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International Journal of Environmental... Feb 2022To determine the effectiveness of pelvic floor muscle training (PFMT) with or without biofeedback or electrostimulation in reducing urinary incontinence and pelvic floor... (Review)
Review
UNLABELLED
To determine the effectiveness of pelvic floor muscle training (PFMT) with or without biofeedback or electrostimulation in reducing urinary incontinence and pelvic floor muscle con-traction in non-pregnant women with urinary incontinence.
METHODS
The following electronic databases were searched: PubMed, Cochrane Central, ClinicalTrials.gov, EU Clinical Trials Register, and sources from NICE, FDA, EMA, and SMC (articles only in English, 2000-2021). Search terms were: urinary incontinence, pelvic floor muscle training or exercises, biofeedback, electrostimulation. We used the PRISMA statement (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) for this systematic review. Relevant articles were selected, data were extracted, and quality was assessed. Data were extracted in predesigned form, followed by narrative synthesis.
RESULTS
Following the search, 15 RCTs were retrieved using the strict inclusion and exclusion criteria, assessing 2441 non-pregnant women with urinary incontinence. Of the 15 studies, 7 were low risk, 5 were medium risk, and 3 were high-risk studies. Of the 2441 patients, 970 were in PFMT, 69 were in extracorporeal magnetic innervation (ExMi) or with PFMT + BF, 30 were in electrostimulation (ES), 21 were in whole body vibration training (WBVT), 23 were in pelvic floor muscle + abdominal muscle therapy (PFM + AMT), 326 were in PFMT + biofeedback, 93 were in vaginal cones (VC), 362 were in PFMT + education, 318 were in education, and 229 were in control groups. The most often measures employed were pad tests, bladder diary, and questionnaire on the quality of life. Stress, urge and mixed urinary incontinence were studied. In all RCT, PFMT significantly reduced urinary incontinence, essentially SIU and MUI, when compared with the control group before and after treatment. Overall, out of 997 PFMT or PFMT + education patients, 504 patients (50.5%) showed improvement in urinary incontinence, and 218 became continent (21.8%) (negative pad test). In total, 62% of patients significantly reduced their urinary incontinence or cured it and improved their pelvic floor muscle contraction. All other physiotherapist techniques also significantly reduced urinary leakages, e.g., vaginal cones, biofeedback, ExMI, and WBVT when compared with the control group. There were no significant differences between these methods in reducing the severity of urinary incontinence.
CONCLUSION
PFMT alone or with bio-feedback or electrostimulation was effective in reducing urinary incontinence and improving pelvic floor muscle contraction. PFMT when compared with other interventions such as bio-feedback, VC, and WBVT did not show significant differences but was superior to the control group. RCT studies with similar parameters used for measuring the outcomes need to be included.
Topics: Biofeedback, Psychology; Electric Stimulation Therapy; Exercise Therapy; Female; Humans; Pelvic Floor; Quality of Life; Treatment Outcome; Urinary Incontinence; Urinary Incontinence, Stress
PubMed: 35270480
DOI: 10.3390/ijerph19052789 -
Nutrients Feb 2018Whey protein (WP) is a widely consumed nutritional supplement, known to enhance strength and muscle mass during resistance training (RT) regimens. Muscle protein... (Meta-Analysis)
Meta-Analysis Review
Whey protein (WP) is a widely consumed nutritional supplement, known to enhance strength and muscle mass during resistance training (RT) regimens. Muscle protein anabolism is acutely elevated following RT, which is further enhanced by WP. As a result, there is reason to suggest that WP supplementation may be an effective nutritional strategy for restoring the acute loss of contractile function that occurs following strenuous RT. This systematic review and meta-analysis provides a synthesis of the literature to date, investigating the effect of WP supplementation on the recovery of contractile function in young, healthy adults. Eight studies, containing 13 randomised control trials (RCTs) were included in this review and meta-analysis, from which individual standardised effect sizes (ESs) were calculated, and a temporal overall ES was determined using a random-effects model. Whilst only half of the individual studies reported beneficial effects for WP, the high-quality evidence taken from the 13 RCTs was meta-analysed, yielding overall positive small to medium effects for WP from < 24 to 96 h (ES range = 0.4 to 0.7), for the temporal restoration of contractile function compared to the control treatment. Whilst the effects for WP were shown to be consistent over time, these results are limited to 13 RCTs, principally supporting the requirement for further comprehensive research in this area.
