-
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 -
PeerJ 2024Structured aerobic or resistance training alone seems to be a beneficial tool for improving glucose homeostasis, chronic systemic inflammation, resting cardiovascular... (Meta-Analysis)
Meta-Analysis
Effects of combined aerobic and resistance training on glycemic control, blood pressure, inflammation, cardiorespiratory fitness and quality of life in patients with type 2 diabetes and overweight/obesity: a systematic review and meta-analysis.
BACKGROUND
Structured aerobic or resistance training alone seems to be a beneficial tool for improving glucose homeostasis, chronic systemic inflammation, resting cardiovascular function, and mental health in people with obesity and type 2 diabetes mellitus (T2DM). The aim of the present study was to synthesize the available data on the effectiveness of combined aerobic and resistance training (CART) on glycemic control, blood pressure, inflammation, cardiorespiratory fitness (CRF), and quality of life (QoL) in overweight and obese individuals with T2DM.
METHODS
A database search was carried out in PubMed, Web of Science, Scopus, Science Direct, Cochrane Library, and Google Scholar from inception up to May 2023. The Cochrane risk of bias tool was used to assess eligible studies, and the GRADE method to evaluate the reliability of evidence. A random-effects model was used, and data were analyzed using standardized mean differences and 95% confidence intervals. The study protocol was registered in the International Prospective Register of Systematic Reviews (ID: CRD42022355612).
RESULTS
A total of 21,612 studies were retrieved; 20 studies were included, and data were extracted from 1,192 participants (mean age: 57 ± 7 years) who met the eligibility criteria. CART demonstrated significant improvements in body mass index, glycated hemoglobin, systolic and diastolic blood pressure, C-reactive protein, tumor necrosis factor-alpha, interleukin-6, CRF, and QoL compared to ST. These findings highlight the significance of exercise interventions such as CART as essential elements within comprehensive diabetes management strategies, ultimately enhancing overall health outcomes in individuals with T2DM and overweight/obesity.No differences were found in resting heart rate between CART and ST. An uncertain risk of bias and poor quality of evidence were found among the eligible studies.
CONCLUSION
These outcomes show clear evidence considering the positive role of CART in inducing beneficial changes in various cardiometabolic and mental health-related indicators in patients with T2DM and concurrent overweight/obesity. More studies with robust methodological design are warranted to examine the dose-response relationship, training parameters configuration, and mechanisms behind these positive adaptations.
Topics: Humans; Middle Aged; Blood Glucose; Blood Pressure; Cardiorespiratory Fitness; Diabetes Mellitus, Type 2; Exercise; Glycemic Control; Inflammation; Obesity; Overweight; Quality of Life; Resistance Training
PubMed: 38887616
DOI: 10.7717/peerj.17525 -
Campbell Systematic Reviews Jun 2024Around 15% of the global population live with some form of disabilities and experience worse health outcomes, less participation in the community and are part of fewer... (Review)
Review
BACKGROUND
Around 15% of the global population live with some form of disabilities and experience worse health outcomes, less participation in the community and are part of fewer activities outside the home. Outdoor mobility interventions aim to improve the ability to move, travel and orient outside the home and could influence the number of activities outside the home, participation and quality of life. However, outdoor mobility interventions may also lead to harm like falls or injuries or have unforeseen effects which could lead to mortality or hospitalization.
OBJECTIVES
To assess the efficacy of interventions aiming to improve outdoor mobility for adults living with disabilities and to explore if the efficacy varies between different conditions and different intervention components.
SEARCH METHODS
Standard, extensive Campbell search methods were used, including a total of 12 databases searched during January 2023, including trial registries.
SELECTION CRITERIA
Only randomized controlled trials were included, focusing on people living with disabilities, comparing interventions to improve outdoor mobility to control interventions as well as comparing different types of interventions to improve outdoor mobility.
DATA COLLECTION AND ANALYSIS
Standard methodological procedures expected by Campbell were used. The following important outcomes were 1. Activity outside the home; 2. Engagement in everyday life activities; 3. Participation; 4. Health-related Quality of Life; 5. Major harms; 6. Minor harms. The impact of the interventions was evaluated in the shorter (≤6 months) and longer term (≥7 months) after starting the intervention. Results are presented using risk ratios (RR), risk difference (RD), and standardized mean differences (SMD), with the associated confidence intervals (CI). The risk of bias 2-tool and the GRADE-framework were used to assess the certainty of the evidence.
