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Frontiers in Physiology 2018The aim of the present work was to perform a meta-analysis evaluating the impact of recovery techniques on delayed onset muscle soreness (DOMS), perceived fatigue,...
An Evidence-Based Approach for Choosing Post-exercise Recovery Techniques to Reduce Markers of Muscle Damage, Soreness, Fatigue, and Inflammation: A Systematic Review With Meta-Analysis.
The aim of the present work was to perform a meta-analysis evaluating the impact of recovery techniques on delayed onset muscle soreness (DOMS), perceived fatigue, muscle damage, and inflammatory markers after physical exercise. Three databases including , and were searched using the following terms: ("recovery" or "active recovery" or "cooling" or "massage" or "compression garment" or "electrostimulation" or "stretching" or "immersion" or "cryotherapy") and ("DOMS" or "perceived fatigue" or "CK" or "CRP" or "IL-6") and ("after exercise" or "post-exercise") for randomized controlled trials, crossover trials, and repeated-measure studies. Overall, 99 studies were included. Active recovery, massage, compression garments, immersion, contrast water therapy, and cryotherapy induced a small to large decrease (-2.26 < g < -0.40) in the magnitude of DOMS, while there was no change for the other methods. Massage was found to be the most powerful technique for recovering from DOMS and fatigue. In terms of muscle damage and inflammatory markers, we observed an overall moderate decrease in creatine kinase [SMD (95% CI) = -0.37 (-0.58 to -0.16), I = 40.15%] and overall small decreases in interleukin-6 [SMD (95% CI) = -0.36 (-0.60 to -0.12), I = 0%] and C-reactive protein [SMD (95% CI) = -0.38 (-0.59 to-0.14), I = 39%]. The most powerful techniques for reducing inflammation were massage and cold exposure. : Massage seems to be the most effective method for reducing DOMS and perceived fatigue. Perceived fatigue can be effectively managed using compression techniques, such as compression garments, massage, or water immersion.
PubMed: 29755363
DOI: 10.3389/fphys.2018.00403 -
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 -
Nutrients Feb 2019Soccer is a complex team sport and success in this discipline depends on different factors such as physical fitness, player technique and team tactics, among others. In...
Soccer is a complex team sport and success in this discipline depends on different factors such as physical fitness, player technique and team tactics, among others. In the last few years, several studies have described the impact of caffeine intake on soccer physical performance, but the results of these investigations have not been properly reviewed and summarized. The main objective of this review was to evaluate critically the effectiveness of a moderate dose of caffeine on soccer physical performance. A structured search was carried out following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines in the Medline/PubMed and Web of Science databases from January 2007 to November 2018. The search included studies with a cross-over and randomized experimental design in which the intake of caffeine (either from caffeinated drinks or pills) was compared to an identical placebo situation. There were no filters applied to the soccer players' level, gender or age. This review included 17 articles that investigated the effects of caffeine on soccer-specific abilities ( = 12) or on muscle damage ( = 5). The review concluded that 5 investigations (100% of the number of investigations on this topic) had found ergogenic effects of caffeine on jump performance, 4 (100%) on repeated sprint ability and 2 (100%) on running distance during a simulated soccer game. However, only 1 investigation (25%) found as an effect of caffeine to increase serum markers of muscle damage, while no investigation reported an effect of caffeine to reduce perceived fatigue after soccer practice. In conclusion, a single and moderate dose of caffeine, ingested 5⁻60 min before a soccer practice, might produce valuable improvements in certain abilities related to enhanced soccer physical performance. However, caffeine does not seem to cause increased markers of muscle damage or changes in perceived exertion during soccer practice.
Topics: Adolescent; Adult; Athletic Performance; Caffeine; Cross-Over Studies; Dietary Supplements; Fatigue; Female; Humans; Male; Muscle, Skeletal; Perception; Performance-Enhancing Substances; Physical Functional Performance; Randomized Controlled Trials as Topic; Running; Soccer; Young Adult
PubMed: 30791576
DOI: 10.3390/nu11020440 -
Cancer Medicine Oct 2022Health professionals predict that the number of people who will suffer and die from oncological diseases will continue to increase. It is vitally important to provide... (Meta-Analysis)
Meta-Analysis Review
Health professionals predict that the number of people who will suffer and die from oncological diseases will continue to increase. It is vitally important to provide comprehensive care to these patients and prescribe physical exercise programs as adjuvant therapy. The objective of this systematic review was to determine the impact of physical exercise on advanced-stage cancer patients. A literature search was performed in eight different databases. This search focused on randomized controlled trials (RCTs) published during the last 10 years. To assess the methodological quality of the sample of 15 RCTs finally obtained, the PEDro scale was used. Aerobic and strength training methods were used. The combination of both aerobic and strength training methods was the most frequently reported. Likewise, different physical and psychological variables were recorded, from which improvements were seen in fatigue, independence, quality of life and sleep, among others. The participation in physical exercise programs by advanced-stage cancer patients has a positive impact on health. Providing these programs serves as adjuvant therapy, facilitating the comprehensive care of patients. Similarly, aerobic, strength or mixed training programs increase the muscle mass of patients and therefore reduce hypotonia, the main side effect during the advanced-stages of cancer.