Topics: Dietary Supplements; Female; Humans; Male; Muscle Contraction; Muscle Fatigue; Muscle Strength; Muscle, Skeletal; Recovery of Function; Resistance Training; Time Factors; Whey Proteins
PubMed: 29462923
DOI: 10.3390/nu10020221 -
Journal of Sports Science & Medicine Mar 2020The gluteus maximus (GMax) is one of the primary hip extensors. Several exercises have been performed by strength and conditioning practitioners aiming to increase GMax...
The gluteus maximus (GMax) is one of the primary hip extensors. Several exercises have been performed by strength and conditioning practitioners aiming to increase GMax strength and size. This systematic review aimed to describe the GMax activation levels during strength exercises that incorporate hip extension and use of external load. A search of the current literature was performed using PubMed/Medline, SportDiscuss, Scopus, Google Scholar, and Science Direct electronic databases. Sixteen articles met the inclusion criteria and reported muscle activation levels as a percentage of a maximal voluntary isometric contraction (MVIC). The exercises classified as very high level of GMax activation (>60% MVIC) were step-up, lateral step-up, diagonal step-up, cross over step-up, hex bar deadlift, rotational barbell hip thrust, traditional barbell hip thrust, American barbell hip thrust, belt squat, split squat, in-line lunge, traditional lunge, pull barbell hip thrust, modified single-leg squat, conventional deadlift, and band hip thrust. We concluded that several exercises could induce very high levels of GMax activation. The step-up exercise and its variations present the highest levels of GMax activation followed by several loaded exercises and its variations, such as deadlifts, hip thrusts, lunges, and squats. The results of this systematic review may assist practitioners in selecting exercised for strengthening GMax.
Topics: Electromyography; Humans; Isometric Contraction; Muscle Strength; Muscle, Skeletal; Resistance Training; Weight Lifting
PubMed: 32132843
DOI: No ID Found -
International Journal of Sports... Dec 2020The gluteus medius (GMed) and gluteus minimus (GMin) muscle segments demonstrate different responses to pathology and ageing, hence it is important in rehabilitation...
BACKGROUND
The gluteus medius (GMed) and gluteus minimus (GMin) muscle segments demonstrate different responses to pathology and ageing, hence it is important in rehabilitation that prescribed therapeutic exercises can effectively target the individual segments with adequate exercise intensity for strengthening.
PURPOSE
The purpose of this systematic review was to evaluate whether common therapeutic exercises generate at least high ( > 40% maximum voluntary isometric contraction (MVIC)) electromyographic (EMG) activity in the GMed (anterior, middle and posterior) and GMin (anterior and posterior) segments.
METHODS
Seven databases (MEDLINE, EMBASE, CINAHL, AusSPORT, PEDro, SPORTdiscus and Cochrane Library) were searched from inception to May 2018 for terms relating to gluteal muscle, exercise, and EMG. The search yielded 6918 records with 56 suitable for inclusion. Quality assessment, data extraction and data analysis were then undertaken with exercise data pooled into a meta-analysis where two or more studies were available for an exercise and muscle segment.
RESULTS
For the GMed, different variations of the hip hitch/ pelvic drop exercise generated at least high activity in all segments. The dip test, and isometric standing hip abduction are other options to target the anterior GMed segment, while isometric standing hip abduction can be used for the posterior GMed segment. For the middle GMed segment, the single leg bridge; side-lying hip abduction with hip internal rotation; lateral step-up; standing hip abduction on stance or swing leg with added resistance; and resisted side-step were the best options for generating at least high activity. Standing isometric hip abduction and different variations of the hip hitch/ pelvic drop exercise generated at least high activity in all GMin segments, while side-lying hip abduction, the dip test, single leg bridge and single leg squat can also be used for targeting the posterior GMin segment.
CONCLUSION
The findings from this review provide the clinician with confidence in exercise prescription for targeting individual GMed and GMin segments for potential strengthening following injury or ageing.
LEVEL OF EVIDENCE
Level 1.