MAIN RESULTS
The screening comprised of 12.894 studies and included 22 studies involving 2.675 people living with disabilities and identified 12 ongoing studies. All reported outcomes except one (reported in one study, some concerns of bias) had overall high risk of bias. Thirteen studies were conducted in participants with disabilities due to stroke, five studies with older adults living with disabilities, two studies with wheelchair users, one study in participants with disabilities after a hip fracture, and one study in participants with cognitive impairments. The evidence is very uncertain about the benefits and harms of skill training interventions versus control interventions not aimed to improve outdoor mobility among all people living with disabilities both in the shorter term (≤6 months) and longer term (≥7 months) for Activity outside the home; Participation; Health-related Quality of Life; Major harms; and Minor harms, based on very low certainty evidence. Skill training interventions may improve engagement in everyday life activities among people with disabilities in the shorter term (RR: 1.46; 95% CI: 1.16 to 1.84; = 7%; RD: 0.15; 95% CI: -0.02 to 0.32; = 71%; 692 participants; three studies; low certainty evidence), but the evidence is very uncertain in the longer term, based on very low certainty evidence. Subgroup analysis of skill training interventions among people living with disabilities due to cognitive impairments suggests that such interventions may improve activity outside the home in the shorter term (SMD: 0.44; 95% CI: 0.07 to 0.81; = NA; 118 participants; one study; low certainty evidence). Subgroup analysis of skill training interventions among people living with cognitive impairments suggests that such interventions may improve health-related quality of life in the shorter term (SMD: 0.49; 95% CI: 0.12 to 0.88; = NA; 118 participants; one study; low certainty evidence). The evidence is very uncertain about the benefits and harms of physical training interventions versus control interventions not aimed to improve outdoor mobility in the shorter term (≤6 months) and longer term (≥7 months) for: Engagement in everyday life activities; Participation; Health-related Quality of Life; Major harms; and Minor harms, based on very low certainty evidence. Physical training interventions may improve activity outside the home in the shorter (SMD: 0.35; 95% CI: 0.08 to 0.61; = NA; 228 participants; one study; low certainty evidence) and longer term (≥7 months) (SMD: 0.27; 95% CI: 0.00 to 0.54; = NA; 216 participants; one study; low certainty evidence). The evidence is very uncertain about the benefits and harms of outdoor mobility interventions of different lengths in the shorter term (≤6 months) and longer term (≥7 months) for Activity outside the home; Engagement in everyday life activities; Participation; Health-related Quality of Life; Major harms; and Minor harms, based on very low certainty evidence. No studies explored the efficacy of other types of interventions.
AUTHORS’ CONCLUSIONS
Twenty-two studies of interventions to improve outdoor mobility for people living with disabilities were identified, but the evidence still remains uncertain about most benefits and harms of these interventions, both in the short- and long term. This is primarily related to risk of bias, small underpowered studies and limited reporting of important outcomes for people living with disabilities. For people with disabilities, skill training interventions may improve engagement in everyday life in the short term, and improve activity outside the home and health-related quality of life for people with cognitive impairments in the short term. Still, this is based on low certainty evidence from few studies and should be interpreted with caution. One study with low certainty evidence suggests that physical training interventions may improve activity outside the home in the short term. In addition, the effect sizes across all outcomes were considered small or trivial, and could be of limited relevance to people living with disabilities. The evidence is currently uncertain if there are interventions that can improve outdoor mobility for people with disabilities, and can improve other important outcomes, while avoiding harms. To guide decisions about the use of interventions to improve outdoor mobility, future studies should use more rigorous design and report important outcomes for people with disabilities to reduce the current uncertainty.
PubMed: 38882933
DOI: 10.1002/cl2.1407 -
Frontiers in Pharmacology 2024(Willd. ex Schult.) DC. (Rubiaceae) is traditionally used by Amazonian indigenous groups to treat inflammatory diseases. To date, there are no systematic reviews and...
BACKGROUND
(Willd. ex Schult.) DC. (Rubiaceae) is traditionally used by Amazonian indigenous groups to treat inflammatory diseases. To date, there are no systematic reviews and meta-analyses on the use of for inflammation control in animals supporting the traditional knowledge about this species. This study was conducted to evaluate the effect of extracts in modulating inflammatory mediators and to determine which types of inflammatory diseases can be treated by this species.
METHODS
We conducted a systematic review and meta-analysis of preclinical studies published before 26 July 2023, identified in PubMed, Embase, and Scopus. Four independent reviewers extracted the data and assessed the risks of bias. The effects of on inflammatory diseases and the inflammatory mediators involved were extracted from the studies. Standardized mean differences (SMD) and 95% confidence intervals (95%CI) of the outcomes were estimated. The meta-analyses were conducted using RevMan 5.4 (Cochrane Collaboration). This protocol was registered in PROSPERO (CRD42023450869).
