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Varicose veins are a common disorder for which different treatments with varied efficacy have been introduced so far. In this study, we review the results of previous studies to evaluate the efficacy of ClosureFast endovenous radiofrequency ablation (RFA) in treating varicose veins. The present study was performed based on the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) protocols, and the results were reported based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guideline. Searches were conducted in all authentic online databases, and the retrieved papers were conducted until March 2021 using Mesh keywords. Study data with the necessary quality to enter the meta-analysis were extracted. Data were analyzed using comprehensive meta-analysis (CMA) software version 2. The cutoff level for significance was determined at 0.05. In total, 36 studies with sample size 7404 procedures were included. Radiofrequency ablation success, recurrence, and recanalization rates in the treatment of varicose veins were estimated to be 95%, 7%, and 3% respectively. The most common complications were bruising 13%, induration 11.6%, edema 8%, ecchymosis 7.4%, and numbness 6.3%. This study showed that the radiofrequency ablation method is a high-performance method with few and often transient complications, and the risk of significant complications in using this method to treat varicose veins is low. More studies are needed to evaluate the effectiveness of this method compared to other treatments. [ABSTRACT FROM AUTHOR]

Study design:Systematic reviewObjectives:To determine the effect of respiratory muscle training (RMT) on pulmonary function in tetraplegia.Methods:A comprehensive search of the research literature included MEDLINE, EMBASE, CINAHL, ISI Web of Science, PubMed, the relevant Cochrane and clinical trials registers and hand-searching the reference lists of appropriate papers. There was no language restriction. All randomised controlled trials that involved RMT vs control were considered for inclusion. Two reviewers independently selected articles for inclusion, evaluated the methodological quality and extracted data. Additional information was sought from the authors when necessary.Results:Eleven studies (212 participants) were included. A significant benefit of RMT was revealed for five outcomes: vital capacity (mean difference (95% confidence interval))=0.41(0.17-0.64) l, maximal inspiratory pressure=10.66(3.59, 17.72) cmH2O, maximal expiratory pressure=10.31(2.80-17.82) cmH2O, maximum voluntary ventilation=17.51(5.20, 29.81) l min−1 and inspiratory capacity=0.35(0.05, 0.65) l. No effect was found for total lung capacity, peak expiratory flow rate, functional residual capacity, residual volume, expiratory reserve volume or forced expiratory volume in 1 second.Conclusion:RMT increases respiratory strength, function and endurance during the period of training. Further research is needed to determine optimum dosages and duration of effect. This article is based in part on a Cochrane review published in the Cochrane Database of Systematic Reviews (CDSR) 2013, DOI:10.1002/14651858.CD008507.pub2. Cochrane reviews are regularly updated as new evidence emerges and in response to feedback, and the CDSR should be consulted for the most recent version of the review. [ABSTRACT FROM AUTHOR]

Introduction: Colonization with Group B Streptococcus in pregnancy is a major risk factor for neonatal infection. Universal screening for maternal streptococcal colonization and the use of intrapartum antibiotic prophylaxis has resulted in substantial reductions of neonatal early-onset Group B Streptococcus disease. To achieve the best neonatal outcomes, it is imperative for maternity healthcare providers to adhere to screening and management guidelines. Aim: This literature review uses a systematic approach and aims to provide a synthesis of what is known about compliance with Group B Streptococcus screening protocols in a variety of global settings, including maternity homes, private obstetric practice, and hospital clinical environments. Methods: The review was carried out using electronic databases as well as hand-searching of reference lists. Included papers reported primarily on compliance with Group B Streptococcus screening guidelines, potential factors which influence compliance rates, and implementations and outcomes of interventions. Results: Six international studies have been retained which all focused on adherence to Group B Streptococcus screening guidelines and demonstrated that different factors might have an influence on adherence to GBS screening protocols such as financial aspects and high caesarean section rates. Findings of relatively low compliance rates led to recognizing the need of developing improved strategies for optimising antenatal GBS screening adherence. Conclusion: Adhering to Group B Streptococcus screening guidelines to prevent neonatal infection is crucial. Various factors influence compliance rates such as financial aspects and high proportions of caesarean sections. The implementation of strategies and different forms of education can result in improved compliance rates. [ABSTRACT FROM AUTHOR]

