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Respiratory Research Jun 2024The term "post-COVID-19 condition" refers to the symptomatology that appears between four to twelve weeks after Covid-19 infection. These symptoms can persist for weeks... (Review)
Review
BACKGROUND
The term "post-COVID-19 condition" refers to the symptomatology that appears between four to twelve weeks after Covid-19 infection. These symptoms can persist for weeks or even months, significantly diminishing the quality of life for affected individuals. The primary objective of this study was to assess the effectiveness of pulmonary rehabilitation programs and/or respiratory muscle training on respiratory sequelae in patients with post-COVID condition.
METHODS
The literature search was conducted in the following databases: PubMed, PEDro, Embase, Cochrane, Scopus, and Web of Science. Randomized clinical trials were included in which participants were aged 18 years or older. Articles were excluded if at least one of the therapies did not involve pulmonary rehabilitation or respiratory muscle training, if the participants were COVID positive, if studies lacked results, and finally, if interventions were conducted without supervision or at home. This review only encompasses supervised non-virtual interventions. This study adheres to the PRISMA statement and has been registered in the PROSPERO database (CRD42023433843).
RESULTS
The outcomes obtained in the included studies are assessed across the following variables: Exercise capacity using the 6-minute walk test, Dyspnea, fatigue, Pulmonary function, Maximum inspiratory pressure, and Quality of life.
CONCLUSION
Despite the absence of a specific treatment at present, it was evident from this review that a well-structured pulmonary rehabilitation program that incorporates both aerobic and muscular strength exercises along with techniques and inspiratory muscle exercises was the most effective form of treatment.
Topics: Humans; COVID-19; Breathing Exercises; Treatment Outcome; Respiratory Muscles; Quality of Life; Randomized Controlled Trials as Topic; Exercise Tolerance; Post-Acute COVID-19 Syndrome
PubMed: 38890699
DOI: 10.1186/s12931-024-02857-4 -
Cardio-oncology (London, England) Jun 2024The effects of exercise in patients with breast cancer (BC), has shown some profit, but consistency and magnitude of benefit remains unclear. We aimed to conduct a... (Review)
Review
BACKGROUND
The effects of exercise in patients with breast cancer (BC), has shown some profit, but consistency and magnitude of benefit remains unclear. We aimed to conduct a meta-analysis to assess the benefits of varying types of exercises in patients with BC.
METHODS
Literature search was conducted across five electronic databases (MEDLINE, Web of Science, Scopus, Google Scholar and Cochrane) from 1st January 2000 through 19th January 2024. Randomized controlled trials (RCTs) assessing the impact of different types of exercise on outcomes related to fitness and quality of life (QOL) in patients with BC were considered for inclusion. Outcomes of interest included cardiorespiratory fitness (CRF), health-related quality of life (HRQOL), muscle strength, fatigue and physical function. Evaluations were reported as mean differences (MDs) with 95% confidence intervals (CIs) and pooled using random effects model. A p value < 0.05 was considered significant.
RESULTS
Thirty-one relevant articles were included in the final analysis. Exercise intervention did not significantly improved the CRF in patients with BC when compared with control according to treadmill ergometer scale (MD: 4.96; 95%Cl [-2.79, 12.70]; P = 0.21), however exercise significantly improved CRF according to cycle ergometer scales (MD 2.07; 95% Cl [1.03, 3.11]; P = 0.0001). Physical function was significantly improved as well in exercise group reported by 6-MWT scale (MD 80.72; 95% Cl [55.67, 105.77]; P < 0.00001). However, exercise did not significantly improve muscle strength assessed using the hand grip dynamometer (MD 0.55; 95% CI [-1.61, 2.71]; P = 0.62), and fatigue assessed using the MFI-20 (MD -0.09; 95% CI [-5.92, 5.74]; P = 0.98) and Revised Piper scales (MD -0.26; 95% CI [-1.06, 0.55] P = 0.53). Interestingly, exercise was found to improve HRQOL when assessed using the FACT-B scale (MD 8.57; 95% CI [4.53, 12.61]; P < 0.0001) but no significant improvements were noted with the EORTIC QLQ-C30 scale (MD 1.98; 95% CI [-1.43, 5.40]; P = 0.25).
