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The Journal of Sexual Medicine Aug 2023The association between pelvic pain and pelvic floor muscle (PFM) tone in women with persistent noncancer pelvic pain (PNCPP) is unclear. (Meta-Analysis)
Meta-Analysis
BACKGROUND
The association between pelvic pain and pelvic floor muscle (PFM) tone in women with persistent noncancer pelvic pain (PNCPP) is unclear.
AIM
To synthesize the evidence of the association between pelvic pain and PFM tone in women with PNCPP.
METHODS
A systematic review was conducted via MEDLINE, Emcare, Embase, CINAHL, PsycINFO, and Scopus to identify relevant studies. Studies were eligible if pelvic pain and PFM tone outcome measures were reported among women aged >18 years. The National Heart, Lung, and Blood Institute's Quality Assessment Tool for Observational Cohort and Cross-sectional Studies was used to assess study quality. Studies were pooled by assessment of PFM tone via a random effects model. Associations between the presence of pelvic pain and PFM tone were assessed with odds ratio (OR), while linear associations were assessed with Pearson or Spearman correlation.
OUTCOMES
Pelvic pain measures (intensity, threshold, and frequency) and resting PFM tone in women with PNCPP, as evaluated by any clinical assessment method or tool.
RESULTS
Twenty-four studies were included in this review. The presence of pelvic pain was significantly associated with increased PFM tone as assessed by digital palpation (OR, 2.85; 95% CI, 1.66-4.89). Pelvic pain intensity was inversely but weakly associated with PFM flexibility when evaluated through dynamometry (r = -0.29; 95% CI, -0.42 to -0.17). However, no significant associations were found between pelvic pain and PFM tone when measured with other objective assessment methods.
CLINICAL IMPLICATIONS
Pelvic pain and increased PFM tone may not be directly associated; alternatively, a nonlinear association may exist. A range of biopsychosocial factors may mediate or moderate the association, and clinicians may need to consider these factors when assessing women with PNCPP.
STRENGTHS AND LIMITATIONS
This review was reported according to the PRISMA guidelines. All possible findings from relevant theses and conference abstracts were considered in our search. However, nonlinear associations between pelvic pain and increased PFM tone were not assessed as part of this review.
CONCLUSION
Pelvic pain may be linearly associated with increased PFM tone and decreased PFM flexibility when measured with digital palpation or dynamometry; however, this association was not observed when other aspects of PFM tone were assessed through objective methods. Future studies are required using robust assessment methods to measure PFM tone and analyses that account for other biopsychosocial factors that may influence the association.
Topics: Female; Humans; Pelvic Floor; Muscle Tonus; Cross-Sectional Studies; Pelvic Pain; Pelvic Floor Disorders; Muscle Contraction
PubMed: 37507352
DOI: 10.1093/jsxmed/qdad089 -
The Journal of Sports Medicine and... Oct 2023Eccentric cycling (ECC
CYC ) has attracted considerable interest due to its potential applicability for exercise treatment/training of patients with poor... (Meta-Analysis)Meta-Analysis
INTRODUCTION
Eccentric cycling (ECC
CYC ) has attracted considerable interest due to its potential applicability for exercise treatment/training of patients with poor exercise tolerance as well as healthy and trained individuals. Conversely, little is known about the acute physiological responses to this exercise modality, thus challenging its proper prescription. This study aimed to provide precise estimates of the acute physiological responses to ECCCYC in comparison to traditional concentric cycling (CONCYC ).EVIDENCE ACQUISITION
Searches were performed until November 2021 using the PubMed, Embase, and ScienceDirect databases. Studies that examined individuals' cardiorespiratory, metabolic, and perceptual responses to ECC
CYC and CONCYC sessions were included. Bayesian multilevel meta-analysis models were used to estimate the population mean difference between acute physiological responses from ECCCYC and CONCYC bouts. Twenty-one studies were included in this review.EVIDENCE SYNTHESIS
The meta-analyses showed that ECC
CYC induced lower cardiorespiratory (i.e., V̇O2 , V̇E, and HR), metabolic (i.e., [BLa]), and perceptual (i.e., RPE) responses than CONCYC performed at the same absolute power output, while greater cardiovascular strain (i.e., greater increases in HR, Q, MAP, [norepinephrine], and lower SV) was detected when compared to CONCYC performed at the same V̇O2 .CONCLUSIONS
The prescription of ECC
CYC based on workloads used in the CONCYC sessions may be considered safe and, therefore, feasible for the rehabilitation of individuals with poor exercise tolerance. However, the prescription of ECCCYC based on the V̇O2 obtained during CONCYC sessions should be conducted with caution, especially in clinical settings, since there is a high probability of additional cardiovascular overload in this condition.Topics: Humans; Bayes Theorem; Exercise; Bicycling; Oxygen Consumption; Heart Rate; Muscle, Skeletal; Muscle Contraction
PubMed: 37410446
DOI: 10.23736/S0022-4707.23.14971-1 -
Journal of Sport and Health Science Jan 2024The aim of this umbrella review was to determine the impact of resistance training (RT) and individual RT prescription variables on muscle mass, strength, and physical... (Review)
Review
PURPOSE
The aim of this umbrella review was to determine the impact of resistance training (RT) and individual RT prescription variables on muscle mass, strength, and physical function in healthy adults.