Topics: Exercise; Exercise Therapy; Fatigue; Humans; Neoplasms; Quality of Life; Resistance Training
PubMed: 35411694
DOI: 10.1002/cam4.4746 -
International Journal of Environmental... Apr 2022Increasing numbers of individuals suffer from post-acute COVID-19 syndrome (PACS), which manifests with persistent symptoms, the most prevalent being dyspnea, fatigue,... (Review)
Review
Increasing numbers of individuals suffer from post-acute COVID-19 syndrome (PACS), which manifests with persistent symptoms, the most prevalent being dyspnea, fatigue, and musculoskeletal, cognitive, and/or mental health impairments. This systematic review investigated the effectiveness of rehabilitation interventions for individuals with PACS. We searched the MEDLINE, Embase, Cochrane Register of Controlled Trials, CINHAL, Scopus, Prospero, and PEDro databases and the International Clinical Trials Registry Platform for randomized controlled trials (RCTs) up to November 2021. We screened 516 citations for eligibility, i.e., trials that included individuals with PACS exposed to exercise-based rehabilitation interventions. Five RCTs were included, accounting for 512 participants (aged 49.2-69.4 years, 65% males). Based on the revised Cochrane risk-of-bias tool (RoB 2.0), two RCTs had "low risk of bias", and three were in the "some concerns" category. Three RCTs compared experimental rehabilitation interventions with no or minimal rehabilitation, while two compared two active rehabilitation interventions. Rehabilitation seemed to improve dyspnea, anxiety, and kinesiophobia. Results on pulmonary function were inconsistent, while improvements were detected in muscle strength, walking capacity, sit-to-stand performance, and quality of life. Pending further studies based on qualitatively sound designs, these first findings seem to advocate for rehabilitation interventions to lessen disability due to PACS.
Topics: COVID-19; Dyspnea; Exercise Therapy; Female; Humans; Male; Quality of Life; Post-Acute COVID-19 Syndrome
PubMed: 35564579
DOI: 10.3390/ijerph19095185 -
International Journal of Environmental... May 2021Due to drawbacks of the percentage-based approach, velocity-based training was proposed as a method to better and more accurately prescribe training loads to increase... (Review)
Review
Due to drawbacks of the percentage-based approach, velocity-based training was proposed as a method to better and more accurately prescribe training loads to increase general and specific performance. The purpose of this study was to perform a systematic review of the studies that show effects of velocity-based resistance training on strength and power performance in elite athletes. Electronic searches of computerized databases were performed according to a protocol that was agreed by all co-authors. Four databases-SportDiscus with Full Text and MEDLINE via EBSCO, SCOPUS, and Web of Science-were searched. Seven studies were found which researched the effects of velocity-based resistance training on athletes after a given training period. The analyzed studies suggest that applying velocity losses of 10-20% can help induce neuromuscular adaptations and reduce neuromuscular fatigue. Using velocity zones as part of a separate or combined (e.g., plyometric) training program can elicit adaptations in body composition and performance parameters. Moreover, velocity zones can be programmed using a periodized or non-periodized fixed velocity zones protocol. Lastly, obtaining instantaneous feedback during training is a more effective tool for increasing performance in sport-specific parameters, and should be used by sport practitioners to help keep athletes accountable for their performance.
Topics: Adaptation, Physiological; Athletes; Humans; Muscle Strength; Resistance Training
PubMed: 34069249
DOI: 10.3390/ijerph18105257 -
BMJ Open Sport & Exercise Medicine 2020Massage is ubiquitous in elite sport and increasingly common at amateur level but the evidence base for this intervention has not been reviewed systematically. We...
OBJECTIVE
Massage is ubiquitous in elite sport and increasingly common at amateur level but the evidence base for this intervention has not been reviewed systematically. We therefore performed a systematic review and meta-analysis examining the effect of massage on measures of sporting performance and recovery.