CONCLUSION
Overall exercise significantly improves the HRQOL, CRF and physical function in patients with BC. HRQOL was improved with all exercise types but the effects on CRF vary with cycle versus treadmill ergometer. Exercise failed to improve fatigue-related symptoms and muscle strength. Large RCTs are required to evaluate the effects of exercise in patients with BC in more detail.
PubMed: 38890692
DOI: 10.1186/s40959-024-00235-z -
Arthroscopy : the Journal of... Jun 2024To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating neuromuscular and clinical outcomes of blood flow restriction (BFR)...
PURPOSE
To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating neuromuscular and clinical outcomes of blood flow restriction (BFR) training after anterior cruciate ligament reconstruction (ACLR) compared to non-BFR rehabilitation protocols.
METHODS
A systematic review was performed in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines by querying PubMed, MEDLINE, Scopus, the Cochrane Database for Systematic Review, and the Cochrane Central Register for Controlled Trials databases from inception through December 2023 to identify Level I-II RCTs evaluating outcomes of BFR training after ACLR compared to non-BFR rehabilitation. A meta-analysis was performed using random-effects models with standardized mean difference (SMD) for pain, muscle strength, and muscle volume, while mean difference (MD) was calculated for patient-reported outcome measures.
RESULTS
Eight RCTs, consisting of 245 patients, met inclusion criteria, with 115 patients undergoing non-BFR rehabilitation versus 130 patients undergoing BFR after ACLR. Mean patient age was 27.2 ± 6.7 years, with the majority of patients being male (63.3%, n=138/218). The length of the BFR rehabilitation protocol was most commonly between 8-12 weeks (range, 14 days - 16 weeks). The majority of studies set the limb/arterial occlusion pressure in the BFR group at 80%. When compared to non-BFR rehabilitation, BFR resulted in significant improvement in isokinetic muscle strength (SMD: 0.77, p=0.02, I: 58%), IKDC score (MD: 10.97, p=<.00001, I: 77%), and pain (SMD: 1.52, p=.04, I: 87%), but not quadriceps muscle volume (SMD: 0.28, p=0.43, I: 76%).
CONCLUSION
The use of BFR following ACLR led to improvements in pain, IKDC score and isokinetic muscle strength, with variable outcomes based on quadriceps strength, volume and thickness when compared to non-BFR rehabilitation.
PubMed: 38889851
DOI: 10.1016/j.arthro.2024.05.032 -
Frontiers in Sports and Active Living 2024Anterior cruciate ligament (ACL) injuries are common among physically active individuals, often requiring ACL reconstruction (ACLR) for recovery. Rehabilitating these...
Effect of open vs. closed kinetic chain exercises in ACL rehabilitation on knee joint pain, laxity, extensor muscles strength, and function: a systematic review with meta-analysis.
UNLABELLED
Anterior cruciate ligament (ACL) injuries are common among physically active individuals, often requiring ACL reconstruction (ACLR) for recovery. Rehabilitating these injuries involves determining the appropriate timing for initiating open kinetic chain (OKC) exercises. Although OKC exercises are effective post-ACLR, their use in rehabilitation remains a subject of debate. Therefore, this study aims to conduct a systematic review to determine whether OKC or closed kinetic chain (CKC) exercises result in differences in laxity, strength of the knee extensor muscle group, function, and functional performance in ACL rehabilitation. Five electronic databases were searched for randomized controlled between-group trials (RCTs). Two reviewers independently evaluated the risk of bias using the PEDro scale. We performed a meta-analysis using a random-effects model or calculated mean differences (fixed-effect) where appropriate. Certainty of evidence was judged using the GRADE approach. The systematic literature search yielded 480 articles, of which 9 met the inclusion criteria. The evidence for all outcomes ranged from very low to low certainty. Across all comparisons, inconsistent results were found in outcome measures related to knee function between OKC and CKC exercises post-ACLR. A significant increase in quadriceps isokinetic strength was found in post-ACLR and ACL-deficient knees in favor of OKC exercises at 3 ( = 0.03) and 4 ( = 0.008) months, respectively. A significant decrease in knee laxity was observed in ACL-deficient knees in favor of OKC at 10 weeks ( = 0.01), although inconsistency was noted at 4 months. Finally, a significant decrease in pain was found in favor of early OKC compared to late OKC ( < 0.003). Additionally, in ACL-deficient knees, low load resistance training (LLRT) OKC showed no significant laxity difference compared to controls ( > 0.05). In contrast, high load resistance training (HLRT) OKC had less laxity than controls at 6 weeks ( = 0.02) but not at 12 weeks ( > 0.05). OKC exercises appear to be superior to CKC for improving quadriceps strength 3-4 months post-injury, whether as a part of conservative or post-surgery rehabilitation. On the other hand, OKC exercises seem to be either superior or equally effective to CKC for improving knee laxity, thus presenting their importance in being included in a rehabilitation protocol from the initial phase.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO [CRD42023475230].