Background: Ankle sprain is one of the most common musculoskeletal injuries, yet a contemporary review and meta-analysis of prospective epidemiological studies investigating ankle sprain does not exist. Objective: Our aim is to provide an up-to-date account of the incidence rate and prevalence period of ankle sprain injury unlimited by timeframe or context activity. Methods: We conducted a systematic review and meta-analyses of English articles using relevant computerised databases. Search terms included Medical Search Headings for the ankle joint, injury and epidemiology. The following inclusion criteria were used: the study must report epidemiology findings of injuries sustained in an observed sample; the study must report ankle sprain injury with either incidence rate or prevalence period among the surveyed sample, or provide sufficient data from which these figures could be calculated; the study design must be prospective. Independent extraction of articles was performed by two authors using pre-determined data fields. Results: One-hundred and eighty-one prospective epidemiology studies from 144 separate papers were included. The average rating of all the included studies was 6.67/11, based on an adapted version of the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) guidelines for rating observational studies. 116 studies were considered high quality and 65 were considered low quality. The main findings of the meta-analysis demonstrated a higher incidence of ankle sprain in females compared with males (13.6 vs 6.94 per 1,000 exposures), in children compared with adolescents (2.85 vs 1.94 per 1,000 exposures) and adolescents compared with adults (1.94 vs 0.72 per 1,000 exposures). The sport category with the highest incidence of ankle sprain was indoor/court sports, with a cumulative incidence rate of 7 per 1,000 exposures or 1.37 per 1,000 athlete exposures and 4.9 per 1,000 h. Low-quality studies tended to underestimate the incidence of ankle sprain when compared with high-quality studies (0.54 vs 11.55 per 1,000 exposures). Ankle sprain prevalence period estimates were similar across sub-groups. Lateral ankle sprain was the most commonly observed type of ankle sprain. Conclusions: Females were at a higher risk of sustaining an ankle sprain compared with males and children compared with adolescents and adults, with indoor and court sports the highest risk activity. Studies at a greater risk of bias were more likely to underestimate the risk of ankle sprain. Participants were at a significantly higher risk of sustaining a lateral ankle sprain compared with syndesmotic and medial ankle sprains. [ABSTRACT FROM AUTHOR]

Due to the high level of violence globally, providing intervention for child victims of trauma has become a priority for various government departments and health professionals including occupational therapists. Child appropriate sensory modulation intervention, which has its theoretical origins within the occupational therapy profession, has been suggested as a suitable treatment approach for children who are victims of trauma, since the initial experience of trauma occurs on a somatosensory level. Advances in trauma care indicate that children may experience the effects of trauma as an inability to appropriately regulate and organize sensory responses. This results in sensory modulation dysfunction associated with emotional and behavior difficulties. This scoping review provides an overview of the extent to which sensory modulation dysfunction has been identified and treated in child victims of trauma. Using the Arksey and O'Malley (2005) framework, five databases and three manual hand searches were conducted. This scoping review confirmed the scarcity of research available. The 13 studies which met the inclusion criteria indicated that child victims of trauma (CVT) present with a sensory modulation disorder (SMD). Sensory modulation intervention, within the theoretical framework of Ayres Sensory Integration® (ASI®), alone and in combination with psychotherapy approaches was found to be valuable for CVT, in the studies chartered. Identification and treatment of sensory modulation dysfunction in CVT has been researched and is becoming an area of increasing need. Therefore, to remain relevant to the violent contexts within communities, there is a need to expand research in this field. [ABSTRACT FROM AUTHOR]

