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Journal of ISAKOS : Joint Disorders &... Apr 2024Men have a higher risk of Achilles tendon (AT) injury, and the impact of morphological and mechanical sex differences may play a role. (Review)
Review
IMPORTANCE
Men have a higher risk of Achilles tendon (AT) injury, and the impact of morphological and mechanical sex differences may play a role.
AIM
The aim of this study is to systematically review the literature to determine whether there are sex-specific differences in AT morphological and mechanical properties and analyze how these differences may impact AT injury in both men and women.
EVIDENCE REVIEW
A systematic literature search of articles published between 2001 and 2021, in the MEDLINE, EMBASE, and Cochrane databases was performed during May 2022 according to PRISMA. The primary outcome measures included sex-related differences in the mechanical and morphological properties of the Achilles tendon. Secondary outcomes included impact of sex on Achilles tendon properties and adaptation.
FINDINGS
Nineteen studies with a total of 1,143 participants (613 men and 530 women) were included in this systematic review. Men had increased measurements when compared with women in the following: AT length, thickness, cross-sectional area (CSA), stiffness, peak force, loading rate, and voluntary muscle contraction. Women had an increase in CSA deformation, strain, and compliance.
CONCLUSIONS AND RELEVANCE
Our study demonstrates that men have an increased AT length, thickness, and CSA, indicating that men may be subjected biomechanically to higher loads in their day-to-day activities. In addition, men have lower deformation and compliance properties, along with increased AT stiffness, reducing their capacity to adapt during loading, potentially increasing their risk of injury.
LEVEL OF EVIDENCE
IV.
Topics: Humans; Male; Female; Achilles Tendon; Sex Characteristics; Tendon Injuries
PubMed: 37967617
DOI: 10.1016/j.jisako.2023.11.001 -
European Journal of Preventive... Mar 2024Several observational studies have investigated the association between hypertension or elevated systolic blood pressure and diastolic blood pressure and risk of heart... (Meta-Analysis)
Meta-Analysis
AIMS
Several observational studies have investigated the association between hypertension or elevated systolic blood pressure and diastolic blood pressure and risk of heart failure, but not all the studies have been consistent. This systematic review and meta-analysis aimed to summarize the available data from cohort studies on the association between hypertension, systolic and diastolic blood pressure, and the risk of heart failure.
METHODS AND RESULTS
PubMed and Embase databases were searched for relevant articles from inception to 10 June 2022. Cohort studies on hypertension or blood pressure and heart failure were included. Random effect models were used to calculate summary relative risks (RRs) and 95% confidence intervals (CIs) for the association between hypertension or blood pressure and heart failure. Forty-seven cohort studies were included. The summary RR was 1.71 (95% CI: 1.53-1.90, I2 = 98.4%) for hypertension vs. no hypertension (n = 43 studies, 166 798 cases, 20 359 997 participants), 1.28 (95% CI: 1.22-1.35, I2 = 90.3%) per 20 mmHg of systolic blood pressure (24 studies, 31 639 cases and 2 557 975 participants), and 1.12 (95% CI: 1.04-1.21, I2 = 92.6%) per 10 mmHg of diastolic blood pressure (16 studies, 23 127 cases and 2 419 972 participants). There was a steeper increase in heart failure risk at higher blood pressure levels and a three- to five-fold increase in RR at around 180/120 mmHg of systolic and diastolic blood pressure compared with 100/60 mmHg, respectively. There was little indication of publication bias across analyses.
CONCLUSION
This meta-analysis suggests a strong positive association between hypertension and systolic and diastolic blood pressure and the risk of heart failure. These results support efforts to reduce blood pressure in the general population to reduce the risk of heart failure.
Topics: Humans; Blood Pressure; Hypertension; Heart Failure; Cohort Studies; Systole
PubMed: 37939784
DOI: 10.1093/eurjpc/zwad344 -
Frontiers in Endocrinology 2023Although subclinical hypothyroidism (SCH) is related to abnormalities in left ventricular diastolic function, the use of levothyroxine as a regular treatment remains... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Although subclinical hypothyroidism (SCH) is related to abnormalities in left ventricular diastolic function, the use of levothyroxine as a regular treatment remains debatable. This meta-analysis aimed to determine whether thyroid hormone replacement therapy affects cardiac diastolic function in patients with SCH as measured by echocardiography.
METHODS
This meta-analysis included a search of the EMBASE, PubMed, Web of Science, and Cochrane Library databases from their inception to May 18, 2023, for studies analyzing cardiac morphology and functional changes in patients with SCH before and after thyroid hormone replacement. The outcome measures were cardiac morphology and diastolic and overall cardiac function, as assessed using ultrasound parameters (including ventricular wall thickness, chamber size, mitral wave flow, tissue Doppler, and speckle tracking). The quality of the studies was assessed using the Newcastle-Ottawa Scale. The standard mean differences (MDs) and 95% confidence intervals (CI) were calculated using fixed- or random-effects models.