METHODS
Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically searched and screened eligible systematic reviews reporting the effects of differing RT prescription variables on muscle mass (or its proxies), strength, and/or physical function in healthy adults aged >18 years.
RESULTS
We identified 44 systematic reviews that met our inclusion criteria. The methodological quality of these reviews was assessed using A Measurement Tool to Assess Systematic Reviews; standardized effectiveness statements were generated. We found that RT was consistently a potent stimulus for increasing skeletal muscle mass (4/4 reviews provide some or sufficient evidence), strength (4/6 reviews provided some or sufficient evidence), and physical function (1/1 review provided some evidence). RT load (6/8 reviews provided some or sufficient evidence), weekly frequency (2/4 reviews provided some or sufficient evidence), volume (3/7 reviews provided some or sufficient evidence), and exercise order (1/1 review provided some evidence) impacted RT-induced increases in muscular strength. We discovered that 2/3 reviews provided some or sufficient evidence that RT volume and contraction velocity influenced skeletal muscle mass, while 4/7 reviews provided insufficient evidence in favor of RT load impacting skeletal muscle mass. There was insufficient evidence to conclude that time of day, periodization, inter-set rest, set configuration, set end point, contraction velocity/time under tension, or exercise order (only pertaining to hypertrophy) influenced skeletal muscle adaptations. A paucity of data limited insights into the impact of RT prescription variables on physical function.
CONCLUSION
Overall, RT increased muscle mass, strength, and physical function compared to no exercise. RT intensity (load) and weekly frequency impacted RT-induced increases in muscular strength but not muscle hypertrophy. RT volume (number of sets) influenced muscular strength and hypertrophy.
Topics: Adult; Humans; Resistance Training; Exercise Therapy; Exercise; Hypertrophy; Muscle, Skeletal
PubMed: 37385345
DOI: 10.1016/j.jshs.2023.06.005 -
Journal of Strength and Conditioning... Oct 2023Santos, PDG, Vaz, JR, Correia, J, Neto, T, and Pezarat-Correia, P. Long-term neurophysiological adaptations to strength training: a systematic review with...
Santos, PDG, Vaz, JR, Correia, J, Neto, T, and Pezarat-Correia, P. Long-term neurophysiological adaptations to strength training: a systematic review with cross-sectional studies. J Strength Cond Res 37(10): 2091-2105, 2023-Neuromuscular adaptations to strength training are an extensively studied topic in sports sciences. However, there is scarce information about how neural mechanisms during force production differ between trained and untrained individuals. The purpose of this systematic review is to better understand the differences between highly trained and untrained individuals to establish the long-term neural adaptations to strength training. Three databases were used for the article search (PubMed, Web of Science, and Scopus). Studies were included if they compared groups of resistance-trained with untrained people, aged 18-40 year, and acquired electromyography (EMG) signals during strength tasks. Twenty articles met the eligibility criteria. Generally, strength-trained individuals produced greater maximal voluntary activation, while reducing muscle activity in submaximal tasks, which may affect the acute response to strength training. These individuals also presented lower co-contraction of the antagonist muscles, although it depends on the specific training background. Global intermuscular coordination may be another important mechanism of adaptation in response to long-term strength training; however, further research is necessary to understand how it develops over time. Although these results should be carefully interpreted because of the great disparity of analyzed variables and methods of EMG processing, chronic neural adaptations seem to be decisive to greater force production. It is crucial to know the timings at which these adaptations stagnate and need to be stimulated with advanced training methods. Thus, training programs should be adapted to training status because the same stimulus in different training stages will lead to different responses.
