal waking]), time of day the exercise task was performed (AM vs. PM) and body limb strength (upper vs. lower body).
RESULTS
Overall, 227 outcome measures (anaerobic power: n = 58; speed/power endurance: n = 32; HIIE: n = 27; strength: n = 66; endurance: n = 22; strength-endurance: n = 9; skill: n = 13) derived from 69 publications were included. Results indicated a negative impact of sleep loss on the percentage change (%) in exercise performance (n = 959 [89%] male; mean % = - 7.56%, 95% CI - 11.9 to - 3.13, p = 0.001, I = 98.1%). Effects were significant for all exercise categories. Subgroup analyses indicated that the pattern of sleep loss (i.e., deprivation, early and late restriction) preceding exercise is an important factor, with consistent negative effects only observed with deprivation and late-restriction protocols. A significant positive relationship was observed between time awake prior to the exercise task and % in performance for both deprivation and late-restriction protocols (~ 0.4% decrease for every hour awake prior to exercise). The negative effects of sleep loss on different exercise tasks performed in the PM were consistent, while tasks performed in the AM were largely unaffected.
CONCLUSIONS
Sleep loss appears to have a negative impact on exercise performance. If sleep loss is anticipated and unavoidable, individuals should avoid situations that lead to experiencing deprivation or late restriction, and prioritise morning exercise in an effort to maintain performance.
Topics: Humans; Male; Female; Physical Endurance; Exercise; Physical Functional Performance; Sleep
PubMed: 35708888
DOI: 10.1007/s40279-022-01706-y -
International Journal of Exercise... 2020The purpose of this study was to review acute physiological responses induced by repeated running sprint ability (RRSA) tests that could serve as references for... (Review)
Review
The purpose of this study was to review acute physiological responses induced by repeated running sprint ability (RRSA) tests that could serve as references for practitioners utilising repeated sprints as a performance measure with athletes. This research was conducted following the PRISMA methodology. The systematic search was conducted in November 2019 and yielded 26 different scientific articles. Only peer-reviewed full-text article were included as abstracts are too short to allow proper explanation of the RRSAT methodology that was employed. According to the present literature, practitioners should use the following assessments: the 6×40m RRSA protocol with one Change of Direction (COD) (20+20 m with a 180° COD) and 25s of passive recovery between sprints with soccer players; the Intensive Repeated Sprint Ability (IRSA) test with men basketball players; the Futsal Intermittent Endurance Test (FIET) with futsal players; the Repeated Shuttle Sprint Test (RSST) with men handball players; and the Multiple Repeated Sprint Ability test for Badminton players (MRSAB). The present review should serve as a reference standard for RRSA tests. Further research should be directed towards creating and validating more specific RRSA tests protocols to each sports physiological and physical demands.
PubMed: 33042370
DOI: No ID Found -
Nutrients Aug 2020Beta-alanine supplementation (BA) has a positive impact on physical performance. However, evidence showing a benefit of this amino acid in aerobic-anaerobic transition... (Meta-Analysis)
Meta-Analysis
Beta-alanine supplementation (BA) has a positive impact on physical performance. However, evidence showing a benefit of this amino acid in aerobic-anaerobic transition zones is scarce and the results controversial. The aim of this systematic review and meta-analysis is to analyze the effects of BA supplementation on physical performance in aerobic-anaerobic transition zones. At the same time, the effect of different dosages and durations of BA supplementation were identified. The search was designed in accordance with the PRISMA guidelines for systematic reviews and meta-analyses and performed in Web of Science (WOS), Scopus, SPORTDiscus, PubMed, and MEDLINE between 2010 and 2020. The methodological quality and risk of bias were evaluated with the Cochrane Collaboration tool. The main variables were the Time Trial Test (TTT) and Time to Exhaustion (TTE) tests, the latter separated into the Limited Time Test (LTT) and Limited Distance Test (LDT). The analysis was carried out with a pooled standardized mean difference (SMD) through Hedges' g test (95% CI). Nineteen studies were included in the systematic review and meta-analysis, revealing a small effect for time in the TTT (SMD, -0.36; 95% CI, -0.87-0.16; I = 59%; = 0.010), a small effect for LTT (SMD, 0.25; 95% CI, -0.01-0.51; I = 0%; = 0.53), and a large effect for LDT (SMD, 4.27; 95% CI, -0.25-8.79; I = 94%; = 0.00001). BA supplementation showed small effects on physical performance in aerobic-anaerobic transition zones. Evidence on acute supplementation is scarce (one study); therefore, exploration of acute supplementation with different dosages and formats on physical performance in aerobic-anaerobic transition zones is needed.
Topics: Aerobiosis; Anaerobiosis; Dietary Supplements; Humans; Physical Functional Performance; Sports Nutritional Physiological Phenomena; beta-Alanine
PubMed: 32824885
DOI: 10.3390/nu12092490