RESULTS
Twenty-four of 523 studies were included. extracts decreased the cytokines interleukin (IL)-6 (SMD: -0.72, 95%CI: -1.15, -0.29, = 0.001) and transcription factor nuclear factor -B (NF-κB) (SMD: -1.19, 95%CI: -1.89, -0.48, = 0.001). However, the extracts did not significantly alter IL-1 (SMD: -0.16, 95%CI: -0.87, +0.56, = 0.67), IL-10 (SMD: -0.05, 95%CI:-0.35, 0.45, = 0.80), or tumor necrosis factor- (TNF-α) levels (SMD: 0.18, 95%CI: -0.25, 0.62, = 0.41).
CONCLUSION
Many extracts of stem bark, roots, and leaves of , mostly aqueous and hydroethanolic, exhibited anti-inflammatory and/or immunomodulatory activities and low toxicity. The extracts decreased NF-κB and IL-6. These findings suggest that this species has the potential to treat inflammatory diseases in which these markers are increased, according to the ethnopharmacological use. These activities are not related to a specific class of compounds.
UNLABELLED
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=450869, Identifier CRD42023450869.
PubMed: 38881881
DOI: 10.3389/fphar.2024.1378408 -
Advances in Nutrition (Bethesda, Md.) Jun 2024Despite the well-documented adverse outcomes associated with obesity during pregnancy, this condition remains a promising modifiable risk factor. (Review)
Review
A Systematic Review and Bayesian Network Meta-Analysis Comparing In-Person, Remote, and Blended Interventions in Physical Activity, Diet, Education, and Behavioral Modification on Gestational Weight Gain among Overweight or Obese Pregnant Individuals.
BACKGROUND
Despite the well-documented adverse outcomes associated with obesity during pregnancy, this condition remains a promising modifiable risk factor.
OBJECTIVES
The aim of this study was to ascertain the most effective treatment modalities for gestational weight gain (GWG) in pregnant women classified as overweight or obese.
METHODS
A systematic search was conducted across 4 electronic databases: Embase, EBSCOhost, PubMed, and Web of Science. To assess the quality of evidence, the Confidence In Network Meta-Analysis (CINeMA) approach, grounded in the Grading of Recommendations Assessment, Development, and Evaluation framework, was employed. A Bayesian network meta-analysis was conducted to synthesize the comparative effectiveness of treatment modalities based on GWG outcomes.
RESULTS
The analysis incorporated 60 randomized controlled trials, encompassing 16,615 participants. Modes of intervention administration were classified as remote (R: eHealth [e] and mHealth [m]), in-person (I), and a combination of both (I+R). The interventions comprised 5 categories: education (E), physical activity (PA), dietary (D), behavior modification (B), and combinations thereof. The quality of the evidence, as evaluated by CINeMA, ranged from very low to high. Compared to the control group, the I-D intervention (mean difference [MD]: -1.27; 95% confidence interval [CI]: -2.23, -0.32), I-PADB (MD: -0.60, 95% CI: -1.19, -0.00), and I-B (MD: -0.34, 95% CI: -0.57, -0.10) interventions showed significant efficacy in reducing GWG.
CONCLUSIONS
Preliminary findings suggest that the I-D intervention is the most efficacious in managing GWG among pregnant women who are overweight or obese, followed by I-PADB and I-B+R-B(m) treatments. These conclusions are drawn from evidence of limited quality and directness, including insufficient data on PA components used in the interventions. Owing to the absence of robust, direct evidence delineating significant differences among various GWG management strategies, it is tentatively proposed that the I-D intervention is likely the most effective approach. This study was registered with PROSPERO as CRD42023473627.
PubMed: 38879168
DOI: 10.1016/j.advnut.2024.100253 -
Globalization and Health Jun 2024Corruption exists at all levels of our global society and is a potential threat to food security, food safety, equity, and social justice. However, there is a knowledge... (Review)
Review
BACKGROUND
Corruption exists at all levels of our global society and is a potential threat to food security, food safety, equity, and social justice. However, there is a knowledge gap in the role and impact of corruption within the context of the global food system. We aimed to systematically review empirical literature focused on corruption in the global food system to examine how it is characterized, the actors involved, its potential impacts, and the solutions that have been proposed to address corruption in the food system.
METHODS
We used a systematic scoping review methodology. Terms combining corruption and the food system were searched in Scopus, PubMed, Web of Science, PsycInfo and Econlit, in October 2021. Two screeners applied a priori selection criteria to screen the articles at the title and abstract and full-text levels. Data was extracted into a charting form and thematically synthesized to describe the types of corruption in the food system, the actors involved, how corruption impacts the food system, and potential solutions. Sankey diagrams and narrative summaries were developed to summarize the included studies and findings.
