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Neuromuscular Disorders : NMD Aug 2020Myasthenia Gravis (MG) is a chronic autoimmune disease affecting the neuromuscular junction. Although a hallmark of MG is muscle fatigability due to dysfunction of the...
Myasthenia Gravis (MG) is a chronic autoimmune disease affecting the neuromuscular junction. Although a hallmark of MG is muscle fatigability due to dysfunction of the neuromuscular junction (peripheral fatigue), a large number of MG patients also report symptoms of central fatigue, defined as an experienced lack of energy, physically and/or mentally. We systematically reviewed the literature on all aspects of central fatigue in MG. Results were categorized in 5 domains: prevalence, diagnosis, pathophysiology, treatment or impact. The prevalence of patient-reported fatigue varies between 42 and 82%, which is significantly higher than in control subjects. Fatigue severity is usually assessed with standardized questionnaires, but the choice of questionnaire varies widely between studies. The pathophysiology of fatigue is unknown, but it is strongly associated with depressive symptoms, female gender and disease severity. Fatigue is also highly prevalent in ocular MG and patients in remission, suggesting a multifactorial origin. Fatigued MG patients have a lower quality of life. Pharmacological treatment of MG is associated with improvement of fatigue and promising results have been found with physical and psychological training programs. Fatigue is a highly prevalent symptom of MG with a severe negative impact on quality of life. Physicians treating patients with MG should be aware of this symptom, as it may be treatable with physical or psychological training programs.
Topics: Fatigue; Female; Humans; Male; Myasthenia Gravis; Neuromuscular Junction; Prevalence; Quality of Life; Surveys and Questionnaires
PubMed: 32718868
DOI: 10.1016/j.nmd.2020.06.010 -
Gait & Posture Jun 2023Interval training (IT) is influenced by several variables and its design. However, there is no consensus about the acute effects of this type of training on running... (Review)
Review
BACKGROUND
Interval training (IT) is influenced by several variables and its design. However, there is no consensus about the acute effects of this type of training on running kinematics and gait patterns due to the variety of session designs.
RESEARCH QUESTION
The aim of this systematic review was to determine the acute effects of IT on gait patterns and running kinematics in endurance runners depending on the characteristics of the training sessions.
METHODS
A systematic search on four databases (Pubmed, WOS, Medline, and Scopus) was conducted on February 22, 2022. After analyzing 655 articles, studies were included if they met the inclusion criteria developed according to the PICO model. Nine studies were finally included.
RESULTS
Only two of these studies measured kinematics changes during IT bouts while seven measured pre-post changes of these parameters. The quality scores of the included studies in the review averaged 5.44 (good quality) points using the modified PEDro scale. The observed changes in running kinematics during IT sessions were an increase in stride frequency, contact time and vertical displacement of center of mass.
SIGNIFICANCE
Regarding the type of IT, anaerobic and short aerobic interval sessions (200-1000 m) should include long recovery periods (2-3 min) to avoid the increase of stride frequency, contact time and vertical oscillation of the center of mass as a results of muscle fatigue. For long aerobic interval sessions (>1000 m), a short recovery (1-2 min) between bouts do not induce a high level of muscle fatigue nor modifications in gait patterns. Coaches and athletes must consider the relative intensity and recovery periods of IT, and the type of IT, to prevent excessive fatigue which can negatively affect running kinematics.
Topics: Humans; Physical Endurance; Biomechanical Phenomena; Gait; Running; Athletes
PubMed: 37075554
DOI: 10.1016/j.gaitpost.2023.04.009 -
Sports Medicine - Open Dec 2019Monitoring athletes' external load during a soccer match may be useful to predict post-match acute and residual fatigue. This estimation would allow individual... (Review)
Review
BACKGROUND
Monitoring athletes' external load during a soccer match may be useful to predict post-match acute and residual fatigue. This estimation would allow individual adjustments to training programs to minimize injury risk, improve well-being, and restore players' physical performance and inform the recovery process.
METHODS
Using a systematic review and meta-analysis of the literature, the aim is to determine which monitoring variables would be the strongest predictors of acute (immediately) and residual (up to 72 h) fatigue states in soccer. PubMed, SPORTDiscus, and Web of Science databases were searched (until September 2018). Studies concurrently examining soccer match-related external load metrics and subjective and/or objective measures were selected to determine pooled correlations ([Formula: see text]) with confidence intervals (CI). The quality and strength of the findings of each study were evaluated to identify overall levels of evidence.
RESULTS
Eleven studies were included (n = 165 athletes). Acute ([Formula: see text] = 0.67; 95% CI = [0.40, 0.94]) and residual (24 h post-match, [Formula: see text] = 0.54; 95% CI = [0.35, 0.65]) changes in muscle damage markers and countermovement jump peak power output (CMJ) were, with moderate to strong evidence, largely correlated with running distance above 5.5 m s. No other external load metric was largely correlated with both biochemical and neuromuscular markers. For every 100-m run above 5.5 m·s, CK activity measured 24 h post-match increased by 30% and CMJ decreased by 0.5%. Conversely, the total distance covered did not present any evidence of a clear relationship with any fatigue-related marker at any time-point.