Background: Autonomic nervous system (ANS) testing has aided in our ability to evaluate autonomic dysfunction in migraine patients. We reviewed the literature in multiple databases which investigate ANS function in migraine patients and healthy subjects. Methods: This systematic review and meta-analysis examined the respective deep breathing, Valsalva manoeuvre, orthostatic and isometric challenge results, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analyses of Observational Studies in Epidemiology (MOOSE) statements. Results: Seven articles met all inclusion criteria. Fixed-effects meta-analysis showed migraine patients (n = 424), collectively, had lower interictal autonomic test results compared with healthy controls (n = 268). In detail, this was true for the standardized mean difference (g) of deep breathing (g= -0.32; 95% confidence interval (CI) -0.48, -0.16), orthostatic challenge (g= -0.28; 95% CI -0.44, -0.13) and isometric challenge (g= -0.55; 95% CI -0.71, -0.39) and for the difference of means (MD) of the Valsalva ratio (MD = -0.17; 95% CI -0.23, -0.10). Conclusions: Interictal ANS dysfunction can be identified in migraine patients when compared to healthy controls. These findings indicate the importance to evaluate ANS function in migraine patients - especially, as migraine-specific prophylactic therapies (such as anti-calcitonin gene-related peptide (CGRP) antibodies) may affect the function of the ANS. [ABSTRACT FROM AUTHOR]

Background: The adolescent 'growth spurt' results in rapid growth of the skeletal system. It has been theorised that absence of a concomitant increase in muscular adaptations in female athletes may predispose them to an increased risk of anterior cruciate ligament injuries. Objectives: To determine if sex differences exist in landing biomechanics and postural stability of adolescent athletes; with a further objective of determining if such differences are propagated during adolescence. Data sources: The following databases were searched: MEDLINE, EMBASE, CINAHL, PEDro, PubMed, SPORTDiscus and Web of Science. Research papers were identified by including search terms for neuromuscular control, lower limb and pubertal development. Inclusion Criteria: Studies were required to be written in English; report on biomechanical analyses; include landing or postural control tasks; be cross-sectional or longitudinal; and include healthy adolescent/pubertal subjects. Study Appraisal and Synthesis Methods: A modified version of the Strengthening the Reporting of Observational studies in Epidemiology checklist was used to rate methodological quality. Meta-analyses were performed when more than one study reported on an outcome measure. Results: Sixteen articles were included. The overall methodological quality of evaluated studies was low (mean score = 5.75/10 points). Adolescent females exhibited increased knee valgus with increasing maturity. There was no consensus on sex differences in postural stability. Conclusions: With increasing maturation, females are characterized by increased knee valgus during landing tasks. To date, no research has longitudinally investigated postural stability development during adolescence in females, despite the importance of postural control training in injury prevention programmes. Therefore, further research on this topic is warranted. [ABSTRACT FROM AUTHOR]

Objectives: A conflicting body of evidence suggests localized periodontal inflammation spreads systemically during pregnancy inducing adverse pregnancy outcomes. This systematic review and meta-analysis aim to specifically evaluate the relationship between periodontitis and preeclampsia. Methods: Electronic searches were carried out in Medline, Pubmed, Embase, Lilacs, Cochrane Controlled Clinical Trial Register, CINAHL, ClinicalTrials.gov, and Google Scholar with no restrictions on the year of publication. We identified and selected observational case–control and cohort studies that analyzed the association between periodontal disease and preeclampsia. This meta-analysis was conducted following the PRISMA checklist and MOOSE checklist. Pooled odds ratios, mean difference, and 95% confidence intervals were calculated using the random effect model. Heterogeneity was tested with Cochran's Q statistic. Results: Thirty studies including six cohort- and twenty-four case–control studies were selected. Periodontitis was significantly associated with increased risk for preeclampsia (OR 3.18, 95% CI 2.26 – 4.48, p < 0.00001), especially in a subgroup analysis including cohort studies (OR 4.19, 95% CI 2.23 – 7.87, p < 0.00001). The association was even stronger in a subgroup analysis with lower-middle-income countries (OR 6.70, 95% CI 2.61 – 17.19, p < 0.0001). Conclusions: Periodontitis appears as a significant risk factor for preeclampsia, which might be even more pronounced in lower-middle-income countries. Future studies to investigate if maternal amelioration of periodontitis prevents preeclampsia might be warranted. [ABSTRACT FROM AUTHOR]

