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Journal of Sport and Health Science Apr 2024The benefits of exercise are well known; however, many of the underlying molecular mechanisms are not fully understood. Skeletal muscle secretes myokines, which mediate... (Review)
Review
BACKGROUND
The benefits of exercise are well known; however, many of the underlying molecular mechanisms are not fully understood. Skeletal muscle secretes myokines, which mediate muscle-organ crosstalk. Myokines regulate satellite-cell proliferation and migration, inflammatory cascade, insulin secretion, angiogenesis, fatty oxidation, and cancer suppression. To date, the effects of different exercise modes (namely, aerobic and resistance exercise) on myokine response remain to be elucidated. This is crucial considering the clinical implementation of exercise to enhance general health and wellbeing and as a medical treatment.
METHODS
A systematic search was undertaken in PubMed, Medline, CINAHL, Embase, SPORTDiscus, and Web of Science in April 2023. Eligible studies examining the effects of a single bout of exercise on interleukin15 (IL-15), irisin, secreted protein acidic and rich in cysteine (SPARC), oncostatin M (OSM), and decorin were included. A random-effects meta-analysis was also undertaken to quantify the magnitude of change.
RESULTS
Sixty-two studies were included (n = 1193). Overall, exercise appeared to induce small to large increases in myokine expression, with effects observed immediately after to 60 min post-exercise, although these were mostly not statistically significant. Both aerobic and resistance exercise resulted in changes in myokine levels, without any significant difference between training modes, and with the magnitude of change differing across myokines. Myokine levels returned to baseline levels within 180 min to 24 h post-exercise. However, owing to potential sources of heterogeneity, most changes were not statistically significant, indicating that precise conclusions cannot be drawn.
CONCLUSION
Knowledge is limited but expanding with respect to the impact of overall and specific effects of exercise on myokine expression at different time points in the systemic circulation. Further research is required to investigate the effects of different exercise modes at multiple time points on myokine response.
PubMed: 38604409
DOI: 10.1016/j.jshs.2024.04.005 -
Frontiers in Endocrinology 2024An increasing number of studies have investigated the effect of exercise on flow-mediated dilation (FMD) in people with type 2 diabetes mellitus (T2DM), while the... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
An increasing number of studies have investigated the effect of exercise on flow-mediated dilation (FMD) in people with type 2 diabetes mellitus (T2DM), while the findings were controversial. The primary aim of this systematic review and meta-analysis was to investigate the effect of exercise on FMD in T2DM patients, and the secondary aim was to investigate the optimal type, frequency, session duration, and weekly time of exercise for T2DM patients.
METHODS
Searches were conducted in PubMed, Cochrane Library, Scopus, Web of Science, Embase and EBSCO databases. The Cochrane risk of bias tool (RoB2) in randomized trial and Physiotherapy Evidence Database (PEDro) scale were used to assess the methodological quality of the included studies.
RESULTS
From the 3636 search records initially retrieved, 13 studies met the inclusion criteria. Our meta-analysis revealed that exercise had a significant effect on improving FMD in T2DM patients [WMD, 2.18 (95% CI, 1.78-2.58), < 0.00001, = 38%], with high-intensity interval training (HIIT) being the most effective intervention type [HIIT, 2.62 (1.42-3.82); < 0.0001; aerobic exercise, 2.20 (1.29-3.11), < 0.00001; resistance exercise, 1.91 (0.01-3.82), = 0.05; multicomponent training, 1.49 (0.15-2.83), = 0.03]. In addition, a higher frequency [> 3 times, 3.06 (1.94-4.19), < 0.00001; ≤ 3 times, 2.02 (1.59-2.45), < 0.00001], a shorter session duration [< 60 min, 3.39 (2.07-4.71), < 0.00001; ≥ 60 min, 1.86 (1.32-2.40), < 0.00001], and a shorter weekly time [≤ 180 min, 2.40 (1.63-3.17), < 0.00001; > 180 min, 2.11 (0.82-3.40), = 0.001] were associated with larger improvements in FMD.
CONCLUSION
This meta-analysis provides clinicians with evidence to recommended that T2DM patients participate in exercise, especially HIIT, more than 3 times per week for less than 60 min, with a target of 180 min per week being reached by increasing the frequency of exercise.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero, identifier CRD42023466575.
Topics: Humans; Diabetes Mellitus, Type 2; Dilatation; Randomized Controlled Trials as Topic; Exercise
PubMed: 38596227
DOI: 10.3389/fendo.2024.1347399 -
Frontiers in Physiology 2024When improving athletic performance in sports with high-speed strength demands such as soccer, basketball, or track and field, the most common training method might be...