CONCLUSIONS
Running distance above 5.5 m·s represents the most sensitive monitoring variable characterizing biochemical and neuromuscular responses, at least when assessed during the initial 24 h (not at 48 h/72 h) post-match recovery period. In addition, total distance covered is not sensitive enough to inform decision-making during the fatigue monitoring process.
PubMed: 31820260
DOI: 10.1186/s40798-019-0219-7 -
Nutrition Research (New York, N.Y.) May 2024The quality of a mother's diet is important to ensure child growth and development and keep women healthy. This systematic review aimed to identify the outcomes of a... (Review)
Review
The quality of a mother's diet is important to ensure child growth and development and keep women healthy. This systematic review aimed to identify the outcomes of a carbohydrate-restricted diet during lactation. PubMed, EMBASE, Scopus, Web of Science, and LILACS were searched for studies published between 2012 and 2023; 16 studies were selected, all of them case reports or care series. The carbohydrate restriction described in the papers mainly was ketogenic, low-carb, low-carbohydrate and high-fat, and modified ketogenic diets. The main goal of women undertaking these diets was weight loss, with therapeutic purposes (monitored and supervised by health professionals) in only 2 cases: (1) ketogenic diet therapy for treatment of seizures in the infant and (2) to reduce symptoms of mother's gastroesophageal reflux. Most articles reported that lactating women were hospitalized, experiencing symptoms such as vomiting, muscle weakness, nausea, abdominal pain, general malaise, and fatigue. However, articles did not mention poor outcomes for the infants. Most of the studies in this review were published in the past 3 years, indicating a possible increase in cases of women practicing carbohydrate restriction during lactation for weight loss caused by body dissatisfaction. In conclusion, carbohydrate restriction during lactation may be harmful to the lactating woman and contribute to the state of lactational ketoacidosis, but infant outcomes are mainly a change in feeding patterns. Thus, education on food and nutrition is necessary for this population.
Topics: Adult; Female; Humans; Infant; Breast Feeding; Diet, Carbohydrate-Restricted; Diet, Ketogenic; Dietary Carbohydrates; Ketosis; Lactation; Maternal Nutritional Physiological Phenomena; Weight Loss
PubMed: 38565002
DOI: 10.1016/j.nutres.2024.02.007 -
Healthcare (Basel, Switzerland) Nov 2022There is scientific evidence that Blood Flow Restriction (BFR) is beneficial in healthy people, the elderly and patients with musculoskeletal disorders. A systematic... (Review)
Review
There is scientific evidence that Blood Flow Restriction (BFR) is beneficial in healthy people, the elderly and patients with musculoskeletal disorders. A systematic review was conducted to evaluate the effectiveness of BFR in patients with neurological disorders. The literature search was conducted up until July 2022 in the following databases: PubMed, Web of Science (WOS), Physiotherapy Evidence Database (PEDro), LILACS, Scopus, Cumulative Index of Nursing and Allied Literature Complete (CINAHL), the Cochrane Library and Scientific Electronic Library Online (SciELO). The PEDro scale was used to analyze the methodological quality of the studies, and the Cochrane Collaboration's tool was employed to evaluate the risk of bias. A total of seven articles were included. BFR seems to be beneficial in neurological disorders. Improvements have been found in sensorimotor function, frequency and step length symmetry, perceived exertion, heart rate and gait speed, walking endurance, fatigue, quality of life, muscles thickness, gluteus density and muscle edema. No improvements were found in lower limb strength or balance. However, results must be taken with caution due to the small number of articles and to the large heterogeneity. More clinical trials are needed. These studies should homogenize the protocols used in larger samples, as well as improve their methodological quality.
PubMed: 36553931
DOI: 10.3390/healthcare10122407 -
International Journal of Environmental... Feb 2023It is well known that there is an obvious 24 h diurnal variation in the individual's mood state and physiological activity, and training at different times of the day... (Review)
Review
PURPOSE
It is well known that there is an obvious 24 h diurnal variation in the individual's mood state and physiological activity, and training at different times of the day may lead to different exercise performance and metabolic outcomes; however, the time-dependent effect of emotional state on physical activity and the influence of its circadian rhythm on exercise performance are still not comprehensively understood. Based on this, this study summarizes the rhythmic experimental research in the field of sport psychology, and it aims to provide the basis for coaches to optimize sports training scientifically and to improve the mental health of the related crowd to the greatest extent.
METHODS
The systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched the PubMed, Web of Science, Medline, and CNKI databases for relevant literature; the search scope was research before September 2022.