RESULTS
Seventeen studies met the inclusion criteria. A total of 568 patients participated and completed the follow-up. All studies specifically stated that serum thyrotropin levels returned to normal by the end of the study period. Compared with baseline levels, no significant morphological changes were observed in the heart. In terms of diastolic function, we discovered that the ratios of E-velocity to A-velocity (E/A) had greatly improved after thyroid hormone replacement therapy, whereas the ratios of the mitral inflow E wave to the tissue Doppler e' wave (E/e') had not. Global longitudinal strain (GLS) increased significantly after treatment with levothyroxine.
CONCLUSION
In adult patients with SCH, thyroid hormone supplementation can partially but not completely improve parameters of diastolic function during the observation period. This meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement, an updated guideline for reporting systematic reviews (11) and was registered with INPLASY (INPLASY202320083).
SYSTEMATIC REVIEW REGISTRATION
https://inplasy.com/inplasy-2023-2-0083.
Topics: Adult; Humans; Echocardiography; Hormone Replacement Therapy; Hypothyroidism; Thyroxine; Ventricular Function, Left; Diastole
PubMed: 37818087
DOI: 10.3389/fendo.2023.1263861 -
Archives of Rehabilitation Research and... Sep 2023To investigate the differences between erector spinae muscle activation in healthy individuals and patients with Chronic Lower Back Pain (CLBP) by conducting (a)... (Review)
Review
OBJECTIVE
To investigate the differences between erector spinae muscle activation in healthy individuals and patients with Chronic Lower Back Pain (CLBP) by conducting (a) systematic review and (b) meta-analysis.
DATA SOURCES
PubMed, ScienceDirect, SPORTDiscus, and Google Scholar were used to conduct the searches, which included studies up to the 31st of March 2023 with no start date specified.
STUDY SELECTION
Any study otherwise meeting eligibility criteria was included if it reported either (1) a standard mean difference effect size; or (2) the means, SDs, and sample sizes for both the patient group and the comparator group.
DATA EXTRACTION
A total of 7 case control trials were used for the systematic review and meta-analysis.
DATA SYNTHESIS
The systematic review and meta-analysis revealed that total standardized mean difference in erector spinae muscle activation between healthy individuals vs patients with CLBP expressed in % maximum voluntary isometric contraction was 0.48 (95% confidence interval=0.21-0.74; <.001) with the heterogeneity being I=0% (=.890). The electromyography (EMG) outputs showed significant differences in activation levels between the healthy and CLBP cohorts (<.001).
CONCLUSIONS
A small effect size was found in the meta-analysis. The muscle activation levels of the erector spinae during forward propulsion were higher in CLBP individuals compared with healthy cohorts. The findings provide more clarity about the muscles that were the focus of previous research, what procedures were used to evaluate muscular contributions and what speeds the participants were moving at during the test sessions. Given the limited methodological quality of the included studies, the findings should be interpreted with caution. Future research should evaluate the effect of other factors such as walking distance and any changes in walking surfaces and gradients (ie, non-flat surfaces).
PubMed: 37744192
DOI: 10.1016/j.arrct.2023.100280 -
International Journal of Sports... Jan 2024Maximal lower-body strength can be assessed both dynamically and isometrically; however, the relationship between the changes in these 2 forms of strength following... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Maximal lower-body strength can be assessed both dynamically and isometrically; however, the relationship between the changes in these 2 forms of strength following resistance training is not well understood.
PURPOSE
To systematically review and analyze the effects of resistance training on changes in maximal dynamic (1-repetition-maximum back squat, deadlift, and power clean) and position-matched isometric strength (isometric midthigh pull and the isometric squat). In addition, individual-level data were used to quantify the agreement and relationship between changes in dynamic and isometric strength.
METHODS
Databases were systematically searched to identify eligible articles, and meta-analysis procedures were performed on the extracted data. The raw results from 4 studies were acquired, enabling bias and absolute reliability measures to be calculated using Bland-Altman test of agreement.
RESULTS
Eleven studies met the inclusion criteria, which resulted in 29 isometric-dynamic change comparisons. The overall pooled effect was 0.13 in favor of dynamic testing; however, the prediction interval ranged from g = -0.49 to 0.75. There was no evidence of bias (P = .825) between isometric and dynamic tests; however, the reliability coefficient was estimated to be 16%, and the coefficient of variation (%) was 109.27.
CONCLUSIONS
As a range of future effects can be expected when comparing isometric to dynamic strength changes following resistance training, and limited proportionality exists between changes in these 2 strength qualities, there is strong evidence that isometric and dynamic strength represent separate neuromuscular domains. These findings can be used to inform strength-assessment models in athlete populations.