When improving athletic performance in sports with high-speed strength demands such as soccer, basketball, or track and field, the most common training method might be resistance training and plyometrics. Since a link between strength capacity and speed strength exists and recently published literature suggested chronic stretching routines may enhance maximum strength and hypertrophy, this review was performed to explore potential benefits on athletic performance. Based on current literature, a beneficial effect of static stretching on jumping and sprinting performance was hypothesized. A systematic literature search was conducted using PubMed, Web of Science and Google scholar. In general, 14 studies revealed 29 effect sizes (ES) (20 for jumping, nine for sprinting). Subgroup analyses for jump performance were conducted for short- long- and no stretch shortening cycle trials. Qualitative evaluation was supplemented by performing a multilevel meta-analysis via R (Package: metafor). Significant positive results were documented in six out of 20 jump tests and in six out of nine sprint tests, while two studies reported negative adaptations. Quantitative data analyses indicated a positive but trivial magnitude of change on jumping performance (ES:0.16, = 0.04), while all subgroup analyses did not support a positive effect ( = 0.09-0.44). No significant influence of static stretching on sprint performance was obtained ( = 0.08). Stretching does not seem to induce a sufficient stimulus to meaningfully enhance jumping and sprinting performance, which could possibly attributed to small weekly training volumes or lack of intensity.
PubMed: 38595642
DOI: 10.3389/fphys.2024.1372689 -
Journal of General Internal Medicine Jun 2024The effect of clinical interventions may vary by patients' frailty status. Understanding treatment effect heterogeneity by frailty could lead to frailty-guided treatment...
BACKGROUND
The effect of clinical interventions may vary by patients' frailty status. Understanding treatment effect heterogeneity by frailty could lead to frailty-guided treatment strategies and reduce overtreatment and undertreatment. This systematic review aimed to examine the effect modification by frailty in randomized controlled trials (RCTs) that evaluate pharmacological, non-pharmacological, and multicomponent interventions.
METHODS
We searched PubMed, Web of Science, EMBASE, and ClinicalTrial.gov, from their inception to 8 December 2023. Two reviewers independently extracted trial data and examined the study quality with senior authors.
RESULTS
Sixty-one RCTs that evaluated the interaction between frailty and treatment effects in older adults were included. Frailty was evaluated using different tools such as the deficit accumulation frailty index, frailty phenotype, and other methods. The effect of several pharmacological interventions (e.g., edoxaban, sacubitril/valsartan, prasugrel, and chemotherapy) varied according to the degree of frailty, whereas other treatments (e.g., antihypertensives, vaccinations, osteoporosis medications, and androgen medications) demonstrated consistent benefits across different frailty levels. Some non-pharmacological interventions had greater benefits in patients with higher (e.g., chair yoga, functional walking, physical rehabilitation, and higher dose exercise program) or lower (e.g., intensive lifestyle intervention, psychosocial intervention) levels of frailty, while others (e.g., resistance-type exercise training, moderate-intensive physical activity, walking and nutrition or walking) produced similar intervention effects. Specific combined interventions (e.g., hospital-based disease management programs) demonstrated inconsistent effects across different frailty levels.
DISCUSSION
The efficacy of clinical interventions often varied by frailty levels, suggesting that frailty is an important factor to consider in recommending clinical interventions in older adults.
REGISTRATION
PROSPERO registration number CRD42021283051.
Topics: Humans; Randomized Controlled Trials as Topic; Frailty; Aged; Frail Elderly
PubMed: 38592606
DOI: 10.1007/s11606-024-08732-8 -
Journal of Clinical Medicine Feb 2024Currently, it is essential to adopt physical therapy strategies, such as resistance training, to enhance muscle strength and gait in middle-aged individuals (ages... (Review)
Review
Currently, it is essential to adopt physical therapy strategies, such as resistance training, to enhance muscle strength and gait in middle-aged individuals (ages 45-65) suffering from Multiple Sclerosis. This is crucial in combating the typical symptoms of neurodegenerative diseases associated with functional loss. The objective of this study is to determine the effects of resistance training interventions on walking and muscle strength in middle-aged people with Multiple Sclerosis. A systematic review with meta-analysis was conducted by searching specific keywords in the PubMed, Scopus, Cochrane, and Web of Science databases. For inclusion, studies had to incorporate resistance training as a primary or significant component of the overall intervention for middle-aged patients with MS. Out of the 3675 articles identified, 12 randomized clinical trials met the criteria for inclusion in the review, with resistance training being a consistent feature in all of them. Muscle strength and gait were evaluated as the main variables, with fatigue and the quality of life as secondary variables. This review reveals that resistance training significantly improves muscle strength. Resistance training achieves modest and non-significant improvements in gait. Notably, studies combining resistance training with motor control exercises achieve results of greater clinical significance in terms of gait. However, resistance training yields variable positive effects on perceived fatigue and the quality of life. Resistance training is useful for improving muscle strength; however, walking needs to be combined with motor control training.