Topics: Humans; Resistance Training; Cross-Sectional Studies; Electromyography; Sports; Adaptation, Physiological; Muscle, Skeletal; Muscle Strength
PubMed: 37369087
DOI: 10.1519/JSC.0000000000004543 -
European Urology Focus Nov 2023Erectile dysfunction (ED) is associated with an increased risk of cardiovascular morbidity and mortality. (Meta-Analysis)
Meta-Analysis Review
CONTEXT
Erectile dysfunction (ED) is associated with an increased risk of cardiovascular morbidity and mortality.
OBJECTIVE
To systematically review and analyze the cardiac structure and function in men with ED assessed with echocardiography.
EVIDENCE ACQUISITION
We performed a systematic review and meta-analysis according to the guideline of the Preferred Reporting Items for Systematic Reviews and Meta-analyses. We searched PubMed and the Cochrane Library on June 2, 2022, and included studies evaluating cardiac structure and function using echocardiography in men with ED compared with controls without ED. The Newcastle-Ottawa Quality Assessment Scale was used for assessing the quality of studies. We analyzed the mean differences in left ventricular ejection fraction (LVEF), the ratio of early transmitral filling velocity to early diastolic mitral annular velocity (E/e'), ratio of the early to late diastolic transmitral flow velocity (E/A), isovolumic relaxation time (IVRT), and left ventricular mass index (LVMi) in a random-effect model computed using means and standard deviations. The review was preregistered with PROSPERO (CRD42022337183). We received no funding.
EVIDENCE SYNTHESIS
We included ten studies with 763 men diagnosed with ED (mean age: 55.6 yr) and 358 control men (mean age: 54.4 yr). E/e' was significantly worse in men with ED than in controls (mean absolute difference = 1.17, 95% confidence interval or CI [0.68, 1.65], p < 0.005). No significant differences were observed in LVEF, E/A, IVRT, or LVMi (-0.06, 95% CI [-1.06, 0.95], p = 0.91; -0.06, 95% CI [-0.24, 0.13], p = 0.55; 11.76, 95% CI [-0.88, 24.39], p = 0.07; and 4.37, 95% CI [-2.91, 11.65], respectively). The studies exhibited heterogeneity regarding study populations, reported echocardiography data, and variations in adjustments for confounding factors.
CONCLUSIONS
Left ventricle diastolic dysfunction, as assessed by E/e', was more frequent in men with ED than in matched controls without ED. The results imply that echocardiography may be useful in the cardiovascular evaluation of men with ED to help identify myocardial impairment.
PATIENT SUMMARY
This study reviewed for the first time previous research on cardiac structure and function in men with erectile dysfunction (ED), as assessed by echocardiography. We found that men with ED, compared with men without ED, had a higher ratio of early transmitral filling velocity to early diastolic mitral annular velocity , indicating a potentially higher rate of impaired diastolic function-a potential early indicator of heart disease. Identification of early signs of heart problems in men with ED may help initiate necessary lifestyle modifications or preventative therapies before the development of heart disease. However, more research is required to determine the clinical utility of using echocardiography as a risk assessment method.
Topics: Male; Humans; Middle Aged; Erectile Dysfunction; Ventricular Function, Left; Stroke Volume; Ventricular Dysfunction, Left; Diastole
PubMed: 37355365
DOI: 10.1016/j.euf.2023.06.001 -
Neurourology and Urodynamics Aug 2023Some authors suggest that breathing exercises should be recommended instead of or in combination with pelvic floor muscle training (PFMT) to prevent and treat urinary... (Review)
Review
INTRODUCTION
Some authors suggest that breathing exercises should be recommended instead of or in combination with pelvic floor muscle training (PFMT) to prevent and treat urinary incontinence (UI) and pelvic organ prolapse (POP).