RESULTS
13 studies comprising 382 subjects examined the effects of exercise timing on mood responses to exercise or the effects of circadian rhythms of mood on exercise performance, which included 3 RCTs and 10 Non-RCTs. The subjects included athletes (both training or retired), college students, and healthy adults. Two studies were designed for long-term exercise intervention (aerobic training and RISE) and the rest for acute intervention (CrossFit training, HIIT, aerobic combined with muscle conditioning training, constant power exhaustion training, and cycling) or physical function tests (RSA + BTV tests, 30 s Wingate test, muscle strength + CMJ + swimming performance test, RSSJA, shooting accuracy tests + 10 × 20 m dribbling sprint, 200 m time trials). All trials reported specific exercise timing; of these, 10 studies reported subjects' chronotypes, most commonly using the MEQ scale, while 1 recorded with the CSM. Mood responses were assessed with the POMS scale in 10 studies, while 3 other studies used the UMACL, PANAS, and GAS scales, respectively.
CONCLUSION
There was much inconsistency between the results, with subjects likely to be exposed to more sunlight (the main timing factor of the circadian rhythm) during early morning exercise, resulting in feeling more positive emotions; however, following a night's rest, delayed responses and poor functioning of the various organ systems of the human body may also lead to higher feelings of fatigue and negative emotions indirectly. Conversely, for athletes, their physical function tests are also more susceptible to the circadian rhythm of emotions, suggesting the importance of synchronizing them. In addition, night owls' emotional state during physical activity seems to be more susceptible to exercise timing than that of early birds. In order to achieve the best emotional state, it is suggested that night owls arrange courses in the afternoon or evening in future training.
Topics: Adult; Humans; Chronotype; Circadian Rhythm; Athletes; Rest; Swimming
PubMed: 36833520
DOI: 10.3390/ijerph20042822 -
Frontiers in Physiology 2022Individuals with neuromuscular and chest wall disorders experience respiratory muscle weakness, reduced lung volume and increases in respiratory elastance and resistance...
Individuals with neuromuscular and chest wall disorders experience respiratory muscle weakness, reduced lung volume and increases in respiratory elastance and resistance which lead to increase in work of breathing, impaired gas exchange and respiratory pump failure. Recently developed methods to assess respiratory muscle weakness, mechanics and movement supplement traditionally employed spirometry and methods to evaluate gas exchange. These include recording postural change in vital capacity, respiratory pressures (mouth and sniff), electromyography and ultrasound evaluation of diaphragmatic thickness and excursions. In this review, we highlight key aspects of the pathophysiology of these conditions as they impact the patient and describe measures to evaluate respiratory dysfunction. We discuss potential areas of physiologic investigation in the evaluation of respiratory aspects of these disorders.
PubMed: 35774289
DOI: 10.3389/fphys.2022.838414 -
International Journal of Environmental... May 2021Due to the high metabolic and physical demands in single-stage one-day ultra-trail (SOUT) races, athletes should be properly prepared in both physical and nutritional... (Review)
Review
Due to the high metabolic and physical demands in single-stage one-day ultra-trail (SOUT) races, athletes should be properly prepared in both physical and nutritional aspects in order to delay fatigue and avoid associated difficulties. However, high carbohydrate (CHO) intake would seem to increase gastrointestinal (GI) problems. The main purpose of this systematic review was to evaluate CHO intake during SOUT events as well as its relationship with fatigue (in terms of internal exercise load, exercise-induced muscle damage (EIMD) and post-exercise recovery) and GI problems. A structured search was carried out in accordance with PRISMA guidelines in the following: Web of Science, Cochrane Library and Scopus databases up to 16 March 2021. After conducting the search and applying the inclusion/exclusion criteria, eight articles in total were included in this systematic review, in all of which CHO intake involved gels, energy bars and sports drinks. Two studies associated higher CHO consumption (120 g/h) with an improvement in internal exercise load. Likewise, these studies observed that SOUT runners whose intake was 120 g/h could benefit by limiting the EIMD observed by CK (creatine kinase), LDH (lactate dehydrogenase) and GOT (aspartate aminotransferase), and also improve recovery of high intensity running capacity 24 h after a trail marathon. In six studies, athletes had GI symptoms between 65-82%. In summary, most of the runners did not meet CHO intake standard recommendations for SOUT events (90 g/h), while athletes who consumed more CHO experienced a reduction in internal exercise load, limited EIMD and improvement in post-exercise recovery. Conversely, the GI symptoms were recurrent in SOUT athletes depending on altitude, environmental conditions and running speed. Therefore, a high CHO intake during SOUT events is important to delay fatigue and avoid GI complications, and to ensure high intake, it is necessary to implement intestinal training protocols.