The aim of this review was to evaluate current evidence regarding the effects of interventions on physical activity in the subgroup of nursing home residents as well as to critically review the assessment methods used in this regard. Published studies through January 2015 were searched in The Cochrane Library, PubMed, CINAHL, Web of Knowledge, PsycInfo, Psyndex, Psycarticles, CC Med, and DissOnline; and by manual search. For randomized controlled trials (RCTs) to be included, an intervention had to be conducted with nursing home residents aged 65 years and above and physical activity had to be assessed using standardized, quantitative methods. Study quality was evaluated using an established Cochrane rating tool for RCTs. Eight studies met the inclusion criteria. Only one intervention study with main focus on a modification of physical activity behavior could be identified. Physical activity assessments used in the studies were partly limited regarding objectivity or psychometric quality. Hence, the documentation of effects of interventions is restricted. Six studies reported significant increases of physical activity in nursing home residents and thus positive intervention effects, which points at the feasibility and high potential of intervention programs to promote physical activity in this setting. Enhanced individual contact as well as physical exercise combined with behavioral interventions and the inclusion of nursing staff seems to be most effective in this regard. As only one study involved post-intervention follow-up assessments, sustainability of effects remained unclear. [ABSTRACT FROM AUTHOR]

Background: Short-sprint (≤ 20 m) performance is an important quality for success in the football codes. Therefore, developing an evidence base for understanding training methods to enhance short-sprint performance is key for practitioners. However, current systematic reviews are limited by (1) a lack of focus on football code athletes, (2) a lack of consideration of all training modalities and (3) a failure to account for the normal training practices undertaken by intervention groups within their analysis. Therefore, this review aimed to (1) conduct a systematic review of the scientific literature evaluating training interventions upon short-sprint performance within football code athletes, (2) undertake a meta-analysis to assess the magnitude of change of sport-sprint performance following training interventions and (3) identify how moderator variables affect the training response. Methods: A systematic search of electronic databases was conducted. A random-effects meta-analysis was performed to establish standardised mean difference with 95% confidence intervals. This identified the magnitude and direction of the individual training effects of intervention subgroups (primary, secondary, combined-specific, tertiary and combined training methods) on short-sprint performance while considering moderator variables (i.e., football code, sex, age, playing standard, phase of season). Results: 121 studies met the inclusion criteria, totalling 3419 athletes. Significant improvements (small-large) were found between pre- and post-training in short-sprint performance for the combined, secondary, tertiary and combined-specific training methods. No significant effect was found for primary or sport only training. No individual mode was found to be the most effective. Between-subgroup analysis identified that football code, age, playing standard and phase of season all moderated the overall magnitude of training effects. Conclusions: This review provides the largest systematic review and meta-analysis of short-sprint performance development methods and the only one to assess football code athletes exclusively. Practitioners can apply combined, secondary and tertiary training methods to improve short-sprint performance within football code athletes. The application of sport only and primary methods does not appear to improve short-sprint performance. Regardless of the population characteristics, short-sprint performance can be enhanced by increasing either or both the magnitude and the orientation of force an athlete can generate in the sprinting action. Trial Registration: OSF registration https://osf.io/kshqn/. [ABSTRACT FROM AUTHOR]

