Objective To systematically review the efficacy of different exercises on inflammatory cytokines in individuals with overweight or obesity. Methods The CNKI, WanFang Data, VIP, PubMed, EBSCO, Cochrane Library, Web of Science and Embase databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of exercise on inflammatory cytokines in individuals with overweight or obesity from January, 2000 to April, 2021. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. The network meta-analysis was then performed using Stata 16.0 software. Results A total of 63 RCTs were included, 49 of which reported the changes in IL-6, 47 of which reported the changes in TNF-α, and 16 of which reported the changes in IL-10. The results of the network meta-analysis found that compared with those in the control group, aerobic exercise (AE) (SMD=?0.9, 95%CI ?1.4 to ?0.5, P<0.01) and high-intensity interval training (HIIT) (SMD=?1.3, 95%CI ?2.3 to ?0.3, P=0.011) significantly reduced IL-6. AE (SMD=?1.3, 95%CI ?1.7 to ?0.9, P<0.01), combined exercise (COM) (SMD=?0.7, 95%CI ?1.3 to ?0.1, P=0.02), and HIIT (SMD=?1.8, 95%CI ?2.6 to ?0.9, P<0.01) significantly reduced TNF-α; AE (SMD=0.8, 95%CI 0.1 to 1.5, P=0.03) significantly increased IL-10. The cumulative probability ranking results showed that HIIT was the most effective in reducing IL-6 and TNF-α and increasing IL-10, followed by AE and COM, and resistance training (RT) was the least effective. Conclusion Different exercise types have different effects on improving inflammation in individuals with overweight or obesity. HIIT can be suggested as the best exercise program to improve chronic inflammation in individuals with overweight or obesity. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
Elderly patients with chronic kidney disease not only suffer from senescence-related muscle strength decline, but also exist muscle attenuation caused by chronic kidney disease. Sarcopenia of this group are more obvious, and falls, incapacity, weakness and death caused by sarcopenia are more prominent. At present, clinicians’ understanding of sarcopenia is still in the aspects of concept popularization and basic research, and there is a lack of practical diagnosis and treatment process and clinical prevention and treatment practice. Starting from the evolution of the definition of sarcopenia, this paper elaborates on the characteristics of sarcopenia in elderly patients with chronic kidney disease, as well as the exercise rehabilitation of sarcopenia in elderly patients with chronic kidney disease, in order to improve the attention and understanding of renal colleagues on sarcopenia in elderly people with chronic kidney disease.
ObjectivesTo systematically review the efficacy of exercise therapy on functional and activity recovery after anterior cruciate ligament reconstruction (ACL).MethodsPubMed, EMbase, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of exercise therapy on functional and activity recovery after ACL from inception to May 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 11 RCTs involving 602 patients were included. The results of meta-analysis showed that: 1 week (MD=3.07, 95%CI 1.37 to 4.77, P=0.000 4) and 3 weeks (MD=4.53, 95%CI 2.34 to 6.71, P<0.000 1) conventional exercise training rehabilitation effects were better than natural recovery under orthopedic routine care in promoting knee joint function recovery. The recovery effects of over 6 months neuromuscular training was significantly increased compared with conventional rehabilitation (MD=11.48, 95%CI 8.25 to 14.71, P<0.000 01). In addition, there was significant difference between open and closed chain exercise rehabilitation after more than 6 months rehabilitation training (MD=6.77, 95%CI 0.86 to 12.68, P=0.02).ConclusionsThe current evidence shows that over 6 months neuromuscular training significantly enhance the recovery of motor function after anterior cruciate ligament reconstruction. According to different reconstruction methods, individualized rehabilitation program is developed to maximize the recovery of knee joint function. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusions.