Topics: Humans; Muscle Strength; Isometric Contraction; Resistance Training; Reproducibility of Results; Athletes
PubMed: 37741636
DOI: 10.1123/ijspp.2023-0066 -
Sports Health Sep 2023Athletes are almost 3 times more at risk of experiencing urinary incontinence (UI) than sedentary women, with prevalence rates varying from 10.9% in low-impact sports... (Review)
Review
CONTEXT
Athletes are almost 3 times more at risk of experiencing urinary incontinence (UI) than sedentary women, with prevalence rates varying from 10.9% in low-impact sports such as cycling to 80% when engaging in high-impact sports such as trampoline gymnastics. To treat UI, pelvic floor muscle (PFM) training (PFMT) is recommended as a first line of treatment.
OBJECTIVE
The aim of the present study was to perform a meta-analysis of the available literature on the efficacy of PFMT interventions in young, nulliparous female athletes.
DATA SOURCES
A literature research was conducted using PubMed, Sport Discus, and Web of Science.
STUDY SELECTION
The inclusion criteria were studies with PFMT intervention in female athletes or recreationally active women. Interventions could be carried out for treatment or prevention of pelvic floor dysfunctions.
STUDY DESIGN
Systematic review with meta-analysis.
LEVEL OF EVIDENCE
Level 5.
DATA EXTRACTION
A descriptive analysis of the articles included in the systematic review was carried out. Meta-analyses could be performed on 6 of the included articles, evaluating the maximal voluntary contraction (MVC) of the PFMs, the amount of urinary leakage (AUL), and the vaginal resting pressure (VRP). Random-effects model and standardized mean differences (SMD) ± 95% CI were reported.
RESULTS
The meta-analysis showed that PFMT produced a significant increase in MVC (SMD, 0.60; 95% CI, 0.11 to 1.08; = 0.02) and a significant reduction of AUL (SMD, -1.13; 95% CI, -1.84 to -0.41; < 0.01) in female athletes. No effects were shown in VRP (SMD, -0.05; 95% CI, -1.27 to 1.17; = 0.93).
CONCLUSION
PFMT is shown to be effective in increasing PFM strength and reducing urine leakage in female athletes, being a powerful tool to prevent and treat pelvic floor dysfunction in this population.
PubMed: 37688407
DOI: 10.1177/19417381231195305 -
Scandinavian Journal of Medicine &... Dec 2023Hamstring strain injury (HSI) remains a performance, economic, and player availability burden in sport. High-speed running (HSR) is cited as a common mechanism for HSI.... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Hamstring strain injury (HSI) remains a performance, economic, and player availability burden in sport. High-speed running (HSR) is cited as a common mechanism for HSI. While evidence exists regarding the high physical demands on the hamstring muscles in HSR, meta-analytical synthesis of related activation and kinetic variables is lacking.
METHODS
A systematic search of Medline, Embase, Scopus, CINAHL, SportDiscus, and Cochrane library databases was conducted in accordance with the PRISMA 2020 guidelines. Studies reporting hamstring activation (electromyographic [EMG]) or hamstring muscle/related joint kinetics were included where healthy adult participants ran at or beyond 60% of maximum speed (activation studies) or 4 m per second (m/s) (kinetic studies).
RESULTS
A total of 96 studies met the inclusion criteria. Run intensities were categorized as "slow," "moderate," or "fast" in both activation and kinetic based studies with appropriate relative, and raw measures, respectively. Meta-analysis revealed pooled mean lateral hamstring muscle activation levels of 108.1% (95% CI: 84.4%-131.7%) of maximal voluntary isometric contraction (MVIC) during "fast" running. Meta-analysis found swing phase peak knee flexion internal moment and power at 2.2 Newton meters/kilogram (Nm/kg) (95% CI: 1.9-2.5) and 40.3 Watts/kilogram (W/kg) (95% CI: 31.4-49.2), respectively. Hip extension peak moment and power was estimated as 4.8 Nm/kg (95% CI: 3.9-5.7) and 33.1 W/kg (95% CI: 17.4-48.9), respectively.
CONCLUSIONS
As run intensity/speed increases, so do the activation and kinetic demands on the hamstrings. The presented data will enable clinicians to incorporate more objective measures into the design of injury prevention and return-to-play decision-making strategies.
Topics: Adult; Humans; Hamstring Muscles; Kinetics; Isometric Contraction; Muscle Strength; Running; Soft Tissue Injuries
PubMed: 37668346
DOI: 10.1111/sms.14478 -
Frontiers in Endocrinology 2023Physical inactivity increases the risk for metabolic diseases such as obesity and type 2 diabetes. Neuromuscular electrical stimulation (NMES) is an effective method to... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Physical inactivity increases the risk for metabolic diseases such as obesity and type 2 diabetes. Neuromuscular electrical stimulation (NMES) is an effective method to induce muscle contraction, particularly for populations with physical impairments and/or metabolic diseases. However, its effectiveness to improve glycemic control is unclear. This review aimed to determine the effectiveness of NMES on glycemic control.