AIMS
The primary aim of the present study was to investigate the evidence for breathing as an intervention alone or in addition to PFM contraction in treatment of UI and POP.
MATERIALS & METHODS
This systematic review included short-term experimental studies and randomize controlled trials (RCTs) indexed on PubMed, EMBASE, and PEDro database. A form was used to extract data that was analyzed qualitatively due to the heterogeneity in interventions and outcome measures of the included studies. The individual methodological quality of RCTs was analyzed using the PEDro scale.
RESULTS
A total of 18 studies were included, 374 participants from short-term experimental studies and 765 from nine RCTs. PEDro score varied from 4 to 8. Activation of the PFM during expiration was significantly less than during a PFM contraction. In general, the RCTs showed that training the PFM is significantly more effective to improve PFM variables and UI and POP than breathing exercises, and that adding breathing exercises to PFMT have no additional effect.
CONCLUSION
This systematic review indicates that the evidence for incorporating breathing exercise in clinical practice in addition to or instead of PFMT is scant or non-existing, both based on short-term experimental studies and small RCTs.
Topics: Humans; Pelvic Floor; Exercise Therapy; Urinary Incontinence; Breathing Exercises; Pelvic Organ Prolapse; Treatment Outcome
PubMed: 37260116
DOI: 10.1002/nau.25218 -
Sports Medicine (Auckland, N.Z.) Aug 2023Several studies have utilised isometric, eccentric and downhill walking pre-conditioning as a strategy for alleviating the signs and symptoms of exercise-induced muscle... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Several studies have utilised isometric, eccentric and downhill walking pre-conditioning as a strategy for alleviating the signs and symptoms of exercise-induced muscle damage (EIMD) following a bout of damaging physical activity.
OBJECTIVES
This systematic review and meta-analysis examined the effects of pre-conditioning strategies on indices of muscle damage and physical performance measures following a second bout of strenuous physical activity.
DATA SOURCES
PubMed, CINAHL and Scopus.
ELIGIBILITY CRITERIA
Studies meeting the PICO (population, intervention/exposure, comparison, and outcome) criteria were included in this review: (1) general population or "untrained" participants with no contraindications affecting physical performance; (2) studies with a parallel design to examine the prevention and severity of muscle-damaging contractions; (3) outcome measures were compared using baseline and post-intervention measures; and (4) outcome measures included any markers of indirect muscle damage and muscular contractility measures.
PARTICIPANTS
Individuals with no resistance training experiences in the previous 6 or more months.
INTERVENTIONS
A single bout of pre-conditioning exercises consisting of eccentric or isometric contractions performed a minimum of 24 h prior to a bout of damaging physical activity were compared to control interventions that did not perform pre-conditioning prior to damaging physical activity.
STUDY APPRAISAL
Kmet appraisal system.
SYNTHESIS METHODS
Quantitative analysis was conducted using forest plots to examine standardised mean differences (SMD, i.e. effect size), test statistics for statistical significance (i.e. Z-values) and between-study heterogeneity by inspecting I.
RESULTS
Following abstract and full-text screening, 23 articles were included in this paper. Based on the meta-analysis, the pre-conditioning group exhibited lower levels of creatine kinase at 24 h (SMD = - 1.64; Z = 8.39; p = 0.00001), 48 h (SMD = - 2.65; Z = 7.78; p = 0.00001), 72 h (SMD = - 2.39; Z = 5.71; p = 0.00001) and 96 h post-exercise (SMD = - 3.52; Z = 7.39; p = 0.00001) than the control group. Delayed-onset muscle soreness was also lower for the pre-conditioning group at 24 h (SMD = - 1.89; Z = 6.17; p = 0.00001), 48 h (SMD = - 2.50; Z = 7.99; p = 0.00001), 72 h (SMD = - 2.73; Z = 7.86; p = 0.00001) and 96 h post-exercise (SMD = - 3.30; Z = 8.47; p = 0.00001). Maximal voluntary contraction force was maintained and returned to normal sooner in the pre-conditioning group than in the control group, 24 h (SMD = 1.46; Z = 5.49; p = 0.00001), 48 h (SMD = 1.59; Z = 6.04; p = 0.00001), 72 h (SMD = 2.02; Z = 6.09; p = 0.00001) and 96 h post-exercise (SMD = 2.16; Z = 5.69; p = 0.00001). Range of motion was better maintained by the pre-conditioning group compared with the control group at 24 h (SMD = 1.48; Z = 4.30; p = 0.00001), 48 h (SMD = 2.20; Z = 5.64; p = 0.00001), 72 h (SMD = 2.66; Z = 5.42; p = 0.00001) and 96 h post-exercise (SMD = 2.5; Z = 5.46; p = 0.00001). Based on qualitative analyses, pre-conditioning activities were more effective when performed at 2-4 days before the muscle-damaging protocol compared with immediately prior to the muscle-damaging protocol, or 1-3 weeks prior to the muscle-damaging protocol. Furthermore, pre-conditioning activities performed using eccentric contractions over isometric contractions, with higher volumes, greater intensity and more lengthened muscle contractions provided greater protection from EIMD.