Background: Despite a rapidly growing body of research, a systematic evidence compilation of the risk and protective factors for middle- and long-distance running-related injury (RRI) was lacking. Objectives: Our objective was to compile the evidence about modifiable and non-modifiable training-related and behavioral risk and protective factors for middle- and long-distance RRI. Methods: We searched five databases (PubMed, CINAHL, MEDLINE, SPORTDiscus, and PsycINFO) for the dates 1 January 1970 to 31 December 2015, inclusive, for original peer-reviewed articles. The eligible designs were cross-sectional, case-control, longitudinal observational studies, and randomized controlled trials involving runners competing at distances from ≥800 m to ≤42.2 km. Outcomes were any specific and/or general RRI, and exposures included training-related and behavioral factors. We extracted authors and date, study design, injury type(s), descriptors and comparators for each exposure, and results and measures of association from the selected studies. Methodological quality was independently appraised using two separate checklists: a modified checklist for observational study designs and the Physiotherapy Evidence Database (PEDro) scale for randomized controlled trials. Results: Among 73 articles eligible for inclusion, 19 (26.0%) and 30 (41.0%) were of high or satisfactory methodological quality, respectively. As a non-modifiable exposure, a history of previous injury was found to be associated with an increased risk of both general and specific RRI. In terms of modifiable exposures, irregular and/or absent menstruation was found to be associated with an increased risk of stress fracture development, whereas the use of oral contraceptives was found to be associated with a decreased risk. High clinical, methodological, and statistical heterogeneity meant it was not feasible to estimate a pooled effect size across similar studies. Conclusions: A history of previous injury was associated with an increased risk of both general and specific RRI. The use of oral contraceptives was found to be associated with a decreased risk of skeletal stress fracture. Conversely, irregular and/or absent menstruation was associated with an increased risk. The varied effect directions and/or a number of statistically insignificant results associated with the majority of factors hindered our ability to draw any definitive conclusions about their relationship to RRI risk. [ABSTRACT FROM AUTHOR]

Background: The FIFA Medical and Research Centre (F-MARC) has designed a comprehensive warm-up program targeting muscular strength, body kinaesthetic awareness, and neuromuscular control during static and dynamic movements to decrease injury risk for soccer players. Prior studies have investigated the effectiveness of the F-MARC programs, but have not consistently reported a statistically significant reduction in injury and reduction in time loss due to injury from utilizing the program. Objective: The purpose of this study was to conduct a systematic review and meta-analysis of randomized controlled trials and interventional studies that evaluated the efficacy of the F-MARC injury prevention programs in soccer. Methods: Two independent researchers searched the relevant article databases. The keyword domains used during the search were 'F-MARC', 'FIFA 11+', 'the 11+', 'injury prevention programs', 'soccer', and variations of these keywords. The initial search resulted in 4299 articles which were filtered to nine articles that met the inclusion criteria. Main inclusion criteria were randomized controlled trials or interventional studies, use of F-MARC injury prevention programs, and the primary outcome measuring overall and lower extremity injuries. Extracted data were entered and analyzed using Comprehensive Meta-Analysis software, version 2 (CMA.V2). Results: The pooled results based on total injuries per 1000 h of exposure showed that F-MARC injury prevention programs had a statistically significant reduction in the overall injury risk ratio of 0.771 (95 % CI 0.647-0.918, p = 0.003) and the lower extremity injury risk ratio of 0.762 (95 % CI 0.621-0.935, p = 0.009). Moreover, FIFA '11+' had a statistically significant reduction in the overall injury risk ratio to 0.654 (95 % CI 0.537-0.798, p < 0.001) and the lower extremity injury risk ratio of 0.612 (95 % CI 0.475-0.788, p < 0.001). However, FIFA '11' did not reach significance for the lower extremity and overall injury reduction. It can be suggested that teams involved in the FIFA '11+' warm-up program will reduce injury rates by between 20 and 50 % in the long term compared with the teams that do not engage in F-MARC programs. Conclusions: This systematic review and meta-analysis indicated that use of F-MARC injury prevention programs, particularly the '11+' program, decreases the risk of injuries among soccer players. These data also support the case for the development and introduction of sport-specific programs. [ABSTRACT FROM AUTHOR]