DESIGN AND ELIGIBILITY
We searched PubMed, MEDLINE and Cochrane to identify randomised studies that tested the effect of manual massage on measures of sporting performance and/or recovery. We performed separate meta-analyses on the endpoints of; strength, jump, sprint, endurance, flexibility, fatigue and delayed onset muscle soreness (DOMS).
RESULTS
We identified 29 eligible studies recruiting 1012 participants, representing the largest examination of the effects of massage. We found no evidence that massage improves measures of strength, jump, sprint, endurance or fatigue, but massage was associated with small but statistically significant improvements in flexibility and DOMS.
CONCLUSION
Although our study finds no evidence that sports massage improves performance directly, it may somewhat improve flexibility and DOMS. Our findings help guide the coach and athlete about the benefits of massage and inform decisions about incorporating this into training and competition.
PubMed: 32426160
DOI: 10.1136/bmjsem-2019-000614 -
Journal of Functional Morphology and... Feb 2021Ashwagandha () is considered a potent adaptogen and anti-stress agent that could have some potential to improve physical performance. This preferred reporting items for... (Review)
Review
Ashwagandha () is considered a potent adaptogen and anti-stress agent that could have some potential to improve physical performance. This preferred reporting items for systematic reviews and meta-analyses (PRISMA)-based comprehensive systematic review and Bayesian meta-analysis aimed to evaluate clinical trials up to 2020 from PubMed, ScienceDirect, and Google Scholar databases regarding the effect of Ashwagandha supplementation on physical performance in healthy individuals. Besides implementing estimation statistics analysis, we developed Bayesian hierarchical models for a pre-specified subgroup meta-analysis on strength/power, cardiorespiratory fitness and fatigue/recovery variables. A total of 13 studies met the requirements of this systematic review, although only 12 were included in the quantitative analysis. A low-to-moderate overall risk of bias of the trials included in this study was detected. All Bayesian hierarchical models converged to a target distribution (Ȓ = 1) for both meta-analytic effect size (μ) and between-study standard deviation (τ). The meta-analytic approaches of the included studies revealed that Ashwagandha supplementation was more efficacious than placebo for improving variables related to physical performance in healthy men and female. In fact, the Bayesian models showed that future interventions might be at least in some way beneficial on the analyzed outcomes considering the 95% credible intervals for the meta-analytic effect size. Several practical applications and future directions are discussed, although more comparable studies are needed in exercise training, and athletic populations are needed to derive a more stable estimate of the true underlying effect.
PubMed: 33670194
DOI: 10.3390/jfmk6010020 -
The Cochrane Database of Systematic... Sep 2015Multiple sclerosis (MS) is an immune-mediated disease of the central nervous system affecting an estimated 1.3 million people worldwide. It is characterised by a variety... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Multiple sclerosis (MS) is an immune-mediated disease of the central nervous system affecting an estimated 1.3 million people worldwide. It is characterised by a variety of disabling symptoms of which excessive fatigue is the most frequent. Fatigue is often reported as the most invalidating symptom in people with MS. Various mechanisms directly and indirectly related to the disease and physical inactivity have been proposed to contribute to the degree of fatigue. Exercise therapy can induce physiological and psychological changes that may counter these mechanisms and reduce fatigue in MS.
OBJECTIVES
To determine the effectiveness and safety of exercise therapy compared to a no-exercise control condition or another intervention on fatigue, measured with self-reported questionnaires, of people with MS.
SEARCH METHODS
We searched the Cochrane Multiple Sclerosis and Rare Diseases of the Central Nervous System Group Trials Specialised Register, which, among other sources, contains trials from: the Cochrane Central Register of Controlled Trials (CENTRAL) (2014, Issue 10), MEDLINE (from 1966 to October 2014), EMBASE (from 1974 to October 2014), CINAHL (from 1981 to October 2014), LILACS (from 1982 to October 2014), PEDro (from 1999 to October 2014), and Clinical trials registries (October 2014). Two review authors independently screened the reference lists of identified trials and related reviews.
SELECTION CRITERIA
We included randomized controlled trials (RCTs) evaluating the efficacy of exercise therapy compared to no exercise therapy or other interventions for adults with MS that included subjective fatigue as an outcome. In these trials, fatigue should have been measured using questionnaires that primarily assessed fatigue or sub-scales of questionnaires that measured fatigue or sub-scales of questionnaires not primarily designed for the assessment of fatigue but explicitly used as such.
DATA COLLECTION AND ANALYSIS
Two review authors independently selected the articles, extracted data, and determined methodological quality of the included trials. Methodological quality was determined by means of the Cochrane 'risk of bias' tool and the PEDro scale. The combined body of evidence was summarised using the GRADE approach. The results were aggregated using meta-analysis for those trials that provided sufficient data to do so.