WHAT IS KNOWN ABOUT THE SUBJECT
Previous reviews on GMed exercises have been based on single electrode, surface EMG measures at middle GMed segment. It is not known whether these exercises effectively target the other segments of GMed or the GMin at a sufficient intensity for strengthening.
WHAT THIS STUDY ADDS TO EXISTING KNOWLEDGE
This review provides the clinician with confidence in exercise prescription of common therapeutic exercises to effectively target individual GMed and GMin segments for potential strengthening.
PubMed: 33344003
DOI: 10.26603/ijspt20200856 -
Ageing Research Reviews May 2021Engaging in physical activity (PA) and avoiding sedentary behavior (SB) are important for healthy ageing with benefits including the mitigation of disability and... (Meta-Analysis)
Meta-Analysis Review
The association of objectively measured physical activity and sedentary behavior with skeletal muscle strength and muscle power in older adults: A systematic review and meta-analysis.
BACKGROUND
Engaging in physical activity (PA) and avoiding sedentary behavior (SB) are important for healthy ageing with benefits including the mitigation of disability and mortality. Whether benefits extend to key determinants of disability and mortality, namely muscle strength and muscle power, is unclear.
AIMS
This systematic review aimed to describe the association of objective measures of PA and SB with measures of skeletal muscle strength and muscle power in community-dwelling older adults.
METHODS
Six databases were searched from their inception to June 21, 2020 for articles reporting associations between objectively measured PA and SB and upper body or lower body muscle strength or muscle power in community dwelling adults aged 60 years and older. An overview of associations was visualized by effect direction heat maps, standardized effect sizes were estimated with albatross plots and summarized in box plots. Articles reporting adjusted standardized regression coefficients (β) were included in meta-analyses.
RESULTS
A total of 112 articles were included representing 43,796 individuals (range: 21 to 3726 per article) with a mean or median age from 61.0 to 88.0 years (mean 56.4 % female). Higher PA measures and lower SB were associated with better upper body muscle strength (hand grip strength), upper body muscle power (arm curl), lower body muscle strength, and lower body muscle power (chair stand test). Median standardized effect sizes were consistently larger for measures of PA and SB with lower compared to upper body muscle strength and muscle power. The meta-analyses of adjusted β coefficients confirmed the associations between total PA (TPA), moderate-to-vigorous PA (MVPA) and light PA (LPA) with hand grip strength (β = 0.041, β = 0.057, and β = 0.070, respectively, all p ≤ 0.001), and TPA and MVPA with chair stand test (β = 0.199 and β = 0.211, respectively, all p ≤ 0.001).
CONCLUSIONS
Higher PA and lower SB are associated with greater skeletal muscle strength and muscle power, particularly with the chair stand test.
Topics: Aged; Aged, 80 and over; Exercise; Female; Hand Strength; Humans; Male; Middle Aged; Muscle Strength; Muscle, Skeletal; Sedentary Behavior
PubMed: 33607291
DOI: 10.1016/j.arr.2021.101266 -
International Journal of Environmental... Oct 2021The load in resistance training is considered to be a critical variable for neuromuscular adaptations. Therefore, it is important to assess the effects of applying... (Review)
Review
Effects of Resistance Training Performed with Different Loads in Untrained and Trained Male Adult Individuals on Maximal Strength and Muscle Hypertrophy: A Systematic Review.
The load in resistance training is considered to be a critical variable for neuromuscular adaptations. Therefore, it is important to assess the effects of applying different loads on the development of maximal strength and muscular hypertrophy. The aim of this study was to systematically review the literature and compare the effects of resistance training that was performed with low loads versus moderate and high loads in untrained and trained healthy adult males on the development of maximal strength and muscle hypertrophy during randomized experimental designs. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (2021) were followed with the eligibility criteria defined according to participants, interventions, comparators, outcomes, and study design (PICOS): (P) healthy males between 18 and 40 years old, (I) interventions performed with low loads, (C) interventions performed with moderate or high loads, (O) development of maximal strength and muscle hypertrophy, and (S) randomized experimental studies with between- or within-subject parallel designs. The literature search strategy was performed in three electronic databases (Embase, PubMed, and Web of Science) on 22 August 2021. Twenty-three studies with a total of 563 participants (80.6% untrained and 19.4% trained) were selected. The studies included both relative and absolute loads. All studies were classified as being moderate-to-high methodological quality, although only two studies had a score higher than six points. The main findings indicated that the load magnitude that was used during resistance training influenced the dynamic strength and isometric strength gains. In general, comparisons between the groups (i.e., low, moderate, and high loads) showed higher gains in 1RM and maximal voluntary isometric contraction when moderate and high loads were used. In contrast, regarding muscle hypertrophy, most studies showed that when resistance training was performed to muscle failure, the load used had less influence on muscle hypertrophy. The current literature shows that gains in maximal strength are more pronounced with high and moderate loads compared to low loads in healthy adult male populations. However, for muscle hypertrophy, studies indicate that a wide spectrum of loads (i.e., 30 to 90% 1RM) may be used for healthy adult male populations.