Purpose: To identify the attributable mortality of central line associated blood stream infections (CLABSI) through meta-analysis. Methods: Meta-analysis of case control and cohort studies, matched and unmatched, that reported on mortality of patients with and without CLABSI was performed. MEDLINE, CENTRAL, CINAHL were searched. Non-interventional studies of all languages that reported mortality in patients with CLABSI were included. Data were extracted on patient population, study setting, design, diagnostic criteria for CLABSI, and mortality. Results from studies comparing mortality due to CLABSI were pooled using a random effects model with assessment of heterogeneity. Heterogeneity of studies was assessed with an I statistic and a funnel plot was generated to assess for publication bias. Results: Eighteen studies were included with 1,976 CLABSI cases. Of the included studies, 17 took place in intensive care unit settings, most involved a mixed population of medical and surgical patients, and ten were matched using an illness severity index. Our findings show an odds ratio of in hospital death associated with CLABSI as 2.75 (CI 1.86-4.07) and 1.51 (CI 1.08-2.09) in the subgroup of the ten matched studies. Those studies where greater than 30 % of CLABSI were attributed to coagulase-negative Staphylococcus had an odds ratio of death of 1.64 (95 % CI 1.02-2.65) compared with 4.71 (95 % CI 1.54-14.39). Conclusions: CLABSI is associated with a significantly increased risk of death supporting the use of extensive efforts to reduce these infections. [ABSTRACT FROM AUTHOR]

Background: The promotion of sport and physical activity (PA) for children is widely recommended to support a healthy lifestyle, but being engaged in sport bears the risk of sustaining injuries. Injuries, in turn, can lead to a reduction in current and future involvement in PA and, therefore, may negatively affect future health as well as quality of life. Thus, sports injury prevention is of particular importance in youth. Objective: The aim of this systematic review was to quantify the effectiveness of exercise-based injury prevention programs in child and adolescent sport in general, and with respect to different characteristics of the target group, injury prevention program, and outcome variables. Data Sources: An Internet-based literature search was conducted in six databases (CINAHL, Cochrane, EMBASE, ISI Web of Science, PubMed, SPORTDiscus) using the following search terms with Boolean conjunction: (sport injur* OR athletic injur* OR sport accident*) AND (prevent* OR prophylaxis OR avoidance) AND (child* OR adolescent OR youth). Study Selection: Randomized controlled trials and controlled intervention studies in organized sport, published in English in a peer-reviewed journal, analyzing the effects of an exercise-based injury prevention program in athletes younger than 19 years of age. Data Extraction: Two reviewers evaluated eligibility and methodological quality. Main outcome extracted was the rate ratio (RR). Statistical analyses were conducted using the inverse-variance random effects model. Results: Twenty-one trials, conducted on a total of 27,561 athletes (median age 16.7 years [range 10.7-17.8]), were included. The overall RR was 0.54 (95 % CI 0.45-0.67) [ p < 0.001]. Girls profited more from injury prevention than boys ( p = 0.05). Both prevention programs with a focus on specific injuries (RR 0.48 [95 % CI 0.37-0.63]) and those aiming at all injuries (RR 0.62 [95 % CI 0.48-0.81]) showed significant reduction effects. Pre-season and in-season interventions were similarly beneficial ( p = 0.93). Studies on programs that include jumping/plyometric exercises showed a significant better ( p = 0.002) injury preventive effect (RR 0.45 [95 % CI 0.35-0.57], Z = 6.35, p < 0.001) than studies without such exercises (RR 0.74 [95 % CI 0.61-0.90], Z = 3.03, p = 0.002). Conclusions: The results provide good evidence and clearly demonstrate beneficial effects of exercise-based injury prevention programs in youth sports as they can result in statistically significant and practically relevant injury reduction. In particular, multimodal programs including jumping/plyometric exercises can be recommended. However, there is a considerable lack of data for children (under 14 years of age) and for individual sports in general. Future research should include these groups and focus on the effect of specific exercises and compliance. [ABSTRACT FROM AUTHOR]