Patients undergoing maintenance hemodialysis are characterized with lower cardiorespiratory capacity and muscle atrophy, thus easily leading to a sedentary lifestyle. These patients are usually associated with lower quality of life and worse prognosis. Evidence indicates appropriate exercise rehabilitation plan could help maintenance hemodialysis patients achieve better health outcomes. However, there is still a lack of evidence data to precisely recommend exercise type, intensity, frequency and timing specially designed for maintenance hemodialysis patients. This article aims to summarize the existing expert consensus on exercise rehabilitation for maintenance hemodialysis patients, important considerations in the implementation process, factors that affect exercise rehabilitation, with a view to encouraging maintenance hemodialysis patients to participate in the development of appropriate exercise rehabilitation plan and maximize health benefits.
Objective
To investigate the influence of the integration of fracture treatment and exercise rehabilitation on the effectiveness in the patients with intertrochanteric fracture of femur.
Methods
Between January 2007 and December 2009, 3 873 patients with intertrochanteric fracture of femur were surgically treated in 56 hospitals. Of them, 1 970 cases were treated with rehabilitation training according to scale of safety assessment of early exercise rehabilitation of patients with fractures (trial group), 1 903 cases were treated with traditional rehabilitation training methods (control group). There was no significant difference in age, gender, fracture type, internal fixation type, or postoperative safety score between 2 groups (P gt; 0.05).
Results
All the patients were followed up 13-49 months (mean, 30.5 months). There was no significant difference in the incidences of bone nonunion, delayed union, and systemic complication between 2 groups (P gt; 0.05); significant differences were found in the incidences of incision complication, deep vein thrombosis of the lower extremity, and the overall complication between 2 groups (P lt; 0.05). At 6 and 12 months after operation, the trial group was significantly better than the control group in the recovery of hip motion, curative effectiveness classification, and the excellent and good rate (P lt; 0.05).
Conclusion
The treatment of intertrochanteric fracture of the femur guided by the integration of fracture treatment and exercise rehabilitation can apparently improve the prognosis and reduce the incidence of complications.
With the prevalence of cardiovascular diseases, the development of cardiac rehabilitation is an inevitable trend. Cardiac rehabilitation is a comprehensive and long-term plan including medical assessment, exercise prescription, correction of cardiovascular risk factors, education, counseling, and behavioral intervention. Evidence-based medical evidence confirms that cardiac rehabilitation plays an important role in the three level prevention of cardiovascular disease. In this paper, we searched the literature in recent 10 years to explain the current situation and future research direction of cardiac rehabilitation, and explore the best mode of cardiac rehabilitation.
Objective To evaluate whether respiratory training can improve motor function, exercise endurance, and activity of daily living (ADL) in stroke patients. Methods The randomized controlled trials of the effects of respiratory training on motor function, exercise endurance, and ADL in stroke patients were searched in PubMed, Embase, Google Scholar, China National Knowledge Infrastructure, Wanfang, and VIP Database. The search date was from the establishment of each database to December 2018. The control group received routine rehabilitation, medical treatment or other interventions, and the trial group added respiratory training on that basis. Outcome measures included the Fugl-Meyer Assessment (FMA), the 6-minute walk test (6MWT), and the modified Barthel Index (BI). The literature was independently screened by two investigators according to the inclusion and exclusion criteria, and the quality of the included articles was evaluated using the Physiotherapy Evidence Database scale and Cochrane Library systematic review criteria. Statistical analysis was performed using RevMan 5.3 software. Results A total of 11 articles with 741 stroke patients were included. Meta-analysis showed that in the trial group the exercise endurance [mean difference (MD)=41.50 m, 95% confidence interval (CI) (7.63, 75.37) m, P=0.02], ADL [MD=9.97, 95%CI (3.99, 15.96), P=0.001], and motor function [MD=8.00, 95%CI (1.29, 14.70), P=0.02] were improved compared with those in the control group. Subgroup analysis showed that after 8-10 weeks of intervention, BI of the trial group was higher than that of the control group [MD=25.37, 95%CI (16.49, 34.25), P<0.000 01]; after 8 weeks and 12 weeks to 3 months of intervention, FMA of the trial group was higher than that of the control group [ after 8 weeks: MD=20.40, 95%CI (9.72, 31.08), P=0.000 2; after 12 weeks to 3 months: MD=6.18, 95%CI (3.57, 8.79), P<0.000 01]. Conclusions The results of this study showed that respiratory training can improve exercise tolerance, ADL, and motor function in stroke patients. In consideration of the limited number of included articles as well as the heterogeneity among included articles in the current study, and the lack of long-term follow-up period, further studies could use more optimized respiratory training programs to conduct high-quality researches with bigger sample sizes.