METHODS
Electronic search consisted of MEDLINE (PubMed), EMBASE, Cochrane Library, Google Scholar, and Web of Science to identify studies that investigated the effects of NMES on glycemic control for this systematic review. The meta-analysis consists of the studies designed as randomized controlled trials. Effect sizes were calculated as the standardized mean difference (SMD) and meta-analysis was conducted using a random-effects model.
RESULTS
Thirty-five studies met the inclusion criteria for systematic review and of those, nine qualified for the meta-analysis. Existing evidence suggested that NMES effectively improves glycemic control predominantly in middle-aged and elderly population with type 2 diabetes, obesity, and spinal cord injury. The meta-analysis is comprised of 180 participants and reported that NMES intervention lowered fasting blood glucose (SMD: 0.48; 95% CI: 0.17 to 0.78; p=0.002; I²=0%). Additional analysis using the primary measures reported by each study to indicate glycemic control (i.e., OGTT, HOMA-IR, and fasting glucose) also confirmed a significant effect of NMES on improving glycemic control (SMD: 0.41; 95% CI, 0.09 to 0.72; p=0.01; I²=11%). NMES protocol varied across studies and requires standardization.
CONCLUSION
NMES could be considered as a therapeutic strategy to improve glycemic control in populations with physical impairments and/or metabolic disorders.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/, identifier CRD42020192491.
Topics: Aged; Humans; Middle Aged; Diabetes Mellitus, Type 2; Electric Stimulation; Electric Stimulation Therapy; Health Services; Obesity
PubMed: 37583429
DOI: 10.3389/fendo.2023.1222532 -
Heart Failure Reviews Jan 2024Iron overload increases the production of harmful reactive oxygen species in the Fenton reaction, which causes oxidative stress in the body and lipid peroxidation in the... (Review)
Review
Iron overload increases the production of harmful reactive oxygen species in the Fenton reaction, which causes oxidative stress in the body and lipid peroxidation in the cell membrane, and eventually leads to ferroptosis. Diabetes is associated with increased intracellular oxidative stress, inflammation, autophagy, microRNA alterations, and advanced glycation end products (AGEs), which cause cardiac remodeling and cardiac diastolic contractile dysfunction, leading to the development of diabetic cardiomyopathy (DCM). While these factors are also closely associated with ferroptosis, more and more studies have shown that iron-mediated ferroptosis is an important causative factor in DCM. In order to gain fresh insights into the functions of ferroptosis in DCM, this review methodically summarizes the traits and mechanisms connected with ferroptosis and DCM.
Topics: Humans; Diabetic Cardiomyopathies; Ferroptosis; MicroRNAs; Autophagy; Diastole; Reactive Oxygen Species; Diabetes Mellitus
PubMed: 37555989
DOI: 10.1007/s10741-023-10336-z -
European Journal of Obstetrics,... Sep 2023The International Continence Society (ICS) recommends the use of perineometry and digital palpation to assess the pelvic floor muscles (PFM). Exploring the degree of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The International Continence Society (ICS) recommends the use of perineometry and digital palpation to assess the pelvic floor muscles (PFM). Exploring the degree of correlation between both assessment strategies will serve to improve safety for clinical practice. Therefore, we performed a systematic review and meta-analysis on the correlation between assessment strategies.
METHODS
Observational studies were included. Bias risk assessment based on Downs and Black scale and the evidence's level were assessed using the GRADE. The random effect model measured the correlation values and were quantitatively analyzed through meta-analysis. Registration in PROSPERO database - CRD42021253775.
RESULTS
Six studies were selected. There was a high positive correlation between perineometry and MOS (r = 0.74; 95%-IC 0.61-0.83; I: 81%, p < 0.01). Subgroup analysis was performed with 3 studies with continent women, and revealed a high positive correlation (r = 0.80; 95%-IC 0.62-0.90; I: 90%, p < 0.01), while 2 studies with incontinent women revealed a moderate positive correlation (r = 0.64; 95%-IC 0.48-0.75; I: 0%, p = 0.40). GRADE analysis revealed a low strength of evidence.
CONCLUSION
The high positive correlation between perineometry and MOS suggests that if the assessment strategies are applied in a standardized way, these tests can be used together or separately to assess the functionality of PFMs in clinical practice. However, the results should be interpreted with caution due to the low strength of GRADE evidence.
Topics: Female; Humans; Muscle Contraction; Pelvic Floor; Palpation; Observational Studies as Topic
PubMed: 37549507
DOI: 10.1016/j.ejogrb.2023.07.011