PubMed: 38887689
DOI: 10.3389/fspor.2024.1416690 -
Disability and Rehabilitation Jun 2024To analyze the effects of exergames on rehabilitation outcomes in osteoarthritis (OA) patients. (Review)
Review
PURPOSE
To analyze the effects of exergames on rehabilitation outcomes in osteoarthritis (OA) patients.
MATERIALS AND METHODS
A systematic review was reported according to the PRISMA statement. Randomized controlled trials (RCTs) were searched in Pubmed, Scopus, WoS, CINAHL, and PEDro (inception to November 2023). Studies that applied non-immersive exergames and assessed physical, functional, cognitive, pain, and psychosocial outcomes were included. Comparisons were other exercise modalities and non-intervention. Methodological quality was assessed with PEDro scale, and risk of bias (RoB) was assessed with Cochrane RoB-2 tool.
RESULTS
Eight studies were included (total of participants = 401). The mean PEDro score was 6.1, and seven studies had high RoB. Seven studies involved knee OA and one cervical OA. The most frequent duration for interventions was four weeks. Exergames were more effective than controls in at least one outcome in all studies. The outcomes for which exergames were most effective were functional disability, postural balance, muscle strength, proprioception, gait, range of motion, pain, quality of life, depression, and kinesiophobia.
CONCLUSION
Non-immersive exergames constitute an effective strategy for optimizing several relevant outcomes in rehabilitation. However, more RCTs with high methodological quality are required to deepen the knowledge about the multidimensional effects of exergames in OA patients.
PubMed: 38879761
DOI: 10.1080/09638288.2024.2368057 -
Journal of Bodywork and Movement... Jul 2024To investigate the effects of combined exercise on fatigue, anxiety, depression, quality of life and physical functioning in gastroinstestinal neoplasm in people under... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To investigate the effects of combined exercise on fatigue, anxiety, depression, quality of life and physical functioning in gastroinstestinal neoplasm in people under chemotherapy with oxaliplatin treatment.
METHODS
We searched pubmed/MEDLINE, Cochrane Central Register of Controlled Trials, PEDro data base, and SciELO (until Nov 2023) for randomized controlled trials that investigated the effects of combined exercise in gastroinstestinal neoplasm people under chemotherapy with oxaliplatin treatment. Two comparisons were made: combined exercise versus usual care, combined aerobic and versus usual care (follow up). The main outcomes were muscle strength, aerobic capacity, fatigue, anxiety, depression and quality of life. Mean differences (MD) with 95% confidence interval (CI) were calculated.
RESULTS
Seven randomized controlled trials met the eligibility criteria, which included 464 people. Compared to usual care, combined aerobic and resistance resulted in decrease of general fatigue (-2.82; IC: 4.92 to -0.69, N = 48), physical fatigue (-5.08; IC: 8.41 to -1.74, N = 48) and improvement of domain physical functioning of quality of life (9.40; IC: 2.74 to 16.06, N = 48). Compared to usual care, combined aerobic and resistance - Follow up resulted in decrease of general fatigue (-2.32; IC: 4.41 to - 0.28, N = 48), physical fatigue (-0.92; IC: 3.31 to -1.47, N = 48) and improvement ofdomain physical functioning of (9.83; IC: 0.66 to 19.01, N = 48).