cardiac rehabilitation has evolved over the past decades from a simple monitoring for the safe return to physical activities to a multidisciplinary approach that focuses on patient education, individually tailored exercise training, modification of the risk factors and the overall well-being of the cardiac patients. It has been proven to be an effective tool for the care of the patients with heart disease. Recent research in cardiac rehabilitation has demonstrated that tremendous benefits can be derived from the optimal use of cardiac rehabilitation in patients with various cardiac pathologies including ischemic heart disease, heart failure and post heart surgery. The benefits of cardiac rehabilitation include mortality reduction, symptom relief, reduction in smoking and improved exercise tolerance, risk factors modification and the overall psychosocial wellbeing. Unfortunately, cardiac rehabilitation remains considerably underutilized mainly because of referral problems and poor enrollment. The development of alternate approaches and the use of transtelephonic and other means of monitoring and surveillance will help expand the utilization of cardiac rehabilitation.
ObjectivesTo evaluate the effects of physical exercises on the vision of students in China.MethodsTrials of the effects of physical exercises on students' vision were retrieved in databases of CNKI, WanFang Data, VIP, Web of Science, EBSCO, PubMed and The Cochrane Library from inception to September 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was carried out with RevMan 5.3 and Stata 13.0 software.ResultsA total of 8 studies including 681 students in the experimental group and 679 in the control group were included. The results of meta-analysis showed that physical exercises were beneficial to improving students' vision (SMD=1.02, 95%CI 0.90 to 1.13, P<0.000 01). The results of subgroup analysis showed that physical exercises in the elementary school students group (SMD=1.361, 95%CI 0.873 to 1.850, P<0.000 01), long period (>24 weeks) (SMD=1.502, 95%CI 0.984 to 2.019, P<0.000 01), medium frequency (3 times/week) (SMD=1.631, 95%CI 1.022 to 2.240, P<0.000 01), and short time (<90 min) (SMD=1.410, 95%CI 0.758 to 2.062, P<0.000 01) had superior results.ConclusionsPhysical exercises have beneficial effects on improving vision. Limited by quantity and quality of subjects, the above conclusions requires verification by more high-quality studies.
ObjectiveTo systematically review the efficacy of aerobic training, resistance training and aerobic training combined with resistance training on non-dialysis patients with chronic kidney diseases. MethodsPubMed, The Cochrane Library, EMbase, EBSCO, Web of Science, VIP, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) of three types of exercise therapy on patients with chronic kidney disease from January 2012 to January 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, network meta-analysis was performed by using RevMan 5.4 software and R software. ResultsA total of 22 RCTs involving 1 633 patients were included. The results of network meta-analysis showed that: compared with the control group, aerobic training, and resistance training reduced resting systolic blood pressure; aerobic training, resistance training reduced resting diastolic blood pressure; aerobic training reduced total cholesterol levels; aerobic training improved peak oxygen uptake; aerobic training combined with resistance training improved six-minute walking test. Aerobic training, resistance training, and aerobic training combined with resistance training improved glomerular filtration rate. The probability sorting results showed that aerobic training had the most significant effect on the improvement of peak oxygen uptake, C-reactive protein, total cholesterol, low-density lipoproteins, and high-density lipoproteins; resistance training had the most significant effect on the improvement of systolic blood pressure, diastolic blood pressure and glomerular filtration rate; aerobic exercise combined with resistance training had the most significant effect on the improvement of body mass index, triglycerides, and six-minute walking test. ConclusionCurrent evidence shows that aerobic training has an advantage in reducing total cholesterol levels and increasing peak oxygen uptake, resistance training has an advantage in improving blood pressure and glomerular filtration rate and aerobic training combined with resistance training has an advantage in improving walking ability of patients with non-dialysis chronic kidney disease.