Topics: Adolescent; Adult; Humans; Hypertrophy; Male; Men; Muscle Strength; Muscle, Skeletal; Resistance Training; Young Adult
PubMed: 34769755
DOI: 10.3390/ijerph182111237 -
International Journal of Environmental... Jun 2020The aim of this study was to systematically review the current literature on the electromyographic (EMG) activity of six core muscles (the rectus abdominis, the internal...
The aim of this study was to systematically review the current literature on the electromyographic (EMG) activity of six core muscles (the rectus abdominis, the internal and external oblique, the transversus abdominis, the lumbar multifidus, and the erector spinae) during core physical fitness exercises in healthy adults. A systematic review of the literature was conducted on the Cochrane, EBSCO, PubMed, Scopus, and Web of Science electronic databases for studies from January 2012 to March 2020. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were used. The inclusion criteria were as follows: a) the full text available in English; b) a cross-sectional or longitudinal (experimental or cohorts) study design; c) the reporting of electromyographic activity as a percentage of maximum voluntary contraction (% MVIC), millivolts or microvolts; d) an analysis of the rectus abdominis (RA), transversus abdominis (TA), lumbar multifidus (MUL), erector spinae (ES), and the internal (IO) or external oblique (EO); e) an analysis of physical fitness exercises for core training; and f) healthy adult participants. The main findings indicate that the greatest activity of the RA, EO, and ES muscles was found in free-weight exercises. The greatest IO activity was observed in core stability exercises, while traditional exercises showed the greatest MUL activation. However, a lack of research regarding TA activation during core physical fitness exercises was revealed, in addition to a lack of consistency between the studies when applying methods to measure EMG activity.
Topics: Cross-Sectional Studies; Electromyography; Exercise; Exercise Therapy; Humans; Muscle, Skeletal; Physical Fitness
PubMed: 32560185
DOI: 10.3390/ijerph17124306 -
PloS One 2020The main purpose of this review was to systematically analyze the literature concerning studies which have investigated muscle activation when performing the Deadlift...
The main purpose of this review was to systematically analyze the literature concerning studies which have investigated muscle activation when performing the Deadlift exercise and its variants. This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Statement (PRISMA). Original studies from inception until March 2019 were sourced from four electronic databases including PubMed, OVID, Scopus and Web of Science. Inclusion criteria were as follows: (a) a cross-sectional or longitudinal study design; (b) evaluation of neuromuscular activation during Deadlift exercise or variants; (c) inclusion of healthy and trained participants, with no injury issues at least for six months before measurements; and (d) analyzed "sEMG amplitude", "muscle activation" or "muscular activity" with surface electromyography (sEMG) devices. Major findings indicate that the biceps femoris is the most studied muscle, followed by gluteus maximus, vastus lateralis and erector spinae. Erector spinae and quadriceps muscles reported greater activation than gluteus maximus and biceps femoris muscles during Deadlift exercise and its variants. However, the Romanian Deadlift is associated with lower activation for erector spinae than for biceps femoris and semitendinosus. Deadlift also showed greater activation of the quadriceps muscles than the gluteus maximus and hamstring muscles. In general, semitendinosus muscle activation predominates over that of biceps femoris within hamstring muscles complex. In conclusion 1) Biceps femoris is the most evaluated muscle, followed by gluteus maximus, vastus lateralis and erector spinae during Deadlift exercises; 2) Erector spinae and quadriceps muscles are more activated than gluteus maximus and biceps femoris muscles within Deadlift exercises; 3) Within the hamstring muscles complex, semitendinosus elicits slightly greater muscle activation than biceps femoris during Deadlift exercises; and 4) A unified criterion upon methodology is necessary in order to report reliable outcomes when using surface electromyography recordings.