CONCLUSIONS
Our results demonstrate that combined exercises improves fatigue (general; physical), domain physical functioning of quality of life in gastrointestinal neoplasm people under chemotherapy treatment when compared to usual care.
Topics: Humans; Quality of Life; Fatigue; Oxaliplatin; Antineoplastic Agents; Exercise Therapy; Muscle Strength; Depression; Randomized Controlled Trials as Topic; Anxiety; Gastrointestinal Neoplasms
PubMed: 38876699
DOI: 10.1016/j.jbmt.2024.02.004 -
Journal of Bodywork and Movement... Jul 2024Pilates exercises have been used by the older adults and have shown potential to improve some components of physical fitness. (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Pilates exercises have been used by the older adults and have shown potential to improve some components of physical fitness.
OBJECTIVE
To verify the effects of Pilates on strength, endurance and muscle power in older adults.
METHODS
The searches were performed in the databases: PubMed, EMBASE, CENTRAL, CINAHL, Web of Science, SPORTDiscus, LILACS and PEDro until September 2022, without filters that limited the date of publications or language. The studies included were: randomized clinical trials (RCTs); interventions that used Pilates; interventions with outcomes involving strength, endurance and/or muscle power; participants over 60 years old.
RESULTS
24 RCTs (1190 participants) were selected. There is low quality evidence that Pilates did not significantly improve muscle strength compared to the control group (Standardized Mean Difference (SMD) = 1.18 [95%CI -0.71, 3.08] I = 93%), and moderate quality compared to other exercises (SMD = 0.01 [CI95% -0.46, 0.48] I = 0%). Very low quality evidence shows that Pilates can improve muscular endurance of upper limbs compared to control group (Mean Difference (MD) = 4.87 [95%CI 2.38, 7.36] I = 88%) and lower limbs compared to other exercises (MD = 2.68 [CI95% 0.26, 5.10] I = 87%). It was not possible to perform muscle power analysis due to the reduced number of studies.
CONCLUSION
Currently, it is not feasible to recommend Pilates exercises as a means to improve strength, endurance and muscle power in the older adults. More RCTs covering this topic are needed given the low quality of evidence available at this time.
Topics: Humans; Exercise Movement Techniques; Muscle Strength; Physical Endurance; Aged; Randomized Controlled Trials as Topic; Middle Aged; Muscle, Skeletal
PubMed: 38876695
DOI: 10.1016/j.jbmt.2024.02.021 -
Journal of Bodywork and Movement... Jul 2024Loss of hand function causes severe limitations in activity in daily living. The hand-soft robot is one of the methods that has recently been growing to increase the... (Review)
Review
INTRODUCTION
Loss of hand function causes severe limitations in activity in daily living. The hand-soft robot is one of the methods that has recently been growing to increase the patient's independence. The purpose of the present systematic review was to provide a classification, a comparison, and a design overview of mechanisms and the efficacy of the soft hand robots to help researchers approach this field.
METHODS
The literature research regarding such tools was conducted in PubMed, Google Scholar, Science Direct, and Cochrane Central Register for Controlled Trials. We included peer-reviewed studies that considered a soft robot glove as an assistive device to provide function. The two investigators screened the titles and abstracts, then independently reviewed the full-text articles. Disagreements about inclusion were resolved by consensus or a third reviewer.
RESULTS
A total of 15 articles were identified, describing 210 participants (23 healthy subjects). The tools were in three categories according to their actuation type (pneumatic system, cable-driven, another design). The most critical outcomes in studies included functional tasks (fourteen studies), grip strength (four studies), range of motion (ROM) (five studies), and user satisfaction (five studies).
DISCUSSION
Function and grip parameters are the most common critical parameters for tests of hand robots. Cable-driven transmission and soft pneumatic actuators are the most common choices for the actuation unit. Radder et al. study had the highest grade from other studies. That was the only RCT among studies.