RESULTS
From the 238 included records, five main types of corruption were identified in the global food system: bureaucratic corruption, fraud, bribery, organized crime, and corporate political activity. These different types of corruption spanned across various food system areas, from policy and governance structures to food environments, and involved a wide range of actors. More powerful actors like those in public and private sectors tended to instigate corruption in the food system, while community members and primary producers tended to be impacted by it. The impacts of corruption were mostly negative and corruption was found to undermine food system governance and regulatory structures; threaten health, safety, and food security; and lead or contribute to environmental degradation, economic loss, erosion of trust, social inequities, and decreased agricultural productivity. While solution-oriented literature was limited, the essential role of strong governance, use of technology and predictive modelling methods to improve detection of corruption, and organizational approaches to problem solving were identified.
CONCLUSION
Our review findings provide researchers and policymakers with a comprehensive overview of corruption in the global food system, providing insights to inform a more holistic approach to addressing the issue. Addressing corruption in the food system is an essential element of supporting the transition to a more healthy, equitable and sustainable global food system.
Topics: Humans; Food Supply; Fraud; Crime; Global Health
PubMed: 38877483
DOI: 10.1186/s12992-024-01054-8 -
Journal of Bodywork and Movement... Jul 2024The upper quarter y-balance test (YBT-UQ) is a functional screening tool used to detect musculoskeletal injury risk, aid rehabilitation, and monitor dynamic function,... (Review)
Review
INTRODUCTION
The upper quarter y-balance test (YBT-UQ) is a functional screening tool used to detect musculoskeletal injury risk, aid rehabilitation, and monitor dynamic function, strength and control, yet little is currently known about intrinsic and extrinsic factors that influence reach scores.
OBJECTIVES
This systematic review aimed to determine if age, sex, or interventions influenced reach scores and whether between-limb differences were common in non-injured sporting populations, with a secondary aim to identify if sport impacted YBT-UQ reach.
METHODS
Web of Science, PubMed, and SportDiscus were systematically searched from January 2012 to November 16, 2023, revealing twenty-three studies satisfying inclusion criteria of published in English between 2012 and 2023, healthy participants of any age including both males and females, athletic populations, YBT-UQ use to assess upper limb mobility/stability, report normalised reach scores, and peer-reviewed full-texts. Methodological quality was evaluated via National Institutes of Health (NIH) quality assessment tools for controlled interventions, observational cohort and cross-sectional designs, and pre-post with no control group.
RESULTS
Age, sex, sport, and fatigue were influencing factors; greater reach scores were achieved in older athletes (i.e. >18 years), males, and in a well-rested state. Between-limb differences were not common in sporting populations; therefore, asymmetries may be useful for practitioners to aid injury risk identification.
CONCLUSION
This is the first systematic review investigating YBT-UQ influencing factors and thereby provides context for clinicians regarding characteristics that impact reach scores in sporting populations, from which normative values could be determined and further aid clinical decisions or areas to improve regarding injury risk.
Topics: Humans; Upper Extremity; Postural Balance; Male; Age Factors; Sex Factors; Female; Athletic Injuries; Adult; Athletes; Muscle Strength; Fatigue; Sports
PubMed: 38876624
DOI: 10.1016/j.jbmt.2024.02.043 -
Environmental Research Jun 2024Nature-based interventions (NBIs) are activities, strategies, or programs taking place in natural settings, such as exercising in greenspaces, to improve the health and... (Review)
Review
Nature-based interventions (NBIs) are activities, strategies, or programs taking place in natural settings, such as exercising in greenspaces, to improve the health and well-being of people by integrating the benefits of nature exposure with healthy behaviours. Current reviews on NBIs do not report the effects on different groups of physical health conditions. The purpose of this systematic review and meta-analysis was to identify and synthesize the evidence of the effect of NBIs on physical health outcomes and biomarkers of physical health conditions. Overall, 20,201 studies were identified through searching MEDLINE, Embase, CINAHL, SPORTDiscus, and CENTRAL databases up to June 7, 2024. Inclusion criteria were: 1) randomized controlled intervention studies; 2) population with a physical health condition; 3) NBIs vs. different intervention or no intervention; and 4) measuring physical health outcomes and/or biomarkers. Twenty-six studies were included in the review, 15 of which contributed to the meta-analysis. Compared to control groups, NBIs groups showed significant improvements in: diastolic blood pressure (MD -3.73 mmHg [-7.46 to -0.00], I = 62%) and heart rate (MD -7.44 bpm [-14.81 to -0.06], I = 0%) for cardiovascular conditions, fatigue (SMD -0.50 [-0.82 to -0.18], I = 16%) for central nervous system conditions, and body fat percentage (MD -3.61% [-5.05 to -2.17], I = 0%) for endocrine conditions. High effect heterogeneity was found in several analyses and the included studies had moderate-to-high risk of bias (RoB). The non-significant outcomes showed a direction of effect in favour of NBI groups for cardiovascular, central nervous system, endocrine, musculoskeletal, and respiratory conditions. This review found some beneficial effects in favour of NBIs for health outcomes in at least three condition groups though RoB and inconsistent effects limited some interpretations. NBIs are promising therapies that healthcare professionals can consider integrating into clinical practice.