Topics: Dietary Carbohydrates; Eating; Fatigue; Humans; Physical Endurance; Running
PubMed: 34071815
DOI: 10.3390/ijerph18115737 -
BMJ Medicine 2023To determine the effect of covid-19 vaccination, given before and after acute infection with the SARS-CoV-2 virus, or after a diagnosis of long covid, on the rates and...
OBJECTIVE
To determine the effect of covid-19 vaccination, given before and after acute infection with the SARS-CoV-2 virus, or after a diagnosis of long covid, on the rates and symptoms of long covid.
DESIGN
Systematic review.
DATA SOURCES
PubMed, Embase, and Cochrane covid-19 trials, and Europe PubMed Central (Europe PMC) for preprints, from 1 January 2020 to 3 August 2022.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
Trials, cohort studies, and case-control studies reporting on patients with long covid and symptoms of long covid, with vaccination before and after infection with the SARS-CoV-2 virus, or after a diagnosis of long covid. Risk of bias was assessed with the ROBINS-I tool.
RESULTS
1645 articles were screened but no randomised controlled trials were found. 16 observational studies from five countries (USA, UK, France, Italy, and the Netherlands) were identified that reported on 614 392 patients. The most common symptoms of long covid that were studied were fatigue, cough, loss of sense of smell, shortness of breath, loss of taste, headache, muscle ache, difficulty sleeping, difficulty concentrating, worry or anxiety, and memory loss or confusion. 12 studies reported data on vaccination before infection with the SARS-CoV-2 virus, and 10 showed a significant reduction in the incidence of long covid: the odds ratio of developing long covid with one dose of vaccine ranged from 0.22 to 1.03; with two doses, odds ratios were 0.25-1; with three doses, 0.16; and with any dose, 0.48-1.01. Five studies reported on vaccination after infection, with odds ratios of 0.38-0.91. The high heterogeneity between studies precluded any meaningful meta-analysis. The studies failed to adjust for potential confounders, such as other protective behaviours and missing data, thus increasing the risk of bias and decreasing the certainty of evidence to low.
CONCLUSIONS
Current studies suggest that covid-19 vaccines might have protective and therapeutic effects on long covid. More robust comparative observational studies and trials are needed, however, to clearly determine the effectiveness of vaccines in preventing and treating long covid.
PROTOCOL REGISTRATION
Open Science Framework https://osf.io/e8jdy.
PubMed: 36936268
DOI: 10.1136/bmjmed-2022-000385 -
Frontiers in Pharmacology 2020Fatigue, as a complex, multidimensional symptom, is associated with many physical illnesses. C. A. Mey (PG) is an important herbal drug which has been used for...
BACKGROUND
Fatigue, as a complex, multidimensional symptom, is associated with many physical illnesses. C. A. Mey (PG) is an important herbal drug which has been used for benefiting Qi for thousand years. C. A. Mey and its compounds (PGC) possess various pharmacological activities, including anti-fatigue. Here, we conducted a systematic review of both randomized clinical trials (RCTs) and preclinical animal studies to investigate the efficacy and safety of PGC for fatigue.
METHODS
Electronic searches were performed in 7 databases from the time of each database's inception to August 2019. The methodological quality of RCTs was assessed using 7-item checklist recommended by Cochrane Collaboration or by the CAMARADES 10-item quality checklist. All the data were analyzed using Rev-Man 5.3 and Stata SE software.
RESULTS
Eight eligible RCTs and 30 animal studies were identified. The risk of bias scores in RCTs ranged from 4/7 to 7/7, and of animal studies varied from 4/10 to 7/10. Meta-analyses showed that PGC was superior to placebo according to their respective fatigue scales, heart rate recovery, and clinical effect (P < 0.05). There were a similar number of adverse effects between PGC and placebo group (P > 0.05). Meta-analyses showed that PGC can significantly decrease level of blood lactate, blood urea nitrogen, creatine kinase, malondialdehyde, and lactic dehydrogenase in serum, level of malondialdehyde in liver and level of gamma-aminobutyric acid, 5-hydroxytryptamine in brain tissue, and increase swimming time, level of glutathione peroxidase, glucose, superoxide dismutase in serum, level of glycogen and activity of superoxide dismutase, glutathione peroxidase, and catalase in skeletal muscle, level of hepatic glycogen in liver and level of dopamine, acetylcholine in brain tissue, compared with control (P < 0.05). Meta-analyses showed no significant difference in animal body weight between PGC and control (P > 0.05).
CONCLUSION
The present findings supported, to a certain degree, that PGC can be recommended for routine use in fatigue. The possible mechanism of PGC resists fatigue, mainly through antioxidant stress, regulating carbohydrate metabolism, delaying the accumulation of metabolites, promoting mitochondrial function, neuroprotection, antiapoptosis, and regulating neurotransmitter disorder in central nervous system.
PubMed: 32765262
DOI: 10.3389/fphar.2020.01031