CONCLUSION
Although few soft robotic gloves can be considered ready to reach the market, it seems these tools have the potential to be practical for people with a disability. But, we lack consistent evidence of comparing two or more soft robot gloves on the hand functions. Future research needs to assess the effect of soft robotic gloves on people with hand disorders with more populations.
Topics: Humans; Robotics; Hand Strength; Hand; Self-Help Devices; Range of Motion, Articular; Activities of Daily Living; Equipment Design
PubMed: 38876658
DOI: 10.1016/j.jbmt.2024.02.025 -
Journal of Bodywork and Movement... Jul 2024The present study aimed to determine the magnitude and intervention time of resistance training required to generate adaptations in the muscle thickness of the... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The present study aimed to determine the magnitude and intervention time of resistance training required to generate adaptations in the muscle thickness of the quadriceps muscle obtained by ultrasound in healthy adults.
METHOD
A systematic review with meta-analysis was conducted on studies recovered from Pubmed, Web of Science, and Scopus databases up to March 2022. The study selection process was carried out by two independent researchers, with the presence of a third researcher in case of disagreements. The methodological quality of the studies was determined with the TESTEX scale, and the risk of bias analysis was determined using Cochrane's RoB 2.0 tool. The meta-analysis used the inverse of the variance with a fixed model, and the effect size was reported by the standardized mean difference (SMD) with a confidence interval of 95%.
RESULTS
Ten studies were included in a meta-analysis. The overall analysis of the studies demonstrated an SMD = 0.35 [95% CI: 0.13-0.56] (P = 0.002), with a low heterogeneity of I = 0% (P = 0.52). No publication bias was detected using a funnel plot followed by Egger's test (P = 0.06). The degree of certainty of the meta-analysis was high using the GRADE tool.
CONCLUSION
We found that resistance training can generate significant average increases of 16.6% in muscle thickness obtained by ultrasound in the quadriceps femoris muscles of healthy adults. However, the subgroup analysis showed that significant effect sizes were only observed after eight weeks of training.
Topics: Humans; Resistance Training; Quadriceps Muscle; Ultrasonography; Muscle Strength
PubMed: 38876638
DOI: 10.1016/j.jbmt.2024.02.007 -
Journal of Bodywork and Movement... Jul 2024Training interventions like Resisted Sled Training, Complex Training, Plyometric training, and recently, Postactivation Potentiation Enhancement (PAPE) protocols are...
BACKGROUND
Training interventions like Resisted Sled Training, Complex Training, Plyometric training, and recently, Postactivation Potentiation Enhancement (PAPE) protocols are being employed by sportsmen for performance enhancement. Currently, there is no conclusive evidence on the effectiveness of the PAPE protocols and methods to integrate them into the training. The current systematic review aims to critically summarize the current evidence on PAPE protocols' effect on Sprint and Change of Direction (COD) performance in Athletes and study the influence of the Type of PAPE protocols, Recovery duration, Volumes, and loads of PAPE protocols.
METHODS
A systematic computerized literature search was performed from December 2020 to June 2022 on the databases: MEDLINE (assessed by PubMed), CENTRAL (Cochrane Library Central Register of Controlled Trials), PeDro, and Science direct. The major criteria for inclusion were Athletes (Population) who performed PAPE protocol as Intervention before Sprint and/or COD assessment tests. The studies were individually assessed for Risk of Bias using EPHPP (Effective Public Health Practice Project) Tool.
RESULTS
A total of sixteen studies were included. For Linear sprint, nine studies reported a significant PAPE effect whereas, six studies reported insignificant effects. Whereas, for COD performance, two studies reported insignificant results and one study reported significant CODS enhancements The recovery duration ranged from 15 s up to 16 min.
CONCLUSION
PAPE protocols can be incorporated provided the recovery duration is of Moderate duration (3-8mins) or Individualized durations, using multiple sets (2-6), moderate-high loads (>85% 1-RM), type of protocol is Barbell Hip Thrust, Plyometrics or Unilateral biomechanically similar exercises to Running.
Topics: Humans; Athletic Performance; Running; Plyometric Exercise; Athletes; Resistance Training; Muscle Strength; Physical Conditioning, Human
PubMed: 38876634
DOI: 10.1016/j.jbmt.2024.02.006