LIMITATIONS
Several outcome measures showed high inter-study heterogeneity. The inability to account for differences in durations between pre-conditioning and the second bout of damaging physical activity was also limiting.
CONCLUSIONS
Pre-conditioning significantly reduced the severity of creatine kinase release, delayed-onset muscle soreness, loss of maximal voluntary contraction force and the range of motion decrease. Pre-conditioning may prevent severe EIMD and accelerate recovery of muscle force generation capacity.
Topics: Humans; Myalgia; Muscle, Skeletal; Exercise; Exercise Therapy; Muscle Contraction; Isometric Contraction; Creatine Kinase
PubMed: 37160563
DOI: 10.1007/s40279-023-01839-8 -
Journal of Athletic Training Feb 2024To investigate whether lower limb strength is reduced in people with patellar tendinopathy (PT) compared with asymptomatic control individuals or the asymptomatic... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To investigate whether lower limb strength is reduced in people with patellar tendinopathy (PT) compared with asymptomatic control individuals or the asymptomatic contralateral limb.
DATA SOURCES
MEDLINE, PubMed, Scopus, and Web of Science.
STUDY SELECTION
To be included in the systematic review and meta-analysis, studies were required to be peer reviewed, published in the English language, and case control investigations; include participants with a clinical diagnosis of PT and an asymptomatic control or contralateral limb group; and include an objective measure of lower limb maximal strength.
DATA EXTRACTION
We extracted descriptive statistics for maximal strength for the symptomatic and asymptomatic limbs of individuals with PT and the limb(s) of the asymptomatic control group, inferential statistics for between-groups differences, participant characteristics, and details of the strength-testing protocol. The risk of bias was assessed using the Joanna Briggs Institute critical appraisal tool for analytical cross-sectional studies.
DATA SYNTHESIS
Of the 23 included studies, 21 reported knee strength, 3 reported hip strength, and 1 reported ankle strength. Random-effects models (Hedges g) were used to calculate the pooled effect sizes (ESs) of muscle strength according to the direction of joint movement and type of contraction. The pooled ESs (95% CI) for maximal voluntary isometric contraction knee-extension strength, concentric knee-extension strength, and concentric knee-flexion strength were 0.54 (0.27, 0.80), 0.78 (0.30, 1.33), and 0.41 (0.04, 0.78), respectively, with all favoring greater strength in the asymptomatic control group. Researchers of 2 studies described maximal eccentric knee-extensor strength with no differences between the PT and asymptomatic control groups. In 3 studies, researchers measured maximal hip strength (abduction, extension, and external rotation), and all within-study ESs favored greater strength in the asymptomatic control group.
CONCLUSIONS
Isometric and concentric knee-extensor strength are reduced in people with PT compared with asymptomatic control individuals. In contrast, evidence for reduced eccentric knee-extension strength in people with PT compared with asymptomatic control individuals is limited and inconsistent. Although evidence is emerging that both knee-flexion and hip strength may be reduced in people with PT, more examination is needed to confirm this observation.