Topics: Electromyography; Exercise; Female; Humans; Male; Muscle Contraction; Muscle Strength; Muscle, Skeletal; Resistance Training
PubMed: 32107499
DOI: 10.1371/journal.pone.0229507 -
Nutrients Jan 2017Athletes use nutritional supplementation to enhance the effects of training and achieve improvements in their athletic performance. Beetroot juice increases levels of... (Review)
Review
Athletes use nutritional supplementation to enhance the effects of training and achieve improvements in their athletic performance. Beetroot juice increases levels of nitric oxide (NO), which serves multiple functions related to increased blood flow, gas exchange, mitochondrial biogenesis and efficiency, and strengthening of muscle contraction. These biomarker improvements indicate that supplementation with beetroot juice could have ergogenic effects on cardiorespiratory endurance that would benefit athletic performance. The aim of this literature review was to determine the effects of beetroot juice supplementation and the combination of beetroot juice with other supplements on cardiorespiratory endurance in athletes. A keyword search of DialNet, MedLine, PubMed, Scopus and Web of Science databases covered publications from 2010 to 2016. After excluding reviews/meta-analyses, animal studies, inaccessible full-text, and studies that did not supplement with beetroot juice and adequately assess cardiorespiratory endurance, 23 articles were selected for analysis. The available results suggest that supplementation with beetroot juice can improve cardiorespiratory endurance in athletes by increasing efficiency, which improves performance at various distances, increases time to exhaustion at submaximal intensities, and may improve the cardiorespiratory performance at anaerobic threshold intensities and maximum oxygen uptake (VO). Although the literature shows contradictory data, the findings of other studies lead us to hypothesize that supplementing with beetroot juice could mitigate the ergolytic effects of hypoxia on cardiorespiratory endurance in athletes. It cannot be stated that the combination of beetroot juice with other supplements has a positive or negative effect on cardiorespiratory endurance, but it is possible that the effects of supplementation with beetroot juice can be undermined by interaction with other supplements such as caffeine.
Topics: Athletes; Beta vulgaris; Cardiorespiratory Fitness; Databases, Factual; Fruit and Vegetable Juices; Humans; Meta-Analysis as Topic; Oxygen Consumption; Performance-Enhancing Substances; Physical Endurance; Plant Roots
PubMed: 28067808
DOI: 10.3390/nu9010043 -
International Journal of Environmental... Aug 2021The aim of the study was to systematically evaluate the biceps femoris long head activation across cross-sectional hamstring strength exercise studies. (Review)
Review
BACKGROUND
The aim of the study was to systematically evaluate the biceps femoris long head activation across cross-sectional hamstring strength exercise studies.
METHODS
A systematic review design was followed. The search strategy conducted in PubMed, Cochrane Library, and Web of Sciences databases found a total of 3643 studies. Once inclusion and exclusion criteria were applied, 29 studies were finally included in this systematic review. A total of 507 participants and 114 different exercises were analyzed. Exercises were evaluated individually and grouped into several categories: Nordics, isokinetic exercises, lunges, squats, deadlifts, good mornings, hip thrusts, bridges, leg curls, swings, hip and back extensions, and others.
RESULTS
Results showed the isokinetic and Nordic exercises as the categories with highest biceps femoris activation (>60% of Maximal Voluntary Isometric Contraction). Nordic hamstring exercise ankle dorsiflexion was the exercise that achieved the highest biceps femoris long head activation (128.1% of its Maximal Voluntary Isometric Contraction).
CONCLUSIONS
The results from this systematic review suggest that isokinetic and Nordic exercises seem to be the best option to activate biceps femoris long head. Future studies evaluating the implementation of these exercises in prevention programs are needed.
Topics: Cross-Sectional Studies; Electromyography; Exercise; Hamstring Muscles; Humans; Isometric Contraction
PubMed: 34444481
DOI: 10.3390/ijerph18168733