PubMed: 38592200
DOI: 10.3390/jcm13051378 -
Journal of Clinical Medicine Feb 2024(1) : The aging population is expected to triple by 2050. Executive functions decline with age, impacting daily tasks, and this is associated with neurodegenerative... (Review)
Review
(1) : The aging population is expected to triple by 2050. Executive functions decline with age, impacting daily tasks, and this is associated with neurodegenerative diseases. Aerobic and resistance exercises positively affect cognitive function in older adults by influencing growth markers. However, the modalities of exercise and the optimal parameters for maximum cognitive benefits remain unclear. (2) : A meta-analysis of randomized clinical trials (RCTs) was conducted. The systematic search was on slowing cognitive decline and performed in the PubMed/MEDLINE and Cochrane Library databases. Articles were included if participants were ≥65 years, healthy, and performing resistance or aerobic exercise, and they were excluded if there was a combination of training and if they have neurological disease or cognitive impairment. (3) : The search strategy found a total of 1635 studies. After removing duplicates and assessing the inclusion and exclusion criteria, eight articles were included in the meta-analysis, with a total of 463 healthy older adults analyzed. No significant differences between the intervention groups and the control groups after the aerobic or resistance programs were found. (4) : Aerobic exercise interventions improved executive function more than resistance training in older adults, but without statistically significant differences. This can serve as a guide to see, with caution, whether we need a multidisciplinary approach to be more effective in improving the cortical health of older adults.
PubMed: 38592139
DOI: 10.3390/jcm13051301 -
The American Journal of Sports Medicine Apr 2024Blood flow restriction training (BFR-t) data are heterogeneous. It is unclear whether rehabilitation with BFR-t after an anterior cruciate ligament (ACL) injury is more...
BACKGROUND
Blood flow restriction training (BFR-t) data are heterogeneous. It is unclear whether rehabilitation with BFR-t after an anterior cruciate ligament (ACL) injury is more effective in improving muscle strength and muscle size than standard rehabilitation.
PURPOSE
To review outcomes after an ACL injury and subsequent reconstruction in studies comparing rehabilitation with and without BFR-t.
STUDY DESIGN
Systematic review. Level of evidence, 3.
METHODS
A search of English-language human clinical studies published in the past 20 years (2002-2022) was carried out in 5 health sciences databases, involving participants aged 18-65 undergoing rehabilitation for an ACL injury. Outcomes associated with muscle strength, muscle size, and knee-specific patient-reported outcome measures (PROMs) were extracted from studies meeting inclusion criteria and compared.
RESULTS
The literature search identified 279 studies, of which 5 met the selection criteria. Two studies suggested that BFR-t rehabilitation after an ACL injury improved knee or thigh muscle strength and muscle size compared with rehabilitation consisting of comparable and higher load resistance training, with two studies suggesting the opposite. The single study measuring PROMs showed improvement compared to traditional rehabilitation, with no difference in muscle strength or size.
CONCLUSION
BFR-t after an ACL injury seems to benefit muscle strength, muscle size, and PROM scores compared with standard rehabilitation alone. However, only 1 large study included all these outcomes, which has yet to be replicated in other settings. Further studies utilizing similar methods with a common set of outcome measures are required to confirm the effects of BFR-t on ACL rehabilitation.
PubMed: 38591459
DOI: 10.1177/03635465241232002 -
Frontiers in Microbiology 2024One of the main threats to public health today is antibiotic resistance. This resistance leads to the persistence of infections in the body. It poses an increased risk...
BACKGROUND
One of the main threats to public health today is antibiotic resistance. This resistance leads to the persistence of infections in the body. It poses an increased risk of transmission to humans and animals through various routes, such as food, water, and the environment.
OBJECTIVES
This study aimed to ascertain the overall prevalence of knowledge, attitudes, and practices regarding antimicrobial resistance in Africa.
METHODS
A systematic review and meta-analysis of published and unpublished studies was conducted in Africa according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches were conducted using appropriate search terms in PubMed, Web of Science, Science Direct, Google Scholar, African Journals Online, and the Cochrane Library. Data were extracted using Microsoft Excel, and STATA version 14 was used for analysis. Publication bias was checked by funnel plot, Egger, and Begg regression tests. A -value of 0.05 was regarded to indicate potential publication bias. Using I2 statistics, the heterogeneity of the studies was evaluated. Using forest plots, the random effect model was used to present the pooled prevalence with a 95% confidence interval (CI) of meta-analysis.