Topics: Humans; Cross-Sectional Studies; Lower Extremity; Knee; Knee Joint; Muscle Strength; Tendinopathy; Muscle, Skeletal
PubMed: 37071550
DOI: 10.4085/1062-6050-0662.22 -
European Journal of Clinical Nutrition Aug 2023It is unknown whether dietary protein consumption can attenuate resistance exercise-induced muscle damage (EIMD). Managing EIMD may accelerate muscle recovery and allow... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
It is unknown whether dietary protein consumption can attenuate resistance exercise-induced muscle damage (EIMD). Managing EIMD may accelerate muscle recovery and allow frequent, high-quality exercise to promote muscle adaptations. This systematic review and meta-analysis examined the impact of peri-exercise protein supplementation on resistance EIMD.
METHODS
A literature search was conducted on PubMed, SPORTDiscus, and Web of Science up to March 2021 for relevant articles. PEDro criteria were used to assess bias within included studies. A Hedges' g effect size (ES) was calculated for indirect markers of EIMD at h post-exercise. Weighted ESs were included in a random effects model to determine overall ESs over time.
RESULTS
Twenty-nine studies were included in the systematic review and 40 trials were included in ≥1 meta-analyses (16 total). There were significant overall effects of protein for preserving isometric maximal voluntary contraction (MVC) at 96 h (0.563 [0.232, 0.894]) and isokinetic MVC at 24 h (0.639 [0.116, 1.162]), 48 h (0.447 [0.104, 0.790]), and 72 h (0.569 [0.136, 1.002]). Overall ESs were large in favour of protein for attenuating creatine kinase concentration at 48 h (0.836 [-0.001, 1.673]) and 72 h (1.335 [0.294, 2.376]). Protein supplementation had no effect on muscle soreness compared with the control.
CONCLUSION
Peri-exercise protein consumption could help maintain maximal strength and lower creatine kinase concentration following resistance exercise but not reduce muscle soreness. Conflicting data may be due to methodological divergencies between studies. Standardised methods and data reporting for EIMD research are needed.
Topics: Humans; Myalgia; Muscle, Skeletal; Resistance Training; Dietary Proteins; Dietary Supplements; Creatine Kinase
PubMed: 36513777
DOI: 10.1038/s41430-022-01250-y -
The Journals of Gerontology. Series A,... Aug 2023A systematic review and network meta-analysis was undertaken to examine the effectiveness of different modes of resistance exercise velocity in fast walking speed,... (Meta-Analysis)
Meta-Analysis
Does High-Velocity Resistance Exercise Elicit Greater Physical Function Benefits Than Traditional Resistance Exercise in Older Adults? A Systematic Review and Network Meta-Analysis of 79 Trials.
BACKGROUND
A systematic review and network meta-analysis was undertaken to examine the effectiveness of different modes of resistance exercise velocity in fast walking speed, timed-up and go, 5-times sit-to-stand, 30-second sit-to-stand, and 6-minute walking tests in older adults.
METHODS
CINAHL, Embase, LILACS, PubMed, Scielo, SPORTDiscus, and Web of Science databases were searched up to February 2022. Eligible randomized trials examined the effects of supervised high-velocity or traditional resistance exercise in older adults (ie, ≥60 years). The primary outcome for this review was physical function measured by fast walking speed, timed-up and go, 5-times sit-to-stand, 30-second sit-to-stand, and 6-minute walking tests, while maximal muscle power and muscle strength were secondary. A random-effects network meta-analysis was undertaken to examine the effects of different resistance exercise interventions.
RESULTS
Eighty articles describing 79 trials (n = 3 575) were included. High-velocity resistance exercise was the most effective for improving fast walking speed (standardized mean difference [SMD] -0.44, 95% confidence interval [CI]: 0.00 to 0.87), timed-up and go (SMD -0.76, 95% CI: -1.05 to -0.47), and 5-times sit-to-stand (SMD -0.74, 95% CI: -1.20 to -0.27), while traditional resistance exercise was the most effective for 30-second sit-to-stand (SMD 1.01, 95% CI: 0.68 to 1.34) and 6-minute walking (SMD 0.68, 95% CI: 0.34 to 1.03).
CONCLUSION
Our study provides evidence that resistance exercise velocity effects are specific in older adults, as evidenced by physical function test dependence. We suggest that prescriptions based on the velocity of contraction should be individualized to address the specific functional needs of participants.
Topics: Humans; Aged; Resistance Training; Network Meta-Analysis; Exercise; Exercise Therapy; Walking; Muscle Strength
PubMed: 36378500
DOI: 10.1093/gerona/glac230