PubMed: 38876421
DOI: 10.1016/j.envres.2024.119421 -
Frontiers in Psychology 2024Patients with cancer experience significant psychosocial distress. Stressors include interpersonal difficulties like loneliness, isolation, thwarted belongingness,...
OBJECTIVE
Patients with cancer experience significant psychosocial distress. Stressors include interpersonal difficulties like loneliness, isolation, thwarted belongingness, communication impediments, and conflicts. Interventions are required that address their specific psychosocial needs. Interpersonal Psychotherapy (IPT) is a promising concept for the treatment of psychosocial distress associated with cancer because it addresses patients' interactions and role transformations. This review aims to provide an overview of the current evidence regarding interventions for patients with cancer based on IPT.
METHODS
A systematic review following PRISM guidelines was conducted, including randomized controlled trials of IPT-based interventions in patients with cancer, assessing effects on distress, depression, and anxiety.
RESULTS
Eight studies were included, sampling 390 patients in total. Seven out of eight studies assessed exclusively women with breast cancer. Two studies described IPT interventions and showed stronger improvement in depression and anxiety compared to TAU and equal improvement in depression compared to other psychotherapy interventions. Six studies described remote Interpersonal Counselling (IPC). One found remote IPC to be superior to control conditions regarding depression, and one found remote IPC to be superior to attention control, but not active control conditions. No study found remote IPC to be superior to control conditions regarding distress.
DISCUSSION
There are few randomized controlled trials of IPT for patients with cancer. Results regarding depression and anxiety are promising for in-person IPT, but mixed for remote IPC.
CONCLUSION
The review suggests in-person IPT, but not remote IPC, may yield benefits for patients with cancer. Research on the subject is scarce, and to inform implementation of IPT interventions, research with diverse groups of patients with cancer is required.
SYSTEMATIC TRIAL REGISTRATION
PROSPERO, Identifier CRD42023410687.
PubMed: 38873503
DOI: 10.3389/fpsyg.2024.1367807 -
Frontiers in Pharmacology 2024In recent years, diverse initiatives have been carried out to control the COVID-19 pandemic, ranging from measures restricting social activities to analyzing drugs and...
INTRODUCTION
In recent years, diverse initiatives have been carried out to control the COVID-19 pandemic, ranging from measures restricting social activities to analyzing drugs and vaccines. Studies on herbal medicines are also increasingly conducted in various countries as an adjuvant therapy or supplement. Therefore, this systematic review aimed to investigate the efficacy of herbal medicines analyzed from various countries through clinical trials with the randomized controlled trial method. The outcomes of Length of Stay (LOS), Negative Conversion Time (NCT), and Negative Conversion Rate (NCR) were the main focus.
METHODS
An extensive review of literature spanning from 2019 to 2023 was carried out using well-known databases including PubMed, Scopus, and Cochrane. The search included relevant keywords such as "randomized controlled trial," "COVID-19," and "herbal medicine."
RESULTS
A total of 8 articles were part of the inclusion criteria with outcomes of LOS, NCT, and NCR. In terms of LOS outcomes, all types of herbal medicines showed significant results, such as Persian Medicine Herbal (PM Herbal), Persian Barley Water (PBW), Jingyin Granules (JY granules), Reduning Injection, and (Amla). However, only JY granules showed significant results in NCR outcome, while JY granules and Reduning Injection showed significant results in reducing NCT.
CONCLUSION
These findings enrich our understanding of the potential benefits of herbal medicines in influencing LOS, NCR and NCT parameters in COVID-19 patients. Herbal medicines worked to treat COVID-19 through antiviral, anti-inflammatory, and immunomodulatory mechanisms.
PubMed: 38873430
DOI: 10.3389/fphar.2024.1383359