Most patients with end-stage renal disease choose maintenance hemodialysis to prolong survival. The clinical application of exercise therapy has a definite effect on maintenance hemodialysis patients, and can effectively improve their quality of life and promote rehabilitation. Individualized exercise therapy under the guidance of medical professionals has positive effects on patients’ physical and mental rehabilitation. This paper mainly summarizes the status of exercise, factors affecting exercise, exercise therapy, exercise and rehabilitation of maintenance hemodialysis patients, and reviews the impact of exercise therapy on the physical and mental health of maintenance hemodialysis patients, in order to provide some references for clinical intervention and prognosis studies.
ObjectiveTo systematically review the efficacy of exercise interventions on thoracic kyphosis in adults. MethodsThe PubMed, EMbase, Web of Science, CINAHL, Cochrane Library, CNKI, CBM, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) related to the objective from inception to November 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.4 software. ResultsA total of 10 RCTs involving 482 patients were included. The results of meta-analysis showed that exercise interventions could reduce kyphosis angle (MD=?5.27, 95%CI ?8.37 to ?2.17, P<0.01) and improve quality of life (SMD=0.78, 95%CI 0.52 to 1.04, P<0.01) in thoracic kyphosis in adults, but there were no significant differences between the two groups in pain and physical function. ConclusionCurrent evidence suggests that exercise interventions can reduce thoracic kyphosis angle and improve quality of life in adults, but the effects on pain and physical function are unclear. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
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.
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.
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.
Pulmonary rehabilitation therapy is gaining more attention. The recent systematic review of domestic and foreign relevant literature indicates pre-operative pulmonary rehabilitation exercise training performs an important role in per-operative period. The rehabilitation therapy can efficiently improve exercise tolerance and quality of life of patients with lung cancer, reduce post-operative complications, shorten hospitalization time, and increase opportunity of operation. However, the evidence comes from small samples reported by present clinical study, and a standard treatment guideline of pulmonary rehabilitation has not been established until now. Further researches are expected to provide demonstration and promote pulmonary rehabilitation. It is an important part of comprehensive treatment of lung cancer. The therapy will benefit more patients suffering from lung cancer.
Under the new era background of actively advocating the " active health” in the elderly, the prevention methods of falls not only include environmental modification, reasonable drugs, emotional support, disease prevention and control, etc., but exercise should also be integrated into them. Exercise training can significantly improve muscle strength, balance, and mobility in the elderly, thereby reducing the risk of falls. This paper reviews the biomechanical causes of falls in the elderly, the sports training prescriptions for fall prevention in the elderly, and the research prospects of sports training for fall prevention in the elderly. It is hoped that the elderly population could establish an active healthy lifestyle based on sports training, elevate the physical fitness continuously, reduce the fall injury, and improve the quality of life through strength, balance, and endurance training.
ObjectiveTo investigate the effect of behavior intervention through diets and exercises on blood glucose controlling in patients with gestational diabetes mellitus (GDM), and to provide the basis for GDM therapy.
MethodsA total of 116 patients with GDM diagnosed and treated in the Sixth Affiliated Hospital of Sun Yat-sen University between March 2011 and December 2012 were taken as our study objects, including 72 patients in the study group and 44 patients in the control group, based on their will. For patients in the study group, we carried out behavior interventions through diets and exercises, including dietary guidance, giving pamphlet and formulating exercise plan, while for patients in the control group, we only gave them oral guidance and publicity materials. The same questionnaire was used to collect all the patients' information. Follow-up was done once in every 3 days, and rechecking was performed 2 weeks later. The results of oral glucose tolerance test and the rate of pathoglycemia were compared in these groups before and after intervention.
ResultsThe fasting blood glucose, 1- and 2-hour blood glucose were lowered after the behavior intervention in the study group (P<0.05), which were also significantly lower than the control group (P<0.05). Fasting blood glucose, 1- and 2-hour pathoglycemia was significantly lower in the study group than that in the control group and that before intervention (P<0.05).
ConclusionCombination of diets and exercises can control levels of blood glucose in GDM patients, and is an important therapy for GDM.
ObjectiveTo systematically review the efficacy of exercise intervention on smoking cessation. MethodsCNKI, WanFang Data, VIP, Web of Science, PubMed and EMbase databases were electronically searched to collect randomized controlled trials (RCTs) and randomized cross controlled trials (RCDs) on exercise intervention for smoking cessation from inception to September 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Then, meta-analysis was performed using Stata 12.0 software. ResultsA total of 47 studies (35 RCTs and 12 RCDs) involving 5 130 subjects were included. The results of meta-analysis showed that acute exercise could significantly reduce the quitters’ desire to smoke (P<0.05), alleviate most of the withdrawal symptoms, and the effect of acute exercise was maintained for at least 30 minutes. Periodic exercise significantly reduced 7-day point abstinence and sustained abstinence rates in ex-smokers (P<0.05), and the effect of periodic exercise was maintained for at least 12 weeks, however, depression and stress were not found to be effectively relieved, and mood was not found to be significantly improved (P>0.05). ConclusionExercise intervention to quit smoking has a positive effect, however, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo systematically review the efficacy of exercise intervention in adolescents with mild to moderate idiopathic scoliosis (AIS). MethodsPubMed, Web of Science, The Cochrane Library, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of exercise intervention in adolescents with mild to moderate AIS from inception to November 2021. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 16.0 software. ResultsA total of 11 RCTs involving 638 patients were included. The results of meta-analysis showed that exercise intervention significantly improved the Cobb angle of the spine in patients with AIS (MD=?1.65, 95%CI ?2.63 to ?0.68, P<0.01), reduced the angle of trunk rotation (ATR) (MD=?0.68, 95%CI ?0.96 to ?0.40, P<0.01), and increased their forced vital capacity (FVC) (MD=0.63, 95%CI 0.10 to 1.15, P=0.02). However, there was no statistically significant improvement in the forced expiratory volume in the first second (FEV1) or the ratio of FEV1/FVC between the two groups. ConclusionCurrent evidence shows that the exercise intervention could improve the Cobb angle of the spine, reduce ATR and enhance FVC. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