RESULTS
This review included 39 studies, with 18,769 study participants. Among these 39 studies, 38 were on knowledge assessment, 28 on attitude assessment, and 25 on good practice assessment towards antimicrobial resistances. The overall pooled prevalence level of knowledge regarding antimicrobial resistance in Africa was 55.33% (95% CI: 47.48, 63.18). The overall pooled prevalence of positive attitudes toward antimicrobial resistance in Africa was 46.93% (95% CI: 35.10, 58.76), and the overall pooled prevalence of good practice of antimicrobial resistance in Africa was 51.05% (95% CI: 45.24, 56.87). In addition, sub-group statistical analysis was performed in this meta-analysis, stratified by population sub-region and study design types.
CONCLUSION
In Africa, the pooled prevalence of knowledge, attitudes, and practices regarding antimicrobial drug resistance among different groups, including the general population, patients, tertiary school students, healthcare workers, and animal owners was found to be low level. Therefore, it is imperative to enhance the education and training programs regarding antibiotic resistance for various groups including the general public, patients, students, healthcare workers, and individuals responsible for the well-being of animals.
PubMed: 38585703
DOI: 10.3389/fmicb.2024.1345145 -
RMD Open Apr 2024This international task force aimed to provide healthcare professionals and persons living with systemic lupus erythematosus (SLE) with consensus-based recommendations...
OBJECTIVE
This international task force aimed to provide healthcare professionals and persons living with systemic lupus erythematosus (SLE) with consensus-based recommendations for physical activity and exercise in SLE.
METHODS
Based on evidence from a systematic literature review and expert opinion, 3 overarching principles and 15 recommendations were agreed on by Delphi consensus.
RESULTS
The overarching principles highlight the importance of shared decision-making and the need to explain the benefits of physical activity to persons living with SLE and other healthcare providers. The 15 specific recommendations state that physical activity is generally recommended for all people with SLE, but in some instances, a medical evaluation may be needed to rule out contraindications. Pertaining to outdoor activity, photoprotection is necessary. Both aerobic and resistance training programmes are recommended, with a gradual increase in frequency and intensity, which should be adapted for each individual, and ideally supervised by qualified professionals.
CONCLUSION
In summary, the consensus reached by the international task force provides a valuable framework for the integration of physical activity and exercise into the management of SLE, offering a tailored evidence-based and eminence-based approach to enhance the well-being of individuals living with this challenging autoimmune condition.
Topics: Humans; Consensus; Lupus Erythematosus, Systemic; Exercise; Advisory Committees
PubMed: 38580348
DOI: 10.1136/rmdopen-2024-004171 -
International Journal of Preventive... 2024Irisin, a myokine that is responsive to exercise, induces significant changes in subcutaneous adipose tissue. By promoting the browning of white fat tissue, it enhances... (Review)
Review
BACKGROUND
Irisin, a myokine that is responsive to exercise, induces significant changes in subcutaneous adipose tissue. By promoting the browning of white fat tissue, it enhances energy expenditure, thereby addressing overweight and obesity. This systematic review and meta-analysis aimed to compare the effects of different types of physical exercises on irisin levels in overweight and obese adults.
METHODS
Specifically, the review focused on studies involving obese or overweight individuals who participated in exercise training for a minimum of 8 weeks, with measured and reported changes in serum irisin levels compared to a control group. Data were collected from four databases (Google Scholar, ISI Web of Science Core Collection, PubMed, and Scopus). The risk of bias was assessed using the Begg and Egger tests, and the results were synthesized.
RESULTS
Initial searches identified 560 titles, out of which only seven met the criteria for inclusion in the systematic review. Statistical analysis demonstrated a significant increase in serum irisin concentration (SMD = 0.957, = 0.005) among obese and overweight individuals who engaged in exercise, compared to the passive control group. High-intensity interval training (HIIT) (SMD = 1.229, < 0.001) had a more pronounced effect on increasing serum irisin levels than other exercise protocols. Furthermore, the effectiveness of exercise varied based on the participants' weight status (significant changes for overweight individuals; < 0.001 and insignificant changes for obese individuals; = 0.1), age (significant changes for those under 40 years old; < 0.001 and insignificant changes for those over 40 years old; = 0.322), and gender (significant changes for men; < 0.001 and insignificant changes for women; = 0.285).
CONCLUSIONS
Consequently, exercise can elevate serum irisin levels, leading to alterations in adipose tissue phenotype and thermogenesis, ultimately contributing to weight reduction in obese and overweight individuals.
PubMed: 38563037
DOI: 10.4103/ijpvm.ijpvm_76_23