MAIN RESULTS
Forty-five trials, studying 69 exercise interventions, were eligible for this review, including 2250 people with MS. The prescribed exercise interventions were categorised as endurance training (23 interventions), muscle power training (nine interventions), task-oriented training (five interventions), mixed training (15 interventions), or 'other' (e.g. yoga; 17 interventions). Thirty-six included trials (1603 participants) provided sufficient data on the outcome of fatigue for meta-analysis. In general, exercise interventions were studied in mostly participants with the relapsing-remitting MS phenotype, and with an Expanded Disability Status Scale less than 6.0. Based on 26 trials that used a non-exercise control, we found a significant effect on fatigue in favour of exercise therapy (standardized mean difference (SMD) -0.53, 95% confidence interval (CI) -0.73 to -0.33; P value < 0.01). However, there was significant heterogeneity between trials (I(2) > 58%). The mean methodological quality, as well as the combined body of evidence, was moderate. When considering the different types of exercise therapy, we found a significant effect on fatigue in favour of exercise therapy compared to no exercise for endurance training (SMDfixed effect -0.43, 95% CI -0.69 to -0.17; P value < 0.01), mixed training (SMDrandom effect -0.73, 95% CI -1.23 to -0.23; P value < 0.01), and 'other' training (SMDfixed effect -0.54, 95% CI -0.79 to -0.29; P value < 0.01). Across all studies, one fall was reported. Given the number of MS relapses reported for the exercise condition (N = 25) and non-exercise control condition (N = 26), exercise does not seem to be associated with a significant risk of a MS relapse. However, in general, MS relapses were defined and reported poorly.
AUTHORS' CONCLUSIONS
Exercise therapy can be prescribed in people with MS without harm. Exercise therapy, and particularly endurance, mixed, or 'other' training, may reduce self reported fatigue. However, there are still some important methodological issues to overcome. Unfortunately, most trials did not explicitly include people who experienced fatigue, did not target the therapy on fatigue specifically, and did not use a validated measure of fatigue as the primary measurement of outcome.
Topics: Adult; Exercise Therapy; Fatigue; Humans; Multiple Sclerosis; Physical Conditioning, Human; Physical Endurance; Randomized Controlled Trials as Topic; Resistance Training; Yoga
PubMed: 26358158
DOI: 10.1002/14651858.CD009956.pub2 -
Annals of Surgical Oncology May 2022Esophageal and gastric cancer surgery are associated with considerable morbidity, specifically postoperative pulmonary complications (PPCs), potentially accentuated by... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Esophageal and gastric cancer surgery are associated with considerable morbidity, specifically postoperative pulmonary complications (PPCs), potentially accentuated by underlying challenges with malnutrition and cachexia affecting respiratory muscle mass. Physiotherapy regimens aim to increase the respiratory muscle strength and may prevent postoperative morbidity.
OBJECTIVE
The aim of this study was to assess the impact of physiotherapy regimens in patients treated with esophagectomy or gastrectomy.
METHODS
An electronic database search was performed in the MEDLINE, EMBASE, CENTRAL, CINAHL and Pedro databases. A meta-analysis was performed to assess the impact of physiotherapy on the functional capacity, incidence of PPCs and postoperative morbidity, in-hospital mortality rate, length of hospital stay (LOS) and health-related quality of life (HRQoL).
RESULTS
Seven randomized controlled trials (RCTs) and seven cohort studies assessing prehabilitation totaling 960 patients, and five RCTs and five cohort studies assessing peri- or postoperative physiotherapy with 703 total patients, were included. Prehabilitation resulted in a lower incidence of postoperative pneumonia and morbidity (Clavien-Dindo score ≥ II). No difference was observed in functional exercise capacity and in-hospital mortality following prehabilitation. Meanwhile, peri- or postoperative rehabilitation resulted in a lower incidence of pneumonia, shorter LOS, and better HRQoL scores for dyspnea and physical functioning, while no differences were found for the QoL summary score, global health status, fatigue, and pain scores.
CONCLUSION
This meta-analysis suggests that implementing an exercise intervention may be beneficial in both the preoperative and peri- or postoperative periods. Further investigation is needed to understand the mechanism through which exercise interventions improve clinical outcomes and which patient subgroup will gain the maximal benefit.
Topics: Esophagectomy; Gastrectomy; Humans; Length of Stay; Physical Therapy Modalities; Pneumonia; Postoperative Complications
PubMed: 34961901
DOI: 10.1245/s10434-021-11122-7