Background: Skeletal muscle plays an important role in maintaining the stability of the lumbar region. However, there is conflicting evidence regarding the effects of exercise on trunk muscle morphology. Objective: To systematically review the literature on the effects of exercise training on lower trunk muscle morphology to determine the comparative effectiveness of different exercise interventions. Data Source and Study Selection: A systematic search strategy was conducted in the following databases: PubMed, SportDiscus, CINAHL, the Cochrane Library and PEDro. We included full, peer-reviewed, prospective longitudinal studies, including randomized controlled trials and single-group designs, such as pre- to post-intervention and crossover studies, reporting on the effect of exercise training on trunk muscle morphology. Study Appraisal and Synthesis: Study quality was assessed with the Cochrane risk-of-bias tool. We classified each exercise intervention into four categories, based on the primary exercise approach: motor control, machine-based resistance, non-machine-based resistance or cardiovascular. Treatment effects were estimated using within-group standardized mean differences (SMDs). Results: The systematic search identified 1,911 studies; of which 29 met our selection criteria: motor control ( n = 12), machine-based resistance ( n = 10), non-machine-based resistance ( n = 5) and cardiovascular ( n = 2). Fourteen studies (48 %) reported an increase in trunk muscle size following exercise training. Among positive trials, the largest effects were reported by studies testing combined motor control and non-machine-based resistance exercise (SMD [95 % CI] = 0.66 [0.06 to 1.27] to 3.39 [2.80 to 3.98]) and machine-based resistance exercise programmes (SMD [95 % CI] = 0.52 [0.01 to 1.03] to 1.79 [0.87 to 2.72]). Most studies investigating the effects of non-machine-based resistance exercise reported no change in trunk muscle morphology, with one study reporting a medium effect on trunk muscle size (SMD [95 % CI] = 0.60 [0.03 to 1.16]). Cardiovascular exercise interventions demonstrated no effect on trunk muscle morphology (SMD [95 % CI] = −0.16 [−1.14 to 0.81] to 0.09 [−0.83 to 1.01]). Limitations: We excluded studies published in languages other than English, and therefore it is possible that the results of relevant studies are not represented in this review. There was large clinical heterogeneity between the included studies, which prevented data synthesis. Among the studies included in this review, common sources of potential bias were random sequence generation, allocation concealment and blinding. Finally, the details of the exercise parameters were poorly reported in most studies. Conclusion: Approximately half of the included studies reported an increase in lower trunk muscle size following participation in an exercise programme. Among positive trials, studies involving motor control exercises combined with non-machine-based resistance exercise, as well as machine-based resistance exercises, demonstrated medium to large effects on trunk muscle size. Most studies examining the effect of non-machine-based resistance exercise and all studies investigating cardiovascular exercise reported no effect on trunk muscle morphology. However, these results should be interpreted with caution because of the substantial risk of bias and suboptimal reporting of exercise details in the included studies. Additional research, using methods ensuring a low risk of bias, are required to further elucidate the effects of exercise on trunk muscle morphology. [ABSTRACT FROM AUTHOR]

Objectives:Spinal cord injury (SCI) research has highlighted links between psychological variables and employment outcome; however, there remains a need to consolidate the available heterogenous data.Methods:Meta-analytic techniques were used to examine and quantify differences in psychological functioning and employment status among adults with an acquired SCI. Fourteen observational studies (N=9, 868 participants) were identified from an electronic database search. Standardised mean difference scores between employed and unemployed groups were calculated using Cohen's d effect sizes. Additionally, 95% confidence intervals, fail-safe Ns, percentage overlap scores and heterogeneity statistics were used to determine the significance of d.Results:Moderate to large and positive weighted effects were noted across three broad psychological constructs: affective experience or feelings (dw=3.16), quality of life (dw=1.06) and life satisfaction (dw=0.70). However, the most compelling non-heterogeneous finding was associated with life satisfaction, a finding that was also not subject to publication bias. Inconsistent and weak associations between employment and individual measures of vocational attitude, self-efficacy, locus of control, adjustment and personality were also noted.Conclusion:Psychological factors and attributes are linked to employment post-SCI; however, the available data are limited in quantity. Longitudinal research is also needed to determine whether these variables can help to preserve employment over time. [ABSTRACT FROM AUTHOR]

Background and Objective: Skeletal muscle wasting resulting in reduced muscular strength and health-related quality of life (HR-QOL) is common in chronic kidney disease (CKD) and may be reversed with progressive resistance training (PRT). Therefore, we systematically assessed the effect of PRT on measures of skeletal muscle hypertrophy, muscular strength and HR-QOL in this cohort to inform clinical practice and guidelines. Design: We performed a systematic review and meta-analysis. Inclusion Criteria: We included randomised controlled trials (RCTs) that investigated the independent effect of PRT (>6 weeks) on measures of skeletal muscle hypertrophy [muscle mass or cross-sectional area (CSA)], muscular strength and/or HR-QOL in adults with CKD. Data Extraction and Analysis: The standardised mean difference (SMD) from each study was pooled to produce an overall estimate of effect and associated 95 % confidence interval (95 % CI) between treatment and control groups on primary outcomes. Results: Seven RCTs in 271 patients with Stage 3-5 CKD yielded seven studies on muscular strength ( N = 249), six studies on total body muscle mass ( N = 200) and six studies on HR-QOL ( N = 223). PRT significantly improved standardised muscular strength [SMD 1.15 (95 % CI 0.80-1.49)] and HR-QOL [SMD 0.83 (95 % CI 0.51-1.16)], but not total body muscle mass [SMD 0.29 (95 % CI −0.27 to 0.86)] in our primary analysis. However, secondary analysis of six studies showed that PRT induced significant muscle hypertrophy of the lower extremities (leg mass, or mid-thigh or quadriceps CSA) [SMD 0.43 (95 % CI 0.11-0.76)], a pertinent analysis given that most studies implemented lower-body PRT only. Conclusions: Robust evidence from RCTs indicates that PRT can induce skeletal muscle hypertrophy and increase muscular strength and HR-QOL outcomes in men and women with CKD. Therefore, clinical practice guidelines should be updated to inform clinicians on the benefits of PRT in this cohort. [ABSTRACT FROM AUTHOR]

Summary A snapshot of current evidence from 6 randomised controlled trials for the effects of short bouts of high-impact exercises in 256 women via meta-analysis reveals that ample osteogenic response could be realised at the femoral neck and trochanter of premenopausal women with rest-inserted bouts of few mechanical bone loading cycles. Introduction Exercise is an important means of improving bone health and preventing osteoporosis. Brief bouts of simple exercises may be useful for aiding lifestyle compliance to physical activity. This study aimed to review the evidence on the effect of brief, high-impact exercise on bone health among premenopausal women. Methods A structured and comprehensive search of databases was undertaken along with hand searching of key journals and reference lists to locate relevant studies published and unpublished up to January 2011. Six randomised controlled trials met predetermined inclusion criteria. Brief high-impact exercises (<30 min) were examined for their effect on bone mineral density (BMD) among premenopausal women. Trial quality was assessed using the Effective Public Health Practice Project quality assessment tool. Study outcomes for analysis, absolute change (grams per square centimetre) or relative change (in percent) in BMD at femoral neck, trochanter and lumbar spine were compared by calculating standardised mean difference (SMD) using fixed- and random effects models. Results Quality of included trials varied from medium to high on a scale of 1 to 3. Brief bouts of exercise led to significant increases in femoral neck BMD (SMD=0.64, 95%confidence interval (CI)=0.38, 0.90, overall effect Z value=4.84, p= 0.001); a modest increase in trochanteric BMD (SMD=0.36, 95% CI=0.10, 0.61, Z value=2.08, p=0.04) and no increase in spinal BMD (SMD=0.04, 95% CI=−0.23, 0.31, Z value= 0.26, p=0.79). Conclusion Based on the meta-analysis, brief high-impact exercise improves BMD at the hip but not at the lumbar spine. Effectiveness of this form of exercise as a lifestyle physical activity for prevention of osteoporosis should be explored in larger populations. [ABSTRACT FROM AUTHOR]